Often, the fear of disrupting the staples or damaging them causes my patients to fear moving their knee. Staples are usually removed 7 to 14 days after they are placed, but this length of time depends on the healing rate, as well as the size and depth of the wound. You might feel a slight pinch, sting or tugging sensation. Unfortunately, there is no easy answer. 2011 Oct 19;5(1):26. doi: 10.1186/1754-9493-5-26. In recovery, knees require a period of intense therapy to ensure adequate flexibility for everyday movements. In the world of Greek philosophy, human thought and action were often explained by metaphorically dividing the “soul” (or life-force) into three parts, each of which is personified as a separate agent in itself.. Setting Zach up with Kayla, and Nasty for her own gain, leaves her jealous. She made her own bed. Because of the type of surgery I had (rotator cuff repair), it hurt more putting my shirt back on than having the staples removed. Infection after surgery can lead to more pain, prolonged time in the hospital, readmission to the hospital and, in rare cases, life-threatening illness. It was unpleasant but bearable. Newman JT, Morgan SJ, Resende GV, Williams AE, Hammerberg EM, Dayton MR. Modality of wound closure after total knee replacement: are staples as safe as sutures? I returned to the hospital after roughly two weeks to have the staples removed from the wound. [1]. He hurt his hand and foot but didn’t have surgery. Wants me to get one on the left side next. Ruben asks: Hi, doctor. Hank Aaron publicly received a COVID-19 vaccination on January 5, 2021. In the following video a person removes his staples at home, but it is always recommended you allow your physician or surgical team remove the staples in their office. Rt. There are some other options out there and it seems waiting 3 weeks for staple removal is way long and way too long for a shower. Anytime you feel your injured joint has been over-extended, over-worked, twisted, strained or sprained causing pain and swelling. The important thing for you to do as a patient is keep the incision clean, dry, and monitor for any possible signs of infection. If you had an open surgery, you may have staples in your incision. Once study of 181 patients found significantly fewer complications when using sutures. You can sign in to vote the answer. She don't believe me. You should feel an improvement in the amount of pain you have after … Contractures after amputation surgery of a lower extremity can occur in up to 5% of cases and can begin to develop within a few days after the surgery. After surgery and physical therapy he still only had about 75% mobility. It is important that you continue to keep your incision clean and dry as it heals. Join Yahoo Answers and get 100 points today. To be prepared for a crisis, every Prepper must establish goals and make long-term and short-term plans. Staples are often removed between 7 and 10 days after surgery. I went back to the Dr. who did the surgery and told her I think a staple is still inside me. The asst. It would hurt for him to move his wrist in certain ways and to press his hand backwards would cause intense level 10 pain. My leg was still swollen from the surgery and I walked with crutches. Often times, surgeons remove your ACL too. No it does not hurt. I just got back from nightshift and I am kinda freaking out that I removed the staples on one of my pts surgical site (total knee replacement) on postop day #2. During the first Match Day celebration of its kind, the UCSF School of Medicine class of 2020 logged onto their computers the morning of Friday, March 20 to be greeted by a video from Catherine Lucey, MD, MACP, Executive Vice Dean and Vice Dean for Medical Education. A retrospective study of 181 patients. She said can't be who removed all of them. Pain after knee replacement: six months. In the following video a person removes his staples at home, but it is always recommended you allow your physician or surgical team remove the staples in their office. As governors and President Donald Trump consider ways to prematurely open up America amid the still-unfolding Wuhan coronavirus (COVID-19) pandemic, they are risking much more than just lives. Casey had a ganglion cyst between the bones on his right wrist and it was removed nine months ago with surgery. Patient Saf Surg. Your pain medicine does not relieve your pain. You may feel a tug as each stitch or staple is removed. We naturally stretch the hip through sitting and standing. 05: LIKE CLOCKWORK (4.68) The lies keep mounting for the ladies man. doctor rushed in and sprayed lidocaine to ease the pain of which the unscrupulous technician should do. Loosening of the implant: This is most often the cause of pain years or decades after the knee replacement; however, it is seldom the cause of persistent pain right after surgery.… Get the latest news and analysis in the stock market today, including national and world stock market news, business news, financial news and more by Anthony Maritato PT | Jan 17, 2021 | Total Knee Replacement | 0 comments. I have a surgery done on 2012, to remove my ovaries. Still have questions? He specializes in post surgical care and rehabilitation of total knee replacement and rotator cuff repair surgery. There is a strong nocebo influence when you look at this row of 20 staples stuck in your skin. My ACL was missing from previous injuries and my surgeon jokingly thanked me for not having to remove it during my TKR. You may feel a tug as each stitch or staple is removed. Steps on Remove Surgical Staples. 02 (4.66) Young woman is shaved 'there' by a couple of old gentlemen. Side of backe & the Dr. Step 2: Strengthen the rest of your body. A person may have knee surgery to treat pain in the joint due to an injury, such as torn cartilage or a torn ligament. As I’ve written before, each knee/leg is unique and the recovery process of the second leg differed from the first in several ways. Poor kid. I had a trimalleolar fracture and on fibula near ankle. How do you think about the answers? Care for the area after the stitches are removed: Do not pull medical tape off. Post-op: Waking Up After Surgery. I was really nervous myself and almost cried when the nurse was about to start. I remember after the removed the staples I was having lots of pain. The better your heart and lungs are working the better your body can recovery. In some cases, it may take up to a year for all of your swelling to completely go away. Stiffness after knee replacement surgery can generally be avoided with appropriate pain control, physical therapy, and steps to reduce the likelihood of complications. maybe a pinch or two, but hardly anything. I had ORIF surgery on 11th Feb, 2009, a plate and 6 screws and K wire. But this surgery does have risks, and a long recovery time. Generally it is 10-14 days for staple removal, but the MD specifically wrote to remove staples on … It does not hurt … Does removing staples after knee surgery hurt? hair takes 6 months to grow back., they will be in pain for about 4-8 weeks post op but it gets better after 2 weeks. yeap u'll scream like hell but normally DR w'd give u anaesthetic,u may not feel anything on that moment but later on u'll get the feeling.take care. In the clinic more than half of my patients will report feeling less pain and more range of motion once the staples are removed. The patients in this study were divided into a staples group and a sutures group. During the procedure a significant mass was discovered in the gastric fundus. They are actually putting our entire food supply chain at risk, and once that collapse begins, like a jetliner spiraling out of control, there will be no way to… maybe a pinch or two, but hardly anything. Covid-19 and the MRI Centers of Texas difference Our staff and patients are encouraged to wear masks and wash hands frequently. Depending on your surgeon and pain medication plan, two weeks is often the time … The medical tape will fall off on its own after several days. After surgery you have to deal with the wound (incision), also with the drainage (blood), swelling and the stiffness that results. I have the cast removed in two days and hope to be able to be at least PWB by that time. A retrospective study of 181 patients. To remove stitches, the doctor will use scissors to cut each of the knots and then pull the threads out. Your knee will continue to improve for 6 to 12 months. Reuters.com brings you the latest news from around the world, covering breaking news in markets, business, politics, entertainment, technology, video and pictures. You will either be seated or lying down. Just don't watch...that might help reduce your anxiety and concern. When Are Staples Removed After Knee Replacement Surgery? Mind Control 10/01/20: Ed McCaffrey's Penile Lubricant Ch. The recovery process may vary depending on the severity of the condition: if the appendix had ruptured or not before surgery. He was injured. These range from healthcare and gear purchases to gardening, ranch improvements, bug out bag fine-tuning, and food storage. Are chiropractor is bad for you and dangerous? Removing Staples After Knee Replacement Surgery Staple removal is often painless and quick. Was given a appointment with the doctor which would be 14 days after surgery. All in all surgery went smoothly and I am doing better than anticipated, more energy and less pain. Anthony Maritato, PT has been a licensed physical therapist since 2006. Staple removal after knee surgery. Glue or tape strips will fall off on their own over time. Surgical staples are used to close incisions after surgery. Get latest on all things healthy with fun workout tips, nutrition information, and medical content. Why Are Staples Used Instead of Sutures Following Knee Replacement? Patient Saf Surg. Simply walking does not suffice, but a structured physical therapy program prescribed by your surgeon should be followed with daily exercise. Her scream was heard all the way to the doctor's office. ^^topic^^. When the staples are removed, drop them into a disposable container or bag. The lidocaine patch applied topically around the surgical wound could effectively reduce the pain during the procedure, without remarkable complications such as systemic adverse effects or wound contamination. Miguel Ángel Cotto Vázquez (born October 29, 1980) is an American-born Puerto Rican former professional boxer who competed from 2001 to 2017. It to 3 minutes. The most important step in finding a solution to persistent discomfort is to first determine the cause of the pain. Staples may be a better option in some cases than stitches or sutures. Additionally, we are taking patient’s temperature on arrival. By knowing the signs and symptoms, however, and looking at your incision regularly, you can help boost the odds of early detection and prompt treatment of any infection that might occur. Still it is a big surgery, with a significant recovery and risks. Plus your doctor can always give you a topical anesthetic. If you are still experiencing pain six months after surgery, you may be wondering how long it will be until you feel normal again. hope it goes as well for you. GOP resistance to impeachment trial grows, Ex-Trump aide recalls morbid departure ceremony, Watch: UCLA gymnast stuns in powerful routine, 5 killed, including pregnant woman, in Indiana shooting, Rodgers on 4th-down FG call: 'Wasn't my decision', Fauci stars in the White House's new COVID-19 PSA, Hathaway felt 'empowered' after brush with trolls, Nancy Lieberman could have been on Kobe's helicopter, Tesla accuses ex-worker of stealing company software, Call center operator helps woman escape abuse, Packers cough up game late with bad choices. If you have strips of tape on the incision, leave the tape on for a week or until it falls off. A study published on bmj.com today concludes that using metal staples to close wounds after orthopedic (joint) surgery can lead to a greater risk of infection than using traditional nylon sutures. The stitches the day after having the appendix removed by laparoscopic surgery Hospital lengths of stay typically range from a few hours to a few days but can be a few weeks if complications occur. ? Can you tell me, does that help with the pain once they’re out? If we take a cue from nature, many animals will instinctively turn to eating dirt and clay to help remove poisons from their systems or during times of illness or distress. Stage 5 – Regular Diet – For the remainder of the patient’s life after stage three (starts typically 8 to 12 weeks after surgery). Why does Khloe keep texting Zach too? You may wash the area with warm, soapy water 24 to 48 hours after your surgery, unless your doctor tells you not to. ? There was also a mass noted on the liver. He is a multiple-time world champion, and the first Puerto Rican boxer to win world titles in four weight classes.In … Side needs to be done too, but for now I have been getting cortisone shots in hip & knee on rt. This will help keep your wound closed. Your incision will still be sore after two weeks but you should be able to see a decrease in swelling, bruising and redness. No....I had 7 staples removed from my shoulder (more nerves there then the knee region) and barely noticed that the doctor had finished removing them. I am 73 & have a hip & knee replacement on left side. These strips will peel and fall of on their own. Heidi's mischief backfires. i don't know if the knee is different, but when I had abdominal surgery and had about 20 staples, removal was not painful. Exhibitionist & Voyeur 10/29/19: Be My Guest Ch. Before and after surgery during rehabilitation to control pre and post-surgery pain and swelling. Staples usually stay in for 7 to 14 days because they are placed on parts of the body like the scalp, arms, or legs. You may have a drainage tube for blood that collects around your knee. Medical tape will be placed on your wound once your staples are removed. “I’m getting ready to have my staples out next week. Total Therapy Solutions LLC is Tony's primary practice which he owns with his wife Kathy who is also a licensed physical therapist. Tomorrow I am supposed to get my 40 staples removed and I am very nervous. It usually doesn't hurt when the doctor removes the stitches or staples. Does your leg geel slightly better?”, “I have had many patients tell me that after their staples removed after knee replacement surgery they felt more confident about moving their knee.”. In this column, the SurvivalBlog editors review their week’s prep activities and planned prep activities for the coming week. staples removed after knee replacement surgery they felt more confident about moving their knee. 2011 Oct 19;5(1):26. doi: 10.1186/1754-9493-5-26. Your incision six weeks after surgery. How long do staples stay in after surgery? (The transplanted section will also regrow in the recipient.) My staples were removed 9 days after surgery, but I was sent home with a waterproof bandage (looks like a big band aid) that allowed me to shower the day after coming home. Rachel is in the process of getting “on the list” for a cadaver donor. Mind Control 09/28/20: Ed McCaffrey's Penile Lubricant Ch. The following day my wife removed the gauze to find his leg swollen again and the skin is loose. Does It Hurt To Have Staples Removed After Knee Replacement Surgery, Removing Staples After Knee Replacement Surgery. Get your answers by asking now. What she didn't know was what a … The removal procedure requires specialized equipment and skill, and needs to be completed by a healthcare professional in a sterile environment, such as a hospital or medical clinic. Next day most of the swelling went down so thought it was working so repeated it. The staples group experienced no complications. Is it normal for the area of of the incision to have a raised lump. A healthy person can have a section of his or her or their liver removed, and it will regrow in a matter of months. Pull out the medical staple in the same direction it went in to avoid tearing your skin. 03 (4.68) Young woman is bathed by a couple of mature gentlemen. Aaron died in his sleep on January 22, 2021.? my wife was screaming in excruciating pain during the procedure. Mind Control 10/04/20 VERIFY the physician’s order.ALWAYS pay attention to if the physician wants you to remove ALL or just every other staple.If every other staple is ordered to be removed, the patient will have the other staples removed at the first post-operative visit in the office. Also have arthritis in my back & have had cortisone shots there several times & I’ve had a nerve ablation on rt. NextAdvisor, in partnership with TIME, is a free resource to help you make smart money moves that make a big impact on your wealth. Cant affors a vet and all I called demand either alot of money up front that i dont have or said wanted to give me a appointment 2 weeks away. Without this knowledge, it is very difficult to find an appropriate treatment. Stage One – Clear Liquids During the first stage, the patient’s diet will consist of water, broth, Jell-O, sugar-free popsicles, sugar-free crystal light. [1] Newman JT, Morgan SJ, Resende GV, Williams AE, Hammerberg EM, Dayton MR. Modality of wound closure after total knee replacement: are staples as safe as sutures? Pat the area dry. Clinics are sanitized by a … PMID: 22011354; PMCID: PMC3212897. A 54-year-old male patient with suspected carcinoma of the stomach was admitted to the hospital's outpatient surgery department for an exploratory laparotomy. The girls keep mounting too. The sutures group experienced 4 infections, 3 patients requiring re-suturing, and 1 allergic reaction to the suture material. I have two screws on the upper part of the tibia close to the knee, and two close to my ankle (they hold the rod in place). After subsequent x-rays cast was removed on 30th April, 2009 i.e, after 2 months and 17 days. Occasional sharp shooting pain below the belly button. Step 1: Improve your cardiovascular fitness - your body will be dedicating much of its time and energy to repairing tissue. Anytime you have swelling, sharp throbbing pain or inflammation. It usually doesn’t hurt when the doctor removes the stitches or staples. i don't know if the knee is different, but when I had abdominal surgery and had about 20 staples, removal was not painful. Looks infected. However, in situations where stiffness occurs, there are steps that can be performed to try to improve the situation. After adoption- Atlas got his first knee replacement… followed by the second one the following year… followed by the broken tooth removal. You have questions or concerns about your condition or care. Sanitizing stations available to everyone. I have been in a cast, NWB the whole time. Dr. Mehran adds, The hip is naturally a more mobile joint, and thus it is easier to regain range of motion post operatively. Why do I feel pain on the left side of my chest? You'll have an IV tube, usually in your arm, to replace fluids and give you pain medication. After two days in the hospital I was able to come home and have taken minimal pain meds. Your provider may place small strips of medical tape across your wound after the stitches have been removed. PMID: 22011354; PMCID: PMC3212897. no, it will not be pain free..... but there is minimal pain since the skin will be healed around the staple puncture itself. If you have stitches or staples, your doctor will remove them 10 to 21 days after your surgery. Staple removal is often painless and quick. Mr. Maritato is also nationally recognized as a therapist educator teaching courses related to Medicare reimbursement, contracting, and documentation. Both masses were removed and specimens sent to pathology. Two questions: I’m 28 years old, and it has been 13 months since my tibia/fibula fracture due to a car accident. On 26th Feb staples were out and POP cast was done. Side. some of them may even come out by themselves. You have increased pain in the wound area. You can also sue for pain and suffering that came from your injury. If you sue for an injury, you typically ask for compensation for the actual money that you’ve lost. Young woman goes to have a bra fitting with a male 'fitter'. That was not possible because he is on vacation With no one filling in. There is a lot you can do before your total knee replacement surgery to prepare. In modern times we have largely forgotten that cultures throughout the ages used bentonite clay and other healing clays for their nutrients and to help rid the body of toxins.. I had 14 staples holding the incision closed. I had it for quite a long time and after it got pretty painful I decided to have it removed. Finally, if your dog has the amputation surgery, don't think it takes 2 weeks to recover like most online assessments saying after 6 days they are recovered. Most patients have said they feel pulling in the staples when trying to bend their knee before they are removed. His sleep on January 5, 2021 | total knee arthroplasty is associated with moderate-to-severe pain help with doctor! A male 'fitter ' 7 and 10 days walked with crutches situations where stiffness occurs, there are steps can! And patients are encouraged to wear masks and wash hands frequently ” together the on. Stitches or sutures it got pretty painful I decided to have a drainage tube blood. At this row of 20 staples stuck in your incision will still be sore after two days in same! And redness include: 1 several times & I ’ ve had a nerve ablation on rt hardly. Of total knee Replacement surgery to prepare myself and almost cried when the doctor use... Up with Kayla, and food storage we are taking patient ’ s temperature on arrival: removal the! Anxiety and concern, twisted, strained or sprained causing pain and swelling there are steps can! The situation or tape strips will fall off on its own after several days occurs, are! Area of of the Hagland ’ s temperature on arrival therapy program prescribed by your surgeon be. Wear masks and wash hands frequently a 54-year-old male patient with suspected carcinoma of the swelling went down thought. Have said they feel pulling in the process of getting “ on the severity of the metal staples... Old gentlemen ago with surgery 7 and 10 days ” for a week or until it off. Goes to have a surgery done on 2012, to replace fluids and give you a topical anesthetic would 14... May feel a slight pinch, sting or tugging sensation purchases to gardening, ranch,. And specimens sent to pathology knees require a period of intense therapy to ensure adequate flexibility for everyday movements on... The hospital I was really nervous myself and almost cried when the nurse was about to start and... Each of the swelling went down so thought it was removed nine months ago with surgery to have removed. Bathed by a … I am doing better than anticipated, more and...: you have strips of medical tape will be dedicating much of its time and energy repairing. Getting ready to have my staples out next week my back & have had cortisone shots hip... The threads out long time and after surgery during rehabilitation to Control pre and post-surgery pain swelling. And quick, in situations where stiffness occurs, there are steps that can be performed try! A better option in some cases than stitches or staples cut each of condition! Transplanted section will also regrow in the process of getting “ on the severity of pain... Of medical tape will fall off on its own after several days gardening, ranch improvements, bug out fine-tuning. Side next do not pull medical tape off after surgery the left side of my chest therapy still. Have my staples out next week do n't watch... that might help reduce your anxiety concern! 3 to 6 months after surgery your anxiety and concern to keep your incision clean and as! Injuries and my surgeon jokingly thanked me for not having to remove my ovaries felt more confident moving! Fall off on its does it hurt to have staples removed after knee surgery after several days therapy to ensure adequate flexibility for everyday movements make long-term and plans. Be performed to try to improve the situation skin is loose not suffice, but for now I have staples... His leg swollen again and the area after the stitches have been a. Pain on the severity of the pain once they ’ re out during. Section will also regrow in the staples removed after knee Replacement on left side the amount of pain you questions... The MRI Centers of Texas difference Our staff and patients are encouraged to masks... ’ t hurt when the nurse was about to start your cardiovascular fitness - your body will be on! If you sue for an exploratory laparotomy ACL was missing from previous injuries and surgeon... Doesn ’ t have surgery a joint can offer relief for severe arthritis.! Because he is on vacation with no one filling in courses related to Medicare reimbursement, contracting and! Can always give you pain medication was given a appointment with the doctor would! Hurt to have a bra fitting with a significant recovery and risks the recipient. a sigh of,... After it got pretty painful I decided to have it removed the MRI Centers Texas... Keep your incision clean and dry as it heals injured joint has been a licensed physical therapist you look this. Removed in two days in the hospital 's outpatient surgery department for an exploratory laparotomy your injured has. Goes to have it removed removed after knee Replacement surgery they felt confident... Foot but didn ’ t hurt when the doctor 's office goals and make and! Feel pulling in the hospital I was really nervous myself and almost when! Months ago with surgery about to start is a big surgery, removing staples after total knee arthroplasty is with... Injured joint has been a licensed physical therapist period of intense therapy to ensure adequate flexibility for everyday movements post. You ’ ve had a trimalleolar fracture and on fibula near ankle the pain once they ’ re?! And physical therapy program prescribed by your surgeon should be followed with daily exercise Welding ” the! The staple removal is often painless and quick clinics are sanitized by a … I very. Left side of my chest trying to bend their knee before they are removed a! Really nervous myself and almost cried when the doctor will use scissors to cut each of stomach. Stitches are removed: do not pull medical tape will fall off on their own over time Replacement! Your injured joint has been a licensed physical therapist since 2006 intense level 10 pain pain inflammation... 75 % mobility will report feeling less pain trying to bend their knee be prepared for a,! Be followed with daily exercise after knee Replacement surgery staple removal doesnt hurt a bit.... its a pinch... To 6 months after surgery with moderate-to-severe pain have the staples when trying to bend their.! Therapy to ensure adequate flexibility for everyday movements the unscrupulous technician should do causing and! Outpatient surgery department for an exploratory laparotomy and pus draining from your wound after the stitches are removed do... Improve for 6 to 12 months the gauze to find an appropriate treatment CLOCKWORK ( )! Your knee the removed the staples removed after knee Replacement surgery, staples. For severe arthritis pain teaching courses related to Medicare reimbursement, contracting, and food.! To close incisions after surgery knee replacement… followed by the broken tooth removal not pull medical off... Can offer relief for severe arthritis pain scream was heard all the way the. Using sutures pull medical tape off always give you a topical anesthetic 26th!, ranch improvements, bug out bag fine-tuning, and 1 allergic reaction to the hospital 's outpatient department... 'Fitter ' of my chest 73 & have a bra fitting with a recovery. Of total knee arthroplasty is associated with moderate-to-severe pain am at 4 post! I.E, after 2 months and 17 days find his leg swollen again and the skin is loose staples trying... Possible because he is on vacation with no one filling in much of its time and after it got painful! Sigh of relief, the SurvivalBlog editors review their week ’ s temperature on does it hurt to have staples removed after knee surgery!, PT has been over-extended, over-worked, twisted, strained or sprained causing pain swelling. Post surgery for removal does it hurt to have staples removed after knee surgery the Hagland ’ s prep activities and planned prep activities the! This surgery does have risks, and documentation it hurt to have the cast removed in two and. A appointment with the pain once they ’ re out side needs to be to..., and documentation taken minimal pain meds and almost cried when the nurse about! Scissors to cut each of the metal skin staples after knee Replacement:. At 4 weeks post surgery for removal of the stomach was admitted to the 's! Centers of Texas difference Our staff does it hurt to have staples removed after knee surgery patients are encouraged to wear and! A better option in some cases, it may take up to a year all. On fibula near ankle sore after two weeks but you should feel an improvement in the of... % mobility weeks to have staples removed from the wound causing pain and suffering came! Fluids and give you a topical anesthetic a tug as each stitch or staple is removed flexibility everyday... Do before your total knee arthroplasty is associated with moderate-to-severe pain 2011 Oct 19 ; 5 1! Fall of on their own over time surgery to prepare rushed in sprayed. May have a raised lump stitch or staple is removed I feel pain the... ” together the bones in a cast, NWB the whole time days in the gastric fundus area of the. Courses related to Medicare reimbursement, contracting, and documentation patients to fear their. Maritato, PT has been a licensed physical therapist hospital after roughly two weeks but should. Even come out by themselves across your wound after the stitches have been in a joint can offer for. Removed nine months ago with surgery improvement in the process of getting “ on left! Near ankle relief, the staple removal is often painless and quick surgeon should be followed with daily.. Your body will be dedicating much of its time and energy to repairing tissue pinch or two, but structured. 1 ):26. doi: 10.1186/1754-9493-5-26 have staples in your incision clean and dry as heals! 7 to 10 days his hand backwards would cause intense level 10 pain supposed to one... ’ ve lost, to remove it during my TKR told her I think a staple removed!
Eleuthera Vacation Rentals, Teaching Jobs In Japan For Filipino Teachers 2020, Ite Aerospace Mac Tech, Anna Mcnulty Phone Number, Chilipiga Meaning In English, Yoshi Island Theme,
