![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 2971 to 2995 of 10407. Go back in thread:
Posted by jannbeau on December 13, 2002, at 18:43:41
In reply to Re: I hate Christmas - how do you cope? » sly, posted by Sioux on December 13, 2002, at 18:03:21
> Sioux, I am so grateful that you posted this response. I so wanted to respond to Sly on this one, but I didn't know HOW to say the things that you said. I just knew that someone needed to say those things. The suggestions that one "must" go home, that parents and siblings are abusive or nonsupportive, or, at best, living in the 19th century, the feeling I had from Sly's post that she is living a life script that says, simply, "you aren't good enough for us" is so veru distressing, but I am not good with anything except, occasionally, answering a medication question, so I hesitated to answer.
Sly, please listen to Sioux's lovely suggestions and solutions, especially that you don't HAVE to go home for the holidays. Sometimes spending those days alone is much better than spending them being abused, either covertly or overtly by those who profess to love us.
Also, have you ever explored the therapeutic modality called ransactional analysis (not "games people play" but the more comprehensive "What do you say after you say hello?" or the textbooks on TA written by Eric Berne?. It seems to me that you are living a life script given you by your family that says that you cannot fulfill their expectations and therefore, that you should not "be" (so very often interpreted as "don't be successful" or "don't be happy"--resulting in depression and anxiety).
Take care! Perhaps you can practice some positive creative visualization (Start by telling yourself in the mirror as often as you can that "I am worthy of love and acceptance just as I am this very moment" and that you can FLY (finally love yourself, courtesy of the Flylady)!
Bless you,
Jannbeau
>>> I don't think I'm drifting back into a full-blown depression, but the holidays aren't easy for me
>
> May I speak here as a Chaplain? There are *many* people for whom the holidays are dreadful for a variety of reasons. Some of the coping strategies that folks I know are using are wonderful.
>
> One couple made it a game to absolutely avoid hearing a single Christmas song or seeing a single relative. They found that the time together without the radio, TV, shopping, or button-pushing family to be really something extraordinary. They've now been married 32 years and continue to keep the tradition, spending their time catching up on projects. They send valentines out each year instead of Christmas cards.
>
> Another good one is to seek out a non-celebrating community if you are near immigrants from Asia, especially. As a street child, I found refuge among the Chinese of our community. The New Year dragon is still one of my most moving symbols.
>
> Don't hesitate to be "weird." People who love you will be glad you are inventing new ways to take care of yourself. The others are not worth pleasing, anyway. Everybody will get used to it. In fact, you may very well help lots of others in the same boat.
>
> The main thing is, it's your life to live as you choose. Investigate the choices.
>
> >>> "hurry up, if you wait much longer your looks will go and no one will want you".
>
> *That* is so destructive and so completely not true. Anyone that goes for the looks isn't worth having, anyway. The truth is most guys don't even notice. My husband still buys me size 10 jeans. He carries a wedding picture with him and sincerely believes I haven't changed a bit.
>
> >>> Unfortunately going away isn't an option, I'm forced to go home
>
> Oh, I do hope you'll examine this! Unless we're talking gunpoint and handcuffs, you probably have more choices than you believe you do. Look into them or call the cops to arrest your kidnappers. It really is okay to disobey your family. If they love you they'll be okay with it. If they don't, you need to know that.
>
> Keep me posted. You are not at all alone and, in fact, there are folks out there hoping you'll speak up so *they* won't feel alone.
>
> -- S
>
Posted by Dr. Bob on December 14, 2002, at 11:10:52
In reply to I hate Christmas - how do you cope?, posted by sly on December 13, 2002, at 13:37:55
> Any advice out there on how to cope - I've thought of increasing my meds but I don't know if that's such a good idea.
It's fine for medication-related responses to continue here, but I'd like for other follow-ups to be redirected to Psycho-Social-Babble:
http://www.dr-bob.org/babble/social/20021206/msgs/33338.html
Thanks,
Bob
PS: And for follow-ups regarding posting policies to be redirected to Psycho-Babble Administration.
Posted by khead on December 15, 2002, at 14:18:18
In reply to Effexor --some little big Qs (to Bizzou and all), posted by zinya on November 23, 2002, at 15:22:45
Hi...I'm pretty new on this board, but
here's my .02 on "inappropriate" vs.
"appropriate" anxiety and/or depression.
My "man in the street" understanding of
extreme stress/disasters in life/loss, etc.
is that enough can in fact cause negative biochemical changes in the brain over time.
Classic example is combat related PTD. Doesn't happen to everyone. Probably most get through the bad stuff without meds. But judging by what has happened to you in your post I'd say it would
be REALLY "inappropriate" for you to currently to be a jolly and carefree soul with a 24 hour case of the giggles. Life can suck bigtime, so what's there not to be depressed about. (Pick up the newspaper any day. Plenty to be depressed about.) So, for me, the Effexor XR thing is about limiting as best I can getting so "stuck" in anxiety/depression that my life just stops.
Posted by TracyL on December 16, 2002, at 0:46:51
In reply to DrBob, anyone- percocet effexor same family? , posted by anais on December 10, 2002, at 7:33:47
Hey guys!
Anyone else start having heart palpitations while on Effexor? I honestly thought my heart was going to stop they got so bad. So I tapered off and quit the meds but I still have them once in a while.(not as bad though) Do they go AWAY? I'm starting to freak out that I have heart disease or something! Just what I need; something else to worry about and feel anxious over.Any advice?
Tracy
Posted by jmmrc2002 on December 16, 2002, at 5:02:39
In reply to Re:Withdrawl » Kenneth Copeland, posted by zinya on December 2, 2002, at 17:39:17
Zinya,
I know that I am late in responding. I'm just reading the messages from early Dec. For me, I have the dizziness after only a few hours of missing a dose. It is so bad that I have no recourse but to take my dose. It stops about 45-60 minutes after taking the medicine. I am trying to wean myself off. I am at the 75mg level after being at 225mg. I haven't tried dropping to the 37.5 yet. I was given a sample pack with only a week's supply of 37.5mg. Will this be enough? Should I take the 37.5 longer before quiting altogether?
Posted by daizy on December 16, 2002, at 7:56:14
In reply to Effexor side effects - heart palpitations, posted by TracyL on December 16, 2002, at 0:46:51
> Hey guys!
> Anyone else start having heart palpitations while on Effexor? I honestly thought my heart was going to stop they got so bad. So I tapered off and quit the meds but I still have them once in a while.(not as bad though) Do they go AWAY? I'm starting to freak out that I have heart disease or something! Just what I need; something else to worry about and feel anxious over.
>
> Any advice?
> Tracywas in hospital twice in the last week from heart palputations off effexor, was on 150mg, now down to 37.5mg. Getting off it cause it hasnt really worked, infact its made things worse. Have you started any other Ad's? How do you feel? back to the point anyways, It is really scary when it happens, thought it was a pannic attack, but then It was way too fast to be, also felt like my heart was going to just give up on me. You need to tell your doctor though, there must be some medication that can sort this out, "Inderal" Maybe? Good luck!
Posted by djmmm on December 16, 2002, at 8:23:27
In reply to Re: DrBob, anyone- percocet effexor same family? » anais, posted by BrittPark on December 11, 2002, at 15:24:11
Both Effexor and Remeron effect opiod receptors
Effexor has some activity at opioid receptor subtypes mu-, kappa1- kappa3- and delta-opioid receptor subtypes.
Remeron has some atiivity at mu- and kappa3-opioid receptors.
Posted by BrittPark on December 16, 2002, at 10:07:03
In reply to Re: DrBob, anyone- percocet effexor same family?, posted by djmmm on December 16, 2002, at 8:23:27
Hi,
I hadn't heard that. Where did you find that? According to the prescribing information Effexor is an inhibitor of NE and 5HT reuptake and a weak inhibitor of DA reuptake. Remeron is an antagonist of presynaptic 5HT receptors. However the prescribing information may be incomplete.
Cheers,
Britt
Posted by Kenneth Copeland on December 16, 2002, at 10:44:10
In reply to Re:Withdrawl » zinya, posted by jmmrc2002 on December 16, 2002, at 5:02:39
> Zinya,
>
> I know that I am late in responding. I'm just reading the messages from early Dec. For me, I have the dizziness after only a few hours of missing a dose. It is so bad that I have no recourse but to take my dose. It stops about 45-60 minutes after taking the medicine. I am trying to wean myself off. I am at the 75mg level after being at 225mg. I haven't tried dropping to the 37.5 yet. I was given a sample pack with only a week's supply of 37.5mg. Will this be enough? Should I take the 37.5 longer before quiting altogether?
>
> I was Never On such A High Dose, but I can tell you that a week of 37.5 probably will not be enough,you will need at least 2 weeks worth..It has been 8 days since I have taken that stuff and all withdrawl symptoms exceopt for some slight vertigo effects..STILL!..have gone.The weaning process takes time.Be patient. After you do come off completely buy some Theraflu Nightime and take it for thw withdrawls. Good Luck
Posted by zinya on December 16, 2002, at 11:34:20
In reply to Re: Effexor --some little big Qs (to Bizzou and all) » zinya, posted by khead on December 15, 2002, at 14:18:18
Thanks, khead, for your response. I wrote you back yesterday but now it's not on the screen, so i guess it got swallowed in cyberspace somehow ... and now am searching to recall what i had said and asked :) ...
I've now seen your earlier post too which helps to understand how long you've been on Effexor and your 'symptoms' thus far...
I certainly identify with the waking up at 4-5 am and then flipping in bed with that interminable stream of screwed-up thoughts... I still have yet to start trying Effexor. Once I read on here about such severe-sounding side effects and even withdrawal after just a few days, i confess i got concerned (my md. hadn't told me of any side effect risks but just the 'plus side' of treating two systems at once - serotonin and norepenephrine)** and I still haven't decided if the risks vs. potential rewards would favor at least a trial. My system has over the years been very sensitive to any drugs even when doctors, knowing that, sometimes have had me try less than the minimum-dose pill for starters, so i was grateful to find this site and to at least be forewarned (since Effexor sounds more potent than others i've tried but couldn't tolerate) -- and so far it made me try a while longer 'on my own' but i'm not finding any force for rallying to do the myriad more important tasks awaiting me -- In your words, i do feel "stuck" indeed. (My main concern was a sense of depression but i am starting to realize in past month that anxiety is a lot of what i'm dealing with.)
Well, i do thank you and i will be glad to hear your input. Right after I first posted here, there seemed to be a sudden lull and few postings so I am appreciating discovering a batch of new posts here to reflect on.** After finding and devouring posts on this site, i re-asked my md. -- internal med. not a shrink -- and he said he has approx 200 patients on Effexor and none with side-effect problems that he knew of. That became kind of mind-boggling (as if he were doling it out -- 200 seems like a lot of patients on it for one md.) and also curious or hard to believe, after reading here, that none of them would be having problems...
Posted by jannbeau on December 16, 2002, at 11:55:42
In reply to Re: Effexor --some little big Qs » khead, posted by zinya on December 16, 2002, at 11:34:20
>>>Absolutely agree that it seems strange that, with 200 patients on this medication, none has complained of any significant side effects! What, he has the perfect patient, or 200 of them???
Cheers and Hopeful Holidays,
JannbeauThanks, khead, for your response. I wrote you back yesterday but now it's not on the screen, so i guess it got swallowed in cyberspace somehow ... and now am searching to recall what i had said and asked :) ...
>
> I've now seen your earlier post too which helps to understand how long you've been on Effexor and your 'symptoms' thus far...
>
> I certainly identify with the waking up at 4-5 am and then flipping in bed with that interminable stream of screwed-up thoughts... I still have yet to start trying Effexor. Once I read on here about such severe-sounding side effects and even withdrawal after just a few days, i confess i got concerned (my md. hadn't told me of any side effect risks but just the 'plus side' of treating two systems at once - serotonin and norepenephrine)** and I still haven't decided if the risks vs. potential rewards would favor at least a trial. My system has over the years been very sensitive to any drugs even when doctors, knowing that, sometimes have had me try less than the minimum-dose pill for starters, so i was grateful to find this site and to at least be forewarned (since Effexor sounds more potent than others i've tried but couldn't tolerate) -- and so far it made me try a while longer 'on my own' but i'm not finding any force for rallying to do the myriad more important tasks awaiting me -- In your words, i do feel "stuck" indeed. (My main concern was a sense of depression but i am starting to realize in past month that anxiety is a lot of what i'm dealing with.)
> Well, i do thank you and i will be glad to hear your input. Right after I first posted here, there seemed to be a sudden lull and few postings so I am appreciating discovering a batch of new posts here to reflect on.
>
> ** After finding and devouring posts on this site, i re-asked my md. -- internal med. not a shrink -- and he said he has approx 200 patients on Effexor and none with side-effect problems that he knew of. That became kind of mind-boggling (as if he were doling it out -- 200 seems like a lot of patients on it for one md.) and also curious or hard to believe, after reading here, that none of them would be having problems...
Posted by djmmm on December 16, 2002, at 13:28:32
In reply to Re: DrBob, anyone- percocet effexor same family? » djmmm, posted by BrittPark on December 16, 2002, at 10:07:03
all of that is true, however, both drugs have some effect on the opioid system...
Posted by Sioux on December 16, 2002, at 13:42:02
In reply to Re: Effexor --some little big Qs » khead, posted by zinya on December 16, 2002, at 11:34:20
>>> and he said he has approx 200 patients on Efexor and none with side-effect problems that he knew of.
May I reflect on this a moment? In my years as a patient with chronic illness (a cluster of autoimmune diseases) I have observed this kind of misinformation many times. My conclusion is that such claims tend to be more naive than ill-intended.
Many docs have a 'chilling effect' on a patient's inclination to speak up. They are bad listeners, or they are so eager to help that they "cue" a patient to please them, or they are genuinely unaware of how much they don't know (and therefore where/how to get informed), or they genuinely believe that a patient is better off if gently manipulated away from self-experience, or they are so frightened of their responsibility as physicians that they *have* to overbelieve themselves. A great variety of very human engines that may be driving this tragic claim.
That leaves you to make the decisions about your health care. This is often a responsbility many folks don't want. But there it is.
It's clear that you are accepting this responsibility. You are informing yourself. You are weighing the price/promise balance. You're taking your time.
For my part, my initial strong negative reaction to Effexor was probably about my sense of outrage and betrayal at my doc's not having informed me of the nature of the drug. This left me feeling horribly vulnerable and betrayed. It felt as if someone ahd told me that they were going to take my tonsils out when in reality they were planning to do experimental brain surgery.
However once I had informed myself and reclaimed my power to care for myself, I was able to choose to use the drug and am satisfied with the results. My life is better with the drug than without.
I hope you find this to be a useful observation and look forward to your feeling better. It's much more fun that way.
--S
Posted by jannbeau on December 16, 2002, at 13:42:24
In reply to Re: DrBob, anyone- percocet effexor same family?, posted by djmmm on December 16, 2002, at 13:28:32
> Both peer-reviewed papers were authored by the same researchers(Schreiber et al, if I remember correctly). Replication by esearchers unassociated with the original researchers . . .?
Also, might wish to further define "family of drugs" vs "drug class" vs "chemical class" vs "therapeutic class"??
Cheers,
Jannbeau
all of that is true, however, both drugs have some effect on the opioid system...
>
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11931344&dopt=Abstract
>
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10505622&dopt=Abstract
Posted by djmmm on December 16, 2002, at 18:33:31
In reply to Re: DrBob, anyone- percocet effexor same family? » djmmm, posted by jannbeau on December 16, 2002, at 13:42:24
Effexor and Opioids may be in a similar "therapeutic class" but only because Opioids make great antidepressants...
Posted by blueheron on December 16, 2002, at 20:01:04
In reply to Re:Withdrawl » zinya, posted by jmmrc2002 on December 16, 2002, at 5:02:39
Hi all...
I'm new to this thread, been on effexor for 10 months now, and thought I might as well add my thoughts on withdrawl... In July I decided I was sick and tired of the sexual side effects, (decreased libido due mainly to frustration with delayed orgasm) and unbeknownst to my doctor, I decided to see what these much feared withdrawl symptoms were all about... also, I wanted to know if I was going to be hooked forever, or if I could get off the stuff... so I quit cold turkey from 150/day.
The first symptoms I felt started two days later, every time I moved my eyes I heard a whooshing sound, sort of like driving in a car with the window down going past telephone poles. Then I started feeling the electric jolts everyone talks about. I must admit it was a little disconcerting, but nothing too dramatic, not as bad as I had been led to belive... I also experienced the depth perception issues, everything looked far away, and I felt a compulsion to mimic a sort of robotic movement... short crisp jerky movements felt "good"... could be I have a bit of experience in this area, I did inhale in my youth, so to speak, and I think anyone who has ever experimented with psycoactive drugs would recognize these symptoms...
Anyway... Much to my relief the sexual side effects went away just as my Doc had said they would, in fact they departed faster than I expected, within a few days. I started to go into a prolonged manic phase, lasting probably 2 weeks, even though I was still feeling the aforementioned side effects, (in fact they were increasing in severity, particularily the electric jolts, the eye movement/sound and the depth perception) I felt great, I started to wonder if my seratonin levels had somehow been kicked into high gear.
But... (there always is a but, isn't there)
After another couple of weeks I noticed the manic high was wearing off, in fact the depression was returning... the good news is, the side effects all went away, the whole withdrawl process lasted about 6-7 weeks... no more shocks, no more eye stuff... great sex!!!, but I could feel myself sliding into the pit. So I started to have second thoughts about my cold-turkey decision.
Bottom line... I went back on Effexor, 75/day for 3 days then 150/day... I figure my little experiment set me back 4-5 months, I started to feel and remember the first recovery, recognized the light at the end of the tunnel a lot faster, and can see the positive effect it is having on me.
Yes the sexual side effects are back, but not as bad this time, because I know they are transitory, and because I would rather feel like I do now then as I did. Depression sucks, and in my opinion effexor rules.
Posted by blueheron on December 16, 2002, at 20:18:48
In reply to Re: Effexor XR? Successful but very ugly! » Dan L, posted by zinya on December 2, 2002, at 15:15:23
I give myself about a 4 hour window to take my pill... if i miss it, i miss the day, sure i feel it the next day, but that just is a reminder... usually i start feeling non-specific, non-directed rage the next day... I just remind my loved ones what is happening... and carry on
> Dan L (or anyone):
>
> When you missed doses, how long was it before these symptoms would show up? What if you were a few hours late on a given day? Would it be like an 'alarm clock' of these electric sensations reminding you to take dose? And then how soon would they subside after resuming dose??
>
> It sounds like Effexor -- which I was prescribed but haven't yet started (i've written a few queries some days ago) -- might be wrong for someone (like me) who's easily distracted as to time of day or remembering to take a pill at a fairly rigid time every day - ??
Posted by JESSsMom on December 17, 2002, at 5:18:12
In reply to Anyone had success on Effexor XR? , posted by jp on October 24, 1999, at 14:59:14
Sorry if I'm reposting, can't get the hang of this board yet.
I am wondering if anyone who's GAD symtpoms have lessened on Effexor XR but their energy level, fatigue, and verocious appetite have returned?
The addition of Wellbutrin seems to be an option but at what dose?
Any thoughts appreciated.
JM
Posted by blueheron on December 17, 2002, at 13:53:38
In reply to Effexor and Me =), posted by ¥ã£ér|é on June 17, 2002, at 16:23:43
> .. Tried to wean off about 10 months into the program (just felt I didnt need it any more), Withdrawls were horrible, the most prevalant was the "eye shocks" or "eye seizures" I experienced. Took me off of work for 3 days. After about 5 days of withdrawl symptoms, I was on "top" of the world !!! OMG I never felt so good in my life !! .. that euphoria lasted for a total of 2 weeks ..
BH] Sounds just like me! What a HIGH!!!, then what a drag
>I began having small anxiety attacks again, and unfortunatly had to return to the medication. But it was okay with me, Effexor XR has done wonders for my life. I can think again clearly and make informed decisions. I am now on 150 mg a day and am doing very well. I have no desire to come off this med, for fear that I will loose the ground which I have gained.BH] I figure my going off set me back about 6 months, and I too am happy to be on it again.
>Although today was interesting, and I will share this experience with my doctor. I suddenly developed "eye shocks/seizures" out of the blue. I was brought home from work roughly 15 minutes of being there, I could not focus my vision and couldnt move suddenly, dizziness was pretty severe. ... The only thing I can attribute to this is that I did miss my dosage yesterday, but I have missed dosages before and never had this reaction.
BH] I get that every time I forget to take my pill, but since stopping and re-starting it seems I am more sensitive to the dosage changes... when I went from 150 to 75 to 0 in 2 days I got incredible non-specific, non-targeted rage (won't do that again :-), had to warn my friends to stay away or die)
>I am sharing this information to all who are either veterans of Effexor or new to the drug. I will not change medications, nor have I tried any other anti-depressant. Effexor works well for me and if there are a few inconveinences once in a while.. I'll live with it.
BH] Although I could stand to have a "quickie" once in a while ;-), now it takes forever to cum, even my lady gets distressed at the third application of KY
Posted by Scot_lass2003 on December 17, 2002, at 20:39:01
In reply to Re: Effexor --some little big Qs » khead, posted by zinya on December 16, 2002, at 11:34:20
Hi all
I am qite new to effexor(6 days) and am experiencing an almost constant sense of motion sickness as well as awful headaches.Am on 37.5mg at the moment but will move to 75mg in 2 days. Please tell me it gets better!!!!
Posted by EGR on December 18, 2002, at 10:01:02
In reply to Re: Effexor --some little big Qs (nm), posted by peterjg on December 17, 2002, at 21:41:05
I was on 150 of Effexor XR and all I could do was sleep. I wasn't suicidal, so that was good... in fact, it was weird... I was high, yet drowsy. I only lasted about a month.
Posted by sly on December 18, 2002, at 10:25:38
In reply to Re: Effexor --some little big Qs, posted by Scot_lass2003 on December 17, 2002, at 20:39:01
I know exactly what you mean about the headaches and motion sickness, I also had poor balance, I found myself actually falling over when I bent down to tie my shoes or put socks on.
Don't worry, all of the side effects go away with time, the length of time ranges, some last a few days, some a few months. The most disturbing were the sexual side effects, but even those are gone now (I was on 37.5 for 2 weeks, and 75 for 9 mos now).
Posted by Scot_lass2003 on December 18, 2002, at 13:36:43
In reply to Re: Effexor --some little big Qs, posted by sly on December 18, 2002, at 10:25:38
> I know exactly what you mean about the headaches and motion sickness, I also had poor balance, I found myself actually falling over when I bent down to tie my shoes or put socks on.
>
> Don't worry, all of the side effects go away with time, the length of time ranges, some last a few days, some a few months. The most disturbing were the sexual side effects, but even those are gone now (I was on 37.5 for 2 weeks, and 75 for 9 mos now).Thank you for the reassurance. What sexual side effects and are they only for men? Is the medication helping in general & if so how do you feel better(ie what is different for you on the medication)
Posted by khead on December 18, 2002, at 13:36:59
In reply to Anyone had success on Effexor XR? , posted by jp on October 24, 1999, at 14:59:14
I'm 3 weeks in, and just started the 150/day
dose...noticed I was jittery and had some
ringing in the ears. Checked my BP and find I'm at 185/105 heart rate at 105 resting! (I've always been somewhat high at around 135/90.) Called my Doc and he told me to ramp down. Dropping to 75 immediately. Probably will go to something else. Sad thing is the stuff seemed to be working. Anyone had a similar experience?
Posted by Scot_lass2003 on December 18, 2002, at 13:37:17
In reply to Re: Effexor --some little big Qs, posted by sly on December 18, 2002, at 10:25:38
> I know exactly what you mean about the headaches and motion sickness, I also had poor balance, I found myself actually falling over when I bent down to tie my shoes or put socks on.
>
> Don't worry, all of the side effects go away with time, the length of time ranges, some last a few days, some a few months. The most disturbing were the sexual side effects, but even those are gone now (I was on 37.5 for 2 weeks, and 75 for 9 mos now).Thank you for the reassurance. What sexual side effects and are they only for men? Is the medication helping in general & if so how do you feel better(ie what is different for you on the medication)
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.