- I SIGNED UP FOR THE ARMY IN 1978.
- I SIGNED UP FOR THE ARMY IN 1978.

I REPAIRED WEAPONS.
I REPAIRED WEAPONS.

ANYTHING THAT THE MILITARY FIRED I FIXED.
ANYTHING THAT THE MILITARY FIRED I FIXED.

GOT HIRED AT THE POST OFFICE IN 1983.
GOT HIRED AT THE POST OFFICE IN 1983.

I ENJOYED BEING A LETTER CARRIER FOR 30 YEARS,
I ENJOYED BEING A LETTER CARRIER FOR 30 YEARS,

AND I WOULD'VE STILL BEEN DOING IT
AND I WOULD'VE STILL BEEN DOING IT

IF I DIDN'T GET BLESSED WITH THIS ILLNESS.
IF I DIDN'T GET BLESSED WITH THIS ILLNESS.

I COULDN'T DRIVE MY VEHICLE NO MORE.
I COULDN'T DRIVE MY VEHICLE NO MORE.

I COULDN'T WALK...
I COULDN'T WALK...

HAD NO MOVEMENT IN MY SHOULDERS.
HAD NO MOVEMENT IN MY SHOULDERS.

I COULDN'T PERFORM MY ROUTE.
I COULDN'T PERFORM MY ROUTE.

I'D GET ON THE ROUTE AND FREEZE UP.
I'D GET ON THE ROUTE AND FREEZE UP.

IT WAS VERY HARD FOR ME.
IT WAS VERY HARD FOR ME.

- MILES IS A 53-YEAR-OLD MAN
- MILES IS A 53-YEAR-OLD MAN

WHO HAS PARKINSON'S FOR THE LAST 14 YEARS.
WHO HAS PARKINSON'S FOR THE LAST 14 YEARS.

HE HAS SUFFERED UNTIL ABOUT A YEAR AGO
HE HAS SUFFERED UNTIL ABOUT A YEAR AGO

WITH REALLY BAD MOTOR FLUCTUATIONS,
WITH REALLY BAD MOTOR FLUCTUATIONS,

SEVERE RIGIDITY, TREMOR,
SEVERE RIGIDITY, TREMOR,

AND WHERE HE DID GET TO A POINT WHERE HE NEEDED A WHEELCHAIR
AND WHERE HE DID GET TO A POINT WHERE HE NEEDED A WHEELCHAIR

TO GO LONG DISTANCES, AND ALSO HE HAD A LOT OF PAIN.
TO GO LONG DISTANCES, AND ALSO HE HAD A LOT OF PAIN.

- PARKINSON DISEASE PATIENTS DO HAVE A LOT OF PAIN,
- PARKINSON DISEASE PATIENTS DO HAVE A LOT OF PAIN,

AND WE OFTEN DON'T STRESS THAT AS THE MAIN SYMPTOM
AND WE OFTEN DON'T STRESS THAT AS THE MAIN SYMPTOM

THAT WE TALK ABOUT WITH PARKINSON'S DISEASE.
THAT WE TALK ABOUT WITH PARKINSON'S DISEASE.

WE OFTEN ARE THINKING ABOUT THEIR MOTOR PROBLEMS,
WE OFTEN ARE THINKING ABOUT THEIR MOTOR PROBLEMS,

THEIR TREMOR, THEIR SLOWNESS, THEIR GAIT,
THEIR TREMOR, THEIR SLOWNESS, THEIR GAIT,

BUT PAIN CAN BE A SIGNIFICANT SYMPTOM, AS WELL.
BUT PAIN CAN BE A SIGNIFICANT SYMPTOM, AS WELL.

HI, MR. GARCIA. - HELLO.
HI, MR. GARCIA. - HELLO.

- DR. OSTREM. NICE TO SEE YOU AGAIN.
- DR. OSTREM. NICE TO SEE YOU AGAIN.

THERE'S A LOT OF DIFFERENT WAYS IN WHICH PAIN
THERE'S A LOT OF DIFFERENT WAYS IN WHICH PAIN

CAN BE A PART OF THE SYNDROME, AND ONE OF THE THINGS
CAN BE A PART OF THE SYNDROME, AND ONE OF THE THINGS

THAT WE OFTEN SEE IT ASSOCIATED WITH
THAT WE OFTEN SEE IT ASSOCIATED WITH

IS THAT OF PROMINENT RIGIDITY.
IS THAT OF PROMINENT RIGIDITY.

- THE WAY A PATIENT WOULD SENSE RIGIDITY
- THE WAY A PATIENT WOULD SENSE RIGIDITY

IS THAT THEY'RE VERY TIGHT.
IS THAT THEY'RE VERY TIGHT.

IT'S LIKE YOU HAVE TIGHT MUSCLES.
IT'S LIKE YOU HAVE TIGHT MUSCLES.

- AND DYSTONIA IS ANOTHER TYPE OF MOVEMENT
- AND DYSTONIA IS ANOTHER TYPE OF MOVEMENT

THAT IS ASSOCIATED WITH CO-CONTRACTION OF MUSCLES.
THAT IS ASSOCIATED WITH CO-CONTRACTION OF MUSCLES.

- FOR EXAMPLE, THE NECK WILL START ACTIVATING
- FOR EXAMPLE, THE NECK WILL START ACTIVATING

ON ONE SIDE REPETITIVELY, CONSISTENTLY WITHOUT STOPPING,
ON ONE SIDE REPETITIVELY, CONSISTENTLY WITHOUT STOPPING,

AND YOU START TO SEE MAYBE THAT SAME TURN OF THE HEAD
AND YOU START TO SEE MAYBE THAT SAME TURN OF THE HEAD

IF THE NECK MUSCLES ARE DYSTONIC.
IF THE NECK MUSCLES ARE DYSTONIC.

- THERE'S MORE OF A ABNORMAL CURLING OF A JOINT,
- THERE'S MORE OF A ABNORMAL CURLING OF A JOINT,

OF A FOOT, OF A TOE.
OF A FOOT, OF A TOE.

IT COULD CURL DOWN. IT COULD CURL UP.
IT COULD CURL DOWN. IT COULD CURL UP.

- AND IT'S OFTEN ASSOCIATED WITH PAIN.
- AND IT'S OFTEN ASSOCIATED WITH PAIN.

- MILES' WORST PAIN WAS BETWEEN HIS SHOULDER BLADES
- MILES' WORST PAIN WAS BETWEEN HIS SHOULDER BLADES

AND IN THE BACK, AND IT WAS REALLY TROUBLING
AND IN THE BACK, AND IT WAS REALLY TROUBLING

TO TRY AND SORT THAT OUT, WHAT THE PROBLEM WAS.
TO TRY AND SORT THAT OUT, WHAT THE PROBLEM WAS.

WE DIDN'T KNOW WHETHER IT WAS AN ORTHOPEDIC ISSUE
WE DIDN'T KNOW WHETHER IT WAS AN ORTHOPEDIC ISSUE

OR WHETHER IT WAS HIS PARKINSON'S,
OR WHETHER IT WAS HIS PARKINSON'S,

FROM RIGIDITY OR DYSTONIA.
FROM RIGIDITY OR DYSTONIA.

- THE PAIN THAT I'M DESCRIBING IN MY BACK AREA
- THE PAIN THAT I'M DESCRIBING IN MY BACK AREA

WAS VERY INTENSE,
WAS VERY INTENSE,

VERY SEVERE,
VERY SEVERE,

COULDN'T GET NO RELIEF AT ALL.
COULDN'T GET NO RELIEF AT ALL.

- I THINK THAT PAIN AS A NON-MOTOR SYMPTOM
- I THINK THAT PAIN AS A NON-MOTOR SYMPTOM

IS VERY DISABLING.
IS VERY DISABLING.

- COULDN'T EVEN GET OUT OF BED SOMETIMES BECAUSE OF THE PAIN.
- COULDN'T EVEN GET OUT OF BED SOMETIMES BECAUSE OF THE PAIN.

- SO PAIN AND DEPRESSION
- SO PAIN AND DEPRESSION

DEFINITELY CORRELATE STRONGLY WITH EACH OTHER.
DEFINITELY CORRELATE STRONGLY WITH EACH OTHER.

- WHEN I WAS HURTING,
- WHEN I WAS HURTING,

I WAS SAD.
I WAS SAD.

I WAS DOING EVERYTHING I COULD TO KEEP POSITIVE
I WAS DOING EVERYTHING I COULD TO KEEP POSITIVE

AND THINKING THAT EVERYTHING WAS GONNA LOOSEN UP
AND THINKING THAT EVERYTHING WAS GONNA LOOSEN UP

AND I WAS GONNA GET BACK TO WORK.
AND I WAS GONNA GET BACK TO WORK.

I WANTED TO FUNCTION FOR MY WIFE AND MY SON
I WANTED TO FUNCTION FOR MY WIFE AND MY SON

AND MY FRIENDS AND MYSELF.
AND MY FRIENDS AND MYSELF.

I WASN'T READY TO THROW IN THE TOWEL JUST YET.
I WASN'T READY TO THROW IN THE TOWEL JUST YET.

- IF THE PAIN IS FROM PARKINSON'S DISEASE,
- IF THE PAIN IS FROM PARKINSON'S DISEASE,

IT OFTEN WILL GET BETTER WHEN YOU GIVE THE PATIENT
IT OFTEN WILL GET BETTER WHEN YOU GIVE THE PATIENT

APPROPRIATE MEDICATION TO TREAT THEIR SYMPTOMS.
APPROPRIATE MEDICATION TO TREAT THEIR SYMPTOMS.

- LET'S JUST GET AN IDEA OF HOW BAD THE PAIN IS.
- LET'S JUST GET AN IDEA OF HOW BAD THE PAIN IS.

CAN YOU GIVE ME A SENSE ON THE SCALE HERE
CAN YOU GIVE ME A SENSE ON THE SCALE HERE

HOW MUCH PAIN YOU'RE EXPERIENCING RIGHT NOW?
HOW MUCH PAIN YOU'RE EXPERIENCING RIGHT NOW?

- I' HAVING MAYBE TWO TO FOUR.
- I' HAVING MAYBE TWO TO FOUR.

- AND SO THE GOAL OF A NEUROLOGIST
- AND SO THE GOAL OF A NEUROLOGIST

TAKING CARE OF PARKINSON'S PATIENT IS REALLY
TAKING CARE OF PARKINSON'S PATIENT IS REALLY

TO HELP IMPROVE THEIR ON TIME SO THAT THEY DON'T HAVE
TO HELP IMPROVE THEIR ON TIME SO THAT THEY DON'T HAVE

THESE WINDOWS IN THEIR DAY WHERE THEIR SYMPTOMS
THESE WINDOWS IN THEIR DAY WHERE THEIR SYMPTOMS

ARE VERY SEVERE AND THERE WON'T BE AS MUCH PAIN THEN, AS WELL.
ARE VERY SEVERE AND THERE WON'T BE AS MUCH PAIN THEN, AS WELL.

- WE'RE REALLY HOPING THAT
- WE'RE REALLY HOPING THAT

WHEN WE TREAT THE PARKINSON'S SYMPTOMS WITH MEDICATIONS,
WHEN WE TREAT THE PARKINSON'S SYMPTOMS WITH MEDICATIONS,

WITH DBS, OR WITH BOTOX THAT WE'RE REALLY RELIEVING
WITH DBS, OR WITH BOTOX THAT WE'RE REALLY RELIEVING

THAT PAIN SYNDROME SO THEY CAN CARRY ON THEIR LIFE.
THAT PAIN SYNDROME SO THEY CAN CARRY ON THEIR LIFE.

- EXERCISE IS ONE OF THE MOST POWERFUL FORMS OF TREATMENT
- EXERCISE IS ONE OF THE MOST POWERFUL FORMS OF TREATMENT

THAT WE HAVE NOT JUST FOR PARKINSON'S,
THAT WE HAVE NOT JUST FOR PARKINSON'S,

FOR MANY OTHER HEALTH CONDITIONS.
FOR MANY OTHER HEALTH CONDITIONS.

- AND WE KNOW THAT IF PATIENTS DO EXERCISE
- AND WE KNOW THAT IF PATIENTS DO EXERCISE

AND ARE MOVING THEIR BODIES MORE THAT THEY WILL HAVE LESS PAIN,
AND ARE MOVING THEIR BODIES MORE THAT THEY WILL HAVE LESS PAIN,

ACTUALLY HAVE LESS PROGRESSION OF THE DISEASE, AS WELL.
ACTUALLY HAVE LESS PROGRESSION OF THE DISEASE, AS WELL.

- IN JANUARY, DR. GLASS INCREASED MY MEDICATION
- IN JANUARY, DR. GLASS INCREASED MY MEDICATION

TO FOUR TABLETS EVERY THREE HOURS.
TO FOUR TABLETS EVERY THREE HOURS.

I WAS ONLY GETTING LIKE SEVEN MINUTES
I WAS ONLY GETTING LIKE SEVEN MINUTES

OF ACTUAL MOVEMENT,
OF ACTUAL MOVEMENT,

AND THEN I WOULD HAVE TO TAKE ANOTHER FOUR TABLETS,
AND THEN I WOULD HAVE TO TAKE ANOTHER FOUR TABLETS,

BUT IT HAD NO RELIEF OF PAIN AT ALL.
BUT IT HAD NO RELIEF OF PAIN AT ALL.

I WENT TO PHYSICAL THERAPY, WHERE THEY PRESCRIBED FOR ME
I WENT TO PHYSICAL THERAPY, WHERE THEY PRESCRIBED FOR ME

A HEATING PAD
A HEATING PAD

AND THE PILLS ALLOWING ME TO TRY TO ADJUST MY SPINE.
AND THE PILLS ALLOWING ME TO TRY TO ADJUST MY SPINE.

I WENT TO ACUPUNCTURE.
I WENT TO ACUPUNCTURE.

I TRIED YOGA, COULDN'T GET NO RELIEF AT ALL.
I TRIED YOGA, COULDN'T GET NO RELIEF AT ALL.

- WHEN HE HAD DEEP BRAIN STIMULATION SURGERY
- WHEN HE HAD DEEP BRAIN STIMULATION SURGERY

ABOUT A YEAR AGO, THE MAJORITY OF HIS PAIN IMPROVED.
ABOUT A YEAR AGO, THE MAJORITY OF HIS PAIN IMPROVED.

- RIGHT AWAY, I NOTICED WITH THE BPS INSERTED IN ME
- RIGHT AWAY, I NOTICED WITH THE BPS INSERTED IN ME

THAT I HAD A FREE RANGE OF MOTION IN MY SHOULDERS,
THAT I HAD A FREE RANGE OF MOTION IN MY SHOULDERS,

AND THE PAIN STILL WAS THERE
AND THE PAIN STILL WAS THERE

BECAUSE IT WAS WITH ME FOR SO LONG THAT I STILL FELT THE PAIN,
BECAUSE IT WAS WITH ME FOR SO LONG THAT I STILL FELT THE PAIN,

BUT I DIDN'T FEEL THE TIGHTNESS IN MY SHOULDERS.
BUT I DIDN'T FEEL THE TIGHTNESS IN MY SHOULDERS.

- AFTER HE HAD DBS, THE PAIN THAT HE HAD
- AFTER HE HAD DBS, THE PAIN THAT HE HAD

IN HIS MID-THORACIC REGION-- AND THERE WAS ALSO SOME PAIN,
IN HIS MID-THORACIC REGION-- AND THERE WAS ALSO SOME PAIN,

I THINK, IN HIS LOW BACK AND IN HIS FEET--
I THINK, IN HIS LOW BACK AND IN HIS FEET--

IMPROVED DRAMATICALLY,
IMPROVED DRAMATICALLY,

AND SO THAT TOLD US THAT THAT PAIN
AND SO THAT TOLD US THAT THAT PAIN

WAS PROBABLY FROM RIGIDITY OR A DYSTONIA.
WAS PROBABLY FROM RIGIDITY OR A DYSTONIA.

- MY PAIN LEVEL RIGHT NOW ON A SCALE FROM ONE TO 10
- MY PAIN LEVEL RIGHT NOW ON A SCALE FROM ONE TO 10

BETWEEN NOW AND MY PAST PAIN,
BETWEEN NOW AND MY PAST PAIN,

IT WOULD PROBABLY BE A ONE AND A HALF TO TWO,
IT WOULD PROBABLY BE A ONE AND A HALF TO TWO,

CONSIDERING BEFORE, I COULD'VE BEEN A 10 OR MAYBE EVEN A 15.
CONSIDERING BEFORE, I COULD'VE BEEN A 10 OR MAYBE EVEN A 15.

- AND SO WE'RE MANAGING HIM STILL WITH PARKINSON MEDICINES.
- AND SO WE'RE MANAGING HIM STILL WITH PARKINSON MEDICINES.

WE'RE OFFERING HIM BOTOX.
WE'RE OFFERING HIM BOTOX.

HE STILL NEEDS PHYSICAL THERAPY,
HE STILL NEEDS PHYSICAL THERAPY,

BUT HE STILL GETS AROUND REALLY WELL.
BUT HE STILL GETS AROUND REALLY WELL.

MILES HAS SOME DYSTONIA,
MILES HAS SOME DYSTONIA,

RESIDUAL DYSTONIA IN HIS GREAT TOE
RESIDUAL DYSTONIA IN HIS GREAT TOE

WHERE IT'S REALLY DORSIFLEXING UP TOWARDS HIS HEAD,
WHERE IT'S REALLY DORSIFLEXING UP TOWARDS HIS HEAD,

AND IT'S QUITE PAINFUL.
AND IT'S QUITE PAINFUL.

- ONE OF THE SIDE EFFECTS THAT I HAD,
- ONE OF THE SIDE EFFECTS THAT I HAD,

IT MAKES MY TOE STICK UP,
IT MAKES MY TOE STICK UP,

POKES A HOLE RIGHT THROUGH MY SHOE,
POKES A HOLE RIGHT THROUGH MY SHOE,

AND THESE SHOES ARE ONLY THREE WEEKS OLD.
AND THESE SHOES ARE ONLY THREE WEEKS OLD.

- WE ARE NOW DOWN TO OFFERING BOTOX FOR HIM
- WE ARE NOW DOWN TO OFFERING BOTOX FOR HIM

TO TRY TO FOCALLY MAKE THAT MUSCLE MORE RELAXED
TO TRY TO FOCALLY MAKE THAT MUSCLE MORE RELAXED

AND SO HIS TOE WILL BE MORE FLAT INSIDE HIS SHOES.
AND SO HIS TOE WILL BE MORE FLAT INSIDE HIS SHOES.

- SO WE WOULD USUALLY PLACE A NEEDLE ABOUT RIGHT IN HERE,
- SO WE WOULD USUALLY PLACE A NEEDLE ABOUT RIGHT IN HERE,

AND THAT'S ABOUT RIGHT WHERE THE MUSCLE BELLY IS
AND THAT'S ABOUT RIGHT WHERE THE MUSCLE BELLY IS

THAT'S CONTROLLING THIS MUSCLE,
THAT'S CONTROLLING THIS MUSCLE,

AND THEN WE'D SEE THE TOE RELAX.
AND THEN WE'D SEE THE TOE RELAX.

WE CAN'T INJECT BOTULINUM TOXIN
WE CAN'T INJECT BOTULINUM TOXIN

THROUGHOUT THE WHOLE BODY TO IMPROVE PAIN...
THROUGHOUT THE WHOLE BODY TO IMPROVE PAIN...

YOU READY TO GO? - YEAH.
YOU READY TO GO? - YEAH.

- OK. HERE WE GO.
- OK. HERE WE GO.

BUT IF THERE'S A SPECIFIC BODY REGION THAT IS IMPACTED
BUT IF THERE'S A SPECIFIC BODY REGION THAT IS IMPACTED

BY OVERACTIVE MUSCLES OR SPASMS OR DYSTONIA,
BY OVERACTIVE MUSCLES OR SPASMS OR DYSTONIA,

THEN YOU CAN TARGET THOSE MUSCLES THAT ARE OVERACTIVE.
THEN YOU CAN TARGET THOSE MUSCLES THAT ARE OVERACTIVE.

ALL RIGHT. YOU DID A GREAT JOB.
ALL RIGHT. YOU DID A GREAT JOB.

NICE JOB HOLDING STILL, AND YOU SHOULD START
NICE JOB HOLDING STILL, AND YOU SHOULD START

TO FEEL BETTER IN ABOUT FOUR TO FIVE DAYS,
TO FEEL BETTER IN ABOUT FOUR TO FIVE DAYS,

SHOULD START TO MAKE THIS TOE RELAX
SHOULD START TO MAKE THIS TOE RELAX

AND NOT CONTINUE TO POP UP LIKE THAT, OK?
AND NOT CONTINUE TO POP UP LIKE THAT, OK?

- I DON'T THINK PEOPLE NEED TO LIVE WITH THEIR PAIN,
- I DON'T THINK PEOPLE NEED TO LIVE WITH THEIR PAIN,

BUT WE, AS PROVIDERS, CAN'T HELP YOU
BUT WE, AS PROVIDERS, CAN'T HELP YOU

IF YOU DON'T TELL US THAT YOU'RE REALLY SUFFERING.
IF YOU DON'T TELL US THAT YOU'RE REALLY SUFFERING.

- I WOULD SPEND SOME TIME WITH SOMEBODY EDUCATING A PERSON
- I WOULD SPEND SOME TIME WITH SOMEBODY EDUCATING A PERSON

WHO HAS PARKINSON'S DISEASE AND PAIN THAT THEY'RE NOT ALONE,
WHO HAS PARKINSON'S DISEASE AND PAIN THAT THEY'RE NOT ALONE,

THAT THERE ARE MANY, MANY PEOPLE WHO EXPERIENCED THE SAME THING,
THAT THERE ARE MANY, MANY PEOPLE WHO EXPERIENCED THE SAME THING,

AND THAT THEY CAN DO SOMETHING ABOUT IT.
AND THAT THEY CAN DO SOMETHING ABOUT IT.

- I'M FUNCTIONING...
- I'M FUNCTIONING...

NOT PERFECT...
NOT PERFECT...

BUT I'M FUNCTIONING WELL,
BUT I'M FUNCTIONING WELL,

AND I'M HAPPY AS A MAN TO BE FUNCTIONING LIKE THIS.
AND I'M HAPPY AS A MAN TO BE FUNCTIONING LIKE THIS.

MY 13-YEAR-OLD SON BENEFITS FROM IT,
MY 13-YEAR-OLD SON BENEFITS FROM IT,

MY WIFE, AND I HOPE EVERYBODY THAT I TOUCH.
MY WIFE, AND I HOPE EVERYBODY THAT I TOUCH.

- WE KNOW THAT IT'S REALLY IMPORTANT TO ACTIVELY ENGAGE
- WE KNOW THAT IT'S REALLY IMPORTANT TO ACTIVELY ENGAGE

IN A SOCIAL LIFE AND GET THOSE LOVED ONES IN YOUR LIFE
IN A SOCIAL LIFE AND GET THOSE LOVED ONES IN YOUR LIFE

TO STAY AROUND YOU, SUPPORT YOU.
TO STAY AROUND YOU, SUPPORT YOU.

- MY PAIN TOLERANCE IS PROBABLY PRETTY HIGH,
- MY PAIN TOLERANCE IS PROBABLY PRETTY HIGH,

BUT MY WIFE COMING HOME TO ME AND MY SON COMING HOME TO ME
BUT MY WIFE COMING HOME TO ME AND MY SON COMING HOME TO ME

HELP ME WITH A LOT OF THAT.
HELP ME WITH A LOT OF THAT.

WHAT MAKES ME HAPPY THESE DAYS IS KEEPING THE HOUSE IN ORDER,
WHAT MAKES ME HAPPY THESE DAYS IS KEEPING THE HOUSE IN ORDER,

TO MAKE DECISIONS, PAY MY BILLS, BEING RETIRED.
TO MAKE DECISIONS, PAY MY BILLS, BEING RETIRED.

EVEN THOUGH I'D RATHER BE AT WORK,
EVEN THOUGH I'D RATHER BE AT WORK,

IT'S KIND OF NICE BEING HOME,
IT'S KIND OF NICE BEING HOME,

MAKING SURE MY SON GETS OFF TO SCHOOL.
MAKING SURE MY SON GETS OFF TO SCHOOL.

I'M NOT SCARED NO MORE. I TAKE A WALK TO THE STORE.
I'M NOT SCARED NO MORE. I TAKE A WALK TO THE STORE.

I WALK MY DOG.
I WALK MY DOG.

I HAVE CONVERSATIONS WITH PEOPLE,
I HAVE CONVERSATIONS WITH PEOPLE,

TRY TO ENJOY LIFE A LITTLE BIT SLOWER,
TRY TO ENJOY LIFE A LITTLE BIT SLOWER,

A LITTLE BIT SHAKIER,
A LITTLE BIT SHAKIER,

BUT EVERYTHING IS OK NOW.
BUT EVERYTHING IS OK NOW.