Chiropractic

What We Do With Functional Medicine | El Paso, TX (2021)

Introduction

In today’s podcast, Dr. Alex Jimenez DC, Health Coaches Adriana Caceres and Faith Arciniega, Massage Therapist Amparo Armendáriz-Pérez, and Clinical Nutritionist Ana Paola Rodriguez Arciniega discuss today what they do and offer with Functional Medicine.

 

Discussion

Dr. Alex Jimenez introduces his guests.

 

[01:00:11] Dr. Alex Jimenez DC*:  Welcome, guys. We’re here talking today about what we do. Today is a special day. It’s my father’s birthday, Alberto Jimenez. Alberto Augusto Jimenez. He is an immigrant from Colombia who gave me my knowledge. My amazing father. So happy birthday, dad. We’re going to be talking today is we’re going to be talking about what we do. We have a group of wonderful individuals here. We have five individuals. We have a whole lot more people in the background. So what we’re doing today is we’re beginning a process of notifying ourselves of a change that is going on. We’re going to be talking about nutrition, wellness, exercise, what we do in the office, how we do a little bit different techniques within the office, and how we compare and contrast to other services and let people understand what we do as we do change. So today, we’re in a new podcast room where we left the Push Fitness Center, which is now going to be another big, fantastic thing. So as they do the construction, we moved our podcast here. So you’re going to notice that we’re going to be communicating from this particular podcast. Still, we’re so connected to our Push counterparts and our Push Fitness centers and Daniel Alvarado, and we’ll be making that happen as it starts coming up. So today, we’re going to be talking about nutrition. I have Ana Paola Rodriguiez Arciniega here, so say hello there. We have Faith Arciniega. We have Adriana Caceres, and we have Amparo Armendáriz-Pérez as a massage therapist there. So we are going to be talking about different things. So each one of us has different specialties. So I’m going to start with some of the unique things we’re doing in our office, such as the types of treatments we do. We deal with a lot of inflammation, many injuries, a lot of trauma, and many soft tissue injuries. But you can’t get away from soft tissue injuries without discussing inflammation. So at the basis of inflammation, what we do is we associate, collaborate, find out the coincidence of inflammation to injuries, and we deal with the true causation of inflammation and come up with treating protocols and health care plans that affect people and their disorders. So many people come to us with a back injury or a neck injury after, let’s say, a motor vehicle accident, a car accident, or a work-related accident. But they may also have, you know, subclinical issues of inflammation that are just looming and then aggravate the direct trauma that’s going on. So what we’re going to do is introduce our team here one at a time so we can see what’s going on. And we’re going to start with Ana Paola Rodriguez Arciniega. Ana, how are you doing?

 

[01:02:57] Ana Paola: I am doing fine, and how are you doing?

 

[01:03:00] Dr. Alex Jimenez DC*: Good, can you hear us OK over there?

 

[01:03:02] Ana Paola: Yes, I can hear you, OK.

 

[01:03:04] Dr. Alex Jimenez DC*: Excellent. Tell us a bit of what you do, and we actually because you work hand-in-hand with us all here, and you are our virtual eye in the sky for nutrition at this point. But the nutrition that you deal with works a little bit with functional medicine. Tell us what you do and how we integrate that particular type of practice in our office.

 

Ana Paola Rodriguez Arciniega

Clinical Nutritionist Ana Paola Rodriguez Arciniega introduces herself and talks about what she does.

 

[01:03:23] Ana Paola: OK, so I am the head nutritionist, and basically, what I do is I take care of their nutritional assessment. But as you said before, we try to look for the root causes, and this allows us to create a more integral treatment plan for our patients, so that is focusing a little bit more on finding what is the root cause of the inflammation because it is related to injuries, accident, and stress, and to maybe delay the recovery part of our patients. So this is what we are trying to do to get like a fast track recovery for our patients for nutrition because it has to do with that.

 

[01:04:09] Dr. Alex Jimenez DC*: Yes. And then? Don’t worry. 

 

[01:04:17] Ana Paola: OK, I’m here.

 

[01:04:18] Dr. Alex Jimenez DC*:  It’s all technology. Just keep on going and telling me. We’ll figure it out as we go.

 

[01:04:22] Ana Paola: So what we always start doing is very simple. I try to focus on what is going on with my patient physically, which has a lot to do with the body composition of my patient. So I find that that is the principle, not the principle, but the first step could do it that way. So we try to integrate this body composition analysis with the Inbody 770 machine that we use. And that way, we can correlate all the body composition, either a fat mass percentage or BMI or muscle mass or lean body mass, that our patient has and try to associate with injuries or correlated with inflammation. And it is often, very often, or all of the time, that we find a direct correlation with inflammation or this type of injury. Specifically, talking about intracellular and extracellular water is one of the most exciting starting with my patients. But the thing about nutritional assessment is that even if it’s like separated into different parts, it kind of overlaps within each other, and that is like the thing that has in common with functional medicine, functional nutrition, then trying to treat your patient as a holistic, like a whole person and try to integrate the nutritional part of it, the fast recovery of an injury, the massage therapist and of course, all the wellness part of their recovery that has to do with our health coaches. So mostly, what I think that I do right here is that I perform for that. I am part of a team that integrates like a holistic care plan for patients.

 

Adriana Caceres

Health Coach Adriana Caceres introduces herself and explains what she does.

 

[01:06:28] Dr. Alex Jimenez DC*: Well said. That is very, very good. I have to tell you there is no separating inflammation, nutrition, and injuries that there’s no way. So as we deal with it, we can learn about it. It’s almost like saying exercising and not talking nutrition. We have to deal with nutritional components. Now, specifically that we are talking about exercise. Adrianna, here, she’s our specialist and our expert on exercise physiology. She works with nutrition. She has extensive experience of working with clients online and in video as well as in your home. So she gets in there and exercises with you as she does her thing. Adriana, tell us a bit of your experience and what you do and what you offer these particular dynamics with our team here.

 

[01:07:14] Adriana Caceres: Sure. Well, my name is Adriana Caceres, and I’m your health coach, fitness trainer, and of course, exercise specialist. And as Ana was saying, nutrition and exercise go hand in hand. Nutrition is the base, but exercise gives you the mobility and gives you that range of mobility that you need to live a proper and, well, life until you know when you age. So definitely, it’s the base for a lot of recovery for injuries. The stretching is super important, and we use that a lot here to stretch our patients and make them do their small stretching so they can grow their range of mobility and have a better life in their daily life, their daily style. Right now, I work online a lot. So since COVID started, we started working out online with our patients and clients, and it’s different. But at the same time is super fun. The difference between going to an in-person exercise session and doing an online session is that you don’t have the time. We always hear excuses like; I can’t make it. I don’t have the time. I’m too busy. I know that I’m in pain, but I just think it’s too far. So the online cuts all those excuses. I mean, you’re doing that from the comfort of your home. You are just opening your TV or your computer, laptop, or tablet and connecting to a session. It’s on your time. So that helps a lot. The second excuse we always hear is if we are parents who watch our kids, what will I do? There’s no daycare, and this is just the same thing. It’s at your home, so you can even involve your family in this new and different lifestyle. Usually, when we have somebody who is overweight, it is a family. It’s the household. Because of course, it’s the same poor nutrition that they have or bad nutrition that they have and the same habits. So starting with the workouts online helps you realize, or your household realize that it’s a group thing, it’s a whole lifestyle, and you want to be the role model for your kids. You always want the best for your kids, so you want to be the role model for them. Normally they will. If you’re overweight or have a little extra pounds on, your kids usually will have the same habits. And of course, we’ll tend to be with the same kind of overweight that you have. So this helps them see a life change experience and get involved in this new experience.

 

[01:10:12] Dr. Alex Jimenez DC*: You know, now that you mention that, you know, it’s essential to be the change that you expect in the world. I think Gandhi or something that says, might that be the change you want to see? Right. So the thing is, when you go purchase foods or exercise in front of your kids and see what you do, this is who they will become and what do we want for our children? We want the best. Our legacy is our family sometimes or our friends. And when you have family, they’re watching you. They learn they observe and appreciate mom, you know, wiggling around the living room and dealing with it. Everyone’s got memories of their parents exercising or doing something. And then, you know what happens, later on, we end up becoming our parents? Right. So if we have good habits, we eventually will become habits. I have become my father, and it’s the truth. The reality is in my son, and I listen to him. He doesn’t realize it, but he says everything I used to say. So it’s a continuous change. So if you’ve got nutrition and exercise, which seems to be one of the most extraordinary kinds of collaborative associative and treatment protocols, you can’t separate exercise from recovery. So Parkinson’s… exercise, Alzheimer’s… exercise, diabetes… exercise, brain disorder… exercise, health issues… exercise is such an essential component of fitness that by not doing it and not being part of it, you’re going to minimize the ability to return to an optimal configuration. Now, whether you like it or not, exercising mobility is one of the most important key factors. I realize that when you start working on so many patients over the years, you kind of start kind of seeing the intent of God. Right. So the intent of God is mobility, and he gives you tons of joints. I mean, why does he give you so many joints so we can wiggle, OK? To move, right? So using that and integrating the brain and the function of the brain with your body moving and pumping, and blood does heal a lot of issues and should be part of most treatment protocols. Even if exercise doesn’t look like, let’s say, a Zumba class, maybe it’s just wiggling around in a chair or doing certain things. We can do it for a lot of people. People think that I’ve seen from, you know, a nine-month literally about to have a baby, women doing CrossFit, and the baby is born fine. The body is designed to handle certain things too. Older adults about 100 years old, exercising. And children, they love to exercise. So it’s an essential component. So yes, that is what you do, Adriana, and we integrate that in the office, and we look or minimize the excuses to do that, so that’s very important. So do you also do nutrition a little bit?

 

[01:13:06] Adriana Caceres: Yes, I do. I’m a nutrition consultant, so I do help a lot with that part. As I said, it goes hand in hand, definitely to have a higher health span. You want to have a healthy habit, so one thing is lifespan, and one thing is healthspan, and lifespan comes out of years we’re going to live. Yes, eventually, we’ll die, and then our health span is how we want to live them. Are we going to leave them healthy our last ten years? Are we going to be able to walk? Are we going to able to say, are we going to be able to get out of a bathtub? So that’s what you want to have, and that’s what we don’t think about when we say, Oh, you know what? I know what I’m doing, and I don’t think exercising is for me. Everybody has a fitness level, and everybody has a way. And the trick for this is to find what you want to do. And what we do here is a lot of that we build up people and save injury, save from injuries and, you know, prolong their life and prolong how they live, their life, their daily activities.

 

Amparo Armendáriz-Pérez

Massage Therapist Amparo Armendáriz-Pérez introduces herself and talks about what she does.

 

[01:14:15] Dr. Alex Jimenez DC*: You know, it’s excellent that approach. Now we also have a young lady named Amparo Armendáriz-Pérez. So for Amparo, she does our massage. And what she does is she works on individuals with a deep level of knowledge of fitness. Now, she comes to us with a vast amount of personal experience working with people and her desire for health care. So I would like her to tell us. Welcome. And tell us about what you do in terms of massage as a component within this group.

 

[01:14:55] Amparo Armendáriz-Pérez: Thank you. Being here as a part of this family, this community of servers, because that’s what we do. We serve those that come to us. We’re all about education. So we’re listening to, you know, nutritional education, physical education on how to help them to make better choices for themselves. What I do is I discuss with our patients what I’m going to do for them, what’s happening as I put my hands on their muscles. What I feel, and they even ask me questions, Well, what is that? Why do I feel so restricted? What’s happening? So I enjoy helping them understand their own body with all my heart because they’re in their own body. We exist in our body, and we know we have hands and feet and all these components. But sometimes, when they’re not operating correctly, we don’t know why, and that’s very frustrating. And so, I enjoy discussing with the patients. OK, well, this is what I’m feeling, and how do you feel as I’m, you know, applying pressure here as we’re moving and grooving here? And the feedback is what helps them to accelerate. They want to learn more. They want to know; well, what else can I do? You know, when I go home, how do I prolong this feeling of feeling like I’m standing up straight now? Like I feel more empowered? You know, I didn’t realize my feet felt that way. I didn’t know my arm felt that way. And I understand where they’re coming from because massage therapy was one of my avenues of healing when I went through a healing process. So it’s just a fantastic tool to reach out to the patients and allow them to know that this is another way that we support them is not just OK; we’re going to do this one two three. No, it goes further than that. These are your muscles, and this is how you can assist yourself, and this is what we’re going to do for you. And you can take it a step further and understand that you have the power to help these muscles become more pliable through nutrition, exercise, movement, and anyway, shape or form. And you can put your hand on yourself and feel like, you know, that’s tight today. I think I can kind of touch that a little and massage that, and you don’t need a license to touch your arm. And I think that that’s what’s beautiful about what we do. We empower our patients, and that’s important.

 

[01:17:16] Dr. Alex Jimenez DC*: You know, when you were saying that in your approach, because I see that when you work on the patients, sometimes there are areas in the body that hurt. However, the human dynamics is that the body was designed with duality, such as one muscle affects another. The tricep, you know, pushes the bicep disengages. There’s a constant synergy with the muscular structure. Sometimes the pain or discomfort in those areas is remote or not, even in the area where you had, you know, you were initially told where the person’s issues were. Tell us a bit of that, Amparo. How you kind of tracked down the discomfort in, let’s say, an area over a problem that you’ve treated in the past.

 

[01:18:07] Amparo Armendáriz-Pérez: One of the most common areas I’ve experienced with many patients is when they discuss low back pain or sometimes even sciatic pain. And they tell me, you know, this is restricting me from sitting up straight. It’s restricting me from just going in the grocery store and walking to and from and not having to feel like I need to sit. And so, OK, I understand. And then they get on the table, and as I’m working on their back, I’m listening to what they’re saying. I also married together, what my hands are saying, and basically, my hands are just interpreting what their muscles are saying because sometimes, we can say something. I know in and out ourselves, OK, I feel this pain right here. However, the muscle is saying, well, something else is happening, and it’s extending, so they’ll tell me my pain is in the lower back while I follow the connection from that low back. And as I’m feeling alongside the side of their leg, I feel how tight it is, and it’s like, that’s got to be very restrictive down to the knee. And I’m like, OK, so let’s release that. And then as I’m working on that, it’s very powerful to hear the patient say, Wow, I can feel that, but you’re on my knee, and I’m like, It all goes together because the knee attachments go straight into the low back or into the hip area. And it was beautiful. Is that when they love to, everybody loves to learn about themselves? Why wouldn’t you want to know about yourself? It helps you become a better you. And so when I love to explain that to them, they’re like, Wow, so if I do this, I can feel better doing this. Absolutely. You know, ma’am or sir, right in here is where I’m touching. I’m massaging, and I’m applying compressions. It’s straightforward. It’s even over your clothes. I’m just playing some pressure right there, gently releasing, and they’re like, Wow, the movement is a lot better. And it’s interesting that just to the right around the knee, in the back and the front even, and it helps to release that low back pain.

 

[01:20:05]  Dr. Alex Jimenez DC*: You know, you mentioned just like the referral pain patterns, it’s incredible. How the body adapts is like that gecko, you know, when it’s hot and lifts its left leg and throws up on a different leg; that’s what the human body works. So if you have a lower back problem, it will affect the mid-back. It will affect your knees. The knees and lower back are directly and indirectly related. So as we look at those dynamic changes. One of the things we look at as we track down the problem. OK, it’s not just so easy to treat a low back problem for what it is. We have to find out the problem for every person and every person’s design, and we can track it down quickly after a couple of minutes of working in your body. We got the suspect in, and it’s not so apparent many times that it’s just a low back problem. You mentioned sciatica. Sciatica is one of these things where it isn’t a disorder. It’s a group of syndrome disorders that creates a lot of drama, and it almost has its mind. It’s like, it’s like you’ve got stress or sciatica flares up. You got, you know, you get upset about financial worries, sciatica flares up. It’s like it sits there looming, and it bites you, and it causes a whole array of problems and hinders a lot of people, which we don’t want to do surgically. And sometimes, there are issues where it does require surgical intervention. We have diagnostic procedures to determine the differences over a thousand reasons, and I would venture to say there are even more than a thousand reasons for causing sciatica. So we got to get to the root cause of it. And does nutrition play? Yes. Will exercise play? Yes, we have to look at all these components. Now we have another individual here, that is Faith Arciniega. So Faith comes to us with a lot of great experiences. She’s going to be an incredible doctor, nurse practitioner. That’s the goal right now. She’s in the process of going through that, but she also does our health coach integration. So she does many different things from, you know, body compositions, as Ana mentioned, all the way to in laboratory tests and X-rays are integrated with Ana. So we facilitate the ability to communicate the issues, treat the problems, and develop an appropriate care plan. So Faith, tell us a bit of what you do here in this particular group of people?

 

Faith Arciniega

Health Coach Faith Arciniega introduces herself and explains what she does.

 

[01:22:27] Faith Arciniega: Absolutely. So as Dr. Jimenez mentioned, my name is Faith Arciniega. I bridged the gap between Ana and Adriana, and Amparo. We all work very closely together to ensure the patients leave here to understand better how their bodies should operate and function. So if the doctor goes in and finds out they’re having issues with their sciatica, I will go in before that gather together their medical history, see what’s going on, and see if they have problems with the gut. Depression, anxiety. And then, I would then communicate with Ana about those issues, and we can work together to find supplements or with the correct diet for them. So I work together with Ana and Adriana to ensure that the patient leads healthier and better understands their body because a car wouldn’t operate correctly. If we fill it with water, the human body will not function if we don’t fuel it correctly, so we teach them. How they should eat, what supplements they should take, and how they should exercise so that they’re moving and operating as they should be like the body was created to.

 

[01:23:26] Dr. Alex Jimenez DC*: You know, as like you, as you kind of work with patients, we mean right before we have this little unified meeting together. We noticed that we had a patient that had, you know, chronic inflammation and pain everywhere. And it’s crazy. But you know, the problem comes as a low back problem and leads to ankle issues. But we could see that there was a dietary issue, and it was almost like inflammation. No injury; keeps on inflaming. Then we find out that there’s a lot of sugar, many processed foods, a lot of meat. Well, to say that those are bad, it’s not just that easy, but we have to figure out the cause for that particular individual. We assess food sensitivities, and we do laboratory diagnostics. We figure out what it is the root cause. Not everything is a surgical procedure; as a matter of fact, most things are non-surgical. So what we try to do is is allow the intelligence of the body wants to figure it out, using the knowledge that we have and the expertise that we have in functional wellness and functional nutrition to be able to come up with a treatment plan that’s appropriate with exercise and the protocols that we use. So we have a lot going on here. So we wanted to do this as a beginning because we will be doing quite a few different presentations. But as we do changes, we haven’t been communicating well. So now what we’re going to be doing is we’re going to be coming back at different presentations, discussing particular topics. If you have a specific topic that you want us to discuss, particularly about an injury, inflammation, and a disorder that falls into the world of functional wellness and even functional medicine, we commonly associate and look for corporations related to the musculoskeletal system. So what we want to do is to be able to assess and determine the true causes because once we fix you, we want to improve you, right? We want to give you the tools to go on and live an extraordinary life because everyone here knows that I touted as much as possible. And man, if we’re designed to live 100 years and probably more, according to even the statisticians out there, if you take care of everything, the heart will continue to pump years after it’s removed from the body. So our body doesn’t get clogged with some atherosclerotic plaques or inflammatory disorders or some diseases or cancers; if we can keep it healthy, we will live a good life. God willing, God wants you to take you now. OK, so we all know that. So the focus of today was to present a little bit of a review. So Ana, thank you very much for helping us out. You know, a little bit of information there. You know, Faith, you’re out there. You’ve got the calm, soothing voice, and she’s cool with her voice there; you’ve got Amparo, which is our therapist that finds and tracks down. We got everyone here. We have many massage therapists that track down the issues. She’s just the one that has been able to formulate the ability to communicate the intention of the human body, which is and also the results, and that takes years to do. You can’t just go ahead and present yourself. Doctors worldwide will tell you a doctor that graduates, whether it’s in any clinical practice on his first day, is not the same doctor ten years later. And they’re like wine. They get better each time, and most of the time, you’ll find that doctors, the wiser they become, the more they rely on the wisdom of the body to manipulate and facilitate the healing process. So for Adriana, she’s our exercise, and she’ll have you dancing and doing the Zumba and seeing, you know, what’s best for you. And by the way, if you feel ugly that day, you can put the screen off, so you don’t have to be showing your body. You just know that she’s there, and you just tell her you’re doing the exercise. It’s pretty funny. Someone probably has the video off and is sitting there, you know, eating something. Yeah, I’m exercising, but we do have tools for that, like a cardio thing. They’ll tell us what your heart rate’s at; we will know if you are fibbing, but it doesn’t happen anyway. But anyway, it was a tremendous little connection today. It was the first, and we looked forward to more. Thank you, guys. Thank you very much, and does anyone have anything else to say. Faith, anything good, anything you want to add.

 

Conclusion

Dr. Alex Jimenez and crew recap on Functional Medicine.

 

[01:27:40] Faith Arciniega: No, just super excited for you all to come in here so that we can work together to find the best treatment plan for you. We’re all very passionate about patient care, and we’re excited to work with you.

 

[01:27:49] Dr. Alex Jimenez DC*: All right, Amparo?

 

[01:27:50] Amparo Armendáriz-Pérez: Just like, she said. We’re ready to help you be empowered. Understand that you are the boss of you.

 

[01:27:58] Dr. Alex Jimenez DC*: I’m the boss of me. I tell my wife that you know what she says all the time; you think you’re the boss of you, right?

 

[01:28:02] Dr. Alex Jimenez DC*: And like I’m saying, OK. Anyways.

 

[01:28:05] Dr. Alex Jimenez DC*: Ana, anything you have to say.

 

[01:28:10] Ana Paola: We’re so excited to work with all our patients, and we try to follow through and listen to all of the symptoms you’re having. So I guess that from our part, you will always have ears to follow through. 

 

[01:28:32] Dr. Alex Jimenez DC*: Thank you so much. Adriana, anything?

 

[01:28:34] Adriana Caceres: Well, we are here waiting for all of you, and we have a great team, all very passionate, as you see. And we are just here waiting for you to come in, and we will help you resolve.

 

[01:28:47] Dr. Alex Jimenez DC*: We’re going to tear it up, guys. We’re going to tear it up. We’re going to make it. We’re going to happen. OK, so this is called Cobra Kai Chiropractic Center. OK, so if you think you’re going to come in here and just have a little talk? We’re going to get it on. We’re going to get it on with your body, and we’re going to take it to the next level. And yeah, we got to go, OK, we’re going to make the body what it should be, OK. And we’re going to release it without in pain, and it’s going to be a very comfortable dynamic. So thank you, guys, and we look forward to being connected the next one. So God bless you guys. Have a good one.

 

[01:29:21] Adriana Caceres: Thank you. 

 

Disclaimer

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Professional Scope of Practice *

The information herein on "What We Do With Functional Medicine | El Paso, TX (2021)" is not intended to replace a one-on-one relationship with a qualified health care professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional.

Blog Information & Scope Discussions

Our information scope is limited to Chiropractic, musculoskeletal, physical medicines, wellness, contributing etiological viscerosomatic disturbances within clinical presentations, associated somatovisceral reflex clinical dynamics, subluxation complexes, sensitive health issues, and/or functional medicine articles, topics, and discussions.

We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system.

Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.*

Our office has reasonably attempted to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez, DC, or contact us at 915-850-0900.

We are here to help you and your family.

Blessings

Dr. Alex Jimenez DC, MSACP, RN*, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed as a Doctor of Chiropractic (DC) in Texas & New Mexico*
Texas DC License # TX5807, New Mexico DC License # NM-DC2182

Licensed as a Registered Nurse (RN*) in Florida
Florida License RN License # RN9617241 (Control No. 3558029)
License Compact Status: Multi-State License: Authorized to Practice in 40 States*
Presently Matriculated: ICHS: MSN* FNP (Family Nurse Practitioner Program)

Dr. Alex Jimenez DC, MSACP, RN* CIFM*, IFMCP*, ATN*, CCST
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