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Little Known Ways to Surviving The Newborn Stage

If you are in your first few days of parenting, congratulations! Welcome to the club! 🙂 The newborn stage is exciting and petrifying. If you are a first time parent, you may be tested in ways that you’ve never dealt with previously. I hope the following tips will help you during these early days.

The 5 S’s.

A fussy baby is one of the hardest part of the newborn stage. It’s not like they can communicate through words, and chances are you’re starting to feel frustrated when you can’t figure out how to settle your little one. If you have heard of Harvey Karp and the Happiest Baby on the Block, this tip will seem familiar for you. Dr. Karp encourages a method that helps calm a fussy baby very quickly, which he refers to as the Five S’s:

Step 1. Swaddle:

Yes, it may seem that your baby hates being swaddled. Your baby may kick up a storm or try and escape those tight confines. However, the swaddle resembles the safe and snug cocoon of the womb, which will feel comforting and familiar. Keeping your little one swaddled also prevents him from accidentally waking himself up due to the Moro reflex. Rather than give up right at this stage, get your baby swaddled and move forward to the next step. (TIP: Using swaddles with a velcro attachment will make life much easier because it reduces the likelihood of babies wriggling out).

Step 2. Side/Stomach position:

When babies are lying on their back, it often feels like they are falling. They are likely to display the Moro reflex when this occurs. While sleeping on their back is necessary, holding them on their side or stomach is a fast way to help soothe a fussy baby.

Another influencing factor is that your little one is watching you trying to comfort her. Although you are using a soft and soothing approach, you may end up stimulating her by maintaining eye contact. The next time you are trying to settle your little one, try holding her in this hold, and see how she responds.

Step 3. Shushing:

Your current strategy may involve ensuring the house is completely silent when it’s time for baby’s nap. After all, having a quiet and dark environment is the ideal way for you to go to sleep. Ironically, a silent environment is not as helpful for babies. When babies are in the womb, things are loud. They can hear all sorts of noises coming from inside of you (e.g. blood flow) and from your external environments (e.g. conversations). Rather than keeping a quiet space, it’s best to include white noise to mimic these familiar rumbling and indistinct sounds. Try setting up a white noise machine (or using a free app on your phone) to help introduce some sound to their sleep environment.

Step 4. Swing

The fourth step: Swing

While gentle rocking or swinging motion will be helpful, what is most effective in calming a fussy baby is using a bobblehead-type movement. The womb is not a smooth, gentle place. Instead, it’s quite jiggly. Take a look at the following video to demonstrate how to create the right swinging movement.

Step 5. Suck/Soother

The soother is either your best friend or your nemesis at this point in time. Many parents find that their baby takes the soother right away and it is a fast way to stop the tears. There is an equal number of parents who have bought 14 different soothers and feel frustrated that their baby continues to gag or spit them out. I find this video really helpful for introducing a pacifier.

Seeing it all in action

The following video shows Harvey Karp incorporating all of these tips together. Again, the newborn stage involves a lot of tears. Putting the 5 S’s together is a fast and effective option to help your little one settle.

The 5 S’s in action

Beware of the Google Trap

google trap. anxious parents. Surviving the newborn stage.

It’s easy to keep researching things. If you are anything like me during my first postpartum experience, you will have diagnosed your baby with 20 medical issues (none of which were actually the case). This is super common, and everyone is aware of the vulnerability of searching on WebMD when anxieties are high. Rather than getting into this spiral, reach out to your health care team (e.g. lactation consultant, family doctor, nurses, social workers). You may worry about “bothering” your health team, but I promise you, they are used to parents reaching out. It is common to have questions , especially if this is your first baby. Whether you are struggling with breastfeeding, worried about baby’s health, questioning your relationship, you don’t have to figure it all out by yourself.

Stay Connected

Whether it’s an online forum or with your fellow friends and neighbours, it’s important to have others to talk to. Getting through the newborn stage is tough. There are a lot of questions and anxieties as the baby does new things (or doesn’t do new things). Please know that with every worry you have had, another parent has dealt with the same fear. Anxiety is normal.

Online communities (e.g. What to Expect) are especially helpful for addressing fears that occur in the middle of the night. There is almost always someone available to support you irrespective of the time of day. Speak to your friends, family, and partner. Sometimes our anxieties can escalate. In these moments, it’s helpful to talk them through with a grounded and non-judgemental person.

Get some sleep

In the beginning, when you are on a two-hour feeding cycle, it may seem that sleep is impossible. The idea of sleeping when baby sleeps feels like a joke. This baby never rests unless being held. Whatever the circumstances are with your baby’s sleep patterns (or lack thereof), you still need some rest. I encourage all parents to find opportunities for shift sleeping. Decide among yourselves who is a night owl and who prefers early mornings. Have a bottle ready and let your partner be in charge for those hours. Ideally, you are trying to get a 4-hour chunk of sleep so that you have the opportunity to enter REM sleep. Remind yourself that this is not permanent. While, it’s hard and challenging, your little one will eventually sleep through the night.

Know when your baby is in Active Sleep

I remember that I used to rush in whenever my kids made the slightest noise during the night. I’d assume they were awake, needing another feed, and that I would have to help them settle in some way or form. Unfortunately, my attempts to intervene only frustrated them. This is because I was actually interrupting their active sleep.

Active sleep is noisy! It involves grunting, squirming and even crying. Of course, in my sleep deprived and anxious state as a first time parent, I would see these cues and rush over to “soothe” my eldest, not knowing he was still resting. This tip involves identifying active sleep, and learning to stay out of the way when baby is resting. This video is a great resource to help you identify active sleep:

Attachment can take time

Some parents feel enamoured with their baby from day one. However, many parents do not feel this way. Building an attachment with your baby can take time. It is perfectly normal to feel scared, overwhelmed, confused, nervous or a variety of other emotions when you first meet your child. The newborn stage is meant to be a time where you develop a relationship. You get to know your child, and like any other relationships, you build trust and communication.

Will this tiny person ever stop crying?

There is a hormonal surge that kicks into full gear as soon as we hear the baby cry. You may be among the few who dash from one end of the house, leaping through obstacles in order to stop the tears ASAP. Alternatively, you may feel a rush of anger coursing through your body when you hear your baby wailing. Both responses are common. Our lovely friend, oxytocin has turned things up a notch making parents incredibly sensitive to a newborn crying.

When you hear someone in distress, it triggers you to respond. You will reach for your baby and start to sing, rock, or nurse. You will use any old tricks to help her calm down. However, if you have found this experience tiring or unsuccessful, those tears can make you feel plagued by helplessness and anger.

What to do if you feel anxious or angry about your baby’s tears:

  • Pause for 15 seconds. Yes, your natural instinct is to rush and rescue, but give yourself a moment to regulate. Give your baby a chance to settle.
  • Remind yourself it’s not personal. Your baby is not mad at you. You are not a bad parent. Babies cry. All. The. Time. It’s their only way of communicating. Sure, it makes your blood pressure skyrocket, but it’s the only way they can let you know something is up. Trying to decipher those tears will take time and practice, but you and your baby are doing your very best in figuring it out.
  • Write a plan for yourself. When your baby is fussy, what will you do? Perhaps you will follow the 5 S’s listed above. You may choose to sit in a rocking chair. You might whip out a bottle to nurse him back to calmness. Whatever option you decide, it’s helpful for you to feel confident and aware of your next step.
  • Ask to switch out. If you’ve already been taking care of a fussy infant all day, you may feel at your wit’s end. Tap out. Have your partner, friend, family member take over for an hour. Try and get out of the house during this time if you’re fighting the urge to run in and fix, correct, or offer suggestions. Take this time for self-care.
  • Shower yourself with positive affirmations. Ideally you’re saying these positive thoughts to yourself. However, if that is too hard, have a loved one reassure you. Get your daily reminder that you are doing your best. These difficult moments do not make you a bad parent.

Reach out

Postpartum anxiety and depression are common and difficult struggles. They go beyond the stressors of the newborn stage. You may find that you are constantly irritable, overwhelmed, unable to sleep, feeling miserable, or disinterested. If you are struggling, please do not stay silent. Your moods can get better. Reach out to find out more.

Kasi

Kasi Shan, MSW, RSW
Kasi Shan, MSW, RSW

Kasi Shan Therapy is located in Kitchener, Ontario. She offers in-person and online appointments supporting individuals with struggling with trauma and perinatal mental health.

Mental Health

8 Tips to improve sleep troubles

When it comes to falling asleep, there are many people who can easily pass out as soon as their heads hits the pillow. This post is not for them. For the rest of the population, please know that it is normal to have sleep troubles at some point in your life. Some of us find that these issues resolve after a few days. However, others may struggle for a long time with poor sleep quality.

ethnic child covering half of face with blanket lying in bed
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Often, what exacerbates our sleep is conditional arousal. Think of Pavlov’s dogs; they learned to salivate as soon as they heard a bell ringing because they were consistently provided food at the time of the bell. Even when food was taken away, they automatically started to salivate as soon as they heard that familiar noise. Similarly, we’ve learned to associate anxiety and restlessness with our bed. We start to anticipate that we will have poor sleep even before we climbed under covers. We stress that it will be another night of tossing and turning. Unfortunately, these expectations cause too much distress to fall asleep.

Luckily, there are ways in which we can create a better sleep pattern. Today’s post is all about simple behavioural changes that you can use to improve your sleep.

Behavioural Changes to Improve Sleep Patterns

1. Go to sleep when you’re sleepy

woman in white shirt lying on bed
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Before you scoff at this point, I want you to consider when you go to sleep. Do you go to bed at a specific hour in hopes that you will be rested enough for the following day? Are you heading to bed when your body feels exhausted? Is your mind still whirling away at this time? If you answered yes to the above questions, this strategy may shift you out of current sleep troubles.

One of the best ways to reduce sleep issues is to recognize when we’re genuinely sleepy. Our “ideal” time for bed is when we can barely keep our eyes open. It’s when you cannot concentrate on your show or book, and are nodding off on the couch. It is at this state of fatigue that you will likely fall asleep when you go to bed. Prior to this time, while you’re body may be exhausted, your brain is still not ready to shut down. Therefore, if you typically go to bed at 10 PM, but you’re not drifting off until closer to midnight, then it’s best to wait until midnight before heading to bed (Don’t worry! There are other strategies to help bump your bedtime to a more ideal hour).

2. Get up at a consistent time

When you make changes to your sleep patterns, your body is working hard to shift its circadian rhythm (your internal 24-hour clock that tells you when to be awake or asleep). Your internal clock gets thrown off with insomnia. Getting up at a consistent hour helps your body regulate, and establish a routine of its awake and rest times. Unfortunately, many of us sleep in on weekends. While we force our system to get up at 6 AM on weekdays, we stay in bed until 2 PM on weekends. This creates more confusion to your circadian rhythm. Chances are that you will not be tired for 10 PM on Sunday night. You end up falling back into the same pattern of sleep disruption and fatigue for the rest of the week as you try and shift back to an earlier bedtime.

3. Do not use the bed when you’re awake

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I encourage clients to only use their bed for sleep or sex. It’s easy to get sucked into patterns of reading, eating, watching TV, or talking on the phone while in bed. However, when there are sleep struggles, we want to eliminate all connections of being alert while using our bed. Again, think about Pavlov’s dogs, and training your minds to associate bed with rest.

Most days, it will take approximately 20 minutes to fall asleep. If it takes you longer, or if you start to feel anxious within the first few minutes of lying down, the best option is to get out of bed. I know this sucks, and I encourage you to do whatever low-key activity will help you stay in good spirits at 3 A.M. This means watching TV (try not to choose something that you’ll feel compelled to binge watch), reading, tidying up, etc. Try to return back to bed in about 30 minutes, or whenever you start to feel sleepy.

Another consideration is getting up when you’re awake at 5 AM versus staying in bed. While your bed is likely cozy and inviting, by lying awake in bed during these early hours, you’re unintentionally reinforcing the message that it’s okay to be alert in bed.

4. Middle of the night wake ups

It is normal for us to have several awake moments during the night. We go through several rounds of REM (rapid eye movement) and N-REM (non-rapid eye movement) sleep cycles, which can typically last 90 to 120 minutes. Usually, we have short moments of being awake during the first phase of NREM sleep. For most of us, we don’t process these occurrences and usually fall back to sleep without any trouble (e.g. think about those times when you vaguely recall fluffing your pillow, turning over, and drifting off to sleep again). Vulnerabilities like conditional arousal can make us more cautious about being awake in the middle of the night. If anxiety kicks in when you have these wakeful moments, it can prevent you from easily falling back to sleep. If elaboration strategies are not enough to help you fall asleep in a few minutes, it’s best to get out of bed, do a low key activity, and try again in 30 minutes.

5. Get rid of naps

woman sleeping on sofa with throw pillows
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Getting out of bed every time you are anxious or unable to fall asleep, and consistently getting up at an early hour will be exhausting. Chances are you’ll experience several sluggish days at the start of your new sleep routine. This is normal, and in fact, a good thing. After a few days of being in this zombie-mode, your body will feel so tired that you’ll start to feel sleepy earlier in the night (thereby bumping your midnight bedtime slowly back up to your ideal hour).

What often prevents people from getting to the above stage is due to naps. Your body is ready to fall asleep at night time, but if you take a rest during the middle of day, your circadian rhythm is getting confused once again. In order for this to work, stay out of bed during the daytime. It’s okay for you to go to bed at 8 PM during the first week if that is when sleep starts to encroach. It will take a few weeks before your circadian rhythm is regulated.

6. Create a bedtime routine

We teach young children about bedtime by using a simple routine at the end of the day. This involves activities like taking a bath, completing toiletries, putting on pyjamas and then reading a story before turning off the lights. When this pattern is followed daily, a child gets used to winding down by the end of this routine.

Unfortunately, we drop all pretences of having a bedtime routine when we become adults. Fair enough; you’re an adult and don’t require being tucked in. However, creating a simple routine (approximately 20 minutes) that you follow daily can help your body learn to settle down prior to bed. Some simple activities to include into your routine are:

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  • Having a cup of decaf tea
  • Stretching
  • Playing a low-key game (e.g. crosswords, candy crush)
  • Toiletries
  • Taking a bath
  • Doing the dishes
  • Prepping lunch
  • Listening to a podcast

The point is that these activities are not so riveting that they’ll hold your attention for a long time. Because the entire process takes approximately 20 minutes, and because it’s repeated daily, your system will learn to adjust to this new pattern.

7. Check your environment

photo of person holding alarm clock
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What kind of distractions are readily available in your room? You know yourself better than anyone else. This means recognising your vulnerabilities and habits. If you can easily spend hours on Instagram at the end of the night, chances are that having the phone next to your bed can make you more susceptible to staying awake.

Another common distraction is the alarm clock. If you tend to obsess about the time (e.g. “It’s 3:00 AM and I’m not asleep yet…. it’s 3:10 AM and I’m not asleep yet… it’s 3:20 AM and I’m not asleep yet.”), then this device is actually causing more harm than good. Turn the clock so it is facing away from you. Set your alarm for the next day so that you can trust the option of waking up on time without having to check the time constantly.

Assess whether your bedroom is truly a comfortable place for sleep. Making small changes like setting a cool temperature and adding dark curtains to reduce light can make a significant impact for sleep troubles.

8. Review your daily activities:

What you do during the day impacts your quality of sleep. Consider the effectiveness of when you work out, play video games, eat large meals, etc. For example, many individuals feel more alert after working out. If you fall under this category, you want to ensure that your work out is done earlier in the day.

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What kinds of foods and beverages have you consumed? If you are experiencing sleep troubles, your best option is to cut out caffeine by midday. Consider the types of food you had for dinner. Digestive issues can make it really hard to feel comfortable when you get into bed. If you struggle with digestion, especially at night, consider speaking with your doctor or a dietitian for feedback about what foods to restrict.

While having a glass of wine at night is a treat, research has also shown us that having too much alcohol reduces your quality of sleep. You’re more likely to fall asleep due to the sedative qualities of alcohol, but chances are you’ll be awake in the middle of the night.

What if none of these strategies get rid of my sleep troubles?

If your sleep issues are caused by more complicated factors like anxiety or trauma, more intensive treatment is recommended. In these circumstances, we can incorporate various therapeutic modalities like EMDR or cognitive-behaviour therapy for Insomnia (CBT-I) to address your unique needs.

Let me know if any of the above tips worked for you!

Kasi

Kasi Shan, MSW, RSW
Kasi Shan, MSW, RSW

Kasi Shan Therapy is located in Kitchener, Ontario. She offers in-person and online appointments supporting individuals with struggling with trauma and perinatal mental health.

Anxiety · Mental Health

5 Tips to handle stress

Many times in life we come across a problem that we cannot fix right away. During these times, therapists encourage a fancy term called “distress tolerance”. But what exactly does this term mean? Distress tolerance is all about handling a stressful moment without making matters worse.

Let’s say you’re expecting to have a difficult conversation with your spouse that evening. It makes sense that you feel at edge most of the day. You may end up drinking, avoiding your family members, being snippy with your colleagues, cancelling work, or any other strategy to cope with the edginess. These behaviours all make sense given that you’re stressed about the upcoming conversation. However, all of these behaviours tend to create further complications. Not only do you have to deal with the difficult conversation with your partner, but you also have to sober up, apologize for the avoidant behaviours, make amends to your relationships with colleagues, and grovel to your boss. All in all, we’ve taken a crappy situation, and made it significantly harder.

5 tips to deal with stress: Reach out to Kasi Shan Therapy for counselling support online & in-person in Kitchener, ON
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Don’t get me wrong, I have also chosen some not-so effective strategies on my worst days. We all make mistakes. The point is not to judge ourselves for these mistakes. Instead, we want to see if there are better ways to help us cope. This is where distress tolerance skills come into play. Using well-known strategies like distractions (i.e. video games, reading, watching TV, exercise) and self-care (i.e. comfort foods, long bath, getting a massage) are perfect at these times. They help you tolerate the waiting period until the end of the day when you can finally address the real issue with your spouse.

People often get frustrated with coping strategies because “they don’t make us feel good”. Fair enough. Distress tolerance isn’t meant to make you feel better (although, if they do put you in a better mood, enjoy it 🙂 ). These coping skills are all about tolerating the pain, not actually fixing the pain. In the above example, your primary concern is getting through a hard conversation with your spouse. Unless this is addressed and resolved, why expect that watching TV, taking a walk, or any other distraction will make you feel better? So how do we practice “distress tolerance skills” effectively? Here are a few key points:

1) Find distractions that actually get you distracted

5 tips to deal with stress: Reach out to Kasi Shan Therapy for counselling support online & in-person in Kitchener, ON
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If you are going to be bored out of your mind reading a textbook, this is not an effective coping strategy! Your mind will naturally return back to whatever is stressing you out. If you’re stuck thinking of effective distractions, I recommend an activity that is active or new so that you have to concentrate on the task at hand. Think about the first time you drove a car on your own. If you were angry that day, consider how difficult it would have been to maintain the intensity of your anger AND concentrate on following all the steps to drive. Your mind doesn’t have the mental capacity to do both at the same time effectively. Instead, you have to mindfully focus on driving so that you don’t crash.

2) Have a bunch of coping strategies to use in a moment of crisis.

Some days we’ll only need to dance along with music in the car to ease our anxieties. Other days, we may have to eat a chocolate bar, go for a bike ride, snuggle up with our pets AND practice some breathing exercises. Neither options are wrong. It just depends on our needs in that moment.

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3) Use the acronym ACCEPTS

This is a great term from dialectical behaviour therapy that is useful for distress tolerance.

A= Activities (Participate in activities that you enjoy, or help you stay effectively distracted)

C= Contribute (Helping others out makes us feel better about ourselves, and it takes us away from our own stress)

5 tips to deal with stress: Reach out to Kasi Shan Therapy for counselling support online & in-person in Kitchener, ON

C= Compare (Think about a time when you struggled more than this present moment. This helps you recognize that you were able to overcome hardships, and puts this current issue into perspective).

E= Emotions (What will create a different emotion than the one you’re feeling? Watching sitcoms makes me laugh. Going for a run makes me feel confident. Giving my son hugs makes me happy. What works for you?)

5 tips to deal with stress: Reach out to Kasi Shan Therapy for counselling support online & in-person in Kitchener, ON

P= Push away thoughts (Definitely not one I recommend long-term. It’s okay to tell yourself that you cannot think about a certain stressor right now. For example, if you’re supposed to be concentrating on your exam, it’s probably not the ideal time to be thinking about a fight you had with your partner the day before. Pushing away thoughts is a helpful method so long as you come back to the thought at a more convenient time).

T= replace Thoughts (Focus on something else. Plan your family vacation. Think about the book you’re reading. How do you think it will end? Basically, focus on anything else except the present issue).

S= Sensations (Find safe physical sensations to use as distractions. i.e. a soothing cup of tea, a cold ice cube, a hot compress).

5 tips to deal with stress: Reach out to Kasi Shan Therapy for counselling support online & in-person in Kitchener, ON
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4) It’s okay to take a mini-vacation from the stressor if it takes a long time to get things sorted.

5 tips to deal with stress: Reach out to Kasi Shan Therapy for counselling support online & in-person in Kitchener, ON

Whether this is a physical escape or a short mental break (i.e. guided meditation, pushing away thoughts). The stressor is still there when you return from the break, but the rest gives you some time to feel calmer and more at peace

5) Problem solve whenever possible!

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At the end of the day, nothing will help you feel fully at peace until the stressor is resolved (or you willingly radically accept that the issue will not be fixed). This means hunkering down and brainstorming various solutions. As always, everyone’s situation is unique. If you have any questions or concerns, please feel free to reach out.

Mental Health

Do you have trouble sleeping? Here’s quick strategy to improve sleep hygiene

How many sheep do you have to count before you get frustrated and give up on sleep? Here’s another option to get your mind to settle, and help you fall asleep.

There are many changes you can make to improve your sleep hygiene, and counting sheep does not have to be your only option. Whether you have anxiety or not, it’s natural for the mind to ruminate at bed time when you’ve got no other distractions to occupy you. Just because your body is physically done for the day doesn’t mean your mind is automatically ready to calm down.

I’m sure many of us have tried counting sheep and it hasn’t been a hundred percent successful. Instead, I’d encourage you to focus on some elaboration strategies. This means thinking about and expanding on a NEUTRAL topic. Some options include: thinking about the ending to a book you’re reading, imagining being at your favorite vacation spot, running through the steps of a recipe, decorating your dream home, etc. These are not the most exciting topics and that’s actually the point. If you focus on an issue that is important to you, you will become hooked and your mind will keep racing. For example, if you go to bed thinking of your to-do list for the next day, chances are your anxieties will just escalate.

Improve your sleep hygiene with this quick tip. Kas Shan Therapy in Kitchener, ON

My favorite elaboration strategy is playing scattergories in my mind before falling asleep.

  • Step one: choose a category of your liking (i.e. countries, TV shows, food)
  • Step two: start with a letter and run through all of the examples you can think of under that category (I.e. Angola, Australia, Argentina, Albania…)
  • Step three: when you run out of examples, move on to the next letter.
  • Step four: continue for as many letters as needed.

I love this strategy for two particular reasons. First, the categories are neutral. I won’t get caught up in a story or memory. My self-esteem will also not be crushed if I get stuck on the letter Q. The second factor is mindfulness. Yes, that term gets used so frequently nowadays, but it really is helpful! With scattergories, I can be mindful of bringing by attention back to the last letter I was thinking of before getting distracted. It’s rare to get to the end of the alphabet because most have fallen asleep at some point throughout the exercise. My fellow sleep-deprived friends, this is only one strategy!

There are lots of factors that go into improving your sleep hygiene. Feel free to contact me if you’d like to review some suggestions for your specific concerns.

Cheers,
Kasi