Archive for June, 2011

June 30, 2011

sticking to save mental health

I came across these nifty ‘Save Mental Health’ and ‘Save Mental Health Care’ sticker templates on the NAMI (National Alliance on Mentally Illness) site’s “Identity Guide.”  I just thought it was kind of cool that they had all this on their website. And it’s not just round sticker templates that are available. There are notebook covers and bumper sticker designs all available here.

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June 28, 2011

surf’s up—-and down and up and down

It’s been over a week since the tides changed, the ones that could’ve certainly driven me to a full hypomania followed by crippling depression. The initial episodes lasted for days at a time, of feeling agitated, nervous and anxious, with my mind spinning around and around like it was put in a washing machine. With help from some pharmaceuticals, following strict schedules and support from my BF, those bouts of rumination became progressively shorter, and though it wasn’t easy to get there, I did not succumb to a full-blown episode.  Once again, the tides have begun to change its course, and it is now considerably smoother than what it had been for the past week or so. I’m beginning to take less and less alprazolam, stuff that would almost instantly attempt to smother the mind jitters, and I find myself making less futile attempts to be able to catch my breath.  I’m awake, and not curled up in a ball, clinging onto my mental surfboard just waiting out the vicious tides to stop.

Right now, I am starting to feel relieved. Last night, I thought I had a moment of clarity—which of course, went away quickly as it came, but at least I had one. What I have to remember, though, is that this isn’t time for me to feel relief. Rather, this moment requires self-vigilance above all else. One thing we know is that tides change. And I have to keep riding the waves as they start to recede. If I get off my surfboard now, I could easily be swallowed up by the water. I have to tell myself that I will be able to go back to the shore for a break once I finish riding out this current ride.

I am starting to be able to see the shore, and realize that I’m not too far away from finding both my feet on the ground. When I get back to solid landing, I will be looking forward to maybe getting a new surfboard to ride out these adventures. After all, a girl’s gotta shop for something cute to go with her ups and downs :)

June 26, 2011

st-abilify-ing with Abilify: is it really safe?

Contrary to popular belief that Abilify is simply an ‘add-on’ to antidepressants, it is really an antipsychotic, initially used to treat schizophrenia and acute instances of mania. Now, in addition to what that cute, illustrated commercial tells you about this Rx, it is also often prescribed as a maintenance drug for bipolar disorder. My psychiatrist recently upped the dosage of my Abilify because of this reemergence of hypomania/mixed state.  Knowing that it’s a drug created in Japan (which obviously makes it totally safe….), I agreed and have been taking double my previous dose since last week. I didn’t even bother to think that much about the potential additional side effects, but then, I came across an article on CNN.com/Health.com titled “Long-Term Use of Bipolar Drug Questioned,” written by Lynne Peeples.

According to the article, the medical research does not appear to justify the widespread use of Abilify for maintenance therapy, says psychiatrist Alexander C. Tsai, M.D., one of the lead authors of the review published in the “PLoS Medicine” journal and a visiting researcher at Harvard University. “We failed to find sufficient data to support its use.” Apparently, the safety of Abilify is based on a single study that may be flawed—-especially for a medication that is advertised to work in the long-run. That trial had several important limitations, according to Tsai and his coauthors. For one, they say, it may have been too short to judge the drug’s true effectiveness in preventing mood swings over the long term. The first phase of the trial lasted for 26 weeks, and less than one-fifth of the participants went on to complete the 48-week follow-up phase.

Great. So, no one in the scientific community really knows what could happen to us if we keep taking Abilify?  Isn’t that a little disturbing? I’m not honestly a bit scared to keep taking this drug.  In the back of my mind, I do think about the fact that I might want to have a baby someday, and whether taking Abilify could harm the fetus. The article did say that the FDA is going to look into this finding, but in the mean time, I get to play the guinea pig.

June 24, 2011

Mental Health News Update: 6/24

Forget to check for mental-health-related news stories this week?  There were certainly plenty of them out this week, but I thought I’d highlight a few of them for your convenience.

Depressive Symptoms: Like Father, Like Child
by Bruce Jancin/Internal Medicine News

His study also demonstrated that the adverse impact on children’s behavioral and emotional functioning is compounded when both the mother and father have mental health problems. For example, in homes where both parents experienced depressive symptoms, fully 25% of children had emotional or behavioral problems, a rate more than fourfold greater than when neither parent was affected.


Criteria Changes for Bipolar Disorder proposed for DSM-V

by Deborah Brauser/Medscape News

June 17, 2011 (Pittsburgh, Pennsylvania) — The upcoming Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), may include revisions for diagnosing mixed episodes while keeping the current duration criteria for hypomanic episodes in bipolar disorders, according to 2 presentations by members of the DSM-5 Mood Disorders Work Group at the 9th International Conference on Bipolar Disorder (ICBD)

Op-Ed: The Future of Psychiatry
by Lloyd I. Sederer, MD/Huffington Post

What do I mean when I say that health and mental health care are not doing enough of what we know works? For example, only half of people with depression who come to their primary care doctor have that condition detected, and of those, less than half receive treatment that follows recognized “care paths,” or guidelines about how to best treat a condition. For example, in New York State, most people who turn to a mental health clinic for a serious mental condition do not stay for more than four visits, far too few visits to effectively improve their condition. For example, only a small fraction of people with an illness like bipolar disorder or schizophrenia receive comprehensive care, in an ongoing manner, where they are on medications, engaged in therapy, have family counseling and receive support to stay in or return to school or work.

 

Blog: Perserverence can pay off in finding the right antidepressant
by David Mrazek, MD/Mayo Clinic

Today there’s a more efficient method that can minimize problems that occur after increasing the dose. It’s now possible to collect DNA by just rubbing a “cheek swab” on the inner surface of the cheek. The swab is then sent to a laboratory to determine your genetic metabolic capacity.

 

The Surprising Silver Lining of Sadness
by Ginny Graves/Prevention

“In studies on depressive rumination—which usually find that it’s an unhealthy habit—most people say they see it as useful in some ways,” says Dr. Andrews. “It helps them gain insight into their problems.” The ruminations could be self-incriminating (If I had been a better listener, maybe he wouldn’t have left me) or anxiety provoking (What if I have the same bad luck at my next job?), but the insights they provide can be useful. “You are thinking about ways to improve your situation—about what you can learn from it and do better next time—rather than worrying about the potential negative outcomes,” explains Natalie Ciarocco, PhD, a professor of psychology at Monmouth University who has also studied rumination.

 

 

June 23, 2011

Study: City living isn’t easy. And sociologists are hypocrites

SOURCE: C. B. PEDERSEN & P. B. MORTENSEN ARCH. GEN. PSYCHIATRY 58, 1039–1046 (2001

There’s a thought-provoking article on Nature.com about city living and risk of schizophrenia. Schizophrenia is twice as common in those who are city-born and raised as in those from the countryside, and the bigger the city, the higher the risk (see graph above). So there’s a study out that is looking at how city life might increase the risk of mental illness.

According to a group led by Andreas Meyer-Lindenberg of the University of Heidelberg’s Central Institute of Mental Health in Mannheim, Germany, their functional brain imaging showed that specific brain structures in people from the city and the countryside respond differently to social stress.

When Meyer-Lindenberg stimulated the study subjects’ brains through a simple study of telling them they were performing below average while taking an arithmetic test, the amygdala, which processes emotion, was activated only in people currently living in a city. And the cingulate cortex, which helps to regulate the amygdala and processes negative emotions, responded more strongly in those brought up in cities than in those who grew up in towns or rural areas. The initial experiment showed such clear associations that Meyer-Lindenberg didn’t think anyone would believe them. So he did a similar experiment on another 23 subjects, this time adding visual feedback that allowed participants to see the investigators’ frowns. He found the same sturdy associations.

Meyer-Lindenberg wants to expand this study by looking at how other risk factors identified by social scientists — such as being an immigrant — affect stress processing. “We will use tools from social scientists to help us quantify things like perceived discrimination, social support networks, or stigma,” he says. But according to him, his social-science colleagues (e.g. sociologists) aren’t all that interested.

The study is definitely interesting, but what I found most disturbing from this article is the lack of interest from sociologists regarding this study. As a ‘junior sociologist’, it bothers me that the very people who claim to care about inequalities in society don’t necessarily want to find ways to rectify such problems.  Apparently, anything having to do with finding practical solutions isn’t of interest to these social scientists because that would mean that there’s less social problems to bark about. It’s like sociologists don’t really have any inclination to ‘make the world a better place’; they only complain and feign a stance that makes them look feel like they’re better than everyone else. Maybe all they actually care about is getting published in their own journals and patting themselves on the back.

I think this rant can go on and on, but I’m going to take a break from it for now.

June 23, 2011

someone to watch over me

I can see the fatigue.

It’s been over a week since I became visibly agitated. Day after day, I went through bouts of restlessness, little sleep, and other clear signs indicating that I was on the edge of hypomania. And throughout this time, my boyfriend has been by my side, not just merely supporting me by being there, but also doing things like asking me how I feel, checking whether I was taking my medicine on time, or helping me keep a strict daily schedule. Without him, I am sure my condition would have deteriorated to a point where not only would there have been some real highs, it would’ve proven to be a precursor to days, weeks or months of deep depression.

But now that I’ve become more clearheaded,  I see the depression in him. I can see that the days of staying up with me when I couldn’t sleep for days have clearly caught up with him, and now he looks, well, sad. He has his own stressors to deal with, and then he’s had to deal with my problems on top of it. He was telling me yesterday about the ways in which I changed from my usual self over this past week, in terms of affect and attitude. And it made me realize just how much stuff he must have had to shoulder himself while I was “away.” But now I hear his deep sighs and see him have a pensive, distant demeanor. I asked him if he was okay, and though he did give me a yes, I could feel from his energy that he was exhausted from the week that he had dealt with.

I’ve often noticed those articles about caretakers of those with mental illness, and through this week, I learned just how much of a toll it takes on the caretaker—in this case, my boyfriend—-to be constantly there.

June 21, 2011

June is Men’s Health Month

Every month commemorates some cause, and June is no exception. I just noticed that last week was Men’s Health Week and  the entire month of June is Men’s Health Month. Because men are considered to be the ‘privileged’ sex in this society, I think that we tend to also just assume that they are stronger and are in better health.  But national campaigns like one for breast cancer almost give off an idea that other diseases are less of a concern. The truth is that men live shorter lives than women and that men also have health issues, including concerns about mental health. According to Menshealthmonth.org, the purpose of Men’s Health Month is to heighten the awareness of preventable health problems and encourage early detection and treatment of disease among men and boys. This month gives health care providers, public policy makers, the media, and individuals an opportunity to encourage men and boys to seek regular medical advice and early treatment for disease and injury.

While going through the site, I came across several brochures about men’s health, including a whole separate one about men’s mental health! ‘Your Head: An Owner’s Manual–Understanding Depression, Anxiety and Stress’ , one in the series of brochures by Men’s Health Network, it is a plain spoken, short read that actually takes into account the situation that the reader must be in to seek such a brochure. Their publication for general health, Blueprint for Men’s Health, is also available here in a PDF format.

There are a few more days left in this month to celebrate Men’s Health Month, so if you’re so inclined, wear blue and talk to your male friends and loved ones about the importance of their health.

 

June 20, 2011

fighting the current

It was like a hard wave that crashed over me as I was finally getting used to treading that water. This sea of agitated state, or near-hypomania, seemed to have calmed down a bit, and with 5.5 hours straight hours of sleep last night,  I was becoming optimistic that I had mostly recovered from what’s been going on this past week. ‘Oh, good, a new week is finally here,’ I thought to myself even though I knew I had woken up a little earlier than I was hoping to get up. I got up to make coffee, and  as I was sitting on the couch checking on some news on the computer, out of nowhere, an overwhelming sense of anxiety came over my body. I made a futile attempt at trying to just continue to sip on coffee and pretend to care about the morning news. But in that instant, all I could do was just ball up and be still. After a few minutes, the wave would recede, and I moved my shivering body to the bed where I thought lying down might help. Even there, these waves of agitation, anxiety and fear all rolled up into one would just slam again and again into my body and mind, causing me to be able to do nothing, except cry. I cried, not because I was sorry for myself, but because I really was scared that I may not be able to stave off a full-blown hypomania or a mixed state even with all the effort I had put into to stay calm (with the help of my boyfriend).

Having also felt like I had swallowed that bitter seawater and now feeling like the agitation had been pumped into my extremities, now, it was becoming more obvious that the best thing (and perhaps the necessary thing) to do was to call my psychiatrist for any appointment that might be available. Despite my misgivings about taking more medication, it just was not worth nearly drowning in the water over and over again if something to grab onto was available. Even I’ll admit that at this point I needed the medication. It was time to ask for professional help.  I called, and thankfully, she had an opening the following hour.  I got to see my Dr. A, who succinctly determined that I needed to up the dosage of Abilify, and to quell this terrible anxiety, try some alprazolam, more affectionately known as Xanax.

I’ve picked up my prescription of alprazolam, and am now clutching onto it before my mind and body get swept away by the waves. This isn’t necessarily the hardest stretch of panic, anxiety and hypomania that I’ve been through, so all I can do now is to remember that this, too, shall pass.

June 18, 2011

sleep tips from the NYTimes

I’ve been trying to get a good night’s sleep this entire week, and I think I’ve turned a corner last night. I used ambien for the first time since that little debacle almost a week ago, but I did sleep through the night and woke up rather refreshed and not nervous. In my pursuit of good sleep, I came across a good article on the New York Times titled “A Good Night’s Sleep Isn’t a Luxury; It’s a Necessity,” by Jane E. Brody. The story’s a good mix of personal experiences and a review of recent studies that emphasizes why sleep is so important.  Accompanying the article was some recommendations for a restful sleep.  Below are the ten ways they listed as alternatives to counting sheep.

1. Establish a regular sleep schedule and try to stick to it, even on weekends.
2. If you nap during the day, limit it to 20 or 30 minutes, preferably early in the afternoon.
3. Avoid alcohol in the evening, as it can disrupt sleep.
4. Don’t eat a big meal just before bedtime, but don’t go to bed hungry, either. Eat a light snack before bed, if needed, preferably one high in carbohydrates.
5. If you use medications that are stimulants, take them in the morning, or ask your doctor if you can switch to a nonstimulating alternative. If you use drugs that cause drowsiness, take them in the evening.
6. Get regular exercise during the day, but avoid vigorous exercise within three hours of bedtime.
7. If pressing thoughts interfere with falling asleep, write them down (keep a pad and pen next to the bed) and try to forget about them until morning.
8. If you are frequently awakened by a need to use the bathroom, cut down on how much you drink late in the day.
9. If you smoke, quit. Among other hazards, nicotine is a stimulant and can cause nightmares.
10. Avoid beverages and foods containing caffeine after 3 p.m. Even decaf versions have some caffeine, which can bother some people.

It’s almost bedtime for me here. I hope I will be able to sleep okay tonight and move closer to getting back to the ‘usual’ self.

June 17, 2011

what’s in a name?

Lunatic Fringe is a term coined by Theodore Roosevelt, used to characterize members of a political or social movement as extremists with eccentric or fanatical views. It was also a title for a 1981 song by Red Rider. But if you didn’t know any of that, when you hear the term ‘Lunatic Fringe,’ what comes up for you?  Well, apparently, it’s the name for a chain of hair salons in the United States.

On their website, the salon defines ‘lunatic fringe’ as “A group of people who share a set of radical principles and strive to create a like-minded atmosphere.” I came across this salon and its name when they were offering a generous groupon for their services. When I noticed that their name was ‘lunatic fringe,’ I could only picture this term as talking about a group of ‘crazy’ people who have been pushed aside to the skirts of society. While the offer was really good, I hesitated to purchase the groupon because I couldn’t get over the name of the salon. Can I really support a salon that uses the word ‘lunatic’ in its name? I eventually bought the groupon, and today, I redeemed the coupon by getting a haircut.

The place was nice, and the haircut went well. But I still haven’t decided if I want to come back for another haircut, not because of the cut itself (it’s the best of the last three cuts that I’ve had at other places), but because the name still bothers me. I don’t consider myself a part of the “PC police” or anything, because I understand that most people are not necessarily aware that they might be using a certain word that comes across as offensive to some others. But I think that my experiences as a mentally ill person has affected how I react to certain terms, even when I know, logically speaking, that the phrase itself is a benign one. Just as the most random things can provoke one’s memory, either good or bad, words can induce a similar reaction, too.

Have I become too sensitive for my own good? I don’t know, but I can see how people sometimes become a bit ‘oversensitive’ about the use of certain terms.  It’s never easy to dismiss all of your experiences when having to place meaning on anything, including words.

June 16, 2011

normalcy. well, not so fast

Maybe I need to take back my last hope-filled post about my update on trying to stop me from reaching  full hypomania. I really thought I was making progress in squashing that agitation, but it’s night time, and I am feeling my nerves stirring. Rather than winding down, I feel like I just got wound-up, like that Pristiq doll. It doesn’t feel like the jitters you get from drinking too much coffee. Rather, it’s like a part of my mind is wide awake while what’s left of the logical side of my brain knows that I need to go to bed. It’s such a conundrum because I do want to get some stuff done while I’m up, like putting away clothes, go grocery shopping, etc. But I recognize that doing any of those things will probably just keep me even more awake–and thus leading to less sleep, and then fueling that seed of hypomania that is dying to break out.

I know what I need is sleep. But after that ambien mishap, I’m scared to touch the stuff, even though I am extremely tempted. So, what am I to do? I’ve decided to take Tylenol PM (the recommended dose) and just hope that I can fall asleep sometime soon—and stay asleep through the night.While a full-blown hypomania admittedly feels pretty darn good, I just cannot afford to go through that phase and then crash fast and hard right afterward. And who knows how long that crash might last. I just cannot deal with that right now.

I have to say, though, that more than anything, I’m just really annoyed that I’m having to expose my boyfriend to all of this. I know that he is not aggravated with me. Instead, he is completely supportive and probably the very reason why I haven’t exploded into some mess already. It’s just that I’m still not used to sharing what’s going on within me with another person—in person, not just via the internet. But I guess the reality of a relationship is in moments like this one.

June 16, 2011

getting back to a routine

Since mid April, it’s pretty obvious I’ve been really lax about keeping up with my journal. I suddenly lost whatever it was that got me writing at a consistent pace, and it’s been kind of hard for me to pick it all back up again. But it’s really not just the journal that’s lost that rhythm in my life. I’ve been really terrible about taking care of my physical self—little exercise, bad eating habits, etc.  In the last few months, I think I’ve  reached my heaviest weight ever. As much as I’d like to tell myself that I love my body however it may look, I also know that lack of exercise contributes to depression. So I’ve reached a point where I realize that I need to get back in shape.

Luck would have it, Groupon recently offered a very discounted rate to a nearby Koko Fit Club, so my boyfriend and I purchased the one-month membership to get our fit regimen going. Koko’s a really interesting ‘gym’ where all members have a flash drive that they insert into their gym equipment, which guides the members throughout the 30-min. workout. It not only establishes the workout for the day, but based on the workout, it personalizes the next session for you (I’m not explaining this system very well here.  It really is very cool). Since redeeming our groupon on Friday, we’ve made it over to Koko everyday since then. I hope we’ll keep up this initial enthusiasm for this program.

And speaking of enthusiasm, I’m starting to regain that umph for writing in my journal. So, my goal for this blog is to write/post at least once every other day.  I think setting very specific goals help me in attaining my larger goal than simply coming up with some nebulous, broad wish. Without defining some short-term, routine tasks to do, I won’t have a road map that can guide me in reaching my goal of losing weight or writing more.

A little update on my emerging hypomania: I’ve also been using this ‘routine’ idea to combat a potential hypomanic debacle from happening. Regular exercise, lots of sleep (thanks partly to Tylenol PM), and staying active throughout the day have almost squashed that agitated self. I hope I am back on track…

 

June 13, 2011

a hard day’s night

I took ambien last night in order to get some sleep, but I decided to keep doing stuff around the house even when that ‘sleep threshold’ hits you after about 30 minutes.  After baking some brownies, etc., I realized that I was wide awake at 2am, so I decided to take another one. I eventually went to sleep, but I woke up even before 5am. If I’m ever up around that time, I usually could pique my interest by watching ‘Mike and Mike in the Morning’ or ‘Scarborough Country,” but I couldn’t seem to gather my thoughts in any coherent manner.  I felt pretty much restless, with my mind awake in a way that didn’t feel clear-headed, but rather running around again and again with nowhere to go.  My boyfriend noticed how detached and confused I seemed to be acting, so he and I went and worked out for about an hour. Even after the workout, I could not get myself to calm down. He and I decided that it was probably best for me to not stand around in the house, so we went to several stores and to lunch, but even after several hours of that, the restlessness would not break. The irritability and the agitation just kept seeping out of me.

By the time I got home (the first time), I realized that I was on the brink of not just anxiety but hypomania. Crap, I thought to myself, as I made a fruitless attempt to take a nap. I could feel the fear crawling through my skin, but my mind just spun around so much that I could not even slow it down enough to shed a tear. We were going to spend time hanging around at the house, but we decided that I needed to ‘wear out’ my turbulence, this time by walking around the mall. We walked around for several hours, interspersed by moments of purchasing random stuff.  We eventually came back and made some dinner.

It’s past 10pm, and I’m finally starting to feel somewhat tired albeit still filled with some nervousness. I know that I have to get a good night’s sleep in order to stop the hypomania in its tracks. Otherwise, it could get very ugly quickly. However, I know it’s not the best idea to take ambien tonight, so I’m facing a bit of a dilemma. Should I just stay awake until I fall asleep (whenever that may be), or take ambien and just hope that another disaster like the night before won’t befall my way this time around? My boyfriend and I came to a compromise that taking Tylenol PM wouldn’t be as damaging as taking the mind-altering ambien. So, that’s what I’ve decided to do.  Plus some ice cream and brownies.

June 13, 2011

getting caught

There’s a song that my boyfriend often likes to mention to me. It’s the Get Up Kids’ “Don’t Worry I’ll Catch You,” and he whispers that line to me when I seem like I need a little encouragement. Thankfully, he hasn’t had to deal with the depths of my emotions lately until late afternoon last week. We were sitting on the couch, and out of nowhere, my anxiety level shot up and I couldn’t control my breathing. Pretty soon, I began to cry continuously for no really good reason. He could’ve kept doing whatever it was he was doing, but instead, he sat with me and let me know that he was there for me. While the episode was still painful, it was the first time I felt that kind of support from someone. And the first time when I knew that it was okay to feel how I was feeling at the time. No rush, no fuss. He just let me be. I eventually came out of that episode a few hours later, and it was, I must admit, really nice to see someone beside me who stood by my side the whole time, no judgment.

So, he’s been my ‘safety net’ in this example but I’ve also wrapped him up in my web of thoughts when he’s down or have concerns. While he quotes that song to me, we both support each other regardless of how our moods are doing.

In six weeks or so, he will be the one taking me to ECT. It’s not the most usual way for a couple to get closer to each other, but his taking me to my ECT appointment will only bring us closer to a relationship that’s already built on understanding, respect and love.

June 12, 2011

Ri-DIRK-ulous

I’m watching the game 6 of the NBA Finals between the Dallas Mavericks and the Miami Heat. It’s been a set of exciting games, with the Mavs leading the Heat 3-2. I’m not usually that much of a NBA watcher, but this series has been a pretty interesting one. Though most critics are speculating on a Heat win, I am rooting for the Mavs. Moreover, I’m rooting for the Mavs’ star player, Dirk Nowitzki. He’s a 7-ft, German guy who really is an amazing player.

Why am I talking about Dirk Nowitzki on this blog? First, I was just inspired by Dirk’s perseverance. In game 4, he was running a 102 degree fever and still managed to score over 20 points, including the game-winning shot. But perhaps more than that is his heart. He lost the NBA finals in 2006, and when I hear him talk about it, it is obvious that it was a crushing blow to him. But what you see in him now is that he is confronting all his demons from several years ago.  I think it’s hard for any of us to lose something we wanted and then regain courage to go at it again, at full or even fuller strength than what we gave last time. We are usually so hurt by such experience that we may never want to even make another run at it. It’s so hard to be brave about something once we’ve been hurt by it once. With Nowitzki, his bravery is in full effect right now.

I get scared to face life since my deep fall into depression, and while I suppose I’m making a slow climb out of it right now through ECT and other treatments, it’s not easy to pull my life up by the bootstraps and act like I really want it— because I am easily reminded about where this could all go again. But watching Dirk and his fight to win it all makes me tell myself that it’s okay to make a run for it, even at the risk of possibly losing. After all, a “life unexamined is not worth living.”

It’s half time, and the Mavs are leading by 2. I’ve got to go back and root for Dirk!

GO MAVS!

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