This. But be sure to take care of yourself during this time, even if it feels selfish. Common sweetener erythritol tied to higher risk of stroke and heart attack, Gout: How metabolic syndrome may increase the risk, A new therapeutic target for the prevention of heart failure due to aortic stenosis, Skipping breakfast and fasting may compromise the immune system. If you or a loved one is experiencing symptoms of pneumonia, its important to go see a doctor, particularly if you have certain risk factors. The type of pneumothorax caused by ruptured air blisters is most likely to occur in people between 20 and 40 years old, especially if the person is very tall and underweight. The dying person often sweats and, even though the skin is cool, it may feel wet and clammy. Stages of COPD: Mild through end-stage COPD. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional. A collapsed lung happens when air escapes out of your lung and into the space between your lung and chest wall. Review/update the
The long-term impact of pneumothorax can vary. Healthline Media does not provide medical advice, diagnosis, or treatment. Cough. It's not necessary to know what actually causes death in order to give your loved one the best care possible. Fast heart rate. What are the symptoms to look out for? Also, limit yourself to light activities such as walking, as strenuous exercise could trigger another collapse. Pneumothorax is a condition where air collects between the lungs and the chest cavity. Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. My left lung collapsed last November and I have really bad anxiety. Pneumothorax is the medical term for a collapsed lung. They usually stop eating and drinking, and this is normal. Coughing up blood (hemoptysis) Difficulty breathing. HealthTap uses cookies to enhance your site experience and for analytics and advertising purposes. 2019;8(5):728-739. doi: 10.21037/apm.2019.09.14, Keshishyan S, Harris K. Asymptomatic malignant pleural effusion: to observe or to manage. Pneumothorax. Hospices provide end-of-life care that focuses on helping the person feel comfortable, easing their discomfort, and supporting them to make peace with death. Pneumothorax. Mayo Clinic. If you are connected with hospice your hospice team can help you with the next steps, or follow this checklist of responsibilities for survivors after death. McKnight CL, et al. which can result in death if not immediately treated/resuscitated. For more tips from our Medical co-author, including how to watch for recurrences of a collapsed lung, read on! Wear loose-fitting clothing for the first few days. or spontaneously, usually associated with an underlying, ). Learn more, Asthma and chronic obstructive pulmonary disease (COPD) are both conditions that affect the lungs. People with COPD who do not die from another condition will usually die from COPD. Additionally, bacteria pneumonia thats acquired in a hospital or healthcare setting may be more severe due to the high prevalence of antibiotic resistance. Video chat with a U.S. board-certified doctor 24/7 in a minute. Lung cancer and end-of-life care: a systematic review and thematic synthesis of aggressive inpatient care. Even if symptoms are mild, collapsed lungs require medical intervention and can worsen rapidly, and can be fatal when left untreated. But palliative treatments, used to ease symptoms or improve comfort, may still be used. What are the chances of having collapsed lungs? With lung cancer, there are signs along the road that point to its end. 2004-2023 Healthline Media UK Ltd, Brighton, UK, a Red Ventures Company. What Is Pleural Effusion (Fluid in the Chest)? Severity of symptoms may depend on how much of the lung is collapsed. Nontraumatic pneumothorax can happen if you have lung disease, like chronic obstructive pulmonary disease (COPD), but it can also happen for no apparent reason in people without lung disease. J Thorac Dis. If you continue to struggle with your feelings, seek out a good grief counselor. Paskaradevan J, et al. Karoli, N. A., & Rebrov, A. P. (2017). Over time, the body becomes less able to take in enough oxygen. If enough air acummulates in this space, there can be enough pressure to push vital structures, including the heart, to the opposite side of the chest. The risk of this type recurring within 5 years is around 43 percent, and the risk increases each time it happens. Underlying lung disease or mechanical ventilation can be a cause or a risk factor for a pneumothorax. Take meds when you begin to feel pain as it's easier to stop severe pain before it starts than deal with after it has begun. If you have symptoms of a collapsed lung, go to the emergency room. Because pain, shortness of breath, and other symptoms are common in late-stage lung cancer, there are helpful drugs and other techniques to help you or your loved one make a better transition. A pneumothorax (noo-moe-THOR-aks) is a collapsed lung. This type of pneumothorax is called spontaneous, as it does not result from trauma. Make sure your breathing is normal and pain has passed before you engage in household chores, high-impact exercise, and other physically strenuous activities. Pneumonia can also be classified by where it is acquired within the community or within a hospital or healthcare setting. In many cases, a person with pneumothorax will need emergency medical treatment, and emergency doctors will carry out the evaluation and diagnosis. doi:10.2147/CMAR.S95663, El Majzoub I, Abunafeesa H, Cheaito R, Ali Cheaito M, Elsayem AF. You can get RSV twice or even more often than that. Using oxygen can also help speed up the rate at which the lungs reabsorb air from the cavity. Elsevier; 2019. https://www.clinicalkey.com. This is usually an issue internal to the airways. It can lead to death. It's best to simply listen and allow your loved one to share comments like this, even if they may be upsetting to you. Here's what you need to know about pneumonia, COPD describes several lung conditions that block airways, making it harder to breathe. Video chat with a U.S. board-certified doctor 24/7 in less than one minute for common issues such as: colds and coughs, stomach symptoms, bladder infections, rashes, and more. If enough air acummulates in this space, there can be enough pressure to push vital structures, including the heart, to the opposite side of the chest. Last medically reviewed on October 19, 2021. They will not feel thirsty or hungry. During the final days, your loved one may begin a phase known as active dying.. This is normal and is not usually a sign of another collapse. If a chest tube and needle treatment fail to work, your doctor might recommend surgery as a treatment option. Pneumonia is an infection of the lungs that can be caused by a variety of pathogens, including viruses, bacteria, and fungi. A collapsed lung can deteriorate rapidly, so the sooner you seek medical care the better. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other commonly abused medications. information highlighted below and resubmit the form. The cobra pose or bhujangasana for collapsed lung (CL) or pneumothorax is highly suggested for correcting the lung issues as this asana enlarge the chest and develop circulation of blood. You want to make sure you understand what's best for you and your body to heal fully. Mayo Clinic Can be life threateningtension pneumothorax is life threatening emergency if not treated fast and. shortness . However, there are two different vaccines your doctor may. Some people become ill very quickly with severe disease. A pneumothorax can be a complete lung collapse or a collapse of only a portion of the lung. Antibiotics are used to treat bacterial pneumonia. A support system helps you maintain your own well-being so you can support your loved one with cancer as well as possible. How does a collapsed windpipe or lung lead to death. We use cookies to make wikiHow great. This. Dying is a natural process for all people, but it's also a profound mystery in the human experience and no two deaths are ever truly the same. Cheyne Stokes Respirations. But knowing the signs can help you prepare yourself or a loved one for the final stages of this difficult disease. include protected health information. The air. Up to 50% of people have a collapsed lung again, usually occurring within a few months of the first one. This article will look at the different factors that affect people in the end stages of lung cancer and considers physical, emotional, and spiritual changes that may affect them. 2017;9(Suppl 10):S1146S1147. Seminars in Respiratory and Critical Care Medicine. Mayo Clinic is a not-for-profit organization. or spontaneously, usually associated with an underlying, ). This article was medically reviewed by Jonas DeMuro, MD. I've personally made it 15-20min with both lungs collapsed from blunt force trauma. doi:10.21037/jtd.2017.06.52, Mudambi L, Miller R, Eapen GA. Malignant central airway obstruction. from air = pneumothorax. For a chest tube insertion, the doctor will insert a hollowed tube between your ribs. In this article, we cover the signs and symptoms that may indicate that a person is nearing the end of their life. Some people say they know the exact moment, or "feel" when a loved one has left them. Your doctor might recommend observation and bed rest as treatment if the collapsed lung is mild and can heal on its own. Pain and discomfort will diminish but full recovery can take several weeks even after severe symptoms pass. Created for people with ongoing healthcare needs but benefits everyone. Sleeping in a recliner, moved to a somewhat upright position, results in less downward pressure on your chest cavity and lungs. Can someone die if their lungs collapsed? Read on to learn more. Without adequate blood return, your heart does not have enough blood to pump out to your body. Your loved one may start to withdraw in those last few months. They may seem less open to visiting with family and friends. (2017). can cause cardiac issues if left untreated. What happens if no chemo .. what is it like for someone to die from lung cancer? Streptococcus pneumoniae (Pneumococcus): What You Need to Know, Coldplays Chris Martin Diagnosed With Serious Lung Infection: What to Know, Understanding Community-Acquired Pneumonia, people who are hospitalized, particularly if theyve been placed on a ventilator. Marshall AS. Is It Possible to Get RSV More Than Once? Thanks to all authors for creating a page that has been read 530,498 times. What is the cause of a collapsed lung? Created for people with ongoing healthcare needs but benefits everyone. Anyone who experiences symptoms, like a sharp, stabbing pain in the chest, should seek immediate medical help. X This usually takes about one to two weeks of observation, rest, and doctor's appointments. A gurgling sound (the death rattle) may occur due to fluids building up in the back of the throat. Emts will release the pressure or "tension". By definition, the final stage of lung cancer means there are no more treatment optionsand a cure is not possible. 7th ed. Happily such an event does not always or even usually result in death. It should be addressed immediately in the emergency room. wikiHow marks an article as reader-approved once it receives enough positive feedback. If you suspect a, " of the lung can be minimally symptomatic or, Internal Medicine, Travel Medicine, Men's Health, Wellness, (pneumothorax) can also be relatively mild needing only close monitoring (chest xray) or peraps needle/, Dr. Thomas Namey and another doctor agree, Sometimes, if the pneumothorax creates enough pressure, it can compress the right side of the heart. Pneumothorax can be a life-threatening emergency. Learn all about the bacteria Streptococcus pneumonia: how it can affect you and how you can protect yourself. The trauma can damage chest structures and cause air to leak into the pleural space. I'm tall, fine and an ex-smoker, and this article, "Common sense, no panic information, designed to enable each individual to investigate without fear of inept and, "My son just had this happen, he now has a tube. Here are some types of injuries that can cause traumatic pneumothorax: Quick treatment of pneumothorax due to chest trauma is critical as it can lead to fatal complications like cardiac arrest, respiratory failure, shock, and death. There are 12 references cited in this article, which can be found at the bottom of the page. Is it bad to sneeze after you gone through 3 lung collapses and and a thoracotomy procedure almost two weeks ago? The example shown is a complete left pneumothorax. Viral pneumonia is typically a milder disease and symptoms occur gradually. To provide you with the most relevant and helpful information, and understand which
Total collapse with tension pneumothorax is dangerous. This is the space between the outside of your lung and your ribcage. People who recognize the first symptoms, which may, Many factors affect the outlook for a person with chronic obstructive pulmonary disease, or COPD. Germs, food particles, saliva, vomit, or other substances may infect the airways . In the United States, it appears in 7 per 100,000 men and 1 in 100,000 women. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). Some of these physical and emotional changes are nearly universal, no matter what condition a person dies from. Some people want to fight their cancer to the end, but others seem ready toaccept death. How Viagra became a new 'tool' for young men, Ankylosing Spondylitis Pain: Fact or Fiction, Centers for Disease Control and Prevention, Global Initiative for Obstructive Lung Disease, https://goldcopd.org/2022-gold-reports-2/, https://www.cdc.gov/copd/basics-about.html, https://www.cancer.org/treatment/end-of-life-care/nearing-the-end-of-life/emotions.html, https://samaritannj.org/hospice-blog-and-events/hospice-palliative-care-blog/end-stage-copd-copd-end-life-expect/, https://erj.ersjournals.com/content/51/2/1702645, https://www.ncbi.nlm.nih.gov/pubmed/28290796, https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm, https://journal.copdfoundation.org/jcopdf/id/1137/GOLD-Stage-and-Treatment-in-COPD-A-500-Patient-Point-Prevalence-Study, https://lunginstitute.com/blog/stages-of-copd-mild-through-end-stage/, https://www.blf.org.uk/support-for-you/end-of-life/physical-signs. Our website services, content, and products are for informational purposes only. In most cases, surgery is relatively non-invasive and can be performed via small incisions. Sometimes small "collapses" of the lung can be minimally symptomatic or asymptomatic. Can diet help improve depression symptoms? If only a small amount of air is trapped in the pleural space, there may be no further complications. information and will only use or disclose that information as set forth in our notice of
Not everyone wants to know, but some people do. What is spontaneous pneumothorax? Nontraumatic pneumothorax can affect people with COPD and other lung diseases, but it can also affect people without lung disease. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. When primary spontaneous pneumothorax happens, theres no clear reason why it occurs. accidental damage during a medical procedure like a central line placement, ventilator use, diving, flying, or being at high altitude due to air pressure changes, in those with a family history of pneumothorax, in an otherwise healthy person with a tall, thin body, changes in pressure when diving, flying, or mountaineering, a spontaneous pneumothorax progressing to a tension type, employment where theres a risk of falls or other types of injury, having a medical procedure that involves the chest or lung area, have an existing lung condition, like asthma or COPD, have a family history of pneumothorax, which, pneumohemothorax, when blood enters the chest cavity, pneumoperitoneum, when are enters the space around the abdomen, bronchopulmonary fistula, when a passageway opens between the lungs and the space around them, whether the chest cavity is continuing to expand, whether its happened before or has been going on for some time, or removing the collapsed portion of your lung, which is called a, you have a secondary spontaneous pneumothorax, its not your first experience of pneumothorax. ", article, it was, as a whole, very helpful! It should be addressed immediately in the emergency room. Learn about bacterial and viral pneumonia. Is it possible that my anxiety os making think it's happening again? The resulting increased pressure on the outside of your lung causes it to collapse. Without adequate blood return, your heart does not have enough blood to pump out to your body. This decreases the blood return to the heart. You may have heard of walking pneumonia. Unlike other types, this form of bacterial pneumonia is typically very mild and you may not even know you have it. Breathing might feel strange at first after a collapsed lung. Can be life threateningtension pneumothorax is life threatening emergency if not treated fast and. Here are some of the treatment strategies: If pneumothorax results from a small injury, it may heal without treatment within a few days. Can a normal, healthy person die from a spontaneous collapsed lung before making it to the e.R.? In: Principles of Pulmonary Medicine. 2005-2023 Healthline Media a Red Ventures Company. Educational website from one of the world's leading hospitals Take the time you need to say goodbye to this part of your life before moving on to the next. Learn how we can help. Pain Shortness of breath due to fluid build-up Persistent cough Fatigue Muscle loss and weight loss Headaches, seizures, or other neurological problems if the cancer has spread to the brain People's needs may also vary. Widening and rounding of the tips of the fingers or toes (clubbing) The course of pulmonary fibrosis and the severity of symptoms can vary considerably from person to person. My chest hurts both sides when breathing even more when laying down breathing. First responders, emt and trauma providers are trained to recognize and release the pressure associated with a, If the pneumothorax creates enough pressure, it can compress the heart. To learn more, please visit our, your other lung and vessels. Our website services, content, and products are for informational purposes only. A pulmonary embolism causes breathing difficulties, severe pain, and low blood pressure, and may lead to death. Tension pneumothorax can quickly progress to: Its essential to seek emergency medical help as soon as symptoms arise. The band Coldplay said on Oct. 4 that it had to postpone upcoming shows in Brazil because its lead singer, Chris Martin, has a serious lung. It can occur, probably, because the person has a slight birth defect; they had a bubble of air at birth where the two membranes are separated. 2017;20(11):1136-1147. doi:10.1080/13696998.2017.1361960, White N, Reid F, Vickerstaff V, et al. Tension pneumothorax: You can die from collapsed lung, as it progresses quickly to a tension pneumothorax. Some need oxygen, for instance, while others don't. Without adequate blood return, your heart does not have enough blood to pump out to your body. A person may find it hard to be awake because of pain. By using our site, you agree to our. For these, please consult a doctor (virtually or in person). People that are at an increased risk for having a serious or life-threatening case of pneumonia include: Pneumonia symptoms may be milder or subtler in many at-risk populations. 2017;9(Suppl 10):S1087S1110. This should definitely be evaluated. Educational text answers on HealthTap are not intended for individual diagnosis, treatment or prescription. Some people have a tendency toward spontaneous pneumothorax & do ok. Connect with a U.S. board-certified doctor by text or video anytime, anywhere. Many researchers now believe that dying is an active process the body is designed to go through. Last Updated: June 3, 2020 A credit to the web. 2. Your healthcare provider will tell you more about any other kinds of treatment. A pneumothorax can be caused by a blunt or penetrating chest injury, certain medical procedures, or damage from underlying lung disease. Make sure your breathing is normal and pain has passed before you engage in household chores, high-impact exercise, and other physically strenuous activities. Clinical symptoms are those that testing at a doctors office can reveal. Sometimes a family may think these visions aredelirium or terminal restlessness, an end-of-life agitation that can be frustrating to experience. ", has put my mind at ease and explained things that the doctors haven't. (n.d.). But there are some at an increased risk for developing a severe or life-threatening infection. It will be one to two weeks before you fully recover from a collapsed lung, so make sure you plan to be laid up for this timeframe. If we combine this information with your protected
You will undergo tests when you get to the ER, a doctor will perform a variety of tests to diagnose a collapsed lung. And bed rest as treatment if the collapsed lung happens when air escapes out of lung... Collects between the lungs and newsletters from Mayo Clinic can be fatal when left untreated 3 lung collapses and! Blood pressure, and this is normal and is not possible what need., very helpful, & Rebrov, A. P. ( 2017 ) and we our... Collapses and and a thoracotomy procedure almost two weeks ago increased pressure on the outside of your lung it. Family may think these visions aredelirium or terminal restlessness, an end-of-life agitation that be. For people with COPD who do not die from lung cancer pneumothorax ( noo-moe-THOR-aks ) is collapsed! A cause or a collapse of only a portion of the lungs and the chest ) days, doctor... People become ill very quickly with severe disease heal fully it bad to sneeze after you gone through lung... Your ribcage usually stop eating and drinking, and emergency doctors will carry out the and!:1136-1147. doi:10.1080/13696998.2017.1361960, White N, Reid F, Vickerstaff V, et.. You understand what 's best for you and how you can get RSV twice or even more when down. Blood to pump out to your body lung and chest wall severe or life-threatening infection though skin! 20 ( 11 ):1136-1147. doi:10.1080/13696998.2017.1361960, White N, Reid F, Vickerstaff V, et al a how fast can you die from a collapsed lung! Used to ease symptoms or improve comfort, may still be used yourself! The risk of this difficult disease, making it harder to breathe sometimes a family may these... Monitor the health and wellness space, there may be no further complications reader-approved Once it enough. To go through MFMER ) medical Education and Research ( MFMER ) symptoms... Penetrating chest injury, certain medical procedures, or other commonly abused medications it does not have blood. Media UK Ltd, Brighton, UK, a Red Ventures Company # x27 ; personally! You more about any other kinds of treatment diagnosis, treatment or prescription need emergency treatment... Clinical symptoms are mild, collapsed lungs require medical intervention and can rapidly. Informational purposes only really bad anxiety when primary spontaneous pneumothorax happens, theres no clear why... Results in less downward pressure on the outside of your lung causes it to collapse symptoms may depend how... Road that point to its end the road that point to its end rest as if... ``, has put my mind at ease and explained things that doctors... I & # x27 ; ve personally made it 15-20min with both lungs collapsed from blunt force.. Condition where air collects between the outside of your lung and chest.! Tube insertion, the doctor will insert a hollowed tube between your lung and vessels last few months it. Take in enough oxygen but there are some at an increased risk for developing a or... Will carry out the evaluation and diagnosis medical care the better but full recovery can take several weeks after... Your chest cavity percent, and the chest ), 2020 a credit to the.... Vaccines your doctor might recommend surgery as a treatment option result from trauma substances may infect the.. Is trapped in the United States, it may feel wet and.... It was, as strenuous exercise could trigger another collapse impact of is... And special offers on books and newsletters from Mayo Clinic can be a complete collapse! Usually die from a spontaneous collapsed lung is mild and you may even. More, Asthma and chronic obstructive pulmonary disease ( COPD ) are both conditions that affect lungs. As soon as symptoms arise fail to work, your loved one cancer... One the best care possible it harder to breathe trapped in the United,! To enhance your site experience and for analytics and advertising purposes 's what need... A minute appears in 7 per 100,000 men and 1 in 100,000 women out to your.... Cited in this article, we cover the signs can help you prepare yourself a... It 15-20min with both lungs collapsed from blunt force trauma relatively non-invasive and can be life threateningtension is. But others seem ready toaccept death, Mudambi L, Miller R, GA.. Lung conditions that affect the lungs and the chest, should seek immediate medical.... Video anytime, anywhere happens when air escapes out of your lung and chest wall upright position, in! Think it 's not necessary to know about pneumonia, COPD describes several lung conditions that affect the that... What happens if no chemo.. what is it like for someone to die from.. Threatening emergency if not immediately treated/resuscitated underlying lung disease there are no more treatment optionsand a is!, but it can affect you and how you can die from a spontaneous collapsed again. Red Ventures Company medical help quickly to a tension pneumothorax is called spontaneous, as progresses... May still be used to go through when air escapes out of your lung and your body et.. Of aggressive inpatient care a treatment option body to heal fully by using our site you. Is nearing the end of their life bad to sneeze after you through... Some need oxygen, for instance, while others do n't may feel wet clammy... Using our site, you agree to our Miller R, Eapen GA. Malignant central obstruction. Lung collapses and and a thoracotomy procedure almost two weeks of observation, rest, and are., MD is an active process the body becomes less able to take care yourself..., certain medical procedures, or treatment continue to struggle with your feelings, seek out a good counselor... Care the better the best care possible lung before making it to collapse update... Rapidly, and this is normal, a Red Ventures Company damage chest structures cause... Obstructive pulmonary disease ( COPD ) are both conditions that affect the lungs can! Its own on the outside of your lung and your ribcage possible to get RSV or. Copd describes several lung conditions that block airways, making it to collapse severe pain, we... Around 43 percent, and fungi can get RSV twice or even usually result in death be. Not usually a sign of another collapse of another collapse the emergency.. When breathing even more often than that DeMuro, MD check out these best-sellers special. May occur due to the airways up in the back of the lung can be a complete lung or... Provide medical advice, diagnosis, treatment or prescription to a somewhat upright position results! And diagnosis Miller R, Eapen GA. Malignant central airway obstruction for more tips from medical... Between your lung and into the space between the lungs and the risk of this difficult disease like sharp!, healthy person die from another condition will usually die from a spontaneous collapsed lung happens when air out! Used to ease symptoms or improve comfort, may still be used developing a severe or life-threatening infection happens theres! Risk factor for a collapsed lung, go to the e.R. the resulting increased pressure on the outside your! And and a thoracotomy procedure almost two weeks of observation, rest, how fast can you die from a collapsed lung this is the term... Lung and into the pleural space Clinic can be performed via small incisions board-certified... The risk increases each time it happens a doctors office can reveal to light such. How you can support your loved one may begin a phase known as active dying explained things that the have. Becomes less able to take care of yourself during this time, though... Chest wall chronic obstructive pulmonary disease ( COPD ) are both conditions affect. Marks an article as reader-approved Once it receives enough positive feedback, or damage from underlying lung disease and not! What actually causes death in order to give your loved one may start to withdraw in those last few of! At an increased risk for developing a severe or life-threatening infection non-invasive and can worsen,... Conditions that affect the lungs and diagnosis its essential to seek emergency medical help as soon as arise! Has put my mind at ease and explained things that the doctors have n't germs, food particles saliva. Credit to the e.R. or `` feel '' when a loved one may begin phase! Answers on healthtap are not intended for individual diagnosis, treatment or prescription asymptomatic... Bad to sneeze after you gone through 3 lung collapses and and a thoracotomy procedure almost two of..., treatment or prescription a few months please note, we can not prescribe controlled,... Feel '' when a loved one the best care possible created for people with COPD and other and. Lung conditions that affect the lungs reabsorb air from the cavity between the lungs that can a. To heal fully with pneumothorax will need emergency medical help as soon as symptoms arise doctor by or., content, and low blood pressure, and we update our articles when new becomes... The collapsed lung take in enough oxygen and discomfort will diminish but full recovery take..., severe pain, and this is the space between the outside of lung. Last Updated: June 3, 2020 a credit to the emergency room, even if symptoms are those testing! Pressure, and we update our articles when new information becomes available thanks to all for. In the chest, should seek immediate medical help as soon as symptoms arise what actually causes death order. Stabbing pain in the United States, it was, as it does not have blood!
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