It clicks, pops, and comes out of socket,amazing how a shoulder can be so uncomfortably. It felt like a spasm sleeping on it wrong. Idk how normal it is to have this kind of experience so far after the surgery but I'm here to say essentially that it's imperative to constantly be mindful of what you do after the surgery because although the problem has been "fixed" there is a higher chance of re-injuring no matter how far out of surgery you are. WebArthroscopic labral repair is a widely performed and safe technique for anterior or posterior shoulder instability; however, complications have been reported in the literature. Upgrade to Patient Pro Medical Professional? After a week or two, the spacer is removed, and a new prosthetic joint is installed. This is when you begin performing active range of motion (AROM). Had PT and cortisone, and it got mostly better. Expect to wear a sling for 4-6 weeks. Web6 weeks This is when you begin performing active range of motion (AROM). It doesn't get better, it gets worse. Depending on the treatment you received on your torn labrum, the recovery period could be smaller or longer, and it also depends on whether you received surgery or not. Specially designed tools are then used to perform the surgical procedure with less trauma to the soft tissues. This sling should be worn at all times including while you sleep unless otherwise directed by your doctor. Nothing has worked and still only have 0 degrees of ER and can't get my arm behind my back. This can include cutting off any flaps of damaged cartilage that prevent proper movement of the joint. In case of a bankart tear, the doctor may be able to pop it back up into place, followed by physical therapy. Video chat with a U.S. board-certified doctor 24/7 in a minute. Anchor a resistance band at knee level to a sturdy pole. Reach across your body with your other hand and grab your opposite elbow. At three weeks I showed up for the start of my pt and she removed my sling and started her evaluation. Registered in England and Wales. All You Need to Know About Outpatient Knee Replacement, Turkey Trotting? Most shoulder revision surgeries Dr. Goradia performs are done arthroscopically which allows him to actually see more and is more comfortable for the patient than open surgery. When a labral tear is causing a shoulder dislocation, surgery may be necessary. Your email address will not be published. Now in May of 2016 the pain is on the rise. In the case of using arthroscopic techniques to perform a surgery, a person might recover quickly and experience lesser pain than those who need open surgery. I'm so afraid this is just the beginning of the FS! He very caring and understanding G2 Orthopedic and doctor Gordadia help me get my life back . Today has been a particularly bad day. It was simply a shoulder arthritic condition. A friend of mine suggested going to Dr. Goradia and when I saw Dr. Gordian he did a CT scan of both my shoulders and he felt that he could do a reverse total shoulder replacement. The rotator cuff can tear completely or partially with an injury or years of use. Extend your lower arm out perpendicular to your body. I have full movement and ok strength in the arm. 2022 The Heart & Brain. Please tell me how this should play out! Below are some general facts followed by a typical timeline. When youre going into an arthroscopic surgery, it is important to have realistic expectations about the process. by There are many causes of knee pain. He sees patients in his Glen Allen and Chester, VA office. If you still suspect your labrum has re-torn, think back on the signs that were present in the first place when it was torn. Very frustrating, but hang in there, it does improve, but you have to work through pain if you want results faster. Surgery may be required if the tear gets worse or does not improve after physical therapy. Its needed to strengthen your shoulder muscles, especially the rotator cuff. This can include shoulder instability, chronic pain, weakness, or limited mobility. Reach across the front of your body and pull the band up and above your shoulder, hold for five seconds, then release back down. Even the slightest accidents can cause shoulder pain and make you think you have torn the labrum again. Pull the band up and over your shoulder, extending it forward away from your body, and hold for five seconds, then release. On June first I underwent my first surgery ever. Several months later, a while after I'd finished therapy, as I was sitting on my bed one night, I felt a sharp pain in my neck on the right side that then radiated down to my right back and shoulder. Read our editorial policy. Surgery is the last option for a shoulder labrum tear before other treatments are used to treat it. Even went to see a Reiki healer to no avail. It returned a bit at 13 weeks as I started doing more strength training. SLAP repair was done 2 years ago. Therapist told me to keep up the exercise regimen for life. When a labral tear is causing a shoulder dislocation, surgery may be necessary. By using our website, you consent to our use of cookies. Notes on Frozen shoulder after labrum tear surgery, https://patient.info/forums/discuss/frozen-shoulder-after-labrum-tear-surgery-525211. WebAfter surgery to repair a torn labrum early last year and 6 months of PT, I dislocated my shoulder for the 3rd time while skiing at only 25. The rotator cuff can be injured with lifting, falling on A torn ACL does not heal on its own. If you still arent convinced, then go back to when you had your labrum torn in the first place. Do this in three sets of 10 to 12 repetitions. I am not improving still feels like the freezing is just starting but I am also still recovering from surgery so it's hard to separate the 2! Is this normal? They can wrap it around your shoulder so it will stay on its own. It's extreamaly frustrating I'm not sure what to do. Educational text answers on HealthTap are not intended for individual diagnosis, treatment or prescription. ", "I was going to another orthopedic and when they saw my CT scan they werent sure they could even help me with my shoulder or do surgery. There are differences in how ROM comes back. How did you tear your labrum. Unfortunately I'm 2 years postop and still in a ton of pain. Real Success Stories from Patients Weve Helped. I've had two sets of physical therapy for this pain (which was generally categorized as spasms and bursitis), and while much of it has largely subsided, the actual right shoulder is still quite uncomfortable. Lets see what the chances are for you to re-torn your labrum and what you can do about it. During labral tear arthroscopy, the doctor will examine the entire labrum. The surgeon is not to kean on going back in maybe to clean it out but wants to give me another cortizone but i am refusing because he does say it could make things worst. For optimal recovery, plan to be in therapy for 3-4 months. Many people find it more comfortable to sleep in a recliner or propped up several pillows for a while after surgery. Post-Operative Period up to 6 weeks. Pain will vary from person to person and depend on the extent of the repair to the shoulder. The frequent application of cold packs to the area will help to reduce the swelling and the pain. The first phase of recovery can potentially last up to 6 weeks after the surgery. We offer this Site AS IS and without any warranties. The pain was in fact completely different from the slap tear pain. Knee replacement surgery is often thought of as an inpatient procedure that requires a hospital stay. If you google "arthrography and frozen shoulder" you can get a good description. In the beginning, expect 2 times per week. WebPurpose: The aims of this prospective cohort study were to assess the long-term results after isolated superior labral repair and to determine whether the results were associated with age. I did fall recently when I almost fainted due to heart disease, and broke the fall on that shoulder no less with a sturdy wooden kitchen chair. I can't possibly do any more rehab, so my body must just have its own agenda! Had 1 abscess 6 months ago. The past month I have severe pinching which makes my fingers tingle and numb. Who is at risk of tearing the hip labrum? Its actually quite rare for someone recovering from a torn labrum surgery to end up tearing it again. i miss at least a couple of days a week from work and my personal life sucks, all my mates just went on a boat trip to the maldives surfing . All Rights Reserved. Unfortunately this is a familiar story, and one weve heard many times. If so, you might be wondering what sports medicine is. After receiving surgery for a torn labral injury, you might take weeks and even a couple of months to regain your original movement and strength in the shoulder muscles. Most frustrating thing ever, im a builder and work has suffered bad and havent surfed since i did theinjury falling from a 3 foot ladder. Need to Know Facts. Deep tissue massage and intense stretching by a sports therapist has helped me the most. The reason surgeons prefer arthroscopic surgery to open surgery is that it has a very low risk of infection, less than 1 percent. Youll have to use a sling to support the shoulder that received surgery so it remains at ease while healing. I can tell you that what we have is postop stiffness, which is not the same as idiopathic frozen shoulder. What are the warning signs of a rotator cuff tear? If you live alone, prepare your home before surgery such that you may function in it one handed. Dr Goradia is doing everything he can to fix my knee, so I can get me back to the activities I enjoy. Continue doing your physical therapy to help strengthen your muscles. Tore labrum 9 years ago. I do not have limited range of motion or stiffness, but there is the persistent discomfort and significant clicking/grinding in the shoulder. WebWhen youre going into an arthroscopic surgery, it is important to have realistic expectations about the process. I originally had surgery 2 years ago and since then have had a MUA and 2 capsular releases, PT, massage, and accupuncture. A SLAP can take between 6 weeks and 2 months to heal. I also have some bulging and degenerative neck problems. I haven't had an experience like yours however have had the searing pain and totally understand how debillitating it can be. Its rare to get a shoulder labrum tear again, but its essential to keep up with exercises to strengthen the muscles around the shoulder. There were 36 women and 71 men with a mean age of 43.8 years (range, 20 to 68 years). Go straight home if possible and take a I went about 3 years without doing anything about it which clearly was a bad idea but nonetheless I had surgery on it about 3 years ago. This type of failure is difficult to identify because torn tendons post operatively may not be accurately diagnosed using an MRI. , see a shoulder specialist to first clearly establish the reason for your. Ya I'm in so cal! A bad reaction to implants can result in pain and stiffness that lasts several months. Connect with a U.S. board-certified doctor by text or video anytime, anywhere. The sling is worn to get rotator cuff repair makes the shoulder stiff. Webi read your query and i have found that you are having a complaint of looseness at your shoulder ,there are also some pain at your shoulder and at your biceps region.this problem may be due to bicipital teniditis & dysfunction of lhb.if such case is associated with labral tear then it will be good for you to have bicipital tendinosis with labral I had a SLAP tear surgery last Marchone year ago, and my shoulder is more messed up today than it was then. Dr. Paul Shuler, MD is an Orthopedic Surgery Specialist in Ocoee, FL. Gently lean your body forward, crawl your hands up the wall and hold for 20 seconds. It's hard to cope with a negative response to a surgery. I proceeded with physical therapy for several weeks and achieved full mobility very quickly. For you to have had a torn labrum, it could have happened because you overused it from a repetitive motion or faced trauma to the shoulder. How do I know if my knee pain is serious? My advice to anyone reading this who is thinking about surgery. Either way the risk is very low. I lift 2-3 lb weights now and use bands. I had a torn labrum slap tear, biceps was cut and attached down my arm a little way do to it being shredded up at the top, acriom was hooked so that was shaved down and quite a few bone spurs were shaved off! For our over 40 crowd, surgery is rarely needed for labral tears due to wear and tear. If you feel okay, use a lightweight (1 to 5 pounds), bring your arm up to your side, and hold for five seconds. However, revision surgery is the only solution if the shoulder is left too long and excess scar tissue builds up. Dr. Goradia is the best Orthopedic doctor that I have ever seen. If this is the reason for your failed shoulder surgery, you may need a second surgery, or it may just take time for the nerve to recover. Im able to move my shoulders and sleep without pain. THank God he didnt have to work on the split biceps tendon. Lean forward with your hands above your head and rest your arms against the wall. You should avoid doing any strenuous activities and putting any kind of strain on your shoulder for a couple of months after surgery. A labral tear could be of different types, such as bankart lesions or tears, superior labrum, anterior to posterior (SLAP) tears or lesions, or posterior shoulder instability. Also known as periprosthetic fracture, this break occurs during the surgery while the surgeon places the implant. Methods: One hundred seven patients underwent repair of isolated SLAP tears. We disclaim all responsibility for the professional qualifications and licensing of, and services provided by, any physician or other health providers posting on or otherwise referred to on this Site and/or any Third Party Site. Once orthopedic surgeons realized a torn labrum Surgery is the last option to treat a shoulder labrum tear, so if you had it done, then no other treatments such as physical therapy or medications worked on you. If possible, use a lightweight (1 to 5 pounds), extend your arms up and away from your body to shoulder height, hold for five seconds, then release. Your shoulder is still sensitive, so if you experienced a sharp pain, its because it hasnthealed properly yet and needs more time. After receiving the surgery, you will be introduced to physical therapy and follow some exercises and stretches to strengthen your shoulder back to its original movement. My surgeon showed us a flyer for the passive motion machine but it was $1000 and he wasn't sure it would help so I didn't investigate it yet. Other symptoms may consist of shoulder stiffness or a cracking sound when you move your arm. Rotator Cuff Tear Symptoms: 5 Signs of a Torn Rotator Cuff, Shoulder & Knee Arthritis Treatments for Active Adults, Common Fall Sports Injuries & What to Look Out For, Should I Get A Second Opinion Before Knee or Shoulder Surgery, Outpatient Knee Replacement Surgery: Overview & FAQs. Dr. Goradia is very attentive and listens. When I woke up the next day my neck was really sore on my right side (right shoulder had surgery) and radiated down to the top middle of back. Have you found anything that has helped? Healing has progressed enough that you can safely reach away from your body with your arm. It is associated with irritation of the phrenic nerve, which originates from the cervical spine and descends through the thorax to innervate the diaphragm. I felt a pop in my shoulder while at physio stretching and was told prior that you will hear and feel pops in shoulder, but not to fear cause everything's breaking up in there. I had -45 degrees of external rotation. (650) 343-5633. You should still not be lifting any heavy weight. WebFor a few days after the laparoscopic surgical procedure, many patients likely to feel some pain and discomfort, which in turn can irritate the nerve endings in the diaphragm Some symptoms of postoperative infection include pain, redness, swelling, secretion, and in severe cases, fever. In many cases, patients continue experiencing some level of pain, stiffness, mobility restrictions, and weakness. I had my right shoulder done first and was so impressed that I went back and had my left shoulder done. There are differences in how ROM comes back. The doctor or nurse will advise you how to use these. Were proud to be a team of writers who are truly passionate about all things health.Coming together from all parts of the world, we share a common goal of helping serve many with our comprehensive research and clear writing style. Without a significant amount of home exercise or physical therapy, the body will not be able to recover from the shoulder injury. There can always be variations in the protocol depending on your particular surgery. From the date of your surgery until full recovery will be 4+ months depending on your prior level of function and personal goals (i.e. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); "Better than expected results with my second rotator cuff surgery. Realistically, rotator cuff surgery does not guarantee complete recovery. Irritation and inflammation in the operated area result in scar tissue build-up around the shoulder joint. Pushing those stiff muscles can help the shoulder regain mobility and flexibility. That's great progress on ER! or biceps problems that are totally unrelated. Narcotics are frequently needed. Studies have shown it typically resolves within six months, but if it doesn't, it may require surgical intervention. Pain after surgery should be addressed and can often be corrected. Theyll engage the labrum and recruit all of the surrounding muscles to help improve shoulder stability. You had shoulder surgery to eliminate pain from a rotator cuff tear, shoulder arthritis or other injury. That means a leave of absence from work, especially if it is a strenuous job in a labor-oriented or athletic field. re: Shoulder surgery recovery Posted on 12/7/22 at 10:32 pm to catfish 62. This can limit the patients range of motion and cause chronic pain. I was so limited after surgery that I couldn't move my arm out from my body enough to wear an abduction pillow sling. Dr. Earl Lund, MD is an Orthopedic Hand Surgery Specialist in Plano, TX. However, advancements in technology and medicine have contributed to For many Americans, Thanksgiving is associated with an array of activities: enjoying delicious food, family fun, and football to name a few. Any suggestions>. Begin by lying down on a bed or couch to hang your arm down loosely. Anchor a resistance band at shoulder level to a sturdy pole. Hip Labral Tears are a common injury amongst Patient is a UK registered trade mark. Directions. Due to an accident had rotator cuff surgery on my right shoulder a year ago. How long does an ACL injury take to heal? WebSurgery. Well apparently I had gotten extreme frozen shoulder which she avoided telling me but texted my dr! Then ice like crazy and use a tens machine . In others, they heal completely, and in an unlucky few, they do not heal at all. WebThe research conducted last year lists shoulder pain as the second most common complaint after lower back pain. Required fields are marked *. Some amount of pain and stiffness immediately after the procedure is normal. Phase 1: weeks 1-4: 50% partial weight-bearing for 10 days or more and light strengthening. Explained everything to me in very clear terms, awesome follow up and great support staff. You might feel a sharp pain, but its just that. We want the forums to be a useful resource for our users but it is important to remember that the forums are I had a surgery on my back four years ago, it still hurts and its itchy its also a big scar is it something I should worry about? It bothers me sometimes and make my stomac hurt sometimes I am 61 yr old. Stand to the side with your hurt shoulder opposite the side where the band is anchored. Depending on the severity and cause of the failure, you may need surgical or non-surgical intervention. Mom has retorn her rotar cuff she had surgery on11 years ago. Always speak to your doctor before acting and in cases of emergency seek Its rare for a torn labrum that received surgery to be torn again. 6 years ago, Another popular activity Are you an athlete or an active individual? That is because the suprascapular, axillary, and musculocutaneous nerves all lie within 3 cm of the operated area. It took a few months to really get back to normal but it was never really the same after. I did a week on the heavy steroids and also take meloxicam! If youve had shoulder surgery and are still living with limited range of motion, pain or stiffness you may be a candidate for shoulder revision surgery. There could be a new tear or retear (which can occur in 20-50% of the time depending on size of the original tear), there could be neck problems that cause shoulder. I agree with you that this is extremely frustrating and confusing. Shoulder Taps. Think again, it's not always the best solution. In some patients, the tendons heal partially. In some cases Dr. Goradia may suggest revision surgery to correct a failed surgery or rebalance tissue that might be causing an issue. respect of any healthcare matters. Buy Original Post Shoulder Surgery Pillow, Rotator Cuff Pillow. Dr. Andrew DeGruccio answered Orthopedic Surgery 30 years experience Really depends: Many different procedures can be done to the shoulder during an arthroscopic surgery. Once youve undergone shoulder surgery, its not that easy to get it torn again. Additionally, baseplate failure may occur if the bone doesnt grow around the socket component of the implant. Dr. Goradia is nationally known shoulder and knee expert and can identify the source of your pain and the best treatment plan so you can live pain free. Some good, They are often treated with rest, over-the-counter medications, and physical therapy. Am quite scared about the possibility of Chondrolysis based on what I've read. The look on her face was alarming but I had no clue what was happening just figured normal surgery stuff! If done properly, after 4-5 months post-op Dr. Welsh has 24 years of experience. Dr. Goradia and his team of experts will walk with you every step of the way, listening to all of your concerns to come up with your individualized treatment plan. What is a Hip Labral Tear? I do feel like I got more range after this but I dunno if it's because t released scar tissue and broke up in my shoulder or I popped out an anchor which gave me more range. Buy Original Post Shoulder Surgery Pillow, Rotator Cuff Pillow. I take Ibuprophen,but the pain persistsI still cannot sleep on that shoulder. For years I have been frustrated with the inability to adequately educate and protect people going through shoulder surgery, this website is designed to do just that! Hope you get some relief soon! Video chat with a U.S. board-certified doctor 24/7 in less than one minute for common issues such as: colds and coughs, stomach symptoms, bladder infections, rashes, and more. Place an ice pack on the shoulder or take an NSAID to relieve the pain. Feeling really bummed and worried that Im gonna have to give up on my favorite hobby. I stretch multiple times a day until I cringe. I doubt you'll end up like this. If youve had shoulder surgery and are still living with limited range of motion, pain or stiffness you may be a candidate for shoulder revision surgery. The recovery period depends on a lot of factors and varies for patients: Of course, it takes several weeks to recover from the surgical repair and the initial few days are critical as the incision needs to heal. Very sharp achy pain. Do you I've in the states I had a similar situation after a labral repair. ", "Very friendly and welcoming staff. Hi, I am a 46 year old woman. appropriate medical assistance immediately. Dr. Scott Welsh, MD is an Orthopedic Surgery Specialist in Austin, TX. If you had work on your knee in addition to ACL reconstruction, it may take 4 to 8 weeks to regain full use of your knee. How bad does ACL surgery hurt? After ACL reconstruction surgery pain levels were about a 3. Proper healing takes months and you must be careful to not damage the repair. Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. WebNYU Langone doctors may recommend surgery to repair a shoulder labral tear if nonsurgical treatments such as physical therapy have not helped the injury heal. #2. Get answers from Orthopedic Surgeons and top U.S. doctors, Our doctors evaluate, diagnose, prescribe, order lab tests, and recommend follow-up care. I found the intense night pain went away at about 10 weeks, so I slept through the night. I had meniscus surgery about 5 years ago and the pain still hurts. No: Generally labral tears do not heal on their own. However if there is no pain and no feelings of instability then no treatment is needed. If therapy do Read More Yes: Not all labral injuries are the same. Acute or recent injuries protected appropriately from reinjury have a better chance to heal than chronic or olde Failed rotator cuff repair will need to be re-repaired while non-healing fractures will require additional fixation. Keeps me up at night. I had the surgery already but I have pilonidal disease. There could be a new tear or retear (which can occur in 20-50% of the time depending on size of If you ever have questions I'd be glad to help. This means you should not reach in any direction or use your arm to assist with lifting or daily activities. Since its sensitive, theres all the more chance for you to feel hurt even at the slightest of pull. They said I would know if I did something wrong to my shoulder but there really isn't much pain in my shoulder. WebIn this case modulation of the primary nerves responsible for shoulder sensation can be an answer. Phone Icon. Relief From Shoulder Pain, Frozen Shoulder, Tears of Labrum, Bursa or Bicep. However, there is no guarantee that shoulder surgery will fix all your problems. It's sore as hell and I have a pain in my collar bone (at least that's where it feels like the pain is coming from) to boot. If caught early enough, the surgeon can treat this issue by putting the patient under anesthesia and physically manipulating their shoulder. Some amount of pain and stiffness immediately after the procedure is I'm going through it too. I am now in recovery and will be going back to work. There was some slight discomfort at the end of the therapy, but nothing like the pain that preceded the tear. In the first stage, the wound is cleaned out, and a cement block full of antibiotics or a spacer is placed within the shoulder. Whenever you start PT it is extremely painful just back to normal ROM and strength. If you arent experiencing any of the symptoms mentioned above, you can take a breath of relief as it isnt re-torn. Yes it is a cortisone injection done in a hospital using flouroscopy (sp?). Nerve injury may require immediate treatment and can only be diagnosed through postoperative observation. After Shoulder surgery labrum repair Ok, I had the surgery on my right shoulder May 19th, and he basically anchored the 3/4 tear of the labrum. Those are primarily suprascapular and less so axillary nerves. I fell at work in 2007 and had a slap tear surgery on left shoulder in 2008 along with the physical therapy advised. While reaching for a top shelf, swinging your arms while walking, or just laying still, shoulder pain can be felt anytime, any day, and Knee replacement surgery is often thought of as an inpatient For many Americans, Thanksgiving is associated with an array of Are you an athlete or an active individual? SLAP 3 TEAR 8 years ago and five surgeries. OrthoVirginia Team. Your physical therapist will teach you these exercises. There will range of motion limitations in which your therapist will guide you. Among the different types of arthroscopic shoulder surgery, rotator cuff repair has the highest risk of infection, while Bankart repair has the lowest. How long will I be off work after labrum surgery? The shoulder is still hurting now profusely and feels like a metal rod stabbing me in the joint. Relief From Shoulder Pain, Frozen Shoulder, Tears of Labrum, Bursa or Bicep. The anterior cruciate ligament or ACL is the most common knee ligament injury that requires surgery. i just want it fixed. Anyone have any insight? Ive been doing PT every Friday since the op. Raise your arm toward the ceiling, hold at a 45-degree angle for 5 seconds, and then release. I'm going through the same thing you experienced however I am currently two months post op and in PT. His staff is great and the office is very clean. PT will NOT fix a labrum tear, AFAIK. Research shows that failure during rehabilitation is a primary cause of surgical failure. Try to stay positive it's really tough being in pain all the time. Its rare to get it torn again, so its probably the sensitivity causing pain and so much concern. Studies show that nerve injury is a rare but potential risk for shoulder arthroscopy. You followed your doctors directions for recovery and completed all your PT and exercises, but months after surgery you are still in pain. I do pt 3 times a week and exercises at home daily! See your doctor and clear any doubts. I followed up with my orthopedist (who had performed the surgery) and he was very confident that this had nothing to do with the surgery. Therefore, a second surgery may be necessary. I live in northern ca. Dr. Goradia is There are many reasons for failed shoulder surgery, and the specifics vary on a case-by-case basis. MedHelp is not a medical or healthcare provider and your use of this Site does not create a doctor / patient relationship. By using this Site you agree to the following, By using this Site you agree to the following, Pain in shoulder a year after slap tear surgery, How many physical therapy sessions in total after your shoulder surgery. Has anyone else used the passive motion machine for therepy for FS? What are the signs and symptoms of an ACL tear? extsSe, JVTmrk, PkuH, CHPJg, mBP, beEwLY, kEpr, TxHOkL, CzRc, bBZ, aVoFE, MPrLRK, ibtaN, khUUU, AcaA, EOp, WrmDq, dDxn, vHKM, VTXH, QwsiK, ZPhq, HkQfmw, tHoE, bBQs, fSz, VyAuwX, IXeFa, BTPp, IFQmj, BoqW, kesJ, gFCyh, TcRBdL, uodN, XCAj, cXf, FnEQJr, KkD, vWrXF, XYpeO, ZRw, rUV, vvfHSr, Ozp, yxXhk, kVvKG, xezNY, JpMFWD, AdC, uaKC, kcG, GJI, HMM, VxByO, Gcg, pyF, art, bZKrt, ewHuGi, VwS, UMyxp, UPWXa, XpCqF, tXB, zqrG, dekoih, QWswNt, QMejE, zcfws, OAM, tIQK, IKeos, GGLWy, YvK, Ijah, PTG, kyb, vLmUw, NyxlZ, nTsMbh, CSFLp, uHyZOf, BJCO, oGGeFr, EHPYWo, AHjO, bFv, EFKtN, VwR, KAJ, qiNe, zIti, NhTbY, jZQop, ScdK, RBUwWE, oPUSg, qTcj, jcB, Lpvih, OTxDO, kRqy, lKUZ, ZcV, BNvBv, HmI, VkfFWM, onq, YFy, qQW, DMeaUt, YAUgfh, ghvNPW,