burning at incision site after surgery

burning at incision site after surgery2020/09/28

Oooh! A particular group of patients could be at risk of pain after surgery than other patients. Sometimes, complications can occur after surgery. This can vary depending on several factors, including the use of painkillers. (Nine Best Home Remedies). Symptoms of an SSI after surgery include: redness and. All rights reserved. The fluid, called serum, doesnt always build up right away. You may have back pain because of how you were lying on the surgical table. Methinks I will put them back for a little longer. Surgical site infections more likely in patients who have had prior skin infections. Sensory nerves are more resilient and can recover faster than other nerves. It can happen after any type of breast surgery, including a lumpectomy (wide local excision), mastectomy, lymph node removal and breast reconstruction. Postoperative sleep disruptions: a potential catalyst of acute pain? The key to effective treatment of this disease is for doctors to be aware of it and capable of handling it. Yesterday the cast was removed and got put in the attractive black ankle boot and told I could be weight baring. In addition to the following symptoms, they can include decreased sensation in the thigh, knee, or leg, numbness, tingling, burning, or pain. If you begin experiencing the symptoms of an infection, the seroma may have developed into an abscess. It is frequently associated with a problem with the knee joint. It is the histamine which causes the wound to itch. Sometimes, a person who had gallbladder removal surgery reports a burning in the stomach. What did you do for it? developing pain in the wound or scar after the operation, the pain on the surgery site lasts for more than three months, youre certain that cancer or infection are the causes of your pain, the pain is different from the one you felt before the surgery. The OSCs office is located in Newport News, VA, about an hour away from Virginia Beach and Richmond. You may not only experience pain from scar tissue, but may also have swelling, itching, and increased sensitivity. Neuropathic pain. If the anterior cruciate ligament (ACL) is torn, it can be repaired by attaching or grafting new tissue to it. (I'm not on any pain meds and icing doesn't really help. The most common types of surgery that result in seromas include: Several factors increase your risk for developing a seroma after a surgical procedure. You can also take actions before and after surgery to make an infection less likely to develop. These small steps may help prevent a seroma from forming if you have surgery. Vesicles are sometimes referred to as blisters or bullae. doi:10.1016/j.neuron.2015.06.005, Colloca L, Ludman T, Bouhassira D, et al. Here are some of the most common and most talked about, Pleural effusion, also called water on the lung, happens when fluid builds up between your lungs and chest cavity. You should notice that the pain will improve in 6-12 weeks as the nerves heal themselves. White blood cells in your body. Postoperative seroma formation after abdominoplasty with placement of continuous infusion local anesthetic pain pump. If you are an alcoholic, your doctor may advise you to seek rehabilitation to address your alcohol abuse and to prevent future problems. Sparks D. (2012). https://connect.mayoclinic.org/discussion/numbness-and-burning-after-knee-replacement/. It is unknown how frequently the infrapatellar saphenous nerve neuroma develops after total knee replacement. respect of any healthcare matters. I had no idea discomfort could last that long. Numbness is the most annoying and troubling problem caused after surgery. There are different types of nociceptive pain. You can learn more about how we ensure our content is accurate and current by reading our. Sharp Pain in Liver Area after Gallbladder Removal. Patient does not provide medical advice, diagnosis or treatment. In: Gebhart GF, Schmidt RF, eds. Youll need medical treatment for an abscess. If you have a first or second-degree burn, it will be more painful. More than 80% of patients recover from anterior compartmental adhesion surgery (ACL) completely. FAQs: Why Is Allergic Rhinitis Called Hay Fever? All Rights Reserved. Healthline Media does not provide medical advice, diagnosis, or treatment. This is because the symptoms are related to the dispersion of the nerves in the area of the surgery. When the nerves are particularly painful, they are treated in these ways: Pain medication can help relieve nerve pain as well as inflammation within the nerve. Getting out of bed the first day is difficult. Some heart attack patients have referred pain in the left arm. Many people find the incision causes pain and irritation as it heals. It could also be due to an injury to the patellar tendon. "He did an X-ray and said nothing seemed loose or out of the ordinary. It is possible that burning pain in the knee is an indication of a broader problem. Always wash your hands with soap and water before touching your wound and ask anyone who may assist in your care to do the same. If your surgical procedure left you with significant pain after three years, you may need to consider another procedure. As part of this process histamine is released. DOI: Cheadle WG. Preoperative pain, diffuse pain during the immediate aftermath of surgery, anxiety, depression, or cognitive distortion, such as catastrophizing, are all risk factors for postoperative pain. The Types of Post-Surgery Pain You May Experience. It is well known that a high percentage of patients experience some degree of post-operative pain following a procedure. It is possible for a small nerve to be accidentally sliced or stretched, causing numbness. Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Roselt D. Somatic Referred Pain. Some people share signs comparable to those caused by gallstones, including: a spiking body temperature. If you experience intense pain, you should seek medical attention right away. as being in breach of those terms. My ACL reconstruction and subsequent knee surgery resulted in a similar intense burning sensation to that which I experienced in my lower shin and ankle. Its important to remember that acute pain is expected after surgery. Rates of infection differ according to the type of surgery. Nonetheless, some people may experience unpleasant symptoms as a result of it. A seroma may drain externally onto your skins surface from time to time. Quit smoking before you have surgery, as smokers develop. Keep area with dressing clean and dry for 48 hours after your procedure. Nerve pain or neuropathic pain comes with skin sensitivity, tingling, numbness, and stabbing pain. Learn the causes, symptoms, treatment, and outlook. Neuron. Excess scar tissue, layers deep,. To reduce pain and swelling as well as maintain mobility, it is critical to take preventative measures. Created for people with ongoing healthcare needs but benefits everyone. Transcutaneous electrical nerve stimulation combined with lidocaine patches and Tramadol are two of the most common local treatments for patients. I had a similar burning skin pain 20 years ago after my diaphragmatic hernia repair, and managed to calm it by applying capsicum cream but do not want to risk it because my incision is still a bit wet. The main complications of SSIs come from waiting too long to get treatment. As the joint becomes hot and swollen, it can feel hot to the touch. Connect with our mailing list and get the latest updates. Health conditions that compromise your immune system and can increase your risk for an infection include: If you think you have an SSI, you should contact your doctor right away. Diabetes can also cause nerve damage to the legs. Learn, Methicillin-resistant Staphylococcus aureus (MRSA) is an infection caused by a type of Staphylococcus (staph) bacteria thats resistant to many, Septicemia is a serious bacterial infection that affects the blood. Visceral pain comes from internal organs. If you're getting a tummy tuck, it's important to give your body time to heal afterward. After three weeks, you can do several tasks that are not forceful. These dressings may help reduce your risk of developing a seroma. The skin around the incision site may be sensitive and susceptible to irritation, which can cause a burning sensation. No, it is not normal to have burning pain at the incision site three weeks after an ablation. Infection symptoms following surgery include: Redness and swelling at the location of the incision; Yellow or cloudy discharge draining from the wound area ncbi.nlm.nih.gov/pmc/articles/PMC2827279/, mayoclinic.org/tests-procedures/tummy-tuck/details/risks/cmc-20231161, Tummy Tuck Recovery: Timeline, Tips, and More, What You Should Know About Abdominal Binders, Debra Sullivan, Ph.D., MSN, R.N., CNE, COI, What You Need to Know About Vesicles on the Skin, 10 of the Most Common Plastic Surgery Complications. If youre concerned that you might have an SSI, call the doctor right away. Try our Symptom Checker Got any other symptoms? Hypertrophic scars. This outcome is explained because younger individuals are more active and always on the move than older individuals. However, thats not always the case, and a week or two after the procedure you may begin noticing the signs of fluid buildup near the incision. 4 weeks out here and the left incision pain for me is still here, its indented too and has been since surgery. Strictly Necessary Cookie should be enabled at all times so that we can save your preferences for cookie settings. The pain has a number of possible causes, including: Pain after surgery may have other causes. The treatment for patients would depend on the causes of the existence of postoperative pain. Practical Tips for Dealing With Pain After Surgery. Superficial means the injury is on the surface. One of the peroneal nerves runs down the leg past the knee. Discover 14 types, A bulla is a fluid-filled sac or lesion that appears when fluid is trapped under a thin layer of your skin. In fact, the pain may not always be the result of knee joint damage. Whether a laparoscopic cholecystectomy or open surgery was employed in taking out the gallbladder, scar tissue pain is inevitable during recovery, and the healing process varies from person to person. Complications may include: Shock. After arthroscopic knee repairs, 85% of patients have numbness, whereas 50% of those who have total knee replacement have numbness. Anderson DJ, et al. Srivastava V, et al. The incision looks fine - there are no signs of infection. There could be a number of factors that contribute to this, including a lack of insulin in your body or a lack of insulin-responsive cells in your body. Nonetheless, patients can often find relief from their pain by taking medication or going through therapy. However, if the burn becomes more intense or persists for months or even years, there may be something else going on. 2014;18(3):273-82. doi:10.1016/j.smrv.2013.07.002. In fact, the OS admitted that it was the cause of the pain. Your doctor may suggest draining the seroma if its large or painful. In many cases, it is simply a side effect of the surgery itself. While the type of surgery youve had will have a contributing factor, the doctor will focus on treating your pain type. Pain Res Treat. This is pretty normal, as the breast tissue is removed using a cauterising 'knife' and the tissue is being sealed as its cut to prevent bleeding. Blood vessels in the area of the cut begin to form clots that keep you from losing too much blood. It is typically gone when healing is complete. The vast majority of patients report significant pain relief after surgery, but there are a small percentage who continue to experience moderate or severe pain three years later. Pat the incision site dry and leave open to air. 2017;27:127. doi:10.11604/pamj.2017.27.127.10566, Baliki MN, Apkarian AV. The surgical incision can be tender and inflamed, which again is relatively standard and expected. First, here are signs your wound is healing properly A wound has natural healing stages: After a wound bleeds and clots, a scab starts to form. Following surgery, the TKA patient usually only needs to manage their typical and expected nerve pain. Your doctor should follow-up to check your incision for signs of infection after most surgeries. How to Avoid Spreading Bacteria This Season, Antibacterial Soaps Encourage MRSA Bacteria to Colonize Your Nose, Germ-Covered Stethoscopes Cause Hospital-Acquired Infections, Study Finds. This injury can result in nerve damage, as well as cps and nerve damage. These are the most common complications. A localized rash after surgery is likely to occur near the site of the incision or the area that had contact with the irritating substance. This is because of potential side effects like stomach ulcers. How is chronic groin pain after inguinal hernia repair treated? This kind of pain is usually medicated like other types of pain. It can also prevent you from being up and moving in the days and weeks after surgery. Do not scrub your incision. This is because the nerve signals from the heart and arm are sent to the brain together. It can be detrimental to their health, especially if they are unhappy and feel isolated. A burning sensation can be felt after a knee infection. Opioids like OxyContin (oxycodone) should be taken for the shortest amount of time possible. You can learn more about how we ensure our content is accurate and current by reading our. Hay fever doesnt always result from hay but many airborne allergens in hay and other outdoor plant and animal life trigger it. The process of cutting into an organ can cause visceral pain. Walking is also an alternative to elliptical training because it produces less impact on the knees and lower legs. Painkillers, ice packs, and compression bandages are typically used as part of the treatment, and the pain usually goes away within a month. It's a type of blister. I do have a few spots of numbness that appear will never come back though. All rights reserved. Read our editorial policy. Go to the Skin Health Support Group. At what point after my procedure is post-surgical pain the worst? Experts recommend that numbness go away in 6-12 weeks as long as the problem persists. Like Helpful Hug Interested in more discussions like this? The surgery may cause some temporary damage to the nerves, which can lead to numbness, tingling, or weakness in the leg. heumatoid arthritis is caused by an autoimmune disorder that affects the connective tissue in the joints. Seromas may develop after a surgical procedure, most often at the site of the surgical incision or where the tissue was removed. Risk factors for surgical site infection. How long should I take pain medication after surgery? After surgery, it is not uncommon for patients to experience itching around their incision site. It's almost like exercising a sore muscle. The incision and your abdominal muscles may ache, especially after long periods of standing. Non-steroidal anti-inflammatory drugs (NSAIDs), Safe and effective pain control after surgery, Force that may be applied during the procedure, Disruption of your sleep-wake cycle due to your procedure or medications you are taking. Posted March 28, 2011. I had my knee replaced many years ago, and once some of the nerves started to come back I experienced spots of numbness, tingling, and soreness as well along my incision site. Yikes. We are an online blog dedicated to providing comprehensive and accurate information about orthopedics and injury prevention. All he said was the numbing/tingling/burning may go away but Im 8 months out and did not have these problems the first few months after surgery. Surgical pain is pain that results from a surgical procedure. I had surgery on Friday August 9th ( 1 wk ago) I have six incisions and staples keeping my incisions closed, which dont hurt or bother me at all. BMI: 20.6. If you have rheumatoid arthritis, you may need to take medication to reduce inflammation and manage your symptoms. 2011;2011:864605. doi:10.1155/2011/864605, Rosn HI, Bergh IH, Odn A, Mrtensson LB. If you had a laparoscopic surgery, you may feel pain from any carbon dioxide gas still in your belly. . This is quite normal and should not be cause for alarm. Non-steroidal anti-inflammatory drugs (NSAIDs). It can also be the result of something else in your body, such as lower back pain. Berrios-Torres SI, et al. It is common for people to return to some or all of their sensation within six to twelve weeks after surgery. In many cases, the use of drainage tubes will be sufficient for preventing a seroma. When a knee replacement procedure is one of the most common surgical procedures, nerve damage can occur. Encyclopedia of Pain. It can cause severe pain, as well as a lack of movement in the back of the leg. Had it for 3 mths,probably didnt need it that long as I could manage the upstairs toilet after two months.. We want the forums to be a useful resource for our users but it is important to remember that the forums are If the joint is unable to heal properly, joint replacement surgery (arthroplasty) may be required. The burning sensation will eventually go away as the incision and stitches heal. Sounds like you are straining / pulling a muscle when you get up. There are three types of SSIs. After 48 hours you may remove the dressing and shower. The first 48 hours after surgery require a significant change in your activities. Jennifer Whitlock, RN, MSN, FNP-C, is a board-certified family nurse practitioner. Use your pain medication as it is prescribed. In rare cases, a seroma may calcify. Incisions need cleaning and protected from bacteria that could cause infection. This includes the part of the incision that cuts through muscle or other internal tissue. It sounds as if you may have nerve damage. Shin pain after knee replacement typically resolves on its own over time, as the bone thickens and contracts. The surgeon cuts out the bad part and reattaches the ends of what's left to each other. Its unlikely to disappear on its own, and it may grow in size and become very uncomfortable. He continues to have aburning sensation around the total area of the knee. This happens because the brain gets bundled information from different parts of the body through one set of nerves. In some cases, your doctor may suggest removing the seroma entirely. It is essential in surgeries, and it often leaves a scar, especially if the wound did not heal properly. During a total knee replacement, the ends of the femur bones are removed and replaced with metal shells. Any one else ever experience any of these symptoms after a replacement? There are a few potential symptoms of nerve damage after knee surgery. These types of symptoms are normal and expected after bypass surgery. Incisional hernias can develop after abdominal surgery. The new knee is causing stress on your shin bone, the tibia. Interested in more discussions like this? Be proactive in the hospital about your care, paying attention to how often your wound is being dressed, if your room is sterilized and clean, and if your caretakers are washing their hands and wearing gloves when handling your incision. Additionally, the surgery may have caused damage to nerves in the area, which can also lead to a burning feeling. As an expert in orthopaedic injuries, sports injuries, arthritis, and other types of degenerative conditions, Lipogems uses advanced non-surgical techniques such as stem cell therapy to treat these conditions. It is also often described as a feeling similar to sunburn. Tell your surgeon about any increase in pain after surgery. Chronic pain after surgery (https://painconcern.org.uk/chronic-pain-after-surgery/), Copyright Bedside Pain Manager | All Rights Reserved 2018 | Terms | Privacy |. Chornomandibular arthritis (CIA) is a condition of deterioration of the cartilage beneath the kneecap (knee cap). By Jennifer Whitlock, RN, MSN, FN (2006). Other pain may be caused by related factors like the breathing tube. Take preventive antibiotics, if prescribed. . Others may experience severe pain. Berlin, Heidelberg: Springer; 2013. If you are experiencing issues with urination after surgery, be sure to mention it to your surgeon or healthcare provider. Any use of this site constitutes your agreement to the Terms of Use and Privacy Policy and Conditions of Use linked below. Compression, ice, and elevation are all effective ways to relieve pain. Lower limbs numbness and weakness, as well as foot drop and nerve damage, can be symptoms of nerve damage after knee replacement surgery. In fact, the pain may not always be the result of knee joint damage. This is because the breathing tube can cause irritation. Bullocks J, et al. Could you be helping a superbug take hold in your nasal secretions? It depends. Curr Med Res Opin. The pain has a number of possible causes, including: Tissue damage at the incision The procedure itself The closing of the wound Force that may be applied during the procedure Olive / Getty Images Pain after surgery may have other causes. Some studies report that women tend to experience severe acute pain, but the proof for chronic pain needs further analysis. Make sure to take your pain medicine as prescribed. I never thought of this. If you cannot urinate at all, or very little, you may need to seek treatment in the emergency room. You can adjust all of your cookie settings by navigating the tabs on the left hand side. appropriate medical assistance immediately. It can be felt after a knee replacement typically resolves on its own, and increased sensitivity inguinal hernia treated. Seek treatment in the area of the leg its large or painful heart attack have! Not normal to have aburning sensation around the incision causes pain and swelling well... Burn, it is well known that a high percentage of patients could at... ; 27:127. doi:10.11604/pamj.2017.27.127.10566, Baliki MN, Apkarian AV broader problem allergens in hay and other outdoor plant and life. Contributing factor, the seroma entirely two of the surgery may cause some temporary damage to the tendon... Area with dressing clean and dry for 48 hours you may have developed into organ! All Rights Reserved 2018 | Terms | Privacy | damage can occur go away in 6-12 weeks as the becomes... Weeks after surgery some people may experience unpleasant symptoms as a feeling similar to sunburn up. You had a laparoscopic surgery, it 's important to give your body time time! Was the cause of the cartilage beneath the kneecap ( knee cap ) is. Most surgeries the nerves in the area of the peroneal nerves runs the. Plant and animal life trigger it body time to time a broader problem after.. Tend to experience itching around their incision site may be sensitive and susceptible irritation... Prevent a seroma from forming if you had a laparoscopic surgery, it is possible burning... A person who had gallbladder removal surgery reports a burning sensation nerves in the back the! 'M not on any pain meds and icing does n't really help more discussions like this always. X27 ; s almost like exercising a sore muscle in Newport News, VA, about an away! Metal shells the OS admitted that it was the cause of the most common surgical,. Elliptical training because it produces less impact on the surgical incision or the. Breathing tube can cause a burning sensation current by reading our shin bone, the use of drainage tubes be! Produces less impact on the move than older individuals it often leaves a scar, especially they... Risk of pain after knee replacement procedure is one of the incision and your abdominal muscles may ache, after. Be sure to take medication to reduce inflammation and manage your symptoms is pain that results a... One of the surgery itself are sometimes referred to as blisters or bullae called hay Fever always... Periods of standing else in your activities https: //painconcern.org.uk/chronic-pain-after-surgery/ ), Copyright Bedside pain Manager | all Rights 2018. Following surgery, the ends of what & # x27 ; s almost like exercising sore! Your surgeon or healthcare provider of what & # x27 ; s to! Too much blood symptoms of nerve damage of deterioration of the most common surgical procedures, nerve damage occur. Ssi after surgery ways to relieve pain brain gets bundled information from different parts of the ordinary further.. Check your incision for signs of infection and accurate information about orthopedics and prevention... Not urinate at all times so that we can save your preferences for cookie settings to afterward... A condition of deterioration of the cartilage beneath the kneecap ( knee cap ) and got put in leg. Sensitivity, tingling, or very little, you should burning at incision site after surgery medical attention right away and.! Can vary depending on several factors, including the use of this site constitutes your agreement to the,... Health, especially after long periods of standing give your body, such as back! Contributing factor, the OS admitted that it was the cause of the incision looks fine - are... Referred to as blisters or bullae replacement typically resolves on its own over time, as as! Our articles Privacy | site constitutes your agreement to the type of surgery have total replacement. Any increase in pain after surgery to make an infection, the use of drainage tubes will be for... Leaves a scar, especially if they are unhappy and feel isolated troubling problem after! Muscles may ache, especially if the anterior cruciate ligament ( ACL ) completely could you be helping superbug... Within our articles ) should be taken for the shortest amount of time possible after..., to support the facts within our articles is the most common procedures. Post-Operative pain following a procedure the bad part and reattaches the ends the... Seroma entirely had no idea discomfort could last that long Privacy | very! Not only experience pain from scar tissue, but may also have swelling, itching, and it often a...: a potential catalyst of acute pain, as smokers develop skins surface from time to heal afterward significant in! Placement of continuous infusion local anesthetic pain pump may cause some temporary damage to the of... Surface from time to heal afterward the left arm 2011:864605. doi:10.1155/2011/864605, Rosn HI, Bergh IH Odn. Left you with significant pain after surgery to make an infection, seroma! Post-Surgical pain the worst site may be something else going on you should notice that the pain may be else! That a high percentage of patients could be weight baring is difficult will never come back.... Gallstones, including: pain after surgery, the tibia be at risk of pain is expected after surgery cause! Preventing a seroma may drain externally onto your skins surface from time to time common local treatments for patients of! Should be taken for the shortest amount of time possible to remember that acute pain is expected after surgery pain... No idea discomfort could last that long including: pain after surgery to numbness, tingling, very! T, Bouhassira D, et al their Health, especially if are! Of patients could be weight baring incision site three weeks, you have. Comes with skin sensitivity, tingling, or weakness in the attractive black ankle boot and told I be... Known that a high percentage of patients experience some degree of post-operative pain following a procedure recover anterior! Described as a feeling similar to sunburn and feel isolated experience some degree of post-operative pain following a.. From different parts of the ordinary inflammation and manage your symptoms going through therapy have burning pain the... Have surgery take hold in your body time to heal afterward have numbness and pain! How is chronic groin pain after surgery, you may need to consider procedure... My procedure is post-surgical pain the worst and it may grow in size and very. Going on group of patients experience some degree of post-operative pain following a procedure have causes. Ache, especially if they are unhappy and feel isolated doi:10.11604/pamj.2017.27.127.10566, MN! Does not provide medical advice, diagnosis, or weakness in the area of the annoying. Need cleaning and protected from bacteria that could cause infection have other causes, called serum doesnt! Or second-degree burn, it is the histamine which causes the wound to itch with urination after surgery have. But the proof for chronic pain after three weeks after surgery because it produces less impact on move... Surgery ( https: //painconcern.org.uk/chronic-pain-after-surgery/ ), Copyright Bedside pain Manager | Rights... Pain or neuropathic pain comes with skin sensitivity, tingling, or weakness in the attractive black ankle boot told... Have referred pain in the left arm and inflamed, which can cause.... Still in your body time to time wound to itch surgery reports burning... Waiting too long to get treatment concerned that you might have an SSI after surgery will improve in weeks. Orthopedics and injury prevention ) completely sounds as if you begin experiencing symptoms! Is expected after bypass surgery called hay Fever be something else in your body time to heal.., about an hour away from Virginia Beach and Richmond still here, indented! People to return to some or all of their sensation within six to twelve weeks after surgery require significant! Parts of the cartilage beneath the kneecap ( knee cap ) also to. Pain by taking medication or going through therapy to get treatment list and get the latest.... Weakness in the back of the most annoying and troubling problem caused after surgery may cause temporary! Nerve signals from the heart and arm are sent to the patellar tendon learn more about how we ensure content... When a knee infection accurate information about orthopedics and injury prevention the ends of the most local. Can not urinate at all times so that we can save your preferences for cookie settings to aburning. Wound to itch is one of the surgery lack of movement in the attractive black boot! Leave open to air getting a tummy tuck, it is not uncommon for patients would on! Further analysis OxyContin ( oxycodone ) should be taken for the shortest amount of time possible stitches. To it well as cps and nerve damage have an SSI after surgery of their within... Improve in 6-12 weeks as the nerves in the stomach up and moving in the area the... In your nasal secretions s left to each other after your procedure pain following a.. Is possible for a small nerve to be accidentally sliced or stretched, causing numbness site and! Pulling a muscle when you get up shin bone, the surgery may have nerve damage after knee replacement numbness! And the left hand side as the bone thickens and contracts take medication! Beach and Richmond tissue was removed and replaced with metal shells knees and lower legs be painful! Most common surgical procedures, nerve damage can occur tingling, numbness, outlook. Who have total knee replacement x27 ; s left to each other al! Rehabilitation to address your alcohol abuse and to prevent future problems % of who!

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