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Dr Louise Newson
United Kingdom
Приєднався 5 чер 2023
Join Dr Louise Newson, founder of the Newson Health Menopause and Wellbeing Centre, on her mission to improve the future health of women around the world, reinvesting profits from the clinic to fund ground-breaking research in the menopause space and provide free menopause resources to millions of people worldwide.
Migraines and menopause: what's the connection? | The Dr Louise Newson Podcast
On this week’s podcast, Dr Louise Newson is joined by Dr Rebecca Walker, a GP who specialises in headache medicine and migraines.
In this episode, Dr Rebecca and Dr Louise (who suffers from migraines herself) get back to basics, looking at what migraines are, why they can occur and management approaches, from lifestyle measures to medication. They also talk about how hormone changes during perimenopause and menopause can impact the frequency and severity of migraines, and bust some myths around taking HRT if you have a history of migraines.
Follow Dr Rebecca on Instagram @dr_rebeccawalker.
For more information on migraines, visit the National Migraine Centre: www.nationalmigrainecentre.org.uk
You can find resources about migraine and menopause on the balance website here: www.balance-menopause.com/subject/migraines
You can also listen to an earlier episode of the Dr Louise Newson Podcast with Dr Katy Munro, author of Managing Your Migraine, by searching for episode 115 on your favourite streaming app.
For more information on Newson Health, visit: www.newsonhealth.co.uk/?Podcast&DLN+podcast&Podcast+episode
In this episode, Dr Rebecca and Dr Louise (who suffers from migraines herself) get back to basics, looking at what migraines are, why they can occur and management approaches, from lifestyle measures to medication. They also talk about how hormone changes during perimenopause and menopause can impact the frequency and severity of migraines, and bust some myths around taking HRT if you have a history of migraines.
Follow Dr Rebecca on Instagram @dr_rebeccawalker.
For more information on migraines, visit the National Migraine Centre: www.nationalmigrainecentre.org.uk
You can find resources about migraine and menopause on the balance website here: www.balance-menopause.com/subject/migraines
You can also listen to an earlier episode of the Dr Louise Newson Podcast with Dr Katy Munro, author of Managing Your Migraine, by searching for episode 115 on your favourite streaming app.
For more information on Newson Health, visit: www.newsonhealth.co.uk/?Podcast&DLN+podcast&Podcast+episode
Переглядів: 422
Відео
Early menopause and hormones in younger women Q&A | Dr Louise Newson
Переглядів 1 тис.16 годин тому
In her latest Instagram Live, Dr Louise Newson hosts a Q&A all about early menopause and hormones in younger women. Additional resources: • The challenges of accessing menopause treatment as a young woman: open.spotify.com/episode/7jUo6zauemnrCooYZggWRB?si=zD1M30HyQWWSm6xIAJItNQ • Surgical menopause: www.balance-menopause.com/menopause-library/my-story-early-surgical-menopause/ • Menopause and ...
Hormonal changes and endometriosis: busting myths and seeking help | The Dr Louise Newson Podcast
Переглядів 79016 годин тому
Joining Dr Louise Newson on the podcast this week is Jen Moore, a campaigner dedicated to raising awareness of endometriosis and adenomyosis. Jen started experiencing endometriosis symptoms at the age of 11, but it took her 22 years to receive a diagnosis of endometriosis, adenomyosis and fibroids. By this stage organ failure was a risk and she required multiple surgeries, including a hysterect...
Motor neurone disease and perimenopause: my story | The Dr Louise Newson Podcast
Переглядів 1,2 тис.14 днів тому
This week, Dr Louise is joined by Nicola McFarlane, who was diagnosed with motor neurone disease (MND) in 2023. Nicola shares the story of her MND diagnosis, as well as the barriers she faced in accessing treatment for perimenopause symptoms - including low mood, anxiety and recurrent UTIs - to improve her quality of life. Nicola talks about how health professionals often put her perimenopause ...
Testosterone Q&A | Dr Louise Newson
Переглядів 3,7 тис.14 днів тому
In her latest Instagram Live, Dr Louise Newson answers questions about testosterone. Further reading: • Testosterone: Missing piece of the jigsaw: www.balance-menopause.com/menopause-library/testosterone-the-missing-piece-of-the-jigsaw/ • Hypoactive Sexual Desire Disorder: What you need to know: www.balance-menopause.com/menopause-library/hypoactive-sexual-desire-disorder-what-you-need-to-know/...
Blind spots in modern medicine, with Dr Marty Makary | The Dr Louise Newson Podcast
Переглядів 2 тис.21 день тому
On this week’s episode Dr Louise is joined by Dr Marty Makary, Johns Hopkins professor, member of the National Academy of Medicine and bestselling author. Together they discuss the impact of the Women’s Health Initiative study on women’s hormone health, menopause education for healthcare professionals and the importance of patient-centred care that focuses on root causes, rather than just sympt...
Endometriosis and hormones | Dr Louise Newson
Переглядів 1,1 тис.21 день тому
In her latest Instagram Live, Dr Louise Newson discusses endometriosis and hormones. Resources for additional reading: • Endometriosis and HRT: www.balance-menopause.com/menopause-library/endometriosis-and-hrt/ • Endometriosis and menopause: www.balance-menopause.com/menopause-library/088-endometriosis-and-the-menopause-chris-mann-dr-louise-newson/ • My story: Why did I suffer for so many years...
What is lifestyle medicine and how can it help your menopause? | Dr Louise Newson Podcast
Переглядів 2,2 тис.28 днів тому
Joining Dr Louise this week are Dr Tash Mirando and Dr June Tan Sheren, who are GPs based at Osler Health International in Singapore. Dr Tash and Dr June explain the pillars of lifestyle medicine, including sleep, nutrition and exercise, and talk about longevity and the importance of taking a holistic approach to menopause care. They also discuss menopause care in Singapore, bust myths on how m...
Heart health, hormones and menopause with Dr Jeremy London | Dr Louise Newson Podcast
Переглядів 2,6 тис.Місяць тому
Cardiovascular disease is the leading cause of death in women and this risk increases after the menopause, and a woman’s risk of heart attack is around five times higher after the menopause than before*. Joining Louise on this week’s podcast is Dr Jeremy London, a board-certified cardiothoracic surgeon based in the US, to discuss heart health, hormones and menopause. They discuss the role of oe...
Hormones: types and doses | Dr Louise Newson
Переглядів 6 тис.Місяць тому
In her latest Instagram Live, Dr Louise discusses hormone types and doses. Resources: HRT doses explained: www.balance-menopause.com/menopause-library/hrt-doses-explained/ HRT basics: www.balance-menopause.com/menopause-library/hormone-replacement-therapy-hrt-the-basics-factsheet/ Menopause, skin and HRT doses with Dr Andrew Weber, Dr Louise Newson Podcast - www.balance-menopause.com/menopause-...
Instagram Live Q&A | Dr Louise Newson
Переглядів 2,5 тис.Місяць тому
In her latest Instagram Live, Dr Louise hosted a live Q&A with topics ranging from testosterone to endometriosis.
World Menopause Month: common questions answered with Dr Rebecca Lewis| Dr Louise Newson Podcast
Переглядів 2,8 тис.Місяць тому
In a special episode to mark World Menopause Month, and ahead of World Menopause Day on 18 October, Dr Louise is joined by Dr Rebecca Lewis, co-founder of Newson Health. Together they cover some of the most frequently asked questions about perimenopause, menopause and HRT, including: • When should I expect symptoms to improve after starting HRT? • How long can I take HRT for? Plus advice on tak...
'How I manage menopause and diabetes' | Dr Louise Newson
Переглядів 1,1 тис.Місяць тому
Joining Dr Louise on this week’s episode is Victoria Faulkner, who was diagnosed with type one diabetes in childhood. Victoria talks about day to day life managing menopause and diabetes, as well as her experiences of a surgical menopause due to treatment for endometriosis. Finally she shares the three things she thinks women with type one diabetes should know about hormonal health, and what ha...
Women's mental health: what must change, with Linda Gask | The Dr Louise Newson Podcast
Переглядів 2,4 тис.Місяць тому
Content advisory: this podcast contains themes of mental health and suicide Joining Dr Louise on the podcast this week is Linda Gask, retired consultant psychiatrist and author of new book Out of Her Mind: How We Are Failing Women's Mental Health and What Must Change. In her book, Linda draws on the lived experiences of women, alongside expert commentators, recent history, current events, and h...
All about HRT | Dr Louise Newson
Переглядів 4,5 тис.2 місяці тому
In her latest Instagram Live, Dr Louise takes it right back to basics and discusses all things hormones and HRT. Resources: • Synthetic vs natural hormones: www.balance-menopause.com/menopause-library/synthetic-and-natural-hormones-whats-the-difference/ • Understanding benefits and risks of HRT: www.balance-menopause.com/menopause-library/understanding-the-benefits-and-risks-of-hrt-downloadable...
Testosterone and the hormone triangle, with Dr Mohit Khera | The Dr Louise Newson Podcast
Переглядів 4,6 тис.2 місяці тому
Testosterone and the hormone triangle, with Dr Mohit Khera | The Dr Louise Newson Podcast
The great menopause myth | The Dr Louise Newson Podcast
Переглядів 3,3 тис.2 місяці тому
The great menopause myth | The Dr Louise Newson Podcast
Hormones and menopause in older women | Dr Louise Newson
Переглядів 9 тис.2 місяці тому
Hormones and menopause in older women | Dr Louise Newson
Introducing Menopause Masterclass | Dr Louise Newson
Переглядів 2,2 тис.2 місяці тому
Introducing Menopause Masterclass | Dr Louise Newson
Introducing Dr Louise Newson Menopause Masterclass | The Dr Louise Newson Podcast
Переглядів 1,2 тис.2 місяці тому
Introducing Dr Louise Newson Menopause Masterclass | The Dr Louise Newson Podcast
My hysterectomy story: here's what I wish I'd known | Dr Louise Newson Podcast
Переглядів 4,2 тис.2 місяці тому
My hysterectomy story: here's what I wish I'd known | Dr Louise Newson Podcast
Progesterone intolerance | Dr Louise Newson
Переглядів 11 тис.2 місяці тому
Progesterone intolerance | Dr Louise Newson
Presenting at the BABICM annual conference
Переглядів 6872 місяці тому
Presenting at the BABICM annual conference
HRT dosing and individualisation | Dr Louise Newson
Переглядів 17 тис.2 місяці тому
HRT dosing and individualisation | Dr Louise Newson
Endometrial cancer, the menopause and HRT
Переглядів 1,3 тис.2 місяці тому
Endometrial cancer, the menopause and HRT
Managing menopause at work: how to help yourself and your colleagues | The Dr Louise Newson Podcast
Переглядів 1,1 тис.3 місяці тому
Managing menopause at work: how to help yourself and your colleagues | The Dr Louise Newson Podcast
Surgical and chemical menopause | Dr Louise Newson
Переглядів 1,2 тис.3 місяці тому
Surgical and chemical menopause | Dr Louise Newson
Testosterone supplementation: what can we learn from men’s healthcare?
Переглядів 3 тис.3 місяці тому
Testosterone supplementation: what can we learn from men’s healthcare?
Presenting to the Australian Senate | Inquiry into issues related to menopause and perimenopause
Переглядів 1,6 тис.3 місяці тому
Presenting to the Australian Senate | Inquiry into issues related to menopause and perimenopause
Exercise during perimenopause and menopause | Dr Louise Newson
Переглядів 2,3 тис.3 місяці тому
Exercise during perimenopause and menopause | Dr Louise Newson
I've had migraines from about age 9 or 10, now 57 and still get them. I take propranolol twice daily to prevent, and almotriptan tablets to abort. Usually an attack lasts 3 days, although I can recognise some subtle things a couple of days before that. But always hope it isn't heralding a migraine, so there's the denial. The main thing I wanted to say was that I don't feel low and depressed beforehand, but the opposite. I feel great, better than well, I can suddenly do more, it's like a euphoria. Only before the migraine. After the 3 days of pain and symptoms, that's when I feel miserable and low. This prodromal euphoria seems to happen in a minority of migraine patients, but I'm not the only one. I'm on HRT and the frequency of my migraines was the same for a few years around menopause and has possibly slightly increased now. I suspect that's due to the HRT patches being too low a dose, and my brain needs more than the maximum currently 'allowed'. Thank you both for this helpful discussion, and for recognition of the debilitating effects of migraine across a person's life. Great information as always 🤗xx
I listen to alot of louise clips as I try to empower myself with info I am a current patient of newson clinic and gave been for approx 4 years I suffer chronic migraines to the point where they govern my life and all the things mentioned I gave to plan cancel prepare etc and when iv had a continuing spell I feel very low it's so hard as my husband doesnt understand and it makes me feel like I'm a failure when I cant attend things or push myself at times he doesn't mean to but he says I need to sort it out etc and iv been down so many avenues physio chiropractor acupuncture various meds from gp I have started taking mag am and PM which seemed to help a little but I will keep listening etc as yet I haven't found much relief had yo give up work etc and my current HRT doesnt always help although I appreciate I dobt know if I'd be worse without it thanks for info Sam annison
Have you seen my comment below, there might be something useful to you there?
3x more women suffer from migraines - surprisingly hardly any research money goes into it.... how unfair once again! 😢 Thank you for sharing your personal experience and stories how migraines can be managed better 🙏! Best wishes from Germany 🇩🇪
Funny, but I have also noticed that before a migraine starts to develop, there are elements of self-doubt or even self-denial involved. In my understanding, migraines are involved with the third-eye chakra, and in simple terms, can be described as saying things that are contridictory to what you know is true. Like for example, saying something like “I don’t khow why the medical industry is against hrt”, when you damn well know that it is because there are some greedy, energy vampires who are taking a financial or social benefit ‘feeding’ off of the suffering of women. It’s a denial of the truth, because it is not political correct, and in society one has to sometimes play along with the forced social agenda.
My symptoms carried on for 15 years and were showing no signs of stopping!!! I was started on HRT (oestrogen and progesterone) after extensive investigations to rule out other causes of my symptoms, which couldn’t possibly be related to menopause!!! I’m now really well and no longer have ANY symptoms, the most significant thing for me is I’m now sleeping really well.
My pmdd is doing a number on me today! Gets worse in perimenopause
I apologize for claiming my doctors are potentially incompetent, but i am coming out of the most difficult season of my life. Not to mention friends had family all "suddenly" have PHDs (opinions based on zero medical backgrounds) on mental health. I have experienced everything you have talked about and i tried to tell my doctors that all my diagnoses didn't seem right. No medication for "mental illness" ever helped. It kept me practically in a coma, but they expected me to function. The best one yet from doctors and everyone i ever crossed paths with is "relax, be mindful, breathe.. " 🙄
Do psychiatrists meet the standard of care (US) by only treating mental health, but never addressing perimenopause or hormonal imbalances in spite of me being in my 40s and experiencing extremely irregular menstrual cycles? I was in 9 hospitals, Mental health facilities in 3 yrs with no prior Mental health issues. I was diagnosed with Psychosis, schizophrenia, schizo-affective, bipolar, depressive disorder and not a single physician ever considered hormonal imbalance (even separate from my mental state). I was forced into mental hospitals and court ordered to stay on medication for a year (never helped). I was suicidal, catatonic, and only recently found out i am post menopause at 50 yrs old through my GP. Do my doctors have any responsibility to address hormonal issues or did i just lose 7-8 years of my life to incompetence? Thank you for addressing this issue.
Ive only just got all these symptoms and Im post menopausal and I feel like Im dying or have dementia or Alzheimer's
Hello 👋 oh wow, what a brilliant podcast, 👏 thank you so much Dr. Louise and Dr. Marty x
Two inspirational Women
I loved hearing the perspective through an adolescent. As a mom of 3 daughters, it encourages me again to keep the conversations open with them. It was a sweet interaction to see between mom and daughter in this discussion and I appreciate your girls' willingness to join the podcast with you! 🙂
This!!! Thank you for sharing your story...as a T1D I wish Dr's could change the narrative of blaming the diabetes. I feel I know my body and monitor on CGM and I feel like my Dr just sighed when I say it's hormones and inability to deal with stress since peri. Bless you 💗
Awesome information!
Where. Can I find the pdf please. My gp is already trying to reduce my medication.. because of my age..61 years, surely it's symptoms, not age, they should go by?
Urologist waiting time 1 year in uk it’s a joke
Why women in uk don’t get help with menopause the is nothing and no clinics only UA-cam it’s disgusting the isn’t even gynaecology in uk only if you are sick you can be referred. And then the waiting list I am scared to be old in uk look different country like Germany or France uk is like Kazakhstan sorry
I´ve got a question too: Which E. value would be good on the 21th cycle day for the age around 30 ?
Great guest. Please focus on hormones because nothing else has worked in the past 60 years. The mostly male doctors have completely failed us in addition to demeaning us.
😅
I have a 35 yo. friend who suffers from endometriosis - she has been to quite a number of doctors who sometimes sympathize but nevertheless lack info, resources and options to help her. Very frustrating! I just felt after listeqning to a lot of Dr. Newson's podcasts that progesterone and testosterone could help. I told her to get her free testosterone levels checked and they were extremely low... ! But I am quite sure she will not find any knowledgable doctor to support her with testosterone.... 😢 We need more research desperately! Thank you so much Dr Newson for all you do!!!♀️💕 Best wishes from Germany 🇩🇪
Thank you for this valuable insight Louise and Jen. My 18 year old daughter has in recent weeks FINALLY been diagnosed with Endo stage 4, Adenomyosis and PCOS. We are still reeling that the MRI showed so much but grateful in ways as she has been doubted by her school, doctors and many others. What type of specialist is best? A gyno or endocrinologist? We are in Melbourne, Australia. Endo is definitely receiving more coverage in recent times, but the follow through with availability of treatment options is incredibly slow and consequently expensive. I can’t stand that my girl has this to battle her whole life. I advocate for her daily and wish I could take this pain from / for her. If there is any specialist you can recommend Louise - I know you were in Australia not that long ago - I would appreciate it. Thank you so much for sharing what you do 🙏🧡🌸
“I didn’t know if to cry or to hit him” 100% my experience the past 4 years ( and 8 doctors). I can’t believe I haven’t been verbally violent to them at this point
I had similar symptoms until i reached menopause when i felt such relief. The pill did help but then i never wanted to rely on that and after a few years came off of it. GPs could never help so i just gave up and tried to deal with it myself through natural remedies with a good nutritionist. But taking hrt for nearly a year and having a few days of a short period i feel depressed. I dont want to go through all these tests what people are going through and investigations. I feel quite a lot better on hrt but loathe relying on it. Im 66 now.
My ovaries were not able to be saved. I was 24.
😢
Same for me, and I was 18 when doctor removed one of my ovaries
Louise, I have heard you talk about 'the wandering womb' for months, and had no idea what that meant... until now... thx
With skin, what about flare ups of autoimmune conditions like Eczema? I suffered as a child into my teens. But 20s and 30s was fine. Now I'm in menopause my eczema is really bad, particularly starting flare-ups when it's cold. At times, I want to rip my skin off 😢
How to maintain progesterone when you have gastric reflux. Do you have any advice?
I am on progesterone and oestrogen and when Dr Catherine talked about the symptoms associated with low testosterone, in women on HRT, not only do I have them, but some of my other symptoms have returned, around 2 years ago. This is but one of many of the revolutionary educational videos that Dr Newson has put out, that I have been binge-watching. I got a blood test on the NHS for testosterone, saying my low sexual desire was causing problems in my relationship (I am single) I just feel like I am existing with a return of the heat issues, bowel issues and worse mental health Dr Newson has talked about in other videos. I hope I can get testosterone on the NHS, but my life is so important to me, that I cannot afford not to go private, while I understand so many women with jobs, kids, other big expenses cannot and my heart goes out to them.
I think Dr Newson is doing a service for humanity, let alone half the population, as menopause affects those around us as well, plus, she is helping, or trying her best to help the medical profession, and some are listening, but those who have to stick by NHS guidelines have ideas that are seemingly exaggeratedly backwards in 2024. Untreated menopause is also a very lucrative business when you think of all the diseases and mental health conditions it causes or aggravates.
Thank you for this video. It's true more education is needed. I know why there is lack of research on menopause and lack of true information out there, because, menopause and all of its morbidities is big business for Big Pharma.
I think loads of people capitalise on untreated menopause and uneducated menopausal women, and, yeah, loads of uneducated doctors. How many women would need Tena Lady products etc, if they took proper hormones? Dr Newson, you are a trailblazer and the mainstream don't like trailblazers, and try to smear and devalue them and spread lies, just like a narcissistic system. Galileo got ridiculed. When I went for HRT in 2014 my GP said oestrogen was risky and new sweet FA about bio-identical, I had to find out online through members of the public.
Endometriosis is linked with neurodivergence
I agree with pillars of health. I agree with sleep being the most important. The thing with sleep is, while I am waiting for my hormones to be balanced, I cannot help but wake up 5 - 7 hours after I have fallen asleep.
8 weeks on Androfeme cream small pea size my hair is starting to shed and more face hair growing. It's worrying, and i can't see a difference with adding to my other HRT body identical E and P. Should i stop taking the T ?
Hi I am 64 . I had breast cancer 2006 clear since, but was estrodon feed. Tamoxifan for 5 years any suggestions
Hello can I have low progesterone if I have extremely low lung function. Thats an odd question, I know.. Do you have anyone in Australia that does similar to you. As I have found, doctors do not look as indepth as you.
This is so important for both men and women.
How exactly do you tell if a patch or gel is absorbing well?
Thank you Dr Newson. I really appreciate your educational videos. I never felt right since 2009, even when I went on HRT (oestrogen and progesterone) and I was one of those who was saying, not so long ago, I am too old for the menopause. I am 58 and I knew menopause was destructive, but had no idea of just how destructive it can be. I am now awaiting testosterone blood results form the NHS. I am glad you came along as you have probably prevented lots of future physical and mental problems for me, thank you again. 🙏
I have been tracking my symptoms daily, and for the last year I have noticed a menstrual cycle related exacerbation of my C-PTSD and chronic fatigue symptoms. Every time my vaginal discharge changes (white, brown, red) I get an increase in anxiety, low mood, pain, fatigue, sensitive skin, internal vibrations, muscle spasms, etc. 😣😫These have lasted for about 2 days and 2 nights and significantly reduce the quality of my life. I have to recover from these major mood swings and energy level changes too. It is jarring! Should I seek further treatment for this (PME)? Via NHS? or private? Gynaecologist? I don't know what to do and when and how.🤔 Plus I am scared of peri-menopause , I'm 31 right now , but my symptoms could get worse during these times since my body is sensitive to hormonal fluctuations. 🌪🌩🌀⚡
I did not know that hormones can be prescribed for women who are not peri-menopausal or menopausal. Do UK GP's do this? Or is this only privately offered?
I was diagnosed with severe PMS in 2018, I've tried 4 different SSRI's and none have helped. The only prescription medication that has been helping is the hormone pill/COCP Rigevidon. I noticed a reduction in my suicidal ideation, nightmares, heavy bleeding and blood clots in about 2 days since I started. I have been on the pill continuously, because having a break has given me higher symptoms. 🩸💊
I'm 31 years old, live in the UK, have been diagnosed with severe PMS and idiopathic chronic fatigue. I also have C-PTSD. There is alot of overlap when it comes to my symptoms. Anxiety, low mood , fatigue, pain can fit in all my diagnoses. Although the severe PMS symptoms are worse several days before brown or red vaginal discharge. Also my internal tremors and muscle spasms get worse during transitions (changes in vaginal discharge) told my GP and got told "I don't know what to do about that". I have tried 4 SSRI's and none have helped. I felt let down and disheartened. Mabye I have pre-menstrual exacerbation?
The pill that was prescribed when I was a teen, was a synthetic estrogen/progesterone, which was also an ANTI-ANDROGEN, that contributed to my low mood levels, and possibly lowering my testosterone levels. Likewise, Roaccutane given is also an ANTI-ANDROGEN that lowers testosterone as side effect. The pill and Roaccutane together, was for me, pure poison.
"This really touched my heart ❤ Thank you for your bravery in sharing 🙏💫"
"Adorei esse Q&A! 👏🩺 Dr. Louise, você explica tudo de forma tão clara e acessível. Muito obrigado(a) por educar e empoderar com essas informações! 🌟💙"
You are FANTASTIC and I appreciate the thoughtful education you are providing to all of us!!!!!! Lucky UK patients!!
I wonder if anyone has progesterone intolerance symptoms such as body jerks when falling asleep? When I remove progesterone for a few days these jerks become milder. It seems to be related to GABA receptors in brains. Don’t know how to deal with it.
I am so in awe of Nicola's strength and spirit. I am also disabled as a result of a brain injury, and totally agree about people being "written off" and denied care for treatable conditions, as if only able bodied or economically active people are deserving of treatment. I actually think if anyone deserves the care more, it is those of us who already face the greatest physical challenges. I am so glad Nicola now has this and wish her a joy filled life.