Baby talk, communication

Babies are not simplistic in their needs. They are fully developed human beings with the ability to express their needs without our “language skills”. They look wrinkled because they are in transition from a weightless water world to a world governed by the laws of gravity. They are thinking, trying to make sense of the sights, sounds, smells and emotions around them. We nearly always look at people’s faces when they are the same way up as ourselves. Babies often have to contend with faces peering at them from all angles. Try sitting above a baby’s head and looking at them carefully “upside down”. Notice the symmetry or otherwise of the head and face. Gently place your hands around their head, obviously with the parent’s agreement. Ease your touch until you become aware of another movement. It is like a slow, gentle wave that appears to change the pressure in the head. This is called the craniosacral rhythm. It is a fluid that protects the brain and allows it to remain in a fluid world. During the first 20 minutes of life the baby starts to re-organise their nervous system. The lungs erupt to welcome their first breath of air. The fluid around the brain starts to flow as it feeds into the spinal chord, nourishes the nerves. An adult will produce, and re-absorb about half a litre a day. The Early osteopaths called the driving force of this fluid the breath of life. Osteopaths emphasise the huge amount of anatomy required to understand the subtle workings of the body. The Upledger Institute  run some great course to teach lay people the techniques of contacting the fluid and gently re-directing it to unblock areas of sluggish activity. The skills are best learned in a group but there is some common-sense intuitive feedback that babies themselves will give you. If they hold their heads or push your hand away when you touch certain areas they are telling you that they feel uncomfortable pressure. Let me explain to you what a therapist might be doing. We sometimes gently spread the fingers of one hand either side of this area and direct the fluid to the area from the opposite side of the head. We let the fluid pressure do the work from the inside. Sometimes a baby will show “projectile poohing”, really uncomfortable and straining then a sudden explosion. The muscles around the anal sphincter are sometimes underdeveloped. Gentle stimulation with the little finger, preferably with a glove on will sometimes stimulate the reflex. Sometime a baby will only feed on one breast preferring to turn their head one way. It could be that a caesarean birth has not subjected the back of the neck to a strong manipulation during the final point of delivery. The occipital bones at the back of the head are four at first then slowly fuse into one bone by the age of three. A therapist might gently spread these bones while directing the fluid or place their fingers under the back of the skull and exert pressure to release the joint. You might find extreme discomfort after feeding breast milk. It is possible that you have switched breasts too soon so the baby only has the sweet milk not the rich fatty milk. They might be suffering from a sugar overload. Either changing your way of breast feeding or using formula will relieve the problem.

Weaning

There is a move towards lumpy feeding, allowing a baby to try foods whole and chew their way through them. It is alarming to see them gag and spit the food out but if they can do this before ten months they are less likely to choke later. Be careful with food of the additives, especially salt. We watched a mother giving their baby a lump of cheddar to eat, unaware that their kidneys can not cope with that amount of salt. If you read labels carefully the sodium content is stated but not allows the salt content. You need to measure by the 100gm and at least double the sodium to allow for the chloride element. A mild cheddar might contain 1.5gm of salt. A vintage cheddar could contain 7gm of salt!

 

Phytic Acid

Phytic acid binds phosphorous into foods as a way of storing it. Phytase is an enzyme that breaks down phytic acid. It is found mainly in bran and the  coating of nuts and seeds. It is also found in soya. Phytic acid binds calcium, zinc and magnesium making them poorly absorbed. Thinking through why some people suffer a bloated abdomen after eating bread made me wonder if phytic acid and bran, not gluten, are making it indigestible. Reading through one of our favourite old cook books called Laurel’s Kitchen I found some comments on phytic acid. In essence if you allowing bread dough to rise at least twice not only improves the flavour but breaks down the phytic acid and makes the bread more comfortable on your digestion. The soft “pappy” bread that is fast proven is probably the cause of much discomfort. Try sour dough or stone baked or simply slowly make your own bread. Laurel pointed out that even in Denmark the government at the time provided starter dough for rye bread to ensure that phytic acid was broken down.

At one time wheat bran was added to horse feeds. Sadly many horses suffered severe colic. Changing the bran source to linseed (flax) remove the source of the colic. Horses “discovered” the benefits of linseed long before us. Even Ghandi said that the health of a nation improved with linseed.

Nuts and seeds are generally processed in some form before we see them. Cashew nuts are roasted in ovens fuelled by cashew nut oil. Peanuts are best eaten in peanut butter or lightly roasted. They are often regarded more as a vegetable in Africa.

Fractures, Ligament strains, bone healing

A recent broken finger tip taught me a number of lessons that I would like to share with you. Winter camping on a beach in Anglesey is a wonderful experience, the stars, the stillness of the night, the spray frozen into a sculpture of leaves on the beach, the feeling that perhaps there were otters nearby in the stream as it rushed into the sea, the neolithic chambered tomb casting a shadow behind the road in the moonlight. I was due to join a sea kayaking leadership course but sadly slammed a numb finger in the car door not aware that it was resting inside the door frame. A weekend in Ysbyty Gwynedd, Bangor hospital convinced me that human kindness combined with humour and skill in surgery go a long way to promote healing. I left in good spirits confident that even though the weekend was not what I expected we can live the present and handle each moment as it arrives. If you ever find yourself injured try the following lessons:

Ask yourself does bleeding help to clean the wound? Then let it bleed long enough to wash out some of the dirt before you apply pressure to close the wound and elevate the limb. Use sterile salted water or spring water to wash the wound if you have it to hand. Be aware that if your injuries are serious like in a fall, you will go into shock. It might be the loss of fluids, a sudden drop in blood pressure, or simply the nausea dawning on you of what has happened. I once felt shock coming on so I crawled into the warm sunshine simply to let the heat and light cheer me up while I thought through what to do next. Once you have the bleeding under control, think through what might else might be missing or needed next. Go through a mental check list as to what you will need when help arrives. It might be something as simple as collecting your glasses, some clean water, your wallet and a good book to keep your mind occupied. Take care of other people around you. They might not be feeling as confident as you about the situation. I once rescued someone who had capsized in a sea kayak, by wading up to my neck and reaching out with a kayak paddle. I did not know at the time that he had been drinking. Everyone made a fuss of him with dry clothes, bundled him into the Land rover and took him off for a warm bath and sweet tea. Meanwhile they left me on the beach in bare feet, half dressed, soaked through, having to run two miles on a newly tarred, stone chipped road back to their croft on a cold, windy Orkney day.

Talk to your body, tell it that the blood is going to start clotting, that the troop of the immune system the neutrophils and other leukocytes are arriving at the scene to mop up up infections. Your immune system is going into action to engulf the foreign invaders. Triggers in the damaged tissues are sending messages to your liver to send reactive oxygen species. They almost act like a micro bleach killing micro-organisms. If the skin is not broken try keeping a cold dressing on to restraint the excesses of inflammation. If the skin has been broken avoid keeping it cold for too long. It will slow down the needed inflammatory process. Concentrate on keeping the wound and surrounding area as clean as you can. For kayaking or wilderness situations a condom and a rubber band are very useful for keeping water out. I personally would never tattoo my skin. Apart from the aesthetic side I believe that tattooed skin is not going to heal well.

Find a surgeon who will set the bones accurately. In my experience hospitals that handle helicopter deliveries and trauma from mountain or sea accidents have excellent orthopaedic surgeons. Many people have been to see me after going to A & E departments that have not addressed the basic issue of ensuring that bones are carefully matched together. Bones that are kept in alignment but subject to gentle stresses will heal much faster and stronger. Osteoblasts are special cells in the surface or periosteum that lay down new bone. In 1892 Julias Wolf observed that bones grow along the lines of stress placed upon them. In practice bones need dynamic stress in the form of compression,  bending and torsion or twisting to grow strong. The practice in yoga of applying strong twists to the body also strengthens your bones. Keeping a bone in plaster for six weeks is a dubious practice that only wastes the surrounding muscle tissues. In most case two weeks would be enough time to transfer to a sling or protective bandage. A lady once came to see me holding her left humerus (arm bone) in two pieces. It had been removed from plaster only to find that it had not healed in the slightest. Careful manipulation through the skin and suggested use of the triceps and biceps muscles to stabilise the arm soon set it on the road to recovery.

Listen to your pain. It limits your activity and acts as a messenger. Personally I believe that the best use of pain killers is to help us get to sleep. Above that we should keep the use of pain killers and anti-biotics to when we really need them.

Take supplements to help you heal. The following regime brought about bone healing in less than five weeks: 2 gm of MSM to repair and remodel collagen, 120 mg Gingko Biloba and anti-oxidant that improves blood flow, 500 mg of lysine and 3 mg of Arginine / 150 mg pantothenic acid B5.

For those of you who are interested I enclose some pictures of how a broken, carefully stitched finger can heal. Thank you to the surgeon Mr Thati and your team at Ysbyty Gwynedd.

Fractured finger Fractured nail bed Mountain Rescue Finger repair Healing with aloe vera Which finger was broken? new nail bed

Hip operation, hip pain, pelvic girdle pain

The freedom to walk is a basic human right. For many people that freedom is curtailed because of complications after a hip replacement, pain in hip muscles, “piriformis syndrome”, “osteitis pubis”, weight gain through being unable to exercise or chronic fatigue syndrome. From meeting thousands of people with hip pain I honestly think that too many hip replacements were really to do with hip muscle imbalances creating tensions that led to wear in one hip joint or both sides. These comments came from a lady who has made a remarkable recovery after 4 years of suffering not only from hip pain but from negative comments and labels like osteitis pubis and, You will be in a wheelchair next and need a hip operation. Why can we not address the imbalances and give people hope instead of drugs and pessimistic prognosis?

Message:
I would like to express my gratitude to John for giving me my life
back as I haven’t been able to walk for four years due to muscle
damage, doctors couldn’t help me and had to look forward to a
wheelchair for my future. Thank you John for caring about my illness
and getting me back walking again.
I am forever grateful, Gillian Lewis, South Wales.

Home Baked Bread

The first bread that I baked resembled a house brick, fortunately I persevered. My bread improve when I discovered the following principles:

Choose strong flour that is within its best before date and sieve it before you use it. Bread flour has a higher gluten content than general baking flour. That is why it is called strong flour. Canadian wheat will be 13% or over. Organic strong flour will be about 11-12% gluten. Baking flour will be 9-10% gluten.

Use either fresh yeast or dried powdered yeast. Always add powdered yeast dry and always activate fresh yeast or granules with warm water and honey or sugar. It is better to use less yeast and prove it for longer than make yeasty bread.

Mix everything in a warm room. If you want to cut down the time don’t touch the dough. Try a mixer or blender and use metal spoons. If wholemeal bread is too heavy try the following recipe, it makes two good sized loaves:

Sieve 900 gm of white organic bread flour. Mix in 100 gm of wheatgerm. Wheatgerm contains the B vitamins, and vitamin E. Wheat bran is not that good for you as it contains phytic acid that binds up calcium and other minerals reducing their absorption. Adding the wheatgerm and leaving out the bran makes a lighter, nutritious loaf. You find more digestible soluble fibre from sources such as oatbran, pectin (the fibre in fleshy fruit), linseed (flax), and vegetables.

Dissolve 2 level teaspoons of salt into warm water. Add into more warm water to make 700 ml in total. Add 6 tablespoons of oil. I use a mix of organic rape seed and extra virgin olive oil.

Mix the dried yeast well into the flour or add the starter yeast mixture. Pour the oil, warm water and salt mixture into the flour and yeast mixture. Set the mixer or blender on slow for up to five minutes or until the dough is sticky and elastic. Or lightly flour a board and Knead by hand until the dough is elastic. Cover with a lightly oiled bag (I use a shopping bag), and leave in a warm place for several hours. Once the dough has risen at least double, Knock it back and cut into two parts. Lay each part into a greased 2lb load tin. I rub butter around the sides of the tins, it gives a good crust.

Leave to rise again in a draught free place until the surface feels light and some bubbles appear under the surface.

Carefully place in a pre-heated fan oven at 180 degrees C. and bake for 40 minutes. A non-fan oven might need 190 to 200 degrees. Knock the bread out of the tins and leave on a wire rack to cool. Cover with a clean tea towel if you need to leave it.

Home made bread & jam
Home made bread

The Origins of Acupuncture

Reading the Journal of Chinese Medicine this evening (http://www.jcm.co.uk) I came across the most extraordinary article. A novice archaeologist on her first dig at the Old Man of Wilmington was helping to unearth a sacred circle at the base of the Old Man of Wilmington. She picked up a piece of slate with unusual man-made markings on it. The picture of the slate was circulated to every university in the world. A colleague in Saudi Arabia matched the markings to an acupuncture text that his wife owned. The markings perfectly matched the lung meridian with an anatomically correct diagram of the diaphragm. Carbon dating confirmed the age of the slate as 9000 years before Christ. This pre-dates any Chinese record of acupuncture by many thousands of years. Could the practice of acupuncture have been common knowledge in England and used by healers? Perhaps these healing practices were known in many parts of the world? It would be wrong to assume it is “British” in origin. Who knows where else we might unearth healers at work?

 

Back pain, vertigo, blocked sinuses

I went to see John with a number of problems i.e Vertigo, blocked
sinuses and back pain being the main ones, I can honestly say that
after 3 sessions with him my back pain, which Doctors over the last
40 yrs have told me will always be there, has gone completely and with
a series of exercises to do hopefully will stay that way. Sinus is
clear and breathing clear, as for the vertigo this has not gone
completely but has been drastically improved, now only get it when I
make quick movements with my head, so again treated correctly in
future I should be free of this problem, I can’t thank John enough for
his help in making life that much better.
David Tissington

Headache, migraine

Headaches can be caused by pressure inside the head from restricted blood flow, increased craniosacral fluid, hormonal imbalances, medication or recreational drugs, neck muscle tension, anxiety, anger, a blow to the head or sudden deceleration, or in rare cases a bleed or growth or tumour pressing on the brain.

One sided headaches like migraine are commonly related to neck muscle tension (cervicogenic). At the top of your neck you have a bone called the axis (C2). It has a peg on it (the ordontoid peg), that stops your head falling off and acts like an axis. Above the axis is a bone called the atlas (C1), The atlas has a hole in it that allows the ondontoid peg to sit surrounded by ligaments. The atlas has two projections that run out to the side called transverse processes. The arteries that run up the vertebrae loop out and in again over these projections. They meet again into one blood vessel called the basilar artery. This joins the loop around the base of the brain called the Circle of Willis. I find with most migraines that there is a rotation of the atlas leading to stretching of the vertebral arteries more on one side than the other. Learn to balance this complex of joints, ligaments, bones and muscles and you will relieve many people of their headaches.

Tip: Stand behind someone who is seated. Place your middle finger tips gently in the dip mid-way between the angle of the jaw and the mastoid process. Ask them to turn their head each way. If you are very gentle you  will feel the tips of the transverse process of the atlas bone.

Pauline (not her real name), came to see me with a frozen shoulder. Her husband was suffering a terminal illness and subsequently died. She was holding onto the memories and felt the pain in her shoulder. As we worked on it I noticed that the trapezius muscles were very contracted on the same side as the shoulder. I asked her if she suffered headaches. She said that she had suffered migraines for 50 years. I worked the head into side bending, rotation and used muscle energy techniques to balance the skull on the neck. As we mobilised the head we both felt a subtle click as the atlas slipped back into place. She reported the following week that she had the first 4 pain free days in 50 years. It took more sessions of course but migraines are now the exception not the rule.

Maureen (not her real name), came to see me with headaches. She had suffered for 12 years from the age of 3, as best her mother could remember. I checked the pressure in the head by very gently placing my hands either side of the temples. When I gently lifted the head either side just above the ears I felt one side resisting more than the other. My impression was that the dura or tough membrane that protects the meninges and spinal chord, was tethered. I asked her mother if she had ever fallen. It turned out that her father was a Judo instructor. She had started Judo at the age of 3. With her mother watching we first of all worked to balance the coccyx and sacrum between the hip bones to remove some of the tension in the dura. Then I followed the subtle movement of the membranes and gentle wave like motion of the craniosacral fluid. The techniques can be learned if you go on courses run by the Upledger Institute. After six sessions the headaches had reduced to just the occasional one before a period. Another young woman of 17 also had migraines that had lasted for 12 years with a similar outcome. For her it felt like the headaches were “expanding and shrinking.”

Craniosacral fluid is produced in the space around the brain at about 0.5 litre a day. It forms a gentle wave with roughly a six second cycle. It flows through fluid filled cavities called ventricles and into the spinal chord. the fluid feeds and lubricates the nervous system, distributes hormones and possible some vitamins. If the small gap behind the ears or the dural membranes are restricted the flow of fluid can be limited. The gap lies between the bony bump called the mastoid process and the occiput or bone at the back of the skull. Underneath is the jugular foramen. The nerves to the trapezius muscles (cranial nerve IX), the vagus nerve (cranial nerve X),the venous drainage all follow a similar route.

Gall Bladder, gallstones

Where is your gall bladder?

Follow your ribs out to the right from the soft cartilage at the centre of the sternum. The cartilage is called the xiphisternum. Now tighten your abdominal muscles (if you can find them!). The gall bladder is buried in the folds of your liver just to the edge of the rectus abdominus muscles. Press in slowly as you massage under your ribs.

What does your gall bladder do?

It stores and concentrates bile salts (they are green). They help you to digest fats, oils and the fat soluble vitamins A, E, D, and K.

What do bile salts contain?

They contain fatty acids, electrolytes, cholesterol and minerals including calcium.

What are gallstones and why do they form?

Cholesterol is not particularly soluble in water, neither is calcium. Secretion of both could lead to stone formation. From autopsy studies 20% of the bodies that were examined had gallstones, most did not cause symptoms.

How can I keep my gall bladder healthy?

  1. Avoid overloading it
  2. Increase secretions
  3. Help it to function normally
  4. Take stimulants to flush and cleanse it
1. Overload
Fats place demands on the gall bladder to produce bile salts. Fats vary in their digestibility. Medium chain fatty acids place a low demand on the gall bladder. Examples are coconut (dessicated, coconut cream and milk), avocados, extra virgin (cold pressed) olive oil, cold pressed rape seed oil or groundnut (peanut) oil, safflower and other oils from nuts and seeds. Fats in processed foods are hard to digest. Processing includes deep frying and restructering foods to increase their shelf life. The process adds hydrogen to the carbon chains to make trans or artificially saturated fats. Trans fats are found in many commercially bought baked foods and some margarines. They give the foods ‘mouth appeal’ and preserve them for a longer shelf life. Nuts which have ‘gone off’ and taste bitter are also harmful and put demands on the gall bladder. Nuts keep best in a paper bag in a cool place. If the pack you buy feels puffy it means they have been flushed with nitrogen to exclude oxygen, it keeps them in good condition. Never store oils or nuts near a cooker or in sunlight. The light sets off a chain reaction that turns the oils into trans fats.
2. Increase secretions
The Mediterranean tradition of squeezing fresh lemon juice onto meat such as lamb helps secretions and aids digestion. Eating half a grapefruit, an orange, lime or lemon or a salad with cut oranges, peppery herbs such as watercress, and walnuts is a great way to start your meal. Bitter herbs and vegetables aid secretions and generally improve your liver. Chicory, sorrel, oregano or marjoram, fennel, aniseed, chamomile,parsley, watercress, spearmint or Quinine in tonic water all contain bitter compounds that aid digestion and stimulate the liver to produce bile. If you have no gall bladder your liver will still make bile but you have no way of storing it for ready use.
3. Normal Function
By far the most effective way of stimulating your gall bladder is to practice deep, sustained breathing making full use of your diaphragm. Your diaphragm is a large dome shaped muscle that attaches like a membrane right around your ribs. The two tendons of the muscle attach either side of your vertebrae in the mid back. The diaphragm tendons pull up and the psoas muscle tendons pull down. Place a hand just below your ribs while you are reading this. Imagine that your diaphragm is widening and flattening as you breathe in through your nose. Your hand should be pushed outwards. Now slowly breathe out through your nose and count to ten. Draw your tummy strongly inwards pushing the air out of your lungs and narrowing your ribs. Keep this up until you can do about five long, strong breaths. There are lots more exercises like Kalabati or Bastrika (forced exhale or forced inhale) but you will need a yoga class to learn them.
4. Take stimulants
Milk Thistle (Silybum marianum), is a well known stimulant for a tired liver, it stimulates bile production through its bitter compounds. Olive oil and lemon juice, cyder vinegar (malic acid) and lecithin are all thought to stimulate bile production. Lecithin contains phosphatyl choline that helps to flush cholesterol through the bile duct. Calcium deposits could be flushed by taking magnesium. Magnesium is found in most unprocessed foods; it is easily removed by processing. We used to run a wholefood shop in Kirkwall, Orkney in the 1980s. We used to happily sell free range eggs knowing that they contained lecithin that flushed out cholesterol.

Soluble fibre in your diet is an important way to flush out the gall bladder. Fibre in grains like wheat is largely insoluble. It increases the bulk of stools but is not absorbed into your bloodstream. Soluble fibre is found in pectin (the flesh of citrus fruits for example), in linseeds and in oatbran. Oatbran is a more gentle fibre than wheat bran. the soluble elements helps to gently flush out your liver and bile duct. Ideally take a dessert spoonful a day. Linseeds should be crushed before eating or crush them in your teeth. They contain lignins which are also good for hormonal balance. Nuts are a good source of fibre. Peanuts for instance contain (weight for weight) more fibre than prunes. Avoid eating peanuts raw. Try peanut butter spread into a stick of celery as a snack.

If you have acute or continued pain the area under your ribs ask someone competent to check it out. It might not be the gall bladder at all. Other causes might be wind in the colon, a peptic or duodenal ulcer, hiatus hernia (to the left of the xiphisternum), old adhesions from a previous operation or car accident or referred pain from elsewhere.


Sports Injuries

Every sport or hobby places repetitive demands your body. Most sports injuries involve accidents, one sided techniques or compounding of life injuries.
Let’s look at some examples taken from people who came to see me.
Rowing
A team of rowing four or eight favours one side or the other. You are constantly pulling more strongly with one side of your body. The pressure goes into your
hip and trunk muscles.
Try to change sides at times in training and use your gym or yoga stretching routine to balance your body. Extended and reverse triangle are good stretches for balance.
Dancing
Sometimes dancers come because of knee or foot pain. Think of your knees as a hinge, when you bend the hinge your knee should stay above your foot.
Turn your feet first before you initiate a move. If you turn your shoulders first you are likely to twist your knees. Avoid really soft shoes if you can. Constantly work at strengthening your feet by spreading your toes and gripping to raise the arches.
Step Aerobics
Again turn your feet first if you bend sideways or step up or down.
Tennis
Turn your whole body into a spring by arching your back as you load your serve. Follow through your volleys by bring your hand right across to the other shoulder. Avoid flicking your wrist, think of your moves as a kinetic chain transferring power from your feet and back, through your shoulders into the racquet.
Golf
Work at improving rotation of your rib cage and trunk to improve your back swing and follow through.
Kayaking
Practice sitting with a straight back, feet wide and rotate your body so that your fingers touch your toes on the opposite side.
Use your feet to transfer power to your kayak. Push with the foot on the same side when you place the paddle for a power stroke.
Open Canoeing
For the J stroke kneel with your knees together and your shins flat on the floor of the boat or mat.
Look through the stroke at the direction you want the boat to move.
Hockey
Hockey is very one sided. Practice weight transfer from one hip to the other in your training.
Football
Work at stretching your hamstrings, the muscles at the back of your legs. You have three hamstrings. They were named from hanging legs of pork up
on hooks from the farmhouse ceiling by their tendons.

In general, avoid crossing your legs, or cross them the less comfortable way first. Crossing your legs can lead to varicose veins just above the back of your knee and to hips that are out of balance. Stand with your feet parallel when you take to someone. Draw your tummy in a fraction and lift your chest.
Sports injuries nearly always relate to other factors. Here are some comments from Olivia, a dancer:

Feedback:
“I went to see John because my foot was excruciatingly painful. Within
seconds of seeing me, he pointed out my uneven hips, something I
thought had resolved itself years before. Clearly not, because this
proved to be one of the main causes of my dodgy foot.

I dance competitively and was distraught at the thought of having to
give up. I’d sought treatment at a private hopsital and was sorely
disappointed. The treatment was aggressive and achieved absolutely
nothing. John, on the other hand, has a way way gentler approach. I
hobbled into his surgery and skipped out. I can honestly say, I owe
the fact that I’m back doing competitive dancing to him.

He even sorted out problems I didn’t realise were such because I’d got
so used to being in pain all the time. I only noticed when the pain
was gone and it had coincided with a visit to him.

He is extremely knowledgeable, incredibly generous, has a brilliant
sense of humour, but I don’t think even he appreciates just how
amazing he is. If I could, I’d bottle him and spray him on demand
because he’s such a genius.

If you’re visiting this site and wondering whether you should see John
or not, my advice to you is this: don’t waste time wondering – just
call him and make an appointment. I promise you, you’ll be glad you
did”.