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Post by bswitched on Jan 21, 2015 15:09:11 GMT -5
I will be having the DS surgery in March. I am curious why there are so many differing opinions on the proper diet for this surgery, after the initial healing process and phases of course.
I tend to be a rule follower and have respect for my surgeon, however it seems that the diet differs from many of the diets I've seen around on the support boards that actual people with the DS are following.
Low carb - check low sugar- check
but the big difference is in the fat part, low fat is what I read from the doctor. However, I see many promoting a full fat diet.
I admit I have read MANY boards so I know everyone's diet is different but there's usually a level starting point, and I've seen drastic differences.
Can anyone help me understand this better?
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Post by aa on Jan 21, 2015 16:14:30 GMT -5
Almost every DSer I know doesn't eat low fat. First, it can help plug you up. You want to keep the wheels greased, so to speak. Second, in many instances higher fat foods taste good. I know that's what I like to eat.
Unfortunately, many bariatric teams have a kind of one-size-fits-all diet. Low fat is much more for other WLS. Not for DSers.
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Post by newyorkbitch on Jan 21, 2015 16:29:46 GMT -5
I will be having the DS surgery in March. I am curious why there are so many differing opinions on the proper diet for this surgery, after the initial healing process and phases of course. I tend to be a rule follower and have respect for my surgeon, however it seems that the diet differs from many of the diets I've seen around on the support boards that actual people with the DS are following. Low carb - check low sugar- check but the big difference is in the fat part, low fat is what I read from the doctor. However, I see many promoting a full fat diet. I admit I have read MANY boards so I know everyone's diet is different but there's usually a level starting point, and I've seen drastic differences. Can anyone help me understand this better? It's pretty simple - why would you need to eat low fat, if the DS works by malabsorbing fat? What are your surgeon's vitamin recommendations? And who is the surgeon? I would suggest very strongly that you get out of the rule following mentality and read the experiences of people who live with the DS.
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Post by cherylbaker on Jan 21, 2015 16:47:17 GMT -5
That has been the hardest part fir me.. i like you am a rule follower. There are a couple if things that helped me. 1) plenty of ppl not just surgery ppl follow a high fat diet.. keto diet is lchf (low carb high fat). It is a valid method of loosing weight. 2) i asked my surgeon if i should eat low carb or low fat and he said li carb 3) yoy only have 3 choices.. fat carbs or protein. You know they want you to eat 90 grams protein at 3 months. If you eat low fat let's say 20 percent of your calories and you eat 1000 calories that means your protein is 360 or about 33 percent and you want 20 percent fat that means you have to eat 47 percent of calories from carbs. . Thats not low carb.. so the math does not add up. So since you can't change the protein your left with sawpping the fats and carbs. . No other choice... Hope some of this way of thinking helps you
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Post by bswitched on Jan 21, 2015 16:51:53 GMT -5
Yes it does seem simple as you stated newyorkbitch, I was curious why the difference? I would think the nutrition team would get things together based on the exact surgery and not an umbrella diet for any bariatric surgery.
I say I am a rule follower in this situation particularly because I understand this is a very serious surgery and I do not take that lightly at all. I want to set myself up for success. This is one of the biggest discrepancies I've seen based on the surgeon and the actual patients.
I think listening to the long term people on here who have lived with this surgery would behoove me. I trust the experience here.
My surgeon recommends 2 multi vitamins, calcium,iron vitamins adek in dry form plus additional vitamin D in dry form.
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Post by newyorkbitch on Jan 21, 2015 17:41:10 GMT -5
Yes it does seem simple as you stated newyorkbitch, I was curious why the difference? I would think the nutrition team would get things together based on the exact surgery and not an umbrella diet for any bariatric surgery. I say I am a rule follower in this situation particularly because I understand this is a very serious surgery and I do not take that lightly at all. I want to set myself up for success. This is one of the biggest discrepancies I've seen based on the surgeon and the actual patients. I think listening to the long term people on here who have lived with this surgery would behoove me. I trust the experience here. My surgeon recommends 2 multi vitamins, calcium,iron vitamins adek in dry form plus additional vitamin D in dry form. Please look at the vitamins board here - you need much more than your surgeon is recommending. Go to vitalady.com and read her DS regimen and plan to get on it. In my 15 years of involvement with the DS, I have seen very, very few surgeons (or their teams) giving sensible nutrition or vitamin advise to DSers. Surgeons are trained to perform surgery, they are not (nor should they be) experts in nutrition or internal medicine. You need to find competent doctors who are not surgeons - a good GI, internist, probably a hematologist and perhaps an endocrinologist. I have not seen a bariatric surgeon in 14 years. There is no need to.
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Post by bswitched on Jan 21, 2015 20:23:49 GMT -5
Okay. Thank you.
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Post by newyorkbitch on Jan 21, 2015 20:44:58 GMT -5
That has been the hardest part fir me.. i like you am a rule follower. There are a couple if things that helped me. 1) plenty of ppl not just surgery ppl follow a high fat diet.. keto diet is lchf (low carb high fat). It is a valid method of loosing weight. 2) i asked my surgeon if i should eat low carb or low fat and he said li carb 3) yoy only have 3 choices.. fat carbs or protein. You know they want you to eat 90 grams protein at 3 months. If you eat low fat let's say 20 percent of your calories and you eat 1000 calories that means your protein is 360 or about 33 percent and you want 20 percent fat that means you have to eat 47 percent of calories from carbs. . Thats not low carb.. so the math does not add up. So since you can't change the protein your left with sawpping the fats and carbs. . No other choice... Hope some of this way of thinking helps you What??? Why do you care about calories?? Cheryl you have been told this many times here. You need to get to 150g protein, and keep your complex carbs moderate and your simple carbs very low. You do not need to count calories or think about calories. You should eat as much fat as you want, as long as the amount you eat keeps your digestive system happy.
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Post by caprice on Jan 22, 2015 6:09:03 GMT -5
Welcome, bswitched! (Just gonna jump around, here, so please forgive the posting style. Random thoughts, OK?)
I beg you to ignore the previous advice to count calories. If you have some time to kill, read that person's posting history. Those posts are filled with good information (not from her, but from the people who are patiently and repeatedly trying to get her to understand that her digestion works differently now). I spent most of my teens and all of my adulthood counting calories. For a non morbidly obese, non surgically altered body, the math usually works. BUT... we DSers are all pretty much formerly morbidly or super morbidly obese. Safe to say that our metabolism wasn't working properly any more. Mine sure wasn't. Then, due to the malabsorption we are given, we only get about twenty percent of the fat we take in to our bodies. A body NEEDS fat to function. A body NEEDS protein to function and repair itself. Carbs, notsomuch. Well, some, but not near as important as the other two. With the smaller stomach you will be given, you will find it difficult to get in just the fat, protein and water that you'll need to stay healthy, at least to begin with.
This was the single hardest thing to wrap my head around, but life got so much easier when i just focused on getting in the nutrition that I needed to live, and not complicate it by counting calories.
Right after surgery, you will want to go easy on the fat, but, as you heal, and your body adjusts, you probably will be able to increase you fat. I remember orange oil slicks in the beginning.... not fun. But it gets better. And, fat makes most everything taste better. If you read the labels on processed, low fat or fat free crap (I'm looking at you, cream cheese...) it's full of carbs to sort of make it not taste like plastic. Blech. Full fat is lower carb, and it will become your friend, if you let it.
I am over seven years out, and make sure that I eat the protein I need, and generally, there's some fat attached to most of that protein. If there's room for some carbs, fine, but if I see a few pounds coming back on, I moderate my carb intake, and the scale works its way back to a number I like. Just like normal people. It's such a wonderful thing.
Surgeons are good at being surgeons. They employ nutritionists to handle the nutritionist stuff, and, sadly, it seems that a large majority don't educate themselves to the differences between the two malabsorptive surgeries. The RNY is more widely performed, so that's the one they seem to know the rules for. We DSers do not absorb fat at the same levels RNYers do. One size does not fit all.
Wishing you a successful journey, and I encourage you to stick around, read and ask more questions.
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Post by jpcello on Jan 22, 2015 6:16:26 GMT -5
No calorie counting with the DS. The rules are simple. High protein, low carb, high fat, lots of water. These are rules you generally won't get from the doctor. The majority of surgeons who perform the DS aren't schooled in the post-op life of a DSer - they cut and that's it. Usually the office staff (dietitians, nutritionists, etc.) are generally more focused on RNY for VSG rules and not DS rules, which why you are getting mixed information.
Read labels. While in your weight loss window, keep your carbs to 50 grams and under. Learn the difference between simple and complex carbs. You want to primarily eat complex carbs (but a bad carb or two now and then is just fine - I don't believe in depriving yourself). Protein rules are 30/60/90 - 30 grams by 30 days post-op, 60 grams by 60 days post-op, and 90 grams by 90 days post-op. The ultimate goal is to get in between 125-150 grams of protein per day.
Once you start reading labels you'll realize the connection between low fat and high carbohydrates. My favorite comparison is salad dressing. Do a side by side comparison of any two salad dressings - one regular and one low fat. The low fat version will have a higher carb/sugar content. To compensation for the lower fat, they add sugar for taste. Do not eat low fat. Fat also helps us DSers stay "regular" if you know what I mean. Some people have hard time with constipation and fat helps.
Check out Vitalady's DS vitamin recommendations. Do not follow the doctor's recommendations on vitamins. Again, surgeons generally don't understand what a DSer needs post-op. This is just a matter of fact. There are a few who "get it" but they are few and far between. My surgeon, for example, started out giving very bad advice, but over the years he has started to listen to his patients, and has embraced Vitalady for DSers.
This is all very overwhelming. We all get it. Keep reading the boards and asking questions.
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Post by bswitched on Jan 22, 2015 7:35:54 GMT -5
Thank you jpcello. I will keep reading and asking
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Post by bswitched on Jan 22, 2015 7:36:33 GMT -5
Thank you caprice!
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Post by bswitched on Jan 22, 2015 9:46:17 GMT -5
On the topic of vitamins, at what point after surgery does one start all the vitamins?
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Post by cherylbaker on Jan 22, 2015 10:42:07 GMT -5
That has been the hardest part fir me.. i like you am a rule follower. There are a couple if things that helped me. 1) plenty of ppl not just surgery ppl follow a high fat diet.. keto diet is lchf (low carb high fat). It is a valid method of loosing weight. 2) i asked my surgeon if i should eat low carb or low fat and he said li carb 3) yoy only have 3 choices.. fat carbs or protein. You know they want you to eat 90 grams protein at 3 months. If you eat low fat let's say 20 percent of your calories and you eat 1000 calories that means your protein is 360 or about 33 percent and you want 20 percent fat that means you have to eat 47 percent of calories from carbs. . Thats not low carb.. so the math does not add up. So since you can't change the protein your left with sawpping the fats and carbs. . No other choice... Hope some of this way of thinking helps you What??? Why do you care about calories?? Cheryl you have been told this many times here. You need to get to 150g protein, and keep your complex carbs moderate and your simple carbs very low. You do not need to count calories or think about calories. You should eat as much fat as you want, as long as the amount you eat keeps your digestive system happy. Just using it As an example of the math nyb..
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Post by jpcello on Jan 22, 2015 11:28:36 GMT -5
On the topic of vitamins, at what point after surgery does one start all the vitamins? You need to start very slowly with vitamins. Ask your surgeon but really not much on vitamins for the first month or so (at least the first couple of weeks). Alot of people start with Vit D (it's a small capsule) and isn't hard on your stomach. Careful with iron or anything too big. May want to split pills for a while (or open capsules and add to apple sauce or something soft). Your surgeon will give you instructions - when to start eating certain stages. All surgeons have different instructions and we generally say follow what your surgeon tells you. Some start with liquids, some start with soft foods. It varies. Sorry, it's been 12 years and I honestly have a hard time remembering some of the early instructions. Hopefully newer post-ops will advise. The most important thing to remember is that after surgery your insides have been torn apart and sewn back together. It takes months for everything to completely heal (some say 3-4 months). It's all baby steps. That's why it's important to work things up (food, liquids, vitamins). Some other tips I was given that are helpful. Don't invest too much in protein supplements. Vitalady sells samples so this way you can try things to see what you like. Your tastes will change after surgery (most of us find that food tastes are heightened - sweet are very sweet, salty is very salty, etc.) Use a small plate (I still eat my meals off a lunch plate and never a dinner plate). I use small utensils - salad fork and teaspoon. It forces you to take smaller bites. Never, ever be without a bottle of water. Have it with you at all times and sip sip sip. It's hard to drink water immediately after surgery.
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Post by caprice on Jan 22, 2015 11:40:17 GMT -5
Your right i have nothing of value to say. Kiss my butt. Perhaps I flatter myself when I think you are addressing this my way, but, if you are, please note that I didn't say that you had "nothing of value to say". I said you refuse to be educated about the folly of counting calories. Your input here is valuable. Just as mine is. And the thing we do have in common is that we were (or are) doing something wrong. I am an excellent example of how "not to" handle eating early out. I didn't eat enough, I didn't come close to staying hydrated, I didn't start in right away taking the vitamins that I needed to. And I got damn sick following that course, and it took me a damn long time digging myself out of the hole I had created. The difference between us, as I see it, is that I can admit that I did it wrong. You're not there yet, although I hope you do eventually get there. Learning from others' mistakes is a valuable teaching tool, as long as it doesn't cost us our health, or our lives, doing it wrong in the beginning. Peace out.
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PeteA
Full Member
Posts: 221
Surgery Date: 4/15/13
Surgeon: Dr. Phillip Schauer
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Post by PeteA on Jan 22, 2015 15:49:22 GMT -5
While you will find pretty universal agreement that low fat is not only unnecessary but unhealthy there is a lot of discussion about going out of your way to add fat. While I'm not an advocate of high fat I especially think the first 6 months it isn't something you should look at. Once you establish some kind of baseline if you want to deliberately add more fat you can give it a try. First 2 or 3 months too much healing going on - results are unpredictable for anything you eat. My personal answer was to just stop buying low fat items and I no longer avoid meats, etc that may be a fatter cut of meat. I saw you listed your vits and it seemed a fine general list depending on dose levels. Calcium citrate for the type of calcium and not too much in one dose. I can't remember if I saw B12 but that would be a good addition. i went into this looking for rules too and I was disappointed that they weren't more clear cut. Very worrisome immediately post-op but in hindsight I realized that you pick your baseline as best you can and then adjust to your own health and your own labs. Early on there is enough tracking via labs, and usually enough leeway, that you can catch problems before they get really bad. Pete
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PeteA
Full Member
Posts: 221
Surgery Date: 4/15/13
Surgeon: Dr. Phillip Schauer
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Post by PeteA on Jan 22, 2015 16:18:40 GMT -5
As for starting vitamins your first priority post-op is hydration. You have some vitamin stores to coast on for a while. People are different about what they can swallow and tolerate right after surgery. As a rule of thumb I would think to give it a try at 2 - 3 weeks. A lot of people that have trouble with tablets find capsules better or for some things like calcium you can get powder to mix with yogurt or other stuff (Upcal D). I think if you haven't had trouble with pills pre-op you probably will adjust post-op with little problem. Sorrry for the double posts - I missed some of this on my first read through.
The only other thing I can think to add is about tracking. You have to figure out what works for you but, at least initially, liquids and proteins, after that add the things that work for you. I found the first year, doing protein first, my food choices were limited enough that I didn't have to track carbs and I still don't but I've tracked my daily meals so it is easy for me to compare and see if I am letting a lot of carbs back in.
Pete
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Post by bswitched on Jan 22, 2015 16:42:14 GMT -5
Thanks so much Pete!!! I've been scouring this help board and a few others. My brain is fried but full on information ! I'm grateful for all the help here.
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Post by jpcello on Jan 22, 2015 16:50:44 GMT -5
Thanks so much Pete!!! I've been scouring this help board and a few others. My brain is fried but full on information ! I'm grateful for all the help here. And just remember that when they wheel you out of the OR, you won't remember any of this You can only take in so much information. It's not until you actually live with the DS that you can appreciate everything that gets posted here (and elsewhere). I think the most important thing when you get home is focus on staying hydrated (thanks for the reminder Pete). It's really hard to drink so your instinct is to not drink. Water may taste awful. I remember I would only drink Desani water (we used to say it was the minerals that made it tolerable). Not drinking enough could be the biggest mistake you can make. You will get dehydrated so fast you won't know what hit you. And you don't want to get dehydrated - been there, done that. Not fun.
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Post by bswitched on Jan 22, 2015 19:17:46 GMT -5
Lol !!! I'll have this site bookmarked. I remember the fog after my band surgery and removal and this surgery is a whole other ball of wax !!!
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Post by goodkel on Jan 23, 2015 1:37:07 GMT -5
On the topic of vitamins, at what point after surgery does one start all the vitamins? The answer is: now, today, as soon as possible. I know that it is difficult to swallow pills when you can only drink one sip at a time. But, not everything has to be swallowed. You can dissolve Calcium Citrate in water and sip on that all day long. B-12 is sub-lingual and shouldn't be swallowed at all. You slip them under your tongue until they dissolve there. The cherry flavored ones are quite tasty. There are chewable multivitamins that will do for now. There is a Vitalady list of chewables at the top of this board. The dry A, D3, and K2 are very small capsules. Taken one at a time, they do not require much fluid to get down. Start with the smallest and work your way up from there. The sooner you can fortify your body with the vitamins you need, the faster you will heal and the best chance you can give yourself of not having a deficiency to deal with at your three month labs. Read more: weightlosssurgery.proboards.com/thread/8817/when-start-vitamins#ixzz3PckFYJak
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Post by goodkel on Jan 23, 2015 2:15:16 GMT -5
I will be having the DS surgery in March. I am curious why there are so many differing opinions on the proper diet for this surgery, after the initial healing process and phases of course. I tend to be a rule follower and have respect for my surgeon, however it seems that the diet differs from many of the diets I've seen around on the support boards that actual people with the DS are following. Low carb - check low sugar- check but the big difference is in the fat part, low fat is what I read from the doctor. However, I see many promoting a full fat diet. I admit I have read MANY boards so I know everyone's diet is different but there's usually a level starting point, and I've seen drastic differences. Can anyone help me understand this better? Sugars ARE carbs. The worst kind. Simple carbs that your body begins absorbing the minute they hit your mouth. Never eat any processed product that is marked as fat free, reduced fat, lite, etc.. Full fat everything. When they remove fat from a product, they add sugar to make it more palatable. We malabsorb 80% of the fat we eat so it does us no harm, but sugar we absorb 100%. Full fat milk, yogurt, cheese, salad dressing, mayonnaise, etc. You never have to watch how much fat you eat. You could eat bacon and juicy hamburgers for every meal and you will still lose weight. AND it won't hurt your heart or arteries because 80% doesn't get that far. Early out from surgery many people have urgency issues when it comes to their bowels. As fat moves through our system quickly, it can exacerbate the urgency. It is wise to go easy on the fats until your body has had time to begin healing and you know how it will affect you. Other than that, there is no reason to avoid fat at all.
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Post by bswitched on Jan 23, 2015 15:26:13 GMT -5
Thank you !! Today I ordered my separate dry A D E and K plus sublingual b-12. I'll hit Walmart for the calcium citrate and multi
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Post by goodkel on Jan 24, 2015 6:09:51 GMT -5
I buy most of my vitamins at Walmart, too. You can find the sublingual B-12 there, too. The dry vitamins A,D,E, and K I usually get from Vitalady. Most everything else can be found at Walmart.
But, for your initial batch of vitamins, we recommend buying her starter pack because they contain the complete set of what we need need to take in the correct formulations and dosages. After your first set of labs at 3 months, you can adjust them based on the results. If you are not getting her pack, be sure to take everything listed in it with careful attention paid to formulations and dosages.
It is also a good idea to get a full set of labs done right around now so you can address any deficiencies prior to surgery. It is always a good idea to go into surgery in the best health.
I am delighted that you are paying attention now to vitamins. I found learning everything else about the DS and my preparations for it so overwhelming that I only had a vague notion about the vitamin requirements. I figured that I would sort it all out while I was recovering. I might have avoided some deficiencies on my 3 month labs if I had been like you. Good job!
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Post by bswitched on Jan 24, 2015 8:01:50 GMT -5
thanks ! I'm using her list, personal input from vets, and my own recent labs.
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Post by bswitched on Jan 26, 2015 19:27:21 GMT -5
For those of you that use the vita lady service, approximately how much more a month do you think it costs you? I've been doing my vitamin shopping and comparing them to each other. I have not ruled out using the service after surgery. I'm currently getting started on some vitamins now to make sure my level are optimim before surgery. In doing this I've been looking at pricing and such.
Yes, my health is of upmost importance but keeping it real here, saving money is important too.
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Post by caprice on Jan 26, 2015 20:31:37 GMT -5
If you haven't already done so, I encourage to go to her website and take a look.
She offers the starter kits, tailored to the needs of the different surgeries, but she also offers everything individually, and in different size bottles, and different strengths, for many of the supplements.
It's a fairly easy site to navigate, so, give it a look. There's more than just vitamin and mineral supplements, too.
vitalady.com
Have fun!
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Post by bswitched on Jan 26, 2015 20:50:58 GMT -5
I have looked it all over many times even called to ask a question about the vitamins. I'm asking about other options for cost purposes. It seems like vitalady is what many seem to direct new people too. Just looking to keep options open and save some $$$ because this will be a forever expense I'm trying to streamline the bottom line if possible.
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Post by goodkel on Jan 27, 2015 4:28:08 GMT -5
We recommend the starter pack (and it is pricey) because it is a no-brainer. It has everything that you need to take in the correct dosages and formulations. Once you have finished it and have had your 3 month labs, you'll make adjustments. You can buy most of your vitamins from Costco or Walmart. The store brand generics at both places are excellent.
Everything except your Dry vitamins (A, D3, E, and K2) and some types of iron, you should be able to find easily locally and be able to shop for sales.
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