tweety, I had internal stitches rip open and believe me, you would know if that's what had happened. If it's necessary to remove your spleen, you'll be at increased risk of serious infections, such as sepsis. This might involve general anesthesia and a stay at the hospital after the surgery is completed. Thanks a lot! Your large intestine is made up of several different parts, including your colon, rectum, anal canal, and cecum a small pouch located in your colon. Also, permanent sutures are used to flatten the abdominal wall muscles by tightening the rectus abdominis muscles. Mental confusion or disorientation. After a successful c-section, a crucial part of your recovery is keeping your stitches from getting ruptured. If youre experiencing a medical issue, please contact a healthcare professional or dial 911 immediately. You cannot see it (yet?). If you experience these symptoms, visit your vein care specialist or the nearest emergency room to avoid excessive blood loss and other complications. When researchers analyzed tummy tuck complication rates and risk factors using the nationwide CosmetAssure database, an insurance program providing coverage for complications related to cosmetic plastic surgery procedures, which are typically not covered by health insurance, they discovered that major complications occurred in four percent of patients undergoing tummy tucksignificantly higher than the 1.4 percent rate after other cosmetic surgery procedures. How do I know if my internal stitches have ruptured? Remove cysts from your dog's toes through surgery, a CO laser, or therapy. The occurrence of a disease could be a sign of rupturing and an open wound. There, the bodys fluids cannot dissolve and decompose the stitch, so it remains intact. Descriptions of recovery times shorter than this, in my opinion, is over-promising. Sometimes areas of skin discrepancy need one or two sutures. Motherhood is beautiful and unique, but it can also feel new and scary. 2010;2010. doi:10.1155/2010/356740, Cooper R, Mishra G, Hardy R, Kuh D. Hysterectomy and subsequent psychological health: findings from a British birth cohort study. The internal stitches used in vaginal hysterectomy will dissolve naturally. Here are some symptoms of torn internal stitches. The following are some symptoms of torn internal stitches and signs of complication after tummy tuck: Severe pain in the incision Fever Incision looks infected (spreading redness, pain) and large red area Incision looks infected (spreading redness, pain) and on face Red streak runs from the incision Early signs can be a rapid heartbeat and shallow breathing. Without treatment, this infection may lead to: According to the Centers for Disease Control and Prevention (CDC), the most common cause of necrotizing fasciitis is group A Streptococcus bacteria. Here are some suggestions to help keep your incision infection and injury-free. I've given birth twice, had three ovarian cyst surgeries, and had an ablation and the stitches ripping open was easily the most pain I've ever felt. Bowel perforation symptoms can include: abdominal pain an abdomen that is firm or tender to the touch fever and chills loss of appetite nausea and vomiting Serious symptoms that might indicate a life threatening condition A perforated bowel is a medical emergency. Last medically reviewed on March 5, 2020, The body breaks down dissolvable stitches over time, so they do not require removal. Their current ages range from almost ten years old down to 20 months old. Your email address will not be published. You do not want an infection to develop at the wound site, and you might also get additional pain medication. How Long Do I Wait to Travel After a Cesarean? Even though ruptured spleen needs emergency surgery, there are some patients . I pulled out a decent size white string and ended up just cutting it off and not pull the whole thing out. Youll be able to see if the incision looks red or angry instead of getting better or if there is sudden drainage that looks a bit worrisome. After adjustment for other factors, the relative risk of major complications was 50 percent higher with combined procedures. It also provides support for the abdominal muscles that would have been cut into during the procedure and are also trying to heal, meaning you are less likely to accidentally overstretch and cause a tear in your internal incision scar as it is healing. Injury to those nerves can interfere with the sensations of sexual contact. In more severe cases, an individual may experience mild abdominal discomfort or severe abdominal pain. You must take proper care of your incision to prevent any problems with your incision. During a cesarean surgery, your doctor will make a 34-inch incision in your uterus just big enough to get your baby out. I feel pain around the bulge, especially after arm movements. Her mission is to share practical and realistic parenting advice to help the parenting community becoming stronger. Once you go home, the healing process truly begins. Removing the spleen (splenectomy). The urethra may tear or become narrower, or you may experience urinary incontinence. However, internal incisions are hidden by absorbable sutures that disappear after they do their work. Just like with any surgery, complications can occur after tummy tuck, your body needs time to heal afterward. How long does it take for an incision to heal completely? Shes an active parent who enjoys indoor and outdoor adventures with her family. After the rupture of the appendix, patients are held in hospital for a longer period of time. Repairing the stitches. The American Cancer Society Guidelines for the Prevention and Early Detection of Cervical Cancer, Clarke-Pearson DL, Geller EJ. J Clin Med. The last thing you want is to need to go back into the hospital after finallymaking it home with your baby. Dont Go Unprepared into C-Section If Youre a Plus Size, Planned C-Sections and What They Mean for You, How to Get Through Your Day-By-Day and Week-By-Week, Pregnancy After C-Section: What to Know When Youre Ready, Worried that You Cant Breastfeed After a C-Section? After my last c-section, my nurse had to remove one of the strips because I was bleeding, and it felt like she would also remove my skin. While we do connect people with vetted, board-certified doctors, we dont provide medical consultations, diagnosis, or advice. Curr Opin Obstet Gynecol. Studies indicate that combined procedures can significantly increase complication rates and should be considered carefully in higher-risk patients. Big mistake,i layed on my bed on my own without a garment,crunched my ab side ways,to look over to my husband,layed back down and then felt a BAD pain! Your belly button most likely wont be moved during this type of procedure. The sutures are used to tighten or plicate the six-pack or rectus abdominis muscles. Ruptured internal stitches will lead to different cases of internal bleeding. A breast lift is really a nipple lift. Youll have internal stitches for the inside layers and an external layer. Some mothers are not careful about their movements and physical activities, even after a c-section. A doctor can easily remove the remaining piece of stitch once the wound is closed. It is possible to feel the implant in areas where tissues are thinnest. Depending on how the wound occurred, a tetanus shot might be necessary. Compared to the 3.1 percent rate with tummy tuck alone, risk increased when tummy tuck was combined with other procedures: up to 10.4 percent when tummy tuck was combined with body contouring plus liposuction. If you are breastfeeding, it is better to avoid ibuprofen and opt for paracetamol. This may be an emergency surgery. Hysterectomies are a major surgery preformed by a skilled surgeon in a hospital. Emergency obstetric hysterectomy for life-threatening postpartum hemorrhage: A 12-year review. The symptoms of an internal hernia vary based on the type and severity of the hernia. Paleness and faintness. If you think you may have torn stitches, do not take any aspirin or blood thinners. It takes up to six-eight weeks for your body to heal, so give it the time it needs. Just pat it dry with a towel. Is the ketogenic diet right for autoimmune conditions? I always ask my patients to maintain a binder at all times for 6 weeks, even while asleep. Symptoms at the incision site start getting worse instead of better and may include: Pain Redness Swelling Bleeding Drainage of other fluids You may also have a fever. It sounds as if your surgeon made some great improvements on your tummy tuck revision. This produces an exaggerated and often pathologic response by the immune system to an antigen. Often, common stitches are used to cover an incision or cut over the skin. After your partial or complete tummy tuck, your incision site will be stitched and bandaged. Internal Rupture. Surgery is generally done as an outpatient procedure. Curb Stomp Your Curb Walk: How to Kickstart Labor (+Some Success Stories). Parents, partners, friends, family accept all offers of help while you are still healing so you can be back on form quicker and able to enjoy the wonders of motherhood. Your doctor will be able to give you tailored advice for the best medication for your specific needs. So this article has really helped. She's an active parent who enjoys indoor and outdoor adventures with her family. Thats it! Too much activity can cause your internal stitches and external closures to break open. All it takes is bacteria entering your incision, and you end up with an infection. Symptoms of a torn calf muscle can include: No calf strength, including being unable to balance or bear weight on the injured leg. SO typically we wait and observe as there is little that would be done on an urgent basis. Women who decide to have C-sections have to cope with the cuts that have been made on their bodies. There are many reasons why your stitches may rupture. When this happens, seek medical assistance immediately. If your stitches get pulled out, it will result in internal bleeding and severe blood loss. In the ideal world, your surgical wounds will heal and close properly, with the edges staying intact while the new tissue forms. on Symptoms of Torn Internal Stitches After Tummy tuck, Symptoms of Torn Internal Stitches After Tummy tuck, Causes and Remedies Of Needle Poking Sensation In The Eye, List Of Worst Foods and Drinks For Brain Health, The Benefits of Mindfulness: Sherief Abu-Moustafa Shares How To Incorporate it Into Your Life, How to Get a Medical Marijuana Card in California, Small Island Developing States accelerate action to tackle biggest killers, WHO announces plans to establish a TB Vaccine Accelerator council, WHO welcomes data on COVID-19 in China, meeting with Minister, WHO updates COVID-19 guidelines on masks, treatments and patient care, Incision looks infected (spreading redness, pain) and large red area, Incision looks infected (spreading redness, pain) and on face, Stitch (or staple) came out early and wound has re-opened. Please enable JavaScript!Bitte aktiviere JavaScript!S'il vous plat activer JavaScript!Por favor,activa el JavaScript!antiblock.org. Leave it alone for now and follow up with your surgeon so that they can monitor the healing. Hysterectomy is the surgical removal of the uterus. These stitches dissolve over time and do not need removing. Lets be real; a c-section is a SERIOUS surgery, and the recovery is sometimes tough. 2001 Jun;184(7):1386-9; discussion 1390-1. Moms need to be vigilant about infections after a c-section. Bursting a stitch is always a risk after abdominal surgery. Some surgeons quote their fee, and you are responsible for the anesthesia and facility costs, which fluctuate based on how long the procedure takes. Steri-strips are like duct tape for surgery; they dont come off quickly. Studies show that, while sutures do take considerably longer to use in the operating room, theyreduce the risk of infection. No, you cannot feel internal stitches after a c-section. Sutures also need to be withdrawn from the drain site. Each staple only takes a few seconds, and it feels like a small pinch. However, there have been many recent studies that suggest cesarean healing time is closer to 24 weeks. Air speeds the healing process. All are efficient ways to close an incision and have the same results as the other. Weve gathered some DOs and DONTs for faster c-section healing here, you can read them. It is unlikely that your sutures pulled out without hearing an popping sound. It does take time to dissolve! A doctor should clean the area and remove any pus that is present. You can learn more about how we ensure our content is accurate and current by reading our. Safe Massage Tips for Pregnant Women: Which Areas Should Be Avoided? The bleeding may be caused by small cuts from straining, infection, poor suturing during surgery or a ruptured blood vessel in the anus. I do have another word of advice for you. (adsbygoogle = window.adsbygoogle || []).push({}); A tummy tuck is a cosmetic surgical procedure to improve the appearance of the abdomen. Give your doctor a call; theyll probably want to take a look and snip it for you. How is sepsis diagnosed and treated? Partial or mini-abdominoplasty: Mini-abdominoplasties are done with shorter incisions and are often performed on people who have less excess skin. Hi Hannah, Id make sure youre drinking plenty of water and check to see if what comes out looks normal. Staples are placed on your external incision to keep everything neat and closed. Your doctor will probably have you stop by for a quick visit to remove them for you. As always, if youre in any pain, have a fever, or are simply concerned, contact your doctor to get checked out and get peace of mind. If the stitches are left in the skin for longer than is needed, they are more likely to leave a permanent scar. I use multiple individually placed sutures, so it would be extremely difficult to tear the whole suture line unless there was some moderate trauma of some sort. Scar forms outside the body on your skin during the healing process of a wound after an injury, fall, or accident. Wait Until After Children for Breast Augmentation? Your doctor will prescribe pain relievers, which you must take to ease discomfort. Contact: 0208 296 9620 Surgery for a ruptured spleen can include: Repairing the spleen. The things that can lead to a burst stitch are the actions which increase pressure in the abdomen. Whimpering on being touched or moved. However, incisions made after this procedure have to be closed properly. Depression. I hope you feel better soon! If your internal stitches rupture and you suffer internal bleeding, you may suffer from infections, including a urinary tract infection. If you follow your doctors instructions and take care of your incision, your internal stitches will be fine after your c-section. That allows you to catch the problems before they become too severe. Usually, there are one or two sutures that are used to anchor the drain to the skin. This repair is typically most vulnerable at week 2 after your surgery. Answer: Possible tear of internal abdominal stitches for tummy tuck repair It is difficult to assess if internal sutures have been torn unless there is a sudden change in the contour of the abdominal wall. If you start to bleed profusely, head to the emergency room. You or your doctor might be. Zhang Y et al. I decided on scar revision,redo belly button,and tighten my lower abs due to bulging on the sides. Iesha is a loving mother of 2 beautiful children. It can be somewhat overwhelming. Hello,Thank you for your question. The particular hernia at issue was a congenital Morgagni hernia. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); How To Know If Internal Stitches Ripped After C-Section, on How To Know If Internal Stitches Ripped After C-Section. I also had an infection in the stitches and along with that came the dull achy burning pain so . A uterine rupture is a tear in the wall of the uterus, most often at the site of a previous c-section incision. A cut or incision about 2 to 4 inches long is made in the lower right-hand side of your belly or abdomen. (March 2019). Obstet Gynecol Int. Its normal to experience some bleeding for a few weeks after you give birth. If doctors do not treat it in time, later symptoms include: dizziness. When a cesarean is performed, the surgeon will make an incision in the abdomen and a second incision in the uterus to get the baby out. If so, its very important that you follow all of your surgeons instructions on wearing this garment and caring for the bandage. Your incision is fully healed after a year. In mild cases, individuals may not have any symptoms at all. Pain can come up from c-section incisions even years later. are bad for the body and could make your symptoms much worse. About a week ago I felt an edgy bulge in my right breast (placed in the bottom, the lateral part of the breast, close to the incision). If you suspect your stitches may have ruptured, you must see a doctor immediately. Sexual problems. Place a pen under your breast where your breast meets your chest. Hospital Revamp: How to Make Your Hospital Room Look Cozy During Labor. How to recognize and treat an infected wound, How to heal a deep cut inside the lower lip, Torso including back, chest, and abdomen, tender and swollen lymph nodes closest to the location of the stitches, pain when they touch the stitches or move the injured area, swelling, a feeling of warmth, or pain on or around the stitches, yellow or green drainage coming from the wound, a bad smell coming from the repaired area, red, swollen, and warm skin in the affected area, ulcers, black spots, or blisters on a persons skin, keeping the stitches covered and dry for the first, cleaning the stitches gently with mild soap and water, avoiding perfumed soaps, alcohol wipes, iodine, and peroxide, patting the area dry gently with a fresh towel after cleaning, using only ointments that a healthcare professional has recommended or prescribed, refraining from touching or scratching at the stitches, avoiding baths, swimming, and other activities that place the stitches underwater, avoiding any activity or sport that could cause the stitches to come apart. Damage to the perineum could also injure an internal part of the penis containing the urethra. During a tummy tuck also known as abdominoplasty excess skin and fat are removed from the abdomen. It is advisable to protect the scar from sunlight for unto 12 months as sun can make the scars darker. Some doctors remove staples as soon as three days postpartum, but in my experience, all of my staples were removed at one week postpartum. If your incision opens wide, cover it and either go to the emergency room or call 911. Your surgeon will also tell you about the best way to sit or lie down so youll be in the least amount of pain. I would not pressure on the implant to 'pop' it in and out. Your skin will be separated between the line of incision and your belly button. // Leaf Group Lifestyle, The Risks of Running After a Hysterectomy. After a tummy tuck, do any sutures need to be removed? Diagnosis and Tests Without any doubt, a c-section is an effective and fast way to deliver a child. Your incision will be sore for a week or two, and heat can help reduce pain and soreness. Thats why you need to know if internal stitches rip after a c-section. I am 2.5 weeks post op getting submuscular BA. clips or stitches. If you are feeling extreme pain, are feeling dizzy or lightheaded, or unwell, consult your doctor, or call 911 right away. From breastfeeding woes to budgeting problems and behavior problems, along with everything in between, chances are Ive faced it over the last ten years. A ruptured spleen is described as an emergency state of extensive internal bleeding because the spleen is the depot of blood. The good thing is that if youre worried that you can tear internal c-section stitchesafter a year, you now know that you cant! You will receive general anesthesia, which will put you to sleep during the operation. Best food forward: Are algae the future of sustainable nutrition? When a wound opens, its called wound dehiscence, which happens in6-7% of c-sections. 3. Here is what you should do if you think you have torn stitches from a hysterectomy. Dont be worried about the staple removal. Dont forcibly remove them beforehand. Obstet Gynecol. If you are traveling out of town to a facility to have the procedure done, youll be asked to stay overnight at a hotel. If you have a phone near you, call 911, or have someone else do it for you. Determining if you have an internal or uterus infection can be a bit more complicated. Join Now - Help for Your Hysterectomy Support Needs. Each surgeon has a different method to close a c-section incision. How long does it take internal incisions to heal? Coz I havent felt any pain in a while.. just this. You may need to have fluids or blood replaced due to internal bleeding. Other risk factors for major complications included male sex, age 55 years or older, and obesity. diarrhea. However, it will lessen as you continue to heal. By quickly identifying torn stitches, you can mitigate the damage to the body and seek help quickly. Independent of the surgeon's fee, the price of OR time and anesthesia can Can I wear a bikini 1 year after tummy tuck? The appendix is taken out through the incision. Empowering Your Family to Thrive in Life's Journey. C-sections may be a planned procedure for expecting mothers. I dont think its come undone since its been a year for you since the surgery, but there may be a possibility of scar tissue interfering with things. 3 Replies, Last Reply 07-14-2009, Started By soldout777, 3 Replies, Last Reply 12-02-2008, Started By iona4, 4 Replies, Last Reply 10-09-2006, Started By kprofthekey1, 1 Reply, Last Reply 04-14-2006, Started By cjgtdg, 2 Replies, Last Reply 04-01-2006, Started By boonbud, 6 Replies, Last Reply 06-30-2005, Started By Pisces57, 5 Replies, Last Reply 05-14-2005, Started By pooodle, 2 Replies, Last Reply 04-19-2005, Started By karinone, 4 Replies, Last Reply 02-22-2005, Started By dallasdmc, 2 Replies, Last Reply 12-10-2004, Started By Fozz, 2 Replies, Last Reply 11-08-2004, Started By Eternity925, 48 Replies, Last Reply 11-01-2004, Started By LadyJo, 9 Replies, Last Reply 07-12-2004, Started By kinderteach, 1 Reply, Last Reply 06-21-2004, Started By Loobyloo, 13 Replies, Last Reply 05-16-2002, Started By JudyAnne, 1 Reply, Last Reply 02-20-2002, Started By kibbutzangel, 3 Replies, Last Reply 02-08-2002, Started By tiredofpain, 6 Replies, Last Reply 04-17-2001, Started By CIDVIC, 3 Replies, Last Reply 03-28-2001, Started By LHardy, 2 Replies, Preparing for Hysterectomy (pre hysterectomy). In general, painful bowel movements should only last for about a week after birth. (2018). If your doctor used a vertical incision on your uterus, you would need to have another c-section if you get pregnant again. You have foul-smelling vaginal discharge. 2013 Mar;121(3):654-73. doi: 10.1097/AOG.0b013e3182841594, Forsgren C, Altman D. Risk of Pelvic Organ Fistula in Patients Undergoing Hysterectomy. Worrying about popped internal stitches after a c-section is normal! They may be closed using staples, regular stitches, absorbable stitches, skin adhesives, etc. Frequently Asked Questions: Hysterectomy. Yes you can wear a bikini once swelling settles down and wounds are healed , which can be 3-6 months from surgery. The first cut is made on the abdomen, while the other is on the uterus. Did you have either adhesions or Interstitial Cystitis? It can involve complications and side effects, such as nerve damage, inflammation, and infection, and should be monitored by a medical team to ensure that the hysterectomy is healing correctly. However, with, Deep cuts inside the lower lip may need stitches or heal with home care. Did you have pelvic pain following your hysterectomy? Having a vertical c-section increases the risk of ripping your internal stitches after a c-section. If a small part of your external incision spreads apart, cover it with a clean, dry bandage, and let your doctor know the situation. Stitches are a simple choice. In simple terms, dizziness is a state of feeling light-headed or slightly dazed. However, I do have a concern. (2020). Lets begin! People are also generally feeling better and becoming more active at this point. Low blood pressure can be very dangerous, so make sure you get it checked immediately. Its time to learn how to know if internal stitches ripped after C-section. Dont judge yourself against other peoples journey, and dont be disheartened if it takes your body a bit longer to recover. Remember that you can speak to your doctor and let him know your closure preferences. Required fields are marked *. This will alleviate pressure from your recovering abdomen. Make sure that you inspect your incision each day, which will help you notice if any issues develop. Heres how you might know that you have an infected c-section incision. 9 common signs or symptoms of ripped mesh include: Bowel obstruction Chronic pain Fistula formation Hernia recurrence Infection Organ or tissue perforation Mesh migration Meshoma (tumor-like bodies resulting from bunched up mesh) Nerve damage. 2017 Nov; 96(45): e8443. Johns Hopkins Medicine. The links below may be affiliate links. How Much Does A Tummy Tuck Cost In South Africa? Ripping internal stitches after a c-section takes effort. Often, dizziness is the symptom of an underlying problem. The number of abdominoplasties has increased in recent yearspartly because of the increased number of patients undergoing body contouring surgery to remove excess skin and tissue after massive weight loss. When there is a lot of excess fat in the back as well as the abdomen, you may have either liposuction of the back or circumferential abdominoplasty. Liposuction may or may not be recommended at the same time. You could have torn stitches after your hysterectomy that need immediate attention. Learn what to do, when to see a doctor, and how to recover at home. you should drink of water per day. ParentalQuestions.com 2021 All rights reserved, Lifting Toddler After C Section 5 Practical Tips. Im concerned Im 3 weeks post partum my sterile strips still havent come off some of them have on the edges but the rest is still really stuck. Still, they can also be an unexpected and daunting last-minute decision their doctor takes based on the birthing circumstances. The only downside is that mothers are left feeling the pain of surgery, even after some days. Whenyoure showering, its safe to let water and soap run down the incision, or you can gently wash the incision with a washcloth. After a few days of your operation, the internal stitches used on your uterus will dissolve, making way for the tissue to heal closed. The common cause of a ruptured spleen is a forceful or traumatic blow to the abdomen as seen in a sporting accident, a car crash, or a fistfight. Glad that it helped! This is why the recovery period can take up to twelve weeks. However, in some emergency situations, this procedure can be done a lot quicker. Most doctors will follow your lead if you prefer one over the other. . Lets begin! At that point, your c-section stitches inside are healing and slowly breaking down into your body. However, the bleeding would reduce as the body continued to heal. An infection will occur when bacteria manage to make their way into the stitched cut. Approximately 1 to 2 percent of people who have a hemorrhoidectomy experience delayed . Will this wound heal again by itself? foul smell coming from the vagina. The standard method is an open appendectomy. Stanford Health Care. Too much force will risk reopening your wound or scar you. Here is what you should do if you think you have torn stitches from a hysterectomy. Thank you for your question. If you notice minor bleeding or blood stains a few weeks after giving birth, its not a cause for panic. At only 2.5 weeks post op, best to let your breast heal fully and see how it looks in ~4-6 months. You must keep the area clean even though youll be sore for quite a while. As your body suffers from reduced blood pressure, you will feel dizzy. Even though the incision is closed, it doesnt mean your body is healed and recovered. This response is often linked to the inheritance of predisposing human leukocyte antigen . Depending on the results you want, this surgery can take anywhere from one to five hours. Muscle strain or pulling pain after muscle tightening is common, especially after certain movements you later realize you shouldn 't have done. While they do have some frustrating parts, I found that I prefer my scars after staples. Hey Victoria, please make sure youre getting them wet and gently running a washcloth over them each day. This procedure generally takes one to two hours. If you live alone and youre sent home after the procedure, you also will need someone to stay with you at least the first night after the surgery. That increases the risk of your c-section stitches opening. I tore internal stitches at 10 days, when I knocked a glass of water off the nightstand and leaned over with a towel to sop up the water. You dont have to worry about the c-section stitches coming out before the incision itself is shut. http://edelsteincosmetics.com/learning-centre/breast-augmentation-post-operative-care-instruction/. Typically, steri-strips should be removed one week after your surgery, but they might fall off beforehand. Your doctor will discuss this with you at your prenatal appointments. Snapping or popping sensation in your calf. Questions? If you are in a lot of pain, your doctor may prescribe you painkillers to help with the pain that many mothers experience postpartum. Theyll let you know when to come into the office, but most will schedule you that day. You will probably need repairative surgery at the hospital. However, the pain will subside gradually and stop completely after some time. Here are some sins of a problem. Complete abdominoplasty: This option is for patients who need the most correction. It doesnt mean youll automatically undergo surgery again; your doctor is trained to handle these problems.
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