ADHD / 3rd class medical GUT PUNCH -- questions.

Skybound-mg

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Skybound-mg
I was diagnosed with adult ADD in my late 20's and have been for short periods on stimulant meds-- come to find out, that's a no-go with the FAA. In order to get my 3rd class medical, I need to get a neuropsychological exam and get all of my records regarding ADHD treatment to my AME, and need a special exception from the FAA.

I've just been reading on r/flying about people who have been in this process for 9-14 MONTHS.... I have been so psyched to get this process going, and this has been a MAJOR gut punch for me--- totally took the wind out of may sails.

Has anyone else been through this process for ADHD? What are your experience like, and do you have any tips for me?
 
Sorry to hear that man, but this is just one of those things you're going to have to go through if you want to fly. Just the hand you were dealt.

Here's a story that might make your struggle seem a bit smaller.

My buddy had a seizure once because one doctor didn't look at what another doctor had prescribed. Somehow, the pharmacist didn't catch it either. The two medications just clashed. The feds found out and he was grounded.

TEN YEARS!

Took him 13 years by the time all was said and done. Partly because of his fear of failing a medical and partly because: bureaucracy.

Anyway, he and I fly together all the time now. He got his medical back and even does some part time 135 work.

Moral of the story: don't just give up because something sucks. If you want to do this, you've got to make it happen.

Work with your doctors and develop a clear plan to get this done.

Do NOT try to do this without working with an Aeromedical Examiner. You might have the best PCP in the world but one that can screw your chances of they don't know the first thing about FAA stuff.

Keep us posted
 
Sorry about this misfortune. Good thing you didn’t invest in a bunch of flight time before learning the rules.

Best of luck.
 
I was diagnosed with adult ADD in my late 20's and have been for short periods on stimulant meds-- come to find out, that's a no-go with the FAA. In order to get my 3rd class medical, I need to get a neuropsychological exam and get all of my records regarding ADHD treatment to my AME, and need a special exception from the FAA.

I've just been reading on r/flying about people who have been in this process for 9-14 MONTHS.... I have been so psyched to get this process going, and this has been a MAJOR gut punch for me--- totally took the wind out of may sails.

Has anyone else been through this process for ADHD? What are your experience like, and do you have any tips for me?

I have a side question, related to your situation. If you can get a student pilot certificate without a medical(I think you can?), could you take training anyway (up to/before solo) while you sort it out. Its one thing to go through a bunch of training with the expectation of no roadblocks to be blindsided by the medical. But, if you know you have roadblocks ahead, it may be worth a few hours a month to 'scratch the itch' while you sort it out. I would.

You'll surely get many replies to the contrary, that you'd just be wasting your time or money but in my opinion, its worth it. I enjoyed every flight lesson I had, and I didn't start flight training with a plan to get my cert, it just kinda happened after I ran out of stuff to complete.
 
I have a side question, related to your situation. If you can get a student pilot certificate without a medical(I think you can?), could you take training anyway (up to/before solo) while you sort it out. Its one thing to go through a bunch of training with the expectation of no roadblocks to be blindsided by the medical. But, if you know you have roadblocks ahead, it may be worth a few hours a month to 'scratch the itch' while you sort it out. I would.

You'll surely get many replies to the contrary, that you'd just be wasting your time or money but in my opinion, its worth it. I enjoyed every flight lesson I had, and I didn't start flight training with a plan to get my cert, it just kinda happened after I ran out of stuff to complete.
I guess you don't even need the student cert (unless you're cfi wants you to have it):
upload_2021-8-17_20-26-3.png
 
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@Skybound-mg ....

This was recently posted on Reddit's r/flying -- https://old.reddit.com/r/flying/comments/p5o43y/medical_finally_approved/

Current FAA Medical Process for ADHD Deferrals (3rd Class)

My previous post had enough interest for a write up, I decided to create my own post. (Admins - if not allowed, please let me know before deleting so I can copy my text without having to rewrite it). Below is a rough timeline for my application for a 3rd class medical with an ADHD diagnosis. My apologies in advance for anyone applying for a 2nd or 1st class - I can imagine the process is roughly the same, however the end decision criteria might be different.

Started flight training September of 2020 - went to go in for medical October of 2020.

OCT 2020 - appointment with AME for 3rd class medical. Basic stuff that anyone else expects (I was one of the guys who both didn't have proper guidance before going, and didn't do my due diligence about medicals beforehand) I'll put all of the blame on myself, but for anyone else - make sure you talk with your instructor about the process of getting a medical, and what is disqualifying and what is not.

This subreddit has a lot of great information you should read before going to see your AME officially.

During the appointment, the topic came up about a current ADHD medication i had been using - after some chatter, he told me he could not approve my medical, and he would have to send it off to OKC for a deferral. He gave me a generic sheet from the FAA website about the ADHD process, and told me to contact a HIMS AME (specialty docs certified for flight med) to get started.

OCT 2020 Part 2 - Call the HIMS AME like i was told to do - was told that I cannot simply schedule an appointment - I would need to wait for a letter from the FAA mandating that I get a psych test done in order to get a med. Cue the waiting game.


Dec 2020 - FAA sends me a letter requesting all records from my treating physician for ADHD. The sheet you can find online and the one my AME gave me broke down exactly what would be needed from the FAA, and what I would need to do. So I already had the records ready to send. As soon as I got the letter from the FAA, I immediately sent the requested records back. Although I will mention, I was seeing a chiro at the time for some general neck stiffness. They wanted full records on that as well. Cue waiting game #2.
By this point I had already spoken with a HIMS AME out of a neighboring state (none located in my state - you can find a list of approved HIMS docs on the sheet I have talked about - do a quick "FAA ADHD Medical" google search and you'll find the form. I was now waiting again for the FAA to come back with a letter telling me I would need an evaluation.

March 2021 - Decline of Medical from FAA - I got a letter in the mail notifying me they declined my request for a medical. If I wished for a reconsideration, I would need to
  1. Go to a HIMS Neuropsychologist to have them preform a battery of tests as an evaluation for ADHD.
  2. Be off any ADHD meds for 90 days.
  3. Take a pee test.
  4. Send records to the HIMS Doc (records such as drivers records, academic records if diagnosed as a child, all medical records of ADHD, and any records I might have from prior psych help, etc.)
Again - I knew the decline was coming, and was prepared with all information I could get. I scheduled an appointment with my HIMS doc for April 2021.

April 2021 - Neuropsych appointment with HIMS AME - There is a really great write up on this sub from someone who went through the testing battery. I won't do a detailed write up of the whole appointment, but the basics of it were
  • a general get to know you conversation,
  • a cognitive screening (CogScreen-AE) which is a computerized test from the early 2000's you do with a stylus and keyboard. Kind of fun - you do tasks like using a keyboard to keep a line balanced on a "see-saw". as well as other tasks like number memorization in patterns. Some of it is difficult, some is boring.
  • You do a language speaking exercise, learning and memory, academic skills, and some other tests.
  • Again - read the detailed write up from before on the testing.
Cost of the appointment for me was $2800 cash. (somewhat on the cheaper side unfortunately). Your doc can not tell you the outcome on the spot - their job is to create a report and send it to the FAA who will decide. If you have an obvious severity, they will likely tell you that the odds are not great. Otherwise, mine said "I don't see any issues - I'll write up the report and send you a copy - you should hear from me in 30 days or so"


April 2020 Part 2 - Urine Test - My AME was nearly useless in this whole process - he was difficult to get in contact with, could not offer any guidance, and pretty much useless as far as the ADHD process goes.

You need to take a pee test and have the data sent to your HIMS doc - MAKE SURE THE TEST YOU SCHEULDE INCLUDES TESTING FOR THE PROPER CHEMICALS. The Urine test needs to be done within 24 hours of the Psych test and I spent all of those hours arguing with his staff about what I need included on the Urine test. They tried sending me in for a general DOT drug test and that will not cut it. The aforementioned sheet above breaks down what exactly needs to be tested. Make sure you are tested for it, or you may be spending another couple grand and a road trip to retake your cogscreen.

May 2021 - After a month of waiting for my HIMS doc to do the write up, she called to let me know that is was complete, she had all the records she needed, and she would be sending it off to OKC. #WIN. Cue the longest waiting game ever.

I called multiple times a week for months (as others have said on here before, if you call "every other business day" or something along those lines, you get flagged as "excited and eager" and they will bump you up the list. Not sure how true this is. I called enough to be on a first name basis with everyone who answered the phone at "DJW".

May 2021 - FAA received my documents and my application was "In Review".

August 16th, 2021 - as my post yesterday said, I was given great news that my app was finally approved. The only conditions I had were to wear glasses (not even sure why they put that - my vision is nearly 20/20 - i wear glasses to help with work) I stopped flying months ago. Will eventually be able to pick it back up.

10 months after going in for my AME visit, I am approved. Let it be known that after that first visit, I was extremely prepared for everything. I knew what the FAA would be sending, and had everything ready to send back or be scheduled. 99% of my time was waiting on the FAA (sigh) and about 30 days waiting for my HIMs doc to write up the report. You can help yourself greatly by being prepared.

Hope this helps guide anyone going through the process - happy to answer any questions as well.​
 
Having ADD and being a pilot might not be a good mix.
ADHD is a spectrum. For some people sure probably not a great idea (but even then I absolutely don’t think it should be a hard no for a class 3 medical).

But then there are others who’s symptoms affect them differently.

It just is a case by case thing.
 
ADHD is a spectrum. For some people sure probably not a great idea (but even then I absolutely don’t think it should be a hard no for a class 3 medical).

But then there are others who’s symptoms affect them differently.

It just is a case by case thing.
I agree, but the members of this forum support one and all without anything more than the claim the man is destroying their dream. Some are misdiagnosis, but the OP states he requires periodic medication, which makes things more difficult than be on meds continuously.
 
I actually have mild ADD, and do not need meds... I just am better on them, can focus better on certain types of (menial) tasks. I've taken stimulant meds twice in my life, once for a 2 year period, and once for 6 months. I did very well in school, graduated summa cum laude for my bachelors at night while working full time, and have a successful career. When I exercise regularly and eat well, I'm almost as good as when I'm on my meds. I've got a super clean driving record, am a very safe driver. I don't have an issue with long distance travel, I just drove 12 hours from the OBX back home on vacation with 2 kids in the car. I'm really not afraid about not getting the exemption, the amount of time just sucks.

I've already started online ground school. I've taken 2 online practice tests and passed with > 70%, but I'm not going for the actual test until I'm MUCH, much closer to 100%-- I'm not just trying to pass, I'm trying to have a firm grasp of the concepts and REALLY know the concepts like the back of my hand.. I'm not trying to memorize-- that's not going to help me in a real-life situation with tons of variables. I've also got a flight sim setup at home (just bought the yoke/throttle quadrant, waiting on the rudder pedals), and I plan on practicing maneuvers as often as possible, and repeating any training at home after a lesson to truly "set" the concepts and methods.

I can definitely start instruction without the medical, but my goal is to SERIOUSLY go for it. 3x a week flights, etc. I feel like starting instruction then stopping for an specified amount of time while waiting on my medical would be detrimental in a lot of ways.. to my enthusiasm, to the continuity of my training, etc. This would probably cause rework, retraining, and most importantly, RE-PAYING.

I was just ready to hit the ground running in October, and it's looking like it might be more like next may or June. I guess that gives me more time to save, more time to practice on the sim, and more time to learn more about weather, emergency procedures, physics, etc. I'm going to try to look at it like this: I'm going to be even MORE ecstatic to get in the plane and start flying once I get the medical issued--- good things come to those who wait and all.
 
OK, if you are determined to try for a medical - get a consultation, find out what kind of testing the FAA is going to want, and get the testing done BEFORE you apply for a medical. If the test results are good, then forge on ahead. If the test results are not what is needed, better to know that up front than to shoot yourself in the foot.

Once an application for a medical goes live, there is no turning back. And, while it may take months for the FAA to tell you what they want, they will expect you to have results back in a short time.
 
I actually have mild ADD, and do not need meds... I just am better on them, can focus better on certain types of (menial) tasks. I've taken stimulant meds twice in my life, once for a 2 year period, and once for 6 months. I did very well in school, graduated summa cum laude for my bachelors at night while working full time, and have a successful career. When I exercise regularly and eat well, I'm almost as good as when I'm on my meds. I've got a super clean driving record, am a very safe driver. I don't have an issue with long distance travel, I just drove 12 hours from the OBX back home on vacation with 2 kids in the car. I'm really not afraid about not getting the exemption, the amount of time just sucks.

I've already started online ground school. I've taken 2 online practice tests and passed with > 70%, but I'm not going for the actual test until I'm MUCH, much closer to 100%-- I'm not just trying to pass, I'm trying to have a firm grasp of the concepts and REALLY know the concepts like the back of my hand.. I'm not trying to memorize-- that's not going to help me in a real-life situation with tons of variables. I've also got a flight sim setup at home (just bought the yoke/throttle quadrant, waiting on the rudder pedals), and I plan on practicing maneuvers as often as possible, and repeating any training at home after a lesson to truly "set" the concepts and methods.

I can definitely start instruction without the medical, but my goal is to SERIOUSLY go for it. 3x a week flights, etc. I feel like starting instruction then stopping for an specified amount of time while waiting on my medical would be detrimental in a lot of ways.. to my enthusiasm, to the continuity of my training, etc. This would probably cause rework, retraining, and most importantly, RE-PAYING.

I was just ready to hit the ground running in October, and it's looking like it might be more like next may or June. I guess that gives me more time to save, more time to practice on the sim, and more time to learn more about weather, emergency procedures, physics, etc. I'm going to try to look at it like this: I'm going to be even MORE ecstatic to get in the plane and start flying once I get the medical issued--- good things come to those who wait and all.

Sounds like you have a plan. Still, your sim practice may benefit from at least a Discovery flight or a couple lessons to lay down a foundation, sprinkle a bit of reality on your virtual. (and also may make some of your written study make more sense). I'd get with a CFI and set up a first hour lesson. Tell him you may not be back for a while. Its worth a couple hundred in my opinion.
 
OK, if you are determined to try for a medical - get a consultation, find out what kind of testing the FAA is going to want, and get the testing done BEFORE you apply for a medical. If the test results are good, then forge on ahead. If the test results are not what is needed, better to know that up front than to shoot yourself in the foot.

Once an application for a medical goes live, there is no turning back. And, while it may take months for the FAA to tell you what they want, they will expect you to have results back in a short time.


I spoke to my AME (Have an appt on Thu) AND the neuropsychologist for my area on the phone yesterday. Both advised the exact opposite actually.

Problem is, insurance pays for none of this.. The test is $2k (initial battery), and if not passed the extended is an additional $1.5k. I'll likely have to take it, but the neuropsychologist told me to go to the AME and do the initial consultation first and get the app submitted and get the initial denial / requirement for additional testing ASAP. The FAA is apparently wildly variant in what they actually want/ need from you to get an issuance after the initial denial.. It's frustrating.

The good news is, my chosen AME is actually the AME for the Neuropsychologist, who is also a pilot. She offered to coordinate with the AME and make this as painless as possible. Before I even had an appointment set with the AME (was waiting for a callback) she had me fill out a Release of Information form and contacted him to start co-ordination. Both seem really eager to get me through and have me pass. The neuropsychologist called me from her day job at the hospital and talked to me for 30 minutes, answering every question I had. I feel like I've got good people here helping me out, which is amazing.

I've already started calling every therapist I've been to requesting medical records, so I should have everything in hand and ready to send as a package as soon as I get the initial denial from the FAA with the request for records.

On the plus side, I just got back from interviewing my first flight school.. Interstate Aviation in Planville, CT at Robertson Airport(4B8). Spoke with a CFI for an hour, got all the info, and went into the hanger to check out the planes. I haven't been that excited in years. I'm still jacked up on adrenaline. There's no question I'm pursing this -- it's like a burning passion at this point.

One minor surprise... I was SURE I wanted to fly low wing (Piper), but am now thinking Cessna.. The no door on the pilots side and the tiny little vent window get me a little clasutrophobic in the pipers, and the Cessna just "feels" bigger, roomier, even though it's probably not. I'm 6 feet, 215lbs -- so squezing into the Piper Archer was an experience to say the least. If I could get a Cherokee 6/300 --- I'd probably change my tune, but yeah I don't see too many of those as trainers :)
 
Sounds like you have a plan. Still, your sim practice may benefit from at least a Discovery flight or a couple lessons to lay down a foundation, sprinkle a bit of reality on your virtual. (and also may make some of your written study make more sense). I'd get with a CFI and set up a first hour lesson. Tell him you may not be back for a while. Its worth a couple hundred in my opinion.
This is EXCELLENT advice. I got the same feeling talking with the CFI. I'm definitely doing a discovery flight before really getting going. I really want to do this, but need to see how I react to an hour in the air in these tiny little planes. I have a feeling I'm going to be on cloud nine.

And I would REALLY like to know what it feels like, vicerally, to take off. What does a bank feel like? Landing? Actually watch the indicators and controls operate. I'm doing this in the next month, for sure. Demo and 1st lesson.
 
I spoke to my AME (Have an appt on Thu) AND the neuropsychologist for my area on the phone yesterday. Both advised the exact opposite actually.

Problem is, insurance pays for none of this.. The test is $2k (initial battery), and if not passed the extended is an additional $1.5k. I'll likely have to take it, but the neuropsychologist told me to go to the AME and do the initial consultation first and get the app submitted and get the initial denial / requirement for additional testing ASAP. The FAA is apparently wildly variant in what they actually want/ need from you to get an issuance after the initial denial.. It's frustrating.

The good news is, my chosen AME is actually the AME for the Neuropsychologist, who is also a pilot. She offered to coordinate with the AME and make this as painless as possible. Before I even had an appointment set with the AME (was waiting for a callback) she had me fill out a Release of Information form and contacted him to start co-ordination. Both seem really eager to get me through and have me pass. The neuropsychologist called me from her day job at the hospital and talked to me for 30 minutes, answering every question I had. I feel like I've got good people here helping me out, which is amazing.

I've already started calling every therapist I've been to requesting medical records, so I should have everything in hand and ready to send as a package as soon as I get the initial denial from the FAA with the request for records.

On the plus side, I just got back from interviewing my first flight school.. Interstate Aviation in Planville, CT at Robertson Airport(4B8). Spoke with a CFI for an hour, got all the info, and went into the hanger to check out the planes. I haven't been that excited in years. I'm still jacked up on adrenaline. There's no question I'm pursing this -- it's like a burning passion at this point.

One minor surprise... I was SURE I wanted to fly low wing (Piper), but am now thinking Cessna.. The no door on the pilots side and the tiny little vent window get me a little clasutrophobic in the pipers, and the Cessna just "feels" bigger, roomier, even though it's probably not. I'm 6 feet, 215lbs -- so squezing into the Piper Archer was an experience to say the least. If I could get a Cherokee 6/300 --- I'd probably change my tune, but yeah I don't see too many of those as trainers :)


Are you SURE you want to follow that advice and go ahead and get the first denial? When you say the neuro and AME advised opposite do you mean the AME advised not submitting it yet and getting the initial denial?

I’m out of my depth here, maybe Bruce or Lou can chime in: is there a situation where you want to go ahead with neuro testing before submitting the application, even though you risk not doing the variables the FAA might want?

Ref post #3
 
Are you SURE you want to follow that advice and go ahead and get the first denial? When you say the neuro and AME advised opposite do you mean the AME advised not submitting it yet and getting the initial denial?

I’m out of my depth here, maybe Bruce or Lou can chime in: is there a situation where you want to go ahead with neuro testing before submitting the application, even though you risk not doing the variables the FAA might want?

Ref post #3
I think what @Rushie and @Capt. Geoffrey Thorpe are trying to tell you here, maybe you know or maybe you don't, but if you get stuck in a situation where you apply and get a denial, then you don't have the option for Sport Pilot(no medical). So, they're saying if you could get a test done that would show promising results that your AME can confirm before you apply then you could make a better decision whether you want to apply or not and go for Sport Pilot instead.

I think what your doctors are saying is that it will take a long time so go ahead and get started, but that may not get you the best outcome depending on your test results.
 
And for the record, you don't need a medical to learn to fly. You need it to solo and take the check ride. You don't have to stop learinig when you get to the solo and can't take it. Skip it and move on with our CFI. Do all the learning and practicing for you PPL if you don't have your medical yet. Then start your instrument training if you don't have your medical yet. When you get it, you'll be ready to knock out the solo hours and take the check ride. Worst case senerio is your medical takes years or never happens. The only difference that whole time is $50 an hour to have a CFI sitting right seat to be PIC.
 
I think what @Rushie and @Capt. Geoffrey Thorpe are trying to tell you here, maybe you know or maybe you don't, but if you get stuck in a situation where you apply and get a denial, then you don't have the option for Sport Pilot(no medical). So, they're saying if you could get a test done that would show promising results that your AME can confirm before you apply then you could make a better decision whether you want to apply or not and go for Sport Pilot instead.

I think what your doctors are saying is that it will take a long time so go ahead and get started, but that may not get you the best outcome depending on your test results.


So, part of my goal/vision for getting a PPL is not just to be able to fly, but to be able to share it with friends/family. A sport pilot license would put me into an expensive hobby that I could never share with my friends and family, which is the exact opposite of what I want.

It's the ability to say "Hey, want to go anywhere within a 100 mile radius today" besides saying "Hey, lets pick from out immediate surroundings like usual". The justification for me for spending the time and money is the ability to share it with people. Without it, I can't justify it, and I'll have to find another outlet and remain disappointed.

For me, If I can't get the PPL and I'm going to get hard denied, I want to know before i get started. I don't want to go spend 10k to find out it's never going to happen. I'd rather rip that band-aid off now. Spend 2k for the test, and if I'm out, I'm out. I'll find a way to get over the disappointment.
 
Besides being able to carry only one passenger—and most of my flights were solo or plus one—you can fly anywhere inside of the continental USA, so where you go is up to you. You can fly 500 nm and camp out. All kinds of stuff. For the most part, SP limitations aren't gonna really affect what you do. I have more fun with a single passenger than three plus me.
 
This is EXCELLENT advice. I got the same feeling talking with the CFI. I'm definitely doing a discovery flight before really getting going. I really want to do this, but need to see how I react to an hour in the air in these tiny little planes. I have a feeling I'm going to be on cloud nine.

And I would REALLY like to know what it feels like, vicerally, to take off. What does a bank feel like? Landing? Actually watch the indicators and controls operate. I'm doing this in the next month, for sure. Demo and 1st lesson.

I don't know you at all, obviously, @Skybound-mg, and I have no useful medical advice. But from your writing here, you seem like the type of person who has both the passion and the commitment, to find out what you need to know and do, and to find in yourself the patience, to see the process through. I'm betting on the "cloud nine" outcome from this discovery flight... Report back to us on how it went!
 
A sport pilot license would put me into an expensive hobby that I could never share with my friends and family, which is the exact opposite of what I want.


Of course you can share it with them using a SP license. You just have to share it one person at a time. You will find it works out like that about 80% of the time anyway.
 
So, part of my goal/vision for getting a PPL is not just to be able to fly, but to be able to share it with friends/family. A sport pilot license would put me into an expensive hobby that I could never share with my friends and family, which is the exact opposite of what I want.

It's the ability to say "Hey, want to go anywhere within a 100 mile radius today" besides saying "Hey, lets pick from out immediate surroundings like usual". The justification for me for spending the time and money is the ability to share it with people. Without it, I can't justify it, and I'll have to find another outlet and remain disappointed.

For me, If I can't get the PPL and I'm going to get hard denied, I want to know before i get started. I don't want to go spend 10k to find out it's never going to happen. I'd rather rip that band-aid off now. Spend 2k for the test, and if I'm out, I'm out. I'll find a way to get over the disappointment.
Sounds like you have a plan and are aware of the repercussions, that's all we wanted to make sure of.

If you get the hard denial and change your mind later, there's always ultralights. :) You could also take some lessons up to solo at that point just to get the experience to carry back to your SIM.
 
Right now I’m waiting on an official letter from the FAA to tell me exactly what they want. My AME told me that I may not even be required to do the testing since my history of ADHD is so short and so long ago. Since you were diagnosed as an adult that could come in to play more than it did for me — I can’t say.

My AME said the same thing, so I am waiting to hear back on requirements, as well. Similar sitatuion as the OP here; 35 years old, was loosely diagnosed from family medicine doctor right out of college and have tried a couple stimulant medications (one for 2 years, the other for about a year) that never made a big enough difference to stay on them and have been off medications ever since. Fingers crossed that the battery isn't going to be required, though preparred to do that if needed.

Best of luck, Tyler!
 
No. NO. NO!
Call Dr. Bruce Chien before you do anything else.
 
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