ML Interest Tag: procedure

Answering the 5 Most Common Questions about C-Sections

By Dr. Alan Lindemann

In the United States, approximately one-third of all babies are delivered by cesarean section. Many pregnant women have questions about C-section safety and frequency and wonder if they will need to undergo the procedure themselves. Here are some of the most common questions and concerns expectant mothers have about C-sections.

1. What is the rate of C-section births in the United States?
The Centers for Disease Control and Prevention report that more than 31% of U.S. deliveries were by C-section in 2018. Alabama, Louisiana, and Florida have the highest C-section rates, while Idaho, Utah, and Nevada have the lowest. C-sections are the most common surgery in the United States.

Few people are aware of this—and many of these C-sections are unnecessary. In fact, the number can be safely reduced to less than 15%, and for those women with low-risk pregnancies, reduced to 11%. When I joined my first practice after residency, the C-section rate in that group was 15%, which I regarded as too high. My C-section rate in my residency had been 10.9%. Working with the clinic staff, we safely reduced the C-section rate to 10% by offering women vaginal birth after cesarean section (VBAC), delivering breech babies vaginally, and using appropriate labor management treatment for dysfunctional labor and fetal distress.

2. Why is the C-section rate so high in the United States?
The rate is high for many reasons, a number of them unfortunate. For example, the use of fetal monitoring during labor and delivery has increased the C-section rate. The intent of the monitoring is to increase the baby’s Apgar score during labor and delivery, but it doesn’t. It just increases the C-section rate. A baby’s heart rate may decelerate after a contraction, and this is considered a sign of distress. This triggers the notion that a C-section is needed because the baby is in distress. The problem is that there is no way to know why the baby is in distress, and hence whether the baby needs to be delivered immediately. Fetal scalp blood samples can be taken, but this delays the C-section if needed.

There is no doubt some C-sections are done to save time. If you know what you’re doing, C-sections take 20-to-30 minutes. Inductions can take hours, as can natural labor. Add to that the fact that insurance companies pay about twice as much for a C-section as for an induced or natural delivery, and it’s easy to see why the procedure is so popular.

3. What are the risks involved with having a C-section?
With a C-section, the two highest risks are infection of the tube that connects the kidney to the bladder, and hemorrhage. Infection occurs in 6 – 11% of C-sections. Bladder or ureter injury is also a high risk with this procedure. These injuries can often be repaired by the surgeon doing the C-section, but the long-term effects of failure to recognize this condition are bothersome.

4. What questions should I ask the obstetrician or surgeon doing my C-section?
The time to ask questions is before the need to have a C-section, during a prenatal visit. Your physician should be able to tell you their C-section rate as well as whether or not they have performed any C-hysterectomies. It’s also important to ask what the hospital’s C-section rate is. Hospitals vary widely in the number of C-sections performed. If you really want to avoid the chance of a C-section for “failure to progress,” choose a physician who regularly delivers babies vaginally, choose to avoid inductions, and check your hospital’s C-section rate.

5. If I’ve had a C-section for a previous birth, will I still be able to have a vaginal birth with a later pregnancy?
In most cases, you may have a vaginal birth after C-section (VBAC) as long as your C-section incision is left to right rather than up and down. When I joined my first practice after residency, I began doing VBACs after one previous C-section. I then offered VBACs after two C-sections, even three C-sections. A nurse practitioner came to see me with four previous C-sections. She knew and understood her options, and wanted to try a VBAC. Her labor and delivery went fine. She delivered her fifth child vaginally with no problems. The patients simply need to be monitored carefully. Checking for uterine rupture is to be expected. In all the VBACs I have done, including with women who’d had multiple C-sections, I have never had a uterine rupture.

Be sure to take these questions and any others you may have to your own obstetric care provider before giving birth with them. It’s important to ensure that you and your doctor are aligned on your goals and wishes for delivery, and it is very wise to advocate for yourself and your baby before delivery.

Dr. Alan Lindemann
Tinybeans Voices Contributor

An obstetrician and maternal mortality expert, “Rural Doc” Alan Lindemann, M.D. teaches women and families how to create the outcomes they want for their own health and pregnancy. In nearly 40 years of practice, he has delivered around 6,000 babies and achieved a maternal mortality rate of zero! Visit LindemannMD.com

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Why Don’t Men Talk about Infertility?

By Brittany Stretchbery

There are several things people seem to “know” right off the bat when it comes to family planning, conception, and infertility.

  1. It’s a women’s issue, certainly not for men to discuss
  2. Infertility is all about the woman
  3. Men are along for the ride—when the woman wants a child, the couple wants a child

First you date. Move-in together. Get married. Then you have kids. In that order. At every wedding—“You’re next, when are you putting a ring on it?” from some nosy person. Chill, bro. Don’t try to press me. Then whenever someone wants to know about your sex life, they ask, “When are you finally going to have a baby?” incessantly. I always wanted to ask if they were having unprotected intercourse. But I digress.

The First Steps

First comes the “I’m not trying, but I’m not trying not to” routine. Really, I think it’s just something us guys say because we don’t want to look too eager to get into the parenting thing. Especially for younger couples, it’s easier to say that than to hear, “You have your whole life” when you say you want kids now. But let’s face it, you want kids and you really are giving it the old college try.

Mood: Great. Sex all the time, no more worrying about birth control or any of that business. Just… fun.

Should It Take This Long?

“If you have sex, you will get her pregnant.” You totally expect it’ll be quick! Two or three months tops? Surely it’ll be happening soon. Like, really soon. Let’s give it a few months. What people don’t commonly know is that your odds of conception are only 20-25% each month for the healthiest of people.

Mood: Still pretty good. Because, sex, you know? But maybe we should try something different

Ok. Really, Let’s ACTUALLY Start Trying

This is where the research comes in. Basal body temps, special lubrication, cutting the booze, eating healthier, monitoring cycles. The list goes on. So after 7-8 months, you reach “let’s actually put a plan in place” status. We’re smart people, we can handle this.

Mood: Well, this is slightly annoying. Still, sex. But now it’s planned. And that’s not so exciting.

Infertility: The Dreaded Word

After 12 months of trying, you now get slapped with the infertility title, by medical definition. We knew it was headed that way, but it still sucks going to the Reproductive Endocrinologist (RE) for the first time. For the wife, it was her feeling like a failure. This goes back to the beginning rule: infertility is a women’s issue.

For us guys, our experience is different. Doctors, nurses, insurance people, etc. all try their best to include the males, but at clinics, the woman is the patient. The woman gets the tests. She has to talk to insurance because the husband isn’t a patient. For me, that was the most frustrating part. Not being talked to as a patient but as the support. Give us your sample and you can go on your way.

Mood: This is such crap. But we’re taking charge, here. Bringing in the experts. As the guy, I might be ignored a bit, but it’s worth it. Also, if you ever posted a baby picture on Facebook, I hated you and probably hid you from my timeline. You’ve since been re-added and I’ve caught up on your awesome journey through parenthood.

On to the Treatments!

Monitoring. Blood tests. Shots. Lots and lots of shots. Have you ever been jealous of someone getting a shot or blood drawn or anything? It’s a very strange experience. If I could have taken my wife’s place as a human pin cushion, I would have. No doubt. It started out gradually with just oral medication and ultrasounds, but then we got into blood tests and a trigger shot (to induce ovulation). And after that, stimulating hormone shots.

Mood: Ok, for real. I am here. Maybe talk to me a bit?

Total side note: I got to be a damn fine shot giver. Like, so good. Me doing the shots, in a way, got me more involved in the process. I was less resentful of the whole thing because I actually felt like I had a role in creating my child. But that wasn’t until basically year four of our infertility journey. Years two and three were super shitty. One failed procedure after another, a canceled IVF cycle. It wears on you.

Mood: Our second cycle of IVF was actually a great experience from my perspective. I had a role. A purpose. And everything she was doing wasn’t going to be a complete waste of time and money.

Looking Back at the Whole Infertility Experience

Obviously, I wouldn’t take it back. I have a daughter (who is now an energetic 4-year-old). Gosh, it sure was terrible at times. And other times it was just laughable. Let’s just say that our dignity took a hit between collecting samples and a million ultrasounds. 

There’s still a ton of stigma associated with infertility—and that’s the reason I am writing this today.

Yes, men can and do want families just as bad as their wives.

Yes, the woman is the patient. But I am still a willing and necessary part of the equation.

This post originally appeared on Bottles & Banter.
Brittany Stretchbery
Tinybeans Voices Contributor

I work for an airline, so our our family of 4 flies everywhere on standby. Meaning, we never know if we'll actually get there. It's like travel Hunger Games. We have young kids and were never sold on the belief that you can't travel with little ones.

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Is It Safe to Send My Child Back to Daycare during COVID-19?

By Natasha Ramirez

Even though children are less at-risk of showing symptoms of the virus, the rate at which they can transmit it to others is still uncertain, and many parents wonder whether it’s wise or not to allow their children to return to daycare.

Make sure that your daycare is taking the necessary precautions before taking your child back. This will keep your child, the other children, daycare employees, and yourself as safe as possible during the pandemic. If you’re struggling to decide on whether to send your child back to daycare, here are some questions and factors to consider:

Do you have the time and resources to keep your child at home? 

Childcare can be expensive, but forgoing a paycheck so you can care for your child can also strain your budget. If you’re the sole provider, staying home may not even be an option. Are there ways to work from home? Even if your company has requested that you physically come back to work, many useful resources out there provide tips on how you might be able to persuade your boss to let you do your job remotely.

Do you live with a person over 65? 

As you know, the elderly are at high-risk of COVID-19 and may catch the virus from your child even if your child is not showing any signs of infection. Be sure to consider whether other people in your household have conditions that can make them more vulnerable to the virus, such as respiratory conditions like asthma.

Does your community already have a high level of transmission? 

Even though states are slowly re-opening, some areas are struggling with virus containment more than others. Safety guidelines will vary by location, but it’s important everywhere to continue being cautious around group gatherings.

Is your daycare transparent about the health measures they’re implementing? 

Daycares should have a clear plan in place on safety measures like how often they’re disinfecting surfaces, what their mask policy will be, and their procedure for if a child starts showing COVID-19 symptoms. Ask your daycare provider about their plans on how they’re going to keep your child safe. Let them know about your concerns upfront about sending your kid back. They will understand this is a stressful decision, and should be able to answer your questions fully and hopefully calm your anxiety.

How will your mental health be impacted by either decision?

The pandemic is taking a mental toll on everyone, keeping tabs on your mental health is just as important as your physical health. Should you choose to send your child back to daycare, will you be worrying about their health and safety the entire day? Are you worried about finances from choosing to stay at home with your child rather than working? While the safety of your child is your top priority, don’t forget about your own health during your decision process.

Questions to Ask Your Daycare Provider

  • What’s your face mask policy? Will staff be wearing masks?

  • Will you be following CDC safety guidelines?

  • How will you screen children for symptoms before they enter the daycare?

  • How often will you be wiping down surfaces?

  • What will be the ratio of staff to children? 

  • What will the drop off and pick up procedures be?

  • What’s your plan if someone becomes sick?

  • Will you be allowing visitors at the daycare?

Should you decide to send your child back to daycare, make sure the daycare is implementing safety protocols. Higher-priority strategies include keeping class sizes small to minimize crossover, utilize outdoor spaces when possible, and to limit unnecessary visitors in the building. Lower-priority strategies include face coverings for the children since it may be difficult to implement due to their age, and reducing classmate interaction and play since it may not provide a substantial risk reduction. Babies and children under the age of two should not wear face masks due to suffocation dangers.

While COVID-19 concerns among adults are entirely valid, you should find some comfort in the fact that daycare aged children (under the age of ten) are substantially less at risk of contracting the virus. And even if they do become infected, studies have shown that over 90% of the pediatric cases of the virus are either asymptomatic or mild. 

Choosing whether to send your child back to daycare is not an easy decision. Financial, personal, and societal responsibilities should all be factors to consider. If you do decide to return to using daycare, make sure that the facility is doing everything in their power to keep children and everyone around them as safe as possible

 

Natasha is an avid writer, storyteller, and dog-lover. Her work has carried her from the bustle of New York at Inc. Magazine to the Santa Fe deserts at Outside Magazine. She enjoys writing about family-focused and community-centered stories.

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Yes To Pulls Vitamin C Unicorn Face Masks Following Skin Irritation Concerns

by Erica Loop

Yes To recently recalled its Grapefruit Vitamin C Glow-Boosting Unicorn Paper Mask following customer complaints.

According to reports, the mask (which was sold at several retailers, including Target and Ulta), can cause extreme irritation, burning and red, itchy skin.

Chelsea Anders and her stepdaughter both used the mask. The Iowa stepmom told WHOTV 13, “Her face was welted with red, swollen, itchy raised abrasions and I had first thought chemical reaction. It’s what a lot of people had assumed when using this product was that it was just an allergic reaction. Then doing the research after I had seen what had happened, it looks like a chemical burn.”

Anders wasn’t the only person to have a problem with this product. Stacy Slater of Tampa, Florida told Today what happened after her 11-year-old daughter Addison used the mask. “She’s like, ‘My face is a little itchy and it tingles.'” Slater went on to add, “She said it felt like it was burning and stinging and at this point she was crying.”

In an emailed statement, a representative from Yes To said, “Yes To is committed to ensuring the safety and integrity of all of our products and has maintained a strong track record of delivering quality products to our customers since our founding in 2006.” The statement continued, “We have recently seen reports on social media that children have used the Grapefruit Vitamin C Glow-Boosting Unicorn Paper Mask, unfortunately resulting in skin irritation. We have also received some similar reports from adults who have used the product.  We apologize to anyone who was affected in this way, especially over the holiday season.”

The brand also added, “While our products are all independently tested for safety, irritation, and allergy—and while we provide both warnings and instructions on our products about the potential for skin irritation—the safety and satisfaction of our customers are our main concerns.  As such, we have decided to pull this particular product off of the shelves while we investigate the complaints that we have received and seen online.”

When it comes to the products and retailers pulling them from store shelves, Yes To’s statement said, “We have reached out to all our retailers and informed them that we are voluntarily pulling the product off the market and to please remove all Grapefruit Vitamin C Glow-Boosting Unicorn Paper Masks off their shelves immediately. However, each store has a different procedure and process when removing products. We hope to have all products completely removed by Friday and will continue to follow-up with each store to make sure that the product is pulled from shelves as quickly as possible.”

Yes To also directed customers who have the product to return unused masks to the store of purchase. In a Jan. 3 statement the company made on its Facebook page, Yes To alerted customers to the problem and added, “If you’ve had an issue with this item, please contact our Customer Care team at customercare@yesto.com.”

—Erica Loop

Featured photo: Yes To

 

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Treating Ear Infections Just Got Easier with These New FDA-Approved Ear Tubes

by Erica Loop

The U.S. Food and Drug Administration recently announced the approval of a breakthrough in ear tube technology. The new system allows doctors to insert the tubes under local anesthesia in the office.

Forget about general anesthesia and a trip to the hospital’s OR. The Rubes Under Local Anesthesia, a.k.a. Tula system, may make this all-too-common procedure easier on everyone.

photo: Burst via Pexels

Jeff Shuren, M.D., director of the FDA’s Center for Devices and Radiological Health said, in a press release, “Today’s approval offers patients an option for the treatment of recurrent ear infections that does not require general anesthesia. As millions of children suffer from ear infections every year, it is important to have safe and effective treatments available to this susceptible patient population.”

Shuren continued, “This approval has the potential to expand patient access to a treatment that can be administered in a physician’s office with local anesthesia and minimal discomfort.”

The system, which is approved for children over the age of six months was tested on 222 pediatric patients. Researchers found the tubes have an 86 percent success rate in children under age five and an 89 percent success rate in the five to 12-year age group.

—Erica Loop

 

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Actress Danielle Fishel Reveals Why Her Son Had a 3-Week Hospital Stay

by Erica Loop

Actress and new mom, Danielle Fishel recently talked to People magazine about motherhood, her 10-week-old son Adler’s early birth, and the newborn’s time in the NICU.

According to Fishel, Adler’s unexpected hospital stay was due to a fluid build-up in his lungs. The newborn was rushed to Children’s Hospital Los Angeles when his lungs didn’t heal themselves. The new mama told People, “Adler is bottle-fed because of the issue that he had, something called chylothorax. It’s a leak in the lymphatic system.”

After 12 days in the hospital, Fishel (and husband Jensen Karp) got news no parent wants, “To hear, ‘We have bad news: The fluid has tripled, and now we no longer think we’re the best place for him. This feels much more like an emergency and we need to rush him to Children’s Hospital,’ was extremely scary.”

While in the hospital doctors told the new parents that they would need to tap Adler’s lungs to drain the fluid. Luckily, the newborn’s lungs started to heal and he didn’t need the surgical procedure.

Fishel went on to explain, “Unfortunately, my breast milk was creating fluid in his lungs, and we had to take him off of breast milk and put him on a specially formulated formula that doesn’t use the lymphatic system.”

At three weeks old, baby Adler was finally healthy enough to go home with his parents. Karp told People, “For every first-time parent, it’s an adjustment to know it wasn’t ideal, but he’s healthy and he’s going to make it. We have the best doctors around us, etc. Those are the things you kind of ease into.”

—Erica Loop

Featured photo: Danielle Fishel via Instagram 

 

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This 11-Year-Old With Cerebral Palsy Has Raised Thousands for the Children’s Hospital Treating Her

by Shahrzad Warkentin

Eleven-year-old Sasha Bogosian was diagnosed with cerebral palsy at birth and has spent a big part of her life receiving treatment at Children’s Hospital Los Angeles. She hasn’t let her challenges stop her from pursuing her dreams, however, and thanks to her artwork she has managed to raise thousands for the hospital through The Sasha Project LA.

When she was nine years old Sasha underwent a procedure that put her in an ankle-to-hip cast for 60 days. To keep her occupied during that time, Sasha’s mom Isabell taught her how to paint on clothing. Her new found skill quickly transformed into a passion and Sasha began to paint custom jeans.

Sasha didn’t stop there, however. She wanted to help other patients with her new passion and, together with her mom, she established The Sasha Project LA, a non-profit raising funds for CHLA’s art therapy programs. For a donation Sasha will handpaint your jeans or other denim item and all of the proceeds go to the Mark Taper-Johnny Mercer Artists Program at CHLA, which allows patients and their families the chance to express themselves through dance, drama, visual arts and music.

Sasha’s art work has caught the attention of many celebs who have ordered her custom designs. Now something of a celebrity herself, Sasha and her mom Isabell are starring in a new web series, Real Moms, which follows the stories of ten moms who bond through raising children with life-altering medical conditions.

—Shahrzad Warkentin

All photos: Courtesy of The Sasha Project LA

 

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This Company Wants to Give Teachers the Gift of Sight at a Discount

by Shahrzad Warkentin

Clear vision is definitely an important quality when you’re an educator, but having a corrective procedure like LASIK completed might not be feasible on a teacher’s salary. LasikPlus wants to help teachers by offering them a discount on their services.

Laser vision correction provides the chance to eliminate or reduce dependence on glasses or contacts and it can be life-changing for many. When you take advantage of the Public Service Personnel discount, you can save up to 20 percent off services! So how does it work?

photo: Plush Design Studio via Unsplash

Public Service Personnel includes firefighters, police, EMT, paramedics, doctors, nurses, military personnel, and teachers. Those who qualify must provide valid proof of employment or service at their appointment to receive the discount. When making an appointment, be sure to check that your local LASIKPlus location offers the discount.

With over 50 locations in 28 states across the country finding a local LASIKPlus for a consultation is easy. Teachers can find their closest vision center and learn more about the procedure here.

—Shahrzad Warkentin

 

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New Moms Should Wait Longer to Give Baby Their First Bath—Here’s Why

by Shahrzad Warkentin

More often than not, a baby’s first bath happens almost instantly after birth, but new research shows that holding off on baby’s first time in the tub could have some big benefits.

A new study published in the Journal of Obstetric, Gynecologic & Neonatal Nursing found that delaying a baby’s first bath for at least 12 hours after birth increased the odds of a new mom exclusively breastfeeding her baby during their hospital stay.

photo: skimpton007 via Pixabay

Every hospital has its own policy in regards to bathing newborns, but at the Mother/Baby Unit at Cleveland Clinic Hillcrest Hospital in in Mayfield Heights, Ohio—where the study was conducted—the general rule was that babies were given a bath within two hours of birth. The study involved 996 pairs of women and their healthy newborns. Of these, 448 were given the hospital’s standard policy or bathing babies when they were about two hours old. The other 548 followed the new procedure of delaying the first bath for at least 12 hours.

The researchers found that exclusive breastfeeding rates went up from 59.8 percent to 68.2 percent with the delay. “It makes us happy to see that happen,” lead author Heather Condo DiCioccio, DNP, RNC-MNN, told TODAY. “Any increase that we can get in breastfeeding rates is going to be significant.”

—Shahrzad Warkentin

 

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Lice, Lice Baby: Where & How to Treat It NYC Without Totally Bugging Out

by alina adams

Lice. If you’ve ever had to deal with the little critters, the mere mention of them is enough to make you run for the hills. Unfortunately for parents, lice are just as likely to come home from summer camp as they are from school, which is why — at the tail end of one season and on the cusp of another — we thought it was time to review the NYC options for de-bugging. From at-home solutions to the big guns of services and salons, here’s how and where to de-louse.

photo: via Liceneders Facebook page

Not Too Cool for School

Lice are a big problem in NYC schools, no matter the type: public, private, charter, parochial. It’s why so many schools do regular checks during the year, especially after summer camp season, and winter and spring breaks, when families have been traveling.

Since 2010, the American Academy of Pediatrics has stated that the presence of nits in the hair is not a valid reason to keep a child out of school, and the Center for Disease Control followed suit. However, many NYC schools still insist on a “no nits” policy, which means that even if no live lice are discovered in your child’s hair, they cannot return to the classroom until every egg has been removed. (It’s wise to check in and see what your school’s policy is.)

Though by now most parents know that lice are not the result of bad hygiene — the critters prefer, in fact, clean hair — or exclusive to any particular socio-economic class or ethnic group, many still don’t know exactly how to treat this unfortunately all too common infestation.

photo: via Hair Faries Inc. Facebook page

Delightful De-licing: The Options

Getting rid of lice can be as “easy” as a trip to the local pharmacy, and most over the counter products will work on most heads. Yes, there are some particularly stubborn cases, but there is no reason to automatically assume yours is one of them. Lice shampoos that you buy at the drugstore — we’ve had success with NIX, for example — work the majority of the time, and usually require a single application, followed by a second dose around a week later. (There’s no way around repeatedly combing through your child’s hair and checking for nits and lice, however, or washing clothes and brushes at high temps. Here’s the full CDC recommendation rundown.)

Both the AAP and the CDC endorse the use of over-the-counter treatments, but these products are often full toxic chemicals (they are, after all, designed to kill lice) and some parents may prefer trying a more natural product. To meet the demand, a number of companies have launched their own, non-toxic lines of shampoos and treatments.

Kitchen Cabinet Method

If you’re interested in going super low-tech (and low price), try remedies using kitchen staples you probably already have in the house. Drench your child’s hair in olive oil, then wrap it in a plastic bag or shower cap for several hours. This will smother the living lice. You can also rinse your child’s hair with a vinegar and water solution. The acid will kill the nits, and unstick them from the hair shafts, making it easier to comb the corpses out later.

A LicEnders Salon photo: via LicEnders Facebook page

Leaving it To the Professionals

There are, of course, people who will come to your home to take care of the problem within hours. LicEnders promises all sorts of high-tech treatments, while Lice Free Noggins boasts a 100% guarantee, as do The Lice Doctors. Nit Picky claims to have the lowest in-home prices in the city, period.

If the salon experience is more your style, try the Hair Fairies in Midtown Manhattan, Hair Angel NY on Staten Island, Lice Busters in Brooklyn, NY Lice Out in Queens, or even DeLiceFul on Long Island.

The procedure of painstakingly going through your child’s hair, skinny strand by skinny strand with a fine-toothed comb to remove both the living lice and their eggs, can take several hours, and cost you several hundred dollars, at least. Some places charge for the time spent and the number of technicians working, while others just bill a flat rate. In-home service will cost more than a salon visit, especially if you ask for add-ons like screening other family members, sterilizing your entire home, and follow up re-checks.

(It’s not uncommon for schools to invite representatives from lice-removal services to come and do a complimentary exam on all the students. Then, if your child is discovered to have lice, the examiners will of course tell you that their service is the only truly effective way to get rid of the pests.)

 

 

photo: Cozy’s Cuts for Kids

An Ounce of Prevention

The idea of a product that can fend off a lice infestation before one can even start is pretty appealing to any parent that’s dealt with the scourge. NYC mainstay Cozy’s Cuts for Kids, has just launched a new line, Boo!, featuring an all-natural shampoo and spray it claims is clinically proven to keep lice away. (They’re not the only ones who offer such products.)

What did you do when lice visited your house? Share in the comments below!

— Alina Adams

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