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Archive for November, 2012

Infertility and Calling in Sick

By Tracey Minella

November 30th, 2012 at 12:15 pm

Today is “Stay at Home Because You’re Well” Day. My first reaction to this was negative.

And it hasn’t changed.

Don’t get me wrong. I’ve certainly played my shared of hooky and I’m not generally such a downer about other people’s wanton irresponsibility, but I know where my negative feelings come from.

The infertility years.

I clearly remember obsessively managing my sick, personal, and vacation days during the seven years I struggled with infertility. Rationing them like they were last morsels of food I had to get me through the winter in Siberia. I didn’t even think twice about coming in to work sick. As long as I could squeak a weak breath through one nostril, and walk reasonably upright, I was there. Fever of 103? Bring it on. (Notice I didn’t say I was particularly popular for my choices.)

Was it my goal to become “Employee of the Month”? No. But I did have another goal in sight at all times…the next IVF cycle.

How can I manipulate the cycle to wrap it around a holiday weekend so I could take advantage of the few days the office was closed? I’d sit with the calendar in hand, jotting down all the possibilities of how the cycle should, could, might play out…trying to figure out when the retrieval would likely happen and what days I should put in for having off. Of course, I couldn’t wait for the hCG shot call, when the rest of the cycle’s important dates would finally be revealed.

Oh how glorious it was when it all worked out. Unfortunately, that wasn’t often.

That’s where the vanishing vacation days came into play. Giving up those rare blocks of time to do a cycle was infuriating… especially when Fertile Myrtle in the next cubicle was complaining she needed the same week to take her tribe to Disney. The only thing worse was when something unplanned happened to throw the cycle off…adding the stress of trying to adjust or trade back the vacation time last minute without telling the boss why.

This “sick day dance” is something you may never forget, even after your infertility journey ends. There may always be a strange feeling about calling in sick when you are well. Maybe it’s just a momentary hesitation that you can’t even put your finger on. After years of this pattern of sacrifice, it took a while for me to realize I could actually use one of those days off just for me…without having to shave my legs and wear a paper gown!

So, to show solidarity for all our patients who get stuck working on all the holidays “because you don’t have kids” or who choose to do so to earn overtime to finance their treatment, or who sacrifice their days off all year long for their treatment, let’s boycott this “Stay at Home Because You’re Well” Day.

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Do you save your days off for your fertility treatments? If so, do you have any stories or tips to share?


Photo credit: Peter Kratochvil




“Attention. This is Your Captain Speaking…”

By David Kreiner MD

November 29th, 2012 at 6:18 pm

“Scuza,scuza , Signore e signori we are experiencing technical difficulties…”

While I sit uncomfortably detained aboard an Al Italia jet on the tarmac at the Sicilian airport waiting for the mechanics to determine if they can repair the mechanical troubles, my mind drifts to the plight my patients experience while they go through their fertility treatments.

Frustrated, with no control over my situation I reflected upon what it must feel like for my patients who must place their trust in people more experienced than them who routinely deal with those issues that are so significantly impacting them.

Like my pilots and their support staff, the fertility doctors, nurses and their staff have dealt with problems identical to or extremely similar to the ones my patients face on a daily basis. As such I felt that I should trust that the pilots and maintenance staff would only proceed with the flight once they were assured the problem was satisfactorily repaired and that the plane was safe.

However, I figured that if we were to be delayed for takeoff that I could take out my iPad and make myself more comfortable during the wait. Immediately, I heard from the flight attendant, in angry Italian, scolding me to turn off my electronics.  Actually, I did not understand but several other passengers quickly added in English to shut off my iPad.   Did I not hear the prior instruction to turn off the electronics?

I did not understand the reasoning behind this as we were obviously delayed for takeoff. I was frustrated with my lack of control and understanding.  I would have felt more comfortable if I understood what was going on and even better if I were able to participate in the process in some way.

I am sure that my patients must also have this great desire to understand and obtain some control.  I believe that many do… often by gaining more knowledge on the subject through the Internet, our orientation sessions, and directly through questioning the doctors and nurses.

The fact was for me I had no knowledge of our problem with the plane and was therefore utterly helpless other than to offer my complete cooperation.  My patients on the other hand do have opportunities to attain some control and an ability to assist on their own behalf achieving their goal of a pregnancy.

What can patients do to improve their success?

Listening carefully to instructions and following them religiously such as obtaining and administering medications, regarding dosages and times is essential.  It is important to their ultimate success if they arrive to monitoring visits, retrievals and transfers at stated times.  Patients’ responses to medications vary over time and are considered when their doctors interpret their hormone levels.  The egg matures over the course of time passed from the hCG shot but if this time is extended too long a patient may ovulate before the retrieval is performed and the egg is lost.

How else can patients improve their outcome?

Studies have shown that stress reduction through support groups, mind body programs, massage and especially acupuncture improve success rates essentially by improving a body’s ability to respond in a healthy fashion to the fertility process.

As my reflections on the unique ability of my patients to impact their fertility were now complete and committed to paper (my iPad safely turned off and stowed away), over an hour later we finally pulled away from the gate and safely took flight.  One hour later we landed in Rome, excited to move on to the next leg of our trip. I thought as I reflected on my successful journey how I wished for my patients to be as successful in theirs.

Yet as we are about to deplane, I hear “Signore e signori I am very sorry…” the pilot announced that the bus transportation to the gate had not yet arrived and it would be another short while.

“I apologize for the inconvenience”.  Yes, this is very familiar.

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How does your infertility journey make you feel out of control or like a traveler in a foreign land?

Photo credit: drummond

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Answer the Call…Make the Call

By Tracey Minella

November 27th, 2012 at 4:06 pm

Would over $13,000 for IVF help you build your family? How about fund an adoption? It’s within your grasp. But only if you act now.

Join RESOLVE’s “Call to Congress” campaign …today through Thursday… and help get the Family Act enacted and the Adoption Tax Credit expanded and made permanent.

By calling your representatives and using the step-by-step instructions and script provided by RESOLVE, you can make your dream of having a family through IVF or adoption, that much closer to a reality by removing a large financial obstacle. The proposed legislation also offers assistance for the costs of fertility preservation in patients facing cancer, so the loss of affected reproductive organs (or the effects of chemotherapy) will not rob them of their ability to have a biological child once their cancer crisis has passed.

This three day movement, organized by RESOLVE, has been strategically planned to make a noticeable impact on legislators nationwide. Fertility advocates across the entire country are mobilizing forces to join in the effort to get the Family Act passed and the Adoption Tax Credit expanded and made permanent. Fertility patients everywhere, current or former, are being asked to speak up and be heard.

Does this sound like a battle? Well, it is! Will you answer the call…and make the call?

Please click here for more information about this ground-breaking legislation and for easy access links to help you show your support: Then make the calls…today through Thursday. Thanks.


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After you make the call, please tell us here (or on Facebook) that you did it! Please share this information with whomever you are comfortable sharing it with. Together we can make a difference.

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Exciting Long Island IVF Study Seeks to Prove that PGD/PGS Improves Pregnancy Rates in Older Women

By Eva Schenkman, M.S., C.L.T., T.S.

November 26th, 2012 at 12:49 pm

credit: Dream designs/

With advancing maternal age more embryos have chromosome abnormalities, from 60% in women younger than 35 to 80% in women 40 and older. This results in embryos failing to implant, pregnancy loss (miscarriage), or affected babies (i.e. Down’s syndrome). Because of that, more than one embryo is usually transferred during IVF. However, if two or more normal embryos implant, twins or triplets may result, which may result in a higher risk of congenital abnormalities, premature birth, and developmental problems.

A technique called PGD/PGS (preimplantation genetic diagnosis/screening) can detect if embryos are normal for chromosomes and may prevent the above problems.

In order to take advantage of this cutting edge technology, a woman must undergo in vitro fertilization (IVF), so her embryos may be examined. Embryos produced after IVF can be tested for the correct number of chromosomes through PGD/PGS.  During this process, a biopsy is performed on embryos on day 3, 5 or 6 of development, by inserting a small needle and withdrawing a few cells. Preliminary studies have shown that the biopsy does not harm the subsequent development of the embryo.

The biopsied cells are sent to a genetics laboratory, Reprogenetics, for rapid PGD/PGS testing using array CGH, a technique that allows for the analysis of all chromosomes, while the embryos remain in the IVF laboratory. PGD results are available in less than 24 hours, and an embryo classified by PGD/PGS as normal, can be transferred back to the woman’s uterus the next day. Extra embryos can be cryopreserved for future attempts at pregnancy.

Most studies performed to date have shown an improvement in pregnancy outcome when PGD/PGS is performed using array CGH.  Yet, so far, only one study (Yang et al. 2012*) has been performed with the utmost scientific rigor, that is, by blindly assigning patients at random to either a control group (no PGD) or to a PGD group.

This study was performed in young patients and showed that PGD significantly improved pregnancy rates even though only one embryo was transferred per woman. However, the same study has not yet been done for older patients (35 and older). In theory, older patients should benefit equally or more than younger ones since they produce more abnormal embryos.

We are excited to report that Long Island IVF has partnered with Reprogenetics and is currently recruiting patients for a study that will determine if this PGD approach is also beneficial for women 35 and older.  

If you are eligible you will be randomly assigned to either a control group (regular IVF and no PGD) or to a PGD group. The cost for PGD will be free. If you are assigned to the control group, have a transfer as a study participant, and do not become pregnant you will be offered PGD for free in your next IVF cycle. Eligibility depends on several factors which are determined at various stages of the IVF process, including the age of the woman (35 or older), having normal ovarian reserve, and producing 3 or more blastocyst embryos by day 5 of development. The PGD group will have only one normal embryo transferred while the control group will have up to two untested embryos transferred.

For more information, including the study’s complete eligibility guidelines and medically-qualifying criteria, contact: Eva Schenkman, MS, CLT, TS Senior Embryologist at Long Island IVF at 631-881-5337 or email at  

*[Yang et al, Molecular Cytogenetics. 2012, 5:24] 

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Does the potential of PDG to significantly improve pregnancy rates in older women make this technology something you’d consider using?

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Black Friday and Infertility

By Tracey Minella

November 23rd, 2012 at 7:15 pm

Of course the true die-hard Black Friday shoppers will not see this until tomorrow. They will be camping out in parking lots all night after stuffing their faces on Thanksgiving, waiting for the pre-dawn opening of stores for the Christmas shopping season’s official commencement. Some may even have ventured out to the few stores opening on Thanksgiving night this year. Good luck and be safe, oh brave ones!


Has infertility affected your holiday shopping?


Do you do the Black Friday thing because the cost of infertility treatment requires you to take advantage of those holiday shopping bargains? Are you cutting back or cutting out gifts because of treatment costs? Do you avoid toy stores when buying for kids because it’s too hard?


Maybe you’re out there enjoying it all! Or at least maybe giving to others helps distract you from the gift you most want to receive.


Well, if you’re the “One for them, one for me” kind of shopper (like me!), consider treating yourself… or an infertile friend… to one (or more) of the books that were nominated or have won RESOLVE’s  Night of Hope Best Book Awards*. Here are a few of past winners/nominees (or just great infertility books!):


  • Pam Tsigdinos (Silent Sorority)
  • Kristen Magnacca (Love and Infertility)
  • Tertia Albertyn (So Close)
  • Liz Falker (Infertility Survival Handbook)
  • Dr. Alice Domar (Conquering Infertility)
  • Helen Adrianne (On Fertile Ground)


These selections include entertaining, educational, and inspirational books to remind you that you are not alone on this journey. Let us know if you’ve read any of these infertility books and which one(s) you liked best.


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Do you have any tips for others on how to make the most of their holiday shopping, or how to get through it for those who are struggling?


What Black Friday bargain was your proudest score of the day?


*According to RESOLVE, “The Hope Award for Best Book is given to an author who has written and published a book that covers one or more of the following topics: coping with infertility, choosing a family building option, mind/body techniques as it relates to infertility or personal relationships and infertility.”


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Infertile at Thanksgiving

By Tracey Minella

November 22nd, 2012 at 8:00 am

credit: imagerymajestic/

There are a few things you can count on each Thanksgiving. Turkey and stuffing. Football. The Macy’s parade. March of the Wooden Soldiers.

And if you’re infertile… the insensitive relative with the big mouth. Seems like every family has one. Mine sure does.

I remember one gathering in particular. First of all, we were knowingly TTC and had recently failed at IVF. As if that wasn’t enough of a reason to walk on egg shells around us, a cousin walked in with her new IVF twins. As the family gathered ‘round to “ooo” and “ahhh”, I put on “the smile” and held back the tears. That’s when it happened.

The Mouth” (a mom of two girls, mind you) bellowed: “I’d NEVER spend $10,000.00 to have a baby!”  Yep, she is always good for a jaw dropper. Spending Thanksgiving with her is as enjoyable as sitting with a wishbone wedged in your throat all night.

I also remember feeling like we weren’t really a “family” because we didn’t have children yet. We were a “couple”. I made a distinction when I shouldn’t have. And in retrospect, that feeling made Thanksgiving harder each year.

I wish someone pointed out to me back then that a couple is a family. I may have rolled my eyes at them, but if they persisted I may have felt better.

So I am telling you now that when a couple comes together to fight infertility, they get a benefit they don’t usually recognize until after their infertility journey is over. They find they’ve built a rock solid foundation upon which to build… as their family grows from a couple to something larger than that. Trust me on that one.

So remember that when “The Mouth” roars today and you want to dunk her head in the gravy boat.

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Please share the most annoying things people have said about your infertility…or their easy fertility…around the holiday table.


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Trying to Conceive with Fibroids

By David Kreiner MD

November 19th, 2012 at 8:05 pm

credit: wiki free public domain

Fertility is dependent upon so many things!

We must have healthy gametes (eggs and sperm) capable of fertilizing and implanting in a uterus with a normal endometrial lining unimpeded by any uterine or endometrial pathology. The sperm need be in sufficient number and capable of swimming up through a cervix which is not inflamed and provides a mucous medium that promotes sperm motility. The eggs need to ovulate and be picked up by normal healthy fimbriated ends (finger like projections) of the fallopian tubes. The tubes need to be covered with normal micro hairs called cilia that help transport the egg one third of the way down the tube where one of the sperm will fertilize it.

The united egg and sperm (the “conceptus”) then needs to undergo cell division, growth and development as it traverses the tube and makes its way to the uterine cavity by the embryo’s fifth day of life at which point it is a blastocyst. The blastocyst hatches out of its shell (“zona pellucidum”) and implants into the endometrial lining requiring adequate blood flow.

And you wonder why getting pregnant is so hard?

All too often patients, in some groups as many as 30% of women, are told that they have fibroids that may be contributing to their infertility. Fibroids or leiomyomata are non malignant smooth muscle tumors of the uterus. They can vary in number, size and location in the uterus including; the outside facing the pelvic cavity (subserosal), the inside facing the uterine cavity (submucosal) and in between inside the uterine wall (intramural). Fortunately, most fibroids have minimal or no effect on fertility and may be ignored.

The subserosal myoma will rarely cause fertility issues. If it were distorting the tubo- ovarian anatomy so that eggs could not get picked up by the fimbria then it can cause infertility. Otherwise, the subserosal fibroid does not cause problems conceiving.

Occasionally, an intramural myoma may obstruct adequate blood flow to the endometrial lining. The likelihood of this being significant increases with the number and size of the fibroids. The more space occupied by the fibroids, the greater the likelihood of intruding on blood vessels traveling to the endometrium. Diminished blood flow to the uterine lining can prevent implantation or increase the risk of miscarriage. Surgery may be recommended when it is feared that the number and size of fibroids is great enough to have such an impact.
However, it is the submucosal myoma, inside the uterine cavity, that can irritate the endometrium and have the greatest effect on the implanting embryo.

To determine if your fertility is being hindered by these growths you may have a hydrosonogram. A hydrosonogram is a procedure where your doctor or a radiologist injects water through your cervix while performing a transvaginal ultrasound of your uterus. On the ultrasound, the water shows up as black against a white endometrial border. A defect in the smooth edges of the uterine cavity caused by an endometrial polyp or fibroid may be easily seen.

Submucosal as well as intramural myomata can also cause abnormal vaginal bleeding and occasionally cramping. Intramural myomata will usually cause heavy but regular menses that can create fairly severe anemias. Submucosal myomata can cause bleeding throughout the cycle.

Though these submucosal fibroids are almost always benign they need to be removed to allow implantation. A submucosal myoma may be removed by hysteroscopy through cutting, chopping or vaporizing the tissue. A hysteroscopy is performed vaginally, while a patient is asleep under anesthesia. A scope is placed through the cervix into the uterus in order to look inside the uterine cavity. This procedure can be performed as an outpatient in an ambulatory or office based surgery unit. The risk of bleeding, infection or injury to the uterus or pelvic organs is small.

Resection of the submucosal myoma can be difficult especially when the fibroid is large and can sometimes take longer than is safe to be performed in a single procedure. It is not uncommon that when the fibroid is large, it will take multiple procedures in order to remove the fibroid in its entirety. It will be necessary to repeat the hydrosonogram after the fibroid resection to make sure the cavity is satisfactory for implantation.

The good news is, when no other causes of infertility are found, removal of a submucosal fibroid is often successful in allowing conception to occur naturally or at least with assisted reproduction.

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Anyone have a fibroid story to share?

Photo credit: public domain:


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Long Island IVF Supports the Family Act

By Tracey Minella

November 18th, 2012 at 11:37 am

credit: photostock/

Thanksgiving is over and the December holidays are coming fast. Think back on the beauty of that Thanksgiving feast. More than any other holiday Thanksgiving is a celebration of families, pure and simple.

Just being together as a family, sharing a meal of thankfulness.

But for people suffering from infertility, it can be hard to celebrate anything. It can be hard to feel thankful for the good things when the ache for a child is so overwhelming. For some, Thanksgiving was just the beginning of a long month of painful holiday events which remind them of the families they don’t yet have.

But there is something that can be done to help the 1 in 8 couples suffering from infertility to have their families. It’s called the Family Act. And it needs your immediate attention and support.

Right now important legislation is pending in both the Senate and the House that seeks to provide over $13,000.00 in tax credit assistance to cover the medical costs associated with in vitro fertilization (IVF) for people suffering from infertility.

It also can be used for fertility preservation for patients facing cancer.

Please click on this link for a short, easy-to-read summary of the benefits of this important legislation. Then act on the easy instructions for how to contact your representatives to show your support. All the contact information and links are provided, including the words to use when making contact.

You wouldn’t be reading this if infertility hadn’t touched your life in some way. You are either suffering from infertility yourself, previously suffered from it, or know someone who is. We all know someone, even if they haven’t shared their secret pain.

We’ve never been so close to mandating IVF infertility medical assistance through a tax credit before now. But we need your help.

Please act. And please share this information and ask others to act on it. Talk about this at your holiday tables.

We need to be heard. Now. Please check our website and The Fertility Daily blog for information on how you and your family and friends can make a real difference in the passage of this legislation by attending Long Island IVF’s and RESOLVE’s big Town Hall Event on December 18, 2012!

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What have or will you do to support the Family Act?

Image courtesy of free digital

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Linking Traumatic Stress of Infertility and Hurricane Sandy

By Bina Benisch, MS, RN

November 15th, 2012 at 6:40 pm

credit: david castillo dominici/

If you’ve been struggling to conceive unsuccessfully, you know what it is to experience feelings of loss of control over your life and your body.  We live in a society which teaches us if we take the right steps, follow our dream, or do the work, we will produce the desired result. While it is true that our lives evolve and grow based on our attempts to attain certain goals, our true sense of safety and security is based on the most fundamental of needs being met.  These needs, for most of us, have been taken for granted: shelter, food, water, plumbing, heat, as well as the freedom to choose the way in which we spend our days.

In the same way, the lifelong vision that so many of us hold as we grow into adulthood – marriage and creating a family, are long held expectations that we take for granted. When we are suddenly faced with a new reality – that conception may not come as expected – our world, our life, as we had envisioned it, feels completely shaken to the core.  This is experienced as an emotional loss of the vision and identity we’ve known.

Now compound the feelings of emotional loss, and loss of control due to infertility with having lived through a hurricane of disaster proportions. Experiencing the loss of our very basic sense of safety due to flooding, loss of electricity, and natural wreckage of neighborhoods, has left many of us completely bereft — through experiencing at least a glimmer of our true vulnerability and lack of control. Even if we were not affected as seriously as others, this heightened sense of vulnerability produces a chronic underlying emotional trauma, as we grapple for ways to challenge or change the current reality and create a sense of emotional or physical stability. This trauma is manifested by physiological stress due to a chronic and persistent anxiety reaction. In turn, this stress causes changes in the body which may cause illness in the long run, as well as interfere with the ability to conceive.

How do you manage this anxiety? What can you do to help cope with this stress?

At Long Island IVF, we provide stress management and emotional support as part of our Mind Body Program in small group sessions for women, as well as a separate support group just for men.

Some tips for alleviating anxiety:


  • Cultivate breath awareness for 10 to 20 minutes by focusing on your inhalation and exhalation, as well as the nanosecond pause between each.
  • Allow your in-breath to be deep, and your out-breath to be slow and a touch longer than the in-breath.
  • Focusing on those things you DO have control over at this time – such as preparation and tasks toward your goals – can reinforce your sense of empowerment while, at the same time, allowing you to let go of the attachment to control those matters which are not in your control.
  • Creating distractions through leisure activities, writing, reading, art, music, games, social activities, or any number of ways, can be healthy coping skills which help us to decrease physical anxiety and quiet the anxious mind.

For more information on our Mind Body Program and support, please contact Bina Benisch, M.S., R.N. or call 631-397-0096.




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Finding Gratitude on Infertility Road

By Tracey Minella

November 13th, 2012 at 6:53 pm


Infertility brings a range of very raw and powerful emotions. Palpable anger and resentment, for example. Yet, when the battle is won… as it often is… and the baby that seemed unattainable is finally in hand, the feelings of gratitude are even more intense. You may want to hug and thank every person even remotely connected to your happy outcome.

As an IVF patient, I felt these emotions myself. As an IVF medical assistant, I witnessed countless patients trying to express their extreme gratitude in a number of different ways. How do you thank someone for making you a parent? What gesture could you possibly make in return?

So when Thanksgiving is around the corner, I always become extra focused on what I have to be thankful for, like many people do. And it’s harder to do when you’re still on your journey and your heart aches.

During my own very long journey, part of what kept me sane was happily imagining what I was going to do to thank everyone once I finally got pregnant. I witnessed luncheons and presents being offered in thanks to the IVF doctors and staff. Of course they were deeply appreciated, but they really weren’t necessary… except for the complete happiness they brought to the patient. Everyone loves what they do here because they are part of something amazing. They are helping to build families. Can you think of a more fulfilling job?

Yet the need to express gratitude can be powerful. Want to know the simple truth? Nothing beats a handwritten note. It lasts forever and can be enjoyed over and over. It can bring comfort and focus after a trying day.

Yes the personal thank-you note wields the greatest power…and of course, the referral of friends and family who are TTC. That’s the ultimate compliment.

So as Thanksgiving approaches, whether you have completed your journey or are still progressing, ask yourself: Is there someone you’d like to thank for helping you along your journey? A particularly helpful doctor or nurse or staff member? How about a friend or family member with a strong shoulder? Maybe even someone whose head you rip off on a regular basis or who you take for granted? Consider sending a note from the heart. You will both feel better.

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Too busy to write a note? How about a shout out right here? Let the world know who has been your hero.

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