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Post by healthy11 on Jul 27, 2010 9:55:13 GMT -5
Correct me if I'm wrong, but the substitute psych is just filling in temporarily, while your regular one is on maternity leave, right? While diet can impact things, I think the best approach with this particular person might just be to say that your son sees his pediatrician regularly, and that doctor is overseeing his general health. I don't have personal experience with Strattera, so I can't give you any feedback about it, but if you don't feel it's as effective as stims, then I'd be inclined to switch back. My son was about the size of yours going into HS, and so maybe yours would have had a growth spurt regardless of whether he was still on stims. You'll never know for sure....
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Post by kc4braves on Jul 30, 2010 18:29:49 GMT -5
She is a substitute but at a really bad time. Not only did we not "hit it off" but I just don't think she understands what we were trying to accomplish, why we were trying it or what oour goals or possible plans were. I really feel sick even thinking about talking to her again. I'm not ready to completely throw in teh towel on straterra and start stims again without talking to our reg pscy providor. I know she had thoughts and ideas on adding a stim with the straterra, etc. but I don't know the plan and the other person seems to contradict everything I say and all of our plans, etc.
We need to reschedule our appt for next week but we need to get back to the stims, I feel, in one form or the other. I have no one to talk to about it so feel stuck. I called up there today to talk to our providor's nurse but got a message machine. I left a message that we were no happy with the substitute providor and asked if our providor is doing any phone calls or anything. I really need to get him on a stim but I don't know what dose or med to use with the straterra. He has a pretty expensive bowling camp next week that I would like him to focus for and then school starts soon, too.
Maybe they will call us back on Monday. I may start looking for a new providor. I would love to find a group where the group takes my insurance not just 1 or 2 nurse practioners. Never thought it matterred but now with her being out, it surely matters. I just wish I could talk with his providor for just 10 mins. I'd feel better. I think talking to the sub providor is a waste of time and money and is very upsetting to boot.
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Post by kc4braves on Aug 10, 2010 15:17:51 GMT -5
Well.....things get more complicated. When they finally did call me back, it was to tell me that our providor will not be returning...at all! I guess she wants to work fewer hours than they will allow now that she has a new baby. She will be moving in with another group but will have limited hours and may or may not take our insurance. We can not even call to try to get in until Sept 1 and then it will be $60/15 min visit until things get worked out with insurance, etc. So.......we were told that there was a MD that was now taking Tricare and would we like to see her since we did not hi it off with the other providor. of course, I said yes but asked whether she had experience with ADHD kids and was told she did. Oh boy! I was really in prayer about it all before we went in. Trying to see something positive...a chance to have an MD instead of an nurse practioner....maybe a new outlook, etc. Well.....let's just say...she is new...very new. Very nice but brand new. So...while my specific prayers that we woould know in one visit if she was right for us, was answered, it was not in the way I had hoped.
She asked me what to prescribe, had never heard of prescribing a stim with Straterra, couldn't understand why we were using straterra, wanted to know why we didn't just want to use Adderall, etc.... Then she wanted to know what "rebound" was and I knew we had not yet found our providor. She also asked me what dexedrine was and if it was a controlled med and if guanfacine was controlled. She was totally at a loss as to what to do and i was determined that someone was going to do something intelligent before I left. Finally after asking me again what she should prescribe, the nurse talked with the other nurse practioner who agreed to prescribe reg release ritalin once a day at 10 mgs to see what happened. He has been taking that for a few days with 80 mg straterra.
I know no one much reads this thread but not sure where to repost. I need to know what type of stims and at what levels docs are prescribing when they prescribe a stim WITH straterra. We have had a few really good days but my son is getting shakey in the mornings and having stomach aches BEFORE we give the 10 mg stim. We have been upped to 80 mgs of straterra for 3 weeks, give it in the morning and have just started these problems on Sunday. So 3 days in a row with stomach aches ( w/wo nausea) and shakiness beginning in the morning.....sometimes before both meds are given. It may be totally irrelevant to the meds but....not sure who to ask about it since we have no doctor really. It does get better as the day goes on but it leaves him drained.....doesn't even want to play lasertag. lol
Please let me know if you have any ideas.
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Post by healthy11 on Aug 10, 2010 19:03:27 GMT -5
Mayleng is due back from vacation in a day or two, and she may be able to give you more specifics, but in the meantime, I'm wondering if you could even ask a pharmacist. In a lot of cases, they're the "front line" for dealing with patients and knowing about drug dosages and interactions...when my son first started taking stimulant meds and I was worried about things, I found our local pharmacist to be very helpful.....
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Post by kc4braves on Aug 10, 2010 20:23:54 GMT -5
I haven't tried that lately. Last time I asked a question about stims, the pharmicist told me that all the meds in the same group were the same, etc. I felt like beating my head into a wall. I may try again, though. He seems to be getting stomach ates after eating....hurting again tonight and he skipped lunch. No shaking tonight...yet, though. Kinda weird. Thanks for your idea.
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Post by dwolen on Aug 10, 2010 23:38:07 GMT -5
The main problem is finding an knowledgable and experienced ADHD provider who also accepts your insurance? It certainly sounds very frustrating, and I sure can understand the wish to bang your head against the wall after reading your account. Do you live near a university medical center or children's hospital that might accept your insurance and takes care of children with ADHD? I have looked for providers on the CHADD web site, and that is possible. I am a member of CHADD. If you are not, you could private message me with your town name, and I could look on the CHADD web site for you, if you wish.
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Post by kc4braves on Aug 11, 2010 11:31:05 GMT -5
OU Medical Center is here but when I called before, they were only accepting in-patients. Nobody in town had med management, out-pt appts. Now my insurance has changed their website and i was ready to scream yeterday. I only found about 5 child.adol psych docs and most were at OU. I know there are other psychs seeing kids with ADHD that take our insurance but, after an hour or so, I gave up yesterday. We will see the MD who knows little on the 18th and i was hoping to have some input from others who may have combined stims and straterra in the past. Then I can start trying to figure it all out. School starts on the 19th.
Still not sure what is going on with the stomach aches and shakiness. Happened to some degree again this morning.
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Post by Mayleng on Aug 14, 2010 12:18:36 GMT -5
One of the initial side effects of Strattera is stomach pains. How long has he been on stratterra?
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Post by kc4braves on Aug 14, 2010 23:10:48 GMT -5
Since the first week of June. None of the titrating caused stomach pains. He has been at 80 mg over three weeks now. Added a 10 mg ritalin reg release last week. Mostly he has said his stomach hurts after eating breakfast before taking meds or too soon after taking the meds for me to think that is it. He has also had some shakiness but maybe that is better. I don't know.
He does not think the 10 mg ritalin is enough. Out of the blue last night told me he thinks he needs to go back on stims. I'm so not looking forwward to it and I can't exactly explain why. I don't miss rebounds at all and worrying about the mornings. I know his focus seemed alot better but I was constanlty managing. I guess in some way the summer was a sort of break.
I still wonder if we might not be able to use a stim and straterra together, but the MD we can see right now has no idea how to prescribe or do much of anything and I don't know what to tell her to do.
As for going back to stims, I don't really have much confidence in this doc for that, either. I know they will want to steer away from teh patch thinking he will lose weight with long acting BUT he has lost weight on every stim and the others that are shorter acting just require more boosters which also decrease appetite. So..... I don't know what to ask for. I mean, I don't know what does to ask for. He has not been on stims for nearly 3 months...the longest time since he was 7. We used to try to go off of stims in teh summer for at least 4 weeks. Even at that, he always started back much lower dose. So what might be a good dose to start back on with the patch and morning booster ( if she will prescribe.)
Once we get him back on stims ( since I don't think the straterra with stims will work out with our current doctor situation), I plan to either change practices and get him back with previous doctor or sstart the process of trying to find another doctor we can start over with. Gosh I hate that idea but we can't stay where we are.
Any thoughts? Could 10 mgs be too high for him after being off the stims all summer? I don't think this affects the stomach but just wondering. He had been taking 20 mgs in teh morning and wearing 30 and 10 patches.
Could really use some advise.
Kathy
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Post by Mayleng on Aug 15, 2010 7:42:54 GMT -5
I still think it is the strattera that is giving him the stomach pains. Remember strattera is in the system 24 hours a day unlike stims. So will you see reduced effectiveness it does not mean it is not causing side effects. After 9 months of being on straterra, my son would still throw up twice a month, and he had problems urinating (this was after 9 months on it).
I don't think the stims are causing it. Is 80 mgs on strattera his target dose?
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Post by kc4braves on Aug 15, 2010 15:36:17 GMT -5
I think it is a little over the initial target dose. He is 97 pounds. 60 mgs WAS our target dose...but our doc had a baby then left the practice leaving us high and dry. The first person who tried to cover really upset me...for alot of reasons...but she dismissed the idea that weight matterred becasue she said it did not take metabolism into consideration. Of course she also acted like if it doesn't work it is all becasue we are feeding him wrong. Anyway, the dose did not cause problems the first 2 weeks or so but i guess could be now.
I am dreading putting him back on stims. Not sure why exactly but he wants to go back for better focus. I hate abandoning the straterra when I feel like there has been no guidance to use it with a stim..none at all..... But, I guess with school starting a know immediate options, we have to give it up. The straterra by itself does not give him enough focus to read or accomplish things that require focus. I think the 10 mg booster they added is a joke....and I think it drops him abruptly ( like i thought it would). I feel we have had worse behavior when it wears off than without it.
The beginning of the summer when we were just starting it was pretty bad...of course puberty is also in full swing and the two together were not the greatest. However, as the summer has progressed, things seemed to improve...mornings were good, more even moods, still quite silly at times in the afternoons and little focus. He was a self-proclaimed book-worm before the summer and, even with rewards from teh library this summer, he only really read 1 book after stopping stims. just can't make himself do it. Other things declines, too. However, I have seen him more willing to try a few things on his own, to do some new things and to not rely on little sister for everything. I hope that is maturity and doesn't go away with the stims.
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Post by kc4braves on Aug 15, 2010 17:50:56 GMT -5
Ok...well my husband does NOT want him to go off the straterra yet...but of course, he will not be with me for the appt on Wednesday so not sure how this will go. He feels like things are "pretty good" on the straterra if the stims could just "tweak" the focus. He is wondering why we could not try an extended release stim with it but at a lower dose. He really feels as I do that some of the really "stupid" behavior we are seeing lately is the reg ritalin wearing off and just dropping him into rebound. The patch and even concerta did not have this same effect. We are also wondering if we backed the straterra back down to 70 or 60 if the stomach problems would go away and we might not lose good things.
I don't know what to do. They ( the woman we didn't get along with is the only one there with the experience to make suggestions) didn't want to put him on the patch again becasue they think he won't eat. However, it is the only one that lets him maximize family life, too...and he eats less on any stim so.....I think we'd like to try it again. I'd be ok trying low does concerta or focalin with the straterra, though, if they will prescribe it. Just not sure of the dose now that he has been off stims for so long.
I would like to call Monday if possible and see if we can go ahead and get a different stim script to try for a couple of days before school. The appt is worthless anyway and costs money. So if you have any suggestions or thoughts, I'd really appreciate it. My husband wants me to call the office the former providor is going to and see if we can get an appt to see her as soon as she starts their in Sept. If not, I guess I will start calling doctors. I just need to get him squared away for school. I'm not sure my husband is right about him just needing a "little help" with concentration but we can try it and see. Not sure just a little help will get him through algebra or English.
Thanks in advance for suggestiosn!!!!!!
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Post by mytqwinns on Nov 6, 2010 9:37:20 GMT -5
This post was what attracted me to this site...I was wondering how many people that posted originally still have kids on Strattera and it is/is not working for them??? We are now going on week 5 at target dose. Not perfectly sure if it IS doing the job??? It is so subtle because I'm so used to seeing the side effects ON top of the improved focus with stims. I guess if I pulled the plug, I would pretty much know, cuz getting ready in the a.m. would change, listening etc. Any input folks??? Thanks!
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Post by Mayleng on Nov 6, 2010 10:15:17 GMT -5
My son was on this for 9 months. You are right the improvements are more subtle. His attention while improved was never as good as being on stimulants, the reason we stopped was even after being on it for so long he developed side effects which I found not acceptable like difficulty urinating, still throwing up at least twice a month, and a dry cough that would not go away.
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Tanya
Full Member
Posts: 85
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Post by Tanya on May 28, 2012 16:20:37 GMT -5
My 10 yr old has just started Strattera. Today is Day 11. He took 10mg for the first few days and is now taking 18mg. This is in addition to 40mg of Vyvanse which he has been on for quite a while now. Doctors did not want to increase the Vyvanse any more. Concerta and Biphenten were not as effective for him as the Vyvanse. The Strattera is an addition to the Vyvanse as his ADHD symptoms were interfering with home and school. Not sure how I am feeling about the drug cocktail yet. Just curious if this is a somewhat common drug combination. He is small, about 46" and weighs around 47lbs. He takes the Vyvanse 1st thing in the morning and the Strattera after school, between 4-5pm.
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Post by healthy11 on May 28, 2012 17:51:55 GMT -5
Tanya, in prior posts, you've talked about your daughter taking Prozac, but did your son ever try any other ADHD medication besides Vyvanse? Since Vyvanse is a relatively new drug (see millermom.proboards.com/index.cgi?board=general&action=display&thread=11565&page=1 ) I suspect that there aren't many individuals who have tried combinations of it with other medications yet. Did you ask your doctor how many other patients he has, taking the Strattera/Vyvanse arrangement? (Is he a psychiatrist?)
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Tanya
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Post by Tanya on Jun 3, 2012 17:49:30 GMT -5
Yes, my daughter used to be on Prozac. Long story short, we have weaned her off anti-depressants. She was med free for a short while but is now trially Vyvanse following a soft ADHD diagnosis. Meds are her choice. Vyvanse was the med of choice because that was the one that yielded far superior results for her brother.
My son tried several stimulants for his ADHD... Concerta, Biphentin and Vyvanse, all with dosage adjustments. He has been on Vyvanse for quite a while now. However, this past February things changed for the worst. It was no longer effective controlling his extreme ADHD symptoms. He may be 10 but due to other medical conditions, he is very small... About 47lbs, 45inches. It was decided not to increase his dosage of Vyvanse from his current 40mg. We opted to supplement with a non-stim med. Strattera and Risperal were the options given. He has slowly gone up to the intended dose of 28mg. I think things are better but have read that it is really to soon to see the full effects. If I recal correctly, the pediatrician that follows the ADHD care for him has one other patient on the same two meds (either this or Vyvanse & Risperal). I know that in theory ADHD care is best done by a psych but based on the services in my area, my pediatrician is by far the best. As a pathetic Example: I advocated strong and hard for about 2 yrs to get him in the a facility about 1.5hr from where we live who is supposed to be the place in my province for pediatric psych services. The psychiatrist who is also the department head tried to convince me that there was no documentation to suggest that ADHD stimulants had any effect on appetite or sleep. I was criticized for the weight loss that followed when my boy started his meds, lol. Anyways, he does see alot of specialists for a variety of things but for ADHD, my Pediatrician is fine I think unless something does change, at which point I will seek out someone else. Always the best for my kiddos I say hense why I post here :-)
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Post by healthy11 on Jun 3, 2012 19:46:00 GMT -5
If I had a psychiatrist tell me that there was no data showing ADHD stimulants affected appetite or sleep, I would have gone to another doctor, too! I can see why you prefer your pediatrician, given the choice! (Is the Canadian socialized healthcare system only able to attract "poorly educated" psychs, or is it more a factor of you living in an isolated area, or )
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Tanya
Full Member
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Post by Tanya on Jun 4, 2012 9:41:04 GMT -5
Honestly, I cannot even imagine the excuse for this doctor. I have been dealing with many, many doctors of varying specialty and reputation for the health needs of my children. I have met some amazing ones and then there are the others. One thing I have learned is that reputation and health care facility is irrelevant. I do not live in an isolated region. I'm in the heart of southern Ontario, not far from Toronto.
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Post by thamir on Mar 9, 2014 18:15:24 GMT -5
Millermom: Thank you for this thread, it is very interesting and instructive as well. I am new in this forum, and I am very interested in learning more about Strattera since my 8 years old son was diagnosed with ADD in November of last year, and he started with Focalin Rx, but we just gave him this for a month and a half and then stop since he started having a lot of tics. We started with Strattera since January this year, first with 10mg, then 18mg and now he has been with 25mg for about a month and a half. My concern is, his weight is 39 lbs (he is so tinny) and he was also prescribed flouxetine 20 mg, so this is 45 mg of atomoxetine and seems like this is wrong. We stopped fluoxetine because he wasn't eating and sleeping, about three weeks ago, but since then he has been very weepy and angry, so we do not know what to do! We decided to try an alternative that is Neurofeedback, but we were recommended to do not give him medicine for the evaluation, would it be ok if I stop giving him the medicine during the weekend before the appointment which is the next Monday March 17 and then return to the 25mg dosage? I am desperate mom and I greatly appreciate your feedback.
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Post by Mayleng on Mar 9, 2014 18:39:15 GMT -5
Why was he given the Flouxetine? Did you see improvements while he was on both the meds? Stopping for a couple of days is not a big issues however, remember that the medication will still be in his system but on a lower level. This is not like a stimulant where it is out of the system in 24 hours. When you do restart it again, and if he is still weepy and angry after a couple of weeks, give 30mgs a try. If after a few weeks on 30mgs he is still angry and weepy, try 20mgs.
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Post by thamir on Mar 9, 2014 19:59:15 GMT -5
Thank you very much for your quick response. He was given Mirtazapine 7.5 mg along with Focalin RX at the very beginning by a Psychiatric, because he is anxious and apprehensive, and he said Mirtazapine would help him to sleep due to Focalin may keep him awake at night, but then, after we saw (and we were very scared and sad) the secondary effects on my son, we decided to see a neurologist and she recommended to switch Focalin Rx by Strattera and Mirtazapine by Flouxetine. We didn't see any advantages on his behavior with this change, but he started doing great at school (same as what he did with Focalin Rx but we don't want to go back to stimulants), but we noticed he didn't want to eat at all and he had insomnia, so the neurologist got rid off flouxetine as she said it was the cause, and we will see how everything goes. But then we noticed he started to be much more impulsive, angry and weepy than usual, so we do not know if we should go back to flouxetine, or maybe stop strattera and try just Neurofeedback. As I said, we have the evaluation appointment on Monday the 17th, and as you mention if I stop giving him medication for a couple of days would not be a big difference, would it be a good idea if I stop giving the medicine for a whole week before the appointment? He is on spring break vacation this week so it may not affect the school, but my concern is, when we go back to the medicine after the evaluation, do we have to ramp up again, maybe with 18mg for a week and then 25mg? another question, I haven't seen 30 mg dosage, just 10,18,25 and then it jumps to 40. Would it be a good idea to try with 18mg in the morning and then 10 mg in the afternoon? and if it doesn't work, then try 10mg in the morning and 10mgs in the afternoon? and if we need to continue with flouxetine would be better if we lower the dosage of Strattera to 18mg?. So many questions, I am sorry but I have so many doubts and concerns, and I really appreciate your help. By the way, I am a Spanish speaker so my English is not so good, but I hope I explain my self correctly. Thank you very much.
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Post by Mayleng on Mar 10, 2014 10:46:48 GMT -5
If you do stop a while you will need to ramp up but it could be a short ramp up like you mentioned. As for the 30mgs, you will need to use three 10mgs pills. I cannot advise you on the flouxetine as it is an antidepressent and I have no experience with them. You should discuss this with the prescribing doctor. As for splitting the dosage into 10mg morning and 18mg afternoon, you could always give it a try but don't give it too late in the afternoon (after 6pm) incase it effects his sleep.
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Post by nancy on Mar 15, 2014 20:52:54 GMT -5
Hi. My son started Strattera 1 week ago at a dose of 18mg. He is 80 pounds and his target dose is 40mg. The doctor prescribed 18mg for 1 week, then 40 mg starting after 1 week of 18mg. The official medication literature says "For children and adolescents up to 70 kg (154 lbs): Take a total daily dose of approximately 0.5 mg/kg for a minimum of 3 days . Then, increase to a target daily dose of 1.2 mg/kg." At first glance I thought this meant jump directly from 0.5 mg/kg to 1.2 mg/kg. (And this is what the doctor prescribed.) But after looking at some of the posts on this site, I have noticed some people gradually increase to the target dose. What is correct? Thanks.
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Post by Mayleng on Mar 15, 2014 20:57:58 GMT -5
We find from our experience, gradually increasing is easier on the side effects.
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Post by kopmom on Aug 13, 2014 20:51:57 GMT -5
Hi. I am new here and looking for some guidance about Strattera. My 10 year old ADHD son has been on stims for the last 5 years, he always metabolizes quickly (long actiing last 3-4 hr max) and rebounds often.
We decided to try Strattera with the hopes of longer coverage and no rebound issues. He is 81lbs. We started with 18mg for 4 days, then 25mg for 4 days and we are now at the combo of the two at 43mg (his final dose for his weight per the Dr) for the last 2 weeks in the morning. I do notice he is more calm but am not seeing much in the focus area at all, and school starts in 2 weeks so I am getting worried. Also throughout the day he goes from being fine to being easily annoyed, agitated and sometimes crying and he is not sure why. The episodes do not last long but I know he will not feel good dealing with those feeling in a school setting. Is this something that may stay the same or could it resolve itself?
Any feedback would be great, thanks !
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Post by healthy11 on Aug 14, 2014 8:53:11 GMT -5
kopmom, I just wanted to say "welcome." My own son also has ADHD and has a fast metabolism, but we don't have any experience with Strattera. Hopefully other parents who do will respond to you shortly! (Often, members "take a break" over the summer, but as soon as school starts, they'll start posting again.)
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Post by Mayleng on Aug 14, 2014 11:33:33 GMT -5
I would advise you read thru' all the previous posts starting from the 1st one on Page 1. All you need to know you will find thru' the experiences of the members who have posted previously.
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