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Jan
Mountain climber
Okinawa, Japan
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Apr 26, 2013 - 07:37pm PT
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You might want to be tested for gout as that is one of the reasons for early kidney stones. Diet is important if you are susceptible to them but first they have to figure out what kind it is.
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sharperblue
Mountain climber
San Francisco, California
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Apr 26, 2013 - 07:44pm PT
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Oh yeah! Love 'em! had my first when i was 19; last one was seven years ago. Lots of water of course, and run/jog just a bit each day; it will quite literally shake them loose when they're very small and passable. Enjoy!
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Vegasclimber
Trad climber
Las Vegas, NV.
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Apr 26, 2013 - 08:11pm PT
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Feel for ya. Had my first one a few months ago, and I am pretty sure you're a bit older then I am.
Like you, I started getting some warning a few days beforehand, but I had an idea what was about to happen. What I didn't realize was how intense the pain was going to be. I have a pretty high pain tolerance, deal with it on a daily basis anyways - but that stone had me on the floor curled up in a ball. They had to give me 2 shots in the ER - and not light ones - before I could even straighten out or respond to anything normally. Took 2 more days for the last of it to pass.
I do NOT look forward to going through that again, but once you get one you are very likely to have more. Trying to up my water intake and hope like hell it doesn't come back for a while.
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Brokedownclimber
Trad climber
Douglas, WY
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Apr 26, 2013 - 08:15pm PT
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Ouch!
You have my sincere sympathy!
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SCseagoat
Trad climber
Santa Cruz
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Apr 26, 2013 - 08:15pm PT
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Doc said the consensus 3 worst pains are....childbirth, heart attack and kidney stones.....
Heard about stones and childbirth...didn't know about the heart attack.
So welcome to the crowd, childbirth one anyways!
Heal fast.. Amazing how something so small could wreak such havoc
Susan
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Leggs
Sport climber
Is this a trick question?
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Apr 26, 2013 - 08:23pm PT
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This too shall pass...
YEP... thank goodness. I hope the "process" is a bearable one for you, Cragman... my thoughts are with you.
(When I had my son, all 8lbs 2oz (22inches long) of him, without drugs on an AF Base in Texas, I realized I could handle a tremendous amt of pain. Still afraid of heights, but I survived giving birth to my son.
Granted, my father stated he could hear me all the way down the hall ... but I'd like HIM to try it and see if HE too threatens the life of an OB Tech.)
~peace to you, D.
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healyje
Trad climber
Portland, Oregon
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Apr 26, 2013 - 08:31pm PT
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Walked into the emergency room and without a word the doc says, "you're passing a kidney stone." So I ask how he could possibly know that? He says, "we get about a dozen a week through here. They all have the same look you're sporting."
Had four of them so far. Now I have a drug kit at home and in the car stocked with Oxycodene and Soma (Carisoprodol). Probably hard to get scripted for the Soma, but it's a muscle relaxant which greatly eases the passage while the Oxycodene deals with the pain.
Of the four attacks, I've had them come on slow with it taking me awhile to even figure out what was happening and had one happen all at once like being hit with a mac truck and making me pass out within a minute of the very first sign.
And that one was when I was belaying. Fortunately my partner was close to the anchor and I had just enough time to tell him to get to it as I was dropping to my knees in a purple haze at which point I locked-off hard with my hand close to the device and passed out on out on top of it. That worked as my partner was then stuck at the anchor until some other guys came rapping off at the end of their climb and could roll me off the belay and let him down. Could have been worse and now I have to make sure I'm solidly hydrated before climbing.
However it happens, you don't want to be more than a few minutes away from some seriously big-time pain meds for the duration. You basically just don't want to be incoherently conscious and writhing in pain for the whole show.
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DonC
climber
CA
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Apr 26, 2013 - 09:14pm PT
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I've had one on each side. For me, the pain was in the back/kidney area as it moved from the kidney to the bladder - like a knife in the side, over and over. I feared the final exit from the bladder, but did not have a problem with that. Good luck!
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dee ee
Mountain climber
citizen of planet Earth
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Apr 26, 2013 - 10:02pm PT
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Yes, I've been there. I have much sympathy.
I dragged the whole family to the hospital at 3 am. OH, the pain.
The only pain that exceeded that was my broken shoulder from this year.
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Toker Villain
Big Wall climber
Toquerville, Utah
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Apr 26, 2013 - 10:29pm PT
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I knew a Vegas nephrologist who referred to April - June as "stone season".
Lots of people dehydrate as things get hot.
(He died of a spider bite though!)
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zBrown
Ice climber
chingadero de chula vista
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Apr 26, 2013 - 10:35pm PT
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I was 34 for the first one of three. Biggest 10mm. All passed.
Can't tell until they analyze the constituents, but mine were due to repeatedly getting dehydrated.
EDIT:
First was at 36.
Second at 53 - 5.0mm calculus ureter, 7.0 mm calculus kidney.
Last:
IMPRESSION:
1. 15 mm nonobstructing stone within the lower pole of the left
kidney
All analyses have found the stones to be calcium oxalate.
If it doesn't pass, there are non-surgical/medical means of "treating" them, which is what I did in the case of the last one. Two doctors tell me it can't possibly have worked, yet the second scan revealed nothing. So either the first scan was in error or ...
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Peter Haan
Trad climber
Santa Cruz, CA
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Apr 26, 2013 - 11:44pm PT
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I have one at 4mm and my urologist warned me to stay hydrated. None of these long waterless days in full sun, for Heaven's sake. We found it on a CT scan. It also turns out I have dual piping out of my kidneys... rare but not unheard of. How fun.
I remember as a kid, my Dad had a bad attack of a kidney stone that started to move. He was rolling and groaning terribly on the family couch. I was all alone with him and about 6 years old. I was terrified. Dean, it was clearly about all the man could take. I do sympathize. Fortunately aside from the pain, the ailment is not completely deadly.
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Lynne Leichtfuss
Sport climber
moving thru
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Apr 27, 2013 - 12:14am PT
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Dean,
Hoa Mon, so sorry for your pain. Praying.
Dee ee, when did you break your shoulder and how? Wonder if it was the same shoulder you threw out in JTree a millineum ago when we were playing Haki Sak? It got dislocated and you were on the ground and Dan yanked it back in. Jess wondering if the old injury had to do with your latest one.
Cheers and Blessings to you and Family, lynnie
PS, are you doing the Amjen Tour Mother's Day Weekend. Nomads is hosting a booth on Grand Ave. in Escondio. I will be there or at our store two blocks away. ANYONE from the Taco stop by and I'll treat you to something.
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Mungeclimber
Trad climber
the crowd MUST BE MOCKED...Mocked I tell you.
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Apr 27, 2013 - 01:44am PT
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going downstairs to get some water
omg
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Gene
climber
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Apr 27, 2013 - 01:52am PT
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I passed one that felt the size of Columbia Boulder. It was about 15 years ago and I was in Dusy Basin. A friend who was up there last year tells me that on a calm night you can still hear the echo of my screaming.....
g
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bluering
Trad climber
Santa Clara, CA
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Apr 27, 2013 - 01:57am PT
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I haven't had one thanks to all the beer I've been drinking.
Seriously, many doctors say beer helps both, preventing and dissolving kidney stones (at least in Poland).
This is why I drink copious amounts of beer. It's for medical reasons. Woo-hoo!
6mm, Dean? Holy!!!! heal up, bro. Piss that thing out. Somehow....
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BruceAnderson
Social climber
Los Angeles currently St. Antonin, France
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Apr 27, 2013 - 02:12am PT
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Just had my first one about two months ago. Screaming and writhing in pain for two hours. When I got to the doc's and he jabbed me with some morphine I literally wept.
I have a relative who's a doctor and his advice-
A six pack and a pogo stick!!!!
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Delhi Dog
climber
Good Question...
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Apr 27, 2013 - 02:12am PT
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Been there too, to many times.
I feel for you, and like healyje i keep a drug kit with me. I'm often times out in the middle of nowhere and need to take care of myself.
The last 4 I've delt with on my own, but shoot I sure as sh#t wish I was could have been in the ER with a morphine drip.
I remember I had just reached the summit of the Grand after climbing the Exum with my brother-in-law and his wife when I felt the pain coming on. At the time I had only 1 or 2 previous episodes so I wasn't too sure if it was a stone or not. Man they were freaked, but I just lay there for awhile until I could move and then told them I'd see them at the bottom and booked outa there at as fast a pace as I've ever done.
I have a little collection now of them.
Feels like a bowling ball with spikes squeezing through your gut when it's happening, and I can time the contractions down to the minute. Usually 10 mins of pain, 5-15 mins of reprieve.
I was so disappointed when I saw the first one, it was so small i could barely see the thing.
Drinking plenty of water is about the best you can do.
Though the tarter remedy sounds like it might be worth trying. Thanks for the info.
Cheers
Edit, hah, hah TT you called that!
1 more month brotha!!
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Toker Villain
Big Wall climber
Toquerville, Utah
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Apr 27, 2013 - 11:00am PT
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I saw one bigger than a softball.
(the vet took it out of a mule)
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otisdog
Big Wall climber
Sierra Madre & McGee Creek, Ca.
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Apr 27, 2013 - 11:39am PT
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Don't you mean centimeter?
You'd be able to see a 6 mm stone progressing down your Johnson!
Yeah, they are a lot of fun...my doctor gave me a screen to pee through, with the hopes of catching the stone. He was delighted when we captured what looked like a grain of sand. Calcium...from my habit of eating 500 mg. orange flavored vitamin C's...
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Reilly
Mountain climber
The Other Monrovia- CA
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Apr 27, 2013 - 12:37pm PT
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No advice other than HEAL UP, BRO!
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Deekaid
climber
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Apr 27, 2013 - 01:23pm PT
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Back to school for you, otisdog
No kidding...what gets me is the certainty.
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phylp
Trad climber
Millbrae, CA
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Apr 27, 2013 - 02:06pm PT
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Hope it's the LAST one you ever have to experience, Cragman. Some people do seem to be more prone to them than others. My husband has only had one in his life, while one of my brothers-in-law has had one every couple of years, it seems.
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perswig
climber
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Apr 27, 2013 - 03:30pm PT
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Was it this little bastard, Dean?
Or did it feel like this?
[/url]
Ouch!
Hydrate, dude, hydrate.
Dale
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healyje
Trad climber
Portland, Oregon
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Apr 27, 2013 - 05:39pm PT
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Magnesium & B6 combo supplement is supposed to help as well.
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Brian
climber
California
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Apr 27, 2013 - 05:57pm PT
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Ouch. Sorry to hear about that Dean, I've I've heard the pain is intense (from Bruce, upthread, and others). Glad to hear you are on the mend, and glad to hear that beer and physical activity seem to be indicated. I'll do some preventative work this week!
Brian
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lubbockclimber
Trad climber
lubbock,tx
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Apr 27, 2013 - 09:19pm PT
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Last year when I was 23 I ended up in the hospital. It started whith a trip to the e.r.. Then another trip to the e.r. two daysater. Then a third the next day. Spent two more days in the hospital in horrible pain. Narrowly missed surgery. I drink more water now. Funny enough the stones were likely caused by my dropping the water off the top of our first rap of five six miles from the car in 90 degree heat. Little dehydration going on that day.
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can't say
Social climber
Pasadena CA
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Apr 28, 2013 - 09:42pm PT
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Check out the microscopic image of the surface texture, looks painful.
Edit: I've had to sit with my dad in the ER 3 different times as he passed stones and can empathize with how painful it must be.
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rlf
Trad climber
Josh, CA
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Apr 28, 2013 - 11:03pm PT
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My wife had this problem once. It landed her in the hospital for three days. It was very "unpleasant".
Heal up!
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Jan
Mountain climber
Okinawa, Japan
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Apr 28, 2013 - 11:55pm PT
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As long as you can still pee, that's a good sign. If suddenly you can't, the thing really is big and you really have an emergency.
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Lynne Leichtfuss
Sport climber
moving thru
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Apr 29, 2013 - 12:04am PT
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Good Grief, Dean, I read your post about you and Flanders and wished the heck I was up there to play a pleasant Nurse Rachet.
What is going on with two of my best friends.......? Dudes, Please get well. God willing I will see you both @ May 20th. Praying for each of yo. Heal up.
I want to climb with you both...the three of us on some nice little route.
Cheers, Peace, Prayers
Lynne
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SCseagoat
Trad climber
Santa Cruz
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Apr 29, 2013 - 12:21am PT
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Oh man Dean, I thought they ultra sounded them to pulverize them..
You and Doug... "Grumpy Old Men"...for good reason!
Susan
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neebee
Social climber
calif/texas
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Apr 29, 2013 - 03:20am PT
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hey there say, cragman... oh my, i am late...
prayers that you can avoid all this again, in the future...
good that flanders was able to help...
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healyje
Trad climber
Portland, Oregon
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Apr 29, 2013 - 03:45am PT
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Yep, emergency med kit's gotta always be close by and once you know an attack has started it has to be on your person for sure. Tough go regardless.
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Jan
Mountain climber
Okinawa, Japan
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Apr 29, 2013 - 10:05am PT
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How big was it finally?
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can't say
Social climber
Pasadena CA
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Apr 29, 2013 - 10:07am PT
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Did you put it with other bodily purged relics, like teeth, nail clippings and naval lint?
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survival
Big Wall climber
Terrapin Station
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Apr 29, 2013 - 10:12am PT
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Frodo?!
Why not Sauron?!
Damn dude, I'm so sorry to be laughing at your misfortune, but you really cracked me up with the Dean/Flanders tale!
Glad the little Satan Jr. is gone!
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pc
climber
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Apr 29, 2013 - 10:27am PT
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This thread is really making me unhappy ;( Glad you got the sucker out.
Through an unrelated investigation my doc found I have a kidney stone 8mm waiting for its "day". I'm terrified of doing nothing and terrified of taking proactive measures... And trying not to fall on my back or bounce around... Maybe someday when I can find the humor I'll post a TR on how the sucker was found...
Brutal business,
pc
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otisdog
Big Wall climber
Sierra Madre & McGee Creek, Ca.
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Apr 29, 2013 - 11:29am PT
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Okay, I flunked the centimeter thing before...but 5 mm equals .19685 of an inch, about 1/5 of an inch. Either that is an awfully large pen or...
Either way, it's amazing how painful those little suckers can be!
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troutbreath
climber
Kanada
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Apr 29, 2013 - 12:01pm PT
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I had a 11 m.m. one that I couldn't pass. So they sent 17 inches of plastic up you know what, to nudge it out of the way so my kidney could drain. After three trips to lithotripsy the broke the back of the beast. Then removed the plastic intruder that was slowly becoming part of my body after seven months. That was 18 years ago and I still occaisonally pass some carnage. I eventually found that when I was in pain and had no pain killers, that getting into a hot as you can handle it bath helped to relieve the pain. Takes about 15 minutes of soaking the back.
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SCseagoat
Trad climber
Santa Cruz
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Apr 29, 2013 - 12:07pm PT
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DEAN, that thing looks ginormous given how svelte the plumbing through which they pass.
May it have no brothers or sisters.
Soldier on....with Spring Falls flowing unimpeded.
Oweeeee
Susan
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dirt claud
Social climber
san diego,ca
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Apr 29, 2013 - 12:14pm PT
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Glad your doing better and that all came out ok Cragman. Sounds like it was painful, but you got lots of support from the taco crowd :-)
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zBrown
Ice climber
chingadero de chula vista
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Apr 29, 2013 - 02:30pm PT
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Calcium oxalate stone 15mm in mutiple renal calculi expelled during micturition.
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SCseagoat
Trad climber
Santa Cruz
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Apr 29, 2013 - 10:13pm PT
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Susan
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healyje
Trad climber
Portland, Oregon
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Apr 29, 2013 - 10:25pm PT
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I usually get by with the Oxycodone + Soma (Carisoprodol) combo, but Oxycontin or MS Morphine + Phenergan (for nausea) is certainly a step up in bad cases. But if it's that bad I'd just go to the ER and get the Dilaudid. Can't recommend the Soma highly enough given it relaxes the pipes and puts you to sleep, but it may be tough to get someone to script it for kidney stones (but I'd ask regardless).
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Seamstress
Trad climber
Yacolt, WA
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Apr 29, 2013 - 11:30pm PT
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I only gave birth 3 times with no drugs involved. Watched my husband deliver 2 kidney stones. I never saw so much vomiting and writhing in my life - well except for the kidney stone patients transported during my EMT ride-alongs. Hardest part was watching the POOR decision to go light on medications at first under the false assumption that more pain killers would be immediately available in the ER. Then all the looney tunes had car crashes, suicide attempts, and other bad events. All ER people were legitimately busy with dying people, and now my husband wants more drugs. None available for 40 loooong minutes. My advice - this is not time to be a hero. It seems to hurt a lot. Get on top of the pain before it turns you into the protagonist of the exorcist. It was ugly to watch, let along experience it.
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Reilly
Mountain climber
The Other Monrovia- CA
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Apr 30, 2013 - 12:42am PT
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Witholding pain meds is verrry old and bad medicine.
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Jan
Mountain climber
Okinawa, Japan
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I'm so sorry! Take the first one with you so they can figure out why you're getting these.
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TravisMcGee
Trad climber
Boulder, CO
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I sympathize. I had my first last summer. Knocked me down hard. My poor kid thought I was dying; wife too. Thank god I was close to the ER. They found a 12mm stone and didn't even begin to ask me to wait for it to pass. Two options; in through the kidney or in through the junk. Either way I was headed for general anesthesia and I was OKAY with that. Ended up going in and pulverizing it. Worse part was the damn stint they installed. No, check that, it was getting the damn stint OUT. No anesthesia for that the sick bastards.
Good luck, brother.
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Alpine Raven
climber
Eugene, Oregon
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I passed one on March 13. A day I won't soon forget. The most pain I've ever endured. My wife had to drive me to the ER as I was curled up in a ball in the passenger seat, feet pushing on the dashboard, trying to find any relief from the constant pain. I went between groaning, moaning to laughing, crying as the pain was soooo intense. I passed a 2mm stone from my right kidney. It was analyzed to be Calcium Oxalate, the most common. So now I'm drinking at least 2-3 liters of water a day and watching my diet, eating items low in oxalate acid: beets, spinach are high. According to the diet sheet I was handed by my urologist, eating calcuim products is good, too much Vitamin C is bad. The CT scan showed at least one more in the right and at least two in the left. So now I have Dilaudid with me at all times as well as Flomax (relaxes the ureter). I'm 58. Did not think I was a Kidney Stone candidate.
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Reilly
Mountain climber
The Other Monrovia- CA
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Man, don't ya love it when they try to tell you you're imagining something?
All the best!
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monolith
climber
SF bay area
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Milk is actually a poor source of utilizable calcium, so poor, the industry needs to fortify it with a different form of calcium, which helps a little, but screws up iron absorption. The highest fracture rates are in countries with the highest milk consumption rates. The problem, it's high protein, and high calcium. Human breast milk is about 6 percent protein by calorie, but cows milk is 15-20 percent and 3x calcium. Pasteurization screws things up even more. I've had very little milk in my life, even as a kid(none for the last 20 years), yet have excellent bone density(had a scan). Calcium is in a lot of plant foods and is easily utilized by the body. Yep, no one wants to be preached to, so I'll not say anything further.
Lots of info out there, so search if interested.
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portent
climber
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Yikes! Sorry Dean! This is the worst!
I was down in Joshua Tree end of March and got "rocked" at the Matt Segal slideshow. I stepped outside to take a leak and next thing I knew I was face down in the dirt. Drove myself to the High Desert Hospital. Don't really remember that part but it happened. Very Fear and Loathing-esque.
They admitted me and it was just the most unimaginable pain ever. I was on the ground, throwing up, punching the floor and screaming.
Fortunately, they gave me morphine.
Unfortunately, It did nothing.
I screamed for another 20 minutes and they finally gave me dilaudid. Good night.
I woke up and they told me it was food poisoning and released me. I drove to the gates and had to pee so bad!!
Next thing I know, face down in the dirt.
Drove back. More dilaudid and then they found it. It sucks and I'm not looking forward to the next.
--Kovar
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Jan
Mountain climber
Okinawa, Japan
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Does anyone have an explanation for why this mostly seems to be a male problem? Women get gall stones but kidney stones seem kind of rare.
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portent
climber
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I was told by the doctor that they are more common in women. Don't know though.
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rottingjohnny
Sport climber
mammoth lakes ca
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portent...are you insuating that cragman is a girlyman..?
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rottingjohnny
Sport climber
mammoth lakes ca
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Cragchick...Skirt...? Sorry , i didn't know...? Kilt...? My friend was pregnant with stones and when we skied at night he would piss blood...Ouch...
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ß Î Ø T Ç H
Social climber
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I'd go the other direction to Reno instead of Mammoth (hospital) if I was you. ; )
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portent
climber
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RJ,
I for sure felt like a little bitch crying on the floor of that hospital.
Sh#t sucks.
Hats off to the High Desert Medical Center though. They were all top notch and I appreciate their patience, humor and compassion. I must have been a handful.
edit: I didn't feel mine pass but after kidney to bladder, I can't imagine worse...
--kovar
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Jan
Mountain climber
Okinawa, Japan
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According to the Wikipedia, about 80% of those with kidney stones are men. Men most commonly experience their first episode between 20-30 years of age, while for women the age at first presentation is somewhat later.
Dietary factors that increase the risk of stone formation include low fluid intake and high dietary intake of animal protein, sodium, refined sugars, fructose and high fructose corn syrup, oxalate, grapefruit juice, apple juice, and cola drinks.
......current evidence suggests the consumption of diets low in calcium is associated with a higher overall risk for the development of kidney stones.For most individuals, other risk factors for kidney stones, such as high intakes of dietary oxalates and low fluid intake, would play a greater role than calcium intake.
Some stones are composed of uric acid, common to men with gout. Since gout is sex linked, women don' get it normally. That could in part account for the higher incidence of stones with men.
Sorry guys, I had no idea they were this common.
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portent
climber
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According to the Wikipedia, about 80% of those with kidney stones are men.
yeah, must have been the dilaudid, had me thinking crazy. I remember my dad having them. My brother's had them too.
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Reilly
Mountain climber
The Other Monrovia- CA
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That does it, I'm not going off the beer. It's gotta be what's kept me pure
lo these many years, right? I wonder if Frenchmen get more stones than Germans?
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Michelle Gill
climber
Redding, CA
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Man, it sounds as though you have been through a terrible experience! I hope the worst of it is over and that you are on the downhill side. Good luck to you.
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Ken M
Mountain climber
Los Angeles, Ca
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Sorry for the terrible experience.
The state of the art for stones has changed. For an attack, the best current treatment is not narcotic pain meds, but a drug called Toradol, given by injection (oral doesn't work). For most people, it works miraculously in about 15 min. The effect may be quite long lasting, as well, and a person may feel no more pain until it passes out of the body.
Toradol is related to ibuprofen, but is the only one that is injected. It is not as strong as narcotics, but it's potent anti-inflammatory effects appear to relax the ureter (the tube in which the stone is stuck). It is actually the spasm of the ureter that causes the pain.
For some, narcotics work poorly. For some, one works better than another, and it is unpredictable. However, for all, the narcotics wear off in a few hours, and the problem is not fixed.
The hot new thing the last few years for treatment after the initial pain is relieved, is Medical Expulsive Therapy, which is the use of drugs to assist the body in pushing the stone out.
http://www.ncbi.nlm.nih.gov/pubmed/17681643
It depends upon the size of the stone, but this approach can move the stone in from 30% to 75% of patients.
The most common drug used is generic Flomax, although there are others.
Prevention of recurrent stones is most efficiently done by drinking more water. There are a variety of other things, but water is the most effective.
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climbski2
Mountain climber
Anchorage AK, Reno NV
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Dean...All i know is if i were in anything close to the type of pain you are describing .. I'd get me some morphine.. f*#k it .. load me up and wake me up when it's over. Or maybe that Toradol that ken mention plus morphine.
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madbolter1
Big Wall climber
Denver, CO
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Puking on the hospital floor, sniveling like a newborn babe, including the wailing.
After morphine (God bless poppies!), I apologized to the nurse for all my carrying on.
She said, "Nothing to apologize for. I've had three kids and one kidney stone. I would give birth to the three kids one after the other instead of having another kidney stone."
The level of pain is beyond description to those that have not experienced it. It's like you become pain itself.
The amazing thing about morphine (in my experience) is that it doesn't take the pain away. It's like you still know the pain is there. But in some weird way, it's no longer YOUR pain. It's like you can say, "There is pain," but it's not "attached" to you; like it's no longer troubling you. It's "distant." At least that's what the experience was like for me.
I hope you've gotten passed it by now! (lame pun intended)
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Anastasia
climber
Home
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Yes, and it was a little bitty tiny stone. I thought I was dying, I was curled up in the fetal position for a full 18 hours before it passed. Goes to show that there is a price to pay for habitually not drinking enough water.
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madbolter1
Big Wall climber
Denver, CO
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Another thing that occurred to me:
When you give birth to a baby, you've really got something to show for the pain and effort. When you give birth to that little fleck of a pebble, you really have almost nothing to show for it.
The pain to gain ratio is quite whacked!
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Reilly
Mountain climber
The Other Monrovia- CA
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Goes to show that there is a price to pay for habitually not drinking enough water.
I rarely drink water, after all, I'm Irish. Beer is the answer.
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