Hi, Tim. How are you today? Good. How are you doing, sir? Excellent. Excellent. So we're here today for your strata procedure. Yes. Just so if we can review, I believe it's been a couple of years since we did your first strata procedure and at that time you were having predominantly reflux type symptoms. And I think we've succeeded in having those all go away, although what's come back recently is the regurgitation. Yes, sir. As well as the LPR type symptoms. So mucus, production and throat clearing is back again. And the medications have not been particularly successful in controlling that, have they? No, they have not. Okay. Now have you been having any difficulty getting those medications? My insurance, you know, I was talking about not covering dexamit anymore, but I've just put the paperwork in for that and they're going to start covering it again. Oh, that's great news. That's great news. So do you have any questions or concerns before we get started? No, I've had this procedure before, so I'm not really worried. Yeah, I know what to expect. It might differ a little bit. Uh-huh. The second time around. So typically what happens is every time we do one of these procedures, we're going to take the muscle and the esophagus and double it inside. And so every time we get a chance to treat it again, it's going to double yet again. So your muscle will be roughly four times its original size. And that is where we're just trying to get to the point where we need to get about four millimeters of mercury worth of pressure to resist the stomach pressure as it normally contracts and digests. Then we'll go ahead and get started. Thank you, sir. Okay, fantastic. Has this throughout been um- Yeah. Okay. Fantastic. Let's go ahead and get you in position. What's very important in the positioning of the patient is that we want to guard against the only complication that can occur, which is aspiration of fluids that would come from the esophagus, we're stomach up into the throat while the patient is sedated. So what we're going to do is we're going to take this young gentleman and put him at about 30 degrees worth of an egg. And this way we have gravity helping us with any fluid that might come up. And now we'll have you turn on your side towards me. So we want the patient to stay on his left side. And so we're going to position the legs with the top legs slightly forward. And the bottom leg we're going to pull back a bit. So it kind of forms a tripod of stability with his shoulder point. And then the other important thing is we're going to maintain his head in an extended position. Because this also facilitates the passage of the instrument and the passage of the stratocatheter. We're going to make sure that the patient has oxygen on at all times so that the oxygen levels will stay high no matter what happens. And we're going to provide him with a pair of protective eye glasses. And this is very important because sometimes things can come up out of the endoscope during the procedure. And we want to protect those beautiful eyes and make sure there's no damage. And so with the patient in proper position, the next thing we'll do is place in a bite block that will protect the patient's teeth, tongue, and lips from the procedure. It also helps to protect our instrument against biting. Let's go ahead and hook the monitors up. So what we're going to do is provide oxygen. We're going to measure the oxygen level. And we do that with a small probe on the finger. Like you see here. We'll also be checking blood pressure and also the cardiac rhythm and rate. We're going to give a series of different medications as part of the sedation process. Initially something called Versed and Fentanyl. And those act as pre-medications to calm the patient down and to relieve any pain. And then the final medication we'll give when we begin the procedure is a substance known as propyl, which is the powerful sedative. Thank you.