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Chrysalis Center is happy to welcome Sarah Voegtle, RD, CSSD, LDN to our staff. Sarah joins our team of dietitians to provide expert nutrition counseling to our clients. She is now accepting new clients and is in-network with BCBS and United Healthcare. I asked Sarah a few frequently asked questions that I often hear from prospective clients when they are considering meeting with a registered dietitian.

What populations do you serve as a dietitian?

I am a board certified specialist in sports nutrition and I have extensive experience in eating disorders. However, as a dietitian I am trained and able to see all ages and genders. I have experience with weight management, diabetes management, eating disorders, GI disorders, food allergies/food intolerance, immune disorders, and renal nutrition.

What is your approach to nutrition counseling?

I have a non-diet approach to nutrition counseling. I firmly believe that all foods can fit into any eating plan and there are no bad or forbidden foods. I strive to empower my clients to help improve their mental and physical health.

I already know what I should eat, why should I see a dietitian?

Most people have some baseline nutrition knowledge. However, a dietitian is the expert in all things food and nutrition. Dietitians base their practice on solid, science-based, peer-reviewed research and likely can add another dimension to your nutrition knowledge.  Additionally, seeing a dietitian gives you someone to help you with accountability. People who consistently see a dietitian see better and more long-lasting results.

What can I expect to happen during a nutrition therapy appointment? 

The first appointment will be an assessment where I’ll gather information about you and your past to best assist you in reaching your goals. Together, we will work on achievable and timely goals. Likely you will be given work to complete in between sessions to help with the continuation of nutrition therapy into your everyday life.

How can my overall health improve by seeing a dietitian?

Food really is the best medicine. A dietitian can help give you individualized eating plans and tips in order to help you be your best self both mentally and physically. Improved eating may help improve sleep, energy, mood, self-confidence, medical conditions and symptoms.

 

 

If you’re ready to schedule your first appointment with Sarah, please call our office at (910) 790-9500 today.



I learned how to shuffle cards when I was 15 years old in September of 1996. What a strange talent to remember exactly when I acquired the skill. But I have distinct memories of sitting with my mother for hours on end at the dining room table that still sits in her house off Middle Sound Loop Road in Ogden. We sat at that table with the windows open and the late summer heat filling our house with no fans and only sunlight in the day and candles or flashlights at night. I learned how to shuffle cards then because my mom and I played cards for hours on end to pass the time away during and after Hurricane Fran hit Wilmington, NC that year.

Fast forward 22 years to a different house on the other end of the county and there I sat, trying to teach my seven-year-old son how to shuffle UNO cards at our coffee table while waiting for Hurricane Florence to pass over our house. Although 2018 brought many technological advances and privileges to waiting out a storm that weren’t possible before the turn of the century, many things were similar during this hurricane: Waiting is painful when the end of a disaster is not yet in sight. Fear is crippling when wondering what the next hour will bring with howling wind, rising water, and threats of tornados. Nerves are shot when people are exhausted and scared, and resources are hard to come by. But the resilience of a community is stronger than any storm when strangers and neighbors come together to get a city back on its feet.

Whether you stayed or evacuated, it’s safe to say that Monday, September 10 was the last “normal” day in Wilmington. The following day, schools closed, evacuations were made, houses were boarded up and the most precious documents and family heirlooms were packed up or put up to prepare for the impending storm. By Wednesday, September 12 – you knew if you were staying or going. My family stayed. My family, a mix of people who are all natives of southeastern North Carolina for all the generations known to us, stayed put.

And we waited… Remnants of the storm started to reach us Thursday, we went outside in the eye Friday morning, and then Florence stalled. She sat and hovered for what felt like a week. Just when we thought she was moving away, the tornados started. As if she hadn’t wreaked enough havoc up and down the NC Coast, Florence continued in her furry with new disasters. I lost track of what day it was, but it wasn’t really safe to even get out Sunday; and even then, our community resembled something out of the Twilight Zone more than what we usually see while driving or walking down familiar roads.

It was painful and heartbreaking driving around right after the storm passed. Power lines were down everywhere, flooding had started, and trees that looked like they would stand the test of time crumpled around neighborhoods, houses, and buildings. Parking lots that have never flooded had 2 feet of water with white caps flowing through them. Neighborhoods that have never experienced standing water were suddenly under feet of flash flooding and people were escaping homes by way of boat or helicopter in the middle of the night. Nights were eerily black when most were still without power, and after all the bands of the storm finally passed, the stars shined brighter than I’ve ever seen from my house because man-made power wasn’t there to obstruct their brilliance. It’s a strange roller coaster of emotions to go from doing nothing but waiting to finding anything to do to help anyone.

Neighbors that I never met came over to ask if we needed help. An old friend who lives on my street brought a chainsaw to my house, and when I told him the downed tree could wait, he said he had to do something, so we shared memories of past while we cut and carried that tree to the mounting debris pile. 

People who had no power but generators cooked for people that had nothing. Volunteers signed up at multiple distribution locations to serve meals and pass out donated items to help people who lost everything. Churches opened their doors to crews from out of state who came as soon as their trucks were allowed in the area.

I came up to the office everyday after I could get here to bail water that came in and mitigate any more possible damage that could come. And every day, I saw more help on the roads. Military planes landed in Hanover Center’s parking lot that had rescued people from their homes. Organizations had huge tents set up in other parking lots to distribute tons of donated items to anyone who could come get them. The Cajun Navy volunteers left their place of safety far away and came with trailers of rafts and Jon boats to rescue people and animals from homes completely submerged. It’s humbling to drive around and see strangers who’ve come to help people whom they’ve never met in a city where they’ve never traveled, all because they believe it’s the right thing to do.

Power is (for the most part) restored. Little by little, water is receding, and blue tarps decorate tops of houses all over the city. Grass that was submerged is now visible, but brown. Debris piles are in front yards of almost every home in the city. The mosquitoes have arrived with furor and other critters will soon as well. But, I hope and pray that the resilience, hope, and compassion that has swept over our community is here to stay.

Right now, there are two types of people: those who have what they need, and those who don’t. If you need something, use the resources that are available to help you. This is not a time for pride to well up in you if you are in need or have lost everything. Organizations are still distributing food, disaster food stamps are now available, food banks are stocked to provide non-perishable food items to families, and shelters are still available in the affected counties. If someone asks you if they can help – LET THEM. If you have what you need – find out how you can help someone else. Do you have an extra room that someone can stay in? Can you provide transportation for someone whose car flooded? Can you cook for a family who can’t afford to buy groceries to replace the ones they lost? Do you have, or can you purchase clothes, cleaning supplies, canned goods, hygiene products, diapers, formula, or any other of the many items people need right now? Can you help someone who isn’t able clean up their yard to get the debris out in time for the first pass? Can you go to a neighbor’s house and listen – just listen – to them process all of their emotions that haven’t yet surfaced after the storm? If you can – DO IT.

In the years that followed 1996, the people in our area would refer to places, houses, trees, and big events as “before Fran” or “after Fran”. I imagine that same thing will happen this time. Our city won’t look the same after Florence and there’s a good chance our lives won’t be the same. But just like we pulled through Hurricane Fran and our area boomed in population and economy, I believe Southeastern North Carolina will overcome this storm too.

I can’t help but wonder what my son’s most specific memory from Hurricane Florence will be years from now. I wonder if it will be something disastrous or something extraordinary that happened.

Maybe it will be that he learned how to shuffle cards.

 

Alexis Hunter oversees all marketing, outreach, and human resources at Chrysalis Center. 


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The Olympics. From the opening ceremonies to the tally of medals, the Olympics is an event we love to watch. The Olympics represents the culmination or continuation of a dream for each athlete attending. A dream that often consumes their lives. And, at times, a dream that causes harm.

As Gracie Gold took a break from ice skating in January, she identified that she needed to pursue treatment for her mental health, broadly, and an eating disorder, more specifically. While we can applaud the courage it took for her to take a break and focus on her wellness, we can also question the environment in which she participated that brought her to that point.

Health, Exercise, and Culture

As a country, we idolize exercise. In fact, attitudes and trends have shifted from women being as focused on “thinspo” to being focused on “fitspo.”  Research also shows that males are being pressured to have “fit” bodies, as well- with an emphasis on bulk and definition. As a result, it is not uncommon for me to see several clients in the same day mentioning they simply want to be “fit” and the role of “healthy” eating and “healthy” exercise to accomplish those goals.

Of course, I am not saying that there is no such thing as healthy eating or healthy exercise. But, as is often the case in our culture, we live in a world of extremes. If one piece of broccoli is good, a whole shake of broccoli (plus all the other so-called super foods) must be better. If running one mile is good, running a marathon must be better. Again, I mean no aspersions towards broccoli or running.

However, there is not an exponential benefit to any one particular food (or food group) or to exercise.

As we watch these athletes who have dedicated their lives to their sport, it is important to recognize what it takes to do so. A balanced and varied diet (purportedly, Michael Phelps eats upwards of 10,000 kcals per day to maintain his stamina). Constant and rigorous physical training (sometimes beyond the point of injury as when Keri Strung completed her second vault after injuring her left leg and had to land on one foot). And, a single-minded focus that when applied elsewhere would be seen as obsessive or compulsive.

Listening to Our Bodies

When we push people to ignore the cues and signals their bodies send them, we set them up for all sorts of problems later on. And, when our criteria of their “wellness” is how well they are performing at their sport, we seriously minimize the reality of the risky world in which these athletes exist.

I can’t tell you how many times I have had someone tell me they cannot recover from their eating disorder because, in their mind, the eating disorder is what makes them excel at their sport. Often, these clients who are living with internal turmoil are getting compliments and positive feedback from others based on their performance.

When our eyes turn towards the Olympics in South Korea, let us do so with greater awareness. And, let us focus on the athlete as a complete, complex, and multi-dimensional person. A person who has worth outside of their sport. A person who deserves to be able to treat their body well. A person who deserves to be celebrated for all that they are.

 

If you are an athlete struggling with eating or exercise behaviors, please don’t hesitate to reach out for additional support. We have a dietitian and several therapists who both specialize in working with athletes as well as being athletes, themselves. Contact our admissions office at (910) 790-9500 for additional information and to get scheduled.

 

Rachel Hendricks, LCSW specializes in working with clients who have had their eating disorder for ten or more years, clients with co-occurring substance use behaviors, as well as working with couples and families. She facilitates two groups: Motivation to Change and Declutter Class, and she is currently accepting referrals for both. She is excited to be making the transition to Wilmington from the Center for Eating Disorders in Baltimore, Maryland. Rachel looks forward to continuing her reputation for providing excellent clinical care in the field of behavioral health.

 



Hoarding and Shame

Working as a therapist, it is not unusual for me to hear clients share stories where they are experiencing feelings of shame, guilt, and sadness. Many clients express feelings of hopelessness and helplessness at least some of the time. But, there is also a sense of shared experience. Therapy is seen as a safe place where they can explore those feelings. Hoarding disorder can test this idea.

When working with clients who hoard, learning about the hoarding can take more trust than you might expect. I have worked with clients for years before they are ready to share what is happening in their homes. Clients who have felt safe disclosing trauma, substance abuse, and their eating disorder have struggled to talk about their hoarding. All the same, it is an equally important issue that impacts them daily. Hoarding may be, to them, their most shameful behavior.

Hoarding Disorder: Statistics

Research shows that individuals experiencing hoarding disorder often feel judged and isolated from friends and family. This happens at rates that are even higher than those experiencing schizophrenia. As a result, it is not surprising that hoarding is a secret that is closely kept.

Hoarding disorder affects between 2 and 5% of the population. It is more common than many people are aware, and there are levels of severity as with any illness. Often times, when working with clients, they will reassure me, “I’m not like the show. I’m not that bad.” I always try to emphasize that no matter the hoard, I will not judge them. This is crucial.

Many times, before the work on addressing the hoarding can begin, there has to be a clear understanding that there is no judgment or critique of what is happening in their home. Rather, there is an understanding and acceptance of the internal distress and frustration hoarding causes. Whether their hoarding is causing health problems, issues with environmental safety, or is a source of embarrassment, the primary concern is the pain it is causing and how to address it.

Hoarding disorder also does not exist in isolation or as a stand-alone illness; rather, it is significantly correlated with anxiety, depression, OCD, and ADHD. These co-morbid disorders can often be the primary reason clients seek out support initially, and clients may be hesitant or reticent to start to address the hoarding, itself. Further, for many, there is a significant discrepancy between their external presentation- professional and put together- and their deeply protected, often completely hidden from others, personal space. When all of these factors are combined, it is clear why hoarding disorder is such a hidden illness and why, for those experiencing it, it can feel so hard to overcome.

What Can Be Done?

In September of 2017, a new group protocol was released to address hoarding disorder in a group format. Chrysalis Center is excited to be among the first offering this “Declutter Class”. The group provides resources, strategies, and hope for change with hoarding disorder. This treatment is research driven, proven to provide results, and addresses 7 “targets” or areas of functioning to reduce the impact of hoarding and improve functioning, overall. While seeking treatment and support for hoarding can be difficult, we are hopeful that this group will offer a safe, non-judgmental space where hoarding can be addressed effectively.

 

For Follow Up

If you are interested in the group or would like more information, please contact Rachel Hendricks, LCSW at (910) 790-9500. You can also reach her via email at Rachel.Hendricks@chrysaliscenter-nc.com.

Rachel Hendricks, LCSW specializes in working with clients who have had their eating disorder for ten or more years, clients with co-occurring substance use behaviors, as well as working with couples and families. She facilitates two groups: Motivation to Change and Declutter Class, and she is currently accepting referrals for both. Rachel is excited to be making the transition to Wilmington from the Center for Eating Disorders in Baltimore, Maryland. She looks forward to continuing her reputation for providing excellent clinical care in the field of behavioral health.



 

A Tale of Two Changes (ish)

A couple of months ago, I was talking to a friend about my yoga practice. I am hardly an aficionado, but I really enjoy practicing yoga, and when I regularly do yoga, I notice my mood is so much better, I feel better in my body, and my distress tolerance increases significantly. And yet, I think the last time I did yoga was at least a month ago with the previous time being a month or two before that.

On the other hand, I used to be someone who was chronically late. I used to joke that it was in my DNA to be late because I was even born late. Then, one day, someone said something to me, and it stuck with me in just such a way, that over time, I have shifted out of the pattern of being late to being on time (I do think I should clarify, though, that I’m still not an early person).

How can I enjoy doing something so much and still not follow through with actually doing it? How was I able to make the change with becoming more on time even though doing so was physically painful at times?

Breaking It Down

Both of these questions have to do with the question of motivation and sustainability. Why are we sometimes able to make change and keep it going, and other times, it feels like a constant struggle or something that we try and fail to follow through with?

In brief, it is our motivation to change and how we approach the change process that makes a difference.

Next Steps

Starting in September, there will be a Motivation to Change group that explores the change process, strategies to make and maintain change, and focuses on goal setting and follow through to meet goals.

By breaking down the steps it takes to make change, becoming aware of our individual values, and increasing our skills and supports, each of us has the capacity to make significant changes.

To be fair, though, it’s both exactly what I said and also more complex. I still am not doing yoga the way I wanted to several months ago, but I also have shifted my focus towards being more flexible with the activities I am incorporating and being less rigid about it necessarily being yoga where I find my peace and tranquility. As a result, I have made change, continue to make efforts at change, and also have further clarified my values to better match up with my goals for change.

Putting It Together

Clearly, as outlined above, I am still human- just a person who is able to make some changes but struggles with others. However, through this group, I am confident that you can gain better understanding of what motivates you in the moment, keeps you motivated over time, and helps you maintain progress towards your goals.

Wishing everyone wellness, flexibility, and motivation during this season and moving forward!

 

For Follow Up

If you are struggling to make change, or if you just want to know more about the process, please reach out, and I am happy to follow up with you. Also, if you would like to work through a group focused on change (and flexibility and self-care and all the things), then please let me know, and I am happy to discuss options for that, as well!

 

 

Rachel Hendricks, LCSW is a new addition to the clinical team at Chrysalis and has been working on the topic of motivation to change for the entirety of her clinical practice. She also specializes in working with clients who have had their eating disorder for ten or more years, clients with co-occurring substance use behaviors, as well as working with couples and families. She is excited to be making the transition to Wilmington from the Center for Eating Disorders in Baltimore, Maryland and looks forward to becoming more familiar with the area as well as continuing her reputation for providing excellent clinical care in the field of eating disorders.



Chrysalis Center will be hosting Wilmington’s 5th Walk From Obesity and Fitness Fun Run on Saturday, October 14 at our office in the Burnt Mill Business Park. This event benefits the American Society for Metabolic & Bariatric Surgery (ASMBS), an organization that is committed to improving public health and well-being. This is done through research and education, awareness, and access to care. Chrysalis Center is a member of the ASMBS and an advocate of these initiatives as we strive to help clients both physically and psychologically become healthy.

This year, our theme for the Walk is “Fight the Stigma”. Today in America, there are many types of discrimination and stigma against specific populations of people. We see this in many scenarios for children and adults who are obese. While any healthcare provider wants to help individuals become healthy and avoid risks associated with obesity, it is very important to fight weight based discrimination. In the workplace, it is becoming one of the top reasons why candidates are passed over. In fact, “it has become a leading cause of either discrimination or termination from jobs for the female population, representing the third most common form of discrimination for women in the workplace, after sex discrimination and age discrimination.” (HG.org)

The ASMBS and Obesity Action Coalition (OAC) are committed to raising awareness for employers and law makers about the dangers of weight based discrimination. By participating in the Walk From Obesity as an individual or as an organization, you are helping to advance this issue so that fewer Americans will be treated unfairly because of their weight. It is important for people who are obese to feel confident in participating in activities (for work or pleasure) despite their weight. We can raise awareness for this by encouraging business to consider thinking outside the box in their marketing efforts. We are already seeing this in some national advertising campaigns who are committed to including plus sized models. Through our fundraising, the ASMBS and OAC can continue to fight the stigma, raise awareness, and provide access to care to those struggling with obesity.

Are you ready to show your support and participate this year? Sign up as a participant here and use the code EARLYBIRD at checkout for a discount by 9/14/17! We’ll have a silent auction, prizes and fun on the day of the event. If you have a business that would like to participate, please email me at alexis@chrysaliscenter-nc.com for more information on those opportunities.

If you are struggling with obesity and you are ready to make a change, contact our office. We have a team of mental health therapists and registered dietitians who want to help you reach your personal and professional goals. We’re here and we believe in you.

 

Alexis is the Director of Professional Relations at Chrysalis Center and oversees all Marketing and Human Resource efforts. 



 

Do you ever feel like you don’t have relationships, like you are alone or isolated, or that you are often misunderstood, overlooked, or unable to connect with others?

Does it ever seem that everyone else your age is doing other things while you feel “stuck” or left behind?

Have you ever seen someone look at you or heard someone say something to you, and your mind was suddenly flooded with eating disorder thoughts?

Or, maybe you experienced a loss, and seemingly the only solution was to turn to your eating disorder to manage your grief.

For many with eating disorders, you already know how interactions with others can impact you. In fact, there is a fair amount of research that shows that people with eating disorders have a vulnerability to over-assessing the verbal and nonverbal feedback from others as a way of checking to see if they are okay.

Research also shows that eating disorders can start or re-occur in the context of major life transitions such as during the grieving process, in mid-life, or starting middle school, high school, or college. One of the reasons these transition periods can be so fraught is because of how our roles and identities change, creating space for an eating disorder to slip in if one is struggling with the transition.

While many people have heard of using CBT (cognitive behavior therapy) or DBT (dialectical behavior therapy) for treating eating disorders, there is another treatment that can be just as helpful but is often not as well known. This therapy is IPT (interpersonal psychotherapy). IPT is a therapy that focuses on relationships and how relationships can affect one’s eating disorder or life, in general.

IPT targets five major domains of functioning:

interpersonal deficits and/or lack of intimacy

interpersonal role disputes (conflict)

role transitions

grief

life goals (like role transitions but for those who missed out on role transitions due to interference from their eating disorder or other barriers)

Like CBT and DBT, it is a time-limited intervention that has multiple phases. Usually, the treatment lasts 16-20 sessions and is broken into identifying the problem area on which to focus, understanding and addressing the interpersonal challenges that were identified, and reviewing the treatment and planning how to maintain the gains made with the treatment.

Generally, one area will be the focus of the treatment though at times 2 areas might be addressed, or an additional area might be addressed after focusing on another area (for example, working initially on grieving and adding life goals as you progress through treatment).

While IPT does not always have the same effect initially as CBT, research shows that the positive effect of IPT grows with time. That means the more you use the skills and strategies you learn with the sessions, the more effective the treatment is- even well after you stop getting additional IPT.

IPT is also a good option for people who struggle with the structure of CBT or DBT or who are unsure about addressing their eating disorder directly, and it has been shown to be helpful for depression, some personality disorders, and social anxiety, as well. Further, IPT is an excellent option for people who have completed CBT but still need supplementary work.

If you have questions about IPT and whether it might be a good fit for you, please don’t hesitate to reach out or consult with your treatment team about if IPT is the right option for you!

Rachel Hendricks, LCSW is a new addition to the clinical team at Chrysalis and loves providing IPT to clients when it is appropriate! She also specializes in working with clients who have had their eating disorder for ten or more years, clients with co-occurring substance use behaviors, as well as working with couples and families. She is excited to be making the transition to Wilmington from the Center for Eating Disorders in Baltimore, Maryland and looks forward to becoming more familiar with the area as well as continuing her reputation for providing excellent clinical care in the field of eating disorders.

For additional research, information, or references for this blog:

https://www.eatingdisorderhope.com/information/anorexia/social-relations

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3886290/



It’s easy to shy away from learning about health insurance – it’s overwhelming just to get past all the acronyms that flood your mailbox when your new insurance cards arrive. Between ACA, EAPs, EOBs and HSAs, sometimes it’s easier to throw our hands up in the air and avoid determining how to best use health insurance. Instead, take a few minutes to look for key terms in your benefits booklet, talk with your HR representative, or the representative who sold you the policy.

In order to determine your cost for health care services, here are some questions you’ll want to ask your potential healthcare provider:

  • What type of service am I receiving?
  • Where will I receive this service?
  • Who is performing that service?
  • Does my insurance company consider the provider IN or OUT of network?

These are questions that any provider’s office will be able to answer, so ask them! Then you will be able to find out from your health insurance company what you’ll need to pay to receive specific services. You can call the number on the back of your health insurance card, go to the website for members, or look in the benefits booklet you received when your policy began.

Your insurance company will be able to provide you with your individual benefit for different types of services. Unless your insurance company covers certain services at 100%, you will be expected to pay a co-payment, co-insurance or the full amount for a service which will go toward your deductible. So what’s the difference between all these things? Let’s define these terms.

  • Co-payment: A fixed amount required by a health insurer to be paid by the insured for each visit or drug prescription.
  • Deductible: A specified amount of money that the insured must pay before an insurance company will pay a claim.
  • Coinsurance: A specified percentage of the total cost of the medical expenses after a deductible has been reached.

It’s important to understand that these rates are determined by your insurance carrier, not your health care provider. Healthcare providers can determine the amount they will bill your insurance company or any non-billable fees they may require from you, but your insurance company determines the amount you are required to pay as long as you see an IN-network provider.

The Chrysalis Center offers mental health counseling and nutrition counseling in an office setting with licensed therapists and registered dietitians. Mental Health counseling and Nutrition Counseling are separate benefits.  Our administrative staff will help you determine the cost you are responsible for when it comes to either service. We are in network with Blue Cross/Blue Shield, United Healthcare, Aetna, Medcost, Tricare and Medicare.

If you are considering mental health or nutrition services, take the time to find out how you can use your health insurance to pay a portion or even cover it in full. You may just find out that you have excellent benefits for these services!

About the author

Alexis is the Practice Manager at Chrysalis Center and performs multiple functions to support the business. Among those are supervising the administrative staff, acting as the Intake Coordinator, Human Resources and Marketing. Alexis was born and raised in Wilmington, graduating from NC State University in 2003. While not leading the team at Chrysalis Center, she enjoys spending time with her husband, Wes and her two boys: Mason (5) and Banks (2)

Alexis Hunter Practice Manager

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About Us

At Chrysalis, we believe that a supportive, healing environment is essential in order for change and growth to occur. We seek to offer such an environment to clients and help them create that in their lives and relationships. Read More

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Mon: 8AM - 6PM
Tue: 8AM - 6PM
Wed: 8AM - 6PM
Thu: 8AM - 6PM
Fri: 8AM - 4PM
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