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Xithras Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-03-04 08:40 PM
Original message
Anyone have any experience with kids and eating disorders?
I just had a disturbing phone call and made an even more disturbing mental connection about my oldest child.

My 10 year old daughter is, like both me and her mother, exceptionally tall and thin...really the definition of "waif-like". Several months ago I noticed that she wasn't eating much for breakfast in the morning, on some days trying to skip breakfast altogether, and that her appetite for dinner had scaled back as well. I mentioned it to her pediatrician at her last visit, and the doctor told me that she was fine physically and that she was probably going through a lull in her growth and was eating fewer calories as a result.

I believed this until 5 minutes ago. My daughters 5th grade teacher just called me with some serious concerns. Apparently she has overheard my daughter on more than one occasion tell her friends that she's "fat" and "dieting to be skinny and pretty", and so the teacher began watching her for any signs of A/B. What she found was that, in three weeks, my daughter has thrown her lunch in the garbage uneaten every single day.

The teacher took her concerns to the school nurse, and they confronted her about it today. My daughter, who is a very quiet, extremely intelligent (all GATE, tests in the top 3% nationwide for reading comp and math), and pacifistic kid apparently flew into a furious and tear filled screaming RAGE that they were "spying on her", and said that she eats as much as she needs. When the nurse asked her why she was throwing her lunches away, my daughter repeated that she was "a fat pig". This, coming from a girl who is 4'8" and weighs less than 60 pounds, alarmed them a bit (just for reference, at 18 I was 6'1", 135 pounds, and I ate like a horse, so a certain component of her weight is genetic).

So now I'm sitting here wondering what the HELL I did wrong, and how to fix this. Her teacher recommended that I get her into her doctor right away, and I'm planning on doing that, but what else can I do? I have absolutely ZERO experience with eating disorders and don't know where to start with this. Do I start making her plates myself and force her to eat? Do I need to take her to a shrink? How does this stuff start? She doesn't like boys yet so I doubt she's doing it to attract anyone, and she doesn't even have a belly bulge so I'm not sure how this whole thought process even got started.

Any advice that anyone can give me would be helpful. I don't think I've ever felt this confused, or this helpless, about a parenting problem before. There's something wrong with my little girl and I don't know how to help her
:cry:
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greatauntoftriplets Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-03-04 08:43 PM
Response to Original message
1. Talk to your daughter's pediatrician.
Even if you tried, you wouldn't be able to force her to eat. Please talk to her doctor as soon as you can and see what he/she recommends.

Good luck to you. This would worry the hell out of me.
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Nevernose Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-03-04 08:44 PM
Response to Original message
2. Does you insurance cover psychiatry?
Run, don't walk...
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Xithras Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-03-04 08:53 PM
Response to Reply #2
7. Yes it does
Should I call a psychiatrist before seeing her pediatrician?
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greatauntoftriplets Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-03-04 09:03 PM
Response to Reply #7
11. Call her pediatrician first.
He/she will suggest a course of action and a trusted psychiatrist experienced in treating this problem.
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Nevernose Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-03-04 09:15 PM
Response to Reply #7
18. I would, but everyone's situation is different.
My daughter's about the same age and in similar circumstances (GATE, high test scores, divorced parents, self-image concerns), so I feel for you. The things this insipid, shallow, juvenile society is doing to all of our daughters is just sickening -- but that's a whole other rant.

You might want to go to the pediatrician just for a referral to a child psychologist or an eating-disorder specialist, if you don't know of one yourself.

This is a psychological problem, not a physical one. It would seem to me that a pediatrician would just be able to recommend a shrink, which, IMO, would be a waste of precious time. I'm willing to bet you that when you call for the appointment with the pediatrician on Monday morning, a quick explanation to the charge nurse will get an equally quick referral to a child psychologist, though they may want to evaluate for bone density, possible malnutrition, and whatever else they evaluate people for.

Thank God you have insurance. With insurance, you can probably do both the pediatrician and the head-shrinkers. If it were my kid, I'd make both appointments first thing Monday morning. Then again, I'm just some jerk on the Internet -- what do I know?
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LiberalEsto Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-03-04 08:48 PM
Response to Original message
3. First of all, tell her you love her
I don't think you did anything wrong. Sometimes these things just happen, and our society's warped values about female beauty don't help.

Go on the web and look up everything you can about the subject. Educate yourself.

Try to find a doctor who really understands and specializes in this. At some point they may recommend a support group.

Don't scold or criticize her. Be helpful and loving and supportive.
Good luck!
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JimmyJazz Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-03-04 08:49 PM
Response to Original message
4. Don't force her to eat - she'll only start a habit of vomitting.
You have to take her to the pediatrician and probably to a psychiatrist. A lot of times A/B is a control issue. If she feels out of control in her surroundings, her school or home environment, she might be doing this to try to obtain a false sense of control. She can't control what the adults are doing, but she can control what that scale says. The psychologist or psychiatrist can help with that.

I wish you all the best with this. Please keep us posted as to her progress.
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roguevalley Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-03-04 08:51 PM
Response to Original message
5. I taught 27 years and had a sister-in-law who was anorexic.
don't wait, this is a mental illness with physical manifestations and don't let her run you about what to do. This is a serious thing and you need professionals. Sometimes kids need to feel they control something and the easiest thing is their appearance. She may not have this as part of her particular thinking but its common, especially with perfectionist kids.

Get pros to help you. Its a long process and she needs treatment. They can ruin their bodies this way, honey. Calcium depletion and brittle bones can result. Call and see who is the specialist for eating disorders in your area. The hospital should tell you if you call. Don't despair. There are even places to send kids like this to get treatment. Action is warranted and the help is there. Hugs to both of you.

RV
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roguevalley Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-03-04 08:52 PM
Response to Original message
6. And, don't beat yourself up, honey. It happens to who it happens
and you shouldn't play the blame thing. Turn the angst into energy and get help.

Tell us how she is. Talk here. You'll feel better for it.

RV, again.
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spotbird Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-03-04 08:54 PM
Response to Original message
8. Is she a perfectionist?
There are medicines that are effective, with counseling. You will never convince her that she is thin, never. The intervention must include pharmaceuticals.

Get her an appointment Monday.
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Xithras Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-03-04 08:58 PM
Response to Reply #8
9. Yes she is.
How do the medicines work? She is an exceptionally gifted, extremely creative child and I wouldn't want to drug her up in a way that would destroy that. Why must an intervention include drugs?
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bettyellen Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-03-04 09:11 PM
Response to Reply #9
14. it's related to obsessive compulsive disorder -- i think it's usually
wellubutrin perscribed, and yes, it has much better result than talk therapy. for some reason, regular therapy does not have a great track record. you've got to get it through her head that there is no such thing as perfect-- that taking good are of yourself is damned near closer to perfection than wasting away like this. even if she's showing no interest in boys yet, the pressure starts to build- the lookism thing kids in, and other kids arerude and competative about stuff like this. little girls can be amazingly cutting and bitchy to their peers. whatever you can do to bolster her self esteem, to rid her for this need to for control. do it. get good counsel for you and your wife as well, she may be picking up signals you are not aware of. But don't waste time blaming yourelf. As soon as you can, a psychiatrist for her, and a really good one.
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politicat Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-03-04 11:42 PM
Response to Reply #14
27. In re: antagonism between girls at puberty...
In mixed sex environments, that IS observed. In single sex environments, it is very much diminished. It still exists, but at a far diminished rate. (Thinking back to my observations, something like 60 negative, inter-female remarks in an hour in a mixed sex environment of 10 children, versus 7 similar remarks? something like that. It's been forever since I did the experiment, and then did not get funding.)

It makes sense from an evolutionary point of view. We know that grudges among female apes can be life-long, and their rivalries are cold rivalries that become worse when males are present. Girls at puberty are in a headspace that is pretty similar to great apes. (They're not apes, just not yet proficient with sorting out emotional, hormonal and social cues and so react instead of comprehend and act.)

Thus, in practice, I tend to recommend single sex schools whenever they're available. They're expensive and they're hard to find, but from what my clients say, worth every penny.

Pcat

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spotbird Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-03-04 09:14 PM
Response to Reply #9
17. You'll be surprised.
check your pm in a minute
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politicat Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-03-04 11:35 PM
Response to Reply #9
26. Because her brain chemistry is non-functional.
That's why drugs are necessary, if her psychiatrist puts her on them. If that's the case, it will not destroy her creativity or her brilliance in most cases once she passes through the adjustment phase, and if she's not adjusting, then either dosage or chemical is not functional for her. The goal of medication is to correct the chemical imbalance without damaging that which is functional. As a psychologist who works closely with my client's psychiatrists on meds issues, I'm a huge supporter of adjusting the meds until you get the right one. And please... murder the myth that creativity and art come from misery and the only geniuses are shattered social wrecks. It's not true and it's not healthy. Mental illnesses of all sorts impede creativity, limit genius, and dim brilliance. And it is a chemical imbalance. That's why it hits at puberty. Recognize that every drug works differently in the brain, and for some, we are not entirely certain HOW they work.

I won't address this further in terms of your daughter, but in terms of coping strategies that I've recommended because I don't know either of you and specifics would be unethical. First, early intervention is absolutely critical, and the intervention team that seems to work best is a nutritionist, a psychiatrist who works with eating disorders, a psychologist who works with adolescent girls, and a general practitioner. An HMO specialist (for dealing with the insurance company) is handy, but not always possible. A family psychologist is a good idea.

A/B/C (Anorexia/Bulemia/Cutting) are control issues. They're also neurochemical issues, social issues, and obsessional disorders. They really do lump together very well because the behaviors are very similar. Families of A/B/C clients must work together to learn to communicate effectively and behave appropriately with each other because they are part of the absence of control that the client feels. This is why family therapy is needed. However, just working to be non-combative and cooperative with each other usually helps immensely.

Nutritionists are useful in that one of the biochemical markers of AN is rapid sensory exhaustion. Basically, for those with A, they tire quickly of the flavor of a single food, far more rapidly than their non-A counterparts. Thus, one of the suggestions that we've worked with here and I will be writing a paper on eventually is the use of nouvelle cuisine methods in A treatment. Very small courses, served elegantly, and with varied flavors. It makes for more work, but it also makes the meal an event for everyone, and has had the effect of repairing familial bonds. (Concept built on Rolls, Barbara J. The Role of Sensory-Specific Satiety in Food Intake and Food Selection APA, 1990) The real world example of this is the large quantities of food people consume at holidays, when there is a greater variety of dishes, compared to a normal day. Thus, the idea with an A client is not to replicate that idea of a holiday menu nightly (which would be detrimental to the rest of the family) but to incorporate small courses and dishes to maximize flavor. A sample menu I've used includes a single piece of sushi, a small (3 oz) bowl of soup, a devilled egg, a ribbon sandwich of turkey, roast beef, ham and cheese, a dressed salad of greens, cucumber slices, grape tomatoes, peas (served on a saucer), a baby red potato with cheddar, bacon and chives, a petit four and tea. Sounds daunting? not terribly. It can be done with forethought... and lots of small plates. With some clients, everything is eaten with forks and knives and spoons.

A/B/C are usually related to puberty. It is always worth looking into the social atmosphere in the school, especially if the lads have a common culture of harassing the girls. (this happens far more often than most people realizes, and very, very few young women come forward and call them on it.) All girl schools, if available, have been beneficial for young women for whom their initial triggers were based in male-peer harassment and bullying. (This also goes for overeating.) Breast and hip development is usually a trigger so encouraging self exploration and appreciation is indicated. Some therapists outside of the United States have encouraged sexuality training as an adjunct to standard and family therapy. I can't do it here, of course. It makes sense to me, since A/B/C are often rooted in a deep fear of sexuality and sensuality.

Good luck. Get help soon. And give her a hug and a cuddle ASAP. One thing that has been mostly abandoned because we thought we'd drilled it into fathers was "Don't abandon your daughters when they hit puberty, don't treat them differently, and don't distance yourself or become overprotective." If a father's behavior changes, it will exacerbate any existing problems by reinforcing them. Give yourself a good, hard look and make sure you're not changing your behaviors. In 95% of cases, there's nothing that any parent did or didn't do that triggered this, it's just biochemical. In 4% of cases, whatever the trigger was was innocently intended. And in the remaining 1, you have really effing cruel people. But you have to be honest and brutal with yourself because there is no time for self delusion anymore.

Pcat

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livinbella Donating Member (477 posts) Send PM | Profile | Ignore Fri Dec-03-04 09:02 PM
Response to Original message
10. This worked for me
I began to eat only when my daughter ate.
I told her "I am going to try the diet you are on."
Simple as that. We agreed to eat all meals together, cutting
out lunch, which I knew she would skip anyway.
When she saw me wasting away, she started eating more, more often.
You don't always need drugs and psychologists to solve things.
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bettyellen Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-03-04 09:13 PM
Response to Reply #10
15. wow, that's an amzing story.. I'm glad you had success with that.
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spotbird Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-03-04 09:49 PM
Response to Reply #15
23. It could easily lead to bulimia.
Since it didn't, congratulations.
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politicat Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-03-04 11:46 PM
Response to Reply #10
28. You got really, really lucky.
I'm going to say that you both could have ended up very ill, and had your daughter had less empathy, you would have. There's no way I could recommend that (and not because I'm a psychologist; it's not cutting into my professional credibility or my pocket) because it doesn't address underlying issues and it doesn't address and resolve what is really going on. And it's dangerous as all hell.

Pcat
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azoth Donating Member (408 posts) Send PM | Profile | Ignore Fri Dec-03-04 09:07 PM
Response to Original message
12. My ss had some eating issues.
As the rest did, I would urge you to get professional help. Be open, honest, and nonjudgmental.

Best of luck to you and your family!
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radwriter0555 Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-03-04 09:08 PM
Response to Original message
13. Anorexia isn't cured by brutality, it's a mental disorder that needs to be
treated by psychiatry and a doctor.

She's not a bad girl, you haven't done anything wrong; there are some emotional issues going on with her. In fact the first thing to observe is her school situation and her peers. Social anxiety plays a HUGE role in these situations.

DO the research. You have the power of the internet at your fingers. Read, read, read, ask questions, read some more, and educate yourself so that you can help her, NOT punish her.

She's not doing anything "wrong." She has a mental and emotional disorder that needs to be treated properly.
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jdots Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-03-04 09:14 PM
Response to Original message
16. Sad but true fact ..... equal rights ... girls hurt themselves
It has been very trendy for girls to not eat,cut them selves,wash thier hands all the time etc.......when my youngest daughter started doing these things I thought it was just her wanting to be like the other girls.NO SEEK HELP NOW ! and good help,not some pediatrition who treats things with a band aide.See the movie "13 " i saw it with my daughters and cryed in the theater,then asked them if it was true,they said " Dad it's even worse " What our kids go thru in one day is something we can't fathom and we think because they are our kids it can't happen.
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Metatron Donating Member (877 posts) Send PM | Profile | Ignore Fri Dec-03-04 09:21 PM
Response to Original message
19. Hi Xithras
I was a teen with similar issues to your daughter. I recommend (as others have here) that you call your pediatrician and do some general research yourself. I know as a parent that you are probably feeling like "What did I do wrong?" - but this isn't a result of bad parenting! There are a host of reasons for eating disorders and rarely are medications the only solution (or even part of the solution). Once you find out more about her condition, the less scared you will be and the more you will be able to help. Forcing her to eat isn't the way.

For what it is worth, I grew up to be a normal sized (although small framed) woman. Once you talk to her doctor, you will be able to make a plan. For right now, my opinion is to be the same parent that you have always been. I know it is hard, but you will both get through this.
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IndyOp Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-03-04 09:24 PM
Response to Original message
20. It's not your fault and there *are* people who can help...
I am not a parent. I do care very much about children and I have fought my own self-hatred about weight for most of my life. Maybe it will turn out that your daughter does not have the full-blown disorder, but just some symptoms that can be treated relatively easily.

I teach college-aged students and hear constantly from them about the pressures they experience about weight. Your 10-year-old is SURROUNDED by children, by books, by magazines, by TV shows that all emphasize that if you are not feeling loved it is probably because of your looks -- you are too fat or too plain or too brown-haired. The first complements many little girls hear is about 'how pretty' they look in this dress or with that hair style. And many of us spend the rest of our lives trying to reach some unattainable ideal of 'beauty'. While you can't easily change your eye-color or 'looks' you can try to be perfect with weight.

The youngest anorexic I have ever seen was 8-years-old and skinny. Her mother caught her one night around 2:00 a.m. running in place and jogging. During the school day she would tear pieces of paper from the corners of her notebook and eat the paper -- she explained that this way she could eat to be full but not take in any calories. She said that she began to believe that she was fat when she saw baby pictures of herself and saw that she had had a double-chin when she was 9-months-old. Again: this little girl was skinny at 8 years of age. Her therapist worked with her to figure out what she dreamed of doing. She revealed that she would *love* to ride horses. Her therapist and her mother let her spend time with horses, but emphasized that she had to have a healthy body before she could ride regularly or show horses. They created a 'healthy diet plan' and made 'healthy weight goals' and as the girl began meeting the goals she got to spend more and more time with the horses. Her self-esteem was then fed by her success with the horses and she could let go of the idea that loosing weight would gain her acceptance and love.

I know a dear counselor who has great success with anorexics. He emphasizes that they are perfectionists and that he *loves* working with them because he can help turn their focus from trying to be perfect at restricting their food intake to being really good in other ways - academically, socially, musically, spiritually.

Your daughter is obviously intellectually and spiritually gifted - she's a pacifist at age 10! You will be able to help her through this. I am really grateful to learn that her teacher was so attentive.

I would suggest that you talk with your pediatrician and ask for references to therapists who specialize in working with people with eating disorders (hopefully someone who has experience with young patients). The therapist may want to have some private sessions with your daughter. At some point the therapist may ask your entire family to be involved in sessions -- it really helps when family members are willing to do this. Families who work through this often become stronger as individuals and as a unit.

An angel for your daughter - O8)

An angel for you - O8)
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IndyOp Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-03-04 09:37 PM
Response to Original message
21. Read up on the medication issues before you start...
Anti-depressants and anti-anxiety meds can be very effective and they can have serious side-effects.

WhatMeds.com is for parents, teachers, relatives, friends -- anyone seeking information about psychiatric medication for children and young people...
<http://www.whatmeds.com/>

There are 100's of websites about eating disorders. Empowered Parents looks like it has some good info... just as a start... <http://www.empoweredparents.com/>

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cally Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-03-04 09:42 PM
Response to Original message
22. You cannot force your daughter to eat
and I recommend that you just let it ride until you meet with the professionals. She needs expert help to deal with this. Don't alienate her at this point, but instead seek help.

My sister specializes in eating disorders as a psychologist. She felt that both my daughters were at risk so I received the papers and articles. :sigh: I read some. It appears..new research.. that some teens who get below weight seem to lose the ability to rationally see their bodies as others do. My sister kept warning me to not let my children get too thin. They weren't dieting but were naturally very thin in early adolescence. Also, some pre-teens react to their changing bodies by trying to stop it. They diet to control the changes happening. Don't blame yourself but focus on getting help. When you get a chance, thank that teacher. She may have saved your daughter's life.
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Xithras Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-03-04 10:03 PM
Response to Original message
24. Thank s to all who replied and PM'd me
Sorry, I guess I kind of panicked after I got off the phone and didn't know how to react. I'm a bit calmer now and, after thinking about it during a short walk outside, I'm going to take the advice of several of you and play it cool for now. I'm calling her pediatricians office first thing in the morning to see if I can get her in on monday, and we'll just take it from there.

As for researching eating disorders on the Internet, I think I'll hold off on that as well. The last time I researched a medical condition on the Internet it was for a red spot on my son's back, and before long I'd convinced myself that he had skin cancer...you can imagine how embarassed I was when the doctor diagnosed him with chicken pox :dunce: I have a habit of getting worked up over worst case scenarios, and usually end up just scaring myself needlessly. I'll wait until I talk to the doctor.

As to the suggestion that we call the shrink first, it turns out that I can't. Our HMO does cover psychiatric (75% anyway), but it requires that the primary physician do the referral thing before I can contact anyone. It looks like I'm stuck until Monday.
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spotbird Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-03-04 10:11 PM
Response to Reply #24
25. Maybe the GP can start her on the antidepressants
while she is waiting for the appointment with the specialist. You could at least ask.
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