Keeping up with the yogis

Woman close to sitting down cross legged, just a foot or so off the ground

I got to thinking yesterday–already a good sign because thinking means I’m awake–about my sleep quotient of late. I realized that I can’t even remember the last time I took an afternoon nap. Sure it was probably within the last few months, but that’s quite a stretch for me. And I haven’t been forcing myself to stay awake; I just haven’t felt the need to nod off.

This is fantastic news because I’ve read that people who sleep either too little or too much are at higher risk of dying sooner than those who get adequate sleep (between 7 and 8 hours per night). I want to sleep eight hours per night like the healthy person I used to be and wake up refreshed and ready for my day. I also don’t want to die anytime soon because I’m currently fairly healthy for a cancerous person. Dying unexpectedly would be a cruel joke.

I’ve been getting more done during the day, yawning less, staying out of the house longer, and feeling much less foggy. Where did tired Annie go? Does it matter so long as I’m feeling fairly well for someone with leukemia? No, it does not. I may not be a going concern until the wee hours, but maybe someday soon I’ll go to an early movie or something outrageous like that.

But if I really want to stay alive, there’s one more physical test I have to pass: The Sit Rise Test (SRT for short). The SRT was developed in Brazil as a predictor of longevity. It’s a rough measure of physical strength, balance, and flexibility. My yoga idol Kathy first introduced me to the test a while back, and she has demonstrated the move many times with ease. (No wonder I want to be more like her when I grow up.) To pass the SRT, I have to lower myself to the ground from standing and then rise all the way back up without any support, bodily or otherwise. The more support I need to do the task, the lower my score is and the sooner I’m predicted to kick the bucket.

Because I want to live to a ripe old age, I have tried to do the SRT several times to no avail. I can lower myself down but I don’t have the leg strength to get up without support of some kind. But in her most recent fantastic on-line yoga summer camp class (check camp out here), Kathy encouraged her devotees to try it. She prefaced the move with something like “It will be fun!” or “You’re gonna love it!” Whenever Kathy prefaces anything in this way, I know that the movement will be well beyond my capability. But I love a challenge, so I gave it the old yoga try.

Boy, did I ever hurt my foot. That’s what happens when I try to be too macho for my own good. I’m all healed now, but I learned my lesson. Sometimes I need to leave my idols alone on the pedestals I’ve created for them, knowing I’ll never merit an invitation up. Scratch my low SRT; with my perfect sleep quotient, I’ll have many years to aspire to such greatness.

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Thank God I’m not a bi-valve

Clam linguine in a large white bowl

Am I inundating you with too much science lately? Are there too many facts to keep straight, is there too much advice to follow? Have you remembered to nag your spouse to slow death by cancer, for example, or to let your coffee cool before you drink it to prevent cancer altogether? I trust you’re taking notes because my work here is never done.

A reputable research lab reported compelling findings recently that I felt worth sharing. Turns out bi-valves can spread a leukemia-like illness to one another. Not only that, this transmission may occur within and between species. That means a sick mollusk can infect another mollusk, or even a poor unsuspecting clam.

Before you panic and stop ordering clam linguine at your favourite Italian restaurant, you should know that you, dear human, cannot get cancer from a cancerous bi-valve. A bi-valve can infect only another bi-valve, not a person. Do you feel better now?

In contrast, there is no evidence that cancer can spread from one person to another. People with HPV are more prone to certain cancers, and that’s why the HPV vaccine is now routinely administered in early adolescence. But you can’t catch cancer germs. We can still hug and kiss (no tongue, though, since I’m not married to you) and you won’t fall ill, or at least not from cancer. So don’t fear me, dear friend, only my laughter is infectious, not my cancer.

I’m glad you can’t get cancer from me because I appreciate the odd hug, even though I’m an awkward hugger at best. Do you remember Dr. Woman? (Bear with my apparent free association here.) Our contact was fairly brief and she was always going at full speed–when we met following Easter, she mentioned she’d spent her weekend in the hatchery–so I worry she didn’t know how much I appreciated her care of me. Sometimes saying thank you, however many times, doesn’t feel like enough.

At the end of our final appointment, when she ditched me (sometimes breaking up with a doctor is a good thing), we both got up to leave. Then, seemingly out of nowhere, she asked if she could give me a hug. Who am I to refuse a hug from a doctor, especially one who has cared for me so diligently and with such compassion?

I spent a lot of time wondering what prompted Dr. Woman to initiate that hug. Did she know she likely wouldn’t see me again because I no longer needed her care but, also, I had leukemia and might not be around forever? Was she acknowledging my challenging health journey, and celebrating, in this context, my no longer needing her care? Was she picking up on my deep appreciation for her? Maybe she just needed a hug herself, although somehow I doubt that. I’ll never know and it doesn’t really matter, but it’s a gesture I’ll never forget.

Would she still hug me today in light of that new research? I can only hope she would.

A recent attempt at boundary setting

Snout and paw of dog visible peeking out under covers on bed

I baked muffins this weekend. Is there such a thing as Strike 4?

In my professional heyday (hey, I’ve never called my work life a heyday before), I counselled many parents whose children were acting up. I learned that when a parent starts setting firmer limits, the child’s bad behaviour initially escalates. Instead of skipping the curfew, a teen may stay out overnight. What better way to test whether the parent means business?

I’m getting too theoretical here, so I’ll share a recent personal example instead. For years, Jelly has enjoyed occasional evening couch time with her moms, but this cuddling ended with the recent purchase of a new couch, which happens to be a dog-hair magnet. We have had the couch for a few months now and we’ve stood firm on our new no-couch-time rule. Every evening, Jelly lays her snout on the couch, looking up at us with her mournful Basset eyes and waiting for her invitation. Every night she is sent back to her bed.

I hadn’t considered how difficult this limit would be to enforce when Jelly’s bestie, Rosie the golden doodle, came over to visit. Jelly and Rosie enjoy the occasional indoor off-leash romp, usually instigated by ours truly. Yes, Jelly races through the kitchen and dining room and, since it is en route, jumps onto the couch, where she stands at her bestie’s height and taunts her. But no more. The couch is now out of bounds.

On this particular day, while I was seated at the table, Jelly instigated a manic romp. I jumped up to obstruct access to the couch, neglecting to push in my chair. Jelly’s pace was frenetic, and nothing would slow her down. She couldn’t quite access the couch, so she had to change her romping route. In a split second, she leapt onto my abandoned chair and, with one more step, onto the table.

Jelly’s expression suggested she was just as surprised as I was to find herself where no dog had ever gone before. She stopped for a split second and looked at me with both terror and confusion in her eyes. Her thought bubble said: “What the heck have I done and how do I get off?” Then she calmly regrouped, walked to the other side of the table, and hopped down to the floor. So much for limit setting; I was speechless.

From my knowledge of parenting, I should have anticipated this turn of events. Set a new limit and expect an escalation. “I can’t get on the couch anymore? Well, then, just watch me jump on the table.” But considering how scared Jelly looked up there, I’m not expecting her to push that particular boundary again. Now if I could just get her to stop jumping up on our bed, which is 5 inches lower with our new mattress.,,,

And so we arrive at my second key parenting principle: Not all parenting decisions are based on what’s best for the child. Parents have needs too. Sometimes I invite Jelly up on the bed because I want to cuddle. Is that really so bad? Don’t answer that.

 

Strike three, I’m out!

Boy licking chocolate batter on spatulaI’ve told you many times how I love to bake. My wares are consistently ugly but tasty. There’s always something in the freezer for unexpected guests, and occasionally for J. and me.

Last week, I suffered a major baking blow: I learned that batter was out, and I’m not talking about baseball here. I’m speaking of the recent cake-mix recall. Betty, how could you betray my trust? Turns out the flour in the mix was contaminated with E. coli. All these years I thought batter was bad because of potential Salmonella in raw eggs, but now raw flour is on the forbidden list as well. I wasn’t up to another loss. Licking the spatula is my baking nirvana.

Of course this recall was announced during a heavy baking week, starting with the Weird Cookies. (Once you hear what’s in them, you’ll understand the name.) Imagine chocolate chip cookie dough with bran flakes and cheddar cheese instead of chips. I know, protein and fibre in your cookie sounds a bit odd, and may lead one to mistake them for healthy, but they are addictive. I begged J. to let me bake them for her work mates just because. They gobbled up every last one and asked for the recipe, of course.

Armed with my new knowledge, as I mixed the weird dough I repeated the mantra: “Bad batter, bad batter.” Did it stop me from licking? Absolutely not. Strike 1. Despite my best effort to scrape every last bit of batter into the cookies, I let a little dough pass these lips before I got the rest safely into the oven. The heat would eradicate any remaining dangerous bacteria.

A few days later, I baked a birthday cake for a friend’s party. (Remember the underbaked cupcakes we brought to last year’s celebration? Those cupcakes could have made everyone sick, I now realize.) I was doing pretty well, cleaning out the bowl as best as I could with my trusty spatula, but suddenly I couldn’t hear my mantra over my licking. Strike 2. That batter was mighty tasty, I must say. Then I overbaked the cake to ensure I’d killed everything bad off. True confession: I overbaked the cake because that’s just what I do.

Wait, there’s more. The cream-cheese icing. I hadn’t even considered the dangers of spoiled milk products! I conducted a thorough internet search on how long to soften cream cheese before bad bacteria would take hold, only to learn there are far too many opinions on this matter. I created the smoothest cream-cheese icing ever because, by many accounts, I left the cheese on the counter far too long. Whoops! And icing doesn’t get baked. Need I confess to tasting it anyhow, only to assess the tart-sweet balance, of course? Strike 3 and I’m out, or am I?

Should someone like me, who has just overcome a serious C. diff infection, be risking my 4-1/2 lbs of healthy gut bacteria–yes, you read that correctly–by ingesting food-borne contaminants? Miraculously, I survived any potential health risks with nary a stomach ache.

J. and I conveniently left the party early so I can’t tell you how the guests’ guts fared. Hopefully nobody cried foul.

The difficult client, or is that the therapist?

Anyone counsellor will tell you that the work is hard. Some sessions may be exciting and invigorating, while others are draining and discouraging. Over the years, I’ve seen the occasional client whom I felt ill equipped to help due to the nature of the presenting concerns or simple personality differences. In these situations, therapists often presume the client is being difficult, but what if the therapist is inadequate?

Allow me to betray my own confidentiality here. Many years ago, as I was finishing my clinical training, I sought help because I wasn’t coping well following a series of break ins. I nervously attended my first session with this psychologist I knew nothing about. She was very nice and I’m sure very competent but I knew within the first session that we couldn’t work together. I learned a lot from this experience both as a client and as a therapist.

Adult hand shown finger painting

I can assure you that this is not my hand.

The psychologist asked me, at age 29, to draw my feelings. I refused politely. I can’t imagine how she understood my noncompliance, but I trust she was relieved when I didn’t rebook. I don’t know if I could have worked things out with that therapist because I didn’t address my discomfort directly with her. In retrospect, I regret my cowardice.

I don’t draw because it’s not a way I express myself. I have never been artsy or craftsy. Although I can colour within the lines, I can’t make the lines myself. Even as an adult, when J. and I leave sidewalk-chalked notes for the neighbourhood kids, J. draws the dog pictures and I fill in the cartoon bubbles. The visual arts are not my thing.

If this same psychologist had asked you to draw your feelings at 5 or 25 or 50, you might have felt immediately at ease. Maybe you’re not a talker; maybe you prefer to express your feelings in other ways. This psychologist might have been the perfect fit for you. She just wasn’t for me.

Over the years, I have had many clients who have come for just one session. Sometimes they’ve let me know they didn’t like my approach and wanted to go elsewhere, but most often they’ve not rebooked, just like I did with that psychologist.

The drawing incident seems insignificant in the retelling but its effect on me was profound. It helped me gain perspective on my challenging interactions with clients. I was trained to view a client as noncompliant or resistant if we were not working well together. What if, instead, my client didn’t feel comfortable with my approach? Maybe my feedback was poorly suited to that client or my intervention was poorly timed. Maybe I misjudged my client’s needs because I wasn’t listening carefully enough.

I carry this knowledge with me today. Just as that psychologist was not a good fit for me, and ultimately I found a therapist who let me talk about my feelings, I am not the best clinician for every client referred to me. After many years of questioning my competence, I think I’m finally okay with that.

I wish life weren’t unfair.

I heard some tough news this past weekend. A family J. and I care about is dealing with a second cancer diagnosis, too soon after the first one. One member was successfully treated a few years ago, but recently another was diagnosed, forcing this family back on the cancer roller coaster. I’ve said it before but it bears repeating: life is unfair.

These are good folks, loving, kind and decent, and they don’t deserve this turn of events. No one does. They haven’t done anything to bring illness on themselves.

No God I know would make anyone suffer like this. You say: “God only gives people what they can handle.” I say: “Balderdash.” God couldn’t be that mean and uncaring. Had anyone ever told me anything so inane following my cancer diagnosis, I know my response wouldn’t have been pretty. Thankfully, for their sake, no one has.

I’m not alone in my beliefs about destiny and God’s will; I have the backing of the wise rabbi, Harold Kushner, author of When bad things happen to good people. Kushner’s son was diagnosed with a degenerative illness at age 3 that resulted in his death at 14. This man knows of what he speaks. Despite devoting himself to serving God, he had the unspeakable befall him and his family.

Although Kushner writes about his faith and references the Bible and teachings of Jewish scholars, his book is not overly religious and accessible even to people like me. He is compassionate and supportive and I have taken great comfort from his writing. Kushner stresses that God is not punitive or vengeful, he does not make bad things happen, but that He is there to help people through challenging times. Believer or not, I can buy that.

Is it fair that this family should have to deal with cancer again so soon? That they should have to hang out with other cancer patients at the same Cancer Centre that they thought they were rid of? Absolutely not. No one would embark on this journey voluntarily, and I certainly wouldn’t wish it on anyone. Cancer isn’t fun at the best of times, but two bouts within one family…I don’t know how to finish this sentence.

Thank goodness this is a strong, close family with a solid support network. This is what I wish them: I wish them permission to accept however they’re feeling, whether it’s anger or sadness or fear or, I can only hope, joy amidst the pain. And I hope they will seek out the support they need from others, whatever that looks like to them, knowing it will change over time.

These friends will muddle through their upheaval as best they’re able. They are experienced cancer survivors so they know the drill. I wish they didn’t have to but they don’t have a choice. Nothing I can possibly say will diminish their pain. I think they know I’m not afraid to talk about the tough stuff if that would help. In fact, tough stuff is my specialty. Alternatively, Jelly is always available for comfort, and she is an excellent cuddler.

Amidst all the bad, good is still happening in the world.

It’s been really hard to turn on the news lately. Every day it seems there’s another tragedy, bigger than the one the day before. Incidents like the mass killing in Nice fuel the xenophobia in the Western world. Some start questioning immigration policies and that crazy scary US presidential candidate only adds fuel to the fire. It’s a mess out there.

Whenever I’m feeling overwhelmed by all the tragedy, I go to the Canadian Blood Services Facebook page. This past week, CBS posted a number of stories that reminded me of the good in the world. Every story is a feel-good story on that Facebook page.

There I read about the Texan student who joined the stem-cell registry during a high school blood drive. A few years later, he was matched with a child in need, so he stepped up and saved a life. A 6-year-old Calgary boy undergoing a recurrence of leukemia, a recurrence that would likely have ended his life, received that healthy Texan’s marrow and is now cancer free and thriving. Donor and recipient met for the first time this week.

I think a lot about the stem-cell registry because I know someone who might have benefitted from it. My dear friend Scott, whom I wrote about in one of my first posts, died of lymphoma 22 years ago this month. I vividly remember his despair upon learning doctors could not locate a bone-marrow match. Gruelling chemotherapy had decimated his immune system. As a result, he developed an opportunistic infection and died 4 short months following his diagnosis. Would a bone-marrow transplant have saved his life too?

Out of interest, I learned that registering to be a stem-cell donor is as simple as four painless cheek swabs. The process of donating stem cells or bone marrow is more involved but that’s assuming the potential donor is matched with someone in need. Somehow I think I could endure a bit of discomfort to save someone’s life, but nobody would want my tainted marrow and I’m too old anyhow (registry age limits are between 17 and 35 years). I will have to count on others to step up, not for me since I wouldn’t survive the rigorous process of a transplant, but for those who could benefit.

There’s another CBS story that made me cry happy tears, one that Trumps all others. (Try fearing people from far lands after you read this.) Over the last few years, a group of Syrian refugees arrived in Canada, settling in Winnipeg. They wanted to find a way to express their thanks to the community that welcomed them.

Group of Syrian men having just donated blood in Winnipeg

So two dozen of these Syrian refugees donated blood. (This picture is from the CBS Facebook page; I didn’t think they’d mind if I borrowed it.) What an amazing way to give back to Canada. They’d escaped a war-torn country. The frequent bombings and shootings resulted in a constant need for blood, so they became experts at donating to help their compatriots. One fellow in the group had donated three dozen times in Syria. When they heard there was a blood shortage here, they willingly pulled up their sleeves. Thanks, Syrians, for giving where you live. You’re helping people like me.

One potato, two potato, red potato, pink?

Basket of red potatoes tipped over

Spot the genetically modified potato!

Turns out my cancerversary will be long past by the time I see Dr. Blood and her fantastic team again. I have been given the summer off my patienting job so I can busy myself with other things, like deciding what to bake for my next celebratory Cancer Centre visit.

Barring counselling the odd client (by “odd” I mean “occasional” and not “unusual”), I will have a fair amount of free time this summer. Lukewarm coffee, anyone? I’m available days. As always, I will keep the home fires burning while J. is off earning our keep. Jelly and I will walk ’til we drop, I will keep us in groceries, and I will cook tempting meals and bake delectable wares.

Why just the other day I went to the mega-grocery store, list in hand, only to have an energy vampire sidle up to me at the red potato bin. This well-dressed older woman had nothing better to do than suck all the energy out of unsuspecting shoppers. You know the type, ready to pick a fight over the produce.

As I was choosing my red potatoes, the EV sidled over and said: “Those potatoes don’t look very red.” I nodded and smiled but did not engage her because I feared what might come next. (When anyone tries to engage me in a negative conversation, I put up my magic shield and deflect all incoming messages. Alternatively, say something nice or engaging or interesting and my shield magically vanishes.) Because she had not garnered the outrage she was hoping, she repeated herself: “Those potatoes aren’t very red.” Then she added: “They must be genetically modified.” That’s quite the judgement on those poor potatoes, isn’t it?

If I were an agronomist, perhaps I could have determined whether the potatoes were genetically modified. But, sadly, I’m an ignoramus. EV was implying through her tone of voice that genetically modified potatoes are evil. I don’t know enough about genetically modified food to care. I may nurture my gut bacteria with daily kefir, yet I wonder whether some genetic modifications are not so bad. If you can make my tomato last longer or pack a more nutritious punch, I’m in. That’s why I bought those pink potatoes despite EV’s protests. For all I know, they’re better for me.

After I laughed (just a bit), I said: “I certainly can’t tell by looking at them.” Then I left to check out the genetically ambiguous lettuce. Were I not wearing my ill-fitting socially appropriate hat that day, my inside voice would have said: “Why the heck are you shopping at the cheap mega-grocery if you have disdain for genetically modified produce? The farmer’s market beckons! There you will find God’s bounty. But don’t complain about the ugliness of the produce or the short shelf life.”

Perhaps my strong reaction stemmed from the fact that I too am genetically modified, albeit by God and not by science. Imagine my life without my genetic anomalies, i.e., my Philadelphia chromosome (a.k.a., CML) and my JAK-2 mutation (polycythemia). I’d kill for a scientist to manipulate my genes. Who knows? Maybe it could extend my shelf life.

I’m not superstitious, or am I?

Black cat, mouth wide open, laying on sidewalk

I know superstitious people. They buy their lottery tickets from the same kiosk every time. They bring their rabbit’s foot or magic coin or lucky pencil to all exams. They wear their special undies or socks to each game if they want to play well.

A black cat can cross my path, no problem, although I’d prefer a cuddly black dog anytime. Show me a ladder and I’ll gladly walk under it. Watch me step on all the sidewalk cracks! I’ll even sleep soundly on the 14th floor of a hotel, even if it’s really the 13th floor.

I may not be overly superstitious, but certain traditions might suggest we Jews are a superstitious lot. Baby showers are one example. No, I am not expecting, I just look pregnant, but if I were, I wouldn’t have a shower before the baby is born. According to Jewish tradition, it is bad luck to celebrate until after the baby is safely out in the world. In fact, some Jewish parents-to-be do not even ready the nursery until after the birth. I have trouble buying a gift for a baby who is inside incubating, even if the family does not share the same belief.

Similar logic is thwarting a current decision, which makes me wonder: Is superstition in my blood? If I celebrate a special day early, will it still arrive or will I jinx it? The day in question is my fourth cancerversary, which I celebrate annually by bringing baked goods to Dr. Blood and her wonderful team. Together, they have helped me kick leukemia’s butt. I was diagnosed in early August, but I will be seeing the team, including Dr. Blood, tomorrow. If things go as planned and I’m sent off, I may not see them again until the cancerversary is long past.

So when to bake? If I bring my wares to my appointment tomorrow, I’m thereby presuming I’ll be alive until early August. This seems a fair assumption given my current health, but I don’t want to tempt fate. I could always get hit by a bus between now and then. If I wait to proffer my baking, I risk dying in the meantime and missing a chance to acknowledge my gratitude for my longevity. Can you appreciate my quandary?

If I do not bake before I die, I risk my guilt following me to the grave. I will have missed my annual acknowledgement of all my team has done to keep me well, and there is so much. They have patiently addressed concerns I have raised at appointments, dealt with issues between visits by telephone as needed, followed up with me on tests of concern, and set up any necessary interventions pronto. They’ve taken darn good care of me for almost four years now.

But then it hit me: I won’t feel guilty, or anxious, or ungrateful after I die. I won’t feel anything at all because I’ll be dead. So, rather than tempting fate, I’ll save the baking for my first post-cancerversary appointment. I have the feeling I’ll make it that long, so long as no black cats cross my path between now and then. Black dogs? No problem.

Black puppy sitting on boardwalk looking up at camera

Time for Jelly to earn her keep

I thank all of you for your thought-provoking and kind musings over the past week. I’ve been grateful for your feedback and your insights. I think we all deserve a break after a week of emotionally overloaded posts, though.

Have I already mentioned that the Canadian version of Border Security has been cancelled? It’s been a good run. Those incredible sniffer dogs astound me. Their sensitive schnozes can be trained to identify drugs and explosives and food and excessive moolah. Turns out a person carrying lots of bucks may be trying to launder money, which does not involve a washing machine, so says J.

Assistance dogs are not just for the visually impaired anymore. Dogs have been trained to help people with specific health conditions, such as diabetic blood sugar crashes and cardiac arrhythmias (I’m talking to you, POTSy). The dogs’ noses are so sensitive they can identify the scents that precede certain medical crises and alert their humans.

Believe it or not, dogs can also be trained to identify some cancers. My leukemia was not diagnosed by a dog, however. I guess my defective blood smells no different than yours.

But there’s a new dog in health care who may improve my chances of survival. Angus, the Springer spaniel who’s been trained to sniff out C. difficile has been all over the news this week. He’s currently employed at Vancouver General Hospital–hopefully he’s negotiated a fair wage since the cost of living in Vancouver is exhorbitant–but if he’s effective, other dogs may be trained to do the same.

C. diff runs rampant among hospitalized patients, especially those on antibiotics, immunocompromised people like me, and long-term-care residents. Stringent cleaning protocols help, and UV lights can identify high concentrations of these germs. Angus is so sensitive to C. diff that he can locate those germ clusters much faster, highlighting the areas that need further cleaning. He’s sent in only when patients are not present.

I can see one problem with Angus’s approach: C. diff is spread from person to person through poor hand hygiene. Humans house the bacteria, and then touch things with their germy hands. Angus checks the environment–tables, countertops and other surfaces–for potential contamination, but why not have him check the people? Go straight to the source, I say.

Unleash Angus’s potential and let him do what he does best: let him sniff real live humans. Get his nose right in there (I’ll leave what I mean by “there” to your imagination). Sniff out the offenders before they spread those nasty bacteria. Sounds more efficient and effective to me, although others might find the dog’s methods a bit intrusive.

Loosen up, folks, and let Angus in for a whiff. It could save your life.

Maybe Jelly could follow in Angus’s stead and get a job. Bacteria detection is probably out, though; she can’t even find a stray kibble under her nose. But if you want to rid your sidewalk of rabbit poop or need a reliable pre-dawn alarm, have I got the pooch for you. Trying to lose those last few pounds? Let Jelly relieve you of the lunch you left unattended on your counter. Contact her directly at 1-800-countersurf.

Dog in colourful room, front feet on side of bed

Hey, isn’t it time to get up yet?