Brachial Plexus Palsy at Two Years

Nicholas will be two in less than a week.  It’s been nearly two years since Nick was born and nearly two years since he sustained a birth injury.

Before Nicholas was born I enjoyed his constant movement and energy as he spent his days (and nights) kicking and squirming.  I thought that he was a boy even before we met him because of his strong, constant movements.

The first time that I saw Nicholas, he was different from the constantly moving baby that I had come to know during the pregnancy.  After his birth, our baby was unable to move either arm.

So what happened?  Nicholas’ head had been born without any difficulty (well, if you consider 5 hours of transition ‘no difficulty’), but his shoulders had gotten stuck  (shoulder dystocia).  In her effort to dislodge Nick’s shoulders the midwife caused two injuries.

Nick’s right arm (humerus) was broken, but his left arm had sustained a more serious injury.  The nerves (C5 & C6) on the left side of his neck were damaged and his left arm was paralyzed  (Brachial Plexus Palsy or Erb’s Palsy).

God created babies to heal quickly and over the next several weeks Nicholas’ broken right arm healed as expected.  The injury to his left arm was more complex.

40 second video of  Nicholas at one month.  (Notice Savannah’s excitement at seeing him move his right (broken) arm.

Because of how quickly babies grow and develop during the first 3 months of life, the lack of nerve impulses to the muscles can cause problems and imbalances later on even if the child regains complete nerve function.  The specialists have vastly divergent opinions as to what should be done for these babies.

We immediately got Nicholas into regular physical therapy.  Then Nicholas was evaluated by three different specialists (Cincinnati, Texas and Philadelphia) and each had a different opinion.   One suggested one type of surgery, the second suggested two different types of surgeries (both surgeries different from the type suggested by the first) and the third wanted us to continue with the PT and wait and see how he would progress on his own.  We chose to wait.

So how has the physical therapy/waiting path turned out for Nicholas?  Take a look.

Two arms up

Palms up (supination)

Hands behind back

While there are some slight differences between his injured (left) and non-injured (right) arm,  if you know or were to meet Nicholas you would probably not notice.  Also, unless he’s arrested ;) he shouldn’t have any difficulty functioning in the world.

A newborn being able to move their arms is a miracle and a mercy of God.  It’s just one of those miracles and mercy’s that most of us take for granted. I still marvel when I see a newborn moving those little arms, it was something I never marveled at before Nicholas, but it is something that I will not take for granted again.

We have been blessed in that Nicholas has had a marvelous recovery (many children don’t and they deal with multiple surgeries, pain and disability their whole life), but before Nicholas’ birth we had never heard of Erb’s Palsy or BPP and with our history, we should have.

If you have experienced a shoulder dystocia, you are at a higher risk for another and some risks, although rare, of shoulder dystocia are Brachail Plexus Palsy, brain damage and infant death.  Also, simply because you birth naturally and are active during labor and birth does not mean that you do not carry these same risks.  If you’ve experienced a birth with a shoulder dystocia it’s worth doing some research so that you can make informed decisions.

More info on Brachial Plexus Palsy / Erb’s Palsy:

When we were beginning to realize the nature of Nicholas’ injury we discovered this video of Femke’s recovery from BPP.  Her father does a great job documenting her progress on video and it is very similar to what we experienced with Nicholas’.

The Brachial Plexus Palsy Foundation offers a lot of useful information for parents as well as a private support forum for parents of BPP kids.

You may be interested in:

 

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49 Responses to Brachial Plexus Palsy at Two Years
  1. Nicki
    April 13, 2010 | 10:25 am

    He’s so cute (and what a great name!) and I’m glad he healed so well. And I don’t think he’ll get arrested. : )

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  2. Phyllis
    April 13, 2010 | 10:34 am

    This post was very touching and informative. Thanks for sharing this with us.
    -Phyllis

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  3. lauree
    April 13, 2010 | 11:42 am

    Amazing. Our God is so good. Just look at that sweet little boy!

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  4. Helen
    April 13, 2010 | 1:04 pm

    So glad things turned out well!

    Nicholas is a doll :)

    Lucy

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  5. Leann
    April 13, 2010 | 1:26 pm

    What a blessing his recovery has been – I am always so awed by how resiliant babies are and by the healing power of God.
    And I completely understand how you now view a ‘normal’ newborn happening as a miricle. I was that way after our 6th was born- about, of all things, baby poop! But after seeing what our baby went through, and nearly loosing him twice, just to be able to do something most take for granted, it changes your view of things.

    Happy Birthday to your Miricle boy!!!1

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    Kimberly @ Raising Olives Reply:

    It is a humbling thing to realize how much we take for granted.

    How is your son doing now?

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    Leann Reply:

    @Kimberly @ Raising Olives,
    thanks for asking – at age 7 he is doing wonderfully. He had a long and rough first 3 month – born breech with a true knot, then spent 10 weeks in NICU very sick, had 2 gut surgeries (illeostomies) and another then at about 6 months to re-connect the plumbing. They treated him as if he had CF until he was 9 months old and could do a more definative screening to rule that out, but never did figure out what caused him to block up in the first place.
    The only way now that you could tell all that happened is by all the scars from surgeries and picc, art IV lines

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    Kimberly @ Raising Olives Reply:

    @Leann, God is good. Glad to hear he is doing well and thank you for taking the time to answer my question.

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  6. Virginia Lee
    April 13, 2010 | 2:05 pm

    I had never heard of this before. So sorry that ya’ll had to. But God is good and he looks wonderful. Happy 2nd birthday!

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  7. My Boaz's Ruth
    April 13, 2010 | 2:30 pm

    THIS is what I was the most afraid of — shoulder dystocia. Because my family tends to have larger babies (though I know small babies can get it too) and once the baby is STUCk, it isn’t like they can change their mind and take him the other way anyway.

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  8. Polly
    April 13, 2010 | 2:49 pm

    What a cutie!

    It’s always hard when you become an expert in something you never even knew about before!

    (With us it was sensory integration issues.)

    As a PT, I have to say yay for you guys for taking the conservative route!

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  9. Jamie
    April 13, 2010 | 3:35 pm

    Thank you for sharing this. My second child had shoulder dystocia, but thankfully was born without injury. It was several years later that I became pregnant with our third child. He ended up being delivered via c-section for many reasons. He was born with a meconium pseudo cyst in his belly and ended up spending 105 days in our childrens hospital (Cincinnati). He was also in breech position and came 3 weeks early (on his own timing). So I say all that to say that I never really got to contemplate how I was going to deliver him. Early in the pregnancy I was given the options of being induced early with the hopes of being able to easily deliver a smaller baby, or just having a c-section. I struggled with those choices. I am bot a fan of inductions unless it’s a emergency, because I don’t want to force them out before they’re ready, but I also didn’t want the added interventions and potential problems associated with a c-section. Thankfully God chose for me by giving our situation all the ingredients for a necessary c-section. Our baby is only 7 months now and our doctor is pretty much ruling out any other option than a c-section for further births. I’m kind of bummed about that, but a healthy baby is the goal and however that happens is the best option. I just wonder if you’ve been given those same options or not. And if so, i’m curious what you’ve chosen to do. Thank you for bringing this topic to light. Before my daughters birth I had never heard of this complication.

    [Reply]

    Kimberly @ Raising Olives Reply:

    Thank you for sharing your experience Jamie.

    We are faced with some difficult decisions. Our history is more complex than just Nicholas’ injury and we are praying for God’s wisdom and guidance. Any additional prayers are appreciated! :)

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  10. MomStarr
    April 13, 2010 | 5:08 pm

    The last picture….”behind the back”….just look at those muscles!!!! Our God is good and oh so incredibly wise in His creation of the human body and how it heals! We are praying for your newest.

    [Reply]

    Kimberly @ Raising Olives Reply:

    Thank you!

    Why haven’t you had that baby yet?? Praying for you and looking forward to hearing your news.

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  11. Young Wife
    April 13, 2010 | 5:16 pm

    I am so thankful he’s doing so well! Praise God!

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  12. Janice
    April 13, 2010 | 7:32 pm

    God is so good! Love that buzz. Really looking like an Olive now! Love all your updates.

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  13. happyheartshelpinghands
    April 13, 2010 | 9:53 pm

    Our now-almost-two-year-old was born with a mild Erb’s palsy that resolved on its own in about a month. After reading your story, I realize just how ‘mild’ it was and how quickly it healed. At the time, though, it was a big deal to us and we celebrated every little movement in the healing process. I so identify with not taking baby movements for granted!! I also applaud you for taking the ‘wait and see’ approach. What an amazing God – to bring about such great healing for Nicholas! I will be praying that you’ll have wisdom as you make decisions about your upcoming labor/delivery. You may or may not feel free to respond to this question, but I’d be interested how you dealt with the situation emotionally and whether or not you struggled with anger related to the midwife’s actions.

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    Kimberly @ Raising Olives Reply:

    I’m glad that your baby healed quickly and fully. Erb’s Palsy is always a big deal when you’re going through it, because there is no way to tell just how well your child will recover. I’m thankful for your child’s healing.

    God taught me a lot through this experience. It’s something that I’ve thought about posting, but it’s difficult to put into words.

    The short answer is that I did struggle with anger.

    I struggled that I felt so much grief when so many others have to deal with situations much worse than ours.

    Through the struggle God taught me that ultimately I was not being content and accepting of His will. I wasn’t happy with His perfect plan for Nicholas’ life.

    Again God showed His mercy. On the day that I looked at Nicholas and was able to say, “God, thank you for the amazing and special plan that you have for this baby.” we began to see signs of recovery.

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  14. Kim from Canada
    April 13, 2010 | 11:18 pm

    My ten yo daughter ended up ‘stuck’ and having her right collar bone broken in the final points of delivery. The injury healed very well in the first few months – but even now, if she twists her head too quickly she tears up from the sudden pain in her shoulders and neck.

    She was a big baby (11 lbs and 23″ long), but the final u/s had the medical team convinced she was smaller than that! Now, ten years later, number two baby is finally on the way and we are NOT trusting any u/s! Our doctor is leaving any decision for c-section until the very end of pregnancy, but we already see signs of another ‘big ‘un!’

    Praying for a more prepared delivery this time around.

    [Reply]

    Kimberly @ Raising Olives Reply:

    Praying that God will give you the wisdom to make the best decision for you and for your baby!

    [Reply]

  15. Tina
    April 13, 2010 | 11:27 pm

    I experienced shoulder dystocia with 2 of my babies. Thankfully the worst that happened was that one of them had a fractured clavicle (shoulder blade) which healed very quickly. When I was expecting my 4th the ob told me the shoulder dystocia happened because my 2nd stage is very fast and the babies didn’t have time to rotate their shoulders as they passed through the pelvis. I was advised to not push my babies out, but let my uterus do all the work. So I did this with my last 2 babies and had no problems. It also helped that they were smaller. My biggest was 9lb 14oz.

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  16. Jamie
    April 14, 2010 | 12:49 am

    Oh, Kimberly, his movement looks GREAT :). I am so, so, so happy for you. I am thankful for this injury as well, because without it, I would never have “met” you! Nicholas looks really good. Definite lack of range in a few areas, but who needs full range, anyway??? That’s what I tell myself anyway :). Titus is doing well, and can supinate about to where Nick can (which is nothing short of a miracle!). Of course, Titus’ scapula has to go all crazy for it happen. Once we are done with our major “season change” of clothes, it is on my list to get pictures to you! That way you can “see” Titus’ shoulder. Question for you: does Nick still “trumpet”?

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    Kimberly @ Raising Olives Reply:

    Thank you Jamie! You don’t see any ‘winging’ with Nick, do you?

    I can’t wait to see pictures of Titus. That much supination is TERRIFIC. I’m so glad that God gave you and Titus a miracle.

    Nick ‘trumpets’ slightly, just to 45 degrees. No one except a BPP mom would notice. ;) Does Titus?

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  17. Kath
    April 14, 2010 | 1:38 pm

    Did you have any chiropractic treatments for Nicholas in the course of his care?

    [Reply]

    Kimberly @ Raising Olives Reply:

    Great question Kath.

    Yes, we did have chiropractic help for Nicholas. They can’t help with the nerve damage, but obviously there was more going on with that birth than just nerve damage.

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  18. Meagan
    April 14, 2010 | 3:07 pm

    I am so sorry to hear about what you guys went through, snd glad to see the recovery so far. Our family hasn’t dealt with the same stuff, but we have become experts in eye issues…. much more than we have ever wanted to be…. The docs don’t know how or why it happened, there is no family history of it at all, and we have low chances of it ever happening again…. I have to wonder if it was a viral thing (shingles) that I didn’t catch but baby did….

    It makes me stop and think how miraculous the eyes of a newborn are…. and how every other piece of that baby is knitted together so perfectly that most kids never have to even see a specialist. If only that had included us….

    I used to ask God why…. and have come to realize that God has knitted together everyone of these precious kids in the exact way that they were intended to be so that they could serve him in ways that they may not have been able to if they were “perfect”.

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    Kimberly @ Raising Olives Reply:

    God teaches us so much through our children, they are a direct line right to our heart.

    Yes, the miracle of newborns, the eyes, arms, hearts, lungs, skin. We really don’t know how amazingly blessed we are when we have a ‘normal’ baby.

    I used to ask God why…. and have come to realize that God has knitted together everyone of these precious kids in the exact way that they were intended to be so that they could serve him in ways that they may not have been able to if they were “perfect”.

    Excellently stated.

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    Meagan Reply:

    Amen

    [Reply]

  19. Kim
    April 14, 2010 | 11:04 pm

    Hey Kimberly!
    SOOOO glad to see Nick’s improvements! God is gracious and merciful!
    I was(and am) so sorry that that had to happen to you.
    No doubt it was difficult for you and you have learned a great deal of mercy yourself and I know a TON of grattitude.
    God does have HIS ways doesn’t he?

    I was just wondering if you could tell me if you had ever tried to use a birthing chair or squat for delivery? I think I heard that is supposed to open your pelvis up by 30% more.(I’ll have to check on that number.) Seems worth looking into.
    I also am wondering why none of the doctors hadn’t mention the dangers before since you had had simialr goings on with the other deliveries. I think if you had known about the dangers, you would have made sure that certain things happened during birth.
    I know you had very good doctors.
    I am definitely praying for wisdom for you and your hubby. I know it is a hard thing.
    We certainly do want the best for both you AND baby! God will give you peace…just wait on Him!
    Thanks for all you do!
    Love and Blessings to You All!
    Kim

    [Reply]

    Kimberly @ Raising Olives Reply:

    Thanks Kim.

    Yes, I have used a squat (and also a birthing bar) for some of the deliveries, each instance of that resulted in an injured or seriously stuck baby.

    I do wish that one of my caregivers had mentioned the risks to me, but am not sure what things we would have made sure happened during the birth that we weren’t already doing. :)

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  20. (the other) mama olive
    April 19, 2010 | 11:50 am

    Wow, that story made me tear up. My most recent (and biggest) baby was compound presentation, but still made it out pretty easily. I guess the “dysfunctional” pelvis served a good purpose! (I was on my side throughout labor and delivery.)
    God is amazing in what He can bring us through.

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    Kimberly @ Raising Olives Reply:

    God is amazing and He is good. Praise God for a healthy baby.

    [Reply]

  21. michelle
    April 22, 2010 | 4:31 pm

    do you still homebirth?

    [Reply]

    Kimberly @ Raising Olives Reply:

    Because of our whole birth history (and not just Nicolas’ injury) we will not have another homebirth.

    That decision was a very difficult one for me, but not for my husband. :)

    [Reply]

  22. julie lloyd
    May 12, 2010 | 9:13 am

    Thank you for sharing your story. Our son has erbs palsy and just had surgery. It is so rewarding to see the pictures of your son and hearing your story. Thank you for sharing as the tears roll down my face. I am crying in happiness!!! So happy to see your son doing so well!!! God Bless

    [Reply]

    Kimberly @ Raising Olives Reply:

    Julie,

    Thank you for taking the time to comment and for sharing in our happiness.

    I read your comment to our children and we wept for you and your son. We understand each other in this trial in a way that many people never will. We will be praying for a marvelous outcome for your little boy and that God would give you peace and comfort as you walk this long road.

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  23. Maria
    December 7, 2010 | 5:49 am

    I’ve just read through your Erb’s posts and it has brought me to tears. Our 5th birth resulted in a Brachial plexus injury. Though I’ve delivered in a hospital I’ve always had drug-free, vaginal births. Two shoulder dystocias. When our sixth birth last March had to be csection I was very afraid. Our son was born healthy, praise God!

    I just am so happy that you are able to rejoice in his bringing his hands together! Each new milestone is such a joy!

    Our daughter also sees Dr K. She has a c5,c6, c7 involvement and her hand and fingers do not function. We are very grateful to God that she is very bright and such kick!

    I know this post was long ago so I’m not sure if you’ll see my comment but I am happy to have stumbled upon an other family experiencing life with a brachial plexus injury.

    You have a beautiful family, rich with God’s grace.

    Thank you for sharing.

    Maria

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  24. Maria
    December 7, 2010 | 5:50 am

    oops, are you able to remove my last name?

    [Reply]

  25. Stephanie
    April 18, 2011 | 8:35 am

    Thanks so much for sharing your blessings in your sweet little one with us .. it was a blessing to me! God has been good to you!

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  26. Cheryl @Treasures from a Shoebox
    April 18, 2011 | 9:07 am

    My last two children were both born at home, weighed over 11 lbs each (one was 11 lbs 15 oz) and with both I experienced shoulder dystocia. I had never heard of Erb’s Palsy before I read about this here last summer; now I’ve been told about it several times from different sources. Both of my children are fine, praise God. Should I become pregnant again, we will need to make our decisions based on new information and bathed in prayer. Thanks for sharing your story.

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  27. Amy Clark
    April 18, 2011 | 9:27 pm

    I know this is an old post, but I found it by accident and had to comment (I am a fairly new reader, having come here because I just began homeschooling). I have a nine year old daughter with a brachial plexus injury. You hear of so few! Lexi’s injury was quite severe – she has had three surgeries, and no improvement. Her entire arm is almost completely paralyzed. But we know the Lord, and realize that she is still “fearfully and wonderfully made!” We are trying to teach her to be thankful to the Lord for the way He allowed her to be born, and she is doing wonderfully! She has learned to compensate for nearly everything – gets herself dressed, helps with chores, plays soccer, even just recently started to play the cello (with some major modifications!) The Lord really does know best, and we are so thankful for his sovereignty in our lives. Glad to have heard your story!

    By the way, I am reading the Bible in 90 days with you all. What a blessing it has been!!

    In Christ, Amy Clark

    [Reply]

    Kimberly @ Raising Olives Reply:

    Thank you Amy!

    Our family can understand only a bit of your grief, but we rejoice that God has been gracious and that your daughter has been able to adapt so well.

    I will continue to pray for you as you read through the Bible and for your daughter during this time.

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  28. Karen Chaffin
    June 13, 2012 | 10:28 am

    Hi,

    Thanks so much for sharing!! Shoulder dystocia was a part of my 4th delivery. My daughter’s head delivered fine, but her shoulders were stuck. My OB tried to break her collarbone to allow her to be delivered, but it would not break. She finally had to pull on her right arm to help her be born & my daughter sustained a birth injury — Erb’s Palsy. It was critical that she be delivered & she had to have CPR when she was delivered. Praise God — she began breathing!! My daughter’s right arm was paralyzed for a month or more. She has undergone some occupational therapy & most people do not notice, unless they know what to look for. Lindy cannot straighten her arm all the way, but it doesn’t slow her down!! She plays soccer & basketball just fine!! I’m so glad that you shared this story!!
    We have since had 4 more children & they were delivered via c-sections.

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  29. Mellissa
    July 13, 2012 | 9:07 am

    Thank you for sharing this. Since the birth of my first son which was an unecessarian (imaptient Dr.) I have been afraid of shoulder distocia. My second labor which was an attempt to vbac with a midwife also ended in a cs. This time it was my choice. Both labors were natural. Both over 24 hours. Both situations I pushed for two hours. Had I been allowed to be fully dilated with my first I believe he could have been born vaginally. My second I believe God led me to elect for a cs to complete the process of forgiving the Dr of my first birth and to show me what sacraficial love is. It is the desire of my heart to have a large family and I know that if I continue having cs eventually a Dr will tell me no more kids. If you think of me will you please pray that God will grant the desires of my heart by blessing me with a vba2c and protect my children and I in birth, also for wisdom to choose an attendent who serves the Lord? Thank you for reading this!

    [Reply]

    Karen Chaffin Reply:

    Hi,

    I just wanted to encourage you!! I have had 8 children. My first 2 were c-sections & then I had my next 2 V-BACs. My last V-BAC is where I experienced shoulder dystocia with my daughter’s birth. I have since had c-sections since that one. I have had 4 more c-sections (6 in all) & God has been gracious!! I so know how you feel, because I have been there!! I am praying for you!!

    [Reply]

    Mellissa Reply:

    Thank you so much for sharing Karen. God bless you & thank you for praying for me!

    [Reply]

  30. The Christian Housewife
    August 22, 2012 | 12:20 pm

    Thank you so much for writing this post. Our last baby (our first home birth out of 5) was a very traumatic experience for me due to shoulder dystocia. In fact, it was such a traumatic event that I vowed never to give birth again. And even though my midwife said that if I ever get pregnant again I need to inform my care giver of the shoulder dystocia with my last delivery, I didn’t understand why until reading this. Thank you so much for posting this!

    [Reply]

  31. Bethany
    January 5, 2013 | 1:13 pm

    Me again!
    No I havent been online this whole time :-) but wow, something else we have in common! My daughter also had shoulder dystocia although she did not have to go through what your poor baby went through. He looks awesome and Im so happy God has blessed him with use of both hands. Our OB said there are few things scarier for an OB than having a baby get stuck in the canal so we chose to have the rest of our littles by section. Ill be praying for your next birth!!!
    Bethany

    [Reply]

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