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What Your Feet Reveal About Your Thyroid Health

While many people associate thyroid issues with fatigue or weight changes, Carrollton Foot Center is here to tell you that your feet provide early warnings of an under or overactive thyroid. It’s National Thyroid Awareness Month, so let’s jump into the signs that can help you identify a potential hormonal imbalance.

Chronic Dryness and Cracked Heels

One of the most common signs of hypothyroidism, or an underactive thyroid, is severely dry and cracked skin. When the thyroid does not produce enough hormones, the metabolism slows down and reduces sweat and oil production.

This lack of natural moisture often leads to deep, painful fissures on the heels and a leathery texture on the soles of the feet. Unlike standard dry skin, thyroid-related dryness typically persists even after the frequent application of high-quality moisturizers.

Temperature Regulation and Circulation

If you find that your feet remain icy cold even in a warm room or under heavy blankets, it may be a sign of low thyroid function. An underactive thyroid can lead to decreased circulation. In some cases, this poor circulation can cause a yellowish tint on the soles of the feet, a condition known as carotenemia, which occurs because the body is struggling to convert carotene into vitamin A.

Swelling and Fluid Retention

Swelling and fluid retention are also closely linked to thyroid health. Patients with hypothyroidism often experience puffy feet and ankles due to a buildup of fluid in the tissues.

As well, those with Graves disease may develop a rare skin condition that causes the skin on the lower legs and feet to become thick, red, swollen, and to have an orange-peel texture.

Nerve Pain and Brittle Nails

Thyroid disorders can also impact the nerves and muscles in the legs and feet, which manifests as tingling or numbness in the toes and soles, a burning sensation that worsens at night, and frequent muscle cramps.

Your nails can also provide clues, because thyroid issues often cause toenails to become brittle, slow-growing, or prone to fungal infections.

Why Podiatry for Thyroid Health

If you notice these changes, a visit to a podiatrist is a great first step. While we treat the immediate discomfort in your feet, we also look for these systemic red flags and can coordinate with your primary care physician for necessary blood work.

Consult with Board-certified podiatrist Dr. Naghmeh Lilly Khavari, a knowledgeable professional who is dedicated to her patients in Denton, Dallas, and Collin Counties. Dr. Khavari treats a wide range of conditions, from ingrown toenails to foot and ankle injuries. Call Carrollton Foot Center’s office (located in Carrollton, Texas) at (469)-998-3668 to schedule your first appointment today!

bottom of foot

What Leneva Fat Pad Replacement Can Do for Your Feet

Nature designed the human foot with a brilliant built-in shock absorber: the plantar fat pad. However, due to aging, genetics, or years of high-impact activity, that fat pad can wear away. And when it thins out, it feels like walking directly on bone.

Enter Leneva Fat Pad Replacement. This isn’t just a temporary filler or a cortisone shot, but a regenerative solution designed to literally replace the cushioning tissue that time has taken away. Dr. Naghmeh Lilly Khavari relies on Leneva Fat Pad Replacement to treat a variety of foot problems. Here is how this restoration process works and the specific conditions it treats.

Understanding Fat Pad Replacement

Unlike synthetic fillers used in cosmetic procedures, Leneva is an allograft adipose matrix. Think of it as a natural honeycomb scaffold derived from sterile fat tissue. When placed into the foot, it acts as a framework that produces its own fat cells.

The result is not a foreign object, but a restoration of the patient’s own natural fat pad. It essentially gives the foot a do-over on its natural cushioning.

Treating Fat Pad Atrophy

The primary use for this technology is treating fat pad atrophy. Patients with this condition often describe the sensation of walking on marbles or feeling deep, bruising pain in their heels or the balls of their feet.

By performing a fat pad replacement, the volume is restored. This puts a functional pillow back between the skin and the bone, relieves that bone-on-ground pain, and allows for comfortable walking again.

Eliminating Pressure Points

Fat pad replacement is also a powerful tool for dealing with chronic corns and calluses. These hard spots form because a bone inside the foot is pressing relentlessly against the skin from the inside.

Trimming the skin only helps temporarily because the pressure remains. But Leneva allows for internal offloading. By replacing the fat layer between the bony prominence and the skin, the pressure is dissipated. With the friction gone, the painful corn or callus often stops forming entirely.

Protecting the Diabetic Foot

For people managing diabetes, pressure points are dangerous precursors to ulcers. A specific area of high pressure can cause the skin to break down.

Fat pad replacement creates a protective buffer in these high-risk zones by restoring the cushion. Then, the risk of tissue breakdown is significantly reduced.

Relief for High-Impact Pain

Leneva Fat Pad Replacement is also excellent for pain in the ball of the foot. Whether caused by the anatomy of the foot or years of running, thinning fat in the forefoot causes burning pain. Replacing these pads provides the shock absorption necessary to return to activity without the burn.

Consult with Board-certified podiatrist Dr. Naghmeh Lilly Khavari, a knowledgeable professional who is dedicated to her patients in Denton, Dallas, and Collin Counties. Dr. Khavari treats a wide range of conditions, from ingrown toenails to foot and ankle injuries. Call Carrollton Foot Center’s office (located in Carrollton, Texas) at (469)-998-3668 to schedule your first appointment today!

Is My Foot Lying to Me? Phantom Feelings from Nerve Damage

Ever feel a weird burning, crawling, or pinching in your foot and swear your sock is bunched up, only to find nothing there? Dr. Naghmeh Lilly Khavari hears reports of these phantom sensations all the time, and they are often the clearest sign of neuropathy, which is a condition that affects how the nerves communicate. Let’s discuss some of the most common sensations in detail.

Common Symptoms of Nerve Damage in the Feet

Your nerves are like the body’s wiring system. When they get damaged, compressed, or irritated by conditions like diabetes, tarsal tunnel syndrome, or a neuroma, they start to short-circuit.

Here are some of the weirdest and most common phantom sensations your feet might experience:

The Stuck Pebble Sensation

  • What it feels like: You constantly feel like you are standing on a marble, a small rock, or a wrinkled sock, usually right under the ball of your foot between your toes.
  • The reality: There’s nothing actually there. This feeling is caused by a Morton’s neuroma, which is a thickening of nerve tissue, and makes the nerve itself take up space and feel like a foreign object when compressed.

Pins and Needles

  • What it feels like: A crawling, prickling, or stinging sensation, like a thousand tiny needles that comes on for no reason.
  • The reality: This is paresthesia, and it means the nerve signals are going haywire, often caused by minor nerve compression or early-stage neuropathy.

The Burning/Icy Effect

  • What it feels like: Your feet feel intensely hot, as if they are perpetually on fire or submerged in scalding water, or sometimes they feel intensely icy and cold.
  • The reality: This is a classic sign of neuropathic pain. The damaged nerves are wrongly interpreting temperature signals.

The Itch You Can’t Scratch

  • What it feels like: An intense, sometimes debilitating itching sensation, often deep inside the skin or muscles, that you can’t scratch away with any relief.
  • The reality: There is no rash or external cause. This happens when damaged nerves misfire, and your brain translates the abnormal signal into an unrelenting itch.

Extreme Sensitivity

  • What it feels like: Normally, non-painful stimuli become excruciating. The slight brush of a pant leg can feel agonizing.
  • The reality: This is called allodynia. Pain receptors become severely oversensitive.

The Muscle Jump

  • What it feels like: You might notice subtle, spontaneous, quick twitching in the muscles of your foot or calf, even when you’re resting.
  • The reality: This is fasciculation, which is minor, involuntary muscle contractions often associated with nerve irritation or damage.

Disclaimer: We’ve all had these sensations from time to time. But if you are experiencing many of these in tandem frequently, it could be a sign of neuropathy. Visit us for a consultation!

Consult with Board-certified podiatrist Dr. Naghmeh Lilly Khavari, a knowledgeable professional who is dedicated to her patients in Denton, Dallas, and Collin Counties. Dr. Khavari treats a wide range of conditions, from ingrown toenails to foot and ankle injuries. Call Carrollton Foot Center’s office (located in Carrollton, Texas) at (469)-998-3668 to schedule your first appointment today!

5 Subtle Warning Signs of Foot Conditions You Shouldn’t Ignore

If we at Carrollton Foot Center know one thing about feet, it’s that they are great barometers of our health. But while a dramatic ankle sprain or a painful ingrown toenail sends a clear message, many foot and ankle conditions begin with subtle, easily missed warning signs. In this blog post, we’ll help you tune your ear to your feet and listen to specific symptoms you shouldn’t dismiss.

That Lingering Ache

If your feet and ankles consistently ache after a normal day of activity, don’t just chalk it up to a long day or being on your feet. A lingering, dull pain that doesn’t disappear with a night’s rest could be an early signal of plantar fasciitis, a stress fracture, or even developing arthritis. While muscle soreness is normal, a sharp or specific ache in a joint or bone is a sign that a particular structure is under too much stress and needs attention.

Numbness and Tingling

A sudden tingling or numbness in your feet is often just a temporary nerve compression from sitting in an awkward position. But if you experience persistent or recurring sensations like pins and needles, or if your feet feel numb without an obvious cause, it’s a definite red flag.

These sensations can be an early sign of peripheral neuropathy, which is a common complication of diabetes. It can also be a symptom of a pinched nerve in your back, or a condition like tarsal tunnel syndrome in your ankle, where a nerve is being compressed. While these aren’t guarantees, it’s important to get them checked sooner rather than later.

Skin, Nail, and Hair Changes

If you notice your feet are consistently cool to the touch, or if the skin on your legs and feet appears unusually shiny, pale, or bluish, it could be a sign of Peripheral Artery Disease and poor circulation.

Similarly, thinning or hair loss on your toes, or toenails that are growing very slowly and have become brittle or discolored, can also be signs that your feet aren’t getting the healthy blood flow they need.

Uneven Shoe Wear

Take a look at the soles of your shoes. If one shoe is wearing down much faster than the other, or if a specific part of the sole is wearing down excessively, it’s a strong indicator of a gait abnormality. This means you might be walking in a way that puts abnormal stress on your feet. And no, not all walking issues are apparent! Biomechanical problems can be subtle, and they’re not just a shoe issue; they need correction, or else they can lead to secondary injuries.

Recurrent Ankle Instability

Believe it or not, that’s exactly what it’s called: chronic ankle instability. If you’ve had a bad ankle sprain in the past and always feel like you’re on the verge of another one, that’s a clear sign of chronic ankle instability. This isn’t just a weakness; it means the ligaments literally haven’t healed properly.

Consult with Board-certified podiatrist Dr. Naghmeh Lilly Khavari, a knowledgeable professional who is dedicated to her patients in Denton, Dallas, and Collin Counties. Dr. Khavari treats a wide range of conditions, from ingrown toenails to foot and ankle injuries. Call Carrollton Foot Center’s office (located in Carrollton, Texas) at (469)-998-3668 to schedule your first appointment today!

Someone performing shockwave therapy on a foot as a person is laying down

Debunking Common Myths About Shockwave Therapy

If you’ve been battling persistent foot or ankle pain that just won’t quit, you might have heard about Radial Pulse Shockwave Therapy. We at Carrollton Foot Center swear by it for the treatment of many foot and ankle conditions. But as with any innovative medical technology, there tend to be a lot of misconceptions. So in this article, we’re giving you our honest insight into how shockwave therapy actually works. What’s true and not true? Keep reading to find out.

Myth 1: RSWT is a Painful and Invasive Procedure

This is a common concern, but RSWT is actually a minimally invasive, in-office procedure. The treatment uses a small device to send harmless, low-energy waves to your skin. While patients typically feel a brief, quick pulsing or tapping sensation, the discomfort is generally well-tolerated and short-lived. There is no need for anesthesia, no incisions, and no downtime. You can walk out of the office and go on about your day.

Myth 2: RSWT is Just a “Freeze” Treatment or Basic Ultrasound

RSWT is completely different from cryotherapy and ultrasound. Cryotherapy relies on extreme cold to numb and reduce inflammation, whereas ultrasound uses sound waves to create heat deep within the tissues.

Shockwave therapy, however, uses radial pressure waves to stimulate a natural healing response in the body. How? By increasing blood circulation, breaking up scar tissue, and essentially resetting the healing process in chronic conditions that have stalled.

Myth 3: You Only Need One Session to Be Cured

Radial Pulse Shockwave Therapy is not a one-and-done solution. A series of treatments (typically 3-5 sessions, spaced a week apart) is standard protocol for most chronic conditions.

While you might feel some relief after the first session, the cumulative effect of the treatments is what truly drives long-term healing.

Myth 4: RSWT is Only for Heel Pain

While RSWT is known for fighting against plantar fasciitis, its use is much broader. In fact, it’s effective for various chronic soft tissue injuries like Achilles tendonitis, shin splints, and even pain from Morton’s neuroma. Any condition rooted in chronic inflammation, scar tissue, or poor blood flow can potentially benefit from RSWT.

Myth 5: RSWT is a Miracle Cure for Everyone

But despite this versatile range of conditions, shockwave therapy isn’t for everyone. Plus, no medical treatment can offer a 100% guarantee for every single patient. Its success depends on many factors, including your overall health, the severity and duration of your injury, and how well you follow post-treatment care.

Consult with Board-certified podiatrist Dr. Naghmeh Lilly Khavari, a knowledgeable professional who is dedicated to her patients in Denton, Dallas, and Collin Counties. Dr. Khavari treats a wide range of conditions, from ingrown toenails to foot and ankle injuries. Call Carrollton Foot Center’s office (located in Carrollton, Texas) at (469)-998-3668 to schedule your first appointment today!

5 Foot Conditions Alcohol Contributes To

While enjoying a drink or two might be a part of social gatherings, excessive alcohol consumption can have far-reaching consequences for the health of your feet and ankles. It’s National Alcohol Awareness Month, which means it’s time to realize that alcohol can interfere with various bodily functions and lead to a range of foot and ankle problems. Today, we at Carrollton Foot Center will unpack 5 of the most common, from causes to symptoms and further complications.

Alcohol’s Impact on Your Feet and Ankles

  1. Peripheral Neuropathy

Peripheral neuropathy can be significantly affected by excessive alcohol intake. Alcohol is a neurotoxin, meaning it can damage these nerves and impair their ability to send important signals.

This damage often manifests in the feet and ankles and gives you numbness, tingling, burning pain, and weakness. Reduced sensation in the feet can make it difficult to detect injuries, which increases the risk of unnoticed cuts, sores, and developing infections.

  1. Diabetes

That brings us to alcohol’s effects on diabetes. Not only does it disrupt blood sugar regulation and cause hyperglycemia and hypoglycemia, but alcohol is also a diuretic that causes dehydration. If you are a diabetic already prone to infection, excessive use can further increase your risk of dry, cracked skin.

Alcohol also weakens the immune system, making such infections harder to fight off, and contributes to weight gain that puts extra stress on your diabetes (which continues the vicious cycle).

  1. Gout

Gout (a form of inflammatory arthritis) is another condition heavily influenced by alcohol consumption. Essentially, alcohol interferes with the kidneys’ ability to effectively eliminate uric acid from the body. This buildup of crystals drives intense pain in the big toe joint (along with swelling, redness, and warmth).

Gout isn’t exclusive to the big toe, though. It can also affect other joints in the foot and ankle, causing unique discomfort and mobility issues.

  1. Swollen Ankles

Alcohol can impair the function of the liver and kidneys, both of which play crucial roles in regulating fluid balance in the body. When these organs are compromised, it can lead to fluid accumulation in the feet and ankles. This swelling can cause the feet and ankles to feel heavy, tight, and uncomfortable, potentially hindering movement.

  1. Injury

Beyond these specific conditions, studies show that excessive alcohol consumption significantly increases the risk of foot and ankle injuries. The impaired coordination, balance, and judgment can result in a variety of injuries, including sprains, fractures, and dislocations.

Consult with Board-certified podiatrist Dr. Naghmeh Lilly Khavari, a knowledgeable professional who is dedicated to her patients in Denton, Dallas, and Collins Counties. Dr. Khavari treats a wide range of conditions, from ingrown toenails to foot and ankle injuries. Call Carrollton Foot Center’s office (located in Carrollton, Texas) at (469)-998-3668 to schedule your first appointment today!

Haglund’s Deformity: Debunking the Bony Bump

What is that odd-looking bump near the back of your heel? It could be Haglund’s deformity, often referred to as “pump bump,” which is a bony enlargement located where the Achilles tendon attaches. This prominent bone can cause significant discomfort and irritation, especially when wearing shoes.

Luckily, we at Carrollton Foot Center are here to debunk the bony bump and offer expert insight into all things Haglund’s Deformity. Let’s take a look.

Causes of Haglund’s Deformity

While the exact cause is often unclear, several factors contribute to the development of Haglund’s Deformity. These include:

  • Foot structure: Individuals with high arches or flat feet may be more susceptible.
  • Shoe gear: Wearing shoes with rigid backs, such as high heels or tight-fitting footwear, can exacerbate the condition.
  • Overuse: Repetitive activities that put stress on the heel, like running or dancing, may contribute to the bony growth.
  • Achilles tendon tightness: A stiff Achilles tendon can pull on the heel bone, contributing to the deformity.

Symptoms of Haglund’s Deformity

Individuals with Haglund’s deformity often experience pain and inflammation at the back of the heel, which can worsen with shoe friction. The affected area may also become red, swollen, or blistered.

Prevention

While there’s no guaranteed way to prevent Haglund’s deformity, certain measures can help reduce the risk:

  • Proper footwear: Choose shoes that fit well and provide adequate cushioning. Avoid tight-fitting shoes or those with hard backs, and regularly replace worn out shoes.
  • Stretching exercises: Incorporate calf stretches into your daily routine to maintain flexibility.
  • Orthotics: Custom orthotics can help distribute pressure and alleviate discomfort.
  • Weight management: Maintaining a healthy weight can reduce overall stress on the foot and heel.

Treatment

Treatment for Haglund’s deformity focuses on pain relief and inflammation reduction. Non-surgical options include over-the-counter pain relievers, shoe modifications, and physical therapy. For severe cases, cortisone injections or surgery may be considered.

Depending on the severity of your bump, consult with your podiatrist to see which treatment option is the best for you.

Board-certified podiatrist Dr. Naghmeh Lilly Khavari is dedicated to her clients in Carrollton, TX. From ingrown toenails to innovative surgical solutions, she offers a vast array of treatments. Contact Carrollton Foot Center’s office at 469-998-3668 to book an appointment now!

Staying Safe at the Salon: 5 Pros and Cons of Pedicures

Many of us can benefit from an occasional pedicure’s ability to reduce inflammation, improve sensation in the feet, and promote healing. However, we at Carrollton Foot Center want you to know that pedicures can also be dangerous, especially for those with diabetes, peripheral neuropathy, and weakened immune systems.

In this article, we’ll weigh both sides of the bathtub, from improved circulation to possible infection, to help you determine if pedicures are right for you.

The Pros and Cons

Pro: Improved Circulation

The massage techniques used by nail technicians stimulate blood flow in the feet and ankles.

Con: Infection

This massaging effect may not stimulate sensation in diabetics or those with peripheral nerve damage, meaning they are still susceptible to wounds from pedicure techniques.

Pro: Early Detection

Trained pedicurists can identify signs of potential problems like calluses and ingrown toenails.

Con: Inexperience

Untrained technicians may not notice the signs of a problem that a podiatrist can, leaving you with a false sense of security and confidence in your feet.

Pro: Exfoliation and Skin Health

Pedicures remove dead skin layers that lead to dryness, roughness, and cracking.

Con: Cuts and Abrasions

Even minor nicks from tools or buffing the cuticle can become entry points for infection, especially for diabetics with decreased circulation.

Pro: Improved Toe Health

Regular trimming and filing during a pedicure helps maintain proper toenail shape and generally prevents ingrown toenails.

Con: Ingrown Toenails

However, improper and aggressive trimming techniques can increase the risk of ingrown toenails and fungal nail infections.

Pro: Maintaining Good Foot Hygiene

The soaking, cleansing, and drying process removes dirt, sweat, and bacteria that can accumulate on the feet.

Con: Harsh and Unsanitary Tools

Improperly sterilized tools can spread bacteria or fungus. Some salons may also use strong chemicals in foot soaks or polishes that can irritate the skin, leading to allergic reactions or rashes.

Consult with Board-certified podiatrist Dr. Naghmeh Lilly Khavari, an esteemed expert who is dedicated to her patients in Denton, Dallas, and Collins Counties. She helps with a wide breadth of issues, from ingrown toenails to diabetic neuropathy. Call Carrollton Foot Center’s office (located in Carrollton, Texas) at (469)-998-3668 to schedule your initial appointment today!

Hitting the Pavement Without the Pain: How Runners Can Conquer Heel Pain

Carrolton Foot Center is all in favor of regular running! It’s an incredibly beneficial form of exercise that delivers consistent benefits, boosting both physical and mental well-being. However, there’s no such thing as a free lunch, and running is no exception.

Heel pain and Achilles tendonitis are among the common costs runners must confront, and like any podiatric problem, they create serious stumbling blocks when left untreated. The blog below should help you stay fit, flexible, and focused on your goals.

Preventing Heel Pain with a Strong Foundation

You can keep heel pain from starting with some of these preventative measures.

  • Supportive Shoes: Invest in well-fitting running shoes with proper arch support and cushioning specifically designed for your running style. Replace them every 300-500 miles to maintain optimal shock absorption.
  • Stretch It Out: Regularly performing calf stretches and foot mobilizations helps maintain flexibility and range of motion, reducing stress on the heel.
  • Gradual Progression: Don’t jump into high mileage or intense training too quickly. Gradually increase distance and intensity to allow your body to adapt and strengthen.
  • Cross-Training: Mix up your routine with low-impact activities like swimming or cycling to provide recovery periods for your heels.

Managing Heel Pain: When Prevention Isn’t Enough

Sometimes, you’ll need to handle pain that’s already present, and RICE (Rest, Ice, Compression, and Elevation) isn’t always enough.

  • Custom Orthotics: Podiatrists can create custom orthotic inserts that address your specific biomechanical imbalances, providing targeted support and pressure relief to prevent conditions like plantar fasciitis and overpronation.
  • Pain Relief Options: Over-the-counter pain relievers can help manage discomfort.

Treating Persistent Heel Pain: Advanced Strategies

If pain persists despite conservative measures, your podiatrist may recommend:

  • Leneva® Fat Pad Injections: These injections replenish lost cushioning in the heel pad, promoting pain relief and tissue healing, which is particularly helpful for plantar fasciitis.

Board-certified podiatrist Dr. Naghmeh Lilly Khavari is committed to helping patients in Carrollton, TX. With advanced treatment methods, she offers assistance with everything from ingrown toenails to sophisticated surgical solutions. Contact Carrollton Foot Center’s office at 469-998-3668 to schedule an appointment today!

How Certain Foods Affect Arthritis Symptoms

We all know how closely related our diets are to our physical and mental health, but one connection that’s frequently overlooked is the relationship between our food choices and our foot health. In honor of National Nutrition Month, Dr. Khavari of Carrollton Foot Center, PLLC, wants to bring our feet into the equation, exploring a very common foot condition that is greatly affected by what’s on our plates – arthritis.

What is Arthritis?

Arthritis is the swelling of one or more joints, and with 33 joints in the foot, there’s plenty of room for arthritis to develop. Arthritis in the feet can manifest in various forms, all of which result in joint discomfort and limited mobility.

The Impact of Poor Nutrition:

Inflammatory Foods

Consuming a diet rich in inflammatory foods can cause inflammation in the body. Processed foods, sugary snacks, and excessive red meat intake are known to trigger inflammation, intensifying arthritis symptoms in the feet.

Lack of Antioxidants

Antioxidants play a crucial role in neutralizing free radicals, which can contribute to joint damage. A deficiency in antioxidants found in fruits, vegetables, and nuts may leave the joints vulnerable to oxidative stress, worsening arthritis symptoms. Anti-inflammatory foods, such as fatty fish, leafy greens, berries, and nuts, can help reduce inflammation and alleviate arthritis symptoms in the feet.

Omega-6 Fatty Acids Imbalance

An imbalance between omega-6 and omega-3 fatty acids can promote inflammation. Diets high in processed oils and fried foods, which are abundant in omega-6 fatty acids, need to be balanced out with omega-3 to maintain joint health. Incorporating sources of omega-3, such as flaxseeds, chia seeds, and fatty fish, while minimizing the consumption of processed oils and fried foods is key!

Vitamin and Mineral Deficiencies

Inadequate intake of essential vitamins and minerals can contribute to weakened bones and joints. This deficiency may lead to an increased risk of arthritis, particularly osteoarthritis in the feet. Make sure to incorporate enough vitamin D, calcium, and antioxidants into your diet to support joint health.

Making informed dietary choices is essential in alleviating arthritis pain and discomfort. Board-certified podiatrist Dr. Khavari in Carrollton, TX, is committed to helping her clients prioritize their foot health so they can feel their best. Contact our office at 469-998-3668 to schedule an appointment!

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