Life after tongue cancer surgery

Life after tongue cancer surgery. Recovery after Mouth Cancer Surgery Helping you recover after your operation is one of our top priorities. For those unfamiliar with this concept, it can seem confusing and even controversial. 93: Quality of life of patients with tongue cancer 1 year after surgeryDid not report method of flap reconstruction and area and extent of tongue resection: 11. 94 Sep 25, 2024 · Around 70 out of 100 people (around 70%) will survive their cancer for 5 years or more after diagnosis. 1 The disease progresses locally in the region, rarely for distant metastases. Other causes are vitamin or mineral deficien In most cases, a swallowed tongue ring passes from the body via a bowel movement without incident. Recovery times range from one or two days up to four or more Different types of bladder surgery include bladder suspension surgery and urinary incontinence surgery, according to WebMD. 007) and occupation (p = 0. HPV prevalence in oropharyngeal tumors increased from 16. A tongue ring typically is designed in two parts, including a blunt component in The devil’s tongue knot is a fictitious device discussed in the book series “A Series of Unfortunate Events” by Lemony Snicket. 3 percent during the 1980s to 72. My biggest problem is coughing and clearing my throat. Post Tongue Cancer Surgery Jun 14, 2023 · Tongue cancer surgery may have significant quality-of-life implications. Jun 16, 2023 · Treatment for tongue cancer usually includes surgery followed by radiation, chemotherapy or both. A total of 289 consecutive patients with tongue cancer who had undergone primary surgery from 2003 to 2008 at our hospital were recruited. 2 Surgery and radiotherapy remain the mainstays of treatment for primary tumors and regional lymph nodes. A tongue barbell that is too short could cause the jewelry to embed itself in the tongue. Jewelry that is too short also has a tend Someone with red spots on their tongue may be suffering from geographic tongue, according to Mayo Clinic. Feb 6, 2021 · If you’ve been diagnosed with oral, or mouth cancer, the most common treatment is surgery to remove the cancerous tissue, especially in early stage oral cancers. She did another biopsy. Aug 22, 2022 · Background. Brown was referred to UCSF Medical Center, where surgeons recommended a drastic treatment that was her best shot at survival: a total glossectomy, or tongue removal, followed by chemotherapy and radiation. Yang et al. I was speaking very poorly a day or two after. Source: www. Been 3 years cancer free, and still have the drastic effects from the radiation and chemo (no saliva, cannot swallow properly, cannot sleep with out proper aids). Twenty-nine patients participated in the study for a minimum of one year after oncologic treatment. Tongue cancer is the most common cancer of the oral cavity, while tongue is the first part of the digestive tract. That’s why it’s so important to tell your healthcare provider if you develop any new lumps, spots on your tongue or sores that don’t go away. Cancer survivors can be affected by many health problems, but often a major concern is facing cancer again. I got my surgery last August 2017 when removing the cancer took 75-80% of my tongue. I had radiation and chemo and I know how tough his battle is ,but I am here to tell you that there is life after cancer of the tongue. 2009. The cost of veterinary care, particularly surgeries, can sometime Some causes of a tingling tongue and surrounding area are stroke, head injury and a reduction in blood flow, according to Healthgrades. She knew that being here was the best place she could possibly be. Childhood cancer survivors may be at risk of additional late side effects. I always seem to have a tickle in my throat. Whether it’s a routine procedure or an emergency situation, the cost of dog surgery During cataract surgery, a small incision is cut on the side of the cornea, and a device that emits ultrasound vibrations is inserted into the eye to break the cloudy lens known as Causes of neck swelling include skin conditions such as acne, boils, cysts and skin infections; serious medical conditions such as throat cancer, anaphylaxis and angioedema; neck i The blue whale is the largest mammal in the world, and its massive tongue can weigh as much as an elephant, or 15,000 pounds, according to National Geographic. Leuko The knee is an essential joint of the body, and it’s complex. The procedure may affect a patient’s ability to speak, eat and swallow. Other times, waiting a while is not a problem. It depends on the type of cancer and other factors. 7 percent during the 2000s, with increasing recognition that HPV-positive oropharyngeal squamous cell carcinoma (OPSCC) is a distinct entity from the tobacco-associated HPV-negative OPSCC Fellow tongue cancer survivor. It is a common trick The most common arthroscopic surgery is arthroscopic knee surgery, which is minimally invasive. 1016/j. Patient QOL was evaluated Nov 13, 2007 · The surgical treatment of tongue cancer, with or without reconstruction and/or radiotherapy, leads to different levels of voice, speech, and deglutition disorders. After surgery: Combining radiation therapy with chemotherapy after surgery can help kill cancer cells that were too small and remained during surgery. Second cancers after oral cavity or oropharyngeal cancer treatment Tongue cancer can be curable with early diagnosis and treatment. Sep 4, 2017 · Background While aggressive treatment for oral cancer may optimize survival, decrements in speech and swallowing function and quality of life often result. Mar 6, 2024 · If you have cancer in the mouth, it can change your life. According to our review to date, there have been no studies with more than 14 patients to report such outcomes 18 months after surgery. Menstruation can be painful, cysts can form and need surgery, and, unfortu Laura Ingraham had early stage breast cancer. People who have a total glossectomy may lose swallowing function. Depending on the extent of your cancer and its removal, your surgical team will perform reconstructive oral cancer surgery to address changes in the function or appearance of your mouth, jaw, or throat as the result of the operation. I had an appointment with head and neck surgeon Dr. Kate Brown was just 32 years old, recently married and beginning a new job, when she learned that a spot on her tongue was stage 3 tongue cancer. I did not have surgery becaue the tumor had taken over my entire tongue. Oropharyngeal cancers Eight months after tongue surgery. Free-flap reconstruction does not seem to palliate the effect of the loss of functional tongue base volume, as r … A total of 289 consecutive patients with tongue cancer who had undergone primary surgery from 2003 to 2008 at our hospital were recruited. Other kinds of bladder surgery include retropubic suspen An allergy to the anesthesia the patient receives sometimes causes a skin rash after surgery, according to the World Allergy Organization. Those firsthand experiences provided her with comfort when she was diagnosed recently with tongue cancer. 2013 Jun;122(6):386-97. This is especially true in new tongue piercings. Most side effects will go away on their own or can be treated, but some may last a long time or become permanent. Unfortunately, on the left side of the reconstructed tongue was not healed. In t To cook beef tongue in a pressure cooker, place whole washed tongue into the pressure cooker, add just enough water to cover the tongue, bring to pressure and cook for about 30 min Without treatment, the life expectancy for someone with hypoplastic left heart syndrome, or HLHS, is a few days to a few weeks. Oct 13, 2023 · Radiation therapy is commonly a part of treatment plans for tongue cancer. 09. Mar 6, 2024 · After tongue cancer surgery, you may experience trouble swallowing and changes in your speech. Nov 16, 2020 · The use of EAT-10 scores as dependent variables revealed denture use (p = 0. Evaluating the quality of life related to these swallowing alterations is important to further our knowledge about the impact of such alterations from the patient’s point of view. The biggest side effect I've experienced is the sore/scratchy throat that makes it extremely difficult to swallow. 1177/000348941312200608. Abstract: PURPOSE: The aim of the present study was to evaluate the effect of early swallowing treatment on dysphagia and quality of life (QOL) in tongue cancer patients after surgery. com, babies sticking out their tongues is a normal reflex that is part of the sucking phase. In fact, she told me: "It has been my experience that surgeons do not always consider quality of life after surgery when performing head/neck surgery. 9%, for stages III Our objective was to describe the quality of life related to swallowing in patients treated for tongue cancer, using specific questionnaires. Her suspicions were correct: it was tongue cancer-- specifically, squamous cell carcinoma of the tongue. For the second year, go every 2-6 months. 3 The overall survival rate after 5 years for stages I, II is 70. Tracheostomies are most often used when treating patients with head and neck cancers, including tongue cancer, oral cancer and thyroid cancer. Four years later, Brown is cancer-free and, unlike many patients who undergo total glossectomy, able to eat and speak understandably. Feb 23, 2022 · A patient’s QOL one year after cancer treatment is a good long-term predictor of QOL in disease-free individuals . org Authors: Zhao-hui Yang et al. But a week or so after the surgery, speaking wasn’t a problem. This is called a second cancer. It took me about a month to be able to eat soft foods and about another 3 weeks for most other foods. It supports almost all of the human body’s weight, making the knee sus A sore tongue can be caused by dehydration, fever and dry mouth, while a sore mouth can be the result of burning mouth syndrome, explains MedicineNet. The tongue. It's not unusual for patients to wait a few weeks after learning they have cancer to have surgery. He shares his experience and advice with other patients facing their own oral cancer treatment. 005) as the factor There are only few studies in the literature that report the quality of life and functional outcomes after mandibulectomy and reconstruction with FFF(11,18,19,20). Sep 19, 2023 · According to one 2022 review, oral cancer recurrence may occur in 50–60% of people with advanced oral cancer and 25–30% of people with early stage oral cancer. Had the same operation (60% of tongue removed), wrist in mouth trick, as well as a modified radical neck dissection. These might include the cancer's location and how fast it's growing. It made a hole in my mouth that connects the chin. Hello everyone. Jan 26, 2018 · They made me a reconstructed tongue out of the soft tissue on my back and I went home after ten days. These parts include the following: The front part is the area you can see. Cancer that develops in this part of the tongue is called mouth cancer. Typically, the doctor There are many ways that a staph infection can develop after surgery, including contaminated surgical instruments, germs in the air,or bacteria that already may be on the body and Ears cannot be made physically smaller without surgery. That's because children's bones, tissues and organs grow quickly. Your speech and swallow Jun 16, 2023 · Tongue cancer treatments have the potential to impact your speaking and swallowing, so your care team strategically plans treatments that will allow you to maintain as much function as possible. Your health care team considers many factors when creating a treatment plan. The life expectancy for a cancer survivor is bas Kidney cancer is a serious health condition that starts in the kidneys but can spread to other areas of the body. More than 55 out of 100 people (more than 55%) will survive their cancer for 5 years or more after diagnosis. Nov 4, 2022 · People who underwent cancer treatment as children may be at risk of many of the same late side effects that can happen after cancer treatment in adults. Many problems are minor but some can be life threatening Jul 5, 2024 · Transoral single-port robotic surgery for tongue cancer Tim underwent single-port robotic surgery , a minimally invasive approach through the mouth that helps patients recover faster. Cancer that comes back after treatment is called a recurrence. The tongue discoloration may appear in a variety of shades, includ Tongue drum music is a unique and captivating form of musical expression that has been around for centuries. And sometimes you might need chemotherapy or radiation before having surgery. 048 Corpus ID: 30422693; Quality of life of patients with tongue cancer 1 year after surgery. METHODS: A sample of 134 tongue cancer patients aging 36 to 74 years was divided into treatment group (67 patients) and control group (67 patients). Other causes of a black tongue include tobacco use, oxidizing or astringent mouthwashes, and medications that contain the e Some popular tongue twisters about love include the statement, “Love’s a feeling you feel when you feel you’re going to feel the feeling you’ve never felt before,” and the well-kno Generally, patients are advised not to eat or drink anything after midnight before surgery, according to the American Society of Anesthesiologists. They should also avoid drinking Are you suffering from chronic acid reflux and considering LINX surgery as a treatment option? If so, it’s important to find a reputable LINX surgery center near you. Nov 17, 2021 · Helping patients recover after surgery. After that time frame, most children and adults should be able to return to the Patients often experience halos for a few days after cataract surgery with toriclens and monofocal lens implants. Patient QOL was evaluated using the University of Washington Quality of Life Questionnaire, version 4. With the incr The average human tongue is 4 inches long. It is also called glossectomy. Second cancers after treatment. Presented at the Annual Meeting of the American Society of TherapeuticRadiology and Oncology, New Orleans, October 11-15, 1993. A Feb 24, 2023 · floor of the mouth below the tongue . Your Mayo Clinic care team. After 4 years I can eat most things apart from meat which I find hard to chew and cannot swallow it. Taste abnormalities, swallowing difficulty, and numbness in the tongue are not uncommon after tongue surgery, usually temporary, and rarely permanent. Studies have shown that people with head and neck cancer who are treated at facilities that perform a lot of head and neck cancer surgeries, tend to live longer. Even if it was not yet healed I went to radiation and Chemo theraphy on July to august, 2016. Life After Complete Removal of the Tongue Hello to all who responded to my post. DOI: 10. At Mayo Clinic, head and neck cancer specialists lead teams of doctors in caring for people with tongue cancer. This is called the oral tongue. How it affects your day-to-day routine will depend on the size and location of your cancer and how advanced it is. Find out the possible complications and support options for people who undergo this procedure. doi: 10. Approximately one-third of this length is located at the back of the throat and is attached to the hyoid bone. My daughter is under the care of the Head and Neck Surgery Department at Kaiser in Oakland, CA. Shirley Su the following week. It Learn more in Life After Cancer. I had surgery in April 2020. Sometimes late side effects develop months or years after surgery. When our beloved furry friends require medical attention, it can be a stressful and worrisome time for pet owners. ” Or it may occur at the base of the tongue, near where it attaches to the bottom of your mouth. This is Standard Follow-up Schedule. Sep 13, 2022 · After glossectomy surgery, length of recovery time is totally dependent on how much of your tongue your surgeon had to remove. This study evaluates the rehabilitation outcomes of Indian patients who underwent tongue cancer surgery, focusing on speech therapy, nutritional support, and psychosocial interventions. Our results imply that the volume of tongue base resection is a major factor in swallowing- and aspiration-related quality of life following tongue resection and free-flap reconstruction. These and other side effects from surgery for oral cancer may cause challenges that require supportive care services to help patients maintain or improve their quality of life. Stage 3. Patient QOL was evaluated using the University Mar 30, 2019 · Tongue cancer can occur on the front of the tongue, which is called “oral tongue cancer. After the discovery of a small lump in her right breast, she was diagnosed in April 2005 with an aggressive type of breast cancer that Swelling of the legs after surgery is called lymphedema, and it is caused by a build-up of fluids in the fatty tissue just under the skin, notes the American Cancer Society. Cancer survivors can be affected by a number of health problems, but often a major concern is facing cancer again. Speksnijder et al. Genetics also p. Oct 29, 2020 · She was stunned how well I was still able to speak as so many tongue cancer patients she has seen in her practice have significant speech problems after surgery for the rest of their lives. All patients Dec 28, 2020 · My tongue cancer diagnosis and surgery. Golf ball sized tumor on the base of my tongue, plus 2 more in my throat. She was referred to Oakland by the surgeon who initially diagnosed her tongue cancer. The skin can also swell and redden in pat Dog owners understand that their furry friends may require surgery at some point in their lives. The tongue is an imp A total hip replacement, also called total hip arthroplasty, is a procedure in which a surgeon removes your hip joint and replaces it with a prosthetic joint. After the cancer is removed, reconstructive surgery might be done to help restore the appearance and function of the areas affected by the cancer or cancer treatment. We'll cover deferent types, side effects, costs, and more: surgery, or a drug regimen to boost success rates. This part of the tongue is The recovery time for umbilical hernia surgery is about two to four weeks, according to MedlinePlus. 033) as factors predicting the quality of life at one month after the surgery, and illness duration (p = 0. Some people may be able to eat and drink normally after two weeks. It’s a diagnosis that many of us fear for our friends and family as well as ourselves, but the sad fact is that an estimated one in three people will get cancer at some stage in li Some causes of stinging in the tongue include a physical burn on the tongue, primary burning mouth syndrome or secondary burning mouth syndrome, according to the Cleveland Clinic a A tongue that has been completely severed does not grow back at all on its own; however, a tongue that has received severe lacerations, if it receives proper treatment, has the abi A discoloration of the tongue, most often called black hairy tongue, is often caused by bacteria or yeast growth. Patients and methods: A total of 289 consecutive patients with tongue cancer who had undergone primary surgery from 2003 to 2008 at our hospital were recruited. }, author={Zhao-hui Yang and Wei‐liang Chen and Hong-Zhang Huang and Chao-bin Pan and Jin-Song Li}, journal={Journal of oral and maxillofacial surgery : official journal Hi Aanchal - I had surgery for base of tongue cancer in December and tomorrow I finish my 6 weeks/30 days of radiation. Sep 2, 2024 · Tongue cancer significantly impacts speech and swallowing functions, necessitating comprehensive rehabilitation post-surgery. The aspects related to how to deal with deglutition problems, time taken for meal consumption, pleasure in eating, chewing problems, food sticking in throat and mouth, choking, and the knowledge of feeding restrictions were factors that contributed to a negative impact for patients with advanced-stage tumors who underwent radiotherapy. Patients and methods: Nine consecutive patients (seven men and two women; average age 51 years) who had been diagnosed with T 4a carcinoma of the mobile tongue and/or tongue base and treated by glossectomy, free-flap reconstruction, and either radiation therapy or chemoradiation responded to the European Organization for Research and Treatment of Cancer Head and Neck-35 questionnaire, the Jun 1, 2013 · Aesthetic and functional radical surgery in young patients with stage one or two tongue cancer: a preliminary report: Insufficient sample size: 10. I was shocked, devastated and scared. Speech therapy and reconstructive surgery can help you redevelop language skills and swallowing function after tongue cancer surgery. Th The expected recovery time from carpal tunnel surgery depends on whether the dominant or nondominant hand is involved. They will determine stage after surgery. Advances in heart surgery have increased the chances If someone can tie a cherry stem into a knot with their tongue, that suggests they may be a good kisser due to the oral dexterity required to perform the feat. For the first year, go every 1-3 months. I just joint this community searching for orientation on what to eat after 8 months tube feeding (G tube). I hurt myself talking, to the extent that I was sweating from the pain. Staff will be aware of this. Our study reviewed a large series of patients Similar Situation. Nov 1, 1996 · Harrison LB, Zelefsky MJ, Armstrong JG, et al: Quality oflife after treatment for squamous cell cancer of the base of tongue--Acomparison of primary radiation therapy versus primary surgery. Apr 26, 2016 · Discoveries related to human papillomavirus (HPV) continue to generate new implications for head and neck oncology. This exploratory study investigated how patients recover their communicative function, swallowing ability, and quality of life after primary surgery [with or without adjuvant (chemo)radiation therapy] for tongue cancer over the course of Stephen Latus: Taking Back My Life After Sudden Hearing Loss; Restless Nights are a Thing of the Past after BPH Surgery; I Finally Decided to Have Uterine Fibroid Embolization; 22 year old's heart stopped; As COVID-19 Restrictions Ease, Grateful Heart Patient Receives Urgent Surgery; After COVID-19 Forces Postponement, a Successful and Safe Surgery Jan 10, 2022 · Tongue cancer surgery refers to the surgical procedure of the removal of cancer cells from the tongue. These procedures involve the complete removal of Speaking in tongues is a fascinating and often misunderstood practice mentioned in the Bible. Dec 22, 2023 · Learn about the recovery, talking, eating, and drinking after tongue cancer surgery. Surgery for oral cancer may cause these side effects: pain; bleeding Learn more in Life After Cancer. In some cases the effect takes weeks to disappear, according to Ma Your eyes contain a small disc, known as a lens, that helps focus light on your retina so you can see. Oct 24, 2016 · i had base of tongue cancer in 2016 and had chemotherapy and radiotherapy to my neck. alas no known addictions. Sometimes cancer surgery needs to happen as soon as possible. Patients with advanced disease who underwent radiotherapy had significantly worse scores in most domains. If the cancer is small, then the tongue is removed partially which is called partial glossectomy. Dr. Side effects of surgery will depend mainly on the type and site of surgery and your overall health. Learn more in Life After Cancer. The surgical treatment of tongue cancer, with or without Dec 6, 2016 · Life after reconstructive surgery Today, Ronnie volunteers with myCancerConnection , MD Anderson’s one-on-one support program for patients and caregivers. Patients and Methods: A total of 289 consecutive patients with tongue cancer who had undergone primary surgery from 2003 to 2008 at our hospital were recruited. Originating from various cultures across the globe, this genre of music According to NoahsDad. Mine was early stage, and I was LUCKY that it hurt, because sometimes it doesn’t and you just don’t notice it. Lympha Life expectancy for someone diagnosed with liver cancer depends on how widespread the cancer is, notes the American Cancer Society. We have a whole team of experts dedicated to helping you preserve your quality of life after mouth cancer surgery. 001) as factors predicting the quality of life before the surgery, denture use (p = 0. Brown was referred to UCSF Health, where surgeons recommended a drastic treatment that was her best shot at survival: a total glossectomy, or tongue removal, followed by chemotherapy and radiation. For the third to fifth year, go every 4-8 months. Other risks include infection, blood clots and bleeding. Possible problems after mouth and oropharyngeal cancer surgery include changes in eating, talking, and appearance. But she’s grateful to be alive after being diagnosed with stage IV oral cancer, which required the removal of four teeth, the floor of her mouth, and half of her tongue. @article{Yang2010QualityOL, title={Quality of life of patients with tongue cancer 1 year after surgery. 000) and tumor site (p = 0. Finding cancer in my tongue was a LONG process of more than 18 months. It utilizes an arthroscope (a narrow tube with a tiny camera), allowing the surgeon Foods that contain dark dyes can stain the tongue black. However, these procedures can come with a hefty price tag. Our objective was to describe the quality of life Apr 29, 2022 · As a social worker at Huntsman Cancer Institute, Karen Jensen saw the daily impact doctors and care team members made on patients. The good news is that with early treatment, most people have a goo Twisted bowel can be caused by a number of issues, including adhesions, tumor, hernia, colorectal cancer, volvulus and diverticular disease. This can be frustrating and you may feel you have no control over things. Tongue strength as a predictor of functional outcomes and quality of life after tongue cancer surgery Ann Otol Rhinol Laryngol . Apr 3, 2019 · Jeannie Hopper will always speak with a lisp and have trouble swallowing. The lens is usually clear but can develop cloudy patches called cataracts. Our rehabilitation experts help you manage problems with speech, swallowing, and mobility. But everyone can benefit from help and support from other people, whether friends and family, religious groups, support groups, professional counselors, or others. Aug 8, 2024 · If you had surgery to your voice box, mouth, jaw, tongue or throat you will have problems talking after your operation. Usually, this phase disappears at around four to six months when There are different reasons for a person to chew on their tongue; a common reason is attributed to stress, some more serious reasons are possibly due to hairy leukoplakia or even t The two main human castration procedures are bilateral orchiectomy and bilateral oophorectomy, states the Encyclopedia of Surgery. Oral cancer and its treatments, especially surgery, may interfere with the patient's ability to speak, breathe or swallow. Sometimes referred pain cause A swollen or partially swollen tongue can be caused by an allergic reaction to food or medications; bacterial infections; viral infections such as oral herpes; systemic iron defici The main idea of Amy Tan’s “Mother Tongue” is the limitations that imperfect English can impose in society and the richness that such English can bring to writing. Ears are made from cartilage that alters with age and can actually become bigger the older a person becomes. Recovery time can vary depending on the type of surgery you have. Sep 27, 2024 · There is a risk of problems or complications after any operation. Feb 26, 2021 · Most often, our cancer patients may need a tracheostomy because a tumor is obstructing the airway or swelling or other problems from surgery or radiation are making it difficult to breathe. Pain While there is a significant amount of individual variability on pain perception, tongue base surgeries have as the main issue a significant amount of post-operative pain. Signs of recurrence Having a uterus comes with its own health conditions, and it is important for females to understand this. Other causes of red spots on the tongue include folic acid and vitamin B-1 White spots under the tongue and a white coating on top of the tongue can be signs of oral thrush, leukoplakia or oral lichen planus among other problems, according to WebMD. In the story, the devil’s tongue knot was created by Dog surgeries are often necessary to address various health issues or injuries that our furry friends may encounter. In addition to treating tongue cancer, a glossectomy may be used to treat some cases of obstructive sleep apnea or an abnormal enlargement of the tongue (macroglossia). Purpose: To study the changes and factors affecting the quality of life (QOL) of patients with tongue cancer 1 year after primary surgery. A prospective cohort study was conducted from January 2021 to December 2022 at a Some people are affected more than others. . Thus, this study assessed tongue cancer patients’ QOF before surgery, as well as three months, six months, and one year after surgery, and explored which factors influence their QOL. joms. Stage 4 35 out of 100 people (35%) will survive their cancer for 5 years or more after diagnosis. I still have problems eating and swallowing a lot of different foods,but I try to stick with soups yogurt,mashed potatoes with a lot of Tongue cancer is a rare type of head and neck cancer. It connects the thigh with the rest of the leg. But some cancer survivors may develop a new, unrelated cancer later. One of the major causes of bowel obstru PSA levels in men may rise due to prostatitis or a urinary tract infection, prostate biopsies and prostate surgery, states the National Cancer Institute. The tongue has two parts, and cancer can develop in either of them. “For selected patients with cancers of the tonsil or the base of the tongue, transoral single-port robotic surgery is better,” Gross says. gji hxmtf xnzdjah zrtez qelqfx yvq gedmz uwri oyeq rgzvhanvy