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Topic: Strength training question.

Forum: Lymphedema — Risks, tips for prevention, and info about products that can address the symptoms of lymphedema.

Posted on: Feb 28, 2019 11:06AM

Dani444 wrote:

Hello! I do not have lymphedema but am seeing an LE therapist to get educated and be proactive. I am getting fitted for a sleeve to wear prophylactic when flying and when exercising. My question is, is it really not advisable to ever increase the amount of weight I lift with my at risk arm? She advised to only lift between 2.5-5 pounds,ever. The lowest weights on the machines at the gym I joined is 10 pounds. I am of course going to clarify with her at my next appointment but was curious of others opinions. I am hoping she says the 10 pounds is ok. I am not confident in doing free weights, I am worried I will use the wrong technique. Also that corner of the gym intimidates the heck out of me.

DX @ 46, premenopausal, mammaprint low risk Dx 8/21/2018, LCIS/ILC, Right, 4cm, Stage IB, Grade 2, 2/3 nodes, ER+/PR+, HER2- (IHC) Surgery 10/24/2018 Lymph node removal: Sentinel; Mastectomy: Right; Reconstruction (right): Silicone implant Radiation Therapy 12/5/2018 Lymph nodes, Chest wall Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Feb 28, 2019 12:00PM Runrcrb wrote:

i had some lymphedema, very minor, but did see a therapist and did wear a sleeve when running during the summer after my mastectomy. I never heard a rule about weight lifting and have not had any issues. I strength train regularly. You’re doing the right thing by meeting with an expert on lymphedema rather than listening to old wives tales and anecdotes. My breast surgeon told me emphatically that i could have blood draws, IVs, etc on the right side. I have not let this experience slow me down. Nor do I hesitate to seek out experts when i need them


Dx 6/27/2016, IDC, Right, 1cm, Stage IIB, Grade 1, 4/10 nodes, ER+/PR+, HER2- Dx 6/27/2016, ILC/IDC, Right, 2cm, Stage IIB, Grade 1, 4/10 nodes, ER+/PR+, HER2- Surgery 9/22/2016 Lymph node removal: Right; Mastectomy: Right; Reconstruction (right): Tissue expander placement Chemotherapy 10/31/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Radiation Therapy 2/9/2017 Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy 4/23/2017 Aromasin (exemestane) Surgery 12/13/2017 Reconstruction (right): DIEP flap
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Feb 28, 2019 01:56PM vlnrph wrote:

Unfortunately many surgeons do not recognize the incidence of lymphedema because they often do not follow their patients long term. Once you have it, LE is pretty much irreversible so, if I were Runrcrb, I would do more to protect my right arm by insisting blood pressures and needle sticks be done elsewhere.

As for Dani, since she does not yet share our diagnosis, it may be safer for her to gradually increase the amount of weight she uses. Look at the stepup-speakout website for further info.

By the way, I wonder if the water and boats in your photo are actually in Indiana. I went to Lake Schaefer once when attending Purdue...

IDC too! 🎻💊👪🐩 🇫🇮 🌹🦋 Rt MX+DIEP 4-2011; ALND 5-2011 d/t micromets; TC X 4; tamoxifen; lymphedema 9-2011; switch to letrozole 3-2014 for 1 yr; bone mets 8-2018: Zometa, rads to spine, Faslodex/Versenio Dx 3/7/2011, ILC, 2cm, Stage IIA, Grade 2, 1/25 nodes, ER+/PR+, HER2-
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Feb 28, 2019 03:15PM PurpleCat wrote:

Dani, I wish we could exercise together! You sound just like me: no problems yet, but being proactive, and trying hard to recover strength without aggravating the situation. I worked with a personal trainer to set up a routine that sounds similar to what you're doing (and yes, those free weights intimidate the heck out of me too! I'm sticking to the machines.) This trainer has worked with a lot of cancer patients, insists that I wear my sleeve to exercise, and started at some pretty low weights and said to work up very gradually, so I've felt confident he knows what he's talking about. I think it depends which muscles are getting worked, though. I do one set with free weights where I hold 3 pounds in each hand and raise and lower my arms while holding them straight, and that's been the most uncomfortable. In fact, I started at 5 pounds and then went down to 3 because my arm was hurting and I was getting nervous. But I'm doing some fifteens and twenties on the pectoral and a couple other arm/upper body machines, and they feel OK. When my arm hurts, it doesn't feel swollen, more like a very mild version of the nerve/muscle/tightness I felt after the lumpectomy. Just nerves complaining because they've been coddled so long and now are being made to work, I think. In any case, I wear the sleeve every single time.

Anyway, I'd say try the tens, but go slow and do just one set the first time, and then go home and see how that feels over the next couple of days. If it's OK, then do two sets the next time.

Dx 10/2018, IDC, <1cm, Stage IA, Grade 2, 0/3 nodes, ER+/PR+, HER2- Surgery 10/4/2018 Lumpectomy Surgery 10/18/2018 Lymph node removal: Sentinel Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Radiation Therapy
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Feb 28, 2019 04:01PM beeline wrote:

Dani, I think that’s an outdated recommendation. I find it very hard to get good info, but have read at least one study that says weight training is helpful for preventing/controlling LE as long as you build up gradually.

American in NZ. Dx’d at 42. Had to stop Taxol after #6 due to neuropathy. Randomised to control group in MonarcheE trial 😩 Dx 7/17/2018, IDC, Right, <1cm, Stage IA, Grade 2, ER+/PR+, HER2- (IHC) Surgery 8/2/2018 Lymph node removal: Right, Sentinel, Underarm/Axillary; Mastectomy: Right Dx 8/21/2018, DCIS/IDC/Paget's, Right, 2cm, Stage IIIC, Grade 2, 10/22 nodes, ER+/PR+, HER2- (IHC) Chemotherapy 9/18/2018 AC + T (Taxol) Hormonal Therapy 2/12/2019 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Radiation Therapy 2/25/2019 Whole-breast: Lymph nodes, Chest wall
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Feb 28, 2019 04:09PM - edited Feb 28, 2019 04:12PM by Binney4

Dani, the StepUp-SpeakOut site offers a couple of handouts about exercise after breast cancer treatment. One is for us:

http://www.stepup-speakout.org/Handout%20doc%20for...

And one is to share with your trainer or exercise instructor (yoga, pilates, whatever):

http://www.stepup-speakout.org/Trainer%20doc%20for...

There's more information on that site as well about the research that's been done regarding post-treatment exercise. I'd say that starting with 10 pounds is a bit much--better to start low and slow and proceed from there. Certainly 5 pounds is not the limit, assuming you've worked up to higher levels.

As for other risk reduction strategies like avoiding IVs, injections and blood draws on the affected arm, there's a trend toward denial of risk that is not based so much on research that shows no risk, as on the lack of research that does. Since there's no way to design a study that deliberately puts women at risk of developing lymphedema, the only evidence of damage from such things is anecdotal. But that evidence is vast and convincing, so it's up to each of us to determine how much we're willing to risk. As vlnrph suggests above, lymphedema is for life.

Hoping you never have to join our Swell sisterhood!
Binney

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Feb 28, 2019 06:05PM Dani444 wrote:

thank you all so much for taking the time to respond! I appreciate everyone’s input.

Vlnrph- The boats are not from Indiana, that’s a picture from our vacation last summer! I actually live pretty much in the middle of the state, just north of Indy!

Purplecat- It really would be perfect if we could work out together! Sounds like you have a great trainer! I will be ordering the sleeve tomorrow so after I get it I might get the nerve to venture to the free weights 😬. There are trainers there, maybe it would be best to get an appointment to learn good technique for the lower weights starting off. I will take the handout from the link Binney4 provided.

Thanks again Runrcrb, Berlin, and Binney4!

DX @ 46, premenopausal, mammaprint low risk Dx 8/21/2018, LCIS/ILC, Right, 4cm, Stage IB, Grade 2, 2/3 nodes, ER+/PR+, HER2- (IHC) Surgery 10/24/2018 Lymph node removal: Sentinel; Mastectomy: Right; Reconstruction (right): Silicone implant Radiation Therapy 12/5/2018 Lymph nodes, Chest wall Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Feb 28, 2019 06:28PM CaliKelly wrote:

I started weight training as soon as my surgeons okayed it. I had 20 nodes removed, I actually think the weight lifting helped prevent lymphedema. Almost back to my former weights! I am careful not to get needles or blood pressure taken in my left arm. I'm a former fitness trainer, so I had to keep up my workouts, it's my drug of choice .😉💖I say, go for it!

Dx 6/17/2015, IDC, Left, 6cm+, Stage IIIC, Grade 2, 8/20 nodes, ER+/PR+, HER2- (IHC) Chemotherapy 8/10/2015 TAC Surgery 1/19/2016 Lymph node removal: Left, Underarm/Axillary; Mastectomy: Left Hormonal Therapy 1/29/2016 Arimidex (anastrozole) Surgery 6/28/2016 Reconstruction (left): Silicone implant Chemotherapy 11/2/2016 Xeloda (capecitabine) Surgery 10/6/2017 Reconstruction (left): Latissimus dorsi flap Surgery 1/30/2019 Reconstruction (left): Fat grafting Radiation Therapy Whole-breast: Breast, Lymph nodes, Chest wall
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Mar 1, 2019 03:18AM Rah2464 wrote:

CaliKelly - did you wear a compression sleeve? I have begun some workouts and a little uneasy because I don't have one.

Dx 5/23/2018, IDC, Left, 1cm, Stage IA, Grade 2, 0/4 nodes, ER+/PR+, HER2- (IHC) Surgery 6/26/2018 Mastectomy: Left, Right; Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Hormonal Therapy 7/26/2018 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Mar 9, 2019 10:33PM - edited Mar 9, 2019 10:39PM by hugz4u

Dani unless you are use to lifting weights regularly then start out with one measly pound even if your at risk. If you have no swelling then increase by one pound again over a course of time. This exercise program was developed by university of Pen for us lymphedema people. It's called PAL program.

A sudden jerking move with a heavy weight can trigger LE. By not being use to heavy weights and lifting it can send lymph fluid rushing to the area and trigger LE. Slowly progressing your weights helps you keep track of any onset of symptoms. I've done this for three years lifting and it works. I'm still lifting under 20 lb. that's good for me. We are all different

Careful if your lifting heavy boxes on a moving day. We usually get carried away and overdo it and BAM lymphedema.

Wearing a sleeve to minimize le while exercising is smart. You can take off about a hour after for those at risk.

Cali exercise is the best for LE. We just want to work up to it. Sounds like you were well prepared.

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Mar 10, 2019 12:05PM CaliKelly wrote:

Yes, that's true, I've been weight training, well , my whole adult life. As s former fitness trainer I should have stressed working up slowly, light light weight, proper form, proper warm up/stretching! I did not wear a sleeve, but listen to the l.e. experts on that. I just restarted my normal workout, with lighter weights, and more stretching. I never got any signs of l.e. ,but I did get axillary cording from the axillary nodes removal. That requires LOTS of stretching! Bottom line, go slow, increase weights gradually, learn proper form, get Dr approval, then go for it! Weight training is great for recovering from all the harsh treatments and you'll look great too!

Dx 6/17/2015, IDC, Left, 6cm+, Stage IIIC, Grade 2, 8/20 nodes, ER+/PR+, HER2- (IHC) Chemotherapy 8/10/2015 TAC Surgery 1/19/2016 Lymph node removal: Left, Underarm/Axillary; Mastectomy: Left Hormonal Therapy 1/29/2016 Arimidex (anastrozole) Surgery 6/28/2016 Reconstruction (left): Silicone implant Chemotherapy 11/2/2016 Xeloda (capecitabine) Surgery 10/6/2017 Reconstruction (left): Latissimus dorsi flap Surgery 1/30/2019 Reconstruction (left): Fat grafting Radiation Therapy Whole-breast: Breast, Lymph nodes, Chest wall
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Mar 10, 2019 05:01PM ParakeetsRule wrote:

One of the first things my lymphedema therapist told me was that the idea that women should never lift more than five pounds is ridiculous and unrealistic. We wouldn't be able to carry groceries, pick up kids, carry any luggage bigger than a small purse, or pick up a dog or even a small cat. It would be nearly impossible to get through day to day life without being able to pick up anything more than 2.5 pounds! You would need a personal assistant to help you all the time.

And she said that the latest research is showing that exercise, not avoiding exercise, has positive effects for women who do have lymphedema. She said that weightlifting and arm-related exercises are fine if you start out slow and increase the weight by small increments. What "start out slow" means will depend on each person, too. Someone who never exercised before might need to start out with one pound weights but people who were already in good shape or weight lifted before might not need to begin so low. I started out using gym items ranging from 5-15 pounds and moved up relatively quickly in some exercises and more slowly in others, just based on what I feel like my arm/chest can handle.

I had joined a Crossfit gym shortly before I started going to the therapist, and she was okay with that, provided that I increase the weight slowly and stop if my arm feels funny. She told me to wear my sleeve and glove at the gym but I'm a bad patient because I don't do it. Lol. I was already lifting a lot more than her recommendations without any problem so I ignored that too. (shh, don't tell her!) Moving your muscles helps move lymph fluid along. When I go to the Crossfit classes regularly, my hand swelling goes away and if I stop, it comes back. And there's been no overall change in my arm since she began measuring it, despite my illicit Crossfit activities. :)

Something else to consider is that you can develop lymphedema for no reason at all. I got it for no apparent reason. There were no triggers, no lifting a heavy object, no injuries, no airline flights. So avoiding exercise because it might cause lymphedema could make somebody less healthy and less mobile, and they could still get lymphedema! Cancer sucks....

Dx at 36 after several years of being told it was nothing. Lymph node biopsy was also positive. Dx 3/21/2017, IDC, Left, Grade 2, ER+/PR-, HER2- Chemotherapy 5/14/2017 AC + T (Taxol) Surgery 9/12/2017 Lymph node removal: Underarm/Axillary; Mastectomy: Left Hormonal Therapy 1/14/2018 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Radiation Therapy Whole-breast: Lymph nodes, Chest wall
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Mar 10, 2019 05:29PM illimae wrote:

I’ve been using 2 & 5 lb handheld weights and up to 20 lbs on the gym machines. I’m up to 3 sets of 12 as part of MD Anderson’s Healthy Heart program and have never worn my sleeve (I always forget). No issues so far and I’ve been focusing on regaining my strength for several months now. I also do my lymphadema exercises each night before bed. Good luck!

Diagnosed at 41 Stage IV De Novo Dx 11/16/2016, IDC, Left, 5cm, Stage IV, metastasized to bone, Grade 3, 3/13 nodes, ER+/PR-, HER2+ (IHC) Targeted Therapy 1/1/2017 Perjeta (pertuzumab) Chemotherapy 1/2/2017 Abraxane (albumin-bound or nab-paclitaxel) Targeted Therapy 1/2/2017 Herceptin (trastuzumab) Surgery 6/26/2017 Lumpectomy: Left; Lymph node removal: Underarm/Axillary Radiation Therapy 8/10/2017 Breast, Lymph nodes Dx 10/5/2017, IDC, Left, Stage IV, metastasized to brain Radiation Therapy 10/19/2017 External: Brain Radiation Therapy 4/18/2018 External: Brain Radiation Therapy 5/23/2019 External: Brain Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Mar 10, 2019 06:31PM Marymc86 wrote:

I lift 10 pound free weights. I have had some lymphedema, too, but not sure it’s from the weights. My swelling actually decreased while I was using the weights. I’m not saying that’s what did it, I’m sure It isn’t, but the fact that I was improving while seeing my PT and at the same time lifting is a good sign it was not the cause

Dx 2/12/2018, IDC, Right, 1cm, Stage IA, Grade 2, 0/3 nodes, ER+/PR+, HER2- Radiation Therapy 6/25/2018
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Mar 10, 2019 07:41PM SummerAngel wrote:

I would recommend finding a LANA certified physical therapist for accurate information.

I lift weights. Started slowly after my surgery, following the advice of my LANA certified PT, and never had a problem.

Age at dx: 45. Oncotype, left-side tumor: 9. Right side had multifocal IDC and "extensive" LCIS. Isolated tumor cells in 1 right-side node. Dx 3/27/2015, IDC, Left, 2cm, Stage IIA, Grade 1, 0/3 nodes, ER+/PR+, HER2- (FISH) Dx 4/27/2015, IDC, Right, 1cm, Grade 1, 0/2 nodes, ER+/PR+, HER2- (FISH) Surgery 6/1/2015 Lymph node removal: Sentinel; Mastectomy: Left, Right Surgery 6/1/2015 Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 8/28/2015 Reconstruction (left): Fat grafting, Silicone implant; Reconstruction (right): Fat grafting, Silicone implant Surgery 12/4/2015 Reconstruction (left): Fat grafting, Nipple reconstruction; Reconstruction (right): Fat grafting, Nipple reconstruction
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Mar 10, 2019 07:51PM ParakeetsRule wrote:

Yes! My PT is a LANA-certified physical therapist. You can find a list of them on the main LANA website.

Dx at 36 after several years of being told it was nothing. Lymph node biopsy was also positive. Dx 3/21/2017, IDC, Left, Grade 2, ER+/PR-, HER2- Chemotherapy 5/14/2017 AC + T (Taxol) Surgery 9/12/2017 Lymph node removal: Underarm/Axillary; Mastectomy: Left Hormonal Therapy 1/14/2018 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Radiation Therapy Whole-breast: Lymph nodes, Chest wall
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Oct 29, 2019 04:23PM mitziandbubba wrote:

I am confused sleeve or no sleeve? I don't have LE

Surgery 5/9/2019 Lumpectomy: Left Surgery 5/28/2019 Lymph node removal: Sentinel Dx IDC, Left, 1cm, Stage IA, Grade 1, 0/4 nodes, ER+/PR+, HER2- Radiation Therapy Whole-breast: Breast
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Oct 30, 2019 06:17AM SummerAngel wrote:

Mitziandbubba, there is disagreement, even among qualified physical therapists, as to whether to wear a sleeve for certain activities if you don't have Lymphedema but are at risk. My therapist said no for me. There is a frustratingly small amount of data on the subject, and many of the studies that do exist are just retrospective self-reporting studies, which are notoriously inaccurate.

Age at dx: 45. Oncotype, left-side tumor: 9. Right side had multifocal IDC and "extensive" LCIS. Isolated tumor cells in 1 right-side node. Dx 3/27/2015, IDC, Left, 2cm, Stage IIA, Grade 1, 0/3 nodes, ER+/PR+, HER2- (FISH) Dx 4/27/2015, IDC, Right, 1cm, Grade 1, 0/2 nodes, ER+/PR+, HER2- (FISH) Surgery 6/1/2015 Lymph node removal: Sentinel; Mastectomy: Left, Right Surgery 6/1/2015 Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 8/28/2015 Reconstruction (left): Fat grafting, Silicone implant; Reconstruction (right): Fat grafting, Silicone implant Surgery 12/4/2015 Reconstruction (left): Fat grafting, Nipple reconstruction; Reconstruction (right): Fat grafting, Nipple reconstruction
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Oct 30, 2019 08:21AM edj3 wrote:

I don't wear a sleeve for strength work. When it was hot & humid (and I was not that far out from surgery and radiation), I did wear a sleeve for my runs. But I've stopped that as of the end of September.

Tried the tamoxifen, no thanks. Dx 4/9/2019, DCIS/IDC, Left, <1cm, Stage IA, Grade 2, 0/1 nodes, ER+/PR+, HER2- (IHC) Surgery 5/5/2019 Lumpectomy; Lymph node removal: Sentinel Dx 5/6/2019, LCIS, Left, <1cm, 0/1 nodes Radiation Therapy 6/2/2019 Whole-breast: Breast Hormonal Therapy 9/22/2019 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Oct 30, 2019 03:32PM mitziandbubba wrote:

I saw my LANA certified PT today. She had mentioned that I could get a very light sleeve - basically if it makes me feel better and more comfortable. But she doesn't think I need one. She showed up with basically a binder full of info on lymphedema risk and reminded me that I do not have it. I think she thinks I am paranoid (she would be right!).

Surgery 5/9/2019 Lumpectomy: Left Surgery 5/28/2019 Lymph node removal: Sentinel Dx IDC, Left, 1cm, Stage IA, Grade 1, 0/4 nodes, ER+/PR+, HER2- Radiation Therapy Whole-breast: Breast
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Oct 31, 2019 06:02AM SummerAngel wrote:

I was paranoid at first, too. I'm lucky because my only risk factor was surgery, and I think it helps if you were strong and fit before cancer. Now I don't even think twice about tasks that scared me right after my treatment. For example, I shoveled snow 4 times in the past two days (big storm in Colorado), no problem! I've never worn a sleeve and don't plan to unless I develop Lymphedema later in life.

Age at dx: 45. Oncotype, left-side tumor: 9. Right side had multifocal IDC and "extensive" LCIS. Isolated tumor cells in 1 right-side node. Dx 3/27/2015, IDC, Left, 2cm, Stage IIA, Grade 1, 0/3 nodes, ER+/PR+, HER2- (FISH) Dx 4/27/2015, IDC, Right, 1cm, Grade 1, 0/2 nodes, ER+/PR+, HER2- (FISH) Surgery 6/1/2015 Lymph node removal: Sentinel; Mastectomy: Left, Right Surgery 6/1/2015 Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 8/28/2015 Reconstruction (left): Fat grafting, Silicone implant; Reconstruction (right): Fat grafting, Silicone implant Surgery 12/4/2015 Reconstruction (left): Fat grafting, Nipple reconstruction; Reconstruction (right): Fat grafting, Nipple reconstruction

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