Tuesday, December 30, 2008
Frostbite which is caused by freezing temperatures, injures the body. There is a higher risk with people that have reduced blood circulation and those who dress improperly for extremely cold temperatures. It most often affects the extremities such as the nose, ears, cheeks, chin, fingers or toes. Frostbite warning signs are the loss of feeling such as numbness, pain and a waxy feeling to the skin. Also, frostbite can change the color of the skin to gray, white or yellow. Seek medical attention immediately if you have these symptoms. Frostbite can permanently damage the body and severe cases can lead to amputation.
What to Do
Do not walk on frostbitten feet or toes when possible and get into a warm room immediately. Immerse the affected area in warm water comfortable to the touch, not too hot. You can even use body heat for the affected area, but do not massage this area. This can cause more damage. These numb areas can be easily burned so do not use a heating pad, heat lamp, a stove, fireplace, or radiator for warming.
Hypothermia is when your body begins to lose heat faster than it can be produced. People who are most susceptible to hypothermia are people who remain outdoors for long periods in extremely cold temperatures. Also, the elderly and infants in cold bedrooms are at risk. Hypothermia can also occur with cool temperatures (above 40°F). Some of these cool temperature types are typically associated with moisture such as sweat, rain or submersion in cold water. Recognizing the symptoms of hypothermia can prevent a serious medical condition or even save your life. Some early warning signs are severe shivering, exhaustion, dizziness, slurred speech and confusion. If you are experiencing these symptoms seek medical attention immediately.
What to Do
To confirm the condition of hypothermia the body temperature of the victim will drop below 95°F, which is considered an emergency, seek medical attention immediately for this individual. If medical care is not yet available these are steps that can help reverse this condition. Move the victim into a warm location and remove any wet clothing. Start by warming the center of the body first. The protocol is to start with the chest, neck, head, and groin. Ways of warming the body externally are with warm loose dry layers of blankets, clothing, towels and sheets or with skin-to-skin contact. Internally you can increase the body temperature by administering warm beverages, but do not give alcoholic beverages. In addition, do not try to give beverages to an unconscious person. As the body normalizes, keep the person dry and wrapped in a warm blanket, which includes the head and neck region. In severe cases the victim may become unconscious and may not appear to have a pulse or to be breathing, this victim may even appear dead. In these severe cases, while the victim is being warmed CPR should be performed. CPR should continue until the victim responds or medical personnel arrive. Even though a hypothermia victim appears dead, you should always follow these steps.
To ensure additional safety, it is always a good practice to have your Med File Now® (MedFN®) ID card with you at all times. If you have a loved one that may become a victim of hypothermia, you should advise them to establish a Med File Now® (MedFN®) account. Simply tell them to go to www.medfn.com to take the tour and join. This valuable service provides your loved ones the security that you would want them to have.
Friday, November 28, 2008
AD is a progressive brain disorder and over time the disease gradually abolishes the memory and mental abilities such as learning, reasoning, making judgments, carrying out daily activities and communicating. As the disease progresses some may also experience changes in personality and behavior.
In the United States there are some estimates that up to 5 million people are living with AD and projected to triple by 2050. Younger people may get AD but it is not very common. The risk of getting AD may start at about the age of 60, but this is still a small percent. The term early-onset refers to this group that occurs in a person under age 65. This early-onset may be in any stage of dementia; early, middle or late. The first notable age group is 65 to 74 with 5% being inflicted with AD and by age 85 almost 50% will have some level of AD.
The duration of AD can range from 3 to 20 years but the progression is widely different, with most people dying on an average 4 to 8 years after diagnosis. The first part of the brain to be affected is the area that controls thinking and memory. As this progression spreads to other regions, the brain cells die leading to the need for complete care of the individual. AD with no other illness will cause death from loss of brain function.
Experts have noted similar patterns of progression of symptoms as AD develops over the duration of the disease. These progressions have several stages but not all people progress at the same rate or experience all the same symptoms. Knowing the stages will help understand the progress of AD and give time to plan accordingly.
The seven stages were developed by Barry Reisberg, M.D., Clinical Director of the New York University School of Medicine’s Silberstein Aging and Dementia Research Center.
Stage 1: No impairment (normal function)
Unimpaired individuals experience no memory problems and none are evident to a health care professional during a medical interview.
Stage 2: Very mild cognitive decline (may be normal age-related changes or earliest signs of AD)
Individuals may feel as if they have memory lapses, especially in forgetting familiar words or names or the location of keys, eyeglasses or other everyday objects. But these problems are not evident during a medical examination or apparent to friends, family or co-workers.
Stage 3: Mild cognitive decline (early-stage AD can be diagnosed in some, but not all, individuals with these symptoms)
Friends, family or co-workers begin to notice deficiencies. Problems with memory or concentration may be measurable in clinical testing or discernible during a detailed medical interview. Common difficulties include:
•Word or name finding problems noticeable to family or close associates
•Decreased ability to remember names when introduced to new people
•Performance issues in social or work settings noticeable to family, friends or co-workers
•Reading a passage and retaining little material
•Losing or misplacing a valuable object
•Decline in ability to plan or organize
Stage 4: Moderate cognitive decline (Mild or early-stage AD)
At this stage, a careful medical interview detects clear-cut deficiencies in the following areas:
•Decreased knowledge of recent occasions or current events
•Impaired ability to perform challenging mental arithmetic-for example, to count backward from 75 by 7s
•Decreased capacity to perform complex tasks, such as planning dinner for guests, paying bills and managing finances
•Reduced memory of personal history
•The affected individual may seem subdued and withdrawn, especially in socially or mentally challenging situations
Stage 5: Moderately severe cognitive decline (Moderate or mid-stage AD)
Major gaps in memory and deficits in cognitive function emerge. Some assistance with day-to-day activities becomes essential. At this stage, individuals may:
•Be unable during a medical interview to recall such important details as their current address, their telephone number or the name of the college or high school from which they graduated
•Become confused about where they are or about the date, day of the week or season
•Have trouble with less challenging mental arithmetic; for example, counting backward from 40 by 4s or from 20 by 2s
•Need help choosing proper clothing for the season or the occasion
•Usually retain substantial knowledge about themselves and know their own name and the names of their spouse or children
•Usually require no assistance with eating or using the toilet
Stage 6: Severe cognitive decline (Moderately severe or mid-stage AD)
Memory difficulties continue to worsen, significant personality changes may emerge and affected individuals need extensive help with customary daily activities. At this stage, individuals may:
•Lose most awareness of recent experiences and events as well as of their surroundings
•Recollect their personal history imperfectly, although they generally recall their own name
•Occasionally forget the name of their spouse or primary caregiver but generally can distinguish familiar from unfamiliar faces
•Need help getting dressed properly; without supervision, may make such errors as putting pajamas over daytime clothes or shoes on wrong feet
•Experience disruption of their normal sleep/waking cycle
•Need help with handling details of toileting (flushing toilet, wiping and disposing of tissue properly)
•Have increasing episodes of urinary or fecal incontinence
•Experience significant personality changes and behavioral symptoms,including suspiciousness and delusions (for example, believing that their caregiver is an impostor); hallucinations (seeing or hearing things that are not really there); or compulsive, repetitive behaviors such as hand-wringing or tissue shredding
•Tend to wander and become lost
Stage 7: Very severe cognitive decline (Severe or late-stage AD)
This is the final stage of the disease when individuals lose the ability to:
•Respond to their environment, the ability to speak and, ultimately, the ability to control movement
•Recognizable speech, although words or phrases may occasionally be uttered
•Eating and toileting and there is general incontinence of urine
•Walk without assistance, then the ability to sit without support, the ability to smile, and the ability to hold their head up. Reflexes become abnormal and muscles grow rigid
•Swallowing is impaired
It is important to remember that AD is not a normal part of aging and new treatments are being worked on routinely. Some treatments are available that may improve the quality of life. Scientists have discovered several genes associated with AD. This could lead to treatments to block the progression of AD. Researches also have encouraging studies, which show a caregiver who provides effective care and support can improve an individual’s quality of life over the duration of AD.
With all the best efforts of a caregiver there may come a time when an individual with AD may wonder off on their own. This could become a frightening thought. As a caregiver you must do everything in your power to protect these individuals. Of course with all the best efforts things like this may occur. The best strategy is to better protect them in advance. That is where MedFN can have a role in the safety of those that are inflicted with AD. MedFN can communicate critical information for this person. MedFN can store information that they may not be able to recall. This may also be their voice in time of need if they are separated from their caregiver. With MedFN on their side, people with AD will have one more level of security with their information readily available.
Tuesday, October 28, 2008
Understanding panic attacks may be more difficult for a person who has never had one. To the person that gets them, it can be like a near death experience. I know a few people who get panic attacks but I could not comprehend how real it was to them. After talking to others who have had panic attacks I realized what a major impact it could have on ones life. I choose to write this newsletter not just for the people who get panic attacks but also for the people who were like me. I did not realize how real these panic attacks are and how they can play a major role in someone life.
Anxiety disorders affect 40 million adults according to the Anxiety Disorder Association of America. A panic disorder is three times more common in women than in men and typically develops in early adulthood. A panic attack is defined as the sudden onset of extreme fear that reaches a peak within minutes. People, who experience out-of-the blue attacks, can become preoccupied with the fear of a recurrence of such attacks. These panic attacks can occur unexpectedly, even while asleep. If you have at least four of the following symptoms you could be experiencing a panic attack.
A feeling of imminent danger
A fear of losing control
A fear of dying
Things being unreal
The need to escape
Shortness of breath
A smothering feeling
A feeling of choking
This affliction may go unchecked due to fear or embarrassment to tell anyone about what they’re experiencing. Instead of seeking help, they continue to endure these symptoms instead of getting help or support. If you or a family member displays the symptoms of panic attacks, tell your doctor and get treatment as soon as possible. The disorder is real and it can be highly responsive to medical treatment.
If anyone is ever in the need to recall their medical information when experiencing a panic attack it could all be there quickly and accurately with a Med File Now® (MedFN®) account. If you have a loved one you want to protect tell them to set up an account. Just go to www.medfn.com to get started. You don’t need a health condition to use MedFN.com just a desire to be safe.
Monday, September 29, 2008
Three times in my life, I feel I have had more stress than most people. The first and most traumatic time was when I was told I had cancer and I was staring death in the face. The second time was when I was told my cancer relapsed. That led to the third time when I was told I would need a stem cell transplant to save me life and that the treatment could kill me. September 16th was 6 years since my transplant, which brings me to my personal view on stress.As the Oncologist explained to me, with the deepest compassion and the highest level of medical professionalism, what I should expect. I could not hear his words or explanation. Thinking back all I could hear was that voice (slow, low, base, trumpet sound) of the school teacher for the cartoon Charlie Brown. My stress level was so high I could not even think straight.
After 11 years of dealing and handling stress, I recently found myself totally stressed out almost to the levels as when I was fighting my cancer. I found myself in what I call false stress. I describe it as, the smaller your problems are in life the bigger the little issues become. So if you are told you may die tomorrow, other big issues may not matter as much. But if life is great and everything is perfect and you get upset over spilt milk you are living under false stress. Realizing where your levels of issues are compared to other might help you out of false stress.It is easy to recognize when others put stress on us, but are you stressing other people out. Ask yourself this hard question. Do you do what you say you’re going to do and by the time you said it would be done? If you can answer yes to this question then you are doing your part to reduce stress, if not, you could be fueling other peoples stress. If everyone could move in the direction of answering yes life, would be a lot less stressful.
I will never judge anyone for what may cause their level of stress or how it manifests itself. I developed Med File Now® so if anyone is ever in the need to recall their medical information when under stress it will all be there quickly and accurately. If you have a loved one you want to protect tell them to set up a Med File Now® (MedFN®) account. Just go to www.medfn.com to get started. You don’t need a health condition to use MedFN.com just a desire to be safe.
Sunday, August 31, 2008
You might ask yourself, why an individual would do that to themselves. Amazingly twenty percent of the population recognizes that they are chronic procrastinators. Procrastination can become one’s routine and it has a dramatic affect on their life. The procrastinator doesn’t prepare properly for uncertainties and puts off health concerns. Even their financial obligations are set aside such as filing income tax returns late or not paying bills on time. The list goes on but as a society we do not view this as a serious problem.
Procrastination is not a problem of time management or of planning. Procrastination is developed; you are not born with it. Procrastination is an indirect learned behavior. It is one type of response to an authoritarian parenting style. A parent that is controlling keeps the child from developing the ability to regulate themselves, from internalizing their own intentions and then learning to act on them. This leads to the procrastinator to seek their friends for support rather than their parents, because they are more tolerant of their excuses. This unfortunately manifests into additional reinforcement of the procrastination.
Signs of a procrastinator can be found in their verbiage. Such as, "I feel like doing it tomorrow" but in fact they feel the same the following day. Or "I work best under pressure", but pressure does not make the difference. To extenuate the procrastination and protect their actions they will say "this isn't that important to me." The procrastinator actively looks for distractions. These distractions typically don't take a lot of commitment on their part. These distractions are ways to control their fear of failure.
There are different types of procrastinators and they procrastinate for different reasons. Adrenalin rush type or thrill-seekers will wait for the last minute for the exhilarated rush. Then there is the circumventor who has the fear in two areas, the fear of failure or the fear of success. Furthermore in either case these individuals would rather have you believe they lack effort, than ability. Then there is the procrastinator who cannot make a decision. They will abstain from making a decision to absolve themselves from the responsibility of the outcome.
There are big health costs that are associated with procrastination. Results of one study showed evidence of compromised immune systems that led to more colds, flu, gastrointestinal problems and also insomnia. Others will feel the consequences of the procrastinator. By shifting the burden of responsibility form the procrastinator onto others, the recipient will feel in addition stress and become resentful. Procrastination also destroys teamwork in the workplace and private relationships. If one recognizes themselves as being a procrastinator they can change their behavior. This does take time and is a step by step process.
For safety reason one should not procrastinate on setting up a Med File Now® (MedFN®) account. Just go to www.medfn.com to get started. You don’t need a health condition to use MedFN.com just a desire to be safe.
Monday, July 21, 2008
Know your Destination
We all plan on having a great time on our vacation but typically no one plans on the unexpected. If you are traveling to a major city one would assume that there would be appropriate emergency facilities available. By doing some preplanning you can find out where some of these facilities are if the need arises. Also if you do have a medical condition that is being treated by a Physician you can consult with them before leaving to see if they might know a colleague in that area.
Theme parks and cruise lines put their best foot forward for the safety of their guest but a simple call, ahead of time, can help you prepare for the unexpected. Plus, you may discover that there is more available than you would have expected. When on a cruise, consult your Cruise Director before leaving the ship for any on shore excursions. Be prepared for that emergency.
The great outdoors is one way to get away from everything. From camping in a tent, arriving in a RV or staying in a cabin, all of them put you right in the middle with nature. At the same time you can be very isolated from the rest of civilization. Knowledge of near by medical facilities could be vital when vacationing in desolate areas.
Traveling abroad will require more preplanning and research. Remember there is always diversity in foreign countries culture and customs in regard to healthcare. Also you will want to check with your insurance carrier about your coverage or if you need additional coverage.
Keeping it Safe
Current and expedient information is the first step in planning ahead and keeping it safe. Losing airline tickets or your passport could lead to travel interruption. An accident could spoil the whole trip. Family members getting separated could lead to panic. Keeping a backup of information could become critical. This can all be accomplished via the Internet. Members of Med File Now® (MedFN®) know that the benefits of having electronic medical information available, in an instant. It is crucial but it is not always just about medical issues. Travelers and their children need to protect themselves with electronic information also. MedFN.com has a unique tri level security system which you can choose who can view this information. If you have a child and they get separated from you, the MedFN.com card would give access to information that you would want to make available. Such information as their name, list of emergency contacts, and insurance card information will ensure they are going to get the best care available in an emergency. Also, you have the ability to enter the location and dates of where you are staying while on vacation. Med File Now® (MedFN®) makes it convenient to store information in different areas on the site, such as ticketing and passport information that can be kept private for your eyes only. You don’t need a health condition to use MedFN.com just a desire to be safe.
Monday, June 16, 2008
A disaster such as an earthquake gives a person little to no warning and can demolish a city in seconds. The devastating tornados in the plain states are a constant reminder that you might only have a minutes warning before your life is turned upside down or even taken. Recent forest fires that ravished the West and what is being called the 500 year flood in the Mid-west gave people just hours to evacuate before having to evacuate their homes. June 1st begins hurricane season. For people living in these regions there is an advance warning to evacuate the area because these large hurricanes can bring unimaginable, wide-spread, massive destruction to the infrastructure.
Being in one of these disasters could be life threatening but what about during the extended aftermath? This was evident when hurricane Katrina plowing through New Orleans. Basic needs such as food, water and shelter where were made available over time but one of the biggest challenges was medication. Not because it was not available but because the individuals could not recall the medications they were taking or their specific health history. This can be brought on by stress, a weakening memory or caused because someone receives their personal healthcare from someone else who was not available.
In any type of disaster, beside the toll it takes on the psyche, there is the devastation that it takes on the infrastructure. Some areas will become inaccessible or even leveled beyond any recognition. If this location is the only place that holds your medical records, they could become unavailable or even worse, destroyed. That is why it is so important to have as part of your emergency disaster plan a backup of your personal health records.
It is vital to have your crucial and non-crucial information, available in one place, with you at all times. By having your MedFN® ID card on you, emergency personal or you can simply go to the website www.medfn.com and access your alphanumeric code to retrieve this vital information. If you are serious about your health then take the next step and protect yourself with a Med File Now® (MedFN®) account. Med File Now® is doing its part in bringing security to you and your loved ones during a disaster.
Tuesday, May 27, 2008
According to Melissa Johnson, executive director of the President’s Council on Physical Fitness and Sports affirmed "For health benefits, adults need 30 minutes a day of moderate physical activity on 5 or more days a week; youth aged 6 to 17 need 60 minutes. If there were a medication that conferred all of the health benefits of regular moderate physical activity, every doctor would prescribe it. Physical activity is the ultimate magic pill. Small steps add up to big results. Taking stairs instead of the elevator, going for a walk instead of a coffee break, parking the car further away from the office or shopping mall, sweeping the floor instead of vacuuming: all of these activities add up to better health."
Twenty minutes of vigorous physical activity, three times a week, such as sports, aerobics, working out in the gym, and running, has added health benefits. Johnson says, “But it’s important to understand that you don’t need to sweat in a gym or run a marathon to reap the health benefits of daily physical activity. Even 30 minutes a day, broken up into shorter increments of ten or fifteen minutes, can greatly improve your health.”
If you are one of those who have already made the decision to increase your health with sports, aerobics, working out in the gym, biking and running have you made the decision to protect yourself too? Most individuals that participate in these actives do not like to carry extra items with them such as a wallet that holds a lot of personal information. But if something happened would this crucial information be available, such as identification, insurance cards, emergency contacts or even more life threatening allergies, alerts and medications?
It is vital to have your crucial information, available in one place, with you at all times. By having your MedFN® ID card on you, emergency personal can simply go to the website www.medfn.com and access your alphanumeric code to retrieve this vital information. If you are serious about your health then take the next step and protect yourself with a Med File Now® (MedFN®) account. Med File Now® is doing its part for National Physical Fitness and Sports Month to bring safety to you and your loved ones.
Tuesday, April 29, 2008
Studies have shown that the new method of CPR, hands-only, works just as well as the standard CPR, which is compressions and mouth-to-mouth together, for sudden cardiac arrest in adults. This is good news, due to the fact, that under the traditional standards bystanders would not get involved in helping a victim. If you are not formally trained with the new CPR, don’t worry, you cannot make the situation worse. If you see an adult fall unconscious and they are not responsive, call 911 and then take action. Remember inaction kills.
This new method of CPR is only if you witness the collapse of an adult. Still use the standard method of CPR when it involves infants, children, adults that had near-drowning, drug overdose, or carbon monoxide poisoning. In these cases using the standard method of CPR introduces the needed air into the victim’s lungs and bloodstream.
Even though this new method of CPR is just now being brought to the forefront, surprisingly it has been used longer than you may think. About one year ago I was shown the 100 compressions per minute CPR by Dr. Robert Tober who is the Medical Director of the Collier County EMS in Southwest Florida. This method of CPR was part of the Collier County’s EMS training since April of 2005. He explained that when a person first collapses there is still oxygen in the lungs and blood throughout the body. The priority is to keep the residual oxygen rich blood flowing to the brain.
Also, in speaking with Dr. Tober I learned that throughout his career he has always been on the leading edge of medicine. He was one of the first pioneers in ideas and methods of rapid responses of personal health records. He said the availability of past information is crucial. The problem is not that the people do not understanding this, but just do not follow through and protect themselves with their medical information.
It is vital to have your crucial medical information available at all times. Are you and your loved ones prepared with their personal health records? It is as simple as having a MedFN® account. Having their www.medfn.com alphanumeric access code on you at all times will give you that security. Med File Now® is doing its part to bring safety to you and your loved ones.
Saturday, March 29, 2008
Selective mutism is described as a psychological disorder in children. Children with this disorder are fluent and have an understanding of the language but fail to speak in certain social situations. Parents often believe their child is refusing to speak due to shyness, but with selective mutism the child is truly unable to speak. It can appear as there is nothing wrong since the child’s functions are normal in other areas of behavior and learning. During these periods the child becomes severely withdrawn in such things as group activities which are due to their extreme anxiety. These group activities typically occur in school or social settings.
Children acting withdrawn from selective mutism unfortunately sometimes may be confused with an autism spectrum disorder which can lead to incorrect treatment. The main difference between selective mutism and autism is that the child with selective mutism can communicate normally when in a situation where they feel comfortable. These are some of the characteristics of selective mutism:
- Will not speak in specific social situations but will at home
- Temper tantrums
- A difficulty in maintaining eye contact
- A reluctance to smile
- Displays blank facial expressions
- Awkward body movements
- Anxious saying hello, goodbye, thank you, etc
- Worry about things more than other people
- Sensitivity to noise
- Sensitivity in crowds or crowded situations
- Difficulty with non-verbal expression
- Fear of using public restrooms
- Compulsive traits
- Clinging behavior
- Extremely shy
- Fearful of people
Wednesday, February 27, 2008
Every February since 1963 - 2008 has been declared American Heart Month by the sitting President. Americans need to be aware of our nation’s number one killer which is cardiovascular disease. It is also one of the leaders in disabilities. Estimates show that 1.2 million Americans will have a myocardial infarction this year. This works out to be about one every 26 seconds and on average one person will die every minute.
You need to be aware of the increase risk factors that can lead to heart disease such as; high cholesterol, high blood pressure, obesity, diabetes, tobacco, physical inactivity and/or unhealthy diet. One can reduce these risks by having a healthy diet and exercise regime. Always seek a doctor’s advice before inducing a new diet and/or exercise program.
February 2008 is also Safety Awareness Month. What should this mean to you? Let’s define each word. Safety: Freedom from harm or danger. Awareness: The state or level of consciousness. The word Safety infers to at that times and the word Awareness infers to being in a state of consciousness. So what would that mean if you were unconscious? You are no longer safe! This could be a reality where no one would ever want to find themselves. To truly be safe you need a voice to be there when you can not speak for yourself. That is why it is crucial to have a MedFN® account and have your www.medfn.com alphanumeric access code on you at all time. Med File Now® is doing its part to bring safety awareness to you this month.
Monday, January 28, 2008
January is here and it is a new year. What does that mean to you? To many, it is the turning of a page to a new chapter in the book of life. As this new chapter prepares to unfold, we all view it a bit differently. Some will wipe the sweat from their brow and be happy to have survived another year. Others may be anxious or some even excited for the mystery of the future. Even though we all have different ideas about the year, most of us will start it off with a New Year’s Resolution.
Most New Year Resolutions are made for self-betterment. The top resolutions according to a pole taken by the US Government are;
Pay Off Debt
Get a Better Job
Get a Better Education
Drink Less Alcohol
Quit Smoking Now
Reduce Stress Overall
As you can see, of the top ten, half of them are related to health. This is good news that people are concerned about their health. The reality of this is that over one third of individuals will break their New Year’s Resolutions by the end of January.
How can you beat the odds? Make your New Year’s Resolutions realistic. Setting your goal so high that it is unattainable is a recipe for disappointment. It is the baby steps of small goals that give you the feeling of success. Writing down your goals and/or even letting others know what your goals are, puts it at a higher level of commitment. Track your progress and always remember to reward yourself along the way as you complete each of your interim achievements. But if you do slip up do not give up. Just remember that no one is perfect even though we would like to think we are. Just simply put it behind you and get your self back on track to achieving that goal. Reaching a goal can be challenging but very rewarding. So when setting new goals it is best to only take on no more than two a time, otherwise it could become overwhelming.
All of us here at Med File Now (MedFN) hope you will accomplish all your goals. If you want to achieve a simple goal this year, challenge yourself to tell one person about our website www.medfn.com and how they can protect them self and their loved ones during a time of emergency. Thank you, good luck and Happy New Year.