Understanding what is making you feel anxious and looking into that more specifically. at the Washington University School of Medicine in 2013. When youre seated on an airplane for an extended period, it can slow your circulation and cause blood to coagulate in the veins in your legs. If you have recently had back surgery or have a surgery scheduled in the future, you may be wondering how it could affect travel plans. Bend your hips and knees and roll onto one side keeping your spine straight and your knees together. Author By Posted on June 8, 2022 Categories elle lively mcbroom age 2021 how to check engine hours on suzuki outboard. That often means anterior cervical discectomy with fusion or ACDF surgery. 2020 New Jersey Neck & Back Institute, P.C. Impatience: Recovering from spine surgery can take between a few weeks and a few months, depending on the exact procedure. Wearing compression tights to prevent blood from collecting in your legs. 3 -4 wks. "The treating physician and nursing staff typically provide written discharge instructions and prescriptions for pain medicine and physical therapy. Approved. Spinal fusion is a common surgery that is performed for correcting problems in the small bones in the spinal cord, known as vertebrae. The recovery time following ACDF varies. You and the family member or friend assisting you during this time need to understand the post-op instructions given to the patient. But your efforts toward pain-free living only renew after the procedure ends. Listening to your body while following the advice of your surgeon is the most important thing you can do to shorten your recovery time. There is no prohibition to being a passenger in a vehicle or even an airplane immediately after surgery as long as you are careful. In other cases, your physician may allow short flights, but not long international flights. wikiHow marks an article as reader-approved once it receives enough positive feedback. If you must make the trip even after a week I would recommend moving your legs in the car as much as possible and also stoping every 30 min or so to . Important notification about information and brand names, Complications Of Anterior Cervical Discectomy And Fusion Surgery, Complications after carpal tunnel surgery, Risk and complications of LASIK eye surgery, Possible complications after back surgery, Recovering From Anterior Cervical Discectomy And Fusion Surgery, Pain After Anterior Cervical Discectomy and Fusion (ACDF) Surgery and What to Do About It, Possible Complaints After Neck Fusion Surgery, Surgical Treatment For Chronic Low Back Pain, Hip Replacement Surgery: Risks and Complications, Recovery After Posterior Cervical Spine Surgery, Post ACL (Anterior Cruciate Ligament) Surgery Complications, An ACL Tear Injury Can Heal On Its Own: Why Surgery May Not Be Your Best ACL Treatment Option, Swelling And Other Complications After Hernia Repair Surgery, Bunion Removal (Bunionectomy): Preparing For Surgery and post OP recovery, anterior cervical fusion/choking and swallowing issues, anterior cervical discectomy and fusion .with the dry heaves. Apr 27, 2019. how soon can i fly after acdf surgery. Physical therapy will help a patient understand how they have to walk, sit, stand, lie down, turn over, and also educate them about the safe ways in which to lift, push or pull objects. Typical Physical Therapy after ACDF This is what the patient can typically expect at physical therapy: Here's a general window of when it's typically safe to fly after surgery: abdominal surgery (complicated): 10 days. This can lead to a very dangerous and potentially fatal condition called pulmonary embolism. Your doctor can assess your personal medical history and make a suggestion specific to your situation. During the three to six months following spinal fusion surgery, the lumbar fusion bone mass starts becoming established. Anterior Cervical Discectomy and Fusion (ACDF), Authorization to Release Health Information, How to Protect Your Lower Back from Pain While Lifting Something Heavy, Cervical Degenerative Disc Disease May Cause Headaches, Dont Suffer with Lower Back Pain from Driving, Minimally Invasive Back Surgery Recovery Time, DISC Spine Institute North Ft. Worth Office. However, that does not mean you will have recovered as soon as you return home. We follow a strict editorial policy and we have a zero-tolerance policy regarding any level of plagiarism. Naturally, trying alternative remedies and treatments is always the first course of action. I have also had multiple ACDF's So I am extremely familiar what is involved in healing and recovery from this type of surgery. The worst of the pain begins to subside by four weeks after the spinal fusion surgery. All interaction must be done via appointment at one of our 4 main offices listed below. For example, brain surgery can leave gas temporarily trapped in the brain. If both your legs are in plaster, it is unlikely that you will be able to fly - Contact your travel operator or airline for advice There is a risk of clotting for up to 4-6 weeks after surgery for all patients, but flying long distances aggravates this problem further. Thank you everyone! Anterior Cervical Foraminotomy - Anyone had it? The surgeon is able to move the neck muscles, esophagus, and trachea aside, and maneuver in such a way that protects the spinal cord, nerves, and neck muscles. "After the surgeon removes the damaged disc, they fuse the bones together.". However, our physicians will be offering ONLINE appointments during this time to address your medical needs. Use a firm pillow to keep your neck aligned with your body. Some patients are able to return to work within a few days or a week after surgery. All symptoms went away completely as soon as surgery was complete, until about. The surgeon removes the diseased intervertebral disc and any tissues . And again Welcome tothe forum and our CP family! - Carl B. Include your email address to get a message when this question is answered. Ive been walking and cleaning (nothing strenuous) and I feel great! wikiHow is where trusted research and expert knowledge come together. DISC Spine Institute and DISC Clinic PLLC 2023 - All Rights Reserved |, Board Certified, Fellowship Trained However, this is dependent on the overall health of the patient and the complexity of the procedure. This will result in a slight swelling at the site of surgery and will be painful to touch. We pride ourselves on our ability to orchestrate personalized care plans that serve the unique needs of our patients in Florida. If you have trouble breathing, call 911or go to an emergency room immediately. Nobody wants to have spine surgery, but it is sometimes necessary. Website by RUNNER. That is a great idea! Medical Videos Privacy Policy, Images and Text Policy Editorial Policy, Information Policy Advertising Policy, Financial Disclosure Policy Cookie Policy, About Us Contact Us. The neck is very sensitive and highly complex, so neck surgery recovery time will vary depending on your physiology, the kind of surgery that is performed, and more. Are you suffering from back pain and dont know what to do? With the knees bent bring your feet to the edge of the bed. Hello All , I am considering having the acdf op and want to ask a few questions ? ACTIVITY. You may find placing a heavy blanket over your body when you sleep can help to keep your arms from shifting or moving in the night. This is an older thread, you may not receive a response, and could be reviving an old thread. does not provide personalized consulting or advice over phone or email. how to screen record on streamlabs mobile; wichita baseball stadium name; liquid bright gold; The best advice is that you use your common sense to understand what type of activity is likely to cause harm to your fused spine. All in all, I know it is a bad decision to fly just yet so I am going to hang tight for a few days and . by | Jun 10, 2022 | is the infographics show credible | alien: isolation working joe | Jun 10, 2022 | is the infographics show credible | alien: isolation working joe Your thoughts??? Image Based Life > Uncategorized > how soon can i fly after acdf surgery You must protect the site of the surgery and your spine from undue pressure and that is done by resting. Bone healing is notoriously slow and can be associated with a dull pain during that time. Some common complications that are seen after an ACDF surgery are: Since the operation takes place close to some of the major blood vessels of the body, there is a chance that they can get injured during the procedure. Flying after orthopaedic surgery As a rough guide, before flying, you should allow: 1-2 days after arthroscopic (keyhole) surgery. There is no evidence of cord compression or cord signal abnormality. Hold for 30 seconds then release. Responses were tallied for lumbar laminectomy, lumbar microdiscectomy, lumbar fusion, and anterior cervical discectomy with fusion. Your surgeon will also have told you how long you will need to stay off work. Plano, Dallas, North Ft. Worth, Arlington, Decatur, Southlake and Frisco. I started shooting with a 28 ga. after 2 months and worked my way back with in 5 months. "Anterior cervical discectomy and fusion (ACDF) is an operation to remove a degenerative or herniated disc from the neck," said Medical News Today. patients should check with their surgeon prior to flying to ensure that it is safe for them to do so. 3 mths. This makes the disc much more accessible. As for the back, I am still limited in how long I can sit. Hence, it is very different from a broken arm, for instance, which only requires a bit of rest and a cast. The neurosurgeon said I will not need a collar, and recovery is usually pretty fast. Objective: The aim of this study was to determine whether any association exists between preoperative cervical epidural steroid injections (CESIs) at various time intervals before anterior cervical discectomy and fusion (ACDF) or posterior cervical fusion (PCF) and the incidence of postoperative infection. I didnt need to do any lifting as part of my job though, I was an activity director and supervised several employees and ran a small cafe. It may surprise you to hear that many of our patients report that they feel more confident driving after their ACDF than they did before the operation. 7 Things You Should Know About Joint Distraction Surgery For Ankle Osteoarthritis, 5 Surgical And Other Treatment Options For Thumb Arthritis, 5 Complications After Wisdom Tooth Removal (And How To Prevent Them), What To Expect From Dental Implant Surgery, Why You Might Need A Sinus Operation If You Want Dental Implants, Complications after Cervical spine surgery, I want to know if anyone has had any type of injections after the surgery. By having surgery, this issue is addressed, thereby stopping it from getting worse. Pain and discomfort in swallowing may be cause of some necessary manipulation of the esophagus and takes a few days to resolve. June 3, 2022 . It is nothing to get worried over and you can always discuss with your doctor if you have any concerns. Airports are notoriously hectic (and crowded) places. Take a few breaths on the edge of the bed and move your feet before standing up. An example of data being processed may be a unique identifier stored in a cookie. Ways to Avoid Twisting and Bending after Surgery 17 Proper Lifting Technique 18 Proper Ways to Push and Pull after Surgery 20 Sleeping after Surgery 21 Sitting after Surgery 22 Sitting at Your Desk after Surgery 23 6 Week Follow-Up Appointment 24 Exercises at 6 Weeks after Surgery 25 . Pain in the back of the neck and between the shoulder blades is common after ACDF surgery. Spinal fusion helps in eliminating any painful motion of the spine and also restores stability to the spine. While these clots can resolve on their own, they can break off, traveling to your longs and blocking blood flow. Some of our partners may process your data as a part of their legitimate business interest without asking for consent. Please Note: This is a general guide only of when you may return to these activities. 8 Reasons To Be Grateful For Chronic Illness, Journey To Self-Care: Behavior And Chronic Illness. Infection of the wound can also occur, however with currently followed asepsis protocols and post operative medication, this is most likely to occur in patients who are immuno-compromised or diabetic. The ACDF helps to relieve symptoms such as neck pain, numbness and tingling in the arms, shoulders, or hand, shooting pain in the arms, weakness of hands, or lower extremities. Complications Of ACDF Surgery ; Complications Of Anterior Cervical Discectomy And Fusion . Fast forward to 2009 when they did a ACDF at C5/6 and they used donor cadaver bone for the graft and hard ware to stabilize it all, and I only had to wear a cervical collar for a few weeks. how soon can i fly after acdf surgery. When youre suffering from a pinched nerve, herniated disc, or disc degeneration, all you want is for the pain to stop. friends phoebe roommate russell. After six weeks of spinal fusion surgery, you will probably begin with physical therapy. how soon can i fly after acdf surgery. As an antidote, a patient of mine underwent a mis discectomy and flew to hawaii that evening for vacation. To perform an ACDF surgery, your surgeon: Makes a small cut on the front of your. COVID-19 UPDATE: Due to ongoing efforts to prevent the transmission of COVID-19 in our communities, our office hours may vary. They have proven now that it causes spine issues/disc degeneration due to dehydration. Sarah has over 10 years of experience teaching and practicing phlebotomy and intravenous (IV) therapy using physical, psychological, and emotional support. You've made the momentous decision to go ahead with spine surgery to fix your chronic back problems. After the spinal fusion surgery, there will be many types of restrictions that you will need to follow if you want to heal properly and also speed up the recovery process. If your pain is severe, your doctor may prescribe a stronger pain medication. Thanks to all authors for creating a page that has been read 80,008 times. 2. Answer: Long care ride after surgery. Bending over to pick something up or lifting in excess of 8 lbs is generally not allowed. Is your surgeon aware of your type of employment with all of the lifting involved? Parental supervision is ultimately required at all times. Beitrags-Autor: Beitrag verffentlicht: 22. Others start physical therapy about four weeks after surgery, and continue for 2 or 3 months. Also, make sure to drink plenty of fluids and eat soft foods to keep your mouth . Rather, they are designed to decrease how much time you need. Unlike many other surgical procedures, this type of fusion is performed through a small incision in the throat. ENGLISH; DEUTSCH; . These include: Last but not least, it is very important that you look after yourself as soon as the surgery is over. However, patients and their families should be aware of several things that can smooth the transition from hospital to home and then back to regular life.". Terms of Use. Lets take a look at the five most important tips. Recovery went well with no problems. Everyone's recovery timelineis different, and lots of factors need to be taken into consideration when making travel plans. Repeat on the other side of your neck. Just an update After an ER visit and finally seeing my surgeon and pushing for a new MRI, it turns out that I have another herniation. ACDF surgery while a major surgery is actually not that big a deal - it isn't fraught with uncertain outcomes and big risks like lower back surgery can be, and the success rate is extremely high for 2 fusions. What is even more important is that you follow the guidelines as set out by your surgeon, who will generally create a program specific to your situation. The numbers in the parentheses (1, 2, 3) are clickable links to peer-reviewed scientific papers. Other factors include: Surgery is always physically demanding, but perhaps never more so than with neck surgery. Take your medications as directed, follow your post-operative instructions carefully, and keep your follow-up appointment with your doctor. Resurfacing Shoulder Replacement Treatment, TLIF (Transforaminal Lumbar Interbody Fusion), A recent hospital stay that involved significant periods of bed rest, Use of birth control or hormone replacement therapy, Extending your legs and flexing your ankles during your flight, Walking around the plane for a few minutes every hour, Avoid drinking any alcoholic beverages and drink lots of water. You will be physically able to ride in a car three days after surgery but an extended car ride will increase your risk for blood clots (deep vein thrombosis). The spinal cord contains many different nerves at each level and they may become irritated or compressed if there is an abnormality within the spine. The average recovery time is 4 to 6 weeks. However, always remember the importance of a comprehensive rehabilitation program that includes a healthy and nutritious diet and regular exercise as advised by your doctor. You should also use pillows and extra support when you sleep, and get in and out of bed correctly to minimize your pain and discomfort as you recover from surgery. If you are traveling from a significant distance (by airplane or longer than 4 hours by car) to our practice, it is recommended to stay in the Vail Valley for 7-10 days after surgery. (Like no heavy lifting of patients or residents etc. As the wound drains blood or fluid, simply change the dressing. The fact that driving is not allowed for at least two weeks, to protect both you and other road users. He said I can travel in a car shortly after surgery. surgery tips. [2] 3 Roll over to your back or side. Do this about 10 times and repeat it every 30 minutes. Metal plates and screws installed. Minimally invasive surgical techniques mean treating chronic back pain is easier than ever, with outpatient treatments, small incisions, and a quicker recovery time instead of a long hospital stay. How soon can you fly after having the op and does your voice get affected as I This topic is answered by a medical expert. Push yourself up sideways and drop your feet over the edge. These usually get better over the next few weeks. NB. As your back continues to heal after the surgery, you will generally start to feel better and over a period of time, you will be able to take on more and more of your daily activities after spinal fusion surgery. Please note that by doing so you agree to be added to our monthly email newsletter distribution list. Oh and no physical therapyI have really good range of motion to in my neck I didnt lose much at all! Here is some important information to know about flying after back surgery. 5 (50%) give driving restrictions after a single-level ACDF, eight (80%) do so after a multilevel. Yes, it is fine to fly after having wisdom teeth extracted. In almost all cases, however, the surgery will allow a specialist to get to the root of the pain, identifying the problem, taking that out if appropriate, and replacing it with an implant, device, or other tool to prevent the pain from returning. Carefully lift your feet up onto the bed as you roll over to your back or to one side, using your elbow to support you. In fact, early activity is what will drive home recovery sooner. When it comes to herniated discs, more conservative treatments work most of the time. After knee replacement surgery, most people can return to their daily activities within a few weeks. The results were miraculous! So now you not only help your overall health but better chances at a good recovery and spine:). Once you have fully recovered, you will be able to resume your regular life, never thinking about experiencing the debilitating pain again. help anybody? If you have had knee replacement surgery, you may be wondering if it is safe to fly. "Physical therapy also teaches patients how to get out of bed or up from a chair safely; how to dress and undress; and how to keep your back safe when doing other activities, which eventually will include lifting and carrying items. Nevertheless, when you fuse even one level of the spine, it changes the overall environment of that particular spine level. how soon can i fly after acdf surgery. Smoking: He says that smoking cigarettes or using other tobacco products hinders healing. Posted 5/3/2020 12:42 PM (GMT -8) I am almost 5 months post op acdf surgery. ", How to Sleep After a Cervical Neck Surgery, https://www.spineuniverse.com/treatments/surgery/cervical/cervical-spine-surgery-recovery, https://www.spine-health.com/treatment/spinal-fusion/1-2-weeks-after-acdf-surgery, https://specialtysurgerycenter.org/best-sleeping-positions-after-surgery/, https://www.hopkinsmedicine.org/orthopaedic-surgery/_documents/patient-information/patient-forms-guides/JHUCervSpineSurgeryGuide.pdf, https://www.youtube.com/watch?v=TyyzsjStVdk&feature=youtu.be&t=27, dormir despus de una ciruga de columna cervical, dormir aprs une opration chirurgicale du cou. Rather, your neck surgery recovery time may be significantly extended and you must make sure that you follow the post-operative instructions that your physician gave you so that your wounds can heal. Anterior cervical discectomy and fusion (ACDF) is anoperation to removea degenerative orherniated discfrom the neck, said Medical News Today. How bad your condition is and which type of surgery you have are two of the most important factors that impact recovery time. I am a medical coder so im sitting all day and I dont do any lifting or anything. For more advice from our Medical co-author, including how to set up the perfect sleeping environment, read on. You will also have been advised on things you absolutely cannot do, such as engaging in strenuous activity. 100% fully recovered with almost no downtime. The content of this article is not intended to be a substitute for professional medical advice, examination, diagnosis, or treatment. If youre in a lot of pain, take a painkiller before bed as well. Anterior cervical discectomy and fusion (ACDF) is an . Here are six things you need to know about the ACDF surgery. You must give the sutures the time they need to close the wound itself. Second cervical fusion, ACDF, anterior attempt is seemingly worsening each day. June 22, 2022 . In most cases, we use absorbable stitches that will not need to be removed, and small strips of tape may be used to keep the wound closed in order to let it heal under less tension. June 3, 2022 Posted by: Category: Uncategorized; No Comments . Would it be a bad idea to ask to go back before my 10 weeks. It is hard to determine whether or not you need neck surgery. Bleeding from the carotid artery or the vertebral artery as a result of the operation can even lead to a stroke or death. www.boxingaddictions.net > Blog > Uncategorized > how soon can i fly after acdf surgery. Answer: It depends (obviously). During the physical therapy session, the exercise techniques will be tailored according to your individual needs, and as your condition begins to improve, more and more activities will be added to your routine post spinal fusion. Better health. It is impossible to take all pressure away from your neck after surgery, which is one of the reason why recovery is often somewhat longer than with other types of surgery. Empty cart. "Some back surgery patients prefer to sleep on their side with a pillow between their knees or behind them to support their back." I hope that you can get some relief soon. Usually, neck pain is a symptom of an underlying condition that must be addressed. Exercising: "Beyond simple walking, don't start swimming, golfing, running, or other strenuous activities without first getting your doctor's OK," Dr. Liu says. The consent submitted will only be used for data processing originating from this website. I am definitely familiar with the duties of a CNA (I took a CNA course and worked as a CNA while going to Nursing School) Brooklyn I personally feel this is definitely not the type of work you should be doing so soon after your type of surgery!!! This should last for at least two to three months. I had a emergency C5-C6 ACDF too, I also woke up pretty much pain free, it was awesome. For more advice from our Medical co-author, including how to set up the perfect sleeping environment, read on. Let us look at some of the permanent restrictions after spinal fusion that you must adhere to. Bleeding from the carotid artery or the vertebral artery as a result of the operation can even lead to a stroke or death. "It is so nice to find a article that brings a lot of relief and is easy to follow.". Keep your wound clean and dry. Schedule An AppointmentLearn About Minimally Invasive. Sleeping after you have had cervical neck surgery can be a challenge, as you will need to avoid putting strain on your neck, shoulders, or back. There can also be damage to the recurrent laryngeal nerve. eight (80%) recommend physical therapy after both single-level and multilevel ACDF. Please let us know what the next step will be. According to Healthline, only about 10% of these patients are still dealing with enough back pain after six weeks of other treatments to move forward with surgery. However, most people who are referred for this surgery have a lot of questions. Do not use nicotine for at least three months. Adjacent Segment Disease: Do All Spinal Fusion Patients Develop Adjacent Segment Disease? For dental work after surgery, you should wait at least six to eight weeks. In most cases, surgery is performed in order to address problems with one or more nerves within the spine. February 25, 2023 Wisdom Tooth. I can't tell you when YOU will be able to travel, but I can tell you when I did. While the cardiac and vascular effects associated with anesthesia typically dont last very long and dont affect a persons safety while flying, long-distance travel puts individuals who have just had surgery at high risk for developing blood clots. Your surgeon will provide discharge instructions that detail what to expect, medicine to take, and what to avoid. But it's important to "refuel." Food gives . If you have air travel planned before or after surgery, its important to consult your doctor to talk about the associated risks, as flying after surgery can result in certain health complications. They're often distracted and running late. "We only want the fastest, most optimal recovery for our spine surgery patients, and being in touch is crucial. Perhaps the nerves of your neck are pinched. how soon can i fly after acdf surgery; kaiserredux american civil war. The risk of flying after surgery can vary depending on the type of surgery youve had, which is why its essential to talk to your doctor to figure out the risks associated with your specific situation. Since the operation takes place close to some of the major blood vessels of the body, there is a chance that they can get injured during the procedure. Continue with Recommended Cookies. Hi nicki61400 and Welcome to Healing Well Chronic Pain Forum! DISC Clinic, PLLC. Most commonly, surgery is recommended when other treatment options have been exhausted and you have: The appropriate neck surgery recovery tips will vary depending on which condition you have. Getting a good nights rest after cervical neck surgery means picking a sleep position that is comfortable and safe. Answer (1 of 5): Flying is definitely an option, but I would proceed with caution (or at least some preparation). Some common complications that are seen after an ACDF surgery are: If after undergoing an ACDF procedure, patients feel that they have one or more of the above mentioned symptoms then it is advisable to opt for an immediate consultation with the surgeon. The surgeon should provide standard postoperative instructions, and cosmetic surgeries like facelifts, neck lifts, and blepharoplasty cosmetic surgery include a two-week to two-month no-fly standard based on an increased risk of blood clots and irritation in the . You can also place another pillow between your legs to help support your back and chest. It also is normal to have some swallowing difficulty. To get into bed, sit on the edge of the bed, lean slowly onto your side, then roll onto your back. However, it may take up to three months to fully recover. Study design: A retrospective database analysis. If you choose to fly after your surgery, there are some ways to improve your circulation and lower your risks of developing blood clots. I will agree with Snowbunny it takes time for the bone graft to take, and for it all to heal. mobile homes for sale in post falls, idaho; worst prisons in new jersey; fda acetaminophen daily limit 2021. how many words are in 10 sentences. I had C3,4,&5 disc repaired & fused to gether. Figure 3. Brooklyn, so glad that you checked back in. When is Spinal Fusion Surgery Done, Know its Risks, Recovery Period, Dietary Dos and Donts for Migraine Sufferers, Shirshasana (Headstand) Versus Inversion Therapy Using Inversion Table, Understanding Joint Pain and Tips to Get Relief Using Home Remedies, Erectile Dysfunction: Does Opioid Cause ED, Libido: Opioid Induced Female Sexual Dysfunction. Cervical Neck Surgery Recovery Guide: 5 Tips To Speed Up Time It Takes To Heal, Lumbar Microdiscectomy for Herniated Discs, contact our expert spine surgeon Dr. Sandro Larcocca, Life is Short Dont Let Sciatica Stop You Living Your Best, Siblings relief from herniated discs shows the difference surgery can make, When the diagnosis is scoliosis: Know your options for optimal quality of life, From surviving to thriving: Pandemic wisdom must chart our course, Less pain and thereby a better quality of life. {"smallUrl":"https:\/\/www.wikihow.com\/images\/thumb\/1\/13\/Sleep-After-a-Cervical-Neck-Surgery-Step-1-Version-2.jpg\/v4-460px-Sleep-After-a-Cervical-Neck-Surgery-Step-1-Version-2.jpg","bigUrl":"\/images\/thumb\/1\/13\/Sleep-After-a-Cervical-Neck-Surgery-Step-1-Version-2.jpg\/aid9585941-v4-728px-Sleep-After-a-Cervical-Neck-Surgery-Step-1-Version-2.jpg","smallWidth":460,"smallHeight":345,"bigWidth":728,"bigHeight":546,"licensing":"