112 Saying Goodbye

by reeger on October 15, 2021

Dear Listeners

I’ve been avoiding this episode, but I owe it to you and to myself to stop proceeding as if my last published episode ended with a semi-colon; to be continued. If it’s possible to place a podcasting period at the end of a body of work, then that’s what I need to do now.

I didn’t know that my last published episode would in fact be my last episode, but now I need to face the facts and acknowledge that the creative muse that kept me going for seven years and over a hundred episodes… well, sometime in the spring of 2020, she, my internal creative muse… she packed her bags and moved out of my creative soul. At first, I thought she was just taking a little break, you know, catch her breath and then come on back for more. But the longer she’s been gone, the more I need to face the reality that she’s not coming back. At least not in the same way that she stayed with me before.

I’ve thought a lot about what’s happened, why I stopped podcasting. I want to share with you what’s happened as best as I understand it.

I stopped podcasting at first because the start of the pandemic was overwhelming and scary. I needed to focus a lot of energy towards my family and the emotional health of my then 18 year old daughter whose senior year of high school had completely gone sideways. And I also needed to focus a lot of energy towards helping reinvent Southern Oregon Bariatric Center, which was originally designed to be a program that was very hands-on, very human interactive. That was part of our strength, but in the face of a global pandemic, all of a sudden our strength became a vulnerability and a liability to our patients, but we couldn’t just let the program die, so we had to reinvent it and reinvent it very quickly.

And then spring turned to summer and the murder of George Floyd and the resulting social unrest gutted me and left me feeling like I needed to listen a whole lot more and talk significantly less.

Then as summer ended, my husband and I had to agree with our younger daughter, that it was in fact in her best interest to still go off to college, many states away from us, even though there was a pandemic happening and at that point, no vaccinations.

Then, days after returning from dropping our daughter off at college, I did ugly cry when I said goodbye, I’m not going to lie to you, my husband ruptured his Achilles tendon in a freak little accident and needed to have surgery.

And then on top of it all, as if 2020 wasn’t hard enough already, the worst day of my life and thousands of others occurred on September 8th, 2020, when an urban wildfire called the Alameda fire ravaged my sweet little town of Talent, Oregon, and the next town just north of us. In less than 24 hours, over 2,500 homes and businesses were utterly destroyed.

My husband and I, we were lucky, incredibly lucky. Our home of 17 years against all odds was not destroyed. Even though the structures on the west and south sides of our property were reduced to molten ash. It’s hard to put my complex feelings about the Alameda fire into words. I will just tell you that I have been living within the duality of both gut-wrenching grief for the total destruction all around us, and profound gratitude that we still have our home to return to each and every day.

And life has gone on. But in fact, it hasn’t gone on for everyone, over 700,000 deaths later (and many more around the world), we are still in the midst of this pandemic and sadly to our own detriment, in the USA we continue to be divided over the essential questions on how best to get on the other side of it.

I have felt a little and sometimes a lot lost amidst all of this, the events of the past year and a half have left me feeling exhausted and heartbroken. And when living in these types of feelings, my inclination is to speak less, not more, to listen, to be quiet. So that’s what I’ve been doing.

I’ve not wanted to say goodbye to you, but neither have I had the ability to pick up the microphone and start recording podcasts again. So I’ve been in this limbo waiting for the muse to return, but she hasn’t, therefore it’s time I acknowledge that although creating the Weight Loss Surgery Podcast has been wonderful and amazing and an honor, it is a creative endeavor that has run its course.

I will keep the episodes up because they remain relevant and offer important educational content that I believe still helps people. But it’s time I put a period at the end of this body of work.

Thank you for all your love and support over all these years and never forget, I will always believe in you.

In kindness, Reeger

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A lot has changed in the past 4 weeks since last I turned on my recorder, the majority of that having to do with the Coronavirus global pandemic. First, let me begin by saying I dearly hope you and yours are healthy and safe. Next, I want to pick up where I left off, one month ago. When I signed off in mid-March I told you that I was home on quarantine waiting for my own COVID-19 test results because a few days before that I had left work early with a fever, a dry cough, and pressure deep in my lungs. I was tested on March 14th. It took six anxiety producing days to get my results back but they were negative. Thank you so much to those of you who reached out to let me know you where praying for me and thinking about me. That warmed my heart more than I can ever express.

Now on to this episode, I asked Dr Walt Medlin if he would be willing to just talk with me while the recorder was running so that we might compare and contrast our thoughts and experiences on not only how this pandemic is affecting bariatric surgery in general and our practices specifically, but also how we move forward from this.

Before I cut to the episode thought, as those of you who are on my email list know, I have put out a call for Kid jokes. Initially my deadline was April 4th, but because I am publishing this episode now, I am extending to my deadline to April 25th. I want to create a WLSP episode entirely made up of kid jokes. I want to fight despair with a little kid joke humor. For those of you that don’t know, for many years now at the conclusion of every single episode I have ended with a kid joke or two. If you have never heard this, then you just need to stick around to the very, very end, like literally that last 30-60 second of the recording time and you will hear the jokes. Its been like my little thing, like when you wait after all the credits of the Pirates of Caribbean or Ice Age movies and you get a little nugget, well, kid jokes are my nuggets at the end.

So now, rather than wait to the very end I want to make an entire episode of kid jokes, not because there is a lot to laugh about these days but rather to help us find a little light in this darkness. But I need your help. Me telling all the jokes, well frankly, that just wouldn’t work. Will you help me? Will your kids help me? You family? Your friends? Everyone and anyone can call in. Please call the WLSP Google voice mail number 541-583-0099. You can also find the number at my website, WLSP dot com. Wont you help?

And one more thing before I cut to the episode, this podcast is listener supported. If you want to become a patron you can do so at Patreon or PayPal.

Discussed in this episode

  • Walt Medlin, MD Bariatric Surgeon and a person who is affected by obesity.
  • The episode that has not yet been published on revisional surgery
  • Mother Nature’s time out
  • Rebuilding the airplane mid flight
  • No elective surgeries until…
  • When we can operate again…
  • Working from home via Telehealth
  • How to keep our bariatric surgery program alive
  • Being proactive with your health
  • Getting used to hunkering down, what next?
  • The levels of worry and preparing
  • Weight gain due to quarantine means something different for people with the disease of obesity
  • Loss of structure- Who are we without our routines?
  • Creating a new structure
  • What will life look like after this?
  • How or will this change us?
  • The importance of recognizing and allowing emotions
  • Bravery is not the absence of fear
  • Helping at the right place at the right time in the right way- know how best to help
  • Limiting social media
  • As we move away from so many things, what are we moving towards?
  • Quality of Life and Quantity of Life.
  • Getting honest about Moral Injury and how to recover
  • Team Hope and Optimism

As always I hope you found this episode helpful along your way. You can find link to this episode and all prior episodes at my website, WLSP dot com. Regarding the kid joke episode, thank you to all of you who already called in your kid jokes and the rest of you who have yet to do, lets crowd source some kindness with some sweet humor by calling 541-583-0099.

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110 COVID-19, Bariatric Surgery, and YOU

by reeger on March 16, 2020

Hi Everyone, this Reeger Cortell, your friendly bariatric surgery nurse practitioner and this is the Weight Loss Surgery Podcast, where in normal times, we talk about obesity and bariatric surgery one episode at a time. But these are not normal times.

At this moment is 9:34 in the morning, PST, on March 16, 2020. 2 months ago, heck even one week ago, I did not know talking about the coronavirus would be my next episode. Just last weekend, which feels like 100 yrs ago, Dr Walt Medlin and I recorded a great episode on bariatric surgery revisions. I was really looking forward to publishing that episode this weekend. But times have changed and rapidly. 

We have gone from in January, 2020 just learning about a novel Coronavirus which started making people sick with severe pneumonia in December in Wuhan, China to the World Health Organization declaring COVID-19 (the infection that results from the coronavirus) a global pandemic on 3/11/2020 the likes of which none of us have seen in our life time. All in less than Three months. As of this morning  169,000 people have been infected (and those are just the ones we know about) and 6,500 people have died. The death toll for this new virus is greater outside of China than inside, in the US school are closed in 33 states, with more closing, restaurants are closing, and the CDC recommends that any and all gatherings of 50 or more people be cancelled for the next 8 weeks. Hour by hour this situation is changing. My heart goes out to everyone, everywhere. 

There is so much information out there, good, scientific evidenced-based information that is open-sourced and available to all of us. Therefore, I am not going to make this episode about proving why we should all be on high alert and rightly concerned. We have not contained the coronavirus. It is out there. Sadly, and frustratingly, the gavel is down on that one and the jury has gone home. 

But rather, I want to use this platform, use my voice, to speak to directly to my listeners who are pre-bariatric surgery patients that are scheduled for their surgery in the near future. What do I mean by the near future? It’s hard to say exactly but why don’t we just round it out to at least the next 1-2 months, perhaps more. In the very least between March 16th to April 16th.

I am sure you are wondering if you should move forward with your surgery? How could you not be asking this question? But on the other hand, I bet you are thinking, ‘Are you kidding me? After all this time, and money, and prep, and waiting, and hoop jumping, and learning (thanks for using this podcast as a resource), and, and, and now this? A Global Pandemic is the reason you might not get your surgery?’ Perhaps you are thinking, ‘the heck with that, lets just do the surgery and we will figure out other issues, including coronavirus if and when we need to.’   

And perhaps you are a looking to your bariatric surgery center for guidance. I do know that at least in USA many programs have stopped group visits in different settings- seminar, classes, and support groups. We are all pivoting to offer what we usually offer in face-to-face visits to some form of virtual setting or at least environments that allows for the two words we have all become so familiar with- social distancing. 

What an oxymoron than phrase is, right?  It’s right up there with “Bittersweet,” “Clearly Confused,” and “Deafening Silence”. And I can think of many things I’d like to do that start with the word, “Social” but not one of those things ends in the word “distancing.” 

But back to bariatric surgery; Programs in the US and around the world have made adjustments and we are all hoping that that will be enough. However, I am rapidly coming to the conclusion it is not enough. We need all hands on deck for this one, folks. And by “all hands on deck” I actually mean off the deck, so to speak, and away from each other. 

To paraphrase Dr Micheal Klompas from the Annals of Internal Medicine: This virus is optimized to spread quickly and widely. Infected people are contagious even when minimally symptomatic or asymptomatic, the incubation period can extend beyond 14 days, and some patients seem susceptible to reinfection. The signs and symptoms of coronavirus are largely indistinguishable from those of other respiratory virus infections. Less than one half of patients with confirmed disease have fever on initial presentation. The sensitivity of a single nasopharyngeal swab early in the course of disease is only 70% (Annals of Internal Medicine). Meaning 70% of those who are tested will be correctly identified as either having or not having the virus. Which sounds great until you factor in that 30% will get either a false positive or false negative result and of those people its really the false negatives that are concerning. 

Therefore if you can minimize your use of the medical system over the next few weeks to months for any forms of elective care, including bariatric surgery, that will leave a bed available for someone who wasn’t planning on needing it but needs it anyway; And for the entire health care system that is there to help whichever person is in whatever bed for whatever reason and especially those who contract coronavirus- our parents, our friends, our spouses, our children, possibly even ourselves. 

So to be clear what I am saying is that if your practice isn’t canceling your elective bariatric surgery, I think you should cancel it any way, now, today. On March 13th, The American College of Surgeons recommended that healthcare systems plan to minimize, postpone, or cancel elective surgery cases. And the next day, March 14th the US Surgeon General Jerome Adams, echoed this recommendation. 

Even factoring in everything you have gone through to get to this point in your bari-great journey. I know am going out on a limb and I may be placing my reputation at stake here. But I would much rather error on the side of caution and be accused of over-reacting than regret underacting by not taking a stand, and by not using this platform that I have built over 6 and a 1/2 years, episode after episode, for the greater good, including sounding the alarm now. 

It is not hyperbole to state that decisions made now will save lives later.  

And I’m not just asking this of you as a way to leave needed resources available during this crisis, but also because I am worried for your health and safety. As we all know, even though bariatric surgery in general is very safe, people who are affected by obesity have higher risks for untoward events compared to people without obesity, especially respiratory risks. But then you start looking at the data that is coming out of China, and what it shows is that not only older people are vulnerable to COVID19, vulnerable as in getting really sick and possibly dying, but also people who have chronic medical conditions like hypertension, diabetes, and coronary are disease (CDC, The Lancet). I don’t how many of you listening have at least one of those conditions but if you are like the patients I see in the office, the majority of you have at least one of those conditions. Therefore, lower your risk. Be careful. Stay home. 

But what would cancelling your surgery look like? For most people, I would imagine we are not looking at cancelling forever, but rather postponing for now. If your surgery was prior authorized through your insurance, then your practice can usually request an extension of the authorization. This is not uncommon. 

Otherwise, what should you do after postpone your surgery? Well, other than avoiding our modern day Covid19 Plague, like, well, The Plague via social distancing; wash your hands frequently, thoroughly, and often; do not touch your face; clean high touch surfaces with appropriate cleaning products… because did you know that coronavirus can live in the air for 3 hours after it is aerosolized (which is fancy speak for sneezing or coughing) and it can live on copper for 4 hrs, cardboard for 24 hrs, and up to 3 days on plastic and stainless steel (MedRxiv)? Yeah, I just learned that fact too.

Sorry, I digress, but what should you do after you postpone your surgery, well, do not give up! Do not stop doing all the health behaviors you have been doing whether they are new or old to you. In fact, if there is an opportunity to up-level, to do more of those healthy behaviors, do them now! Optimize your health as much as you can- things like eating healthy nutrient and vitamin dense foods, getting some physical activity, getting plenty of good quality sleep, staying well hydrated, taking your medications that keep your medical conditions well controlled and taking your vitamins and minerals. Optimize your internal forces to fight this invisible invader- because that’s where the fight will happen, inside us. 

Although you and your bariatric programs are rapidly making adjustments that directly impact your trajectory to surgery, trust me when I tell you we will still be there for you when all this calms down, which it will, and you will still be our patients, and we will still work towards our common goal of your improved health and wellness, which includes bariatric surgery as part of your treatment plan.  

Lastly, I want to share with you I am currently in self-quarantine waiting for results on my own COVID-19 tests. I have debated back and forth whether to tell you this or not, but I am opting for transparency because really we are all in this together, including me.

Last Friday the 13th, (yeah I know right?!) I had an asymptomatic, low-grade fever while at work, 99.9 F/37.7C. I did not know I had a fever until we were routinely checking temperatures on all staff. Because I had a fever, even though I did not feel poorly, I went home. I also developed an ache deep in my central chest, that feels similar to when you step out into a very cold Vermont night after sitting in front of a warm fire; that kind of ache. And I have an occasional dry cough. These are all symptoms that are not common for me. I have been more tired than usual but that is a pretty non-specific finding- all things considered. I have not had a sore throat or body aches. And I am not sure if I still have a low-grade fever or not because I don’t have a reliable thermometer at home and all the stores are sold out. I should be getting a thermometer from Amazon today. 

In normal times, I would likely be back to work today. But these are clearly not normal times. 

On Friday, after a little bit of a runaround, and reconciling with my desire to be in denial (I have to confess to that), I was able to talk with a telemedicine nurse practitioner who recommended I get tested for COVID-19. I should also say, I have not travelled out of the US, nor have I been to areas of known higher outbreaks in my region of the US. However, it is no secret that US has been woefully and frustratingly behind on testing for coronavirus. Our low reported case numbers are much more a reflection of low access to testing, than the actual scope of the outbreak. 

But, I was lucky I did get tested on Saturday at a newly opened drive-through testing center. And I am now waiting for the results. After feeling very worried initially I am now, as of this moment, feeling a lot more optimistic. I hope I get the negative results back in the next day or so, and that I have no fever or other symptoms and that I am able to return to work any day now; because after-all, we do need all hands on deck from healthy healthcare professionals. Either way I will keep you posted, most likely via an email to my WLSP email list, which you can sign up for at my website, weightlosssurgerypodcast.com. Don’t worry, I wont spam you- never have, never will

As far as when will my next podcast be and what will it be about? Well, as I mentioned at the beginning, I have an episode on Revisions that I will be publishing but honestly I am not sure when. Right now, even though the topic of bariatric surgery revisions is important, it does not currently feel particularly pressing. We are all playing this day-by-day, me included. When I pause for a moment and consider all the reasons I might break from monthly podcast episodes, a Global Pandemic was NOT one of those potential reasons. But here we are.

Links to resources I turn to for evidence-based knowledge are in the shows notes to this episode which you can find on whatever device you are listening to this on and at my website, weightlosssurgerypodcast.com. 

If you have episode requests, especially those that at this time intersect between obesity and coronavirus feel free to email me your thoughts at reeger@weightlosssurgerypodcast.com. And if you simply want to email me, please feel free to do so. Ill do my best to respond in a timely manner. 

POST CREDIT: I usually tell a kid joke or two in this post credits segment, but honestly even I am not in the mood to tell a joke right now. Rather, I want to remind us all of the wise words from Gandalf in J.R Tolkens “The Fellowship of the Rings” When Frodo said, “I wish it need not have happened in my time.” Gandalf replied “and so do all who live to see such times. But that is not for them to decide. All we have to decide is what to do with the time that is given us.”   

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109 Finding Your WHY with Marilyn Clark

February 3, 2020

In this episode I bring you my conversation with Marilyn Clark. Marilyn is a certified Nutrition & Lifestyle Coach, a radical self-care advocate, an obesity survivor, a bariatric patient, and a nutrition nerd. As part of our conversation, Marilyn shares her history as a person affected by obesity, how/why/and when she came to her decision […]

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A House Called Tomorrow by Alberto Rios, read by Reeger Cortell

January 1, 2020

This poem moved me and helped me and maybe it will move you and help you too. Thats all. Happy New Year. A House Called Tomorrow Alberto Rios You are not fifteen, or twelve, or seventeen— You are a hundred wild centuries And fifteen, bringing with you In every breath and in every step Everyone […]

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108: 10 Years, 10 Milestones in Obesity and Health with Ted Kyle, RPh, MBA

December 30, 2019

In this episode I bring you my conversation with Ted Kyle, RPh, MBA. Ted founded ConscienHealth in 2009. He is a pharmacist and healthcare innovation professional who works with health and obesity experts for sound policy and innovation to address obesity. He serves on the Board of Directors for the Obesity Action Coalition, advises The […]

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107 Geeking Out on Bile, Bugs, and Bariatric Surgery with Randy Seeley, PhD

December 2, 2019

In this episode I bring you obesity and bariatric surgery research scientists, Dr. Randy Seeley. If you have been a longtime listener of the podcast then you will likely remember Dr Seeley from Episode 34 where he helped us understand the theory of Set-point for body fat mass and Episode 56 where we did a […]

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106 Kelley Gunter On Living in the Truth

October 28, 2019

In this episode I bring you Kelley Gunter. As you are about to hear, Kelley is many things including a woman with a history of obesity who underwent bariatric surgery, specifically Biliopancreatic Diversion with Duodenal Switch in 2002; she is also a writer and author of the autobiography, “You have such a pretty face: A […]

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105 Don Moe of Weigh In Radio Interviews Reeger Cortell, FNP

September 29, 2019

This episode is a little different because I am on the other side of the mic. Rather than asking the questions, I am answering them. Podcaster Don Moe asked me to be a guest on his podcast, Weigh In Radio.  I was honored he asked and had fun chatting with him, so much so that […]

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104 What if Food Addiction is Part of the Problem? A Talk with Dr Vera Tarman

July 26, 2019

In this episode I talk with food addiction expert Dr Vera Tarman. Dr Tarman has been working in the field of addiction medicine since 1994 and has been the director of Renascent, an addiction treatment center in Toronto, Canada since 2006. Although she works full-time in all areas of addiction, her particular passion is helping […]

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103 Making Connections with Bariatric Surgeon Dr Neil Floch

June 26, 2019

In this episode I chat with Dr Neil Floch. Dr Floch is a bariatric surgeon at Western Connecticut Health Network, now known as NuVance and is in private practice at Fairfield County Bariatrics. This episode starts with Reeger’s preamble acknowledging two important anniversaries in the month of June, getting closer to our 5% patron goal […]

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102 Living with Bariatric Surgery: A Conversation with Author Denise Ratcliffe, DClinPscyh

May 26, 2019

In this episode I speak with the wonderful Denise Ratcliffe, DClinPsych. Dr Ratcliffe is a Consultant Clinical Psychologist based in London, United Kingdom. Since 2007, she has specialized in helping people with the psychological issues that may arise before and after bariatric surgery. I invited her on the podcast because she has recently published an […]

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101 Addressing Weight Regain with Angela Fitch, MD

April 23, 2019

In this episode I bring you my conversation with Dr Angela Fitch. Dr Fitch is medical doctor at Massachusetts General Weight Center in Boston, Massachusetts.  As you are about to hear, her role is very comprehensive in that she provides obesity medicine care for pediatrics and adults seeking medical and bariatric surgery as part of […]

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100 The Listener’s Episode

March 22, 2019

EPISODE 100! In 2013 when I launched the Weight Loss Surgery Podcast if you had asked me how many episodes I hope to publish I may have dared to say 20. In this episode I want to take a look back over some highlights between episodes 01 and 100. To help me do this I […]

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099 Let’s Talk About Addiction with Dr James Mitchell

February 11, 2019

In this episode we explore the topic of addiction. Much of the focus is on alcohol because as it pertains to bariatric surgery, that’s what been most significantly studied up to this point. However, as listeners will know, addiction comes in all forms and is certainly not limited to alcohol and drugs. To guide us […]

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098 Loss of Control Eating with Drs Ivezaj and Lawson

January 20, 2019

This episode brings an important topic to the forefront of the pre- and especially post bariatric surgery journey- the phenomena of Loss of Control (LOC) eating. In order to help us understand what Loss of control eating and is not, I had the pleasure of talking with two experts in the field, clinical psychologists and […]

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097 Catching Up with Leslie

December 27, 2018

In this episode we catch up with Leslie who had bariatric surgery, Vertical Sleeve Gastrectomy specifically, in Tijuana, Mexico in May, 2018. If you have not heard our first episode together, published in June 2018, I strongly encourage you to go back and listen to episode 94, titled “Leslie Goes to Mexico.” This was a […]

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096 Tips From The Team

November 19, 2018

In this episode, I called upon my professional colleagues from around the USA to offer some tips for you. Specifically, I reached out to non-physician professionals. You know, these are the team of people you see so often when you go to your bariatric surgery practice who are usually there with you each step of […]

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095 Catching Up with John Bukenas

September 24, 2018

In this episode, we catch up with our old friend, John Bukenas. This is John’s fourth time being a guest on the podcast. John is a fellow podcaster who is very open about his struggles with his weight. John and I have chatted on this podcast in 2014, 2015, and 2016. Our last conversation found […]

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094 Leslie Goes to Mexico

June 17, 2018

  In this episode, we follow the journey of Leslie, a 43 year old woman who went to Mexico for her bariatric surgery, and lucky for us, she took us with her. I have danced around the topic of medical tourism a little bit over the past five years, but I have never gone to […]

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