Getting Diagnosed With Prostate Cancer
I guess I should begin this blog with a little back story. I began running my sophomore year of high school, in 1975. I have been running pretty much ever since, in one form or another. I won't delve into details of my running or medical past prior to the prostate cancer unless it becomes pertinent along the way.
On November 23, 2015, I had a blood test done at the request of my doctor as part of my normal physical. When I went into the doctor's office to get my results, she said she had good news and bad news. The good news was I had perfect results for my age except for one thing. My PSA was high. The number was 9.674. The doctor went through a series of symptoms, I said no to all of them. She suggested I do a second blood test to verify the findings. When I got home, I looked up what PSA was, and what could make it higher than normal. I adjusted my diet(less red meat, more fruits, and veggies), and started drinking pomegranate juice. On February 24, 2016, I had a second blood test. I went in and got the results. My PSA had dropped to 7.5. The doctor saw this as encouraging, so told me to have a 3rd test in another 60 days to see if the trend continued. Unfortunately, my PSA went back up to 8.4. This time she suggested I see a urologist. The doctor's office recommended one, but when I hadn't heard anything for 6 weeks, I called the office and requested a different urologist. This time I got to make an appointment with Dr. Nalesnik. By this time it was August. I went in, fully expecting to get the one finger wave. Instead, he said based on my PSA numbers, I needed a biopsy. he made sure I knew there was about a 70% chance I didn't have cancer. I made the appointment for mid-September.
Now I know how people abducted by aliens feel. Thankfully the numbing gel worked great before the probe and 12 needles went in. 10 days later I ran a 5k, it was a little painful in the second half. I slowed, but still finished in 20:15. When I went in for the results of the biopsy, I took my wife Robin, just as I had for the biopsy. Dr. Nalesnik gave us the news that the biopsy had come back positive for cancer. One percent of the core on the right side, and four percent of the core on the left side tested positive, and my Gleason score was 3+3. The doctor spent over 30 minutes explaining our options, and we scheduled an appointment in 3 weeks to plan my treatment.
I decided to take this time and learn as much as I could about prostate cancer and the options I had. I read the Dr. Walsh book in one weekend. I read the book called Outsmarting your Cancer that is mostly about natural cures. I also interviewed guys I knew or heard of, that had gone through prostate cancer treatments. This was the best thing I did, and I highly recommend it to anyone facing the same options. I spoke or texted with Doug, Chuck, Tom, Don, Dave, Tim, Mark, Ben, and Andy. Most of them had surgery. One had HIFU, one had cryotherapy, and one had radiation. One had been through surgery in 2004, radiation in 2006, and was now going through chemotherapy. All said they were satisfied with the choices they had made. After doing this, and talking it over with my wife, we decided to have Dr. Nalesnik and his team perform DA Vince surgery. When we went back to the doctor's office, we informed them of our decision, and a surgery date of December 27, 2016, was set. In the meantime, I started doing Kegels. This would make the return to normal continence easier after surgery.
I aced my pre-op on December 22nd, so fast forward to the 27th. We got to the hospital, Kern Medical Center, on time, 5:45 a.m. Walked into the surgery waiting room and went right in. Blood pressure was high, but my pulse was only 56. Undressed and into the backless gown I went. The pre-op nurses were great. Robin came in after the IV was in. I remember meeting the doctor and his team. The anesthesiologist was a fellow red-headed runner. She said there would be no problems with me. I remember getting the happy juice before being wheeled into surgery. The room looked like a cool workshop with a surgical robot in the middle.The next thing I knew I was waking up, and the clock on the wall said 1. I think I slept again until 2. That's when I remember talking with my doctor and his assistant. My prostate was officially gone. He said it went well. It did not appear the cancer had left the prostate.He said my nerve bundles moved away from the sides easily, hopefully E.D. won't be an issue. The 2 months prior to surgery I had done my kegels 5 days a week, building up to over a hundred a day, and the doctor said my schpincter was textbook. Hopefully incontinence wont be long. I laid in the recovery room waiting for a bed in a real room. Other patients came and went. Robin started getting upset. She didn't want to leave until I was in a room. She was getting really tired, so I got her to leave at 7:30. I didn't care if I was in a room, I felt good. Finally, at 9:30, I was wheeled to a room. Before I left I asked the nurse to call my house and relay the room number to Robin, and ask her to bring a pillow for my lap for the ride home the next day. One thing that the doctor stressed was keeping my catheter and urine bag safe. He told me to treat it like a briefcase full of a million dollars worth of jewels. First thing that happens to me in my new room is a nurse catches my urine bag on a chair she was trying to scoot out of the way. It was not a quiet scream I let out, and the bag was safe. I had the nurse turn on my light, and I started reading. My new roommate was snoring or coughing into a bowl, so I didn't sleep much. At 5 a.m. I got checked out, and blood taken. At 7 a.m. the doctor comes in, says my blood was fine. I can go home after I walk, fart, burp, and Robin picks up my prescriptions. Robin shows up feeling much better than when she went home. Sleep is awesome. Robin went to get the prescriptions, PT showed up and I went for a walk. PT guy got his degree at UC Davis. To the red mark on the hallway wall and back we walked. I passed the PT test. Almost done. Robin came back. The pharmacy was short on 2 of the prescriptions. Told her to come back Saturday morning to get the rest. Nurse practitioner Shiva was next. She changed the dressing under my girdle/bandage, and hooked my catheter up to a travel bag. She gave us extra bags and other wonderful stuff to take home, including her cell number in case I had any problems. Two lunches come for me, one liquid, and one Chinese. I nibble at the Chinese food, anxious to leave. One of my nurses came in to check something, and we're asking when I can leave. She leaves, comes back to say the doctor forgot to sign the patient release after it was filled out. First I couldn't get in a room, now I can't get out. 1 1/2 hours later, signature is obtained, and I'm wheeled out, prostate free. The ride home was uneventful, save for some potholes and sharp turns.
Being home brought me face to face with Maggie, our Husky mix. Luckily she was understanding, and just laid at my feet. Now that I was home, it was time to start my home meds, take short walks, and sleep. We made a bed out of the recliner. For the next 13 days my life would be based out of that recliner. It was easy to hang the urine bag from, and I could watch bad T.V. to my hearts content. All that changed about 2:00 a.m. Thursday morning. I woke up and started vomiting. Not a pleasant thing after abdominal surgery. This woke Robin, my wonder nurse. She was kind enough to empty the bowl I had used, and gave me one of the anti nausea pills the doctor had prescribed. Needless to say I had lost my appreciation for clam chowder and Gatorade. Thinking the pain pill caused the vomiting, I quit taking them, and switched to extra strength Tylenol, continuing the antibiotics that were prescribed. Later that morning, after the sun had risen, I resumed the vomiting, and threw some diarrhea in just for fun. Still, the anti nausea pills weren't working. Robin re read the pages of info that came with the prescriptions. The antibiotics papers said it(septra-ds) could cause nausea, vomiting, and diarrhea. I quit taking them, and soon felt better. It was late Thursday, and lucky for us, nurse practitioner Shiva had given us her cell number in case we had any issues since we lived so far away. She told us to stop the drug, and she called in a different prescription to the pharmacy. Friday, December 30th, Robin headed back to Bakersfield to pick up my new antibiotics prescription, along with the remainder of the prescriptions that weren't ready when I checked out. When she got to the pharmacy, it was closed. Again she looked up Shiva, who called in the prescription to a different pharmacy. Only catch, we would have to pay out of pocket for the prescriptions since the pharmacy that was closed had already billed the insurance company. A couple hours, and one chick-fil-a sandwich later she was headed home. The new antibiotics were Keflex. The bottle said to take 4 a day, so I got 2 in me before bedtime. No nausea, vomiting, or diarrhea. Life with a catheter just got a little better. On the 31st I was able to walk almost 200 steps, and get closer to standing up straight again. I had pain in my lower right abdomen, especially when I coughed. New Year's eve, my catheter and I were asleep by 9. The next day was 2017. It was a beak from college football bowl games, there were pro games.
The new year also brought a new problem. I was getting a rash in spots on my upper torso. By January 2nd, my rash had spread. We called the doctor, and I was told to quit taking the Keflex. The good thing is I was up to over 800 steps on the treadmill. Life was getting better. January 3rd saw the return of daycare, and Robin driving back to Bakersfield after daycare to get the rest of my prescriptions. My walking on the treadmill continued to improve. January 4th I topped 2400 steps. The walking got easier. I had a canvas bag attached to the treadmill handle I put the Foley bag in. The 5th saw me hit 2700 steps. I was also feeling tired. I didn't do the steps non stop. I worked up to 10 minutes straight, and walked every couple of hours. Walking also seemed to help get the bowels moving. January 9th couldn't get here fast enough. That was when the catheter would be removed, and I would get the results of my pathology test of my prostate after it was removed. On the 9th I hooked the travel bag to the catheter, and off we went to the hospital. Originally, my appointment was at the doctor's office, but before I was discharged from the hospital, the doctor told me to come to the hospital instead, as he would be working there that day, and he would take care of changing the appointment.
When we arrived and checked in, we found out that something had fallen through the cracks, as the nurse insisted that we were at the wrong place. After some phone calls and discussion, it was decided we were at the right place. I didn't have to wait to long before being called into an exam room. This was the smallest exam room I have ever seen.It was obviously built before America got fat. The doctor came in and gave me the news. The pathology report showed my cancer was more aggressive than the biopsy had shown. The Gleason score was moved up to 4+3 from 3+3. The cancer was only in 10% of the prostate, but it was all near the bladder, and it had reached the edge of the prostate. I had a positive margin. The pathology report on the lymph nodes came back cancer free. My decision to have the prostate removed turned out to be the right one as far as I'm concerned. With the pleasantries over, it was time for fun. First the removal of the 16 staples in 4 of my incisions. It wasn't too painful or ticklish. Next up the removal of the catheter. First the balloon inside the bladder was drained, then out came the catheter. Not too painful either, but also not the most fun thing that's happened to my penis. Immediately I dribbled urine before I could get my diaper on. I decided to start with diapers instead of pads because I didn't know what to expect. Especially since we had a 50 minute drive home. Every move I made, I peed myself. No matter how hard I tried, pee just came out, like I still had the catheter. The doctor wanted to see me again on February 13th, so we made the appointment with the nurse. He also wants me to have a blood test for PSA the week before, I will do that near home, and bring the results with me. Robin got us to the car, and off we went to the 24th street Cafe. This was a Fantastic little cafe in Bakersfield near the hospital. I had eggs and fried green tomatoes. They were awesome. For the first time in 2 weeks I got behind the wheel and drove us home, dribbling on myself all the way, The diaper was the right choice for me. I went to work the next day, and I work standing up and walking a lot. This meant I was peeing myself constantly. I think the first day I went through 2 diapers in 7 hours. I did build a Subaru head between trips to the bathroom. My problem was I couldn't get my bladder to store any urine. As fast as I drank water, I peed myself every time I moved. By the time I got to the bathroom there was nothing left to pee into the toilet. Soon I discovered that if I sat down, I could keep some liquid in me, and if I was lucky, waddle to the bathroom and pee into the toilet. I say waddle because I was trying to walk and do a kegel at the same time so I wouldn't pee myself. This was very frustrating for me. I knew that I would be incontinent for a while, but it seemed to me I was peeing more than dribbling. I did a little research on the Internet, and I learned that the bladder, while I had the catheter in, no longer functioned like it used to. It wasn't filling up, then telling me it was time to find a place to empty. It just had the tap open, and out ran the fluids. This seemed to me to be similar to muscles that haven't been used, and have to get back into shape. Since I could sit, and retain fluids better than standing, I started drinking more fluids when I sat. My theory was my bladder had shrunk due to not being used normally, so if I could drink fluids in a sitting position without constantly peeing, it should stretch out some. By the time the weekend came, I had a plan. I was going to sit and drink water. First I slept 11 hours straight after my 4 days of work. I quickly learned that I could sit for 2 hours, drinking water, not pee myself, and make it to the toilet with hardly a dribble. All this time I had also restarted my kegel exercises. In fact, I did so many kegels it hurt to sit down. Feeling encouraged by my ability to sit and not pee, I decided to switch from diapers to pads. Maximum absorption Depends. I wore the pads for the first time over night on Saturday. I only dribbled a little, and woke up twice to pee. So sitting and sleeping were getting better as far as incontinence went. When I was on my feet, I was still frustrated by the dribbling. My time on the treadmill went to 30 minutes walking nonstop at 2.5 mph, but I had to change my pad as soon as I was done. The 1st weekend without the catheter I did 30 minutes each day on the treadmill, not wanting to over do my walking like I had with my kegels. Monday, January 16th, I went back to work in a pad, not a diaper.
On November 23, 2015, I had a blood test done at the request of my doctor as part of my normal physical. When I went into the doctor's office to get my results, she said she had good news and bad news. The good news was I had perfect results for my age except for one thing. My PSA was high. The number was 9.674. The doctor went through a series of symptoms, I said no to all of them. She suggested I do a second blood test to verify the findings. When I got home, I looked up what PSA was, and what could make it higher than normal. I adjusted my diet(less red meat, more fruits, and veggies), and started drinking pomegranate juice. On February 24, 2016, I had a second blood test. I went in and got the results. My PSA had dropped to 7.5. The doctor saw this as encouraging, so told me to have a 3rd test in another 60 days to see if the trend continued. Unfortunately, my PSA went back up to 8.4. This time she suggested I see a urologist. The doctor's office recommended one, but when I hadn't heard anything for 6 weeks, I called the office and requested a different urologist. This time I got to make an appointment with Dr. Nalesnik. By this time it was August. I went in, fully expecting to get the one finger wave. Instead, he said based on my PSA numbers, I needed a biopsy. he made sure I knew there was about a 70% chance I didn't have cancer. I made the appointment for mid-September.
Now I know how people abducted by aliens feel. Thankfully the numbing gel worked great before the probe and 12 needles went in. 10 days later I ran a 5k, it was a little painful in the second half. I slowed, but still finished in 20:15. When I went in for the results of the biopsy, I took my wife Robin, just as I had for the biopsy. Dr. Nalesnik gave us the news that the biopsy had come back positive for cancer. One percent of the core on the right side, and four percent of the core on the left side tested positive, and my Gleason score was 3+3. The doctor spent over 30 minutes explaining our options, and we scheduled an appointment in 3 weeks to plan my treatment.
I decided to take this time and learn as much as I could about prostate cancer and the options I had. I read the Dr. Walsh book in one weekend. I read the book called Outsmarting your Cancer that is mostly about natural cures. I also interviewed guys I knew or heard of, that had gone through prostate cancer treatments. This was the best thing I did, and I highly recommend it to anyone facing the same options. I spoke or texted with Doug, Chuck, Tom, Don, Dave, Tim, Mark, Ben, and Andy. Most of them had surgery. One had HIFU, one had cryotherapy, and one had radiation. One had been through surgery in 2004, radiation in 2006, and was now going through chemotherapy. All said they were satisfied with the choices they had made. After doing this, and talking it over with my wife, we decided to have Dr. Nalesnik and his team perform DA Vince surgery. When we went back to the doctor's office, we informed them of our decision, and a surgery date of December 27, 2016, was set. In the meantime, I started doing Kegels. This would make the return to normal continence easier after surgery.
I aced my pre-op on December 22nd, so fast forward to the 27th. We got to the hospital, Kern Medical Center, on time, 5:45 a.m. Walked into the surgery waiting room and went right in. Blood pressure was high, but my pulse was only 56. Undressed and into the backless gown I went. The pre-op nurses were great. Robin came in after the IV was in. I remember meeting the doctor and his team. The anesthesiologist was a fellow red-headed runner. She said there would be no problems with me. I remember getting the happy juice before being wheeled into surgery. The room looked like a cool workshop with a surgical robot in the middle.The next thing I knew I was waking up, and the clock on the wall said 1. I think I slept again until 2. That's when I remember talking with my doctor and his assistant. My prostate was officially gone. He said it went well. It did not appear the cancer had left the prostate.He said my nerve bundles moved away from the sides easily, hopefully E.D. won't be an issue. The 2 months prior to surgery I had done my kegels 5 days a week, building up to over a hundred a day, and the doctor said my schpincter was textbook. Hopefully incontinence wont be long. I laid in the recovery room waiting for a bed in a real room. Other patients came and went. Robin started getting upset. She didn't want to leave until I was in a room. She was getting really tired, so I got her to leave at 7:30. I didn't care if I was in a room, I felt good. Finally, at 9:30, I was wheeled to a room. Before I left I asked the nurse to call my house and relay the room number to Robin, and ask her to bring a pillow for my lap for the ride home the next day. One thing that the doctor stressed was keeping my catheter and urine bag safe. He told me to treat it like a briefcase full of a million dollars worth of jewels. First thing that happens to me in my new room is a nurse catches my urine bag on a chair she was trying to scoot out of the way. It was not a quiet scream I let out, and the bag was safe. I had the nurse turn on my light, and I started reading. My new roommate was snoring or coughing into a bowl, so I didn't sleep much. At 5 a.m. I got checked out, and blood taken. At 7 a.m. the doctor comes in, says my blood was fine. I can go home after I walk, fart, burp, and Robin picks up my prescriptions. Robin shows up feeling much better than when she went home. Sleep is awesome. Robin went to get the prescriptions, PT showed up and I went for a walk. PT guy got his degree at UC Davis. To the red mark on the hallway wall and back we walked. I passed the PT test. Almost done. Robin came back. The pharmacy was short on 2 of the prescriptions. Told her to come back Saturday morning to get the rest. Nurse practitioner Shiva was next. She changed the dressing under my girdle/bandage, and hooked my catheter up to a travel bag. She gave us extra bags and other wonderful stuff to take home, including her cell number in case I had any problems. Two lunches come for me, one liquid, and one Chinese. I nibble at the Chinese food, anxious to leave. One of my nurses came in to check something, and we're asking when I can leave. She leaves, comes back to say the doctor forgot to sign the patient release after it was filled out. First I couldn't get in a room, now I can't get out. 1 1/2 hours later, signature is obtained, and I'm wheeled out, prostate free. The ride home was uneventful, save for some potholes and sharp turns.
Being home brought me face to face with Maggie, our Husky mix. Luckily she was understanding, and just laid at my feet. Now that I was home, it was time to start my home meds, take short walks, and sleep. We made a bed out of the recliner. For the next 13 days my life would be based out of that recliner. It was easy to hang the urine bag from, and I could watch bad T.V. to my hearts content. All that changed about 2:00 a.m. Thursday morning. I woke up and started vomiting. Not a pleasant thing after abdominal surgery. This woke Robin, my wonder nurse. She was kind enough to empty the bowl I had used, and gave me one of the anti nausea pills the doctor had prescribed. Needless to say I had lost my appreciation for clam chowder and Gatorade. Thinking the pain pill caused the vomiting, I quit taking them, and switched to extra strength Tylenol, continuing the antibiotics that were prescribed. Later that morning, after the sun had risen, I resumed the vomiting, and threw some diarrhea in just for fun. Still, the anti nausea pills weren't working. Robin re read the pages of info that came with the prescriptions. The antibiotics papers said it(septra-ds) could cause nausea, vomiting, and diarrhea. I quit taking them, and soon felt better. It was late Thursday, and lucky for us, nurse practitioner Shiva had given us her cell number in case we had any issues since we lived so far away. She told us to stop the drug, and she called in a different prescription to the pharmacy. Friday, December 30th, Robin headed back to Bakersfield to pick up my new antibiotics prescription, along with the remainder of the prescriptions that weren't ready when I checked out. When she got to the pharmacy, it was closed. Again she looked up Shiva, who called in the prescription to a different pharmacy. Only catch, we would have to pay out of pocket for the prescriptions since the pharmacy that was closed had already billed the insurance company. A couple hours, and one chick-fil-a sandwich later she was headed home. The new antibiotics were Keflex. The bottle said to take 4 a day, so I got 2 in me before bedtime. No nausea, vomiting, or diarrhea. Life with a catheter just got a little better. On the 31st I was able to walk almost 200 steps, and get closer to standing up straight again. I had pain in my lower right abdomen, especially when I coughed. New Year's eve, my catheter and I were asleep by 9. The next day was 2017. It was a beak from college football bowl games, there were pro games.
The new year also brought a new problem. I was getting a rash in spots on my upper torso. By January 2nd, my rash had spread. We called the doctor, and I was told to quit taking the Keflex. The good thing is I was up to over 800 steps on the treadmill. Life was getting better. January 3rd saw the return of daycare, and Robin driving back to Bakersfield after daycare to get the rest of my prescriptions. My walking on the treadmill continued to improve. January 4th I topped 2400 steps. The walking got easier. I had a canvas bag attached to the treadmill handle I put the Foley bag in. The 5th saw me hit 2700 steps. I was also feeling tired. I didn't do the steps non stop. I worked up to 10 minutes straight, and walked every couple of hours. Walking also seemed to help get the bowels moving. January 9th couldn't get here fast enough. That was when the catheter would be removed, and I would get the results of my pathology test of my prostate after it was removed. On the 9th I hooked the travel bag to the catheter, and off we went to the hospital. Originally, my appointment was at the doctor's office, but before I was discharged from the hospital, the doctor told me to come to the hospital instead, as he would be working there that day, and he would take care of changing the appointment.
When we arrived and checked in, we found out that something had fallen through the cracks, as the nurse insisted that we were at the wrong place. After some phone calls and discussion, it was decided we were at the right place. I didn't have to wait to long before being called into an exam room. This was the smallest exam room I have ever seen.It was obviously built before America got fat. The doctor came in and gave me the news. The pathology report showed my cancer was more aggressive than the biopsy had shown. The Gleason score was moved up to 4+3 from 3+3. The cancer was only in 10% of the prostate, but it was all near the bladder, and it had reached the edge of the prostate. I had a positive margin. The pathology report on the lymph nodes came back cancer free. My decision to have the prostate removed turned out to be the right one as far as I'm concerned. With the pleasantries over, it was time for fun. First the removal of the 16 staples in 4 of my incisions. It wasn't too painful or ticklish. Next up the removal of the catheter. First the balloon inside the bladder was drained, then out came the catheter. Not too painful either, but also not the most fun thing that's happened to my penis. Immediately I dribbled urine before I could get my diaper on. I decided to start with diapers instead of pads because I didn't know what to expect. Especially since we had a 50 minute drive home. Every move I made, I peed myself. No matter how hard I tried, pee just came out, like I still had the catheter. The doctor wanted to see me again on February 13th, so we made the appointment with the nurse. He also wants me to have a blood test for PSA the week before, I will do that near home, and bring the results with me. Robin got us to the car, and off we went to the 24th street Cafe. This was a Fantastic little cafe in Bakersfield near the hospital. I had eggs and fried green tomatoes. They were awesome. For the first time in 2 weeks I got behind the wheel and drove us home, dribbling on myself all the way, The diaper was the right choice for me. I went to work the next day, and I work standing up and walking a lot. This meant I was peeing myself constantly. I think the first day I went through 2 diapers in 7 hours. I did build a Subaru head between trips to the bathroom. My problem was I couldn't get my bladder to store any urine. As fast as I drank water, I peed myself every time I moved. By the time I got to the bathroom there was nothing left to pee into the toilet. Soon I discovered that if I sat down, I could keep some liquid in me, and if I was lucky, waddle to the bathroom and pee into the toilet. I say waddle because I was trying to walk and do a kegel at the same time so I wouldn't pee myself. This was very frustrating for me. I knew that I would be incontinent for a while, but it seemed to me I was peeing more than dribbling. I did a little research on the Internet, and I learned that the bladder, while I had the catheter in, no longer functioned like it used to. It wasn't filling up, then telling me it was time to find a place to empty. It just had the tap open, and out ran the fluids. This seemed to me to be similar to muscles that haven't been used, and have to get back into shape. Since I could sit, and retain fluids better than standing, I started drinking more fluids when I sat. My theory was my bladder had shrunk due to not being used normally, so if I could drink fluids in a sitting position without constantly peeing, it should stretch out some. By the time the weekend came, I had a plan. I was going to sit and drink water. First I slept 11 hours straight after my 4 days of work. I quickly learned that I could sit for 2 hours, drinking water, not pee myself, and make it to the toilet with hardly a dribble. All this time I had also restarted my kegel exercises. In fact, I did so many kegels it hurt to sit down. Feeling encouraged by my ability to sit and not pee, I decided to switch from diapers to pads. Maximum absorption Depends. I wore the pads for the first time over night on Saturday. I only dribbled a little, and woke up twice to pee. So sitting and sleeping were getting better as far as incontinence went. When I was on my feet, I was still frustrated by the dribbling. My time on the treadmill went to 30 minutes walking nonstop at 2.5 mph, but I had to change my pad as soon as I was done. The 1st weekend without the catheter I did 30 minutes each day on the treadmill, not wanting to over do my walking like I had with my kegels. Monday, January 16th, I went back to work in a pad, not a diaper.
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