As a board-certified neurosurgeon with advanced fellowship training in spine surgery, it’s not unusual for Dr. Ricky Kalra to be asked to weigh in on challenging surgical cases involving the spine. But one recent request garnered a little more attention than some!

Expert Opinion Headed to Hollywood

In August 2020, television personality Simon Cowell reportedly sustained a severe back injury after falling from an electric bike at his home in Malibu, CA. Afterward, the America’s Got Talent star underwent a five-hour surgery and subsequent hospital stay before going home to complete his recovery.

Hollywood-based celebrity news website Nicki Swift reached out to our very own Dr. Kalra, who is also on staff at Texas Health Presbyterian Hospital in Plano. Reporter Amanda Byerly asked him to weigh in on Cowell’s injury, surgery and recovery, which has reportedly been challenging and is taking longer than originally projected.

Why would a surgery that seemingly went well be met with setbacks now? And what might be in store for Cowell as he works to regain his mobility? Those are the questions that were posed to Dr. Kalra, who spoke with Nicki Swift to offer insight into Cowell’s prognosis and recovery.

According to Dr. Kalra, Simon Cowell’s recovery may have taken a turn for the worse due to the severity of the surgery itself, but Dr. Kalra was also able to give Cowell fans hope.

Once the muscle damage from the injury and the insult from the surgery start subsiding, the recovery process speeds up. He will more than likely have a stiff back with some loss of flexibility. Otherwise, as long as he sustained no spinal cord injury, he should make a full recovery with no major long-term issues.

Read the full story here.

Most Back Pain Doesn’t Require Surgery

The entire KBS team wishes Simon all the best in his recovery!

But great news: In most cases, and apart from an acute injury (as was the case with Simon Cowell), you can find relief from your back pain without surgery. Things like ice, heat, spinal injections, physical therapy and nonsteroidal anti-inflammatory (NSAIDs) medications can often help. Research shows that regular exercise also eases back pain and can keep it from recurring.

For some, however, these first-line treatments are not enough. If more conservative treatments have failed to bring enough relief and your pain is persistent and disabling, it may be time to see a surgeon, more specifically, a neurosurgeon.

When Back Surgery is Needed, Trust an Expert

A neurosurgeon for back pain? Absolutely.

Why? Dr. Ricky Kalra is a specialist in both the brain and the spine, so his expertise gives him a hard-to-beat understanding of how nerves interact with the rest of the body. At Kalra Brain & Spine, we believe in utilizing a wide range of treatment options from pain management and physical therapies to innovative minimally invasive procedures and surgeries that have helped many patients reclaim their lives.

Another important piece of information to know? Dr. Kalra sees second-opinion cases nearly every day. We believe this is proof of his commitment to the well-being of every one of his patients. His confidence in his diagnosis and recommended treatment plan means he’s always happy to work with the greater medical community to achieve the best outcomes for his patients.

At Kalra Brain & Spine, you’re in good hands. Dr. Kalra specializes in the most up-to-date evidence-based neurological care. He has helped countless people get out of pain and regain their lives. If you’ve experienced a back injury or have unexplained pain (even if you’ve seen other doctors and still have not found relief), we’d love to meet with you to see if we can help. Schedule an appointment today.

Dr. Kalra Earns D Magazine’s Best Neurosurgeon in Dallas for Fourth Year in a Row

D Magazine’s “Best Doctors” is Dallas’ number one resource for finding the highest-quality, most respected doctors in the area. We’re proud to announce that our own Dr. Ricky Kalra has made the prestigious list once again as a D Magazine Best Neurosurgeon in Dallas for 2020.

The Selection Process

D Magazine begins the review process by reaching out to thousands of local doctors to nominate their peers in different categories. The nominating doctors must all be located and practicing in the DFW area, so you know you can truly trust their nominations. Then, a rotating panel of esteemed doctors reviews the nominees and chooses only the most deserving candidates.

No one can pay to be on the list, and D Magazine has a detailed process to avoid abuse of the voting process. With all that effort, you can rest assured that everyone on the list offers fantastic care, all based on the opinions of the people who know medicine best – other doctors.

Proud to Be Recognized

Dr. Kalra is proud to have been recognized – especially by his peers – for inclusion in the Best Doctors in Dallas list in D Magazine in 2017, 2018, 2019, and now, in 2020. Combining his incredibly caring and hands-on patient care with the convenience of many minimally invasive treatment options has helped him stand out.

From my earliest days in practice, I have held the desire to provide world-class comprehensive care in a warm, compassionate environment. To have been recognized, year after year, for our ongoing commitment to our patients assures me we are headed in the right direction.

—Ricky Kalra, MD

Check out Dr. Kalra’s profile below.

 

Car Accident Reveals Lemon-Sized Tumor

When Julio Molina of Little Elm, Texas, was in a serious car accident in early 2020, he felt fortunate to walk away with minor injuries and just a few scratches on his face. But while in the emergency room, a routine CT scan to check for internal injuries found something quite alarming. A large tumor was growing on Julio’s spinal cord, threatening his mobility and quality of life.

The tumor was a Schwannoma tumor and it was slowly destroying Julio’s spine. Cancerous or not, if left untreated, it could lead to breathing and muscle problems, even paralysis of the face.

For more than two years, Molina unknowingly experienced one of those symptoms but thought he just had a pinched nerve in his back.

“Sometimes my neck and the back of my head would feel numb, and every couple of months, my hands would become numb,” said Julio. “I didn’t know it, but the tumor was putting pressure on my spinal cord.” Julio learned he would require surgery to have it removed and our own Dr. Ricky Kalra, who serves on the medical staff at Texas Health Presbyterian in Plano, was just the neurosurgeon for the job.

Surgery in the Days of COVID-19

In the middle of a world health pandemic, the 27-year-old expectant father was understandably nervous about having surgery in the days of COVID-19. He worried about contracting the virus and bringing it home to his girlfriend and unborn baby daughter. But the seriousness of his condition, the tingling and numbness caused by the growing tumor, and the impending loss of motor function meant surgery was his best chance of feeling completely healthy again.

Dr. Kalra performed Julio’s spine surgery, a procedure that took ten hours to complete, at Texas Health Presbyterian Plano. “The tumor was wrapped around his cervical spinal cord and the vertebral artery. It was pushing on the spinal cord and compressing the nerves that go down to your hands,” said Dr. Kalra.

To stop the tumor from corroding the vertebrae in Julio’s spine, Dr. Kalra performed a laminectomy, in which he removed the corroded vertebrae. He then performed a spinal fusion to permanently connect several vertebrae in Molina’s spine. The delicate surgery took weeks of planning.

Blessing in Disguise

Thankfully, Julio’s tumor was benign and his recovery is going well. Physical therapy is helping him to regain neck strength. He considers the accident a blessing in disguise and says he felt completely safe having surgery during the pandemic. “Knowing that the tumor is out, I can raise my daughter with the quality of life that I would like to have,” said Julio.

Julio’s story understandably attracted quite a bit of media attention. Watch Dr. Kalra interviewed in Julio’s story by clicking any of the links below.

If you suffer from a herniated disc (also called spinal disc herniation), you’re not alone! The Mayo Clinic estimates this very common condition affects more than three million Americans per year. At Kalra Brain & Spine, we see many individuals who are experiencing arm or leg pain, numbness and tingling. These symptoms can be alarming, and many of our patients are surprised (and relieved!) to learn they’re dealing with a very treatable spinal condition.

What Exactly Is a Herniated Disc?

Your spine is made up of bones called vertebrae and a rubbery cushion between each vertebra called discs. A herniated disc (sometimes called a slipped disc or ruptured disc) occurs when the soft inner portion of the disc becomes pushed out through the exterior border. A herniated disc can occur in the neck or the back and often is the result of trauma or excessive strain.

The diagram in the video below shows a representation of the disc “pushing out”. As you can see by the arrow, a disc herniation (the bulging part in the video), often impinges directly on a nerve root (the yellow part), resulting in shooting pain, numbness and tingling, and sometimes weakness.

What are the Symptoms of a Herniated Disc?

As we get older, the discs in our spine can lose flexibility and elasticity. The ligaments surrounding the discs can become brittle and are more easily torn. Sometimes, using your back muscles instead of your leg and thigh muscles to lift heavy objects can lead to a herniated disc, as can twisting and turning while lifting. A traumatic event such as a fall can also cause a herniated disc. Symptoms of a herniated disc usually present on just one side of the body and can vary depending on the location of the herniation. Depending on the severity of the herniated disc, you could experience varying degrees of pain. When a herniated disc affects a nearby nerve (radiculopathy) or the spinal cord (myelopathy), the following symptoms can occur:

• Tingling
• Numbness
• Sharp pain
• Weakness

How are Herniated Discs Treated?

Some people do not experience symptoms and don’t even know they have a herniated disc. But it is time to seek medical attention if you are experiencing neck or back pain that travels down your arm or leg, or if you also have numbness, tingling or weakness. In many cases, conservative treatment, such as rest, modifying movement and taking over-the-counter pain medications (acetaminophen, ibuprofen or naproxen sodium) offers relief of symptoms. But for more serious instances of a herniated disc, Dr. Kalra may recommend:

• Cortisone injections. If your pain doesn’t improve with the use of oral medications, Dr. Kalra might recommend a corticosteroid that can be injected into the area around the spinal nerves.
• Muscle relaxants. If you are experiencing muscle spasms, a muscle relaxant can help.
• Physical therapy. Dr. Kalra may suggest physical therapy to help with your pain. Physical therapists can show you positions and exercises designed to minimize the pain of a herniated disc.
• Surgery. At Kalra Brain & Spine, surgery is always a last resort. Dr. Kalra will only suggest surgery after all other treatment methods have failed to bring sufficient relief.

Surgery for Herniated Disc

Depending on the severity of your pain, if weakness is present, the location of your herniated disc and how much it is affecting your quality of life, Dr. Kalra may recommend a Microdiscectomy. Microdiscectomy is the surgery indicated to remove the affected disc to relieve the pressure on the nerve causing the extremity pain, weakness and numbness. But even if Dr. Kalra does recommend surgical intervention, you’ll be happy to hear that he’s a fellowship-trained spinal surgeon with tremendous experience in the treatment of herniated discs. For those who are good candidates, Dr. Kalra may recommend a less invasive option. For example, when a disc herniation occurs in the neck, an Artificial Cervical Disc Replacement may be a treatment option. Dr. Kalra was one of the first spine surgeons trained in implanting the Mobi-C artificial disc when it became approved by insurance companies. Some of the benefits of the Mobi-C include: a minimally invasive surgery, no down-time, no cervical collar and no fusion. This option also preserves the natural motion of the neck and substantially decreases the risk of another neck surgery down the road. Not sure if you’re a candidate for artificial disc replacement? Take this quiz to learn more.

Why Should I See a Neurosurgeon for a Herniated Disc?

At Kalra Brain & Spine, our wide range of treatment options from pain management and physical therapies to innovative spine surgeries have helped many patients with spinal disc herniation reclaim their lives. We often see individuals seeking a second (or even third!) opinion for their condition. We love it when this happens because by seeing Dr. Kalra, you just may find a treatment you had never considered. We always suggest getting a second opinion when a serious surgical solution is suggested to address a medical issue. At Kalra Brain & Spine, we treat every patient like the neighbor, friend and family member they are. Our collective commitment is to educate, diagnose, treat and help each patient get out of pain and regain their life. We treat conditions of the spine, brain and peripheral nerves.

Neurosurgical Care You Can Trust

At Kalra Brian & Spine, you’re in good hands. Dr. Kalra specializes in the most up-to-date evidence-based care. He has helped countless people get out of pain and regain their lives. As a D Magazine “Best Doctors in Dallas” award winner in 2017, 2018, 2019 (and counting!), you can feel confident knowing Dr. Kalra is trusted by his patients and respected by his peers. If you’re experiencing any of the symptoms of a herniated disc or have unexplained pain (even if you’ve seen other doctors and still have not found relief), we’d love to meet with you to see if we can help. Schedule an appointment today.

Find Out Why Your Back Hurts and if Surgery Can Help

Do you live with chronic back pain? You’re not alone. Back pain that just won’t go away is the most common type of chronic pain reported in the U.S., with millions of Americans suffering. But how do you know if surgery is necessary to find the relief you’re looking for?

Most Back Pain Doesn’t Require Surgery

In most cases, you can find relief from your back pain without surgery. Things like ice, heat, spinal injections, physical therapy and nonsteroidal anti-inflammatory (NSAIDs) medications can help. Research shows that regular exercise also eases back pain and can keep it from recurring.

But for some, these first-line treatments are not enough. If more conservative treatments have failed to bring enough relief and your pain is persistent and disabling, it may be time to see a surgeon, more specifically, a neurosurgeon.

When Back Surgery is Needed, Trust an Expert

A neurosurgeon for back pain? Absolutely.

Why? Dr. Ricky Kalra is a specialist in both the brain and the spine, so his expertise gives him a hard-to-beat understanding of how nerves interact with the rest of the body. At Kalra Brain & Spine, we believe in utilizing a wide range of treatment options from pain management and physical therapies to innovative back surgeries that have helped many patients reclaim their lives.

Another important piece of information to know? Dr. Kalra sees second-opinion cases nearly every day. We believe this is proof of his commitment to the well-being of every one of his patients. His confidence in his diagnosis and recommended treatment plan means he’s always happy to work with the greater medical community to achieve the best outcomes for his patients.

Having a consultation with a surgeon doesn’t mean you’re committing to surgery. Instead, think of it as a chance to learn more about your condition and treatment options.

Helping you find relief from pain is the most important work we do. We are committed to exploring every treatment option and finding what will work best for your unique body and your unique life. Treatment plans are often multidisciplinary and directed toward nonoperative management of your condition, including physical therapy, injections and lifestyle modifications. While surgery has helped so many people finally live a life without pain, it’s never the first treatment we recommend for people suffering from back pain.

Ricky Kalra, MD, Founder of Kalra Brain & Spine

When Back Surgery is the Best Option

In cases where surgery is determined to be the best option, treatment at Kalra Brain & Spine is customized to each patient. Dr. Kalra uses the latest technology and techniques to provide the most minimally invasive surgery that will get the job done.

Back surgery often more predictably relieves pain or numbness that goes down one or both arms or legs. These symptoms often are most often caused by compressed nerves in your spine.

Nerves may become compressed for a variety of reasons, including:

• A slipped or herniated disc that isn’t getting better on its own
• Bone spurs in your spine (these are often caused by arthritis) that are putting pressure on your spinal cord
• A degenerative spinal condition like stenosis (narrowing of the protective bony canal around the spinal cord) that’s causing side effects, like weakness

And a few other reasons you might need back surgery:

• A traumatic injury to your back
• A spinal infection, or a high fever with back pain (this can be a sign of a spinal infection)
• A broken or dislocated bone in your back
• A tumor on your spinal cord

Types of Back Surgery

There are several different types of back surgery, and depending on the root cause and severity of your back pain, Dr. Kalra may recommend one type versus another.

• Discectomy. This involves removing the herniated portion of a disc to relieve irritation and inflammation of a nerve. Discectomy typically involves full or partial removal of the back portion of a vertebra (lamina) to access the ruptured disc.
• Laminectomy. This procedure involves the removal of the bone overlying the spinal canal. It enlarges the spinal canal and is performed to relieve nerve pressure caused by spinal stenosis.
• Fusion. Spinal fusion permanently connects two or more bones in your spine. It can relieve pain by adding stability to a spinal fracture. It is occasionally used to eliminate painful motion between vertebrae that can result from a degenerated or injured disc.
• Artificial discs. Implanted artificial discs are an alternative treatment to spinal fusion for painful movement between two vertebrae due to a degenerated or injured disc.

At KBS, not only is surgery a last resort, Dr. Kalra is trained and experienced in many advanced procedures that are less invasive than traditional open back surgery and often more effective. Our goal is always the same—to get to know you, treat your symptoms and help you recover as fast as possible. So you can live life the way you want to live it. We dedicate a significant portion of our practice to rendering second (and even third!) opinions for people seeking relief from debilitating pain.

The Revelational Mobi-C® Cervical Disc

Dr. Kalra was one of the first physicians trained in implanting the Mobi-C® artificial disc when it became approved by insurance companies. He strongly believes that patients who are candidates for a minimally invasive surgery greatly benefit from the Mobi-C cervical arthroplasty (artificial disc insertion), which offers minimal down-time and doesn’t require a cervical collar. This option preserves the natural motion of the neck and substantially decreases the risk of another surgery down the road.

How Mobi-C Works

Mobi-C contains patented mobile-bearing technology that allows the polyethylene core to slide and rotate inside the disc for self-adjustment to the cervical spine movements. In real-life terms, this means that Mobi-C can react and adjust to the normal motion of your back. Additionally, Mobi-C provides bone-sparing fixation, meaning the device is able to be fixed in place without the need for chisel cuts into the small vertebral bodies of the cervical spine.

Find Freedom from Back Pain

At KBS, we see people every day who have been living with significant back pain and are just ready for a solution that works. We’ve helped moms and dads, men and women just like you to regain their lives free from the debilitating pain. Don’t wait. No matter where you are in the treatment process, Dr. Kalra is ready to help. We look forward to serving you!

If you’re interested in seeing if the Mobi-C or any of our other therapies could be right for you, schedule an appointment to consult with Dr. Kalra today.

What’s the Difference Between a Neurosurgeon and a Spine Surgeon (and a Neurologist, for that matter?!?)

At Kalra Brain & Spine, we hear many of the same questions from patients who come our way. Things like, Is a neurosurgeon the same as a neurologist? and What’s the difference between a neurosurgeon and a spine surgeon?

We love educating the community about how spine fellowship-trained neurosurgeon Dr. Ricky Kalra and his team change lives every day here at Kalra Brain & Spine. And we thought it might be useful to talk it all through with some easy-to-understand definitions thrown in. But don’t worry, there won’t be a test over the material at the end!

Similar but Not the Same

Neurosurgeons (like Dr. Kalra) are specifically trained to treat issues dealing with the nervous system. This includes the spine, spinal cord and the brain. They are specialists in both the brain and the spine, giving them a hard-to-beat understanding of how nerves interact with the rest of the body.

Regarding spinal surgery, neurosurgeons characteristically receive more intense training, hands-on preparation and focused specialization than other specialties. A neurosurgeon will offer the advanced training you need for performing microscopic, top-of-the-line spine surgeries.

Many people confuse the term neurosurgeon with the term neurologist. A neurologist is a brain specialist but not a surgeon. In other words, both neurosurgeons and neurologists specialize in the same organ, but one operates and the other does not. For patients afflicted with a brain disorder, these two specialists often work together toward a treatment plan.

So, is a Spine Surgeon a Neurosurgeon or Orthopedic Surgeon?

Full disclosure: here’s where it can get a bit confusing. But we promise it will all make sense soon!

Orthopedic surgeons specialize in the musculoskeletal system, focusing on bones, ligaments, joints and muscles. They are typically the surgeons responsible for knee surgeries, hip replacements and athletic injuries. Many orthopedic surgeons work with athletes in the field of sports medicine, treating conditions that emerge with the stress, strain and injury of athletic wear and tear on the body.

Some orthopedic surgeons do receive additional specialized training in treating conditions that afflict the spine. However, in most cases, spine surgery is performed by a neurosurgeon like Dr. Kalra. This means if you are dealing with neck and back pain that has not responded to other treatments, an experienced neurosurgeon offers you the best chance at finding the relief you need.

In a nutshell, the most significant and fundamental difference between the two types of physicians is this: orthopedic surgeons and neurosurgeons receive different training in different medical fields.

Let’s Talk More About that Training!

Neurosurgeons and orthopedic surgeons receive significantly different training during the medical residency portion of their education. Neurosurgery residency typically lasts between 7-8 years, and here’s why. Neurosurgeons in residency receive daily training in both brain and spine surgeries, with about 60-70% of their time devoted to spine surgeries in particular.

Some neurosurgeons, like Dr. Kalra, pursue an additional fellowship year in order to practice more with advanced or especially complex spine surgeries. As part of his training, Dr. Kalra completed a spine surgery fellowship with training in Germany, focusing on minimally invasive approaches to the spine and complex scoliosis.

Why Kalra Brain & Spine

If you’re suffering from neck and/or back pain that is negatively affecting your life, you deserve relief. At Kalra Brain & Spine, we believe in utilizing a wide range of treatment options from pain management and physical therapies to innovative spine surgeries that have helped many patients reclaim their lives.

Another thing we want every patient we see to know is that back and neck surgeries are always a last resort. We often see individuals seeking a second (or even third!) opinion for their condition. And by seeing Dr. Kalra, you just may find a treatment you had never considered. For example, we offer artificial cervical disc replacements and other minimally invasive treatments for those who qualify. We always suggest getting a second opinion when a serious surgical solution is suggested to address a medical issue.
But even if Dr. Kalra ends up recommending surgery for your particular situation, you’ll be happy to hear that back and neck surgery is much less invasive than in the past. Learn more about our surgical treatment options (including minimally invasive procedures) here.

Conditions We Treat

At KBS, we treat every patient like the neighbor, friend and family member they are. Our collective commitment is to educate, diagnose, treat and help each patient get out of pain and regain their life. We treat conditions of the spine, brain and peripheral nerves. See a complete list of conditions treated here.

Neurosurgical Care You Can Trust

At KBS, you’re in good hands. Dr. Kalra specializes in the most up-to-date evidence-based care. He has helped countless people get out of pain and regain their lives. If you’re experiencing any of the symptoms described here or have unexplained pain (even if you’ve seen other doctors and still have not found relief), we’d love to meet with you to see if we can help. Schedule an appointment today.

Baine Brooks of Allen, Texas, is a busy guy. A restaurant owner and Allen City Councilman, Baine and his wife Juli are also proud parents of two high-achieving daughters in college. One is a collegiate gymnast and the other is pursuing her doctorate.

Even though Baine was experiencing increasingly intense pain under his shoulders, he refused to let it slow him down. But when long hours at the restaurant mixed in with community commitments, family time and the occasional round of golf found him in a chronic, constant state of pain, Baine knew it was time to stop ignoring it.

“I really didn’t want to stop doing anything, so I kept doing everything but I was doing it in a significant amount of pain,” said Baine. “I figured it was just a pinched nerve or something, but my primary care physician referred me for an MRI to rule out other possibilities.”

Without a diagnosis, Baine was then referred to a neurosurgeon and found himself in the office of Dr. Kalra at Kalra Brain & Spine. Dr. Kalra showed him how the bulging discs in his upper spine were causing all the problems. After a lengthy consultation, many questions from both sides of the table and diagnostic testing, Dr. Kalra recommended artificial cervical disc replacement as a solution to Baine’s near-constant pain.

Patient Turned Ambassador

In early November of 2019, Baine met Dr. Kalra at the hospital for his minimally invasive procedure. “Surgery was a Thursday, I was back at work by Saturday and off all pain meds by Sunday,” said Baine. “I couldn’t believe it. It was amazing! I was back and it felt so great.”

There were so many things Baine appreciated about his experience with Kalra Brain & Spine, and specifically, with Dr. Kalra. “He spoke to me in a very relational, approachable way and I really appreciated that,” said Baine. “And I never once waited more than five minutes for my appointment. He respected my time and that, I appreciate as well. And when he told me that he’d eaten at my restaurant in Houston frequently back when he was in college, I knew we had a match! I am a guy who is going to get second opinions, and with Dr. Kalra, I just didn’t feel I needed one.”

Today, Baine is back to swinging a golf club and pounding the ball on the racquetball court. He travels with Juli to watch their daughter compete in gymnastics events and continues his civic commitments to the city of Allen. He recently spoke at a large event for restaurant owners. And after sharing about his life-changing experience and how all his pain was now gone, several people found him afterward to ask more questions because they, too, were dealing with either back or neck pain that was affecting their lives.

“I tell everyone who will listen about what a great guy Dr. Kalra is and how much he helped me get my life back. I feel great!”

Hope for Chronic Neck and Back Pain

When world-class training meets hometown values deeply rooted in family and community, the result is the kind of medical care you’ve always hoped for. This describes Kalra Brain & Spine, the practice of Dr. Ricky Kalra, who specializes in the most up-to-date, evidence-based care. If you’re living with chronic neck or back pain and don’t know where to turn, schedule a consultation with Dr. Kalra today.

The Kalra Brain & Spine team is here for you. We are up and running with telemedicine capabilities for consultations and non-emergent needs, so if you’d prefer to be seen from the comfort of your home, please let us know.

If you have an in-person appointment at Kalra Brain & Spine, we want to make you aware of the following precautions we are currently taking to keep you safe:

• We ask that you stay home if you are ill. We will be happy to reschedule your appointment.
• We ask that you please wear a mask for the entirety of your appointment. We can provide one for you.
• Only patients are allowed in the office at this time. Others are asked to stay home or to wait in their vehicles during your appointment.
• To lessen the chance of contact between patients in common areas, we are allowing more time between appointments. Your patience is appreciated!