BREAST IMPLANT ILLNESS - Latest research and news stories

in #health6 years ago (edited)

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Is it real?

Breast implant illness (BII), as the name implies, is disease that occurs in the body because of the presence of breast implants. The majority of journalistic pieces on BII tend to include a clause that says something like, "BII is not yet recognised in the medical world or by the FDA as a real disease." I would like to take everyone reading this on two different roads that can help reach a conclusion as to whether BII is real or not. The first path is looking at the history of the medical field, in terms of medical mistakes, disasters and of a disruption in the accepted beliefs of the general medical world. The second path will be a presentation of all the current evidence for BII. Hopefully, this will help people in need of finding this information to make the critical decisions that will impact the rest of their lives.

Medical world in retrospect

The initial problem that a person with breast implants is faced with when first coming across BII, is that most doctors the person might visit are prone to reject the idea that breast implants can be the cause of any health problems. I have indeed heard of some doctors admitting that people tend to feel better after having the implants removed, but they also say that it does not necessarily prove anything meaningful.

While pondering this problem, I remembered a topic that I was very accustomed to during my nursing studies. It is called evidence-based practice (EBP). EBP is a gold-standard in the medical world, the pinnacle of each field of specialty. It refers to providing the absolute best care that is proven to be the absolute best by serious research. The challenge presented though, is the amount of time it takes before the evidence (research) becomes practice (hands-on treatment). To be more specific, it can take 17 years before new research is implemented.

17 years is a long time to wait and sometimes, the medical world continues to follow practices that are not in the best interest of the patients, despite the existing research showing the need for change. For many people with BII, 17 years might be too long to wait for doctors to start agreeing that their breast implants might play a part in their deteriorating health.

My other point is that everyone needs to remember that doctors are human, too. There is a myriad of problems in the medical industry. One pertinent and frightening example of this is that preventable medical mistakes are the third leading cause of death in the United States. The conclusion of this study states:

"All evidence points to the need for much more patient involvement in identifying harmful events and participating in rigorous follow-up investigations to identify root causes... Hospitals are simply not going to heal without attentive, systematic listening to those harmed patients or their survivors."

With this in mind, I would like to respectfully address a trend that is prevalent with health care providers (HCPs), then one amongst "laypeople", or rather, those with no tertiary training in the healthcare field.

HCPs often get annoyed and offended when a patient comes to them with some form of self-research ("I went on Google"), questioning the HCP's decisions. They sometimes under-inform their patients and don't adequately explain what is on a prescription. There is an impression that HCPs see themselves as superior to their patients.

The tendency among patients is that they surrender the responsibility for their health to their HCPs. They see HCPs as infallible and all-knowing, and take what they say as the final word. There is an impression that patients see themselves as inferior to their HCPs.

These mindsets set people up for a lot of avoidable medical disasters (as we can see in the above study). I want to mention some medical mistakes, detrimental practices and seemingly unavoidable tragedies that I hope will bring a sobering realisation to HCPs and their patients alike. The aim is not to discount the medical world, but to put everything into perspective. HCPs, do not disregard the patients' right to knowledge. Patients, do not be disillusioned by the status of HCPs, and take responsibility for your health.

Another very important point is that doctors have an extremely high-stress occupation, very often with unreasonable expectations placed upon them in terms of work hours and patient quotas. Patients should let go of the unrealistic expectations that they have regarding the standard of perfection that they hold their HCPs to. Saying things like, "I would just listen to the doctor, they always know best," and "Your doctor always has your best interest in mind" are absolute statements and place unnecessary burdens on HCPs.

In 1991, the famous artist Andy Warhol died from neglectful fluid overload in the hospital:
https://www.nytimes.com/1991/12/05/nyregion/care-faulted-in-the-death-of-warhol.html

X-rays were used from the 1920's to mid 1970's to visualise the babies and pelvic structure of pregnant women. In the 1950's, research started showing that obstetric x-rays were linked to miscarriage, microcephaly, leukemia and other malignancies in babies. It took more than 20 years of published studies and constant warnings about the dangers of X-rays in pregnancy for the practice to fall out of use:
https://pubs.rsna.org/doi/full/10.1148/radiol.14140238

Babies used to undergo surgery without pain medication up until the 1980's, because it was believed that babies couldn't feel pain:
http://www.ox.ac.uk/news/2015-04-21-babies-feel-pain-adults#

Pregnant women in the late 1950's and early 60's were freely given thalidomide to treat morning sickness. What followed was one of the biggest man-made medical disasters, as thalidomide caused an increase in miscarriages and severe birth deformities affecting multiple body systems, most notably phocomelia, grossly underdeveloped or absent limbs:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4737249/

Pursposefully adulterated heparin from China killed 85 people and left nearly 800 seriously injured in 2008; in 2016, another Chinese heparin manufacturer was involved in falsification and Good Manufacturing Practice non-compliance:
https://www.gmp-compliance.org/gmp-news/chinese-heparin-manufacturer-again-involved-in-falsification-and-gmp-non-compliance

The pharmaceutical company, Merck, released Vioxx as a treatment for pain related to arthritis, dysmenorrhoea and other general painful conditions, despite its own scientists expressing concern over its adverse effects on the cardiovascular system. Merck purposefully withheld information from doctors about Vioxx's risks and even intimidated and pressured doctors who were questioning Vioxx's safety. After about 140,000 serious cardiovascular incidents (including strokes and heart attacks), the drug was recalled in 2004:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1779871/

In 2012, 64 patients died from fungal meningitis and more than 700 others suffered from this infection due to a steroid injection (commonly used to treat arthritis pain and severe allergic reactions) that had been improperly sterilised by the manufacturer. The pharmacist involved purposefully covered up the contamination and shipped the medication anyways:
https://www.fda.gov/ICECI/CriminalInvestigations/ucm594800.htm

In 2007, cough syrup in Panama was unknowingly mixed with diethylene glycol (used in antifreeze) instead of glycerine (seemingly purposefully mislabeled by manufacturers in China). Diethylene glycol causes organ failure and can lead to death, even in very small doses. This led to the poisoning of hundreds of children, with families claiming 365 deaths and 100 deaths confirmed. Similar events have occured in Bangladesh, India, Argentina, Nigeria and Haiti:
https://www.nytimes.com/2007/05/06/world/americas/06poison.html

In 2003, a girl accidentally received an incompatible heart and lung transplant with the wrong blood type, leading to her death:
https://core.ac.uk/download/pdf/81975795.pdf

Lastly, a very relevant example from 2011, French breast implant manufacturers used industrial-grade instead of medical-grade silicone for their breast implants. The industrial-grade silicone implants were much cheaper and were known to have high amounts of contaminants. People who received these implants were exhorted to get them removed, with concerns over inflammation and cancer:
https://edition.cnn.com/2012/01/27/world/europe/pip-breast-implant-scandal-explained/index.html

These are just a handful of examples amongst thousands of stories. I want to reiterate that I am not saying the medical world is bad and we should stay away from it. The solution to breast implant illness is to have an explant (the surgical removal of the implants), and for that you would need a team of HCPs. The point I want to make is that if a person goes to a HCP and says, "I think my breast implants are making me sick," the reaction from the HCP should not be, "Of course not, that is ridiculous." For people who have heard that from HCPs, the examples that I have highlighted should provide enough reasons to help them realise that the word of a HCP is not always right, true or founded in research. Again, I'm not saying that this is the case with all HCPs, all the time.

The evidence for BII

I first came across the concept of BII on social media in 2016, specifically Facebook. I was made aware by a close family member of a woman asking what her best options were for making her breasts look like they used to before her first pregnancy, more than 12 years prior to her post. This family member mentioned me in the comments of a handful of women saying to stay away from breast implants and linking a few other Facebook groups dedicated to BII. One of these groups has over 60,000 members and is filled with personal testimonies and experiences linked to severe systemic illness that practically resolved after having their implants removed.

There is a growing body of research showing that these testimonies are not made up or merely a placebo effect.

My succinct summary of the research is as follows:

Silicone implants bleed silicone into the body and act as a constant stimulant to the immune system. There are several ingredients other than silicone, in these implants, many of which are believed to cause toxicity in the body, leading to endocrine disruption, toxicity and malignancy.

Saline implants are encased in a silicone shell, so they present with similar problems as silicone implants. Saline solutions' sterility is known to expire, especially when stored under unfavourable conditions (think warm, dark, wet environment; also the sterility is compromised by constant pressure from, for example, hugs, sleeping on the stomach, falls, car accidents, mammograms, and can lead the faults in the valve) and the solution starts to harbour harmful microorganisms that form a microfilm and lead to biotoxicity.

The symptoms of BII are extensive, and that is because the entire body, with the majority of its systems, is compromised by the breast implants.
BII symptoms from https://healingbreastimplantillness.com/breast-implant-symptoms/:
FATIGUE
BRAIN FOG, MEMORY LOSS
MUSCLE AND JOINT PAIN
HAIR LOSS, DRY SKIN AND HAIR
PREMATURE AGING
WEIGHT PROBLEMS
INFLAMMATION
POOR SLEEP AND INSOMNIA
DRY EYES, DECLINE IN VISION
HYPO/HYPER THYROID SYMPTOMS
HYPO/HYPER ADRENAL SYMPTOMS
PARATHYROID PROBLEMS
HORMONE IMBALANCE, DIMINISHING HORMONES, EARLY MENOPAUSE
HYSTERECTOMY
LOW LIBIDO
SLOW HEALING, EASY BRUISING
THROAT CLEARING, COUGH, DIFFICULTY SWALLOWING, CHOKING, REFLUX, METALLIC TASTES
VERTIGO
GASTROINTESTINAL ISSUES SUCH AS ACID REFLUX, GERD, GASTRITIS
LEAKY GUT, IBS AND SIBO
PANCREATITIS
FEVERS, NIGHT SWEATS, INTOLERANT TO HEAT/COLD
PERSISTENT BACTERIAL, VIRAL, FUNGAL INFECTIONS
YEAST INFECTIONS, CANDIDA, SINUS AND UTI INFECTIONS
SKIN RASHES
EAR RINGING
SUDDEN FOOD INTOLERANCE AND ALLERGIES
HEADACHES, MIGRAINES AND OCULAR MIGRAINES
SLOW MUSCLE RECOVERY AFTER ACTIVITY
HEART PALPITATIONS, CHANGES IN NORMAL HEART RATE OR HEART PAIN
SORE AND ACHING JOINTS OF SHOULDERS, HIPS, BACKBONE, HANDS AND FEET
SWOLLEN AND TENDER LYMPH NODES IN BREAST AREA, UNDERARM, THROAT, NECK, GROIN
DEHYDRATION FOR NO REASON
FREQUENT URINATION
NUMBNESS/TINGLING SENSATION IN UPPER AND LOWER LIMBS
COLD AND DISCOLORED LIMBS, HANDS AND FEET
GENERAL CHEST DISCOMFORT SHORTNESS OF BREATH
PAIN AND OR BURNING SENSATION AROUND IMPLANT AND OR UNDERARM
LIVER AND KIDNEY DYSFUNCTION
GALLBLADDER PROBLEMS
TOXIC SHOCK SYMPTOMS
ANXIETY, DEPRESSION AND PANIC ATTACKS
FEELING LIKE YOU ARE DYING
SYMPTOMS OF FIBROMYALGIA
SYMPTOMS OF LYME DISEASE
SYMPTOMS OF EBV
SYMPTOMS OF AUTO-IMMUNE DISEASES SUCH AS; RAYNAUD’S SYNDROME, HASHIMOTO’S THYROIDITIS, RHEUMATOID ARTHRITIS, SCLERODERMA, LUPUS, SJOGREN’S SYNDROME, NONSPECIFIC CONNECTIVE TISSUE DISEASE, MULTIPLE SCLEROSIS
SYMPTOMS OF BIA-ALCL LYMPHOMA
DIAGNOSIS OF CANCER

I felt that I didn't need to mention the fact breast implants are well-known and accepted to not be life-time device, and that the recommendation is to get them replaced every 7-10 years. But here I go. The longer the implants stay in, the rate of complications increases.

Here are studies about the effects of breast implants on the body.

This study looked at participants with autoimmune/inflammatory syndrome induced by adjuvants (ASIA) due to silicone implants. The participants had symptoms that included fatigue, muscle and joint pain, cognitive dysfunction, fever and dry eyes and mouths. The study concluded that there is limited evidence that silicone breast implants are safe:
https://link.springer.com/article/10.1007/s12026-016-8821-y

Silicone-filled breast implants may increase the risk of developing (auto) immune diseases and immune deficiencies:
https://link.springer.com/article/10.1007/s12026-013-8401-3

There is increasing evidence of a plausible link between silicone exposure from breast implants and the appearance of full-blown autoimmune inflammatory rheumatic conditions:
http://www.clinexprheumatol.org/article.asp?a=8023

Individuals with breast implants have a risk of developing breast implant-associated anaplastic large cell lymphoma, or BIA-ALCL. BIA-ALCL is not breast cancer—it is a type of non-Hodgkin’s lymphoma (cancer of the immune system):
https://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/BreastImplants/ucm239995.htm

The chronic inflammation associated with silicone-induced immune system irritation and toxicity from biofilms may be linked to the development of the cancer known as anaplastic large cell lymphoma:
https://www.sciencedirect.com/science/article/pii/S0896841115300275

A clear pattern of symptoms was reported in women with silicone breast implants, including fatigue, joint and muscle pain, morning stiffness, night sweats, cognitive and dermatological complaints. The observed pattern of symptoms was compatible with ASIA. In 69% of women, explantation of implants reduced symptoms. The probable association between the silicone implants and their complaints should be taken seriously:
http://njmonline.nl/getpdf.php?t=i&id=168#page=37

Fungus growing inside saline breast implants can move through the semi-permeable silicone shell into the body:
https://www.ncbi.nlm.nih.gov/pubmed/16996440

The product insert for breast implants states that the safety of breast implants has not been established in people with existing autoimmune diseases:
https://www.accessdata.fda.gov/cdrh_docs/pdf3/p030053c.pdf

Fungus infection in saline breast implants can cause severe capsular contracture (internal scar tissue developed by the immune system around a foreign object that forms so tightly that it can misshape and harden the breast implant). The fungus was able to thrive in the saline solution because of diffusion of its nourishment through the silicone shell:
https://www.ncbi.nlm.nih.gov/pubmed/7480245

Several types of bacteria and fungi can grow and reproduce in saline breast implants over a long period of time:
https://www.ncbi.nlm.nih.gov/pubmed/9207676

Biofilm disease (biofilms are strong, slimy layers of bacteria or fungi that tend to grow around foreign objects in the body, like breast implants, and they cause and complicate many infections in the body) is a likely cause of capsular contracture:
https://www.ncbi.nlm.nih.gov/pubmed/12655204

Here are some of the latest news stories about the controversy surrounding breast implants:

The U.S. Food and Drugs Administration (FDA) sends a letter to all HCPs to make known to them the association between breast implants and BIA-ALCL, regardless of the breast implant's filling or texture:
https://www.fda.gov/MedicalDevices/Safety/LetterstoHealthCareProviders/ucm630863.htm?utm_source=CDRHTwitterI&fbclid=IwAR3B0i18hcvKdmB4gStc979G1-n-WoKlu5mZOyS9_TPGBRMzncPx-C2BlQs

U.S. and European authorities allowed manufacturers to keep breast implant injury reports hidden from the public:
https://www.icij.org/investigations/implant-files/breast-implant-injuries-kept-hidden-as-new-health-threats-surface/

Global investigation into breast implants finds lack of clinical oversight and failure to track long-term outcomes:
https://www.theguardian.com/society/2018/nov/26/breast-implants-study-reveals-serious-safety-concerns?CMP=share_btn_fb

Investors have filed a class action lawsuit against leading breast implant manufacturer Allergan, alleging that the company concealed from them association between textured breast implants and a rare form of cancer, BIA-ALCL:
https://www.icij.org/investigations/implant-files/allergan-faces-fresh-woes-as-investors-sue/?utm_content=buffer45fe9&utm_medium=social&utm_source=twitter.com&utm_campaign=Buffer+-+Twitter

Allergan can no longer sell its Microcell and Biocell textured breast implants in Europe and the FDA is also holding a meeting to discuss the potential risks of implants in 2019:
http://fortune.com/2018/12/19/europe-bans-allergan-breast-implants/

Textured Biocell implants, made by Allergan, have come under scrutiny among a growing number of plastic surgeons who are documenting high incidents of health problems. Some are blacklisting the once-popular devices and calling for their removal from the market:
https://www.thestar.com/news/investigations/2018/11/26/biocell-breast-implants-at-centre-of-biggest-controversy-in-plastic-surgery.html

Silicone breast implants increase arthritis risk by 600%, stillbirth risk by 450% and skin cancer risk by 400%:
https://www.dailymail.co.uk/health/article-6410599/Silicone-breast-implants-increase-risk-arthritis-stillbirth-skin-cancer.html

A comprehensive piece about BII:
https://www.longevitylive.com/anti-aging-beauty/anti-aging-health-studies/breast-implants-poisoning/

Personal stories are the next piece of evidence I have to present. Tens of thousands of people are testifying that they were extremely sick and felt remarkably better after getting a breast explant. The majority of those were people who had HCPs disregard their symptoms for many years and deny the possibility that their implants contributed to their health condition. I would like to quote again the study about medical mistakes being the third leading cause of death in the US:

"All evidence points to the need for much more patient involvement in identifying harmful events and participating in rigorous follow-up investigations to identify root causes... Hospitals are simply not going to heal without attentive, systematic listening to those harmed patients or their survivors."

With the ever increasing numbers of explant healing testimonies, the opinion, intuition, research and worries of a patient should not be ignored.

I have a lot of links to news stories of women who had breast implants removed. All of their stories have a similar unfolding: They were mostly healthy, decided to get breast implants, their health deterioated, they removed the implants and they started getting better.

If you only read one of these stories, please make sure to read the entire first story that I am posting here!
https://www.eastidahonews.com/2019/02/local-mom-issues-warning-after-breast-implant-nightmare/?fbclid=IwAR1Vj6nBz6H4ziHr8Tjr1hTgePqchayR894xnGyfl6hLQTM1GzGEZ0gbCgA

https://www.dailymail.co.uk/health/article-6602655/Former-Miss-Virginia-left-suicidal-bed-ridden-agonizing-pain-BREAST-IMPLANTS.html

https://inews.co.uk/news/real-life/breast-implant-illness-allergan-woman-bedridden-toxic-leaking-removed-after-years-of/?fbclid=IwAR3HpPVabqqDeGtJGTuCa4GdqwYKYRonPeO9nVOMkpAGGh_zcXikA1acda8

https://www.dailymail.co.uk/femail/article-6590239/Woman-removes-34DDD-breast-implants-says-sick.html

https://m.belfasttelegraph.co.uk/news/northern-ireland/the-fatigue-was-unreal-i-was-convinced-i-was-going-to-die-cancer-survivor-tells-of-her-implants-nightmare-after-breast-surgery-37697422.html

https://wisemindhealthybody.com/collective-evolution/playboys-crystal-hefner-truth-behind-breast-implants/?c=aan&utm_term=aan

https://philadelphia.cbslocal.com/2018/12/06/many-women-getting-breast-implants-removed-in-light-of-health-concerns/

https://inews.co.uk/news/real-life/breast-swelled-implants-enlargement-risks-cancer-allergan-bia-alcl-lymphoma/

http://www.nbc12.com/2018/12/17/i-wanted-feel-more-feminine-woman-warns-breast-implant-illnesses/

https://www.shape.com/lifestyle/mind-and-body/breast-implants-removed-feel-better-years

https://medium.com/@jodysedgwick/health-is-the-new-fake-8fe5b62acaa5?fbclid=IwAR15FPb4jPEBnrkv-Lb5UAq6Wj3ML3nKCxr6Ca_xn6Ku4RWRKWeaJaqnMW0.

I hope this information will empower everyone to make the best decisions for their health! There are a lot of websites and Facebook groups with information pertinent to getting breast implants out. The implant needs to be removed with the entire capsule around it, a procedure known as explant en bloc capsulectomy.

I also want to add that there should be no judgement for people who decided to get breast implants in the past, as we all do what we deem best with the information we had available to us at that time. I want to reach out to each person who has gotten implants or considering to get them, and implore you to realise that our standard of beauty should not be measured against a fake image in a magazine, but against our best and healthiest self. If your healthiest self has no boobs, then that is your most beautiful form.

P.S. A very big thank you to my dad and his wife @febeje for the technical editing they did on this article!!

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Getting sued for medical mistakes doesn't help the stress levels placed on the HCPs either. They just add more and more procedures, paperwork, double checking and hoops to jump through to try and avoid mistakes, making an environment so stressful that mistakes are actually more likely to happen. If someone does make a mistake, it's costly for the company if they admit it. So they are more likely to cover it up for fear of losing their job or worse. Hence contaminated medicine being sent out.

I can imagine that a doctor who agrees that someone's implants are likely causing them to get sick and advise removal or advise against having them, will come under fire from those in the industry, who can threaten to sue as there is no concrete evidence that they cause illness. HCPs continually walk on eggshells.

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This is absolutely true. The levels of stress that HCPs have to deal with is terrible. I have read that doctors have the highest rate of suicide amongst professionals. It's a big problem. HCPs can't just try to do their jobs with their whole hearts. They constantly have to be checking their backs and do what they perceive is least dangerous for themselves, not what is best for their patients.

FAKE BOOBS AREN'T COOL!

There. Just needed to get that out.

What a post, and very well annotated!

Great comment! I love how you went through all the effort to emphasise the weight of your conclusion!!! :'D

Hahaha it's a topic I'm passionate about 😂 we'll suffice to leave it at that. Now I have a scientific reason too!

Haha, best response! :D

Patients need to know the pros and cons of every management/procedures. They need also to be involved in their care...it's their bodies, their lives...their choices.

A big factor though is the reliability of all the informations given to them. Neglected or omitted informations. Most times, doctors are only aware of what they've been fed, of the research-based results, that can be fake or real. There are fake scientific results out there and growing.

Like the Gershon therapy, a number of patients coming out to have been cured of cancer are not believed by medical practitioners for the lack of scientific data to prove it. There would be none or very little as no pharma will conduct something to the detriment of their business.

Implants are no longer there to save lives, for people to have quality of life. Corporations, medical practioners, private institutions are here now to make money. This is what we see and experience today. As for the consequences, acknowledging it means they've done wrong for the world to see. Even if the endpoint are diseases, death or destroyed lives. In contrast to what was the aim before a procedure.

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I agree with you. I feel that people need to also take responsibility in finding information to direct their choices. As you mentioned the questionable reliability of info given to patients, people really need to make sure that what is being done is really the best. The responsibility definitely doesn't lie solely on the HCPs.

And the fake studies are really a scary thing that is rising up. We all need discernment in every situation...

Sadly, there are still many who rest everything with their practitioners, nor want to get involved in the decision-making.

Learning of the presence of fake studies was very alarming. Discernment needs time too so we need to be diligent. Your research was very thorough.

Great post! There is a TON of info and references in here. I am going to have to re read some of this to better absorb the info!

Hopefully this will help some people out there suffering from illness from their implants and help them decide what to do about it! Personally, I would never have something implanted in me, but that's just me, no judgement toward anyone who opts for these things.
The medical field is full of craziness, and I deal with it mainly by staying FAR away from all that, andmaintain my families health at home. :)

I agree that I would never choose to implant something into my body!! I personally can't imagine having surgery because I feel like having it 😅😅😅.

And I'm right there with you!!!! Absolutely don't need to go running to the medical world constantly, especially when our lifestyle choices make medical world mostly redundant.

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Yhank you so much for this post @vanessamidwife. I didn't know that implants effect so much on all the body..

Those poor woman! I can see the companies who stand to.profit from them don't want to admit fault but wow.. there's so much evidence stacked against them I'm suprised people don't take this into account now when they get them. The body positive movement has come a long way... let's hope it continues so woman don't resort to killing themselves to look good. It must have been so terrifying.. the first woman's story was intense!!

What a well researched and written article.

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Thank you! Yes, the body positive movement needs to carry its momentum over into helping women choose quality of life and health over vanity. To help each woman realise that she does not have to measure up to the fake standard of all the fake magazines... We each are our own standard. We need to do what is best for us, not for a moment comparing ourselves to someone else.

What an excellent and informative post! So many links, I was shocked about the babies feeling no pain link.... unbelievable and unthinkable!!!!

Sadly, we pay a price for “beauty”; money would be better spent teaching us to accept our natural beauty instead of continuously relying on foreign substances!

Thank you for sharing!

I saw a quote similar to this somewhere on the internet... Imagine how many industries would go out of business if women woke up and decided they like how they look.

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A very well-written article! Your dad and I thank YOU for trusting us. Keep on writing xx