I've felt better the last few months but I was also recovering from a hernia surgery so hadn't been as active

Today I saw my doctor and he said it was 50% and the normal rate being 55%

I'm happy beyond belief

Where do we find long skinny pants for our teen boys? He grew several inches this summer. At 5'8 and 100 lbs, I can't find anything long and slim enough.

I got valve replacement had a heart attack and endocarditis ,now i have 1 and half of weeks done of the 4-6 week treatment for endocarditis but i can’t take it anymore i don’t know what to do
Inside.. coloring,word searching,movies,series? All done i don’t know what to do to
Make time pass easier any suggestions?😭

Hey guys, 25M from India here. I’m 5’11” and very thin, and I’ve had body image issues because of it since I was a kid.
I’ve finally started making peace with how I look but I genuinely want to put on some weight now .. especially around my arms, torso, and glutes.

Has anyone here with Marfans actually gone through the process of gaining weight/muscle? How long did it take? was it difficult? what worked for you? diet and exercise?

Would really appreciate hearing about your experiences, even the small things. Anything helps.Thanks guys, lots of love ❤️

Hi, one of my overseas family members suddenly passed away from some kind of internal bleeding. Unfortunately I can't learn the specific cause of death due to estrangement & language barrier.

My direct family members and I have lots of the outward signs like being very thin, long fingers/toes, flat feet, retrognathia, food allergies, skin issues, myopia, etc etc. I don't know if it's specifically LDS or maybe Marfans /another connective tissue disease, or just all flukes and I'm worrying for nothing.

mainly I'm really scared of dying suddenly from a ruptured aorta or artery or something.

I managed to secure stable income and my health insurance begins next month. I am very unfamiliar with the US health system and trying to figure things out,

I don't have a PCP yet, If I want to screen for my risk of arterial issues should I try to get a cardiologist, or gene testing first? Ideally I want to get my aorta and major arteries scanned to see if they are enlarging. Do I ask the doctor for a referral directly or do they need the details on my family member? And roughly how much USD$ do I need to save up for a scan if the insurance doesn't cover it?

Also should I do anything in the meantime to make sure I get medical attention if I go down with an aorta rupture? I have stopped most of my strenuous activities like bouldering and gym. I want to make sure at least that I can call 911 before I black out or someone's there to call for me.

I'm sorry for all the questions but it's been so difficult to research this and I would really appreciate some help thank you everyone 💜

Hi, I'm a woman and I was diagnosed with possible Marfans at age 8 and had a scoliosis surgery when I was 13. I'm 33 now and things have been really hard on me. I hear so many stories about people being able to live normal lives, but it just hasn't been that way for me.I was probably doing well until I got into the work cycle and in just a few years the damage became permanent. I would constantly go to doctors but my pain was ignored for a very long time until it was too late and my issues are mostly inoperable. I have such a long list of things wrong with me and I can barely leave my bed now and I always feel guilty when I complain so I have tried to stop. I now have empty Sella syndrome from my surgery, arthritis basically everywhere and slipped disks in my lower back and neck, foot drop, lupus, and the main reason they can't operate is because I have a condition called arachnoiditis which is seen as a mass petruding from the spine (which is really a bundle of nerves.)

I stopped going to the pain clinic because they don't help and I'm tired of getting poked with so many needles. I only get relief whenever I get a small dose of pakn meds for a tooth removal or other surgery. My joints are all getting arthritis now and I'm overweight because I can't walk much anymore or cook like I used to love doing. Im just so tired all the time and everyone tells me God will heal me if I believe and pray.

I've been on disability since 2019, but dont get paid enough to survive on my own, but luckily I have my partner who helps me a lot, but I cant help but feel guilty for that too because im taking up so much of his life. His parents also agree that he can do better than me and its so hard. They treat me like I'm a huge complainer. I cant even afford a new wheelchair right now and barely fit in my old one because it was for a thinner older person. Im also 6 feet tall so my legs drag.

I have no one to talk to about it because no one else understands. I look somewhat normal on the outside, but all I know is an existence of pain. It doesnt help I have so many mental health comorbitidies that come with a connective tissue disease. I cannot have kids, even though it was a dream of mine. My hands are starting to break and throb and I'm an artist and gamer. I feel like I am losing it all. The words of my parents ring through my head whenever I feel an ounce sorry for myself. From age 8 I was told babies are dying from cancer and I can walk and talk and breathe ao I have no right to complain.

I've lived ny life with this mentality.

This is just a rant, but I was just wondering if there's anyone out there who understands me. Everyone seems so hopeful and like they live normal lives and I feel like I am trapped inside of my own body. I have done nothing with my life and have been through abuses other than my own body abusing me. A lot of trauma physically and mentally. It might help me just knowing I'm not alone and all this pain is real. Sometimes a light goes off in my head on a good day like oh, maybe I AM faking it and being dramatic and I just have to stop being lazy. That kind of thinking makes me work on cleaning the whole house and then be stuck in bed for weeks.

Uh just life.

I traveled from the US and had PEARS surgery completed by Mr. Conal Austin at London Bridge Hospital last Friday, 8/7/2026. I cannot possibly thank Mr. Austin and the hospital staff enough. Mr. Austin is a gentleman and a scholar - he thoughtfully answered all of my questions, would negotiate healthcare concerns in a meaningful way (more on this later) and genuinely cares about his patients. He reached out after the surgery for get a cup of coffee because he was in the area...he's a fantastic surgeon and great human. The other hospital staff were really all helpful and caring. And, it's a small thing, but the food was great. Due to the extremely high standard of care, I was able to walk out of the hospital a little over 72h after the surgery concluded. The PEARS graft reduced my 48mm root aneurysm to 41mm and reinforced the walls of my aorta to prevent Type A dissection. Other than the root, the rest of my aorta was normal. I also need to thank my wife, whose support was most important in the early days of this diagnosis when it was most emotionally difficult, and our families for their financial support and care of our 3 young children.

This post will be comprised of posts I made while in the hospital as well as my thoughts in the days following about pre- and post-op.

Prior to surgery: One of the hardest parts of the surgery process was figuring out how to get the process started. Thankfully the online user communities (r/aortic_aneurysm and r/marfans) are full of extremely helpful users. I don't want to e-mail drop per-se but there is ONE person responsible handling the logistics of the PEARS program: Alan Rayner. Once I was able to contact him, things started moving.

In terms of health, (1) I do not have Marfan's or a diagnosed connective tissue disorder so your mileage may vary and (2) I'm 41 m, regularly doing athletic competitions (think running, lifting, diving while wearing 40+ lb of equipment) and either lifting or doing cardio every day. Returning quickly to this level of activity was a major factor in pursuing PEARS surgery. Having done research on sternal precautions, mobility restrictions and potential complications, I adjusted my physical training regimen from traditional weightlifting to more functional core training and cardio. I believe this made recovery a bit easier.

In terms of mental health, I wanted to get out of the hospital ASAP (everyone does really) and there is a list of things you need to do before you can leave. I told myself that I was going to (1) treat every one of these milestones as a challenge and crush it + 10% and (2) try to be the most pleasant patient ever because I can only imagine how difficult it is working night shift in a stepdown unit, or how boring it is watching a patient in an ICU. Mindset is very important when committing to surgery. What worked for me, was telling myself that the first stick for the IV is the worst part of the whole thing. You're asleep for all the action, and when you wake up, you're able to control your pain through your clicker. The lines, once in, don't really hurt (even the chest tube, the PICC line which I was somewhat dreading, and urinary catheter, both of which I never really even felt) since they're just plastic and you were asleep when they put them in. I told myself that, when I woke up, I would be at the point of no return: can't go backward, only forward toward recovery and the only alternative is death. It sounds morbid, but the inevitability of discomfort allows you to accept it easier. YMMV of course, but this strategy worked for me and not once did I ever feel depressed or upset in the hospital, or fearful before a procedure, only frustrated that I couldn't sleep well. Hopefully this helps someone.

I arrived in London a week before the surgery. We flew in on Monday and arrived Tuesday in time for pre-op bloodwork, x-ray and echocardiogram. This appointment was mostly in St. Olaf's House, a historical building. London is literally thousands of years old and can trace back to the Roman empire so while the exterior may appear very dated, the equipment itself is top notch.

Day 1 (Surgery): Met with the nurse who will be caring for me. She drew some blood and told me to shave chest and groin. Filled out some forms. Showered after that, had an IV placed, and met with the surgeon and anesthesiologist. I thought I had a slight upper respiratory cold but that turned out to be a non-issue.

In speaking with Mr. Austin, he indicated that the locations of my coronary arteries says this is definitely an aortopathy so surgery is needed. He closed my sternum with Fiber Tape instead of wire. I had asked for titanium plates due to a nickel allergy. This was a happy medium as he knows people in the hospital who use it routinely, and just speaks to his care for patients and willingness to work with them to achieve healthcare outcomes.

"Just woke up in the ICU. No bypass. Feel pretty good actually. I wasn't on the vent when I woke. Chest pain maybe 4 out of 10. Mainly stinging and pain when breathing deep.

Evening, felt well enough to eat some salmon for dinner the food is good. Sternum feels like a bunch of bricks when I breathe. Otherwise no pain to speak or. I had a bradycardia episode and almost passed out not sure why. Off to try snoozing."

Snoozing didn't happen. I didn't sleep a wink in the ICU (kept snoring myself awake like kids do in class).

At this point, I had,

Left arm: IV (arm), arterial line (wrist, for drawing blood, this thing is great...no needle sticks), and my pain management line (hand) - this was hooked up to a clicker that I could engage every 5 minutes (it changes colors to let you know when it's time to party).

Neck: PICC line

Chest: Chest tube, EEG leads

Urinary catheter

One point to make: Some of the stuff I'll talk about sounds painful or unpleasant but truthfully, it wasn't at the time, just uncomfortable, and every time honestly felt better once it was over. They give you tons of lead time for any procedure they're going to do (e.g. removing chest tube) so you can hit your clicker several times beforehand.

Day 2 (Day 1 postop): "Last night I didn't really sleep at all just in and out mashing the painkiller button all night. I'm not sure if the pressure in my chest is from the chest tube or the sternotomy. The physio will be coming shortly to get me up and walking. Hopefully I can get some lines out.

Met with Mr. Austin a moment ago. He said my aorta was very thin in places so he's glad we got this done. He was able to close my sternum with fiber tape as I mentioned, since I'm allergic to nickel. Apparently the sales rep came out to demonstrate and it takes a lot of torque but he's saying it's a great closure, very strong.

I just stood up for the first time. Easier said than done with all the lines in, and required the expert help of two other guys.

Chest tube was removed a little bit ago now having some lunch. It wasn't that bad, the suture was the worst part. Just feels really weird. I can finally breathe fully. Urinary catheter came out which was an extremely unpleasant sensation.

After that it's time for a walk. Did a walk around the ICU and walked some stairs. No issues just need more lung capacity. The physio issued me a spirometer to play with every hour and I'm no longer attached to the lines. Things are looking up.

Day 2 evening. Moving from the ITU was maybe a mistake. Total agony, took a bunch of oral Tylenol and opiates and nothing. Hopefully it passes"

Day 2, early afternoon they moved me to the stepdown unit.

Back to the mindset thing here, originally the plan was to walk a few steps, but knowing stairs came next, just told the physio "it's fine take me to the stairs." Apparently early movement is really important for recovery too so proving to yourself you can do it is important.

The pain thing had to do with losing access to the on-demand IV pain med dispenser around 30 hours postop. The oral meds don't do nearly as much. That said, the pain I was feeling wasn't from laying there, it was from trying to use the wrong techniques to move around in bed. Later, someone gave me this multi-colored hand ladder thing that allowed me to pull myself around the bed and adjust, and this made a huge difference.

Day 3 (Day 2 post-op):

"Day 3 morning. Last night was hell. Eventually figured out that I need more elevation in my bag. Got maybe a couple hours sleep. Also feel like my chest tube stitch is tearing from all the up and down. It sounds trivial but that stitch prevents pneumothorax.

I probably should have waited another day in ITU

Day 3 mid day. Night and day, feeling much better. Got some more lines out, now it's about trying to do the physio routines. Anyone entering into open heart surgery should be prepared for a lot of ups and downs."

In the stepdown unit, they pulled my arterial line and pain management line (left arm, wrist and hand). They had them in there just in case. One thing I should mention - at this point I was on paracetamol and some oral opioid. I did ask if I could stop taking the oral opioid because I know what comes next (massive constipation) but they were pretty adamant about controlling pain, and piling on the laxatives as needed. This strategy was pretty effective, because I didn't end up blocked up after leaving the hospital though going in the hospital was a little sporty.

One of my primary caretakers (a big teddy bear of a man, Mohammed) came in to remove my picc line in the early afternoon. Mo, you were awesome man, thanks for putting up with my insomnia. Lacking any lines, my last day blood draw was a regular butterfly in the arm and I barely felt it, which is not what you expect when the nurse doing the draw is a big dude.

At this point, I had:
Left arm: Cannula

Day 4 (Day 3 post-op):

I was cleared for release around 10 AM, which is ~72h after surgery concluded.

My wife and I took a ride back to the hotel (to be honest I could have walked but we had a few bags and I was self-conscious about walking with my wife loaded down like a pack mule and me carrying nothing lol)

In the hotel gym, I walked 1 KM on the treadmill at 2.5 kph. I thought this was 1 mi at 2.5 mph, which felt awfully slow...realized the mistake at the end of the walk lol. In subsequent days, I changed the settings to Imperial.

Sleeping that night was pretty bad. I couldn't sleep lying flat and couldn't get comfortable. We brought this huge wedge pillow thing that kept sliding my body down toward the middle of the bed creating friction.

Day 5+

Each day gets easier and easier. Every day I'm adding to my walks in the hotel gym (1m, 1.25, 1.5...) in addition to just walkin' around miles, which gets us to around 10k steps a day. My wife left on Day 7 so I've been on my own yesterday and today, and it's fine. Yesterday (a week post-op) I ditched the wedge and was able to just use a few pillows to get comfortable. Initially my lungs were really congested (but too deep to cough it out). Yesterday (8 days post-op) I felt like I could have jogged. I want to jog today but will ask Mr. Austin Monday during clinic when I have my last bit of LBH-issued hardware removed (stitch from the chest tube).

I'm looking forward to going home. Now begins the process of trying to get insurance to pay for the surgery.

What can I do on my own: Dress myself (even t-shirts though stretchy is easier), wipe my own backside (this was never a problem post-op but people get concerned), use more or less unrestricted sternal mobility, carry a water bottle, walk for miles.

What I can't do on my own yet at ~9 days postop: Sleep flat (or well lol), lift or carry >5kg

Addendum: As of Saturday (1 week and a day after surgery), I am side-sleeping again comfortably.

My wife was in town until a week after surgery so I've been on my own the past couple days and it's been fine. To be honest, while it was helpful having her there in case I got stuck putting on a shirt, it probably wasn't necessary. She spent most of the time traveling and shopping, which is great because our room is really small! She'd been wanting to travel more so this was a rare opportunity to see London. While I'm mobile post-op I'm trying to avoid public transport which would have limited our options greatly.

Things to note for US Patients

1. Give yourself time to get the logistics in place. This is probably not an emergency surgery and things WILL come up. We had last minute things come up despite having been planned months in advance.

2. Passport. Check your passport early. I had to expedite the renewal.

3. ETA for UK Travel. This one is new and important. I didn't realize this (nobody did since it's new as of a year or so) but now you need a travel approval to come into the country even just for <6 mo. THERE ARE A TON OF SCAM SITES FOR THIS. A lot of them look legitimate. They take your personal information, do who knows what with it, and file the application for you while charging you 5-10x what it costs to do it through the actual UK app. Do not fall for these schemes. Poke around the contact info and if it redirects to anywhere but UK it's a scam.

4. The CT scan data is really important since that's how they're going to make your implant. It is not easy to find a US hospital familiar with it. There are many versions of the Exstent protocol. Pete Davies is my contact for this and we had to go back and forth a few times to get the correct scanning protocol. I ended up calling, e-mailing, and otherwise badgering the local US healthcare system into letting me talk to senior staff in the radiology department to ensure it would be done correctly, and on the day brought 3 paper copies of the protocol. This worked pretty well.

5. Book your return flight ahead of time. I made the mistake of booking a one-way ticket because I thought there would be a lot of variability in the return flight timing. What I didn't realize is that British Airways charges a hell of a lot more for one way flights than round trips (because we booked several months out, we didn't notice). If I were going to do it again I'd just book the return flight for 2 weeks after surgery. If you need to adjust, it's like $200 as opposed to THOUSANDS. Seriously...ticket here was like $700, ticket home will be over $2,000.

6. I know some people get an Air BNB, but IMO a hotel is the way to go. They'll give you clean sheets and breakfast, have snacks available, and most importantly: AIR CONDITIONING. AC is not standard in the UK, and we've had a heat wave over the past few days breaking 95 degrees. I couldn't imagine being cooped up in a 95 degree room trying to recover. The Residence Inn Marriott London Bridge is where I am staying and it's great.

That's basically it. The user community here is great. Throughout the process I was talking with other folks who had gone through the same thing. Happy to answer questions you guys have.

I’m an 18yo female, and I’ve grown two inches since January, now standing at 5’10”. Tf? I am now taller than my boyfriend, and I was shorter than him when we started dating last June, and I’m brutally and embarrassingly reminded of that every time I stand up.

I’ve steadied out the past few months and haven’t really grown much since, but my height always comes in weird spurts. As much as I love his music, I don’t want to look like Sombr.

When did you guys stop growing height-wise, and what height are you now?

Ty for any replies!!

xoxo

Hello everyone! I'll keep it short. I am 19M and heavily suspecting Marfan's for a plethora of reasons (pectus excavatum, stretch marks on knees, long limbs and fingers among other stuff like joint pain). I scheduled an appointment with a cardiologist to get an ECG but it will take a while. Am I taking the right steps? I'm going in completely blind and very terrified. I don't want medical advice obviously, but how were you all diagnosed?

Long story short. My sons an I (35F) are in limbo for a diagnosis.

My youngest is a premie (now 10 months old but 7 and a half corrected). While in the NICU, they suspected Marfan because he's quite tall, has long fingers and hernias. During the hospitalisation, we had a genetician consult. We were mostly asked about our family medical history. The doctor was quite reassuring.

A couple months ago (about 6 months after the discharge from the NICU), we had a follow-up appointment with the genetician. He brought up Marfan again.

I'm positive for the wrist and thumb signs. He didn't calculate my Ghent score. The doctor asked me to get my aorta checked. Based on my age, if I do have Marfan, it will be dilated and we will pursue with the genetic testings.

My cardiac echo is set in december (about a year after the NICU discharge). I feel very frustrated by the delay.

I was also bummed that my oldest son (2yo) wasn't evaluated. He's way taller than his younger brother, consistently at the 99th percentile for height since birth. So I pushed to got a referal for him to see a cardiologist.

We just had the appointment. His aorta is on the high end of the normal range. The cardiologist want to see both kids again in a year (my youngest's aorta was fine when it was measured while in the NICU).

I was hoping to get some reassurance but it's not looking good.

I've been lurking on this sub for quite a while now. I don't know exactly what I'm seeking by posting this.

Has anyone been thought something similar? Any positive stories about toddler with enlarged aorta? How about folks with late diagnosis (mid 30s like me)?

I'm feeling pretty defeated right now.

Thanks.

So I’m 18. I had spontaneous pneumothorax about a month ago, and I followed up with my doctor today, and they want me to get tested for Marfan syndrome. I have like all the symptoms: I have some S-shaped scoliosis, my chest sticks out, and I'm skinny, tall, and flexible.

I’m just scared. I just wanna be normal and live a happy, long life. If anybody has recommendations if I do have it, it would be much appreciated. Please send prayers my way.

So I don’t have full blown Marfans but I’m on the spectrum regarding connective tissue disorders. I had terrible sleeping issues for decades and I thought it was related to my connective tissue disorder. I tried a few things that worked for a while but ultimately went back to poor sleep.

There is a hypothesis that the constant effort by your body to repair fibrilin might deplete ATP.

Anyway, on a fluke, I bought this supplement called Urilithin A. Wild thing happened. After about a month on the supplement I started sleeping better. Urilithin A is supposed to help your body's mitochondria become more healthy and increase ATP efficiency by helping getting rid of damaged mitochondria.

Im curious to know if anyone else has tried Urilithin A for Marfans.

I got a call from a Pediatric Cardiologist this morning. They have booked a phone appointment with me to go over what tests should be done for my son. This was all news to me. We were never told he was getting a referral to a cardiologist. My son's Pediatrician told me he didn't think Marfans was likely six months ago. We were leaning towards EDS as it's thought I may have EDS. The referral was from my son's pediatrician for aortic root size and cardiac function test echocardiogram. This was after being sent to an neuro-ophthalmologist. Needless to say im concerned.

My teenage son is thin and quite tall at 6'6". He has Pectus excavatum, crowded teeth, flat feet, potentially long arms and fingers (pediatrician said if they are they aren't by much) plus a few other potential symptoms. Now looking through other Marfan resource sites I see pneumothorax is another possible symptom of Marfans and my other adult son has had two with unknown causes as well as having Pectus excavatum, flat feet, mild scoliosis, etc. I see also that this syndrome can look different in each person with different levels of severity. I called the Pediatricians office but didn't get a call back today. Any insight on what I need to be doing and what I need to be asking would be very much appreciated. I'm feeling very overwhelmed right now and trying not to panic. Is the echo done to start recording a sort of a baseline and if there is change in the aortic root over time? If so should he be getting tested annually? Should we be seeing a geneticist? Should we be limiting his sports participation? If he is diagnosed with Marfans what are the next steps if any? While thankful this is all being investigated I am not feeling I can trust the pediatrician to properly inform me since he didn't even mention this referral.

Hi everyone
My husband (49M) experienced an aorta dissection three days ago. He had emergency surgery as is currently recovering in ICU. There has been some damage… his kidney function is low and he is experiencing paralysis, though he is regaining sensation in his legs every day. They currently have a spinal lumbar in.

He will be in hospital for a while. He has also previously had an aortic valve replacement and a descending aorta graft.

To be honest, I don’t think he was receiving the most thorough aftercare. Yearly appointment with cardiologist and monthly INR tests. On blood pressure meds etc but I was surprised he was not more closely monitored.

Still, this seems inevitable.

I just wanted some advice on what people would recommend in terms of care and lifestyle modifications now following a dissertation? Obviously heavy lifting is totally out. But any other suggestions? How often should he get his BP checked at GP? What kind of exercise?

Thank you so much.

I’ve never met anyone else with marfans and I also don’t have any family members that have it. I have the de novo marfans so I’m the first one in my family to have it

I’ve heard about the marfans conference but I don’t live in the us and I think there’s something on discord but I don’t use that app

Are there any other ways? And is anyone else also hoping to meet more people with marfans?

Hi, everyone.

I’m just scared. My aorta measured at 5.3 CM, so Dr wants to operate.

Can anyone give me some reassuring words? Have you been through this? How was it? What was recovery like?

Does anyone have experience with a bioprosthetic valve? I really don’t want to go the mechanical route. I don’t want to be on blood thinners or hear constant ticking. My dad had a mechanical valve and I could not handle that

My father (56M) and I (32F)were both born with dislocated lenses. We were tested at University of Michigan 30 years ago for Marfans (due to my eye surgery) and it came back that we do not have Marfans

Fast forward to now, we have now detected that my 4 year old daughter has dislocated lenses. We will be removing them, but the doctor is concerned about Marfans due to family history. He is having her sent for a cardio appointment before he will schedule lens surgery.

He also wants me to get her tested for Marfans and wants me to get my heart checked.

My dad and I have never had heart issues. He is tall. I am short (5’3”).

I am just wondering what anyone’s thoughts are. Could it be that we do have a form of Marfans that just wasn’t caught? Or just another genetic abnormality?

I am 21 years old, 188 cm tall, and weigh 65 kg.

I went to a doctor because I had pain in my left shoulder after doing lateral raises at the gym. As soon as he examined me, he said I might have Marfan syndrome. He only performed the thumb test and the Walker–Murdoch (wrist) sign. To reassure myself, I measured my arm span, and it exactly matched my height.

About two months before this, I visited an ophthalmologist for an eye check-up. I had a slit-lamp examination, and everything was normal.

No one in my family has heart problems, and I had never even heard of Marfan syndrome before. Now I'm really scared and stressed. The doctor asked me to come back after three weeks, so I'm feeling very anxious.

One more thing: I have functional scoliosis caused by a true limb length difference due to a childhood injury.

What tests are still needed to diagnose or confirm Marfan syndrome? Has anyone else had a similar experience?

Hello. I (18, male) have been recently having some sharp and quite intense pain in my knees and elbows mostly almost every time I wake up.

I thought it maybe had something to do with the posture I took when sleeping or something like that. But it just started to happen a few weeks ago so I don't know if that could be it.

Does this also happen to anyone? Is it normal when you're hypermobile and such? Any tips?