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FROM THE DOC
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Nobody Expects The Spanish Inquisition!
I think we all have a vision of ourselves, a kind of mythical creation as a running reel of our consciousness, and in it, more and less actively, is concern about our health and what may befall us. Oftentimes these concerns are based either on our knowledge of family history (grandpa Joe died from pancreas cancer, therefore I may get pancreas cancer), or something we just heard about (A friend of a friend had an aneurysm and keeled over, so maybe that's how I'll go), or something that relates to our bad habits that we have been meaning to correct (I ate another donut...so I suppose I'll get that heart attack that I deserve)
No matter how you come to it, we each have a limited repertoire of maladies we anticipate, but really, there are an endless list of possible health conditions that can befall us, many that we've never heard of before or even were away could take a life or cause harm. As Shakespeare noted "There are more things on heaven and earth, Horatio, than are dreamt of in your philosophy." A class-mate of mine from Hopkins, Phil Branton, noted that as the pathologist of a large hospital, one can become a professional pessimist, seeing all the various tissue samples sent to in from throughout the hospitals and clinics, many of them defining serious or life-threatening conditions, covering a wide spectrum of diseases....yet despite this, he somehow still can maintain a sense of reassurance in his own world that such things are uncommon and not likely to befall him anytime soon, or that such serious conditions make his minor day-to-day woes pale in comparison.
So, with all of this in mind, I would tell you that your own anxieties are the biggest influence on
your worries, and that controlling those fears and worries is the key to keeping your mind away from overarching concerns about your health so do keep yourself in a positive frame-of-mind. It will be good for your health.
CARPE DIEM.
Yours in good health, Dr. Lakin
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Meet Our Featured Healthy Lifestyle Patient,
Steve 81yrs young!
"About twenty-five years ago, facing the reality that I was about forty pounds overweight, I decided it was time to do something about it.
Approaching retirement and enjoying a wonderful marriage to Marie, it seemed like an appropriate time
to take some important steps to improve my health for the future.
The first thing I did was to join a health and fitness center after getting a physical exam to ensure I could manage some exercise after many years seated at a desk while owning an advertising and marketing agency in the Chicago area.
All was fine except I was informed that I had diabetes and oral medications were prescribed.
I started treatment and began my twenty-five year adventure, three times a week, learning how to use training
machines like treadmills, ellipticals, pulleys, and free-weight.
I am still going to a fitness center three times a week for about one and one-half hours per session.
Losing the weight, exercising, following a healthy diet, getting regular check-ups, and keeping active in mind and body has certainly paid off for me and allowed me to be a better husband, father, grandfather, and friend...as well as enjoying life more."
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| VOL 9 / Issue: #4 | Fall/ 2013 |
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Office Flu Clinic . . . .
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It's Back! 
The flu season is nearing, and we are giving the flu vaccine in our office and at our Flu Clinic
Our flu clinic is on Wednesdays, 1:00pm - 3pm,
Please call and make an appointment for the date you wish to come in now!
You can track the flu season on our website, 'Resources for our Patients, Favorites' at www.doctordoug.com.
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What kind of Flu Vaccine Should You Get?
|  It used to be simple to get the flu shot...there was only one type and everyone was to get the same one. Now, there are multiple options and it's a bit confusing, so I'd like to give some clarification.
There are a few options out there, but generally, you will get what is available at the office or pharmacy that you go to. For instance, our office will have the trivalent low and high dose only. We will not have any of the other special vaccines, for logistical reasons.
So....first....let me go through the options and availability. I'll start with the most important that....the ones that apply to most people in my practice:
Low Dose (standard...OK) vs. High Dose (recommended): The higher dose flu shot has become available in the past few years and provides a stronger immune reaction. It is thought this will provide better protection, but there is no definitive proof.
It has been proven as safe as the standard flu shot in two seasons of widespread use.
Trivalent (3 flu strains...standard....recommended) vs. Quadrivalent (4 flu strains): All flu shots contain the same virus protection, as it is based on national recommendations from the government bodies in charge of this issue. Trivalent contains 2 Type A flu strains + 1 Type B. Quadrivalent contains 2 Type A flu straines + 2 Type B.
Since Type B is a minority of the flu we see, and since this is a new vaccine, I would recommend passing on this shot until it has been used for a few seasons and proven safe and effective. Then I may change my mind.
Live vs. Inactivated/Dead virus (recommended): The live virus (weakened) is available as a nose spray only and is for people 2-49 years old. This does not apply, in general, to our patient base. They are equally effective, although perhaps the nose spray is better for children...but that is unclear.
Egg based (recommended) vs. Non-Egg based: If you do not have an egg allergy of note (and most people who claim to have an egg allergy do not) then there is no advantage to the non-egg based flu shots. That said, these are a great advance in the technology of flu immunization production and may become more common in the future. Again, they are new and I would like to see them available for a few seasons before generally considering them. For egg allergic patients who want the flu shot, this is a great option that was not formerly available.
Intramuscular (recommended) vs. Intradermal: There are flu shots that can be given with a very tiny needle, like a bee stinger, just under the skin. These flu shots are just as good as the standard one with the longer needle and will soon become standard, but they are not currently generally available. In the next few years these will be the flu shot of choice.
So, rather than confuse the issue, this year I am recommending for those over 65 the HIGH DOSE, TRIVALENT VACCINE, but we do have the STANDARD DOSE, TRIVALENT VACCINE as well. Either is fine. As for the specialty vaccines, I would ask your local pharmacy if they have them available for special circumstances that may apply to you.
I recommend for all adults over 65: Trivalen
-Dr Lakin
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October: National Breast Cancer Awareness Month
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 The National Breast Cancer Awareness Month (NBCAM) is a collaboration of national public service organizations, professional medical associations, and government agencies working together to promote breast cancer awareness, share information on the disease, and provide greater access to services.
Since its inception more than 25 years ago, NBCAM has been at the forefront of promoting awareness of breast cancer issues and has evolved along with the national dialogue on breast cancer. NBCAM recognizes that, although many great strides have been made in breast cancer awareness and treatment, there remains much to be accomplished. Today, we remain dedicated to educating and empowering women to take charge of their own breast health.
Although October is designated as National Breast Cancer Awareness Month, NBCAM is dedicated to raising awareness and educating individuals about breast cancer throughout the year. We encourage you to regularly visit these sites to learn more about breast cancer, breast health, and the latest research developments. Click on any of the websites below for more information.
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Be Sure You Have Our Correct Address!
| Paradise Valley Medical Clinic
Ninety Mountain View
9977 N. 90th Street, Suite 180
Scottsdale, AZ 85258
480.614.5800 (Phone)
480.614.6322 (Fax)
**Additional Top Floor Ramp Parking:
The 2nd floor ramp parking is very close to our door, but the entrance is at the VERY NORTH END of the parking area of the two buildings. You drive all the way North...enter at the NORTH END, then drive down to the SOUTH END of the 2nd FLoor Parking to get a space very near the entrance.
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All Ears! Causes of Hearing Loss
|  You know aging plays a role in hearing loss. And you'd expect that incessantly blasting music into your ear buds or spending your working years around loud machines might also damage your ears. Some other potential causes of hearing loss, however, may surprise you. Here's a look at four of them, and the actions you can take to maintain good hearing throughout your life:
Ear infections.Though anyone can get them, they are particularly common among children. Mild hearing loss can come and go with an ear infection, but if it lingers more than a few weeks and becomes chronic, or fluid buildup in the middle ear is persistent, it may result in more significant hearing loss or cause permanent damage. Keep an eye out for symptoms in your little ones, such as complaining of ear pain (especially when lying down), tugging or pulling at an ear, fever, crying more or sleeping and eating less. See a physician immediately if you suspect your child has an infection.
Obesity. A new study has found that obese teens had greater hearing loss across all frequencies and were almost twice as likely to have one-sided, low-frequency hearing loss compared with their normal-weight peers. Scientists suspect that obesity-related inflammation may be a factor, and though more research is needed, the findings suggest a risk of early, and possibly ongoing, injury to the inner ear that could progress as obese teens become obese adults. It's another reason to help your children maintain a balanced diet and healthy weight.
Smoking. In case you need another reason to quit: Earlier research has shown that smoking magnifies the threat of losing your hearing and that teenagers who are exposed to secondhand smoke nearly double their risk of hearing loss. Now researchers at New York University School of Medicine have found that teenagers are more likely to have hearing loss if their mothers smoked during pregnancy.
Medications. Women - particularly those under 50 - who took ibuprofen or acetaminophen two or more days a week were linked to an increased risk for hearing loss, according to research out of Brigham and Women's Hospital in Boston. More than 200 other drugs - over-the-counter and prescription alike - also can damage hearing, sometimes permanently, says the American Speech-Language-Hearing Association; they include certain types of antibiotics and chemotherapy treatments, aspirin (in large doses), anti-malarial drugs and certain diuretics used for heart and kidney problems.
-The Doctors, USA Weekend
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| Medicare Open Enrollment & Health Insurance Marketplace Information Update |
 Medicare Open Enrollment October 15, 2013 - December 7, 2013 is when all Medicare participants can change their health coverage for 2014. This is the time of year when all Medicare enrollees are encouraged to review any notices received from their current health and prescription drug plan for changes that will take effect next year. This includes any changes to premiums, coverage and benefits. People with Medicare can call 1-800-MEDICARE or visit www.medicare.gov for plan options and information beginning in October 2013. If you are satisfied with your current Medicare plan you do not need to do anything. Health Insurance Marketplace Many of you have heard about the Health Insurance Marketplace. Beginning in October 2013 people who DO NOT have any health insurance will be able to research new coverage options. If you have health insurance through Medicare, the Marketplace will not have any effect on you or your Medicare coverage. It is against the law for someone who knows you have Medicare to sell you a Marketplace plan. It is important to know the Health Insurance Marketplace open enrollment period overlaps with the Medicare open enrollment period. Therefore, people with Medicare who are looking to make changes to their Medicare coverage should make sure that they are reviewing Medicare plans and not Marketplace options.
For more information about non-Medicare health insurance plans through the Marketplace, go to:
https://www.healthcare.gov/
https://www.healthcare.gov/marketplace/individual/#state=arizona
https://www.healthcare.gov/how-do-i-apply-for-marketplace-coverage/ Dr. Lakin and Medicare FOR 2014 DR. LAKIN WILL CONTINUE TO PARTICIPATE WITH ORIGINAL MEDICARE ONLY. Original Medicare is a traditional fee-for-service program offered directly through the federal government. Under Original Medicare, the government pays Medicare participating providers directly for the health care services you receive. You can see any doctor that participates with Medicare anywhere in the country. Original Medicare is sometimes called "traditional" Medicare. Under Original Medicare you schedule an appointment with your doctor or go directly to the hospital when you think you need medical care. You do not need to get permission from Medicare first. After Medicare pays your claim you will be billed a coinsurance amount for each time you see your doctor. If you have a Medicare supplement plan the coinsurance amount will be billed to them on your behalf. Original Medicare includes Part A (Inpatient coverage) and Part B (outpatient coverage) Medicare Advantage Plans DR. LAKIN DOES NOT PARTICIPATE WITH ANY MEDICARE ADVANTAGE PLANS. If you choose coverage through a Medicare Advantage Plan for 2014 please contact the office before the first of the year so we can assist you in transferring your medical records to your new primary care physician. A Medicare Advantage Plan is a type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Part A and Part B benefits. Medicare pays a fixed amount for your care each month to the companies offering Medicare Advantage Plans. Medicare Advantage Plans include HMOs, PPOs, PFFS Plans, Special Needs Plans, and Medicare Medical Savings Account Plans. If you're enrolled in a Medicare Advantage Plan, Medicare services are covered through the plan and aren't paid for under Original Medicare. Each Medicare Advantage Plan can charge different out-of-pocket costs and may have different rules for how you get services (like whether or not you need a referral to see a specialist or if you must go to only doctors, facilities, or suppliers that belong to the plan for non-emergency or non-urgent care). These rules can change each year. Important Reminder The Medicare open enrollment period is a time when there is a higher risk for fraudulent activities. DO NOT share your Medicare number or other personal information with anyone who knocks on your door or contacts you uninvited to sell you a health plan. Listed below are Medicare approved resources for finding the information you need to assist you in making the decision that is right for you. Feel free to contact me directly if you have additional questions about how your insurance will work in the office. Veronica
Billing Supervisor
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 Introducing:
DoctorDoug's Academy 
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Dr. Lakin's guide videos on how to better understand your lab work results.....
Check the first edition here: | | DoctorDoug's Academy: Lesson #1 CBC |
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We Need Your Help!
|  Keeping you on your correct medication is as important to us as it is to you. With your help, we can be more efficient and be sure you are getting your refill requests on time and to your correct pharmacy.
Tips:
1. If you need a refill, be sure to call your pharmacy FIRST, not our office. They will know if you have more refills, and if not, they will call/fax/electronically message us with your request. Then we will contact you if there is a question or concern.
2. Remember to call your pharmacy in plenty of time so you do not run out of your medications. Sometimes we need up to 48 hours to complete a request and we do not want this to be a hardship for you.
3. Register and use our SECURE PATIENT PORTAL for refill requests. We monitor this continually and again will contact you if there is a problem.
4. Remember we do not refill pain medications on Fridays or weekends and all pain medications must be picked up at our office. We cannot mail or any medications outside our office. Please plan ahead and make arrangements!
We are always here to help you and appreciate the opportunity to care for your healthcare needs!
Yours in good health,
Dr. Lakin & Staff
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Women Are Better At Remembering New Faces ....and here's how they do it
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 You're at a party, and you see a new face in the room, someone you haven't met yet. You introduce yourself, and it turns out -- you totally have met this person before. (Maybe even a couple times before.) You are probably feeling very awkward. And you're also probably a guy.
A new study shows that women are better than men at remembering new names and faces, something past research has also shown. But this new paper, just published in the journal Psychological Science, also suggests the reason why women are so good at it: In the first few moments that we meet someone, we tend to take in more details about the new face in front of us. We study the eyes, the nose, the cheekbones, the mouth -- without even knowing we're doing it -- and then neatly file that information away for our brains to retrieve next time we come across the new person.
To figure this out, researchers at McMaster University in Ontario, Canada, used eye-tracking technology -- basically, a helmet with two small cameras that monitor where a person's eyes are moving. In one experiment, participants put one of these on, and were "introduced" to 120 faces, including names, over four days. Each day they saw three different sets of 10 photographs - often repeats from the day before - and they were asked whether they'd "met" the person before, and, if so, what that person's name was. A second experiment was similar but shorter, done over just one day. Each face was on screen for five seconds at a time.
Every time, the women were better than the men at recognizing the faces they'd seen before and remembering the names. The eye-trackers showed that the women spent more time looking at different facial features than the men, moving their eyes around more and noticing more about this new person's many features than men tend to.
To be fair, the numbers show women aren't much better than men at recognizing new faces. Jennifer Heisz, author of the new paper, dumbs down the figures for us thusly: "Let's say you just were introduced to 10 new people. On average women would recognize seven faces, whereas men would only recognize five or six faces." So, not a huge difference. But Heisz points out that there's a social cost to not remembering a person you've met before, and that that small difference translates into many, many more socially awkward situations for men than women.
This study didn't examine the reasons why women might unconsciously take in more information from a new face, but Heisz has a few theories. "Our eye movements are really linked with our attention, so it could be related to women paying more attention to being more socially engaged with people," she explains. Or, it could be that women process visual information differently than men. And in general, Heisz explains, women tend to be better at what researchers call episodic memory - recalling specific scenes from your own past. Remembering a face could be one more example of that.
Next time you meet someone, in the first few seconds of the introduction, try to take in the whole face - look the person in the eye, of course, but also notice things like the curve of the nose, the arch of the eyebrows. (But be subtle about it and move your eyes around quickly; don't stare too long at one particular feature or you risk weirding out your new potential friend! Remember, people who do this naturally also do this unconsciously.)
"There's so much going on when you are first meeting someone, right? You have to learn their face - and this is a really complex thing. I mean, you have two eyes, a nose and a mouth - but so does everyone! And trying to distinguish those really subtle differences - that's a really difficult thing," says Heisz, who will be an assistant professor in kinesiology at McMaster starting in July. "It's not surprising that some of us struggle with this."
- By Melissa Dahl, NBC News, Body Odd
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Have You Scheduled Your Physical Yet?
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 As you all know, Dr Lakin is a strong supporter of annual physicals. This is a time we can visit and explore any unresolved medical problems and any new health issues that need to be addressed. Annual physicals are one of the best ways to safeguard your health.
The American Medical Association recommends that if you are between the ages of 40 - 49 years, physicals should be done every two years. If you are 50 years plus, it is recommend you have yearly exams, especially if you have any chronic medical conditions that need to be monitored. Call to schedule your well care visit today!
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Are You registered For Dr. Lakin's Secure Patient Portal?
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Now is the time!
For help on how to register and FAQ, check our these videos:
It's as easy as that!
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After Meal Walks May Help Control Diabetes. . . . . .
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 Once upon a time, people routinely took a short walk after a meal. That old tradition should make a comeback according to a study released today in the journal Diabetes Care. It found that a 15-minute, moderate speed walk about 30 minutes after eating exerts significant control over the high blood sugar of older people.
That's important because blood sugar spikes after meals. In young, fit, people, insulin helps drive that sugar, glucose, into muscle cells and the liver where it's stored for energy. This system becomes less efficient as we age, explained the study's leader, Loretta DiPietro of the Department of Exercise Science at The George Washington University School of Public Health and Health Services.
Leaving too much glucose in the blood can not only lead to type 2 diabetes, but cardiovascular damage.
That exercise helps prevent these effects is hardly news. That's why experts recommend 45 minutes of exercise most days of the week.
But, DiPietro explained, many older people may not be able to, or motivated to, exercise for such sustained periods.
So in one of the first exquisitely-controlled experiments of its kind, DiPietro and her colleagues put 10 volunteers with an of average age of about 60, and with elevated, but not diabetic, levels of blood sugar, through three different two-day tests, each four weeks apart, in a special room designed for the purpose.
While their glucose levels were continuously monitored with an implanted meter, they exercised by walking on a treadmill for 45 minutes mid-morning, or for 45 minutes in the afternoon, or for 15 minutes half an hour after each tightly controlled meal by walking at a pace of about 3 miles per hour, what DiPeitro calls "the low end of moderate." The first day of each two-day period, they did no exercise at all.
As expected, without exercise, post-meal blood sugar spikes were not well controlled. Both the mid-morning 45-minute treadmill session, and the three 15-minute sessions, controlled blood sugar over the 2-day period better than the afternoon 45-minute session.
But only the 15-minute walks managed to significantly reduce blood sugar spikes during the important three-hour post-meal window.
But only the 15-minute walks managed to significantly reduce blood sugar spikes during the important three-hour post-meal window. Walking could be one tool to help prevent diabetes in older people, the research suggests.
"This is not for weight loss, and it's not going to increase your cardiovascular fitness very much," DiPietro told NBCNews.com. "It's very specifically for glycemic control with older age."
But, she added, everyone can benefit because we all experience glucose spikes after eating.
"If you're sitting at your desk all day, and you eat lunch, go for a short walk," she advised. "More than likely you won't get that food coma."
- By Brian Alexander NBC News contributor
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Recipe:
A Healthy Breakfast Choice
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A bowl of with Kellogs Crispix.
One banana
One half a peach
One tbsp. of raisins
Half a cup of blueberries
Four strawberries
Quarter cup of slivered almonds
Tsp of wheatgerm
10 oz. glass of non fat milk.
"That's about it. You will not be hungry again until lunch time and it's very tasty!"
- Recipe by Charles Villbeau
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AT THE MOVIES WITH BARB A. . . . .
|  A MUST SEE! + + + + +
GREAT + + + +
ENTERTAINING + + +
RENT THE MOVIE + +
FORGET IT! +
**EMAIL ME! ???
'I have seen quite a few movies in this Arizona heat. Some of t hem I loved and sadly a couple of films which had had good reviews, I did not enjoy. I even left one of them when I just couldn't watch anymore.' + THE WORLD'S END Maybe I didn't enjoy this because I didn't see the first two of this trilogy. Simon Pegg is truly comical as are his cohorts, however the end of the world doesn't occur in ice or fire but in a pub. I am not a fan of science fiction and violence, and there is much of both. My comment is "don't bother". I left after an hour.
+ + THE BUTLER Only two stars for this one, but at least I stayed until it was over. As a history major at UD Berkeley, I was very interested in the attitude of each president regarding the black issues of the time. I didn't get much of that and I was consumed with Black Panther and Freedom Rider information. Forest was excellent. Oprah who was cast as "Star Power
I am sure was equally good but I saw too much of her and not enough of the presidents and the Butler. Only a fair film I feel after all the hype. And when Jane Fonda appeard as Nancy Reagen I just about threw up.
+ + + + + BLUE JASMINE Here is the gem of the year. It must be Woody Allen's best in a long time. Blue Jasmine is a compelling character study and Woody develops Cate Banchetts persona to the "nth degree I can't stand Alec Baldwin but once again he is superb. Sally Hawkins who plays Jasmine's sister is also great. Obstacles to Jasmine's recovery from alcohol, drugs, loss of dignity and sanity was so painful to watch. Amazingly enough there are many humerous sections. Don't want to tell you too much. Just go and see this outstanding film. + + + + THE WAY WAY BACK This was a departure for me. It is a compelling documentary about a large killer Orca named Tilikum who attacked a well trained female trainer at Sea World. See this and you will never pay go to the the Sea World show. The film is narrated by four or five former trainers. They expose the treatment of the baby orcas who are taken from their mothers at birth to train. The sound of the mother wailing and crying brought tears to my eyes and the discovery that food is withheld as punishment was just too much. A real eyeopener. + + + + SHORT TERM 12 A powerful movie regarding main character Grace. She is a supervisor at a facility for at risk teens. Grace has her own issues in her background so is a compassionate therapist for the teens. Each resident has his or her story and each one is fascinating. The interaction between staff and residents is compelling. Barb A. Back To Top |
Is Apples New Operating System, iOS 7 Making You Feel Sick?
Here's Why. . . . . .
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 Apple's new iOS 7 software is apparently making some people seasick on solid ground. Experts on motion sickness say the sharpness of the screen and the motion of the icons may be partly to blame.
Users who have upgraded to iOS 7 are reporting nausea, headaches and vertigo in a message thread that started Sept. 18 on Apple's support website.
"I just used my phone for about 20 minutes, and now I feel like I'm going to vomit," one user wrote in a comment on the site. Another said, "It's exactly how I used to get car sick if I tried to read in the car."
iOS 7 has animations and a dynamic background that were not in previous versions of the software, which is used on iPhones and iPads.
"We haven't done any experiments with this phone, but this is what I think is happening - it's definitely linked to the motion of the screen," said psychologist Frederick Bonato, of Montclair State University in New Jersey, who has studied cybersickness. "Also, the resolution is very high, so you've got a very sharp, clear image - moving."
The icons on the phone constantly move slightly, and with the background, this produces a 3D impression, or a parallax effect, making it look as though the icons are floating above the background. [ 9 Odd Ways Your Tech Devices May Injure You ]
"Seeing a three-dimensional space, on a phone you know is flat," can trigger queasy feelings, Bonato said.
The new software also produces the impression of zooming in and out when a user switches between applications, which may confuse the brain into thinking that the person is moving.
"Visually, the input is indicating that the person is moving, but all the other senses indicate the person is not moving - or, even worse, with these phones, is moving in a different way," Bonato said.
Such conflicting information can cause dizziness, headaches and nausea - effects that can also sometimes be caused by IMAX movie theaters and flight simulators. Although phone screens are much smaller than movie-theater screens, phone screens are placed closer to the eyes, which means the visual input dominates the brain, experts said.
"With the iPad, it's even worse, because it's larger and is covering more of your field of view," said Andrea Bubka, who researches cybersickness at Saint Peter's University in Jersey City, N.J.
Some users may also experience eyestrain due to the parallax effect.
"It looks three-dimensional, but it's actually two-dimensional. When that happens, your eye doesn't know exactly where to focus," Bonato said.
Higher-resolution and sharper images in iOS 7 may make the visual input look less like it is coming from a display, and more like a piece of the real world.
"I'm not surprised to hear this about iOS 7," said Thomas Stoffregen, a professor of kinesiology who studies motion sickness at the University of Minnesota. "As imaging technology develops across platforms, and we get greater frame rates and resolution, we find an increasing tendency for it to make people sick."
One solution that may reduce some of the motion on the screen is to go to Settings, then General and then Accessibility. There, users can turn on Reduce Motion. Although the effects may make symptoms worse for people who have disorders of the inner ear that affect their movement and balance, for most people, this is not going to be a big issue, Bubka said. "There are little tricks you can do to adapt. You just have to look elsewhere for a little while," Bubka said.
- By Bahar Gholipour LiveScience, Body Odd
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Dr. Douglas Lakin & Staff
Paradise Valley Medical Clinic PC
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