please please help me

[jesserose]

Hi all, new here.  I have problems and need help but having trouble with docs.

Around 7th of dec I was at the store and got vertigo and was having trouble seeing straight, seeing dots and felt 'odd.'  I went home thinking I was just tired again bc I have been extremely tired for a while now.  The eye stuff went away after a while, but still felt odd.

A few days later I woke up and couldn't urinate, I had to force it out.  I went to er thinking infection or stone, but blood, urine and CT were all fine.  Woke up the next day and couldn't urinate again.  Then the rest of the day and night I was peeing very frequently, up all night with nocturia.  My balance began getting worse, loss of coordination and terrible balance.  The next morning I woke up and went numb-tingly-prickly   from the waist down for only about 15-20 minutes.  Migratory numbness followed in various areas.  I was also having whole body twitches for a few days.  The balance/coordination trouble and cognitive impairment were most troubling to me.  I felt lost and like I couldn't find words.  

I remember on several occasions when things went numb before, or I would fall over without balance.  I also rememeber my bowels either having to push out or sometimes almost falling out.  I shouldn't have ignored but I did.

I finally went to doc bc this attack was pretty bad.  she did balance and reflex things.  I fell over during romberg and my reflexes were abnormally brisk.  she got me into an apt with a neuro, and saw him about a week or so later.

I had trouble explaining to him what was going on, for some reason I couldn't articulate the severity of this attack.  He said I don't think ms bc you didn't go numb for a month, it only lasted 20 minutes.  But the numbness lasted weeks, just went to different areas.  It was prob my fault for not explaining myself.  But then he left the office for a few minutes and came back saying I had a few 'tiny like the size of the tip of my pen white dots that I feel are normal.'  I was last patient before his vacation and I felt rushed.  I didn't get any spine results, bc they weren't in.

Well, I got tired of waiting for my results and went to hospital to get mri reports myself.  

Here is what my brain mri really says.  My sis is a nurse and says clearly he read the wrong report.

""There are focal regions of abnormal signal within the periventrical white matter. The largest lesion is adjacent to the posterior aspect of the body of the right lateral ventricle and is somewhat ill defined and measures 9 mm, ovoid in configuration. Within the right parietal corona radiata, there are two additional rounded foci of white matter signal abnormality measuring 2 mm and 3 mm respectively. There is a 2 mm rounded focus of abnormal signal within the left frontal white matter as well. There is an additional lesion seen within the parietal white matter within the left hemisphere measuring 7 mm just lateral to the atrium of the left lateral ventricle."

"white matter signal changes are noted and described above. these could certainly be significant in a patient of this age and clinical correlation with regard to the possibility of multiple sclerosis or other demyelinating disease is recommended."

so I'm very confused.  I have no energy, doing a few things and I feel wiped out.  I can't sleep right.  I am supposed to begin student teaching on monday and I have a 3 year old.  I don't know how to do this.

what do you think?

I get weird little butterfly or bug under my skin feelings or occasional twitches now.  My bowel/bladder still seems to be 'firing wrong' at times.  I have fatigue.  I forget things easy now and can't 'think right' anymore.  When a bunch of people talk I feel overwhelmed and can't make sense of it.  How am I going to listen to a room full of kids?  I 'm scared.  I really feel either MS or Lyme, but I don't think a Lyme attack would have been this bad, but yet I don't know.

Can you help me make sense or tell me what to do?

[essdipity]

Welcome to our forum, Jesserose. You've come to the right place for sure.

That neuro is a jerk. You need a better one, one who actually looks at MRIs and knows how to read them. And also, bothers to read what the radiologist has to say. Start right away to find a neuro who specializes in MS. Neurology is a big field and MS can be elusive.

Your symptoms do sound like MS and so do your brain lesions. However, there are other diseases to be ruled out first, including Lyme disease, as you say.

As you await your next appt., we hope with a competent doctor this time, please read our Health Pages (see upper right). There's an enormous amount of accurate info there that should help you know what to expect and what questions to ask. Also, make yourself a timeline of symptoms that you can take to your next neuro. It's unusual that all this has happened to you in just a month, but it's still possible. The more you write down the less confused and hesitant you will feel. A good doctor will not 'pooh-pooh' what you say.

Please keep in touch, and ask here about what you don't understand.

ess

[jensequitur]

Wow... it sounds like this guy doesn't have a clue.

What I would do is make sure you have copies of all your reports and tests from the first neuro.  Then I would seek an appointment with another neurologist.  You might call your PCP and tell her that you need a 2nd opinion, and she can set up an appointment with somebody else.

Considering the results of your MRI, your tests definitely point toward MS as a diagnosis.  Your symptoms are classic MS symptoms.

You have my sympathy!  It's hard enough to deal with the cognitive fog that comes with a full-blown MS flare.  But to have to put up with a neurologist that's not doing his job at the same time?  Sheesh.  It seems like when you have an illness, it becomes even harder to seek out and receive quality care, which is exactly the opposite of what should happen.

I would also look for a neuro-psych exam to test your cognitive abilities at this time.  During a flare, I test with moderate cognitive impairment, so I'm currently on Aricept.  This allows me to work a full time job, even when I'm having fatigue and other symptoms.

[nncdalton]

I cannot tell you what to do other than find another neurologist that you feel comfortable with and that you feel takes the time to talk to you about all of your symptoms. I finally found a good one after 3 not so good ones. Dr's are in a service industry and there are times that I think they might forget that. We as patients are not a bottom line or a number we are people with families and worries that need to be delt with, not hurried through so someone can go play golf.
I know the frustration that you feel and it is over-powering. The Dr that I have now said that he wanted me to call him when ever I felt something was not normal for me, whether it was tingleing or pain or plain exhaustion. I think you need that same kind of care.
I just came off steroids IV and oral for an episode where I went numb on the right side of my face. I first thought that it was an allergic reaction but because it was abnormal for me I called the Dr and he saw me immediately. Never brush anything off and if you do not feel good about the opinion that you get from one Dr then go to the next until  you have the right answer for you. It took me a long time to find a good Dr but the search was worth it.
It saddens me to read your story. I know that feeling of not knowing where to turn. Your mind is reeling from all of this and that only adds to the symptoms that you are having. There will be more people that respond to your post that will know far more than I do about what to do, but I felt that I needed to tell you that you are not alone in this and you will get through it. Please take care and you can write me anytime if you need to talk or vent.

Christy D

[jesserose]

thank you for responding. it is very frustrating.  I called my neuro today asking for an explanation as to why he said something completely different from what the mri results were.  He was supposed to call back and never did.  I called my PCP too because I think I need depression medication or something/maybe something to help with the fatigue.  She said I need to follow up with the neuro.  I don't understand.  I don't think I need or should wait for another attack, bc who knows what it might do to me?!  I have a little girl to worry about.  

I'm about to enter something even difficult for people with nothing wrong and who don't have children-which is student teaching.  I don't know how I am going to do this.  what if I am driving or in front of small kids and something happens?  I'm so tired now, am I supposed to take caffeine pills until someone hurries up with procedure?  He scheduled a VEP but not until the 29th of Jan.  He mentioned a spinal tap but he didn't say when.

I did have some blood work done, maybe someone can help me with mri and the lab too?  My b12 is within normal range. My albumin-electro is high, alpha-2 is high and a/g ratio is low. It says consistent with acute or sub acute inflammation.  what does this mean? Also my spine did not have contrast, isn't that important?

my goodness I'm at a loss but thank you for tking the time and everything.

[biowham]

HI, Jesserose--

Just wanted to second or third or fourth what everyone else said and just express my growing frustration at reading all of these infuriating stories.

At least he scheduled those other tests, which will provide useful information. But that misstep over the MRI is pretty serious.

Bio

[CareBayer]

Please find another neuro. What that dr did was wrong plain and simple. If you had not gone and gotten the reports yourself it could have taken a long time before you knew what was in them. Makes me upset what that dr did to you.

[jesserose]

So you all think this report is not good?  that's kind of a dumb question on my part....but i was more than shocked when I read it.  I don't get it.  He is a new doctor, but I heard he was a good neurologist.  I assume he read the wrong report as I can't think of any other reason for such a differing view.  

From everything I research, most of my lesions are typical ms locations.  along with the one that is ovoid in configuration is something like a dawson finger I think from what I am reading.  And the blood tests seem pretty conclusive with autoimmune. and the only autoimmune symptoms I have are extremely consistent with MS. I need medicine.  

Do I have to wait for another attack?  I'm so scared.  Do I call him again tomorrow and see if they admit to error on report on their part? I know mistakes happen perhaps his receptionist gave him the wrong one....if they blow me off again, how do I get a second opinion? Do I call one and just book it? That could take forever.  Is a spinal tap even necessary with these lesions/symptoms? I'm reading as much as I can and it is so close it is frightening.  I know people wait long time for dx but I'm tellin ya that attack was awful and where it affected me concerns me.  I do not want to potentially lose mobility and I couldn't walk right for a while there between the balance/coordination problems and heavy/clumsy feet/legs whatever.

sheesh

[Lulu54]

Hi Jesserose,

Lots here to comment on so lets get started----------

Welcome to our forum.  As you have already experienced, we have a lot of knowledgeable and compassionate members who are willing to share with everyone.  I am so glad you found this place - hopefully you will continue to visit and find it helpful..

Congratulations on getting to the student teaching part of your education.  The world needs more quality teacher - you have picked a very noble profession to enter and I am sure you will do well.

Now to the MS c rap - your neuro obviously missed the boat with your MRI's.  Let's give him the benefit of doubt and assume he read someone else's MRI and not your's .  That's bad enough, but the sizes of the lesions on your brain are definitely larger than tiny pen points.  Do you have to get a referral from your PCP to see a neurologist because of insurance or are you free to look for someone else on your own? If you can move on, I would because confidence in your medical team is of the highest importance and I'm not sure I would ever completely trust his judgement again.  Please explain this to your PCP is you need her blessing to move on.

Has the neuro's office called you back yet since you challenged the results you werre told?  If it has been more than a couple days, I would call again.  And call again after that until you get a reply.  Make it obvious that you are not going away by being ignored.  

It is a good sign that the LP was mentioned along with the VEP - if they get done before you switch neuro's that's fine.  You can always take the test results with you to the new doctor.  

Get  and keep copies of everything - it will save you lots of time and grief down the road.

The LP isn't required, but it can seal the deal with your dx.  I have no regrets about having mine done, but the test has mixed reviews here.  Some have no problems, others have days of misery afterwards.  

The possibility of having MS is frightening  - and especially so when we first start down this road because we don't know everything.  Once you have the time to process this, I hope you become more comfortable with learning everything you can and being active in the dx process.  

MS won't kill you but it sure could make your life he llish.  It can't be stressed enough that the current thinking is the sooner you can begin a DMD   the better off you might be.  But this also doesn't mean that you have to panic and feel that you are doomed if this isn't done by the end of the week.  

You do want the doctor to make an accurate dx - labeling you with MS changes a lot of things for you and they need to be sure.  Starting a DMD without a sure dx wwould be irresponsible because some of the drugs are toxic.  You wouldn't want to take them unless they are absolutely necessary.  

Having MS should not stop you from becoming a teacher.  It won't stop you from being a good mother to your three year old either.  Lots of things change with knowing you have MS, but you can control many other things as well and live a happy, productive life.

I hope some of this helps to calm the nerves while you work through this dx.  Again, welcome to MedHelp - I hope you are a regular and keep us informed.

My best to you,
Lulu

[sllowe]

Hi there!

Welcome from me too!

Oh yea, get yourself back to that guy, and fast.  I would.  If it were me, I'd bring that report w/me to the appt., and I'd be sure to ask him if "THIS" was the report he was referring to when he mentioned your "normal" brain.  I'd do it nicely though.

WOW folks, this is so hard to understand isn't it?

I'm glad you found us here Jesse, and I hope we can be here for you while you make these next steps.  I hope being here with us and learning brings you some peace to your mind and body.

Nice to meet you, and see you around,
Shelly

[doni54]

Hi Jesserose,

Welcome to our forum, this is a great place with the most wonderful and caring people you will find anywhere.

I can't really add to what everyone has said, but I agree!!  Find a new neuro!!! And get copies of all your records.

Good luck and keep us up to date about what's happening with you.  I think you will love it here, so I look forward to talking to you again.

Take care,
doni

[ShockedToday]

I just want to welcome you.  I am very new to MS myself.

I agree with all the wonderful advice that everyone is giving you.  Get the tests done and then get a 2nd opinion, and if need be, a 3rd opinion.  Do not stop trying to find out what is wrong.

God Bless,

Cee

[jensequitur]

>  Do I have to wait for another attack?  I'm so scared.  

Jesse, don't panic!  I know how scary it can be when you're in the middle of a flare.  I called up my PCP's office in a panic (this was before diagnosis) and she prescribed oral steroids for me, which really helped bring me out of the fog.  You might see if your PCP will do the same for you.

As to whether a spinal tap is necessary - it seems to be the decision of the neurologist.  I had to have one, and I had only one real lesion in my cerebellum - everything else was either 'white matter enhancement' or punctate lesions.

At this point, I would look for another opinion, but I know that's difficult.  If the neuro is willing to schedule a spinal tap, you might as well go for it.  It's painful and horrible, but it's one test you shouldn't have to do again.

Meanwhile, make sure you get plenty of rest!  Take naps during the day, and it will help your cognition.  I know this can be very difficult with a 3-year-old!  Do you have anybody around that can help out?

[jesserose]

Hi.  Thanks for responding.  I don't have a big support system and now I can't even get docs to help. I think my husband is having a hard time with this too.  I have not been the same since the attack.  While the worst of it has left, the memory/cog impairment has stayed.  And a few other weird little things.  My head feels odd, it's hard to describe. Like there is something in it or like a hole in the middle or something.  or just an occasional random sharp shooting pain somewhere in my head. I wanted to ask someone if the ms hug feels like braxton hicks sometimes?  In that area I get either pain/burning feeling right under my ribcage, just uncomfortable feeling, or a braxton hick contraction feeling.

I called PCP for depression or something to help me deal with all of this while I 'wait' but her secretary called back to say she said the neuro needs to handle 'all of this' now and to followup with him.   I have called 3 times since Friday.  I understand he did not technically get into office until Tuesday, but I also called on Tuesday and I don't understand why he is not calling me back!  even if he saw 'nothing abnormal' on my picture he still can call and give me an explanation....no?  I'm so confused.  I'm depressed too.  I don't feel like myself anymore and I am not functioning properly.

I need help and I feel stuck.  

[jesserose]

woops forgot to add that if he does not call by tomorrow morning I am calling for a referral somewhere else.  What does inflammation in my blood work mean?  

Right now I would feel better if I had something to help me with depression, something to help me with fatigue, something mild to help with the random pain things, and something to help me sleep properly.  It makes no sense I am dead tired all day, especially 11-5 or so, and I try to go to bed and while I am still very tired it is like my brain is wide awake.  I'm not necessarily thinking about anything sometimes I just feel or think nothing, but still have a wide awake feeling in my head.  

The fatigue is weird.  It's not quite like sleepy fatigue.  It's not quite like muscle/body fatigue.  It's a little of both of those but it's like an all over heavy fatigue.  Like I'm being pushed down by something invisible.

Maybe I am giving it too much thought.  I just can't imagine what kind of doc would be a wait for second attack with an mri like that? prob not the worst he has seen or the worst anyne else has, but after someone first real attack of something? I should have been given a LT ASAP not mention it and leave it go at that.  I was pretty much unable to function at all during that bc I had no balance or energy.  

I'm just babbling here.  I laid down with my lil one at 9, and got woken up, decided to come down and take a unisom and get online for a bit.  I had to take 2 unisom last night just to get to sleep.  I was never a sleeping pill person I used to have no trouble going/staying asleep.

[sheznolady]

Welcome.

I'm with you on the anxiety over seeking a definitive diagnosis; your desire to find a neuro that gives a rats @$$;  all the while fighting depression and trying to launch a new career.

Prior to October 2008, I was pretty normal. Depressed, yet normal, exuberant, hyper, life-of-the-party type.  During the 2nd week of Oct, I woke up in a panicked state of mind - like I was having a nervous breakdown for no apparent reason.

It scared me enough to consult with a neuro who ordered a brain MRI. Results: Deep white matter lesions in the centrum semioval, however their location is atypical of MS. Given my family history of MS, I've accepted the fact that, atypical or not, it's a possibilty.

And while I have not experienced attacks of any sort (VEP negative for optic neuritis), I feel you on the onset of the debilitating chronic fatigue (mine leaves me feeling punch-drunk), cognitive impairment, depression, etc.

As the lovin' folks have advised, if you have the option to find another neuro on your own, DO SO!  ALSO, get yourself in to see a psychiatrist for your depression. The last thing you need to allow the anxiety to send you over the edge. Your little baby needs her Mummy!!

Luckily, I have insurance which allows me to pick and choose whomever I want to see, so this is how I chose to FIGHT, going down my particular list of symptoms:

1) ENT - based on the location of my head pain and constant dizziness, thought it might be an inner ear imbalance. He was gracious enough to order a full skull base MRI which ruled out nerve tumors of the face, neck, and head, but still...those pesky lesions.

2) ENDOCRINOLOGIST consult to rule out adrenal failure or thyroid disorder - results normal.

3) CARDIOLOGY consult to rule out heart obstructions that may be cutting off blood flow to my brain - heart normal, blood count normal

4) NEW NEUROLOGIST specializing in fatigue and sleep disorders/migraines/chronic head pain - Appointment 1/13.

5) NEW PSYCHIATRIST to help me with the depression. I have been diagnosed clinicallyh depressed, so I need to be on meds. My old shrink prescribed crazy meds like crazy, with no reliable treatment plan. Appointment 1/14.

6) NEW INTERNAL MEDICINE DOC!  Like yours, mine told me that I was in the hands of specialists now, so she wiped her hands of me, just like Pontius Pilot!!! My new lady specializes in Intergrative Medicine (Eastern philosophy), that is more holistic methods of healing in addition to the traditional Western menthods. He specializes in chronic fatige and depression, Appt 1/19.

Careful-careful with the sleep meds, darlin'. And I'm also worried about your anxiety.  SOrry, but I don;t care about what hubby thinks right now, get on the phone and seek HELP for your state of mind so that you at least have the PRESENCE of mind to do what you have to do.

I am a single mother of two teenagers, and every morning when that clock goes off, I want to break down and cry, because I literally have no energy after a full night of sleep. It is not easy.

Not sure how to advise you on the student teaching other than to say that you need to take care of YOU first.

Lastly, be kind to and patient with yourself. If you need immediate help, consider calling a reputable 24/7 crisis line. All areas have these support resources.  You can do so anonymously.

Google it and get some numbers in your local area. These folks save lives.

I'm new here, but these caring human beings have already inspired me to rise above my circumstances, and I plan to do just that!!! If I have to march to the Emerald City to ask the Wizard for a new brain, I will do that, too!!

Please let everyone know how you are doing!

Best
Liz

[ShadowsSister]

Hi, I can tell by all the comments, you have been told a lot of good stuff, so I'll just add myself to the long list of supporters. I am here for you and will keep you in my Prayers.
I found that some times just knowing I am not alone really helps to get through the dark times.
Sending you hugs on the winds{{{~!~}}}

[Octarine]

Hi, I agree with everyone about finding a new neuro, but wanted to answer a couple of your questions and maybe help you get set to start teaching.  

"It says consistent with acute or sub acute inflammation.  what does this mean? Also my spine did not have contrast, isn't that important? "

Inflammation is part of the disease process of MS.  It's also part of many other illnesses.  So your test result doesn't confirm an MS diagnosis, but I believe it's consistent with a flare-up.  

Contrast is important in brain MRIs but I believe that lesions in the spine don't pick up the gadolinium as readily, so spinal MRIs don't use contrast.

As for starting your student teaching, my heart goes out to you.  Maybe some of these suggestions will be realistic and/or work for you?

Call or meet with your supervising teacher privately and say you're recovering from a serious illness that doctors are still trying to figure out.  Assure her (him?) that there's no indication it's contagious, and ask how she copes when she's under the weather.  Maybe she'll have practical tips, but at least she won't think you're on drugs or irresponsible.

During the work day, it sounds as if it will be tough.  These are some ideas that have helped me at various times, before I was in Limbo Land.  Just as a parent, teacher, and someone who's had many first days on the job:
   -- Figure out a signal for the kids that says "one at a time."  This cuts down on the multiple inputs.  In my classroom, I physically give one student's question all of my attention (with body language), and if another one raises a hand or speaks up I very briefly make eye contact and raise one finger ("I'm aware of you and you'll get your turn") and then turn back to the one with the question.  The students learn that they will get my attention, and they appreciate that I pay attention to each one in turn -- they see themselves in each other.
   --  In general, have a plan in mind for classroom management.  This is another thing to talk about with your mentor; she'll have her own system that may help you, and you don't want to step on her toes with your own.  
   -- When cog fog starts, focus on the task at hand, then move on to another.  Remember that everybody spaces out to some degree.  Ways to buy a little break time include opening or closing the door, taking a drink of water, stepping into fresh air briefly, stretching.
  --  The same tips help me with fatigue, plus I keep sugarless hard candies in different flavors in my purse.  I use sugary ones only when I really need a jolt.  Also, set small goals like "till recess," "till lunch," "till dismissal."  

You didn't mention your child care arrangements or whether your daughter's father is in the picture.  If you can afford it, buy an extra hour or two of care instead of picking her up right after work, and use that time for REST, not paperwork.  And if you're not a single parent, now is when your partner should be doing most of the parenting -- when you're starting a new position, or dealing with an illness, and of course when both are happening at the same time.  

If you are a single parent, here's a huge cyberhug.  Any way to arrange play dates with her friends, so that sometimes you get a rest break and sometimes she has a friend and you can at least lie down on a sofa?  Three-year-olds do need supervision, but imagination and language have kicked in so much that two friends probably can amuse themselves for 30 minutes at a time.  Avoid groups of three kids and you'll minimize the fighting.

Another way to buy rest time is to borrow books and their audiobooks on CD from the library.  Your daughter can turn the pages while listening, snuggled up against you, while you doze.

As for caffeine, that will mess up your bladder worse and it's no fun as a teacher because you can't get to the rest room very often.  (Pause for additional tips:  generic Poise pads just in case, and avoid orange juice as it can also irritate the bladder.)  And sugar has those big downs that follow the ups.  

But you're on the right track, thinking about managing symptoms through food.  Great nutrition may help keep inflammation down, and certainly won't hurt.  For me, it's a way I can take care of myself and it really feels good to eat right.  I know it's tough on a budget, but the latest Consumer Reports has tips about that:  consider eggs, baked potatoes, beans, and frozen veggies.

I hope at least some of these tips help you weather your first week of student teaching.  Please let us know how it goes!

[jensequitur]

> It makes no sense I am dead tired all day, especially 11-5 or so, and I try to go to bed and while I am still very tired it is like my brain is wide awake.

Jesse, you're not alone!  What you're describing is classic MS fatigue and cognitive impairment.  I get that quite often - I'm exhausted, so I lie down - and my body feels so tired that I can't sleep!  It feels like I'm wired up on coffee or cold medication, but I'm so tired that I can't think straight.

I think that you're on the right track - let us know how your referral to a second neurologist goes.  You really need somebody that's going to listen to you - this is ridiculous!  I don't understand why your PCP won't at least prescribe oral steroids for you - it sounds like you're going through a flare.

[jesserose]

thank you guys for listening and for great advice.  I am going to try and get LT next week, and work on nutrtion and try to reframe and stuff.  I am also planning on looking into lyme.  Doc says MS does not usually present paradoxismally (sp) with one symptom for a few days then onto something else...so I don't know. I think I will be able to come to a better conclusion after VEP which isn't until the 29th, and LT.  If those are both negative for MS, then....

I am fortunate to have my husband but this is putting a strain on everything.  I'm afraid he thinks I am nuts! The thought has crossed my mind. But he insists he doesn't... he was there and saw what happened.  I don't know what to think and why there are so many conflicting reports and stuff, but all I can do is take the tests, be a good mom/wife and student teacher and change nutrition and so forth.  I really might have lyme goin on here.  The 'what is wrong with me' freaks me out but I need to focus bc I am about to get real busy here in a few days.  I just hope I do ok and I hope no other attack.  I hope the same for you all as well. ((((hug))))

Thanks a lot

[Octarine]

I'm so glad your husband is with you on this!

As usual for me, I thought about you and about my post for hours and hope I wasn't patronizing you or minimizing your problems.  Your fatigue sounds a lot worse than mine; maybe others are rolling their eyes at my tips.  

But at the risk of telling you one more thing your classroom management classes probably already mentioned, Post-it notes help a lot with cog fog.  I carry them around the classroom with me and use them for students' requests, colleagues' requests, and my own mental notes about preparation for the next lesson.  One task per sheet.  It feels great to be able to throw each one away later, as that task is done.  Also they can be sorted and prioritized easily.

Good luck next week ((((hug))))