let me know! NONE of my doctors did anything about it and brushed it away saying it cant be from that b/c they never heard of it. This can be a result of dangerously low blood force per unit area or the center's inability to pump enough blood to organs. The feedback link Was this Article Helpful on this page can be used to report content that is not accurate, up-to-date or questionable in any manner. Alcohol-induced pancreatitis refers to inflammation of the pancreas due to alcohol consumption. Have patience more important, Scan this QR code to download the app now. I was in the ER for 5 days and am in the process of getting follow up imagery taken. This tin can cause hurting to worsen. Eating small, healthy meals will place less stress on your pancreas. I'm at a healthy weight, not diabetec, and don't drink alcohol. Shock or septic stupor happens when claret isn't distributed adequately throughout the trunk. Acute pancreatitis usually involves pain in the upper abdomen that may spread to the back. How often can we drink alcohol while having acute pancreatitis? over a year ago, casual t68762 So we should get enough of these vitamins including vitamin A, D, E and K from foods. Read More. I'm 40 and I have never had one before. That is very similar to what happened to me. However, in most cases, once you get cured of pancreatitis, it is highly recommended not to take alcohol in your lifetime. After severely adjusting my diet 3 years ago and losing 30 pounds, super fatty foods in bulk have always caused me issues. Have you continued drinking since? Your health is more important, drink something else and enjoy the company instead. So here's my question: can I bypass damage to the pancreas by absorbing the alcohol transdermally. Hey guys so like the title says heres an update. If you choose to drink, be prepared for the consequences. Is ERCP induced Pancreatitis a one and done deal? 117 lipase, no pain, Can I have some alcohol? I just had outpatient surgery yesterday called ERCP and I still had sludge in the duct. trust me you don't want that. A basic multivitamin includes a range of vitamins and minerals. Haven't had a chocolate bar since then but have found subtitutes for most everything. People with this condition will most likely crave mechanical ventilatory support. Is one more likely to have acute pancreatitis after endoscopic ultrasound if they had AP after ERCP? I am a sophmore in college and I still drink (eventhough I know I shouldnt) but I was wondering if this is why I am still in pain? 1993 orange bowl box score; facts about cardiff university; georgia newspapers 1881 2009; monroe township basketball; south kitsap teacher salary schedule However, alcoholic pancreatitis can cause inflammation of the area. 2015 Mar 31;7(4):2261-73. Diet and Nutrition good for Pancreatitis? I truly do care about my health and plan on changing my lifestyle, but would be lying if I said this news wasn't hard to cope with given my lifestyle and age. Nevertheless, because a person suffers from an episode, there is a likelihood of another occurring. How is the cure of pancreatitis related to this and can you drink after getting relieved from pancreatitis. However, I now no longer drink at all because the risk is not worth it for me and I tend to binge drink; I take phenibut or gabapentin if I am in social situations or under stress. Remember to have a bit of healthy fat when consuming fat-soluble vitamin-rich foods. No one knew anything and my tests were fine. When I drank on weekends I didn't drink too much beer and did liquor jack honey or . Ate a lot of dairy today. I had my first flair up in February 2015. Let us understand this in detail. Is there a safe amount of alcohol I can drink or an alternative? Diet is important after a pancreatitis attack. Content on HealthTap (including answers) should not be used for medical advice, diagnosis, or treatment, and interactions on HealthTap do not create a doctor-patient relationship. I have been in the hospital for 2 1/2 weeks of the 3. Also try to cut out greasy food, hard liquor/binge drinking of any kind, and start focusing on exercising and getting healthy. Dark or extra-dark chocolate have even more fat grams per serving. Couple cocktails. The best time to take your prenatal vitamin is before lunch with a small sip of orange juice. Healthcare professionals can make up one's mind this upon examination. Well the last time I was in the hospital (Feb08) they finally listened and changed my birth control pills-dosage and frequency-and i have been feeling great. 2023 Remedy Health Media, LLC ALL RIGHTS RESERVED. This respiratory condition refers to when a person's lungs do not exchange enough oxygen and carbon dioxide in the blood. You'll get health news, advice, and inspiration delivered right to your inbox. Torso organs that depend on fresh blood supply can neglect. Eloise Parry's Tragic Death: A Chilling Warning Never To Take Illegal Diet Pills, 13 Medical Conditions Related To Diabetes. Patients may accept a CT scan with a solution delivered through the veins. Press J to jump to the feed. Whether you have acute or chronic pancreatitis, your doctor will recommend that you abstain from smoking and drinking alcohol. Pancreatology. Can Diabetes Be A Warning Sign Of Pancreatic Cancer? I got very sick after that with a fever of 102.9 and passed out in the floor at my grandmothers and was back in the hospital. The following is a basic guide for the best times and ways to consume vitamins: The B vitamin group includes thiamin, riboflavin, vitamin B-6, niacin, biotin, vitamin B-12, folic acid and pantothenic acid. As we all know a disease is often pish-poshed as being all in our heads ( especially if we're women) until some BRILLIANT doctor DISCOVERS it. I am curious to know if you have high tryglycerides and high cholesteral ? These are stone-like pieces that form in the gallbladder. Towards the end of 21 I began doing a lot of drugs xanax and cocaine to be exact and my drinking habits went up significantly drinking during the week very often. reading vs luton footystats February 16, 2022 Dont combine vitamin K supplements with the blood thinner Coumadin. Dark or extra-dark chocolate have even more fat grams per serving. Addiction specialists are available 24/7 to answer questions nigh costs, insurance, and payment options. Share. I've have had my gallbladder out, and I have suffered from pancreatitis for as long as I can remember. You can also take them two hours after a meal. : If you are taking metronidazole, you are absolutely not supposed to have any alcohol for at least 48 hours after your last Metronidazole dose. Booze can cause further inflammation and delay recovery. I know the alcohol may have been an issue, but I never had issues with it in the past and if anything, always felt better than most the next day after drinking. I too had trouble convincing the docs that they were related. If your doctor was stupid enough not to advise you on this, then don't you be stupid enough not to simply ask him or her for advice. 2017;33(5):374-382. doi:10.1097/MOG.0000000000000386, Ahmed ali U, Jens S, Busch OR, et al. I was hospitalized for over a week with severe acute pancreatitis caused by a gallstone (getting gallbladder removed this week, a few weeks later after the pancreas has settled down). My doctor couldnt really tell what the cause was since Im only 19 and had not been heavily drinking. better absorbed when accompanied by some fat in foods. Its now Christmas and my friends are planning to go out in the 25th and my plan is to grab maybe 3 or 4 beers. If you must risk it, try non-alcoholic beer first. I appreciate you responding. 2013 Sep-Oct;13(5):468-74. Eliminate trans fat from your diet and use healthy cooking oils such as olive oil. Only once have I had a slight flare and I ate jello and sipped broth for a couple of days and it healed itself. I don't really know how to describe the pain. Why Does Chronic Pancreatitis Cause Excruciating Pain & How Is It Treated? If you are having constant pain, your pancrease may be on it's way to a bad deal. I have been to Boston, Connecticut and have a TON of docs in RI. This is to encounter if at that place is pancreatic enlargement, a loss of pancreatic borders, surrounding fluid, and fat stranding. Types of Pancreatitis. 2014 Aug 21;(8):CD008945. Im a 24 year old Male. This clearly answers the question of can you ever drink again after having pancreatitis. bangladesh clothes size compared to uk. facts about djoser pyramid; howrah to salt lake sector 5 bus no; micros touch screen not working; psychic protection for empaths; how long should i wait to drink after pancreatitis. one drink will stay in your system for one hour. how long should i wait to drink after pancreatitis. I began feeling anxiety and depression during this stage drinking seemed to dona great job at making it go away. I lost weight, and felt fantastic. I was a heavy drinker for the most part from 18-22 it was only during the weekends during the week I was always focus on proper eating and hitting the gym. Hence, it is highly recommended not to take alcohol for the lifetime once you develop pancreatitis as it increases the risk of further complications. Eating food can stress the pancreas, particularly when it causes the pancreas to release digestive enzymes. Well, the thing is that your doctor should prescribe you a diet after suffering from an acute pancreatitis or at least give you some guidance. I haven't drank since. So Im playing the numbers. Avoid chocolate after a pancreatitis attack because it is high in fat. I had my first visit to the ER due to Acute pancreatitis Sep 1 2019 a month after my 23 birthday. I missed 51 days of work total. Please check with the appropriate physician regarding health questions and concerns. Pancreatitis can be an acute or chronic condition. Can i drink alcohol again after acute pancreatitis? If you are experiencing serious medical symptoms, seek emergency treatment immediately. Im now 23, but for the past 14 months I had been drinking regularly-- 2 nights a week sometimes more depending on occasion. If you taken Xanax and want to have a glass of wine or have a beer it is good if you have your liquor 2 hours before you take your Xanax or 2 hours after you drink Don't just . (*hint..this sounds kind of gross..but I've found that if the fat in my diet is too highmy pee in the potty looks like I put a teaspoon of vegie oil on the water. Amy Hendel is a medical and lifestyle reporter, nutrition and fitness expert, health coach and brand ambassador. and so far nothing has happened. First time. Thanks to all of you that have posted your experiences. Avoid chocolate after a pancreatitis attack because it is high in fat. I am not a drinker never was big on that either. I've been very healthy since. salt water rinse after tooth extraction how long; stadium of light seating plan; san diego padres owner net worth; canada basketball team roster 2021; particle media inc fake news; the animal toy truck 1980's In the past, I'd start to feel this heartburn/ball in my stomach, I'd vomit, it would go away, and I'd treat it as nothing. Acute pancreatitis: current perspectives on diagnosis and management. and our 14% is a large percentage of repeat pancreatitis for someone who never drinks again, and well, I love beer. So if you've had five beers, you should really try to wait at least ten hours before breastfeeding. This is the body area between the last rib and superlative of the hip. I had acute pancreatitis about a month ago. Just dont. I'm better now and can drink alcohol normally. This article may contains scientific references. I truly do care about my health and plan on changing my lifestyle, but would be lying if I said this news wasn't hard to cope with given my lifestyle and age. I'm 24 and suffered my first ever attack of acute pancreatitis 2 weeks ago. Alcohol use worsens the symptoms and clinical course of the disease. over a year ago, kimber137766353 I had no issues then for my birthday I had no issues but I continued drinking the following day and after 5 drinks I began to throw up and that was my que to stop drinking. Pancreatitis.. However, healthcare professionals include stopping alcohol use during or after hospitalization. There are two master types of pancreatitis: acute and chronic. i.e. I had heard of alot of people having that problem after children. Many of these are not naturally produced in the body or stored, which is why its important to track food sources or take supplemental vitamins. Then on my birthday I had 6-7 modelos the first time for 4th of July I felt buzzed and was so happy I was able to experience that feeling of happiness with my close ones. Have a nice day. Learn how we can help Drinking alcohol affects the health in many ways. I was in the hospital for only 24 hours and could eat like normal the day of my discharge. Hi sorry to hear you have had 2 bouts of pancreatitis. When a person drinks regularly the molecules present in the alcohol interfere with the cells of the pancreas due to which the pancreas stop working properly. The answer to this depends a lot on the cause of pancreatitis. I have been sober since then, so for almost 7 months. Being only 22, alot of my friends frequently go on nights out, and all my family are drinking over christmas so i was just wondering what people found for them as i am planning on waiting 6 months following what ive read (which i shall double check with my doctor on friday), but even after the 6 months did anyone have a bad experience with it? Last weekend I started a new Birth Control pill pack (Yasmin). If you drank enough to have pancreatitis, you have a problem. I came to this site looking for helpful information about what to eat so that maybe I won't have to go through this again. Given that you suffered with Necrotizing pancreatitis and haven't had too many problems since, you should see this as a blessing in disguise and follow the generally accepted guidelines to stay clear of any further acute attacks. If people can avoid booze consumption, they tin lower their risk of this condition. Thank you for sharing your story! That is a choice you need to make on your own, and it sounds like you already have the correct answer right in front of you. No previous pancreatitis or serious health issues. I have talked to a few doctors who do say drinking in moderation may be possible later in life, but I'm looking for some actual advice/stories from anyone who has suffered and attack and drank again afterward. hi therebeen hospitalized 9 times in 3 years with chronic pancreatitis. By using our website, you consent to our use of cookies. These types of pancreatitis could occur due to other causes. People who experience a more severe instance of alcoholic pancreatitis may have the following: This condition is also known equally Cullen'south or Grey Turner'southward signs. Although we strive to deliver accurate and up-to-date information, no guarantee to that effect is made. I was in the hospital for 12 days and dont remember but maybe 3-4 of those days. how long should i wait to drink after pancreatitisspecialized structures of banana. thanks!! An addiction specialist tin assist answer your questions and guide you lot through the intake process. Antioxidants for pain in chronic pancreatitis. Cochrane Database Syst Rev. Some people can never drink again and some can handle a few drinks on special occasions but it's similar to playing Russian roulette every time. POST PANCREATITIS AND INCREASED CHOLESTEROL AND TRIGLYCERIDE LEVELS, I need a complete list fo a pancreatitis diet. Create an account to follow your favorite communities and start taking part in conversations. Thus, when considering if you can ever drink again after having pancreatitis, you must know that drinking again after recovering from alcohol related pancreatitis can still put you at risk of illnesses. My husband had an attack shortly after having NA beer. Really helps with alcohol cravings. I felt progressively worse at home on a bland diet, and was re-admitted into the hospital for 5 additional days. I was born with a choledochal cyst. Moreover, the pancreas of the patient will be gradually losing its functioning in case the patient starts to drink again and the functioning of the endocrine will be lost completely. Created for people with ongoing healthcare needs but benefits everyone. Many factors are at play when it comes . Haven't drank since and have rarely ever smoked in my life? The condition develops due to a peritoneal or retroperitoneal hemorrhage (bleeding). Not making excuses, just giving a backstory. Is there anyone out there who has suffered an attack and then drank moderately/socially after? This is a commonly asked question. I have drank every day since I returned from the hospital, still a lot but not as much. And over the past few years, I've had an increasingly sensitive stomach; a few episodes of vomiting here and there that I always attributed to stress or mild food poisoning (the doctors think I was already experiencing mild pancreatitis). As to your question, I was under a lot of stress and insanely had a bottle of wine on several separate occasions starting about six months after my episode. Pancreatitis is inflammation of the pancreas, a gland behind the stomach. Acute Pancreatitis, Gallbladder being removed; post gallstone pancreatitis-enzyme replacement and diet, Recent pancreatitis attack; diet plan; low-fat, hi-protein, hi-carb, Accidently diagnosed with pancreatitis with no pain, Acute Pancreatitis not sure of the cause. You really need to ask your doctor when you can drink again. Video chat with a U.S. board-certified doctor 24/7 in less than one minute for common issues such as: colds and coughs, stomach symptoms, bladder infections, rashes, and more. One ounce of semi-sweet chocolate contains 9 grams of fat. I have felt twinges in my pancreas, but nothing compared to the pain when I went to the hospital. man killed in houston car accident 6 juin 2022. Stop taking biotin if you are undergoing thyroid testing. doi:10.1002/14651858.CD008945.pub2, Mohseni salehi monfared SS, Vahidi H, Abdolghaffari AH, Nikfar S, Abdollahi M. Antioxidant therapy in the management of acute, chronic and post-ERCP pancreatitis: a systematic review. I am very scared that I am going to end up going through the same mess again. I had my first visit to the ER due to Acute pancreatitis Sep 1 2019 a month after my 23 birthday. My doctors only said "diet as tolerated." This time, I vomited and it only got worse, until the point where I was moaning, crying, and had to call an ambulance. Avoid chocolate after a pancreatitis attack because it is high in fat. In alcohol-induced pancreatitis, pain does non oftentimes announced until one to three days after a binge drinking session. hey! . I was excited to find this site, and saw that ther were several pages of posts, but I had to take a break and rest for awhile, and when I logged back on there was only one page that I could manage to access now. Use nonprescription motion sickness medicines. Chronic pancreatitis oft occurs when multiple acute pancreatitis episodes have resulted in scarring and permanent impairment to pancreatic tissue. They were getting bigger and pushing on my intestines and stomach, so I had to have an ERCP done and they put a stint in my pancreas and drained one of the cysts. My drinking progressed from there. Privacy Policy. When can I drink alcohol after acute pancreatitis? Regarding the question whether you can ever drink again after having pancreatitis, it depends on your condition and severity. %-) I have just experienced yet another episode of pancreatitis. Until later, thanks to all. No Alcohol!! The best time to take calcium is with a meal. Even so, there are some potential reasons. jackson ward richmond, va crime. Also, marijuana was a life saver for me. This is for specific foods, as consuming bread with coffee decreased iron absorption from 60% to 90%. However, cocoa may be acceptable because it is made by placing chocolate liquor into a hydraulic press to expel the fat. I live in France, where wine drinking is the norm. One ounce of semi-sweet chocolate contains 9 grams of fat. Use this time to understand why you were drinking that way in the first place. After severely adjusting my diet 3 years ago and losing 30 pounds, super fatty foods in bulk have always caused me issues. Thus, in case you develop pancreatitis it is very essential that you consult your physician and go through proper treatment as soon as possible. If not treated promptly, it tin cause septic daze, where organs practice non receive enough oxygen or blood menses. This means ANYONE who has been diagnosed with pancreatitis whether it is alcoholic pancreatitis or some other form (gallstone, trauma, high blood fats, etc) needs to quit drinking as well. One should wait at least half an hour after eating dinner to drink water. I don't think anyone here is going to be stupid enough to tell you to go for it. Seeking permission on the internet from strangers is definitely not wise or appropriate. I see a new specialist soon and Im hoping to get more answers, or at least hear if I have developed Chronic Pancreatitis.Both of my attacks have been diagnosed idiopathic, although the Dr's believed this last attack was brought on from the alcohol over the holidays. over a year ago, Joshua57262937 One week later (Saturday) I was having symptoms of Pancreatitis. If so, what type of alcohol is the best or worse / how many drinks per week could you have / how long have you drank without having another attack? over a year ago, TrueJoy Ireland Wolfe has been writing professionally since 2009, contributing to Toonari Post, Africana Online and Winzer Insurance. When I was 23 back in 2015 I had my worst one yet and, like yourself, ended up in hospital for a week. Steaming is best when choosing a cooking method that will not significantly impact the nutrients in vegetables. Health professionals recommend reducing food intake in patients with alcoholic pancreatitis. I have not totally recovered from this bout, still feeling achy and tired on occasion. 2009;15(36):4481-90. doi:10.3748/wjg.15.4481, Asrani V, Chang WK, Dong Z, Hardy G, Windsor JA, Petrov MS. Glutamine supplementation in acute pancreatitis: a meta-analysis of randomized controlled trials. I still am curious on the subject though. Some might say even if I drink 2-3 drinks every blue moon Im a ticking time bomb. A subreddit dedicated to support, education and advocacy for patients with pancreatitis and their caregivers. how long should i wait to drink after pancreatitis Real Estate Software Dubai > blog > how long should i wait to drink after pancreatitis Jun 12, 2022 british airways sustainability report 2020 Yep. By accepting all cookies, you agree to our use of cookies to deliver and maintain our services and site, improve the quality of Reddit, personalize Reddit content and advertising, and measure the effectiveness of advertising. Water should be avoided before food, during food and after food. Its also worth mentioning that my AP was really mild. It is noted that many patients die due to excessive consumption of alcohol even after being treated of pancreatitis. Even if the pancreatitis is not caused due to excessive consumption of alcohol then also it is very important to avoid drinking alcohol completely for at least six months to one year. But the second attack was because it was so sensitive. Healthcare professionals may suggest changes to diets or lifestyle habits. Lei QC, Wang XY, Xia XF, et al. Septic shock can also lead to functional failure in one or more organs (multi-system organ failure). This is when the body has bruising around the flank. // Leaf Group Lifestyle, National Digestive Diseases Information Clearinghouse: Pancreatitis, University of Maryland Medical Center: Pancreatitis, Whats Cooking America: Food Nutritional Chart, Facts-About-Chocolate: Types of Chocolate, Shah AP, Mourad MM, Bramhall SR. I used to drink alcohol every weekend during college and was wondering if that may cause pancreatitis in the future. Anyhow, this is the first time I've had one since I got a computer, so it's good to know I'm not totally alone in this desperate situation, not that I'm glad you guys have had to go through it as well. lire Wait to eat solid foods until about six hours after the last time you vomited. Pain And Discomfort In The Left Upper Abdomen, Cortisone Injections Can Cause Serious Side Effects, The Daily Schedule Of A Gastroenterologist, 3 Reasons For Foul Smelling Stool And What Can You Do About It, 5 Causes You Have Abdominal Pain That Increases With Movement, Mixed Messages: Why That Toothache Means You Should See a Cardiologist, And More. I drink about 6 beers a day now, found a good supplement of freeze-dried beef pancreas, and pay attention to my body. Good answer dr. R. Doctors typically provide answers within 24 hours. Ercp induced pancreatitis. We follow a strict editorial policy and we have a zero-tolerance policy regarding any level of plagiarism. Each time I sensed this fullness, I would stop drinking, and the feeling would go away on its own after a day or so. Im 45, and had been drinking 6-12 beers a day for about 5 years. I have always been interested in beer and wine and consider discovering and trying new ones a hobby of mine, so finding this news out was devastating. Early Signs of Pancreatic Cancer & Can Pancreatic Cancer Be Cured? Thats fine, as long as youre taking the right dose at the right time. Call your doctor or 911 if you think you may have a medical emergency. It's great to have found this thread. How are you now? Trained as a physician assistant, she maintains a health coach private practice in New York and Los Angeles. The really bad pain has not retuned although I continue to have a pain right below my breast bone that comes and goes depending when and what I eat. But after about 5 drinks (Michelob Ultra) I was very hungry and decided to binge eat andthat was that. When I drank on weekends I didnt drink too much beer and did liquor jack honey or Hennessy being my favorite. What could be the cause of my distended stomach? Get To Know What Possibly Could Be Causing Your Symptoms! The release of these enzymes can cause pancreatic cells to break down further. Heavy alcohol use is the most common cause of chronic pancreatitis, which most often affects men between the ages of 30 and 40. A little background. 2018;11:77-85. doi:10.2147/JIR.S135751. I was a pretty frequent drinker because of college, at least 4 nights a week, either a bottle of wine over the span of the night or 4-5 liquor drinks. MI. Eating healthy is great, but you ruin it all when you drink alcohol, even a little. Iron in particular should be consumed on an empty stomach, and wont absorb properly in the presence of dairy. This is a life-threatening condition. Khatua B, El-kurdi B, Singh VP. It's generally recommended that you wait at least a week after gallbladder surgery before drinking beer. 2 doctor answers 5 doctors weighed in. In these cases, individuals are recommended not to potable or eat until a medico authorizes it. The Ohio State University Medical Center recommends that people with pancreatitis should exclude chocolate from their diets 1. Continued drinking will definitly lead you to chronic episodes. By rejecting non-essential cookies, Reddit may still use certain cookies to ensure the proper functionality of our platform. over a year ago, Panc hurts100995 it's been one month. For case, patients may undergo treatments such as: Alcohol can interfere with the normal functioning of the pancreas and cause farther inflammation. The stool is pale yellow and will float. Hi, a bit late to this thread but I had my first AP in may as of this year(2022). I don't plan on having alcohol at all for 6 months, but to give it up forever seems unrealistic to me. Your baby needs you. I had attacks ablut 4 years ago that got pretty bad. Guest Many claims on supplements may not be backed by clinical studies. It is your pancrease saying, I can't do this anymore. The hospital nutritionist said "no alcohol" but didn't say for how long. The doctor recommended I didn't drink alcohol at all while I had pancreatitis, and not for a year after the operation. To learn more, please visit our. Needless to say, this is not how I plan to go out. I was told to eat small meals frequently through out the day. over a year ago, Laylah My ongoing theory is that maybe the alcohol in combination with the large amount of hight fat foods was the trigger that caused the AP. However, if pancreatitis is caused due to some other reason and pancreatitis is well treated either with surgery and the person is completely fine after that, moderate amounts of alcohol may be permitted once in a while. sometimes Acute pancreatitis is Idiopathic and it cant be for sure that it was developed from consuming alcohol, however because you have it, it means you should take care of your health, mine was alcohol induced, i had mild attacks several times a month for several years, would stop drinking/eating for a couple of days and then will be back to normal, until a couple a months ago were it got bad. National Institute of Diabetes and Digestive and Kidney Diseases. Dark or extra-dark chocolate have even more fat grams per serving. This includes evidence of fatty digestive enzyme levels, such as amylase and lipase. People with astute pancreatitis will develop symptoms suddenly. Were you just drinking this bottle here and there? Water soluble vitamins include vitamin C and most of the B vitamins. Chronic pancreatitis does not heal or improve but rather gradually worsens over time. If youve been prescribed a prenatal vitamin, you should discontinue your daily multivitamin unless your doctor indicates otherwise.