It usually moves up the body and can cause shoulder pain. By rejecting non-essential cookies, Reddit may still use certain cookies to ensure the proper functionality of our platform. Plan for the healthiest pregnancy possible. Why is there pain after egg retrieval? I won't get an update now until Day 5/6, so here's hoping for some happy, healthy blasts! Aside from pain, patients may also experience mild cramping, bloating, soreness in the vaginal area, and constipation. We will all be thinking about you and your growing family. Mayo Clinic is a not-for-profit organization. 2017; doi:10.1016/j.rbmo.2017.03.024. The views expressed in community are solely the opinions of participants, and do not reflect those of What to Expect. Our anesthesiologist will administer medications through your IV so that you are comfortably asleep the whole time. An egg retrieval is carried out as follows: A speculum . This infection only occurs in 0.2 percent of patients undergoing the procedure. The list includes: Rheumatoid arthritis. Make sure they take you seriously. No matter which group you are in, use this checklist below for tips on what you should implement as part of your post-retrieval recovery regime and possibly continue for a couple of days as well. The egg retrieval is an extremely safe and relatively simple procedure that averages only 15 minutes from start to finish. So 48! You will be monitored for approximately an hour, then sent home to rest for the remainder of the day. From my experience, this was spot on. She said the ovaries are putting pressure on my diaphragm which can cause the breathing/shoulder pain and to wait 24 hours to see if it gets better with tylenol/advil. In some cases, each egg may need to be injected individually with a single sperm. we did get the call this morning that 12/15 of ours fertilized so praying we get a good number to blast and then good PGT-A normal embabies! | Dynamic Physiotherapy & Sports Injury Clinic Inc. The discharge of watery fluid is not an uncommon side effect, and it will eventually stop after some time. I had really bad shoulder pain after my retrieval. Symptoms of ovarian hyperstimulation syndrome. The cramping should subside within 2-3 days and respond well to over-the-counter pain medications. Find advice, support and good company (and some stuff just for fun). Ovaries swell as fluids build up and sometimes leak, leading to deep pain. The doctor said she had another RE help because my right ovary was difficult to get to. About 1 in 10 patients undergoing IVF develop mild OHSS symptoms, while only around 1 in 100 need to be hospitalized due to severe symptoms. ), Related: IVF Dos and Donts: Your Guide to Diet, Exercise, Sex & More. I always self-diagnose but then worry I'm overreacting. What to Expect supports Group Black and its mission to increase greater diversity in media voices and media ownership. Im a crazy self diagnoser and my internal webmd says it could be a stitch in your side or a pulmonary embolism. I thought my my recovery would be like my last one in June but I have been wrong. Egg retrieval is a minor operation wherein the eggs are sucked from the ovaries of a woman either as part of the IVF cycle or for egg freezing. Learn more about, Twins & Multiples: Your Tentative Time Table. I made this post 3.5 years ago :) All is well! There was no fluid buildup and it did eventually go away. Injury to the axillary nerve: this nerve can be injured if you dislocate your shoulder or break your humerus. Postpone your rigorous exercise routine to a later date after youre fully recovered. She feels privileged to be able to help fertility patients go from feeling broken and overwhelmed to feeling empowered with options about their future. Will my retrieval hurt? Signs of inflammation are pain, swelling, limited movements and . Create an account or log in to participate. Any new onset chest pain after any procedure needs to be evaluated asap and OHSS with that many eggs is a very real possibility, even if youre low risk. After an egg retrieval you should not: Do any heavy lifting for 1-2 weeks. This chronic autoimmune disease targets joints in your body, including your shoulder. You likely have/had bleeding from the ER which irritates the diaphragm when you lay flat (and the blood can reach that level vs staying in your pelvis when youre upright). Maskot/Getty Images. This procedure is often done by women or couples who are not prepared to have a baby yet but are worried about diminishing their egg quantity or quality. Some women tolerate the egg retrieval process pretty well and may have light cramping but can go right back to work the next day while others, especially those in danger of ovarian hyperstimulation syndrome (OHSS) may need more recovery time. Jesus baby girl, did they do an ultrasound to see if you had fluid? Or, if you experience the below symptoms contact your clinic, your doctor or GP on the same day: The condition is characterized by pain around the abdomen. She warned me that I would be sore from that. What to Expect at Your IVF Embryo Transfer | A Patients Perspective, What to Expect at Your IVF Embryo Transfer | A Nurse's Perspective. All of this leads to the uncomfortable bloated feeling you experience at ovulation. Hi, I was just looking for a little advice in regards to side effects after egg retrieval. I did! This site complies with the HONcode standard for trustworthy health information: verify here. I had my egg retrieval this morning (18 eggs retrieved!) Your post will be hidden and deleted by moderators. OHSS(Ovarian hyperstimulation syndrome), If your doctor over-stimulates the ovaries using IVF fertility medication, it may put you at risk of OHSS. After your egg retrieval, you are carefully transported back to the recovery area where you will be monitored as you wake up. I consulted with the clinic and they said . Usually, symptoms start showing 4 to 5 days after the egg retrieval operation. 3. It will further provide ways to alleviate the symptoms and recover faster from this minor operation. The whole recovery was just really tough since they retrieved 37 eggs from me. Dont rely on your pain meds too much. Create an account to follow your favorite communities and start taking part in conversations. I had my ER 5 days ago and I am basically bed ridden still. 48 eggs! Also might be noteworthy that Im 26 and they got 30 eggs. Shoulder pain is common in our community. The pain may be deep and sharp, or there may be numbness, tingling or pins and needles. What Are My Chances of Success with Fertility Treatment? Youve made it through some of the hardest parts of the process. She started experiencing pain in her lower abdomen before leaving the recovery room. Regardless, get to the ER. Leafy green vegetables, fruits and foods rich in fiber are also great for constipation. After anaesthesia administration, he does the following: After your doctor finishes collecting the oocyte, he gives it to an embryologist for fertilization or freezing. The chances of infection can be reduced further by administering antibiotics to the patient for cases when the needle punctures an endometriosis cyst, the bowel, or a damaged fallopian tube. I hope the Motrin helps - makes sense when she puts it that way! However, Hillie experienced some slight discomfort after surgery, including bloating and fullness. Normal Egg Retrieval Side Effects. The good news is that with appropriate treatment shoulder pain will . If you have been identified as high risk for OHSS, we will advise you to eliminate exercise and avoid sexual intercourse. It usually occurs in women taking injectable hormone medications to stimulate the development of eggs in the ovaries. https://www.uptodate.com/contents/search. The clinic wanted to CYA and put her health at risk. If you happen to fall under this minority group, youll go through a shooting pain after egg retrieval. If you prepare for nothing else, prepare for the fight against constipation. You probably won't need a follow-up . I only ever took Tylenol. Put your left hand on your right shoulder. please PLEASE go to the ER. Egg collection takes 5-15 minutes from start to completion. This article will . However, it took me about 2 weeks after the retrieval for me to really feel 100% again. Third reason is when a woman is donating her eggs to another woman or couple trying to get pregnant. Wow, that's no joke! 2023 Illume FertilityAll Rights Reserved. Press J to jump to the feed. This is what we expect of your ovary during any given month; one egg follicle growing to full maturity in one ovary. This content does not have an Arabic version. I had really bad shoulder pain after my retrieval. As another person said your symptoms are also consistent with other rare but possible problems. It's been 3.5 years since my retrieval (Jesus!) Get those bowels moving! The chances for this to occur is only 0.1 percent. Are you doing a fresh cycle? I hope youre okay! Most women feel "back to normal" by the next day. I did a low dose IVF med trial and showed good results. Injectable fertility medications are more likely to cause OHSS than is treatment with clomiphene, a medication given as a pill you take by mouth. Amazing doctors, nurses, and medical assistants. Create an account or log in to participate. The collected eggs are mixed with your partner's or the donor's sperm in a laboratory to fertilise them. To help you feel more confident, let's walk through an egg retrieval and talk about what to expect in terms of side effects. I had minor lower abdomen pain day 1, day 2 it shifted to my stomach/diaphragm and my stomach was visibly bulging out. Resting a heating pad on your abdomen will help with any vaginal soreness and/or cramping from the egg retrieval process. If youre getting close to your egg retrieval, its a very exciting yet nerve-wracking time! Causes. Other Common Painful Side Effects After Egg Retrieval, Causes of Severe Pain after IVF Egg Retrieval. If you feel pain after egg collection or shoulder-tip pain the day of egg collection. It is important to avoid strenuous activities right after the operation in order to prevent complications. Whatever your side effects, we will help you manage them until they subside, so you can focus on the next big milestone of IVF treatment: your embryo transfer. Group Owners uphold the core values of the brand by reporting content that violates the community guidelines. Everything you need to know to get started. When the ovaries are punctured to remove eggs, they ooze bloody fluid for a. I literally couldn't move. 24 I talked to the on call doctor and she said this is common for such large ovaries and getting so many eggs! After the procedure, wearing a supportive bra is recommended to avoid putting unnecessary strain on the chest. Is it normal? As soon as your follicles are in clear view, the doctor will advance a thin needle through your vaginal wall and into the egg follicle. While there was no statistically significant difference in terms of the number of patients who needed opioid treatment within the first 24 hours between patients with and without STP, a . hey lady how did this turn out for you? There was no fluid buildup and it did eventually go away. Contact your provider right away if you develop breathing problems or pain in your legs during your fertility treatment. Broken arm. Go to the ER as everyone else has said. My second retrieval I had only seven eggs retrieved and no pain at all. When To Call Your Doctor About OHSS Symptoms, IVF Dos and Donts: Your Guide to Diet, Exercise, Sex & More, 11 Ways to Manage Stress During Fertility Treatment, [DOWNLOAD] Your Step-by-Step Guide to IVF (eBook), Why Do We Need So Many Eggs for IVF? Not sure how that is not a risk for OHSS but maybe Im wrong? Its rare but can happen. Mild symptoms resolve after around two weeks, but severe symptoms must be addressed by a doctor immediately and may require hospitalization. Elbow joint "mouse" is treated surgically. Third, if you have managed water and/or electrolyte intake but still experience lower abdominal bloating, schedule a visit with your acupuncturist. A few hours later, I woke up and my shoulder was hurting. thank you!!! Hillie says her surgery took 24 minutes - "but I think most people are done in 15-20 minutes," she adds. Inserts a hollow suctioning needle with a catheter into your vagina through the uterus. During my stims, they found a polyp. Please select a reason for escalating this post to the WTE moderators: Connect with our community members by starting a discussion. Hold. Since youve made it to the second stage involving egg collection, soon youll be through with the whole IVF Process. Pain from a problem with the rotator cuff is often called shoulder impingement. So sorry youre going through this sending you prayers. There are different reasons why you are feeling stabbing pain after egg retrieval, such include Hyperstimulation ovarian syndrome (OHSS), ovary enlargement, ovarian infections and internal bleeding. Reddit and its partners use cookies and similar technologies to provide you with a better experience. 2005-2023Everyday Health, Inc., a Ziff Davis company. It was painful but manageable until the fresh transfer. He had to push down on my stomach so she could get to it. The Biggest Side Effects of IVF Egg Retrieval. Treatment depends on the severity of the condition. Please whitelist our site to get all the best deals and offers from our partners. Temperature above 101 F. Severe abdominal pain or swelling. Focusing on electrolytes is a great way to maintain optimal hydration before and after your egg retrieval. I had this my second round; couldn't lay down without pain, couldn't laugh. Ask Nurse Monica. 2005-2023Everyday Health, Inc., a Ziff Davis company. Good to know. Take your temp, if you have a low grade fever (maybe 99-100 ish) it could be a clot and I would recommend you call your clinic or go to the ER. I believe it was because of fluid/air from the retrieval. I wake up around 3am to take Tylenol and use a heating pad. The process of going back to normal is gradual and painful. During the surgery freely "floating" fragment in the joint (joint mouse) is removed. This is the 4th time I have donated and the procedure is the same (egg retrieval) I usually have bloating and some minor chest pain. which could last a few days. Few patients, approximately 1 in 800 patients will experience this bleeding. It really helped me in my recovery. I can still feel how large my ovaries are (dr. said the size of cantaloupes!) I over explained each thing I was feeling to my doctor and they eased my mind. However, it wont catch us off guard, and we have lots of helpful ways to get you through it safely and swiftly. Group Leaders communicate with staff moderators and escalate potential violations for review, but they dont moderate discussions. Please select a reason for escalating this post to the WTE moderators: Connect with our community members by starting a discussion. Injury to ovaries, blood vessels, bowel and bladder. The morning of my ER I woke up in excruciating pain in my pelvic/ovary area. What if, however, after interviewing 45 candidates, human resources decides to hire 12 employees instead of just the one! While Tylenol and paracetamol are popular for alleviating pain, talk to your doctor for advice on the most suitable medication. I went to see my RE just to be on the safe side. Benches/Squat Racks For Sale | Buy Benches/Squat Racks Online | Fitness Equipment Empire, Are You Listening? Be proud of yourself! Posted 19/2/14. OHSS may improve on its own in mild cases, while severe cases may require hospitalization and additional treatment. I took their advice and increased the pain medicine and fluids (incorporating advil in addition to tylenol seemed to do wonders). Ovarian blood vessels react abnormally to HCG and begin to leak fluid. Im in the same situation with the pain in right shoulder and fellow self diagnoser so hoping its not internal bleeding hahah. We respect everyones right to express their thoughts and opinions as long as they remain respectful of other community members, and meet What to Expects Terms of Use. The recovery should also be quick and with manageable/bearable discomfort. The pain feels like cramps women experience during their monthly menstrual period. Please specify a reason for deleting this reply from the community. Make sure to ask your doctor exactly what type of pain-reliever you can use, as certain medications such as Ibuprofen should not be taken after an egg retrieval. I had my egg retrieval yesterday, and today after I had been awake for a few hours my back (upper right mostly) started hurting like a severe pulled muscle. Any sharp pain with inspiration could be gas, a pulled muscle, inflammation from the fluid leaking from the follicles, or a blood clot. This is called intra-cytoplasmic sperm injection or ICSI. However, it took me about 2 weeks after the retrieval for me to really feel 100% again. The shooting pain may be a result of OHSS, ovary/pelvic infections and enlargement of the ovaries among other causes. Further, quit alcohol and caffeinated drinks to avoid dehydration. It occurs when the ovaries have an abnormally robust response to the fertility medications that we prescribe. If youre suspicious, I recommend talking to a health professional. If your egg retrieval doesnt happen with your primary doctor, know that you are still in great hands and that your doctor will be monitoring your progress remotely and getting updates throughout the day. Dr. Jesmarie Macapagal is a Pediatrician and full-time mom to her 2-year-old daughter. Thank you for taking the time to respond! This article will discuss the probable risks and common side effects of the egg retrieval procedure. By drinking plenty of water, the stool will be softer, and the colon will be wet enough to allow easier passing of waste. Honestly, I work EMS and I think you should go to the emergency room. Have more questions about IVF? i dont want to scare you but i had shoulder pain when i was internally bleeding. 100% agree with getting to the emergency room immediately. Shoulder Pain Diagnosis Chart. Concerning symptoms and ones where we would definitely want to hear from you are listed above under the OHSS symptoms. The symptoms you're describing are exactly like what I experienced with my PE. Group Leaders communicate with staff moderators and escalate potential violations for review, but they dont moderate discussions. After they are sedated, the vagina is washed with a sterile water solution. do not rest your shoulder in a sling for longer than 4 weeks unless your GP tells you to - this may lead to stiffness. Broken collarbone. Specifically, though, keep an eye out for: These are all signs that your ovaries are swelling and putting pressure on your diaphragm. Laxatives. Should I call my doctor? Note that once you confirm, this action cannot be undone. Bottom line. DH is convinced it's nothing (mostly because admittedly I tend to assume the worst). After the egg retrieval process, you may experience some soreness in the vaginal area, some abdominal cramping, or some spotting, which could last a few days. Therefore, it is essential to ensure that the eggs are healthy and retrieved properly to boost the whole cycles chances of success. Pain after egg retrieval is a common side effect that patients may experience after the procedure. I've had absolute nightmare complications from my egg retrieval and I'm telling the whole story here. Busso CE, et al. The pressure has made it so I can't eat and breathing is tough at times. Use of this site is subject to our terms of use and privacy policy. I love cooking, reading, and writing stories from my life. The pain can be sharp and aggravating, usually lasting up to 3 days. I hope youre able to get some answers but Im sure youre fine. Specifically, though, keep an eye out for: What is Ovarian Hyperstimulation Syndrome (OHSS)? Haha thanks so much for the update!!!!! Our Checklist of Top Tips To Follow for Egg Retrieval Recovery after IVF or egg freezing. Symptoms can range from mild to severe and may worsen or improve over time. To help with constipation and bloating from the excess fluid that has accumulated in your ovaries, you need to intake electrolytes and water to help balance everything back out and keep your body from holding onto that excess fluid build-up. Just call the doctor ASAP so you can relax and rest. I had my egg retrieval this morning (18 eggs retrieved!) Keep an eye on it! oh lol I guess people have been commenting on it which is what brought it up in my feed. Discover helpful information I learnt from Sophies experience about the causes of pain after egg retrieval and how to curb it. Ideally, some degree of pain taking up to 10 days after undergoing the procedure is normal. She prescribed Norco (hydrocodone plus tylenol). We ended up with 6 good quality embryos. Having a high level of human chorionic gonadotropin (HCG) a hormone usually produced during pregnancy introduced into your system plays a role. Mild symptoms include bloating, nausea, diarrhea, and weight gain. Let me elaborate on that. Related: 11 Ways to Manage Stress During Fertility Treatment. Good luck! Before a patient leaves, she will be told how many mature eggs were collected. A heating pad may be a good option to soothe your aching abdomen. Ovarian hyperstimulation syndrome is an exaggerated response to excess hormones. While a majority of women recover within two days, people are different with some experiencing post-complications. These are the most common symptoms of If you experience any of the following symptoms, reach out to your nurse or doctor: hbspt.cta._relativeUrls=true;hbspt.cta.load(60131, '39f5eeac-f522-4650-b50d-59c12549127b', {"useNewLoader":"true","region":"na1"}); During an IVF cycle, we are asking the ovaries to do something that they dont typically do: produce a lot of egg follicles, all at once. Excessive strain may irritate the cervix and cause heavier fluid discharge. I worry this could be happening here, too. Luckily the cysts go away with time, but to avoid them affecting your fertility treatment, seek medical attention early. I was told I was at very low risk of OHSS since I only had the Lupron trigger shot. , Go to ER shoulder pain is a bad sign!! In younger people, shoulder pain is more likely to be due to an accident or injury. OHSS happens when there is enhanced stimulation of the ovaries caused by fertility medication and hormones. Ok, great! The educational health content on What To Expect is reviewed by our medical review board and team of experts to be up-to-date and in line with the latest evidence-based medical information and accepted health guidelines, including the medically reviewed What to Expect books by Heidi Murkoff. Pain after egg retrieval - posted in Ask the Embryologist: Good morningI had my egg retrieval last Saturday Aug 16--(3 follicles but only one egg retrieved). Very rarely do we need to administer anything more than Tylenol after the procedure. Are you planning a transfer next month? Mild to moderate OHSS With mild to moderate ovarian hyperstimulation syndrome, symptoms can include: Mild to moderate abdominal pain Abdominal bloating or increased waist size Nausea Vomiting Diarrhea Tenderness in the area of your ovaries It would hurt my chest to laugh. Post-traumatic arthritis. To minimize the soreness in the pelvic and vaginal area, take OTC painkillers such as ibuprofen or ask your doctor to . It got so intense they thought I had an ectopic pregnancy. Her doctor prescribed pain relievers but strangely, the pain persisted for over two months after egg retrieval. You wont be able to eat anything the morning of your egg retrieval so youll likely be starving by the time you get around to any food. Hope you feel better soon! stand up straight with your shoulders gently back. Are you struggling with stabbing pain after retrieval weeks later? She said I had more follicles on the right side and they had to dig around, so she expected I would be in pain. Shoulder pain causes include: Avascular necrosis (osteonecrosis) (death of bone tissue due to limited blood flow) Brachial plexus injury. Youll also meet the anesthesiologist and the reproductive endocrinologist who will be performing your procedure that day. If you feel a message or content violates these standards and would like to request its removal please submit the following information and our moderating team will respond shortly. On a Tuesday afternoon in 2011, Chicago-based author Nadine Kenney Johnstone went into an in vitro fertilization egg retrieval procedure at a fertility clinic in Massachusetts. This is a medical complication that affects approximately 3% (or less) of women undergoing IVF each year. I'm sorry that your recovery stemmed over 5 days. This is done several times for all your follicles in both of your ovaries. However, it should not be taken with other acetaminophen drugs, since Vicodin already contains 500mg of acetaminophen. Please go to the ER and get evaluated for a pulmonary embolism, asap. Accessed Sept. 11, 2019. OHSS may occur in women undergoing in vitro fertilization (IVF) or ovulation induction with injectable medications. Dont try to run or workout again. Severe nausea or vomiting that doesn't go away. (We will always call you to make sure you're feeling well after your procedure. Get checked out if the pain is severe. Abdominal bloating or increased waist size, Rapid weight gain more than 2.2 pounds (1 kilogram) in 24 hours, Polycystic ovary syndrome a common reproductive disorder that causes irregular menstrual periods, excess hair growth and unusual appearance of the ovaries on ultrasound examination, High or steeply increasing level of estradiol (estrogen) before an, Fluid collection in the abdomen and sometimes the chest, Electrolyte disturbances (sodium, potassium, others), Blood clots in large vessels, usually in the legs, Rupture of a cyst in an ovary, which can lead to serious bleeding, Pregnancy loss from miscarriage or termination because of complications. Age is a defining factor in regards to the appropriate number of eggs suitable for In vitro fertilization treatment. If you suspect OHSS, A ketogenic (Keto) diet full of proteins may help. The cause of ovarian hyperstimulation syndrome isn't fully understood. This is normal, but let your doctor know if you are having trouble eating or drinking, are in excessive pain, or have any fevers. I wish there was something to provide relief though! Any unusual symptoms or pain after 10-15 days isnt normal. H Haybaby This usually goes away after about a week. how has your IVF journey gone? Youve finally made it to your egg retrieval! Research shows that only 1 in 1000 women experience internal bleeding after the procedure. When trying to shrink into its usual size, youll experience shooting pain. Less often, OHSS happens during fertility treatments using medications you take by mouth, such as clomiphene. Yes, I was super uncomfortable with back pain for a few days! Should I follow up with the doctor after this incident even tho I feel much better now? Depending on the experience and expertise of your surgeon, you may get an infection in your ovaries and pelvis. This is poor advice (probably from a fellow taking weekend call). Now I begin chemotherapy for Hodgkins Lymphoma this was my one chance to do IVF and as horrible as it was to go through, I'm thankful my body had a good response. Hopefully I'll be able to get some sleep tonight. Avoid strenuous activities such as bending or twisting as they could hurt your ovaries, and increase the pain. It's probably rare but you should also have them rule out a pulmonary embolism while you're there. i had mild anesthetic they use for egg retrieval but just pasting what i found. Immediately after egg retrieval, you may have cramps, or feel pressure or fullness. After such procedure, patients can experience shoulder pain and/or pain below the diaphragm from residual gas in the abdomen. Please be sensitive and kind. The fertility institute of Hawaiicitesovarian cysts as common in fertility patients specifically, those using IVF. A Group Leader is a What to Expect community member who has been selected by our staff to help maintain a positive, supportive tone within a group. Egg retrieval was tues. may12. Most of it comes from blood vessels that are "leaky" due to . I don't really have any other side effects of OHSS so don't know if I've just moved abit 2 much 2day. Privacy Policy. I had this happen, and I was bleeding internally from the procedure. Imagine there is a job opening at a company with ONE office available for ONE new employee to sit in. Any pressure, discomfort or pain in your stomach or abdomen is actually caused by bloated ovaries and not air in your gut. You will be asked to check in to our Norwalk office approximately one hour before your scheduled procedure time. The rotator cuff is a group of muscles and tendons that keep the upper arm bone held in the shoulder blade socket. Your personal experience might vary slightly based on your fertility clinic's protocol, but regardless of clinic, the process should be very similar. Your ovaries might be edematous enough to reach the level of the diaphragm, but that too is a reason to go to the ED. I had my egg retrieval this morning (48 eggs!) Press question mark to learn the rest of the keyboard shortcuts, F 30 | MFI 31 | ICSI #1 = CP | 1 frozen left. Thank tou I really hope so this is my 4th fresh IVF and definitely the most painful. How to Make Bloating Go away after Egg Retrieval. I just discovered them (trying to maintain milk supply after being sick) and they're so good! The views expressed in community are solely the opinions of participants, and do not reflect those of What to Expect. In addition to the heating pack, pop some Tylenol to help with any mild discomfort. Many women who have undergone follicular punctures say that the pain after the procedure is similar to the one during the menstrual period and can be controlled by taking regular pain medications.

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