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E106 - CannMed 23 – These are the People in Your Neighbourhood Part 2

We've got another amazing group of attendees from CannMed 23!

One evening they said dinner was on Lanai Beach. In Manitoba, if you are at a conference and someone says dinner is on Lanai Beach, then Lanai Beach is the name of a room. But in Florida, they actually meant dinner was on a beach. That sounds like a lovely idea, unless it is over 30 C and there is no shade. Thankfully, I brought a ball cap for my bald head and I met Dr. Joe Thompson also looking for some shade beside a pole. Dr. Thompson trained as a pediatrician, but now is the President & CEO of the Arkansas Center for Health Improvement. They have a program where they are going to analyze the data of people who got medical cannabis in Arkansas and see what happened to Health Outcomes. You want to hear about how that study will be done.

Dr. Leah Johnson Pharm D is a pharmacist and we met her in the Poster Hallway. Her Poster was about palliative care patients in California. Her group believes that if patients have access to cannabinoid medicine during palliative care, that will promote a better quality of life for the patients. Dr. Leah helps patients with their cannabis therapy and is a Cannabis Speaker and Educator across the US. She is on the Executive of the Pharmacist Cannabis Coalition of California (PCCC).

I met Akeem during the opening reception of CannMed 23. I didn't know anyone at the conference yet, so thankfully, he came up to me, read my name tag and introduced himself. Soon we discovered we were both from Canada, and we laughed over the fact the sliders were taken away too quickly. He told me he was nervous about a main stage talk he was giving. Now I understand why. He was giving a very technical, science heavy talk to a room full of cannabis doctors and researchers. But he killed it during his talk. He even handled challenges from the audience. I got to collect some audio from Akeem right after his talk. He’s from Mississauga. He’s a huge basketball fan. He has a nephew who Uncle Akeem really wants to become the next Lebron James. But for our story, Akeem is a Canadian lawyer turned hemp farmer turned CEO of the BioTech company Canurta Inc. His talk was about cannaflavins and their potential to treat glioblastoma, a common and aggressive form of brain cancer.

Bruce Mackler was involved with Prairie Plant Systems in Flin Flon when all “legal” Canadian Government Cannabis was grown in a mine in 2000. That became Cannimed in Saskatoon. And that got bought out by Aurora. Former lawyer that fought cases against the FDA. Former immunologist. His company, Ethicann, is developing a sublingual tablet for Multiple Sclerosis as a competitor to Stativex.

Episode Transcript

Trevor: Kirk we are back for part two. 

Kirk: Part two This is really cool. This is a cool these are cool stories you've brought. 

Trevor: So so for those of you who haven't listened to Part One, go back and listen. It doesn't really matter. But I think you're missing out on some cool interviews if you don't listen to Part One. But so I was at a conference in Florida, CANNMED 2023, talked on a panel. Listen to some interesting talks. But of course, one of the most interesting part is just sort of wandering around and meeting people and saying, "hey, can I record a little bit of audio from you?" So this time I'd like to start with Dr. Joe Thompson. So one of the nights, they said dinner will be on Lanai Beach. So if you go to a conference in Manitoba and they say dinner will be on the Lanai Beach, that means there is some room at the conference center called Lanai Beach. But we're in Florida, so dinner on Lanai beach meant literally dinner out on a beach. That sounds like a lovely idea. But when it's over 30 degrees C and you have a bald head, it's not as comfortable as you think. So thankfully, I found a ballcap, threw that on and spend a goodly chunk of time before supper was served trying to find some freaking shade. And then I met another gentleman who was trying to find some shade beside a pole, and his name was Dr. Joe Thompson. So Joe Thompson is a pediatrician by training, but he is now the president and CEO of the Arkansas Center for Health Improvement. And one of the really cool things I thought is they they're going to try and link up some databases. So they got a database of people who sort of have a medical authorization to use cannabis, a green card, if you prefer, and they have a database of health stuff going on in Arkansas. So, you know, people who you know, what drugs were paid for, what tests were done, what medical conditions, all that sort of thing. And they're going to try to link those up and see what they can find about sort of the health status of people in Arkansas who both are using cannabis and are hopefully in these these other insurance databases. And what that reminded me of instantly was the TOPS trial where they took people who are going in Canada, who are going to various cannabis clinics across Canada using medical cannabis, and they sort of track their prescription drug use and saw that all of their prescription drugs started dropping, including especially things like opioids and benzos and even just how much money they were spending on their prescription drugs. Yes, as a pharmacist, I focus in on the prescription drugs, but it'll be really cool to see six months a year down the road. What this this group from Arkansas, led by Dr. Joe Thompson, might find. 

Kirk: I'm on the Web page. Off of camera we're talking about this. I just clicked on as you were talking. I just clicked on something here, Arkansas's Health Care Transparency initiative. So this is how it is, includes all state, all payers claims database is a large scale database that contains medical pharmacy and dental care and enrollment data and providers file as well as vital records, disease registries, hospital discharges, emergency departments, medical marijuana data, etc.. So this is a huge database. Now, what I've got here is Arkansas Department of Health data. 100,617 individuals are registered as medical marijuana cardholders from August 2018 to September 2020. They also had 372 696 children born between 2013 and 2021. So it's quite a, quite a robust database. 

Trevor: Yeah. As as both, you know, we like the prescription drugs and, and math. I think there hopefully will be some interesting and surprising correlations they get out of sort of putting these databases together and querying them and see kind of what pops out. 

Kirk: Yeah, well, and. And as we're saying, the only thing that I wonder about is it the name of the database is called. It's called the Arkansas All Payers Claims Database. So there's an assumption here that medical card, cannabis medical card holders are getting some sort of insurance. 

Trevor: Well, again, we talked about off camera. The short answer is neither of us know for sure, but I interpret that just meaning that is all sort of insurance claims in the state, because you remember, you know, south of the border, everything from, you know, setting a leg in an emergency room to, you know, getting a chest X-ray to filling your antibiotic all gets paid either you shell out, out of pocket or insurance company pays. So I when it's all payers, I just think it's all, the whole health record is how I interpret it. 

Kirk: But yeah no this is, this is a this is fantastic. It's interesting though during COVID, I think one of the things we learned about the Canadian and the American health systems is that none of them are linked. And they and they and they have to ask different questions and define things differently. So it'd be interesting to see how this database works. 

Trevor: But with how instead of us speculating on what they'll be looking for. Let's listen to Joe Thompson talk about the project. So we've got Dr. Joe Thompson from Arkansas, and he's got a really interesting database that he's starting to work with. Dr. Thompson, tell us about what you who you're working with and what you're what you guys are doing. 

Dr. Joe Thompson: So I run the Arkansas Center for Health Improvement, and we run a unique database that our state has, several other states have, called an all payer claims database. This is a requirement of health care companies, insurance companies, Medicaid, Medicare, to put their claims data into a database to support transparency efforts on cost containment and improve quality. In Arkansas, we also had introduced medical marijuana in 2019 so that we're able to track individuals not with their identity, but that have been participating in the medical marijuana use to see if it affects their health care utilization. 

Trevor: So I'm kind of picturing this being like the TOPS study in Canada we've talked about. But I'm really interested see what you guys find in, you know, six months, six or seven months. Do you mind if we contact you later to see what the what the follow what, what happened. 

Dr. Joe Thompson: So please feel free to come back. This is the first of its kind funded study by the National Institutes for Health. And I think there will be a lot of interest on the findings that we generate. 

Trevor: Thank you very much. So another person I ran into was Dr. Leah Johnson. She is a pharmacist. She does lots of different things. But for this, I guess she was with the Pharmacist Cannabis Coalition of California, which she happens to be the treasurer of at the moment. And they were talking about palliative care. So, Kirk, you did a little bit of reading on Ryan's law in palliative care. They had a poster on this. So what were you? What were some of your thoughts? 

Kirk: Well, first thing is more than one Ryan's Law in California. But having said that, I found this one and it's very cool. And without getting specific because they talk about in his spiel. But what I found interesting is that on a Web page called Americans for Safe Access, which is an organization of basically helping people access cannabis, they have a health care facilities guide to implementing Ryan's Law. So basically what I find very cool about this is that they have a system wide paint-by-numbers process on how to supply cannabis and allow patients to have cannabis. This reminds me of our story that we did with Manitoba's Top Pot Doc, Dr. Daeninck and Episode Dr. Daeninck was episode What? Why is Cancer Gone to pot? Episode 71 Googling my own web page. But yeah, he he they talked about how Winnipeg allows cannabis now in the palliative care. But I'm just thinking I don't think that system wide in Manitoba I would think through Shared Health that you could get it but you know I never checked if cannabis was part of our local cancer program. But I digress against Ryan's Law. So yes, statewide they have a law that means that facilities must honor families that want to bring cannabis. 

Trevor: Yeah and so let's let Dr. Leah talk about the poster. So, Kirk, I didn't have to go very far, but of course, I found a pharmacist. We've got Dr. Leah Johnson, and she's going to tell us a little bit about Ryan's law in California. 

Dr. Leah Johnson: Thank you so much, Trevor. So Ryan's law is very important. It means a lot to me and my organized nonprofit organization, the Pharmacists Cannabis Coalition of California. The purpose of Ryan's Law is to help bring to allow the use of medical cannabis for compassionate use for patients who are terminally ill, meaning they have about a year to live or less. And this is to be used at facilities such as long term care facilities or hospitals, which normally you would not be able to use it. It's a really great law. It's really effective and it really should be promoted in other states to get patients off of their all these the end of life meds they put them on. It helps patients reduce the amount of they don't usually use morphine, their anti-anxiety or their pain meds, and instead they utilize their cannabis and they're happy and they actually have the ability to say goodbye to their family, which is really just the purpose of the law of Ryan's Law is really just to allow the patient to die with dignity and to be able to enjoy the last bit of their life in peace. 

Trevor: So can you talk a little bit about current, the current treatment and things like comfort packs versus patients getting access to cannabis? 

Dr. Leah Johnson: Yeah, So it's sad that in especially in California, but in all over the U.S., we're seeing that in many other countries actually, that they just give comfort packs when patients are terminally ill, meaning that it's just pretty much a set regimen of morphine, anti-anxiety, usually lorazepam and also the anti-anxiety. Yeah, it's anxiety. I apologize. It's anxiety. Anti pain and sleep medication. So a lot of times with these together, they're just they just call somebody's problem. The patient just ends up sedated. And a lot of times it's made as a scheduled regimen as opposed to an "as needed." So the patients are forced to take it and they might not actually need those at the time. Ryan's law, sadly, is it's to get the cannabis in the facility. You have to go through hoops. So you can easily get this packet of meds that is not really the best way to have the end of your life. First is cannabis, which you have to the patient themselves will have to leave the long term care facility or hospital to go to a doctor to get a recommendation for cannabis. Then they have to have either themselves or their family members or friends, buy the cannabis, bring it into the facility, needs to be asked to be checked, marked by the nursing team or the pharmacist, and then it needs to be kept in a locked box by their bedside. And then you have to have somebody such as themselves or an administrator or a caregiver to give it to them, which is ludicrous because the nurses in the facilities, at least in the state of California, cannot give them the cannabis that they need. So as much as Ryan's Law is amazing and we're so happy that it exists to allow for the use of medical cannabis, there's so much more that needs to be done to really allow the patients to be able to access the cannabis easily, especially for those who are unable to leave the facilities to access their cannabis. 

Trevor: Thank you, Doctor. Leah. That was great. And we'll post links later, but she's got a podcast too, and we'll post out how to get to that. Akeem Gardner. So so I think I mentioned a little bit last episode without sounding like a you know, I'm socially anxious, a little socially anxious. And so, again, the first event was just a big mixer that one night. And I'm not quite I don't know what he won. I'm not quite sure who you talk to. But thankfully this guy came up to me and read my nametag and said, "Hi, Trevor, what are you doing here?" And we got to talking. And turned out he was Canadian. So, you know, one of the reasons he's a nice guy and then, you know, we got to laugh over the fact the sliders were taken away too quickly. And he said he was nervous about this talk that he was going to be doing on the main stage. After the fact, I now understand why. So he was going to be giving a very technical, very science heavy talk to a roomful of cannabis doctors and researchers. Good news is it Akeem killed during his talk. He did a fantastic job. He even handled some challenges. Hecklers as too strong, some challenges from the audience afterwards. And then I got to collect some audio from Akeem right after his talk. And I think he was still sort of riding the high of the talk, going so well. You know, before we got on Mic, you know, he's from Mississauga. He's a huge basketball fan. He has a nephew who Uncle Akeem really, really, really wants to grow up to be the next LeBron James. But for the purposes of our story, Akeem is a Canadian lawyer who decided to become a hemp farmer. And then he said, well, that hemp farming thing might have been the best, worst mistake I ever made because that didn't turn out so well. And he's now the CEO of a biotech company. It's called Canurta. And the talk he was giving was about Cannflavins, which was a part of the cannabis plant I'd never heard of before. But apparently they have some potential to be anti-inflammatory. And specifically in his talk, they were talking he was talking about the Cannflavins and potential to treat glioblastoma, which is a common and aggressive form of brain cancer. 

Kirk: Yeah, I'm on his web page. It's fascinating. Fascinating stuff. This is this this is scientists and businesses that are taking in the cannabis, the cannabis plant, and taking its components and studying it. Now, big parts of our audience and cannabis culture don't believe that you can do this because it's the entourage effect. Right? But I guess when you look at it from a scientific perspective, that there's so many components this plant that why shouldn't it be studied? Why shouldn't we look at every component of it? And it's a. 

Trevor: Yeah, and sort of a teaser for future episodes that was actually even at this conference, a big dichotomy. There was definitely the whole plant people who, you know, you shouldn't ever treat a disease with anything other than the whole plant. And then I was at the capital markets part. Well, the way pharma makes, the way pharma works is you extract a component from something and use that one component or say, one cannabinoid to treat one indication. That's how pharma works. So, you know, if you're going to quote unquote make money at this, you need to pull out a component and treat a condition. And the two groups don't really meet really kind of. Well, but, you know, we've got a future interview with Dr. Ethan Russo, and I will we'll tease with it. He thinks, you know, maybe there are third ways between whole plant and just individual extractions.  

Kirk: I am one of those that sit on the fence. I mean, in, in health care, as a nurse, registered nurse, I have to think of the science. I have to think about the social science of it and, and the chemical science of it that, that if we're going to treat cannabis as medicine, then isolating the various components of it, is important. But then looking at it from the perspective of, of, of, of the social science and the green culture and how the plant is the plant, the entourage effect is powerful because especially and again, we're sneaking in the Ethan Russo's episode, which I'll probably run next, you know, after this one. But, you know, sometimes when you isolate a certain component and pharmacology, what do you do when you pharma-size it?  When you make it into a chemistry medicine, sometimes as severe side effects and it doesn't always work. I mean, so I get it. I think. I think Akeem on to something. I support the fact of break to plant up study the hell out of it. I support that. And Akeem, I think I think is a powerful, a powerful future entrepreneur in the cannabis industry. 

Trevor: So with that, let's hear from Akeem. So we're still hereat CANNMED23 and there's a number of Canadians here. One of the very interesting ones is Akeem. So Akeem started in law and then decided to make a transition in his career. Akeem Where did you go from Law? 

Akeem Gardner: Yes, So I graduated from law school, and in the midst of accrediting my law degree, I ended up on a farm growing hemp. Who knew? Right? But the best decision that I ever could have made, even though it got my ass kicked, like who tries to go and farm 60 acres of hemp with garden clippers in a 4x4 truck? Only Akeem. Right? But like I said, the best decision I ever could have made because I knew that there was opportunity in cannabis when we were legalizing in 2018. And industrial hemp is one of the hidden gems that the Earth has given us, God's given us. And that led me eventually to these professors at the University of Guelph who are doing some really, really interesting work on novel molecules found in the cannabis hemp plant. And I'm very fortunate enough to be the beneficiary of their work. Now being the CEO and founder of Canurta Inc, moving for these cannabis polyphenols and working through all the incredible activity that they can have to impact both human and animal health. 

Trevor: Akeem That's great. Now, you just gave me a long talk. We won't make you repeat the whole thing, but tell me a little bit about what you guys are doing with it. Well, tell us what glioblastoma is and a little bit about what your molecules might do there. 

Akeem Gardner: So over here in Canada, I'm here giving a talk about limiting glioblastomas. Glioblastoma survival with cannabis derived flavonoids. And as I mentioned, what we are looking at is some of these rare molecules that are in the plant, the Premier League of Flavonoids can plug in A and B and what impact these Cannflavins might have on glioblastoma or brain cancer and how what we learned there might be attributable to other cancers like breast, liver, lung, so on and so forth. The big thing that we know is that our Cannflavins inhibit receptor. That's one of their main mechanisms of action when it comes to anti-cancer activity. And because of what these molecules do in inhibiting this receptor that's deregulated in a variety of different cancers, we can then start to formulate and concentrate different solutions that might be able to halt the underlying abnormalities in GBM brain cancer. 

Trevor: Thanks a lot of Akeem and we look forward to hearing more out your company down the road. Thanks a lot. 

Akeem Gardner: Thanks for having us Trevor. 

Trevor: So Bruce is kind of the definition of a jack-of-all-trades in the nicest possible way. So from just from the Canadian part, and he's an American dude, but so he was involved with Prairie Plant Systems. So if you remember way back to the late nineties, early 2000s, this was the place in 2000 where you could get legal Canadian government grown cannabis and they're growing it in a mine near Flin Flon, Manitoba. Now let's ignore the fact that many people weren't particularly impressed with how good it was, but it was it was legal Canadian government grown stuff. And this was from Prairie Plant System. So Prairie Plant became eventually became Cannimed in Saskatoon, and that eventually got bought out by Aurora. But Bruce was involved with that. Bruce is a former lawyer who used to fight cases against the FDA. So he is incredibly steeped in, you know, all the legal intricacies of the FDA. Got to listen to him, be on a panel or to talk about the ins and outs of that. Of course, you know, he's also a former immunologist, so he's got the heavy duty science background. But what we're talking with Bruce today is his company is developing a competitor to Sativex and Sativex is a spray. CBD/THC spray under the tongue for MS, which was it's been relatively successful. Now it's got a few downsides, including there's a lot of alcohol you're spraying under your tongue that you know, not everybody wants. And the second is it doesn't taste so good. So Bruce's company is looking at making a sublingual tablet to go under the tongue for the same indication. I know you've been Googling Bruce too.  What are the things of Bruce did you find. 

Kirk: Oh, I just it is a fascinating character. I learned he is biomedical science expert science experts, and he's considered a top investor in biomedical ventures and consulting FDA, USDA, the EPA. He's been management of boards of biomedical companies. They basically refer to him as a successful entrepreneur, starting several pharmaceutical companies and raising funds and continues on the board of several biomedical companies. So he's definitely a bio chemical investor. So he's and I mean, he comes with the science background, He comes with a what is it? Is he not also a lawyer? 

Trevor: Yeah. 

Kirk: Yeah. So a lawyer and a PhD, a dangerous combination. 

Trevor: And super nice. When he heard I had an early flight out to leave, he said, well, you know, I think so-and-so is is leaving at that. At that point you want me to see if the two of you can share a cab? So. Well, I appreciate that, Bruce, but I did actually organize that. Right. Okay, well, you just let me know. So on top of everything else, just a nice guy. 

Kirk: You gave up another interview in a cab to the airport. 

Trevor: Yeah, well, I was. 

Kirk: I imagine we imagine you were quite exhausted after all this. 

Trevor: I was just going to say that that cab ride to the airport was just semi-conscious. But let's ignore my cab rides for the moment. And let's listen to Bruce. At CANNMED again And we've got Bruce Mackler and Bruce and his team have a sublingual cannabis treatment that they're working on for me and other conditions. And that's how. Bruce, tell us a little bit about it. 

Bruce Mackler: I'm delighted. Thank you for the opportunity. We are developing a cannabis may be big stretch. It's more like a drug which has highly purified components of cannabis, THC and CBD. Both THC and CBD have been approved and other drugs and THC has been around since 1985 and Marinol to treat chemotherapy induced nausea and vomiting. CBD has been approved about five years ago to for juvenile pediatric epilepsy syndromes. So these are drugs reagents which are previously approved and very safe. And we have formulated them into a tablet that you put under your tongue. Now, why under the tongue? Because believe it or not, when you put something under your tongue, it's absorbed through your carotid usually, into your carotid artery and goes to the brain. And so therefore, we bypass the stomach. When people take cannabinoids. So they go to the dispensary and they buy CBD or other cannabinoids and they swallow them into the stomach. The liver removes about 30 to 45% of the cannabinoids. So your dose is reduced the effective dose through the stomach. Whereas when you do it under the tongue or on the tongue, the dose you get is the dose that is effective because it is all of it is absorbed and not removed by the liver. So we are developing a drug that's already been approved in another format as a spray, but it contains 50% alcohol and it tastes horrible. And but it's a good drug and it's a treat MS. But so we've reformulated it into a sublingual tablet which if you go to your store and pharmacy, many of the drugs you get over the counter come in a little aluminum packet. These many of them are for what we call sublingual especially I think there's a diarrhea medicine that. So these are a common delivery system. It's not a new it's not innovative in itself, but it's innovative when you put it together with the drug to deliver a drug more directly to the brain, to have a better therapeutic effect. And that's what we're doing and we're doing for MS spasticity. We're looking at ALS spasticity and we're also looking to do to treat adult focal epilepsy with CBD using a sublingual drug as well. So we're a originally we started in Canada, in Toronto as a company. We have now a subsidiary in the U.S. So we bridge the border as a Canadian U.S. and we're also in Prince Edward Island in the emergence incubator there for a while. So we've been very Canadian based many of us worked for I was on the Board of Prairie Plant Systems, also Cannimed, which was we sold to Aurora many about five years ago. So we're very much understanding what the Canadian opportunities are. And this is really a company that started in Canada and is growing worldwide. Thank you very, very much for the opportunity. 

Trevor: Thank you very much, Bruce. That was great. So, Kirk, I keep forgetting till the end of it. I'm Trevor Shewfelt, I'm the pharmacist. 

Kirk: Oh, I'm not ready to introduce myself. I wanted to congratulate you. I thought. I thought going down in the CANNMED23 and sitting on a on a on a panel and talking with Ethan Russo was was fascinating. And I was thinking about you and I compliment you on doing so? Well done. 

Trevor: Well, and since we're talking about the panel, I'm going to talk about one of the other panelists was Professor Dedi or David Meiri from Israel. Another super fascinating, dude. On top of everything else, there was a memorial dinner at CANNMED23 for Dr. Raphael Mechoulam, the literal discoverer of THC, and Dr. Meiri worked with him, sort of considered sort of a grandfather like figure. But back to our previous bit about, you know, should cannabis be picked apart for its cannabinoids and throw those at an indication or it should use the whole plant. Dr. Meiri was also another person who what figures as a third way and he gave sort of a wrap up talk about, you know, he's actually discovered new cannabinoids and one of the cannabinoids after much looking at it, they found this one single cannabinoid that could probably be used to treat breast cancer. But then a little later on, they found a combination of three cannabinoids that could be used to treat leukemia. But you couldn't just use one and you couldn't just use two. You literally had to use all three of these cannabinoids they discovered or it just didn't work. So he was another one of these. It's probably not going to be an all or nothing. It's probably yeah, there are probably going to be individual cannabinoids that can come out and treat something, but other things are probably going to have to be treated with teams of cannabinoids. So, you know, the the whole plant versus the individual cannabinoid, probably a bit of a false dichotomy.  

Kirk: Yeah. Fascinating stuff. This plant, this plant medicine. 

Trevor: It is. It is. 

Kirk: And I guess I'm Kirk Nyquist. I'm registered nurse and we are found on and most of the podcast platforms. We ask you to give us a rating and tell a friend we've got over 100 episodes up, got a very dynamic web page and we got that guy in the team that Hobnovels with famous people. 

Trevor: It was a lot of fun. So I'm going to pick music for the end of this one. So I've been listening to other podcasts and I was listening to a really fascinating one, about Nine Inch Nails and Johnny Cash doing a fantastic cover of one of their songs called Hurt. And I love the song, but it's The Little Dark. And then another one about Kermit the Frog and Rainbow Connection, and I love that song too, but that might be a little fluffy. So for the end of this one, I'm going to the Tragically Hip and So Hard Done By because, you know, I may have whined once in a while about long flights and and burnt heads and and things going in. But you know people like say my wife really think all my whining about going to Florida and really kind of whining about being so hard done by so you know I think Tragically Hip So Hard Done By is a good a good way to end this episode. 

Kirk: Also always bring a hat. 

Trevor: Well yeah, yeah. I stuffed the hat in the bag because I. It's bald. There's nothing there. 

Kirk: Hey, I'm working on it, too. I'm working on it as well. All right. Congratulations, Trevor. That was well done. 

Trevor: It was a good time and come on back. We've got lots of good episodes coming.