Dr. Chad: This is Doctor Chad Edwards and you are listening to podcast #11 of “Against the Grain,” podcast. This episode is brought to you by the revolution health and wellness clinic, are you tired of fatigue? Are you frustrated with doctors because they don’t listen? Do you want to fix your pain without surgery? If you answered yes to any of these questions, then we are the clinic for you. We offer Prolotherapy, PRP and stem cell injections, IV nutritional therapies, bioidentical hormone replacement therapy and functional medicine to get you back on track to optimal health. Call our clinic at 918-935-3636 or visit our website at www.revolutionhealth.org to schedule your appointment today.
Speaker 1: Welcome to “Against the Grain,” podcast with doctor Chad Edwards, where he challenges the status quo when it comes to medicine. We get into hot topics in the medical field, with real stories from real patients to help you on your way to a healthy life style. Get ready because we are about to go. “Against the Grain.”
Bryan: Welcome back this is Bryan Wilks here with doctor Chad Edwards, Arthur of revolutionize your health with customized supplements and board certified in family medicine by the American Board of Family Medicine. How are you doing today Chad?
Dr. Chad: Bryan, if I were any better vitamins would be taking me.
Bryan: Wow. Wow, I don’t know…
Dr. Chad: You don’t even know what to say, do you?
Bryan: I don’t even know what to say, Marshall is looking at me like “ah, you’re with me on this Marshall right?” This is awkward. This is an awkward moment. We should never start the show. But I will tell you this, my father was a minister and I’ll put ministers and doctors in the same category, that when they tell a joke it’s funny to them. You know what I mean? They tell some pretty stale jokes.
Dr. Chad: I crack myself up.
Bryan: Oh yeah, that’s what doctors and ministers do. I put them in the same category.
Dr. Chad: I don’t care if anybody else laughs. I think it’s hilarious.
Bryan: That’s it. Hey, listen we have some important stuff to talk to you about today, right?
Dr. Chad: This has been a huge topic that affects a ton of people. Today we are talking about low back pain and what you can do about it.
Bryan: That is a good one. Wow. Yeah I know several people that it’s just a persistent little pain in their back and they can never get rid of it, right?
Dr. Chad: It ranges the spectrum from being just a little bit of pain that can disrupt, all the way up to you can’t get out of bed because your back hurts so bad and there is a lot of different things that can cause this, but across the board low back pain is incredibly common. Did you know 27 million Americans have low back pain? It is an incredibly common thing and we spend over 30 billion dollars a year on issues related to low back pain. When patients get low back pain, you wonder what do you do. What is the typical timeline?
A lot of times they will kind of deal with it themselves, they will take their anti-inflammatory Motrin, Naproxen, those kinds of things, they might do a little bit of stretching, they might go to their doctor and say “I’ve got low back pain.” A lot of times they will work on some stretching, they will try to do some things to try and strengthen their core, that’s really common. Sometimes they will get referred for physical therapy but if you go into your primary care doctor and you say “I’ve got low back pain,” I can’t speak for every primary care doctor; all I can do is speak from what I saw and what I did. Prior to my approach that I had today.
Bryan: This back pain thing though, people should know it’s a big business too. 30b illion dollars.
Dr. Chad: Yeah, and that obviously impacts days from work and that is factored into that number but yes, there is a lot of surgeries and operations that are done for low back pain and we are actually going to talk about that too. Before we get into the surgery component, the typical timeline for patients when they have low back pain, is they will go to their doctor, and again just speaking from what I saw and what I did, will try those anti-inflammatories, here’s your Motrin, here’s your Naproxen, we might use some pain medications, if that’s not working, a lot of times we will get an MRI (Magnetic Resonance Imaging).
There is a pretty high likelihood that you are going to see something on that MRI and if they do then you get sent to a surgeon. Remember one of those podcasts that we did, just a couple podcasts ago, was on MRI and how sensitive it is. It picks up a lot of stuff but that doesn’t mean that is the cause of your low back pain. So, go back and take a listen to that podcast, check that one out. So, you get this MRI and in that former podcast we talked about, it’s really just a road map to surgery. Do you need surgery or do you not? You will get sent to a surgeon and it’s not that every surgeon that sees low back pain is going to do surgery but you are definitely without question getting a surgical perspective, if you’re a surgeon.
If you take your car to mechanic you’re getting a mechanics perspective on your car. It’s the nature of the beast. In doing research, the surgery actually really helped low back pain. There is a lot of data out there and you will see some things for very specific conditions, low back surgery can be a benefit and specifically, if you have pain going down your leg. We called this radiculopathy. Now you have to be very, very careful with that statement and I will come back to that later on. So, if you have this true nerve root impingement, the nerve that is coming out of your spine, going down your leg, if that’s getting pinched then surgery can be good for that.
But, surgery has a horrible track record if it’s just for generalized low back pain and you get an MRI and there is something abnormal in there. I read an article by this lady that got low back pain and one of her friends actually commented in this article, her name was Marilyn Seiger and she said, “I don’t know anyone who has had surgery for back pain who had success.” I remember a story about low back pain. This patient came to me hoping to get Prolotherapy and she had 4 low back surgeries. The first surgery, they went and put hardware in there. So, they put these metal devices in her back and kind of screwed everything together, did a fusion. That didn’t help her pain, so they went back in thinking, “well maybe that stuff is causing pain,” so they went in and took that hardware out. She still had back pain, so she had another surgery and they put hardware back in and then they had a fourth surgery, where they took it back out.
Bryan: It’s like the jiffy lube.
Dr. Chad: In, out, in, out and yet she still had pain.
Bryan: But wait, let me ask you, when we talk about lower back pain, clinically speaking, what are those areas? I know it’s in your lower back, but what’s involved? I hear the word disks; I hear the words lumbars, what makes the lower back pain typically?
Dr. Chad: That is actually a great point. What makes up low back pain typically is kind of like saying I had a car accident, what’s typically damaged? Well did you get hit front the front, or the back, or the sides, or did you roll your car? We are using this low back pain as a “catch all,” and accurate treatment is going to depend on an accurate assessment. In my training for family medicine was not comprehensively trained in this. I remember getting educated on what we call these “red flags,” and so there are some red flags for low back pain, where if you have a sudden onset or a pretty progressive onset of bowel or bladder problems, meaning you are having trouble going to the bathroom or your messing yourself or wetting on yourself, or you can’t go. So that is concern for some things that need to be intervened on fairly quickly.
There are others that, we are trained on these red flag symptoms but that is just like “oh you’ve got to get to a surgeon because you have to get that fixed.” Everything else was this functional low back pain and we will try some of these things. We will try physical therapy, physical therapy where I did residency actually had a back pain class and you would go into the class and you would talk about doing all of these little different movements and contractions and all of those kinds of things and I went to that class because I wanted to hear what they were telling the patients. It’s helped some people for sure but again, you’re lumping everyone with low back pain into this category, so I don’t think there is a very straight forward answer to your question. It depends on an accurate assessment.
Bryan: Let’s get down to the statistics behind back pain and surgery. I know you read this article but, is there any statistical information that the average person could look to, that you were educated on and say it works or it doesn’t.
Dr. Chad: Yeah, so it depends specifically on what’s causing the back pain. There are some– If you’ve got a MRI that shows the nerve coming out of the spine or has the bone kind of growing around the spine, that’s what we call Stenosis.
Bryan: Okay, for back pain is this common?
Dr. Chad: I don’t know the incidents, in my practice, it’s not that common. So, I would have to look at the actual numbers but I don’t see it commonly in my practice. If your symptoms are consistent with nerve root impingement, on that nerve, which would have a very specific distribution going down the leg, or other sequence of events, then yes, going in and cleaning that out can have a fairly high success rate.
Bryan: Physically moving it, cleaning it out, yeah that makes sense.
Dr. Chad: Correct.
Bryan: Yeah, that makes sense.
Dr. Chad: But again, understanding M.R.I. and its sensitivity and then correlating that with physical exam, I just don’t see a tremendous number of patients that would benefit from surgery. In fact I would say that I don’t routinely recommend surgery for virtually any musculoskeletal condition until they have maximized the benefit with Prolotherapy.
Bryan: Tell me about the more common conditions you see two or three more common conditions associated with back pain still a large area. A lot of different complications but what are the most common?
Dr. Chad: Without question the most common cause of low back pain that I see is because of muscular– because of ligaments or tendons being disrupted. No I’m not talking about someone who was out lifting a couch or lifting something, lifted something felt a little bit of a pop immediate onset of pain that last two weeks and then goes away. That’s not what I’m talking about. I’m talking about pain that’s persistent beyond six weeks. In that short term, I would argue that the most common would be just a muscular skeletal strain so muscles, tendons, ligaments just getting strained. Now we know that the vast majority I think the numbers around 80% of those conditions are going to heal on their own within eight weeks right, six weeks.
Brian: It’s a waiting game?
Dr. Chad: Correct, then we do symptom control in the middle of that but again if you go to your doctor the most likely thing that you’re going to prescribe is an anti-inflammatory motor naproxen celebrex one of those and we have studies. You can look at the mechanism of how those medicines work and the mechanisms of how your body heals and those two are at odds. Your body heals through inflammation and with the anti-inflammatory we’re inhibiting that inflammation.
Brian: Inhibiting the healing process.
Dr Dr. Chad: That’s exactly right and Prolotherapy is specifically formulated to heal those ligaments and tendons.
Brian: For those people that don’t know what Prolotherapy is or haven’t to listened to our podcasts on Prolotherapy you can go back and listen to it but also give us a brief on what Prolotherapy is.
Dr. Chad: Prolotherapy is a minimally invasive in office procedure where we’re injecting a proliferate solution, proliferate meaning that we’re stimulating the growth of new collagen and that is through the body’s normal natural healing mechanisms for it to heal itself to proliferate and grow new collagen. Collagen is like the strands of a steel cable right. It makes the steel cable. We’re growing new strands so to speak and it’s the inflammatory process that does that.
Brian: Let’s take a quick break when we come back I want to talk a little bit more about why people don’t know about Prolotherapy and why they should.
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Brian: Welcome back from the break this is Brian Wilkes here with Dr. Chad Edwards author of Revolutionize your Health with custom Supplements. Dr. Chad before the break we were talking a little bit about Prolotherapy and why people don’t know about it and why they should. Why do you think it’s– first of all let’s talk about the success rates of Prolotherapy as it relates to lower back pain.
Dr. Chad: When you look historically, Prolotherapy has been around in its current form right since the 1930’s somewhere in there. Dr. Hackett Pro published his first case series reports in the 1950’s and he began doing his papers in the 1930’s so it’s been around for a long time. It has a track record across the board not just with low back pain of an 85% success rate. He published all of his case series and all of these different things. It’s got a great track record and an excellent safety record over decades and it works very well. One of the studies that was done on Prolotherapy was done by a guy named Yelland Y-E-L-L-A-N-D and he was evaluating treatment with Prolotherapy versus Seylin injections. He was doing what was what’s called a randomized placebo controlled double blinded study.
Brian: That ten times real fast.
Dr. Chad: Exactly that ten times. They separated the patients into two separate groups. When we get into why haven’t– why don’t people know about this? I would argue that some of the reasons that people don’t know about this is because doctors don’t know about it. Why don’t their doctors know about it? Partly, I don’t know. I had never heard of Prolotherapy until I was in the military and one of my commanders came and said I need Prolotherapy and I had no idea to what he was referring.
We had to learn about it, and he got all fixed up because of it and so as I started doing my research one of the things we talked about the Cochrane Collaboration. It’s a group of researchers that look at all of the available studies and they’ll make a consensus on this works or it doesn’t. The Cochrane review looked at the Cochrane Collaboration looked at five studies and their conclusion at the end of reviewing this was that there’s conflicting data on it but we were not convinced that it works right.
Again that larger study was by Yelland and he had I think it was 110 patients in the study. He did Prolotherapy injections on one group and then he did seylin injections on the other group. I didn’t know who was who it was at the in a study that was that it came out in the in the data. At the end of the study they compared the two groups and there was no statistically significant difference between the two groups.
It was within the margin of error and so it wasn’t considered statistically significant so their conclusion according to the Cochrane review was that it didn’t work, versus placebo. That caused my head scratching. I had to scratch my head about this because, I had been doing Prolotherapy for at least several months when I started looking into this and I knew that it worked and not only did it work it works very, very well.
Brian: You were giving this to soldiers in the field of battle right?
Dr. Chad: Not while they’re getting shot at but yes they-
Brian: Is that another doctor joke?
Dr. Chad: Maybe they were having a lot of muscular skeletal problems and these were things that I didn’t typically have a good solution for. We did Prolotherapy and then they got better. When I see this study that shows– that says this doesn’t work and then I read the Cochrane Collaboration that says this doesn’t work but I know darn good and well it works. We have a problem. I got all of the studies I read them now the interesting thing about the Yelland study was the average duration of pain for the patients in that Yelland study was 14 years.
In both groups, the control group and the Prolotherapy group. They both had an average duration of pain of 14 years. They had pain for a long time, and they assumed that seylin injections were a placebo. Now we’ve got studies that show that dry needling sticking a needle anybody in a physical therapy room will certainly know what dry needling are myriad patients may know. But we know that sticking a needle in the tissue not injecting anything just sticking a needle in the tissues has an effect and they’ve compared that versus placebo and we know there is an effect with that beyond placebo.
When you’re doing a seylin injection, we cannot say fairly that a seylin injection is a placebo. Some would argue with me on that but I think the data speaks for itself beyond the Yelland study. The second piece of this is that at the end of the study they asked the two different groups what do you think, how are you doing and both groups were very happy with their results. If basically what you’re doing is comparing one therapy versus another and then saying that one of them doesn’t work but yet all of them were very happy and they had pain for 14 years.
Brian: Chad you actually read the study? No one does that.
Dr. Chad: I read the entire study.
Brian: Mark Twain said pull up this quote here, ‘There are lies, there are damn lies, and then there are statistics.’
Dr. Chad: That’s exactly right. I say that every day.
Brian: It’s important that you go to the doctor that actually reads the studies right?
Dr. Chad: Because-
Brian: There’s contrary evidence
Dr. Chad: We see this throughout medicine, we’ve talked a little bit about it and we’ll talk more about in the future but we’ll get a study and then we’ll say this is the truth because the study proves it. But it was never asking the question that you’re bringing up or it wasn’t asking the question in that population or it wasn’t under those circumstances and-
Brian: I think that if you back away from this conversation and you ask yourself so I’m going to take a liquid
That Dr. Edwards injects in my leg that really has no harmful effect at all even if it doesn’t work.
Dr. Chad: That’s exactly right.
Bryan: That’s like the worst case scenario you pay some money. It doesn’t work and Prolotherapy does work. I’m just saying and you encourage anybody to,come try it and you’ll prove it to them. But I guess the opposite of that is let’s trust the study and go get our back cut open and to your earlier point, to your earlier analogy the downside is that they put hardware in, they can take hardware out they put it back in and you’re getting cut up which is pretty big risks in those things.
Dr. Chad: Absolutely.
Bryan: Time off work and I think people need to back away from all these conversations we have and it’s not a conspiracy. You just have to look around your work and I think it was Steve Jobs that said “The world is a much different place when you finally realize that everything created around you was created by people that were no smarter than you.” When you look at these statistics and you look at these surveys, you do have to go against the grain because the grain says they are a smart people looked at it and this one must be right.
But the problem with that is if you look around your work wherever you work right now and you go, “I’m not sure all these people are smart.” Because you’re with them right. But that’s how it is in every organization you really have to look into these statistics and you have to begin to question the viability of the study itself and then you have to compare it against the risk analysis. Surgery on your back or try an alternative treatment and the alternative treatments are much cheaper too. You can’t really sell this to the hospital as compared to surgery. Surgery is a costly thing. It’s a bigger bill in other words. All the sudden you have 80% of those people cured from the pain by Prolotherapy and I would assume that’s a big drop in revenue for a hospital. A substantial drop in revenue.
Dr. Chad: We need to be careful about using the word cure because that statement has not been evaluated by the F.D.A. and we have to be very careful and I-
Bryan: Do I have to be careful?
Dr. Chad: You can say whatever you want right. I am being clear and saying, I’m not saying that we’re curing people off their low back pain.
Bryan: I’m saying whatever I want.
Dr. Chad: Exactly.
Bryan: God bless America.
Dr. Chad: Go for it you know.
Bryan: There you go.
Dr. Chad: I can tell you that I have multiple, many patients that came in with pain and leave without pain. However you want to get from point A to Point B, is up to you.
Bryan: Whatever words you want to use. Tell me about what does the average–so the average person comes in and they complain about pain, you would say let’s say out of the 10 people that come to your office about lower back pain right. You inject– let’s throw out the nerve pain which I said would be substantial to have surgery. Out of 10 people generally how many see improvements from Prolotherapy?
Dr. Chad: Statistically, I think it depends on patient selection, but across the board-
Bryan: Let’s just say your experience.
Dr. Chad: Across the board my experience right in excess of 85% of them.
Bryan: That’s pretty substantial.
Dr. Chad: I agree.
Bryan: Now when you say improvement is that generally like they don’t feel pain anymore or they just have less pain or no pain.
Dr. Chad: My goal is that we eliminate their pain and restore them to full function. That’s my goal.
Bryan: We didn’t say cure.
Dr. Chad: Correct, so my goal is to improve pain, improve function and Prolotherapy has an excellent track record of doing that with next to no risk right and we review all of the risks when they come in.
Bryan: Which are?
Dr. Edwards: Generally we talk about bleeding and infection. I participate in the Hackett Hemwall Foundation and they’re arguably the largest organization in the world on Prolotherapy and we have people in multiple countries and whenever there’s an adverse event we share the information.
Bryan: But this is a–I know people may be afraid of this but you should be more afraid of a knife. This is a needle. This is a needle right?
Dr. Chad: Exactly.
Bryan: This is a shot. So, the risks associated with these are similar to getting a shot.
Dr. Chad: That’s correct. So in this other first part is just that bleeding and infection we have to talk about that needle itself.
Bryan: Again, same thing you get a vaccination for something.
Dr. Chad: Hitting something that we don’t intend to hit like a nerve, an artery and something like that. In medicine we hit arteries with needles, we actually hit nerves with needles and we hit veins with needles all the time. You get your blood drawn, we’re hitting a vein with a needle. We intentionally do that in some cases, most of the time with Prolotherapy the vast majority of the time, even if we were to hit one of those structures, it is not a severe consequence. In fact, I’ve been doing Prolotherapy for nearly eight years and doing thousands of procedures I’ve never had a single consequence or a single negative outcome of any kind.
Bryan: I would suggest to people out there listening. If your back pain isn’t bad enough that eliminates your fear of a needle then it’s probably not that bad. You get a lot of people that have had years of back pain. I know personally and I think we talked about it on other shows. I know former pro baseball players have been to you, former football players and they’ve got chronic pain in their back.
Dr. Chad: Multiple military special operations. I worked with several special operations units had great success with that stuff with police officers, SWAT department, fire department running the game and then the other age range all the way from I think 13 was the youngest one I’ve done 12 all the way up to 95.
Bryan: I know you have a very credible network of people that have been to the clinic. Some high profile people that have been to the clinic and would testify on Prolotherapy give us an example of one case that sticks out in your mind. Sorry to put you on the spot, but someone that you remember not by name that was in a great deal of lower back pain that came and got Prolotherapy.
Dr. Chad: Actually the one that comes to mind and I could– in fact on my website revolutionhealth.org/ I think it’s testimonials but on my website you can see the testimonies and you can see their stories.
Bryan: Just Google Revolution Health.
Dr. Chad: Exactly the one that comes to mind is the–one of the very first Prolotherapy patients that I did Prolotherapy on she was an active duty young lady Staff Sergeant she was a very motivated soldier, worked hard and she had this low back pain and she actually came to see me because she needed a profile meaning she needed a letter that said she didn’t have to do sit ups on her physical fitness test.
She could run, she could do pushups, she couldn’t do sit ups it just hurt too bad to do those and we did three rounds of Prolotherapy. After the second round she had two weeks where she had no pain at all and after the third round she had basically resolved her pain and she had gotten to where she couldn’t even clean her house. This was a young girl. I’ve got– there’s tons of cases like that.
Bryan: Interesting to me. I think I mentioned it on the last podcast I had watched a Frontline series on P.B.S. And– I’d watched a Frontline special on P.B.S. and it was talking about supplements. They had tested various supplements to ensure that a clinic had tested it to ensure that there were the right properties in it. They weren’t over a third had the wrong properties. It was in the 90’s and the supplement industry came together and lobbied Washington to not restrict supplemental use in those categories that people that had in essence been caught and red handed been caught. It didn’t work. Wasn’t working. It can’t work didn’t have the ingredients. It can’t work.
They didn’t have people testifying it did work either they were actually having the opposite. People were having pain and they found that it was aligned some of the toes were aligned with anabolic steroids and they were having lower back pain as a result which is crazy. Women growing hair facial hair. Crazy stuff and what was interesting about this and I think it relates to our topic is they lobbied Washington and there was no punishment and today those same people make the same drugs and supplements. My point is when you think about things like Prolotherapy you think, “oh, I never heard of it can’t work.”
It’s not true. I would argue that there are lobbyist in Washington, D.C. right now arguing for surgery, arguing for surgical methods of back pain and they probably have a lot more money than the Prolotherapy people.
Dr. Chad: There’s no question.
Bryan:When a possible solution to a very large problem happens in the medical industry. It is far from the first thing that’s considered of does it work or not. Is it profitable? Who’s involved? Washington lobby– who will lobby Washington to keep it down? I think you see it in a lot of documentaries I think people know it and I think Tulsa Prolotherapy is one of those things that I think anyone that uses it knows that it works. I said that anyone that uses it. I assume that in some cases where probably wouldn’t work as well as others. Tulsa Prolotherapy
Dr. Chad: Sure.
Bryan: But, in your clinic, 85% of the time people see improvement; That’s pretty dramatic, and I think some people probably wonder why that is, and I think if you think carefully about it it’s not hard to figure out. Talked about it numerous times on the show, and you think everyone would be rushing towards it?
Dr. Chad: Right. Yes, there is– but, when there is something that is new. This isn’t new, but it’s new to them, and often what I see is people looking for a reason that it won’t work. I get a lot of people that will look for a reason that it will work, I would argue that those people have a real true need. But, some people, it’s just the way they are wired, they “Nope, I’m going to go talk to my surgeon and he said surgery and that’s what I’m going to do.” Tulsa Prolotherapy
Bryan: Yes. It’s like that in business too, we have—it’s actually the law of diffusion of innovations, it’s called the S curve, and they say that you have to get 15% of the people to get the next 20%, and you have to get the next 20% to get the next 30%. And then, there is the lated– there is the laggard stage as people are still using rotary phones, you know? They don’t believe in the cell phone. Tulsa Prolotherapy
Dr. Chad: Right.
Bryan: People have sort of changed on this kind of things, very sort of changed. That’s not just in medicine, but that’s in business. Right?
Dr. Chad: Absolutely.
Dr. Chad: Yes.
Bryan: So you get people that you tell about this and they still come in to your clinic and they say “I want surgery”?
Dr. Chad: Well, it’s rare. Once they come into my clinic– you know, they– my front office would probably say “No, we get a few”, but it’s not many. I do what I can to get them in the door for evaluation because that’s when we’re really going to be able to make a difference because on the physical exam I’ll be able to determine “You know; I don’t know if this is going to help you” or “I think this is the best thing for you”. I had a patient last week that he was undergoing some stuff and with his issue, we had done two rounds and I say “you know, based on what you are telling me, I don’t know that Prolotherapy is the best solution for you”. Tulsa Prolotherapy
And I would have love to have done Prolotherapy, I like doing the procedure, and, certainly I wanted to get paid for the procedure, but I didn’t think that that was in his best interest. I wasn’t convinced that I was going to be able to help him.
Bryan: Well, that’s one, I hear people talking about you, right? And that’s one of the things that people say about you, is “This guy is passionate about what he does, he believes in what he does, and he is going to do what’s best for the patient.” I think that’s missing from the medical profession these days. I think you take your oath seriously, and I think it’s reflected in this, you just taking the time out to do this podcast. The goal of this podcast is for people to know, and knowing is half the battle. Tulsa Prolotherapy
Dr. Chad: That’s right.
Dr. Chad: That’s right
Bryan: That’s your slogan right? That’s your vision, right? People to know about it.Right?
Dr. Chad: Yes, I want people to know about it, yes.
Bryan: Yes. I think [unintelligible 00:02:57] is better.
Dr. Chad: Yes, that’s true.
Bryan: So, hey, we look forward to seeing you on the next podcast. Thank you.
Dr. Chad: Thanks Bryan.
Bryan: Thank you.
Speaker 1:Thanks for listening to this week’s podcast with Dr. Chad Edwards. Tune in next week, where we’ll be going against the grain.