A Podiatrist's Opinion on The Shetcher Shape-Up Debate...

 

The Great Sketcher Shape-Up Debate...

The Rocker-Bottom "toning shoes" are being attacked in the media, which is frustrating because there is so much misinformation out there about shoes...

The main reason I started the blog 

was to provide information to my patients about proper shoegear. There are so many crappy shoes out there that I can't believe this is the shoe that is getting a bad rap. 

One of the lawusuit is suing over "false claims" 

that the rocker-bottom shoes will tone you up. Okay, I'll leave that to the attorneys to duke it out whether false claims were made or not.  I don't have the answer to that one. Show me the research and we'll talk...

But, 

the actual Rocker Bottom shoes - 

whether the "claims" are true or false - 

I don't know but -

  I do know that the rocker bottom shoes are... Excellent. 

 However...  

 

The Rocker-Bottom shoes are not for everyone! 

If you are elderly, have balance issues, nerve damage, muscle or leg weakness, Achilles tendonitis, Charcot foot, Diabetic foot ulcers, multiple back surgeries (several other issues) - this is NOT the appropriate shoe for you!

However, if you do not have any of the above issues and suffer from foot pain or are recovering from a fracture - 

this may be an excellent shoe for you. 
I have found that most patients need to ease into the rocker bottom shoes. Wear them for one hour the first day, two hours the second, three hours the third, ect - until you are in them a full day. Jumping into full activities too quickly with a rocker bottom shoe can cause some knee, hip, lower pain aggravation. 

There is not one shoe that is perfect for everyone! 

A patient's specific foot type, pathology and individual biomechanics all play an important role in determining what type of shoe is best for that patient.

The rocker-bottom shoes are typically great for patients with foot pain caused by biomechanical issues. 

Think of it this way, 

if you broke your wrist and you go to the doctor and she puts you in a cast - you are going to leave her office feeling much better and in less pain because the fracture has been stabilized and immobilized. 

Now, this is a simplistic explanation but basically, less motion across the sight of injury (whether it's soft tissue, bone or joint) will lead to less pain, less inflammation, less swelling and faster healing. 

If you break a bone in your foot, we as Podiatrists place patients in below-the-knee walking boots (CAM walkers) which have rocker-bottom soles. 

The CAM walkers allow the patient to walk with less pain while the healing occurs. 

The Sketcher Shape-Up and all of the rocker bottom shoes are based on the same concept - 

if you eliminate motion across the area of pain - you will have less pain. 

Biomechanically speaking, in most cases, 

less motion equals less pain.

What's also important is having a wide, soft toe-box, arch support (whether it's a custom-molded orthotic or a good over-the-counter insert) and rearfoot control.  

I know there are people out there who will disagree with me and that's fine. All I can say is I am a Podiatrist and this is my career. 

Every working day for the last eleven years, I spend my day talking to patients about their foot and ankle issues. Over the years, I've learned a lot from patients about what works and what doesn't. Lots of school and thousand of hours of working with patients has taught me several things:

1. There is an exception to every rule!

2. The first step is to heal the foot, the second step is to make sure the patient's foot is biomechanically controlled with proper shoes and inserts so the problem/pain does not reoccur. 

3. Most patients don't need foot surgery! 

4. If I stick to the basics - I have an extremely high success rate!

I love what I do.

I love helping people.

I love being a Podiatrist - it's a great career. 

I feel like the luckiest person in the world that I get the opportunity to help people. 

Have a wonderful day...

Sincerely,

Dr. Cathleen A. McCarthy

Top 20 Comfortable Women's Boots - Podiatrist Recommended...

TOP TWENTY 

COMFORTABLE 

WOMEN'S BOOTS

(Yes, some are not so pretty - but keep going -  there's a little bit for everyone in this list!)

Born Bitsy 

$210

I'm partial to the Born Brand of shoes! This boot has soft, good quality leather and allows for extra room in the calf which is great for women with more muscular calves. They have good arch support and a rigid sole which allows for more protection of the foot. It has a decently wide toebox and the soft leather is good for women with mild to possibly moderate hammertoes and bunions. 

The slightly tapered toebox may not work for women with severe hammertoes and bunions.  

Born Christina 

$150

Once again, Born is a wonderful boot! The thick rigid sole allows for better biomechanical control of the foot which allows for comfortable all day wear. The wide toebox is great for women with mild to possibly moderate hammertoes and bunions. The boot is true to size and has good arch support. 

If you have moderate to severe Hallux Limitus (limited range of motion of the 1st toe joint) or any forefoot issues like capsulitis, osteoarthritis or degenerative joint disease - this may not be the boot for you because of the heel height. 

 
Also, 
Check out the Born "Sash" boot for $78 on 
6pm.com.
It's not officially on the "Top Twenty" list but it should be! I came across it and I love the Born brand and I couldn't resist the price...

Dansko Aurora 

$185 

Bar none, Dansko are top-notch when it comes to comfort! Dansko shoes and boots have been a staple of my wardrobe for years. If you are on your feet all day, on concrete floors, have a history of foot pain or are looking for a great boot that will be comfortable - Dansko is it!  

The only caution I give with Dansko is that if you have prominent "bumps" on your feet - particularly on the top of your midfoot area - the Dansko might apply too much pressure and it could be uncomfortable. Also, if you are older (geriatric), have muscle weakness or significant nerve damage - Dansko boots may be too heavy for you. You need something supportive but light. 

 Dansko Finley 

$209

Okay, not the prettiest thing on the block but hey, if your feet hurt and you need a dependable solid comfortable boot for all day activities - this is an even better Dansko boot than the one above. It's hardcore Dansko comfort! 

Durango Boot 

$128

In an attempt to have some less expensive boots on the list, I found this Durango Boot at $128. It's hard to find a high quality boot for less than sixty to eighty dollars but they are out there. This boot offers a thick rigid sole for more comfort and protection. The toebox tapers in a bit too much so if you have moderate hammertoes or bunions - this may not be the right boot for you. 

Durango Harness The Dream

$59 on 6pm.com

A better price than the Durango above and a wider toebox. This boot has an awesome thick rigid sole which allows for exceptional comfort for all day wear on concrete surfaces. It has a low heel so that works especially well if you have forefoot problems such as Hallux Limitus (limited range of motion of the 1st toe joint), osteoarthritis,  degenerative joint disease, mild to moderate hammertoes and bunions, and metatarsalgia.  
 Also, 
check out the Durango "Flower in Love" boot for $84 on 6pm.com. 

Fit Flop Hooper 

$159

Fit Flop Hooper - once again, not the cutest boot ever but - ridiculously comfortable! As I tell my patients, having style and looking fabulous is all about your attitude - not what's on your feet. If your feet hurt, if you have chronic pain, if you are on your feet on concrete surfaces all day - don't knock this boot till you try it! 

If you have muscle weakness, significant neurological problems, are elderly or have balance issues, this might not be the boot for you.

Harley Davidson Huston Boot 

$123

I bought this boot for a winter trip to Germany because I knew I was going to do tons of walking. It was very comfortable and it has a great look that was easy to dress up or down. The toebox does taper in and is a bit narrow so if you have any issues with hammertoes, bunions, corns or calluses - proceed with caution!  

John Fluevog Arresto 

$459

I love John Fluevog shoes! The low heel, wide toebox and supportive sole provides lots of comfort. This is a great boot for light office wear but I wouldn't necessarily recommend it for hard-core all day, run around on concrete floors kinds of work.

John Fluevog Cece

$299 

 

Excellent John Fluevog Boot! This has the rigid supportive sole as well as the lower heel for more comfort. Great for anyone who can't tolerate heels due to Hallux Limitus (limited range of motion of the 1st toe joint) as well as metatarsalgia, capsulitis, hammertoes, bunions and osteoarthitis. 

John Fluevog Together Hi Nico

$325

 

I own the shoe version of this boot. The construction is basically the same and I absolutely adore it! It's very comfortable and I can wear it all day long for light office work. However, if I was going to be doing increased activities - I would probably bump it up to my Danskos. I like the John Fluevog thick chunky heel, the supportive sole and the wide square toebox. 

 

 MBT Boots 

$199

 MBT is the ultimate classic boot when it comes to comfort! The rocker-bottom sole gives exceptional support, comfort and biomechanical control which is great for people with chronic foot pain and are on their feet all day. 

The MBT boot is not recommended for patients with Achilles Tendonitis issues, balance issues, muscle weakness, and significant nerve damage. Also, just as an aside, don't wear a rocker bottom shoe on a cruise. Nothing worse that wearing a rocker-bottom shoe on a rocking cruise ship!

Merrell Martina Waterproof

$200

I think this is a cute look! And waterproof - what's not to love?  This boot has a thick rigid protective sole, wide toebox and low heel which is great for all day wear. 

 Naot Illusion

$300

I love this boot! It's gorgeous and also super comfortable. The Naots tend to run narrow to medium widths so if you have large or muscular calves - this is not the best boot for you. 

It also accommodates a dress orthotic although it doesn't necessary need arch support as it has a thick rigid protective sole with decent arch support already in it. 

Naot Modesto 

$220

 Another great Naot boot! Thick rigid sole, decently wide toebox and it accomodates a dress orthotic although it doesn't necessarily need one. 

It's a great looking boot and works great if you have mild hammertoes and bunions, metatarsalgia, and mild Hallux Limitus (limited range of motion of the 1st toejoint). It does run narrow to medium and does not work well for women with wide feet and calves. 

 

Spring Step Thrive 

$99

Love the price! Not to mention it's a great boot. The thick rigid sole is very protective and comfortable for wonderful biomechanical control of the foot. The wide toebox offers adequate room for mild to moderate hammertoes and bunions. 

Excellent for anyone who has forefoot or midfoot issues such as osteoarthritis, Hallux Limitus (limited range of motion of the 1st toe joint), degenerative joint disease, capsulitis and mild to moderate tendonitis. 

Ugg Ultimate Short 

$200

You can't go wrong with Uggs! 

This Ugg has a sole that is thick, rigid and protective for more comfort as well as a wide soft toebox that is awesome for mild to possibly even severe hammertoes and bunions. 
The Ugg will accommodate custom-molded orthotics as well as over-the-counter inserts for more arch support. Many of my Pediatric patients wear Uggs with their orthotics because it's one of the few shoe choices that is biomechanically sound for their feet (which pleases their Parents and Podiatrist!) and also lets them feel like they are wearing something cool and somewhat fashionable (which pleases them!).

Worth the money!

Dr. Marten's Bellissa 
$150

I love the way this boot looks! 
Dr. Martens have always been a standard of comfort because of its trademark thick, rigid, protective sole. The more traditional "combat boot" style of Dr. Marten's are popular with many of my teenager patients who have "biomechanically challenged" feet and can't comfortably wear the Converse or Van's. When I tell them they can wear Dr. Martens with inserts - their eyes light up. Funny how they were cool when I was a teenager and still are...
Check out the Dr. Martens website - they have lots of cool colors and styles and if you have a kid with foot issues and you need to wean them away from Converse or Van's - try luring them into comfort with Dr. Martens!
The more traditional Dr. Marten's "combat style" boot (not pictured here) is great for kids (or adults) with flat feet, hypermobility, ligament laxity, ankle instability - as long as they are worn with arch support.

 

Dr Martins Triumph 1914

$150
 

What's not to love? These are cool! 
Perhaps it's the remnants of my nineties Goth days (I admit it - just a little Goth - circa 1999!) but I love these. Great for trooping all over the city in all sorts of weather - durable, comfortable and, one again, great for anyone with "biomechanically challenged" feet who want a cool look with comfort. 
The laced boot allows for more give so if you have trouble with boots being too tight in the calf or pressing too much on the top of your foot because of a high arch or a bump (exostosis) on the top of your foot - this would be a good option as you can adjust the tension with the laces. 
For the more daring fashionista - you can go to 6pm.com 
get this boot in some bold colors for $75).



 

Dansko Vail 
$115


 I couldn't resist! I've got a long term love affair with Dansko shoes and this waterproof boot is great for trudging trough all types of gnarly weather. I did my residency in Buffalo and many is the time I had to walk my sweet pitbull Sheba at ungodly hours in sleet, rain, snow and all types of foul weather - this boot would have come in handy...
P.S. If you are in horrible weather and need a hardcore coat - try the "Stadium Parka" from LandsEnd. I'm not sure I would have survived Buffalo without that coat! 
Funny to end a blog on shoes with a recommendation on coats but - c'est la vie! 


P.S. 
Keep scrolling down for my September 17, 2011 blog on a great Donald J. Plimer boot! 

One of my patients said she asks a salesperson at DSW call her when they get in a shipment of Donald J. Plimer shoes in because she gets first pick of the shoe she wants at deeply discounted prices. Make friends with salepeople! They can be great assets in helping you in your search for the perfect shoe! 

I hope this was helpful!

Remember, good boots are an investment...

Hope all is well,

Dr Cathleen A McCarthy

:)

******

Check out my first novel written under the pen name C. Mack Lewis. It's available on Kindle or you can get a free Kindle app and read it on your iPad. 

Thank you for your support!

http://www.amazon.com/Gunning-For-Angels-Mack-Lewis-ebook/dp/B00I84NSE0

Comfortable Boot For Autumn...

DONALD J PLIMER

Tikle Wedge Boot

 

Although a little pricey at $225 (on 6pm.com) this is a boot worth checking out - especially if you're on your feet for long hours. The thick wedge sole will provide protection and comfort for your forefoot and the wide, soft toebox allows for more room for mild hammertoes and bunions. If needed, for more prominent bunions, you can take the boot to a Shoe Repair/Cobbler and have them to stretch the leather in that area. 

 This boot would benefit from having a dress orthotic in it to give more arch support - especially if you have a history of heel pain, hypermobility, ligament laxity, over-pronation, flat feet and/or arch pain. If your dress orthotic pushes your foot up too high and causes any discomfort on the top of the foot - you may not be able to tolerate an orthotic in the boot and you might want to consider getting an over-the-counter arch support for dress shoes to give you support and takes up less room. 

Overall, this is a great boot. Expensive but well worth the cost - especially if you have foot issues. 

This Boot is Recommended For:

*Mild to Possibly Moderate Bunions & Tailor's Bunions

*Mild Hallux Limitus (Limited Range of Motion of the 1st Toe Joint)

*Mild to Moderate Hammertoes

*Mild Metatarsalgia

*Mild Morton's Neuromas

*Mild Capsulitis of the Toe Joints

*Mild Tendonitis

*Mild Plantar Fasciitis (Heel Pain)

*Mild Achilles Tendonitis

*Mild Corns & Calluses

*Mild Osteoarthritis

This Boot is NOT Recommended For: 

*Severe Bunions, Hammertoes & Tailor's Bunions

*Severe Haglund's Deformity (Bone Spur on the Back of the Heel)

*Severe Exostosis (Prominent Bone Spur on the the top of the Foot) 

*Moderate to Severe Hallux Limitus (Limited Range of Motion of the 1st Toe Joint)

*Moderate to Severe Degenerative Joint Disease of the Toe Joints

*Moderate to Severe Osteoarthitis/ Rhuematoid Arthritis

*Diabetics with a history of Ulceration (Open Sores)

*Peripheral Arterial Disease (Poor Circulation) - especially with a history of Ulcerations.

*Peripheral Neuropathy (Nerve Damage) - especially with a history of Ulcerations.

*Charcot Foot

 

Hope all is well!

Dr. Cathleen A. McCarthy

 

Doggers for Kids - Great Deal at CVS...

Doggers
 

This is a great option for kids. They are a knock-off of Crocs and can be found at most CVS Pharmacy's for $7.99.

I recommend that you get your kids into the habit of wearing Crocs or Doggers around the house (like a house slipper) for added protection to their feet. They are much better than barefoot, flip-flops or wearing socks. They will help prevent everything from Warts, Foreign Bodies like cactus or splinters, broken toes, and many other injuries. As a parent, it will add to your bottom line in savings in medical bills and hopefully save some trips to Urgent Care.

Crocs are awesome but if you need a less expensive alternative (although they can sometimes be found at a great price!) - Doggers are the ticket! 

Hope all is well,

Dr. Cathleen A. McCarthy 

 

Can MBT's and Crocs RX be Tax Deductible?

Hmm. 


I'm not a CPA so I can't give you tax advice 
BUT...


I often write prescriptions for my patients who need specific shoes for their foot problems. For those patients who need better shoegear but are hesitant about spending the money - I find that (as long as the shoes are medically necessary) I can write RX's for the patients which may make it tax deductible. Sometimes patients can use their "Flex Dollars" through their insurance plan to reimburse them for the shoes. I had a patients several years ago who had severe foot problems and she absolutely loved her retail job which required that she spend long hours on her feet. She talked to her boss and the company decided to purchase the shoes for her because she was such a valuable employee. 


The usual prescriptions are for:


*MBT's (For Heel Pain, Osteoarthritis, Hallux Limitus, Metatarsalgia, Tendonitis, ect)


*Rocker Bottom Soled Shoes (same as MBT's)



*Extra-Depth Shoes (For Diabetics, Neuropathy, Severe Hammertoes, Corns on the tops of toes, Painful toes, Morton's Neuroma's, ect)


*Crocs Rx (For Everybody! I highly recommend wearing Crocs Rx as your house shoe - for "puttering" around the house - this will prevent everything from warts, foreign bodies, fractures, heel pain, broken toes, ect). We carry Crocs RX in our office that cost $50 and our staff is trained to fit patients properly. Also, you can use our referral code and save 20% if you order through the Crocs website (the code is 40011802). I always tell patients that I don't care if they purchase cheap knock-off's - it's still preferable to walking barefoot!




*Shoes with a Steel Shank (For Severe Biomechanical Strain caused by Flat Feet, Over-Pronation, Ligament Laxity, Tendonitis, Hypermobility, Metatarsalgia, Overuse Syndrome, ect). A good site for this is: vanderbilts.com



*New Balance (Great Walking Shoe for many different foot types - especially if you get a NB with "Roll Bar" Technology).




Talk to your Podiatrist about possibly writing an RX for the shoe that you need...




Have a great day!


Dr. Cathleen A. McCarthy 

Podiatrist's review of Skyscraper Six Inch Heels...

Having stayed out late last night at a Girl's Night Pool Party complete with a "Just Dance" Wii Deathmatch - I'm taking the liberty of posting a "rerun" of an older post that I thought might be of interest. Last night, the ladies thought it was hilarious that right before the Wii "Just Dance" competition - I put on my Kuru sneakers and orthotics but, seriously, I had so much fun and I danced my booty off and my feet feel fab! I'm off to Target to get me some "Just Dance" so I can kick in the the Kuru's at home!
:)





Skyscraper Six Inch Heels...

As an adjunct faculty member of MidWestern University's Podiatric School of Medicine, I was fortunate enough for appear on Channel Three's Good Morning Arizona to discuss the newest fashion trend to hit the red carpet and the cat walk - the six inch "Skyscraper Heel." 

Previous to my appearance, I suggested to the Producer that we take X-Rays of her feet in the "Skyscraper Heels" and, although I knew the shoes were bad, examination of the actual X-Rays were horrifying. The central two-thirds of the foot are almost at a complete vertical and the first toe joint is so dorsiflexed that the woman is actually bearing her full body weight on the inside cartilage of the first toe joint. Yikes! 

This extreme stress across that small area can cause:

Degenerative Joint Disease

Osteoarthritis

Bunions

Hammertoes

Stress Fractures

Knee, Hip, and Lower Back pain

Tendonitis

Ankle Sprains 

Achilles Tendonitis Contracture

The shoes that we reviewed on the show were all beautiful in an artistic "Wow" factor way but I am amazed that women would subject themselves to this kind of pain (the words "Medieval torture devices" were the first words that sprung to mind when I saw the extreme six inch heeled shoes). It's rumored that some of the celebrities who wear this fashion do what's called a "PT BLOCK" prior to appearing on the red carpet or at an event in these shoes. Basically, that means they are injecting the Posterior Tibial Tendon with Lidocaine to numb it up prior to an event so they can walk pain free. 

Being a woman and a Podiatrist, I'm in a unique position to not only be a big fan of beautiful shoes but also to know what constitutes a good shoe and I've spent over a decade treating people for various foot ailments - many caused by poor shoe-gear.  

I'm not advising that women give up their heels - unless of course you have a specific foot problem that makes it dangerous and/or uncomfortable to wear such shoes (such as Diabetes, Neuropathy, ligament laxity, extreme flat feet, Posterior Tibial Dysfunction, ect). I am recommending, however, that women follow some simple rules when looking for a good dress shoe. 

If you feel you must wear a high-heel shoe, here are some things to look for:

* Try to limit yourself to a two and a half inch heel. 

If you have limited motion of the big toe joint (hallux limitus) be particularly careful of your heel height. There's a simple test for this - stand on the ground and, without shifting your weight, have someone try to pick up your big toe. How far does it go upward? However high it goes - you should not ever go in a higher heel height than that. If you do, your body will compensate: just remember, if your body cannot get the motion it needs across one joint, it will find the motion it needs across another joint - whether it is your knee, your ankle, or, more commonly, walking on the outside of your foot which can lead to multiple "mechanical strain" problems. 

* Look for the "Wedge" shoe as it has a more rigid sole that will protect your foot. There are several advantages to the "Wedge" shoe. First, you can get some of the height that you are seeking from a dress shoe while limiting the range of motion that you are forcing across your big toe joint. You can have a four-inch wedge but actually only be in a two-inch heel. Secondly, a solid wedge will decrease the wear-and-tear on your foot that a more flexible, thin sole will allow. 

* Avoid a thin, flexible forefoot area - try to get a dress shoe with a thicker more rigid front.

* Look for a shoe with a wider front - the wider the front of the shoe, the more pressure per square inch for the force/weight of your body to be distributed over. 

* Although you are looking for a thick, rigid-soled sole - try to find a shoe with some padding and cushion built into the interior.  

* Strap in the Forefoot area and the Rearfoot area securely for more protection and to minimize injury. Remember, the more motion you have, the greater the chance of injury. Everyone thinks that you need a thin, cushy, flexible shoe but it's the exact opposite - you need rigid, biomechanical control. 

* Most importantly - everyone is different! What works for one person does not necessarily work for another. The acid test is PAIN! If the shoe hurts, forget it. Pain is a warning sign that something is going on and you need to stop and listen to what your feet are telling you. (If you have Peripheral Neuropathy you should not be in this type of shoe at all because if your feet are numb - you can't feel the pain that is warning you of a foot problem, which can set you at risk for limb threatening problems). 

I really enjoyed my stint into television land and, as much as I appreciate the aesthetics of these lovely shoes as works of art to admire - I cringe at the thought of the damage that occurs to the foot, knee, hips and lower back while walking in them. 

As I tell my patients, what would you rather do - wear a more sensible shoe so that you can run around in, having a blast as you do everything you want to do or look fashionista fabulous but be in pain and not be able to keep up with your friends as they run around and do everything that you can't do? 

Have a great day!

Cathy McCarthy, DPM

Born Tierney - Comfortable Women's Casual Heel at Dillard's at Paradise Valley Mall

THE BORN TIERNEY

GENE TIERNEY  

Okay, Gene Tierney and the Born Tierney shoe are not related - I just happen to be a big fan of both the actress and the shoe!

I purchased the Born Tierney today and have enjoyed wearing it out this evening. 

Very stylish and comfortable... 

I love the beautiful rich finish and I love the height it gives me (four inches) but because of the wedge sole - it comes out to about only two inches of actual elevation for the foot. The thick rigid sole is protective of the foot and the forefoot and excellent rearfoot strapping allows for more biomechanical control of the foot and ankle and therefore - more comfort. 

This Shoe is Recommended For Most Patients with:

*Mild Heel Pain

*Mild Bunions and Hammertoes

*Mild Tailor's Bunions 

*Mild Achilles Tendonitis 

*High Instep

*Bumps/Exostosis on the top of the Midfoot Area

This Shoe Is NOT Recommended For Patients with:

*Diabetes

*Neuropathy (Nerve Damage)

*History of Ulcers or Open Sores

*Charcot Foot

*Moderate to Severe Bunions or Hammertoes

*Hallux Limitus/Rigidus (Limited Range of Motion across the 1st Toe Joint)

*Osteoarthritis or Degenerative Joint Disease of any of the Forefoot Joints

*Capsulitis of the Forefoot Joints

*Moderate to Severe Morton's Neuroma

*Moderate to Severe Ankle Instability 

*Moderate to Severe Hypermobility 

*Moderate to Severe Tailor's Bunions 

*Metatarsalgia

I'm love this shoe! 

It's flattering and comfortable. 

If you have any serious forefoot problems - particularly pain or limited range of motion across the forefoot joints - this is not the shoe for you. 

Rating: 

8 on a scale of 1 to 10 with ten being the best. 

I paid $99 at Dillard's at Paradise Valley Mall. 

I also highly recommend the 1944 classic movie "Laura" starring Gene Tierney. 

Enjoy!

Dr. Cathleen A. McCarthy 

:)