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Posts Tagged ‘Medicine’

Every 20 minutes an American dies for lack of health insurance: one man’s story

In behavior, culture, Health, journalism, life, Media, Medicine, Money, politics, US on October 19, 2012 at 12:11 am
Prostate cancer

Prostate cancer (Photo credit: Wikipedia)

This, from The New York Times:

So why didn’t I get physicals? Why didn’t I get P.S.A. tests? Why didn’t I get examined when I started having trouble urinating? Partly because of the traditional male delinquency about seeing doctors. I had no regular family doctor; typical bachelor guy behavior.

I had plenty of warning signs, and that’s why I feel like a damned fool. I would give anything to have gone to a doctor in, say, October 2011. It fills me with regret. Now I’m struggling with all my might to walk 30 feet down the hallway with the physical therapists holding on to me so I don’t fall. I’ve got all my chips bet on the hope that the radiation treatments that I’m getting daily are going to shrink the tumors that are pressing on my spinal cord so that someday soon I can be back out on the sidewalk enjoying a walk in my neighborhood. That would be the height of joy for me.

The writer of those words, Scott Androes, is now dead. He did not have health insurance so he did not see a doctor when he first noticed the signs of prostate cancer.

When Times’ columnist Nick Kristof yesterday wrote about his friend’s death, he got replies like this one:

“I take care of myself and mine, and I am not responsible for anyone else.”

Here’s some of Kristof’s column:

I wrote in my last column about my uninsured college roommate, Scott Androes, and his battle with Stage 4 prostate cancer — and a dysfunctional American health care system. I was taken aback by how many readers were savagely unsympathetic.

Readers’ Comments

Readers shared their thoughts on this article.

“Your friend made a foolish choice, and actions have consequences,” one reader said in a Twitter message.

As my column noted, Scott had a midlife crisis and left his job in the pension industry to read books and play poker, surviving on part-time work (last year, he earned $13,000). To save money, he skipped health insurance.

The United States, whose own Declaration of Independence vows “life, liberty and the pursuit of happiness”, has become a shockingly divided place, where far too many of those who have inherited, cheated, conned, off-shored — or yes, fairly earned — their good fortune — are now hammering the oars of their lifeboats against the desperate, clutching, frozen hands of those now dying and drowning in the icy waters of an ongoing recession.

Too many of of those now driving gleaming new luxury vehicles see people like Androes, if they acknowledge them at all, as mere bugs on the windshield, something small and annoying to be ignored or dismissed.

Androes screwed up. He, God forbid, decided to step off the hamster wheel for a while and take life a little easier, something many of us long to do at mid-life. With no wife or kids to support, he was able to do that. But he was not able to afford health insurance, which is sold here like any other consumer product — and which can be brutally expensive. When I was able to get onto my husband’s health plan at work, even unmarried, in 2003, I was then, as a single, healthy woman in my 40s, paying $700 a month.

That meant an overhead, every year, of $8,400 just to avoid medical bankruptcy. Given that my mother has survived five kinds of cancer, I went without many other amusing choices (new clothes, travel, eating out) for years just to be sure I could, and did, get annual mammograms and Pap smears and all the preventive medicine possible to stay healthy.

Many people in the United States now earn $7 to 12/hour, since the two largest sources of new jobs in this country are foodservice and retail, which pay badly, offer only part-time work and no benefits (i.e. employer-subsidized health insurance). They might as well make out their will now. Because they can’t afford regular medical checkups, nor medication nor ongoing counseling to manage their diabetes or heart disease, even if it’s been diagnosed.

A young friend  — sober — fell on a slippery sidewalk, on a steep hill in the rain, and severely damaged one of his knees. He needs surgery that will cost $22,000. His employer, a Christian-based organization, the YMCA, refuses to help.

Yet another writer to Kristof said that people who are destitute medically have all created their own hells, and that’s where they belong:

“Smoking, obesity, drugs, alcohol, noncompliance with medical advice. Extreme age and debility, patients so sick, old, demented, weak, that if families had to pay one-tenth the cost of keeping the poor souls alive, they would instantly see that it was money wasted.”

I am ashamed to live in a country where selfishness is considered normal behavior.

I am appalled by such vicious callousness.

I am sickened by a growing lack of compassion from those who have never known, and utterly dismiss in others, the sting, shame, fear and misery of poverty and desperation.

And you?

How does this make you feel?

I don’t (only) want to do more faster. Do you?

In behavior, business, culture, domestic life, life, Medicine, Money, urban life, US, work on June 1, 2012 at 12:16 am
productivity

productivity (Photo credit: Sean MacEntee)

Since my wedding in September 2011, (when we took a week off locally afterward), I haven’t taken more than four days off in a row. My last extended vacation was in May 2005, three weeks in Mexico.

I’m taking a month off, starting today — but will still blog here three times a week. I’ll also be working on a book proposal and one or two short articles, but only after the first 12 days of rest, relaxation, seeing friends and family, recharging my spent battery.

In the past 12 months, I’ve:

published my second book; done dozens of media interviews and speaking engagements to promote it; written a new afterword for the paperback, which is out July 31; hired an assistant to help me with all of this; negotiated more speaking engagements; addressed two retail conferences in Minneapolis and New Orleans; gotten married in Toronto; helped my husband deal with kidney stones; had my left hip replaced and done 3x week physical therapy for two months; served on two volunteer boards, and additionally visited Chicago and Toronto for work.

Oh, and blogging here three times a week, working with a screenwriter on the television pilot script for Malled (not picked up), and writing for a living.

Kids, I’m fried!

Time to not be productive, which leads me to this essay raises an important question, and one especially germane to any economy premised on “productivity”:

But there are sectors of the economy where chasing productivity growth doesn’t make sense at all. Certain kinds of tasks rely inherently on the allocation of people’s time and attention. The caring professions are a good example: medicine, social work, education. Expanding our economies in these directions has all sorts of advantages.

In the first place, the time spent by these professions directly improves the quality of our lives. Making them more and more efficient is not, after a certain point, actually desirable. What sense does it make to ask our teachers to teach ever bigger classes? Our doctors to treat more and more patients per hour? The Royal College of Nursing in Britain warned recently that front-line staff members in the National Health Service are now being “stretched to breaking point,” in the wake of staffing cuts, while a study earlier this year in the Journal of Professional Nursing revealed a worrying decline in empathy among student nurses coping with time targets and efficiency pressures. Instead of imposing meaningless productivity targets, we should be aiming to enhance and protect not only the value of the care but also the experience of the caregiver.

The care and concern of one human being for another is a peculiar “commodity.” It can’t be stockpiled. It becomes degraded through trade. It isn’t delivered by machines. Its quality rests entirely on the attention paid by one person to another. Even to speak of reducing the time involved is to misunderstand its value.

The only thing this industrial mindset — speed the production line! -- produces in me is frustration and annoyance.

I also attach value to the production of:

deep friendships; a happy and thriving marriage, my own physical and mental health, daily, and weekly, periods of rest and reflection.

I recently asked a friend, who out-earns me by a factor of 2.5, how she does it. The answer was to quadruple my workload, and at a speed I think probably, for me, unmanageable.

My book “Malled”, which describes my 27 months working as a part-time retail sales associate — supplemented by dozens of original interviews with others in the industry — has brought me paid invitations to address several conferences of senior retail executives. I suggest to them every time that focusing solely on UPTs (units per transaction — i.e. why they try to sell you more shit unasked for, than you want) and sales per hour is not the best or only way to go.

But numbers are safe and comforting. When corporate players hit their numbers, they keep their jobs and get their promotions/bonuses. Metrics rule.

Except when they don’t.

I once spent an hour talking to a female shopper in our store. Turns out we had a lot in common. She spent $800, which remained the single largest sale I ever had there. She also asked if I knew a good local psychotherapist. Not many people would have asked that question of a minimum-wage clothing clerk, but she’d clearly decided to trust me. I did know one and recommended him.

A year later she returned, glowing, with one of her teenage daughters, to thank me for helping her survive a very tough transition in her life.

That “transaction” is completely meaningless in any economic sense.

Yet:

— it enriched the therapist, who well deserved a new client.

– it enriched my customer’s soul, which needed solace.

– it enriched her three daughters’ lives as their mother found help she needed.

– it enriched my heart to know I’d been able to make a good match and help her.

But these powerful emotional connections are routinely dismissed as valueless behavior on any corporate balance sheet — because they can’t be quantified, measured and compared to other metrics.

Which is why I have such a deeply conflicted relationship with capitalism.

How about you?

Do you think working harder and faster is our wisest  or only choice?

Ten warning signs you’re an adult

In aging, behavior, children, domestic life, family, life, Medicine, women on April 9, 2012 at 12:07 am
My Mortgage Docs to be Reviewed by an Expert

My Mortgage Docs to be Reviewed by an Expert (Photo credit: Casey Serin)

We all know the standard metrics: graduate college, grad school, marry, have kids, acquire property and a vehicle.

I never had kids, so that typical dividing line into Maturity escaped me.

But for many of us, different moments mark a definite end to innocence.

Here are ten that resonate for me:

Taxes!

I grew up in a family of freelancers whose approach to paying income tax — which is never deducted at source, for those of you who’ve never done it — was, hmmm, variable. One day my Dad said, “I have two pieces of advice for you about taxes.”

“Running and hiding?”

Suffice to say I now have a very good accountant and genuflect to him deeply.

A mortgage

In New York, getting a mortgage is like some bizarro obstacle course littered with lawyers with out-stretched hands. Check, check, check, check!

Knowing — and caring about — your FICO score

For those of you outside the U.S., this is your credit score whose quality determines whether life is pleasant (low interest rates on mortgages, car loans, credit cards) or a hell of slammed doors refusing you access to any sort of credit. Surprisingly few consumers realize what sort of leverage you have with a good score — a lot!

Giving informed consent for my mother’s brain surgery

That was very weird, given how deeply private she always was. I looked, literally, into her head, staring at the four-inch tumor on X-ray that soon, successfully, came out.

Putting my mother into a nursing home

Pretty much the hell you’d expect: having to sell 95 percent of her things and make consequential decisions quickly. Being an only child makes it both easier and harder.

Getting a colonoscopy

For those of you under 50, something to look forward to! (And those putting it off out of fear, it’s no big deal. You have one wearying day beforehand to cleanse you colon, go to sleep during the procedure. Done.)

Knowing your neighbors

When you’re young, single and often behaving badly, you may not want to know your neighbors. Who was that guy/girl skulking out of your apartment? What were those weird noises at 3 a.m.? Once you’re a bit older, maybe traveling for work, maybe with a place you own and/or value more than a dive shared with six roomies, having kind and watchful neighbors is a wonderful thing.

Regular mammograms/Pap smears/prostate exams

I’m always a little stunned when I hear of someone, (who has health insurance, which in the U.S. means these are no-brainers), who skips these essential tests. No one wants to hear bad news. My mother has survived breast cancer, so mammo day is always a little shaky for me. But seriously? Just do it!

Joining a faith community

No disrespect to atheists and agnostics. But for many of us, finding a congenial place to nurture your spiritual growth is a major step. It’s easy to focus solely on family/work/friends/fun — until the shit hits the fan.

Making a will/living will/power of attorney/health care proxy

So cheery! But if you have been fortunate enough to have accumulated anything of value, it’s worth deciding who to leave it to. And facing any sort of major surgery — even childbirth, my mom-pals tell me — means facing the scariest of fears about mortality or severe injury.

How about you?

What milestones have marked your path to adulthood?

One (slow, halting) step at a time

In aging, behavior, Health, life, Medicine, women on March 2, 2012 at 12:06 am
English: Walking with the parallel bars

Image via Wikipedia

There’s a new sound in my life — the click, click of my sexy French crutches — as I learn to walk normally again after two years of 24/7 pain and a gait so altered I started to look like Quasimodo, that ruined my shoes and swelled my right foot and increased the diameter of my right calf by an inch from overcompensation.

It’s been almost a month since my hip replacement, and I’m learning to trust my body again. It feels really good to stretch, to break a sweat and (yay!) to reach my toes.

“Patient”  — the adjective, not the noun — is not my most obvious quality. This recovery, from full hip replacement, includes dire warnings about doing too much too soon and how not to push it. More is not better. But you don’t know you’ve done too much until…

Daily, I circumambulate our apartment building and garage in warm, dry weather and our apartment building hallway, where 12.5 laps equals a mile, when it’s wet or really cold. My goal is a daily mile, only after which do I get to shed my $38/pair white surgical stockings I wear 23 hours a day to prevent blood clots.

Physical therapy, three times a week, (and $60 week in copays), is slow, incremental, dull, repetitive — and utterly essential to a full recovery.

When I met my surgeon, I handed him a list of a few of my many sports, and asked how soon I would be back at them. My softball team, having missed me for two years, keeps asking when I’ll return. I’m hoping within six months; friends my age (and much older) who’ve had this procedure have since climbed the Great Wall, hiked Guatemala and climbed four flights of stairs without trouble.

I’ve had to recuse myself from real life for a while, missing a friend’s book party, unable to get to my regular hairstylist in Manhattan, a 45-minute drive or train/cab away, closed off from movies, concerts and anything that would require me to sit more than than 60 minutes at a time I’m allowed.

Maybe because I did a silent 8-day retreat last summer, I’ve really appreciated a time of peace and quiet, of reflection and withdrawal. For weeks, I had to rely fully on my husband for the simplest of tasks, from helping scrub me in the shower, (after an 18-day wait!), to putting on my left sock and shoe, counting out my 10 pills a day, cooking.

I miss his companionship since he returned to work this week, leaving home at 7:30 and only returning 12 long hours later after his commute.

Soon, I hope, I’ll once more be my usual blur.

A new definition of love

In aging, behavior, domestic life, family, Health, men, women on February 17, 2012 at 1:08 am
Love heart uidaodjsdsew

Image via Wikipedia

What’s romantic?

What’s loving?

What makes you feel cherished?

The past two weeks have revealed new sides of my husband, even after 12 years together. I knew he was fun, funny, kind, affectionate.

But since coming home from major surgery, the replacement of my left hip, I’ve seen, (as has he), wholly new sides to his character.

Our days right now are so overwhelmingly focused on my health and healing, (including avoiding infection and complication), that I’ve gotten the whole bed to myself while he sleeps on the (too soft) sofa. I bought a bottle of chlorhexidine, (what surgeons use to scrub their hands with), and latex gloves and, once a day, he uses both to clean and dress my incision.

He’s been making meals, buying groceries, doing laundry, (which he normally does), helping me in and out of bed, putting on my shoes, socks and sweatpants. Helping with sponge baths, since no showers are allowed for two weeks.

The hardest part? Wrestling me in and out of my (so sexy!) surgical stockings, thick, tight white hose that go up to my thigh and which I wear 23 hours a day to help prevent clots.

He hands me the 10 pills I need every day, at the time I need them, after drawing up and taping to the wall our daily schedule that starts at 7:30 a.m. and stops at 6:00 p.m. He cranks up raucous rock and roll to boost my energy for physical therapy which I have to do two to three times a day. He brings me me a well-hammered ice pack (four times a day.)

He walks slowly and patiently with me as I do my crutch-aided circuit a few times around the garage.

As someone who prides herself on being feisty, strong, quick-moving, independent and modest, you can imagine how this has felt for me. Weird!

It’s one thing to be seen naked when you feel sexy, quite another when you’re bruised, sore, covered with surgical magic marker notations.

Instructive, to say the least.

He apologized this week for not getting me a Valentine’s Day present; I brought him shoes, socks and a sweater from one of his favorite shops, Rubenstein’s in New Orleans.

I can’t imagine a greater gift than a man willing to give up three weeks’ vacation to nurse me back to strength.

Healing is emotional as well

In aging, behavior, Health, life, Medicine, sports, women on February 11, 2012 at 2:19 am
Doctor's office again

Doctor's office again (Photo credit: Sidereal)

One of the most essential elements of healing a body that has been injured, damaged or ill is to soothe and comfort the psyche, the soul of the person whose corporeal armor has, in a significant way, (even in the aid of better health), been pierced.

But it’s the piece that is consistently left out. When you leave hospital after a major surgery, you’re handed a thick sheaf of instructions, some in boldface type, all of which are — of necessity — focused on the physical.

Who addresses the needs of the soul?

Which is why, when I met a fellow hip patient in the hallway, a former dancer, a woman my age, we couldn’t stop talking to one another about how we felt.

Not our bones or muscles, but our hearts and minds.

A sense of shame and failure that years of diligent activity and careful eating and attention to posture…led us into an operating suite. The feeling of isolation, of being cut from the herd of your tribe, the lithe and limber, the fleet of foot. The fragility of suddenly relying very heavily on a husband whose innate nature may, or may not be, to nurture.

And a husband who knows all too well that physical intimacy is almost impossible, sometimes for years, when your loved one is sighing not with desire but in deep pain. When your hips simply can’t move as you wish they would, and once did. It is a private, personal loss with no place to discuss it.

I’m deeply grateful to know a few women like me: feisty, active, super-independent and all recovering, now or a while ago, from hip replacement. Every tribe has a scar, a mark, a tattoo.

Ours is  a vertical six inches.

Time to wear it proudly.

The Bionic Blogger Returns…

In blogging, Health, life, Medicine, women on February 7, 2012 at 7:41 pm
Here’s an update:
I entered the hospital early Monday morning for hip replacement surgery and in a very short period of time  — a little over two hours — my doctor told my husband Jose, that it all went well.  He even handed him a small x-ray showing the new device secure in its place.
I’m scheduled to be in the hospital for three days and the physical therapy team assigned to me hopes to have me walking down the corridor by the end of today, my second full day.
My husband was kind enough to develop an email blast list, containing the names of family, friends, colleagues, etc.  This allows him to write one letter and send via the list which then goes out to our circle of support.  Well wishes have poured in from Tucson to Tel Aviv to Toronto.  One friend who was at the Pyramids in Egypt even wrote saying he was “sending the power of the pyramids” to me as he thought about me.  Flowers have started, with one NTC friend, ending a lovely bouquet of pink, yellow and orange flowers.
My hope is that I will be posting once again as soon as Friday of this week.  Stay tuned, thanks for checking in and for all your good wishes.

Thanks to blogging and a bum hip, I’m a cover girl!

In beauty, behavior, blogging, Health, journalism, life, women on October 27, 2011 at 12:42 am

Too weird for words, really…

It all started out thanks to my blogging for True/Slant, which is where the editors of this magazine found my writing and liked it enough to ask me to write about my miserable left hip, whose arthritis worsened severely in January 2010, just in time for me to combine writing a memoir with — agonizing pain! Five specialists! Xrays! MRIs! Heavy painkillers!

The corticosteroids I took to reduce the inflammation then destroyed the bone in my hip — necessitating hip replacement (which I am trying to get up the nerve to just get done.)

Joy.

The cover shoot was a hoot. Five (!) strangers converged on our small suburban apartment: an art director and photographer from Atlanta, a make-up and hair artist from Chicago, a photo assistant from Brooklyn and a wardrobe stylist from New York City who brought an entire garment rack filled with possibilities they had chosen for me, based on my many bossy emails of what I refuse to wear and (shriek) my clothing size.

Brave souls, all of us.

It took 4.5 hours to achieve this shot. What you can’t see is the July sweat dripping down my back, nor the photographer sliding up and down my living room wall for support, also drenched from non-stop focus and exertion. Nor the art director, Susan, peering after every shot at her laptop to see how it all looked.

Luckily for me, the photographer, Kevin, and Susan and I had had time the day before to enjoy a long, leisurely lunch and have a chance to get to know one another personally, which made the shoot much less scary than it might have otherwise been. They’re lovely people, warm and down-to-earth, so I never felt intimidated or nervous.

(Thanks to my new book and other projects, I’m fairly used to being photographed for national publication. I even had my pic taken in a bathing suit for some paid web writing I did about my hip.)

The necklace is my own (Ann Taylor), as are the invisible earrings. I’m leaning against our sofa, with lots of artificial light thrown in. The curly hair is natural.

I never thought in a million years this might happen, but it’s already prompted some kind and supportive emails from AT readers.

Here’s a link to the issue…although you can’t access my story (!) online.

The First Emesis

In aging, behavior, domestic life, family, Health, life, love, Medicine, men, parenting, seniors, women on July 11, 2011 at 12:02 pm
The Doctor, by Sir Luke Fildes (1891)

Image via Wikipedia

There are those special moments in every relationship — the first glance, the first shared laugh, the first kiss.

And then…

The sweetie, who is normally very healthy, has been passing the broken-up bits of a kidney stone, which, sadly, involved a day and night of intense and frequent vomiting. (He’s back to work today, finally, and seems fine.)

In all our years together, I’d never seen him clutching the toilet bowl and weeping in pain and exhaustion, and it was a hell of a shock. (He saw me on my knees, in of all places, a small hotel room in Bayeux, the victim of food poisoning from a chicken lunch.)

There I was, standing in the hallway with the doctor on the phone, waiting for him to stop vomiting long enough to come and describe his symptoms.

It’s awful when your sweetie is sick and you can’t do much of anything to help them beyond running to the pharmacy, driving them to and from doctors’ appointments and, worst case, the hospital. (I know we are very lucky this is nothing more serious.)

And when someone I love is ill or in pain, confused or worried, I’m a total mama grizzly, snarling at everyone (so attractive) in my worry and concern. I want action, stat! The pharmacist took too long to reach the doctor and Jose was home writing in pain. Not an option! (I later apologized and she was understanding.)

I’ve had too many years, starting when I was 12, worrying about someone ill who relied on me to advocate for them; my mother has been in and out of hospitals for decades for a variety of issues. I’m her only child and she’s never taken great care of herself, nor has she ever fought for the best care possible. And, sometimes, you do have to fight!

A former medical reporter with an MD ex-husband, I never mistake doctors for Gods. I know they can be brusque, rude and condescending — and warm, wise and compassionate.

God help anyone near me who is the former, and I’ve seen plenty of it. It hasn’t left me with a warm, fuzzy feeling for anyone in a white coat with a clipboard.

How do you handle yourself, or medical staff, when your loved ones are ill?

Hospital Thoughts

In aging, behavior, family, Health, life, Medicine, men on June 29, 2011 at 11:30 am
A Greco-Buddhist statue, one of the first repr...

Image via Wikipedia

It’s been a nerve-wracking few days.

The sweetie needed some tests, and one of them involved a CAT scan with a dye injection. (Looks like he’s OK, thank heaven — only a kidney stone. I shouldn’t say only, as everyone who’s had one or knows someone who has says it is excruciating.)

I’m the one who’s usually lying on the gurney/MRI platform/X-ray table. We’ve been back and forth to our small local community hospital so many times in the past decade — thankfully, for nothing serious — we’re on a first-name basis with the doctor who works the overnight shift at the ER. On one of our last visits, he asked: “So, whose turn is it now?”

It was my turn, then, with a fever of almost 104 and a spot on my lung so dark and ominous he drew the curtain and said it might be lung cancer. The sweetie, a photographer by trade, asked to see the films, as he can read negatives with the skill of a radiologist, even if he doesn’t know what he’s looking at.

It turned out to be only pneumonia, but it still meant three days on an IV, sharing a room with a 95-year-old who startled awake at midnight, sat on the edge of my bed and tried to pull out her tubes. I coughed, as one does with that disease, so hard my body ached from exhaustion; I wrote an essay about it for The New York Times.

This time it was my turn to watch the phlebotomist wheel in her cart and overhear her explaining to him how his body would react to the contrast dye. I kept him company as long as I could. In our 11 years together, I’d never seen him lying flat inside a diagnostic machine, grateful for this and shocked at the sight.

I sat and waited, staring at the lavender wall trim and burgundy cupboards and a cheerful British print on the opposite wall, aware for the first time how soothing it all was and how much I needed it to be so.

My last ER visit was January 2009, the beginning of a five-month odyssey to figure out my painful/arthritic/inflamed left hip — I was in so much pain I could barely walk and I do remember admiring the handsome design of our shiny new ER.

When I’m scared, and I admit to not loving going anywhere near that hospital by now (three orthopedic surgeries since 2000, a hip replacement my next, and more than five times to the ER, for everything from a broken finger to a mild concussion the sweetie incurred in a biking mishap) I do not want to be soothed or distracted by television. Old copies of People don’t do it for me either.

The sweetie, a devout Buddhist, did a lot of deep breathing to stay calm.

I’ve spent a fair bit of time around hospitals, thanks to my mother’s various illnesses, which included a mastectomy and a brain tumor (both of which, 10 years apart) she survived. I’ve seen her in hospitals from London to Sechelt, BC, and have learned to make medical staff crazy when necessary with my direct questions and insistence on information.

We’re glad we have a good hospital nearby, deeply grateful for good health insurance and generally good health, and knowing we can get there within a 10-minute drive.

Wish we didn’t know it quite so well!

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