Background: Monkeypox is a poxviridae virus closely related to smallpox (variola).  It was first described in humans in 1970 and has since become endemic in parts of Africa.  In recent weeks, clusters of cases have been described in several countries prompting us to revisit this topic as it is not one we typically deal with in the ED.

The Virus:

• Family: Poxviridae
• Subfamily: Chordopoxvirinae
• Genus: Orthopoxvirus
• Species: Monkeypox virus
• Brick-shaped virus , surrounded by a lipoprotein envelope with linear double-stranded DNA genome
• Genetically distinct from other viruses of the Poxviridae family (i.e. variola, vaccinia, ectromelia, camelpox, and cowpox)
• There are two distinct clades of monkeypox virus [3]
  • West African: More favorable prognosis with case fatality rate <1%
  • Central Basin: more lethal, with a case fatality rate of up to 11% in unvaccinated children

Image from Science Website [Link is HERE]

Epidemiology/Transmissibility:

• 1^st identified in monkeys in 1958
• 1^st human case reported in 1970
• Endemic in areas of Africa
• Typically, only see sporadic cases outside of Africa in people who have traveled to certain regions or have been in close contact with those travelers
• From the 1970s up until 2003, sporadic cases were identified in central and western Africa
• Before 1980, case-fatality rate was 17% and secondary transmission was the cause in 9% of cases
• From 1981 to 1986, the case-fatality rate was 10% and secondary transmission was the cause in 28%
• From 1996 to 1997, the largest outbreak of human monkeypox occurred, which had a case-fatality rate of 1.5% and secondary transmission was the cause in 78%
• The 2003 outbreak, was the first documented cases in the western hemisphere with a case-fatality rate of 0% and secondary transmission was the cause in 0%
• Cases of Monkeypox in 2022 from May 6^th – 20^th [2]:
  • UK: 20 (Confirmed)
  • Spain: 23 (Unconfirmed)
  • Portugal 5 (Confirmed) + 15 (Unconfirmed)
  • US 1 (Confirmed)
• Precise prevalence and incidence are limited (But both have increased since the discontinuation of routine smallpox vaccination)
• Wide range of hosts which has allowed a reservoir in wild animals and some sporadic cases in humans
• In contrast to smallpox, monkeypox associated with low transmissibility between human beings
• Mode of transmission remains poorly characterized:
  • Large respiratory droplets most likely mode of transmission
  • Direct contact through bodily fluids also possible
  • The likelihood of transmission between individuals without prolonged close contact is considered to be low

Hosts/Reservoirs:

• Primary reservoir is thought to be squirrels, non-human primates, prairie dogs, rabbits, and rats
• Primary reservoir for human infection remains unknown

Who to Suspect:

• Travelers to known endemic areas
• Anyone in contact with a traveler to a known area

Clinical Features:

• Clinically monkeypox is almost indistinguishable from smallpox, chickenpox, and other causes of vesiculopustular rashes
• Typical incubation period 10 – 14 days (up to 21 days)
• Infectious period occurs during the 1^st week of the rash
• 2-day prodrome manifested by fever, malaise, and lymphadenopathy typically occurs before development of rash
• Lymphadenopathy is key distinguishing characteristic of human monkeypox compared to smallpox
  • 90% of patients infected with monkeypox develop lymphadenopathy (Typically in submandibular, cervical, postauricular, axillary, or inguinal areas)
• Rash begins as maculopapular lesions of 2 to 5mm in diameter
  • Typically, centrifugal pattern (from the torso outwards)
  • Can be monomorphic (like smallpox) or pleiomorphic (like chickenpox)
• Skin lesions typically progress from popular, to vesicular, to pustular, and crust phases over a 14-to-21-day period
• In patients with smallpox vaccination the rash will be milder and only ≈50% will have lymphadenopathy
• Most patients will not become seriously ill
• In the 2003, US outbreak (81 confirmed cases) there were zero deaths [1]
• Mortality seems to be higher in children, young adults, and immunocompromised individuals
  • Generally, cases are mild, and people tend to recover within weeks

Image from [1] 

Image from [1]

 Image from [1]

Monkeypox vs Chickenpox vs Measles

Complications:

• Bacterial superinfection of skin
• Skin scarring
• Corneal scarring/vision loss
• Pneumonia
• Dehydration (secondary to painful oral lesions and insensible fluid loss)
• Encephalitis
• Death (Very rare)

Diagnosis:

• Skin biopsy tissue and/or blood
• At a minimum, 2 scabs or material from vesicles should be collected in separate sterile containers
• DNA-based tests, such as PCR with sequencing, is the most precise method available for orthopoxvirus identification and species assignment
• Serological testing for monkeypox antigens is difficult because of close antigenic relation between surface antigens among orthopoxviruses

Treatment/Management:

• There is no proven treatment for monkeypox
• For contacts of a case, recommend twice daily fever/symptom monitoring for 21 days + Isolation recommended
• Currently, CDC recommending airborne and contact precautions (i.e. negative pressure room, N95, gloves, and eye shield)
• Pre-exposure smallpox vaccination has been shown to confer 85% protection against monkeypox [1]
• Role of post-exposure smallpox vaccination is less clear
  • According to the CDC, vaccination within 4 days of exposure may prevent disease onset and vaccination within 14 days may reduce disease severity [3]
• Vaccinia immune globulin has no available data on effectiveness in the treatment of monkeypox
• For severe cases, antiviral agents with known activity against orthopoxviruses in animal studies (No published data on its effectiveness for treatment on human monkeypox)
  • Cidofovir a broad-spectrum antiviral agent with in-vitro activity against virtually all DNA virsuses
  • Brincidofovir an oral DNA polymerase inhibitor
  • Tecovirmat an oral intracellular viral release inhibitor

Get ready to ho-ho-howl with laughter! These 10 Christmas jokes are packed with holiday cheer and cheeky humor to keep your spirits bright. Whether you need a quick laugh or a joke to share at the holiday table, these festive funnies will surely bring everyone joy!

Elleп DeGeпeres, the beloved televisioп host, comediaп aпd media mogυl, has made a life-chaпgiпg decisioп that has captυred the atteпtioп of her faпs aпd the media alike. Αfter decades of sυccess iп the Uпited States, Elle has takeп the plυпge aпd made the move to the Uпited Kiпgdom, leaviпg her glamoroυs Hollywood life behiпd. Iп a sυrprise tυrп of eveпts, DeGeoffres has poυred his impressive Motecito estate oп aпd revealed that he has пo plaпs to retυrп to the US iп the пear fυtυre. The υпexpected move marks the eпd of aп era for the televisioп icoп, who has beeп a fixtυre iп state pop cυltυre for years.

Her decisioп to leave the Uпited States aпd settle iп the Uпited Kiпgdom has left maпy cυrioυs aboυt Elle’s motivatioпs aпd what it meaпs for her fυtυre career. Kпowп for her loпg-rυппiпg daily talk show, “The Elle DeGeeres Show,” which coпclυded iп 2022, Elle has beeп oпe of the most iпflυeпtial figυres iп eпtertaiпmeпt. Bυt пow he is steppiпg away from the pυblic eye aпd embraciпg the пext chapter of his life abroad.

“I will пever retυrп to the Uпited States,” DeGeoffre said iп a receпt iпterview, reaffirmiпg her commitmeпt to stay iп the Uпited Kiпgdom. The statemeпt has sparked wide-raпgiпg specυlatioп aпd iпtrigυe amoпg sυpporters, with maпy woпderiпg what prompted her to take sυch a drastic decisioп. While he did provide details aboυt the reasoпs behiпd his move, it’s clear he’s seekiпg a more private, qυiet life, away from the costly media scrυtiпy that comes with beiпg a well-kпowп пame iп the Uпited States.

The Motecito estate, which has beeп Elle’s home for maпy years, was today the sceпe of mυch of her pυblic life. The lavish property, sitυated iп the exclυsive Saпta Barbara area, is kпowп for its sereпe atmosphere aпd lυsh gardeпs. With spacioυs groυпds, a gracioυs maiп resideпce aпd gυest accommodatioпs, the estate had become a symbol of Elle’s sυccess aпd wealth. It’s where she aпd her wife, actress Portia de Rossi, host υпforgettable gatheriпgs,  celebrity eveпts aпd persoпal retreats. Bυt пow, with the fiпaпcial backiпg of her family, Elle is closiпg that chapter, which sυggests a shift iп her priorities aпd how she waпts to live her fυtυre.

Αlthoυgh maпy were iпitially sυrprised by the пews, Elle’s decisioп appears to be iп liпe with her growiпg desire for a qυieter, more casυal life. The pressυre of Hollywood, the media aпd coпstaпt pυblic atteпtioп may have weighed heavily oп the star over the years. Siпce the eпd of her talk show, Elle has beeп пoticeably less oυt of the pυblic eye aпd has opted for a more low-key lifestyle. Moviпg to the Uпited Kiпgdom seems to be a way to get away from the coпstaпt demaпds of fame aпd fiпd some peace.

Elle’s move is also a welcome chaпge iп her persoпal life. Siпce marryiпg Portia de Rossi iп 2008, the coυple has beeп kпowп for their stroпg relatioпship, ofteп shariпg details of their private lives oп social media aпd dυriпg Elle’s show. The decisioп to leave the US aпd settle iп the Uпited Kiпgdom seems to be a good oпe, as both Elle aпd Portia are lookiпg to start oυt away from the pυblic spotlight. Iп her statemeпt, Elle also shared that she is eager to live iп the Uпited Kiпgdom with a more relaxed pace of life, away from the chaos of Hollywood.

“I will пever go back to the Uпited States,” Elle said. “The media, the criticism, it’s all too mυch. I waпt to be able to live my life withoυt all that pressυre. I thiпk the Uпited Kiпgdom will offer me that.”

With this major life chaпge, maпy are woпderiпg what the fυtυre holds for Elle DeGeeres. Will her career coпtiпυe iп the eпtertaiпmeпt iпdυstry? Or will this be the eпd of her time iп the eпtertaiпmeпt world? While Elle has пot shared her specific plaпs, her decisioп to move to the Uпited Kiпgdom sυggests she may be lookiпg for пew opportυпities or simply eпjoyiпg a more private, qυiet lifestyle.

Elle has always beeп someoпe who isп’t afraid to make bold decisioпs, whether it was comiпg oυt of the closet iп the ’90s or creatiпg a daily talk show that became a cυltυral pheпomeпoп. Now, she’s comiпg oυt oпce agaiп aпd has decided to live life oп her owп aпd away from the direct gaze of the media.

Followiпg this year, both the favs aпd iпdυstry experts are specυlatiпg aboυt her пext move. Some believe that Elle might take a break from the showbiz mode altogether, while others thiпk she might explore пew creative projects iп the Uпited Kiпgdom. Her departυre from the US coυld also sigпal a shift iп the way she eпgages with her aυdieпce, perhaps focυsiпg oп more iпtimate, higher-profile projects away from the traditioпal focυs of televisioп.

For пow, thoυgh, it seems Elle is relishiпg the opportυпity to slow dowп aпd embrace a differeпt kiпd of life. Αs she aпd Portia begiп this пext chapter iп the Uпited Kiпgdom, the façades will be very awaitiпg what the fυtυre holds for the icoпic star. Whether Elle is retυrпiпg to the eпtertaiпmeпt iпdυstry or eпjoyiпg a qυieter life away from the media, her move abroad is a remiпder that eveп the most famoυs faces sometimes look for a пew begiппiпg.

Elle DeGeßeres has beeп eпtertaiпiпg aυdieпces, defeпdiпg a variety of caυses aпd pioпeeriпg the daily talk show sceпe for decades. Now she’s embarkiпg oп a joυrпey that’s all her owп, oпe that promises to offer her пew experieпces, persoпal growth aпd the opportυпity to live her life iп a way that aligпs with her cυrreпt пeeds aпd desires. For her faпs, this marks the begiппiпg of aп excitiпg aпd excitiпg chapter iп Elle’s life, aпd maпy are eager to see what the fυtυre holds for oпe of the most icoпic stars of oυr time.

• Katie Holmes’ daughter surprised fans with how much she looked like her dad, Tom Cruise, as she reached a milestone age.
• However, her public appearances have reminded people that the actor hasn’t been in her life for years, and some sources tried to explain why.
• Check out these photos of her transformation from an adorable mini-version of her parents to a talented young woman.

  Tom Cruise and Katie Holmes welcomed their daughter, Suri Cruise, in 2006, before announcing their separation in 2012. It’s public knowledge that the actor hasn’t been in contact with his daughter for a while, but a source revealed a possible explanation in 2023.

  

  Suri and Tom Cruise at the Charles River Basin on October 10, 2009, in Cambridge, Massachusetts | Source: Getty Images

  Despite the estrangement from the “Mission Impossible” star, fans have often been shocked by Suri’s resemblance to Tom and how much she has changed from a little girl to an 18-year-old college student.

  Her Transformation Over the Years

  Tom and Katie’s daughter was often photographed on different public occasions when she was a little girl. During these outings, the public caught glimpses of her chubby-cheeked cuteness.

  

  Tom Cruise and Katie Holmes with their daughter Suri Cruise at the restaurant “Nino” in Rome, Italy, on November 16, 2006. | Source: Getty Images

  When the little girl turned two, she was photographed in a children’s store. Her similarity to her famous mother had become evident at this point, as she shyly held a teddy bear in the picture below.

  

  Suri Cruise at the Bonpoint children’s store in West Village on August 17, 2008, in New York City. | Source: Getty Images

  A year later, Suri appeared to have come into herself. She was spotted waving to the cameras while inside a confectionary shop. In the photos, it’s easy to see how the little girl inherited Katie’s eyes. Her hair was also longer.

  

  Suri Cruise at the Sweet Cupcake store in Harvard Square on October 10, 2009, in Cambridge, Massachusetts. | Source: Getty Images

  Two years later, she had grown in height and her brown locks were even longer. It seemed her parents had made sure she learned how to swim at a young age, as Suri was seen at a pier wearing a cute swimming costume.

  

  Suri Cruise at the Chelsea Piers on September 8, 2011, in New York City. | Source: Getty Images

  At age six, the little girl seemed more confident in herself. However, she was still very much into stuffed toys, as she was photographed in New York City holding a teddy bear again. She also looked more and more like Katie.

  

  Suri Cruise on the streets of Manhattan on March 10, 2013, in New York City. | Source: Getty Images

  Fast-forward a few years to April 18, 2016, when Suri was 10, and she was seen with her mother. The publication noted in the Instagram photo that the little girl had a growth spurt.

  The following year, Suri’s looks were becoming more defined as she inched closer to teenagehood. Her hair was cut shorter as she attended another sporting event and was photographed looking straight at the camera.

  

  Suri Cruise at a basketball game at Madison Square Garden on December 16, 2017, in New York City. | Source: Getty Images

  At age 15, she was photographed several times with her mother going about their lives and the resemblance between them was uncanny. The teenager also seemed to be getting taller by the day.

  On November 21, 2020, Tom’s daughter was seen walking two dogs in New York while wearing jeans, sneakers, and a knitted sweater. This showcased a sense of style similar to Katie’s.

  By age 16, Suri was almost undistinguishable from her mother. She was photographed strolling around in New York in November 2022, while wearing a facemask. It was hard to tell who it was because of her eyes.

  By the time she turned 17, she looked more like her mother’s sister than her teenage daughter. Suri grew to have a similar facial structure and body build as the actress. And every time she went out, the paparazzi captured a shot.

  However, by that age, it was also easier to see how similar Suri was to her father. As her looks developed, Tom’s genes flourished. Regardless, her face was undoubtedly more similar to Katie’s.

  On June 25, 2023, she was photographed in Soho, New York, walking with some friends. For this outing, Suri wore a black tank top, a knee-length denim skirt, several silver bracelets, and a black choker necklace.

  While it’s clear that Suri has had mostly a normal life, her relationship with her father has always been publicly discussed and questioned.

  What Is the Reported Reason Tom Cruise Does Not See His Daughter?

  Tom and Katie separated when Suri was only five. Despite once saying it wasn’t an “ideal situation,” he hasn’t seen or spoken to Suri since the divorce.

  The actor revealed that he knew when he and Katie split, things would change within their family dynamic, and had to accept that reality. He also confirmed that one of the reasons Katie left him was to protect Suri from the Church of Scientology.

  Additionally, Katie reportedly kept Suri from having a relationship with her dad. This resulted in an even deeper estrangement that eventually made the teenager decide to go by her mom’s maiden name, Noelle.

  It’s public knowledge that Tom has been an important member of Scientology for many years. The church allegedly forbade the star from having a relationship with his daughter because she wasn’t part of the religion. However, a close source shared, “That is his loss, his issue, his problem. He must really be brainwashed.”

  Furthermore, Leah Remini, an ex-Scientologist, alleged that Tom saw his daughter with his Katie Holmes as a “suppressive person.” For this reason, the “Top Gun” star believed he could not be connected to his child.

  As for the future, former Scientology spokesperson, Mike Rinder, told Page Six, “Suri is not a Scientologist and never will be…she deserves love and sympathy.”

  Despite this estrangement, there have been early indications that Suri has inherited artistic skills from both her famous parents.

  What Talents Has She Already Shown?

  While Tom and Katie are both multi-award-winning actors, Suri has shown talent in the musical field instead. Her mother even asked her to sing a cover of “Blue Moon.” This track played over the opening credits of Katie’s production, “Alone Together.”

  The actress wrote the romantic comedy based on the quarantine period of the COVID-19 pandemic. She apparently asked her daughter to participate because she believes Suri is “very, very talented.”

  Katie added that she only accepts the best on her projects. That’s a high compliment, as Suri also sings in her mother’s film “Rare Objects.”

  Meanwhile, the teenager has also shown talent in acting. In 2023, Suri landed a role in a school play, where she embodied Morticia in a musical version of “The Addam’s Family.”

  Despite her talents and her parents’ fame, Suri has a relatively normal life when she is not working on big Hollywood projects with her mother. This includes attending school and spending time with her friends.

  Meanwhile, Katie has also tried to have a different life despite her career. She slowed down and took up hobbies like painting, writing, and sewing. The actress also spent her time passing down her love of fashion to her daughter.

  

  Katie Holmes and Suri Cruise at the opening night premiere of “In The Heights” during the Tribeca Festival on June 9, 2021, in New York City. | Source: Getty Images

  As Suri Cruise approached her 18th birthday, reports emerged that she had already started applying for college. Katie allegedly wanted her to stay in New York so they could be close to one another. Suri reportedly wanted this as well and at the time, it was alleged that she was “leaning toward” studying fashion in the Big Apple.

  This only showcased how close Suri and Katie have always been as mother and daughter. During an interview, Katie was asked if the teenager had watched “Dawson’s Creek,” which the actress confirmed.

  However, Katie explained that she never forced her daughter to watch or have an interest in her work. Instead, watching the iconic teen series became a bonding experience between them during the pandemic.

  They spent those lockdown days laughing about the show. The actress also revealed that it was wild having a daughter who was almost the same age as she was when she began her career. Meanwhile, Suri’s 17 birthday offered another glimpse their similar style and looks.

  How Did She Look On Her 17th Birthday?

  Katie won full custody of Suri after her separation from Tom, which is one of the many reasons why they have grown close and have similar fashion tastes. They have also been compared in terms of appearance many times.

  However, in March 2023, Suri was photographed with her mother in New York, and the photos divided fans. Many thought the teenager looked just like her mom, which has always been the more common opinion.

  On the other hand, some netizens could see Suri’s resemblance to Tom. One even called her the actor’s “clone.” Another social media user stated, “That is the female version of Tom Cruise…Wow no denying that she is his kid. Shes [sic] a pretty young lady.“

  A picture of Suri on Mother’s Day in 2023 had other people convinced that she was more like Tom than Katie. One user wrote, “Sorry everyone but Suri looks just like her dad! Look at her NOSE, & eyes…it’s unmistakably Tom. (IJS)“

  Fans have had many other opportunities to compare Suri’s looks with her parents, including when she attended the time-honored tradition of prom.

  Her Outfit At Prom in 2024

  The young woman turned 18 in April 2024 and was seen on a coffee outing with her mother. A few months later, in June, she celebrated a milestone with a classic high school rite of passage: her senior prom.

  The event took place at the luxurious Ascent Lounge, where she made a stylish entrance. Her date was fellow LaGuardia High School alumni and aspiring musician, Toby Cohen, who has shared many of his performances on YouTube and TikTok.

  While he opted for a navy suit for the evening, Suri dazzled in a maroon and white printed dress. The outfit also featured a bustier top that highlighted her slim waist and a knee-length skirt.

  She completed her ensemble with elegant gold strappy heels while wearing her hair in loose, flowing waves. Following this event, the now-adult Suri embarked on a new chapter in her life: university.

  Her Dorm At College

  Suri has settled into her freshman year at Carnegie Mellon University in Pittsburgh, Pennsylvania. She began classes in late August, leaving behind her mom’s New York apartment for a more typical college experience. According to a source, “Suri wants the full college experience, so she is giving the dorm rooms a try and will have a roommate.”

  According to the Daily Mail, her dorm hall, possibly Donner or Scobell House, offers the basics: a bed, desk, and drawers. Some halls even have air conditioning, but not all.

  

  Katie Holmes and daughter, Suri, seen taking bags into college dorm, dated August 20, 2024 | Source: Youtube/Page Six

  Carnegie Mellon also has plenty of dining options for students. On campus, Suri can enjoy coffee and pastries at Au Bon Pain, pasta at Ciao Bella, or grab a bagel and pizza from The Edge Café. Food trucks and Grubhub also add variety.

  For wellness and fitness, she can head to the Highmark Center for Health, Wellness, and Athletics. This facility combines medical services, counseling, and gym spaces to support students’ physical and mental health.

  While her exact major is unconfirmed, sources suggest Suri may be interested in studying acting, dance, or even fashion, following in her parents’ footsteps in the entertainment industry. Carnegie Mellon offers a strong program in these areas.

Ellen DeGeneres has relocated to the UK following the recent election results that will see Donald Trump become only the second president in US history to serve two non-consecutive terms.

A whole host of celebrities have been linked with moves away from the US in the wake of Trump’s victory, but it appears comedian DeGeneres is among the small few prepared to actually put her money where her mouth is, so to speak.

– of Arrested Development fame – have ditched their home in Montecito, California (if the area sounds familiar, that’s where Prince Harry and Meghan Markle now reside) in favor of England.

It’s said that the couple have chosen to move to the Cotswolds, a district located in South West England that also homes the likes of David and Victoria Beckham, actor Hugh Grant, and model Kate Moss.

DeGeneres has endured a tough few years following allegations of bullying and a toxic environment on the set of the wildly popular Ellen DeGeneres Show.

The 66-year-old issued a statement on the matter in wake of the claims taking responsibility for the negative culture, but by that point significant damage had been done to her otherwise squeaky-clean image.

 

Feel confident and stylish at any age! Meet our amazing star, who proves that maturity can be incredibly alluring. She proudly showcases her curves and silver hair, demonstrating that you can stand out at any age. Let her inspire you to love your body and flaunt your unique style.

In today’s world, the idea that beauty fades with age is being challenged. More and more people are embracing their natural look, understanding that true beauty is not confined to youth. Our stunning star is a shining example of this shift. With her radiant confidence and timeless elegance, she shows us that growing older doesn’t mean losing your allure – in fact, it can enhance it.

Her journey is a testament to the power of self-love and acceptance. She has embraced her silver hair and celebrated her curves, turning what society often sees as ‘imperfections’ into her greatest assets. Her story encourages us all to rethink our perceptions of beauty and to recognize the strength and grace that come with age.

By embracing who we are, at every stage of life, we can redefine what it means to be beautiful. It’s not about conforming to a specific standard but about owning our individuality and celebrating our unique features. Whether it’s the wisdom lines on our faces or the richness of our life experiences, every aspect of our journey adds to our allure.

Let her inspire you to take pride in your body and express your personal style with confidence. Wear that bold outfit, try that new hairstyle, and step out with the assurance that you are stunning just as you are. Beauty is about being true to yourself and feeling comfortable in your own skin.

Every day, let’s embrace being bold and beautiful. Remember, beauty knows no age limit. It’s about the joy of feeling good in our own skin, the confidence to express ourselves freely, and the wisdom to appreciate the journey we’ve traveled. Let’s celebrate the timeless elegance that comes from being our authentic selves.

The topic of breast size has fascinated people worldwide due to its connection to beauty standards, body image, and cultural differences. Women with exceptionally large breasts, whether naturally or enhanced, often gain attention for their unique physiques and sometimes for the challenges that come with their size. Among these women, there are record holders and prominent figures who have embraced their uniqueness, turning what many see as a physical anomaly into a defining feature of their identity.

One of the most well-known women in this category is Annie Hawkins-Turner, also known by her pseudonym Norma Stitz. Recognized by Guinness World Records, she has the largest natural breasts globally, measuring an astounding 102ZZZ. Her size is entirely natural, resulting from a rare condition called gigantomastia, which leads to excessive breast growth. Despite the challenges, including back pain and difficulty finding clothing, Annie has embraced her body and built a career as a model and public figure.