Living With Facial Pain

Persistent ear pain , jaw pain , throat pain , neck pain ,shoulder pain over 2 years . Calcified Tonsilolith , Tonsil Stone

Hello !
I am male 40 yrs old from Romania. My english is not so good so please excuse misspelling.

Since June 2016, I felt a diffuse pain in throat on the right side.
The pain was DAILY only on the inside of the pharynx at a fixed point and in the right amygdalian fossa especially when rotating head to the rihgt.

I was ok in the morning but after 1 PM symptoms come back every day.
On a scale of 1-10, the pain felt about 2 - 3.

July 2016

I was consulting an ENT and he said I had a chronic pharyngitis and gave me some blood tests to do. All blood tests were good including ASLO VSH CRP

The pain persisted, I have been to countless ENT controls but nobody has detected anything wrong except for an alleged chronic pharyngitis.
I did 5 fibroscopies, 4 MRIs, 1 angio-MRI HEAD, 3 Cervical MRI.

Symptoms have worsened and throat pain inducing paraesthesia in the mandible, neck, ear on the right, shoulder and neck on the right side.
Also paresthesies at the tongue level.

Symptoms worse when I turn my head to the right and seems to come from the right tonsil or right inside the tonsil.
Also, the right tonsil is swollen at the top.
All exudates i made, the results were negative.

I have not discovered any factor that would trigger these states, nor any factor to improve them.

MRI found bilateral small enalrged reactive laterocervical lymph nodes .


In October 2016, a submandibular palpable swollen lymph node appeared on my right side followed in December 2016 by a palpable swollen lymph node at the jugulodigastric level on the right.
I followed treatment for 10 days with antibiotics: Zinnat, 7 days with amoxicillin, 5 days with sumamed. The pain in the throat did not disappear and the lymph nodes remain swollen.


Paresthetic sensations have begun to improve, but the right side throat pain is very pronounced.
I was reffered to a neurological consultation where I was sent to the psychologist.
Following my consultation, I was prescribed Lorazepam and Xanax . Xanax did nothing but all my pain was gone with Lorazepam only 1/2 pill 0,5 mg .
I was also told that swollen lymph nodes should be investigated in hematology, not the psychiatrist.

MARCH 2017

Following the numerous ENT controls at Dr. Sarafoleanu, he decided to do right tonsil cryptolysis.
I did the cryptolysis but the lymph nodes and the pains did not disappear and did not improve.
I have been treated with non-steroidal anti-inflammatory drugs for over 30 days but none have had no influence on pain ,paraesthesis and lymph nodes.

August 2017
Repeated ALL blood tests , all normal !
Hematology consult - nothing wrong .

October 2017
A calcified tonsil stone came out of my right tonsil. The stone was about 1 cm long , banna shaped and was rough and verry sharp, like sand paper.
After a short period of relief, all the pains came back and in January 2018 i was sent for a tonsillectomy.

CT scan rouled out Eagle Syndrome
MRI Cervical spine found small cervical discopathy C4-C5 vertebrae with no radiculopathy no compression and no protrusion .
I had billateral Tonsillectomy

FEB 2018
All the symptoms worse by 20%

My daily simptomps are - ONLY ON THE RIGHT SIDE

Fixed point pain pharynx near right tonsillar fossa - note 4 - 5
Pain under the ear, behind the ear and in the ear note 2 - 3
Pain and inflammation of the sternocleidomastoid muscles and trapeze especially when turning the head to the right or rotation + inclination on the back note 5 - 6.
Mandibular pain and mandibular joint 4 - 5.
Pain in the right side of the hyoid bone
Clavicle, shoulder, first part of the right arm as note 4 -5.
Under Arm 4 - 5
Pain and paresthesis in the tongue, under the tongue, in the right tonsillar fossa in the spot where the tongue insert in the mouth (lingual tonsil area) 5 -6
swollen submandibular lymph node on the right, swollen right jugulodigastric lymph node, right neck on mastoid, behind right ear.
Numbness of the skin in the parotid area, right mandibular joint.
In some days, due to these symptoms I’m physically bad !! I feel sick !
Pain and pharesteis are in the deep structures of the neck not on the surface.
Symptoms occur in turn or all at once but none disappear.


Wearing the motorcycle helmet tied under my chin
Strong and tall collars rubbing on my right side of the neck
The hour - after 1 PM the evening being the worst.
SHAVING (with razor blade or electric machine)
Blocking head rotation to the left by hand produce stabbing pain like somthing sharp is cutting my throat in the area where the pain is comming from and in the right ear.
Physical activities aggravate the pains at the level of the right shoulder, the cervical column on the right and the deep neck structures on the right causing
a kind of bad feeling, the splinter in the whole body without being physically exhausted!


In the morning a fell PERFECTLY FINE ! But as the day goes on , i fell bad , especially after 1 PM.
Eating and swallowing (disappear both pain and paraesthesia during the meal), liquor drinking does not have the same effect and chewing gum.
Getting drunk lower my pain .
Massage of painful areas in the pharynx with an exudate harvesting stick.
Staying with a wide open mouth improves pharyngeal pain
Keeping my right shoulder elevated or close to my right ear
Lying in bed with my head on the pillow
If a stay too much in bed, i have to get up to lower the pain if i stand up to much i have to lay down to ease the pain.
Standing in the chair with elbows on my desk and leaning over the desk with my head
Does this symptoms sound like TN2 or Glossopharingeal neuralgia ?
Nobody can tell me what is wrong with me.

My ENT diagnosed me with Glossopharingeal neuralgia but i think i have Trigeminal neuralgia .
ENT abbandoned me saying that there is nothing he can do for me and he reffered me to a neurologiyst and a pain speciallist.

I think all this nightmare started becouse of the calcified tonsil stone that rubbed and cut inside my tonsil. Now i dont have tonsils but the pain is still there and is worse.
I cand find small relief from lorazepam , oxycodine and tramadol but i dont like the side effects and diziness so i suffer like an injured dog every day for 2 years .

Dos anibody have this symptoms ?

It sounds to me like you’re on the right track, that the stone has damaged something in your interior neck. The surgeries have probably aggravated it. You’ve already done everything I would have suggested in terms of trying to figure this thing out.

Trauma nerve damage often takes a year to start improving and longer than that to heal completely. Since your last invasive procedure was Jan 2018 I would say you have until Jan 2019 to see any real improvement, assuming it’s trauma-based damage.

I would say you’re in the position of pain management right now. I know this sounds impossible, but, I tend to think you need to give it year and see where you are next Jan. You may just need time to heal and nerves take a long time to do so.

Dear Lifeowner- many of your symptoms sound like mine. The majority opinion is an atypical facial neuralgia { they are not sure what nerves are involved}. Mine started 4 years ago after an infection following an appendectomy. I questioned if it could be caused after being intubated but most docs say no. Carbamazepine 4xday does keep pain from being overwhelming and Gabapentin at night. I hope you will find relief and the pain will finally disappear…I agree with you alcohol seems to be the best pain killer - I laughed when I read that ! Hopingfor relief for all of us suffering thru this !!! Vicki9

Hi Vicky ,

I dont know why alcohool ease the pain and sometimes makes it completly dissapear but it’s good to know it works for you too :slight_smile:
Now you know what to do :slight_smile:

I never drink alcohol … becouse i dont like the brain fog similar to pain killers and i dont like the headache in the day after.
I “tested” alcohool becouse i read that SCC of the mouth is verry painfull when drinking alcohool and , after 2 yrs of medical tests to exclude all the possibilities i still didn’t trust doctors so … i got drunk just to test it :-))

Hi LifeOwner,

Thanks for sharing your story. Your symptoms sound very similar to mine. I will tell you my details in case it helps us come closer to understanding what is going on.

Like you, my pain is steady, not electric stabs. The pains rise and subside all day, sometimes all at once, but never completely go away. I have wondered if I have atypical glossopharyngeal neuralgia and/or trigeminal neuralgia or something else. I’m female and 48.

Here’s how mine compares: For me, it started in October 2017 with severe sore throat and severe pain on the left side of my tongue (near the back, not under, tongue). Then it spread to my ear. At the end of 2017 and beginning of 2018, I had some dental crowns put in, and started wearing a hard dental nightguard (because the dentists wondered if the pain was caused by clenching my teeth) – that’s when the pain started spreading even more. The tongue/throat pain continued. The left ear pain got worse, and I started getting strange pains on the sides of my chin and back of my head. Then a more consistent prickly/numb pain started along my left mandible, and occasionally behind my left eye. So now I have throat pain, left-side tongue pain (at back but now at front too), left ear pain, left mandible prickly/numb/ache, strange sensation behind eye – and like you, I have a strange pain deep in my neck that I can feel especially when I turn my head.

Doctors I’ve seen, in order, with impression in square brackets:

  • dentist [no idea]
  • periodontist [suspects TMJ issue]
  • oral pathologist [no idea]
  • 2 ENTs [no idea]
  • facial pain dentist [suspects TMJ inflammation + burning tongue]
  • 2 neurologists [no idea; prescribed gabapentin + nortriptyline]
  • speech language pathologist [saw tense vocal chords; no idea]
  • supposed TMD specialist (who is just a periodontist working in a facial pain clinic) [simply said it’s neuropathic pain]

Tests: I’ve had a brain MRI and jaw MRI recently, and a head/neck CT scan back in November – nothing to explain the pain. The jaw MRI showed I have a dislocated left jaw disc, but most doctors don’t think that explains the pain. One facial pain dentist says she thinks this is all connected to jaw inflammation and related neck muscle tension.

Medications: Gabapentin (600 mg/day), nortriptyline (went from 10 to 20 mg/day), plus I have been taking zopiclone for sleep for many years. These meds might have taken some of the edge off the pain (I’m not sure since it’s always changing), but they have not completely taken it away. When I doubled the nortriptyline to 20 mg per day, it seemed to help more, but now (a month later), the pain seems to be climbing a bit. The facial pain dentist suggested I also start taking low-dose clonazepam (0.5) but I haven’t started this yet.

What seems to make it worse: When I’m hot, or have a scarf around my neck (especially acrylic), mandible prickly feeling increases; also cold wind seems to sometimes cause that mandible feeling. Sleeping on my left side makes ear/jaw worse. Coffee and sugar seem to make it all worse, especially tongue/throat. Makeup brush along my jaw. Talking a lot. Being hungry. Being stressed.

What seems to help: Mindfulness exercses, positive visualization (seeing myself healthy and pain-free), pushing myself to take care of myself and do things I really enjoy. Started gargling my mouth with baking soda after brushing my teeth; seems to calm the burning feeling on tongue and throat. Eating usually makes my tongue feel better. Some essential oils like frankincense etc seem to help (maybe because they are calming). Not sure if these have helped: sublingual B12, vitamin D, fish oil, krill oil, occasionally iron and full-spectrum B vitamins.

Let’s please keep each other posted on things we try, what works or doesn’t work. Thanks again!

Incidentally, LifeOwner:

  • I had my tonsils removed when I was 2 years old, so although our symptoms are similar, at least in my case there would be no connection to tonsillar stone
  • I asked about Eagle’s syndrome but ENT said he saw on the CT scan that I have a normal-length stylohyoid (although it has calcification and he couldn’t say whether there was widening there)

I’m wondering if we both have a pain sensitization that occurred as a result of an initial trauma that “switched on” the nerve signals. I read about sensitization and centralization of pain. I really do believe in that case that meditation and visualization can help rewire the neural response.

I wish a good weekend and solutions! :slight_smile:

Do you have inflamatory lymph nodes ?
Have you reconstructed CT images to 3D to see if you have calcified ligaments in your neck or long styloids ?
Upload your CT to a google drive and give me the link to download it and see if that’s the case .

I’ve been to a neurolog consultation and he prescribed me the following treatment witch i think it’s working :slight_smile:
Clorzoxazon 250 mg for 3 months 1 , 1 , 1
Vimovo 10 days / month for 3 months . 1 , 0 , 1
Paracetamol 500 mg 10 days / month for 3 months . 1 , 0 , 1
Silimarin 0 , 1 , 0 for 6 months

I think this treatment is starting to work . I dont have much pain this week , maybe 30% of the pain .
As you can see, i dont take any pain killers becouse my body dont like diziness , brain fog … beeing out of this world.
I think most doctors are IDIOTS , they prescribe pain killers , anxiolitic drugs , muscle relaxants etc … but NOBODY is talking about the CAUSE that is producing pain .
I think their approach is wrong , they shoul be focused on finding the cause and then treating cause and symptoms.
In the last 2 years , i read verry much and i am trying to find the cause by myself becouse doctors are only intrested in caching consultation price.
I dont like them and i dont trust them !
They gave me tons of prescriptions , took out my tonsils , irradiated me wit CT scans 6 MRI SCANS etc … and ALL this for nothing . No cause forr all this pains , lymph nodes , strained muscles , sholder , trapezus , neck pain , tongue , ear They dont even bother looking at MRI and CT pictures , they just read medical report and that’s it . They dont let me talk and explain my simptoms …
They think … oh , you dont have cancer you are fine, but i am not fine , my life is messed up ! lost friends , jobs , not in the mood for gym , exercising make paine verry bad , i cant hang out, i cant do anything not even house activities - all day long just beeing in pain and searching for a cause to my symptoms .
That’s not living every day that’s just surviving every day.

I agree with you.
I am not sure why no one suggested-doctors or therapists- diagnostic muscle blocks.
Although the block I had has worn off I now know the cause of the pain and it has made all the difference to me in my outlook on life.I see a couple paths to follow-not thousands- and although in pain right now-I have hope that it will be gone or at least better managed by the end of the year.
It was me that asked for the injection,and the doctor agreed.
I would like imaging of the hyoid region and don’t have any idea what kind to beg for.If you have info on that I would appreciate it.There is so much going on in that small area of our bodies-I don’t even knw what doctor looks after that.
I have found a Bowen Therapist guy who ,last time I saw him,managed to really cut bac my pain for a couple days.
Maybe that is another approach for you.
I was surprised at the effect of the treatment.
Maybe it is the practitioner-he has a steady stream of clients who rave about him after treatment-and these are not new age treatment kind of people.They are older men and women ,so it makes me confident that I have chosen someone good.
I hope you continue sharing your story,maybe start meditating-I now do 30 minutes of sitting meditation at night-just trying to watch my breathing-and it seems that has opened up other doors or maybe coincidence.
Just keep trying new things.

Ellen glad your making progress, here is hoping for a better time.

Eagle syndrome, consider a fair load of tosh, in the main. Symptoms, xray/ mri of you’ve got elongated styloids, nothing says it is causing symptoms, it’s as normal as saying my thumb is bigger than your thumb. Your body isn’t that stupid, it isn’t in the main causative, hence the ambiguous name- syndrome.

LifeOwner, thanks so much for the offer to look at the CT scan for me. Unfortunately, I don’t have the scan images, just the report. I will see if I can get it, but I suspect they won’t give it to me. And as far as I know, I don’t have enlarged glands.

I totally understand you on the matter of doctors being idiots. I was going to post the same thing. I am astonished by how uninterested they are in really finding out what the cause is. (I thought it was just a Canada problem, but I guess it’s everywhere.) I’m also astonished by how few options there are for people living with pain – it’s always many months’ wait for each specialist, and then sometimes months more for the diagnostic tests.

By the way, have you had any dental problems in recent years? How is your posture – do you lean your head forward or slouch? I’m just wondering about additional factors that might have contributed to your discomfort.

Like my friend Ellen6, I am finding that mindfulness and meditation are helping. Positive visualization (where I concentrate deeply on the image of myself feeling good and healthy and pain-free) seems to help too. Cognitive Behaviour Therapy also helps, even if it’s done independently without a therapist. I know this all might sound like rubbish, but if it’s true that our pain has something to do with malfunctioning nerve signals that went off track for some reason, then maybe we can do some neural rewiring.

If aiculsamoth has any insights, I’d listen carefully to what he has to say.

Have you considered acupuncture? Some people seem to get great relief from it. (A few have said it made their symptoms worse.) I intend to try it soon but just have to get more testing out of the way first – I must say I’m a bit afraid of being told there’s something really bad going on, and when I think about that, it makes things less tolerable. When I’m not thinking about that, and I focus on the positive, everything really does feel better, pain or no pain.

Please keep us posted on what you try/discover.

I was verry healthy and strong person . I never been in pain or sick all my life until 2 years ago when this stared . I had my winsdom teeth removed 20 yrs ago and i
regularly go to dentist so my teeth are ok . I am IT manager so 90% of time i sit at my desk. I dont work outside in cold weather and i only had a cold 3 -4 times in my life . I regularly go to the gym , i am not fat . I drink alcohool 2 - 3 times / year and never get drunk . I try to eat healthy food but i like meat so i eat meat almost every day . I dont like coffee but i am coca cola addicted , i drink 500 ml to 1 L daily .
My posture is ok but i had a cervical MRI and they told me i have “straight spine” . I thought it is good but straight spine is a problem. I have cervical discopathy c4 c5 but doctors say it is minor and i should not have symptoms from it.
Nobody in this world is PERFECT by health standards , medical standards , beauty standards etc … My grandmother is 97 yrs old and never had pains from cervical discopathy so i dont think this is the problem .
I have some positions that alleviate the pain leaning head forward , pulling back sholders etc …

My first simptoms was cardiac arrithmia … i have done tons of tests for the heart , blood work , kidneys ultra sound , heart ultra sound , effort tests but nothing was clinically wrong . They say i have a healthy heart, but my heart beat 1 , 2 ,3 , skip 4 and beats 5 strong for 3 weeks . After this , everything came back to normal so no diagnosis or treatment for me .

After 3 months i started having globus sensation , then a calcified tonsil stone came out of my right tonsil after 1,3 years of pharingeal pain and countless tests and ENT controls , psichiatry , neurology , hematology , oncology , gastrointestinal tests… you name it. Maybe my vagus nerve got irritated somewere in my body.

I never head feaver , loss of apetite , vomiting , weight loss , night sweats , fatigue but i feel sick from the pain .

ENT decided that i have chronic tonsillitis and took out my tonsils . After tonsillectomy i thought i will be better but globus sensation , glossopharyngeal neuralgia , trigeminal neuralgia , neck muscles on the right and shoulder pain , cervical pain , neck pain got even worse .

ENT decided i have GPN and he did 4 anesthetic injections in my right tonsillar fossa . The anesthetic injections didn’t work , after short period relief 4 - 5 hours , all the pains came back .

I tryed acupuncture for 20 sessions , i felt verry relaxed but the pain was still there .
Doctors told me that i have 2 separate problems:

  1. GPN and inflamatory lymph nodes in the neck caused by the calcified tonsil stone that rubbed and cut inside my tonsil.
  2. Cervical pain , shoulder pain , deltoid and trapezus pain from straight cervical spine and C4 C5 discopathy .

I dont buy this . All my pain started with the calcified tonsil stone GPN and cervical pain . After the stone came out , symptoms never got better , after removing tonsils symptoms got worse .

This is why i say doctors are IDIOTS , they dont let me talk and describe all the symptoms. They say that i am clinically healthy and there is nothing medicine can do for me. If i am so healthy, then why am i in pain for 2 fkin years ?

I think you should be positive becouse if it was something bad going on with you , it would be descovered by now and you would have many other symptoms.

To be a little bit of a devil’s advocate…

Doctors say straight cervical spine and C4 C5 discopathy should NOT be causing any problems. UMMMMMMMMMM…

But they can see that there’s something outside of normal range there, why is it assumed there should be no problem? There may be no problem for 99% of the people within your range, that doesn’t mean 1% doesn’t have major problems like you do.

Using myself as an example, I have ATN that has no visible reason. But just because there’s nothing showing on any test that doesn’t mean I don’t have blinding pain. You actually have something that shows on a test and yet they say it can’t be causing the problems? That doesn’t make sense to me. In fact, that sounds to me like you need a third (or forth, or fifth) opinion.

In 2 years i spent huge ammount of money … arround 40.000 .
Maybe for US or Cannada it’s not much but for Romania , you can buy a house in a verry good residence with this money and i paid it from my pocket.
More frustrating is that nobody discovered anything to explain my symptoms.

I consulted 14 different ENT’s , about 100 ENT visits , 1 Angio MRI , 4 Neck MRI , 3Tesla MRI of neck , 1 CT with contrast for neck bones and artheryes , 12 Ultrasounds of neck soft parts , 2 Doppler ultrasounds for carotid arterys , 2 Ultrasounds for thyroid gland , 3 Blood tests for tyroid hormones , Hematology tests repeted monthly for about 20 months , All toxicologic tests available , Ionograms ,
Gastrointestinal endoscopy with biopsy , 2 radiographys of the lungs, 1 sinus radiography 5 Neurology consultations , 2 psycologists , took out tonsils , tonsils biopsy … and many more i dont even remember. I shared all my tests on google drive here : https://drive.google.com/drive/folders/0B5h8T6KAs74pVmEtbG9Da0FjdlU

and sent the link to numerous doctors across country hoping somebody will see something and treat the CAUSE not the symptoms.

ALL this tests discovered:

  1. straight cervical spine and small C4, C5 Non-compressive discopathy ( doctors say i shouldnt have symptoms from that)
  2. cervical inflamatory lymph nodes and inflamation of adenoids
  3. thyroid micro nodule 3 mm
  4. small acid reflux without throat burns or errosion

On one side , i am happy they didn’t find anything . I preffer GPN than a painless cancer but on the other side , i need my life back i need my old me i need a cause for beeing in all this daily pains and for this spent money.

Hi LifeOwner and everyone here,

I’m only stopping in here for a moment as I’m half stoned from a procedure sedative, but I want to post how heartened I am by the goodwill shown here, and how much I agree with almost everything in the thread. Not a very helpful proclamation but I’m inspired to post it anyway.

LifeOwner, please know I understand your frustration and pain, and I hope my questions/suggestions didn’t come across as dismissive of your mental health (when I mentioned meditation, for example) – it’s that I truly do believe these things have helped me where conventional medicine has faltered.

This pain thing is just so rotten and yet I can’t deny the good things it has unearthed for me, including the goodwill and intelligence of others who are similarly plagued.

I’ll return with (I hope) more practical commentary when my head’s less in the clouds. In the meantime, I wish you all a good night!

Reken you should investigate ellen6 pathway, anatomically there is a shared pathway with GPN and TN. You say they didn’t find anything, I’d take it as a general wake up for my health. The above says so or are you going to wait for it to problematic? They didn’t find anything??? they did. Again look at ellen6 and the fact GP nerve bundle is also in the neck.

I’m with 'moth… you say they didn’t find anything yet you list four things that were found. The two that concern me the most and may be fundamental issues are the cervical spine (equals possible cause of facial pain) and the acid reflux.

Acid reflux is extremely serious. It actually leads to cancer in about 5% of the cases – it’s the kind of cancer that killed my husband, actually, he had “heartburn” for 45 years and was told it was nothing, use TUMS, he was actually told this right up until the stage 4 cancer Dx.

I would say they did NOT not find anything. They found several things that need addressed. You need to continue to be proactive about all of these. It’s your body, you know it best and you know what it’s wrong.

Hi there
I have been diagnosed with Glossopharyngeal Neuralgia of the cervicogenic trigeminal nerve complex … since 2005 I’ve experienced sharp burning pain deep inside my right ear and sometimes my jaw and under my eye on right side … I have had two MVD surgeries where the neurosurgeon gained access to my brain by drilling a circular hole above the mastoid sinus behind my right ear …after each surgery the pain was alleviated for about eight months but has returned with time … I’m told there is no cure
So I manage the pain with anti inflammatories and pain medication but do not take any of the Neuro meds or psychotic medication because it totally messes with my head … as it is, I cannot work because the pain is bad most days … but I look forward to the good days when it is not so bad …

May sound a bit brutal Lorraine but unless ’ Glossopharyngeal Neuralgia of the cervicogenic trigeminal nerve complex …’ was diagnosed post MVD what on earth were they doing, MVD wasn’t going to affect the cervicogenic TN complex. If pre MVD would lead credence to general anaesthetic being the saviour not MVD, I’d be interested to know. The answer may contradict ’ the no cure’, which often means we can’t with our needles and knives, so no one else can, we can’t possibly refer it would bruise our ego.

After 3 years i finally DID IT , i cured my glossopharyngeal neuralgia.
I found a “pain clinic” and they recommanded scrambler therapy .
After only 1 session i was pain free for 2 hours.
Now i am on 7 session from a total of 10 and NO MORE PAIN.
My pain level decreased from 9 to 3 after 3 sessions .
Now, my pain is about 1 , just a slight discomfort that i can ignore.
NO MORE OPIOIDS, NO MORE antiinflamatory medication , just the feeling that i am healthy again.
GPN and TN are higly curable this days with this Scrambler Therapy and NO side effects !
Here in Romania it only costs 50$ / session but it cand be verry expensive in other locations .
Any how, dont waste your life in PAIN , i am the living proof that this therapy is HIGHLY effective, go for it !
You dont have to belive me, just read articles below.