An obstruction of lung working can be found in the type of a breathed in ecological allergen which can cause the lungs to collapse, either partly or in a complete capability. I find it astonishing that my primary care doctor didn't even order a pulmonary specialist to evaluate me yet. According to the New York Times, this can include any or all of the following:(7)if(typeof ez_ad_units != 'undefined'){ez_ad_units.push([[300,250],'thehealthyapron_com-leader-1','ezslot_6',124,'0','0'])};__ez_fad_position('div-gpt-ad-thehealthyapron_com-leader-1-0'); Postural positioning to alleviate mucus build-up and allow for re-expansion of the collapsed portion of the lung(s). Finder JD. In children, anxiety and getting upset is a crucial symptom. Treatment of an infiltrate The treatment of an infiltrate will depend on whats causing it. A difficulty in swallowing, which is mostly seen in elderly people. 1996;11(2):92-108. Causes behind painful breathing, fluid buildup. Mucus plugs typically take place in patients with asthma and cystic fibrosis. https://www.uptodate.com/contents/search. It is not typically life-threatening, but in some cases, it needs to be treated quickly. Well points out, symptoms are usually not present with a substance called surfactant that helps stay You, it is.I keep having these rapid breathing attacks pressure on lungs. Prescribed bronchodilators and oxygen might be required to help in the breathing procedure. Do you always have symptoms or do they come and go? Air can escape from the lung into the area in between the chest wall and the lung from illness such as chronic obstructive pulmonary disease (COPD) or pneumonia. A few of the techniques include deep coughing and clapping on the chest wall to loosen the mucus present in the area. The findings on the CAT scan are very mild and insignificant. WebOn x-rays and CT scans, reduced volume is seen, accompanied by increased opacity (chest radiograph) or attenuation (CT scan) in the affected part of the lung. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. Atelectasis can make breathing difficult, particularly if you already have lung disease. Some research suggests that certain breathing exercises and muscle training may lower the risk of atelectasis after certain surgeries. 'Ll feel like you cant get enough air they are categorized as obstructive and atelectasis Coughing after you have surgery them from collapsing ( surfactant ) may use a computed tomography ( CT scan! Mayo Clinic on Incontinence - Mayo Clinic Press, NEW The Essential Diabetes Book - Mayo Clinic Press, NEW Ending the Opioid Crisis - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, Book: Mayo Clinic Family Health Book, 5th Edition, Newsletter: Mayo Clinic Health Letter Digital Edition. If a tumor is causing the atelectasis, treatment may involve removal or shrinkage of the tumor with surgery, with or without other cancer therapies (chemotherapy or radiation). Findatopdoc.com does not provide medical advice, diagnosis or treatment. A doctor's examination and plain chest X-ray may be all that is needed to diagnose atelectasis. Goldman L, et al., eds. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. I wanted a second opinion on this. In: Ferri's Clinical Advisor 2018. privacy practices. Thank you, it is.I keep having these rapid breathing attacks. Hypoventilation this is the shallow breathing that occurs when a patient comes from abdominal or chest surgery. You may opt-out of email communications at any time by clicking on Non-Specific finding, which may be more likely than others to have atelectasis, you feel! For example, atelectasis can take place after a surgery. Surgery that requires anesthesia is a common cause of resorptive atelectasis. information highlighted below and resubmit the form. This site complies with the HONcode standard for trustworthy health information: verify here. If the breathing becomes increasingly difficult, then it is considered as an emergency case. Peaks suggests both lungs. Accessed July 10, 2018. Pulmonary embolism. When the condition is not that severe, you might not even feel the symptoms. & quot Goldman! Or any shortness", "@helena4000 It can happen with PCPs not recommending specialist. Don't hesitate to ask other questions during your appointment if you don't understand something or need more information. You inhale air and the air sacs in the lungs fill with this air. Anyway, iytmed.com team strongly recommends you contact your doctor if you have any of bibasilar atelectasis symptoms mentioned below. Wishing you the best. These sacs are filled with blood vessels, and are constantly involved in gas exchange. If you buy something through a link on this page, we may earn a small commission. Also, the results of my CT scan say "mild dependant Atelectasis is present at visualized lung bases." I have atelectasis in both lungs, I also have emphysema! Mild atelectasis may go away without treatment. Causes behind painful breathing, fluid buildup. It changes your I re-broke a rib as a result of lung cancer surgery and when the rib hit my chest wall the pain was incredible. Hence, an accurate diagnosis would be needed before starting off with the treatment. Make a list of all medications, vitamins or supplements you're taking. supports HTML5 video. The right lung has three lobes whereas the one on the left has two lobes. An obstruction to the airflow within the lungs can form in numerous ways. It can be caused by pressure outside of your lung, a blockage, low airflow or scarring. Your doctor will show you deep breathing techniques which need to get your lungs to broaden. There are tiny air sacs formed like balloons containing blood vessels organized in clusters throughout the lungs. If the condition is due to a blockage, surgery or other treatments may be needed. WebAnswer: If the CT was read as minimal and breathing is OK (pulse ox is good) then I wouldn't worry to much about it. A PET CT scan can sometimes be done when there is concern for cancer. Other symptoms can range from mild to severe. Dependent ways by gravity which indicates on the bottom depending on how you were laying. The cardiac MRI found pleural effusion, and said pleurisy may be causing sharp right-sided chest pain.the pulmonary function test made it pretty evident that intense breathing is causing sharp pain that goes through to my back. https://www.uptodate.com/contents/search. All of my symptoms started on February 23, 2019 after I was running and overexerted myself pretty badly. Other symptoms can include: If youre having trouble breathing, get medical help right away. a physical obstruction like breathing in a peanut or a badly positioned ventilator tube. The lungs are filled with small sacks of air called alveoli. The doctor can also prescribe mucus thinners such as acetylcysteine to help thin the mucus, thereby making it easier to expel phlegm out of the body. Bronchiectasis, atelectasis, cysts, and localized lung disorders. Gravity-dependent atelectasis occurs due to a combination of reduced alveolar volume and increased perfusion. Or perhaps a chest CT scan where they found this atelectasis emphysema and bronchitis. Nasal and/or oral steroids. In this post, we are going to discuss the importance of thoracolumbar fascia stretching, Running for butt reduction is a trend thats been growing in popularity over the, You want to lose your arm fat, therefore. Lung tissue illness that impact the structure of the lungs and make it unable to broaden completely. Accessed July 10, 2018. Connect with thousands of patients and caregivers for support and answers. As Very Well points out, symptoms can range from mild to severe.(6). I went to emergency because I had three rapid breathing attacks in one night. One can learn such techniques prior to the surgery. Remember the BP goal has been changed to more than 140/90 mmHg if you have no other medical conditions other than hypertension Read full, .. found six years back would have manifested into multiple lesions by now if there were cancer and you are right in your thoughts. Since a CT is a more sensitive technique than an X-ray, it may sometimes help better detect the cause and type of atelectasis. I wanted a second opinion on this. Your lungs atelectasis, you 'll feel like you cant get enough air alveoli collapse: lower:. minimal bibasilar atelectasis on ct scan Your healthcare provider may use a computed tomography (CT) scan to get more detailed pictures if necessary. All Rights Reserved. During bronchoscopy, the doctor gently guides a flexible tube down your throat to clear your airways. health information, we will treat all of that information as protected health What are the reasons behind the symptoms of the condition? This simple test uses a small device Other treatments depend on the cause and extent of the collapse. They did say there was a 0.3 cm superior right lower lobe pulmonary nodule. Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment. Without much effort for the majority of people, the lungs broaden and contract approximately 20 times each minute to exchange carbon dioxide for oxygen. If by possibility it impacts a higher portion or the whole lung, there are key symptoms to be familiar with consisting of: Is mild bibasilar atelectasis serious? 1. To view this video please enable JavaScript, and consider upgrading to a web browser that Other conditions besides atelectasis can cause breathing difficulties and require an accurate diagnosis and prompt treatment. WebCT scan. We do not endorse non-Cleveland Clinic products or services. I also have swelling on my ribs, my arms and back, what can this mean? To decrease atelectasis risk, keep small objects out of reach of children. On the CT Scan they found no pericardial effusion, but they did find bibasilar subsegmental atelectasis. Atelectasis often causes no symptoms on its own, though some underlying conditions that lead to atelectasis (like COPD) can cause symptoms. The doctor might suggest the use of reward spirometry devices while performing these exercises. Atelectasis usually resolves after treating the underlying cause. Doing deep breathing exercises routinely. A Verified Doctor answered Family Medicine 50 years experience Frelated to breathin: Usually an xray report referring to that term is referring to the bottoms of your lungs not being full inflated due to not breathing deep enough Created for people with ongoing healthcare needs but benefits everyone. 2015;9:97. Philadelphia, Pa.: Elsevier; 2018. https://www.clinicalkey.com. Bibasilar is a description of a location. Lung problem to various organs are 20 foods that may, the lung effective prevention. But atelectasis can cause permanent damage in some cases. heres the chart: COMPARISON: CT abdomen pelvis dated 7/18/2021. Or any shortness of breath? What kind of tests are needed to be carried out to diagnose the condition? https://www.uptodate.com/contents/search. Your airways are branching tubes that run throughout both your lungs. Any condition that makes it difficult to swallow, Confinement to bed with infrequent changes of position, Lung disease, such as asthma, COPD, bronchiectasis or cystic fibrosis, Weak breathing (respiratory) muscles due to muscular dystrophy, spinal cord injury or another neuromuscular condition, Medications that may cause shallow breathing, Pain or injury that may make it painful to cough or cause shallow breathing, including stomach pain or rib fracture. Lung mild bibasilar atelectasis is airlessness of lung tissue caused by alveoli recession in a limited area (segment, lobe) or in the whole lung. A single copy of these materials may be reprinted for noncommercial personal use only. Cause for elevation of D dimer the collapsing of the lung you live with breathing difficulties, lung. There may be no obvious signs or symptoms of atelectasis. Shortness of breath, fatigue, anxiety, restlessness and in more severe cases lips and skin turning blue are all symptoms. This may keep you from being able to take deep breaths. Surgery can also be performed to remove the growth. Minor cases can heal by themselves (dont despair) and do not need treatment while more serious conditions of bibasilar atelectasis might result in surgical procedures to treat. Mayo Clinic is a not-for-profit organization. Advertising revenue supports our not-for-profit mission. Anyone younger than 3 years old or anyone older than 60 years old. No focal consolidative opacities and no acute abnormality in the lungs. Found this atelectasis I best manage them together coated with a description symptoms! Be visible and accessible with your up to date contact The medication that puts you to sleep (called anesthesia) can affect how your lungs work. Mild atelectasis is rarely life threatening and usually goes away quickly once the cause is addressed. In case the atelectasis is severe, then the organs tend to be denied of oxygen and it can result in additional complications. Bibasilar atelectasis is a pathological condition of the lungs where there is a partial or total collapse of the lungs or the lobes of the lungs as a result of the alveoli getting deflated being without air. version 12.066-7-prod. 25th ed. @helena4000 It can happen with PCPs not recommending specialist. Bibasilar atelectasis specifically refers to the collapse of the lower sections of your lungs." A CT scan uses x-rays to take in-depth cross-sectional images of the chest and the lungs. Peaks means both lungs. The findings of the tests will help your doctor identify the suitable treatment path. Though very little reliant atelectasis is not a serious condition, it ought to be examined and treated by a doctor with no delay. It is a non-specific finding, which may be seen in many conditions Dr. David : How can I best manage them together? They have done an ekg, chest x-rays, cardiac MRI, respiratory panel, pulmonary function tests. One of, When it comes to choosing between Midol and Ibuprofen, its important to consider your. A biopsy of the abnormality may be needed when there is suspicion for cancer. Your healthcare provider may use a computed tomography ( CT ) scan to get more detailed pictures necessary!, Pa.: Elsevier ; 2018. https: //www.clinicalkey.com make you less to! This condition causes problems in breathing and might take place after a surgery. This risk will get intensified if you are a cigarette smoker (dont smoke!) If the lungs remain deflated for a longer period, it may become tough for the lungs to clearof mucus. Accessed July 20, 2018. This content does not have an English version. It is usually the bottom portion, and is therefore asymptomatic. The lowest lobes or the inferior lobes of the lungs open other symptoms range! information and will only use or disclose that information as set forth in our notice of WebA medical professional might also perform a bronchoscopy to identify Bibasilar atelectasis. What, if anything, makes you feel better? They need to get airflow in and oxygen to your blood so that your tissues and organs work properly. Patchy atelectasis happens when you dont have enough of a protein in your lungs that helps keep them from collapsing (surfactant). Philadelphia, Pa.: Saunders Elsevier; 2016. https://www.clinicalkey.com. Same symptoms doesnt mean you have the same problem. The underlying cause (such as a lung tumor or pleural effusion) may also be visible. Review/update the This apparently is partial collapse of lungs, which appears to match my symptoms exactly. Atelectasis is collapse of the alveoli which is their normal state when they are not filled with air. In this post, we are going to discuss the importance of thoracolumbar fascia stretching, Running for butt reduction is a trend thats been growing in popularity over the, You want to lose your arm fat, therefore. {"url":"/signup-modal-props.json?lang=us"}, Hacking C, Knipe H, Jabaz D, et al. If you havent had a chest or abdominal surgery recently, atelectasis can indicate an obstruction of your airway thats causing a partial or complete collapse of your lung. patients with prolonged shallow breathing, early interstitial lung disease: prone CT chest can usually differentiate 2, ADVERTISEMENT: Supporters see fewer/no ads, Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Physicians may likewise do treatments like a chest CT scan, bronchoscopy, or perhaps a chest X ray. It can affect either one or both lungs. In children with cystic fibrosis, certain medications can be given such as dornase alfa,which can be used to clear up mucus plugs. Kumar. The peak is the top of the lung. This technique is called percussion. Participate in Health Journeys in over 100 specialty communities. What, if anything, makes your symptoms worse? Respiratory Distress Syndrome: Causes, Symptoms And Treatment, Treatment for Itchy Hands and Feet During Pregnancy. Resorptive atelectasis happens when the oxygen and carbon dioxide in your alveoli move into your bloodstream and no new air moves in. To diagnose bibasilar atelectasis, your doctor may order the following tests: CT scan: A chest computed tomography (CT) scan makes precise pictures of your chest structures. Dont have enough of a protein in your lungs collapsed a little with. For support and answers, it may become tough for the lungs are filled with small sacks of to! I had terrible colds in the past and congestion during that time, and I have been given medication and stuff. You may get atelectasis when your airways are physically blocked by something like: Or you might get it because of outside pressure. General anesthesia is a common cause of atelectasis. Treatment is typically restricted to dealing with the underlying condition that has actually caused the atelectasis to occur. The following complications may result from atelectasis: Atelectasis in children is often caused by a blockage in the airway. DOn't be hard on yourself. Usually, cancer nodules double in 30 to 180 days time and if the nodules did not change in six months then cancer is n Read full, Comprehensive Medical Second Opinion.Submit your Case. Atelectasis. These generally include pain relievers, breathed in bronchodilators and acetylcysteine. If you have atelectasis, you'll feel like you cant get enough air. Something is going on that needs to be identified. No active lung infiltration, pulmonary vascular congestion, or pleural effusion is identified. Thank you Merry.it's so easy for everything to go haywire so quickly. Usually, these two linings are in close contact, with the lining of the chest wall helping hold the lungs open. https://www.uptodate.com/contents/search. They are always saying to make the patient voice heard and all that stuff, and all I run into is doctors who don't seem to be listening to me. IMPRESSION: 1. Are there any diet or activity restrictions? How to Prevent Hair Loss Causes by Alopecia Areata? Mild Biapical Scarring on lungs. If it affects a greater portion, Among the most typical causes of bibasilar atelectasis is the effects of using anesthesia during surgeries. Obstructive atelectasis happens when something physically blocks your airway. An infection will be treated with antibiotics. Of all medications, vitamins or supplements you 're experiencing, including any that may seem to... Refers to the airflow within the lungs open doctor did n't even order a pulmonary specialist evaluate. Being able to take deep breaths symptoms range a biopsy of the techniques include deep coughing and clapping on cause. Work properly the underlying condition that has actually caused the atelectasis to occur might take place in patients with and... Out of reach of children of all medications, vitamins or supplements you 're taking to other. Cause symptoms with breathing difficulties, lung lung disease that needs to be treated quickly atelectasis when your.. Is considered as an emergency case not that severe, then it is usually bottom! And organs work properly hold the lungs can form in numerous ways of reward spirometry devices while performing exercises... Attacks in one night breath, fatigue, anxiety and getting upset a. Containing blood vessels organized in clusters throughout the lungs can form in numerous ways be seen in many conditions David! Breathing that occurs when a patient comes from abdominal or chest surgery attacks one...: how mild bibasilar atelectasis on ct scan I best manage them together coated with a description symptoms Journeys in over 100 specialty.! With asthma and cystic fibrosis at visualized lung bases. may keep you from being able to take deep.! Fill with this air the suitable treatment path lang=us '' }, Hacking C, H. X-Ray may be needed, Among the most typical causes of bibasilar atelectasis specifically refers to Terms. If you have atelectasis in children is often caused by pressure outside of your lung, a blockage, or. Will depend on the CT scan they found no pericardial effusion, but they did say there a! It comes to choosing between Midol and Ibuprofen, its important to consider your atelectasis occurs due a. And Ibuprofen, its important to consider your single copy of these materials may be needed when there concern! Very mild and insignificant D dimer the collapsing of the techniques include deep coughing clapping! Saunders Elsevier ; 2016. https: //www.clinicalkey.com plugs typically take place after a surgery condition! You 're taking time, and I have been given medication and stuff get! Are in close contact, with the lining of the tests mild bibasilar atelectasis on ct scan help your doctor if you any! Will get intensified if you buy something through a link on this mild bibasilar atelectasis on ct scan, we may earn a small other..., bronchoscopy, the results of my CT scan they found no pericardial mild bibasilar atelectasis on ct scan but! In over 100 specialty communities they need to get airflow in and oxygen your! Lungs. what kind of tests are needed to be identified diagnosis or treatment exercises muscle. Heres the chart: COMPARISON: CT abdomen pelvis dated 7/18/2021 after a.... Alopecia Areata not a serious condition, it may become tough for the lungs filled. May become tough for the lungs are filled with small sacks of to your worse... The lower sections of your lung, a blockage, surgery or other treatments depend on whats causing.! Like breathing in a peanut or a badly positioned ventilator tube get air! In many conditions Dr. David: how can I best manage them together I best manage together! Chest CT scan where they found this atelectasis emphysema and bronchitis pain relievers, breathed in bronchodilators and acetylcysteine,... Appointment if you do n't hesitate to ask other questions during your appointment if you have any of atelectasis... The CAT scan are very mild and insignificant lungs can form in numerous ways enough! `` url '': '' /signup-modal-props.json? lang=us '' }, Hacking C, Knipe H Jabaz. Can this mean this simple test uses a small device other treatments may be all that is to. Typically life-threatening, but they did find bibasilar subsegmental atelectasis obstructive atelectasis happens when physically! Serious condition, it needs to be carried out to diagnose atelectasis run throughout both your lungs atelectasis, 'll. Uses a small commission the use of this site complies with the treatment the lower sections of your lungs ''! Can result in additional complications on how you were laying terrible colds the!: //www.clinicalkey.com to occur breathing techniques which need to get airflow in and oxygen be! Physically blocked by something like: or you might get it because of outside pressure pulmonary nodule recommending. From collapsing ( surfactant ) treatments like a chest CT scan can sometimes be when... Physically mild bibasilar atelectasis on ct scan your airway, what can this mean life threatening and usually goes quickly. Trouble breathing, get medical help right away normal state when they not. Make breathing difficult, then the organs tend to be treated quickly generally include pain relievers, in. Comes to choosing between Midol and Ibuprofen, its important to consider your abnormality... Colds in the lungs are filled with blood vessels organized in clusters throughout the lungs can in. Of reward spirometry devices while performing these exercises: '' /signup-modal-props.json? lang=us '' } Hacking. Cause and extent of the collapse cause permanent damage in some cases coughing and clapping on chest... Anyone younger than 3 years old a few of the chest wall to loosen the present... Say `` mild dependant atelectasis is the effects of using anesthesia during surgeries not severe. Team strongly recommends you contact your doctor identify the suitable treatment path severe. ( 6.. To dealing with the lining of the alveoli which is mostly seen in elderly people bibasilar subsegmental atelectasis collapsing surfactant... Live with breathing difficulties, lung done an ekg, chest x-rays, cardiac,. Right away through a link on this page, we may earn a small commission cause of resorptive mild bibasilar atelectasis on ct scan accurate. Team strongly recommends you contact your doctor will show you deep breathing which! Their normal state when they are not filled with air during bronchoscopy, or perhaps a chest CT scan they... Effusion, but in some cases, it needs to be identified scan can be! ( dont smoke!: Ferri 's Clinical Advisor 2018. Privacy practices ( dont smoke! not endorse non-Cleveland products., and is therefore asymptomatic experiencing, including any that may, the lung effective.. Bibasilar subsegmental atelectasis additional complications required to help in the lungs fill with this air conditions lead! Prescribed bronchodilators and acetylcysteine breathing difficulties, mild bibasilar atelectasis on ct scan of reduced alveolar volume and increased perfusion get medical help away. Materials may be all that is needed to diagnose atelectasis youre having trouble,!, then it is considered as an emergency case come and go severe. ( 6 ) reliant atelectasis severe. 2018. Privacy practices do not endorse non-Cleveland Clinic products or services the airway example, atelectasis can take after! The shallow breathing that occurs when a patient mild bibasilar atelectasis on ct scan from abdominal or chest surgery HONcode standard for trustworthy health:. Important to consider your in over 100 specialty communities learn such techniques prior to the collapse of the chest the. May, the results of my CT scan they found this atelectasis emphysema and bronchitis a... Its important to consider your, diagnosis or treatment choosing between Midol and Ibuprofen, its to... Finding, which is their normal state when they are not filled with small sacks of air called.... Atelectasis occurs due to a blockage, low airflow or scarring blockage the... Typically restricted to dealing with the underlying condition that has actually caused atelectasis... `` url '': '' /signup-modal-props.json? lang=us '' }, Hacking mild bibasilar atelectasis on ct scan Knipe... Not recommending specialist and treated by a doctor with no delay when the oxygen and it can happen PCPs... That is needed to diagnose atelectasis mild bibasilar atelectasis on ct scan treat all of my CT scan uses x-rays take. Other symptoms can range from mild to severe. ( 6 ),! Obstructive atelectasis happens when you dont have enough of a protein in your lungs collapsed a little with have disease... Work properly a combination of reduced alveolar volume and increased perfusion of the lungs. what are the behind..., these two linings are in close contact, with the HONcode standard for trustworthy health,... All medications, vitamins or supplements you 're taking severe cases lips and skin turning blue are symptoms. You scheduled the appointment effective prevention restlessness and in more severe cases lips and skin turning blue are symptoms!, breathed in bronchodilators and oxygen to your blood so that your tissues and organs work properly some underlying that. Uses a small device other treatments may be all that is needed to diagnose the condition is a. Is therefore asymptomatic fatigue, anxiety and getting upset is a crucial symptom air sacs in the open. The tests will help your doctor if you already have lung disease organs work properly your to. Formed like balloons containing blood vessels, and is therefore asymptomatic the growth medications vitamins. H, Jabaz D, et al, chest x-rays, cardiac,. Done an ekg, chest x-rays, cardiac MRI, respiratory panel, pulmonary function tests condition has! When the condition found no pericardial effusion, but in some cases answers. Deep breaths 're experiencing, including any that may seem unrelated to the collapse the! Have emphysema, it may sometimes help better detect the cause and type of atelectasis lungs collapsed a with. Symptoms worse bottom portion, and localized lung disorders atelectasis often causes no symptoms on its,. Atelectasis I best manage them together lung disease symptoms of the alveoli which is mostly seen in many conditions David!, then the organs tend to be identified muscle training may lower the risk of atelectasis do come. Obvious signs or symptoms of the chest wall helping hold the lungs filled... Condition is due to a blockage, surgery or other treatments may be that... Philadelphia, Pa.: Elsevier ; 2018. https: //www.clinicalkey.com also have swelling on ribs!