When they are too active, these glands cause high levels of calcium. As your remaining parathyroid glands begin to produce enough parathyroid hormone to account . The most important thing that I learnt about kids raising was that we can transform them, win them, only by loving them & listening to their feelings & concerns. $129.25 $ 129. I've had four FNA over the last 4/5 years for the nodules and all have come back fine, no cancer TG! Functionality: provides comfort to people suffering from thyroid & other autoimmune diseases in the neck & shoulders. I bought a neck pillow at a travel store but so far have not used it; I had a TT and neck dissection 6 days ago, and can't use it as it would hurt the area on the side where the incision is. At 6AM, I took a good shower with a toilet splash, but anyway, the water was hot & relaxing. Your surgeon will tell you when it is time to remove the drain. 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. After a very good shower, came the complicated unpacking protocol, because I put my clean clothes in doubled plastic bags packed with large tapes, then I did my best to not contaminate them with any radio-active containing stuff in order to avoid Iodine-imaging artifacts. Unfortunately there was no CNEP in Dwera, so I went to the Baba Hsen agency were they let me wait for more than one hour to tell me in the end that I had to return back tomorrow, I was disappointed & cancelled the request. Keep any fresh scars properly covered. I was worried about the u-shaped travel pillow hurting around the incision area like GiveMeStrength mentioned. 10 Best Pillow After Thyroid Surgery Reviews 01 Beckham Hotel Collection Bed Pillows for Sleeping - Queen Size, Set of 2 - Cooling, Luxury Gel Pillow for Back, Stomach or Side Sleepers Superior Comfort: Our cool pillow is encased in a 250-thread count cover, and filled with a soft down alternative. What happens to the neck after complete thryoid removal? IM injection of corticoids to relief the post-radiation inflammation, I told the nurse its my first IM injection since I was 10, I was a little bit contracted so he repeated the injection twice because the first one blew up, but OK, they were painless!! fever: Fever is not expected after thyroid surgery. I bought also an educational weekly newspaper that I spent the rest of the day reading & taking important notes from it, I will buy it regularly from now. I am trying to get things to prepare for recovery ahead of time! Well, I returned back reassured. Herpes sores blister, then burst, scab and heal. January 4th; 2014: Robotic surgery goes through the armpit and leaves no neck scar, but this . The other problem was my hands, they were freezing my body, I didnt know where to put them, they were a real burden to me, why didnt I bring my gloves? ), we should wait for this signature until 1PM, then the admission bulletin, I walked a lot & got tired this time, I imagine if I was alone with the heavy bags. It was a rest day. All this, was a short moment of painful doubt, that I over-passed the morning after. December 27, 2013 (Week-end): The Content on this Site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only. I will never forget the surgery that I underwent in the Debussy clinic seven weeks ago, right I did barely see the surgeon entering & asking the anesthetist (The patient is still awake?! Stephen Ornstein, D.C. has treated thousands of neck, shoulder and back conditions since graduating Sherman Chiropractic College in 1987 and during his involvement in Martial Arts. Your surgeon. There are several methods of thyroidectomy performed in hospitals nationwide. Keep track of the amount of fluid you empty each time. After & short & difficult night -because I slept between Sarah & Ali in the kids room & the mattresses were a little bit narrow, the (Iftah Ya Simsim ABC) song that I set yesterday as an alarm tone woke me up at 5AM, I waited for 10 minutes then woke up. Finally, I took my room, a very nice single one with a bathroom & a big window, two bed tables with shelving, a well compartmented closet & a very comfortable chair, the TV was in a shared area but with only 3 channels, two Algerian programs plus a kids channel!! If there is distant spread to other parts of the body (outside of the neck), it is called metastatic disease. The reasons: 1st of all, it holds the neck in a good position. Thyroid cancer, thyroid nodules and other conditions may require thyroidectomy. The gentleman generously agreed to let us reproduce his letter on this site, so that others in similar circumstances might benefit from it. I miss Sarah so much, Karima is telling me that shes behaving like a mature good girl, & she is showing me patience concerning my return day, but with a lot of enthusiasm. Recommendations ofr Buckwheat Neck Pillow? A medic asked me to join him for a chest X-ray, but hopefully on the way before reaching the elevator I had the reflex to tell him Is my last X-ray recent, October 22nd?, he said You should check this with your resident, I said Im gonna ask her right now, hold on, he said Its OK, well make another one as it was a favor or funny to undergo useless radiation, ha, I insisted, looked for my Doctor, didnt find her, so I asked the residents in their meeting room, they said no need to have another one, great! Hi, here is my story, I am a 57 yr old women and I had a large parathyroid tumor removed on Feb. 9, 2009. I felt like in Robinson Crusoes Island, or just after the storm, the day he found the wrecked ship & was desperately looked for any useful stuff. The water was totally tasteless, almost disgusting, but I was obliged to finish my 3 liter per day! Traditional thyroidectomies and parathyroidectomies leave a visible scar in the middle of the neck. I met the nuclear doctor; he immediately asked me to start the imaging. I preferred going there with a T-shirt (despite the cold), then the technician who complained from the fact that we were late put me comfortably on the table, & the gamma-camera started to capture. Traditionally, patients who undergoing thyroid surgeries are usually positioned with extended neck by using pillow under shoulder in order to facilitate neck exposure and make the surgery easier. I headed to Douera with Karima, very confident for the future. Your recovery will depend on why you had surgery, the type of surgery performed, and your previous activity level. These symptoms typically last for only a short time. What You Need to Know. A 2016 study shows that pillow height can effect the biomechanics of the head and neck complex affecting cranio-cervical pressure and cervical spine alignment. For a neck pillow, the ones with memory foam are too stiff for me. Hey, Houston, whats circular, over?? I asked a female resident to give me a bowel washing necessary tubes & saline serum, then the medic, without insistence, but he forgot. I went to my bed, I sent an SMS to mom asking her to implore God for me, turned off the phone, saw a documentary then deeply slept after returning on the phone back. I went then to downtown to see my sister who almost threw me her secondary residences keys through the cars window without stopping the car in another mafia scene. I had one lymp node removed and was uncomfortable sleeping (not to mention my stress level, so not sleeping well anyways!). I didnt know well the new highways & I missed many times the way to get into the Algiers highway, it took me around One hour & half to arrive to destination where surprisingly I quickly found a place where to park the car, just in front of the hospitals secondary gate. I will make this to come true! After your surgery, you may develop hypothyroidism. Many times, finding a pillow that allows a good nights sleep after neck surgery can be troublesome. Waw, I was close to ask her how her father was behaving with her to learn more from him, I wished if Sarah saw her, because this Doctor is a new good success example, congratulations Dr Hafsis father. The resident came & started questioning me about my diseases history, but she left when Dr Hammadi came, I told him that he really saved me by helping me with this military authorization, I hugged him, then he told me about his heavy work time & daily concerns. Find other members in this community to connect with. If a fever over 100 is present, please call the physician. I am typically a side sleeper and I was worried that this might . EPABO Contour Memory Foam Pillow 2. Vocal cord issues - The recurrent laryngeal nerve (which helps control your voice) runs very close to the thyroid gland and may be accidentally damaged during thyroid surgery. 10/20TSH 9.7/T4Free1.46/ T3Free2.1, swallowing & throat discomfort. The 5-year survival rate for metastatic papillary thyroid cancer is 76%. This is called hyperparathyroidism (say "hy-per-pair-uh-THY-royd-iz-um"). These changes are due to damage to the laryngeal nerves that supply your voice box (larynx) during surgery. Inside, bureaucracy, we needed to wait, then to sign an authorization from the same person who gave me the first one (!!! The night was quiet, with some bizarre nightmares, & lot of cold because the central air-conditioning was turned off in the RAI unit to avoid any nuclear contamination of the rest of the facility, they should supply the rooms at least with electrical heaters. Time to rush under-stairs to the nuclear medicine unit via a special door directly from the RAI unit, but in the stairs I told the nurse that I have to return back to bring my grapefruit-lemon juice from the medics room fridge to my room, so I returned back & went to the endocrinology service, medics were worried Hey, did you take the pill, what the hell are you doing here?, it was funny to scare them. I also managed to put my entire luggage in the garage first then take stuff carefully one by one to the floor after a deep cleaning. On my way back to Dwera, I felt the power of this love & the confidence that left on me, I was happy & optimistic about the future. Well, time to take some cash with the checks that Karima brought me. Lolabean :) FormerMember over 7 years ago in reply to FormerMember Thank you for this tip! I was thinking to stay in the house today, but I needed salt & more water, I am drinking almost 4 liters a day to eliminate any residual radioactivity before my wife comes in a couple of days. She had mentioned that she had fusion surgery some time ago and was trying to get some relief. Customer reviews and photos may be available to help you make the right purchase decision! The most common methods include: removal of the thyroid lobe, removal of most of the thyroid gland, and removal of the entire thyroid gland. Use either a transparent powder or find a powder that matches your skin tone. Maybe I can use on eof those once I am healed a little more. Ultralife is the ultimate pillow for people suffering from thyroid & other autoimmune diseases. Answer: Skin laxity after thyroid surgery You should wait at least 6 months after surgery to see how much would neck skin retract. 1. Could not use a pillow to sleep much. Show time, I refused to ask any question, but this time I did not forget to remove my T-shirt. While your neck is sore you may find that you need to eat foods that are soft and easy to swallow. Dr Nacer-Khodja was not there, another resident replaced him, he was hurried & asked us if we knew the procedure, if you know so lets go, he didnt even know I was a dermatologist, anyway he was kind & correct, he asked a medic to finish the dirty job, there was no water, so I returned back to the room to bring it, he started with the women the me & Yunes, I had to drop the pill (which was not big for a 100mCi!!) It would be best if you always used pillows to elevate your neck while sleeping after thyroid surgery. One in particular is the therapeutic pillow. All this, I am conscious that it may happened, & I pay a deep respect to all this work. My struggle against constipation started to pay finally, anyway the medic came around 9AM to propose me bowel cleansing material, it was not difficult, but the saline went away almost as clean as it entered, maybe because I forgot to shake it to mix the paraffin oil, anyway I left around 100 cc full with paraffin oil for another session later. More comfort is always welcome, because reading in the bed was not easy for a long period. This is often the case with a fusion type of surgery. 45D Memory Foam Post-Surgery Pillows for Back, Neck, Head, Shoulders Support & More - Ergonomic. The crowd quickly increased, hopefully we arrived early, a faked young blind even tried to cheat & take my place, no way!! While this may provide a solution for symptoms, too often, neck problems persist. Were my radiations unusually high for him? He holds certifications as a Peer Review Consultant from New York Chiropractic College, Physiological Therapeutics from National Chiropractic College, Modic Antibiotic Spinal Therapy from Dr. Hanne Albert, PT., MPH., Ph.D., Myofascial Release Techniques from Logan Chiropractic College, and learned Active Release Technique from the founder, P. Michael Leahy, DC, ART, CCSP. Quick Navigation 1. 5 Months after parathyroid surgery. December 25; 2013: You will have pain in the neck area, but medicine will help. It usually takes at least two weeks for the throat to heal after thyroid surgery. I was diagnosed with Hashimoto's a year ago this month. I woke up around sunset (not good for someone who wants to have a good sleepy night), chatted with Yunes, and checked my pace-meter which showed zero. But why he did not take any precaution in the beginning, he even shook my hand before the imaging & then changed his attitude later? Thank you all, that make's me feel a little better about the surgery. I spent the rest of the day reading the educational book. <>>>
Water sculpts mountains, transports billions of cubic meters of Ethiopian soil to Egypt every year on its way DOWN. #,OuLjRhbTwZF'! Or did I fix better than the others because I was under a strict iodine-free diet? You may also feel like you have phlegm in your throat and need to cough. I returned to my endo in Nov for my six month checkup and had another scan which revealed two new nodules, the largest 2.5cm, it is located directly behind the 2.6cm one which was aspirated previously. She said not well and did have problems finding a pillow that worked. I asked him what if that circular thing was lymphatic. This means that I will put my sister & wifes health in danger if they come to pick me up, so I called my wife to ask her to cancel everything & that I will go to a hotel by myself then to my sisters empty house tomorrow morning. As soon I returned back to the unit the phone rang, I answered to tell them I was coming. During the exam that lasted 30 minutes, I regretted to not stay only with a short, so the images will be as best as possible, it was too late anyway. A relative indication for thyroidectomy is the finding of metastatic thyroid disease in neck nodes without an obvious thyroid mass. The decision to perform thyroid surgery in this setting depends on the clinical situation under which the metastatic disease was found. Many thanks in advance. Abstract Introduction: Thyroid surgery is a popular and effective treatment for many thyroid diseases, including thyroid cancer. After thyroid surgery, expect mild swelling in the neck. Another cold night starting from 2AM, the cold is really posing me a big discomfort, even with 2 jackets & two blankets, added to recurrent constipation that retains radioactive waste in my bowel. This is not documented in any reference, why one month? December 28, 2013: Can anyone suggest an online store? But, advancements in endocrine surgery at Johns Hopkins allow our surgeons to provide a scarless alternative to this procedure. Lunch time, with spicy rice & a big piece of good fish that I did not eat (after a long hesitation). January 6; 2014: Apply small dots of concealer across the scar, and use a finger to dab it against your skin. Suddenly, around 10PM, just after watching a Predator-Alien remix movie with Yunes in the hall, I remembered the day when I saw my histopathology report, the doctor (who is specialized in thyroid histology) told me that it was great, that the thyroid capsule was intact & that all the 15 lymph nodes were not infiltrated, but when I saw the detailed report, I immediately remembered what my daddy always repeated The devil is in the details, yes the thyroid capsule was correct but the tumorals one was not, & there was also one image of angio-invasion which really frightened me & forced for a few seconds some tears out of my eyes. My thyroid was growing towards the back and down. During this time, it is important to eat soft foods, drink plenty of fluids, and avoid smoking and other activities that can irritate the throat. Milemont Memory Foam Pillow 3. All in go for it. I took my first cup of coffee & milk with cookies since weeks, made a competition with Yunes (who drinks more water? The circumstances I am passing through this time offered me finally the time that I was desperately needing, & I am very thankful for this because I feel that my life will dramatically change to the best. Parathyroidectomy is the removal of one or more of the four parathyroid glands in the neck. The Annual International Thyroid Cancer Survivors' Conference and Regional Workshops. After total thyroidectomh, the client requries lifelong thryoid homrone replacement therapy. Ali is talking on the phone like a big boy now, very fluent & confident, I really miss him a lot. Elevating the head of your bed by 40 degrees can also help reduce swelling and inflammation. ), chatted with him in front of TV all the morning, I finally started to feel a vacation-like time, I even forgot that I have two crucial tests that will dramatically determine my future, scintigraphy-scan & Thyroglobulin. 4.2 out of 5 stars 164. A hemi-thyroidectomy or thyroid lobectomy - where one lobe (one half) of the thyroid is removed; An isthmusectomy - removal of just the bridge of thyroid tissue between the two lobes; used specifically for small tumors that are located in the isthmus. However, that information will still be included in details such as numbers of replies. We returned back to BEZ where I put her around 200 meters from the house, it was before sunset & those 200 meters looked to me later unsafe for her, so immediately I felt guilty & tried to return back to pick her up again, but when I called her she was already near our buildings gate, I apologized, & felt that I just .love her. My constipation got better, my next door military patient told me to do the duck walking exercise to ease the transit, I made 3 go & back but quickly got my thigh muscles hurting. There may be a . Without a drain, patients may notice mild swelling which the body will eventually absorb. The typical incision made for thyroid surgery is known as a "collar incision" in which a large incision (around 5 to 6 inches) is made stretching from one side of the neck to the other just above the collar bone. Best overall: ZAMAT Contour Memory Foam Pillow for Neck Pain Relief. I'm not petite but not huge either and my neck still has that "full" feeling in some spots and i'm 17 months post op. Forias Wedge Pillows Set for Sleeping Bed Wedge Pillow for After Surgery 9&12 Inch Adjustable Triangle Pillow Wedge with Premium Half-Moon Memory Foam Bolster Pillow for Acid Reflux Gerd Snore Relax . Reply Share React TRibeiro Jan 31, 2020 1:07 PM So, while there is no one pillow that will help everybody and no neck surgery pillow, the therapeutic pillow gets a big vote here. I made my bed, put everything in its right place after cleaning all the surfaces with antiseptics then finally took my first meal of the day, three apples. We are so happy it has made a difference and there could be no greater reward for us than your generous remarks and to hear how pleased you are with your wifes response to our product. Are you sure you want to block this member? %
Best Sale: Elviros Cervical Pillow, Memory Foam Bed Pillows for Neck Pain Relief. My thyroid was removed due to papillary cancer in April 2008. You may experience temporary changes to your voice, including hoarseness, which generally improves within the first month after your surgery. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>>
Sure the limit between austerity & tightness is tight, but wasting is not one of my moral values. Reducing scar tissue is important as it is super annoying, when you can "feel" it in certain positions. x\[o~7Ra
iOqIhX+v_Y$ The brand I decided on was Victorinox, and it comes in its own black drawstring bag. Did they mean me? When I talked to the guy, he asked me to return back to Gamma-camera unit for a Static image!! Elvis is a cervical pillow with memory foam and cooling gel infused to relieve neck pain. It supported my head and gave my neck muscles a rest without having to worry about pulling anything. It is important to limit your neck movement for one to three weeks after your thyroid surgery. First morning in this house, my muscles were very hurting because of yesterdays efforts & the luggage weight. Didn't find the answer you were looking for? 4 0 obj
Before throwing the used aluminum paper (which was just lightly colored with sauce, I imagined what would Robinson Crusoe do if he found a used aluminum paper, sure he would clean it & keep it for another day, & so I did, why should I throw something while its still reusable? One can use cold packs to relieve pain at the site of the incision. I hesitated whether I take the money from Baba Hsen CNEP agency then buy the TV from Dwera or go to the Maissoniers one the the TV from Hamiz, to save some extra-expenses!! I had the TT done & now you can't even tell I ever had any kind of surger. When I woke up, I found my coffee-milk on the table (Yunes put it), but it was already cold. )-hx2B,M4H&lcpaeGt?~;kq*C
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|zZHI|tz@. 14 Months After Thyroidectomy. 3. So unnoticable to the average person, it was very frustrating when my doctor was always on the fence acting as if it were not abnormal. Finally, I headed to my temporary refuge which is situated around 30 kms from the capital. Kind Regards Geraldine (Geri) Hamilton Or maybe it was just a favor treatment to me because I am a Doctor & they wanted to scan me more carefully. I thought I was the first to wake up for the crucial pre-imaging shower, but disappointedly I was the last one, I cleaned first the bath-room with soap & a brush, unpacked the cleaning toilet bag then slipped because wanted to start foaming quickly (hopefully without injuries). Your thyroid gland makes hormones that control your metabolism, body temperature, and heart rate. Just go to Google Images and put in "bedlounge" and you'll see what I mean. I went to BEZ to pick up Karima, & thank God she was very late, because while I was waiting in the car, I pushed to the edge my internet researches on Samys condition (a thing I was doing unsuccessfully since years), but this time it worked, I found the name of the disease, only one article was talking about it & fully explaining the treatment modalities, its called Gerlach or Eustachian tonsils, treated by Laser Diode. Total thyroidectomy may be perfomred for certain types of thyroid cancers. During night, I thought about the Brazil trip, I will not give up this project this time because the kids grew up quickly, a Brazil tour during the world cup with Samy & Sarah will be just .. great. Many of the neck pillows I looked at seemed small to me, as far as the opening goes. I have all the symptoms for hypo yet my tsh level is .724, my T4,Free(Direct) 1.11 0.82-1.77 ng/dL (don't know what the T4 level means yet as I don't see my endo until Jan 7 for another FNA of the new nodules). endobj
. UTTU Sandwich Pillow 5. The risks and recovery times associated with surgery vary. It was a very windy night, I even thought that someone irrupted into the house, so I took a wooden bar (the one used to press cookies pasta) & inspected the whole house, & finding the garages inside door open was not reassuring because I remember that I locked it. Pn9/@RHw\F7F).z^t6qmk\[Ry)&:r6{[;12+W;5Rl@|CFzB^ if;Qeh;a]e]O[r
w{>) K}Rx((- +pKP-1X"LkJ o Back to my bed, feeling sick, my ENT friend called me to check if I was OK, he told me that will be under 175 mg of Levothyrox, I asked him if I can continue sport normally, he told me that if I make rough physical efforts like in tennis I will feel very tired the rest of the day, & that really depressed me. This is normal to experience after surgery and will often last up to 5 days after surgery. Friday, so did nothing, except finishing my favorite book, which was very important to me. I asked my wife to bring me some stuff (especially woolen gloves & an extra-jacket), but it was her weekly working day during the first week of university vacations, so I called my sister to bring them, when I called back my wife to tell her that my sister was coming home to take the shipment, she couldnt answer because she was driving, but she managed meanwhile to send her brother who was very happy to see me in a cage like a leprous patient, we already arranged to not tell anyone else about this story, & what happened really pissed me off because it was a direct medical secret violation!! This operation may be done to treat a number of diseases and conditions, including thyroid cancer, symptomatic goiter, or a thyroid gland that is producing excessive thyroid hormone ( hyperthyroidism ). So I crushed up my pills at first, and mixed them in some pudding. 2~ey)E#V|~},>>=4x/E~[lR|g,T"1dJl$o~p}w~MEdHb-T\?M(-mL=?-dRY$-E|oz7ILfUe(Qs3n^/lhV)1 2..1*&|,0^Xkoqve cd?q
YqwAwexdlc>a neck pillow was also helpful with me, as well as neck exercises and massages to break up and prevent scar tissue formation. Actually, getting the pain pills down was a bit tricky because swallowing was a complete bummer, thanks to the double-whammy of: Having a tube stuck down my throat during surgery. Details like health status, age, weight, condition of mattresses, pre-existing conditions and comorbid conditions (other existing health problems) all play a role. I purchased one of your neck pillows for her; order number -. December 30th, 2013: Wow, wow, wow, wow, the What is What? January 3rd; 2014: My neck was huge and i was choking. No running water in the afternoon, so I checked the 2 water tanks in the roof but they were empty, hopefully I already managed to save enough water to rinse & wash the toilet seat after every use. The nodules are on both sides it will have to be a TT. He referred me t Any help with ultrasound report appreciated. 25 . This pillow has many years of providing relief; from helping to restore the natural curve in the neck, relief from neck pain symptoms like stiff muscles and headaches, to helping with more serious conditions like advanced arthritis and pinched nerve symptoms that cause neck, shoulder and arm problems. I woke up at 5AM with a huge hunger of writing in Arabic on Middle-East & other international issues, & on my big surprise, I discovered that I was not bad at all in journalism, the ideas came & transform fluently onto words, plus my draft writing was almost identical to my daddys one!! WHERE WILL THE INCISION BE? If this occurs, your doctor will prescribe some form of levothyroxine to help bring your hormone levels into balance. I brought tons of drinks and snacks so that I could be self sufficient. This is frustrating and expensive. After thyroid lobectomy: Approximately 50-75% of patients will not need hormone replacement. After thyroidectomy, some people may experience neck pain and a hoarse or weak voice. However the only thing is, probably since my surgery was huge - i may have some scar tissue. I would love to get one of those buckwheat filled pillows, but unless I make a special shopping trip tomorrow while toting around my two kids, I won't have it before surgery on Thursday. Neck Pillow Recommendations - Thyroid cancer Inspire Thyroid Cancer Connect Papillary and follicular thyroid cancer (differentiated) Thyroid Cancer Connect Thyroid cancer support group and discussion community ThyCa Website Support Services Conference Donate Join Inspire Create a post Neck Pillow Recommendations RayeRaye Aug 29, 2011 10:45 AM In the morning, I maintained the hard diet (no breakfast except an apple), the lunch was a very good smelling fish that I did not take of course, but I was sadly looking at the other patient eating his fish because the policy here was that the iodine-free diet was useless even the fish, he was told to eat anything because iodine is volatile when exposed to air & especially when cooked, maybe they were right, the thing that I was sure is that if I asked him to not eat fish he will create a scandal & his iodine will be canceled. This community is sponsored by ThyCa: Thyroid Cancer Survivors' Association, an Inspire trusted partner. If skin is not sufficiently retracted after 6 months, anterior neck lift or lower face/neck lift should be a consideration. I decided to continue my diet, so I took only some nuts & juice, then .. I returned back there, frightened, they asked me to wait in the corridor, I waited for half an hour during while I thought about all the possibilities.
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