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Unread 04-20-2011, 05:14 PM   #1
frances
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Thumbs down My (very short) experience with the Butrans patch

Wow, It's been so long since I have posted...I almost couldn't remember how to start a thread. So I have been on Sub for a year and 1/2 (2 years june) started with 12 mg and have worked my way down to 2mg a day. I take sub for pain and addiction. My chronic pain made me turn to opiates (norco) and I guess once I figured out I could numb all my pain (mental & emotional too), i started taking more than prescribed and next thing I knew it was a couple years later and 10-12 Norco a day.

I turned to this site and sub and therapy to start my recovery. For almost two years now, I have been Norco free and in addiction remission. I thought I was doing great...but today was a real eye opener for me.

Because, Sub works for my pain (which I know it doesn't for everybody), my Dr prescribed the Butrans patch (5mc/hour), told me to just switch over and call him if I had any problems. Well, for those of you who know me here, I am a bit of a anxiety ridden-hypochondriac. Let me also mention that I was happy taking sub the way it was prescribed, never abused it (and only increased the med when I had break through pain). My insurance company does not recognize sub for pain so every time I renewed a RX, it was a huge pain in the butt dealing with getting a Auth (for me, my pharmacist and my Dr). This is why I was switched to the patch. So.... To make a long story short...yesterday at 6:00am I tok my 2mg film, this morning at 7:00am I put on my patch...by 9:45 am I was a wreck (thank God I happened to have a therapy apt this AM). I don't know if I went into w/drawl for real or if it was all in my head...but I was yawning, tearing, having the hot/cold sweats, major anxiety, crying...it was getting worse by the hour. The patch felt like it was burning my skin as well. So I called my Dr (message machine) left a message, by 1:00pm I had to take off the patch, I took 1 mg film under the tounge and am starting to feel better already. All I'm my head??? Am I still as addicted to opiates as I was two years ago? I sure feel like it right now.

So now I feel like I am in a horrible situation. I'm still addicted to something and I don't think I've actually come as far as I thought in my recovery. I seriously thought I was fine, and had kicked this whole thing...that I could switch to the super low dose patch and be fine. I still am not 100% sure if the w/drawls symptoms were real...or if I was just having a major panic attack...but I do know that I feel better now after pulling off the patch and taking 1 mg of sub. I think I do metabolize things very quickly and have felt minor w/drawls in the afternoon after having missed a dose in the AM. I guess it doesn't really matter...except, I had to take the film to start feeling better physically...but mentally, I feel like I have failed! And, I only have approx 5 doses of sub left until I run out. Still waiting to here back from my Dr. And I'm sure (now) everything will work out fine (even if I have to pay cash for the sub). However, this morning everything was dome and gloom and the patch felt like a burning weight on the side of my body.

Sorry to ramble...but I have always gotten such great support here and I promised to let Nancy and Tim know what happened with the patch. Not a very good guinnea pig after all, huh? I suppose I should have left the patch on and maybe taken a tiny bit of sub with it....but really, I could not stand to have it on my body.

Thoughts anyone?

Frances
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Unread 04-20-2011, 05:40 PM   #2
gotoffmdone
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I was told that even at the highest patch dose, 20mcg, it came down to where you were taking about one mg per day. If that is true and you were rx'd the 5mcg patch, then divide the one mg by 4. My bet is that you were headed into wds. The symptoms you describe are not in your head.

I have never found ANY type of patch(regardless of medication) to be as effective as the other routes of administration. That is my pet peeve about Bupes now new approval for pain. If Bupe is good for pain it should be allowed to be used in the most effective manner possible for the patient. My guess is the patch may work well for the novice but not for someone that has been on Sub for a long while.

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Unread 04-20-2011, 05:55 PM   #3
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Hi Frances,
Sorry you didn't have a good experience with the patch. IMO I don't think your symptoms were caused by the patch but instead might have been a combination of anxiety and withdrawal, not sure how much of each. It actually takes a few days for the patch to pass enough bupe to get blood levels up to a steady state or dose that you are used to. This absence of bupe could cause withdrawal but its unlikely it would happen as fast your experience which is why I think anxiety about switching may have played a big role. I'd ask your doctor if you could try it again and use small amounts of Suboxone if you start to feel withdrawal between the time you start the patch and the time its working at full transfer rate. Check out this graph on page 23 http://www.purduepharma.com/pi/presc.../ButransPI.pdf of the Butrans prescribing info.
Tim
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Unread 04-20-2011, 05:59 PM   #4
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Thanks for responding Wayne,

And I think you are right. Especially because I feel close to "normal" now that I took that 1 mg of Sub. But I can't help but feel a little discouraged and depressed. I haven't felt like I've been "addicted" to anything for almost 2 years...and to realize how dependent I am scares me.

My therapist said to me this AM, that if I did take off the patch and go back to sub, that I should write out a taper plan and stick to it. He has never been a big fan of Sub (although I thought I had kind of changed his thinking on that) and he has always kind of encouraged me to try to go off it. However, my argument was that I was on a low dose and that it helped with my pain...and I didn't feel like I was getting high, didn't crave more and never craved My DOC. When my pain got really bad, I would take 2mg, every 2 hours and that seemed to work for me. I thought that was much better than going off....only to be RXed vidicon or Norco when I couldn't take the pain.

I don't know...I am over thinking everything....like I always do and freaking out! Nan, where are you??? LOL

Thanks Wayne...you made me feel better

Frances
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Unread 04-20-2011, 06:26 PM   #5
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Thank you so much Tim....that is a lot of good information (however, I don't understand all of it . So according to the graph, I would not be feeling really any of the Bupe from the patch this AM but would need to wait 3 days to feel full effects, right? Is it possible that I had a allergic reaction to one on the other minor ingredients in Butrans? My side still is sensitive where I had applied the patch (and I didn't apply heat, soap, anything before or after application and removal).

Is it possible to feel withdrawal from 2mg Sub in 24-30 hours? Like I said in my original post, I think some of the symptoms were in my head...but it was so awful, that I don't think I can try it again...even with the added sub.

Agh.....I hate this awful anxiety. I feel so WEAK.
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Unread 04-21-2011, 07:14 AM   #6
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Hi Frances, sorry that the patch didn't work out. You gave it a try, but not every medication is good for all people. But, please, you are not addicted to anything. Addiction is the uncontrollable, compulsive behavior despite negative consequences. http://www.naabt.org/faq_answers.cfm?ID=1 You've come a long way since you stopped norco, right? Right! The patch isn't for you. No big deal, let's find a way to work around it.

If you had a sensitivity to the patch, then think about reporting it to Perdue:
http://www.butrans.com/contact-hcp.aspx
This is from that link also (in the left scroll bar thing):

"ADVERSE REACTIONS
Most common adverse reactions (≥5%) included: nausea, headache, application site pruritus, dizziness, constipation, somnolence, vomiting, application site erythema, dry mouth, and application site rash."

Pruritus = itching
Erythema = redness of the skin

I wonder if your doctor reports that to your insurance company, they could continue covering the Suboxone for pain. That might be worth a try because of the adverse skin problems.

If not, then there's the $45 coupon:
http://suboxone.com/patients/here_to_help/copay.aspx
Get some prices from different pharmacies and see if you can get enough that most, if not all, would be covered by the coupon. Price out the 8mg strips also because you can then cut those down to the 2mg and 1mg.

Most of all Frances, you are not weak! You gave it a try! Also, if you're not ready for a taper, please don't do it just because your therapist seems to be a bit anti-medication. Especially if it's helping your pain. You can always give it a try, and it will help you to see where you are pain-wise with no medication. But please don't force yourself and don't hurry. You need to do what is in the best interest of YOU, YOUR pain management, and YOUR quality of life; not what your therapist thinks.

Let us know how you're doing today, ok?

Nancy
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Unread 04-21-2011, 08:23 AM   #7
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Hi Frances Im glad I read your thread, and you trying the patch (although sorry to hear it didnt work out). You and I are in the same boat I think. Both taking sub for addiction and pain control. I completely know where you are coming from on what you describle when you lower your dose. Same thing happens to me. I have been on sub for over 2 1/2 yrs, and take 2mgs some days, or 1mg others. And excedrin in between, or mobic from the doctor.
Just wanted to let you know Im with you on this, lets see what we can come up with to keep the pain away and taper off sub
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Unread 04-21-2011, 10:17 AM   #8
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Thank you Nancy and Deanna,

I know Nancy, you are right...I am in a much better spot(state of mind) today. I HAVE come far and I WILL get through this. It's like Deanna said, the mind plays these awful tricks on us....and yesterday was such an awful anxiety attack....and I was scared to take even half of a diazapam because I was scared of all those Butrans warnings (even though I logically knew it was ok).

So, today, a much better day...just took 1 mg and I'm just gonna roll with that until I need to maybe take another 1 mg. I read through Marys posts about her taper....and I like how her Dr said it was okay to stretch your dosing...or take less and shorten it while tapering. I'm going to do this until at least I get my insurance thing situated...or can feel comfortable knowing I have enough of my RX.

Then, I will make a decision on how I am going to continue my taper...

Thanks so much guys for your support...it means a lot to me. And Deanna, I'm with you...let's work on this together. After reading through your thread yesterday, I was struck by so many similarities between us (BTW, I'm 43). I am sorry that I stopped checking in and posting regularly....this is such an amazing place for support. I'm am going to try to make this a regular part of my recovery too

So see you around. Much Love,

Frances
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Unread 04-21-2011, 11:03 AM   #9
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Hello Frances! Guess I was MIA yesterday when all this was going on. Sorry the patch didn't work out. Interesting what Tim wrote(the graph) about it taking time to get fully in your system. That certainly could make a difference for one switching from the sublingual doses. I think it would make sense if a person would continue with a low dose of the oral medication when transitioning to the patch.

However, it sounds like you had a skin reaction to the patch. It happens, some people have reactions if they have a bandaid or bandage tape on. That being said, imo, the feelings you had probably were not withdrawals as much as anxiety. You had built up worry in your mind as to whether or not the patch would work. You almost were anticipating problems with it. Therefore, the patch worked exactly how you thought it would, by not working.

There are many things to look at. The first being that you were willing to try it and that is a positive step. The second is to look at how much importance you are putting on the power of the suboxone to make you feel good. I hope you can try to put it in its place and not worry as to whether you are going to feel withdrawals when you lower your dose. It sounds to me like when you change your dose you start to concentrate on how you are feeling-so your mind is constantly waiting for some symptom to pop up, and then when it does you go into high gear and think, oh boy here comes the bad withdrawals. Some people have written that when they lower their dose and they start to feel a little "different" they just get busy with something else and that feeling passes. In other words, don't give so much power to the medication.

I guess I don't know what your pain issues are. Is it something that can be "fixed" or is it a chronic condition that you will have to just live with? I know Omike and some others speak of the OTC medication they take along with the sub.

So, I guess the question now is do you need to continue to take the suboxone for its pain relieving properties? If not then a slow taper will get you off suboxone as long as you are mentally prepared. Don't overthink it, stretch the time out between doses, and just continue living your life. A slow, drawn-out taper does work as long as you decide that it is going to work. Put your focus on your daily activities, not on the medication you are taking.

I hope you are having a better day today and that you get things straightened out with your dr. Best wishes,

nan
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Unread 04-21-2011, 12:02 PM   #10
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Even though some Drs do not see it this way, people on Sub are supposed to start the tapering process when they feel ready and mentally prepared to do so, and even then weening and jumping may not be a picnic by any means.

Being that you have pain issues along with the fact you were not ready to taper below where you are now(and going from 12mgs to 2mgs is very commendable), your going from what you were taking to a seven day 5mcg patch, IMO, was no different than a forced taper. Its no wonder you feel anxious and a bit fearful.

Your comment/question, "Am I still as addicted to opiates as I was two years ago? I sure feel like it right now" got me to thinking about my own history. I can understand why you would ask yourself that question.

That statement appears to be born out of your feeling as though you went into wds. And I think it is a good question to ask. How could we know whether we are still addicted to opiates, incuding Sub, until and unless we find ourselves INVOLUNTARILY cut off from what it is we need to stay well.

If I was in Sub wds and found and bought some off the street, illegally, possibly to face some serious negative consequences, would that make me an addict or just someone who needs to find myself another Sub Dr.

Before pills, I was a regular guy who would have never thought of doing anything wrong, especially live outside the law. The definition of addiction I learned was the continuing use of pills despite negative consequences. The negative consequences of going into wds and putting my entire life on hold overrode all reasoning in terms of what may have happened if I got caught altering a script, or Dr shopping, or dentist shopping, or ER shopping, or worse, raiding other people's medicine cabinet. It shames me to say that.

I never did that sort of thing feeling as though I was a criminal trying to see what I could get away with. I considered myself to be sick with the only cure being secured and unaccesable to me. I felt I needed to do what I had to do to get well, one day at a time, so I could take care of my responsibilities. Whenever I would be lucky enough to get a script that would last me several days, by definition I was not addicted those days, just dependent.

wayne
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Unread 04-21-2011, 06:17 PM   #11
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Quote:
Originally Posted by nan View Post
imo, the feelings you had probably were not withdrawals as much as anxiety. You had built up worry in your mind as to whether or not the patch would work. You almost were anticipating problems with it. Therefore, the patch worked exactly how you thought it would, by not working.

nan
Thanks Nan,

And I know you are right about the anxiety...I can make many things WAY worse in my head than is logical...I thought I was ready for the patch (did research, posted here, got opinions, talked to a couple pharmacists besides my DR)...but obviously I was not prepared because I went into a full on panic attack. However, the thing that is completely irrational is that one of my main concerns was that I was going to die...not so much the w/drawls but that I was going to somehow overdose on Bupe (because of all those warnings). My therapist even made a joke when I left his office and said if you die, can you please call and cancel (he was trying to get me out of my head and make me laugh i think). Thats what so scary about anxiety and panic attacks...I was not thinking rationally at all...I had sub I could take if i needed to curb w/drawls (so that shouldn't have been a concern) AND I knew it was a lower dose...but all those pamphlets and the pharmacist freaking me out about "accidental fatal overdose".
Also, I think I was so scared to do something different when what i have been doing was working so well AND I had no control over the dosage...what if it hit me like a ton of bricks and i couldn't function or worse...die!!!! I know, I know, crazy! Thats why I was thinking where is "Kind, but firm" Nan? I need some reasoning here.
...I have forgotten doses and not felt anything or even when tapering conciously, have not had a problem (except a minor issue when going from 4 to 2...but then i just switched from 4,3,4,3 then 3,2,3,2 now I have been on 1mg today and 1mg yesterday and I am fine...not feeling or anticipating and w/drawls. BUT....I am back in the drivers seat...so maybe I need to look at some control issues?

I think Wayne is right that maybe because it was a force taper thing, that triggered something...I dont know. But I do know that I do need to look at some stuff within me and continue to focus on my recovery.

Wayne...I really like what you had to say...and thank you! That was a big part of my anxiety yesterday too....was "Am I just as worse off as I was two years ago?" But you know what, today I am back on track...and like you, I did things I was not proud of, at first to get high...and later to control my withdrawl so I could function and take care of my family and try to get better on my own. And when I look back, you are right...I was two different people...I wanted help before i was ready to admit I had a problem and ask for it. But I DID ask for it...and not only that, I asked for help from my Dr that was prescribing me the Norco's (talk about cutting off your source). So thank you for your understanding and your post...you really got me thinking about my past and addiction and how we view ourselves within that role.

So today, I am a rational thinker (thank God for that) and I have talked to my Dr and am feeling so much better about everything. I will continue on with my taper while taking care of my pain issues (chronic BTW Nan) and just take care of myself and my recovery!

One good thing that has come out of this is that I am back here, on this site, which has always been a tremendous help to me

Thanks all for your individual input...everything helps!

XOXO, Fran
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Unread 04-23-2011, 07:14 AM   #12
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Hi Frances, just checking in to see how you're doing.

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Unread 04-23-2011, 09:00 AM   #13
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Me too! How are you Frances?
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Unread 04-23-2011, 10:02 AM   #14
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Hi ladies,
I'm doing great. Thank you so much for asking. I felt like I was back to my normal self (as opposed to my freaky self by Wednesday. I have been alternating 1,1,2... And so far No problems. I called my Dr office on Thur and the receptionist said "you sound SO much better!"....Wednesday was just a BAD day for me. Anyway, My Dr is going to change my RX to 2mg 1 to 2 times a day as needed. I think part of the problem is that he has not altered my RX in so long that 1 fill lasts me 5 months... So then when I go to fill it, blue shield is confused. So hopefully, this will get things straightened out with them.
How are you Deanna? Did you "jump" yesterday? How's it going? I'll check ur thread to see your progress...I know you'll do great!
Happy Easter!
BTW nancy, is there still chat Sunday pm? I'll try to make it. Thanks for checking in guys.
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Unread 04-23-2011, 10:18 AM   #15
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Good morning frances! Gosh you sound sooooo much better, I am glad to hear that things have smoothed out for you. Sounds like you have a really great dr to work with you so that helps alot. Good to hear the alternating is working as well. So many folks here have written that has worked for them as they tapered. It does make sense because of the long half-life and your body steadily gets used to smaller and smaller amounts. Sounds like a plan!

Next chat is on Tuesday because of the holiday on Sunday. Too many people will be out looking for the Easter bunny, or too full of chocolate to get to chat on Sunday. ha ha ha

Keep up the good work, looking for solutions, knowing the solutions are there. Not sure I will get to chat on Tues but I am glad you are back here posting and chatting!

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Unread 04-23-2011, 09:01 PM   #16
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Hi Frances, so good to hear you're back to your regular self.

I hope that new prescription works with the insurance company. Fingers crossed!

As Nan said, no chat tomorrow night, but we'll be there Tuesday. Did someone say choc-o-late. hahaha I hope you're having a good weekend!

Nancy
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Unread 04-25-2011, 09:28 AM   #17
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Hi Frances! Hope you had a great weekend! Glad you are feeling so much better! I am going to take the sub every other day for a bit, I wrote about it this morning. I knw you will understand in my thread, since you have anxiety also. So glad you are doing better!
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Unread 04-25-2011, 09:07 PM   #18
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Thanks for checking in guys...still doing great. had a really nice Easter with the family. Still waiting to haer from the insurance co weather they will cover the new RX. Hopefully, someone there will "get-it" and make the approval. My Dr is pretty relentless about the letter writing back & forth and always manages to make it happen so I am feeling positive. I have a 2 mg film and approx 3mg pill...so I'm taking very little to hold me over and so far so good . I also talked to my pharmacist today and she said if the auth doesnt go thru b4 im out, which is likely, to come in and get a couple to hold me over. Actually, like you said Nancy, I could just get my $35.00 coupon worth.
So maybe after all this I'm doing a natural taper to 1mg...wouldn't that be a great thing to come from all this? And the beautiful thing is my pain has been in-check so I am able to just take Ibuprofen with the 1-2mgs in the AM and feel ok.
. All is good in my world (at least in this area). I have lots of shit going on personally...but that's a whole other subject...for now, I'm taking care of me
XO, Fran
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Unread 04-26-2011, 06:56 AM   #19
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Hi Frances! Glad to hear you had a nice Easter and that your pain in check! Sorry that there's crap going on, but you're doing the right thing and taking care of you.

If you end up having to use the $45 coupon, check the price difference between the 8mg and 2mg film. Since the films are supposed to have the same price structure as the pills, it would probably be more cost effective to have your doctor write for the 8mg films and then you can cut them down to 1 or 2mg. But hopefully the insurance company will realize that they aren't doctors and have no right interfering with a patient's care...

I'm with you in thinking that this a natural taper working for you! Fingers crossed that the doctor gets insurance company to cover it.

Keep us posted!

Nancy
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Unread 04-29-2011, 08:40 PM   #20
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Hi...just checking in. So far no info regarding the insurance co...I went into the pharmacy on Wednesday and my pharmacist gave me 5 2mg strips to last until we hear something...so fingers crossed. With my new dosing that should last me close to 8-10 days. So far, every things good.
Thanks for checking in Nancy...I really wanted to come to chat this week...but with two kids under 6, sometimes things get away from me. I am going to try to be there Sunday PM.
have a great weekend!
F
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Unread 11-19-2012, 11:21 AM   #21
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Default Butrans Patch from Oxycodone 15mg

i was prescribed the patches and filled them a couple of times but never took because i was afraid the pills would not work after reading a lot about them. I ran out of pills and the WD's started and it was bad. Laying in bed as the leg cramps and anxiety were increasing and I knew what was next. I did some quick reading and I learned Butrans is perfect for WD from Percs, you just need to let the symptoms kick in first. I was on a completely empty stomach and I slapped the patch on. Maybe it was psychological but the WDs stopped within an hour. I have now lost my desire for the pills and take as needed. I had major C5-6 reconstruction about a year ago - now i have extra patches because i did not use them for 6 weeks and my pills will last longer as well - Lucky Me - need to keep them locked up from pesky friends for sure
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