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Top 10 Causes of Death in Men

Men have shorter life expectancies than women. While we will all dieeventually, there are things we can do to live longer and healthier lives, whichimproves the overall quality of our lives and our families lives.

According to the U.S. Centers for Disease Control and Prevention (CDC), in2003 just over one million American men died of heart disease or one of thenine other leading causes of death. That represents 80 percent of all deaths bymen that year. Men are more likely than women to die from most of thesecauses. Luckily, because many of these causes can be prevented, men cantake steps to avoid them by knowing the symptoms, by having regularcheckups by a doctor or health care provider and by taking steps to live ahealthier life.

Heart DiseaseCancerUnintentional InjuriesStrokeChronic Obstructive Pulmonary Disease (LungDiseases)DiabetesInfluenza and PneumoniaSuicideKidney DiseaseAlzheimer’s Disease

Number 1 – Heart Disease

Heart disease is a term that includes many specific heart conditions. Accordingto the U.S. Centers for Disease Control and Prevention (CDC), coronary artery

Men's Health - Top 10 Causes of Death in Men http://www.idph.state.il.us/menshealth/healththre...

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disease (CAD), which can lead to heart attacks, is the most common heartdisease in the United States. Other heart conditions include chest pain knownas angina, heart failure and irregular heart beats known as arrhythmias.

About Coronary Artery Disease (CAD)

CAD develops when arteries that supply blood to the heart muscle becomehardened and narrowed from plaque buildup. Because buildup reduces bloodflow, and therefore oxygen, to the heart it can lead to a heart attack.

Statistics

Because men usually develop heart disease 10 to 15 years earlier thanwomen, men are more likely to die of it in the prime of life. (AmericanHeart Association)Heart disease is the leading cause of death in both men and women.Nearly 700,000 people die of heart disease annually – the equivalent of29 percent of all deaths in the United States. (CDC)About a quarter of all heart-disease-related deaths occur in men ages 35to 65. (CDC)In 2004, heart disease was the cause of death for 410,628 males.(American Heart Association)

Symptoms of Heart Attack

According to the National Heart Attack Alert Program, major symptoms of aheart attack include:

Chest discomfort: This discomfort is usually in the center of the chestand can last for a few minutes or come in waves. It can feel likeuncomfortable pressure, squeezing, fullness or pain.Upper Body Discomfort: This can include pain or discomfort in one orboth arms, the back, neck, jaw or stomach.Shortness of Breath: This may occur before or in conjunction with chestdiscomfort.Other: Some people may break out in a cold sweat, feel nauseated orlight–headed.

Prevention

Several health conditions can lead to heart attacks. These conditions includehigh cholesterol, high blood pressure and diabetes. Here are some things thatyou can do to lower your risk of a heart attack.

Treat high blood cholesterol by eating a diet low in saturated fat andcholesterol and high in fiber, keep a healthy weight, and get regularexercise. If in spite of your best efforts, your cholesterol remains high,discuss with your doctor medications that may help.Control high blood pressure with a healthy diet, regular exercise, notsmoking and maintaining a healthy weight. If after doing all these things,you still have high blood pressure, discuss options with your doctorregarding medications.If you have diabetes, be sure to keep your blood sugar levels undercontrol. People with diabetes have a heightened risk of heart disease. Quit smoking and drink in moderation. Both smoking and excessivealcohol consumption are linked to high blood pressure, some heartdisease and stroke.


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Number 2 – Cancer

According to the U.S. Centers for Disease Control and Prevention (CDC) theleading causes of cancer death in men are lung cancer, prostate cancer andcolorectal cancer.

Statistics

In 2003, nearly 288,000 men died of cancer in the U.S., the second-leading cause of death for both sexes. (CDC)Lung cancer is the most common cause of cancer death for both menand women. (CDC)Ninety percent of lung cancer is caused by cigarette smoking. (CDC)In 2003, 89,964 men died of lung cancer. (CDC)

Symptoms

Lung Cancer

Nearly a quarter of people with lung cancer do not have symptoms fromadvanced cancer when their lung cancer is found. While symptoms mayvary, the CDC lists the following as common symptoms:

Shortness of breathPersistent coughingWheezingCoughing up bloodChest painFeverWeight loss

Prevention

While there are some people who never smoke and who get lung cancer, thevast majority of those who get lung cancer smoke.

One of the BEST things you can do for your health is to quit smoking.http://www.idph.state.il.us/smokefree/sf_quit.htm

Prostate Cancer

The Prostate Cancer Foundation lists the following symptoms:

A need to urinate frequently, especially at night.Difficulty starting urination or holding back urine.Weak or interrupted flow of urine.Painful or burning urination.Difficulty in having an erection.Painful ejaculation.Blood in urine or semen.Frequent pain or stiffness in the lower back, hips, or upper thighs.

Prevention

While preventing prostate cancer may not be possible, early detection doessave lives. Discuss with your doctor whether you should have a prostatecancer screen and look for the symptoms above.


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Colorectal Cancer

According to the U.S. Centers for Disease Control and Prevention, manypeople with colon cancer have no symptoms in the early stages. Signs andsymptoms include:

A change in bowel habits, including diarrhea or constipation or achange in the consistency of your stool for more than a couple ofweeks.Rectal bleeding or blood in your stool.Persistent abdominal discomfort, such as cramps, gas or pain.Abdominal pain with a bowel movement.A feeling that your bowel doesn't empty completely.Weakness or fatigue.Unexplained weight loss.

Prevention

While colon cancer cannot be prevented, early detection saves lives. Startprevention health screenings at age 50 or earlier if you have a family history ofcolon cancer or have other risk factors.

Testicular Cancer

Testicular cancer occurs more commonly in younger men (age 20 to54). According to the American Cancer Society, common signs of testicularcancer include:

Lumps (masses) Swelling Pain

Overall Cancer Prevention

Have regular preventive health screenings.Quit smoking and avoid second hand smoke and other tobacco products.Eat a healthy, varied diet rich in fruits and vegetables.Maintain a healthy weight and exercise regularly.Limit your exposure to sun and use sunscreen.Drink alcohol only in moderation.Be aware of potential cancer-causing substances (carcinogens) in yourhome and workplace, and take steps to reduce your exposure to thesesubstances.Know and review your family’s medical history.

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Number 3 – Unintentional Injuries

Unintentional injuries are simply accidents. Though a leading cause of deathfor men – and Americans of all ages – many unintentional injuries can be easilyprevented. Injuries in this category include, for example, injuries due to falls,fire and impaired driving.

Statistics

In 2002, unintentional injuries were the leading cause of death for peopleages 1 to 44 years and the fifth leading cause of death overall. (CDC)


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More than 106,000 people died in 2002 from unintentional injuries.(CDC)Men are more likely to die from a fall. After adjusting for age, the fallfatality rate in 2004 was 49 percent higher for men than for women(CDC).Residential fires accounted for 76 percent of fire-related injuries and 79percent of fire-related deaths in 2002. In this year alone, more than401,000 home fires in the United States claimed the lives of 2,670 peopleand injured another 14,050. (CDC)In 2003, 17,013 people died in alcohol-related motor vehicle crashes,representing 40 percent of the year’s total traffic deaths. (CDC)Male drivers involved in fatal motor vehicle crashes are almost twice aslikely as female drivers to be intoxicated with a blood alcoholconcentration (BAC) of 0.08 percent or greater (NHTSA 2006). It is illegalto drive with a BAC of 0.08 percent or higher in all 50 states, the Districtof Columbia and Puerto Rico. Driving while distracted or tired increases your likelihood of being involvedin an accident. Using a cell phone, blackberry or other electronic devicecan be hazardous while driving and should be avoided.

Prevention

Falls

The CDC recommends the following preventative steps for older adults:

Exercise regularly. Exercise programs like Tai Chi that increase strengthand improve balance are especially good.Drink only in moderation.Ask your doctor or pharmacist to review your medicines — bothprescription and over-the counter — to reduce side effects andinteractions.Have your eyes checked by an eye doctor at least once a year.Improve the lighting in your home.Reduce hazards in your home that can lead to falls.

Fires

The CDC identifies a few main risk factors for unintentional injury due to fire.

Install Smoke Alarms: Approximately half of home fire deaths occur inhomes without smoke alarms.Double Check Safety of Heating Units: Most residential fires occurduring the winter months.Drink in Moderation: Alcohol use contributes to an estimated 40 percentof residential fire deaths.

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Number 4 – Stroke

A stroke occurs when blood flow to an area of the brain is interrupted by eithera blood clot blocking an artery or a blood vessel breaking. Under theseconditions, brain cells begin to die and brain damage occurs. Brain damagefrom a stroke can lead to a loss of abilities, including speech, movement andmemory.

Statistics


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In 2004, more than 58,000 men died of stroke (American HeartAssociation).About 700,000 people suffer a new or recurrent stroke in the UnitedStates each year and more than 150,000 of these people die (AmericanHeart Association).About 5.7 million U.S. stroke survivors are alive today, many withpermanent stroke-related disabilities (American Heart Association).

Symptoms

The National Stroke Association lists the following as common symptoms ofstroke:

Sudden numbness or weakness of the face, arm or leg – especially onone side of the body.Sudden confusion, trouble speaking or understanding.Sudden trouble seeing in one or both eyes.Sudden trouble walking, dizziness, loss of balance or coordination.Sudden severe headache with no known cause.

Try this easy-to-remember test and “Act F.A.S.T” if you think someone youknow is having a stroke:

F FACE Ask the person to smile. Does one side of the face droop?

A ARM Ask the person to raise both arms. Does one arm drift downward?

S SPEECH Ask the person to repeat a simple sentence. Does the speechsound slurred or strange?

T TIME If you observe any of these signs, it’s time to call 9-1-1 or get to thenearest stroke center or hospital.

http://www.stroke.org/site/DocServer/STROKE_101_Fact_Sheet.pdf?docID=4541

Prevention

According to the American Heart Association and American Stroke Association,leading risks factors for stroke include:

High blood pressureTobacco useDiabetesCarotid or other artery diseaseAtrial fibrillation or other heart diseaseHistory of “mini-strokes” known as TIAsHigh red blood cell countSickle cell anemiaHigh cholesterolPhysical inactivityObesityExcessive alcohol intakeSome illegal drugs

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Number 5 – Chronic Obstructive Pulmonary Disease (LungDiseases)

Chronic obstructive pulmonary disease (COPD) is a term physicians use torefer to two lung diseases – chronic bronchitis and emphysema. The diseasesfrequently exist together and both are conditions that cause a blockage ofairflow that interferes with normal breathing.

Statistics

In 2003, 60,714 men died of COPD. (American Lung Association)Between 80 percent and 90 percent of COPD deaths are caused bysmoking. Men who smoke are nearly 12 times as likely to die from COPDas men who have never smoked. (U.S. Department of Health and HumanServices)

Symptoms

Chronic Bronchitis: Chronic cough, increased mucus, frequent clearingof the throat and shortness of breath.Emphysema: Shortness of breath and a reduced capacity for physicalactivity – both of which worsen over time.

Prevention

Smoking is the leading cause of COPD. Take preventative steps by notsmoking and avoiding secondhand smoke. Minimize exposure to workplace chemicals. According to a study in theAmerican Journal of Epidemiology, occupational exposure to certainindustrial pollutants also may increase the chance of developing COPD.

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Number 6 – Diabetes

According to the Illinois Department of Public Health, diabetes can refer eitherto a deficiency of insulin or to the body’s decreased ability to use insulin. Insulin is a hormone secreted by the pancreas that allows glucose (sugar) toenter cells and be converted into energy. The body’s ability to synthesizeprotein and to store fats also depends on normal levels of insulin. If diabetes isleft untreated, glucose and fats remain in the bloodstream and, over time,damage the body’s vital organs and contribute to heart disease.

There are two main types of diabetes -- non-insulin dependent (type-2) andinsulin dependent (type-1). Non-insulin dependent diabetes, which usuallyappears after the age of 40, is the most common type, affecting 90 percent to95 percent of those who have the disease. Insulin-dependent diabetes, ortype-1 diabetes, affects the remaining proportion of those with the disease. Although this type of diabetes can occur at any age, it most often appears inchildhood or during the teen years. Over a third of people with diabetes do notknow they have the disease. This is why diabetes is sometimes referred to asthe “silent killer.”

Statistics

As of 2005, 10.9 million or 11 percent of all men aged 20 years or older inthe United States had diabetes (U.S. Department of Health and HumanServices)


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Adults with diabetes have heart disease death rates about 2 to 4 timeshigher than adults without diabetes. (U.S. Department of Health andHuman Services)Heart disease and stroke account for about 65 percent of deaths inpeople with diabetes. (U.S. Department of Health and Human Services)Diabetes is the leading cause of new cases of blindness among adults 20to 74 years of age. (U.S. Department of Health and Human Services)Diabetes is the leading cause of kidney failure, accounting for 44 percentof new cases in 2002. In 2002, 44,400 people with diabetes begantreatment for end-stage kidney disease in the United States and PuertoRico. The risk for stroke is 2 to 4 times higher among people withdiabetes. (U.S. Department of Health and Human Services)

Symptoms

According to the American Diabetes Association, diabetes often goesundiagnosed because many of its symptoms seem harmless. Recent studiesindicate early detection of diabetes symptoms and treatment can decrease thechance of developing the complications of diabetes.

Symptoms include:

Frequent urinationExcessive thirstExtreme hungerUnusual weight lossIncreased fatigueIrritabilityBlurry vision

Prevention

Your risk for type-2 diabetes and heart disease depend on factors that can bemanaged (modifiable risk factors) and others that are genetic (non-modifiablerisk factors). Understanding and managing your risk factors can help you avoiddiabetes and heart disease and live a longer, better life.

Modifiable Risk Factors

Overweight and obesityHigh blood glucoseHigh blood pressureUnhealthy cholesterol levelsPhysical inactivitySmoking

Non-modifiable Risk Factors

AgeRaceGenderFamily history

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Number 7 – Influenza and Pneumonia

Influenza


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According to the CDC, influenza (the flu) is a contagious respiratory illnesscaused by flu viruses. The flu can cause varying degrees of illness from mild tofatal. The flu is spread from person-to-person in respiratory droplets of coughsand sneezes. Some people, such as older adults, pregnant women, children,and people with certain health conditions, are at high risk for serious flucomplications including death.

Prevention

The best way to prevent the flu is by getting a flu vaccination each year. Hand-washing and avoiding others with the flu also may help.

Pneumonia

The Mayo Clinic reports that pneumonia is an inflammation of the lungs usuallycaused by infection with bacteria, viruses, fungi or other organisms. Pneumoniais a particular concern for older adults and people with chronic illnesses orimpaired immune systems, but it can also strike young, healthy people. Thereare many kinds of pneumonia ranging in seriousness from mild tolife-threatening. Pneumonia acquired while in the hospital can be particularlyvirulent and deadly. Although antibiotics can treat some of the most commonforms of bacterial pneumonias, antibiotic-resistant strains are a growingproblem. For that reason, and because the disease can be very serious, it'sbest to try to prevent infection in the first place.

Statistics

Every year in the United States, on average 5 percent to 20 percent ofthe population gets the flu,more than 200,000 people are hospitalizedfrom flu complications, and about 36,000 people die from flu. (CDC)Every year, more than 60,000 Americans die of pneumonia. (Mayo Clinic)Worldwide, pneumonia is a leading cause of death in children. (MayoClinic)

Symptoms

The CDC states the flu usually comes on suddenly and may include thesesymptoms:

Fever (usually high)HeadacheExtreme tirednessDry coughSore throatRunny or stuffy noseMuscle achesNausea, vomiting, and diarrhea also can occur, but are more common inchildren than adults

According to the Mayo Clinic, signs and symptoms of pneumonia may vary withmany cases of pneumonia developing suddenly. Symptoms may include:

Chest painFeverChillsCoughShortness of breath


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Infection often follows a cold or the flu, but it can also be associated with otherillnesses or occur on its own.

Prevention:

Pneumonia is slightly more complicated compared to flu because you usuallydon't "catch" pneumonia from someone else. Instead, you develop the diseasebecause your immune system is temporarily weakened, often for no knownreason. The following suggestions from the Mayo Clinic can help preventpneumonia:

Get vaccinated. Because pneumonia can be a complication of the flu,getting a yearly flu shot is a good way to prevent viral influenzapneumonia, which can lead to bacterial pneumonia. In addition, get avaccination against pneumococcal pneumonia at least once after age 55and, if you have any risk factors, every five years thereafter.Wash your hands. Your hands are in almost constant contact with germsthat can cause pneumonia. These germs enter your body when you touchyour eyes or rub the inside of your nose. Washing your hands thoroughlyand often can help reduce your risk. When washing isn't possible, use analcohol-based hand sanitizer, which can be more effective than soap andwater in destroying the bacteria and viruses that cause disease. What'smore, most hand sanitizers contain ingredients that keep your skin moist.Carry one in your purse or in your pocket.Don't smoke. Smoking damages your lungs' natural defenses againstrespiratory infections.Take care of yourself. Proper rest and a diet rich in fruits, vegetablesand whole grains, along with moderate exercise, can help keep yourimmune system strong.Protect others from infection. If you have pneumonia, try to stay awayfrom anyone with a compromised immune system. When that isn'tpossible, you can help protect others by wearing a face mask or alwayscoughing into a tissue.

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Number 8 - Suicide

According to the Mayo Clinic, men are more likely than women to commitsuicide because they are more likely to use deadlier means, such as firearms. Depression is one of the most important risk factors in suicide. Unfortunately,male depression is under-diagnosed because men are less likely to seek helpand because men don’t always develop standard symptoms, such as sadness,but instead are more likely to experience fatigue, irritability, sleep disturbances,and a loss of interest in work and hobbies. (Mayo Clinic)

About Depression

According to the Men’s Health Network, depression is the leading cause ofdisability in the U.S. In some cases, it can be caused by a deficit of thechemicals in the body that are responsible for maintaining energy. Having afamily member with depression also increases your risk and major life crisesmay make it worse. Fortunately, in most cases, depression is treatable. If youare depressed, be sure to see a doctor right away. Waiting will only make itworse for you and those loved ones around you. (Men’s Health Network)

Statistics


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According to the CDC:

In 2004, more than 32,000 suicides occurred in the U.S. This is theequivalent of 89 suicides per day; one suicide every 16 minutes or 11suicides per 100,000 people.Males take their own lives at nearly four times the rate of females andrepresent 79 percent of all U.S. suicides.Suicide rates for males are highest among those aged 75 and older (rate36 per 100,000).Firearms are involved in 57 percent of suicides among males, making itthe most commonly used method for men.The number of deaths from suicide reflects only a small portion of theimpact of suicidal behavior. In 2002, more than 90,000 people werehospitalized following suicide attempts.

Symptoms

According to the Mayo Clinic, people at risk of suicide may:

Be depressed, moody, socially withdrawn or aggressiveHave suffered a recent life crisisShow changes in personalityFeel worthlessAbuse alcohol or drugsHave frequent thoughts about deathTalk about death and self-destruction

Prevention

Don’t expect to overcome depression by yourself. It is a disease, notsomething that you will just “get over.” If you are depressed, talk to yourdoctor. In an urgent situation, go to an emergency room or crisis center forhelp. Also, take advice from friends and family members if they areencouraging you to seek help. They are often the first ones to notice. (MayoClinic)

Also, work to improve your emotional health and well-being. When stressdoesn’t go away, it begins to weaken your immune system and increase yourrisk of developing a number of physical and mental conditions. The Men’sHealth Network recommends some lifestyle changes to help you cope:

Take Care of Yourself – Exercise, eat well and get plenty of sleep.Meditate – It has been shown to lower blood pressure and relievetension.Talk to Someone Else – It creates a support network.Prioritize – Save the least important things for later.Know Your Limits – Sometimes it isn’t bad to just walk away.Don’t Self-Mediate – Don’t turn to alcohol, tobacco or drugs.

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Number 9 – Kidney Disease

According to the CDC, kidney disease occurs when the kidneys becomedamaged and lose their ability to filter the blood. Kidney disease most oftenhappens slowly and may go undetected until the kidneys have almost failed.The two most common causes of kidney disease are diabetes and high bloodpressure. It can also be hereditary. People with these risk factors should get


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tested for kidney disease on an annual basis. African Americans, AmericanIndians, Asian and Pacific Islanders, and Hispanics are particularly vulnerable.

According to the National Kidney Disease Education Program, if your kidneysstop working completely, your body fills with extra water and waste products.This often leads to seizures or a coma and will ultimately result in death. Ifyour kidneys stop working completely, you will need to undergo dialysis orkidney transplantation.

Statistics

According to the CDC:

More than eight million Americans have a major loss in kidney function.Nearly 400,000 of those Americans require dialysis or a kidney transplantto stay alive.The number of kidney failure patients is expected to more than double to650,000 by 2010 because of the growing number of people withundiagnosed or uncontrolled diabetes.The demand for kidney transplants far outweighs the supply. In 2000,about 100,000 people developed kidney failure, but only about 14,000transplants were done.

Symptoms

Because kidney disease progresses slowly and may be hard to detect, it is veryimportant to know the symptoms. While kidney disease cannot be cured, yourdoctors can take steps to help your kidneys last longer if the disease is caughtin the early stages.

According to Life Options, symptoms to look for include:

Changes in urinationSwelling in the legs, ankles, feet, face and/or handsFatigueSkin rash or sever itchingMetallic taste in mouth or bad breathNausea and vomitingShortness of breathFeeling cold all of the time, even in a warm roomDizziness and trouble concentratingPain in the leg, back or side

The CDC notes that many people do not know they have kidney diseasebecause there may be no symptoms until the kidneys have nearly failed. Theonly way to find out if you have kidney disease is to have a urine or blood test.

Prevention

The Mayo Clinic suggests these preventative measures:

Drink plenty of fluidsExercise regularlyMaintain your proper weightDon’t smokeGet checked regularly for diabetes and high blood pressureLimit your use of over-the-counter pain relieversTake all medications only as directed


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Additionally, according to the CDC, people with diabetes can prevent or slowkidney disease through blood pressure and blood glucose control. People withkidney disease also must maintain low protein and low salt diets, take dailymedication and follow-up with their health care providers.

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Number 10 – Alzheimer’s Disease

Alzheimer’s disease is an incurable, progressive degenerative disease of thebrain. It is the most common form of dementia. It is not just memory loss, butalso a decline in the ability to think and understand. Consequent changes inpersonality are accompanied by an inability to function. The type, severity,sequence and progression of the mental changes vary widely amongindividuals. Because age is the most important known risk factor forAlzheimer’s disease, the longer people live, the more likely they are to developthe disease.

Statistics

About 4.5 million Americans have Alzheimer’s disease and an estimated222,300 of them live in Illinois.About one in 10 persons 65 years of age and older and almost half ofthose 85 years of age and older will develop Alzheimer’s disease.More than 70 percent of those suffering from Alzheimer’s disease live athome, where the majority of their care (75 percent) is provided by familyand friends.Unless a cure or prevention is found, an estimated 14 million Americanswill be stricken with Alzheimer’s disease by 2050. A person with Alzheimer’s disease lives an average of eight years and asmany as 20 years or more from the onset of symptoms.The most common cause of death for persons with Alzheimer’s disease isinfection.

Symptoms

An early diagnosis of Alzheimer’s disease can increase the chance of potentialbenefits from approved medications. It also allows that person to participate inhealth care, financial and legal decisions.

Symptoms/warning signs of Alzheimer’s disease may include the following:

Memory loss or unexplained confusion that interferes with daily activitiesDifficulty in performing familiar tasks and choresProblems speaking, understanding, reading or writingForgetting words or substituting inappropriate wordsDisorientation to time and place (e.g., getting lost in familiar surroundings)Poor or decreased judgment (e.g., wearing a winter coat on a hotsummer day)Problems with abstract thinking (e.g., difficulty balancing a checkbook)Misplacing things in inappropriate places (e.g., putting the iron in thefreezer)Changes in mood or behavior (e.g., rapid mood swings for no apparentreason or cursing)Drastic changes in personality (e.g., suspiciousness)Lack of interest and involvement in usual activities

If several of these symptoms/warning signs are present, the person should be


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evaluated by a physician. Frequently, the early symptoms of Alzheimer’sdisease, which include forgetfulness and loss of concentration, are mistakenlydismissed as normal signs of aging.

Additionally, it is important to determine the actual cause of the cognitivesymptoms, as they may not be caused by Alzheimer’s disease and manycauses, such as depression, drug interaction, thyroid problems and vitamindeficiencies, are reversible if detected early and treated appropriately.

Prevention

According to the Mayo Clinic, there is no proven way to prevent the onset ofAlzheimer’s disease. However, they suggest improving your cardiovascularfunction may help. Suggested steps are:

Losing weight if you are overweightExercising regularlyControlling your blood pressureKeeping your cholesterol levels in normal range

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The CDC also notes that there is some research indicating that doingintellectually challenging activities may help delay the onset of dementia. Whilethere is some controversy about this research, maintaining your mental fitnesscan’t hurt.

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