Pain Killers

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Recently I had a Doctors appointment because I wanted to discuss getting an update on my Percocet prescription. I asked about getting a refill and she denied me because my GI said Percocet and Crohns don`t mix. Although back in August he said " I won't give you a prescription but you can ask your family doctor." Now all of a sudden he doesn't want me on them. So I was pretty pissed off about that since I have really horrible flare ups. Sometimes I can go weeks/months without having a flare up but when I do have them the pain is unbearable. I was pretty angry but I had one refill left at the pharmacy that I was going to pick up the next day, turned out she cancelled the last refill while we were in her office and she didn't care to mention it. When I found out I was livid :ymad: It's the holidays they are going to be rough. Since I will be eating and drinking more then usual, I didn't want to have to worry about whether or not I am going to have crippling pain but now I have to stress. I want to just be able to enjoy and relax throughout the holidays. I've read a lot of other peoples post and it seems that a fair amount of them take pain medication. Got any advice? Merry Christmas and Happy New Year to all :ysmile:
 
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Percocet can reduce intestinal motility, which can be a boon for those with Crohn's when their diarrhea is extreme. That said, if you have stricturing or are at risk for blockages, Percocet amplifies the risk of a negative outcome. I'd recommend you get the script for Percocet or other pain meds from your GI doc if possible - they are best equipped to determine the specific risk. There are other possible pain meds that they can put you on with different risk profiles. Your GI doc may be willing to do a quick script to tide you over for emergencies. Best of luck through the holidays.
 
You cannot get refills on any narcotics usually. I think she just did not call you in any. I remember I was given percocet a couple years back for my IC bladder pain and the doctor put 1 refill on it. Well when I went to pick up the script noticed that they did not put my one refill on the bottle and asked about it. The pharmacist said they Do not give any refills for those type narcotics ever, even if the doctor puts refill on the bottle. They just do not give them. You have to have a fresh prescription each time.

I do not know why your doc wont give you any pain meds, There are people who have crohns that are on pain meds all the time. I mean in the hospital they give you the big guns like Dilaudid usually which is WAY more potent than any oral pain med. I just think some doctors dont want to give them out for some reason. Couldn't she give you something at least for the pain?? It is horrible to leave someone in pain. Are you taking steroids or something for the inflammation?? She should not have left you in pain like that, that is very bad practice on her part. I know my regular prinary care doc gave me a script for tylenol 3 and percocets for just in case for when my IC bladder gets extreme. I myself have a hard time with all pain meds, they constipate the crap out of me and I usually get nauseas so I only take them if I absolutely am dying. I just think it was awful for her to not give you anything at all.

Hope you get some releif somehow. Maybe try a heating pad...











Recently I had a Doctors appointment because I wanted to discuss getting an update on my Percocet prescription. I asked about getting a refill and she denied me because my GI said Percocet and Crohns don`t mix. Although back in August he said " I won't give you a prescription but you can ask your family doctor." Now all of a sudden he doesn't want me on them. So I was pretty pissed off about that since I have really horrible flare ups. Sometimes I can go weeks/months without having a flare up but when I do have them the pain is unbearable. I was pretty angry but I had one refill left at the pharmacy that I was going to pick up the next day, turned out she cancelled the last refill while we were in her office and she didn't care to mention it. When I found out I was livid :ymad: It's the holidays they are going to be rough. Since I will be eating and drinking more then usual, I didn't want to have to worry about whether or not I am going to have crippling pain but now I have to stress. I want to just be able to enjoy and relax throughout the holidays. I've read a lot of other peoples post and it seems that a fair amount of them take pain medication. Got any advice? Merry Christmas and Happy New Year to all :ysmile:
 
My "new" Dr said he didn't treat Crohns with pain meds as it was not a cure for Crohns. I said its not a cure for kidney stones or a women in labor BUT it does treat the symptoms and that seems to be the only thing to do. "We" can't cure Crohns but, we can "manage" the symptoms.

I left the office with a prescription for pain meds! Ya just gotta explain things so "they" understand them!

Good luck I hope you find relief- if you need to go to the ER- I have had some of my best care there!


Lauren
 
Ariel,
I totally agree with tots. Just explain with a senerio they understand.
If that is uneventful, go to the ER, don't put yourself at risk. There is pros and cons to pain management and a lot of docs just don't get it. Best wishes to you. Hope you find relief. Muah-hugs-
 
She prescribed me a prescription for Prednisone but only for 28 pills and no refills. Now Prednisone for the lesser pain would help but when I wake up with severe pain that is going to do absoultely nothing. I have already used 8 Prednisone in the past 4 days.
 
Arial,
I can't stress going to the ER for treatment if need be enough. I feel for you my dear.
It might minimize the waking up with pain if you sleep with a heating pad/hot water bottle. Also, if you can tolerate eating- eat very small meals frequently throughout the day. It cuts down on the potential of overwhelming the GI tract. Best wishes!!! -hugs-
 
Ariel, If you go to ER, they will give you pain meds with instructions to follow up with your doctor -find a diff doctor if yours does not want to help you, there is no need to suffer!
 
Ariel, If you go to ER, they will give you pain meds with instructions to follow up with your doctor -find a diff doctor if yours does not want to help you, there is no need to suffer!

I am planning to get a new GI because I'm not really connecting that will with him. I want someone that I am comfortable with and I'm not comfortable with him. Hopefully my new GI will have a different outlook on pain killers. Although I don't believe that my family doctor will want to give me pain meds which will make it difficult.
 
Honestly, going to the ER will probably be a waste of time for you. They are pretty useless and they WILL NOT be readily willing to hand out pain meds, I can guarantee you that. Most doctors are not that knowledgable about IBD, especially doctors in the ER. They will likely load you full of radiaiton doing a CT scan and then send you home with a huge bill telling you to follow up with your GI doc. What you need to do is possibly get in to see your primary care doc and see if she will be willing to give you something until you can get in to see a different GI doc. If your gastro is not willing to help you relieve your pain, then kick him to the curb, he is not going to help you.

I am sorry you are dealing with all this. Do you have a heating pad?? I find when I am having severe cramping pain that is the only thing that helps me a little. Hang in there..








I am planning to get a new GI because I'm not really connecting that will with him. I want someone that I am comfortable with and I'm not comfortable with him. Hopefully my new GI will have a different outlook on pain killers. Although I don't believe that my family doctor will want to give me pain meds which will make it difficult.
 
I've had my fair share of awful experiences with painkillers. I'd advise against relying on them for crohn's pain, because they can be habit forming and that can lead to troubles with getting prescriptions refilled. Most doctors are highly, highly against giving them out because of the negative stigma.

If you really feel that you need them, and I totally understand if you do, because I've been on them for a while now and get really pissed when a doctor denies me my pain relief or calls me an addict, then I'd consider seeing a pain management doctor. I don't personally have one, but my GI doc is okay giving out prescriptions for pain meds. A lot of doctors will do ANYTHING to avoid them, so seeing someone who specializes in that could do you a world of good.

My suggestion, though, would be to stay away from painkillers. For me, they've been nothing but trouble and I've been called an addict by many a doctor and even by my parents for wanting the simple pleasure of being pain free. So, stay away if you can, but if you need them I'd suggest a pain management doctor. In the meantime, if you're experiencing crippling pain, the ER might be your best bet. There they can give you an IV and good pain medication to help you through the holidays. I really feel for you and hope you're doing okay! Send me a private message if you want to talk, okay? :)

Kyle
 
Arial,
I do hope the holiday treated you well and you were able to enjoy the day. Thoughts n prayers with you! -hugs-
 
Arial,

When I have gone to the ER- I am doubled over in pain- the Drs are able to tell I am in a great deal of pain. Elevated B/P, I break out in a red rash (flushing) from my cheast up. There are ways they can tell your pain is real .

I am not understanding the use of prednisone for pain. Maybe I am misunderstanding you. You should be on a set does everyday, not as needed for pain

I hope you find relief very soon!
Be well,


Lauren
 
I was not advocating running to ER as your ongoing everyday pain management option Arial, you do need to find a doctor who understands you, in my case it’s my GI and NOT my family doc. I agree with Kyle - pain management specialist is another option.
BTW: I am always able to receive IV pain meds in ER when I come in double over with pain and sometimes vomiting from pain, whether its Crohn’s pain or kidney stones pain. That’s another “lovely” gift I have from this disease in addition to other external manifestations of Crohn’s. Because of ongoing mucosal inflammation of the colon, I was not absorbing enough liquids and that caused creation of kidney stones.
Hope you feeling better soon Arial!
 
Second or third the pain management doc.
They have all different types of meds and some non med techniques to have a plan in place so the pain doesn't get out of control and so you have some control.
I also recommend asking about a tens unit.
It will not stop severe pain but can keep low level pain from getting worse .
I am confused by the pred for pain??
It can be used for a flare but then you should have specific instructions on how even etc to take it.
Good luck
 
Decreased motility may be a temporary boon, but it can also aggravate intestinal inflammation and in the worse case lead to impaction which can do a lot of damage.

Aside from the more direct intestinal effects, narcotic painkillers can strongly intensify Crohn's related fatigue and depression and lead to more severe consequences both to your Crohn's itself from the stress and elsewhere in your life.

There are very good reasons that many/most GIs shy away from prescribing narcotics. My GI won't give me any, ever, plain and simple. The few times I have been on them have been post surgery and my most recent experience, about 10 years ago, was 12 months of absolute misery and torture that almost ended my relationship with my wife (then my fiance).

Not that my example is everybody's experience, but generally speaking, narcotics and Crohn's DON'T mix and any other way you can find to deal with the pain will probably be better for you. I use meditation and occasional hyoscyamine when the spasms get really bad in a flare, but building up a tolerance is what I think it comes down to. Some people are more predisposed to be able to do that than others, though.

Prednisone for pain makes little sense. Prednisone doesn't treat pain, but the underlying inflammation that can lead to gastro (or other) pain. You should not be using Prednisone like you'd use pain drugs. They need to be part of a prescribed course and you must wean off of them properly or your condition might be badly exacerbated. Are you sure she didn't prescribe a schedule for them? If not I'd look strongly at getting a new GI, but not necessarily for the purpose of shopping for a narcotic-friendly one, who may not be doing what's best for your condition.
 
I was on pain meds for along time and I can tell you that you are better off without them. I was addicted to them and it is NO FUN coming off of them. I understand what you are going through BUT, I have less pain than I did when I was taking them. After being on them for a while we think that we can't do without them but WE CAN. Please do yourself a faver and don't use them anymore. You will like yourself better.
 
Yeah, the general consensus here is that narcotics are generally bad for Crohn's patients. But in some cases, they are necessary. I was dealing with a partial obstruction due to intestinal scarring that caused me tons of pain, almost to the point of not being able to function at all... So, in that case, my GI doc had no problem with prescribing them.

I took them pretty regularly and am now "habituated" to them... Meaning that it's going to take significant time and effort to wean myself off of them. So, Ariel, if you feel that you need to be on something to manage your pain, and choose narcotics, just realize that it is a rocky road and there might be better options... Ultimately, you are the one who makes the decision, and I know you probably hate everyone telling you "do yourself a favor" and not even bother. They are out there for a reason and they DO have a legitimate medical use... Ultimately, only you can decide if your pain warrants the use of narcotics, and I totally understand if you think it does! Luckily, you don't have to make the decision on your own! Talk to a doctor about your pain and have him help you out! And as always, feel free to ask any questions on here! I've got experience with that stuff and am more than willing to help! :)
 
I do own a heating pad and it does help when I have moderate pain but when I have the really horrible flare ups nothing seems to help except for the Percocet. Even taking Percocet didn't always relieve the pain but it at least made it manageable. To all of those who have been asking about the Prednisone, my family doctor prescribed it to me for the inflammation she said it would lessen the pain a little because it would decrease the flare up. She didn't give me a set way to take them. She said if you are having pain take 2 a day for a couple of days and it should slowly start getting better. I was already on Prednisone for the months of September to November and my GI slowly weened me off them but now I am supposed to take them as needed? I am hoping to find a new GI in the New Year.
 
I think you should call your old GI doc just to ask about the
Prednisone. I worked for a GI doc and I never ever heard
Used that was.

Check it out

Lauren
 
Unfortunately in my profession, they have never been prescribed " as needed". Taking them a couple days as needed could potentially do more harm for you than good. Now, i have seen them prescribe say 20 tabs with the understanding that if you are in flare/pain crisis take 4 on day one, 3 day two, 2 day three and 1 day four ( this would give you 2 full taper treatments) of correct use. But yes, i would give the nurse a call at least and ask about proper use. Prednisone isn't something you want to "play" with without guidelines. -hugs-
 
I use codeine for pain, which can be addictive. You build up a tolerance to it pretty fast too (meaning you have to take more and more to achieve the benefits). I've got on ok with it now because I make sure I only take it when I need it (it usually says it's ok to take as long as it's not for more than three days in a row, which is when tolerance/addiction kicks in), and have breaks to make sure my tolerance goes down again.

There was a time where I took it everyday for a while. I had to stop it before a hospital test assessing gut motility (codeine slows your bowel, which is usually a benefit for me, but it would have interfered with the test), and the withdrawal wasn't so bad - a bit like having the flu and I felt depressed for a couple of days. Now I cut back really gradually - a bit like how you taper prednisone - which avoids any withdrawal symptoms.

Codeine is the only painkiller I've found that works for me, and it does make me feel better. I get it on prescription so my doctor decides how much I get and keeps track of how much I'm taking. A lot of doctors will be wary of prescribing pain meds - for good reason - it comes down to the doctor's discretion - some will, some won't.

I think deciding to take addictive pain killers or not is about whether you have a tendency to get addicted to things as well as how bad your pain is. Since I've never smoked or drunk, I didn't know if I get addicted easily or not, but I found out that although I becames physically addicted to them, I was able to stop when I needed to. Also the nature of your pain - if you need something everyday over a long period, it's best not to use anything that could become a problem. If you're able to just use them on occasional really bad days, or on days when you have something important to do and need to relieve the pain, then it might be safe enough to try if you've exhausted all other options and your doctor agrees.
 
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I will generally only take 1/2 a pill. I don't usually need it
everyday. But, I have to work and take care of my kids. I
can't do that curled in a fetal position. It's ok with me to
take the edge of the pain and not take it away 100%. For
some people this is a very painful disease. Sometimes more
more than others. I just feel you need to treat the pain.


Lauren
 
I understand that everyone feels pain differently and everyone has different tolerances. Our brains are all wired uniquely w.r.t. physical sensations, etc. It's stuff that gets "hooked up" as we grow and develop, so it's very likely that different people perceive pain differently.

Still, I've been without pain medications for 29 years of moderate to severe disease, and sometimes the pain was so bad that I'd pray to God asking for it to stop, so I know it can be done. My few experiences with narcotic painkillers have not been positive. While I've never become physically or psychologically addicted, I do definitely suffer GI consequences from extended courses and the effect on my mood and morale is something I'd rather do without.
 
I take dihydrocodeine and paracetamol and unless it is a mild episode it doesn't help very much, I do feel a little buzzed with them which can be helpful to forget about the pain rather than actually relieving it.

I've never felt I was going to get addicted to them to be honest and no doctor has ever checked up on me taking them tbh. I have had repeat prescriptions for over a year with no questions asked, although I take way less than I'm prescribed. Can't take them at work because of the side effects.
 
I agree that some pain drugs, particularly Demerol for me, tend to make me not care about the pain more than they take away the pain. Unfortunately the side effects are just as bad.

While there are certainly many people who will not get addicted, habitual use will almost certainly have bowel consequences (and in the few cases I've heard people report no bowel consequences from extended use, I frankly don't believe it.) The reason for care is that many people DO get addicted, if not physically to the drug, then psychologically to the relief, and tend to build a tolerance as they continue to use it, requiring higher and higher doses for the same relief, all the while exacerbating the inflammatory conditions in their bowel. The potential for harm is very high.
 
I agree that some pain drugs, particularly Demerol for me, tend to make me not care about the pain more than they take away the pain. Unfortunately the side effects are just as bad.

While there are certainly many people who will not get addicted, habitual use will almost certainly have bowel consequences (and in the few cases I've heard people report no bowel consequences from extended use, I frankly don't believe it.) The reason for care is that many people DO get addicted, if not physically to the drug, then psychologically to the relief, and tend to build a tolerance as they continue to use it, requiring higher and higher doses for the same relief, all the while exacerbating the inflammatory conditions in their bowel. The potential for harm is very high.

What do you mean by bowel consequences?

I've never felt I was going to get addicted as my work restricted my use anyway so I literally take one 30mg tab a day around 5 days a week. I try to be careful. But in a phase like I'm going through now where I'm having very little pain I take no painkillers and I don't think twice about it. I worried a lot about getting addicted but my GP and rheumatologist thought that was hilarious at my level of use as I'm very careful...

I can definitely see how you could get addicted to the 'high' they give you. In fact when I was in hospital last year a nurse told me to take them cause they would give me a buzz!!
 
Narcotic painkillers decrease your motility, and while this can sometimes be seen as a benefit because it can resolve diarrhea, it can also lead to increased inflammation through prolonged contact of inflamed tissue with stool, and more seriously can lead to constipation or impaction which can damage the mucosal lining of your bowel, especially if it's already inflamed.

Most people don't get a "buzz" from narcotics, instead they're generally "downers", which can exacerbate Crohn's related fatigue and depression, which can have lifestyle consequences which will increase your stress and therefore your bowel issues. Even if the effect on your bowel is milder than most, the psychological issues can be very problematic for a lot of people.

Those who get away with chronic narcotic use are few and far between, and such cases rely heavily on self-reporting and in my opinion that hinders their credibility.
 
Ah, you're talking about an opiate. Yeah, those will give you a kick, but they still have the addiction problems and the motility issues.
 
Wow, this is getting intense. Take a senerio of a very very ( never used a drug/otc of any kind for life) medication naive person until hospitalized with major complications. There is a way to use narcotics, and if properly, no addiction is acquired AND tolerance or what's called ceiling effect is never reached. When i was hospitalized, almost too late I'm told, i was actually rep remanded from the docs/nurses b/c i wasn't using my PCA pump enough for the crisis i was facing. I was so afraid of being " labeled" that i thought crippling over from the pain in severe agony was a better choice- i was wrong. I have worked in specialty pain centers and even report a lot of drug abusers, that's my job, but honestly with correct monitoring and education- it is far and few between for addicts. I've spent my life studying drugs and their effects and know they provide a benefit whether we want to admit it or not. We just have to completely understand what we are asking for and provided the resources on correct use. This can become a very touchy deep subject. With that said, there is alternative ways of treatment as well, but, as we are individuals-they may not always help either. All things must be considered in treatment of pain. It is actually the number one most misunderstood diagnosis in America, and most under treated b/c of exactly what you are saying Muppet. Doctors are scared to accurately treat and assist patients b/c they are scared of law suits, overdoses, and addiction. This is due to LACK OF EDUCATION, and not taking the professional time to listen to their patients needs and prescribe accordingly. We are rushed thru like chattle and completely misunderstood, as is any chronically ill person.
Pease don't take this wrong, or as an attack of any sort as i highly respect you ( Muppet), but there is so much in this great world of ours that doesn't allow for accuracy and complete education.
Have a great day! -hugs-
 
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I've never heard before now of any narcotic regimen or protocol that prevents drug tolerance and addiction for most patients, but I'd love to read about it.

Anecdotally speaking, every patient I've encountered who chronically uses narcotic medications for long term pain management ends up regretting having done so, but I'm not a doctor and I certainly do not work in a pain clinic.

Have you got any good sources that show the data behind what you're saying? I'm really interested to see it. I want to never give bad advice.

I have no problem with people in agony needing pain management. I don't have any cultural baggage about these meds. My concerns are medical and are based on what I've read. I've used Vicodin, Percocet, Demerol, Codeine, pretty much everything and I don't really give a damn about any stigma attached to those medications. When 3 out of my 4 wisdom teeth erupted I was in the ER howling for any drug at all that would make it stop.

My concerns are decreased motility and its effects, exacerbated depression and fatigue, and the potential for addiction and abuse. If there is a published protocol that takes those dangers away I will be happy to read it and improve my advice and my own care as well. :thumleft:
 
Acheallova-
Well said. Pain managent comes with a very negative
picture. Drs can very easily control how much you get.
I no longer, as I did when I was younger, think its a good
ideat to suffer as I have in the past. I have to be able to work
etc.... If you are using pain meds to the degree of addiction
during a flare the you are not at all in a good spot anyway
And your Dr should be working with you very closely during
that time.


Lauren

Hope that didn't sound to mixed up. Hooked up to my Remicade
and the bendryl is getting to me!!
 
Narcotic painkillers decrease your motility, and while this can sometimes be seen as a benefit because it can resolve diarrhea, it can also lead to increased inflammation through prolonged contact of inflamed tissue with stool, and more seriously can lead to constipation or impaction which can damage the mucosal lining of your bowel, especially if it's already inflamed.

Most people don't get a "buzz" from narcotics, instead they're generally "downers", which can exacerbate Crohn's related fatigue and depression, which can have lifestyle consequences which will increase your stress and therefore your bowel issues. Even if the effect on your bowel is milder than most, the psychological issues can be very problematic for a lot of people.

Those who get away with chronic narcotic use are few and far between, and such cases rely heavily on self-reporting and in my opinion that hinders their credibility.

This might be a dumb question, but what's a narcotic? I just looked it up on Wiki which says it's a psychoactive drug which makes you sleepy? But wouldn't some opiates come in that category?

My doctor was surprised when I told her I feel more energetic when I take codeine, because it's supposed to be a "downer." I'm also one of the ones who finds the motility issues a benefit. I guess I'm also one of the ones who uses it regularly without finding it too addictive or problematic, although I do have to be strict about not using it too often so maybe I don't fit the "chronic" user category (or do the chronic narcotic users you referred to not include codeine users?).

My doctors have always been happy to prescribe codeine for long term use. They had completely the opposite approach to sleeping meds (benzodiazepines). When I told them I was having sleeping difficulties, I saw two different doctors about it before we settled on something else that worked, but both of them talked about how they can't prescribe benzodiazepines because they're so addictive, without me even having to ask about them. Their standard answer to a patient reporting insomnia seemed to be to first explain what they can't prescribe. But from what I've observed, in the US these are prescribed quite often for anxiety? Sorry for going off topic.
 
A narcotic is a drug which induces "narcosis" --drowsiness or sleep. Most often used to describe an opiate/morphine derivative, and I'm personally not aware of any that are not considered addictive, but some more so than others.

Not everyone becomes addicted though, any more than everyone who drinks becomes an alcoholic. Not even if used and/or abused on a long term basis. If they did, then a majority of college students would probably all become alcoholics, long before graduation.

Percocet is a combination of tylenol and Oxycodone, which is a morphine derivative. It has also become a very popular street drug that carries a rather high risk of addiction, resulting in it's nickname, "hillbilly heroin."

My brother was in a serious accident, where he was put on a morphine drip for several MONTHS. Afterwards, he successfully sued his doctors for his resulting addiction and subsequent rehab. bills, which amounted to over $60,000. That was over 15 years ago, and somehow, he's managed to stay "clean and sober" but even now, it's a constant struggle.

Again, that was over 15 years ago. Many doctors have become more cautious about prescribing narcotics on a long-term basis now. Aside from the risk of lawsuits from patients and/or surviving family members, if it can be determined that they have over prescribed these types of medications, they can be subject to legal sanctions and even lose their license to practice medicine.

Not all states (or countries) have a centralized database that advises doctors of every medication that may be prescribed to a patient, and there are addicts who will visit several doctors to obtain the quantity of narcotic drugs desired. When pills are prescribed, narcotics also run a greater risk of accidental death from overdose than most other medications because judgement may also become impaired. (Resulting in those lawsuits from surviving family members.)

An additional risk of using narcotics is they may give patients a false sense of "well being" which may result in taking actions that cause even greater injuries. For example, running on a sprained ankle--or eating certain foods that would normally cause severe distress, because they don't feel the pain that's trying to warn them to stop.

Pain is actually an important survival mechanism. If nothing else, it teaches us not to stick our hands in fire.

I was once given Demerol so I could perform on stage with strep throat, and I sang like a bird all night. But couldn't talk for 2 weeks afterwards, and was scared to death. Even my doctor couldn't tell me whether or not the throat damage from that stupid stunt was permanent. Fortunately, my voice did return.

Doctors who specialize in pain management will usually require frequent visits, so they can run tests and closely monitor patients who require narcotic medications on a long term basis.

But of course, all doctors are different and medical opinions on this subject differ as well.
 
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