Conditions
Allergies
An allergy occurs when a person experiences hypersensitivity of the immune system, which causes one to respond aggressively to otherwise harmless elements found in the surrounding environment.
An allergy occurs when a person experiences hypersensitivity of the immune system, which causes one to respond aggressively to otherwise harmless elements found in the surrounding environment. There is a wide variety of common allergens, which when inhaled can cause various reactions such as sneezing, tearing of the eyes and coughing burst. These can include pollen from trees and flowers, animal dander (much like human dandruff), dust, and mould. There are also some allergens that only cause a reaction when they are ingested such as medications (i.e. penicillin) and foods, which can include (but are not exclusive to) eggs, peanuts, wheat, tree nuts, and shellfish. Some other sensitivity triggers can include nickel, copper, and latex.
When an allergic reaction is in its most potent form it is called anaphylaxis, which is potentially lethal as it causes severe respiratory distress and swelling of the larynx. This is swelling and breathing difficulty is often followed by the body going into vascular collapse, or shock. Anaphylaxis episodes must be treated as soon as the first symptoms are noticed. Death if a very realistic outcome if not rectified within minutes of coming into contact with the allergen. People that are prone to anaphylaxis normally ensure they have a self-injecting pen of epinephrine with them, to prevent such situations from being out of control.
Allergens can affect various parts of the body and does so differently in all people. The symptoms can have an immediate onset, or it might take days before any signs of allergen contact become visible. The severity of symptoms varies from mild to severe and can result in death.
Your Doctor at Health Renewal will perform a physical examination and request a comprehensive blood analysis at your local pathology laboratory. These results will be analysed by your Doctor who will advise you on your treatment options.
Tests and Diagnosis for Allergies
To properly begin diagnosing a patient presenting allergies- the Medical Doctor will do a full physical examination after having worked through medical history with the patient. Once an allergen(s) is linked to the patient experiencing specific symptoms, that relationship can be examined and tests ordered to identify the specific allergenic substance and subsequent treatment of the presenting symptoms.
1. The most common allergy test used by Doctors is the scratch or skin prick test. This test entails using the patient’s forearm or the upper back area to test small amounts of various suspected allergens-this is done by introducing the allergens on the normal unaffected skin through a small needle prick and watching monitoring the patient for a response. If there is a positive reaction to the antigen the patient might experience an itching feeling, reddening of the area and a raised wheel (or welt). In addition, there might be hives around the wheel. The only downside of this test is running the risk of causing the very rare, but possible, the life-threatening anaphylactic reaction by introducing possible triggering allergens during the test.
2. Radioallergosorbent test (RAST): This test evaluates the levels of specific IgE (immunoglobulin) antibody and activity in serum. Similarly to the skin test, the RAST provides allergen-specific information. This test is performed by working with the patient's blood sample, obtained from the laboratory. The RAST test has the advantage of not having any exposure risks, as when testing on direct skin. The only downside is that of giving blood, and the patient might experience slight pain or bruising.
3. Enzyme-linked immunosorbent assay (ELISA): This method is an alternative to the RAST test, also testing immunoglobulin levels. This test provides an indirect determination of what substances a patient may react negatively to. Like the RAST, this test carries no direct risk to the patient by direct exposure to allergens.
4. Differential leukocyte count: The white blood cell count and the differential are part of the complete blood count(CBC). In this test, the total number (and types) of white blood cells are counted to obtain valuable information. The CBC generally includes neutrophils, lymphocytes, monocytes, basophils, eosinophils, and bands. If a patient has an allergic reaction the Eosinophils levels are often elevated. The downside of this method of testing is that it does not provide any specific information on allergic substances, as it is nonspecific in nature.
5. Elimination-challenge diet: This test is mostly used to identify food-related allergens, but due to the process of elimination it needs to be followed diligently and is very dependent on the patients' participation to get accurate results. The timeframe of the diet will normally be for a minimum of two weeks and remove typical allergenic foods such as dairy, soy products, corn and wheat. In addition other foods that can cause food, allergic reactions include overly processed foods, food dyes, and spices which may also be eliminated. It is up to the patient to very closely monitor symptoms for several weeks, and to continue removing certain trigger items from the diet until there are no more allergic signs or symptoms present. Once al symptoms are gone, the patient can slowly start to reintroduce food types, one at a time, to see how the body reacts and in such a way find the food element that is the cause of allergic response.
Natural remedy: Herbs and supplements
Quercetin, a heart-healthy chemical called a flavonoid, found in tea, onions, grapes, and tomatoes, is a natural anti-inflammatory that can block histamine's effects before they start. At Health Renewal we recommend taking a 500mg supplement up to twice a day, starting a few weeks before allergy season. Quercetin works best when you take it with vitamin C, which prevents it from degrading.
Another helpful herb is butterbur, a perennial scrub, which may block the production of leukotrienes in the body.
With allergies, the supplements are individually tailored. Please do not self-medicate, which refers to a patient taking prescription medication or nutraceuticals on their own, without a doctor's supervision and/or consent. There is no single supplement given to all clients with allergies. The doctor will decide based on your examination, history and blood tests, what would be the best for you and your specific needs and/or deficiencies. Some supplements include:
Vitamin D, the amount given will depend on blood levels of 25-OH-vitamin D; Natural Vitamin E, which is a free-radical scavenger and fat-soluble vitamin: alpha-tocopherol and gamma-tocopherol; and daily Vitamin C.
Magnesium; Fish oil (with olive polyphenols); Butterbur and stinging nettle (leaf) in a standardised extract; Rosmarinic acid; Quercetin (providing quercetin glycoside derivatives and free quercetin); Hesperidin methyl chalcone; Spirulina and, DHEA: Based upon blood test results.
A multi-gene DNA test can routinely be added to the assessment of:
It includes analysis of variation in clinically useful genes that may contribute to:
Some of these abnormalities contribute to the development of type II diabetes, obesity and hypertension. Oxidative stress, detoxification of carcinogens and oestrogen exposure are also important considerations in this context.
This pathology supported genetic test is performed in conjunction with assessment of any food allergy or intolerances known to be associated with many chronic disorders. The results of the genetic test are combined with clinical indicators and lifestyle factors to identify a combination of risk factors that may lead to disease development or progression if left untreated.
For all health conditions, the nutraceuticals are individually tailored by the Health Renewal Doctor. The doctor will decide- based on your history, physical examination and blood tests what would be the best for you and your specific needs and/or deficiencies. It cannot be overemphasised that one must not self-medicate. Self-Medicating is done when a person takes prescription medication or nutraceuticals on their own without a doctor's supervision and/or consent. By not having a physical examination and blood testing done by a qualified and practising integrative medical practitioner, you could be not treating vital deficiencies or conditions such as elevated blood pressure, high sugar level, high stress levels (that can lead to adrenal burnout ) and high blood clotting factors that could lead to heart attacks and stroke. In addition, the aggressive program of dietary supplementation should not be launched without the supervision of a qualified physician. Several of the nutrients suggested in this protocol may have adverse effects. There is no single supplement prescribed to clients as there is no magic bullet that can support all the essential nutrients that one's body needs. Today's food is not functional and we need to supplement in order to maintain optimal bodily functions and nutrition.
Make an appointment to consult with your Health Renewal Doctor who is an integrative doctor and he or she will assist you in determining your risk factors and how best to prevent any problems or conditions that you may be susceptible to. The importance of early management of any condition cannot be overstated. Once certain conditions set in and damage to organs occurs, complete recovery may be difficult to attain. Best results for prevention and longevity is early detection of a possible problem combined with conventional treatments, nutritional supplements and a healthy diet and lifestyle.
The initial medical consultation at Health Renewal will be approximately 45 minutes. As this is a prolonged medical consultation, the initial consultation fee will be R 975 on arrival (for non-loyalty programme members) you will have to complete an in-depth questionnaire before the consultation so please arrive 20 minutes before the time. During the 45 minute consultation, your Health Renewal doctor will obtain a FULL medical history from you to determine your personal risk. A physical examination will be done after which the Doctor will decide which blood tests need to be requested from your local pathology laboratory. If you have a medical aid, these should be able to be claimed as well.
Once your blood results are received, they will then be analysed by your Health Renewal doctor who will begin working on a unique prescription plan for you with the compounding pharmacy. At your pre-scheduled second appointment 2 weeks later, the results and examination findings will be discussed with you. This will determine what abnormalities or deficiencies exist and you will be advised on your treatment options. These options may range from prescription medications, nutraceuticals, bio-identical hormonal creams or tablets or alternatively to having bio-identical implants or pellets inserted.
In office treatments such as carboxytherapy may also be recommended for certain conditions such as hair loss, erectile dysfunction ED, menopause or PMS. If you need to lose weight our Body Renewal Medical Weight loss program may be recommended. All these recommendations will be summarised on a sheet or print out which you can take home with you. The nutraceuticals offered at Health Renewal are of superior quality (Solgar) and are not rancid nor contain Hg (mercury ) or PCB'S (which is very important for Omega 3 Essential fatty acids EFA's). They are also free of gluten, preservatives, wheat, dairy, soy, yeast, sugar, artificial flavour, sweetener and colour. We have a great professional team made up of doctors, trained and registered nurses and therapists to support you at any time.
1. You are kindly requested to bring any supplements that you are currently taking, along to your consultation. The doctor can check the ingredients in this and take into account when prescribing a treatment plan for you.
2. Also, if you have had any blood work done in the past 6 months, please bring the results along to the consultation. Should you not be in possession of the hard copies, please request these results from the lab you visited. Usually, your ID number is sufficient.
Depending on the exact prescription given, you may be required to return to the doctor within 1-4 months’ time, in order to ensure optimum hormone levels are achieved. This will be determined by a repeat blood test and may be requested by your Health Renewal doctor.
You should ensure that you are current with your gynaecological visits/breast exams/mammograms (for female patients) and prostate exams (for male patients) as recommended by your GP/gynaecologist.
Depending on which form of supplementation you and your Health Renewal Doctor have decided on, one could expect to follow up with your physician from anything between every 3 months to once every 6 months.
The importance of early management of any condition cannot be overstated. Once certain conditions set in and damage to organs occurs, complete recovery may be difficult to attain. Best results for prevention and longevity is early detection of a possible problem combined with conventional treatments , nutritional supplements and a healthy diet and lifestyle.
You'll fight allergies more effectively if you know what you're allergic to. A skin or blood test from an allergist will narrow down your particular allergens, so you can avoid them by, for example, staying indoors with the windows closed during your worst pollen days. Also, be aware that trees predominantly pollinate in the morning, so if you are planning an outdoor activity, save it for the afternoon.
It is a common sense solution–remove the pollen, dust, and other allergens from your nasal passages so they won't bother you with sterile nasal saline rinse at the drugstore like Sterimar. Lean over the sink with your head tilted to one side and use a squeeze bottle to pour the solution into your top nostril, letting it flow out the bottom. Then switch sides. But be sure the solution is sterile–tap water can hold organisms that cause serious infection.
These familiar drugs work by blocking the inflammation-causing histamine that your body produces in reaction to allergens. The first generation of antihistamines, such as Benadryl, could make people sleepy and worked for only 4 to 6 hours; the second, longer-acting generation includes loratadine (Claritin) and cetirizine (Zyrtec).
Often, the best allergy strategy is to combine an over the counter (OTC) oral antihistamine with a prescription nasal spray. Prescription sprays containing corticosteroids (including Flixonase) reduce inflammation and mucus production, while sprays with antihistamines block symptom-causing histamine. For an OTC spray, consider a cromolyn sodium spray.
If your most irritating allergy symptom is red, itchy eyes drop formulated from the same medications used in nasal sprays may be your go-to therapy. Prescription antihistamine eye drops and OTC ones are effective and non-sedating.
With SCIT–you probably call this allergy shots–you're given injections of allergens at increasing dosages until your immune system becomes less sensitive to them. Treatment typically involves weekly shots for the first 3 to 6 months, then monthly for 3 to 5 years.
Originally developed to treat asthma, this drug has recently come into favour as a prescription therapy for allergies. Montelukast pills (known by the brand name Singulair) block the actions of leukotrienes, inflammatory chemicals that react to allergens by tightening the airways and producing mucus. Several studies have shown that montelukast is effective as a treatment for the seasonal allergies that typically strike in the spring and fall when pollen levels are at their highest. Potential side effects of montelukast include headaches, various sleep problems, and digestive issues. This drug is currently still prescription only, but a generic form is now available.
Immunotherapy is a preventive treatment in which you're given gradually increasing doses of an allergen to desensitise your immune system.
Here are ten quotes from great thinkers to challenge, motivate and inspire us to exercise, eat right and live healthier lives: Health and intellect are the two blessings of life.
An allergy occurs when a person experiences hypersensitivity of the immune system, which causes one to respond aggressively to otherwise harmless elements found in the surrounding environment. There is a wide variety of common allergens, which when inhaled can cause various reactions such as sneezing, tearing of the eyes and coughing burst. These can include pollen from trees and flowers, animal dander (much like human dandruff), dust, and mould. There are also some allergens that only cause a reaction when they are ingested such as medications (i.e. penicillin) and foods, which can include (but are not exclusive to) eggs, peanuts, wheat, tree nuts, and shellfish. Some other sensitivity triggers can include nickel, copper, and latex.
When an allergic reaction is in its most potent form it is called anaphylaxis, which is potentially lethal as it causes severe respiratory distress and swelling of the larynx. This is swelling and breathing difficulty is often followed by the body going into vascular collapse, or shock. Anaphylaxis episodes must be treated as soon as the first symptoms are noticed. Death if a very realistic outcome if not rectified within minutes of coming into contact with the allergen. People that are prone to anaphylaxis normally ensure they have a self-injecting pen of epinephrine with them, to prevent such situations from being out of control.
Allergens can affect various parts of the body and does so differently in all people. The symptoms can have an immediate onset, or it might take days before any signs of allergen contact become visible. The severity of symptoms varies from mild to severe and can result in death.
Your Doctor at Health Renewal will perform a physical examination and request a comprehensive blood analysis at your local pathology laboratory. These results will be analysed by your Doctor who will advise you on your treatment options.
Tests and Diagnosis for Allergies
To properly begin diagnosing a patient presenting allergies- the Medical Doctor will do a full physical examination after having worked through medical history with the patient. Once an allergen(s) is linked to the patient experiencing specific symptoms, that relationship can be examined and tests ordered to identify the specific allergenic substance and subsequent treatment of the presenting symptoms.
1. The most common allergy test used by Doctors is the scratch or skin prick test. This test entails using the patient’s forearm or the upper back area to test small amounts of various suspected allergens-this is done by introducing the allergens on the normal unaffected skin through a small needle prick and watching monitoring the patient for a response. If there is a positive reaction to the antigen the patient might experience an itching feeling, reddening of the area and a raised wheel (or welt). In addition, there might be hives around the wheel. The only downside of this test is running the risk of causing the very rare, but possible, the life-threatening anaphylactic reaction by introducing possible triggering allergens during the test.
2. Radioallergosorbent test (RAST): This test evaluates the levels of specific IgE (immunoglobulin) antibody and activity in serum. Similarly to the skin test, the RAST provides allergen-specific information. This test is performed by working with the patient's blood sample, obtained from the laboratory. The RAST test has the advantage of not having any exposure risks, as when testing on direct skin. The only downside is that of giving blood, and the patient might experience slight pain or bruising.
3. Enzyme-linked immunosorbent assay (ELISA): This method is an alternative to the RAST test, also testing immunoglobulin levels. This test provides an indirect determination of what substances a patient may react negatively to. Like the RAST, this test carries no direct risk to the patient by direct exposure to allergens.
4. Differential leukocyte count: The white blood cell count and the differential are part of the complete blood count(CBC). In this test, the total number (and types) of white blood cells are counted to obtain valuable information. The CBC generally includes neutrophils, lymphocytes, monocytes, basophils, eosinophils, and bands. If a patient has an allergic reaction the Eosinophils levels are often elevated. The downside of this method of testing is that it does not provide any specific information on allergic substances, as it is nonspecific in nature.
5. Elimination-challenge diet: This test is mostly used to identify food-related allergens, but due to the process of elimination it needs to be followed diligently and is very dependent on the patients' participation to get accurate results. The timeframe of the diet will normally be for a minimum of two weeks and remove typical allergenic foods such as dairy, soy products, corn and wheat. In addition other foods that can cause food, allergic reactions include overly processed foods, food dyes, and spices which may also be eliminated. It is up to the patient to very closely monitor symptoms for several weeks, and to continue removing certain trigger items from the diet until there are no more allergic signs or symptoms present. Once al symptoms are gone, the patient can slowly start to reintroduce food types, one at a time, to see how the body reacts and in such a way find the food element that is the cause of allergic response.
Natural remedy: Herbs and supplements
Quercetin, a heart-healthy chemical called a flavonoid, found in tea, onions, grapes, and tomatoes, is a natural anti-inflammatory that can block histamine's effects before they start. At Health Renewal we recommend taking a 500mg supplement up to twice a day, starting a few weeks before allergy season. Quercetin works best when you take it with vitamin C, which prevents it from degrading.
Another helpful herb is butterbur, a perennial scrub, which may block the production of leukotrienes in the body.
With allergies, the supplements are individually tailored. Please do not self-medicate, which refers to a patient taking prescription medication or nutraceuticals on their own, without a doctor's supervision and/or consent. There is no single supplement given to all clients with allergies. The doctor will decide based on your examination, history and blood tests, what would be the best for you and your specific needs and/or deficiencies. Some supplements include:
Vitamin D, the amount given will depend on blood levels of 25-OH-vitamin D; Natural Vitamin E, which is a free-radical scavenger and fat-soluble vitamin: alpha-tocopherol and gamma-tocopherol; and daily Vitamin C.
Magnesium; Fish oil (with olive polyphenols); Butterbur and stinging nettle (leaf) in a standardised extract; Rosmarinic acid; Quercetin (providing quercetin glycoside derivatives and free quercetin); Hesperidin methyl chalcone; Spirulina and, DHEA: Based upon blood test results.
A multi-gene DNA test can routinely be added to the assessment of:
It includes analysis of variation in clinically useful genes that may contribute to:
Some of these abnormalities contribute to the development of type II diabetes, obesity and hypertension. Oxidative stress, detoxification of carcinogens and oestrogen exposure are also important considerations in this context.
This pathology supported genetic test is performed in conjunction with assessment of any food allergy or intolerances known to be associated with many chronic disorders. The results of the genetic test are combined with clinical indicators and lifestyle factors to identify a combination of risk factors that may lead to disease development or progression if left untreated.
For all health conditions, the nutraceuticals are individually tailored by the Health Renewal Doctor. The doctor will decide- based on your history, physical examination and blood tests what would be the best for you and your specific needs and/or deficiencies. It cannot be overemphasised that one must not self-medicate. Self-Medicating is done when a person takes prescription medication or nutraceuticals on their own without a doctor's supervision and/or consent. By not having a physical examination and blood testing done by a qualified and practising integrative medical practitioner, you could be not treating vital deficiencies or conditions such as elevated blood pressure, high sugar level, high stress levels (that can lead to adrenal burnout ) and high blood clotting factors that could lead to heart attacks and stroke. In addition, the aggressive program of dietary supplementation should not be launched without the supervision of a qualified physician. Several of the nutrients suggested in this protocol may have adverse effects. There is no single supplement prescribed to clients as there is no magic bullet that can support all the essential nutrients that one's body needs. Today's food is not functional and we need to supplement in order to maintain optimal bodily functions and nutrition.
Make an appointment to consult with your Health Renewal Doctor who is an integrative doctor and he or she will assist you in determining your risk factors and how best to prevent any problems or conditions that you may be susceptible to. The importance of early management of any condition cannot be overstated. Once certain conditions set in and damage to organs occurs, complete recovery may be difficult to attain. Best results for prevention and longevity is early detection of a possible problem combined with conventional treatments, nutritional supplements and a healthy diet and lifestyle.
The initial medical consultation at Health Renewal will be approximately 45 minutes. As this is a prolonged medical consultation, the initial consultation fee will be R 975 on arrival (for non-loyalty programme members) you will have to complete an in-depth questionnaire before the consultation so please arrive 20 minutes before the time. During the 45 minute consultation, your Health Renewal doctor will obtain a FULL medical history from you to determine your personal risk. A physical examination will be done after which the Doctor will decide which blood tests need to be requested from your local pathology laboratory. If you have a medical aid, these should be able to be claimed as well.
Once your blood results are received, they will then be analysed by your Health Renewal doctor who will begin working on a unique prescription plan for you with the compounding pharmacy. At your pre-scheduled second appointment 2 weeks later, the results and examination findings will be discussed with you. This will determine what abnormalities or deficiencies exist and you will be advised on your treatment options. These options may range from prescription medications, nutraceuticals, bio-identical hormonal creams or tablets or alternatively to having bio-identical implants or pellets inserted.
In office treatments such as carboxytherapy may also be recommended for certain conditions such as hair loss, erectile dysfunction ED, menopause or PMS. If you need to lose weight our Body Renewal Medical Weight loss program may be recommended. All these recommendations will be summarised on a sheet or print out which you can take home with you. The nutraceuticals offered at Health Renewal are of superior quality (Solgar) and are not rancid nor contain Hg (mercury ) or PCB'S (which is very important for Omega 3 Essential fatty acids EFA's). They are also free of gluten, preservatives, wheat, dairy, soy, yeast, sugar, artificial flavour, sweetener and colour. We have a great professional team made up of doctors, trained and registered nurses and therapists to support you at any time.
1. You are kindly requested to bring any supplements that you are currently taking, along to your consultation. The doctor can check the ingredients in this and take into account when prescribing a treatment plan for you.
2. Also, if you have had any blood work done in the past 6 months, please bring the results along to the consultation. Should you not be in possession of the hard copies, please request these results from the lab you visited. Usually, your ID number is sufficient.
Depending on the exact prescription given, you may be required to return to the doctor within 1-4 months’ time, in order to ensure optimum hormone levels are achieved. This will be determined by a repeat blood test and may be requested by your Health Renewal doctor.
You should ensure that you are current with your gynaecological visits/breast exams/mammograms (for female patients) and prostate exams (for male patients) as recommended by your GP/gynaecologist.
Depending on which form of supplementation you and your Health Renewal Doctor have decided on, one could expect to follow up with your physician from anything between every 3 months to once every 6 months.
The importance of early management of any condition cannot be overstated. Once certain conditions set in and damage to organs occurs, complete recovery may be difficult to attain. Best results for prevention and longevity is early detection of a possible problem combined with conventional treatments , nutritional supplements and a healthy diet and lifestyle.
You'll fight allergies more effectively if you know what you're allergic to. A skin or blood test from an allergist will narrow down your particular allergens, so you can avoid them by, for example, staying indoors with the windows closed during your worst pollen days. Also, be aware that trees predominantly pollinate in the morning, so if you are planning an outdoor activity, save it for the afternoon.
It is a common sense solution–remove the pollen, dust, and other allergens from your nasal passages so they won't bother you with sterile nasal saline rinse at the drugstore like Sterimar. Lean over the sink with your head tilted to one side and use a squeeze bottle to pour the solution into your top nostril, letting it flow out the bottom. Then switch sides. But be sure the solution is sterile–tap water can hold organisms that cause serious infection.
These familiar drugs work by blocking the inflammation-causing histamine that your body produces in reaction to allergens. The first generation of antihistamines, such as Benadryl, could make people sleepy and worked for only 4 to 6 hours; the second, longer-acting generation includes loratadine (Claritin) and cetirizine (Zyrtec).
Often, the best allergy strategy is to combine an over the counter (OTC) oral antihistamine with a prescription nasal spray. Prescription sprays containing corticosteroids (including Flixonase) reduce inflammation and mucus production, while sprays with antihistamines block symptom-causing histamine. For an OTC spray, consider a cromolyn sodium spray.
If your most irritating allergy symptom is red, itchy eyes drop formulated from the same medications used in nasal sprays may be your go-to therapy. Prescription antihistamine eye drops and OTC ones are effective and non-sedating.
With SCIT–you probably call this allergy shots–you're given injections of allergens at increasing dosages until your immune system becomes less sensitive to them. Treatment typically involves weekly shots for the first 3 to 6 months, then monthly for 3 to 5 years.
Originally developed to treat asthma, this drug has recently come into favour as a prescription therapy for allergies. Montelukast pills (known by the brand name Singulair) block the actions of leukotrienes, inflammatory chemicals that react to allergens by tightening the airways and producing mucus. Several studies have shown that montelukast is effective as a treatment for the seasonal allergies that typically strike in the spring and fall when pollen levels are at their highest. Potential side effects of montelukast include headaches, various sleep problems, and digestive issues. This drug is currently still prescription only, but a generic form is now available.
Immunotherapy is a preventive treatment in which you're given gradually increasing doses of an allergen to desensitise your immune system.
Here are ten quotes from great thinkers to challenge, motivate and inspire us to exercise, eat right and live healthier lives: Health and intellect are the two blessings of life.
