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How to use perforomist?

Hi everyone! I am 42 years old and I am a hypertensive patient. My last blood pressure count was 135/90. As if someone has cast a badluck spell on me recently. My problems have become never ending since then. My heart has gone really weak now and now I am suffering from chronic obstructive pulmonary disease. My doctor has called for a bypass surgery but before that I have to use perforomist. I want to know how to use perforomist?

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