• The FEM SEM

    by Meredith Nathan, Director of Massage at Pulling Down the Moon, LMT
    Fertility massage is a cutting edge field, with far-reaching benefits that are still being explored.  At Pulling Down the Moon®, we’ve developed researched-informed and results-oriented techniques for working with the body after seeing thousands of fertility clients for over fifteen years. Our award winning, nationally recognized FEM Protocol™ is a five-part series using massage and related techniques to enhance the health and functioning of the pelvic and abdominal organs, and to promote the client’s mental, emotional, and physical well-being.
    The five parts of the protocol focus on cleansing and detoxification, enhancing reproductive circulation, oxygenating the pelvic organs, encouraging pelvic alignment and combating stress. Benefits may include:
    * promoting egg quality by improving the follicular environment and increasing it’s supply of oxygen-rich blood
    * lowering hormone disruption through stress management and clearing lymphatic congestion (a common storehouse for excess hormones and toxins)
    * supporting uterine lining and alignment through melting abdominal scar tissue, clearing circulatory pathways, and releasing structural tension patterns
    * encouraging relaxation and an overall sense of well-being during your fertility journey
    Learn more about why this protocol has caught the attention of the American Massage Therapy Association, the National Certification Board for Therapeutic Massage & Bodywork, and thousands of patients-turned-parents at The FEM SEM, a seminar geared towards helping you understand if The Fertility Enhancing Massage Protocol could assist your fertility journey.  The replay of the free webinar is available here.

  • How PDtM’s Online YFF Works

    By Beth Heller MS RYT, co-founder of Pulling Down the Moon and Online YFF instructor

    Much more than a typical yoga class, this six-week Yoga for Fertility program, created by Pulling Down the Moon, helps students develop skills to manage the stress and anxiety of fertility treatment, as well as learn a yoga posture practice that promotes blood flow, supports hormonal balance through stress reduction and calms and relaxes the nervous system.  Two separate clinical studies have shown this study to reduce fertility patients’ anxiety by more than 20% over the course of six weeks, for both online and in-person groups!   We are also following our study groups to see whether yoga has impact on conception rates.

    Unlike heated, vigorous vinyasa and power yoga classes, Yoga for Fertility is safe during medicated fertility treatment.  Click here to register for class starting 9/23!

    Online Class Format

    Our online class uses a webinar format to replicate the group interaction and discussion portion of the class and uses Pulling Down the Moon’s Fully Fertile Yoga Companion videos to direct your individual home practice.  In addition, participants are provided with links to different practices, including our Moon Salutes, Hip and Heart Opening, Hormonal Regulation/Digestion Practice and Mood Elevating Practice.  The goal is practice 3-4 times per week on their own.

    While you may initially shy away from the discussion part of the class, it may be this point of connection (which in yoga we call sangha) that creates the greatest shift in our body and mind.  Research suggests that women have an additional defense against stressors, called the “tend and befriend” response.  What this means is that in addition to the fight, flight or response to stress, women who seek out female companionship during times of stress may activate another defense against stress that helps to physically induce relaxation.

    Why Yoga for Fertility?  

    *Yoga balances the nervous system. Unlike intense, high impact cardiovascular exercise, which places considerable strain on the body, yoga uses deep breathing, mindful movement and unique stretches to stimulate the body’s relaxation response.

    *Yoga massages and stimulates our internal organs, promoting blood flow and oxygenation. Unlike exercises like weight lifting, cycling and running, which direct blood into the large skeletal muscles and are largely two-dimensional, yoga uses subtle multi-dimensional movements like twists and folds, inversions and backbends. This gentle action stretches and massages internal tissues and organs, promoting not only blood flow but the movement of lymph.

    *Yoga trains your “letting go muscles.” Women in the thick of their fertility need tools to manage stress and anxiety in the here and now. Learning to hold a challenging standing pose or sensation-filled stretch, while staying calm and breathing deeply, is rehearsal for staying calm in stressful life situations.

    *Yoga for Fertility classes create “sangha,” the yoga word for a like-minded and supportive community. Everyone on the fertility journey needs a positive environment and a place they can go to feel safe and understood. Struggling to conceive can turn a woman’s social network upside down. With girlfriends on the mommy-track, family get-togethers feeling like minefields, and ordinary interactions can become excruciatingly painful, our Yoga for Fertility class creates a safe haven – and most women don’t realize how much they needed one until they join a group!

    Try Online YFF and another service to save in September with the You Pick Two promotion!  Call us if you have any questions about this class, promotion, or scheduling at: 312-321-0004 today!

     

  • The Other Half: Male Factor Infertility

    By Christine Davis LAc, MSOM

    At Pulling Down the Moon, we primarily treat women’s fertility concerns. Sure, we can treat just about everything: allergies, digestive problems, pain, stress … you name it. Mostly, though, we see women who want to get pregnant and have a baby. We help reduce the impact of stress on her life, we work on regulating her cycle or combating the side effects of IVF meds, and even women who are trying to conceive still have headaches and back pain and allergies. We help her body be in it’s very best condition to be able to grow new life in her belly. But there’s one thing we don’t see very often, a critical missing element, an equally important part of the equation to creating that new life: Men!

    Acupuncture and Chinese Medicine is a 5,000 year old tradition. Embedded within this long history is a strong theory and framework for treatment of fertility concerns. We are fantastic at helping to resolve known fertility concerns for both men and women. So, why are only women coming in to see us? This problem goes deep and it’s one that may continue to grow based on recent assessment of global infertility rates. A recent study of sperm analysis from 1973-2011 showed 50-60% decline in male fertility rates suggesting that by 2060, most men in the US and Europe could be infertile. And here’s the scariest part: scientists don’t know why (or at least they can’t agree on it).

    Much has been written about why there is such a dearth of information and focus on male infertility. Many men see even the suggestion that there may be something “wrong” with their side of the court as an attack on their manhood. They see it as an insinuation that they are somehow less virile, less capable, less manly. Just think of the language we use to describe a man who we consider manly: “He’s got big balls!” “Balls of Steel” or unmanly: “Don’t be a girl.” This isn’t just a generational thing. Historically, much of the research and treatment of infertility has focused squarely on the female.

    So, what can we do? Let’s start talking about it! Ladies, bring research to your partners/husbands. Get evaluated by a Urologist who focuses on fertility or a Reproductive Endocrinologist. If there are identifiable issues, consider an appropriate course of action. If you are in the “unexplained” camp, there are other things you can do to support male fertility including taking CoQ10, a multi vitamin, and possibly additional selenium (ask your doctor first before beginning a new supplement). Come experience Fertility Enhancing Massage at Pulling Down the Moon.

    Acupuncture has been shown to be more effective than Western medicine in improving sperm quality and quantity. Regular acupuncture treatment (once per week, generally), helps to reduce stress, eliminate pain throughout the body, and achieve wellness by balancing the body. It has been my experience that couples who both receive regular acupuncture see so much benefit and often achieve pregnancy sooner. The needles are teeny tiny and are placed mainly on the arms and legs, never in sensitive areas (none near the genitalia). The first visit takes about an hour or so because we go through a very thorough consultation of medical history and questions about symptoms. Follow ups can be performed in 45 min or less.

    We have to open this conversation up if we are going to find a way to resolve it. Women are currently doing so much to become pregnant – thousands of shots, thousands of doctor visits, emotional stress, fielding the comments about why you’re not pregnant yet. Men, please get involved (if you are not already!). Talk with each other about your goals, fears, desires, and plans about growing your family. Seek the help if you need it. We must keep the doors open to conversation to finding solutions to this growing problem.

    Learn more about Acupuncture and schedule your consultation today!

  • Nutrients for Thyroid Support

    Nutrients for Thyroid Support

    By Margaret Eich, MS, RDN

    Did you know there a number of nutrients required for your thyroid to function properly? At Pulling Down the Moon, we’re interested in helping you ensure your thyroid is functioning optimally, because thyroid health is integral to fertility. Here are some of the key nutrients to focus on to support thyroid health:

    Iodine is an essential mineral for thyroid hormone production, and 30% of women of childbearing age are iodine deficient. A recent study also noted that women with sub-optimal iodine levels had reduced fertility. The American Academy of Pediatrics recommends women who are pregnant take a prenatal vitamin with 150 mcg iodine. To learn more about the impact of iodine on fertility, read this post . Food sources of iodine include seafood, seaweed, meat, eggs, dairy, grains, and iodized salt.

    Selenium is another essential mineral required for the conversion of T4 to T3. T3 is the active form of thyroid hormone. In addition, a few studies have shown that supplementation with selenium reduced the levels of antibodies in people with Hashimoto’s thyroiditis, an autoimmune cause of hypothyroidism. Food sources of selenium include Brazil nuts, meat, and seafood.

    Iron is also essential for thyroid hormone production. Iron requirements for women of childbearing age are quite high at 18 mg and even higher at 27 mg during pregnancy. Given iron needs are so high, it’s not that difficult for iron stores to become depleted, especially if you are a vegetarian or vegan, because iron isn’t as well-absorbed from plant sources as from animal sources. In addition, heavy periods can make it more likely that your iron stores become depleted. Food sources of iron include meat, poultry, fish, legumes, leafy greens, whole grains, nuts, and seeds.

    It can be difficult to make sure you’re getting enough of these nutrients on a daily basis, thus it’s important to take a prenatal vitamin while trying to conceive and during pregnanct that covers your bases. The Pulling Down the Moon prenatal vitamins ( Supplement Pack while trying to conceive and the Prenatal Pack once pregnant) contain 175 mcg iodine, 200 mcg selenium, and 30 mg of iron to help support your thyroid along with a healthy diet.

    Looking for more ways to support your thyroid with nutrition? Make a nutrition appointment today!

  • Finding Your Ground on Mother’s Day

    By Cassie Harrison

    Depending on where you are in motherhood journey, Mothers Day can raise a dichotomy of emotions. Those of us who find ourselves lost in thought on this day or for any of us who want to spend less time in our heads, finding a yoga practice that focuses on grounding your root chakra, muladhara, will take you out of your head and guide you to reconnect with the earth and find peace from within. When this chakra or energy center is open and flowing freely we feel connected to something greater than ourselves, more secure and well… grounded.

    Now that spring finally feels like spring (thank you, Chicago weather!) you can take your practice outside and get down and grounded with the earth. Little else will ground you as fast as standing barefoot on the ground; no mat, no shoes, and a fresh pedicure. Do not despair if this is not an option, a quiet location inside will do just fine, but consider removing your mat, aka barrier between you and the earth. This practice need not be difficult, look for asanas that keep your feet or bum (it is right next to your root chakra after all!) secure on the ground.

    Try the following – Sukasana (easy pose). Upavistha Konasana (wide angle seated forward bend). Tadasana (mountain). Virabradasana (warrior) I and II. Prasarita Padottanasana (wide angle forward bend). During your practice focus on the points that are contact with the ground, this will help you feel a deeper connection to it. Now breathe… Obvious right? Not really, our attachments to our devices or need to be in control tends to leave our minds tight from took much thinking. Finding your breath is the quickest way to send the all clear signal to the brain and the body will quickly follow suit. Try not to fly though your yoga practice and instead slow down and be mindful of each posture, holding each for several breaths; focusing on being calm and steady, soon you will begin to take on those qualities. Making this practice a daily practice will have long lasting effects.

    I hope your feet land on the ground this Mother’s Day. Let us take care of you this holiday with special events just for you including a FREE yoga class in Chicago or virtual wine sip webinar. New yoga classes are also available!

    Namaste.

  • Does Iodine Deficiency Reduce Fertility?

    By Margaret Eich, MS, RDN

    A recent study, the first of its kind, investigated the impact of iodine deficiency on fertility. Iodine isn’t a nutrient that you hear very much about, but it’s essential for proper thyroid function. The thyroid is the master regulator in the body, governing metabolism in all the body’s cells. In addition, during pregnancy, adequate iodine is essential for baby’s brain development. About 30% of women of childbearing age (who aren’t pregnant) aren’t getting enough iodine. This study measured levels of iodine in the urine of more than 450 women as they were starting to try to conceive and looked at how long it took these women to conceive. (Iodine in the urine is considered to be reflective of the iodine status of the body.)

    The results: A whopping 44% of women had iodine levels below sufficiency and 23% where moderately or severely iodine deficient. Women who were moderately or severely iodine deficient were 46% less likely to get pregnant per cycle than when with sufficient iodine levels. This is a striking result and definitely points to a need to ensure you’re getting enough iodine while trying to conceive. Iodine deficiency may cause your thyroid to not function optimally, which impairs fertility.

    Iodine is in a variety of foods including seafood, seaweed, meat, eggs, dairy, grains, and iodized salt. Vegetarians and vegans are most at risk for iodine deficiency. The American Academy of Pediatrics recommends women who are pregnant and breastfeeding take a prenatal vitamin with 150 mcg iodine in order prevent iodine deficiency. Both Pulling Down the Moon prenatal vitamins contain 175 mcg of iodine, so either would be a great choice to ensure adequate iodine intake. It’s important to note that certain types of seaweed are very high in iodine, and people with Hashimoto’s thyroiditis should avoid high iodine intake, as it may make Hashimoto’s worse.

    Are you wondering if you’re getting enough iodine and other nutrients in your diet to support optimal fertility? Book an appointment today with one of our nutritionists.

    Reference: Mills JL, et al. Delayed conception in women with low urinary iodine concentrations: a population-based prospective cohort study. Human Reproduction. 33(3): 426-433.

  • Yes, You should eliminate the “shoulds” when trying to get pregnant.

    Here’s how.

    When we decide it is time to get pregnant, there’s no shortage of information of how to go about it. And if it takes longer than expected, or we run into a medical diagnosis that puts us into the infertility category, the list just grows.

    On one hand, this can be helpful. There are lots of avenues and resources to get you to baby.

    On the other hand, the list can be overwhelming, conflicting, and stressful.

    Maybe you’ve been there. I know I was, and when most of my clients first come to me they have feelings of exhaustion, disappointment, and failure.

    Have you found yourself saying or thinking any of these?:

    • “I am doing everything “right,” but nothing seems to be working.”
    • “It didn’t work because I ate or drank <insert “bad for fertility” food or drink here>. I feel so guilty.”
    • “I spent hours last night researching and now I’m more confused than ever.”

    When we lose track of the big vision of parenthood and who we are in our pursuit to pregnancy, we begin to micromanage ourselves and our process. We start to live in a place of constant questioning and unknown. We keep doing and going and checking boxes in the hope that one of them might be the ONE thing that will unlock a successful pregnancy.

    Take heart, sister. There is a better way.

    You can find the combination of tactics, support, resources, and treatments that work for you. You will know when you’ve found it because it will feel empowering, not stressful. You will feel energized, not depleted. Your plan will give you hope and purpose, not leave you feeling empty.

    Sound good? Here’s an exercise I do with my clients to identify which aspects of their fertility plans truly help them – and which ones they are doing simply because they feel they “should.”

    You will need a pen, at least 3 sheets of paper, and a highlighter, marker, or pen with a different ink color than your main writing tool. (If you’d like a template, download it here .)

    (1) Write it all down:

    On your first sheet of paper, make a list of everything you are doing, have tried, or are considering trying to do to conceive. Be very honest with yourself about the true purpose or intent behind all of your actions. If there’s a little bit of you that thinks/hopes/prays that a particular action will help you become pregnant – write it down. It counts.

    Score each of the items on your list (scale of 1 – 10) on how empowered, energized, and hopeful it makes you feel.

    (2) Identify your mama values:

    Imagine yourself as a mother. What lessons do you most want to teach your child? What values do you hope to share? What do you need in order to become her? Not just the physical parts, but the emotional and spiritual needs, too. In a separate list, write down a few words that describe the mother you want to be.

    (3) Categorize:

    Create a chart with three columns: Mind, Body, Heart. Categorize all of your activities from your first list according to which element they fill up for you. You can have activities that fit into more than one column.

    Next, review the list of words or values describing the mother you wish to be. Circle the activities that most help you fulfill this wish.

    (4) Evaluate:

    Look at each column. Which seem off balance? What might you be able to put down or pick up in order to bring more eveness to the three elements: Mind, Body, Heart (or Spirit)?

    Then, review where your highest scoring tasks fall. If you add up the scores in each column, are they roughly the same? Do you have a column that is low? High? Do you have several low scoring tasks or a few really high ones? What do you make of this?

    How many activities are circled, indicating they align with your values for motherhood? How can those be enhanced or prioritized?

    (5) Make a plan:

    Based on your evaluation, which new way of looking at your plan makes the most sense for you – aiming for balance between mind/body/heart; by “score” of which make you feel most empowered and hopeful; or alignment with your motherhood values? Perhaps they all line up similarly to paint a clear picture. If not, that’s ok. Choose the organization method that seems most appealing and comfortable for right now.

    Identify 1 – 2 adjustments you can make right now that will help shift your plan into the new alignment. Commit to them for a short period of time (1 – 2 weeks is great). Resist the urge to change more than a couple of things right away.

    6) Revisit and adjust as needed:

    Keep your lists and check in with yourself at the end of your trial period to see how you’re feeling. Go through your new list and give yourself a score between 1 – 10 of how empowered, energized, and hopeful you feel because of each activity in your plan. Compare your new score to the scores you gave yourself at the beginning of the exercise. How have things changed?

    If you aren’t yet feeling more energized, hopeful, or in control, review your chart again and see what else can be tweaked. If you chose one organization method – balance, values, or score, consider looking at your chart from a different one. Ask yourself if you are holding on to some “shoulds”. How can you let them go?

    This may be an ongoing exercise, but if you stick with it and stay true to what is really serving you, it will help make your path easier. If you feel stuck, ask a partner, friend, coach, or practitioner for their input.

    Yes, infertility is stressful. Yes, you can do many, many, things to improve your fertility and reduce stress. I encourage you to consciously evaluate all you are doing. Give yourself the gift of a plan that empowers, energizes, and fills you with hope.

    Erin McDaniel is a six-time IVF “survivor” and now mom to two boys. As a fertility coach, she helps women improve their fertility process by identifying and reducing stress points, creating balanced fertility plans, and implementing positive mindset strategies. To learn more, visit MyFertilityCoach.com .

    Get proven strategies to improve your fertility journey with the Fresh Start Program from My Fertility Coach. An 8-week course, the Fresh Start Program focuses on key aspects of your fertility experience with group discussion and support to transform your family building experience. The group dynamic will connect you with women in a similar situation and give you the opportunity to build relationships, camaraderie, and support. Pulling Down the Moon readers get $30 off enrollment; use offer code PDTM30. Learn more and apply to join here. https://myfertilitycoach.co m/fresh-start

  • Focus on Nutrient Density to Optimize Your Fertility Diet

    By Margaret Eich, MS, RDN

    Did you know that there are a variety of vitamin and minerals that may impact your fertility? Our bodies require 27 vitamins and minerals to function properly. These vitamins and minerals are involved in a wide variety of processes in our bodies including breaking down our food for energy, allowing cells to communicate with each other, contracting our muscles, as well as bone and skin health. Specific nutrients may also impact fertility and pregnancy, including folate (important for DNA integrity), iodine (essential for thyroid hormone production), and vitamin D (thought to be involved in embryo implantation), just to name a few!

    It can feel overwhelming to make sure you’re getting enough of these nutrients on a daily basis. Instead of trying to track how much you’re getting of each nutrient, it’s helpful to focus on eating a nutrient dense diet. Nutrient density refers to the concentration of vitamins and minerals per calorie of food. In order to maximize the nutrient density of your diet, start by focusing on these tips:

    Eat whole, real, and minimally processed foods.

    Limit refined grains and added sugars.

    Maximize your vegetable intake by including at least 5 servings of vegetables per day. Work on including a variety of different vegetables. Does 5 servings per day seem too daunting? Start where you are, and set a goal of increasing your vegetable intake by 1 serving per day.

    Include especially nutrient dense foods like leafy green vegetables, cruciferous vegetables, berries, and nuts and seeds.

    Would you like to dig deeper and make sure you’re meeting your daily nutrient needs? Are you a vegetarian or vegan, or do you have other food intolerances or allergies that mean you’ve had to eliminate foods or food groups? Schedule a nutrition appointment today to ensure that you’re meeting your daily vitamin and mineral needs to maximize your fertility. Try our FREE special event for National Infertility Awareness Spring Cleaning: Using Yoga and Nutrition to Cleanse !

  • Better Egg Quality and Follicular Development: Acupuncture Can Help

    by Dr. Amie Shimmel

    In honor of National Infertility Awareness month we at Pulling Down the Moon like to remind patients how acupuncture can help with better eggs and follicles.

    Here’s how it works:

    Medical research shows that acupuncture can influence hormone secretion from the pituitary hypothalamus and ovaries, collectively called the (HPO) axis. One of the most recent studies was conducted at Georgetown University Medical Center, July 2015; they found that acupuncture balances this HPO axis.

    When an acupuncture needle is inserted into a specific acupuncture point this triggers the release of prostaglandins and opioid peptides into the bloodstream which lead to the production of a substance that transmits messages to the hypothalamus and pituitary and then transmits to the ovaries.

    The acupuncture normalizes the secretion of the hormones such as (GrRH), (FSH), and (LH). This improves ovarian function creating more follicles and better egg quality.

    The (HPO) Hypothalamus pituitary ovarian axis can be disrupted by stress, poor diet, age, etc. However this (HPO) axis can be positively influenced by many things, especially acupuncture.

    The bottom line; women’s follicles and egg development can be enhanced by the balance of the endocrine system. Acupuncture balances the endocrine system.

    We, at PDtM, recommend weekly acupuncture sessions to get the hormones in better balance and to help get the body as relaxed as possible. Acupuncture is accumulative therefore regular sessions can help shift the body in the direction the patient is looking for.

  • 8 Keys to Communicating & Staying Connected During Infertility

    Image result for couples communication

    Infertility is a trauma that impacts 1 in 10 people. Since it’s so prevalent, then it must be easy for friends and family to understand your feelings, right? Well, as you may have experienced, it’s not.

    Often the people you love most, say just the wrong thing. Those who have experienced the pain of infertility often hear things like, “Just relax. Then it’ll happen;” “You should enjoy your time without kids. I’ve got kids and I can’t tell you the last time I got to sleep in or go out to dinner.”

    Not only are these types of responses angering, they can be painful. These comments often lead to not sharing feelings in the future. Thus, feeling more and more isolated. Going through infertility is traumatic and just the kind of situation where one needs the most support and care possible. Learning to communicate your feelings with those you trust is an essential skill for surviving infertility.

    Here are 8 Keys to Communication During Infertility:

    1. Build awareness of your feelings . This is the very first step to open, productive communication. Understanding oneself and one’s feelings allows for communicating those feelings and needs.

    2. Practice breathing skills. It may sound simple, yet it’s crucial. When communication breaks down it’s often due to at least one person being flooded with emotion. We’ve all been there! Something a person says strikes a nerve and we fire back with a harsh or passive aggressive statement. When we can bring our focus to our breath even for a few seconds, we have a better chance of responding vs. reacting. This leads to a more productive conversation. Try meditation, practice mindfulness , or try Yoga for Fertility to get started.

    3. Talk with someone you trust about your feelings. Perhaps it’s a friend who has always been there for you and is sensitive to your feelings. It can be a parent or a therapist. Just make sure it’s a person that you feel safe talking to. Find your community.

    4. It’s ok to acknowledge hurtful comments. Using simple language like, “When I hear ‘just relax and it’ll happen,’” I feel hurt and frustrated. It makes me feel like I’m doing something wrong.”

    5. Use “I” statements & avoid critical labels. Instead of “You can be so insensitive” try something like, “This is a very painful time for me and I want nothing more than to have a child. So, hearing that I should just enjoy the time feels like a minimization of how important having a family is to me.”

    6. Tell people what you need. A good friend wants to be there for you. She just may not know how. The friend might think that bringing up the topic will make you sad. And maybe you desperately want to talk about it, but expect the friend to ask if she cares. Whether you need her to ask how you’re feeling or to not bring up the topic of kids, let her know.

    7. Vent your feelings to a confidant. Or if you prefer to write your feelings, get a journal and let loose! As you know, it’s important to express your feelings because feelings seep out either directly or indirectly. When we understand our feelings we can respond in a direct way vs. letting our feelings control us.

    8. Know that you can always revisit a conversation. If a conversation didn’t go how you wanted, go back to it. None of us are perfect! There are bound to be miscommunications, hurt feelings, and things left unsaid. Know that you can always try again with a fresh perspective.

    If you’d like to work on these skills more or have a particularly challenging dynamic with a friend or family member, feel free to contact me. You are going through one of the most painful experiences in life and are growing stronger through it.

    Alison Moran, MA, LCPC

    Founder & Psychotherapist

    Evolve Counseling & Wellness, Inc.

    53 W. Jackson Blvd., Suite 1119, Chicago, IL 60604

    825 W. State St., Suite 214, Geneva, IL 60134

    p: 312.340.9511

    alison@evolvecounseling.com

    www.evolvecounseling.com

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