Posts Tagged 'Elderly Care'

Dementia And Dehydration, The Double D’s

For months it’s been one thing or another. I have so much to tell you but I have not had the energy to sit and write. But here it goes my entries will not be in order of their occurrence they will be more of a hit and miss of what I am thinking about at the time.

For the last five years I have been living my life constantly yelling. My mother tells everyone; “I’ve never liked to eat, my mother would sit next to me and yell to get me to eat.”

My mother lives constantly on the verge of malnutrition and dehydration. In the last four years she has gone by ambulance to the hospital four times, one time last year she was so dehydrated she almost didn’t make it. So I constantly yell at her to drink.

Last August I knew my mother either had a bladder infection or was becoming dehydrated she had a horrible body odor. Every time I would try to get her to drink it would end like this;

“Mom, you need to drink more.” “I’m not thirsty.” “I know you’re not thirsty, but you need to drink.” “I don’t have to do anything I don’t want to do.” “Mom, your diapers have a strong ammonia smell.” “I don’t smell anything. You must be smelling your own dirty butt”

I took her to the doctor’s and sure enough she had a bladder infection. She also lost 7 pounds in the last for months. When they told us she had an infection I look at my mom and said,” I knew you were sick just from the odor” without skipping a beat my mom looked at the nurse and said;

“My daughter knew I was sick because she’s a witch.” “What did you say?” “You’re a witch.” “Oh witch, I thought you said something else.”

So now I’m getting to what I want to write about, the last six days.

Okay, Saturday October 15th and Sunday the 16th, mom’s diapers again had the odor of straight ammonia, she was refusing to drink more fluids. I’m thinking dehydration. When I would say something to her it would go back to the same song and dance. I made a decision to take her to the doctors on Monday or Tuesday if she was still refusing to drink.

Monday the 17th, mom got up around 9:30.

“Mom, take a bath before it gets too late.” “Why I’m not going anywhere.” “That’s not the point you’ve been in the same diaper all night and if it gets any later you’ll be getting lunch instead of breakfast.” “I’ll take a bath and eat when I’m ready just worry about your own fat butt.”

Now, she knows it bothers me when she talks about my being heavy. Heck I know I’m big but everyday for whatever reason she brings it up. She must truly have dementia because a sane person wouldn’t be making those kinds of comments to the person who makes their food.

By the time she’s ready for breakfast its lunch time so I make her a half of turkey sandwich with swiss cheese, a bowl of soup and a few pieces of cantaloupe and watermelon. She sits down and starts to complain that it was too much food. I let her know if she kept complaining I would give her the other half of the sandwich. I walked into the den to finish my crossword puzzle.

It was about two maybe three minutes and I heard my mother snoring. “Mom wake up, mom are you sleeping, wake up” Nothing so me and my fat butt get up, I touched her shoulder nothing then I notice she had thrown up and had passed out. She was breathing but making a sound between gurgling and snoring.

“911, is this a medical emergency?” “Yes my mother was eating and passed out, I need help.” “Is she breathing? How old is she? The address and number you’re calling from?”

Finally after all the questions were answered, I called my husband and kids everyone showed up the same time as the paramedics. My husband and son stayed to clean the mess and close up the house, Dana drove ahead to the hospital and I went in the ambulance with my mom.

First before I go any further let me tell you about the ambulance. Why are all emergency vehicles so high off the ground? This was my fourth time having to call for paramedics and an ambulance to my mom’s house, I now feel like I have a close enough relationship with the dispatcher that when they see my mom’s address pop up to send a truck with a bucket to help lift my big behind into the cab of the ambulance. It’s embarrassing I felt like a Weeble (you know the roly-poly characters).

We arrive at the hospital the paramedics had already cut open my mom’s favorite dress. The nurses take her torn dress and sweater all the way off and were going to hand them to me. Hell no! I wasn’t even going to touch the bag. The look on my face let them know it was trash time.

Dana came to sit with me, lab work, x-rays, a CT scan all showed how healthy my mom was, the diagnosis was dehydration. They plumped her up with fluids and we ignored her requests for a Babe Ruth bar. The hospital would have released her but her insurance Kaiser has a policy if a patients loses consciousness they stay overnight for observation.

When the ambulance came to transport my mom to Kaiser, Dana drove me home so I could pick up my car. Now I haven’t eaten anything all day. I down a banana and three cookies and then Paul drove me to the hospital.

When I walked into the room my mom was stuffing her face with Fig Newton’s, she feeling good and wanted to know who came with me to see her and who I called. I let her know everyone knew she was in the hospital and no one came because she wasn’t ill, she was there because she was to stubborn to drink water. I told her I’ve had it. I explained the paramedics, the ambulance, doctors and nurses had more seriously ill patients that they needed to tend to, also her taking space in the hospital is one less bed available for someone else more seriously ill. I was so upset and exhausted I left.

Late that night and early the next morning I received a call from the attending doctor at Kaiser, he wanted to let me know my mom was doing well and would be released around noon.

I got there at twelve thirty. When I walked into her room my mom immediately started asking me if anyone came with me to see her in the hospital. I said no because she wasn’t sick just too lazy to drink fluids. I started to get her ready to go when the nurse came in. She was letting me know my mom didn’t want to eat breakfast but she managed to get her to eat some cereal. Lunch was delivered and she needed to try and eat something. My mom flatly refused saying she would eat at home. Knowing that I would have to continue the battle at home I let my mom know if she didn’t eat she wouldn’t be going home. She began eating.

When I pulled the car up to the hospital patient loading zone, the young man who was helping my mom into the car said; “Have a wonderful day” my mom replied “I’m on the way out.” The young man didn’t know what to say, my mom made it seem like she was going home to die.

I stepped on the gas and looked at her and said;

“So where are we going? Dancing? Lunch? On a trip? Where?” “Aren’t we were going home?” “I thought we were until you told that young man you were on the way out. You’re not dying I know this because the doctors in two hospitals just examined you, the only thing wrong with you is your need for attention.”

When we got home;

“Mom, you need to take a shower you had thrown up and haven’t had a shower in two days.” “Don’t worry about me, worry about yourself.” “Mom take a shower.” “Shut up fat ass!”

Okay this time I picked up the phone, should I call the county morgue or my brother? I ended up calling my brother because I knew his number. I put the call on speaker and asked my mother to repeat what she called me and she did. Well, my brother let her know he wasn’t happy and was coming over.

Intervention (this entry is so long maybe it should be an Intermission).

Since I have tried in the past with the Scared Straight approach having only two bad cops wasn’t working. But now were doing Beyond Scared Straight, oh yeah everyone is on board.

The next day my brother came over, he had my back; even without a script he was remarkable. (Now remember in my last entry I had placed my mom in a really nice assisted living facility for a week, so I had to change it up).

I started to explain that I could not afford to put mom into the nice facility. The cost was $150.00 a day when I placed her in for a week of respite care. Placement for long term would be a little more as she needs assistance bathing, medications and walking to and from the dining room. Now keep in mind this conversation is in front of my mom. Without a dress rehearsal this is how it went down between my brother and me in front of my mom.

“I’m going to be honest with you I can’t ask my husband to do any more than what we’ve done its going to cost two thousand more a month to put mom into a home. Can you pay it?” “Two thousand no way, I’m retired.” “Well, if I can come up with half and I don’t think I can would you be able to pitch in one thousand?” “No, right now it would be tough.” “I know that’s how it is with everyone, I do know that there’s facilities that take only SSI and pensions that don’t have the extra frills but it’s doable.” “Sounds good.”

I told my mom I could no longer take care of her, I was done until I sold the house she was going to the cheaper home, the one where she would have to share a room with one to four other woman, the one where the meals would be simple, like bologna or ham sandwiches for lunch and casserole’s for dinner. Her eyes were bigger now, she understood.

My brother also confronted my mom with his disappointment with the way she talks to me. Surprise!

What a good day this was becoming. My aunt even showed up unexpectedly, without clueing her in about us taking a firm stance in Spanish she asked;

“Eva, how are you doing?” “Not good.” “No, Eva say you’re doing fine” “Fine.”

She even let my mom know she needed to do better so she could remain home. Yes today is a good day, I feel like the troops are with me.

Now on the fourth day, Kaiser sent a very nice young girl to evaluate my mother for Palliative Care. The only ailments my mother has is dementia and RA, since she was not in the final stages of life she did not qualify for assistance.

The only thing my mom understood is that this woman was from Kaiser, she asked me what she wanted. I explained she came to see if she could help, but since she didn’t have a medical condition and it was just that she’s too stubborn to eat and drink a facility might be the answer.

Well, that night no problems, this morning I woke her, gave her breakfast, she showered no problems. My brother just called, he remarked I sounded better, and I’m actually feeling better. Mom’s not sleeping she’s watching TV quietly in her room, when she heard the phone she came out to see who called; I said my brother and he asked if I found a home for you yet.

If I can keep it fresh in her mind, I do believe it will be a good day. Peace.

I’m Back

I haven’t had a real bout of depression since my post back in November 2008 titled Depression. Every November it seems like I struggle around my dad’s birthday then add the holidays, while my grief is better I just miss him terribly.

This time however my depression was different, it lasted longer.

Taking care of my aunt for the last two years had started to take a toll on me. I could no longer do the 150 miles round trip two to three times a week to deal with her issues. Every day she was either upset, arguing with someone, dying or depressed. I was physically and emotionally exhausted. I now recognize I had become codependent. I found myself adapting or ignoring her behaviors which allowed me to be involved in fewer of her conflicts.

Then you toss in my mom. I felt like there was a contract out on me and they were the hit men.

I started experiencing anxiety and a rapid heartbeat. I was stressed and on the verge of tears all the time. My family was in protect mode.

But, like I said this time was different, I realized I needed to change. I started to prioritize everything that I was dealing with. I needed to make a decision what I could deal with. Changes had to be made.

I am no longer taking care of my aunt, I can no longer ride an emotional roller coaster and deal with someone’s problems if that person is not willing to see themselves and meet me halfway. While I miss her I realize she needs to seek help, I cannot do it for her. With just this one change in the last six months I have not had a problem with anxiety attacks or rapid heartbeat.

In May I placed my mom in respite care of eight days. EIGHT DAYS of not being responsible for meals, exercise, bathing, incontinence, EIGHT DAYS of not hearing the same questions a zillion times, and the biggie EIGHT DAYS of not being insulted. I called that one week Cinco de Mayo, because it gave this Mexican independence.

I would like to say my husband and I enjoyed those eight days catching up with friends; unfortunately it was spent redoing my mom’s bedroom. We redid her ceiling; crown molding, painting, hung new pictures, new bedspread the works. When she came home she was surprised and happy, her happiness lasted two days.

It’s still rough, she still makes me cry, but when she was gone I did miss her.

I have learned the meaning of “Don’t bite off more than you can chew.” I am now being selective agreeing only to take on responsibilities that I know I can handle.

I’m back and have a lot to tell you about, my white haired stalker, my two granddaughters, my husband, kids, Christmas…

I will post soon and try to post every few days, so hold on the rides about to begin…..

Go Ahead Make My Day

Remember the scene in Sudden Impact when Harry Callahan (played by Clint Eastwood) confronts a robber who’s holding a waitress hostage with a gun to her head, instead of backing off, Clint puts his gun into the guys face and says, “Go ahead make my day.”

They must be planning to do a sequel and my mom is practicing for the lead. For the last two days, minus a cigar hanging out of her mouth, she’s been doing her impression of Clint.

I was in the kitchen talking on speaker phone with my daughter Dana today at 11:45 when my mom came out;

“I’m not eating breakfast today”
“What do you mean your not eating breakfast?”
“I had Ensure this morning and that was my breakfast.”
“You had Ensure, before you showered, so you wouldn’t be in a hot shower with an empty stomach.”
“I’m not eating breakfast.”
“Okay, then I’ll make lunch.”
“I’m not eating.”

Now keep in mind my mother only eats a small breakfast and an even smaller lunch that’s it, only two meals a day and dessert, and now she’s telling me no breakfast.

So, I placed her breakfast on the table and said;

“Here’s your breakfast, if you don’t eat it, I’m making you lunch and then later I’ll make you dinner.”

The thought of actually eating two meals was too much for her, as I picked up the phone and slid out the dining room chair my mom yelled;

“Why did you throw the chair at me?”

Now keep in mind my mom’s dining room set is old and made of solid wood, the chairs all have arms and weigh about twenty pounds.

“What!”
“Why did you throw the chair?”
“I didn’t throw the chair I slid it out for you.”
“Well, why don’t you just hit me?”
“Why, would I hit you?”
“Just hit me.”

I started talking with Dana and said this is what it’s been like the last two days; she keeps telling me to hit her. I don’t know what’s going in her mind. Maybe she wants me to audition for Jerry Springer.

I find myself yelling, just to get the simplest things through to her, and there she is all 110 pounds in my face saying “hit me, hit me.”

I have to see the humor in everything she does, I have to remember she’s not all there and I have to remind myself the little old piñata yelling, hit me, hit me, doesn’t have enough candy for this Mexican to pick up a bat….

Big And Rich And I’m Not Talking About The Singing Group

I’M RICH, I’M RICH as soon as someone pays me what I’m worth.

I’ve taken care of my parents for at least twenty years. When my dad was alive it was a piece of cake but when he passed three years ago my life drastically changed. I retired at age fifty-three without an income until I reach fifty-nine, my husband retired six years ago at age fifty-three so were now living on his pension until I get my pension and our Social Security.

I knew from the get go my life as I knew it would change. I do not have the freedom to pick up and go until I secure a babysitter. I knew most of our combined income with my mother would go to depends, nutritional drinks and bed pads. I knew I would have to live in a house with the thermostat set at ninety degrees. I knew I could no longer brush my teeth in the dark to make sure I grabbed the toothpaste and not the Ben Gay. What I didn’t know was how difficult my mom was, or how much I would miss the freedom of the ability to get up and go with my husband. But after all she is my mom I have to do this.

Well, for the last eighteen months I’ve been traveling the one hundred and sixty miles twice a week to check on and visit my aunt. She also has a good neighbor that she pays to assist when I’m not available, but sometimes it’s not enough so a decision was made to hire a home health caregiver for four hours a day, three times a week.

Hello, I’m big and rich.

I called three agencies and we picked the mid priced one. For three times a week not including mileage it should run around $935.28 a month or $11,223.36 a year, yikes!

So what did I do I started calculating for seven days a week for four hours it would be $2,232.00 a month or $26,784.00 a year, double yikes.

Did I stop? Heck no.

Six hours a day for seven days was $3,637.20 a month or $43,643.40 a year. (I’ll refrain from using any more yikes.)

Eight hours a day for seven days was $4,364.64 or $52,375.68 a year.

So I jumped to twenty-four hours, seven days a week (which is a reduced flat rate.) If you’re standing, sit down before you read any further.

The price was from $5,425.00 to $6,200.00 a month or $100,380.00 to $109,680.00 per year. Ok just one big YIKES!

So when my mom sat down for soup I let her know she owes me $301,140.00 for the last three years. Her reply “the checks in the mail.”

Just A Little Soap, Just A little Water

Ever since my mom’s doctor told her she needed to go to an assisted living facility my mom’s disposition has changed. It’s been about six weeks since she’s called me or my husband a name. She has had a few mini tantrums but the full blown ones have stopped.
Every once in awhile I remind her it’s me keeping her home, if she feels she can longer behave she’s just a moment away from being taken to “the home”. Life has been good, not perfect but good.

Well, I’ve been doing the best not to control everything, she doesn’t like is to be told when things need to be done or for me to do something before she thinks it should be done.

My mom doesn’t use the tub/shower in her bathroom she prefers to use the stall shower in the extra bathroom, so her tub has become her personal hamper.

Well, the other day I couldn’t stand it any longer she has a few robes but tends to favor two in particular the green robe has been in the tub for over a month so everyday she’s been wearing the mauve one. This morning her robe looked like she’d been hit in the chest with a shotgun blast or had a horrible nose bleed, I almost called CSI to have forensics done to see who blood it was. It was splattered all down the front of her robe; it couldn’t be her blood no one could lose that much and still be walking. I watched her as she sat down to have her (two) Ensures. There it was the answer, I saw her transfer the straw from the first bottle to the second she splattered Ensure everywhere; the chocolate on the mauve gave the appearance of blood. I usually say nothing and just wait until she’s ready for me to do her wash today was different her robe was filthy.

“Mom, what’s all over your robe?”
“Stains.”
“Mom, that’s not stains it’s your Ensure we need to wash your robe.”
“We don’t need to do anything; my robe is clean their stains.”
“Mom, you’ve been wearing that robe for over a month, it’s dirty.”
“It’s not dirty, it stained. I wouldn’t be wearing it if was dirty.”
“Whatever, lets wash it with the green one.”
“Wash your own clothes; you’re the one that’s dirty.”

So she draped her robe over her dresser to wear later, I picked it up along with the green one to wash and guess who following me down the hall yaking away.

“Where are you taking my robes?”
“To the wash.”
“Their not dirty, there stained, and you don’t know how to wash anyway.”
“Mom, calm down I’m putting your robes into the biohazard unit adding soap and water, if their stains they’ll be fresher stains and if their just dirty they’ll come out like new.”
“You can’t tell a stain from dirty, you’ll see I’m right.”

“Mom, here’s your robes.”
“They were stains, right?”
“No mom, they were dirty.”
“They weren’t dirty.”
“Your right they were filthy.”
“You’re filthy,”

Knowing that this would continue back and forth I turned to leave, and guess who was just a few steps behind.

“They were stains, what did you put on them,”
“Water and soap.”
“What else?”
“Nothing else water and soap.”
“No you did something else what was it?”
“Well I did have help; it was either a stain angel or a real pretty bio hazard tech that had wings.”
“Real funny.”

Don’t Touch The Buttons

Help me understand, with dementia your long term memory stays intact and your short term memory goes to hell. Then why is it that my mom can’t remember how to work the TV.

We had put in Direct TV for my parents over eight years ago. The boxes were in the den and in the bat cave (my mom’s room). While my mom never really strayed from the regular channels she could work the controller.

Well about two years ago, our TV time was constantly interrupted. The controller for the Direct TV has forty-five buttons and mom started to become confused.

“Nancy, I can’t get channel two.”
“Mom just hold the controller and press the channel number you want once and your show will come on.”
“I did that, I’m not dumb.”
“Well I just changed the channel and it worked, show me how you change the channel.”
“I did the same thing as you.”
“Mom, you need to turn the controller around and change the channel, your pointing the controller in the wrong direction.”
“Well this is how I always did it, something must be wrong.”

“Nancy, hurry come quick something’s wrong with my TV”.
“Now what’s wrong?’
“I’m trying to watch channel two and everything is in Spanish. I think I need a new TV.”
“Mom that’s not channel two its twenty-two, it’s a Spanish station, just press the button once.”

“Nancy, nothing works on my TV.”
“Mom you keep pressing the input button.”

Then it happened. She noticed the little door on the bottom of the TV and more buttons to push. Thank God for electrical tape she didn’t need more buttons.

Finally the decision was made since she didn’t watch the expanded channels we would go to regular TV. Another problem since mom’s TV is seven years old it would need a converter box.

“Nancy, my TV won’t turn on.”
“Mom you need to leave the converter box on.”
“The TV still won’t go on.”
“Mom you still have to turn the TV on.”

“Nancy my TV won’t go off.”
“Mom, you need to press off, your pressing on.”

So for Christmas mom got a new TV, no converter box, just a nice flat screen TV, along with it a new easy controller. Life is good, no more problems. Wrong the new TV now picks up about three channels for every regular station instead of just one channel two, she gets two-one, two-two and two-three, shit! Thank goodness for channel locks.

Did it end there? No, she now noticed the red lights on the bottom of the TV, I told her it’s just to let you know the TV’s on. But there was something about the red lights, she just had to push, hell they’re working buttons.

We now have fewer problems thanks to the new TV, electrical tape, and an easy controller, because the next step would have been to take out the TV and give her crayons.

Happy Birthday Chris! (January 3rd)

Hello My Name Is Dementia

I pray everyone had a wonderful Christmas, and I’m wishing everyone a Happy New Year.

Believe it or not, this Christmas was one our best. Our families traditional Christmas Eve dinner with my husband’s brothers and their families was great, It lasted almost until midnight, my kids, niece and nephews were trying to get me to take an idiot test but my son was laughing so hard when he was doing it, I got the clue I would fail right away, besides I live with my mother what more of a test do I need.

Christmas Day was relaxing, breakfast at Dana’s while watching my granddaughter open gifts, a little nap then an early dinner with just our kids, my uncle and mother. Yes finally a few good days in December, now let me explain why I haven’t written in over a month.

Hello My Name Is Dementia

Since I started writing this blog, I’ve avoided saying my mom has dementia, I would dance around by saying she has a little or slight dementia well folks dementia is dementia and by placing a word in front of it doesn’t change what it is. It’s taken me how many years to finally admit it.

I was recently asked if I was embarrassed to admit my mom suffers from dementia. It has nothing to do with embarrassment; its knowing that one day my mom will no longer be mentally aware of family. So it’s been easier for me to skirt around it. Don’t get me wrong my mom is a far cry from the final stages of dementia; I would venture to say she’s in the mild and entering the moderate stage. I’ll call it “she’s driving me crazy stage.”

I was asked by the medical professionals when I started to notice my mom’s mental decline, I would automatically say about three years because that’s when I became her 24/7 caregiver and when I started to notice changes, big changes. I now realize the dementia started about five years ago I was just to close and the changes to gradual to notice.

Some of are conversations we had three years ago that weren’t so gradual that should have clued me in to the dementia;

“Wasn’t it nice of Kaiser Hospital to give me and your dad a room before he died to have sex?”
“WHAT?”
“Wasn’t it good of Kaiser to give me and your dad…?”
“Mom, stop I don’t want to hear it, Kaiser did no such thing.”
“Yes they did you weren’t there.”

It took a year to get her to stop telling that story.

“It took me a few trips around the cemetery in the back of Chuck’s and Em’s car to throw dads ashes out of the box.”
“Mom, we had dad’s ashes placed in an urn and buried at the gravesite.”
“No, I threw his ashes out of the car you buried the ashes that were stuck in the cracks of the box that I couldn’t get out.

She is still sticking to that story.

“My name growing up was Patricia.”
“Mom, your name is Evangelina, Eva, and Eve not Patricia.”
“No growing up at school they knew me as Patricia.”
“Mom, your parents were from Mexico, you were born in 1924, your brothers and sister had traditional names from Mexico, why would they name you Patricia?”
“Well, that’s what they called me.”
“What ever Pat.”

“When you were younger I used to model.”
“Mom, you were a stay at home mother, you never worked.”
“I used to model.”
“Mom, your 5’1’ models are tall, dad worked nights and you never drove how did you get to the modeling jobs?”
“I modeled in stores.”
“Mom, coming out of the dressing room and showing the salesgirls and other customers how you looked while dad sat in the car isn’t modeling its showing off.”

This past month there has been other changes that have added to my stress, accusatory behavior and aggressiveness.

My aunt and uncle came over for a visit and my mom informed them;

“Nancy picked me up out of bed and threw me to the ground.”
“Mom, what are you saying, I can’t pick you up one let alone throw you to the ground you know that’s not true.”
“Well you did.”
Later that day;

“Mom, why did you say I picked you up and threw you to the ground?”
“Now I remember you picked me up and we both fell to the ground.”
“Mom, if I fell to the ground I would still be there.”

Now our family and friends know I have a dropped bladder, four herniated discs and bad knees, so lifting anything more then twenty pounds forget it. But what if someone who doesn’t know the situation hears her? Hmm, a misdemeanor maybe 6 months in lock up, or as I would call it a vacation.

“Mom, we need to get haircuts today, with your doctors appointment on Monday and with company and the holidays coming today is the only day we have to get it done.”
“Get your own hair cut, leave mine alone, I don’t need you to tell me my hairs long, in fact get out..”
“Mom, were getting our hair done today.”

Well, you thing that would have been that, but no she turned around and picked up her walker (one of those light weight aluminum ones) and threw it at me hitting my foot.

“Ouch mom what are you thinking that hurt.”
“Good, now get out.”

She has a few new names for me, they all have to do with the size of my butt, finally I couldn’t stand it any longer and said “I could lose weight to make my butt smaller, but there’s nothing you can do to change the size of your mouth,” she hasn’t called me names in a week. So here it is, while she is in the beginning stages of dementia she’s in the late stage of pure meanness.

But a few days before Christmas, we gave my mom one of her Christmas presents a new TV with an easier remote (this will be another entry later) since then she’s been trying to control her mouth and behavior. I guess the trick is to give a present every few days to keep her happy.

We have been referred to a neurologist hopefully he’ll explain what stage of dementia she’s in, if there’s medication that will help, or if it’s just her venting frustration and anger.

I think the New Year is going to be like a Roller Coaster, so fasten your seats belts the ride is about to begin….


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