Oct 05 2010

Living with ADHD

Published by under amy's head,kids,likes & irks

James and I hold our breath every time Ethan seems to be in a “good stretch” — in behavior, in not getting into trouble, in getting his homework done, etc. It seems that everytime we feel like we can let out a sigh and relax a little bit, that is when things take a turn for the worse. We’ll get an email from his teacher, or there’ll be some altercation in the neighborhood, and it seems to spark off a hellish 4-6 weeks of sullen behavior, and/or reports of not doing work at school, and aggressiveness.

So it’s hard to actually breath that sigh of relief — knowing that in the past, right afterward usually comes the kick to the gut. But we tentatively are, and we’re making sure that Ethan knows how proud we are of all his hard work.

He is doing awesome in school. This year he has a male teacher, and Mr. A has been great. His special ed teacher is also male, and Ethan is really stepping up to take charge and be responsible for his work.
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Mar 29 2009

A Big Big Ethan Update

Published by under amy's head,kids

I debated writing this but finally decided to go ahead and do it.

Ethan had probably the worst 2 weeks of 1st grade.

But let me back up. I haven’t given any Ethan updates in a while. James and I met with the school folks a few weeks ago for the outcome of the child study/big bout of testing. In November, they mentioned the possibility of Asberger’s, but it has been ruled out (for now). The rest of the various results showed (and this is just me remembering, with nothing in front of me) normal results, with elevated results in attention/focus, issues with social interactions, and a high need for sensory interaction. Academically, he is on grade level for everything, including reading (which he was below grade level on earlier in the year), and below grade level for writing. Writing seems to be the time when he gives attitude to his teacher. Most students are writing 5 sentences, where she will accept 3 from Ethan. Sometimes, he will only do one.

At the end of the meeting, we agreed that the issues he is having is hindering his education, and thus, he qualified for special education. They assured us that he would stay in his classroom and that “special ed” is nothing like it was in our day. They also noted that while he was in the ‘average’ range in all of the IQ tests, his inattention and wiggliness may have affected the results to be lower than in actuality. In the vocabulary tests, he scored in the very high range, which for kids, can be a better indicator of IQ. We will probably be looking into the gifted program as well.

Mostly, I am SO GRATEFUL that we have such a great school, with kind, caring administration and teachers. They all commented on what a special guy Ethan is, and in everything they said and did, showed me that they want the best for Ethan and his education. We have a meeting this coming week to develop a specialized education program for him.

We had met with the new psychiatrist, and I guess in my mind, I thought he’d start weekly sessions and work through this stubborn/angry/borderline behavior, but we went over everythign that’s going on, and all the steps we’ve taken so far. He said that the group class is probably the best thing for him and this is a process that will probably take years for him to work through. He said that it will mostly be him learning the hard way, that when you treat people/friends a certain way it doesn’t work to your advantage. He said that since Ethan is a smart kid, it may be quicker for him to catch on. He gave us some information on ADHD medication – it’s been around for 60 years, and works by increasing bloodflow to the part of the brain that handles organization, etc. (I am probably getting this wrong, so keep that in mind!) I said I didn’t think we were quite there yet, and he suggested if we weren’t seeing any improvement in 3-4 months, then it’d be a good time to revisit it.

So the week we met with the shrink, Ethan’s behavior went down the crapper. He was not doing super good before, but suddenly, it just sucked. He was not doing his work, being super defensive and aggressive when asked to do things, handing in BLANK assignments, antagonizing other kids. Ugh. The vice principal took him out of the class to walk around and cool down, and he threw his library books over a railing and ran away from her. These past two weeks have been pretty hard on James and I. It sucks to be in a pretty good mood on your way home, and then get the email from the teacher about how he tried to turn in a writing assignment COMPLETELY BLANK and then sassed his teacher when she tried to give it back to him to do. Then I would pick Ethan up and have to deal with his total shut-out-everyone because he’s so pissy (because of the consequences he has at home for not getting a “green” at school). It’s very hard to keep your patience up and keep your cool when your 6 year old is talking like a sullen teenager, or refusing to talk at all while he sits alone behind the couch. Generally, after he cools down, he does better, but even then when you try to talk about what happened, it can throw him back into this angry defensive mood again.

Pretty soon we were living each day dreading the news from school, feeling sick to our stomachs all the time, and feeling HELPLESS. What more could we do? Not much. I halfway joked that this whole situation was going to drive ME to medication, let alone him. My back has been killing me, I got sick and missed a day of work, James has been stressed out with all of this, plus midterms, papers to write, and projects to complete.

Social Achiever’s was abysmal. Kicking. Whispering to other kids to shut up. Getting in other people’s personal space. Giving attitude to the counselers. The conversation with the counselor afterward was laughable, but it was very telling. She let me know all the issues they had with him in class and I told the counselor he had a terrible week at school as well.

She suggested we coordinate with the teacher to use some sort of system when he does good or not.
I told her we were already doing that.

She suggested maybe some sort of immediate reward for good behavior.
I told her we were already doing that and explained the system they were doing in class for him.

She suggested contact with the teacher every day.
I told her we were doing that and that I was feeling very discouraged and I just didn’t know what else we COULD do.

She reassured me, and said she would like to have some psychological testing done so she could make some recommendations on what steps to take next. She didn’t feel comfortable giving any recommendations without seeing results, which would give a general look at his outlook.
I told her we had already done that in the round of testing from the school and we agreed I’d send her the results and she’d call me with ideas.

I had called the psychiatrist and told him of all this new trouble we were having and he suggested starting Zoloft, which would help keep him from having such dramatic mood swings. I had called still hoping I guess for .. well, a miracle, I guess. Weekly sessions that would miraculous suddenly get through to him and turn off the sullen teenager switch! Disappointed, I thanked him and said we weren’t quite there yet.

After I sent the test results to the group counselor, James and I both got on the line and called to hear what suggestions she had. She also suggested a mood stabilizer. She said that once he was a bit more on an even keel and able to keep his emotions from getting the better of him, he would be in a better position to get more out of the social achiever’s class.

There was more to the discussion but that’s about what it boiled down to. After James and I hung up with her, I cried. James was on board with the medication when the doctor had suggested it, but after talking to the counselor, I had to get on board too. They both had suggested it unbeknownst of each other, and honestly, it made a lot of sense to me. The more I thought about it, the better I felt.

Not only is Zoloft a mood stabilizer, but it is anti-anxiety medication, which I am sure he has. I think he is very anxious about failing at writing, which is why he is refusing to do his writing assignments at school. I know he gets anxious about reading still as well, even though we try to keep it as light-hearted and easy going as possible. Just yesterday, he mentioned how he is nervous meeting new kids and commented on how he wished it was as easy for him as it seems to be for Jocelyn. I think he is anxious of being rejected by other kids, which is why he acts FIRST – on the defensive and aggressive. I’ve always thought that is has been kind of a “i’ll hurt them before they can hurt me” sort of a thing.

A part of me is wondering why a mood stabilizer seems “better” .. or perhaps, “more acceptable” is a better way to put it, than ADHD medication in my mind. Maybe it’s because I have more personal experience with friends and family needing antidepressants, or more likely, it’s probably because of the “press” or “word of mouth” bad rap ADHD meds have, which I obviously have taken to heart. I spoke to some family who has 2 of their kids on ADHD medication and have seen great results. I just want to make sure we need to, before we take that step.

So to cut a too long story short (TOO LATE!), we’ve started Ethan on Zoloft. It’s been 3 days now at a low dose. I’ve heard that sometimes you can see some improvement right away, and I’ve also heard that it takes 2-3 weeks to really start working. I don’t know if I’m just imagining it or not, but I think he has been a little less apt to fly off the handle.

We’ve talked to him a bit about it and said that it is to help him not get quite so angry. His very first response was, “HOW can MEDICINE help THAT???!?” in disbelief. James told him that it for the brain. Today on the way home from Target he asked me again, “Why am I taking medicine?”

“Well, it’s to help you with anger, and I think that if you’re not getting as angry, then it can help you with that then I think it’ll be easier for you to be polite and respectful and use a bit more self discipline.”

“I think it’s working. Well, I dunno, but maybe. I think my brain thinks it is.”

I have no idea what to read into this response, but I’m glad he doesn’t feel weird or strange.

I’m nervous posting this. I know some people I care about a lot, friends and family alike, who disagree with giving medicine to these precious growing bodies. All I can say is, I really believe we’ve explored every avenue, and this is the right choice for our precious growing boy.

-amy

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Mar 10 2009

Complicated Birthday Day!

I have actually been meaning to post on the old blog-er-oo for a while now. I know! Crazy! I have had things to say that take more than the 140 characters allowed by twitter! I just haven’t had the time to sit down and write. Which is a bogus excuse because I’ve had time enough to play Fallout 3 on the PS3!

Today was Jocelyn’s birthday. I hope it was lovely for her, I think it was. It was not as lovely for James and I.

We planned to do her “party” at her school. Meaning, not really have a party at all, but make a bit more of a fuss than just send in cupcakes. We got party hats for all the kids, enough balloons for everyone in her class (36 kids!!) to take one home, and cake of course.

I was on my way from work when I got a call from Ethan’s school’s vice principal. Something had set him off in his classroom and he wasn’t able to settle down, so his teacher asked the VP to take him out of the classroom. She walked around with him for a bit but he still was giving her attitude. At one point he threw his library books, and finally, she had the Principal come get him, and carry him to the office (because he would not go himself).

Ugh. I mean… UGH. Our first objective was to make sure that Jocelyn’s birthday didn’t get ruined. James picked him up right away (he was planning to get him early anyway so we could all do to Jocelyn’s class) and we didn’t make a fuss about it. We basically didn’t do anything about it, except let him know we would talk about it later.

We got to Jocelyn’s class and she was so excited and happy. Birthdays are her absolutely favorite things EVER 🙂 Everyone was very excited to have cake and see the balloons and sing happy birthday. It was very low key, lower than I had anticipated, really. We sang, served cake, popped party hats on everyone, and after the cake was consumed, everyone went out to play outside. Jocelyn and Ethan went out and ran around on the playground a bit, and then we came home to open presents. We got her a new scooter, a little pink bin of legos, a Barbie mermaid, fairy, and (of course!) a strawberry shortcake doll (Rainbow Sherbet!)

After a few scoots around the driveway on the new scooter, we left and went to Jocelyn’s choice of dinner restaurant: Chuck E. Cheese. That place is so much nicer on a weeknight than it is on a weekend. Wow. The kids ran around and had a ball, eating bites of pizza in between video games and crawling around in the kid-sized gerbil tunnels.[1 Seriously. All they need to add is a big wheel and a water drip and the illusion will be complete.] Home, little more playing, and then bed. We still have a pinata that we will probably gather the neighborhood friends together for tomorrow evening. Overall, a big success, and all without the stress of planning a major party – which I love to do, and usually have fun doing, but still, the stress is there. I’ve had enough stress, thank you. I hope we can do something similar for Ethan’s birthday when it comes up, but I’m not sure what.

So, the birthday girl had a lovely day. James and I were pretty much on edge with that sick feeling one gets when their child is having issues. The Ethan update is pretty much, he’s got issues, man. He had a good spell in January, and DOES seem to be less in trouble for *hurting* others, but his behavior still has the same issues. Impulsive, inattentive, aggressive. The plethora of testing done by the school is complete, and tomorrow we meet with everyone at the school to discuss the results. James and I have the reports already and have read them over, and as far as we can tell, it’s really nothing new. Which I guess is good – no mention of any learning disorders or anything — just the same things that we already know. Hyperactive, short attention, impulsive, little self control… We’ll see what they recommend.

On the shrink front, we had an appointment with a psychiatric nurse practitioner but it got canceled for insurance issues. I called back and went ahead and made an appointment with someone different, a psychiatrist who was recommended by another child psychologist from a practice that doesn’t take our insurance. Our appointment with him is next week.

I’m feeling pretty down, but this is an atypical feeling.. just because his day at school today went so badly. I am usually pretty upbeat.. because I have seen a significant improvement in our interactions with him at home. He is playing with his friends pretty well, which was NOT the case at the beginning of the year. I am feeling down because I feel like we’re a step closer to an ADHD prescription which I really am not ready for. And I am definitely not taking the final step until I *really* feel like I’m ready.

I also feel down because I took the most ridiculous fall down the 3 steps down into the garage pre-party. I mean, RIDICULOUS. I don’t even know HOW I fell. I just went ass over end and I hurt ALL OVER. It doesn’t help that I’m having back issues again, which really sucks. So basically… HOST BODY BROKEN. MUST FIND NEW HOST BODY. (god don’t I wish!)

Ahhh well. In other news, I have become a chainmaille weaving addict. I bought a jump ring cutting system and am impatiently awaiting my latest order of silver wire so I can go crazy with the SILVER chainmaille. In the meantime I have oodles of copper wire and even have a few new things up in my etsy shop, so take a look 🙂 I had my very first silver byzantine bracelet up there, but it was purchased by an old friend from High School who saw it when I posted to facebook! How’s that for a go ’round, I love it! I’ll post more about the jewelry soon. I have LOTS to say, especially about how much jewelry photography can suck it, and how sick I am of taking a photo I think will totally ROCK, get it into photoshop, and it looks shitty. SUCK IT, JEWELRY PHOTOGRAPHY! I used to think I could take a decent picture! No! I can’t! I suck! Ahhh well. I will learn.

I hope!

That’s it for now. Wish us luck for our meeting with the school tomorrow!

-amy hears the whoosh, whoosh, whoosh, of the tumbler, tumbling her newly cut jumprings to a burnished, awesome shine!

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Feb 03 2009

More Ethan!

Published by under amy's head,daily,kids

Yesterday I hightailed it in to work early because Ethan’s school had a half day. I picked him up at 12:15 and then went home. I wasn’t planning on finishing up my work day until evening, after the kids are in bed, because often it’s too distracting to try to work with them around. I emptied the dishwasher while shouts of running and playing eminated from outside, but they had faded away by the time I was done. I had asked Ethan to stay in our courtyard, but he had wandered off, so after I got the dishwasher started, I put on my coat to check.

He was in the courtyard right behind ours doing just fine. In fact, he’s been doing just fine for a while now. Before christmas, I would definitely have been outside “hovering” just to make sure everything was going OK, to be present in case anything needed moderating. When friends are over at our house playing, I used to hover, for the same reasons. But it seems more and more that there is less and less of a need to “hover”.

If you’ve read any of the Ilg and Ames books on child development (I recommend them ALL, they are AWESOME), you know that they talk about the cyclical nature of developmental milestones, and how a child will go through cycles of equilibrium, and unequilibrium. The unequilibrium can be anything from your dextrous kid suddenly being a butterfingers or clumsy, which may happen before a new developmental milestone is achieved. It can be social as well. At the beginning of the year when we started having all these issues with Ethan I rushed out and bought the 6-year-old book, which helped me realize that 6 can be a tricky year, even if your kid is NOT having issues. The actual title of the book: “Your 6-year-old, Loving and Defiant.” Ha. Loving AND DEFIANT. It’s not just my kid! It can be a year where they test their boundaries and see what they can really get away with. It is a year where they really start to see themselves as separate from Mom and Dad, and the need to please Mom and Dad is nowhere near as strong as it was at Five.

When we met with the psychologist who gaves us the dreaded ADHD diagnosis, I couldn’t help thinking that even though we got the results of the test in early January, the test itself was administered in the THICK of the problems we were having, all the way back in early November. Thoughts I thunk and expressed at that meeting, “But he’s doing so much better now. Could he have just been having a bad day? Or a bad month?”

I think that it was naive of me to think of it as a bad day – we KNOW it wasn’t just a bad day, it was a bad 6 months! But now, we’re heading in to February and looking back at January, he really has made a marked improvement. He seems to have gained the ability to listen and change his attitude when asked (OK, when threatened! usually with loss of allowance!) We have had one bad incident where he would not listen and had to be put in his room, where he threw things, so I don’t want to discount that ugliness, but more and more, and especially after yesterday when he played with neighbor kids so well, I have to wonder, Was he just having a bad six months? A REALLY bad six months? Could we be reaching the end of the unequilibrium and heading into equilibrium? I also don’t want to discount the help that his Social Achiever’s class have given him. I have no idea if it’s helped, but hopefully it has.

I’m not saying that I’m just tossing the ADHD diagnosis out. But I do think the test itself is very subjective, and as things stand now, I am definitely in the “let’s wait and see” camp.

I must say it’s a pleasant place to be. Tomorrow we meet with the new psychiatrist, and I’ll be happy to tell her we’ve really been doing pretty well lately. And that hopefully we won’t need to see her much 🙂

-amy

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Jan 26 2009

Ethan Update Part 2

Published by under amy's head,kids

Ethan had a pretty good spell at school right after his 2 week break for the holidays. He was very excited to get back to school, colored in 8 pieces of his space shuttle that first day and was “green” for the first two weeks (they get greens for good behaviour). But I think now, he’s pretty much back to “normal”. One good thing – normal seems to not include nearly as much hurting other people. There was always something going on, each week, kicking someone, punching someone, some sort of scuffle, and thankfully, it seems to have lessened quite a bit – he did do some pinching last week, but that has been it so far this year.

Just a general sort of round up on his behaviour: He has a few friends in our neighborhood that he will play with, but James and I feel the need to “hover” if they’re outside or even inside, to mediate any issues that come up or step in if things get rough. When he is over at their house(s), we worry the whole time. At school, he will roll around on the floor at times, if too close to his neighbors, he will get in their space and/or poke them – his desk is generally pulled away a bit for this reason. He will sometimes circle his desk around and around. Some sensory things we’ve noticed, he will also often chew on things, and will make a sort of whistling noise through his teeth. He loves to wear super soft clothing – he won’t wear jeans, and loves the pants that are made from sweatshirt-type material. He loves footsie jammies partly because he prefers to be on the warm side when he’s sleeping, but partly because every inch of his body is covered in softness.

Actually, now that I think about it, I think he’s stopped the chewing (or if not stopped, it’s lessened a great deal) as well as the whistling through his teeth.

He is very inventive and curious about all sorts of things. They were doing surveys and votes in class, and he decided to do one at home – he counted up all the smoke detectors and all the sprinklers and tallied them up with tally marks. He loves to tinker on James’ workbench – taking apart an old printer, or attaching components to an old mother board. He knows how to make a computer fan work by attaching the wire ends to a 9volt battery. We used to have him read us a book every night, but during the winter holidays he complained he was too tired at the end of the day, so we switched it to mornings, and we call it our snuggle reading time. He is growing more confident with reading, but still will sometimes just look at the beginning of a word and guess at the rest instead of seeing the whole word. He’s grown so tall that it’s hard to snuggle with him (and yet we still manage somehow!)

He is very sweet and compassionate, loves anything that is “cute” (puppies, kittens, wee little robots, the color pink) and lately the WALL*E obsession in our house has reached epic proportions. A number pad has been installed in front of the stairs where numbers are entered before walking up them. “Trash cubes” are made from anything handy (blankies and laundry mostly). Anything picked up is picked up with robotic WALL*E-ish movements, and whole conversations from the movie can be repeated verbatim. “Give me the plant! -Tell me Auto! That’s an ORDER! -Very well sir.” “HALT!” is also a common order given around our house, like the steward bots on the Axiom.

Well, I think that’s enough for now. We’ll see how it goes from here.

-amy

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Jan 24 2009

Ethan Update

Published by under amy's head,kids

I haven’t updated on Ethan in quite some time (except for my cryptic twitters), and so it’s about time I did so.

He has been going to a weekly “Social Achievers” class at the counseling center for about 2 months now (big gaps for the holidays) and each time, they’ve said he has really struggled with it – giving attitude and fighting the redirecting they’ve done. The last few times have been better though, with less attitude and more cooperation.

In the meantime, he was tested by a psychologist in the same center for ADD/ADHD in mid-November, and before we received the results of that testing, the school asked us to come in for a child study. This was in early/mid December.

The child study went well. “Well” being defined as my ability to hold it together and not be too devastated by what was discussed! Also defined by the sensitivity and obvious compassion those involved displayed for my son. His teacher, the vice principal, the reading specialist and the school’s psychologist were present at the meeting, as well as James and I. We went over areas that he shows strength (science, math) and areas that he is weak on (reading) and his behaviour throughout everything. Even though he is struggling in reading, he loves nothing more than to sit with a book or be read aloud to.

His teacher and the reading specialist have worked out a system of rewards for good behaviour, when he is on task and staying focused he will get to color in part of a space shuttle. When he has colored a certain number of pieces he gets a bigger prize, such as lunch with his teacher, extra time in an activity he loves, lunch in the classroom with a fellow classmate, etc. His teacher also has been charting how often he is on task, with the goal that he stays on task 70% of the time. This means that she marks down how he is doing every ten minutes throughout the day. She also keeps James and I appraised of how his day went with an email home at the end of each day. I can’t tell you how blown away I am by the school, his teacher, and the administrative staff. I am so grateful that they have been so open and helpful and truly concerned about helping him be the best student he can be.

After discussing Ethan in great detail, they basically said that we can just continue as we have been, and have another meeting in the spring to see how he is doing, or we could start testing to see if there is more going on that we don’t know. We opted to start testing. They will test for a wide spectrum of items and hopefully it will give us a bigger picture and more insight into how we can help him.

In the meantime, right before the holidays I received a few voice mails from the psychologist who did his testing at the counseling center, and after playing phone tag, got a meeting set up to go over the results. We met with her last week, and she has diagnosed him with ADHD with a recommendation for a psychiatric consultation for medication.

I don’t know if it’s because of some of the possibilities that were tossed around in the school meeting (Asberger’s was one) that totally freaked me out and made ADHD a walk in the park by comparison, but I took this news very well, although it was exactly what I had been dreading. I am totally freaked out at the possibility of giving my SIX YEAR OLD a DAILY medication. (Totally. Completely. Did I mention I’m totally freaked out? LIke, WAY FREAKED OUT. A medication EVERY DAY. That will screw up WHO KNOWS WHAT as a side effect. Just want to be clear here! Me = FREAKED.)

From what I’ve read, ADHD can be a pretty subjective diagnosis. But I can’t avoid the fact that Ethan definitely has some problems that points pretty clearly to ADHD. I am not fighting this diagnosis, I just want to make sure that the help we give him will be the best for him, his health, and his physiological well being. I’ve talked to a few friends whose kids do use medication, and heard their stories. I’ve talked to my sister who has kids with ADHD and does not medicate. I am definitely more open to medication THAN I WAS before the holidays, but I honestly don’t feel the rush to make a decision RIGHT NOW.

However, what we are going to do RIGHT NOW, is get him in to see a psychiatrist. I’ve always felt like what we’re doing for him now is not right, or rather, not enough. I think he would benefit with one on one sessions, and I think James and I would benefit as well – part of the reason I don’t like what’s going on now is it gives James and I no feedback with how we should be doing things. When he acts impulsively or throws a tantrum, or comes home from school with a report of a bad day – are we handling it adequately? Is there something we could be doing better? I feel like we could use someone to help us with ideas on the homefront that we can employ in specific situations. I mentioned this once to the counselor who runs his class, and I think she thought I was playing a “But I’m such a BAD PARENT!” sympathy bit or something and told me I’m not a bad parent, I’m doing fine.

But I didn’t say I was a bad parent – and I don’t think we are bad parents. I don’t have to be a bad parent to want better parenting skills and skills to help Ethan cope better, not to mention, skills to help ME COPE BETTER. I think some one on one sessions well help Ethan, but also help us, and after a psychiatrist knows him and has worked with him a bit, I’ll be interested to see what their opinion on medication is.

So, once again, I’ve looked around for a new psychiatrist/clinic we can switch him too and once again I keep looking at this clinic that was recommended to us and moaning that they aren’t in our insurance. I called to get their self-pay rates, and even though we would be reinbursed 50% for out of network providers, AND we pushed our medical flexible spending account sky high for this year, it would be tough to say goodbye to that much money. The office staff person actually had one of the doctors call me back and after talking with her for a minute, she recommended some other psychiatrists in the area – one of which I had actually looked up after finding him on the insurance website’s network of providers. Relieved, I called this clinic and set up an appointment.

So right now, we’re kind of in a wait and see mode. Wait and see how it goes with the psychiatrist. Continue taking him to his social achiever’s class until we see the doctor. Wait and see what the school testing results looks like.

Since this is getting pretty long, I’m going to write more about Ethan himself tomorrow, lest I kill anyone with all these words!

-amy

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