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Serious thoughts to serious Questions!
I do not flame anyone here at OH. I am not a person who stands in judgement of others. However, when given a chance to voice my opinion, I make every attempt to offer knowledge, and allow the other person to make their own decisions regarding their life. I am writing this to offer knowledge to questions that I read nearly each day in the forum. If your opinion differs from mine, then wonderful, I am pleased that you think independently.
1. WLS MEMORIAL PAGE - I'd like to echo that being scared is normal. I am not going to discount a single one of those names on that memorial board. It is a crying shame that they are no longer with us. However, the names listed there are a small percentage of all of the wonderful people that have had this surgery and come here everyday to support others in their journey.
Please RESEARCH the topic. Knowledge is the key to comfort. While I was researching, I kept thinking of all of the people who have Type II diabetes, heart disease, high blood pressure, cholesterol, and other co morbid factors that were killing them slowly or EVEN WORSE, leading them to diminished quality of life such as dialysis, stroke, and paralysis. Then I began to think of how fortunate I was to undergo the vast array of testing prior to my surgery. All of those tests were ultimately to insure that my body could withstand surgery. My next thought was that if I were to have a Heart Attack, the doctors at Wake Memorial Hospital would not have the chance to run all of those tests. They would open me up, do bypass and pray for the best. At that point, my chance of survival would have been much less than what it was when I had my RNY. I was on the path to that major heart attack, and thank God that I made a right turn onto the healthy highway.
Please research and gain knowledge before you reach a decision. The co-morbid factors may easily take you away from your loved ones as well as WLS.
2. I was so depressed that I ate _________________ - Please folks, take a long look at what behaviors brought us to WLS in the first place. When I began this journey, I vowed to change my lifestyle and eating behaviors to make the most of this weightloss tool. Thus far, I have been able to accomplish this. I refuse to pay out as much money as I have for this diet, put my body through the pain that it has been through, only to fail at this too. Please if you eat for comfort, find a therapist or someone to help you to deal with the problem without the use of food. I refuse to be a person that allows other people or things rule or control my life.
3. Will my Husband/Wife/Boyfriend/Girlfriend/Significant Other leave me after WLS - Well, if he or she does, then good riddance. Please do not be a doormat to anyone regardless of how much you weigh. Fat or thin, you are a viable wonderful human being that deserves to be treated with love and respect. With WLS will come more confidence (even those of us with plenty to spare) and more self esteem. Some partners do not or can not cope with independent people. Many people look at those of us with weight problems as being dependent. THIS IS NOT TRUE!!!!!!! Just because we have a disease does not make us weak or dependent.
4. I am ___ days from going onto soft/pureed?___ foods, Can I eat that now? - Think here folks, why in the world did our surgeons give us post op instructions? Did they write the instructions for everyone but me? NO! The instructions are written and intended to be followed for the best recovery of our butchered bodies. If you are told to wait 3 weeks before moving from the liquid diet to the soft stage, then wait 3 weeks. There is no hard and fast rule here as to how many days we are to wait. Each surgeon gives us instructions as to what he/she knows to be best. The surgeon that gave the instructions has done numerous surgical procedures, whereas you and I have only undergone one (1)!!!! We (or our insurance) are paying a hefty fee to the surgeon for his skills and expertise. Do what the surgeon says!!!!!!! After all, you and I went to our Surgeon because we thought that he/she knew best.
5. I had surgery ____ weeks ago and I have only lost ____ why isn't this surgery working for me??
COME ON!!!!!!!!!! ONLY LOST _____??? Prior to surgery, how much weight would any of us have lost? For me, I can say, NONE! I would have gained. Why are you berating yourself? You have lost some, and in all honesty, you have probably lost those pounds much faster than you put them on! Stop the whining! Be thankful for what you have lost. And rather than damning your body for what it is not (or you think that it is not doing) be thankful for what has happened.
After surgery, we are in an instant malnourished state. Our body is trying to find homeostatis and it cannot do that because we cant get the food in that our cells are used to getting. Therefore, we loose some weight, stop or plateau, the body tries to catch up, and then the process begins all over again. Our bodies are trying to make sense of what is going on. Many people don't think about this and instantly jump on the "the surgery didn't work for me" bandwagon. That simply is not true. It is physically impossible to consume what we ate prior to surgery....FACT - IT has to work, at least to some degree!
If you still are not convinced that surgery will work for you, re-evaluate what you are eating and in what quantity. Are you really getting enough water? Are you really doing some exercise?? Did you give any thought at all to the fact that muscle weighs more than fat? and that when you exercise, you build muscle? How about the thought that protien (yes those 45-60g that we must have each day) assists in the building of muscle? What is your body showing you? Are your clothes loose now? Can you walk twice as far as you used to without giving out of breath? Can you feel bones on your body that you have never felt before?
Please give away your scale and stop being a slave to what it has to say. And for God's sake, please stop beating yourself. As well as changing the body, work on changing your mind. We are all worthy people who happened to have had a problem with food........Stop beating yourself for it!
6. What does the doctor mean by distal and proximal?
Roux-en-Y anastomosis (surgery - An opening created by surgical, traumatic or pathological means between two normally separate spaces or organs.)
Anastomosis of the distal end (Remote, farther from any point of reference, opposed to proximal.)of the divided jejunum to the stomach, bile duct, or another structure, with implantation of the proximal end (Nearest to, closer to any point of reference, opposed to distal. ) into the side of the jejunum at a suitable distance below the first anastomosis, the bowel then forming a Y-shaped pattern.

Information Helpful to EVERYONE interested in WLS!
Information from Center for Disease Control!
Overweight and obese individuals (BMI of 25 and above) are at increased risk for physical ailments such as (NIH pp.12-20; Stunkard p. 224)
High blood pressure, hypertension
High blood cholesterol, dyslipidemia
Type 2 (non-insulin dependent) diabetes
Insulin resistance, glucose intolerance
Hyperinsulinemia
Coronary heart disease
Angina pectoris
Congestive heart failure
Stroke
Gallstones
Cholescystitis and cholelithiasis
Gout
Osteoarthritis
Obstructive sleep apnea and respiratory problems
Some types of cancer (such as endometrial, breast, prostate, and colon)
Complications of pregnancy such as; gestational diabetes, gestational hypertension and preeclampsia as well as complications in operative delivery (i.e., c-sections).
Poor female reproductive health (such as menstrual irregularities, infertility, irregular ovulation)
Bladder control problems (such as stress incontinence)
Uric acid nephrolithiasis
Psychological disorders (such as depression, eating disorders, distorted body image, and low self-esteem).
The Relation Between Body Mass Index and Selected Risk Factors, Behavioral Risk Factor Surveillance System, 2001.
In 2001, the prevalence of obesity (BMI greater than or equal to 30) was 20.9% and the prevalence of diabetes was 7.9%, an increase of 5.6% for obesity and 8.2% for diabetes in one year.
Overweight and obesity were found to be significantly associated with:
Diabetes
High blood pressure
High cholesterol
Asthma
Arthritis
Poor health status
Compared to adults with normal weight, adults with BMI greater than 40 were found more likely to be diagnosed for diabetes, high blood pressure, high cholesterol, asthma, arthritis, and fair or poor health.
- Taken from CDC 08/25/2004

Understanding Binge Eating
If you gorged yourself on chocolate during Halloween or ate so much of your grandma's pumpkin pie during Thanksgiving that you had to wear elastic-waist pants for the rest of the day, you know what it feels like to overeat. Most people overeat from time to time. Teens are notorious for being hungry frequently - in fact, they need to eat more to support the major growth of muscle and bone that's happening. A teen's normally increased appetite is just his or her body's way of signaling that it needs more nutrients to fuel growth. But binge eating, also called compulsive overeating, is different from normal appetite increases or overeating now and then.
Teens with a binge eating problem eat unusually large amounts of food and don't stop eating when they become full. They binge not just from time to time, but regularly. And binge eating involves more than just eating a lot - with binge eating, a person feels out of control and powerless to stop eating while he or she is doing it. That's why binge eating is also called compulsive overeating. With binge eating, a person may feel a compulsion (a powerful urge) to overeat.
Teens with a binge eating problem may overeat when they feel stressed, upset, hurt, or angry. Many find it comforting and soothing to eat food, but after a binge they are likely to feel incredibly guilty and sad about the out-of-control eating. Teens who binge eat may do so to deal with (or avoid dealing with) difficult emotions. For this reason, some say binge eating is about having an unhealthy relationship with food.
The Problem With Binge Eating
Binge eating can lead to other problems, too - such as weight gain, unhealthy dieting, and emotional distress.
Weight Gain
Gaining weight is a natural consequence of regular binge eating. Most people who binge eat are overweight, and over time many become obese. Being overweight may make someone more prone to health problems such as diabetes, high blood pressure, joint problems, and breathlessness. And being overweight as a kid or teen makes it more likely that someone will be overweight or obese as an adult. Not all people who are overweight have a binge eating problem - but many do.
Unhealthy Dieting
Concerns about weight gain may lead teens who binge eat to diet. Extreme diets and yo-yo dieting (a pattern of repeatedly losing and then regaining weight) have their own health risks, especially for teens. Plus, dieting may make binge eaters so hungry that they end up bingeing again.
Emotional Distress
Regular binge eating may lead to low energy, low self-esteem, or depression. Feelings of helplessness, hopelessness, or worthlessness may surface when a person feels little control to put the brakes on overeating. These painful feelings may make the binge eating worse and can spill over into other areas of a person's life. Some teens who binge eat don't have the coping skills to express or tolerate difficult emotions. When eating is used as a way to deal with (or not deal with) emotions, a person may be less likely to learn and practice healthier coping skills.
How Common Is Binge Eating?
Both guys and girls can have eating disorders. Anorexia and bulimia appear to be more common among girls than guys. Binge eating seems to be just as likely to occur in guys as girls. It's hard to know just how many teens may have a binge eating problem. Because people often feel guilty or embarrassed about the out-of-control eating, many don't talk about it or seek help. At least 4 million Americans are thought to have a binge eating disorder. It's estimated that between 30% and 90% of all people who are obese have binge eating problems.
What Causes Binge Eating?
There is no known single cause for binge eating. Most experts believe that a combination of factors is responsible, including genetics and biology, emotional issues, and learned behaviors.
Experts believe that some people may be more prone to overeating because the hypothalamus (pronounced: hi-poh-tha-luh-mus), the part of the brain that controls appetite, may fail to send proper messages about hunger and fullness. Serotonin, a normal brain chemical that affects mood and some compulsive behaviors, may also play a role in binge eating. These are some of the biological factors that may make someone more likely to have a binge eating problem.
Patterns of overeating often begin in childhood, sometimes as a result of unhealthy eating habits learned in the family. It's normal to associate food with nurturing and love. But in some families, food may be overused as a way to soothe or comfort. When this is the case, kids may grow up with a habit of overeating to soothe themselves when they're feeling pressured because they may not have learned healthier ways to deal with stress. Some kids may grow up believing that unhappy or upsetting feelings should be suppressed and may use food to quiet unsettling feelings rather than express them. These are some of the ways emotions and learning may play a role in binge eating.
What Are the Signs and Symptoms?
Binge eating is defined as eating more food than most people would eat in a short period of time (such as 2 hours), while feeling a lack of control over eating. Someone is said to have a binge eating disorder if the binge eating happens frequently (at least twice a week), continues over a period of time (at least 6 months), and causes distress or problems in the person's life. Teens who have a binge eating problem may do the following:
eat much more rapidly than normal
eat until uncomfortably full
eat large amounts of food even when not hungry
eat alone because of embarrassment
feel disgusted with themselves or depressed or guilty after a binge eating episode
gain weight excessively
Getting Help for a Binge Eating Problem
It's common for binge eating to begin during the teen years, even though many people don't get treatment for the problem until they are adults. Often people get treatment because they are seeking help to lose weight. In most cases, unhealthy overeating habits that are part of a binge eating pattern start during childhood. The sooner someone with a binge eating problem receives treatment, the better, because some of the long-term health problems associated with binge eating and with being overweight can be reduced or eliminated.
Teens can start to get help with binge eating by letting a trusted adult know about the problem. Many teens who binge eat consider going on extreme diets, but this is not a healthy practice and can lead to additional health problems. A checkup with a doctor is an important first step in having an overeating problem evaluated and getting guidance on how to lose weight safely. In addition to asking questions about eating habits, a doctor may ask about feelings about school, parents, and other aspects of life. The doctor may also check a person's overall health and nutritional status.
A variety of health professionals often work together to help people with binge eating disorder meet their individual goals for managing eating, weight, and feelings. Nutrition specialists or dietitians can help people learn about healthy eating behaviors, nutritional needs, portion sizes, metabolism, and exercise. They can also help teens design an eating plan that's structured and specific and monitor their progress. Psychologists and other therapists can help teens understand the connections between emotions, thoughts, and eating behaviors and can help teens begin to control binge eating. Therapists can also help teens learn healthy ways to respond to stress and deal with compulsions.
If a teen is depressed, taking care of the depression will be an important part of the therapy. For some teens, antidepressant medications might be prescribed along with therapy. Sometimes certain family members can be a big help by talking with the person and his or her therapist about shared eating patterns, feelings (and beliefs about how feelings should be expressed), and family relationships. Doing this can help a person to examine some of the eating patterns that may have been influenced by family - and to shed the patterns that he or she no longer wants to follow. As with any eating disorder, there is no quick fix for binge eating. Treatment can take several months or longer while a person learns a healthier approach to food.
Dealing With Binge Eating
If you're a teen with a binge eating problem, you may feel that the temptations to overeat are always present. Unlike a problem with drugs, alcohol, or smoking, in which part of the treatment is avoiding the substance altogether, teens still have to eat. So part of dealing with a binge eating disorder is learning how to have a healthy relationship with food.
People with binge eating disorder may find it helpful to surround themselves with supportive family members and friends. Critical comments and judgments from others about eating are rarely helpful and usually add to a person's feelings of self-criticism, making matters worse. Trying a new extracurricular activity or hobby is a great way to meet people, have some fun, and boost self-esteem. Finding a way to express feelings, whether through conversation, music, art, dance, or writing, can also be helpful.
If you think a friend might have a problem with binge eating, it may be difficult to talk about it, but your concern and support may be just what your friend needs to get help from a professional. Offering your heartfelt caring, being willing to listen, and just being there are important parts of being a good friend in any difficult situation.
The good news is that help is available for teens who have problems with binge eating. With the right guidance, commitment, and practice, it is possible to overcome old habits and replace them with healthier behaviors. Teens can overcome overeating and enjoy food without having it control their lives.
Reviewed by: D'Arcy Lyness, PhD
Date reviewed: September 2003
Taken From: http://kidshealth.org/teen/your_mind/mental_health/binge_eating_p4.html

Hurricane Survival - Items to keep handy during a storm -
From the State of NC Emergency Management
Store up to 14 days of supplies and equipment
Food
Baby needs
Water
Canned Sodas
Disposable plates, cups and utensils
Plastic garbage bags
Medicines - Prescription and Non Prescription
First aid supplies
MOSQUITO REPELLENT
Bleach
Petfood
Bedding
Cooler
Non-electric Can opener
Ice
Dry goods - Toilet paper and paper towels
Toiletries
Flashlight and spare batterieis
Portable Radio and/or Portable TV with spare batteries
Clean clothes and sturdy shoes
Clothes & dish detergent
Clothesline and pins
games, cards, & quiet toys
Camp stove & fuel
Lantern & fuel (not candles)
Fire extinguisher (ABC type)
gloves & goggles
small tools
cleaning supplies
brooms and mops
pails and buckets
rope
butane lighter and matches
Fuel all vehicles before the storm hits.
Get to the ATM or Bank and secure cash since banks will probably be closed due to power outages.
PHOTO ID THAT SHOWS HOME ADDRESS!!!!!!

Some information that I found concerning the Panni & how to grade it. This information is with much thanks to Leigh Lea
The apron can be graded on a scale of 1 - 5. Generally, higher grades occur as the weight of the patient increases. Also, the higher grades tend to have more problems and medical, physical, and social limitations.
Grading
Grade One: Apron just barely covers the hairline and the mons pubis, but not the private areas.
Grade Two: Apron covers the private areas in line with the upper thigh crease.
Grade Three: Apron covers the upper thigh.
Grade Four: Apron covers mid thigh.
Grade Five: Apron covers the knees or beyond.

My Story and Updates throughout my journey!

Hello All!
I have been thinking (not seriously) about WLS for years. A few months ago, standing at the kitchen sink, it dawned on me that I had to take 12 medications every morning. Lets see, there were 5 for diabetes, 1 for hypertension, 2 for allergies, 2 for ashtma, 1 diuretic, 1 that was my daily vitamins. At 34 years old, this is quite a bit of medication that I DO NOT WANT to take for the REST of my life. I am the genetic copy of my father. God rest his soul, he died in his sleep at age 56. A little more serious thought, combined with some serious prioritization, and I decided that I HAD to do some MAJOR changing.
Thus, I began to look very seriously at WLS. I spoke with my mom, she is a retired RN, and was very much against the idea. Then I tried the idea out on my fiance who is currently an RN. He was hesitant, but tried to be supportive. I asked both of them to attend a free Seminar at Duke with me. I told them that the information there should help me to make up my mind, and hopefully shed some light for the two of them. I promised that I would include them in my decision. Well, the 3 of us went to the seminar. After the facts were presented, all 3 of us were POSITIVE that this was the HELP that I NEEDED. I filled out my application and got the ball rolling.
Between the 3 of us, I am not certain who is most excited! I would be lying if I said that the thought of being thin once in 34 years is not appealing. More importantly, I have found a tool that will help me to turn my medical problems around. I cannot wait. I am like a child waiting for Santa to bring me some goodies!!!!
A little background...First and foremost, I am a Telecommunicator (not a dispatcher). I am currently employed as the Director of Communications for Northampton County, North Carolina. April of this year began my 18th year in this fabulous career. I do this work because I love helping other people in times of emergencies. In addition, I am a paramedic student and hope to sit for my state exam in November 2004. I also love my EMT work because it is another opportunity to help other people. I cannot describe how awesome it is to have GOD to use my hands to save the lives of others! I also teach at several Community Colleges around NC in Law Enforcement, EMS, and Communications programs. And when I am not busy with all of that, I fill in for our County Emergency Management Coordinator. (did I mention that I am an adrenaline JUNKIE?!?)
God be with me, my family at home, and the family here. Since I began this journey, I have had the opportunity to meet and chat with some of the most amazing and compassionate people that God ever created!

4-21-04 Went for my first round of tests and Psychologial Interview. Whew, I thought I was lucky when the Doc let me leave the hospital. LOL! Honsestly, all of my friends and family were at home taking bets as to whether or not I would be allowed to come back home! I am just a fun loving person that cracks jokes about EVERYTHING....and they pick at me.
Now I am just waiting for the time when the surgeon reviews my case and it heads off to insurance. Pray for me!


5/17/2004 - WOW!!!!! What a week last week was! On Tuesday, my patient status at Duke's web site changed. Said that I had met approval for the surgeons & Insurance submission was pending. Well, the following day, My finace and I were heading to Myrtle Beach for Bike Week. My cell phone rang, and my mom asked "are you sitting down?" I said yeah, she then said, well good, cause Duke just called, you were approved! I don't know who was most excited, my finace, my mom or me.
Surgery is May 24th!!!!!!!!!!!!! A week away. At least they didn't give me much time to worry!

5/17/2004 - I met with Dr. Grant this morning. I honestly believe that I am the most capable hands! He was honest, blunt, forthright, and sincere. He told me things that I did not want to hear, but I admire his honesty. This man actually cares about the problems of obesity. While explaining complication risks, he put the information out there even though it was hard to swallow. He has a mild manner, and confidence! I am thrilled to be his patient!
Every thing is still a go for May 24th!

5/28/2004 Everything went exceptionally well with my surgery. I have been fortunate enough that I have not experienced any nausea, vomiting, or any other problems. I don't even have pain. I am tender around the incisions, but that is the extent. I feel very blessed. I know that God is looking out for me.

6/1/2004 Dr. Grant wanted me to walk a mile a day within 7 days of surgery & then walk 2 miles 3 times a week. Last night I walked 2 miles & feel wonderful! This morning, a check of the scales says that 16 lbs are missing already! This is so wonderful! When I made up my mind to have the surgery, I never had a doubt or second thought. I am so thankful that GOD provided a way for this to happen in my life!

6/11/2004 Not much to post right now. I am doing very well. Have had no complications at all. So far I have lost 24lbs by my scale, and I could not be more happy.

6/21/2004 Had a visit with Dr. Grant today. All went very well. I am down 32lbs. Of course I can't see it, but everyone else says that they can. Nonetheless, I am very proud. From the appointment with Dr. Grant, we went on to Group Therapy. I really enjoyed that! It was a great time to get with the other folks who felt the same things that I did & have some laughs. Boy did we laugh. The most hilarious thing was that we have all been addicted to the Food Network! Audrey and I had a couple of the recipies memorized. Great people in that group! I am very fortunate and continue to recieve blessings daily.

07/13/2004- I finally hit the 40 lb mark this morning. I must say, I feel better than I have ever felt in my entire life. Still not having to use any medication for diabetes, High BP, or fluid. I have not even had to use my meds for asthma or allergies. I have been trying to work out at the gym to get my flab under control! LOL. My arms are almost to the point where I wave hello and goodbye from two different locations. If I can just convince myself to wake up earlier, I'm sure I will be doing more in the gym. Thank you GOD for all of the blessings that you have given me.

8/5/2004 So many wonderful things are happening, I don't know where to begin. Yesterday I hit the 50 lb mark. I feel WONDERFUL!!!!! It is utterly amazing how this surgery has changed my life. I have always loved myself, but I am now beginning to love my body. In doing that, I treat it with a new found respect. I finally realized that I have to eat to survive, not because I want comfort in a rough time. What a wonderful feeling. I must have been in denial earlier, because I never believed that I ate for comfort. Boy is it ever true that hindsight is 20/20.
I pray daily for all of the wonderful people at OH. I never thought that I would have such wonderful friends. God Bless each of you!

08/20/2004 Hi all! I had my 3 month check up with Dr. O'Connell yesterday. I went to the office thinking (and happy) that I had lost 56lbs. Well, I stepped up onto their scales, only to find out that I had lost 60 lbs. What a shock!!!!! Before surgery, I weighed 284. Yesterday I was at 224. I have not much of a clue what happened after that. I was just so excited. What an ego boost! I have 44lbs left before I reach my goal. This is the least that I have weighed in my adult life.
I cannot explain what a joy it is to be able to fit into rides at amusement parks, to have room left in a seat at a concert, to cross my legs, to see my clavicals & feel my bones. This is all totally new to me! What a joy. I am thoroughly enjoying this new body & new life!

09/25/2004 - Wow! What a night. We went to the Duke WLS reunion. It was a ball, a gala, a prom, and one of the most wonderful nights of my life. Lee (fiance) and Mom went with me. I had the best time talking to others who had been through WLS or were about to go through it. Then there were some of the others that I was able to meet (ones that I had chatted with here) like Amy Flannery...What an absolute angel. Then there was Terri, we had met in Group. It was so good to see her, and did I mention that she looked absolutely gorgeous! I am sure hoping that Duke will continue to do this on a yearly basis!
New pics were put on for me a few days ago. A pictorial of my journey so far. I'm not sure who did the posting for me, but if you are reading this, I am very thankful!

































Click here for my surgeon
Photos
Hospital Reviews (Durham, NC) - Duke University Medical Center
Product Reviews Hood milk - Carb Countdown
Member Interests:
Humor - Love a great joke
Travel - Love the City of New Orleans
Motorcycles - I own a Yamaha Roadstar 1600. It isn't a Harley, but I have the title.
Dispatchers - 17 years in Communications! Currently 911 Director
Click here to see interests of other ObesityHelp members.
Surgeon Info:
Surgeon: John P. Grant, M.D.
Dr. Grant is wonderful. I first saw him at the informational session provided by Duke. I immediately knew that he was an authority on the subject of Bariatric Surgery. As I came to know him better, I found that he has a wonderful bedside manner. He does not sugar coat things, he tells you exactly as they are. He is friendly, attentive, and genuinely concerned for his paitents. His office staff is also wonderful. Dr. Grant was very quick to stress the importance of the aftercare program and spent some time discussing the outcome if this were ignored. Duke does have a structured after care program that I am thrilled to be a part of. To me this signifies their committment to patient success.
Insurer Info:
Blue Cross, NCACC Group benefits pool
My surgeon's office took care of all of the paperwork. I did have to fill out a 5 year dieting history. I had some that were physician supervised, some that were not. My surgeon's office submitted to insurance on Tuesday 5/11 & I was approved on Wed. 5/12.
I greatful for the staff at the surgeon's office, The team at Blue Cross & Blue Shield of NC, and most of all, I am eternally thankful to God!
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