Dr Armando you are truely the hero of every student wether he was in medical school or pharmacy school like me .. Thank you thank you thank you ❤ for every single thing you've done for us .. you 're a life saver ") Greetings from Jordan - Amman!
I'm an Australian ER nurse currently learning about paediatrics and this was so informative and gave me all the information I was looking for. Thank you
I have CECS for 8 years now. When i was 15 i couldn't walk for 10 meters without pain. When i was 19, I got my first surgery. They made a little cut in the fascia in both shins. This cut recovered after a year. So the problems were back. The second surgery was a half year after that. They removed a bigger piece of the fascia in both shins. I did some fitness after 2 months of recovery, for like 4 months. Then I started indoor climbing. I feel my legs getting stronger and I was able to do a 3 km walk in 30 minutes, average speed was 6 km/h. That is my limit now but i believe it is possible to go further after more exercise. I advice to take it easy after the surgery, take small steps and let your legs and feet get used to the exercise. Especially if you have not been able to do sports for a long time, because your muscles and tendons might be weak, as in my case.
Dr. Hasudungan, First I would like to congratulate you for such wonderful presentations. Second, I would like to know if there is a book or DVDs with your illustrations/explanation that could be bought by those looking for a fresh, different approach to important clinical concepts such as the ones you present on these videos. Thank you and please, keep up what you do.
Thank you for explaining this. I had this last March. I presented at hospital and they suspected deep vein thrombosis and arranged for me to get a scan a few days later. Before that the pain went off the charts, I literally crawled to my neighbour’s car and after 3 hours waiting at the hospital they diagnosed it just in time. I had no injury but did have an undrained baker’s cyst. Skin grafts were taken from my upper leg. I have recovered but have to wear a compression sock for life to deal with the swelling.
Thank you for sharing your experience as a patient! As a medical student real life patient experiences really adds to my learning. Hope you're feeling better again Pete. 😊
I had a friend who after a prolonged period of unconsciousness in an awkward position with the circulation cut off to his leg, suffered an infarction in one of his thigh muscles, a portion of which was removed after he almost died from rhabdo. I actually had a similar thing happen, but I was fortunate enough only to have moderate to severe pain and a limp for a couple of weeks as the circulation hadn't been cut off long enough to kill the muscle. I had remained unconscious in an upright, cross-legged position for some amount of time, I'm not sure how long. But when I came to, my leg was almost completely paralyzed and as the sensation and mobility returned over the course of the next hour, it was replaced with terrible pain.
Nothing\ I developed it from a similar cause (fell unconscious and wasn't found for about 24 hours) but I had extreme damage in both calfs. My left was amputated just below the knee, and I had fasciotomies on my right, left open for 3 weeks with a vac thing and then closed up with skin grafts. I lost the ability to move my ankle, toes etc and required a triple arthrodesis to stop my foot twisting, and have had chronic pain ever since. That was about 6 years ago. I can't stand on my remaining foot for more than a few seconds, so I am totally wheelchair bound. Oh and I too nearly died from rhabdo, the surgeon wasn't sure if I'd make it off the table, when I did he thought I'd be on dialysis for the rest of my life. I was on dialysis for about a week, my body is strong and I have no lasting effects on my kidneys.
I was diagnosed with compartment syndrome. Had a paper for surgery. Decided to fix it myself. Basically your muscle grew way faster than the slimy tube around them. Calf muscles puts a lot of preassure to that capsule. Thats why it hurts. Especially when you run. Because muscles get all pumped up and larger. Thats why you can sometimes run abit before it gets really bad. So there is a fix. Buy a set of calf compression sleeves. If possible and fits, size down by one. Not some crapoy sock looking ones. A real solid tight ones. Like compression sports ones. Wear them as often as possible. If you can, go for a run. Basically they are tight enough that give that slimy capsules around your calf muscles some time to recover and get bigger. Fixed my problem with less then a week. Can you imageine, nearly went for a surgery with both legs. PS! Once you recover, it wont come back.
@@seyharobertson-zurzolo1194 bro this guys talking about chronic compartment which is vastly different from acute compartment can causes dead nerves and muscles as well as anemia in the affected limps why would u wanna further restrict blood flow just recompressing ur leg
Great video! But just a correction, the increase intracompartmental pressure leads to venous and lymphatic obstruction which then further increases the pressure and eventually causes arterial compromise. Why venous first? Low pressures and the blood vessels are less muscular and thus easily compressed. Arterial blood vessels are more muscular and have a high pressure; thus, needing an increased amount of pressure for compromise to occur.
Great video ! Just one correction though! The increased intramuscular pressure leads to venous lymphatic obstruction first then followed by arterial occlusion.
wish i could write a very long paragraph venting abt my trauma and disability, but all im gonna say is, i had this when i was 5 in my arm and the doctors were...... not great. i was in hospital for 3 weeks, had 10 or 11 surgeries and later taught myself to be left-handed. since i was so young i only learned details and truths over 10 years later. sometimes i get upset abt it but im so much wiser now than i ever was.
Came so close to losing my leg due to missing the compartment syndrome diagnosis . No fasciotomy performed on leg so we just crossed our fingers and I was lucky it went away. My arm had fasciotomy and though I still have some use of right arm, but the nerve damage and all the surgeries Heber taken its toll. Not much use
Hello I’ve had 4 Compartment syndromes in both my legs was hospitalized more then 1 year I would really like to meet others who have been thought the same thing
Pretty long since you posted, but I had compartment syndrome in my right leg. 3 surgeries in one week trying to save it. That was June 2017. It took about 6 months to walk normally, and i can even run for about 1 minute now, though my endurance won't get any better. I lost 60-80% of my lower right leg, and several nerves never recovered. I have chronic pain, but was lucky. Sounds like you got it worse.
What sucks is I’m watching this after getting this while snowboarding about a week ago. No insurance. Don’t know what to do. I’ve been stretching and massaging it, but swelling persists. Makes me sick just watching
I have this chronic pain in the posterior part of my right leg. I can feel the pressure and swelling in a certain area. It hurts more after running but the pain remains when I massage the area or apply pressure. I might need that surgery. I've had the same symptom since high school. 40 years old now.
Hi Armando! Can we support you with euros ? Because as I went to the site Patreon, it is only notified in dollar, and I'm afraid there is taxes with the conversion dollar-->euros. I really want to support you, you are doing a great job !
I had severe trauma , 3-4 over a 2 yr period,and a life of severe abuse. However I was a workaholic,84 hours a week. I got a virus from my husband spraying my vegetable garden and I went out with girls ,I’m always the DD . I had one glass of homemade white wine ,and everyone threw up but me . I went home ,and awoke to use WRoom , and was 100% paralyzed for 5 days . I couldn’t move at all and 5 days later ,it just left. I began to swell bad,and then one day I looked like a burn victim,my edema was severe. I feel like a porcupine,any kind of stimulation at all. Coughing,sneezing,vomiting,sneezing,goosebumps,crying,orgasm, hug, blood pressure cuff , it’s like the nerve endings extend far ,and it feels like their on fire burning,with the tips of nerves feels like their being sliced with razor blades . My sed rate was so high , and I’d had 85 surgeries, from 8 car accidents,rape victim,and malnutrition as a child . Toxemia when pregnant, 4 days induced,nothing for pain , emergency surgery,placenta Snow White . I went into convulsions and 106 temperature because drs let me go to long in more labor,after they broke my water,so infection set in ,so my 10 pound baby was infected as was I . The preemie ward incubator barely fit ,IVS everywhere,on top on a severe 32 day bowel obstruction . I was full of stitches. In hospital for7 wks. CFS is hell. ReMag Magnesium Chloride 99,99 % was the only thing that helped with severe fatigue, I’m talking 4 days sleeping straight. I was exhausted all the time ,severe cramping in muscles and deep bone pain . My blood pressure went sky high in pain,normal whenever it was below a 4 .
Can we talk about dancers having this issue when training for endurance running because we never sickle our feet which in turn activates the anterior tibialus? Because someone needs to talk about this issue.
there is so called chronic exertional compartment syndrome ,often encountered in athlets and dancers ...there are some videos on this issue check youtube videos
I believe I am currently dealing with this. Im an aspiring police officer, and need to run. You mentioned drug use can be a cause or could increase its effects, could energy drinks like monster/ redbull do that? Or perhaps pre-workouts? Also if youre not suppose to run once it sets in how can i run a mile and a half?
My friend has surgery last week for this. But she had a swollen leg around the calf which was the diagnosis evidence. She didn't have a bone fracture or crush injury or any trauma. So what causes that type of compartment syndrome. it just repetitive use as in runners or drummers etc? Or an underlying vascular issue?
Need advice please help. I just had compartment syndrome on my elbow can corrective surgery be done. Cause I went for my 1st physio and was told that i should visit another orthopedic surgeon to see if corrective surgery can be done cause my hand is not on a straight position
Dr. Armando, how does Chronic Compartment syndrome develop? I have reoccurring compartment syndrome in both of my legs and I wonder how I developed this, is it possible to much running while in the Army was the cause?
Kyser, have you found out more? My son has been diagnosed with chronic compartment syndrome (4 compartments?) also from too much running in the Army. He is being med-boarded now. Do you know anything about non-surgical treatments?
They, doctors, are not going to give you any medical advice. If you're not a patient there is too much liability. Besides, they don't have enough of your medical history to give an informed decision. It would be an educated guess, at best, and there ,in turn, lies the risk of someone suing. Medical students probably have just as many classes about risk, obligations, and liability in medical school as they do science-based classes. I would think if any answer was provoked it would have to be a broad and hypothetical situation. For example: Could (not would) a fasciotomy be a possible treatment for a patient with chronic type compartment syndrome suffering from shin splints? Or what are some treatments for patients with chronic type compartment syndrome suffering from shin splints where conventional treatments have failed? See the difference? Best of luck to you.
i suffer from this greatly. Im a former football player but now I cant run more than 7 minutes before my left leg stiffens up and starts to flop on the pavement or treadmil. I always thought it was shin splints but Im just now finding out that I have either CECS or maybe even PAES. Is surgery the only option? I live in a remote area with no medical experts in this field.
Hello Ed, Surgery is apparently the only option, and even worse the surgery is only effect 50% of the time, I hear the surgery is also a painful and extended process.
📌 MAKE THIS LECTURE STICK: FREE PRACTICE QUESTIONS HERE! 🎓
youmakr.ai/test-playground/questionnaire/673d3fb5859b9c170836ed8b
Dr Armando
you are truely the hero of every student wether he was in medical school or pharmacy school like me ..
Thank you thank you thank you ❤ for every single thing you've done for us .. you 're a life saver ")
Greetings from Jordan - Amman!
Thank you x
Love your videos man!!!! It help so much you have no idea!! keep posting please, you are changing lives!
I'm an Australian ER nurse currently learning about paediatrics and this was so informative and gave me all the information I was looking for. Thank you
Hello Devine, I am a medical student, I would want to be in touch with you so that we assist each other academically. Thank you.
Absolutely amazing explanation of compartment Syndrome!!!
Great job DR
New fear unlocked
your drawing skill is next level, and its very helpful for clearing concept
Great review and sketching as you give detailed information really gives clarity. Thank you!!
I have CECS for 8 years now. When i was 15 i couldn't walk for 10 meters without pain. When i was 19, I got my first surgery. They made a little cut in the fascia in both shins. This cut recovered after a year. So the problems were back. The second surgery was a half year after that. They removed a bigger piece of the fascia in both shins. I did some fitness after 2 months of recovery, for like 4 months. Then I started indoor climbing. I feel my legs getting stronger and I was able to do a 3 km walk in 30 minutes, average speed was 6 km/h. That is my limit now but i believe it is possible to go further after more exercise.
I advice to take it easy after the surgery, take small steps and let your legs and feet get used to the exercise. Especially if you have not been able to do sports for a long time, because your muscles and tendons might be weak, as in my case.
the BEST teaching way ever ! thank you sooo much !
Dr. Hasudungan,
First I would like to congratulate you for such wonderful presentations. Second, I would like to know if there is a book or DVDs with your illustrations/explanation that could be bought by those looking for a fresh, different approach to important clinical concepts such as the ones you present on these videos. Thank you and please, keep up what you do.
Thank you Hernando. Look I wish I could create a book with the illustrations. Hopefully when I get a team going we could make this work :)
Thank you for explaining this. I had this last March. I presented at hospital and they suspected deep vein thrombosis and arranged for me to get a scan a few days later. Before that the pain went off the charts, I literally crawled to my neighbour’s car and after 3 hours waiting at the hospital they diagnosed it just in time. I had no injury but did have an undrained baker’s cyst. Skin grafts were taken from my upper leg. I have recovered but have to wear a compression sock for life to deal with the swelling.
Thank you for sharing your experience as a patient! As a medical student real life patient experiences really adds to my learning. Hope you're feeling better again Pete. 😊
Wow! I just found your channel today and I'm so mad I didn't find it sooner! great content! thank you!
Thank you for such a thorough explanation. 🙏🏽
Love your vids! The best medical stuff on YT! Greetings from Brazil!
th-cam.com/channels/WrKpl3L6uGT6gDwzihdCaw.html
I had a friend who after a prolonged period of unconsciousness in an awkward position with the circulation cut off to his leg, suffered an infarction in one of his thigh muscles, a portion of which was removed after he almost died from rhabdo. I actually had a similar thing happen, but I was fortunate enough only to have moderate to severe pain and a limp for a couple of weeks as the circulation hadn't been cut off long enough to kill the muscle. I had remained unconscious in an upright, cross-legged position for some amount of time, I'm not sure how long. But when I came to, my leg was almost completely paralyzed and as the sensation and mobility returned over the course of the next hour, it was replaced with terrible pain.
Nothing\ I developed it from a similar cause (fell unconscious and wasn't found for about 24 hours) but I had extreme damage in both calfs. My left was amputated just below the knee, and I had fasciotomies on my right, left open for 3 weeks with a vac thing and then closed up with skin grafts. I lost the ability to move my ankle, toes etc and required a triple arthrodesis to stop my foot twisting, and have had chronic pain ever since. That was about 6 years ago. I can't stand on my remaining foot for more than a few seconds, so I am totally wheelchair bound. Oh and I too nearly died from rhabdo, the surgeon wasn't sure if I'd make it off the table, when I did he thought I'd be on dialysis for the rest of my life. I was on dialysis for about a week, my body is strong and I have no lasting effects on my kidneys.
I was diagnosed with compartment syndrome. Had a paper for surgery. Decided to fix it myself.
Basically your muscle grew way faster than the slimy tube around them. Calf muscles puts a lot of preassure to that capsule. Thats why it hurts. Especially when you run. Because muscles get all pumped up and larger. Thats why you can sometimes run abit before it gets really bad. So there is a fix.
Buy a set of calf compression sleeves. If possible and fits, size down by one.
Not some crapoy sock looking ones. A real solid tight ones. Like compression sports ones.
Wear them as often as possible. If you can, go for a run. Basically they are tight enough that give that slimy capsules around your calf muscles some time to recover and get bigger. Fixed my problem with less then a week. Can you imageine, nearly went for a surgery with both legs. PS! Once you recover, it wont come back.
can you link me some good ones
How often do i wear the sleeve? Everyday until it's better and when i play sports or train, should i wear them? More Detail Please.
@@seyharobertson-zurzolo1194 bro this guys talking about chronic compartment which is vastly different from acute compartment can causes dead nerves and muscles as well as anemia in the affected limps why would u wanna further restrict blood flow just recompressing ur leg
Great video! But just a correction, the increase intracompartmental pressure leads to venous and lymphatic obstruction which then further increases the pressure and eventually causes arterial compromise.
Why venous first? Low pressures and the blood vessels are less muscular and thus easily compressed.
Arterial blood vessels are more muscular and have a high pressure; thus, needing an increased amount of pressure for compromise to occur.
yes...
Thank you so much for this video. Very educative and easy to understand.
Great video ! Just one correction though! The increased intramuscular pressure leads to venous lymphatic obstruction first then followed by arterial occlusion.
th-cam.com/channels/WrKpl3L6uGT6gDwzihdCaw.html
Very great video and very educating
wish i could write a very long paragraph venting abt my trauma and disability, but all im gonna say is, i had this when i was 5 in my arm and the doctors were...... not great. i was in hospital for 3 weeks, had 10 or 11 surgeries and later taught myself to be left-handed. since i was so young i only learned details and truths over 10 years later. sometimes i get upset abt it but im so much wiser now than i ever was.
Amazing.... 🎶 there are 3 you tubers i watch for school. Only 3 out of thousands....that i can always rely on.....
th-cam.com/channels/WrKpl3L6uGT6gDwzihdCaw.html
Came so close to losing my leg due to missing the compartment syndrome diagnosis . No fasciotomy performed on leg so we just crossed our fingers and I was lucky it went away. My arm had fasciotomy and though I still have some use of right arm, but the nerve damage and all the surgeries Heber taken its toll. Not much use
Great video Armando. Just small point. CK stands for CREATINE kinase, not creatinine kinase.
Wonderful explanation. Thanks
Thank you for your knowledge and how you present it!!
Excellent tutorial.
Thanks! Very simple and informative
Your my Hero Armando
great stuff as always Armando!
th-cam.com/channels/WrKpl3L6uGT6gDwzihdCaw.html
Hello I’ve had 4 Compartment syndromes in both my legs was hospitalized more then 1 year I would really like to meet others who have been thought the same thing
Oh man! That’s terrible! I expect you have had several skin grafts and live in compression socks! At least we can still walk!
Pretty long since you posted, but I had compartment syndrome in my right leg. 3 surgeries in one week trying to save it. That was June 2017. It took about 6 months to walk normally, and i can even run for about 1 minute now, though my endurance won't get any better. I lost 60-80% of my lower right leg, and several nerves never recovered. I have chronic pain, but was lucky. Sounds like you got it worse.
Thank you so much!! Going to quote this!
Love your videos! So informative!
Korlu Bosillo physotharpe forleg muscle
Great teacher 👏👏
Wow! You’re amazing!
Verygood presentation
Thanks for the video.
What sucks is I’m watching this after getting this while snowboarding about a week ago. No insurance. Don’t know what to do. I’ve been stretching and massaging it, but swelling persists. Makes me sick just watching
update?
Very nicely explaned 👍 loved it
th-cam.com/channels/WrKpl3L6uGT6gDwzihdCaw.html
I have this chronic pain in the posterior part of my right leg. I can feel the pressure and swelling in a certain area. It hurts more after running but the pain remains when I massage the area or apply pressure. I might need that surgery. I've had the same symptom since high school. 40 years old now.
Hi Armando!
Can we support you with euros ? Because as I went to the site Patreon, it is only notified in dollar, and I'm afraid there is taxes with the conversion dollar-->euros.
I really want to support you, you are doing a great job !
Thank you
Brilliant explanation.
th-cam.com/channels/WrKpl3L6uGT6gDwzihdCaw.html
Great video
I had severe trauma , 3-4 over a 2 yr period,and a life of severe abuse. However I was a workaholic,84 hours a week. I got a virus from my husband spraying my vegetable garden and I went out with girls ,I’m always the DD . I had one glass of homemade white wine ,and everyone threw up but me . I went home ,and awoke to use WRoom , and was 100% paralyzed for 5 days . I couldn’t move at all and 5 days later ,it just left.
I began to swell bad,and then one day I looked like a burn victim,my edema was severe.
I feel like a porcupine,any kind of stimulation at all. Coughing,sneezing,vomiting,sneezing,goosebumps,crying,orgasm, hug, blood pressure cuff , it’s like the nerve endings extend far ,and it feels like their on fire burning,with the tips of nerves feels like their being sliced with razor blades .
My sed rate was so high , and I’d had 85 surgeries, from 8 car accidents,rape victim,and malnutrition as a child .
Toxemia when pregnant, 4 days induced,nothing for pain , emergency surgery,placenta Snow White . I went into convulsions and 106 temperature because drs let me go to long in more labor,after they broke my water,so infection set in ,so my 10 pound baby was infected as was I . The preemie ward incubator barely fit ,IVS everywhere,on top on a severe 32 day bowel obstruction . I was full of stitches. In hospital for7 wks.
CFS is hell. ReMag Magnesium Chloride 99,99 % was the only thing that helped with severe fatigue, I’m talking 4 days sleeping straight.
I was exhausted all the time ,severe cramping in muscles and deep bone pain . My blood pressure went sky high in pain,normal whenever it was below a 4 .
Damn thats crazy dont remember asking tho
I had acute compartment syndrome with rhabdomyolysis you dont see me writing a novel, nobody asked.
@@Gamertag955 fucking RUDE reply. Didnt ask for that one..... I gotchoo mutual fuckah... you didn't need to ask. I did you a solid.
your work is really awesome!!😀😀😀 can u do a video on Bell's palsy...
th-cam.com/channels/WrKpl3L6uGT6gDwzihdCaw.html
Thank you!! can you cover more surgery related topics ?
th-cam.com/channels/WrKpl3L6uGT6gDwzihdCaw.html
I had this n nearly lost my leg at 15. Funny how I have to Google it to find out
Thanks that was realy helpful I had no idea what fasciotomy is do u have a website?
In the description~~
Thank u..
How many folks are marine or army veterans here after having your knees and shin destroyed after years of running in hard asphalt?
Not a vet, but a distance runner. I think we might have chronic compartment syndrome lol
@@thefman20 yep, aside from surgery, what can we do? I’ve heard of a new Botox treatment.
@@G.Harley.Davidson I think we would be better doing physio if the pressure is not that high. If not, the best way around it is surgery I believe
@@thefman20 dammit.
Can we talk about dancers having this issue when training for endurance running because we never sickle our feet which in turn activates the anterior tibialus? Because someone needs to talk about this issue.
there is so called chronic exertional compartment syndrome ,often encountered in athlets and dancers ...there are some videos on this issue check youtube videos
How long is it estimated that tissue becomes necrotic from compartment syndrome in the forearm?
I believe I am currently dealing with this.
Im an aspiring police officer, and need to run.
You mentioned drug use can be a cause or could increase its effects, could energy drinks like monster/ redbull do that? Or perhaps pre-workouts?
Also if youre not suppose to run once it sets in how can i run a mile and a half?
My friend has surgery last week for this. But she had a swollen leg around the calf which was the diagnosis evidence. She didn't have a bone fracture or crush injury or any trauma. So what causes that type of compartment syndrome. it just repetitive use as in runners or drummers etc? Or an underlying vascular issue?
I didn’t have an injury either. I believe I overdid it at the gym.
@@peteowen3539 how did u get it fix and how was ur symptoms ?
Need advice please help. I just had compartment syndrome on my elbow can corrective surgery be done. Cause I went for my 1st physio and was told that i should visit another orthopedic surgeon to see if corrective surgery can be done cause my hand is not on a straight position
Dr. Armando, how does Chronic Compartment syndrome develop? I have reoccurring compartment syndrome in both of my legs and I wonder how I developed this, is it possible to much running while in the Army was the cause?
Kyser, have you found out more? My son has been diagnosed with chronic compartment syndrome (4 compartments?) also from too much running in the Army. He is being med-boarded now. Do you know anything about non-surgical treatments?
I suffer from Chronic. Would a fasciotomy solve my shin splint issues? I've suffered for years and no treatment has helped.
Joe Mullin too bad this question hasn’t been answered. I hope you get relief someday. GL!
They, doctors, are not going to give you any medical advice. If you're not a patient there is too much liability. Besides, they don't have enough of your medical history to give an informed decision. It would be an educated guess, at best, and there ,in turn, lies the risk of someone suing. Medical students probably have just as many classes about risk, obligations, and liability in medical school as they do science-based classes. I would think if any answer was provoked it would have to be a broad and hypothetical situation. For example: Could (not would) a fasciotomy be a possible treatment for a patient with chronic type compartment syndrome suffering from shin splints? Or what are some treatments for patients with chronic type compartment syndrome suffering from shin splints where conventional treatments have failed? See the difference? Best of luck to you.
Hi, what factors can increase the pressure in the muscle compartment which inhibits the drainage of the veins from distal extremities? Thanks
Cut the compartments open, piss out the extra creatine kinases, iv hydration, wound vac?
Thanks! 27/3/22
Can high hematocrit cause this?
can it give you blood shedding?
i suffer from this greatly. Im a former football player but now I cant run more than 7 minutes before my left leg stiffens up and starts to flop on the pavement or treadmil. I always thought it was shin splints but Im just now finding out that I have either CECS or maybe even PAES. Is surgery the only option? I live in a remote area with no medical experts in this field.
Hello Ed, Surgery is apparently the only option, and even worse the surgery is only effect 50% of the time, I hear the surgery is also a painful and extended process.
jeh got this more in the legs and arms
Is this similar to CRPS?
Crush injuries
Thank you so much the video is amazing, but I think there is an error ant compart dorxiflexion and posterior compart plantar flexion, Have a nice day.
مو شرح ضيم 😂❤️
Thnk u
This is very evil 😈 attack of the devil
Quite the hog on this fella.