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My concussion: Be nice to your brain
After a couple of hours of waiting in the ER, Liz gets an ice pack.
August 2nd, 2011
07:18 AM ET

My concussion: Be nice to your brain

Elizabeth Landau is a writer/producer for CNN.com. This is her story of recovering from a concussion.

I write about health issues every day but I honestly thought that concussions happened only to football, soccer and hockey players. Since kickball is the only sport I play competitively - and there's an obvious limit to how cut-throat an adult kickball game can be - I never considered that a serious head injury would happen to me.

But at kickball in mid-July, I was standing in my usual less-than-important position in right field when the other team's kicker sent the ball flying right toward me. Excited to be useful, I jumped to catch it. Unfortunately, so did one of my teammates, according to my friends who watched in horror.

They say we collided in mid-air, and the force of his body knocked me to the ground. But all I remember is seeing the ball, feeling pain, and suddenly struggling to breathe and speak.

After a few seconds I was able to tell everyone "I'm OK" and lift myself off the grass, with assistance. One of the refs came over and suggested I go to the hospital. I wasn't having trouble speaking or thinking, but I remembered that actress Natasha Richardson said she felt fine immediately after she fell while skiing, and died later of an epidural hematoma - when blood accumulates in the area between the lining of the brain and the skull - in 2009.

My friend Christina drove me to my apartment to grab my insurance card, and then to the hospital, where my boyfriend, David, met us. In the waiting room, I attempted but failed to even halfway finish a game of Sudoku on David's smartphone, and tried to read the Economist but can't really tell you which articles I read.

My head hurt and I was having a hard time concentrating on anything; as hours went by, I became increasingly annoyed that the ER staff did not seem to take my complaints of head injury seriously.

At around 12:30 a.m. I got to see a nurse practitioner, who tested my eyes and reflexes and sent me to get a CT of my head. Finally, at 2:30 a.m. one of the nurses told me that my CT was clear, and handed me a few printouts about what concussion means and how to treat it.

In the morning I further read up on concussions from such trusted websites as the MayoClinic, with a much different eye than if I had been writing an article about them. Apparently I had already violated the "don't use a computer" rule simply by looking up this advice. And I'm a 27-year-old with a high-intensity job and music projects on the side; telling me to "slow down" and take a rest from mental activities is like telling a mouse to not eat the cheese that's right in front of it. But I did end up sleeping for much of the day, with David working from my couch to make sure that I didn't develop more pain or other new symptoms. Admittedly I did use my computer to check Facebook, and appreciated the outpouring of support from friends who'd read my status message about my injury.

I consider myself extremely lucky that my injury was as mild as it was, but I've still experienced a bunch of little symptoms that I never used to associate with concussion. During that first week, anything that jarred my head in one direction or another - even nodding "yes" during a conversation or walking fast - made it hurt more. Riding Atlanta's subway for 20 minutes at a time made me nauseated (although some friends say that this is their normal experience).

So I've had to make some adjustments. Antihistamines are out because they'd make me exceedingly sleepy, so I have to make do with a stuffed nose. I tried watching a psychedelic laser light show at a planetarium recently, and couldn't keep my eyes on it for more than about 30 seconds before I thought I would vomit; no more big-screen action movies for a little while. And I'm not supposed to drive until my symptoms go away, lest I lose concentration or get distracted by lights.

It's hard not to stress out about inadvertently stressing my brain. Suddenly, I've had to take care of myself in a whole new way, which includes healthy habits I'd neglected before. I've had to make sure to get eight hours of sleep or more so that my head doesn't hurt as much. I've had to eat normal meals on a regular schedule, otherwise I feel weak, nauseated and unusually grumpy. Noises are louder and lights are brighter, so I've had to avoid ridiculously loud environments and make sure to wear sunglasses outside.

I take over-the-counter acetaminophen as a painkiller for my head since ibuoprofen and naproxen can increase the risk of bleeding. I worried about taking my scheduled flight to Oregon six days after the accident, but I didn't really feel increased pain or nausea during the ride there. Coming back was tougher because I'd bumped my head earlier that day, hadn't eaten well, and there was some turbulence. Doctors say concussion symptoms usually clear up in a matter of weeks to months after it happens.

My biggest fear is injuring my head again. After a person has had one concussion, it's extremely dangerous to have a second one before the brain has healed. If an athlete comes back to play too soon and gets a second head injury, it can result in something called second impact syndrome, a rare phenomenon that can lead to paralysis, epilepsy and even death.

Of course, head injuries can happen in non-athletic settings too. When I got into a cab Thursday, I hit my head on the door frame and panicked, but the impact wasn't that hard and my fears about losing consciousness made my body feel all the worse. But it was a wake-up call to be extra careful about keeping my brain healthy. I feel a whole new level of sympathy for the countless athletes and and non-athletes who have concussions happen to them - an estimated 300,000 concussions happen annually to professional, college, and high school football players alone. I wish everyone else out there with similar problems a smooth recovery.

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soundoff (99 Responses)
  1. Laura

    While I do sympathize with your little bump to the head, what is more disturbing is your utter lack of understanding of Traumatic Brain Injury (in your case, Mild TBI). Per your article, the only two complaints you had were "my head hurt" and difficulty concentrating. You displayed NONE of the red flags of traumatic brain injury: witnessed loss of consciousness, amnesia, unusual behavior, unequal pupils, seizures, repeated vomiting, double vision, worsening headache, weakness, unable to recognize people, imbalance, or abnormal speech. Perhaps the reason you were "not taken seriously" in the ER was because you were not an emergency...but hey, guess what: in a few hours, your non-emergency was evaluated, taken seriously, given a state of the art imaging study (confirming what the ER staff already knew...that you did not have a serious injury), and sent home with written instructions, which you promptly ignored.

    To add insult to injury, you set out to write "story" (not article, as that would imply some level of research) about your experience with TBI. Your story, which could have been used to bring awareness and understanding to this often misunderstood diagnosis was instead the intellectual equivalent of a "poor me" facebook status update. Fail.

    Here's the bottom line: TBI is a very real diagnosis, and occurring with alarming frequency in both athletes and our deployed military members exposed to blasts while in theater. This increasing frequency is most likely not because of increased rate of injuries, but increased recognition of the symptoms. Knowing the red flags (immediately after injury and in the weeks to follow) and when to be assessed is essential to treating those who have sustained trauma to their brain. The vast majority of mild and even moderate TBI heal without any long term sequellae (aside from the transient headache, nausea, and difficulty concentrating the first 1-2 weeks following your injury...your brain is bruised, after all). Recovery is greatly enhanced when you follow your medical provider's instructions and avoid reinjury while your brain is recovering. Severe TBI has longer lasting effects, but if recognized and given appropriate care can also have an impressive rate of recovery.

    Recommendations for your post-concussion care (as you have seemed to forgotten) are as follows: 1. reduce stimulus. 2. rest. 3. aggressive headache management (tylenol). 4. regular sleep schedule. 5. avoid reinjury...no contact sports, no dangerous activities.

    By the way, I'm a doc for the military where I evaluate and treat patients with real TBI all the time...patients who have been within 50 meters of an IED blast and have gotten their world (and thus, brain) rocked by the explosion. Patients who understand that their mild TBI will be evaluated, but first we have to evaluate patients with no kidding life-threatening emergencies...patients who would never think about complaining about a few hour wait because they knew that their buddy's life is on the line. Patients who follow instructions, get better, and get back to the fight...for their country, for their buddy next to them, for their families and loved ones waiting for them back home. THAT'S a high intensity job. My Marines would laugh at your little injury and give you a straw.

    August 3, 2011 at 08:40 | Report abuse | Reply
    • elandau

      Hi Laura, thank you for your comment. With all due respect, I did lose consciousness for a few seconds, according to witnesses. Furthermore, a person can be perfectly lucid at first but still have a life-threatening brain injury, as in the case of Natasha Richardson. See our article:
      http://www.cnn.com/2009/HEALTH/03/18/brain.injury/index.html

      Regards,
      Elizabeth Landau, CNN

      August 3, 2011 at 10:07 | Report abuse |
    • Laura

      Liz, with all due respect, when I want valid medical information, I don't go to CNN.com Health. Nevertheless, I read the article on your link...yes, epidural and subdural hematomas can occur, but they present with signs and symptoms that you did not demonstrate (particularly coupled with your mechanism of injury). Natasha Richardson's case, while tragic, is not the norm...and an "n = 1" does not make for a very compelling or legitimate argument.

      August 3, 2011 at 11:00 | Report abuse |
    • Bob F

      I read Laura's article first about treating TBI in the military theater. While I appreciate your considering Elizabeth's incident "mild" compared to what you deal with daily, one doesn't have to pass out in order to have a TBI. I fell during an ice storm – feet out from under me, fell on my back, hit my head on an 8" concrete curb – and I didn't pass out, but every synapse in my body exploded. Aftermath – blurry vision in one eye due to optic nerve damage, blanks in recalling words or names, reduced stamina, and more. I defy anyone to tell me I didn't have a traumatic brain injury.

      December 19, 2012 at 19:19 | Report abuse |
    • Pam

      Laura, I have to agree with Bob F. Often you can sustain severe damage without experiencing the obvious tell-tale signs. I slipped on ice, feet out from under me, whacking my head on our asphalt driveway and did not lose consciousness, no vomiting, nothing weird with my pupils, etc. Took motrin and went to bed. Over the course of 2 months the headache became unbearable, difficulty finding words, coordination issues. Upon evaluation I had a huge subdural hematoma which required emergengy evacuation. When the doc asked me if I had sustained a fall recently I had to think, oh yeah, 2 months ago. You can never be too careful with a head injury... I was very lucky.

      December 22, 2012 at 19:22 | Report abuse |
  2. Stefy

    Dear Elisabeth,

    It was nice to read your story and hope you are feeling much better now. My name is Stefy Bau and I am a former Women World Motocross champion. In my beloved sport, unfortunately, concussions are a serious problem (I even had a few during my professional career) and I know that the Mayo Clinic is deeply looking into this issue.

    However, it seems like that there is not an available source or product that could help minimize the result of a concussion in sports where it is a given that sooner or later you are going to hit your head. Moreover, with the increasing heat we are experiencing, my sport recorded few deaths of athletes as young as 11 years old for blunt trauma to the head, just in the last couple of months.

    Everyone that decides to take on, what it is considered a "dangerous sport", knows of the risk involved in the sport, but I think we are due for a project that will help spare lives of those athletes.

    I would like to have a chance to connect privately and brainstorm with you on this matter.

    Thank you.

    Stefy Bau, FIM (Federation Internationale du Motocyclisme) member

    August 3, 2011 at 11:37 | Report abuse | Reply
  3. Julesa

    Having this analytical perspective from an adult is fantastic. My son had a similar experience when he was almost 4. It was difficult for him to articulate what he was feeling, but from my observations, it must have been quite similar to what you describe. It was almost a month before he could tolerate looking at any screen, and had very little interest in TV for months after that. He ended up with some eye movement damage which requires bifocals. His CT scan was clean, but for 4-6 hours he had altered level of consciousness and nausea and vomiting. If I had not been a nurse with neurology experience, I would not have been cool with him being discharged from the hospital. Creepy stuff.

    August 3, 2011 at 14:02 | Report abuse | Reply
  4. Brandon

    text

    August 3, 2011 at 17:53 | Report abuse | Reply
  5. marylou sakosky

    PLease keep a eye on youself an have someone watch you for 24 hrs ...bet ..i dont want to tell you any bad news but it happens its not good soo take care ...you in my prayers ^!^

    August 3, 2011 at 18:53 | Report abuse | Reply
  6. Diva

    Elizabeth, thank you for your story. My son is an athlete and has had two concussions on separate occasions and since then I make sure he sees a doctor as soon as possible; he is only 15. I am glad that you are recovering and I appreciate the article.

    August 3, 2011 at 19:03 | Report abuse | Reply
  7. Anna Kelly

    Thank you so very much for sharing this. I received a grade 3 concussion at work. Passed out, the whole schmoo. I also was able to say I thought I was okay though I also did need help to get back up. I hit my head and upper shoulder blade on steel shelving, so hard that the one pound jars of ointments and creams fell off the shelves. (I work in a pharmacy). I was dazed to say the least, and was told I looked like crap so an ambulance was called. They did an EKG and said honey you are off to the ER. After about an hour there my head felt like it was going to explode. They took a CT scan and said it was clear. I went back to work the next day, lasted 5 hours. My store manager said I looked horrid, and told me to go home. I didn't go back to work for almost 8 weeks. Meantime, worker's comp does not believe anything since 2 CT scans were clear. I was in the ER another 2 times in 7 days that same week, with EXCRUCIATING pain. I also landed in the hospital about 3 weeks later as I had gotten so very sick I thought I would die. The hospital said I was and it was good that I came in. They were very concerned about my head pain, and would allow pain meds every 3 hours. It only helped for 90 minutes. Long story short, my doctor is doing all she can to get this covered and help with meds, and my lawyer is doing all he can to get this covered, so I don't have to pay anything back, nor have HORRENDOUS medical bills. It has not been a very good year for me. I am praying it gets better. I still hurt where I hit my shoulder and hip/leg. My head. well, it ALWAYS hurts, have good days and bad days. Took me about 5 weeks before I felt safe driving, and about 7 weeks before I could play the radio in my car and house. I still cannot read a book. I can deal with the computer, thankfully, as I have to for my job, and can read little bits at a time. My magazines are stacking up, and I am not going to renew my subscriptions. I do word puzzles to keep things going. I have absolutely THE worst depression and anxiety from this. I seriously do not know how I get through most days. All I can say is, it is VERY difficult.
    Thank you again for sharing this, now maybe my other half will understand. I get yelled at for asking to turn things down, and he drags me along to concerts. I have to wear earplugs. Still get horrible pain later. I do not like being the way I am anymore. I use to be a very happy person. Now, I am very sad and depressed. Thank you for letting me vent and explain what I am going through.

    August 3, 2011 at 19:10 | Report abuse | Reply
  8. Leslie

    I hope you are feeling better. Unfortunately, Stuntpeople are being forgotten in all the studies. We have people dying young of stokes, suicides for seemingly no reason at all, headaches and all sort of PCS symptoms. Unfortunately the Screen Actors Guild and Producers do not believe in Concussions so they do not have to cover SAG Members by the Producer-SAG Health Plan.

    August 3, 2011 at 19:35 | Report abuse | Reply
  9. Kiley

    I passed out in February. I was extremely unlucky at the time, since I was in JCP, and standing in the checkout line. I was with my mom and the last thing I remember is putting my head on her shoulder. For a few weeks, I didn't remember my head hitting the (tile) floor, but then one day, all the sudden, I felt the impact while sitting on the couch. I've never felt anything like that.
    I've studied and written papers on concussions, so I knew right away that I had one. I went to the Dr. and he never told me not to drive or anything like that. I couldn't drive at night (and still have issues with it), but during the day wasn't an issue.
    I was diagnosed with a Grade 2 concussion and mild to moderate whiplash because my head hit with such force. They did a CT to make sure I hadn't fractured my skull.
    When I hit, I landed on my back, so I hit the back of my head, which is where vision is controlled. I have recently been diagnosed with what they called "occipital migranes" which just affects my eyes and not the rest of my head. I get double vision, and can't focus on anything. The diagnosis came after my left eye felt like it was going to explode.
    I have never felt anything like any of this (except the whiplash). Wost headaches I've ever had, motion sickness, everything. I definately have alot more sympathy for people who have had them the same or worse. And I get more upset at athletes who say they're fine after a hit. They don't know the damage they're doing.
    Be careful with ANY blow to the head. They aren't anything to mess with.

    August 3, 2011 at 20:03 | Report abuse | Reply
  10. Tonya

    Thanks for sharing,
    I had a closed head injury 6 years ago now and still have symptoms. My concussion lasted 3 days and all I did was fall and land on my head. I couldn't even walk right after the fact and went through all therapies, only one did I pass and that was speech the others discharged me not knowing how to help me. As far as the neurologist they never supported me. My treatment was treated like a stroke. I have never been the same since that day, though I have made it out of my wheel chair and have put the walker away but I still use a cane for balance. I still get motion sickness,dizziness, my balance is off, sensitivity to light and sound, memory loss, it's hard to focus and get confused easily if I can't keep up with a conversation, even my left and right gets confused. It's hard when you don't have any doctor support and all they tell you is it's all in your head, well obviously it is but not the way they are saying. I haven't seen a doctor or found one that understands, I finally had to leave my last one. I do by the grace of God get disability which was for after a closed head injury but mainly chronic pain, which effected my back and neck. All from a what seemed to be a simple fall was so life changing and I hope to never go through that again because I still don't understand completely what happened to me. I am thankful for how far I have come since that day and for the love and support from my family and I would never wish to see anyone go through what I have.
    Good luck to any and all who have been there and a quick recovery to you.

    August 3, 2011 at 21:11 | Report abuse | Reply
  11. Abdul

    Thanks for sharing your story about. I'm sure it really means something to people who exposed all
    the time to concussions (athletes like you mentioned). I hope you recover soon. Take care Liza

    August 3, 2011 at 23:00 | Report abuse | Reply
  12. Stella

    Liz, as a fellow concussion sufferer (I had a cycling accident and hit my head on the ground), I certainly understand how you are feeling right now. It has been more than 5 months and I still have headaches. I hope you have a speedy recovery.

    August 4, 2011 at 09:59 | Report abuse | Reply
    • David

      In their original acitrle, the doctors argue that most preparation can be done using a combination of a "blunt, round nose" knife and another which, although sharp, is also short enough (under 5cm) to render it less likely to be lethal if used as a weapon.They're quite happy for people to use pointy knives for cooking, just not great big fatal wound killing ones. Can't blame them either, they're the ones dealing with the crap in A E every Saturday night.

      March 4, 2012 at 06:27 | Report abuse |
  13. Becky Weiss

    Glad to hear you are doing better Elizabeth. I too had a concussion re: car accident from many years ago and had developed symptoms related to the accident concussion. I was lucky to find a Chiropractic Neurologist in Wilmington DE who treats brain injuries such as these. I'm doing much better and my symptoms were resolved. Other readers might want to know that there is help out there.

    August 7, 2011 at 13:49 | Report abuse | Reply
  14. Joshua Rotenberg, MD Pediatric Neurologist

    I hope you recover quickly. Concussion symptoms in children & teens can last longer than in adults. Falls are the #1 cause of concussion. Sadly too few get and expert evaluation of neurologic and psychological effects. Dr. Rotenberg, Houston TX

    August 14, 2011 at 14:07 | Report abuse | Reply
  15. Jan Lee CH RN

    Liz:
    Hope you feel better. My mom fell at home and sustained a hip fracture and concussion ( this after discharge from a hospital for spinal fusion revision and hospital acquired meningitis) ...she is amazing and recovered, but still has some headaches and vertigo. One doc said it was meniere's..no, it is most likely post concussive syndrome than can las months.. I am a nurse turned hypnotist and work with mom on relaxation and keeping the brain calm..Be gentle with yourself.
    I don't know how to reach you on another topic. You wrote an article on PGAD in April of 2010? This must be a horrible condition . I have been reading about Irwin Goldstein and what treatments are available. Our minds are powerful and I believe that hypnosis can give these women some real relief. I am a certified Hypnotist and I am going to begin to explore this and work with women who will come forward with this. This is my new business and I'm thrilled that I will be able to help. I know I can help them "short circuit" the crazy wiring that may be present in the brain. I can help them visualize a way for them to desensitize to this stimulation. I am going to research it more and would love to be in contact with you as a way to reach these women and offer my services. Thank you..Please take care of your precious brain. Jan Lee 724-884-3307

    August 18, 2011 at 09:27 | Report abuse | Reply
  16. Susan

    When my teenaged daughter went to the fair for the first time, she sustained a concussion on one of the rides, hitting the back of her head and then the front. I thank God that her older sister was with her because she couldn't even remember getting off the ride or getting back home. There was an E/R visit and lots of doctor's visits before she was sent to a neurologist after months of symptoms. They told us it would take up to a couple of years after the injury for her to heal. One year after the concussion, when she was a camp counselor, she fell on the slip-and-slide the kids were using and hit the back of her head, blocking her memory from the names of the campers she's spent a week with (she did remember their names by that evening). That injury caused another concussion. Back to the neurologist we went, and we were told that any bumps, even small ones, could cause permanent memory loss. I encourage you to be aware of fair rides and any bumps to the head, whether for yourself or your children. When my daughter was basically whispering after the initial concussion, I had no idea it was because the concussion made her so sensitive to sound that she thought she was talking in a normal volume. Watch for the little things. They might be an indicator of a concussion.

    September 20, 2011 at 08:46 | Report abuse | Reply
  17. RUSS WOOSLEY

    IF YOU ARE LIKE I AM, THEN YOU GOOGLE FOR HELP FINDING THE ANSWER TO ANY QUESTIONS YOU HAVE. FROM WHAT I UNDERSTAND, ITS ALL OUT HERE...... THE ANSWERS......TO YOUR QUESTIONS.....ABOUT WHATEVER YOU WANT.......... ANYWAY.... I AM LOOKING FOR HELP UNDERSTANDING MY CONCUSSION. I WAS ASSULTED ON 9-13-2011 AND NOW THAT I THINK OF IT..... I MAY HAVE EXPERIENCED 2 CONCUSSIONS WITHIN SECONDS. I WAS STRUCK BY AN UPPERCUT TO THE JAW AND DONT REMEMBER ANYTHING, INCLUDING THAT. WITNESSES SAY THIS...... THE YOUNG BLACK GUY, HIT THE OLD WHITE GUY AND HE FELL DOWN AND HIT HIS HEAD ON THE PAVEMENT. HE IS 24, I AM 60 BUT I NEVER THOUGHT OF MYSELF AS BEING OLD........ ANYWAY .....I ONLY REMEMBER WAKING UP IN THE ER AT THE HOSPIITAL. I WAS UNCONSCOUS FOR QUITE A WHILE..... PROBABLY 1 TO 3 HOURS........AND LOST BLOOD FROM MY HEAD WOUND.
    THEY DID ALL THE NORMAL TESTS TO MAKE SURE I WASN'T BLEEDING INTERNALLY. ANYWAY I WAS RELEALSE THE NEXT DAY AND THEY SAID TO TAKE IT EASY. I HAD PAIN PILLS TO TAKE BUT THEY ONLY MADE ME MORE SLEEPY. I WANT TO GET BETTER AND BACK TO NORMAL BUT IT'S BEEN 6 WEEKS NOW AND I AM STILL NOT THINKING PROPERLY...... I GET TIRED EASILY......AND FORGET MOST THINGS I NEED TO DO...... IT REALLY KINDA SUCKS BECAUSE I OWN MY OWN BUSINESS AND HAVE A LOT I NEED TO DO.........JUST WONDERING AROUND OUT HERE TRYING TO FIND A WAY TO IMPROVE MY RECOVERY........LOOKING FOR ANSWERS ANYWHERE....... FROM NUTRITION, TO EXERCISE, THERAPY, VITAMINS...MESSAGE......ETC.....

    October 24, 2011 at 11:23 | Report abuse | Reply
  18. Corina Bermea

    Dear MarynI don't know what kind of bookstore you're looking in! I just bought two new books today in series that feature young men about that age: Leven Thumps, by Obert Skye, and Artemis Fowl, by Eoin Colfer. Not quite as recent, but very good is Terry Pratchett's "Nation" a great book on the expectations surrounding young men.

    December 1, 2011 at 08:30 | Report abuse | Reply
  19. Alicia

    I hope that everyone who has had a concussion or "bump to the head" like some think of it as a very serious situation, people can seem fine and then lay down, never to wake up again. Sidney Crosby was out of hockey for almost 11 months before finding treatment with the GyroStim and it finally treated his dizzyness and blury vision. This amazing machine is now available on the West Coast of California (www.millerchiropractic.com) and can hopefully help those with concussions.

    March 7, 2012 at 16:12 | Report abuse | Reply
  20. Jack

    I just had a concussion yesterday, so I too have a new found appreciation for these sports guys getting their bells rung like they do, and then they comeback in a matter of weeks only get their heads knocked off all over again. Austin Collie with the Indianapolis Colts comes to mind... I guess concussions are just one of those things you don't really respect until you suffer one. Being concussed really does kind of put you in a strange frame of mind. Time really flies too, I find, like I can't remember much.

    May 19, 2012 at 03:30 | Report abuse | Reply
  21. Paige Mihalco

    concussions can be dangerous that is why you always need to have some x-ray or cat scans to make sure that it does not have some complications.,

    Our favorite web-site
    http://www.melatoninfaq.com/liquid-melatonin/

    November 3, 2012 at 02:31 | Report abuse | Reply
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