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It’s me again!  My mother complains about not being able to make it to her toilet (bedside commode) and wets through her pad (Poise 6). I end up changing her clothes all day and night long. She says diapers and pads don’t hold more than one time she urinates. I change her immediately at her request.


She has mentioned this to her doctor and the doc has offered to write a script for meds. She has refused getting script.


She is in process of home health at this time due to falls. I mentioned this to her nurse and the nurse told her to go on meds for it. Now she says she may try them. Do these meds help?

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Get the name and speak with your pharmacist. They are the ones with the knowledge of medications and all the good, bad and uglies that are associated.

Does she try to make it to the potty? Have you tried a potty schedule, she may be waiting far to long. Taking her every hour or two could possibly help.
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She does try very hard to make it to potty. She’s 93 though and moves at a snail’s pace, plus has mobility issues due to Parkinson’s.

She has tried decreasing her fluids, especially before bedtime but does not seem to make much of a difference.

One thing that I have noticed as well is that she doesn’t seem to be emptying her bladder completely. She will go and then go again immediately afterward. Is that a natural part of aging? I’m 63 and that happens to me sometimes and I think to myself, geeeez! I just went to the bathroom and have to go right back. It’s annoying to say the least.

Trying to think if what will help her and also give me relief from changing her undies and pants, sometimes even her compression stockings or socks too!

Pharmacist is a good idea. Will see what her doc has to say, also speak to pharmacy.
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Glendaj2 Feb 2019
In order to empty herself out completely have her rock her upper body back and forth a couple of times and then side to side. This helps me empty out any remaining urine at times I don’t feel as if I’ve emptied out fully. I hated the meds that help with incontinence, they died my mouth out so badly my tongue would dry out mid sentence! Talk about annoying.
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Yes they do, I had gotten to the place that I wore adult pull ups with heavy pads in them. I'd get an urge to go and the minute I stood up the urine would start running, I finally asked my doctor about something to help.

She prescribed Oxybutynin ER (I think the brand name is Detrol)-- 1 tablet a day and it has helped so much - I still wear the pull ups, but without the pads and very little leaking. Talk to her doctor and try something like that for a month to see if it helps.
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cetude Feb 2019
Detrol also has side effects that can increase weakness, predispose to falls, affect sense of taste which can retard appetite, and..worst of all..cause urinary retention which will predispose to UTI. Someone very elderly or with impaired mentation, this can potentially cause problems.
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Please consider the cause of the incontinence. Elderly people can have an UTI, with sudden urge, causing incontinence issues, without other symptoms. Or it may be bladder spasms causing her problem. There’s other things, like the muscle that holding the opening closed may not close completely. Without knowing the cause, it’s difficult to treat with medication. And why give a person the wrong medication, risking unnecessary side effects, not to mention the cost of many of them. Also, if giving medication and not treating the underlying cause, if it can be determined, doesn’t treat the underlying issue, it may still continue. Always look for the cause first.
There are genitourinary specialists who are very good at getting to the source of the problem. Has infection been ruled out?
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Zdarov Feb 2019
Great answer, I’ll bet it will be helpful.
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Most bladder control meds are anticholinergics. This class of drugs have been implicated in dementia just FYI. (As are antihistamines and others in this class)
These drugs block acetylcholines which are important in the brain for memory and learning . However if she has Parkinson’s this may be the least of your worries now but it could speed up decline. They do make pull-ups that are ultra absorptive. Definitely find a urologist who will do more than write a Rx. Making sure she doesn’t have something else wrong. They can even use Botox injections now for urinary incontinence. And yes ...a pharmacist knows more about medications than any physician. So frustrating for you and her.
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NeedHelpWithMom Feb 2019
Harpcat,

I like the idea of a urologist. How could I have not thought of that? I will see if my mom would like her doctor to recommend a urologist for her to see.
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Medications are not without side effects -- if your mom is elderly she will be at increased risk for falls because the med will affect the nervous system. At least your mom is cognizant enough to communicate with you. Mine isn't.
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whaleyf Feb 2019
You are right. I forgot to add on my post that one med made my hands shake really bad.
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I've taken several different meds for incontinence and boy do they dry out your mouth. You can't drink enough water to make it better and of course that makes you have to pee more and more. Best idea is to a product that will work for her. Maybe a thicker pad or diaper.
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NeedHelpWithMom Feb 2019
Gee, did not realize if it dries up urine that it can also dry up mouth. That’s a pretty bad side effect too. Yeah, if you replenish with extra water, makes sense you’re urinating more often too.
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Your mother sounds like me. I was thoroughly tested and found to have a mild prolapse and an overactive bladder. If I feel the need to go and stand up, the urine pours out. My urologist explained that it is like a full water balloon being squeezed. The medicine for these spasms does work.

Unfortunately, I also need Requip for restless leg, and the two meds interact to cause some dementia, which can become permanent.  I decided on diapers rather than dementia.  If she doesn't take a med like requip, go for the incontinence med. Yes, they work.
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NeedHelpWithMom Feb 2019
Grannie,

Sounds like a lot of people prefer diapers to pads. I buy the highest number pads but they aren’t doing the trick anymore. I will buy diapers next time I go to store or order online. Expensive to age, huh? Buying all these extras. I wish she didn’t have this to deal with.
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My dad has practically made a urologist’s house payments for years trying to get rid of this issue. The meds have not been helpful for him, either due to being contraindicated because of other meds or because they just weren’t effective. Make sure you get all the good and bad info on whatever is prescribed, as all meds have side effects, and hopefully you’ll find help with the problem
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NeedHelpWithMom Feb 2019
Daughter 1930,

It sure is expensive to age, isn’t it? So sad.

I hope your dad and my mom finds relief somehow.
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With as many UTIs my mom has had, I’d fear retaining urine, but of course then there’s the fear of sitting in urine soaked pull-up. Catch 22. :-(
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NeedHelpWithMom Feb 2019
Cmthatcher,

I keep hearing about UTI’s in the elderly on this site. How common is it? Has to be terribly uncomfortable for those who get them. Are they easy to detect and cure? Whew! I have a bunch of questions and hoping that you can explain it to me since you have experience with it.
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Incontinence is not a disease but a problem. Because of back muscle tightness the pressure on the bladder increases. body massage is a must to keep all muscle s in good condition. Yes there are medication to control the muscle and it will help the quality of life but it will not cure the problem. The muscle needs to be conditioned.
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NeedHelpWithMom Feb 2019
Sankarrph,

I see. Are there exercises that she could learn to strengthen those muscles?
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I have this problem and went to a urogynecologist. He fitted me with a rubber ring that sits inside the vagina and it really works at preventing constant flow. Apparently this is the old fashioned solution that has been around a long time. Not for everyone of course but another possibility. I heard botox is now an option as well. The meds have side effects to be careful of.
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NeedHelpWithMom Feb 2019
Wow, a urogynecologist. Wonder if we have that kind of physician near us. Sounds like a neat device. Sometimes simpler solutions may be the best all around. Wonderful suggestion. Thanks.
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Don’t know about meds. We got up our client every two hours checked and changed whether she wanted to or not. She wore briefs, they have extra thick ones for overnight but we still all checked every two hours. It helped. no meds.
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NeedHelpWithMom Feb 2019
She goes very often! Probably smart to check every two hours because she has fallen asleep during the day (her afternoon nap) after being up all night urinating to a soaking pad, wet underwear, she stands up and urine drips into her compression stockings or socks, shoes or slippers. It’s a shame.
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If she is not getting up to go to the bathroom medications will not help.
Medications are usually for people that can not completely void the bladder. Or for other reasons have a weak urine stream.
She should be getting up every 2 hours to go to the bathroom even if she says she does not have to go. If you have to set a timer to remind you and her to get up and at least try going to the bathroom, and for you to check to see if she is dry. If she is wet then it is easier to change just the pad rather than all the clothes. Is it possible that she may need more than a pad to contain the urine?
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NeedHelpWithMom Feb 2019
That is the problem. Pad doesn’t hold enough even though I buy the ones that hold the most. It drips on her clothes and runs down her legs. I have to change her into fresh clothing. Leaks, so I need to check into diapers. She told me that she tried diapers a long time ago and maybe some are better than others because even the diaper didn’t hold it al. My mom does drink a fair amount of water. She tries to decrease what she drinks in the evening.
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No experience beyond pointing out to be aware of meds having side effects, and that HDIS delivers products to your/her home...so that hassle can be alleviated. They also know about all the products and there may be something more absorbent she has yet to try.
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NeedHelpWithMom Feb 2019
Thanks. Will look into that.
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Garlic is a natural source of urinary tract health., and helps with preventing and treating UTIs.
You can Google that and get some ideas. There are garlic capsules, too, in case your Mom isn't a fan of garlic.
Two other urinary issues that can be resolved naturally :
Incontinence, the inability to retain urine, is caused by a deficiency of magnesium, which also treats leg cramps.
An inability to pass urine is the result of low potassium, Vitamin B2 and pantothenic acid, which is Vitamin B5. Amounts of B2 and B6 should always be the same, so if you give one, give the other in equal amount. All of this is from Adelle Davis, "Let's Get Well". Worth it's weight in gold!
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Segoline Feb 2019
Garlic is very good. Get the supplement, if you choose to go this route, with parsley. It prevents the garlic burping.
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I take 2 types. It has helped my quality of life! A urologist could help. If she insists on not taking them she needs to wear the incontinence underwear. Give her those 2 choices.Then let her decide! My husband has post prostate cancer incontinence so I feel your dellima. He is very co-operative and wears pads. I hope this helps.
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NeedHelpWithMom Feb 2019
I do like the idea of a urologist. It is their specialty field. Wish I had thought of that sooner. So thankful to all of you. How is your husband doing? Better, I hope.
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Personally I have not used this product so I cannot comment on it's effectiveness, but I have noticed this product at the grocery store & drug store- Poise Impressa. It's a vaginally inserted tampon that adds a little pressure on the urethral wall & lifts the urethra. It comes in different sizes. Maybe your Mom could try it once to see if it helps since it can be bought over the counter.
Needhelpwithmom; You also mentioned that you have had some difficulty completely emptying your bladder. I have had experience working for a Urologist and there is an in office procedure- Urethral Dilatation(dialation). A little anesthetic gel is applied to "metal sounds" of different sizes to gently stretch the urethra to allow more urine to flow, emptying the bladder completely. As we age, the urethra can narrow in a section or a "stricture" can form & the urethral sounds help with gently widening it.
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NeedHelpWithMom Feb 2019
Caring RN,

Thanks. Looks like a trip to urologist is a good thing to do. Appreciate the info on product. I haven’t seen that but going to look for it and read reviews.
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I am 85 yrs old and have night time incontenence. When I wake at night to go I can not get to the bathroom in time to stop wetting myself. It runs right down my legs, I have found that wearing Tena overnights plus a diaper stops the overflow. I still soak the pad and my undies, but I don't wet the floor anymore. And my night clothes and bed remain dry. I am interested in some of the solutions that I read about and may try them, but during the day I do not have any problem whats so ever. I have read that there is some thing that takes place in our brains that allows us to shut down the urine flow at night so we can sleep, but in some elderly that does not happen, so that is why there is one type of medicine that works for this problem. However I am afraid of the side affects so have not asked for it. I hope this helps.
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NeedHelpWithMom Feb 2019
Mary,

I wrote this question to help find solutions for my mom. She is miserable. I hope you, my mom and all others find a way to deal with this inconvenience.

My mom is a bit nervous about taking new meds too, which is completely understandable because of side effects. She has a primary care doctor appointment this month and will bring up the topic again.
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I used Vesicare a few times, but then found I didn't need it as long as I was close to a bathroom. But you may want to try it for frequent urination.
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NeedHelpWithMom Feb 2019
Any side effects?
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A friend who is having severe short term memory loss was told last week to get off the Vesicare. It is her belief that this med has really done a number on her memory.
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Harpcat Feb 2019
Yes they are implicated in dementia.
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Also, one of the other symptoms of dementia is incontinence as the dementia becomes more advanced. So it’s not all that unusual.
This is not for your mom, but for others as a preventative, this exercise has helped me with urgency. I do bridge hip lifts and contract my abdomen and the pelvic muscles that are used to stop urine flow. It has helped me a lot. Similar to doing kegel exercises.
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NeedHelpWithMom Feb 2019
Wonder if her doctor can teach her these exercises. Sounds good. Glad they helped you.
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In my post here, I forgot to mention, from personal experience, might keep in mind. I’ve been plagued with a tendency toward UTIs, post-menopause. Also have bladder spasms, along with pretty severe IBS-D. I try to limit the amount of Dicyclomine I use for the IBS-D, but when a person has that, it’s almost guaranteed you will suffer from non-stop bladder spasms as well. The urinary sphincter muscle does not fully close either, so I have to go to the bathroom pretty much hourly. Was considering possible procedure to help with that, plus genitourinary doc wanted to try Botox. Was in the middle of moving to another state, then illness, didn’t get in to local genitourinary doc here as yet. Whenever I experience increased urgency, it’s usually due to an UTI. As we get older, we ladies don’t necessarily have the pain and smelly urine with a low grade UTI, but can be symptomatic with urgency. So, even if there is sub-clinical amount of bacteria in a urine sample, if symptoms present, insist the infection be treated. Not all docs are aggressive with treating UTIs in elderly. So make sure to rule out even low-grade infection, if incontinence flares up.
So many good ideas here. Sure is getting expensive to get old in the US, what with diabetes supplies times two people, home oxygen, the dang meds for liver malfunction and IBS-D....
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NeedHelpWithMom Feb 2019
Incontinence issues seems to be very common. I like the feedback about the possible procedures that are available. Thanks.
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Requip and other Dopamine agonists are one type of med for Parkinson. It reacts with tolterodine, one of several for incontinence. Together they can cause dementia-type brain changes, which is why I stopped. Try online search for heavy-duty adult diapers. I use NorthshoreCare supplies and their waterproof cover pants. It works for me, sometimes along with a booster pad for a long ride. Yes, expense, and inconvenient. I sympathize!
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NeedHelpWithMom Feb 2019
Wow, drug interactions are scary. Glad you stopped taking those meds.

Parkinson’s is already a neurological problem so why add to that. She is blessed not to have any form of dimentia but I am aware that some Parkinson’s patients do have dimentia. After reading these posts I don’t think I am comfortable filling a script for the incontinence meds.
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NeedHelpWithMom: Let me see if there is a web site --
VESIcare.com.
Or WebMD.com
Yes, there were at least 10 side effects. I tried to copy & paste, but it failed.
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NeedHelpWithMom Feb 2019
Thanks a bunch! This site has such caring, intelligent people. I want to thank all of you again. You have been such a blessing in my life! I don’t feel quite as alone as I did before. Wouldn’t it be great if we could all meet for a meet and greet type of thing?
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NeedHelpWithMom:

Regarding UTIs: "Has to be terribly uncomfortable for those who get them.
Not necessarily - MANY years ago I got a call after my physical telling me they called in an Rx for UTI... I had absolutely NO symptoms!

As for those with dementia, UTIs often are not found because of "normal" symptoms, but bad sun-downing episodes! This was the case for our mother. We have Lorazepam on hand to keep her calm, but still have to get urine tested and if UTI, treated.

Mom was DXed years ago by a urologist, long before the dementia, with interstitial cystitis and given a list of things to eat/drink or not to eat/drink (and some medications, perhaps some OTC, I don't recall now as I was not involved in her care at that time.) She was also told she was not emptying her bladder and was to use some kind of catheter to "empty" herself. (note - kidneys don't produce urine on demand - if you sit on the commode for a minute or so after going, there is more urine produced!) She would still get UTIs. Eventually the "diet" and emptying via catheter went by the wayside. She has NOT had many UTIs since! She is on BP meds and most recently a "water pill", which increases her need to go... rock and hard place, treat one issue, make another! I am mostly in the 'less medications is better' camp, but some are a necessary evil. In your mom's case, sounds like many suggested meds would result in other issues, so most likely are better avoided. I also have read that some medications are counter-indicated with Parkinson's.

Definitely use adult "pull-ups" vs pads. Pads won't stop full urine flow, only catch the dribbles that might happen before getting to the toilet, so yes, she would soak everything! They come in various "strengths", so if hers is bad, go with the most absorbent. Our mother was not a fan of pads or pull-ups. She still knows the urge to go and makes the attempt, but sometimes cannot get there or undressed fast enough. After multiple monthly extra cleaning fees for her room carpet, we cold-turkeyed her (removed all underwear and replaced with pull-ups - so far no complaint.)

"Are there exercises that she could learn to strengthen those muscles?" Yes, kegels and core exercise can help, but with age and ability these might not help if she cannot do them. For others, these might help (kegels only work on the uro-genital muscles, core exercise strengthens all abdominal muscles, which can help even more.)

You would want to limit any caffeinated beverages (and foods, if there are any) as these will increase the need to urinate (my mornings while drinking my watered down coffee are spent with many trips to the bathroom!) Water is best, but don't overdo it!

Beware medications, as others have noted there are many side effects, and yes, your pharmacist is more knowledgeable about these than most doctors. Botox - beware this as well. They tried this in my esophagus, and I ended up with hives!! One time, that was it for me! Even before trying it, I was leery of this - from medlineplus: "Botox is a drug made from a toxin produced by the bacterium Clostridium botulinum. It's the same toxin that causes a life-threatening type of food poisoning..." I gave it one try, never again!

So, if you can find an appropriate urologist for exam/testing/possible treatment, and/or switch to adult pull-ups, combined with regular trips to the bathroom, you might get some relief.
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NeedHelpWithMom Feb 2019
disgustedly,

Yes, that is my mother’s problem too. Even if she can get to the bedside commode in time, she can’t get undressed quickly enough. It’s tough for a 93 year old to move fast!
Of course her Parkinson’s magnifies the problem as well. As my mother says at times, “It’s hell to get old!”

You gave great info, especially echoing what many others have said about meds, definitely can be a tricky situation to correct. It’s all a balancing act!
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Yes. They do.
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Meds are super pricey and not effective in certain cases. They also cause dry mouth which makes patient want to consume more water which increases the urge to go. Vicious cycle
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Dear NeedHelpWithMom:
I am sorry I keep posting. One more thing comes to mind that may be a factor. I had forgotten about this. If any of your mom’s medications lists possible side effect of water retention, and this one happened to me, she may be retaining fluid during the day as a result. Once I would go to bed, with gravity no longer helping the fluid to pool in my legs, my kidneys could more easily deal with the extra fluid, causing a lot of urine production and bathroom need at night. The medication I was taking at the time, Amlodipine, is a blood pressure medicine. I have lost a bit of weight, and was able to eliminate the Amlodipine from my meds arsenal, and a lot of the major water retention and nighttime kidney catchup no longer plagues me. So, please check her medicines.
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NeedHelpWithMom Feb 2019
Geeez, that’s awful with your meds.
My mom actually doesn’t take a lot of meds, Parkinson’s meds, seizure meds, vitamins, that’s about all. Good idea to check that though. I’ll look into it but she can’t go off of her Parkinson’s meds. She hasn’t had a seizure since 1996 but she is scared to go off those meds, even though her doctor told her that she could try getting off of them.
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I don't think anyone has suggested a suprapubic catheter.  My MIL had one done after trying numerous other options, including meds (she will still take one for spasms when necessary) and also botox, which didn't help.
This was suggested as a last option by her urologist.  I'm not sure why it wasn't the first, at her age.  She is now 96 and has had it in place for about 5 years.  While it has its own set of special care requirements, in her case it has worked out for the best. 
It may sound scary to have a full-time catheter, but it really has been a god-send in so many ways.
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