Spending 3 Days A Patient In My Home62 Minutes - Apr 24, 2019
I had a friend come stay with me for a few days for an low back evaluation and stay in treatment for her on-going low back pain.
In this show, I cover the whole story and the things I learned in the process.
I recorded part of her examination that day that will appear on Youtube as well.
Subscribe to my channel to see it when it comes live.
Sebastian Gonzales DC: 00:08:08 So we did have someone come in just recently and she was with us for a, it was Friday morning and all the way to Sunday night. And I was able to work with her three times throughout the weekend and I have worked with people from out of towners before and but it wasn\'t to the extent of this. And I started thinking about all of the other things that some people do an extensive things with, you know, where you get them every day.
Sebastian Gonzales DC: 00:08:32 And I think I\'m only about yoga retreats, you know, or, people spend thousands of dollars to go spend a week with someone to learn to eat better, you know. and I, and I actually, there was a guy that I know that he was a personal trainer, that he, he said he had clients fly in that just really wanted to make sure that he was helping them develop their habits throughout the, and making healthy meals and meal prep and going for walks throughout the day and so on and, or whatever it was that he was going to have them do. And so I, this was my first time really experiencing that. And it was, it was interesting. Like I said, the other, the out of towners that I\'ve worked with before, I\'ve worked with him, but it\'s like they\'ll come two days in a row and I don\'t talk to them between, you know they\'re free to go throughout their day.
Sebastian Gonzales DC: 00:09:17 and, and I don\'t get to, answer all their questions and direct them as you go walk down the street and have dinner. And so, this person in particular came with a, I\'d worked with her in the past a little bit with giving her some guidance on things to try, but she hit some sticking points. And so prior, I\'ll give you a little bit of history with her is that she had a baby and when she started having her pregnancy, she had some back pain develop. And I didn\'t talk to her much at that point about it, but we talked after and she wasn\'t really convinced that she wanted to have a baby, another baby yet. Like they want to have another baby. And she wasn\'t really sure that she wanted to go through that again. Like, especially if she hasn\'t recovered from the first baby.
Sebastian Gonzales DC: 00:10:00 And this is actually an interesting thing to me is because I\'ve, I\'ve heard a lot of ladies who have been pregnant who just have kind of thought like, this is what it is, the sacrifice I make as a mother to have kids. And this is just the way it is. Like the baby wrecked my body. I\'ve heard some people say that, you know, and it\'s just not going to be the same and I don\'t think that\'s completely true. And I think there\'s a lot of things that we can do to prep yourself really well to having a baby. you have to be conditioned I think to have a baby. And I might not be the perfect one to speak about all this stuff since I don\'t have kids and I have not been pregnant, but this is just my thought. I think that the human body was really meant to, have a baby.
Sebastian Gonzales DC: 00:10:43 So, but at the same time, people who are my people were meant to run too. But sometimes when people run, they don\'t fare very well and that the same humans, they might not take it as well as the other human, but for the most part it shouldn\'t disable you for the rest of your life. And so she was really confused about what to do and she really couldn\'t figure out what was triggering her symptoms. It seemed to happen haphazardly. She had really no rhyme or reason, no direction anymore. Originally I had coached her into some, Stuart McGill based principles and some McKinzie, as well as a little bit of loading into a hip hinge, a carry and a pull. But it was like I only seen her for like an hour, you know, it was quick. And so it was really, I would say incomplete and this is what I have experienced throughout my own patient care when I was the patient is sometimes you have questions and sometimes the lack of ability to put things together just cause you\'re not, maybe you\'re not in that industry or maybe you don\'t have a good understanding about what\'s going on or maybe you\'re just scared, and you don\'t know where to go next.
Sebastian Gonzales DC: 00:11:49 And there are sticking points in there for a lot of people. And that\'s why my personal second round of care or my second, interaction with carriers, typically just question, answer as well as retention. Show me what we did last time. And so I didn\'t really need to have this potential with her, but some, she did have some good success over those first couple months, but then it started to revert back and some things she had tried throughout her time there as she had a friend who was a physical therapist who was doing some adjusting and tissue work as well as some, I\'ll call it tool assisted. cause I don\'t know exactly the methodology she was trying. She had, she said she had some really good hope for this one guy who, he said it was about eight weeks or so of care and or sorry, eight sessions of carousel.
Sebastian Gonzales DC: 00:12:33 And he\'s very comprehensive. He took the time, he answered questions and she was very, she was, she was hoping that was going to be the thing and she said she really liked the guy. It just didn\'t tend to work out very well, but for the most part he was nice. He was a great doc and he took the time. He just, he just didn\'t succeed or help her through that last little bit. But it did help out quite a bit. And so last thing that she was suggested was injections into the SI joint and they were, everyone was really convinced there was and SI joint issue. And so, I\'m not going to say it or it is or it is or it isn\'t. By the way, we did a videotape her examination, in some of her initial care on day one when she stayed with me here.
Sebastian Gonzales DC: 00:13:14 And, we didn\'t do the stuff on day two, but I it day two and day three, but I can tell you about that stuff as well. And so by the time she left, we had a couple of days of nearly no back symptoms and she, when she was triggering or when their symptoms did trigger, we just cued and do some movement. some cleaned up some movement and then it went away. And so I feel very confident that I think what her major thing was was that we needed to get her to the point where she developed her hip hinge again versus her spinal hinge and she had two symptoms really driving her to the confusion was that number one, there was a right sided symptom right around the area, the SI joints. So that\'s why I ever, everyone I think was saying SI joint. It happened mainly in the morning.
Sebastian Gonzales DC: 00:13:56 We did trigger it through the exam was sit ups as well as an SI Sheer test, which could have been another type of symptom generator as well cause I didn\'t go through the entire XXX on her. But for the most part we were able to reduce her symptoms. There was also a left sided higher lumbar flank pain and so it was kind of around the area where you reach behind your back and try to put sunblock on, but you can\'t really retire enough to get to your shoulder blade. It was kind of around there. And so they were a unique different symptoms and they came different times of the day. And so the left or the right sided lower right sided symptom around the SI joint tend to come a little bit more in the morning as well as walking. Washing dishes tended to happen a little bit.
Sebastian Gonzales DC: 00:14:36 and the upper left sided flank area stuff tended to happen more with like say carrying a baby since she had a baby, and prolonged standing tend to do it. And over the course of the remainder of the day, it seemed like that was the one that seemed like it was the thing that if she had to stop, she would stop in address. That one, she wouldn\'t necessarily address the lower one. It was more of just kinda like a dull, achy tightness. The upper one is kinda like a cramping, so she felt like she had to stretch it out. And so there was two different types of symptoms there and I want it to trigger them differently and uniquely. and they were a little bit tough because she was kind of like a car when you got into the, when you got into the, this is the mechanic, he just couldn\'t trigger it really well.
Sebastian Gonzales DC: 00:15:26 We did eventually do some stress testing, like I said, into the SI joint as well as some sit ups or some flexion based movements. We were able to generate some symptoms. But the cool thing was that when she was finally, we\'re all said and done with that day of videotaping and just showing what we do with that type of case. Like, so we went into dinner later that night and she triggered it, the upper flank stuff just with walking. And so it was nice to have someone around just to, as I was still troubleshooting. But as I learned when I was going through that over the next day or so, she\'s like, so you\'ve told me to do all these different things. I don\'t know which one to do. It\'s confusing. And so I had a really reel back with my communication or my, I did frame it while I said, look, I\'m not everyone, I have the opportunity to at least troubleshoot their stuff and I just want to make sure I get it right cause you\'re not going to be in town very long.
Sebastian Gonzales DC: 00:16:17 Then I\'ll be a little bit more shooting from the hip. But for now I just, I\'m just collecting data really. And I just want to see what helps and doesn\'t help. And typically with patients, I play the game better, worse, the same. And so with her it\'s the same thing. I\'m like, I\'m like, I\'m going to suggest a couple things while we\'re walking here. I just want to see. So just, just try them. Let\'s just see. And it gave me a lot of good data throughout the day, so I\'ll share some of that stuff with you as we get into it. So her lifestyle though overall wasn\'t bad. I mean, she did rather regular mother\'s stuff. I call it, you know, like, but her and her husband did a really good job of like every morning they\'ll get up and they\'ll, they\'ll, they\'ll do five days a week of gym work.
Sebastian Gonzales DC: 00:16:56 there was weight training in there, there was biking, there\'s that kind of stuff. But they would, they would kind of switch it up. So one one would be with the baby, one hour, one would be the baby the other hour. And by the way, I don\'t see a lot of parents doing this. a lot of times they\'ll let their own health go down because they have a baby and the baby comes first type of thing. But she\'s very active. She bikes, she danced, she did weight training in monthly stuff. So that was all really cool. And so through the exam, my main goal with being able to figure out my data points and being able to suggest to her was that I wanted to see, number one, if we could trigger the symptoms, with some type of specific testing and figuring out a directional preference.
Sebastian Gonzales DC: 00:17:33 Maybe for the spine, but also too to see if we can offload some of the pain generating structures. And so just by what, by the way, to clarify with offloading, I did mention at the beginning of this podcast that we would, that I have a seminar coming up in the seminar is mainly about this offloading of symptoms and I think it\'s confusing to a lot of people. So I\'ll clarify this. and this was helpful, I think an explanation to her about a resiliency, the body and all that kind of jazz. So offloading is basically, in my opinion, it\'s finding what will actually decrease pain or the alarm system of the pain generating structure.
New Speaker: 00:18:12 Let\'s just reel it back into stuff that you guys might be familiar with. So disc injuries usually don\'t like to go forward with flexion or bending forward or arching the back or sorry, rounding the back, and extending it.
Sebastian Gonzales DC: 00:18:23 We\'ll give it a chance to recover. You just give a structure, a chance with nerve based conditions. A lot of times with let\'s just say a straight leg raise or Sciatica, a straight leg raise with dorsiflexion or toes back toward the head might light him up. But also too, if you do the other side according to Clinical Neurodynamics by Michael Shacklock and by the way, listen to that episode, then, the other side in a, into a straight leg raise will reduce their symptoms significantly. And so this is all about offloading the structure of interest.
New Speaker: 00:18:53 And as we went to dinner one night and she said, you know, it\'s told me a story about the, the one doc who really did, she felt very comfortable with and he was very, open to questions and he few, she feel like she felt like he diagnosed her correctly and she\'s like, I really wish he was able to, do some of this stuff with me when I\'m at home because I really like him.
Sebastian Gonzales DC: 00:19:15 And I said, look, I, you know, like I think, I think our profession has, we have different, there\'s different skill sets for different things and some people are really good at it. Diagnosis of things, which is great because we need to be able to diagnose things, but at the same time, learning what the diagnosis is. it takes, it takes a very detailed exam, which is, it\'s, it sounds like he did with you, but at the same time, knowing what the diagnosis is, it has nothing to do with what we know will decrease the symptom, I don\'t think, I mean it gives us theories to tasks, but the application of being able to test the theories is a whole different skillset. And so I think in that case, maybe he did a really good job of diagnosing, but the treatment was just, there was just something a little bit lacking.
Sebastian Gonzales DC: 00:20:02 It sounded like he had good, some good first aid in there because it helped to reduce her symptoms, but it wasn\'t able to completely get it away. And in this, again, this is not me tooting my own horn, I\'m just, I\'m just saying from a offloading standpoint is that if someone bent their finger back words and it pissed off the joint capsule, then you can say, oh, well that\'s stress testing shows that there\'s an issue with the joint capsule, right? It doesn\'t tell us anything to do with it. Now you might tape it out of that range of motion and then get people into maybe doing some, sand grabs or some rice grabs or something like that, maybe do some basic loading of the hand, then maybe that makes her symptoms reduce. And so the different skill sets, and I think we should all be good at both of them.
Sebastian Gonzales DC: 00:20:46 So in regards to her examination, typically what I look for is I look to identify the, the actual diagnosis and then we look to see what actually, what entry points we can have into her care. and sometimes the triggers will give us clues of what to do. By the way, carrying a baby. To me that means there\'s a possibility that, loaded carries her or are going to be a dominant thing in her future. And, in regards to offloading, we found that, I had her do, I wasn\'t quite sure if there was a directional preference to her spine, because she had a, we couldn\'t really duplicate it with some of the stress testing, which I could have made a little sloppy. And so finally I said, look, can you just do a partial sit up cause I know this will usually irritate a little bit of a disc.
Sebastian Gonzales DC: 00:21:29 And so she said, yeah, that\'s my, that\'s my Si joint pain. And so I said, okay, let\'s go down and come up again. Said, yeah, that\'s it. That\'s it. That\'s it.
New Speaker: 00:21:39 Michael Shacklock has a good saying. He says that once at one time, is that an incident\'s two times is a coincidence, three times the pattern. And so I\'m looking for patterns on things. And so she was able to trigger it very, very frequently with rounding her spine.
New Speaker: 00:21:53 And so I took that as a possibility that we are still looking at a little bit of a, of a flexion intolerance with the disc. So I wanted her to do, some McKinzie extension just around that area. I won\'t keep her doing it too long, but I thought it would be a good starting point.
Sebastian Gonzales DC: 00:22:08 And now the exam of that, I don\'t like you\'re doing things that are triggering their symptoms too long, but I wanted to see what we can do to decrease your symptoms overall because again, if I don\'t really know what\'s going to decrease the symptom of the disc or these, I suspect she had a spinal hinge, into extension of the mid lumbar as well. Is that I feel like, so when I, when I, when I went through the unloading process, a lot of times the first thing I\'ll do there is I\'ll, I\'ll check intra abdominal pressure or pressure queuing or a bracing cueing. And I think breathing and bracing are different. They\'re different skills, but for the most part I\'ll do a try a couple things. I\'ll try a little bit of a set up. And so she came from a dance background, so she was a little bit more of a, of a skinnier, like she just attempted to get skinny.
Sebastian Gonzales DC: 00:22:55 And so I just put my hand on her belly. I said, look, don\'t, I\'m gonna, I\'m gonna lean on you, right. Don\'t let me force your guts out of your mouth. I want you to fight back a little bit with your guts. And she did. I sit up like that and it didn\'t help. So I tried the sides, the finger poking that Stuart McGill does. And that seemed to help. Okay. And so she said it helped them the way up and on the way down. So on the way down, Oh, I noticed that she was losing tension in there again. So I said, look, all the way down I might, I might have you do a sit up again really quickly from whatever point you\'re going down from. So I want you to be ready to go really, really slow. And so at that point she was able to reduce her symptoms by keeping some protection in her spine and her lumbar spine while she was having flexion.
Sebastian Gonzales DC: 00:23:35 And so to be clear, I don\'t think there\'s anything wrong with having some flection but in people who have this type of symptom generating condition then maybe adding a lot of flexion back in early is probably not the best idea unless you have some support with it, which I will talk about later also to something that helped was that in this doesn\'t always help is that, so I just took, I raised the table up and I physically tried to pull your pelvis, ring her pelvic ring together, like compressing it together. Imagine like stabilizing the ring via compression at the pubic symphasis as well as the SI joints. And so at this point she was the, I was also able to do some sit ups and so I concluded that there\'s a possibility that let\'s just, let\'s just say we\'re going to go off with theories here.
Sebastian Gonzales DC: 00:24:19 Many we\'re looking at intera-abdominal pressure may be, as, as a problem. They were looking at the Co contraction of the abdominal wall, front, back, side, top, bottom maybe. Or maybe we just strengthen the muscles that are or increased the tone of the muscles are crossing the SI joint that would help her out with single leg stance or gate. They would stabilize the SI joint, maybe. I Dunno. So, we eventually went into a, I like to be it, take people originally through a rehab process first and just see if we can get some things that were reduced their symptom. I do attempt to do some of the Mckenzie stuff first just to see directional preference and then we\'ll start to do some loading just to see if we can reduce the symptom just with increasing tone of the area. And I know we did a podcast back, I think it was 122 with Cody Dimak about loading, about how do we should load our patients.
Sebastian Gonzales DC: 00:25:12 And in this case, loading came as manual and so I started her off into a high diagonal sits or let\'s just say, a downside clamshell. And we got the glute medius involved and I looked originally and I saw that she was sliding side to side a little bit. She was offloading the left side. I will leave in the video and a, I start with the left side. It reduce her symptoms a little bit but not completely. And then eventually when you started walking after she said, well it hurts who my right leg, which is the other side, the right leg hit. It\'s when I\'m standing on it and it hurts into the SI joint area again, that same side. And so I, I concluded there\'s a, there\'s a possibility that maybe we need to address that hip tail. And so we did into a single leg stance.
Sebastian Gonzales DC: 00:25:56 I just improved her single leg stance for that time. I think of it as reducing the threat. And so I just put her into a position called a frozen skater for me, which is like kinda like a bowling. You just get them to load and find that hip area, or the gluteal area and you just stay. And so this is kind of building that, that brain muscle connection I\'d say or the motor pattern. and then she was able to walk without having a symptom at all. And so she asked me, she\'s like, I don\'t, I thought we were looking at the left hip, the other hip. And I said, yeah, I know we were, but I\'m going off what you\'re telling me now. And so this is, this is the benefit of having a long exam process is that I tell people all the time that I get things wrong at time times too.
Sebastian Gonzales DC: 00:26:34 And so I\'m picking up a book halfway through and I\'m reading your novel and I\'m just learning more about you every single time we have this interaction. And so in that case she\'s like, well, maybe it should I do that left-sided thing, that thing on the ground. We did that high diagonal sit. Should I do it on the other side too? I\'m like, well, there\'s nothing wrong with doing it on both sides, but I do want you to get to foot on ground stuff, which is now into our loading process. And so that day I took her through a hip hinge from a block with a, with a lighter kettle bell, a light or than that Kettlebell to set her tension. And then I went into a heavier kettlebell. And so my goal was, is sent a had or the second day was that number one, the first day I was gonna build the hinge, and also to just make sure that we had the correct diagnosis and theory going forward.
Sebastian Gonzales DC: 00:27:22 The second day she woke up and she felt a lot better. And so her hips really, her hip, a pain or joint pain really didn\'t seem like a thing, but both of her hips really sore. And she\'s like, I don\'t know, I can\'t tell if it\'s better. Both hips are really sore. And I said, well, it\'s both sides down. They feel very equal, right? And she said, yeah. And I\'m like, great. I\'m like, it\'s normal to feel this tightness. it\'s the change of tone and you just made some of the muscles work in there. And so we\'re sitting down there drinking coffee. she was able to sleep on a futon or rollout mattress with without a problem. and it\'s not the firmest mattresses. So that was, that was enlightening to see. And so her morning time pain was no longer there at that point.
Sebastian Gonzales DC: 00:28:05 So, after that I want, I really wanted to see, with her walking, what was she doing during her walking to, to create the symptoms. And I wanted to go for a walk with her and just have a conversation. So we got up that morning, I got my cup of coffee. She didn\'t get any, we went for a walk one for about a 20, 30 minute walk. And so through that, she didn\'t really have that lower SI joint symptom trigger. But after about 10 minutes, she did have the flank area first come. And so the way I\'d describe it as that she, just to clarify what the premise I was working on with her is that, I believe a lot of people with this low back disc-based pain originally, or a pure form is pain or sciatica type of stuff.
Sebastian Gonzales DC: 00:28:50 A lot of times they have a, they have a protective mechanism which occurs, and I have been describing it to people as the sniper in the, in the Korean jungle and say, so say we have this Korean War occurring in this sniper out there. He\'s out there just waiting. Okay. And he loses radio and he\'s just waiting and he\'s trying to fight the good fight for 50 years. Right? We\'re whenever the Korean War stopped. And, so you go out there and you finally find the guy and you\'re trying to convince him Korean war is over and he says, Nah, man, like it\'s not real. I\'ve been fighting this thing. I know. And so you show him pictures of the surrender and you show this and this and that. And, it takes a little while to build a relationship, you know? And so I believe these people who have this problem with first, the lumbar spine disc issue, according to McGill\'s observations is the gluteal areas turn off.
Sebastian Gonzales DC: 00:29:38 according to Janda\'s work the, low back muscles tighten the hip flexors, tighten the belly wall, loses its tone or the front belly will lose its tone. I guess we can say the TA and the oblique, in the gluteal region loses its tone. I think that\'s the areas that were, people have been traditionally told that things aren\'t turning on, you know, and so this is the good fight and say, you know, I\'m like, and, and at some point the good fight, needs to just cool down, you know, and not everyone tends to work on this over the course time. I like people really fresh when they have a disc injury. I like him to get the cheeks going again and to reduce the potential. The spinal hinge at the hip hinge with the spinal hinge, the extension from becoming a thing.
Sebastian Gonzales DC: 00:30:25 according to a Dr Snell\'s who work, he would kind of categorize this as like, like your Maigne\'s Syndrome, your flank pain, which becomes a, it can becomes a symptom found with that mid lumbar extension. You also feel you also find groin pain come from that you\'ll find a hip bursitis type of pain. You\'ll find inner groin problems or thigh issues, sometimes inner neat issues, sometimes saphenous nerve, a contribution issue. So you\'ll find a lot of these things which are the secondary results of that back, flexion intolerance and tendency to be an extension. And so I\'m also a fault of that too. And a lot of, a lot of us are, I think you\'re gonna see a lot of people who tend to not want to bend forward that much. All the bending forward doesn\'t, is not really painful anymore.
Sebastian Gonzales DC: 00:31:18 The body subconsciously, that sniper has not really been told to stop yet. And, I personally use a lot of, Guido Van Ryssygen\'s Attractor state work to reduce this stuff here. So anyways, anyways, we went on the walk and we had this conversation and throughout, throughout that she had a little bit of, pain in the flank. And so I just asked her, we did a little bit of arm swing cueing with walking the McGill\'s stuff. And so that reduced the symptom. She was also already doing some dermal traction or pulling up on the skin in the area which reduced the symptom. And so I found actually a lot of people, especially dancers tend to have this, mid spinal hinge, which occurs, or sorry, mid lumbar hinge which occurs but also too, they, it seemed to trigger it with some rotation and when you put them down into like a, a buttress plank, the buttress plank seems like even the remedial one from the knees, it tends to get them, it\'s, you see this big sag, this gully occur around like l two l three area and it tends to sag in, it changes very quickly with them removing a hand.
Sebastian Gonzales DC: 00:32:26 And so the not very stable right there. And I say the spine just kind of shimmering around and it just pisses off a little nerves when they go through. And so for her, they seem like two different conditions. But I believe that we\'re looking at mainly just one large situation. And I don\'t like to break it down as simply as this because it makes it seem like we can do a bunch of exercises, which I wouldn\'t really love, but, but you think about the things that people want, things, things that people are like, oh, ask a really attractive, they want absolutely one glutes. Okay. And so I guess if we can tie those two together, we\'re basically rotating the pelvis a little bit posteriorly or to neutral and we\'re given the belly wall a chance.
New Speaker: 00:33:06 And so just to clarify too, cause she, she was, she was asking him about some extensions. She\'s like, should I so should I not be an extension? I\'m like, no, extensions, fine.
New Speaker: 00:33:15 Flexion is fine. You just need the protection of, to do both. And I think it\'s normal for the spine to do normal things, but at the same time you\'re just not giving your stuff a chance to desensitize and chill down.
New Speaker: 00:33:26 So that was the basics of the first day. Went for that 20, 30 minute walk. We had a good conversation and get to know her even more. and we, we got to figure out also to the game plan for later that day. And so, that was actually the time where I learned that when she carries her baby, typically that\'s when we have the, the flank pain type of stuff. And so I\'m, I\'m learning more every time again. And this just from an overall, like spending the whole weekend standpoint.
Sebastian Gonzales DC: 00:33:54 This was really interesting to see. And before I go into the next day, just tell you that we did go to dinner that night. And so she was sitting on a bar stool and she, I said, look, I know where it is. We\'re all just hanging, just having a good time at the same time. Tell me when you\'re, when you feel and stuff, cause I do want to keep, given, given some suggestions and we\'ll just see I\'m still testing. And so she, she said, well, I\'m feeling right now. And I said, okay. So, and she was just kind of leaning forward, leaning onto the table and I guess it wasn\'t a barstools a chair. and so I said, can you, let\'s just, let\'s just see if we can increase the symptom. Is it, can you, can you poke your ribs out or make re, like a big proud chest?
Sebastian Gonzales DC: 00:34:33 And she said, yeah, that increased the symptoms a little bit and it took a little time to get there. And so, cause we had to wait for it to kind of set in and I said, great, can you reverse that now and just get rid of that? And I said, from the bottom half right there from your pelvis, can you just kind of push your pubic bones forward? Like you got your sit bones just to, you\'re, you\'re going to lean a little bit more into your sit bones or you\'re going to perch off the end of the chair. I tend to have people Iq it as a dialing your pelvis forward. And so she\'s correcting for the bottom half now versus the rib lift, the chest lift.
New Speaker: 00:35:04 And she\'s like, Oh yeah, I went away. And so throughout that night she was, I don\'t like people getting super neurotic about this stuff, but at the same time want to set them up for success so we don\'t keep picking the scab.
Sebastian Gonzales DC: 00:35:16 And so she\'s like, every time I dialed in my pelvis forward, I was able to reduce the symptom. And so I said, great, cool. So we\'re looking at that. We\'re looking at, it\'s still that there\'s, there\'s a lot of things we can, we can improve on. Okay. And so I know it seems like this whole thing is very, it\'s very mysterious. Like we can\'t tell what\'s going on or, and you haven\'t been able to anyone to help you so far. you get through the tail end of this thing, both for the most part, I don\'t think it\'s as mysterious as we think. And so, on the, on day two, we went to the office when we just did a morning workout.
Sebastian Gonzales DC: 00:35:52 So on day two, oh, actually, let me recap real quick. day one. So day one, we went through the exam, we confirmed what direction we\'re going, we, we\'ve created some theories and we\'ve confirmed the diagnosis that we\'re working with. And so day one, in regards to the strength conditioning and we went over mainly the hinge and some crawling patterns because of the mid spinal hinge. and so day two I wanted to give her some other options of things. And typically this is where I get into the weeds with care a little bit is that when I am giving options of things to try, people tend to get overwhelmed a little bit with the options. And so I believe that some people are given the option and I say, look, number one is that I can, do you want me to make this so you can, you want me to help you through it, take to get you kind of into your own a routine.
Sebastian Gonzales DC: 00:36:42 Like you can develop your own routine, you want to understand it or you just want to do it. And some people say they want to do it. I\'m in this case, she\'s not going to be here. So I wanted to understand it and she was on board with understanding it. And so the, the second day I went into some, some DNS face down, face up stuff. honestly I\'ve been to one DNS course, I\'ve used it quite a bit in regards to the exercises. And I went to theory, I don\'t know the months, I don\'t have a baby, I don\'t know the month, so I\'ll be completely honest with you. but we tend to go into some crawling patterns as well as kind of the baby get up kind of stuff. And so I took her from a face down, face up approach and we went through about five minutes or so of that.
Sebastian Gonzales DC: 00:37:20 I said, look, we\'re going to let her go through this little flow right here in the attempt of this as a decrease the potential of that spinal hinge and keep you keep you keep that pressure involved, as you\'re loading into the ball socket joints, the shoulder as well as the hip. And so I met, I said, remember that exercise we did the other day, where I, where I kind of leaned on you, which was the high diagonal sit. I\'m like, this isn\'t that series right there. So I\'m like, I\'ll tell you what, I\'ll give you everything here. that I, that is an option of just a nice little flow thing to do so you can have a little something to do and kind of have a plan in the morning, but I don\'t want you to get married to the idea and the whole point of the, of a corrective exercises to get you off the ground at some point and load ya.
Sebastian Gonzales DC: 00:38:00 And so these things are a good starting point and if you feel like there\'s one area of this flow that you\'re really suffering with, it\'s really challenging to do, then start there. You don\'t have to do the other parts. Okay. so we, we found that one of the most challenging things for her was being into a crawling position and being able to keep that mid lumbar area really supported. And so I suggested that\'s a good area to start with you. and that\'s why on day one I went through some crawling cause I thought it was going to be a thing for her. And so we scaled that back into remedial thing. I give her some cuing just to make sure she was getting. And so, I do plan on videotaping some stuff for her as well, just cause he\'s out of town.
Sebastian Gonzales DC: 00:38:41 And so into strength conditioning part, I, I tried to be very clear with what I wanted and if you\'ve already heard the episode that I did on loading and strength conditioning as an exit plan to care, which was probably about, I don\'t know how many episodes that was, but it was going to release I think on May 10th or May 3rd. So, or sorry, March 10th or March 3rd. And so that one, I go into more of the Dan John Model of the push, pull, carry, squat, hinge, not in that order and just some basics of things to do in there. And now some of you might think, wow, there\'s other exercises. I know, but general categorization, we\'ll stick with that. And I know there\'s arguably the lunge as well as a twisting or rotation, which is within your categories. It doesn\'t matter to me right now. Okay. Like I\'m trying to make things simple, the simplest of people that we can.
Sebastian Gonzales DC: 00:39:29 and I\'ll tell you how I typically add into that as I usually have people do a reactionary sport and rather than the twisting and so on, within their strength conditioning, I just want them to go catch butterflies or you know, go to the batting cages and just hit softballs or play pickle ball or it\'s a reactionary sport where we start to expose herself slowly to the range of motion that is typically not within our strength conditioning program or we\'re not moving like robots anymore, moving like actual humans. And she do it without just kind of lollygag through it for a while. And eventually as you get more comfortable, you start to increase your pace. She picked pickleball, and I said, good do both sides. Great, cool. You know, like I\'m in. Those are things where you start to explore the range of motion that are the ranges that you\'re not supposed to within strength conditioning.
Sebastian Gonzales DC: 00:40:12 And also in a really not much of a loaded fashion. I just want to get people to build their brakes before they really get onto that kind of stuff.
New Speaker: 00:40:20 So on day two I wanted to give her something of each grouping, with single sided options since she said she was having issues with gait also to attended. It seemed like when we were getting into a double leg pattern or standing, she tended to extend a little bit, which is what I wanted to get away from because I believe that life happens when you\'re doing single sided stuff. Like we\'re not bunnies. I, I do, I do like that analogies that we don\'t hop around like bunnies. So we have to make sure that we\'re loading a single side per side. And most times when people hurt themselves or they have a trigger there are reaching somewhere to get a pen with one hand than a two handed lifting a pen.
Sebastian Gonzales DC: 00:40:57 And so exposing them to those types of movements, and using the weights as a tool to improve the ability to tolerate them throughout life is really my goal. And so we went through a single leg, a single leg variety of a deadlift, which is a SLDL, a single leg deadlift. Interesting. On Day one we found that she had been, copying people doing dead lifting. So she went for this true straight knee variety. And so I said, look, I, I don\'t teach the straight knee variety. I teach a soft knee but don\'t lock the knee on me, you know, and same thing with the single leg. Once she was having trouble finding her, finding her, her cheeks to assess, she was finding a lot of thigh. And so I just had her find it over and over again until she found it.
Sebastian Gonzales DC: 00:41:41 also too, we went through a single leg variety of squats, which we went through split squats, which keeps them a little bit more upright and axial loading the spine versus using the spine as a lever. We also did a mixed carry. I had her do a rack and a suitcase. I\'m opposite sides because I was not quite sure we can do a single sided carry really aggressively with her yet because she was triggering herself with her baby caring, which is probably, she said about 30 pounds, 25 pounds. And I think that\'s what you said. And so I had her do about 20 pounds on the rack carry and about, I think it was 40 on the other side on the, on the lower when the suitcase, we also did a single arm, pressing option in a single arm rowing option as cued how we do in the PRO Chiropractic Online CE course.
Sebastian Gonzales DC: 00:42:26 focus on your floor contacts in and you can only move with high quality if you\'re, if you have a fixed point of contact. And so we went through a, a single arm dumbbell press or a kettlebell press as well as a single arm horizontal pole. And so it was interesting going through these, actually, that was the day and into the next day, she really didn\'t have any sleep symptoms at all. And so because she had so much success on that day, I\'d probably stick to a single leg variety program to her for a while or single arm, single leg variety program. and just work on high tension because she even mentioned that with, she was really struggling to have someone queue her, in the way that she, she really, responded to and she\'s like, she\'s like, we only went through through five reps of this stuff with similar weight to what she was doing at the gym.
Sebastian Gonzales DC: 00:43:18 And she\'s like, usually at the gym, I can talk through this and I\'m doing 15 reps and I\'m barely sweating, but we\'re doing this five reps or so here and I\'m just like leaking from every pore in my body and, and we took breaks and everything. and so she\'s just, I think lacking intention. Just similarly how on day one we had the set up that was lacking intention the way down and she created a symptom with that. And so I would like her to improve her ability to co create a dimmer switch. And so we want 10 out of 10 tension. although we\'re not going to use 10 out of 10 through all of our movements through life, it just, it\'s not possible. And so I would just want her to get a feel for what tension is so she can turn it on and off and have that skill built.
Sebastian Gonzales DC: 00:43:59 I told her like, honestly, I don\'t, I don\'t know what the possibility is, but I said, look, you live right by Dan John. Go up there and I\'m gonna keep created half the stuff that we use are more than half the stuff that we use and even use a very similar cues. And so I bet it\'s a very good benefit to go see somebody like him. or someone who like learned what that style. And so I reminded her that it\'s, it\'s very, it\'s very common for people to get stuck in this thing and they get very confused. And I reminded her that when I went through by back Rehab recently, that I had someone manage my care and I had, someone, I had Brennan Ghassemieh come in two times a week as we started to load because I can, I noticed that I was a little bit fearful of loading.
Sebastian Gonzales DC: 00:44:40 And so he came in a couple of times a week for a few months and then he came in one time, one time a week for a few months. And then we, then we stopped and I can load on my own now and I feel good and great. And so, it\'s, it\'s useful to do that. And she\'s, if she\'s having problems finding somebody to cue her through that and she\'s not, keeping the cueing, then maybe she needs a little bit of reminders here and there, you know? So, and I understand, trainers or coaches and a one on one help or even like, probably like two, three on one help would be fine with this too. it\'s expensive. I get it, you know, but at the same time, it\'s like, if you\'re not getting results, you need to pay for it. You know, and I went back into the idea of, the yoga retreats.
Sebastian Gonzales DC: 00:45:24 It\'s like people go and pay 3000 - $4,000 for these retreats and people spend money typically on things that are luxury luxurious. and I\'m not saying that that yoga is only luxury, but for the most part, you don\'t need to do this down in Tahiti, you know, and, you don\'t need to buy your Gucci Bag. You don\'t need to buy, a, a high end Lexus or a BMW. You know, like people spend money on things that they want to spend money on. And I think if, if health is an important thing to you, hire someone that this is going to coach you through it effectively. And, I, I believe that at some point you should be, you should be managing your own symptoms. You should be able to program for yourself.
Sebastian Gonzales DC: 00:46:06 And this is why like program and people in this fashion and directing them to Dan John\'s things with it didn\'t, did mention in that podcast, go by Interventions. Right?
New Speaker: 00:46:15 So I, until almost every patient that has the question about strength conditioning to go by interventions, it\'s just a good starting point. And so all these questions you\'re asking are going to be formatted very well in there without, not, not to say I don\'t want to share with them, but at the same time it\'s gonna be easier if they can go back to it a couple times, you know. So on day two, like I said, we, she didn\'t really have any symptoms and so we progressed into day three it was interesting. She woke up, she did some DNS to start the day. she also did some McKizine extension.
Sebastian Gonzales DC: 00:46:49 we went for a walk again and went to the beach and just hung out. Right. Laying in the sand and just chillin. had no problems there at all. Rode bikes, no problems. and so those were all big wins. I think for her, you know, and showing that you could challenge your body, pretty well because we had really challenged it a bit through, through that workout and really not have any symptoms at all. So it, it kind of breaks the aspect of the fragile nature that people think they have with, with back issues or injuries in general. And so, well I asked her that day as I said what, what\'s sore on you? She said, and she said mainly the glutes are sore. And so I concluded that we could probably amp stuff up a little bit the next day if we wanted to.
Sebastian Gonzales DC: 00:47:36 And so I reminded her that what I would expect is that I think there\'s pretty probably beginning to hear because we\'re doing a little bit of a shock factor, you know, where I\'m biasing certain exercises, to, get certain movement or getting certain muscle groupings in the end of the movement because I want you to utilize them. but I think the shock factor is going to go away pretty quickly. And tomorrow we\'re going to do a little bit more of loading and walls. Change it up slightly by the way. Any questions you have throughout the entire day, let\'s just answer these things. So we went on to day three and day three, again, we started with something that was familiar to her. He went through DNS again, she went to the flow, she had good retention, he was great. They went to some do only three exercises.
Sebastian Gonzales DC: 00:48:17 And I said, look, we have five movements that we can go through today. But since, we spend a little bit more time with a single leg dead lift variety of the day, let\'s go into something different.
New Speaker: 00:48:26 I typically explain my programming as an entree platter. All right? You got two or three major entrees. You have chicken or entree highlights. I\'d say if you\'re a meat eater, you have chicken, you have beef, you have lamb, veal, right? So you have different things where they\'re your starting point.
New Speaker: 00:48:45 And I said, what\'s our, what\'s our, what\'s our, what\'s our meat today? And I said, well, we\'re probably, we\'re going to goblet squat.
New Speaker: 00:48:50 So our major meat today is squatting, build around that, like build the other parts of the meal around that. and so the priority was mainly hinge. And so the thing that I built around that, because coupling with the inability to control the spinal hinge is I like to add mid back extension and rotation.
Sebastian Gonzales DC: 00:49:09 We want to make sure the extension and rotation is preserved at the, at the mid back. And so for that I picked a little bit of, again, DNS stuff. I like to use it with that. There\'s also, there\'s other things you can do. I did do one, something, one thing different. It\'s like a sideline, make a big rainbow, keep your knee attached to a yoga block type of thing and a or fingertip drag along the ground. I forget what you call it, but for the most part it\'s big rainbows on when you\'re laying on your side with your arm. So we did that and we did it and on DNS- based thing. And then we did DNS and then we, went into a kettle ball armbar as, as the strength and stabilization component with that to drive the mid back rotation. And so, we did a squat that day.
Sebastian Gonzales DC: 00:49:53 We did oppressing variety, which is the kettlebell armbar and I, I took her pretty heavy on that. So she did about 35 pounds. I\'m treating it like is 500 pounds. And then we did a aspect of a pull. We did a front lever just hanging from a bar. And so those three in particular was interesting to see. The, actually she had a little bit of a symptom after that. And so I would conclude that the actually with the hanging, she extended a little bit more than I would want. And that was just an issue I think with endurance and strength there. And so I might scale her back a little bit accordingly. take her to more of like a, like an ab wheel or something like that or, or the crawl would also work or like a TRX rowing would also work or horizontal pull and the Goblet Squat.
Sebastian Gonzales DC: 00:50:34 I think she did okay an okay job with that, but I\'ll probably scale it back a little bit to a split squat or something like that. And so, that was kind of like the whole thing that we did throughout the weekend. And the very last thing that we did I guess was the very last night we sat there and we just talked and he said that, she still questions about programming. This is kind of when I went more into like, I really think you should watch Dan Johnson Intervention. I can explain it to you, but at the same time as he can get very complicated with all these things, but I break them into four parts in regards to what we did. Number one is the scab picking mentality. I don\'t think she\'s super sensitive to the scab picking, but perhaps if we improve our ability to carry your child, and just make sure that, when she was washing dishes, she had a little bit of a of an issue.
Sebastian Gonzales DC: 00:51:24 I said, don\'t, don\'t be afraid to get your shirt wet, lean, lean on the counter and get in there, right. Rather than hanging back. And so, I think if we take those scab picking things away and just clean them up a little bit, the very few she had, she\'ll be in good shape. And second is that we have the first aid, she was using some dermal traction with work, which worked. I\'m dialing the pelvis a little bit, reduced the scab picking in phase one with sitting. and also too, I gave her some sideline Shacklock\'s openers as well as a McKinzie and end range loading in extension. And so those are all things that would help decrease your sensitivity very quickly. and I said, look, other stuff, which is like your, let\'s say it\'s endurance based floor stuff or \"core things.\" You got your DNS there.
Sebastian Gonzales DC: 00:52:04 we\'ve got a bunch of other things that we\'ve done over the course of time or that she\'s tried that would fall into that category. And then you got your loading. Okay. A lot of this things we did on day two and day three, reloading, or your strength. and that\'s going to be more of the falling into the Dan John Principles. So go ahead and just download that and check it out and I\'ll tell you what, after that, if you have more questions, just tell me. And the last part, like I said in the beginning was the, I think there\'s a very big gap between moving like a weightlifter in, moving like an athlete or a human. And I don\'t think they always carry over. So I liked those reactional sports and just doing something. She\'s like, oh, I like biking. I said, that\'s good thing for cardiovascular fitness.
Sebastian Gonzales DC: 00:52:45 Let\'s keep that. And she said, and pickleball, I like pickle ball. I said, great, do pick a ball. That\'s it. That\'s it. And so it was Kinda like a, like a lag of conversation there. And she\'s like, anything else you want to add? I\'m like, well, you already picked pickleball and that\'s fine with me. And so we can over complicate these things. but for the most part I would watch that last thing. I would watch the Dan John Intervention. I would add a little bit of, of reactional based movements in there and just a sport and then we\'re just kind of off to the races there. Her plan was to go through that for about six weeks and just kind of recap with me and I thought that was going to be a good thing to try. So I think the last part, we\'ll go through this.
Sebastian Gonzales DC: 00:53:22 I\'ll go through my takeaways of what I learned over the weekend is number one, I don\'t think I should overcomplicate things. I have a tendency of thinking that a lot of people want to know all these little parts about their thing and I don\'t try to make it too, I don\'t make it complicated on purpose. I just, as I understand it, they asked you a very complicated question and one is very simple answer with it and it\'s not always possible. And so I tend to, now I realize that it\'s really important to ask them what they want out of the experience. And do they want to understand the mechanics, what\'s going on, do they want just some suggestions and if they want some suggestions, are they okay with just, returning after a couple of weeks and saying what next? And being okay with just asking w with what\'s now, what\'s next?
Sebastian Gonzales DC: 00:54:08 Because there\'s, there\'s typically things I like them to do later on. Not to say that care, it goes forever, but like I said in an episode and the episode where we talked about resistance training as an exit plan is that, if they\'re not under some type of program programming by somebody, they\'re going to want it to change the programming a little bit, especially if they haven\'t wanted to take the time to understand the aspects of programming, which I don\'t think it\'s too complicated, but also too, they have different skillsets than, than I do and other people do. So the other thing I like to ask is do they feel in control and don\'t feel dumb about asking questions that seem very basic because that\'s why they\'re here. And so, also too, I did learn that and I\'ve learned this a couple of months ago, just reiterated it again, was that I like to clarify it with people as we start through the exam is that everything that we\'re doing is not going to be stuff that they need to know about, but I do need the information from them.
Sebastian Gonzales DC: 00:55:03 And so, I\'ll, I\'ll play the game better, worse, the same. But I, I keep reiterating that, look, I know we did a lot of stuff, but I\'m only asking you to do, to do a few, so don\'t be overwhelmed by the other stuff. also too, I like to tell them that they\'re going to be fine if I think they\'re going to be fine. I try to leave him with, you\'ll be fine and you\'re resilient and you will get better. And because I think the mental mindset of this part is really huge. And if they think they\'re broken inside or they\'re going to be like that forever, then I think that you reap what you sow on, that kind of thing. I tell them to not overthink things too much unless they really want to get into the weeds of things. And in that case they\'re going to be doing a lot of reading.
Sebastian Gonzales DC: 00:55:41 And also too don\'t avoid motions and activities forever. that first aid process in the beginning we might avoid certain things. And for her case, she really didn\'t have a lot of things I wanted her to avoid. I just wonder, cleaned a couple of things up for a little bit of time. both the most part you want to bring back, bring life back kinda how you, how you were. And if you look around and you see all these people doing things, sitting in walking, quote unquote in the wrong way and they probably don\'t have any problems, you know, and some people who are very attentive about their posture and their walking and there\'s the correct way of doing things. They developed more symptoms than, than the other people, you know. So I think there\'s a lot of variables with this obviously, but for the most part, I wouldn\'t overthink this too much and don\'t think that you can\'t do things again.
Sebastian Gonzales DC: 00:56:22 I remember I met a guy at home depot and he, saw me at, he saw me with a Baseball Jersey on, cause I was just coming from game and he was talking about, we\'re talking about adult league baseball and he\'s like, I dunno, like, yeah I can\'t do that. I\'m a, I\'m old, you know, and he was like 45 and I\'m like, damn, like 10 years younger than you and yeah, you can, we have older people in new on my team. And he\'s like, no, no, no. My days of that are over. And it\'s like, okay, if you say they\'re over, they\'re over, you know, and that, that\'s your choice. So you\'ve, you\'ve kind of sealed your own destiny in that. So, I would encourage you guys that if you have not already gone through this type of intensive care with someone, just just try it and I think you\'ll learn something along the way just like I did is that, I think, she was a perfect one to do it with, with me because she didn\'t over analyze stuff and she didn\'t, she didn\'t over ask and she retained things really well.
Sebastian Gonzales DC: 00:57:17 And so I think that she\'ll have a very good, I think she has a good success rate and I think she\'ll do it perfectly fine. And I would venture to say probably over the next couple of weeks she won\'t even realize the symptoms anymore at all. but it was, it was nice to take her through the, the part of resiliency and if you guys tend to use corrective exercise or loading in weight training as part of your care, this is probably the most menacing part for people like laying there and I\'m having someone do something to you and treat you is like, that\'s the easiest part. And they just got to show up. but, being able to incorporate these parts into their life as a, as a means to just overall being healthy and being resilient it is a little bit more complicated than we think.
Sebastian Gonzales DC: 00:58:02 And so I do think a lot of times personal trainers and coaches have a better, they ever better ability to make a dent in someone\'s life for the better then than we do as clinicians because we don\'t see him all the time. And so I think implementing those systems is really helpful and I think you\'ll find that when you take someone through this kind of thing, like I was surprised by it. Like she was, she was working hard, she didn\'t have any symptoms. that popped up really. And then on that last day, we had a little bit, but it\'s a really good opportunity for me to refine things with her and just make sure that to clarify what I want to add of out of her strength conditioning for the first couple of weeks. And so I feel good that she felt good, that she felt safe and they shall continue to do it because I think we all know that over the course of time that as you age, you just want to have some mobility and you want to have some strength to get off the toilet, to be able to, and to be able to walk, to be able to live on your own.
Sebastian Gonzales DC: 00:58:52 And there\'s a that that gradual decline that, that we say happens after the age. I think it\'s 28 or so. You got to start with a lot, you know, so just, just, make sure that you\'re, you\'re fighting, fighting the aging process. And the best way I do I think is just being active and being strong. And so, I think that strength conditioning is probably one of the best things we can give our patients and showing them that it is safe and it\'s not the stereotype that they\'re thinking it is the Arnold stuff. and just show, it doesn\'t have to be crazy. It just, it just simple stuff. Over the course of time building volume. She left feeling fresh every single time we did it and it wasn\'t, it wasn\'t too much, but it was challenging. That\'s all I would ask for.
Sebastian Gonzales DC: 00:59:36 And so I think I\'ll leave it at that for today, but if you guys have suggestions and more topics for me to do, I\'m looking to expand the topic based a little bit more. over the course of this year, I think we covered a lot. We covered a lot of back based things. We covered a lot of loading this year. we covered a lot of the educational stuff for the, PRO chiropractic online. which is if it, I don\'t know when this one we\'ll release specifically. It might be the one before that whole series starts. Her might be just after, the date of release of that curriculum is, is a little bit more of a moving target just because we have some accreditation things just to address. But I hope this is opening Pandora\'s box for you. And I hope you did start to explore different types of corrections and implementations with people because like, I, I know I sound like I\'m always like a Debbie Downer and manual therapy.
Sebastian Gonzales DC: 01:00:27 I do manual therapy and adjustments on people every day. I just think it\'s a very small part of the puzzle and it\'s very helpful for getting people out of symptoms. But for the most part, I think the resiliency over time as the target for me, and I didn\'t make sure that my communication with patients is like that the resiliency is important. Like weak people, they tend to fall apart more in my opinion. So, again, if you have not subscribed this podcast, please do it. Okay. All you gotta do, scroll down and hit a little subscribe button, and give me a review. I just want to review telling me how I\'m doing. Tell me if this inspired you in any way. And by the way, if this, if you think of fellow clinician or a patient would benefit from this or, or if you are a patient, you have a friend dealing with, back type of condition and they think you think this information is valuable for them, please share it.
Sebastian Gonzales DC: 01:01:15 I\'m, the only way these in the information gets around is, is through viral share. Okay. Like, I, I\'d love to say that promotions on Facebook and Instagram and all that kind of stuff works. But for the most part, I think you sharing is the most powerful tool because the people you\'re sharing with really trust you. And hopefully you guys trust me by now. I mean this has been a hundred and gosh, 50 something episodes now and hopefully you guys trust me by now. So I\'m not trying to screw you on anything. So, share it and I\'m learning more every day. And if you want to be part of this journey, please share it with your fellow clients or sorry, your f your fellow clinicians and subscribed the podcast with, with, with me. as always lead people better. And how you found them. And if you\'re dating, dating, dating Eagle Scout, and if you are still in the California area before Jan, before June 8th and ninth, please come to the workshop. If there\'s still spots available, we\'re gonna Cook Tomahawk steaks as you\'ve seen him on Instagram. you don\'t have to pay a thing for that part. We\'re just going to hang out in my garage and just cook those steaks after and just broke down and just meet other great likeminded, open clinicians. Talk to you guys next time.
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