Recovering from Laser Eye Surgery

I am 13 days post Lasik Eye Surgery, and I can happily say the surgery was a complete success. The journey hasn’t nearly been as simple as they would have suggested at the first consultations though. As a Naturopathic Doctor, I certainly have quite a few more recommendations than they suggest!

First, and foremost, my clinics literature suggested that the day after surgery I could “go to school or work.” And, while I did indeed see two patients the following day (IVF acupuncture that was time sensitive) my eyes would have been Much Happier had I Stayed home and Rested them. Therefore, my recommendation to all future patients would be to book a minimum of 2 days off work post surgery for R&R. Its also very important especially the day of the surgery to have someone to bring you food and check in on you. I found my left eye especially was *very* scratchy and sore, and I just needed to lie quietly with my eyes shut. Cooking or preparing snacks, or even being up and walking around wasnt much of an option. Schedule a friend to come over and hang out for the 5-6 hours after surgery. I wasnt in pain, but just needed to lie quietly with sunglasses and closed eyes…. Take Out Thai was delicious!

I wasnt able to watch TV or read for a good week after the procedure – then again I had some inflammation and complications. I suggest getting a book or two on audio for entertainment. Its hard to lie quietly for hours on end! I greatly enjoyed Elizabeth Peters Amelia Peabody detective book “The Mummy Case.”

Finally, I have a few therapeutic suggestions based on my experience. First, for about 2 weeks pre and post surgery, its helpful to take a supplement to promote eye health. The one I liked best after surveying the options was NFH Vision SAP. http://www.nfh.ca/en/products.html. NFH is a Canadian company and may not be available in the US. This improves blood flow to the eye and helps promote ocular health overall. Several studies also suggest Omega 3 and 6 are important for post-surgical recovery. EPA and DHA in fish oils were evidenced to increase tear volume and decrease inflammation as well as assist in regeneration of corneal nerves.(see references at end of article.) I took 2 tsp daily of Metagenics EPA:DHA 1:1. For omega 6 oils I use olive oil, and increased my sunflower and sesame seed intake (on salads.)I also increased blueberries for the week before and after surgery for their proanthocyanadins – chemicals for the blood vessels of the eyes –  and carrots for the carotinoids, long associated with good vision!

Finally, Homeopathic medicine is brilliant for post surgical recovery for several reasons. The primary reason is that there is no risk of interaction between medications. Secondarily, and as important, they work fantastically well. I recommend 2 remedies post-surgery.

  • Symphytum 200ch – This is a first line trauma remedy, and is “the arnica of the eyeball.” 2 pellets 4 times a day for the first 2 days. This will be the same as your eyedrop schedule from the MD.
  • Euphrasia 30ch – 2 pellets twice daily from day 3 until your eyes stop feeling inflammed. This remedy is for corneal inflammation and redness.

No one talks about the Psychological effect of the surgery; however, this has been an unexpectedly important part of my recovery. I didnt know how much I appreciated my “bedroom eyes” or soft vision until it was gone. Having sharp as a tack vision 24-7 is a new experience, and others who have had the same surgery have told me it takes up to 6 months for the brain to really adjust to the change in eyesight. I believe it! It was also quite scary to have my vision be blurry at times for the week following the surgery. I ended up having to go back daily for follow-ups to assess my vision and recovery as my eyes were inflamed. Waking up each morning with scratchy blurry eyes and having to lie there and apply drops and rest was stressful! However, with time and rest, my eyes did heal on their own, and as of today (day 13) I barely needed the morning lubrication.

All in all, I am so grateful that I gave myself this surgery. Many times I have reached up as if to remove my glasses before doing something like lying down or getting in the tub and behold! No Glasses! It Is a surgery though, and as such there needs to be some time and space carved out of your daily life for recovery.

Summary of Key Points:

  • Take a Vision support formula for 2 weeks before surgery and finish the bottle.
  • Take 1200mg EPA & DHA for 2 weeks before and 1 month after surgery.
  • Take  2 days off work post surgery.
  • Have a friend to help you at home after the surgery.
  • Symphytum 200ch for day of and day after
  • Euphrasia 30ch for days 3+ after surgery
  • Make sure to rest and give yourself recovery time for 2 weeks after.
  • Enjoy your fantastic vision!

Prostaglandins Leukot Essent Fatty Acids. 2010 Apr-Jun;82(4-6):319-25. Epub 2010 Mar 3.

Curr Opin Clin Nutr Metab Care. 2011 Mar;14(2):132-7.

J Fr Ophtalmol. 2008 Mar;31(3):282-6.

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Nutrition and Lifestyle Support for First Trimester

Pregnancy Nutrition for First Trimester

More than half of all women suffer from nausea and vomiting during their pregnancy.  No one knows what causes “morning sickness” but it has been linked to higher hormone levels, changes in blood sugar, and stress.  Nausea and Vomiting usually begin around the 6th week of pregnancy. It usually stops at about the 12th week, although it can continue throughout pregnancy for 20% of women. L During these weeks,  allow yourself to change your activity level and adjust your schedule to help yourself cope with the physical symptoms. Your body is doing some incredible chemistry creating a tiny new being!

Here are tips for keeping the nausea at a minimum.

Lifestyle

  • Eat a few crackers before you get out of bed and rest for 15 more minutes.
  • Keep small snacks in little jars and containers in your purse, your desk, your car, and your kitchen.
  • Eat every 1.5 -2 hours in little bits. You may feel nausea if you eat, but you will feel even worse if you don’t eat!
  • Try not to skip meals
  • Eat slowly, and do not lie down right after eating
  • Ask friends and family for help with errands and housework!
  • Take naps – Nausea is worse when you are tired.
  • Get fresh air daily
  • Avoid hot and stuffy rooms
  • Taking a prenatal multivitamin in capsule form that can be split up throughout the day with meals can make it easier to take your vitamins. If there are days you cant stomach it, don’t worry.
  • Take your folic acid daily even when you don’t take your prenatal.
  • Acupressure “sea sickness” wristbands are helpful for some women.

Food Choices

  • Choose easily digested foods – baked potatoes, mashed yams, homemade gravy, stewed fruits, watery fruits, crackers, etc
  • Avoid cooking spicy or greasy foods at home
  • If you are craving greasy foods, have a few plain potato or rice chips
  • Hot women – put grapes in the freezer to snack on
  • Cold women – drink ginger teas, eat candied ginger
  • EmergenC packets also contain electrolytes and can help rehydrate if you have been vomiting.  Drink 1-2 per day as needed.
  • Soups, porridges, and stews provide healthy  liquids and nutrients.
Food Ideas To Relieve nausea
Ø    Salty Ø    Chips, Spelt Pretzels, Tamari Almonds
Ø    Tart / Sweet Ø    Pickles, Organic Lemonade, Kombucha
Ø    Earthy Ø    Brown Rice, Mushroom Soup, Almond Butter
Ø    Crunchy Ø    Celery Sticks, Apple Slices, Nuts
Ø    Bland Ø    Mashed Potatoes, Broths
Ø    Soft Ø    Bread, Rice Noodles
Ø    Sweet Ø    Homemade Muffins, Cereal with Honey
Ø    Fruity Ø    100% Juice Popsicles, Watermelon
Ø    Liquid Ø    Juice, Seltzer, Ginger Ale
Ø    Dry Ø    Rice Crackers, Saltines, Rice Cakes

Beverages

  • Dehydration will make you feel worse!
  • Plain water can make some women feel worse. Try drinking lemon water, or lemon water with a little maple syrup.
  • Drink in small sips.
  • Avoid drinking before, during and after meals.

Smells can be very nauseating for a pregnant woman. A good tip is keeping a piece of fresh lemon peel or ginger root on a hankie, and sniff it when feeling nausea. Don’t use synthetic scents as these often make it worse.

What if you can’t keep anything down?

Hyperemesis Gravidarum affects 1% of pregnant women per year. Lack of food, fluids and nutrients can be harmful to mom and baby. Severe cases of dehydration require IV fluids and nutrient supplementation from a hospital. Seek medical attention if you have frequent vomiting and infrequent urination or dark yellow urine. Early diagnosis and treatment is best, so don’t try and “be brave!”

Acupuncture, B6, ginger capsules, and homeopathy can treat mild to moderate cases of nausea and vomiting. Use 50 mg of B6 twice daily with food. Severe Nausea may need a prescription medication called Diclectan.

Summary: Congratulations on being pregnant! For this first trimester 3 keys are:

1.     Rest Rest Rest Rest

2.     Eat frequent small amounts – every 2 hours is a must! Remember, eating might not help but Not eating will make you feel worse

3.     Follow your body’s cravings, trying to stick to wholesome home cooked versions of the more junky cravings. And. Don’t forget to sip lots of water!

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Weight Loss and Other Mysteries

Weight loss is and will always be immensely complicated, full of chutes and ladders of self esteem, deprival mentality binging, and whirlpools of addiction. Still, there is a forest beyond the trees. Or, a Candyland amidst the candy as the case may be.

Successful weight loss has 4 steps: detoxification, cortisol balancing, optimizing diet and exercise. Detoxification is the new key step to integrate – at the beginning of the weight loss process. Evidence is mounting that our body uses our fat cells and between-cell fluids to store toxins that it is not able to metabolize effectively. Some Persistent Organic Pollutants (environmental toxins) have even been suggested to be “obesogens” contributing to further weight gain. 1 . When we exercise or reduce caloric intake to facilitate fat burning, the matrix between our fat cells can be so thick with unprocessed environmental and metabolic toxins that the body preferentially burns muscle to get the fuel it needs! Therefore, Step 1 must be to detoxify. Our body has 3 primary routes of detoxification: bowels, kidney and liver. All three will eventually need some fine tuning, and the order of tonification depends on your signs and symptoms, as well as your medications and general vitality.

Step 2: Optimizing Diet. Its so hard to eat well consistently. It is even harder if food is one of your chosen drugs, and you are addicted. Weight loss would be so easy if everyone was willing to go gluten and dairy free! In my experience if you have a 65%  whole foods diet, then the remaining 35% can be whatever you want.  To figure out how to shift your eating with an approach that will work for you in the long term there are many resources – The Glycemic Diet and Eating Right for Your Blood Type both explain more about the underlying principals of nutrition. Weight Watchers also works for a reason – being accountable for what you are eating and restricting some foods to moderate amounts *will* help you lose weight. What does “whole food” mean to me? 65% of your diet will be cooked grains, steamed or sauteed vegetables, organic fruits and juices, tofu, beans, eggs, wild fish, coconut milk, olive oil, butter, nuts and seeds. The remaining 35% can then be everything else – beef, bread, cheese, bacon, alcohol, etc. What does 35% mean for real? 2.45 days a week you can eat whatever you want, the remaining days are pretty basic, healthy, and “granola” food choices IF you actually want to lose weight.

Stress Management aka Cortisol Regulation is the golden child of any weight loss program. Several books have been written in the past 10 years outlining the connections between stress, hormones and weight gain. I like cracking The Metabolic Code by James LaValle R.Ph, C.C.N., ND. The bottom line is this – when you are stressed out, your blood cortisol levels increase. Just in case you are running from a rabid dog and need to climb a tree your body makes sure (via increased cortisol) you have lots of sugar available in your blood for extra energy. However, if you aren’t in fact running, and don’t need to extra sugar, your body turns that blood sugar into belly fat. Therefore, its important with all weight loss programs to address stress at some point to treat the biochemical imbalances leading to increased weight. There are a few herbs and vitamins that specifically rebalance cortisol levels, and reteach the body how to respond appropriately to the every days stress of life.

Finally, exercise and an active lifestyle. Getting the blood pumping and muscles moving mobilizes fat toxins into the bloodstream, and serves as an excellent antidote to daily stress. Check! I also find that getting ones body moving in whatever form works for you is invaluable to setting the positive cycle of weight loss in motion. The positive cycle is this: eat a good meal –> feel good about yourself –> go for a walk/to the gym/to yoga –> feel sexier–> feel motivated and excited about life –> make a good food choice. The cycle keeps going so that sooner than you expect it, you start to feel the benefits in the way your clothes fit which makes the supplements and brown rice and kale suddenly get much more appealing!

There is no one quick fix, no one diet or pill or product or form of exercise that will resonate for everyone. The structure is fluid and fundamental – the individual components are designed to be strategically tailored to fit your life and style. I also think  its worth asking yourself – do you Really want to lose weight for You? Or, are you holding your Self up against an ideal that you actually don’t want to attain? Personal honesty will take you further than anything else. Allow yourself the option of total success if you truly want to revolutionize your self image. And, weight loss takes time. It is only reasonable to lose 10% of your total weight in any given period of weight loss. So, if you are 160lbs, losing more than 16 pounds is more than your psyche will be able to maintain. Therefore, when you reach your new goal weight (144) you will need to start over and reassess where you are, and where you want to be before another 14 pounds is sustainably lost.

Every Body is Beautiful.

1. Lim, JS, et al. Inverse association between long term weight change and serum concentrations of persistent organic pollutants. Int J Obes (Lond) 2010 Sept 7 [EPub head of print.]

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Materia Medica, Or, the Dispositional State

Homeopathic Diagnosis and Prescription are part of classical Naturopathic Medicine. Its taught every semester of the 4 year post-graduate program to become a ND, alongside our other basic modalities of Acupuncture, Botanical Medicine, Nutrition, and Physical Medicine. Personally,  I have always had an equal passion for Homeopathy as for Acupuncture. For the first half of my professional career, I focused more on Continuing Education in Chinese Medicine – learning the historical and modern teachings of acupuncture, fertility and gynecology. However, I have continued to practice homeopathy throughout, balancing the two according to individual case needs.

Two years ago, I was finally able to take a Master Clinician course in Homeopathy from Louis Klein – www.louisklein.com –  a brilliant teacher and practitioner of Homeopathy. The course www.luminoushomeopathy.com is 4 weekends a year for 3 years, and has focused on relearning remedies from an entirely new perspective without the classical bias of archetypal polychrest homeopathy. The course has also emphasized case taking, and has revolutionized how I view a client, and can categorize the information while deconstructing a case. Each semester investigates a different group of remedies – i.e. minerals, acids, insects, milks, plant families – and delves deeply into the psychology, pathology, and physical presentation of each subsection of the Materia Medica. Its been utterly and completely fascinating.

Now that I will be moving from a province where Acupuncture is licensed under my Naturopathic Degree to a State where Acupuncture is a separate license, I will be drawing more deeply from the well of homeopathic knowledge. Acupuncture and Chinese Medicine will always remain a passion for me – And I will continue to develop my academics to ensure that I can get my L. Ac as soon as possible. However, I am excited on a personal and professional level to further develop my homeopathic case taking and prescribing skills with this new level of academic mastery.

As one patient described it, the correct homeopathic remedy has the power “to unlock that tiny door to your heart, and finally let the light shine through.” That is, If, the doctor is perceptive enough, and trained well enough in Materia Medica, to be able to recognize the size and shape of that oh-so-personal key.

The Fairer Sex – Gender Bias in Homeopathy

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A City Rose – Urban and Modern Fertility Care

You have a little plot of dirt, a garden. Maybe its a barrel above ground on your balcony, or maybe its a carved out border in your backyard. It bakes in summer heat, and freezes in winter. Acid rain and snow are its primary nourishment. Some years you transplant hydroponic Impatiens, adding some pre-packaged chemically enhanced  soil. Other years you just let the wild clovers and violets grow. One year you planted wildflower seeds and now an occasional Cosmo and Echinacea blossom will sprout up, summers gifts. This year, you want to grow a Rose. And not just any rose, You want to grow one from the seeds you saved from your Mothers garden. You have tried, a few times, carefully planting 2 or 3 of the seeds you have saved. Watching and waiting, watering, only one little shoot grew once, then shriveled and died. What will you do? You can buy a nursery-perfect blossom and transplant it, and hope it grows and thrives.  Or, you can redeem the quality of the soil,  find the right balance of elements for your location, and carefully nurture your roses into life.

http://www.rdrop.com/~paul/manners_seed.html

This is, of course, a thinly veiled metaphor for modern fertility. The overheating effects of alcohol and nicotine and cold harsh winds of stress are our basic elements. Our reproductive system is the highly chemically influenced plot of earth, exposed to the acid rains of caffeine, sugar and pesticides.  But gardens can be restored, and so can our vital human bodies. In fact, some women have an inherently fruitful composition, and with just a little consideration and TLC, natures natural abundance takes root easily. Other women have more work to do.

As a fertility Naturoopathic Doctor in downtown Toronto, I see many women in their late 30’s and early 40’s preparing for their first baby. Whether a woman is mid-IVF, mid-insemination or doing it the old fashioned way, there is always work that can be done to improve the chances of conception.

After 20+ years of stress, drugs, alcohol, and junk food, the reproductive “soil” always can benefit from some rejuvenation.  There are some general principals, and some individual components to this. Generally,  Vitamins B5 and B6 are important for hormonal health. These should be taken as *at least* 100mg each daily with food, or up to 500mg B5, 250mg B6 for up to 3 months. CoQ10 is a fat soluble antioxidant that works at the cellular mitochondrial level, increasing each cells energy bank. CoQ10 can protect and rejuvenate ovarian cells at 100mg daily, with food. Nutritionally, everyone can benefit from adding 3 servings of organic brown rice per week, and eating 1 head of steamed broccoli or cauliflower and 1 head of steamed kale each week, minimum. Finally, fresh berries are powerhouses of antioxidant value – have about 1/4 cup 4 times per week. Also, drink 2 liters of water daily. Measure it, drink it. Cervical fluid cannot be fluid if you are chronically dehydrated.

Now, I wouldn’t be a naturopath if I didn’t also do some food eliminations! Caffeine in the form of black tea and coffee are natural enemies to fertility. Anyone with PMS can tell you it activates crampy reactive uterine muscles and promotes tender, swollen breasts – evidence of its actions on the female reproductive system. However, the small amount of caffeine in  green tea is overcome by the enormous benefit of  ECGC. Therefore, I reccomend 2 cups of organic green tea daily, *especially* in the week prior to ovulation. Small amounts of chocolate are also ok, as there have been many studies on the stress reducing chemical components of chocolate! Try to get organic higher cacao content chocolate with lower amounts of sugar for maximal benefit. Other foods that need to be eliminated are food dyes (anything artificially red, blue, green etc) and pre-packaged pre-made foods – whether boxed, frozen or bagged. Bathing your newly optimized internal soil in chemicals and preservatives will only re-establish a barren hospitality; feeding yourself fresh fruits, whole grains, organic meats and vegetarian proteins will produce a rich compost for your inner loam.

The secrets to an inner green thumb are also about recreating a fertile mindset. How do you perceive your uterus? Your ovaries? When you look within, what do you see? I encourage you to actually picture your uterus as flower almost in full bloom. Layers of rich red petals, folding tightly around a secret center. Find a metaphor or image that works for you, dependent on where you are in your own evolution of creation. Create rich, fertile soil.  Sprouting a tiny seedling. Water, sun and nurture the seedling in your rich nutrient-filled inner earth. And enjoy the fullness of  your Rose (Jenny, Aiden or Simon)  in bloom.

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Women Over 30 -The New Eating Disorder

Eating Disorders – just as prevalent in women over 35 as they are in teens. The thirties are a time of life when, like for teenagers, life can seem extremely stressful and out of control. This is the prime ground to feed a renewed, or a new eating disorder. Family, Career, Finances, Fertility – Life can become overwhelming, and food is one thing we have been taught we can control (or not.) Recovery from binge eating, purging, calorie deprivation and/or exercise bulemia  is possible.

As a ND, lifestyle counseling and stress management are always important components of treatment for eating disorders. Giving up “dieting” and re-learning how to eat for your body type is a cornerstone. Every woman will have a different story, and unique circumstances. This is where Naturopathic Medicine shines, as Naturopathic Doctors are trained to listen, and help you come to your own solutions for regaining a sense of center amidst the uncertanties of life. Often minerals, nutrient rich foods, herbs and homeopathics are used to to restore hormonal and digestive health and emotional wellness. Psychotherapy is also needed to unpack and address childhood issues that may have led to the original eating disorder.

http://health.nytimes.com/ref/health/healthguide/esn-eating-disorders-ess.htm

http://www.nytimes.com/2010/04/07/health/07eating.html?_r=1

The National Eating Disorder Information Center is a great resource for all people affected by disordered relationships to food. Their Eating Disorder Self Checklist is an interesting and objective way to gauge your own relationship to food.

http://www.nedic.ca/knowthefacts/selfcheck.html

http://www.nedic.ca/knowthefacts/overview.shtml

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As Fertile as the Day is Long

Fertility is a crossroads of mysticism, science, religion, psychology and medicine. I come to this practice with more than dollars in my eyes.  With two infertile stepmothers and an adopted brother 25 years my junior, (in)fertility been in my life for many years. Plus, lets be honest – I’m a 37 year old nulliparous woman. Why do you think I am so passionate about knowing the ins and outs of how to get pregnant! (My time will come when I will be sitting in the patient chair.)

My approach to fertility is twofold. First and Foremost, the monthly cycle must be optimized. Good quality blood, clear fertile fluid, effective ovulation, and strong luteal phases all provide a premium conception opportunity. Chinese medicine is brilliant at working with each of these phases. Eastern medicine has a way of understanding the body’s intersections of physical/mental/emotional/hormonal health in harmonized, century old patterns. Phrases like Liver Qi Stagnation and Heart Fire sound so much easier to embrace than a luteal phase defect. So, using nutrition, acupuncture and chinese herbs we set out to smooth and tonify the monthly cycle to set the stage for conception.

The second half of the work is the mysterious part. It is helping women access that intangible quality of uterine receptivity. It is finding the balance between living the daily life of a healthy adult and becoming a vessel for an unborn possibility. The mystery of fertility comes in symbols and half thoughts and an inherent feeling. It lies tangled in childhood preconceptions of womanhood, success, career, family, and production. It is in the crux between your sexuality and personality. Alot of my work is helping you find yourself. To find your own balance and your own mystery, is to unlock your own secret (fertile) chamber.

There are many tools that can be used to dissolve obstacles encountered along the way. For example, herbs for PCOS, supplements for endometriosis, homeopathy for anxiety, counseling for stress reduction, massage therapy for relaxation. This is where the individualized nature of Naturopathic Medicine comes into play. Few women will receive the same treatment, as few women will have exactly the same picture. As a ND, I also  promote the scientific basis of fertility – doing bloodwork and  ultrasounds to rule in and out hormonal imbalances, uterine dysfunction and sperm motility issues are integral to understanding difficult conception. If we know what the mechanisms are, it unravels the mystery that much more.

I have a special passion for fertility medicine. It speaks to the alchemist and doctor and midwife in me. It gives me hope for my own potential to conceive, and inspires me. I am grateful for the women who have taught me their secrets and trusted me with their mysteries. We are all fertile in our hearts and minds, every one of us.

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A Little About Me

I had an unusual childhood that has certainly influenced my career. When I was three my mother  and I moved into Kripalu Yoga Ashram in rural Pennsylvania. http://www.kripalu.org. Kripalu has had many incarnations from the early 70’s, and is now a beautiful holistic health center in western Massachusettes. At the time, it was a residential community based on the classic principals of yoga. We ate a macrobiotic diet, and lived a simple lifestyle. I was not vaccinated, and treated primarily with homeopathic medicines for all my childhood fevers and such.  As the community developed into a retreat center for spiritual learning and the yoga teacher training programs developed, the community moved to the current site in Lenox, MA.

I was at Kripalu on and off for 18 years until the community formally changed from a non-profit religious residential community in 1995 to a for profit holistic health center. I left in 1987 for boarding school, and then attended Middlebury College in 1991 so I only lived there a few summers after age 13. Still, the influences of diet and nutrition, stress management,  healthy lifestyle and homeopathy as remedies for our modern disease are at my very core.

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And in the Beginning, There was Nothing

The absence of sound, a quiet rock on a still afternoon. Sunshine. This is todays first entry. This is the quietness before the first beginning; the dark hour while babies wait to be born and everything seems its most terrible, or wonderful.

I look forward to what this will become, beyond its naming.Thank you for joining me here – See you in the sweetness of what is to come.

Masina

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