Got stress? The answer to that question should undoubtedly be yes, no matter whether you feel “stressed out” or not. What you may not realize is that when stress is left unchecked, it can have long-term negative consequences. Do you realize how stress affects digestion and why even if you’re eating the best diet possible, you still may not feel well?
When you’ve got digestive issues, stress levels must be addressed even if you think you can handle everything that’s coming your way. The American Psychological Association found in a 2012 survey that only 37% of respondents believe that they’ve got their stress levels well-managed. For the rest of us, we are either struggling with stress or unable to realistically acknowledge the extent of stress. The reality is that if excessive stress is left unchecked, it will impact your digestive system as well as pretty much every other system in your body (CLICK HERE to see a neat graphic). Even your adrenals will take a hit so much so that the constant release of cortisol, a stress hormone, can lead to elevated blood sugar and insulin resistance.
Today’s podcast is one that’s near and dear to my heart because of how much I strongly believe in stress reduction for those with chronic digestive issues. Some of the techniques shared within are what I have used (and still do) to keep high levels of stress from affecting me. When you’ve finished listening or reading, please leave a comment and share how stress impacts your life and digestion as well as any steps you’ve taken to successfully mitigate it.
CLICK HERE to listen and subscribe through iTunes!!!
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How Stress Affects Digestion with Eva Selhub, MD
Jennifer: Welcome back to the Gluten Free School Podcast. I’m your host, Jennifer Fugo. Today, we’re going to talk about stress and how stress impacts not just your health as far as mentally, but how it also impacts your health from a physiologic standpoint, what it can do to you and how you can start to take back the reigns and deal with stress on a physical, emotional and spiritual basis.
I have a really interesting guest with me today. I’m actually quite excited to speak with her because she’s the first guest that I’ve ever had on the podcast that is dealing specifically with this topic. Her name is Dr. Eva Selhub. She’s a clinical associate in medicine at the Massachusetts General Hospital and the Benson-Henry Institute for Mind Body Medicine. She also has an appointment at Harvard Medical School.
Board-certified in internal medicine and specializing in integrative medicine, Dr. Selhub has a practice of treating and coaching her clients to be resilient, balanced and healthy in every aspect of their lives, physically, emotionally and spiritually.
As a transformation and resiliency consultant and speaker, Dr. Selhub lectures throughout the world and acts as a consultant to help individuals transform their health and their lives for the better. Dr. Selhub is the author of The Love Response, co-author of Your Brain on Nature and her newest book, Change Your Health Destiny. She has been published in medical journals and featured in national publications including the New York Times, USA Today, Self, Shape, Fitness and Journal of Women’s Health and has appeared on radio and television in connection with her work, including the Dr. Oz Show.
Welcome to the Podcast, Dr. Selhub!
Eva Selhub: Thank you! Thank you for having me.
Jennifer: Why don’t you start off by telling us how you became so interested in stress?
Eva Selhub: I had stress. I’m laughing about it, but it is true! I think most people can relate to this notion that we don’t actually search for meaning unless we’re suffering. We don’t look for something new unless something’s broken. And so yes, that’s really what stress does. Stress motivates change, and as we’ll talk further, we’ll help the audience understand why stress isn’t necessarily bad. In fact, for the most part, it’s necessary and good.
But my own life, I was in residency (I was doing an internal medicine residency), which is three years long. I was at the end of my second year when I was stuck with a needle stick, an HIV needle stick. And basically, it was a very, very bad exposure that required that I take cocktail medications to prevent from converting into HIV. And this is back in 1996 when really, people died from this horrible disease. And there was really nothing you could do.
It’s scary and I got quite sick from taking the medications for six weeks. So between being physically ill for the first time, seriously physically ill for the first time in my 28 years at the time, being mentally distressed and really assessing my life, I thought, “What are you doing with your life? And is this what you really want to do?” I did my bargaining with God, that sort of thing.
But to just make a long story short – and this is all in my book. In The Love Response, I talk about my story. But basically I said, “There’s something more that I need to learn.” I can’t just treat people allopathically the way western medicine does. It’s not enough and it doesn’t have all of the answers. I don’t want to just help people when they’re at their end of their life. I want to figure out what to do before they get there.
And that’s what brought me to the Mind Body Medical Institute with Henry Benson, which is now actually called the Henry-Benson Institute for Mind Body Medicine. I started volunteering and learning. I’ve started learning about mind body medicine. I started learning about stress and about what it had to do with health and illness.
Within a year of actually volunteering, they asked me to be the medical director. As the medical director, they asked me to lecture about stress and stress physiology, which I had really had to know well.
So I started looking at all the literature and research and then I started applying the information clinically. Basically I was practicing translational research meaning that I was translating the research into reality and looking at the patterns, what’s really going on, how does this relate to everyday life, how does this relate to the mind body approach. And that’s really how it all came to be for me to actually develop this expertise and true understanding of how the whole system works, and why stress, in many ways, is good, and when it’s not utilized correctly, it can harm you.
Jennifer: Stress is one of the largest reasons why a patient or anyone listening might end up at a doctor. We know that stress is connected to so many inflammatory diseases and all sorts of other health concerns. But I think we throw the word stress around assuming that we know what it is, but maybe we don’t. Could you define stress for us, so that we actually have a better understanding of what it is?
Eva Selhub: Absolutely! And that’s a really, really good question. The bottom line is that stress is actually a term in physics. It simply implies that a system is under duress of some kind or another.
What you want to think about is the notion that a human being is actually a living, breathing system and a human being lives in a living, breathing system which is our earth and our universe. It’s constantly changing, constantly breathing, expanding and contracting, constantly changing.
For a human being to be able to survive in a constantly changing system, it needs to change as well. And for any living organism, you need to have some type of alerting system that says it’s time to change.
When the weather changes, your alert system in your body lets you know that it is cold outside. Without it, you would go outside without putting on something warm and you would freeze to death. It’s not conducive for survival of the species not to have an alerting system that lets you know when change is necessary.
Anytime that there is a change in the system, or what’s called a challenge to the balance of the system, it’s called stress. When you feel cold, that’s stress. When your blood sugar drops and you get hungry, that’s stress. When you’re uncomfortable the way you’re sitting, that’s stress. And that stress then propagates an action, a corrective action.
So if you’re uncomfortable, you shift positions. You correct the problem and now you’re back in balance again.
Every living organism desires to be in balance, which in scientific term is called homeostasis and our attempt to achieve that balance through change is allostasis.
We are in constant allostasis because homeostasis would mean that you’re not moving and nothing’s changing. You’ll never be able to actually stay in that forever. But you can be in allostasis which is discomfort or stress, making a change, getting back into comfort, staying there for a while, then discomfort and stress, making a change and so on and so forth. That’s how we exist.
Since the day you’re conceived, you’re born with an ability to take care this. Every cell of your body has a signaling system that aligns itself with the stress response, which is an automatic and unconscious response, then it initiates these physiological changes that will then initiate the brain, making an executive decision to make an action that will correct the problem.
You have this ability since the day you were born to, what we call, self-regulate. Your blood vessels can change according to the temperature. But to do much about it as an infant, you really can’t because you don’t have much of a brain and you don’t have much coordination. As an infant, you’re being taken care of. You don’t even have to label hungry, you just don’t feel good and you cry. And somebody comes and fixes it.
Over the course of your life, your brain, your body, your cells develop a database of information of how to take care of stress, what to do when you’re hungry, what to do when you’re tired, what to do when you need to go up the stairs, what to do when you have discomfort in a certain position. Because you don’t want to have to think about everything for the first time, it goes into a database so that it can become automatic, so that you can automatically handle a given stress as you go through your day.
Now, there are certain stresses that you can never learn how to manage or you just simply can’t. And those become what’s called unmanageable stressors which are what you think about when you think about stress. Those are the ones that cause anxiety or cause pain or cause the stress response, which is that physiologic response to continue firing. That physiological response is controlled by stress hormones like adrenaline and cortisol, and when they fire, they cause a persistence in the firing of the stress response like an increased heart rate, increased blood pressure, increased muscle tension, worsening of the digestive system functioning, slowing down of metabolism, et cetera, et cetera.
If that stress response fires too long or too fast or too hard, that’s when pathological problems arise and when the system starts breaking down and losing its balance.
Stress itself isn’t bad. It’s stress that is our warning signal that lets us know it’s time to change. It’s our inability to actually know what those signals are that cause issues because we don’t know to pay to attention to our body signals. People, instead of resting when they’re tired, drink caffeine. We ignore those signals of fatigue. That stress response is going to continue firing. Or we put chemicals in the body that causes the stress response to fire, or we don’t sleep which causes the stress response to fire, and so on and so forth.
And if these stressors are not taken care of, then the system goes out of balance and now, we’re going into the bad stress. That’s why when I lecture, one of the titles is Use Stress So That It Doesn’t Use You.
Basically, if you don’t learn to pay attention to these signals and utilize them accordingly, stress can actually take over and make you sick.
Jennifer: What’s interesting that you say all of this because it sounds like we went from, “Well, stress is good, but too much of it becomes a problem.” It’s almost this deluge of any one thing – you know what they say, moderation in life. That’s okay. Anything in life, we can handle in moderate amounts. But when you start eating sugar all day long, when you stop eating the proper foods, when you’re not sleeping enough at night, and this goes on chronically, it builds up and all of a sudden, you find yourself two, three, four years down the road not feeling like you think you should.
Eva Selhub: Well, yes. Exactly. But I like to use the analogy of a car. If you never use a car, it’ll just die out from misuse. You actually have to use the car so it knows how to work, and it continues to work, and it gets better because it is being worked. But it also needs time for rest. You can’t drive your car all the time. It needs maintenance, it needs oil changes, and it needs good oil put in it so that it can last a really long time.
The physical body isn’t really very different. We need a certain amount of stress to learn how to be more resilient. This whole idea of not being exposed to any bacteria is not a good thing because your body needs exposure to bacteria in order to learn how to be resilient to it. But to be overexposed to it and then have a body that’s so tired that it can’t handle it, now that’s not a good thing.
It is about that balance.
Jennifer: Here’s another question for you because again, we’ve used that word resilient. You’ve said it several times here. What exactly is resilience?
Eva Selhub: You know what? You’re great. I love these questions. The best way to think about resilience is bounce back. What is your bounce back quotient? It’s not about not being exposed to stress because as long as you’re human and you live on earth, you will experience stress.
Nature just lets a forest fire burn as a flower blooms. It’s not personal, it’s just going to happen. The question is, how do you manage? Do you believe you have the resources to handle adversity and uncertainty come what may? That is resilience. That means, “Yes, I might fall down but I can get back up.” “Yes, I might get exposed to the flu and I might even get sick for a little while but I’ll bounce back. It’s not going to get me. I’ll bounce back.”
So it’s about bounce back – how you do after you’re hit with something.
Jennifer: If a person or a woman who’s confronted with this whole digestive system, autoimmunity deluge, they’ve got to go to the doctors. They are trying to figure out what is wrong with them. They have no idea. They’re having trouble eating. They get sick to their stomach. That is all stressful, right? All of that circle that we seem to go in. Is there something missing in the entire process of us trying to figure out what’s wrong with our health? When we’re going to these medical appointments and dealing with practitioners that might not actually be looking for the root cause of a problem, do you feel that, in a sense, patients are –I don’t necessarily want to say justified, but there is a reasonable conclusion that one could draw that the process of trying to figure things out creates an excess amount of stress in that individual that could actually exacerbate their condition?
Eva Selhub: Well, again, yes. Think about the definition of stress. There are two kinds of stress. That’s it. There’s the stress you believe you can manage and the stress you believe you cannot manage. The stress you believe you can manage will offset a stress response that is well-controlled and short-lived so that you just manage whatever you need to manage. It rounds everything up to help you take care of whatever you need to take care of.
A stress that you perceive you cannot manage, aka. a worry or it could be the body that perceives it can’t manage, or just a constant toxin or constant inflammation or what have you or an illness, that stress response will continue firing which causes more and more of a load. We call it an allostatic load on the system.
Yes, you can remove that load. You can stop worrying and allow and believe in the body’s natural capacity to heal itself. You could rest more. You could do an elimination diet where you’re actually not exposing the body to toxins for a while and just giving it a rest. But the constant worry and the constant attachment to an end solution is invariably a stress you believe you cannot manage. In that case, it’s actually adding to that load.
Jennifer: You mentioned nutrition. How exactly do you believe that your food could then play a role in stress? And now before you answer that, I’ve mentioned several times on different podcasts since I’ve certainly talked to several different psychiatrists and whatnot about the relationship between gluten and mental health and whatnot. But for my entire life, I’ve had obsessive compulsive disorder. And for a period of time in my 20s, granted I was eating horribly. I was in college and my favorite food was anything with gluten in it, for sure.
Eva Selhub: You and every other teenager or college student.
Jennifer: Yes, and I became incredibly depressed. I suffered with a lot of anxiety. I even was placed on antidepressants. One of the highest loads that they could give someone for Prozac, and I just became more and more depressed, never really helped things.
In changing my diet after I hit rock bottom, I started to feel more in control of my life. I got my creativity back because that was lost in the process. I began to find joy in relationships again. And I don’t personally have any proof that those are connected, but I would love for you to speak directly to moms, sisters, and even girlfriends who are listening to this and they know somebody or maybe they themselves, who doesn’t feel well. They feel bombarded by stress, and yet, they’re watching either themselves or someone else eat an unhealthy, processed diet. Is there a connection between the food that you eat and the amount of stress that you may feel in your mind and your body?
Eva Selhub: Well, again, let’s go back to physiology. The majority of immune cells are actually in your gut, not the rest of your body. And one of the more important things to understand about the stress response and how the brain and the body communicate with one another is through the nervous system. That’s how they send signals back and forth, or the by neurotransmitters, through the hormonal system or the endocrine system, and through the inflammatory system. These little particles that are going back and forth are actually little messengers, and they message each other, just like we message each other on the phone. Your brain and all of the cells of your body message each other through neurotransmitters, hormones, and immune cells.
The majority of your serotonin comes from your gut, and the majority of your immune cells come from your gut. In other words, there’s a little brain inside of your gut. It’s what we call the second brain. And so it’s speaking up what’s happening in your environment as much as your brain is. And it’s signaling your brain constantly.
And it’s very, very, very much connected. There’s a huge connection with the gut and the mind when it comes to mental health. Huge. Not only because of toxins like gluten which can affect what’s happening in a signaling system, but more than that is the ecosystem. The friendly bacteria that are supposed to live in the gut are dealing with all of the stress that we incur and the antibiotics we take and the food that we ingest which ultimately destroys these natural bacteria that are meant to help you digest, metabolize and eliminate and sends happy signals to your brain that you’re okay.
And without them, that ability to stay happy and health actually will be deterred. And we have very good research to quantify and qualify that.
Yes, there is a very, very strong relationship between a poor diet and poor mental health. Not only because of these bacteria, but also because processed foods and foods high in sugar may raise serotonin and dopamine shortly, but then they also cause a change in the insulin, and the insulin dropping and changing cause all kinds of serotonin and dopamine changes as well.
Again, there’s a whole feedback loop that’s happening with the hormones and the immune system, as well as the neurotransmitters that affects people negatively when they eat poorly, not to mention that processed and junk food is extremely void of nutrients, and you need those nutrients like magnesium and thiamin and other amino acids to actually make your hormones and make your neurotransmitters and give the energy to yourselves to function.
It’s a very complex physiology but there’s an absolute connection between your ability to concentrate, your ability to thrive, your ability to be happy, and what’s happening in your gut.
Jennifer: If your body is really bombarded by stress, it’s going to affect the cells and no wonder that you then feel this overwhelming sense of dread, maybe throughout your day, in your relationships. Many times when women and men and even children have gone gluten free because they need to be. they start to feel very disconnected from their community. They feel like they’re weird, they’re singled out at the table, they don’t like to go out anymore, they start to lose their social life and they begin to feel very alone.
You mentioned at one point this idea that having a community, it’s important to feel like a part of the group because feeling like you belong is so important. Is that a stressor for people, feeling they don’t belong?
Eva Selhub: Absolutely. That’s a huge part of the stressor. I write a lot about that in the Love Response, which is about social, spiritual and self-love. We’re social beings. Our ancestors lived in the wilderness. There is no way that we could have survived on our own. We have this hormone called oxytocin that allows us to bond and reproduce and survive and to feel good. And when we’re socially isolated, it’s a huge, huge stress. And it definitely affects the ability to feel resilient because if you don’t feel that you’re supported by another, you’re not going to feel that you have this much capability to handle adversity.
So it is very important to feel like you belong. I have many different techniques and exercises that I write about in all my books about helping people feel that way. And one of them is something as simple as just being out in nature.
But it is very important. I went through this myself when I became a Crossfitter and I went pretty much strictly Paleo. The rest of my family and friends outside of my Crossfit gym weren’t like that. And definitely, I called them the diet saboteurs and how not to fall prey to them and to really hold your ground because you’re doing something because it feels good.
And I think what the most important message here is it’s about learning how to reconnect with people outside of food, not having food be the reason that you feel like you belong or connect with people, but being connected to them because you love them or because you have other things in common, and that you support yourself to eat in a healthy way, not because it’s a fad and it’s not about, “You do this and I don’t.”
When you’re healthy, it makes people oftentimes feel badly about themselves. So you have to understand it really has nothing to do with you and have compassion for them. And once you’re able to do that, that sense of not belonging can actually be alleviated.
Jennifer: I agree with that. When I was initially diagnosed with gluten sensitivity and I started telling family members and friends, I’ve got some very interesting reactions. Some people were supportive, a lot of people were confused, and some, especially my family, which was most surprising, were very negative, and felt like for some reason there needed to be a confrontation because somehow it threatened their diet even though it had nothing to do with them.
Eva Selhub: Exactly.
Jennifer: So I understand what it’s like to feel different and I know that in the beginning of one’s journey, making any major lifestyle or diet change can cause stress. And like you said, having compassion is a great way to approach those conversations so that you don’t get stuck in a cycle of feeling like a victim to it and just avoiding people all together.
Now, I wanted to talk about some tools that people could use in order to start alleviating stress. And I personally love breathing exercises. I don’t know how you feel about those but have you ever made any suggestions to some of your patients to give some breathing exercises a try?
Eva Selhub: I have stuff on my own. I have YouTube videos I’ve made. I have produced many, many guided meditation CDs. So that is definitely something that I do. And I actually have a very, very simple exercise. And essentially, it’s what you want to do, especially anytime you start feeling threatened, stressed, or upset for any reason, or even if your body just feels unwell. What you want to do is take a deep breath in and focus on your heart. Count to three as you breathe in and then, as you breathe out, you’re actually going to count to five. You allow that exhalation to be longer than the inhalation. And that’s going to signal that stress response to calm down.
Normally, when you’re under stress, your body will automatically move into very rapid and shallow breathing. By extending that exhalation, you’re actually not only not going to be air trapping, but any air that has gotten trapped from shallow breathing will actually get released which will then send a physiological signal to your brain and your body that you are about to go to relaxation and that you’re okay.
And then what I also do is I will start throwing in some words of comfort. So for instance, you might say, “I breathe in the feeling of gratitude,” or ,”I breathe in the feeling of expansiveness, the feeling of love, the feeling of compassion.”
So whatever it is you actually would like to feel, you say that to yourself. You breathe in and you embody the feeling of whatever it is you really actually want to feel, and then as you breathe out, you say, “I’m letting go of the” feeling of whatever it is I’m feeling. Maybe you’re feeling resentment, maybe you’re feeling fear, maybe you’re just feeling stressed.
That way that’s encouraging the mind and the body to go along with those statements as you breathe in and out. It’s a very simple exercise and you don’t have to do it very long to feel good.
Jennifer: And for somebody who wants to give this a try, is it okay for them to use this multiple times a day? Say they have a stressful commute to work, they’ve got a difficult boss, 24/7. You can do this breathing.
For people that are looking for proof that activities like meditation or breathing exercises actually work… In your experience and all of your training, have you found or come across information that shows that when you commit to doing this, you absolutely can reduce your stress in 30 days or 60 days or a year from now. If you kept up this habit, this new habit, it would help you feel better?
Eva Selhub: This is Dr. Benson’s research which he’s been doing this since 1969. There’s tons of research on this now. This is a burgeoning field in the past 10 years, tons and tons. It’s basically about finding a mediation practice that you like, but really 10 to 20 minutes a day will have a carryover effect like any pill in your system. It just gets stronger and stronger and reduces your body’s reactivity to stress, reduces your brain’s reactivity to stress, or able to cope more effectively, reduces your symptoms, reduces inflammation.
Dr. Benson’s recent research even looks that it might even change how genes can express themselves for the better. Yes, there’s absolutely evidence… scientific evidence that this is worth it.
Jennifer: That’s wonderful to hear and I’m glad that you’re able to share that with people because I know personally that breathing exercises work and it’s great when you can personally share something. But sometimes you have, every once in a while, those women that are like, “I really need to know. Does this really work? Does science say that it works? Can science get behind it?” And it does.
And so I wanted to talk for a moment about why you wrote your book, Your Health Destiny.
Eva Selhub: Well, it’s an interesting thing because I do love to write. And the first book was a work – when I started delving into the world outside of allopathic medicine and learning more about spirituality and meditation and stress and all that sort of thing. And then this book is really a combination of all my work for 20 years. It’s really what I do in my practice, what I do when I coach people. And it’s to help people understand that you’re not a label and you haven’t been given a label, that you have the ability to move beyond anything.
Some of us have more wiggle room than others. Yes, some people are born with a genetic malformation and they don’t have a lot of wiggle room, but they have some to create change. We all are living, breathing systems that are constantly changing and you have the ability to change for the better.
This is a combination of my 20 years of work of helping clients and patients alike to shift and change. I have seen amazing, miraculous changes over the course of 20 years. And I wanted to create something or write something that gave this knowledge to everybody and put it together this concept of bringing allopathic western medicine together with wisdom traditions or eastern medicine and putting it together in a format that’s accessible to everybody.
Jennifer: You also have a really great website. If the folks listening go and check you out, what will they find there?
Eva Selhub: Ooh, lots and lots. I’ve just updated it, so it’s really awesome. It’s DrSelhub.com. There are a lot of different things there, a lot of information about me and ways to contact me. Of course, you can sign up for a wonderful newsletter and we send out wonderful information and articles all the time. It also tells you where to find other articles that might be written or videos that I’m doing or events that I’m appearing at.
And coaching. If you want to sign up to do coaching with me, which we have all different kinds of packages for that. I do work with people all over the world. Right now, I have a person in Australia and a person in Hong Kong. Those are my farthest.
Jennifer: And for someone who wants to dip their toe into the stream of breathing exercises and meditation, they can also find some audios or videos on your website as well?
Eva Selhub: That’s right, on my website and also YouTube. And also, if you follow me on Facebook and Twitter, we’re always posting that stuff there as well.
Jennifer: Great! I look forward to sharing them and I’ll put the links below the transcript of this podcast. This has been a very good refresher in understanding how stress affects digestion and the entire body. For many of us, we’re dealing with these chronic stress issues and yet, we figure somehow when we get better, maybe the stress will go away. In reality, we should be taking little steps every day, almost as if you’re taking your life back in 10-minute chunks.
Eva Selhub: I want to point out something that’s very important and what you’re saying is absolutely true. And it’s a big point that I think people need to understand, and this is where the coaching comes in and working with other healers or experts… because it’s hard to do this on your own. If you’re more than 15 or 20 years old, your brain actually is not even fully developed until you’re 25, but your programming, how you see yourself in a larger context with this world, “Am I enough? Do I have enough? Am I resilient enough?” that’s already been formed by the time you’re 20.
And what drives your behaviors and what drives the way you handle stress is actually really, really old stuff and old beliefs. If you don’t address the underlying beliefs and your underlying motivations and what drives you to begin with, these deep-seated wounds, then the stress will actually continue.
A lot of people’s physical problems don’t just show up. They are pre-existing issues of energetic, psychological, emotional components from way, way back when you were a kid that’s actually showing up in your body now. That’s actually what Your Health Destiny writes about and teaches people how to go into the body and heal old stuff.
Jennifer: Wow. I’m really glad that we were able to have you come on and we can all start digging into that. So thank you so much for joining us! I appreciate you being here.
Eva Selhub: Thank you so much for having me. It’s been fun.
Jennifer: Remember, please go check out and stay in touch Dr. Selhub at her website. She’s got an amazing newsletter, her new book is called Change Your Health Destiny. I’ll put a link to that book and all of her social media links below.
And I’d really appreciate if you’ve been listening to the podcast for a long while, you love what you hear here, please subscribe, rate and review this podcast over on iTunes, and then head over to Gluten Free School, leave your questions and comments about this. I also have quite a bit of experience with meditation and breathing exercise and I’d be happy to answer any of your questions. And thank you guys for listening. I love having you all here and I wish you a wonderful day. I’ll see you the next time. Bye!
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