Mm-hmm.

And so you gotta watch out for, um, bad behavior when that starts to happen.

So what we recommend is, at, during this time, is to get them some extra, um, chew toys, interactive toys that they can play with while, uh, you're away.

If you're crate-training your dog, have them have something in there that maybe smells like the, the, you or the children, like a T-shirt or a blanket.

That way it kinda soothes them, and they're not missing them so much.

But having long-lasting chews, 'cause you don't wanna give them something that they're just gonna eat right away.

So things like elk or deer antlers, um, the yak cheese, which is really super hard-

Mm-hmm.

What are your thoughts?

I think that low dose and specifically ultra-low dose naltrexone really has some interesting potential application for a situation where you're concerned about opioid-induced hyperalgesia.

I'll tell you that when we've used low-dose naltrexone in, in my particular practice, and I'm talking about ranging between two to four and five milligrams a day, we, we haven't really seen the efficacy that we would really love to see.

We have trialed really, really low doses, what we would call ultra-low dose naltrexone, on top of or concurrently with an opioid that we continue, and we've seen reduction in some of the adverse effects and noticeable improvement in pain.

We haven't seen that anecdotally as, as much as we probably would like, but we have seen it on occasion.

And it also allows us in, in certain circumstances to at least reduce the overall opioid burden and allows us to back down a little bit in some s- circumstances.

I'd be interested to hear what Stephanie thinks or what her experiences are.

What's a realistic and evidence-based approach for someone like DW?