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Painful hysteroscopy

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Thanks so much for taking time to share your experience. Glad it worked out well for you. 
 

That’s an excellent idea, the ‘dry run.’ Is that widely available, I wonder? I’m sure colleagues will let us know! 

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I had this procedure on Monday and i consider my pain threshold to be pretty good. It was brutally painful. Horrendous. On the pain scale, on a par with breaking my back - although obviously a totally different type of pain. I felt faint and it was breathtakingly agonising. I cried throughout and have NEVER cried because of pain like that before 

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Hi Dawn,  so sorry to hear this has happened to you.  What an awful experience. Unfortunately you are far from being alone with feeling extreme pain with hysteroscopy.  Research has shown that 1 in 4 women will experience severe pain. I hope this was explained to you before your procedure and you were given the opportunity to have it carried out under general anaesthetic or sedation. The RCOG guidelines state that all of this should be discussed with women prior to the procedure but unfortunately this very often doesn't happen.  Also the procedure should have been stopped given the pain and distress you experienced. The Campaign Against Painful Hysteroscopy is working tirelessly to bring about change but its an uphill battle.  Men would never be expected to go through a procedure this painful without anaesthetic.   Are you on facebook?  If so the campaign has a facebook page and from there you can ask to join a private group where women who have had a bad hysteroscopy experience can talk about it and support each other. Or message  https://www.hysteroscopyaction.org.uk/contact-us/.  I hope you begin to feel better very soon.

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11 hours ago, Dawn said:

I had this procedure on Monday and i consider my pain threshold to be pretty good. It was brutally painful. Horrendous. On the pain scale, on a par with breaking my back - although obviously a totally different type of pain. I felt faint and it was breathtakingly agonising. I cried throughout and have NEVER cried because of pain like that before 

Hello Dawn,

So sorry to hear of your brutal experience at the hands of the NHS; sadly you are not alone. 

Please seek support if you feel you need to speak to someone about your experience; I wish that I that I'd had the courage to seek support as I now struggle dealing with the NHS for other issues such as my Covid-19 vaccinations and health check. Thankfully I have a supportive GP surgery.

Not all NHS staff behave like this so please don't let this experience put you off seeking treatment for any other issues, most of the staff are supportive.

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I had this procedure on Monday and i consider my pain threshold to be pretty good. It was brutally painful. Horrendous. On the pain scale, on a par with breaking my back - although obviously a totally different type of pain. I felt faint and it was breathtakingly agonising. I cried throughout and have NEVER cried because of pain like that before 

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Thank you for your reply. The staff were actually amazingly supportive - probably because they knew how excoriating it was going to be. They couldn’t have been more supportive or any kinder. My issue is why, when its clearly known how painful it is, (the disclaimer you sign prior to the procedure), you aren’t given at the very least a local anaesthetic beforehand. 

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The Campaign Against Painful Hysteroscopy hears this all the time - "It was like being tortured by nice people".  Regardless of how supportive and kind they were, they should not have let the procedure continue if you were showing signs of severe pain and distress which you clearly were (see below).  They do it without anaesthetic to save money. The hospitals aren't paid any more for hysteroscopies for GA in Day wards or conscious sedation with analgesia in OP which requires an anaesthetist, but they are clearly more costly. There seems to be a myth that women can endure pain because of childbirth, periods etc., so ok to do in outpatients.  In some clinics gas and air is available and sometimes women are offered local anaesthetic into the cervix, but research shows that this is largely ineffective for pain control.  Also the manufacturers of the hysteroscopes use the discomfort/acceptability/cost-saving factors to sell their equipment, thus compounding the myth.  They also give free training to hysteroscopists and pay for gynaecology conferences.

Below are the key points from the RCOG patient information leaflet.  All of this should have been explained to you before the procedure and before you signed the consent form, otherwise it isn't informed consent.  Too many gynae depts don't even tell their patients it might be painful, preferring to say you might feel cramping like period pains.  Nothing could be further from the truth for so many women.  It just destroys trust and many women won't return for more procedures, not even regular smear tests.

Sorry, this has turned into a bit of a rant.  I had my procedure 8 years ago and become increasingly angry hearing that more and more women are suffering this barbaric procedure in this unnecessary way.  I've attached a couple of links below - one is to Care Opinion where you can post anonymously about the hospital and your experience - you'll find a lot of hysteroscopy accounts on there.  The other is to CAPH's survey - click on survey on Hysteroscopy Action webpage.  If you are on twitter you can follow the campaign @HysteroscopyA.

Best wishes for your recovery.

https://www.careopinion.org.uk/

https://www.hysteroscopyaction.org.uk/

https://www.rcog.org.uk/en/patients/patient-leaflets/outpatient-hysteroscopy/

 

Key points

  • Outpatient hysteroscopy (OPH) is a procedure carried out in the outpatient clinic that involves examination of the inside of your uterus (womb) with a thin telescope.
  • There are many reasons why you may be referred for OPH, such as to investigate and/or treat abnormal bleeding, to remove a polyp seen on a scan or to remove a coil with missing threads.
  • The actual procedure usually takes 10–15 minutes. It can take longer if you are having any additional procedures.
  • You may feel pain or discomfort during OPH. It is recommended that you take pain relief 1–2 hours before the appointment.
  • If it is too painful, it is important to let your healthcare professional know as the procedure can be stopped at any time.
  • You may choose to have the hysteroscopy under general anaesthetic. This will be done in an operating theatre, usually as a daycase procedure.
  • Possible risks with hysteroscopy include pain, feeling faint or sick, bleeding, infection and rarely uterine perforation (damage to the wall of the uterus). The risk of uterine perforation is lower during OPH than during hysteroscopy under general anaesthesia. 
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Since April 2021 I’ve been seeing my doctor regarding heavy periods, uncontrollable pain, bloating and skin issues. I’m 26 and trying to have a child for the last year. Nothing was working.

upon seeing my doctor she could tell straight away by my face how much pain I was in and gave me anti-inflammatorys and Co-Codamol. I was then red flag to the gynaecologist.

 

I was seen 6 weeks later for an internal ultrasound. I found this painful but bearable, when looking at the scan she told me I had fibroids or polyps lining my uterus and would be refer for a hysteroscopy. I received a leaflet that day telling me what to expect.

 

4 weeks later I got my appointment, was dreading it and due to covid rules I wasn’t allowed anyone with me. I was told that it could be uncomfortable and that woman who hadn’t had chiller usually find it harder and it doesn’t always work, so don’t be disappointed. My consulted was lovely and the nurses were great. Sat in the chair raised up in the air with a Bucket placed underneath me. She entered my cervix and all was good, but the neck of my uterus was unusually small. I screamed in pain, felt faint, sick and thought I was going to pass out. She stopped and got me gas and air. It done nothing for me as she attempted again. Nothing didn’t work and told me I would be refer for GA. I went home cried, slept and was in the worse pain for 5 days.

Fastforward to 2 days ago. I had my hysteroscopy under GA, hospital was great and there were 8 woman 4 morning and 4 afternoon all having similar procedures so was nice to know I wasn’t alone. However I was the youngest and the rest were above 50, so I was alone in the sense of being there for different reasons. Went to sleep at 2.30ish and woke up at 4.30. My procedure seemed to run longer than expected. I woke up crying, I was in horrible pain and they had to give me 10ml of whatever painkiller they gave me. That knocked my pain from a 8 down to a 3. The nurse placed a pad in between my legs and then 2nurses rolled me and another checked my back and placed a pad under my bum to stop the blood from running over me. My uterus was filled with Saline during the procedure so that was also coming out. My consultant came to speak with me, I had no polyps or fibroids but my uterus was that thick and bulky it acted like one. This was abnormal and a biopsy was taken, my cervix is also unusually small and tight that she cut me on the way out. I bleed heavily while in hospital and told to keep and eye on this at home.
 

Since being home, I’ve been in pain pretty much all day. I have only eaten minimal food, drank what I can. I have pain peeing, lifting my arms in the air and get massive stabbing pains in my side. I was told the risk of infection is less than 1 in 100 and told to keep and eye on certain things. Currently I haven’t passed a number 2 and can’t have any weight on my tummy. Clothes feel tight and now I’m playing a waiting game on my results. 

 

 

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I’ve just had a hysteroscopy today. Well- it failed. 
I have long term heavy bleeding which has increased in frequency and also an ovarian cyst/endometriosis. I was referred for this procedure to check fro any abnormalities in the womb. 
Ive already had one attempt that was very painful right from when the speculum went in but the sample taken was insufficient. The pain was bad but not unbearable. I felt very emotional afterwards but I’m unsure why. 
Today was a reattempt with local anaesthetic gel and injection. Again it was painful right from the speculum, the injection and I could feel intense tugging pain inside my tummy abs she hadn’t even managed to get into the womb. 
The procedure was stopped- luckily by the doctor as I felt I should tolerate it and continue. I dread to think what the pain would have been like if I had. The doctor said she was unable to get into my womb as the neck of it was scarred badly from my 2 precious c sections. By this point I was sobbing- for some reason this procedure is very traumatic for me. Connnected to my trauma during birth maybe? 
I’ve been added to the waiting list to have the procedure done under a general but I am lucky enough to have private healthcare under my husbands work so am taking that route instead. 
I found this procedure more traumatic than both my emergency c sections and I don’t think I could ever do it again. I now worry about how a simple smear will affect me which I’ve been able to manage in the past. 
I don’t feel I was well enough informed. I expected the procedure with local to be ok- it was actually much worse for some reason. My private consultant is doing this procedure under a general. Enough said. 

 

 

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I was utterly terrified going into this procedure due to reviews online, and whilst it was awful, I was lucky that it wasn't as bad for me as for some (and I would like to say I'm a wuss as far as pain goes).  I had mine at the Royal Hallamshire in Sheffield (UK).

I took two paracetemol and a mefanamic acid (a godsend) an hour before, and rung in advance to check if I would be able to get the gas and air (I have respiratory issues) which they were able to confirm I could.  I would recommend ringing up with queries before so you maybe feel a bit relaxed.

I pretty much broke down the minute I got in there and was shaking with fear and the staff were so thoughtful.  They explained I didn't have to have it, could stop if it hurt too much etc so I decided to try.  I was given the gas and air from the beginning, which combined with the drugs I'd taken did help but it wasn't without pain.

I struggle with speculums and explained that.  I find it super painful and that was awful but required for part of the procedure, and they tried to use the smallest one on my request and complete that part as soon as possible.

The gyno tried without anaesthetic but my cervix wasn't playing ball so I had 3 injections into it which thanks to the prior drugs and gas/air wasn't too bad, then he dilated it.  Once the speculum came out (once the camera was in) I felt a lot more comfy and just had some sharp period cramps at various points (again dampened by the pain relief) as well as the weird feeling when they fill you with water.

Afterwards I just felt very sore internally and had bleeding, but less than I do on my period as they are super heavy.

I have to go back for a spinal for them to take out some fibroids, as the gyno suggested that would be best for my comfort.

I would recommend the pre-drugs and explaining beforehand that you want all the pain relief.  I wouldn't want to do it again but based on this experience I wouldn't be as terrified the next time.  I wish anyone who is having one good luck :)

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Sorry peoples experiences terrified you. It certainly is not the aim. The aim is to inform you of the alternatives. Because you were forewarned you were able to express your preferences for pain relief. This has been sadly denied to so many including myself. Not knowing if you ask the procedure to stop there is an alternative? I see you took over counter meds, recieved pain relief to cervix & had access to gas and air, however you still describe the experience as awful, not without pain, the fact you struggle with speculum too all suggests you didnt recieve adequate care, in my opinion. Thankfully you went into the room with prior knowledge so that it made it tolerable for you. Wish you well for your next procedure for fibroid removal with spinal sedation.  

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8 hours ago, SarahFox said:

I was utterly terrified going into this procedure due to reviews online, and whilst it was awful, I was lucky that it wasn't as bad for me as for some (and I would like to say I'm a wuss as far as pain goes).  I had mine at the Royal Hallamshire in Sheffield (UK).

I took two paracetemol and a mefanamic acid (a godsend) an hour before, and rung in advance to check if I would be able to get the gas and air (I have respiratory issues) which they were able to confirm I could.  I would recommend ringing up with queries before so you maybe feel a bit relaxed.

I pretty much broke down the minute I got in there and was shaking with fear and the staff were so thoughtful.  They explained I didn't have to have it, could stop if it hurt too much etc so I decided to try.  I was given the gas and air from the beginning, which combined with the drugs I'd taken did help but it wasn't without pain.

I struggle with speculums and explained that.  I find it super painful and that was awful but required for part of the procedure, and they tried to use the smallest one on my request and complete that part as soon as possible.

The gyno tried without anaesthetic but my cervix wasn't playing ball so I had 3 injections into it which thanks to the prior drugs and gas/air wasn't too bad, then he dilated it.  Once the speculum came out (once the camera was in) I felt a lot more comfy and just had some sharp period cramps at various points (again dampened by the pain relief) as well as the weird feeling when they fill you with water.

Afterwards I just felt very sore internally and had bleeding, but less than I do on my period as they are super heavy.

I have to go back for a spinal for them to take out some fibroids, as the gyno suggested that would be best for my comfort.

I would recommend the pre-drugs and explaining beforehand that you want all the pain relief.  I wouldn't want to do it again but based on this experience I wouldn't be as terrified the next time.  I wish anyone who is having one good luck 🙂

I'm very pleased it went well for you, Sarah.  I don't want to rain on your parade but think it might be useful for others to know how your experience might differ to experiences in other hospitals. Sheffield Hallamshire is known to be better than most at managing pain in hysteroscopy with spinal anaesthesia and others including gas and air being available - these aren't available in most hospitals for outpatient hysteroscopy. It is questioned by many gynos as to whether local anaesthetic to the cervix has any effect against pain, but maybe yours team allowed enough time for it to become effective before continuing, something else that often doesn't happen, and were adept in applying this local. They also explained to you that you could stop the procedure if too painful and what would happen if they did - something else that often doesn't happen. A final observation - if GA or spinal is available, why are women being subjected to painful procedures without. Does this happen to men? Best wishes for your future procedures. 

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I’ve been reading the stories of other woman here and it leaves me completely in shock. 
I’ve had 5 hysteroscopy’s myself (and the sixth scheduled for the day after tomorrow). All my experiences were good and nothing barbaric or to painful. 

The first hysteroscopy was because a polyp was suspected on ultrasound. Entering the womb was a little painful, the gynecologist paused at that point till the pain subsided a little and told me she was nearly there. Two seconds later she was in my womb and the pain completely gone. Taking a sample and removing a polyp I didn’t feel at all. VAS (1-10) was 3 during the procedure. She inserted an IUD afterwards what was way more painful. 

The second hysteroscopy (different hospital, different gynecologist) was because my IUD was in my cervix, to see if she was able to move it up higher in my uterus. VAS 1, most uneventful thing ever. She wasn’t able to properly locate the IUD because I have a heartshaped uterus. 

The third hysteroscopy was to determine how big the ‘heartshape’ was due to the fact I wanted to become pregnant and wanted to now how the shape could affect a pregnancy. This was the most uncomfortable hysteroscopy, because she had trouble passing my IUD which was still in place. VAS 5, but only at the moment of passing the IUD - afterwards I was fine during the remain of the hysteroscopy. 

The fourth hysteroscopy was to remove my IUD, as the strings were no longer visible and they were unable to remove it the normal way. It was actually less painful than the normal IUD removal attempted. VAS 1. 

The fifth hysteroscopy was to see if there was any evidence for asherman, as IUI procedures were difficult and I remained unpregnant. I was fine again, VAS 3 max, but she wasn’t able to enter my uterus - she couldn’t find the way through the cervix. 

So now I’m going for a new try this Thursday and I am completely relaxed in the process. Yes, it was painful some times, but only for a short amount of time, nothing I couldn’t handle with just a focus on my breathing and all doctors (had 3 different gynecologists) where wonderful and kind. 

I was able to drive myself home after every scopy, took only 500mg naproxen beforehand and was given the option to having the hysteroscopy with sedation/GA every time. For me that wasn’t necessary and I was happy to be awake, able to see what was going on at the monitor and feeling completely fine afterwards so I went home myself within 10 minutes after finishing the procedure. 
The insertion of an IV needed to administer sedation/GA is more terrifying and more painful for me.

I wasn’t the ideal candidate for a hysteroscopy, never had children, history of sexual abuse (so every gyn exam is difficult), scared what to expect the first few times, but I chose myself to try it without sedation/GA, and everything went well. Prefere a hysteroscopy above a PAP. 

I just want to tell my story because it can be alright, I would do it again with no doubt tomorrow (o wait, I am), found it way easier than an IUD insertion.
The most important is that you’re able to give informed consent. But if they say it isn’t that painful, for a lot of woman that is the truth, but those woman are less likely to share their story because it wasn’t that eventful. 
I hear your stories and my heart is filled with pain, because the way you have felt and been treated is not okay, nor is the amount of pain you are describing. I feel sorry for you all. 
 

~ Sorry for my non native English

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Thank you for your story. It's great to hear positive outcomes. The reason for my and others pain is we are post menopausal. The cervix closes/ narrows, when the hysterscope is forced through it causes severe pain, shock ect.

Wish you well for your future. Xx

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I have just had a hysteroscopy on the 2 week wait pathway for post menopausal bleeding, which was carried out under general anaesthetic as a daycase procedure at the William Harvey Hospital in Ashford. I feel so fortunate reading the horrific stories of what other women have been through. The gynaecologist I saw at clinic carried out an internal examination and said there was no way I could have an outpatient hysteroscopy as he could immediately see that I had a stenosed cervix. This is extremely common in any woman who has gone through menopause or a sustained length of time without high levels of oestrogen. The cervix shortens and thickens causing the passage through to the uterus to become very narrow, sometimes closing completely. As most women who have hysteroscopies to investigate post menopausal bleeding are likely to have cervical stenosis I cannot understand why it is even attempted to do this in this cohort of women without anaesthetic.

At first I was disappointed that I would need a general anaesthetic with its risks and longer 'down' time. However it all went very smoothly. I did wake up in terrible pain which is not surprising as cervical surgical dilation is ALWAYS going to hurt. They gave me IV morphine and the pain vanished in minutes. They told me before the operation that if need be they would send me home with liquid morphine but I didnt need this and have not even had to take codeine which I was supplied with. Just taking ibuprofen or paracetamol for mild pain. No bleeding despite having a biopsy done.

All I can say is that women's bodies appear to be less valuable than men's. Can anyone imagine a man having any kind of internal procedure/biopsy done without anaesthetic and strong pain relief? It simply does not happen. Its time that these health inequalities come to an end. All human bodies should be treated the same, with adequate anaesthesia and adequate pain control. 

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I.had a hysteroscopy a week ago for PMB. Was absolutely dreading it having seen the testimony of ladies on here and elsewhere who had a bad experience. It's so scary putting your feet in the stirrups and it freaked me out when I saw the (lovely) doctor brandishing what looked like a giant needle getting ready to stick it up me.

Before signing the consent form I asked her if I could have a local anaesthetic as I was expecting a lot of pain. But she told me that women tend to have higher pain scores if they have the injection, and that the flowing water can help with the catheter's entry to the womb. So I gritted my teeth and prepared for an awful experience.

She started entering the cervix and it was fine! Not pleasant but not any worse than a smear, just the odd pang like manageable period pain. Also I could see my womb and fallopian tubes on the screen looking very pink, which took my mind off what was going on 'downstairs'. It turned out that there was nothing for them to biopsy and my womb was in good condition.

I was ridiculously relieved that I didn't have to go through hell (I believe it's one in four who suffer badly) but I'm so sorry for the women who have a terrible time. The doctor actually said that I should post my alternative experience to give people hope, so this is my purpose today - to let people know that they may be one of the lucky ones, and to take heart. Wishing everyone a good experience with this procedure.

Maire123

 

 

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Thank you for posting. I’m really pleased it worked out well for you and your health is good. Such a relief.
 

It would be awful if women are put off having a necessary procedure because of fear of pain. But as you say, the percentage of women who do experience severe pain is very high. 
 

I don’t know the evidence base for the Drs statement that women who have an injection have higher pain scores. Does anyone reading this post have more information on this? 

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I’m 2 years post menopausal and have no children. I had an hysteroscopy this morning. Put it this way, one of the staff said afterwards that if the doctors actually told patients in advance how painful if can be, nobody would ever do it. The staff were lovely, to be fair, but the procedure was horrible. They had to dilate my cervix and the pain was excruciating. I had gas and air, thankfully, but because of that I’m not sure if I was ever given a LA. Apparently I went very pale and they tipped me up head down. They had to put me in a recovery room for a while afterwards and my partner was allowed in. I’m home now and thank god the pain killers are finally doing their thing. I told the doctor afterwards that if I have to do this again then I’m having a GA and she immediately said yes. This is going to haunt me for a while. 

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Sorry for the experience you have suffered. Same happened to me. I did require a further investigation 2 years on but insisted on a GA. It is available to you, you just  have to be firm with the care you expect to recieve. Best wishes, hope you feel better very soon.

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On 12/10/2021 at 13:36, Deess said:

Sorry for the experience you have suffered. Same happened to me. I did require a further investigation 2 years on but insisted on a GA. It is available to you, you just  have to be firm with the care you expect to recieve. Best wishes, hope you feel better very soon.

Thank you 🙏 

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I had my first yesterday.
I was so anxious after hearing all the horror stories that a lot of woman have experienced and I watched a few YouTube videos of the procedure to ensure I knew what I was going to experience but it only made me worse. I went into the room in tears. But I was met by the most amazing nurses who reassured me. My doctor was awesome too. He reminded me of the pros of this procedure and ensured me that I am in the driving seat and at any point I found it too painful we could stop and a new appointment could be made for sedation and procedure. He also said as I had never been in labour or given birth that it may be too difficult to go in and I may require him to stop and rebook. 
 

I went into the room and the tiles above my head were decorated with butterflies and celebrities faces were on them and we laughed and joked the whole way through my procedure. I felt very little discomfort, the worst I felt was after the initial procedure and biopsy. We had decided my best treatment would be a coil fitted. I felt the coil insertion more, it was a little more painful but I would do it again in a few weeks if I had too. Right now I’m a little uncomfortable and crampy but it’s nothing compared to the pain I experienced passing the giant clots that put me on the table in the first place. 

I wanted to share my story as it was a massive success and I really felt very little discomfort. I hope it helps anyone reading this who is due to undergo the procedure themselves. I mean after all we are all different and all experience things differently. 

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Edited by Maggie

Thank you so much for posting. I’m so pleased it worked out really well for you and the staff sound fabulous.
 

Have you thought about sharing on  CareOpinion too? It’s a great site for giving positive feedback that shared directly with the staff concerned. 

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