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Consent✅ Another - possible - genicular nerve case Runner, bilateral lateral knee pain Treated as ITB overload; exhausted all non-surgical options so reasonably proceeded to targeted partial ITB release Unfortunately symptoms persisted but changed in nature - 'burning' now (L more than R), slightly more diffuse & symptoms with...

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James Noake

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19,381 Aufrufe • vor 7 Monaten •via X (Twitter)

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Consent ✅ Very interesting case!! 🤓🤓🤓 Young teenager - laparoscopic cholecystectomy months ago Persistent debilitating R upper quadrant pain around port scar site Burning, stabbing - provoked by minimal activity eg sitting up, bracing in car turning corners 4 weeks as in-patient in hospital, having further general surgical work up .... MRI, US, CT, bloods normal Off school Examination - +ive Carnett's sign, pain / inhibition on sit up, clearly abdo wall issue POCUS - can appreciate subtle port site hypoechoeic channel through rectus abdominus - this has injured the anterior cutaneous nerve at this level (T9 / T10 - see ACN schematic) Video - US guided nerve block / hydrodissection..... immediate pain relief 🥳 So at least the potential (harmful) hunt for a non MSK / gastroenterological cause can stop now Only one other case report of this in 2022 - but not a typical laparoscopic complication or tick box form. If the block fails to improve pain beyond short term, RF ablation might be helpful - then last resort surgical neurolysis.
0:32

Consent ✅ Very interesting case!! 🤓🤓🤓 Young teenager - laparoscopic cholecystectomy months ago Persistent debilitating R upper quadrant pain around port scar site Burning, stabbing - provoked by minimal activity eg sitting up, bracing in car turning corners 4 weeks as in-patient in hospital, having further general surgical work up .... MRI, US, CT, bloods normal Off school Examination - +ive Carnett's sign, pain / inhibition on sit up, clearly abdo wall issue POCUS - can appreciate subtle port site hypoechoeic channel through rectus abdominus - this has injured the anterior cutaneous nerve at this level (T9 / T10 - see ACN schematic) Video - US guided nerve block / hydrodissection..... immediate pain relief 🥳 So at least the potential (harmful) hunt for a non MSK / gastroenterological cause can stop now Only one other case report of this in 2022 - but not a typical laparoscopic complication or tick box form. If the block fails to improve pain beyond short term, RF ablation might be helpful - then last resort surgical neurolysis.

James Noake

15,559 Aufrufe • vor 1 Jahr

Consent✅ Runner, HIIT Deep left buttock pain Occasionally travels down posterior thigh with intermittent parasthesia & numbness lower leg & foot Brought on with pigeon stretching, yoga, as well 4 point kneeling core hip extension / adduction work 🤷‍♂️ Sitting main aggravating factor - isometric single leg bridging as well Clinical exam difficult to reproduce pain but discomfort on palpation through deep gluteal space MRI: Lumbar spine - normal Pelvis - mildly reduced ischiofemoral interval L side - subtle oedema in quadratus femoris (QF) POCUS video: With passive hip external rotation (closing down the ischiofemoral space) can see bunching of QF and tenting of sciatic nerve (SN) - 'Eruption Sign' - maintaining probe pressure on this soft tissue during the manoeuvre reproduces typical pain US guided injection (lateral to medial to avoid SN) to QF and ischiofemoral space - immediate reduction in sitting pain post procedure
0:54

Consent✅ Runner, HIIT Deep left buttock pain Occasionally travels down posterior thigh with intermittent parasthesia & numbness lower leg & foot Brought on with pigeon stretching, yoga, as well 4 point kneeling core hip extension / adduction work 🤷‍♂️ Sitting main aggravating factor - isometric single leg bridging as well Clinical exam difficult to reproduce pain but discomfort on palpation through deep gluteal space MRI: Lumbar spine - normal Pelvis - mildly reduced ischiofemoral interval L side - subtle oedema in quadratus femoris (QF) POCUS video: With passive hip external rotation (closing down the ischiofemoral space) can see bunching of QF and tenting of sciatic nerve (SN) - 'Eruption Sign' - maintaining probe pressure on this soft tissue during the manoeuvre reproduces typical pain US guided injection (lateral to medial to avoid SN) to QF and ischiofemoral space - immediate reduction in sitting pain post procedure

James Noake

16,304 Aufrufe • vor 6 Monaten

Consent✅ Female, 20s L upper abdominal pain since lockdown - on back of increased home work outs including ab & core work Now pain lying supine, prone, trunk rotation, being hugged, deep inspiration.... Hugely impactful on QoL Seen multiple specialists - GI, gynae (!), respiratory - utterly frustrated Referred as possible ACNE syndrome - but not in the right place anatomically (ACNE is peri-umbilical semilunaris border) OE - hypermobile ? EDS Focal pain on gentle palpation into immediate L inferior costal margin EROM thoracic rotation painful, plus trunk flexion / extension POCUS video - L 'floating rib' - possibly 11th - seen subluxed superficially over adjacent rib, vs normal side sat 'flush' On deep inspiration, pain reproduced with probe pressure maintained as irritable over-lying soft tissue 'tents' Diagnosis - 'Floating rib' or 'rib tip' syndrome Outcome - symptoms validated - no more medical 'rabbit holes' - surgical resection
0:29

Consent✅ Female, 20s L upper abdominal pain since lockdown - on back of increased home work outs including ab & core work Now pain lying supine, prone, trunk rotation, being hugged, deep inspiration.... Hugely impactful on QoL Seen multiple specialists - GI, gynae (!), respiratory - utterly frustrated Referred as possible ACNE syndrome - but not in the right place anatomically (ACNE is peri-umbilical semilunaris border) OE - hypermobile ? EDS Focal pain on gentle palpation into immediate L inferior costal margin EROM thoracic rotation painful, plus trunk flexion / extension POCUS video - L 'floating rib' - possibly 11th - seen subluxed superficially over adjacent rib, vs normal side sat 'flush' On deep inspiration, pain reproduced with probe pressure maintained as irritable over-lying soft tissue 'tents' Diagnosis - 'Floating rib' or 'rib tip' syndrome Outcome - symptoms validated - no more medical 'rabbit holes' - surgical resection

James Noake

24,669 Aufrufe • vor 7 Monaten

Consent✅ "I’m at the Point of Breaking – Hang 10, take it thighs-an easy, I’m Hunting for a solution" Runner, surfer Massive ramp up in marathon training – rapid onset medial mid to lateral burning thigh pain (see pain map below) with low grade parasthesiae Exacerbated by deep knee flexion and running beyond 20 mins and a faster pace Struggled further on surfing holiday in prone on board and kneeling MRI excluded femoral bone stress injury and no adductor injury or knee intra-articular / ligamentous injury OE – Meniscal and ligamentous testing normal Lumbar spine and hip joint cleared POCUS video reel – Adductor magnus tendon & wider musculature normal Saphenous nerve swollen at mid Hunter’s canal point – almost same calibre as the adjacent femoral artery! (point of maximal tenderness with probe pressure - Tinel's positive) US guided hydrodissection (LS) – soft tissue planes around SN seen to open up effectively Post procedure – complete abolition of pain on treadmill running and deep squats for the first time in 8 months (excuse the language) Pearls - This area is diagnostic ‘No Man’s Land’ – ie, if there is no femur bony pathology, and in the absence of trauma, it can only really be neural ‘Adductor splint syndrome’ – a form of bone stress injury – is one of the key medial thigh pain differentials in runners Research links – ‘Surfer's neurapraxia - an uncommon surfing injury of the saphenous nerve’ ‘Adductor insertion avulsion syndrome (thigh splints): spectrum of MR imaging features’
2:19

Consent✅ "I’m at the Point of Breaking – Hang 10, take it thighs-an easy, I’m Hunting for a solution" Runner, surfer Massive ramp up in marathon training – rapid onset medial mid to lateral burning thigh pain (see pain map below) with low grade parasthesiae Exacerbated by deep knee flexion and running beyond 20 mins and a faster pace Struggled further on surfing holiday in prone on board and kneeling MRI excluded femoral bone stress injury and no adductor injury or knee intra-articular / ligamentous injury OE – Meniscal and ligamentous testing normal Lumbar spine and hip joint cleared POCUS video reel – Adductor magnus tendon & wider musculature normal Saphenous nerve swollen at mid Hunter’s canal point – almost same calibre as the adjacent femoral artery! (point of maximal tenderness with probe pressure - Tinel's positive) US guided hydrodissection (LS) – soft tissue planes around SN seen to open up effectively Post procedure – complete abolition of pain on treadmill running and deep squats for the first time in 8 months (excuse the language) Pearls - This area is diagnostic ‘No Man’s Land’ – ie, if there is no femur bony pathology, and in the absence of trauma, it can only really be neural ‘Adductor splint syndrome’ – a form of bone stress injury – is one of the key medial thigh pain differentials in runners Research links – ‘Surfer's neurapraxia - an uncommon surfing injury of the saphenous nerve’ ‘Adductor insertion avulsion syndrome (thigh splints): spectrum of MR imaging features’

James Noake

16,741 Aufrufe • vor 1 Monat

Consent✅ Lots to think about here Male, 40s- super fit - skiing, running, weights Always had stiff hips and tight 'hip flexors' 👀 hmmmm Recalls aggressive breaststroke kick right side (ie minimal trauma) - sudden catching pain right groin Remained intrusive with mechanical symptoms - pain at rest, sitting, rolling over, deep squat Exam - both hips reduced ROM especially into FADDIR -right particularly irritable Video - AP Xray pelvis - bilateral dysplasia R > L, plus cam bumps.... a hip pain 'perfect storm' POCUS - extensive R sided delamination labral tear (use passive hip rotation to manipulate & 'milk' effusion fluid into tear to highlight it) MRI images (surrogate markers of dysplasia) 1. 'Saturn Sign' (I made this up) - anterior to posterior labral tear 2. Cystic change in ligaments teres 3. Hypertrophic cystic labral changes It's not just women that have dysplastic hips This needs experienced surgical input rather than 'kicking the can down the road'
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Consent✅ Lots to think about here Male, 40s- super fit - skiing, running, weights Always had stiff hips and tight 'hip flexors' 👀 hmmmm Recalls aggressive breaststroke kick right side (ie minimal trauma) - sudden catching pain right groin Remained intrusive with mechanical symptoms - pain at rest, sitting, rolling over, deep squat Exam - both hips reduced ROM especially into FADDIR -right particularly irritable Video - AP Xray pelvis - bilateral dysplasia R > L, plus cam bumps.... a hip pain 'perfect storm' POCUS - extensive R sided delamination labral tear (use passive hip rotation to manipulate & 'milk' effusion fluid into tear to highlight it) MRI images (surrogate markers of dysplasia) 1. 'Saturn Sign' (I made this up) - anterior to posterior labral tear 2. Cystic change in ligaments teres 3. Hypertrophic cystic labral changes It's not just women that have dysplastic hips This needs experienced surgical input rather than 'kicking the can down the road'

James Noake

14,346 Aufrufe • vor 6 Monaten

⚡️📣👇Tremendously excited to share our new Cell article, where we develop TriPath, a method for analyzing 3D pathology samples using weakly supervised AI. Article: TriPath enables 3D computational pathology via 3D multiple instance learning allowing AI models to capture intricate morphological details from pathology volumes. Code: Blog post: Tested on two different imaging modalities, and patient cohorts from two institutions. Our superstar Andrew H. Song put in a monumental effort of leading the study, in a fantastic collaboration with Jonathan Liu at University of Washington . Interesting aspects: - Utilizing the whole tissue volume and leveraging 3D deep learning enable superior risk prediction performance compared to 2D deep learning baselines based on a few sampled tissue sections that emulate standard clinical practice. This indicates TriPath can harness additional information provided by 3D tissue morphology. - The performance is also superior to clinical baselines from a reader study that involved six expert pathologists. - The morphologically heterogeneous tissue volume could lead to opposing patient-level outcome predictions, dependent on which portion of the tissue volume is used. This concurs with current clinical literature warning that tissue sampling bias can lead to misdiagnosis. Some limitations: - While the 3D pathology cohort size is unprecedented, it is smaller than typical 2D pathology cohorts. Further large-scale studies will be required for validation. Nevertheless, we believe that this study will initiate a positive cycle, encouraging academic institutions and pharmaceutical companies to contribute large banks of human tissue blocks with paired clinical outcomes, thus speeding up advancements in 3D computational pathology. Concluding insights: We believe that 3D pathology is just around the corner - It has the huge potential to not only augment/improve the current clinical practice centered around 2D examination of human tissue, but also help reveal novel biomarkers for prognosis and therapeutic response.. Harvard Medical School Harvard Data Science Initiative Mass General Brigham Broad Institute
4:23

⚡️📣👇Tremendously excited to share our new Cell article, where we develop TriPath, a method for analyzing 3D pathology samples using weakly supervised AI. Article: TriPath enables 3D computational pathology via 3D multiple instance learning allowing AI models to capture intricate morphological details from pathology volumes. Code: Blog post: Tested on two different imaging modalities, and patient cohorts from two institutions. Our superstar Andrew H. Song put in a monumental effort of leading the study, in a fantastic collaboration with Jonathan Liu at University of Washington . Interesting aspects: - Utilizing the whole tissue volume and leveraging 3D deep learning enable superior risk prediction performance compared to 2D deep learning baselines based on a few sampled tissue sections that emulate standard clinical practice. This indicates TriPath can harness additional information provided by 3D tissue morphology. - The performance is also superior to clinical baselines from a reader study that involved six expert pathologists. - The morphologically heterogeneous tissue volume could lead to opposing patient-level outcome predictions, dependent on which portion of the tissue volume is used. This concurs with current clinical literature warning that tissue sampling bias can lead to misdiagnosis. Some limitations: - While the 3D pathology cohort size is unprecedented, it is smaller than typical 2D pathology cohorts. Further large-scale studies will be required for validation. Nevertheless, we believe that this study will initiate a positive cycle, encouraging academic institutions and pharmaceutical companies to contribute large banks of human tissue blocks with paired clinical outcomes, thus speeding up advancements in 3D computational pathology. Concluding insights: We believe that 3D pathology is just around the corner - It has the huge potential to not only augment/improve the current clinical practice centered around 2D examination of human tissue, but also help reveal novel biomarkers for prognosis and therapeutic response.. Harvard Medical School Harvard Data Science Initiative Mass General Brigham Broad Institute

Faisal Mahmood

65,541 Aufrufe • vor 2 Jahren

Tyrannotitan now released in Path of Titans! Introducing the Tyrannotitan, a massive bloodthirsty predator from the early Cretaceous period. This carnivore rivals even Tyrannosaurus and Spinosaurus in size, and is one of the most powerful dinosaurs in the Path of Titans roster. Tyrannotitan is our 'mobile' colossal predator, using bleed and attrition to bring down its prey. It can weaken its opponent's ability to heal, and uses its fairly nimble maneuvering to dodge incoming attacks. This video is a re-upload of the previous video that excludes information that is now outdated, please read on for a full explanation! We're excited to release Tyrannotitan earlier than originally planned as it was originally scheduled for after the full game launch. We knew having the "Titan" in "Path of Titans" was a must-have. This content was originally intended to be purchased separately in a bundle, however due to community feedback we have decided to make it included for free if you already own the "All Base Game Dinosaurs" pack. This also includes the Tyrannotitan Backer skin also being included for free in the "All Backer Skins" bundle. If you purchased the bundle for full-price while it was for sale, you can request a refund through Alderon Games support. This can either be refunded to a Path of Tians coin balance, or payment method depending on what is possible. However, if you would like to keep your bundle, we plan on turning the pack into a skin bundle with 2 additional skins instead, so it is more in line with our other skin packs. We will be making a follow up post very soon with more information about the skins for this bundle that will be included with the next hotpatch. We apologize for the miscommunication around this launch, and we have made changes based upon community feedback. We will announce our future goals on how we plan on handling our post release content, but for now, instead let's enjoy this new dinosaur, and we will focus on releasing the remaining planned dinosaurs and dinosaur TLCs as among our highest priorities. #pathoftitans #dinosaurs
3:05

Tyrannotitan now released in Path of Titans! Introducing the Tyrannotitan, a massive bloodthirsty predator from the early Cretaceous period. This carnivore rivals even Tyrannosaurus and Spinosaurus in size, and is one of the most powerful dinosaurs in the Path of Titans roster. Tyrannotitan is our 'mobile' colossal predator, using bleed and attrition to bring down its prey. It can weaken its opponent's ability to heal, and uses its fairly nimble maneuvering to dodge incoming attacks. This video is a re-upload of the previous video that excludes information that is now outdated, please read on for a full explanation! We're excited to release Tyrannotitan earlier than originally planned as it was originally scheduled for after the full game launch. We knew having the "Titan" in "Path of Titans" was a must-have. This content was originally intended to be purchased separately in a bundle, however due to community feedback we have decided to make it included for free if you already own the "All Base Game Dinosaurs" pack. This also includes the Tyrannotitan Backer skin also being included for free in the "All Backer Skins" bundle. If you purchased the bundle for full-price while it was for sale, you can request a refund through Alderon Games support. This can either be refunded to a Path of Tians coin balance, or payment method depending on what is possible. However, if you would like to keep your bundle, we plan on turning the pack into a skin bundle with 2 additional skins instead, so it is more in line with our other skin packs. We will be making a follow up post very soon with more information about the skins for this bundle that will be included with the next hotpatch. We apologize for the miscommunication around this launch, and we have made changes based upon community feedback. We will announce our future goals on how we plan on handling our post release content, but for now, instead let's enjoy this new dinosaur, and we will focus on releasing the remaining planned dinosaurs and dinosaur TLCs as among our highest priorities. #pathoftitans #dinosaurs

Path of Titans

43,507 Aufrufe • vor 1 Jahr

Brianne Dressen had never reacted to a vaccine in her life. Fully vaccinated, no problem, ever. Then she volunteered for the AstraZeneca COVID-19 trial, and within an hour of the shot, her body turned on her. "When I got my COVID vaccine, my reaction started within an hour, and it started with tingling down the same arm as my injection and moved to my other arm, then it moved to my legs, and then it moved to my head, into my brain and I had this horrific electrical pulsating sensation through my body 24/7." The list kept growing: extreme leg weakness, incontinence, dizzy spells, brain fog, confusion, dissociation, depression. The first time she ever passed out in her life was after the shot. The doctors had no answers. Only more drugs. "The doctors didn't know what to do with it, so they just drugged me up with all kinds of medications that are supposed to help nerve pain, but really all it did is just make me a zombie." "So then I didn't feel the nerve pain, but I also couldn't feel anything else. I didn't even know I was in a room sitting up or if I was in bed laying down." "It was not a good way to exist."
1:28

Brianne Dressen had never reacted to a vaccine in her life. Fully vaccinated, no problem, ever. Then she volunteered for the AstraZeneca COVID-19 trial, and within an hour of the shot, her body turned on her. "When I got my COVID vaccine, my reaction started within an hour, and it started with tingling down the same arm as my injection and moved to my other arm, then it moved to my legs, and then it moved to my head, into my brain and I had this horrific electrical pulsating sensation through my body 24/7." The list kept growing: extreme leg weakness, incontinence, dizzy spells, brain fog, confusion, dissociation, depression. The first time she ever passed out in her life was after the shot. The doctors had no answers. Only more drugs. "The doctors didn't know what to do with it, so they just drugged me up with all kinds of medications that are supposed to help nerve pain, but really all it did is just make me a zombie." "So then I didn't feel the nerve pain, but I also couldn't feel anything else. I didn't even know I was in a room sitting up or if I was in bed laying down." "It was not a good way to exist."

Epoch Health

14,663 Aufrufe • vor 5 Tagen

👤: What have you learned from each other? 🐒: For me, I’ve picked up on how quiet she is when she works. I mean, that’s just her natural vibe, she’s not even trying to be quiet, it's just who she is. So, I’ve actually changed because of it. It’s not that I’ve become grumpy or less friendly, it’s just that I’m learning to hold back my words and really focus on what’s right in front of me. I used to have this habit of feeling like I had to entertain the crew and keep everyone hyped up, which just left me completely drained by the end of the day. We can still chat and mess around while getting our makeup done or during breaks, but once we’re actually on set, I don’t really need to talk with anyone. It really helps save my battery, keeps me grounded, and lets me focus on the job. 🦙: For me, I've learned how to loosen up and relax more while working. Before this, I used to feel like, 'Okay, I'm here to work now, so everything has to be serious and I have to get things done strictly in order: “one, two, three, four”’. But Jayna is so playful and loves to chat. She’ll talk to absolutely everyone, and it makes the whole atmosphere on set so much better. Once I tried opening up and chatting more, I realized that coming to work each day feels a lot happier. It doesn't feel as stressful as just 'showing up to do a job.' Now, we can joke around on set and with each other, and chat with the makeup and hair stylists. 🐒: so basically, 🦙: we swapped! 🐒: exactly. I talk less because of her and she talks more because of me 🦙: yes exactly #GinJay #ginnynatnicha #aangelinaass #EveryMomentwithGinnyJayna
1:46

👤: What have you learned from each other? 🐒: For me, I’ve picked up on how quiet she is when she works. I mean, that’s just her natural vibe, she’s not even trying to be quiet, it's just who she is. So, I’ve actually changed because of it. It’s not that I’ve become grumpy or less friendly, it’s just that I’m learning to hold back my words and really focus on what’s right in front of me. I used to have this habit of feeling like I had to entertain the crew and keep everyone hyped up, which just left me completely drained by the end of the day. We can still chat and mess around while getting our makeup done or during breaks, but once we’re actually on set, I don’t really need to talk with anyone. It really helps save my battery, keeps me grounded, and lets me focus on the job. 🦙: For me, I've learned how to loosen up and relax more while working. Before this, I used to feel like, 'Okay, I'm here to work now, so everything has to be serious and I have to get things done strictly in order: “one, two, three, four”’. But Jayna is so playful and loves to chat. She’ll talk to absolutely everyone, and it makes the whole atmosphere on set so much better. Once I tried opening up and chatting more, I realized that coming to work each day feels a lot happier. It doesn't feel as stressful as just 'showing up to do a job.' Now, we can joke around on set and with each other, and chat with the makeup and hair stylists. 🐒: so basically, 🦙: we swapped! 🐒: exactly. I talk less because of her and she talks more because of me 🦙: yes exactly #GinJay #ginnynatnicha #aangelinaass #EveryMomentwithGinnyJayna

พิ้งค์กี้(Pinky)

15,663 Aufrufe • vor 2 Monaten

𝗩𝗜𝗗𝗘𝗢: '𝗪𝗵𝗲𝗻 𝗬𝗼𝘂 𝗛𝗲𝗮𝗿 𝗘𝗽𝗶𝗱𝘂𝗿𝗮𝗹, 𝗥𝘂𝗻,' 𝗧𝗼𝘆𝗶𝗻 𝗟𝗮𝘄𝗮𝗻𝗶 𝗪𝗮𝗿𝗻𝘀 𝗘𝘅𝗽𝗲𝗰𝘁𝗮𝗻𝘁 𝗠𝗼𝘁𝗵𝗲𝗿𝘀 Fashion and beauty entrepreneur, Toyin Lawani, has opened up about her experience with epidural anesthesia, an injection administered to pregnant women in the spine to relieve pain during childbirth. In a video posted online on Tuesday, the mother of three revealed that since receiving the injection, she has not felt like herself. She claimed that doctors do not fully inform women about the long-term side effects of epidurals. According to Lawani, she has been suffering from severe back pain and spinal degeneration since receiving the anesthetic injection during the birth of her last two children. She said, "When you hear 'epidural,' run. Doctors tell you about the side effects but do not tell you about the long term effects on your body. I have about three friends having the same issues that I am having. "Like, I am just 42, how did I end up with spine issues? I have a degenerating spine. I have implants in my spine. I go paralyzed. I can't stand for a long time. I can't even breath properly some times because it affected so many things in my body when I had the surgery. "They will not tell you because you just want the pain to go away. I have had two epidurals. I had my first as natural birth. The last two were epidural. The last one I had epidural because I had to undergo a surgery and I had no choice. "See, the pain does not stop. My back is killing me and my spine is degenerating.'' --- Follow us for more breaking news and videos
2:13

𝗩𝗜𝗗𝗘𝗢: '𝗪𝗵𝗲𝗻 𝗬𝗼𝘂 𝗛𝗲𝗮𝗿 𝗘𝗽𝗶𝗱𝘂𝗿𝗮𝗹, 𝗥𝘂𝗻,' 𝗧𝗼𝘆𝗶𝗻 𝗟𝗮𝘄𝗮𝗻𝗶 𝗪𝗮𝗿𝗻𝘀 𝗘𝘅𝗽𝗲𝗰𝘁𝗮𝗻𝘁 𝗠𝗼𝘁𝗵𝗲𝗿𝘀 Fashion and beauty entrepreneur, Toyin Lawani, has opened up about her experience with epidural anesthesia, an injection administered to pregnant women in the spine to relieve pain during childbirth. In a video posted online on Tuesday, the mother of three revealed that since receiving the injection, she has not felt like herself. She claimed that doctors do not fully inform women about the long-term side effects of epidurals. According to Lawani, she has been suffering from severe back pain and spinal degeneration since receiving the anesthetic injection during the birth of her last two children. She said, "When you hear 'epidural,' run. Doctors tell you about the side effects but do not tell you about the long term effects on your body. I have about three friends having the same issues that I am having. "Like, I am just 42, how did I end up with spine issues? I have a degenerating spine. I have implants in my spine. I go paralyzed. I can't stand for a long time. I can't even breath properly some times because it affected so many things in my body when I had the surgery. "They will not tell you because you just want the pain to go away. I have had two epidurals. I had my first as natural birth. The last two were epidural. The last one I had epidural because I had to undergo a surgery and I had no choice. "See, the pain does not stop. My back is killing me and my spine is degenerating.'' --- Follow us for more breaking news and videos

Punch Newspapers

41,399 Aufrufe • vor 1 Jahr

I am so fortunate to still play tennis at my age. But there sure is a lot of (completely worth it) prep work involved! Here's some background on my pre-tennis routine from this video: 1. Put on two braces: one on each knee 2. Switch to my tennis glasses, and l always carry a backup pair with me, just in case. One pair is a throwback to my favorite pair from the 1970s 3. Wear gloves, both to protect my hands from sun, and also to help with carpal tunnel 4. Use exercise bands to warm up shoulders, triceps, and biceps for forehands/ backhands. 60 reps for each 5. Perform 20 squats + stretching. And an important tip: Watch the ball all the way to the contact point. At the pro level, 50% of balls are missed because of not watching the ball all the way to the contact point. At the rec level, it's 90%. Get out there and play!
0:41

I am so fortunate to still play tennis at my age. But there sure is a lot of (completely worth it) prep work involved! Here's some background on my pre-tennis routine from this video: 1. Put on two braces: one on each knee 2. Switch to my tennis glasses, and l always carry a backup pair with me, just in case. One pair is a throwback to my favorite pair from the 1970s 3. Wear gloves, both to protect my hands from sun, and also to help with carpal tunnel 4. Use exercise bands to warm up shoulders, triceps, and biceps for forehands/ backhands. 60 reps for each 5. Perform 20 squats + stretching. And an important tip: Watch the ball all the way to the contact point. At the pro level, 50% of balls are missed because of not watching the ball all the way to the contact point. At the rec level, it's 90%. Get out there and play!

Billie Jean King

47,368 Aufrufe • vor 1 Jahr

🐻‍❄️ Last year I was diagnosed with myocarditis. Since it’s a heart condition, it wasn’t something minor or easygoing. If I had gone to the doctor later than I did, I might not even be here now. At the time, I just felt unwell overall. Luckily, I went to the hospital in time and they found it early enough. Back then, my hearing in my left ear dropped. It felt muffled and tight, then my heart started racing. On March 4, I had slept very little and also drank a lot of green tea. Suddenly my heart started fluttering again. It felt exactly like before, and it happened right around the one-year mark. About two weeks before the concert, my left ear also went out, and I had a bit of vertigo too. It felt very similar to last time, so I got worried and went to see a doctor. After the checkup, they did not find anything clearly specific, so the doctor told me to rest more. The symptoms got better, but my hearing still has not fully returned. My ear still feels blocked, like there is a wall in front of it. I cannot hear clearly on that side, so I have to rely more on the other ear instead. Right now I am monitoring the symptoms for a month. It seems like when I do not get enough rest, blood flow may not be reaching my ear properly. I feel upset with myself because last time I went to the doctor too late due to carelessness. So now I have to take better care of myself than before. If I feel unwell, I go to the doctor right away. Lately, I have also been finding it harder to sleep. It is not like one or two years ago, when I could fall asleep easily. Now, even if I do fall asleep, once I wake up, I cannot go back to sleep again. Right now we are filming A Dog and A Plane, but P’Tay is currently in Paris for Fashion Week, so filming is on pause and I get to rest for a bit, which is fortunate. As for today, I came to work. The hearing loss in my left ear has not really affected my work. I can still hear, just much less than before, but I can still understand what people are saying. I really want to recover soon because I feel like it is harder to keep my balance. It feels strange, like something is blocking on my left side. It feels blocked and muffled, hard to explain. I will keep monitoring it, so please do not worry. I will recover as soon as I can and I will rest more. I have sleeping pills now, but they do not help that much. I still wake up anyway. I will take good care of myself and get better soon, so please do not worry. NEWWIEE AT SUMMER THE MALL BANGKAPI #THEMALLSUMMER2026xNEWWIEE #Newwiee
5:49

🐻‍❄️ Last year I was diagnosed with myocarditis. Since it’s a heart condition, it wasn’t something minor or easygoing. If I had gone to the doctor later than I did, I might not even be here now. At the time, I just felt unwell overall. Luckily, I went to the hospital in time and they found it early enough. Back then, my hearing in my left ear dropped. It felt muffled and tight, then my heart started racing. On March 4, I had slept very little and also drank a lot of green tea. Suddenly my heart started fluttering again. It felt exactly like before, and it happened right around the one-year mark. About two weeks before the concert, my left ear also went out, and I had a bit of vertigo too. It felt very similar to last time, so I got worried and went to see a doctor. After the checkup, they did not find anything clearly specific, so the doctor told me to rest more. The symptoms got better, but my hearing still has not fully returned. My ear still feels blocked, like there is a wall in front of it. I cannot hear clearly on that side, so I have to rely more on the other ear instead. Right now I am monitoring the symptoms for a month. It seems like when I do not get enough rest, blood flow may not be reaching my ear properly. I feel upset with myself because last time I went to the doctor too late due to carelessness. So now I have to take better care of myself than before. If I feel unwell, I go to the doctor right away. Lately, I have also been finding it harder to sleep. It is not like one or two years ago, when I could fall asleep easily. Now, even if I do fall asleep, once I wake up, I cannot go back to sleep again. Right now we are filming A Dog and A Plane, but P’Tay is currently in Paris for Fashion Week, so filming is on pause and I get to rest for a bit, which is fortunate. As for today, I came to work. The hearing loss in my left ear has not really affected my work. I can still hear, just much less than before, but I can still understand what people are saying. I really want to recover soon because I feel like it is harder to keep my balance. It feels strange, like something is blocking on my left side. It feels blocked and muffled, hard to explain. I will keep monitoring it, so please do not worry. I will recover as soon as I can and I will rest more. I have sleeping pills now, but they do not help that much. I still wake up anyway. I will take good care of myself and get better soon, so please do not worry. NEWWIEE AT SUMMER THE MALL BANGKAPI #THEMALLSUMMER2026xNEWWIEE #Newwiee

WittySmirK

77,016 Aufrufe • vor 5 Monaten

Some stories are too painful to watch. But this one? It was too painful to write. Omoshalewa was in law school when her life was first interrupted in 2014. What started as a sharp stomach pain quickly turned into an ovarian cyst and a hospital that left her on a bench, unattended for hours. Since then, she’s had 14 surgeries. Fourteen. Each one promised relief. Each one offered a bit of hope. But the pain always came back stronger, stranger, harder to name. By 2021, she was being injected with Kenalog-40 daily which led to her skin changing and her memory declining. Later on, she found out that she had Cushing’s Syndrome: A result of long-term steroid overuse. She passed out in her sleep, choked on saliva and developed necrosis in both hips. But through it all? She kept working, asking questions and more. What struck me most wasn’t just the trauma. It was how often she was dismissed, told to pray more and told that her symptoms were imaginary. Omoshalewa’s story is not rare. That’s the part that should scare us. Because beneath the medical errors and systemic failures… Is a young woman who just wanted to breathe without pain. We talk about reform. But real reform starts with respect. With humility. With care that doesn’t punish people for surviving. If you’re a health worker reading this, I hope it reminds you that every patient has a story. And sometimes, their life depends on whether you listen. Find the full video on Aproko Doctor TV on Youtube
1:37

Some stories are too painful to watch. But this one? It was too painful to write. Omoshalewa was in law school when her life was first interrupted in 2014. What started as a sharp stomach pain quickly turned into an ovarian cyst and a hospital that left her on a bench, unattended for hours. Since then, she’s had 14 surgeries. Fourteen. Each one promised relief. Each one offered a bit of hope. But the pain always came back stronger, stranger, harder to name. By 2021, she was being injected with Kenalog-40 daily which led to her skin changing and her memory declining. Later on, she found out that she had Cushing’s Syndrome: A result of long-term steroid overuse. She passed out in her sleep, choked on saliva and developed necrosis in both hips. But through it all? She kept working, asking questions and more. What struck me most wasn’t just the trauma. It was how often she was dismissed, told to pray more and told that her symptoms were imaginary. Omoshalewa’s story is not rare. That’s the part that should scare us. Because beneath the medical errors and systemic failures… Is a young woman who just wanted to breathe without pain. We talk about reform. But real reform starts with respect. With humility. With care that doesn’t punish people for surviving. If you’re a health worker reading this, I hope it reminds you that every patient has a story. And sometimes, their life depends on whether you listen. Find the full video on Aproko Doctor TV on Youtube

Dr. Chinonso Egemba

24,690 Aufrufe • vor 1 Jahr

exactly one year & hundreds of posts later, this account has been dedicated to posting exclusively all things wicked. as of now, i don't know if or when i will next post, and this well may be my last one. with the wicked films all wrapped up, i have no more news to provide. additionally, i have posted almost all of the extra content that i wanted to post, such as comparisons, parallels, and those sorts of things. i may briefly return once the ozma film becomes relevant if it happens, as i am looking forward to that. running this account has probably been the, or at least one of the, most fulfilling things i've ever had the pleasure of doing, and that is not an exaggeration. quite honestly, it vastly improved my quality of life. i will continue to reflect on the last 2 or so years of my life (especially the last 12 months) every single day, just as i already do. wicked will forever be a part of me. lastly, i'd like to thank everyone who followed me or followed along with my posts. it was so fun being the first to post new information/unseen movie clips and seeing everyone's reaction. and i want to especially thank all of those whom i spoke with in DMs, as those individuals made this whole experience even more important to me. i was going to keep this post under 280 characters, but as it turns out, that was clearly not possible lol. thank you all once again, and in case this is truly my last post, i wish you all a wicked good rest of your lives.
0:45

exactly one year & hundreds of posts later, this account has been dedicated to posting exclusively all things wicked. as of now, i don't know if or when i will next post, and this well may be my last one. with the wicked films all wrapped up, i have no more news to provide. additionally, i have posted almost all of the extra content that i wanted to post, such as comparisons, parallels, and those sorts of things. i may briefly return once the ozma film becomes relevant if it happens, as i am looking forward to that. running this account has probably been the, or at least one of the, most fulfilling things i've ever had the pleasure of doing, and that is not an exaggeration. quite honestly, it vastly improved my quality of life. i will continue to reflect on the last 2 or so years of my life (especially the last 12 months) every single day, just as i already do. wicked will forever be a part of me. lastly, i'd like to thank everyone who followed me or followed along with my posts. it was so fun being the first to post new information/unseen movie clips and seeing everyone's reaction. and i want to especially thank all of those whom i spoke with in DMs, as those individuals made this whole experience even more important to me. i was going to keep this post under 280 characters, but as it turns out, that was clearly not possible lol. thank you all once again, and in case this is truly my last post, i wish you all a wicked good rest of your lives.

Wicked Info

15,205 Aufrufe • vor 1 Monat

LSU’s senior Captain greg brooks was recently diagnosed with brain cancer, and the outpouring of love has been amazing. The optimism held by those that root for him, his LSU Football Tigers, and just hood people winning has been moving. Still, Greg’s fight can’t be won by support or optimistic thinking. His mother & father have seen the worst of it; from fetal positions are the floor before his brain tumor was removed to now Greg not being able to speak nor stand up. There is so much pain, death, sadness in each room on the floor of his ICU that you can’t help but think “this kid doesn’t not belong here, he just played 65 snaps Vs FSU”. I know we all want him to fight like a Tiger but it will take more than that, & the reality of seeing him reminds you in the most devastating way. Pivot Podcast is Live now on YouTube!! #PrayFor3
3:57

LSU’s senior Captain greg brooks was recently diagnosed with brain cancer, and the outpouring of love has been amazing. The optimism held by those that root for him, his LSU Football Tigers, and just hood people winning has been moving. Still, Greg’s fight can’t be won by support or optimistic thinking. His mother & father have seen the worst of it; from fetal positions are the floor before his brain tumor was removed to now Greg not being able to speak nor stand up. There is so much pain, death, sadness in each room on the floor of his ICU that you can’t help but think “this kid doesn’t not belong here, he just played 65 snaps Vs FSU”. I know we all want him to fight like a Tiger but it will take more than that, & the reality of seeing him reminds you in the most devastating way. Pivot Podcast is Live now on YouTube!! #PrayFor3

Ryan Clark

428,365 Aufrufe • vor 2 Jahren

** Sega MD 3D engine update 7 ** Speed up rendering by another 15-20 % ! Massive unrolling of the line drawing hotpath has seen a good pickup in the rendering although further improvements are needed , particularly for small triangles as most of the overhead is not in the drawing ( more time in setup vs drawing ) . Added partial drawing of Quads , this was a major pain due to all the edge cases , as Quads are basically a triangle top (optional) - a middle trapezium and a bottom triangle (optional) and any part can be clipped or offscreen . Implemented a frame pacing algorithm for the camera so as Frame rate fluctuates with detail the forward Z rate is altered, its as bit janky still . Track control just snaps back to position after it runs through a short sequence. Work continues on Parodius and we have some cool things to show in a video soon . #SGDK #SegaGenesis #MegaDrive
0:24

** Sega MD 3D engine update 7 ** Speed up rendering by another 15-20 % ! Massive unrolling of the line drawing hotpath has seen a good pickup in the rendering although further improvements are needed , particularly for small triangles as most of the overhead is not in the drawing ( more time in setup vs drawing ) . Added partial drawing of Quads , this was a major pain due to all the edge cases , as Quads are basically a triangle top (optional) - a middle trapezium and a bottom triangle (optional) and any part can be clipped or offscreen . Implemented a frame pacing algorithm for the camera so as Frame rate fluctuates with detail the forward Z rate is altered, its as bit janky still . Track control just snaps back to position after it runs through a short sequence. Work continues on Parodius and we have some cool things to show in a video soon . #SGDK #SegaGenesis #MegaDrive

Shannon Birt

18,004 Aufrufe • vor 2 Monaten

Awakening "inner fire" to completely make gall bladder polyps disappear is the new rubbish "medinfluencer" Ayurveda practitioners are bringing to town. Do not for a second believe this nonsense. "Before" and "After" reports based on anecdotal, single patient "stories" are a common tactic by alternative medicine practitioners to mislead people into believing that their voodoo treatments work. In fact, I know of a Homeopathy practitioner, who famously "cured" patients with chronic hepatitis B virus infection by simply changing the positive report to a negative one using Adobe Photoshop. The same can be true here too. Please do not believe or opt for pseudoscientific alternative treatments for diseases that require realistic care based on "before and after" social media stories. The reports may be manipulated or it could be another patient's report - which is possible in this video too. Removal of gall bladder is a best option and curative treatment for certain gall bladder diseases. Removing the gall bladder does not increase pressure on the liver (trust me, I am a Liver Doctor) and does not make the liver "work hard!" Removing the gall bladder will anatomically change the storage of bile produced by the liver to the upper part of small intestine and nothing more. This does not affect the functioning of the liver in any way. All gall bladder polyps do not require surgical management. Here is what the science has to say on it. To oversimplify: Polyps even in the absence of symptoms, smaller than 10 mm do have the capacity to become cancerous and surgery is recommended when patient has one of more risk factors such as: age more than 60 years, history of primary sclerosing cholangitis (PSC), Asian ethnicity, sessile polypoid lesion (including focal gallbladder wall thickening > 4 mm). For polyps smaller than 10 mm without risk factors, a follow-up at 6 months, 1 year and 2 years with abdominal ultrasound seems to be appropriate. The indication for gall bladder removal should be discussed with the patient in the case of dynamic or unexpected polyp growth. Here is a very detailed and simple guideline on when to surgically manage gall bladder polyps (and no, it does not mention "inner fire or AGNI awakening.") Also please go and educate this Ayurvedic practitioner and reel poster on the real thing:
1:00

Awakening "inner fire" to completely make gall bladder polyps disappear is the new rubbish "medinfluencer" Ayurveda practitioners are bringing to town. Do not for a second believe this nonsense. "Before" and "After" reports based on anecdotal, single patient "stories" are a common tactic by alternative medicine practitioners to mislead people into believing that their voodoo treatments work. In fact, I know of a Homeopathy practitioner, who famously "cured" patients with chronic hepatitis B virus infection by simply changing the positive report to a negative one using Adobe Photoshop. The same can be true here too. Please do not believe or opt for pseudoscientific alternative treatments for diseases that require realistic care based on "before and after" social media stories. The reports may be manipulated or it could be another patient's report - which is possible in this video too. Removal of gall bladder is a best option and curative treatment for certain gall bladder diseases. Removing the gall bladder does not increase pressure on the liver (trust me, I am a Liver Doctor) and does not make the liver "work hard!" Removing the gall bladder will anatomically change the storage of bile produced by the liver to the upper part of small intestine and nothing more. This does not affect the functioning of the liver in any way. All gall bladder polyps do not require surgical management. Here is what the science has to say on it. To oversimplify: Polyps even in the absence of symptoms, smaller than 10 mm do have the capacity to become cancerous and surgery is recommended when patient has one of more risk factors such as: age more than 60 years, history of primary sclerosing cholangitis (PSC), Asian ethnicity, sessile polypoid lesion (including focal gallbladder wall thickening > 4 mm). For polyps smaller than 10 mm without risk factors, a follow-up at 6 months, 1 year and 2 years with abdominal ultrasound seems to be appropriate. The indication for gall bladder removal should be discussed with the patient in the case of dynamic or unexpected polyp growth. Here is a very detailed and simple guideline on when to surgically manage gall bladder polyps (and no, it does not mention "inner fire or AGNI awakening.") Also please go and educate this Ayurvedic practitioner and reel poster on the real thing:

TheLiverDoc™

72,092 Aufrufe • vor 2 Jahren

The fact #MilagroGramz made this because she’s upset that the white republicans are being propped up for the propaganda and getting more attention than what she did is funny to me . Remember you put Megan a Black woman who was a victim on the frontlines of your hatred? You attacked her for everything and currently still is even when it has nothing to do with that case you did it in front of the very white ppl that you are jealous of ….now you’re mad cause you’re not getting attention . Also idk why you’re upset all y’all are the same lol imo Getting on Stationhead to sub Tory for talking to the white republicans is funny but front online so his Stan’s & WrittenByRay won’t see it lol someone gonna post that audio you just did I’m quite sure of it #opinionatedtruthspodcast #nosympathy !! Cry your ssa a River dusty !! Mythoughts&opinions
0:53

The fact #MilagroGramz made this because she’s upset that the white republicans are being propped up for the propaganda and getting more attention than what she did is funny to me . Remember you put Megan a Black woman who was a victim on the frontlines of your hatred? You attacked her for everything and currently still is even when it has nothing to do with that case you did it in front of the very white ppl that you are jealous of ….now you’re mad cause you’re not getting attention . Also idk why you’re upset all y’all are the same lol imo Getting on Stationhead to sub Tory for talking to the white republicans is funny but front online so his Stan’s & WrittenByRay won’t see it lol someone gonna post that audio you just did I’m quite sure of it #opinionatedtruthspodcast #nosympathy !! Cry your ssa a River dusty !! Mythoughts&opinions

OPINIONATED_TRUTHS_PODCAST™️

26,516 Aufrufe • vor 1 Jahr

MUST LISTEN: Congress Rep Chip Roy Exposes How Corrupt US Government Has Become “I’ll be damned if I'm going to empower a government to extend beyond its constitutional limits” “Government that is now tyrannically using its power to: - Go after the American people - Go after former politicians, including the former president - That is spending money we don't have - That is using that power to regulate us to death on virtually every bill that virtually every Republican on this side of the aisle that claims to be a limited government conservative votes for Why? Because they don't want the Fraternal Order of Police or other law enforcement organizations to come after them.” “Over the last 16 months, there's been a battle which represents the larger war brewing within the Republican Party because unfortunately my colleagues on the other side of the aisle are so far gone, down the rabbit hole of radical progressive policies that absolutely destroy our country every single day, littering our country with regulations, littering our country with all sorts of crime, littering our country with open borders, engaging in endless wars. All of the stuff that is happening because our Democratic colleagues are frankly undermining the American dream and undermining Western civilization and undermining everything we hold dear. There's been a battle going on for the soul of the party in the country within the Republican Party. And I want to tell you, I'm not in the majority. I'm not. Say, Chip, you're in the majority in the House. You have a razor-thin majority. No, I'm not. I'm not in the majority. I'm in the minority. A minority of Republicans who try to wake up here and change this place rather than just campaign on it.” “I work for 750,000 Texans. I respond to them, to God, and the Constitution of the United States. I do not work for anybody in this chamber. I do not work for any organization. I don't work for any donor. I work for the people and I work for a people who are sick and damn tired of this institution run by a bunch of people who campaign saying one thing and they get here and do another.” “34.5 trillion of debt, $1 trillion every three months. We already spend more on interest than our defense. We're about to crack $1 trillion of interest. They say we will hit $2 to $3 trillion of interest by 2030. - Our borders are wide open - We have kids dying. We had Austin, Texas. Four more people the other night died from fentanyl poisoning. Bunch of others had to be resuscitated with Narcan. The people of Texas are continuing to deal with thousands of people pouring across the border. It's not in the headlines right now because universities are in the headlines. But everybody in Texas who are reeling from inflation, who can't afford a car, who can't afford their home, who can't afford the interest on their mortgage, who can't afford to buy groceries, who are dealing with crime on their streets, who are dealing with open borders, they all want some sort of sanity coming out of this institution. And what do we do? What do Republicans do in all of their infinite wisdom? We fund more of it. We fund the Department of Homeland Security again. We give the FBI a brand new $200 million headquarters. You can't even make this stuff up. We give more power to the intelligence community to spy on Americans. Don't even protect Americans with warrants. You can't even make it up.“
4:45

MUST LISTEN: Congress Rep Chip Roy Exposes How Corrupt US Government Has Become “I’ll be damned if I'm going to empower a government to extend beyond its constitutional limits” “Government that is now tyrannically using its power to: - Go after the American people - Go after former politicians, including the former president - That is spending money we don't have - That is using that power to regulate us to death on virtually every bill that virtually every Republican on this side of the aisle that claims to be a limited government conservative votes for Why? Because they don't want the Fraternal Order of Police or other law enforcement organizations to come after them.” “Over the last 16 months, there's been a battle which represents the larger war brewing within the Republican Party because unfortunately my colleagues on the other side of the aisle are so far gone, down the rabbit hole of radical progressive policies that absolutely destroy our country every single day, littering our country with regulations, littering our country with all sorts of crime, littering our country with open borders, engaging in endless wars. All of the stuff that is happening because our Democratic colleagues are frankly undermining the American dream and undermining Western civilization and undermining everything we hold dear. There's been a battle going on for the soul of the party in the country within the Republican Party. And I want to tell you, I'm not in the majority. I'm not. Say, Chip, you're in the majority in the House. You have a razor-thin majority. No, I'm not. I'm not in the majority. I'm in the minority. A minority of Republicans who try to wake up here and change this place rather than just campaign on it.” “I work for 750,000 Texans. I respond to them, to God, and the Constitution of the United States. I do not work for anybody in this chamber. I do not work for any organization. I don't work for any donor. I work for the people and I work for a people who are sick and damn tired of this institution run by a bunch of people who campaign saying one thing and they get here and do another.” “34.5 trillion of debt, $1 trillion every three months. We already spend more on interest than our defense. We're about to crack $1 trillion of interest. They say we will hit $2 to $3 trillion of interest by 2030. - Our borders are wide open - We have kids dying. We had Austin, Texas. Four more people the other night died from fentanyl poisoning. Bunch of others had to be resuscitated with Narcan. The people of Texas are continuing to deal with thousands of people pouring across the border. It's not in the headlines right now because universities are in the headlines. But everybody in Texas who are reeling from inflation, who can't afford a car, who can't afford their home, who can't afford the interest on their mortgage, who can't afford to buy groceries, who are dealing with crime on their streets, who are dealing with open borders, they all want some sort of sanity coming out of this institution. And what do we do? What do Republicans do in all of their infinite wisdom? We fund more of it. We fund the Department of Homeland Security again. We give the FBI a brand new $200 million headquarters. You can't even make this stuff up. We give more power to the intelligence community to spy on Americans. Don't even protect Americans with warrants. You can't even make it up.“

Wall Street Apes

726,641 Aufrufe • vor 2 Jahren