Usually, we will prescribe Hydrocodone or Oxycodone. Contact our office for any concerns at 970-879-4612 or 877-404-4612. Athrynne 2 yr. ago. This is often a last resort solution, but it works in nearly 80% of cases! Plantar fasciotomy is typically an outpatient procedure. If recommended, you must take any medication 2 hours prior to surgery (or as per the instructions of your podiatrist). The plantar fascia ligament runs along the bottom of the foot and connects the heel to the front of the foot. Surgery for plantar fasciitis is often a good solution to get rid of this nasty problem. The first few days I was fine and could even walk without assistance. Surgery isnt a first-line treatment. Its one of the leading causes of heel pain. ;U0p9Y-y[x6AW%GY6Nc-/81\1Jn:gksPou,oRl$)t-xi O?@VqvR}YQm. Respecting your privacy is important to us. Appointments 216.444.2606 Appointments & Locations Request an Appointment Symptoms and Causes Diagnosis and Tests Management and Treatment Prevention Call for a same-day appointment 801-270-9000. gj]?4m79;Oai4ja}+%S:o+Sge[>,H )iBJ^H8`?dRW?KclLEHqdt{iEZ`dz}4)%hX'l^e2Bze=_0vR] Y)C3 #'Dx^[i76uI|xQJ\ Carefully following these medical instructions will have a direct impact on your recovery and the success of the procedure. The podiatrist must properly grasp the patients expectations regarding the upcoming procedure. The surgical procedure known as gastrocnemius recession allows the calf muscle to be lengthened, and the fascia surrounding it is separated. You can then verify the podiatrists background, and see if they have proved themselves. Please try to anticipate the need for any refills on your pain medication, and contact our office early in the day the day before running out completely. Im actually fine with that plan. %%EOF Plantar fasciotomy is surgery to detach your fascia from your heel bone in order to relieve tension. The maximum daily dose of Tylenol if you have a normal liver is 3500-4000 mg. 2. It is used to create trauma in your plantar fascia to assist with the healing process and relieve symptoms. The podiatrist then accesses the plantar fascia and releases it several millimetres to reduce tension. Let your doctor know if you have increasing pain or signs of infection. It is important to consult if in doubt. Recovery: I is normal to experience mild to moderate pain, numbness . 3 Frozen Water Bottle Rolls. In the right patient, this can be a very successful . Over the long term, plantar fasciitis can change the way you walk and move, leading to other problems with your feet, legs, hips, and back. Marcia was extremely helpful post-op and made sure I . %PDF-1.6 % @zHqnKUAc9/m^hf Y *`DD, T) TK9DA"TS `K"`-n6' bpx00:1`II);-L00a`gUZ9%^dpg'}h0\? This can happen for a number of reasons, including the surgery's risks. The following are post-operative instructions for patients who have undergone a release of the plantar fascia of their foot. (17.98/Unit) + 29.99 P&P. Post- Op Shoe Gypsum Shoe Plantar Fasciitis Splint Night. According to the literature, approximately 80-90% of people suffering from plantar fasciitis will have a complete resolution of their symptoms in 6-18 months, with or without treatment. ), Surgery that did not work or a recurrence after several years. Plantar fasciitis is a complex pathology involving the ligament-bone interface at the inferior aspect of the calcaneal tuberosity [3]. This would be characterized by a sudden onset of new pain (usually different from your surgical foot pain) or tightness in the foot or calf. Usually, it's a simple nerve injury, but it can also result in permanent nerve damage and pain. You will have your first appointment 2 weeks after surgery in the Fracture Clinic. Cast: You will have a dressing and a sandal/shoe following surgery. The same applies if you have tried various conservative treatment methods, without success. The surgical team cares for you and prepares you for the procedure. An -ectomy means that an incision is made and parts of the tissue are removed. Most procedures take place without IV sedation and general anaesthesia. The professional you choose must master a wide range of surgical techniques that respond to a wide range of cases. You can expect some discomfort or minor pain for several days. The presence or absence of a blood clot can usually be determined by a simple non-invasive ultrasound test at the hospital or some doctors offices. In the meantime, your post-surgery recovery may include flexibility and strengthening exercises, either with a physical therapist or on your own. Plantar fasciitis: Everything you need to know about cortisone injections, Plantar fasciitis: causes, symptoms and treatments, Im a podiatrist and I would like to join the network, People with flat feetPeople with hollow feet, Overweight persons (or those who gained weight suddenly), A pre-surgery evaluation can be performed throughout the province of Qubec, A detailed report of your medical situation, A clear surgical plan adapted to your specific situation. Dr. Bennett has 23 years of experience. If you must use the shower you will need to apply a plastic bag around the foot and tape it at the top. If you have further questions that need immediate answering, contact my staff at our office at (970) 879-4612 or 877-404-4612. Henadzi Pechan / Getty Images Patients are encouraged to have one physical therapy session at 2 weeks for patient education and The surgery is best for patients who have tried non-surgical treatment methods for 6-12 months without relief. . We use cookies to operate and improve our services. We will discuss your exercises and activity limitations when you are seen in the office. Normal post-operative care including rest, ice, elevation, and maintaining a clean surgical site would be followed. Your doctor can help determine if this surgery is a good option for you. Wrap a towel around the bottle or cover it with a pillow case. This can vary plus or minus several days depending on your schedule and ours, as we want the wound, swelling, and pain to settle down prior to the first dressing change. Heres what happens in each type of surgery: The incisions will be sutured and bandaged. The plantar plate is a ligamentous structure on the bottom of the foot which connects to each toe. They manage your foot care from A to Z, before, during and after the operation. Use the postop shoe or fracture boot when you are up. Your foot will be examined and your vital signs will be checked just prior to surgery. Ice compresses. A sandal/shoe will be worn for 2 weeks. Plantar fasciitis is a painful condition involving the plantar fascia, a ligament that goes from your heel to your toes. Wearing foot orthotics. This usually takes place in a hospital setting. If not treated properly, plantar fasciitis can result in the plantar fascia tearing. 1125 0 obj <>/Filter/FlateDecode/ID[<3F0ABF03658D5A4483B222B2B8B14099>]/Index[1099 42]/Info 1098 0 R/Length 121/Prev 336765/Root 1100 0 R/Size 1141/Type/XRef/W[1 3 1]>>stream Use the postop shoe or fracture boot when you are up. 188 0 obj <>stream At times, a bony spur may require excision as well, but typically it is the plantar fascia that is the source of the symptoms. Post-Operative Shoe You will be provided with a postop shoe or fracture boot for your comfort. This can be done by sitting on the floor with one leg outstretched and then pulling back on your toes with your fingers for 30 seconds at a time. Surgical intervention for plantar fasciitis involves detaching the plantar fascia from the heel bone. Various possible complications are identified, such as the presence of heel spurs. You can expect to: Wear a boot, cast, or special shoe to keep the weight off your foot for 2-3 weeks while your foot heals Ask yourself these questions before making a choice: This is an important issue. Plantar Fasciitis Treatment Exercises hide. Your first post-op visit Your doctor may want to see you 1 to 2 weeks after surgery. After day 4 the pain started slightly again. Several factors related to your condition can explain it, including: Knowing about this information and sharing it with your podiatrist before your evaluation can help to speed up the process. During your surgery, your doctor will likely cut part of your plantar fascia ligament so it won't be so tight. To begin, the surgeon makes a small incision above the heel pad, specifically where thick sole skin meets the thinner skin at the back of the heel. The critical healing period will have an impact on the rest of your life. 17.98. A recurring stabbing pain in your heel can make it hard to stand, walk, or exercise. Plantar fasciotomy can be accomplished two ways: Open surgery. Please try to anticipate the need for any refills on your pain medication, and contact our office early in the day the day before running out completely. endstream endobj 189 0 obj <>stream If you have plantar fasciitis and chronic heel pain even after months of treatments, it may be time to talk with a doctor about plantar fasciitis surgery. While surgery for plantar fasciitis may resolve the issue, some people continue to have problems. For an appointment, submit our online form or call 1-877-277-8641. It is therefore essential to ensure adequate prevention following surgery and to book a consultation quickly if symptoms return. You must allow for a convalescence and rest period following surgery. What was the experience of the actual surgery? Remove a small piece of damaged tissue. Plantar fascia massages. For a plantar fasciectomy, an incision is made and any scarred or inflamed tissue is removed. The costs vary a lot based on surgeon's fees, facility costs, and services such as anesthesia and follow-up care. By partially cutting this tissue, the surgeon releases tension and allows the tendon to lengthen. Save the handout to your files. Plantar fascia release, also known as plantar fasciotomy, is the most common surgical procedure for plantar fasciitis. Plantar fasciitis surgery then becomes the best option. This usually begins about 5-7 days from the day of surgery. But when youve tried other remedies and still have chronic heel pain, surgery is an option. The procedure can be divided into 4 steps: This step allows you to understand all the details of the upcoming procedure so that you can make a clear and informed choice about the desired treatment. Day 5 becoming worst and making me so anxious. To limit pain and swelling, ice your foot for 10 to 15 minutes several times a day. There will be an initial X-ray for a bone evaluation of your foot. If everything goes well, your surgeon will most likely recommend that you start to wear a CAM walker (often referred to as a moon boot) for 2 to 3 weeks after surgery. 6 ways to treat your plantar fasciitis with a podiatrist. This may occur even if no sign of a clot in the leg is present. The anaesthesia is long lasting, which means that you will not feel any symptoms for several hours following surgery. Plantar Fasciitis Surgery can be scary to face. Medically reviewed by Deborah Weatherspoon, Ph.D., MSN Written by Ann Pietrangelo on October 26, 2020. Generally speaking, the day of surgery for plantar fasciitis takes place as follows: Normally, you will receive a local anaesthesia and sedation through oral anxiolytic tablets. hXn7|I AZ_HEXYggHIie^'eHq Make sure your foot professional has hospital experience and has been certified by an accredited organization. It took at least 6-7 months before I saw any real difference, but I now feel a lot better than I did pre surgery. This gives the muscle more flexibility, and reduces the pressure on the foot and heel. You must be accompanied by someone for the surgery, and they must be available to take you home and stay with you for 24 to 48 hours. You continue to have severe pain, despite trying other measures. During the evaluation, the podiatrist will determine the functional limitations of your foot. You should contact Dr Sterling (through the switchboard of the hospital where you had your surgery), or his secretary on 1300 478 375. Rule out the following differential diagnoses: Some operations require a few weeks; others may take a few months. You may put weight on your foot and use your crutches as necessary. Your surgical history will be studied, as will your medical history, medication and allergies. Given that our feet are subject to so many demands, the slightest imbalance of it can lead to a new pathology (and some complications!) They have been trained to properly care for your feet. Surgery of plantar fasciitis should be considered only after all . The X-ray evaluation is conducted as follows: Keep in mind that if your operation does not involve any bone structure of your foot, an X-ray is not necessary. There are many non-surgical options for plantar fasciitis. The professionals at PiedRseau can offer you several advantages when it comes time to evaluate your condition: PiedRseau allows you to make an informed choice! Lets take a closer look together at the main causes of plantar fasciitis and the various methods used to treat it. March 17, 2022. was scheduled for my first fill today but am down another 7 lbs. Remove a heel spur. You may notice some bloody spotting coming through the outer dressing. In some more rare cases, fasting is required 12 hours before surgery. The procedure involves releasing the ligament to relieve tension. This may help decrease swelling and pain. Massage your plantar fascia as directed. It is recommended to keep your leg elevated and apply an ice pack to reduce any swelling. Plantar fasciitis is a condition caused by the thick band of tissue that extends from your heel to your toes becoming inflamed. This procedure can be done in a hospital, surgical center,. The Tenex procedure may, in some cases, be a reasonable alternative to conventional tendon surgery when conservative . Please do not hesitate to contact us with any questions or concerns. Plantar fasciitis surgery can cost $10,000 or more, depending on your insurance and where you live. Your podiatrists training enables them to recognize any possible biomechanical complications of surgery. Most of the time it can handle the everyday stress and strain that we put on our feet, but . Sponsored. Youll be given post-op instructions specific to your medical needs. Post Operative Instructions. Following open surgery, you may need a walking boot, a cast, or a special shoe for several weeks as you heal. How severe was the pain and problem? That is why you should consult if you have the slightest doubt about your feets health. and not having hunger between meals. Wearing plantar orthotics following surgery is highly recommended: The risk of recurrence for this pathology is very high. Now, I've hiked up to 10k without major issues. For the 1st 3 weeks, it is used day and night. Plantar fasciitis is a common foot condition that occurs when the band of tissue on the bottom of your foot becomes inflamed. What was the recovery like? You will be provided with a prescription for a pain medication when you are ready to leave the hospital. The convalescence timeframe depends on the type of procedure performed. To ensure proper healing of your plantar fascia, it may be suggested that you wear a foot orthosis or a special shoe. In a small 2017 study, for example, it had a 70 to 90 percent success rate. You can keep ice packs on the foot more or less continually during the first day or two after surgery without risk of frostbite injury to the underlying skin as long as the original thicker dressing is in place. Normally, if there are any stitches, they will be removed within 10 to 21 days. Open plantar fasciotomy. What is Calf Surgery For Plantar Fasciitis? Please contact our office the first business day after discharge from the hospital to make your first post-operative visit 2-3 weeks after surgery. Some patients report that the tingling sensation persists . Wart post-op instructions. Your doctor will let you know when you can start wearing normal shoes. Plantar fascia release, or plantar fasciotomy, is a type of outpatient foot surgery in which small incisions are made in the plantar fascia to relieve severe heel pain caused by plantar fasciitis. You will be provided with a postop shoe or fracture boot for your comfort. While some of these same risks exist, there are generally few complications. nerve injury or entrapment resulting in loss of sensation (. In addition to helping with the paperwork, we also have some appliances in the office that can really make recovery a breeze. A treatment plan will then be drawn up. Plantar fasciotomy is surgery to detach your fascia from your heel bone in order to relieve tension. endstream endobj startxref Try to take this medication regularly at first and prior to taking the narcotic pain pills to allow it to be most effective. Plantar fasciitis surgery, or fasciotomy, is often an effective remedy for chronic heel pain. Tightness in the calves can be a big contributor to plantar fasciitis, so be sure you're stretching your leg and foot muscles thoroughly before every workout. Physiotherapy- for an individualised stretching and strengthening program. If you have a history of nausea with surgery we can prescribe an antinausea medication (Phenergan). Make incisions on either side of the plantar fascia to relieve tension. Your symptoms have lasted 6 months or more. Raise your foot above heart level as often as you can. For example: Wearing proper footwear. Before electing to have plantar fasciitis surgery, it is very important to list what you have already tried or what can be tried. Toll Free: (877) 404-4612 It is possible to perform surgery on these at-risk patients suffering from this problem. Remember, the short acting pain pills often have acetaminophen (Tylenol) in them. For example: However, sometimes the situation is so advanced that it is impossible to correct it with conservative treatments. Recovery after open surgery typically takes 6 to 10 weeks but may take up to 7 months depending on your condition and circumstances. Pre surgery, I was at a point where I could only hike for about 5km before I started to experience pain. Xn]@E#X* Y ; They have in-depth knowledge of the foot and its biomechanics. Your foot will be draped and cleaned with antiseptic. The mean visual analogue pain score dropped from 8.5 of 10 preoperatively to 2.5 of 10 postoperatively. Before choosing surgery, your doctor may recommend less invasive therapies, such as: About 90 percent of people respond to conservative treatment within 12 months, according to a 2018 study. Most surgeons require that patients fail at least 9 months of conservative treatments (such as injections, physical therapy, arch supports, etc) before surgery. It is very important that you carefully follow the instructions given you before, during and after surgery. They will be removed at approximately 2 or 3 weeks after surgery. (212) 389-9918 Manhattan Foot Specialists (Union Square) 55 W 17th St Ste 106, NY 10011. Before electing to have plantar fasciitis surgery, it is very important to list what you have already tried or what can be tried. Your doctor may prescribe pain medication. Your doctor may suggest you wait 12 months. Pain under the foot: plantar fasciitis or heel spur? Sometimes, some patients require a blood test and prescription for antibiotics before surgery. 0 Roll the water bottle under your foot for 10 minutes each morning and evening. The operation for plantar fasciitis is usually day-case procedure and can be done under local anaesthesia, twilight sedation or general anaesthesia. Place your cursor in the shaded box at the bottom of page 4 of the handout to type in your practice name, contact information, and web address, as shown here: 4. And remember that the first step will not necessarily be to refer you for surgery if your condition can be treated by conservative treatment methods. If you've been given pain medicines, take them as directed. Each procedure requires special care at home. Other potential diagnoses have been ruled out. Exercises and stretching. In addition, a vascular assessment of your feet will be conducted to ensure optimal healing. They are able to provide you with clinical results and can closely monitor you to ensure the surgery is a success. Most people with plantar fasciitis wont ever need it. Please refer to this reference sheet, which should probably answer most of the questions you might have. Post-operative visits usually occur 3 to 5 days after surgery and are also set up by a team member shortly after you arrive home from surgery. When this happens, heel pain becomes unbearable at all times, especially when you wake up from sleeping. Follow instructions about whether you should take regular medications that morning. If you need special care, they must be able to handle your case quickly. So, for a plantar fasciotomy, an incision is made and your fascia (the connective tissue that covers the muscles) is detached from your heel bone. The surgery requires the surgeon to cut a section of the plantar fascia ligament. The first line treatments you are recommended to try: Massage- for 5-10 minutes with a golf ball or ice. You must receive surgical care specifically adapted to your needs. After surgery, we can do home exercises or physical therapy based on your individual needs and desires. Youll have a small scar where the incision was made. Plantar fasciitis occurs when you strain or irritate the plantar fascia ligament. 2 Hip Hovers. Sign up here to receive our newsletter and stay ahead of innovations in podiatry! For those who've undergone a minimally invasive surgery, you'll normally be able to begin putting weight on the affected foot as soon as you're comfortable enough to do it. Following the operation, you must ensure you heal well. Open surgery If you undergo open surgery, you will need to wear a cast or brace for the first two or three weeks of recovery to keep your foot stable. OK, I thought I was all out of breath when it came to talking about plantar fasciitis . Physical therapy (ultrasounds, lasers, shockwave, etc.) Paying attention to the instructions will allow you to regain your autonomy more quickly and limit any residual pain. Youre unable to participate in physical activities. A small incision (usually 2-3 cm in length) is made directly under the arch of the foot. A partial list includes: arch supports, stretching, ice, non-steroidal anti-inflammatory drugs (NSAIDs), cortisone injection, physical therapy and immobilization in a walking boot. Icing. 5. The plantar plate often tears at its insertion on the base of the toe and sometimes when the . A small incision is made in the skin near the heel. @u^&O2y>E]&w-1j~b4-uU?Lj]^Ode08w pt:.q2,ofl4RnYqf&9[# )&2nBgc5{zq]=kvYe3WJ\er1~Wdd~|qMzUwp RqbV d\XCUZURU/Nitz8^{rzG $HC[&6OWoH\M8b[uS HmZ6@dB* a1>*w pqC-!qVU _?_9lv&`sAae}K If you are aware of a certain pain medication that you have previously had problems with or one that you normally respond favorably to, please inform us so that we can give you the appropriate prescription. Surgical complications of endoscopic plantar fasciotomy. After 10 days, it can be removed for showering. One of the treatment options is partial plantar fascia This will ensure that you receive the treatment that best suits your needs. (212) 389-1886 Manhattan Foot Specialists (Midtown) 51 East 25th Street, Ste 451, NY 10010. 15.65. Please try to anticipate the need for any refills on your pain medication, and contact our office early in the day the day before running out completely. I cannot provide prescription refills after business hours or on weekends. You will have a dressing over your hind foot. Fax: (970) 879-0583, 2018 All Rights Reserved Dr. Bryan Bomberg, MD |, 705 Marketplace Plaza, Suite 200, Steamboat Springs, CO, 80487, Plantar Fascia Release for Heel Pain Surgery: Post-operative Care. Normally we will not have any physical therapy after surgery. m@IN)plgp. Recovery after endoscopic surgery is shorter, typically 3 to 6 weeks. Stretching your muscles. Do not remove the dressing unless instructed to do so. Although it is unlikely to be significant bleeding, contact us if it continues to become saturated. The drain is usually removed 3 to 5 days after the surgery. If you have plantar fasciitis and chronic heel pain even after months of treatments, it may be time to talk with a doctor about plantar fasciitis surgery.. Read on to learn what makes an ideal candidate, what happens in surgery, and what recovery is like. @,H_#-zF` p Also known as percutaneous ultrasonic tenotomy and percutaneous ultrasonic fasciotomy, the Tenex procedure is commonly used to treat tendinitis of the elbow, hip, knee, shoulder, and ankle, as well as plantar fasciitis foot pain. Once the dressing is removed on the first or second day, ice should be applied for 20-minute periods, 3-4 times per day. Subsequently, you must wear an aircast walking brace for 4 to 8 weeks in order for the plantar fascia to heal properly. Overall, surgery to release the plantar fascia is successful. The walker boot is used for all walking. Recommencing daily activities depends on your healing progress and the type of procedure performed. (212) 378-9991. In the first group (EPF), using the visual analog scale the average post-operative pain was improved from 9.1 to 1.6. Once we have removed the original dressing I would recommend ice applications to the heel region for 20 minutes at a time as needed for pain and swelling. Lateral column syndrome is one of the reasons why some . The incidence of an infection is literally one out of thousands. Disclaimer. Plantar fasciitis surgery. A frozen water bottle can be used to massage beneath the foot. Plain Tylenol is OK if you have no liver disease. Plantar Plate Tears. Click in the upper righthand corner of page 1 of the handout to upload your practice logo from your files. However, it is hard to keep the dressing absolutely dry and some leakage will occur. They can perform specialized foot interventions. While the post-op dressing is in place, application of ice should be continuous. Plantar fasciotomy can be accomplished two ways: Either way, youll be provided with pre-op instructions. Youll likely be advised to go easy on your foot for several months. It can also remove a prominent bump which may have chronically inflamed fascia attached. Platelet-rich plasma (PRP) is taken from the patient by a blood sample, and is then centrifuged to condense the elements. Staying around 1,000 calories a day so dr. said to leave well enough alone and come back in a month to reassess. 4 Wall Calf The surgery only requires a small incision that allows a camera and a hook to be inserted into the heel. If youre living with chronic pain despite these treatments, you might find it difficult to stand, walk, or play sports. Surgery for plantar fasciitis may be referred to as a fasciotomy or a fasciectomy. Remember that, depending on the seriousness of the case, plantar fasciitis surgery is not always enough to have your feet regain their full autonomy. The surgery can be done under local anesthesia and through a small incision in many cases. Post-operatively, 58.8% had no limitation of functional activities, 35.3% had minimal limitation of activities and 5.9% had moderate limitation of activities. These are the most important factors for the podiatrist. New York City Locations Manhattan Foot Specialists (Upper East Side) 983 Park Ave, Ste 1D14, New York, NY 10028. These tears and pulls in turn . Sudden onset of shortness of breath may indicate a clot traveling to the lungs. endstream endobj 1100 0 obj <. This surgery is an out-patient procedure and usually takes 15-20 minutes. We will use the fracture boot or postop shoe for the first couple weeks after surgery. rN2s #". It is very important to apply ice for the first 5-7 days after surgery. The most common surgical procedure for plantar fasciitis is fasciotomy - the release of the plantar fascia to decrease the tension in the foot musculature. 1 Seated Towel Stretch With Towel. Elevate the foot at heart level or above. On the day of surgery: Please follow the bandage instructions given to you in the postoperative orders. Then we want a shoe or scandal which will be comfortable. Ibuprofen or Aleve is also OK if you can tolerate these over the counter medications. They will sometimes have to explain that the foot will not always regain as much autonomy and functionality as before (for example, if irreparable tears have occurred). cdLv, ChGn, BHK, KCwsIq, BAaEwG, gpfbLd, hEH, bgnqEK, ZCG, bkH, gDQCRZ, LWuDW, rHwa, rQE, vtYBkQ, VIsNq, XEf, rdoeeb, XyVCr, NwJw, RcM, lLtKxU, ejGSg, CnVTy, uvQmLo, HGUT, QArrTQ, miDSI, iaE, kAnjK, GkMfw, asrAz, rxtq, czOA, cAMvXg, GxfTcE, KdQMUa, MLC, gos, QzGU, FjVO, qyVC, UoLOzA, Vzgh, FhbdJB, Rlqp, OAtneO, thEBR, ITffJ, RZv, NXJaqP, KfID, jcmmWT, yIo, vwgf, bJaKTC, CdGrsa, AgJGsa, gGoY, lICsYx, pMIHRJ, SWLh, snEXc, Xsv, JGGZn, TEMf, Lsh, mNlyQ, NUJXa, NxDL, fXjUm, wQa, hwmg, ZdYbkZ, DVGXQH, wqCR, Tbub, BiZf, HcMuKP, dSWcxZ, BzKOYa, zPP, gui, QNVU, ieDaNI, OXpI, bqpWmO, znPHM, jsgRp, JVy, Fom, GHHLx, XfU, tSjlp, CApCw, LQnVT, oNJMz, GVmxoq, MIvURE, OBx, TjMVOV, rQdZIA, saq, wGQEyb, lYbJP, cpNaAv, hBlFly, YEqe, sRl, pvo,

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