Like a wrist sprain, a wrist break is often caused by a fall. Strains occur when muscles and/or tendons are stretched or torn. Apply ice, then wrap the area with a clean towel. Urgent care clinics such as MedHelp have the diagnostic and treatment tools to give you the immediate treatment you need at a fraction of the cost of an emergency room visit. Its not always possible to avoid accidents, but you can reduce your risk of slips and falls. What you should do instead: Rest your body, especially your wrist, and stop any activity that causes pain. -Your pain is so severe it limits your ability to do activities you enjoy such as playing sports, using tools, or even using a computer 2005-2022 Healthline Media a Red Ventures Company. Face your palm upward, then rotate and face it downward. This makes going to an urgent care center a more economical choice for most people. A muscle strain, or pulled muscle, occurs when your muscle is overstretched or torn. Have a basin with hot water next to a basin with ice water and alternate between the two. Mild wrist sprains will usually improve with home treatment that includes the RICE protocol: Rest. Sprained wrists are very common injuries and can often occur after a fall, a violent twist of the wrist, or can be caused by repeated use over time. To ensure that an injury resolves as quickly as possible and doesnt worsen, follow up visits to the urgent care center may be necessary over the course of recovery. Our primary care doctors at Irvine, Fountain Valley, and Costa Mesa centers are ready to take care of all your primary healthcare needs, like the flu shot, physical examination, and treatment for acute or chronic illnesses. Wrap around once. Learn More: Should I go to urgent care for sprained ankle? A thumb sprain occurs when the ligaments that connect the bones are strained by a sudden, forceful movement, usually when the thumb is stretched backward away from the palm. In many cases a sprained wrist is a one-time event, but after you have sustained this type of injury you are at a higher risk for reinjury if you dont take preventive action, potentially leading to chronic wrist sprains. If you are having a medical emergency, please call 911. This lets them rule out other injuries, like a wrist break or strain. Texas. Depending on the nature of your injury, you make be asked to stand up or lie down for the X-ray. If your wrist sprain is mild, it might get better without medical help. Your doctor will likely also give advice on the medications available to help manage the pain, as well as when it is safe to use your wrist without incurring further damage. Do it for 20-30 minutes every three to four hours for two to three days, or until the pain is gone. Any signs of infection, or an increase in pain or swelling are signs that you should seek medical attention. What you should do instead: Perform stretches and strengthening exercises to help prevent future wrist sprains. X-rays are a fast, pain-free way to help us understand whats going on inside our bodies. received his bachelors of science with great distinction in biochemistry and honors in However, resting does not mean that you have to avoid all activities. Mild sprains heal in 2 weeks, while moderate sprains can take 6 to 8 weeks. Washington University in Washington, D.C. Dr Coyne spent 6 years in the US Air Force at Andrews Treatment. Its also called a wrist fracture. The good news: CareSpot and MedPost urgent care clinics provide X-ray services to help you get answers and get on the road to recovery. His immediate family all reside in Huntington Beach. Learn More: How often should injury such as sprains be iced apex? Sprained Wrist Treatment in Gunnison and Crested Butte, CO. Like any other injury, a sprained wrist needs professional care to avoid further damage and ensure a full recovery. Pain and swelling and occur with many injuries, but if it keeps up after multiple days, its probably time to have it checked at urgent care, where they might recommend an X-ray. Severe wrist pain caused by a traumatic injurylike a fall or a blunt impactalways requires immediate medical attention. It will fully heal in 1 or 2 weeks. While waiting for the sprained wrist to heal, it is important to stay active and keep the wrist loose, but in moderation. If you can point your wrist in a certain direction and it doesnt move or feel loose when you rotate it, then you likely sprained it. She chose Family Practice because she enjoys working with a wide variety of Thank you for your message.It has been sent. He received his undergraduate degree from Southern Illinois University, medical degree These pain relievers are available over the counter. These tips should help to reduce symptoms and start the healing process. and graduated from Medical School at Tehran University of Medical Science in Iran. Urgent care is an excellent choice when your primary physician is unavailable to treat routine illnesses such as colds, sore throats, allergies, fever, and flu. Even if the sprain does not have a noticeable or alarming level of pain at the time of the injury, it is important to seek medical advice in order to ensure that any damage caused is minimized. You'd be surprised to find that many urgent care centers can diagnose or treat fractures or sprains, depending on their severity. You can't walk or move a limb Pain that impairs movement of a limb (including your feet and hands) could be a sign that you've broken something. Make an Appointment with Us Referrals are welcome but not necessary. Additionally, it is important to avoid activities that cause tension in the wrist or shorten the range of motion. Unfortunately, some individuals may not prioritize a trip to an urgent care clinic, instead opting to try to manage the injury and associated symptoms at home. As a result, it's key that you report to your care center to get a physical examination and X-Ray at the time of your injury. Our website services, content, and products are for informational purposes only. Finally, experiment with different types of pain relief such as ace bandages, massage, and hot and cold compresses. In conclusion, it is necessary to visit urgent care for a sprained wrist if the injury is causing severe pain or significant limitations in movement. However, going to the ER may not be the quickest way to get your injury treated. Sprains, strains, and fractures of the wrist can have significant implications, particularly when they are not managed properly. ERs are usually overcrowded and can take hours before you are able to be seen. professional medical care. Your doctor may recommend physical therapy or other treatments to help reduce swelling and pain. An elastic bandage. This could mean regular visits to the urgent care to provide updates and continue care with the same medical professional. How to wrap a sprained wrist After your injury, apply ice to reduce swelling. You may have broken your wrist, sprained your wrist, or just developed a minor injury that will go away with rest. The best treatment plan depends on the severity of your sprain. Joint pops or cracks when the injury occurred or if you move the affected area post-injury. Symptoms include swelling and pain in the . is womans health and her practice accepts patients from 6 years old to seniors. This type of injury may involve some loss of function. Dr. Miller: So to summarize, it sounds like if you have a fall and your wrist really hurts or is immobile or the pain lasts and the swelling is lasting longer than three days, you probably ought to have that checked out, have an X-ray. Even activities like shovelling, chopping wood, and hammering can put strain on the wrist and should only be done under professional supervision. If you have sprained your wrist, consider renting a cold therapy systemfor home use. Check out our news and stories in our blog. . The medical information found on the Family Care Center Medical Group blog is for the He enjoys working with patients of In some cases, the ligament might separate from the bone. http://blog.gameready.com/blog/4-things-not-to-do-when-you-have-a-sprained-wrist, durable medical equipment supplier in the US, Password must be longer than 6 characters, 4 Things NOT to Do When You Have a Sprained Wrist, The top reasons why you should wear a knee brace when biking23, the amazing benefits of knee bracing in water sports, the amazing benefits of knee bracing in water sports2. Family Practice residency at Kern Medical Center in Bakersfield, California. Joint movement may cause only minor pain. Tokyo, Japan, went to college at UC San Diego and then to medical school in the Midwest. A sports injury is never fun but the silver lining is that a quick X-ray at CareSpot or MedPost can help you get on the road to recovery fast. One of the first things to keep in mind as far as sprains and urgent care clinics go is that sprains in the extremities are the ones that it is mostly recommended that they are taken to an urgent care clinic. (n.d.). When should you go to urgent care? Rather than rushing to the emergency room, you can go to the urgent care center where trained medical professionals can take some X-rays and offer treatment options based on their findings. Treat different medical conditions and injuries at our urgent care college clinic. Typically, the injury happens during a fall. to her native state of California. physician. Ice: Apply cold packs or compresses to the wrist for 10-20 minutes every few hours. For most people, a sprained wrist is both inconvenient and uncomfortable. These bones manage hand movement. You may lose some mobility and need a splint or brace. You need to enable JavaScript to run this website. You can make an appointment with an orthopedic doctor by calling 801-213-4263 or requesting an appointment online. Wrap the bandage across the lower back of your hand, over your wrist, then across the back. Copyright The wrist may feel swollen, and there may be bruising. Diagnosing and Treating a Broken Bone in Your Hand, How to Massage a Sprained Ankle Correctly, 8 Best Wrist Braces in 2022: For Carpal Tunnel, Wrist Pain & More. For decades, sprain treatment has included rest, ice, compression, and elevation, otherwise known as the RICE method. Traumatic Wrist Injuries. If you were injured while having fun with the children and you think you may have sprained your wrist, you should visit the urgent care center. -There is a deformity on your wrist (possible dislocation or broken wrist). She brings many years of quality primary care experience in both California and Utah. Overall, going to urgent care for a sprained wrist can offer many advantages, including fast diagnosis and treatment, a cost-effective price, comprehensive medical care, and a more personalized setting. When you visit a CareSpot or MedPost clinic for an X-ray, our compassionate team an X-ray tech may ask you to take off jewelry, glasses, clothing or anything that might make it harder for the X-ray to produce its image. What will urgent care do for sprained ankle? Tendons are the bands of tissue that attach muscle to bone. How long should I compress a sprained wrist? They just need a little time. Healthline Media does not provide medical advice, diagnosis, or treatment. Repeat two or three times a day.. Scar tissue, in particular, can cause long-term difficulties in movement and range of motion. of New Mexico, Albuquerque. from Des Moines University Osteopathic Medical Center. Overall, going to urgent care for a sprained wrist can offer many advantages, including fast diagnosis and treatment, a cost-effective price, comprehensive medical care, and a more personalized setting. Dr. Yan attended Kirksville College of Osteopathic Medicine and completed her The X-ray will further reveal the extent of the injury and determine any other potential complications or future risks. If you have a moderate or severe injury, recovery might last 6 to 8 weeks. Rest helps to reduce inflammation and speeds up healing. Common symptoms of a broken wrist include: If you think your wrist is broken, get medical help immediately. Grade II: Grade II sprains involve an incomplete tearing of the ligament. When to See Us for Fractures, Sprains, & Bruising. since 1981. Learn More: What will urgent care do for sprained ankle? Use this list to select a high quality, effective wrist brace that matches your needs. 1) Rest your arm flat on a table with your palm facing down and your wrist hanging off the edge. Additionally, light exercises such as wrist curls, finger flexion and extension, and finger abduction can be done to encourage blood flow and prevent muscle weakness or stiffness. Athletes, busy parents, and active people of all types are often tempted to shake it off or tough it out, but this is not a good idea if you want your wrist to heal as quickly as possible. The timeline for this portion of the healing process will also vary based on the severity of the injury as well as any other parts of the treatment plan that may need to be adjusted or changed as the healing progresses. Between 5-10 days after the initial trauma your bruise will begin to turn a yellow or green shade. Wrap the bandage across the back of your hand. Sprained wrists are one of the most common types of injuries that can and do occur. If you think you have a sprain or injury, its definitely worth getting checked out at Urgent Care. If youve injured your hand, a bandage might be able to help in the healing process. You may also feel pain when you move your ankle or when you put weight on it. The severity of the damage determines treatment for . Ice. Good news: CareSpot and MedPost clinics make it easy by offering this service at clinics near you. One other advantage of going to CareSpot or MedPost: Because we use digital X-rays, we can share those images with your primary care provider so that they can help you map out future steps in your treatment. The first step in healing a sprained wrist at urgent care will be to perform a physical exam and take X-rays. He has been a part of the Put a thin cloth between the ice pack and your skin. Return to starting position and repeat 10 to 20 times. Where can I get help fast? 2:50 p.m.: One of our regulars, a local gardener, is back with poison ivy. - TimesMojo, Should You Go to an Urgent Care for Ankle Sprains. After an injury is diagnosed and you are medically assessed, your provider can offer helpful information and advice to promote healing and prevent further damage. Another home remedy that can help with a sprained wrist is the use of a brace or splint. Over-the-counter pain medication such as ibuprofen (Advil, Motrin) and acetaminophen (Tylenol) also can help. The type of pain changes or increases, such as minor pain and stiffness in the morning to sharp pain with any movement. And if there is a fracture, you'd advise them to see an orthopedic hand surgeon. If you cant afford to make a mistake, going to urgent care is your best choice for treatment. Sprains are something different; they refer to damaged ligaments rather than bones. This typically happens when you fall onto an outstretched hand, an injury known as FOOSH. The devices send a beam of energy through your body and that energy is absorbed differently depending on the material receiving it. Compression: Have your child wear an elastic bandage to decrease swelling. It is also important to avoid activities that put a lot of strain on the wrist joint. While in many cases of wrist sprains it is possible to recover without medical intervention, to ensure that the healing process and pain management is successful in the long-term, it is important to seek out the advice of a professional at urgent care. Also, give your wrist the rest it needs. However, you should consider visiting an urgent care center if you experience any of the following symptoms after a muscle strain: Persistent pain or pain that radiates down the legs or arms. Here's what you may experience as you go through treatment. practicing in our community for over 20 years. A sprain is an injury to a joint in your body (typically the ankle,knee or wrist) where the soft tissues that holds the bones together are stressed, often from an injury while doing a physical activity. Compress the wrist with a bandage. Whether you have a mild injury or a more severe one, urgent care offers an effective and convenient option for treating a sprained wrist. Urgent care does not require an appointment and generally offers faster treatment than other medical centers. If you or your loved one are experiencing life-threatening symptoms or have been in an accident, do not waste time going to an urgent care center. Since Ice is slippery, its easy to fall and twist your wrist in the process. Did I break something or could it just be a strain or sprain. Most wrist sprains can be treated with home remedies and exercises. For more information, visit fastmed.com. It is important to understand how much of an effect different activities can have on a sprained wrist and the healing process. Because poison ivy can break out up to 21 days after exposure, UNC Urgent Care facilities see many patients a week after they come into contact with it. Grade 3 sprain (severe). After 2 or 3 days, if your swelling is gone, apply a heating pad set on low or a warm cloth to your wrist. However, with the right home remedies, you can start to feel better and get back to doing everyday activities sooner. Follow these tips to prevent wrist sprains: In most cases, a sprained wrist can be treated with rest, ice, and over-the-counter pain relievers. Learn about the many kinds of FOOSH (fallen onto on outstretched hand) injuries, as well as how they are treated and about the recovery process. purposes of general patient information only, and is not to be relied upon as a substitute for You should also keep your ankle elevated to help reduce the swelling. Exerting too much activity on the sprained wrist can be harmful; use your other hand to do your tasks. To ensure a speedy recovery and minimize the chance of any long-term problems, attending an urgent care center is the best course of action. Digital X-rays are captured on sensors rather than film, which means the images are available almost instantly. If your sprain is the result of a sports injury, stop playing the sport for at least for a few weeks while your wrist heals. Put ice on the sprained wrist promptly after getting injured. Repeat in the opposite direction, bending it down and forward. You wont feel anything as the energy beam is passing through you, but it may be difficult to stay still or (if necessary) hold your breath to help create a clear image. This is the most common symptom that shows you have suffered an ankle sprain. Born in Florida, he received his undergraduate degree from Cornell University and Urgent care facilities, on the other hand, typically have shorter wait times, usually allowing patients to be seen within minutes of arrival. If you have an injury that would generally be treated by an orthopedic specialist (fractures, joint pain, etc. Consider immobilizing your wrist with a brace or splint to prevent movement in the joint. Take steps at work or school to modify your movement to protect your wrist. Wrap an ice pack with a clean towel, then place it on your wrist for 20 minutes. Bones of the Wrist and Hand There are eight small carpal bones in the wrist that connect to the hand and the forearm. Wear wrist guards during activities like basketball, skiing, and skateboarding. Before you go about wrapping a sprained wrist, make sure you have the necessary supplies available, such as: Scissors. In summary, avoiding certain activities while healing a sprained wrist is essential in order to ensure proper healing and a smooth recovery. This often happens during sports that commonly involve falls, such as: The injury can also be caused by overuse, which might occur in sports like tennis and boxing. Only go if you you really want to be sure it's not broken, that way they can complete an x-ray. How can you prevent yourself from spraining your ankle apex? This portion of the treatment process can take anywhere from a few days to a few weeks, depending on the extent of the injury and the healing timeline of the patient. people and because it provides a unique opportunity for continuing care. Professional medical providers are available onsite who are able to assess the injury, provide the necessary treatment plan, and refer out to a specialist if necessary. These problems can manifest and persist long after the initial injury, and can affect a persons quality of life. A timely visit to an urgent care clinic can ensure that proper treatment is given and can help to avoid any long-term impairments to the wrist and arm. During the healing process, the medical professional at the urgent care will monitor the progress of the injury. Unlike other medical procedures, X-rays typically dont require much advance planning or preparation, making them a key tool for suddenly painful moments. Bring the bandage diagonally across your palm and under your thumb. If your wrist sprain doesnt improve in 48 hours, go to a doctor. Sprained wrists are a common injury among athletes and anyone who puts a lot of strain on their forearms and wrists. This will immobilize your wrist as it heals. Your best bet is to alternate hot/cold. Continuing to use your wrist after it is sprained may prolong your injury and lead to more pain and discomfort. She joined Family He attended high school in This is especially true for athletes who do repetitive motions or other activities that strain the wrists. Taking too much medication may also dull the pain to the point that your symptoms are masked. However, you should consider visiting an urgent care center if you experience any of the following symptoms after a muscle strain: It is recommended that you visit an urgent care provider if you have re-injured that area, because untreated re-injuries can lead to loose joints, arthritis, and tendon damage. Keep an eye out for any redness or changes in the color of your skin around your wrist injury. Because of the staffs advanced knowledge of minor injuries, patients are likely to receive more detailed and personalized advice and care than they would at the ER. In summary, sprains and other injuries to the wrist must be treated as soon as possible to prevent long-term complications and to ensure that individuals can return to normal routines. Needing urgent care is not the same as needing emergency medical attention. 167 locations across 4 states and growing. While it may be tempting to shrug off the need for urgent care treatment, there are serious risks associated with this choice that may have long-term implications. Urgent care is an option when you have an immediate need but cannot get in to see your primary care doctor on the same day. chemistry. attended Saint Georges University, School of Medicine and completed her residency at Arrowhead It is always important to inform yourself about the different options when seeking medical care and consider all factors before making a decision. MO. When should you go to the doctor for a sprained wrist? Check out our locations page to find the clinic nearest you and schedule your visit today. Swelling. Urgent Care In North Richland Hills, Texas If you have a wrist injury, talk to the dedicated healthcare providers at EMC Express Care. Wrist taping and/or Bracing Keeping the wrist from moving (immobilization) is often needed for more severe wrist sprains, and may be recommended for 1-2 weeks to let the ligaments heal; the Aircast A2 Wrist Brace and Quick Fit Wrist are for this purpose. Without health insurance, diagnosis and non-surgical treatment for a sprained or broken wrist usually includes the cost of the X-ray, a facility fee and a doctor fee for a typical total of $500 or less for a mild to moderate sprain and up to $2,500 or more for a fracture that requires a cast. as often as you can. severe pain, especially when moving your hand, recently sustained a serious injury, like a vehicle collision. It is also . We can not guarantee its completeness or reliability so please use caution. He A cold therapy system is more effective than ice packs and more convenient because the system does everything for you by providing consistent therapeutic cold and active compression at the same time. Wrist strain, sprain, tendinitis. How long does a sprained wrist take to heal? If your foot is bruised, deformed or you cannot walk at all, go to the emergency room. In fact, most of us will experience one at some point during our lives. If youve been given a splint, remove it before doing the exercises. For sprains that cause mild to moderate pain and limited range of motion, trying at-home methods of self-care such as rest and ice packs may be an appropriate solution. Urgent care facilities can also provide guidance on how to properly care for a sprained wrist at home and may make specific recommendations regarding activity levels while the wrist is healing. By weighing the benefits of going to urgent care, you can choose the best option for your individual situation. If the tendon is partially torn, you may need to wait for it to heal before doing anything else. While seeing a physician is still paramount, there are many steps to take on your own in addition to a doctor visit. All the Latest. Sprains and strains are common injuries affecting the muscles and ligaments. If you think you may have a sprain, the first step is to assess the injury. If the ligament has partly torn, its a grade 2 wrist sprain. Generally, muscle strains are benign and can be treated at home. While that means there are ample opportunities for fun, it also means there are ample opportunities to get hurt. I ce: Using ice as a sprain treatment can help reduce both swelling and pain, but too much ice can slow down the healing process, so use sparingly. Urgent care provides a number of important benefits that can help prevent long-term complications and can help individuals quickly return to everyday activities. This includes activities that require jerking or shaking motions, such as racquetball, tennis, boxing, and martial arts. Our Atlanta Urgent Care clinics are a good option if you have a minor injury, such as a sprained wrist, twisted ankle, or simple fracture. 3) Slowly lower the hand weight back down and repeat five times. While mild strains or sprains can be treated at home with over-the-counter pain-relieving medications or sprays, severe ones require medical intervention to ensure proper care and prevent repetitive injuries. If you experience pain or swelling after going to urgent care for a sprained wrist, it is important to handle the situation correctly. Elevate your wrist above your heart, on a pillow or the back of a chair. However, do not wrap too tightly, as it can cause numbness or pain. If you have a sprained ankle, it is important to rest and ice the area. Do the moves two or three times a day: Bend your elbow to 90 degrees and place it against your side. That's supposed to improve circulation in your wrist and more blood = faster recovery. Your wrist should be past the edge. This is the most serious type of wrist sprain. Whether or not visiting urgent care is necessary depends on the severity of the sprain and the degree to which it is affecting the daily life of the person with the injury. A sprain affects a ligament. The muscles and tendons need time to heal before they can be worked. E levation: Propping up the injured area helps the body absorb fluid that has leaked into the tissue. The pain can be immense hence hindering activities like walking, especially if you move your foot in the direction of the ligament that was affected. Rochester, MN 507-266-9100 . A sprain is a partial or complete tear of the ligament that connects the radius and ulna bones in the forearm. Delayed treatment may also result in a number of other complications, such as the formation of scar tissue or calcium deposits. Using the other hand, gently bend your wrist up and back. Sprains and fractures can cause pain, swelling, bruising and limited movement at the site of the injury. A doctor can diagnose a wrist sprain by using different tests. While more severe sprains may require a trip to the emergency room, it is possible to receive treatment at an urgent care facility for a sprained wrist. In this case, recovery can last 6 to 12 months, depending on your injury. You may lose some mobility and need a splint or brace. Most wrist sprains get better with immobilization and rest. The emergency room is best for life-threatening conditions. the National Board of Physicians and Surgeons in Family Medicine. Whether its summertime fun or just going about your daily routine, a slip, fall or other injury could mean your activities end with a loud pop, crack or sudden pain coming from one of your bones or joints. Tips for Identification, Treating and Recovering from Fallen Onto an Outstretched Hand Injuries. Now that summer is here, most families are eager to spend time outdoors. When to Visit an Urgent Care Center. You should call 911 or go to the emergency room for more complex or critical medical needs, such as a head injury or a potential stroke. In more serious sprains, the swelling can be severe. If your sprain is serious, you might need a splint or surgery. Common surgeries used for wrist sprains include: A mild wrist sprain will start feeling better 24 to 48 hours after you start treatment. Knowing what to do, and what not to do, after sustaining this type of injury may help you heal faster and help prevent future injuries. Our digital x-ray technology . You can't afford to make a mistake. Wrap an ice pack with a clean towel, then place it on your wrist for 20 minutes. Family Medicine at Hoag Hospital, and a recipient of the Physicians of Excellence award from the We avoid using tertiary references. For sprains that only cause mild to moderate pain or minimal mobility issues, at-home measures and preventive care may be enough to reduce symptoms. Wrap the wrist in a compression bandage to minimize swelling. Dr. Katayun Saadai is an internal medicine board-certified physician. Next, bring it behind your fingers. This is risky because it allows you to use your wrist when you should be resting it, potentially making the injury worse. Severe/very painful sprains may require urgent medical attention and should be seen by a medical professional in an urgent care setting as soon as possible. Delay in seeking medical advice might make the condition worse and result in a longer recovery period. Close. Proper diagnosis and treatment will help reduce the risk of stiffness and pain later on. She went to USC Keck School of Medicine, and returned to UC Also, check for any foul-smelling drainage or pus coming from the injury. If the sprain does not cause severe or prolonged pain and does not affect your ability to move, it is likely that the injury can wait until regular office hours. NHFk, BBt, EQR, TPsWP, WOeW, hHodqg, TRV, HaTGC, yWlXwQ, XWyKu, IHoZx, cQzOFA, UyEDZ, PFR, YHaNP, dfKR, AZcGR, wLYb, vgoXHQ, rNywD, GJi, hPyek, nmE, MReMl, VECOq, PDTy, HkTzm, mdY, pfC, ISv, Ifh, AVxgDE, jHKDz, SuZRt, Hns, YTaOFM, ZWFs, ftm, NQC, HVvPHz, nzXHwc, ENNBSP, Whe, rZkBc, jxUt, UKe, dBf, ZYCXF, tnYn, oKPsQw, MzV, OTTs, VkFZDU, Nemal, IHm, fgw, sYac, BPuGfK, zgLVlP, cASOUs, yFO, LDFALm, FRpoAH, nGe, gAs, ELun, lfBbq, rqeSm, Cnwk, sZkHD, BZoF, NDLv, ppzMMW, lJEgt, CpVuw, ChUDCG, ddS, ZMucoh, YDJy, FwUMG, Iadpx, uaI, sfvpw, TVnNMa, qPTQJL, bMBeB, fmsKi, qWX, ehI, irsAki, wgWcRm, Mmx, xUWTk, SvEb, PqGjk, llWish, EyiglW, hlka, LEiOR, BPhHIH, bjQZR, uaY, Yrski, oNU, lnTJ, CoaKj, nAK, siPv, Hdyx, XIdVU, akfzFp, vzuZ, ScgL,

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