Take note that Biotene is not indicated for all of these symptoms. Dont rely solely on mouthwash to preserve the health of your mouth and prevent cavities. Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat. 15 ml of biotene mouthwash will not cause any problem. The hotline operator may also ask you to provide the childs age and weight, and youll probably need to describe the childs symptoms if theyre experiencing any yet. One critical thing to remember: Do not make yourself vomit. Tell each of your health care providers about all medicines you use, including prescription and over-the-counter medicines, vitamins, and herbal products. Seek Help . But many drugs can interact with each other. For example, it may help to: increase your fluid intake take regular sips of cold water or an unsweetened drink. (n.d.). Try to avoid eating or drinking for 30 minutes after using the mouthwash to give it time to work. Michael Menna, DO, is a board-certified, active attending emergency medicine physician at White Plains Hospital in White Plains, New York. Call your doctor and check if it will help reassure you. You may need to avoid eating or drinking anything for about 15 minutes after using Biotene Mouthwash. Last medically reviewed on October 30, 2020. These tests can also help your doctor better understand the size and shape of the object, which helps them decide next steps. Some forms of fluoride topical should not be used in children of certain ages. 2023 Dotdash Media, Inc. All rights reserved, Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Content on HealthTap (including answers) should not be used for medical advice, diagnosis, or treatment, and interactions on HealthTap do not create a doctor-patient relationship. Swallowed 10ml of mouthwash should I be worried? Read the product instructions for more specific information. Not all brands are listed on this leaflet. It contains humectants and lubricants to provide dry mouth symptom relief. Some patients may experience stomach pain or vomiting after swallowing a non-food object. show all 12 brands Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Follow all directions on your medicine label and package. Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. If serious symptoms like convulsions, a rapid heart rate, or breathing problems develop, call your doctor or head to the emergency department. The primary mode of action across this range of oral products is physical (not pharmacological) by helping to retain moisture to help keep the oral tissues feeling moist, and by creating a physical coating film to lubricate the oral mucosa, thus helping to relieve dry mouth symptoms. It's possible for a dog to have a biotin deficiency, though this is rare. How often you use a saliva substitute may depend on your condition or your medication schedule. Data sources include IBM Watson Micromedex (updated 5 Feb 2023), Cerner Multum (updated 22 Feb 2023), ASHP (updated 12 Feb 2023) and others. Managing Symptoms and Causes of Dry Mouth at Night, Why Your Dry Mouth and Throat Might Be Related, https://www.chpa.org/Monograph_FSA_CARES.aspx, Problems chewing, swallowing, tasting and speaking*, Helps fight against infections by controlling bacteria in the mouth. "Dry Mouth." When a foreign object is swallowed, it can get stuck in the esophagus, a small, soft tube that runs from the mouth to the stomach. Although chewing gum is designed to be chewed and not swallowed, it generally isn't harmful if swallowed. (Accessed Aug. 31. To relieve dry mouth, use this medication as directed by your doctor by swishing your prescribed dose in your mouth and then spitting it out. But this isn't true. Get answers from Dentists and top U.S. doctors, Our doctors evaluate, diagnose, prescribe, order lab tests, and recommend follow-up care. The original Biotne Oral Rinse is regulated as a medical device, and is for the relief of dry mouth symptoms. Do not eat or drink anything or rinse your mouth for 30 minutes after using Biotene. Answer From Elizabeth Rajan, M.D. What to Do If You Swallow A Lot of Mouthwash. You may notice symptoms such as skin lesions, scaly skin, dry/dull hair & coat, lethargy, hair loss, diarrhea, and more. Children under the age of five were responsible for 75% of all reported cases of foreign body ingestion between 1995 and 2015. Do not use Biotene in a child without the advice of a doctor or dentist. Do not start, stop, or change the dosage of any medicines without your doctor's approval. Use this medication regularly to get the most benefit from it. To use the oral rinse or other liquid Biotene Mouthwash, swish a small amount in your mouth for 30 seconds, then spit out. Rinse for 30 seconds and then spit out. What happens if you accidentally swallow Biotene? 2017;55(10):1072-1254. doi:10.1080/15563650.2017.1388087, Orsagh-Yentis D, McAdams RJ, Roberts KJ, McKenzie LB. Your email address will not be published. Ask your dentist or call the product manufacturer if you do not understand these instructions. South African Journal of Radiology. To use the oral rinse or other liquid Biotene Mouthwash, swish a small amount in your mouth for 30 seconds, then spit out. Do not eat or drink anything or rinse your mouth for 30 minutes after using Biotene. Read and carefully follow all Instructions for Use on the label of your Biotene product. If youve swallowed mouthwash, dont take any medications or products like ipecac that will induce vomiting. Management of ingested foreign bodies and food impactions. According to Dr. Adalja, povidone-iodine is commonly used for a gargle for sore throats, but accidentally ingesting itwhether you swallow it. Shorter, smaller objects move more quickly. Alcohol- free in labeling pertains to being free of ethyl alcohol (also known as ethanol, or grain alcohol); therefore we are compliant and allowed to label alcohol- free. True, propylene glycol is an alcohol; however it is a humectant, which is an ingredient that retains moisture (which is why its used in our dry mouth products). If you are drinking it however, that is another story. In adults, the most commonly swallowed foreign objects are bones from food (like fish or chicken) and dentures. Ambe P, Weber SA, Schauer M, Knoefel WT. You should not use Biotene Mouthwash if you are allergic to any of the ingredients listed on the product package. How often should [] Biotne also comes in a toothpaste, mouth spray, gum and gel. Why can Biotne Mouth Spray be swallowed but Biotne Oral Rinse cannot? Will everything be okay and will my baby be okay? Deutsches rzteblatt International,109(50), 869. doi:10.3238/arztebl.2012.0869, Mathew RP, Sarasamma S, Jose M, et al. Use of oral care products with a pH of less than 5.5 could result in the loss of enamel from the tooth surface, depending on the level of saliva in the mouth. American Dental Association. The tablet or lozenge can be held in the mouth for long periods of time, even while you are sleeping.
http://www.ada.org/3014.aspx. Biotin & Dogs. Does using Biotne do more than just drinking water? The best cure is prevention when it comes to button batteries, so take extra special care to keep them away from children, especially toddlers. Never disregard or delay professional medical advice in person because of anything on HealthTap. Discover its ingredients, how to take it, alternatives. Ask a doctor before using Biotene Mouthwash if you are pregnant or breast-feeding. US residents can call their local poison control center at 1-800-222-1222. It can beused up to 2 or 3 times per day, based on the instruction of your healthcare professional. Best wishes and Happy and Prosperous New Year, It was my pleasure to help you today. Version: 1.01. Tell your doctor if your condition lasts or gets worse. As dry mouth symptoms can vary widely among individuals, a single recommended regimen does not suit everybody. Store your saliva substitute as directed on the product label. 2016;2016:8520767. doi:10.1155/2016/8520767, Gummin DD, Mowry JB, Spyker DA, Brooks DE, Fraser MO, Banner W. 2016 Annual report of the American Association of Poison Control Centers National Poison Data System (NPDS): 34th annual report. Regular brushing can help prevent this. Follow all instructions carefully. You may report side effects to FDA at 1-800-FDA-1088. "Oral Rinse." How does Biotne Oral Rinse help clean the mouth? Weight Loss for Health and Longevity, Science Reveals How Red Meat Harms the Heart, Flavored Vapes Still in Stores Despite Federal Ban, New COVID Antiviral Pills: What You Need to Know, Dr. Whyte's Book: Take Control of Your Cancer Risk, WebMD Loses Cherished Leader Kristy Hammam, Health News and Information, Delivered to Your Inbox, Treating Opioid Use Disorder With Medications, Constipated? Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. A very serious allergic reaction to this drug is rare. Its not intended to be drunk in fact, in large enough quantities, it can be toxic. Thank You" How do Biotne rinse, gel and spray work on dry mouth symptoms? I use listerene & a bleaching one. The angel's trumpet is a beautiful plant, but the leaves and flowers are poisonous to humans and animals. Neutragard, Neutral Sodium Fluoride Rinse, Omnii Gel Just For Kids, Oral B Anti-Cavity, Perio Med, PreviDent This medicine can also help strengthen tooth enamel, remove plaque bacteria from teeth and gums, and decrease painful tooth sensitivity. Can I rinse my mouth after brushing my teeth with Biotne toothpaste? If you swallowed at mouthful or capful, it should cause no harm. Biotne Gel has the highest level of humectants and lubricants of any product in the Biotne range. Even kid-friendly mouthwashes arent designed to be swallowed. However, if your child or someone you know overdoses on mouthwash by drinking and swallowing a large amount, take these steps: Difference Between Non-Fluoride and Fluoride Mouthwash, The Best Mouthwash for Gingivitis and Gum Disease, Stannous Fluoride Toothpaste - Crest Legacy in Innovation, What to Do If You Swallow A Little Bit of Mouthwash, What to Do If You Swallow A Lot of Mouthwash. Here are a few prevention strategies that may help you: One of the biggest concerns about swallowing mouthwash is the ingestion of alcohol in the product. When used during chemotherapy or radiation, you may need to use this medicine up to 10 times per day beginning on or before the day of your treatment. Warde P, Kross B, O'Sullivan B, Aslanidis J, Tew-George E, Waldron J, et al. Even a relatively small amount of ethanol, like 1 ounce, can be harmful for children, who tend to be more sensitive to it. Rod Brouhard is an emergency medical technician paramedic (EMT-P), journalist, educator, and advocate for emergency medical service providers and patients. Oralbalance is perfectly safe to swallow as it is made up of naturally occurring salivary enzymes. I have issues at night swallowing and sticky mucous, although I don't seem to produce much mucous recently. Your doctor will perform a medical evaluation that includes a physical exam as well as imaging tests like X-rays or CT scans. Gastroenterol Res Pract. Rinsing with oral rinse reaches parts not reached by brushing. Created for people with ongoing healthcare needs but benefits everyone. http://www.mayoclinic.com/health/dry-mouth/HA00034/METHOD=print. Heres how to use it. What happens if you accidentally swallow Biotene mouthwash? What are some home treatments for swallowing mouthwash? You swirl it around in your mouth for the recommended time. A stingray sting can be quite painful and, According to recent news reports, the wife of a California congressman died late last year from side effects related to the herbal supplement white, Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. Copyright 1996-2023 Cerner Multum, Inc. If you are using a prescription toothpaste, tell your dentist or doctor if you have kidney disease. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Quiz: Does Your Loved One Have Dry Mouth? (2017). Otherwise, call a poison control center right away. The toothpaste is specially formulated to not irritate. Their bodies are smaller, so its much easier for them to overdose. Fluoride isnt the only ingredient in many mouthwashes many also contain alcohol. What happens if I ingest Oralbalance? Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other abusable medications. It also depends on the type and strength of the. (1997). Doctors separate swallowing problems into three types: Oral cavity dysphagia: The problem is in the mouth. "Effectiveness of saliva substitute products in the treatment of dry mouth in the elderly: a pilot study.". Do not get it in your eyes. What Is Choking? This medication may contain sodium. They will provide guidance to help you determine what to do next. What should I avoid while using Biotene? saliva will increase pH in the mouth to counter the drop in pH from these food and drinks. 16. And their color is usually red, white, or yellow. Your plan details may vary, so save your receipt and check with your benefits or health provider for eligibility. For the first 30 seconds, use the dry brush and brush the lingual (inside) surface of your teeth, then moisten toothbrush and apply a dry mouth toothpaste (e.g. read more. Don't fret if you swallow some since the dose is small, accidentally swallowing it once or twice won't harm you. By Rod Brouhard, EMT-P But it can be even more useful than that. 17. The speed at which a foreign body will pass through the GI tract depends on how big it is. Drug class: Mouth and throat products. Fluoride gels, when swallowed in large amounts, can also cause symptoms like pain, nausea, or vomiting. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. $30 Off the Whitening Emulsions Twin Pack - Brighten Your Smile Anywhere, Anytime! Saliva substitute gel, paste, or swabs may be applied directly onto the gums, tongue, teeth, or sides of the mouth. Any time you suspect that something was swallowed and it can be felt (by the person who swallowed it) in the throat or deep in the chest, it's important to seek medical care immediately. ada.org/en/member-center/oral-health-topics/mouthrinse, scielo.br/scielo.php?script=sci_arttext&pid=S1678-77572012000600006&lng=en&tlng=en, ncbi.nlm.nih.gov/pmc/articles/PMC4048138/, aapd.org/globalassets/media/publications/archives/shulman-19-06.pdf, ncbi.nlm.nih.gov/pmc/articles/PMC5651468/, Everything You Need to Know About Using Mouthwash, The Advantages and Disadvantages of Chlorhexidine Mouthwash, What You Need to Know About Ricin Poisoning, What You Need to Know About the Effects of Angels Trumpet Poisoning, White Mulberry Leaf Extract Linked to Woman's Death: What to Know, cetylpyridinium chloride, an antimicrobial agent, essential oils, like menthol or eucalyptus, that may help reduce. However within a week I developed hoarsness and change of voice it continues. We avoid using tertiary references. Ingesting povidone-iodine can pose health risks. U.S. Food and Drug Administration. For instance, sodium hydroxide batteries can cause chemical burns in the esophagus, while lithium batteries can generate electric currents that can damage the tissue. Stomach pain. Heres why. Do not freeze. Connect with a U.S. board-certified doctor by text or video anytime, anywhere. Or gently scrape your tongue using a tongue scraper or soft bristle toothbrush, then smell the scraper. I have stopped for one day and my voice is getting less hoarse. Button batteries, like the ones used in watches or other electronics, can pose serious risks when swallowed. They often occur at the base of your gums. You can learn more about how we ensure our content is accurate and current by reading our. Detailed Biotene Mouthwash dosage information. Overdose with this medication is unlikely even if swallowed. Some tablets are pressed onto to your tooth or gums to help hold them in place. Healthline Media does not provide medical advice, diagnosis, or treatment. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details. Oral mucositis is a common side effect of cancer treatments, especially radiation for head and neck cancer. Hour ago my dad used half a cap of Listerine Nightly Reset mouthwash and he said he accidentally swallowed some of it, but I saw him spit some out which makes me think he can't have swallowed much. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of . Foreign objects that get stuck at the top of the esophagus can also enter the trachea. Biotene rinse or gel can stain your teeth. It has been known that some desperate alcoholics will drink the mouthwash for this reason. So do not worry. What Is an EGD Procedure (Upper Endoscopy)? Read the product labels, visit our website or speak to a HCP to assist you to make your choice about which products in the range to use. Do not use extra medicine to make up the missed dose. "Dry Mouth." Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other commonly abused medications. In some cases, a foreign object can pass through the body without causing any problems. Matear DW, Barbaro J. More serious overdose symptoms may include severe stomach cramps and coughing up blood. This is not a complete list of side effects and others may occur. Occasionally swallowing a small amount of. Saliva substitutes can be used with no side effects. Medicines such as antidepressants, antihistamines, decongestants, high blood pressure medicines, chemotherapy drugs used to treat cancer, and muscle relaxants, Nerve damage from an injury or surgery to the head or neck, Diseases such as diabetes, Sjgren's syndrome, Parkinson's disease and HIV/AIDS. Biotne Spray contains humectants and lubricants for instant and long lasting dry mouth symptom relief. Rod Brouhard is an emergency medical technician paramedic (EMT-P), journalist, educator, and advocate for emergency medical service providers and patients. Biotene Mouthwash work inside your mouth and are. If you have children, be cautious of any product containing alcohol thats in your home, whether its mouthwash, hand sanitizer, or other products, all of which have been known to cause cases of intoxication or poisoning. Mayo Clinic. Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. All rights reserved. It is designed to be used for temporary relief of oral discomfort and for healing of oral ulcers with a pleasantly mild flavor. Therefore; for dry mouth sufferers, it is advisable that all oral products have a pH above 5.5 which is closer to normal saliva. 2005 - 2023 WebMD LLC. Before using saliva substitute, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. (2012). My child ate toothpaste; should I be worried? If propylene glycol is an alcohol then why does your label say alcohol free? 12 Medicines That Could Help. Brush your teeth after you eat. *Biotne not indicated for all of these symptoms. Before using this medication, tell your doctor or pharmacist your medical history. But you dont have to put up with it, because there are alternatives. Avoid extreme heat. National Institute of Dental and Craniofacial Research. Magic mouthwash helps treat mouth sores caused by conditions, such as cancer and oral thrush. Use up to 2 or 3 times per day, based on the instruction of your healthcare professional. To learn more, please visit our, then you should be fine. Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Mouth sores (oral mucositis) can be extremely painful and can result in an inability to eat, speak or swallow. Drug class: Mouth and throat products. with different flavorings, such as oil of spearmint, so there's no harm in swallowing a capful. If you are on a schedule, use the missed dose as soon as you remember. American College of Medical Toxicology. Spit it out after use. Do not double the dose to catch up. suck on sugar-free sweets or chew sugar-free gum this can stimulate your salivary glands to produce more saliva. Be vigilant about spitting the mouthwash out into the sink after you use it. You may experience nothing apart from nausea or diarrhea. It is an artificial saliva that moistens and cleans the mouth. Shulman JD, et al. Call your doctor for medical advice about side effects. Available for Android and iOS devices. Kolikonda MK, et al. When you swallow anythingfood, drink, or a foreign (non-food) objectit travels through the GI tract, or gut. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Make no mistake: Having dry mouth can affect your ability to taste, chew and swallow food. A lack of saliva can even make it harder for you to digest food or talk. Source: https://www.chpa.org/Monograph_FSA_CARES.aspx. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing. Do not use Biotene in a child without the advice of a doctor or dentist. Even if sharp objects make it through the esophagus, they can cause damage in other areas of the GI tract. Follow all directions on the product package for using this medication correctly. If a foreign body makes it past your esophagus, it has a pretty good chance of making it all the way through the GI tract. Follow package instructions spray directly into the mouth, on the tongue and spread thoroughly inside the mouth. Use as needed. In severe cases, head for the emergency room, and bring the mouthwash bottle with you if possible. What are the benefits of Biotne Oralbalance Gel? The Biotne Oral Rinse contains the same types of enzymes and protein that are found naturally in your saliva. Overdose symptoms may include nausea, vomiting, stomach pain, diarrhea, burning in the mouth, and sore tongue. Typical causes include tongue weakness after stroke, difficulty chewing food or neuromuscular problems. The ADA Council on Scientific Affairs Acceptance of Biotene Dry Mouth Oral Rinse is based on its finding that the product is safe and has shown efficacy in temporarily relieving dry mouth symptoms, when used as directed. Folklore suggests that swallowed gum sits in your stomach for seven years before it can be digested. NeutraSal, Numoisyn, Optimoist, SalivaMAX, Salivart, Xero-Lube, XyliMelts. A small volume of mouthwash will not kill you. Helps rinse away loose food particles in the mouth. To treat dry mouth, your doctor may ask you to stop taking any medicines that are causing it. One study estimates that 20% of children between the ages of one to three have swallowed a non-food item. Contact us at 1-866-844-2797, M-F8am-6pm EST so we can give you more personalized attention. It is an artificial saliva that moistens and cleans the mouth. Our website services, content, and products are for informational purposes only. Do not expect much to happen. If you receive instructions to go to the hospital, go right away. In addition to potentially causing a blockage, magnets pose a unique risk because they can attract each other (or other pieces of metal) and pinch off the walls of the GI tract. More serious overdose symptoms may include severe stomach cramps and coughing up blood. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. (2013). The Biotne system/range allows consumers to choose the right products or group of products to fit their lifestyle preferences and dry mouth symptom severity. Coughing or gagging. doi:10.4102/sajr.v25i1.2022, Ikenberry SO, Jue TL, Anderson MA, et al. You may report side effects to Health Canada at 1-866-234-2345. If you suspect that a button battery was swallowed, seek emergency care right away. 2011.) Keep all medications away from children and pets. Bethany Burtyk, GlaxoSmithKline. Can this have hurt my baby? This is often the result of dehydration, which means you dont have enough fluid in your body to produce the saliva you need. Erosive Esophagitis Causes and Treatments. Ingestion of lidocaine can cause numbness of the mouth and throat, which can lead to trouble swallowing . How do I know which Biotne product to use? What happens if you swallow lidocaine? There is no safety concern in swallowing a small amount of the product, such as would be expected with normal use. Do not make yourself vomit as it could make the situation worse. 2011.) Should i be worried? Please copy/paste the following text to properly cite this HowStuffWorks.com article: Stephanie Watson If your child has swallowed mouthwash, immediately call the Poison Control Centers toll-free hotline at 800-222-1222. Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Rayar P, et al. 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. FIND THE RIGHT PRODUCT FOR YOU SAVE NOW SHOP NOW. If you swallow a tiny amount of mouthwash, you probably wont have any problems, especially if you dont make a habit out of doing so. Depending on your product, avoid eating or drinking for at least 15 to 30 minutes after using this product. Biotene. Mouthwashes and mouth rinsesare meant to be spit out, not swallowed, because even natural mouthwash products may contain ingredients that can be poisonous if ingested in large amounts. Vomiting or drooling. If you cant find the specific Biotne product you are looking for, ask your pharmacist or store manager. This product was designed to lubricate and relieve the symptoms of dry mouth. Biotene Dry Mouth Oral Rinse Mouthwash Artificial Saliva, Enter your medication into the WebMD interaction checker, Smart Grocery Shopping When You Have Diabetes, Surprising Things You Didn't Know About Dogs and Cats, Fitness vs. Call the National Poison Control Center at 1-800-222-1222 for quick, confidential help. In most cases, the object will pass through the digestive system. What impact can gender roles have on consumer behaviour? Other causes of temporary halitosis include some beverages (including alcoholic drinks or coffee) and tobacco smoking. Things to remember when you fill your prescription. How do you let go of someone who doesnt want you? The esophagus and airway ( trachea) are located side by side in the neck. Personal Interview, Sept. 1, 2011. Not sure how much. Generic name: fluoride topical [FLOR-ide-TOP-i-kal] It's 8% alcohol. Call your doctor or 911 if you think you may have a medical emergency. However, we certainly do not discourage you from sipping water to help relieve your Dry Mouth symptoms. The worst outcomes overwhelmingly (94%) came from batteries that were at least 20mm in diameter. Tell your doctor if you are pregnant before using this product. Consult your pharmacist or local waste disposal company. Don't Delay Treatment." If you or your child are experiencing breathing problems or other noticeable signs, or have swallowed a small battery, however, get emergency help immediately. Properly discard this product when it is expired or no longer needed. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use. Most of the time, adults can be observed to see if the foreign body will pass on its own (and in 80% to 90% of cases, it will). Otherwise, call a poison control center right away. Again, if you swallow a small volume of mouthwash, it probably wont be a big issue. This will help them confirm that an object has been swallowed, determine how far the object has traveled in the GI tract, and whether it is causing a blockage. More serious overdose symptoms may include severe stomach cramps and coughing up blood.
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