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Archive for the ‘Health and Wellness’ Category

National Wear Red Day 2012

National Wear Red Day 2012 (Photo credit: U.S. Embassy Montevideo)

By Sue Shekut, Owner, Working Well Massage, Licensed Massage Therapist, Certified Wellness Coach, ACSM Personal Trainer

Are you surprised that heart attack is the number one cause of death for women? I was.  I wrote a paper for my Behavioral Medicine class in my graduate program in Psychology about women and heart disease. I learned so much about women’s heart attack symptoms and important screening exams that I thought I’d share some of what I learned with my loyal workingwellresources readers!

A heart attack, also known as a myocardial infarction, is considered to be an acute manifestation of cardiovascular disease. Heart attacks are usually caused when a blockage of the blood vessels supplying the heart with oxygenated blood causes blood to cease flowing to an area of the heart, causing that portion of the heart to be damaged or die. These blockages are most frequently caused by fatty deposits or plaque that builds up in the inner walls of arterial blood vessels. Symptoms for a heart attack are different in women than for men. In women, a heart attack may be occurring when a woman feels pressure or fullness in the center of the chest for more than a few minutes.  However, in men, heart attacks are often reported as feelings of intense discomfort or pressure in the chest. Women may experience shortness of breath even without chest discomfort. Women may also break out into a cold sweat feel nauseated or light-headed during a heart attack. In women, a heart attack can also manifest as shortness of breath, pain or discomfort in the back and/or jaw and nausea or vomiting. Men and woman can feel pain or pressure in the chest, but because symptoms tend to be less severe in women with heart attacks, many woman ignore the symptoms or take an aspirin and go to bed, thinking they have the flu, acid reflex or are just getting older. And since women tend to have heart attacks, on average, 10 years later than men, female heart attack victims tend to have a higher tendency to occur along with other chronic disease like diabetes or hypertension which puts them at greater risk than men for heart attacks to be fatal.

 According to the American Heart Association, each year approximately 785,000 U.S. citizens have an initial heart attack and another 470,000 have a recurrent heart attack. In 2007, according to the American Heart Association, 391, 886 U.S. men and 421, 918 U.S. women died of heart attacks.

Medical Treatments

Current medical treatment for hear disease includes prevention in the form of eating a healthy diet, getting regular exercise, and avoiding tobacco smoke, first and second-hand. Those that have heart attacks and survive them, as well as those with high cholesterol and/or high blood pressure, can lower the risk of another heart attack by taking statins to lower cholesterol, drugs to lower blood pressure and aspirin.

When a woman is having a heart attack, she needs emergency medical care in the form of cardiopulmonary resuscitation (CPR) or electric shock (defibrillation) until she can get to the hospital. At the hospital, medical personnel will conduct tests to decide if she is experiencing a heart attack and determine the best course of treatment depending on the severity of the attack and her general health.

For those with heart disease, or for those surviving heart attacks, surgeries such as coronary artery bypass, balloon angioplasties, heart valve repair and replacement and heart transplants are available. For some patients, there are also medical implants that can help keep their heart operating, including pacemakers to keep the heart beating regularly, prosthetic valves to replace faulty heart valves and patches which can be used to close holes in the heart muscle.

Psychological Factors Affecting Risk, Onset, Severity and Recovery

Since women tend to have less severe symptoms of heart attack and tend to be caretakers of others, females may not take signs of a heart attack as seriously and may not seek appropriate medical attention. In addition, since women tend to have greater Cardiovascular diseases like heart attacks, on average 10 years later than men, females may discount the severity of the attack, thinking their symptoms are a sign of aging or are not serious enough to go to the hospital. If a weakened heart is left untreated, by the time a woman has a serious heart attack, it is likely to be more severe than a man’s heart attack for these reasons. And lastly, since women tend to be caretakers, after a heart attack, females may not feel comfortable taking the required time to recover and may push themselves to go back to work or childcare before they are fully recovered, thus increasing the risk of re-occurrence of a heart attack.

Sociocultural and Economic Influences

Aside from females being underrepresented in clinical trails for heart disease, over 80% of fatalities from heart diseases occur in people living in low-income and middle-income countries. Some of the risk factors for heart disease in low and middle-income countries include poverty and stress, as well as unhealthy diets and sedentary lifestyles. People in these countries also tend to have reduced access to effective health care including early detection. So being poor and having a stressful life with little exercise and a poor diet makes you a winner–in the heart attack game, that is. And who wants to “win” by having a heart attack?!

Since 80% of coronary heart disease is caused by behavioral risk factors such as poor diet, lack of exercise and cigarette smoking, you can reduce your risk of having a heart attack by engaging in healthier lifestyle behaviors such as quitting smoking, eating more vegetables and fruits and exercising more. Isn’t this list of healthy lifestyle behaviors becoming repetitive? It seems that most of our health problems, obesity, heart disease, diabetes, high blood pressure–all share the same common lifestyle risk factors of poor diet, not getting enough movement in our bodies easy day and cutting down on tobacco smoking and alcohol drinking. But even if you don’t engage in these unhealthy behaviors, getting regular medical exams for blood pressure and cholesterol tend to be lower your risk of having a heart attack. Lastly, learning stress management techniques as well as coping skills to better manage stress in your live can help your heart beat more easily, help your body overall work better and help you feel better and live longer!

So what is your game plan to reduce your risk of having a heart attack? I’d like to hear from you!

Sources

American Heart Association (2012) Heart Attack Symptoms in Women. (http://www.heart.org/HEARTORG/Conditions/HeartAttack/WarningSignsofaHeartAttack/Warning-Signs-of-a-Heart-Attack_UCM_002039_Article.jsp.)

Center for Disease Control and Prevention (2012) Heart Disease. (http://www.cdc.gov/HeartDisease/coronary_ad.htm/)

Mayo Clinic (2011). Heart disease. (http://mayoclinic.com/health/heart-disease/DS01120).

McSweeny, J.C., Cody, M., Elbertson, K., Moser, D.K., Garvin, B.J. (2003) Women’s early warning symptoms of acute myocardial infarction. Circulation 108(21), 2619-23.

Roger, V.L., Go. A.S., Lloyd-Jones, D.M., Adams, R.J., Berry, J.D., Brown, T.M.,…Wylie-Rosett, J. (2011). Heart disease and stroke statistics–2011 update: a report from the American Heart Association. Circulation, 123(4), e18-e209.

World Health Organization (n.d.), Cardiovascular disease. (http://www.who.int/cardiovascular_diseases/en/)

Worrall-Carter, L., Ski, C., Scruth, E., Campbell, M & Page, K. (2011) Systemic review of

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By Sue Shekut, Owner, Working Well Massage, Licensed Massage Therapist, Certified Wellness Coach, ACSM Personal Trainer

Dr. Jay Parkinson reminds me of my behavioural Medicine professor this summer. My prof is the picture of health, muscular, lean, and enthusiastic about preventative health care. His classes really challenge me to think creatively about our nation’s health care system. I am currently working on a presentation about the problems associated with health care costs. As I am researching the existing literature, I cam across Dr. Jay, who is all about prevention and helping improve people’s health from a biopsychosocial perspective and blogs are The Future Well.

Check out Dr. Jay’s blog post, “Most health solutions aren’t medical, they’re social,” here. I love his message and it echos research I’ve read about the effects of your social circle on your health. If your friends are sedentary, pizza-eating gamers, you will likely eat a fair share of pizza, game and not move much. If you start hanging out with those that are more active and eat healthier, teach you to cook or a new hobby like hiking or human origami (I just made that one up but it sounds fun doesn’t it!), you are more likely to adopt healthier behaviors. And if you inspire your pizza eating friends to try a hacky sack game or two with you on a regular basis, you may be able to keep your friends and improve your health.

Who is Dr. Jay?

Dr. Jay Parkinson, MD, MPH

(From his blog site)

Instead of pills and scalpels, Dr. Jay Parkinson uses creative design to improve health. He’s been called “The Doctor of the Future” and one of the “Top Ten Most Creative People in Healthcare” by Fast Company. Esquire Magazine included him in 2009’s “Best and Brightest: Radicals and Rebels Who Are Changing the World” issue.

Jay is a pediatrician and preventive medicine specialist with a masters in public health from Johns Hopkins. After completing residency, he started a practice for his neighborhood of Williamsburg, Brooklyn in September 2007. People would visit his website; see his Google calendar; choose a time and input their symptoms; his iPhone would alert him; he’d make a house call; they’d pay him via Paypal; and he’d follow up by email, IM, videochat, or in person. This concept led to Jay co-founding Hello Health, a novel way of experiencing healthcare via a Facebook-like platform that uses technology — including email, instant messaging, and video chat — to restore the traditional doctor-patient relationship but updated for today’s lifestyle.

He’s been called “The Doctor of the Future” and one of the “Top Ten Most Creative People in Healthcare” by Fast Company. Esquire Magazine included him in 2009′s “Best and Brightest: Radicals and Rebels Who Are Changing the World” issue. He’s been featured in GOOD Magazine, CNN, Newsweek, and Health Affairs. The leading trade publication for hospital and system executives, Hospitals and Health Networks, dedicated a cover article to Jay entitled, Your Future Chief of Staff? Jay also appears in Seth Godin’s new book, Linchpin.

Selected Writings of Dr. Jay

BusinessWeek: How to Redesign Healthcare

Design Observer: Road to Wellville. How to redesign a broken healthcare system.

GOOD Magazine: Fixing What Ails the Sickness Industry.

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By Sue Shekut, Owner, Working Well Massage, Licensed Massage Therapist, Certified Wellness Coach, ACSM Personal Trainer

For those that know me, I am a big fan of treadmill desks. However, up until recently the main treadmill desk available was the Walkstation, for $4400-$4900, from Steelcase. And that may be too hefty of a price tag for small offices and the self-employed. Now more options are lower prices have become available! I am posting some of the best user reviews and options I found to date.

 LifeSpan TR1200-DT Treadmill Desk from LifeSpan Fitness

LifeSpan TR1200-DT Treadmill Desk

Here are some of the more specific Amazon reviews on the LifeSpan TR1200-DT Treadmill Desk

Eclectic Teacher says this about the  LifeSpan TR1200-DT Treadmill Desk:

I type this as I walk at 2mph on the treadmill in my home office. The desk is a fairly solid, almost stupidly-simple to assemble, unit in five easy pieces (not counting nut’n’bolts). It’s not too hard to adjust to get it to the right height, though changing it regularly for multiple users would be a real pain. The controls at the front of the desk are fairly unobtrusive, quite intuitive, and quite literally easy enough for my five-year-old to use (he thinks it cool, and keeps asking to use it before school for five or ten minutes – he hops on, starts it up with me nearby, walks and trots for a little while, stops it, and says “thanks, dad.”)

The treadmill part comes totally preassembled, and you just have to unpack it and roll it into place. It seems to work just as you’d expect, and feels solid under my feet. It plugs into the desk with a really simple, only-one-possible-way to plug it together plug to connect it to the desk controls. The wires run almost entirely interior to the desk leg, an elegant solution. While in use, it’s very quiet.

My biggest annoyance is that it doesn’t plug into your computer via a USB or something to track your long-term progress, and if you pull the dead-man stop it resets all your mileage / time, etc.

Personally, I think 2.5 mph is great for just surfing the net. Two mph works for most typing. 1.5 mph is for drinking coffee and more serious typing, and about 1 mph for eating breakfast with a plate under it while surfing the web before the coffee kicks in.

Shelly.Daniels says “I was surprised how quickly you pick up the “feel” of walking while using the desk. When I first started I was walking at 1-1.4 mph and felt comfortable typing while walking. Now, 1.6 is comfortable for me…What has surprised me is how often this is now being used. This was bought just for me to be used in the office but we have found many other uses…I use it at night now on occasion to do my Facebook updates, recently it was where a good bit of my Christmas shopping was completed! ”

Shelley goes on to talk about the desk itself: The work surface allows me to comfortably stores my laptop, phone, folders, mouse and water bottle. The console was very smartly designed where it does not slide under the desk or sit on top of the desk like the others I looked at. One of my favorite parts is the built-in step counter…it is fun and VERY motivating to watch the steps add while you work or play. As mentioned earlier the treadmill is very quiet and have asked people while on speakerphone if they could hear the treadmill and they could not! The treadmill has 4 levelers to ensure that the desk is level and the desk is very solid and stable. I get no movement and vibration on the desk and assume that is because the treadmill and desk are not attached.

WorknMan “worknman”  brings up some issues about typing versus mousing on the Treadmill desk: From the very beginning, typing seemed very easy for me while walking on this thing. Unfortunately, mouse precision took a pretty serious hit. This probably won’t be a problem if you’re a typical office worker and/or spend most of your day typing. But if you do a lot of mousing (like me), this could be a problem. In my case, using the mouse while on the treadmill is getting easier over time as I get more used to it, plus it is forcing me to use shortcut keys more to save time, so I guess that can only be a good thing 🙂 When I first got the treadmill, I couldn’t go any faster than 0.5mph before I could no longer control the mouse. Now I’m up to 1.0, and I can go as fast as 1.5, depending on what I’m doing.

To order yours for about $1300, click here.

TrekDesk Treadmill Desk

TrekDesk Treadmill Desk

Another option is the TrekDesk Treadmill Desk by Trek, for about $480. However, Amazon reviewer say this desk is not adjustable, rattles and shakes and is of such poor quality it’s not worth it. Check out the desk and reviews here.

TreadDesk

TreadDesk

Another option is to simply add a treadmill, without handlebars to your existing desk set up. This may require you to add monitor risers to raise your monitor high enough to see it comfortable while standing. The TreadDesk is currently on back order, but at $840, this would be my first pick to retrofit an existing desk to a treadmill. The TreadDesk control panel sits on top of the desk and is attached to the Tread with a six-foot long wire. The control panel keeps track of distance, time, speed, calories burned and comes with an emergency shut off cord which should always be worn when using the TreadDesk. A rubber treadmill mat is also included with the purchase of each TreadDesk. If you want to read detailed user comments about the TreadDesk, click here.

Build Your Own Treadmill Desk

A cheaper option but far more labor intensive one is to build a treadmill desk yourself.  Jay Buster, an options trader, created a blog called Treadmill Desk. (Today, while walking on his Treadmill Desk, Jay manages a private investment fund which is involved in option and structured product arbitrage.) He writes this post, The $39 Treadmill Desk, to tell you how to build your own treadmill desk for $39 (minus the cost of the treadmill, natch!).

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By Sue Shekut, Owner, Working Well Massage, Licensed Massage Therapist, Certified Wellness Coach, ACSM Personal Trainer

One of the frustrations I hear from clients is how to get enough veggies into a daily diet when you are on the go and don’t have time or an appetite to eat breakfast. Eating wraps with lettuce, cukes and red onions is one way. Eating salads, of course is great when you have time. But for that early morning pick me up or when you don’t have time to eat a full meal, I suggest you try Orgain.

Orgain

Orgain is a meal replacement drink that tastes like a milkshake but includes veggie juices, is low sugar and low-fat and is packed with protein! It comes in 3 flavors: Creamy Chocolate Fudge, Sweet Vanilla Bean and  Iced Cafe Mocha.  Fat is only 7 grams for Vanilla and Fudge.

From the product website-more factoids about Orgain:

Organic Ready-to-Drink Nutritional Shake
– USDA Certified Organic
– 16 grams of Organic Whey Protein
– Organic Complex Carbohydrates from Brown Rice
– Omega 3 Fatty Acids from DHA
– Organic blueberries, bananas, acai berry, apple and raspberry
– Organic kale, beets, spinach, carrots, tomatoes
– Organic Pomegranate and Green Tea Extracts
– 24 Vitamins and Minerals
– Antioxidant equivalent to 10 servings of fruits and veggies per serving
– Lightly sweetened with Organic Brown Rice Syrup and Organic Evaporated Cane Juice (only 13 grams of sugar per drink)
– No caffeine, preservatives, gluten, corn syrup, saturated fat, hormones or antibiotics!

You can buy it at Whole Foods Market for about $3.50 per drink or by the case at Amazon here for about $33 for 12.

Orgain was founded by a practicing medical doctor and cancer survivor, Dr. Andrew Abraham. Read his story and the story of Orgain here. (Click on About Us and Founder.) Orgain also donates a share of the proceeds to people struggling with cancer that don’t have the funds to afford adequate nutritional or medical care.

I say, “Thank you Dr. Abraham and thank you Orgain!”

Note: I have absolutely no affiliation with Orgain now does my company, Working Well Massage. I just think it’s a great product and I buy it for my boyfriend and friends!

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By Sue Shekut, Owner, Working Well Massage, Licensed Massage Therapist, Certified Wellness Coach, ACSM Personal Trainer

I was speaking to a client about his son’s video game habits and his lack of physical activity the other day. I pointed out that there has been recent research showing that some aspects of video gaming are actually positive and can be helpful in helping people learn to work with others, problem solving, improve hand-eye coordination and more. Then I got an email from a fellow blogger, FugalDad who created an insightful graphic that shows some of the research info graphically.

At the same time, I do believe in moderation i all things, including video gaming! And I don’t think that sitting for long periods of time without physical activity is healthy. But a balance of  some video gaming, especially of the active sort like Wii or Kinect, and real life outdoor activities, can be a healthy part of your children’s life and yours!

Since a picture is worth a 1000 words, I thought I’d share his graphic and link to his blog. For more about Frugal Dad, click here.

Gaming is good for you

Source: Frugal Dad

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By Sue Shekut, Owner, Working Well Massage, Licensed Massage Therapist, Certified Wellness Coach, ACSM Personal Trainer

These past few weeks have been intensely busy for me and I haven’t had time to share my amazingly insightful thoughts about fitness, nutrition, relaxation and wellness with you. I do have some good posts coming up, but in the meantime, enjoy some of the scenic pics we took while in Maui’s Haleakula Crator in January. Even if you have never been to Maui, just looking at these pics can help calm you down, make you plan your own next vacation getaway and let you take your mind off work!

 

The natural beauty of Haleakula Crator, Maui, 2012. Image by Sue Shekut.

 

Another peaceful, breathtaking view of Haleakula Crator, Maui, 2012. Image by Sue Shekut

 

What is it about clouds that is so relaxing! Image by Sue Shekut

 

Vegetation on Haleakula Crator, Maui, is so colorful and varied! Image by Sue Shekut

View of the other side of Haleakula Crator, Maui. Image by Sue Shekut

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By Sue Shekut, Owner, Working Well Massage, Licensed Massage Therapist, Certified Wellness Coach, ACSM Personal Trainer

Everyone in Chicago is remarking how unusually warm the weather is this march. We are experiencing 80 degree F  days and sun, sun, sun. Not your usually March fare for us Northerners. But this Sunday. my man and I took advantage of the lovely weather and grabbed our bikes for our first bike ride of the season…at Tinley Creek Forest Preserves. Tinley Creek has a paved bike trail and the Red loop is about 9 miles. You can add a route to other nearby Forest Preserves for a longer ride or you can bike a portion of the loop for a shorter ride if you need to.

We did the full loop and my odometer showed we did a reasonably long ride for our maiden voyage: 10.88 miles. Not bad and  nice way to warm up the body after the winter!

BMX biking at Tinley Creek Forest Preserves. Image by J. Porys.

The Red loop was our bike trail. About 9 miles for the entire loop at Tinley Creek Forest Preserves. Image by J. Porys.

The wind in my hair, the path is clear, I take my first ride of the year at Tinley Creek! Image by J. Porys.

Buds on the trees, a slow moving stream, green grass growing tall and proud. It feels like California, but it's Chicago in March! Image by J. Porys.

Tinley's bike trail crosses a few sturdy bridge, I slant into the curves of the path. Image by J. Porys.

Clear blue skies with a hint of clouds in Tinley gives us a scenic ride. Image by Sue Shekut.

I hope off my bike to take more pics! (and let my glut muscles catch a break from the bike seat!) My photographer boyfriend does his best to capture the scene form his angle. Image by Sue Shekut.

As the sun sets, it sends shards of light into this forest, making it look almost haunted! Image by Sue Shekut.

Total Miles biked = 10.88 by the time we reached our car. Image by Sue Shekut

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By Sue Shekut, Owner, Working Well Massage, Licensed Massage Therapist, Certified Wellness Coach, ACSM Personal Trainer

Recently I helped a client adjust her chair to better reach the arm rests of her chair to reduce tension in her neck and shoulders. She had done a fantastic job of repositioning her monitors and keyboard, but we found that her arm rest height was too low for her to rest her arms comfortably on the chair as she worked.

 

Arm rest positions. Image from OHSA website.

After we found some potential fixes for her workstation, I thought I’d share some resources with Working Well Resource readers in case you are having similar problems with your chair. For starters, if your arm rest are not adjustable and you can’t reach them, you may need arm rest pads or a new chair. If you do not have a way to rest your arms as you work on your desk or computer keyboard, your poor shoulders have to hold your arms up all day. That may not seem like a big deal, but think about it, if you went tot he gym and had to hold a 5-pound weight or even a 1-pound weight up in front of you for 8 hours, your arms would be exhausted!  And you likely wouldn’t even be able to hold the weight for that long no matter how strong you are. But that is what many of us expect our bodies to do at work.

Ergononmic Resources for Arm Rests

OSHA has some of the best information about workstation ergonomics and office chairs here. 

, from About.com Guide, has great tips on office chair ergonomics in her article, Before You Decide on Office Chair Arm Rest Adjustments. This post describes optimum settings to adjust your chair for the most ergonomic Arm Rest Height, arm rest width and rm rest pivot as well as how to handle Non-Adjustable Armrests and the Armless Chair.

And here is a great tutorial from Prometheus Training Corporation, explaining self assessment tools you can use to determine if your workstation is set up as ergonomically as possible.  The video is a bit dry, but the graphics and information presented is excellent!

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By Sue Shekut, Owner, Working Well Massage, Licensed Massage Therapist, Certified Wellness Coach, ACSM Personal Trainer

Last Sunday my man and I went to Starved Rock State Park near Ottawa, IL for a much-needed bit of fresh air, exercise and time in nature. We hiked the Illinois Canyon (Starved Rock has many canyons and this one is the deepest so it allows for much exploring!) on Sunday and saw a few hardy folks with their dogs and walking sticks. Some families treated their bundled up children to the wonders of this canyon along with us.

Since it’s been a mild winter, the ground was fairly muddy and the entire area looked ready for Spring. Yet, it’s only mid February so there are still frozen waterfalls and other cold sights to behold. I am posting a short video of water droplets falling from one of the more intricate waterfalls and some pics of the great outdoors. Check it out yourself before the actual spring comes and the frozen water turns the mud into a much stickier mess. For a map and Directions to Starved Rock click here.

Frozen waterfall at Illinois Canyon of Starved Rock State Park, IL. Image by Sue Shekut.

My hiking poles came in handy as we crossed this stream! Image by Sue Shekut

My favorite waterfall and pool in Illinois Canyon, Starved Rock, IL. Image by Sue Shekut.

Although its February in Illinois, this looks a lot like Spring in Maui. Image by Sue Shekut

My photographer boyfriend illustrates how high the walls of the canyon are. It doesn’t feel like we are This doesn’t look like Illinois at all. And to think, this area was once likely ocean! Image by Sue Shekut

A trio of collie dogs shared the waterfall with us. Image by Sue Shekut.

Crossing the streams of Illinois Canyon requires agility and great balance–or you get wet! Image by Sue Shekut.

Outside of the state park near Ottawa, we saw this car and wondered how what distracted the driver enough to miss the road–and dry land–so entirely! Image by Sue Shekut

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By Sue Shekut, Owner, Working Well Massage, Licensed Massage Therapist, Certified Wellness Coach, ACSM Personal Trainer

US Navy 050203-N-4729H-005 Navy Delayed Entry ...

Image via Wikipedia

For anyone that’s ever dieted or struggled to keep excess fat off, you know that conventional wisdom (increase activity, decrease calories) has tended to recommend very caloric intake for losing weight. But living on super low-calorie diets is not only not sustainable int he long-term, but it’s very difficult to maintain even for short-term results. Now scientist shave found the way to lose weight is not as strict and severe as we once thought! And the National Institute of Diabetes and Digestive and Kidney Diseases has produced a wonderful new tool that allows you to more accurately estimate how many calories you need to consume and how you need to adjust your activity level to lose unwanted fat. This tool is called the Body Weight Simulator and is accessible here.

To use the Body Weight Simulator, you need to enter your Base Weight, your activity level and your age and height. The tool does the rest, providing you with an estimate of the number of calories you need to reduce each day to lose weight for the short-term as well as the number of calories you need to reduce to maintain the loss for the long-term. I tried the simulator myself and the number of calories I’d need to cut to lose 10 pounds in 6 months is just much smaller than most diet plans would have me reduce. (About 270 per day versus 500-1000 calories per day.)

The tool also provides graphs and charts that show the progression of weight loss, body fat % change, and activity level change.  Try it yourself and see how reasonable the new calorie goals and activity levels can be for your own fat loss plan!

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