Psychiatrist Dr. Mohammad Alsuwaidan
Surprise everyone! I’m not writing a rambling 3500 word post this week. Are you amazed? Grateful? I hope so! 😉 Consider it my early holiday gift to you…
Ever since we had a death in the family on September 6th, it has been tough around here. I wasn’t close to my brother-in-law, but my husband loved his brother very much. Some of you know what it’s like to be around deep grief, and it’s hard. Plus the specific circumstances of this death were awful.
In the past an event like that could’ve easily triggered my depression, but I’ve been able to avoid it this time. I’ve felt sad, overwhelmed, anxious, yes, but the Big D? (I’ve stopped using the silly term “black dog”.)
Meet Dr. Mohammad Alsuwaidan
I first became familiar with Dr. Alsuwaidan’s work through the International Society for Bipolar Disorders (a.k.a. ISBD) as well as my blogging friend Kitt O’Malley.
In 2014 Kitt provided her followers with a link to Dr. Alsuwaidan’s free ISBD webinar Exercise Treatment for Mood Disorders: A Neurobiological Rationale. Her post caught my eye and I clicked on that link.
Here Dr. Alsuwaidan describes his webinar:
More recently, studies have demonstrated positive effects of exercise in mood disorders (primarily unipolar depression). What remains unclear is the underlying brain biology. What are the neurobiological deficits that occur in bipolar disorder? Do we have proof that exercise works at these levels to alter brain function? How do we translate laboratory evidence into clinical realities? These are some of the questions that are addressed during this webinar.
That blurb got my attention. I started listening.
I usually am so all over the place I can’t focus on webinars, but I’m so glad I paid attention to that one.
While listening, something clicked. I started looking at exercise differently. This was profound, you see, because I’m a former American Council on Exercise certified personal trainer. That certification may sound flighty, but I assure you, it was hard-won. I struggled more studying for the A.C.E. exam than I did for my oral exam administered by a panel of literature professors in order to graduate from the University of California!
I was so glad I passed my A.C.E. exam that when I opened up my results, I actually burst into tears…
In my mid-20’s I worked in a French family-owned gym (i.e. a wacky place) for two years. When I wasn’t teaching 6:00 a.m. circuit training classes or training members, I handed out towels to a future billionaire (the founder of Netflix),the editor-in-chief and writing staff of Santa Cruz’s biggest newspaper, and many cultured, cool residents. I opened the gym five days a week, and I noticed these movers and shakers, many of whom I got know well and who seemed genuinely happy, worked out every day.
Suffice it to say, I’m aware of exercise basics. But I didn’t know anything about exercise’s potential for bipolar disorder and achieving mood stability the way that Dr. Alsuwaidan did.
His webinar and blog post about what exactly to do, exercise-wise (which I share below with his permission) has changed my life. I don’t want to sound like a commercial for pigfeed that claims it cures bipolar, because this form exercise is not a cure. I don’t burst into unicorn songs after each workout. But following Dr. Alsuwaidan’s advice helps keep me from going down into my own personal sinkhole, and I know you all understand the significance of that.
I work out almost daily, and life remains hard. But following these principles as much as I can makes me feel like I have some influence in dealing with a mental illness I despise.
If you’re struggling, I want you to join me now. I know it’s cold in most parts of the world, and it’s a particularly difficult time to begin working out – you can even complain to me about it here. I won’t bill you. Even better, you can announce your accomplishments to us. I’ll keep track of what you do and we’ll cheer you on.
In the past I would’ve burned out exercising daily or near-daily. But now I know there’s something I can do to truly help avoid suicide territory. If doing these workouts can help me avoid Dante’s Level 7, I’m going to do them.
I have support in order to exercise and I advise you get some too. Craig hangs out with the kids while I work out at night. They can watch themselves now, but I feel better if he’s around them. Lucy is so cute- she comes in and hangs out with me; that poor collie has to listen to my loud 80’s music but she wants to – go figure. I used to be a morning workout person, but this schedule fits better for now.
What makes ALL the difference apart from support, my Kindle & music, is that I have a home elliptical machine. By the way, while I love reading, friends tell me they can’t read on a machine or else it makes them dizzy/nauseous, but I hope you can try it, because it makes it much easier for me to exercise.
We’re going to pay Sears off for two more years for our elliptical, but that’s how it goes. I used to walk near the house, but this way the machine is right here, it’s safe to use at night, etc. Some friends tell me they can’t afford any exercise machine, yet I’ve noticed they buy all kinds of other things. So that’s something to consider. BUT there are other low-cost/no-cost options – you can also do a workout video or jump rope like Dr. Alsuwaidan has been known to do – he gives more suggestions below and in his webinar!
So here goes – even if you don’t listen to Dr. Alsuwaidan’s webinar, please read the following blog post. I’ll be really proud of you!
Dr. Alsuwaidan’s blog “Exercise & Mood Part 3: From Science to Action”
There is probably no one word that can sum up what people want in terms of emotional or mental health. Whether it be clients I meet in the clinic with a mood or anxiety disorder, or a friend or acquaintance asking for an opinion in a social setting, the theme of the question is common, but each one is different. However, I think there is one common thread that joins the questions and ONE word that captures 99% of what is ideally sought: STABILITY.
Those with recurring depressive episodes or mood swings want mood stability. Others with anxiety, nervousness or worry want calm stability. The frazzled, stressed, workaholics want relaxed stability. For many, achieving stability would make them happier, more productive, more sociable and have a better quality of life.
I don’t claim that exercise is the only way to achieve stability. There is no panacea. The correct treatment of all of the above situations is an individually tailored combination that could include medications, talk-therapy, lifestyle changes and other components but should ALWAYS include exercise.
Now let’s make the leap from the science we reviewed in the previous blog posts to action.
How do we “dose” exercise? What kind of exercise? What time should I exercise? For how long? How do I start and how do keep going?
For an easy reference I will summarize the answer in one sentence then explain the details and the fine tuning will come later. Remember here we are talking about the ‘dosing’ of exercise that changes the biology of the brain and not the number of packs in your abdominals! Although that might be a welcome side effect — if you are trying to achieve that, talk to a personal trainer. Here we are treating the brain and going after STABILITY.
Where the magic happens….I read many of your blogs on my Kindle; that’s why I don’t comment too much!
Exercise for 30 minutes 6 days a week at a high-impact level.
That’s it – simple, right?
Okay, okay, I know it is not that easy. So let me explain further by breaking it down into 3 rules.
Rule #1 — Exercise: For brain health, the exercise can be any type that suits you. It does NOT have to be weight-lifting or running on a treadmill. You do NOT have to go to a gym or use a workout DVD. Do any exercise that you enjoy. Swim, run, hike, climb, lift weights, tennis, basketball, soccer, yoga, cycling and on and on. Adapt the exercise to your body if your capacity is limited by physical needs or injuries, but anyone can do some sort of exercise unless you are fully paralyzed.
Rule #2–30 minutes 6 days a week: The bottom-line is that the research shows this is the average of the dose needed for the brain to adapt. Now, let’s break this rule down. First reactions are usually — 6 days?! That’s a lot! Yes it is, but we are only asking for 30 minutes. Think about it, how many hours a day do you sit at the internet or TV? 30 minutes is very short.
Dyane adds: “For those who usually work out an hour, the below section is the really important part to follow for long-term success!
In fact, DON’T do more than 30 minutes (unless you have a routine and have been doing this for years). Doing more will lead to inconsistency and skipping workout days. The science shows it is far better (at least for the brain) to be consistent in exercising most days of the week rather than spending an hour exercising 2 or 3 days a week. In fact, for you gym-goers if you think about it (and research also supports this) if you are spending more than 30 minutes at the gym then you are chatting and resting too much.
(photo added by Dyane)
Thirty minutes makes it harder to come up with excuses such as: There is no time! or I’m too busy! If you work a lot or travel, find 30 minutes to do some stretches, pushups, air-squats, jumping jacks etc. 30 focused minutes is all you need, Done! Six days too much? Fine – five days is the absolute minimum, but better to aim for 6 so that if you fall short then you have a day to save for later.
Rule # 3 — High Impact: For the scientists reading this that is 16 kcal/kg/week. What?? English please! Okay, so here is how I explain high-impact to people: For most of the 30 minutes you’re exercising you should be sweating and it should be difficult to speak in complete sentences without needing to catch your breath. This means you work hard for 30 minutes, then you are done. Walking doesn’t count unless it meets the criteria above. Commuting does not count! That is your normal energy expenditure. Remember we are trying to change the brain, and you can’t do that without effort.
Last few tips:
- You can exercise anytime in the day that fits your schedule. I find first thing in the morning works best because it is the time of day with the least demands on your schedule. Plus there is evidence this timing may have a more efficient effect than other timings. If it means you have to wake up 30 minutes earlier, then do it and just sleep 30 minutes earlier at night. No big deal. But if it doesn’t work just exercise at any time that’s the most important thing. Get it done.
- You can either start slow and build up to 6 days a week over a number of weeks or just pick a week and start. If you have started and stopped exercise routines in the past you’ll find this one is easier to maintain because it is more flexible. You can do anything as long as you break a sweat. Jumping rope is great if you don’t have a lot of equipment and can’t go to a gym. Keep telling yourself it’s only 30 minutes and just get up and do it.
- If you skip days and don’t exercise at least 5 days in a week don’t be discouraged and go back down to zero. Just start again. It is normal to stumble. I do all the time. The important thing is to keep the 30 minutes 6 days a week in your head and keep as close to that as you can. But the closer you are to that ‘dose’ the better the result will be.
Dr. Mohammad Alsuwaidan is a specialist psychiatrist at Mubarak Al-Kabeer Hospital in Kuwait and an Assisstant Professor of Psychiatry at both Kuwait University and the University of Toronto. He has trained at the University of Toronto, Stanford University and Johns Hopkins University. He is a Fellow of the Royal College of Physicians of Canada and a Diplomate of the American Board of Psychiatry and Neurology. More information at http://about.me/MoAlsuwaidan
Here’s the direct link to Dr. Alsuwaidan’s Medium.com site & blog:
Dyane’s memoir Birth of a New Brain – Healing from Postpartum Bipolar Disorder with a foreword by Dr. Walker Karraa (author of the acclaimed book Transformed by Postpartum Depression: Women’s Stories of Trauma and Growth) will be published by Post Hill Press in 2017.
Good advice! I can attest to the value of daily exercise. I go to the gym between 4-5 days a week (aiming for 6 times a week) and spend between 45-60 minutes there. (That includes the warmup and cool down time, and I don’t waste the time. My rest periods are minimal between weight-lifting sets. At 4 a.m., very few gymgoers want to chat; it’s mostly the serious body-builders or insomniacs there.) I’ve been doing this for years and it helps so much! Word to the wise: fuel your body adequately before and after, and drink plenty of water before/during/after exercise.
Wow – I’m so impressed with your commitment. 4 a.m. is not for the faint of heart! And yes, Laura,excellent advice about making sure you fuel up & drink water…not too much…but enough!I like the Mayo Clinic guidelines which state that the adequate intake for women is about 9 cups (2.2 liters or 74 oz. which sounds better!) of total beverages a day with an extra 1.5 to 2.5 cups (400 to 600 milliliters/13 oz-20oz) of water on the days you exercise. That sounds like a lot, doesn’t it? I used to pull that off easily but not lately, so I’m going to give it a shot again, especially since I take lithium. I remember I drank too much water years ago and diluted the lithium to under the therapeutic level, so that’s always a concern, for I became hypomanic.
ANYWAY……Dr. Alsuwaidan would be most pleased with your comment. 😉 Thanks so much for stopping by & sharing – I love hearing from you!
p.s. here’s a link to the Mayo Clinic article for the full explanation:
Oh, I’ve done the too much water thing, too. My sodium levels are slightly below normal (my doctor and psychiatrist keep careful eyes on it!) so drinking too much H2O isn’t good. I’d always restrained from sports drinks like Gatorade because of the sugar content, but my doctor reasoned that if I’m sweating that much and need to keep my sodium up, then I need Gatorade.
Well written daughter. Comprehensive and informative. But… Now as I approach 80 in 12 weeks I am happy just to be able to do the laundry in the garage of my apt. Bldg or make my bed! Do I have B: P. ? No but a host of other problems. 🎼🎼
You do much more than that!!!! Thanks for reading. XOXO
This is very informative. I remember reading a study a few years ago which supported that exercise helps us live longer. A key finding was that relatively small amounts of physical activity, such as 75 minutes of brisk walking per week, was associated with a gain of 1.8 years of life expectancy, which increases to 3.4-4.5 years as the amount of physical activity increased to 150-450 minutes per week.
BUT CONSISTENCY IS THE KEY!
Hi there bittersweet1976! It’s great to hear from you. Interesting findings indeed! That’s pretty amazing that the weekly walking translates in to living so much longer, not to mention the increased activity causing life expectancy to extend potentially up to 4&1/2 years. I’ll let my kids know that because they sometimes worry about Mommy dying – their uncle died in September, and their best friends lost their great grandmother the same month. (The great-grandmother was 97!!!! Drank wine every day and was lovingly, lovingly cared for by her retired daughter and son-in-law in their home!)
Love this post! I’ve always been an exerciser, but your previous post on this inspired me to get more consistent and strive for 6 days a week. Thanks again for the motivation! I’m off to do my workout now!
I’m so happy to read your comment about this! 🙂 Thanks for checking this post out for I know you’re already familiar with the material.I revised tit to include new links (the former ones no longer work) and of course provide y’all with some fresh ramblings.
I hope you had a great workout the other night! I’ll be SO cheering you on *when* (not if)
you up them to 6 days/week.
I’m trying to stick to 30 minutes min. because I kept overdoing it – for a while I was staying on the thing for 60 minutes, and that was going to lead me to burnout. My knees weren’t happy with that either. Arnica helps me with the pain, but still….
The good Dr. Alsuwaidan is right in advising quality/30 min. & not quantity.
Sending you big HUGS!!!!!!!!
And happy perspiring!
Great advice! When I was at the clinic a few weeks back j got to gym for 30 minutes every second day… Ok twice a week. It made a major change to my mood. The effects were also long lasting. I can feel my mood dipping because I haven’t continued with my workouts. Thank you for this post. I know you’ve preached about this great man before but I think it’s going to stick this time!
I’m going for a umbilical hernia(discovered this while doing sit ups at the gym) operation on 13 Nov so as soon as I can exercise I will be doing so.
Speedy recovery dear Yve
Hello lovely friend! You haven’t gotten your hernia repaired yet, so I hope you read this in time to know I’ll be thinking of you on the 13th! It *will* go well, and I’m glad you’re taking care of it. I have a friend who has needed a similar operation for months and she kept putting it off – her husband got quite sick and she had to care for him, etc. I know she was upset at not having it done. So I’m extra-glad you are taking good care of yourself.
You’ll get back into your workouts once you heal and get the doctor’s blessing. The fact you were working out so beautifully just a few weeks ago is awesome. I’ll check in with you about it! XOXOXOXOXOXOXO💪 Thanks for your comment! 💜
This… is great advice for anyone 🙂 Thank you.
You’re certainly someone who would know! :)))) And you’re right – this info. could really apply to anyone. It’s so cool to know that there’s a reason to do it apart from looking cute. (And there’s nothing wrong with that IF it’s a not-too-obsessive motivating force, right?) Great to hear from you, Joe!
Hey, you ‘respun’ this ….I think I just printed it out. I printed out every single link you gave me. You are really quite giving. I have to go send this critical application and need to lift today. Lifting is critical in preventing diabetes, I need to ask Google why that is. It’s not about weight. Oh, my Eating disorder piece just posted. https://www.facebook.com/InternationalBipolarFoundation/posts/10150592298469984 That is the Facebook link. I have one reply. Tonight, I am going to lie down and read everything you have ever sent me. I wrote to that editor you sent me a link to. My computer, social media and internet skills are not good. Heather sent me the link for the website posting. I was unable to make it live by right clicking and clicking on the drop down menu to ‘hyperlink.’ I have to go now I will read your two latest emails first. allison Date: Wed, 4 Nov 2015 17:51:18 +0000 To: firstname.lastname@example.org
Oh yes, I respun my web! Links in the previous post are no longer active, and while I still need to fix those, I figured I’d re-do this topic, since I now know about that 15 tag/category WordPress rule!!!!!! 😉 Gotta get this info. out there! And the tag thing works, as you know. I don’t know how many folks viewed the other exercise-related got last time, but I’m very happy with this time around and I know it’s because people know it exists.
Congrats on the ED piece with the International Bipolar Foundation, and good for you for having the courage to share about your experience with a wide audience. I know it’ll help people!!! you have your 💙 in the right place, Allison!
My new exercise program consists of going up or down the stairs an extra time every time I have to use the stairs, like on my morning commute. At least I don’t have to buy gym clothes for this. Like all my other usual daily activities, it can be performed in my pajamas. Hey, it’s a start. At least I do it several times daily.
For those of you who are able to do more, I say GO YOU!
Hi Janet! That’s awesome you’re using the stairs an additional time whenever you must use them. Stairs are *great* for improving strength and challenging ye olde heart muscle. Pajamas sound fun to me! And taking the stairs several times daily is nothing to sneeze at. Keep it up! 💪
Thanks for reading/commenting! Consider it your brain workout du jour! ;)))) 👍
This is golden. One of the reasons why you know this doctor is spot-on, is that he’s not trying to sell you anything. No drugs, no supplements, he’s not selling gym memberships. He’s just plain saying, THIS WILL BENEFIT YOU. And, I know from personal experience, I need the “exercise medicine” every single day!! I consider it a vital part of my treatment and I shoot for every single day. I am a very fast walker and that is good enough for me 🙂
You’re absolutely right – Dr. Alsuwaidan is NOT a charlatan and that’s a good, good sign! Every single day is AB FAB!👏
When I used to walk daily at the high school track or wherever, I started using an iPOD (which made all the difference-I loved my music) and when I started feeling better, I swung my arms up (pumping them….you know what I mean) up to my upper chest level to up the ante…i.e. get me to make it a workout and not a stroll. I felt like a dork at first, but then I didn’t care!
I’m super proud of you and thanks for coming by, my little ray of sunshine!
(Big ray, come to think of it! 😉
I’ve walked regularly now for about 25 years. It makes a huge difference in mood, and I rarely skip a day. If there’s such a thing as a runner’s high…it applies to dedicated walking as well. There are some great links here. Thanks for a very important post, Dyane. ❤️
Thanks for writing, dear Van! Now I’m really into using those special characters – I’m thrilled you turned me on to them!. 👏
When you can, check out what I wrote in response to “Bipolar On Fire”‘s comment which is directly below your comment, and keep up your absolutely fantastic daily habit of walking. 25 years is a good sign you will stick with it! Walking is my favorite exercise apart from the elliptical, and both forms are so much better on your joints than some other options (I have knee problems), so I’m really into the low-impact features as well!
Sending you lots of ❤️💙💜
(see what I mean about those characters/emoji things?) 😉
Whoa…so glad you like the emoji things, Dyane, looks like you’re having fun with them. I bought a treadmill that sits idle, I found out that I need to be outdoors to get the best benefit, even in bad weather. My favorite time to walk is winter, somehow. I sweat a lot in the warmer months. Thanks for the comment and the emoji love. ❤️ 💛 💙 💜 💔 ❣️ 💕 💞 💓 💗 💖
Great summary of Dr. Alsuwaidan’s webinar. Did you really get his permission to share it? By email? Phone? I’m all atwitter wondering…
Thanks my dear (also for the retweet), and yes, I have his email. He also kindly allowed me to excerpt his post in my book. I’m wondering if he might be up for writing an afterword…….
I’m impressed. Keep up the great work.
I love how you used the word “summary” – at over 2000 words, this post was more like a novella, but in my defense, many of those words belonged to the witty and brilliant Dr. Alsuwaidan. And his were worth reading, of course.
I rest my case! 🙂
p.s. sorry I didn’t give you enough credit in this post for inspiring me & giving me the easy means to visit the International Society of Bipolar Disorders link so I could listen to his webinar – I owe you! 💙
You gave me props, which I appreciate. You didn’t have to do so.
Hey Lady, look I must say it straight, that guy is cool. I can sit thru his webinars and seminars till past midnight cause even if l lose track of his teachings, I wouldn’t lose sight of his smiling handsome self. Ok that aside, I am a fitness fan and uh I try my best. I always feel bad when I remember pleading with my brother to do some exercise. Anything I begged, but the black dog had so gripped him that he barely left his room and had put on so much weight! Yes, We Go Girls – Gents you come along sure 🙂
Ooops – hope you see my reply above – I’m not sure why it popped up there! 👅
Go easy on yourself about your brother, honey – you were only trying to help him! You didn’t know how low he felt…..and yes, go girls and gents, I knew I left them out there but hoped no one would be bummed with me! p.s. this is for you: 👑
A crown? Omg what have I done again? Lucy come to my aid oh 🙂
Fairy Godmother Crown!!!!
Reblogged this on Marie Abanga's Blog and commented:
A smashing post I must say. Yeh am a fitness fan and near fanatic 🙂 Gosh it does me so much good that I feel so bad not being able to do it as much as I would have wanted. I truly envy Dyane and her ellyptical 🙂 And to say that Dr is Dashing, hmm you can only but feel good if you at least give his advices a go 🙂
Like you, Marie, Dr. A’s kindness, compassion and true beauty come shining through both your pictures and words. I think of his advice when I’m weary, when working out is the last thing I want to do. Some spans of time are easier than others, and I’m dealing with chronic knee problems that flare up and make it all hard, but my brain tells me it’s good. As does my heart! And speaking of hearts, I love *you*! :)❤️💜💙
I love you loads to my fair lady. It’s funny but it just worked for me. I have been having a bad knee for almost two weeks now, and I was asked to rest that foot a while eg no workout with that leg. How was I to do it you tell me! So I went to the gym and worked it out gently full time. Each time I felt better and gradually saw the swelling go. A little hint now but I think it’s the knee’s stubbornness 🙂
I use arnica gel (at the health food store) which is homeopathic,not too $$$ and they have cheaper tablets too If you can’t find it there, maybe you could do mail order although I know that’s costly; I don’t do mail order much myself.
Arnica really helps with my chronic knee joint pain, I had 2 knee surgeries in my right knee….I don’t have the pain every time, but frequently and I believe in arnica’s power. I like Boiron – here’s the link :
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My exercise regimen is this: baby-wearing disco parties, stroller pushing sessions, & trying to keep up with two hyper-active toddlers who are just learning to run the opposite direction when mommy says, “come here!”
I burned 5000 calories just reading that! Whew! 😉 ❤️
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2nd day in a row manhandling the elliptical for 30 minutes woo hoo! This post pumped me up. When I move to Madison Ima do it Rocky style, layered up and jogging around carrying lumber! (Right;)
Once you listen to this jam, it won’t go out of your head for a least 3 hours!!!!!!
Keep it up, Andrew!
30 minutes is golden……I must say I’m very proud of you! You’ll “rock” it in Madison, especially if you do it Rocky-style in the layers and the jogging!!!!!! I bet you could even pull off those one-arm frog push-up things!
Dyane, I just listened to the jam, and I’m afraid to say I got it out of my head in 35 seconds. Phew. Ha! I need my exercise music still tinged with emo and heartache. However, if I’m feeling particularly embattled/defeated, I will use this as a nice slap in the face https://m.youtube.com/watch?v=hRK7PVJFbS8
Just had Craig watch King Kunta & he was digging it! I think I’ve been to Compton in the 70’s – oh yeah – he added “The Beatles it ain’t!” 😉 Almost 23,000 comments on YouTube – wow!
35 seconds Andrew? You are so funny & brighten my day. Do whatever helps you, whether it’s cheesy or music tinged with me and heartache! I’ll check out that link you posted…..thanks, my friend!
Great info; thanks for sharing. I’ve heard this kind of thing before, and have been wondering if my lifestyle here in Rotterdam has been part of my long ‘up’ mood. Exercise is just part of life: sprint for the metro, walk here and there, swim, dance..I don’t have a bike yet, but hope to get one soon. I’ve found I get an average of an hour of exercise every day – before I head to the pool. Days I can’t move due to the RA I feel much more subdued.
Thank YOU bp709! I bet you anything you’re 100% right about how your Rotterdam lifestyle has contributed to your stable, “up” mood. It’s so inspiring to learn of this. I hope you get a bike soon too! It sounds like you’d definitely put it to good use!!!
An hour of activity every day (before you even get to the pool) is amazing!!!! Keep it up!!!!!
I hope they come up with a cure for RA SOON – I used to know a wonderful woman who had it. She was a member at the gym where I worked. We’d talk a lot in the mornings – I saw her five days week, usually, and she explained how difficult it was to have RA, yet most of the time she hauled herself to the gym in spite of the pain etc.. I have so much admiration for her and for you too!!!!!
take good care, Dyane 🙂
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So much detailed information and so helpful! Thank you and sending you love and hugs. 💖💖💖
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