Episode Transcript

Trevor:  Kirk. We're back.

Kirk: Hey. Hey, Trevor. How's it going?

Trevor: Good. And so, just off air. You were telling people how you like that I say what I do, and I do what I say, i.e. when I'm hitting the record button, I say I am now hitting the record. Oh, I after I hit a record on the phone, oh, I have to hit a record of the computer. So, so yeah, you know, I, I really can't do two things at once. So if I'm doing something, I tell people about it and you're thinking, all our guests must get a giggle out of that.

Kirk: Well, I think, Rene, I think Rene cancels a lot of that stuff, that stuff that happens behind the camera that people don't hear. But yeah, as I'm as I was listening to, this interview, I was laughing at you talking to yourself in the computer, and, I mean, I. Who doesn't talk to their computer, right?

Trevor: I won't tell you all the nasty things I say to my computer. We have a semi abusive relationship, I think.

Kirk: Yeah.

Trevor: Speaking of that, this one was delayed because my computer got back at me by deciding to restart as soon as the Zoom call started. So, you know, I think my computer gives a good as good as it gets.

Kirk: Yeah. This guy was on time for a change. I had everything all set up waiting for you. So you, this interview happened. Like, how much? How many hours of sleep did you have before you talked Aldwin?

Trevor: 2 or 3. Without boring everyone to say, you know, CANNMED was awesome. CANNMED was awesome and really has nothing to do with the Aldwin interview, other than I had a whole bunch of delays on the way home from CANNMED and I had Aldwin schedule that morning and got in real late and got a couple hours sleep and then talked with Aldwin. So hopefully I'm not sounding too punchy on the interview.

Kirk: No, no, it's a good interview Trevor. I just found it interesting the guests that we get, you know, we often talk to doctors who were dragged in kicking into the cannabis industry because they have patients that are interested in using cannabis. And then through their interaction with the, client in cannabis, they started becoming advocates, and now they're cannabis doctors. Now, you bring a scientist in who seems to have been dragged into the cannabis industry because he had an interest in Terpenes.

Trevor: Yeah. And, you know, I will admit some of the things he was talking about, about, how the cannabinoids sort of fit into the broadly polyphenol class was a little, chemistry wise, went a little bit over my head. But, yeah, he was looking at some stuff in other plants that have to do with, cancer treatment like Taxol, which is from the Pacific Yew tree. And then he. So, sorry I mentioned cancer chemo, so that he was sort of looking at that and looking at apparently some moss that might be able to be tweaked a little bit to produce more of these, you know, medicinal, call them medicinal phenols. And then he said, well, cannabinoids are really awesome. If I get this wrong, biochemists don't yell at me are really Terepenolic compounds. Hey, that sounds interesting. And kind of there we go.

Kirk: So, this is a really disjointed kind of discussion you're having. Right. So let's walk this through.

Trevor: How about I set it up.

Kirk: Yeah. Set up the interview before we get into it.

Trevor: So the reason we're kind of all over the place is, as starting to become semi common, I first sort of made contact with Aldwin through LinkedIn. I really. LinkedIn should be sponsoring this podcast because that seems to be where half of our, our guests come from. So and Aldwin was talking about CHS, cannabinoid hyperemesis syndrome, and I assumed he was a researcher, researching causes, effects, etc., of CHS, which is an interesting thing. So I said, hey, that you're doing that, that that's great. Can can we interview you? And he came back with actually I want to interview you. So. Okay. Well why do we interview each other. So we started, he interviewed me. That wasn't recorded. Then I interviewed him. And that's what's on the, the, the podcast. So. But the him interviewing me is Aldwin is involved in the NIH, which is in the US and that's the National Institutes of Health and  they have a course or program that is, helping scientists become more entrepreneurial. And that'll become the reason for that becomes obvious in a second. So this is, my understanding of him interviewing me and other people, about CHS is almost kind of part of a class project or market research. This isn't like, scientific research where, you know, you get a whole lot of info together and turn it into a paper. This is more like market research for a company. Like, is there enough interest in this product to to take it to market? Is my understanding of his class project. So he was interviewing me who you know, I know what CHS is. But to be honest, people don't come into the pharmacy puking their guts out and asking for help. That's more an E.R. doc sort of thing. But he was talking to people who had CHS, E.R. docs, hospital administrators, and he was sort of interviewing them all about sort of how CHS affects them and their, you know, either their business or their life or the people around them. And so that's sort of how Aldwin and I started talking. So yeah, during our part of the interview, we jumped back and forth between CHS and, him starting up, starting several businesses, which for me was, you know, lots of interesting things here. But one of the more interesting parts is you have Aldwin who has this deep scientific background with everything from, you know, using HPLC and GCMs, so things to identify little compounds to, use in qPCR, which is something we use in microbiology to identify microbes.  Like you heard, the public heard qPCR a lot in, in the Covid pandemic, because that was one of the things you used to see if someone had Covid. And we can use it for things like micro microbial contamination. And, with this background, he thought he would start a lab to, you know, identify, you know, how much TC, etc., cannabinoids in a plant and, you know, if it had any contamination, you know, lead, etc., or any microbes like, Aspergillus or something. So that's what he wanted to do. And I think the interesting part of this, aside from some of the CHS stuff, is how hard it is, even if you have this really extensive, scientific background to bring that to a business and have the business succeed.

Kirk: Okay. That's a good that's a good summary. You want to just get into the into the discussion?

Trevor: Absolutely. Let's go listen to Aldwin.

Aldwin Anterola My name is Aldwin Anterola. So I'm in Southern Illinois, University Carbondale. Associate Professor there. And I got into cannabis in 2014, because I was asked to consult for an applicant for a cultivation license. So I'd like, well, they wanted me to, write a portion of the application for the laboratory component for the cultivator. They want to be able to test the products. Right. So I wrote that and they did not get the cultivator license. But they did get a dispensary license, which is good. On the side, they are actually pharmacists. So if I were the one reviewing their application, I would give them the dispensary license because they're pharmacists. They're not growers. So. So it's good for them and they're doing well. So what I told them is, okay, you've got you don't need the laboratory anymore because you're not growing. You will not be testing your dispensary. I'm going to take this, what I wrote and set up my own lab. So that's what I did in 2014. It became, well, the medical program here in the state became, legal. So I said I wanted to yeah, to check this out. Be involved in the industry. Safety is what I'm concerned about. All the products. So yeah, I did that actually only for a month. We were operational. It turns out that when you offer something that nobody else wants, then the business won't succeed. What I'm offering is, here's the test. You've got pesticides and you they shouldn't get there. And they don't like the results that I'm giving them. So yeah, we're out of business, basically.

Trevor: No, no, that's that's too bad. I just recently at a conference.

Aldwin Anterola That's just my reality of the situation. And that's why I'm also participating now in this program. It's called BIO-E, supported by the NIH, National Institutes of Health here in the United States. It's e stands for entrepreneurship. So it teaches, scientists like me how to commercialize research, you know, the business side of things because, yeah, when I tried it by myself, didn't it work. Because I don't know anything about the market. So we are being taught to go ask the customers or the patients for any products that you're working on, make sure that what you're working on is something that the market wants or needs or they're willing to pay for it. So that that's the exercise that we're going into. And that's a lesson for me that I've learned the hard way because, yeah, I'm offering something accurate results. Nobody wants them. Nobody wants to pay for them. Then they won't succeed. So that's that's that's the idea.

Trevor: So Aldwin your scientific background, it's like chemistry, biochemistry, toxicology. Do you just you mentioned labs.

Aldwin Anterola Yes. My undergraduate is in chemistry.

Trevor: Okay.

Aldwin Anterola And then my PhD is in plant physiology, although, my boss, my PhD advisor is a chemist. So, the project is really more on plant biochemistry. I'm studying the what's known as the phenylpropanoid pathway. So the phenylpropanoid pathway they are the precursors to phenolic compounds, flavonoids and lignin, for example.

Trevor: Yeah. Okay.

Aldwin Anterola And then, after finishing my PhD, I started my position at the university. I work on Terpenes.

Trevor: Okay,.

Aldwin Anterola So I work on Taxol, Taxol, the anti-cancer drugs. So I, I my project was to, genetically modified moss. It's a moss that can be genetically modified. It produces a lot of Diterpenes. Diterpenes precursors. So I was thinking that we can convert this Diterpenes precursors into Taxol instead of another terpene that they're making. It's called Kauri. But anyway, so, yeah, so I got NIH funding for doing that. And so we were able to produce Taxol precursors. So there's some publications there. And then later on, yeah, there's this cannabis. Cannabis is actually a terpenephenolic, you know. So it has a phenolic component in the terpene component. So I said, oh, this would be interesting for me. Cannabinoids, I would combine my, PhD background with what I've been doing the Terepenes becomes Terpenephenolic yeah. So so my interest is in, biochemistry, you know, the biosynthesis of metabolites. Although the practical application would be interesting, I realize that because my background in chemistry, I know HPLC, and there are things that I'm GCMS and things like that that are things that are related I don't have complete expertise in. But it's easy enough to make that leap because it's there all equipment. And I also have background in PCR. During my PhD, we were actually once one of the early adopters of qPCR, you know, at that time, 1995. So it's true beginning. And I was one of tghe first ones to okay, let's do qPCR. So yeah,  PCR for microbial contaminations. And then I also have a molecular biology experience. So yeah. So culturing and things like that. So yes. Perfect. I mean yeah, setting up a lab is technically is perfect for me. So I did that 2014. As I've said, it's the business component that that never really that was missing. Yes.  Believe it or not, I tried it again. I had my sabbatical. In 2020, during the pandemic. We started a another lab in California this time. This time I have a business partner, so he's the CEO. I'm the CSO. Yeah. Did it work? I mean, same problem. I thought, California is very nice because the regulators are actually starting to become more, giving more oversight on the industry. And you probably heard of the recalls that are happening. No, they have their own, prescribed method for it. So, so they're starting and so and that's the that's the environment that I want to operate in. Meaning I want oversight, I want to be inspected. Right. But then the bottom line is you still have, the money still comes from your customers. They still have power over you. You know, who pays you is, that's, that's the customer. Right. So it didn't work. I mean, because there's still that demand for results that you know that they like.

Trevor: Yeah. I was just going to say. We will get to CHS eventually. But this is just interesting. And I again just came back from a conference where we heard lots of people saying, you know, the problem is, you know, Lab X will give you whatever THC result you're looking for and all that doesn't, you know, as a, I guess as an a grower that's great. But as a consumer, I'd like to actually know what's in my product.

Aldwin Anterola That's right, that's right. And of course, not all labs are like that. And so good labs, there are some good labs, my hats, you know, off to them because they stay, they keep doing the right thing and they can survive. But for some reason, we just can't. I mean, we we are losing money, and our investors aren't happy either, right? That that we can only serve a fraction of the market that wants true results. And there's not a lot of them. Right. And so we are competing with a very small market that and there are other good labs, right. There are other good labs that would also do the same thing as we are doing. But there's not a lot of good, I mean, I don't want to say good, but, you know, cultivators that want real results.  That they don't mind because they're not using pesticides, for example, or they're not, they don't care about THC inflation or whatever. They know that their product is good or whatever. I don't know, but so so there's not enough customers to be served in that case, you know, at least in our experience. Or maybe we haven't found them or they haven't found us. So it's interesting, though, that you you said that yes, the consumers, the end users wants the real results. And so I have this idea now, right, of, why don't we and is this still an idea. I'm going to resurrect the lab that I had, here in Illinois. And thinking of providing results directly to consumers. So I was thinking of having a database, for example, where we'll test different products because it's recreational now. Before they didn't like it. It's hard because if it's medical, if you don't have a medical card, you cannot be in possession. Right. But now that it's recreational, you can easily buy. Anybody can buy as long as you're over 21. Right. So, as a lab and independent lab, a really independent lab, you can just take, you know, a product from the shelf, test it yourself. Look at the lab number or batch number, put it in a database. And then I was thinking of maybe we can have a subscription type model where consumers who really want to know, you know, the real results of an independent lab that paid by the cultivators, right? What what, you get a real result.

Trevor: That you're going to be the Consumer reports of cannabis. That'd be great.

Aldwin Anterola Exactly, exactly. I'm still thinking about that. We will probably have a Kickstarter campaign because, okay, if you want this to work, then $10, you'll have a one month subscription to the database, $100, you'll have a free sample to test for. You know, we can test your own sample or some, there are different tiers. $500 we can test it for more, you know, and then and and so on and so different tiers. So that's what I'm thinking of doing now because as I've said, the way the system is set up, the customer is the cultivator. They have a different goal. Their goal is to sell. Right. So if you want to be their friend or if you want to serve them, you have to have them sell their product. Right. Because they are that's the customers. That's how business works. I mean, at least that's what I, the successful business is if you can help your customer succeed. Right. So but if your customer because and that's what I realize is before even though they are the ones paying me, my customer really is the one that I'm serving is really the patient that time. But the patient's not paying me, right. So there's a disconnect. So that's why that kind of arrangement did not succeed. But if I can get, consumers to pay for the results then it might work. And I'm not sure. The caveat is, do they really care? And that's that's something that I do not know. And that's why I'm participating in this NIH BIO-E program. Is that what I. What I've taken away from it is the importance of talking to the customers. You're talking to customers. And so what I'm planning to do now next, I guess it's talk to the consumers. Maybe they don't care. Do you really care? Or even if you do, are you willing to pay? That's the important thing. Are you willing to pay for real results on the product that you're consuming? Because you might care, but you're not willing to pay that there's no business, right? So that's why there has to be a Kickstarter campaign. Because if they are willing to pay $10 to make this succeed in order to get to the database, then I would know. And if they don't, then there's no business. They don't like. So that's that's that's the whole idea.

Trevor: I think that's a great way to start. So. But back to the NIH. Let's talk about this CHS survey that, before recording this, you had me participate in, which was very cool. Thank you for reaching out. We've done a few episodes on, CHS but just for the people out there who might not have heard of it before. Tell me, explain what CHS is. And then a little bit about this, this survey, this project you're you're involved with.

Aldwin Anterola Okay. So CHS stands for cannabinoid hyperemesis syndrome right. Some people call it cannabison. But the real time really is cannabinoid Hyperemisis Syndrome. But I don't care CHS is CHS. It's a condition where, patients or consumers of, high THC cannabis, would just have, would vomit. And it's not just regular vomit. Some people call it a exscreaming because they scream, while their vomit because it's ex-retching really is probably a better term,  for that. And so, this NIH program that I'm part of, really it's not focused necessarily on CHS, but what it is, is, it is a program called BIO-E, BIO - Entrepreneurship.  Training scientists and other researchers in the life sciences.  Could be entrepreneurs to other, who are interested in the biotech space and life sciences research. Training us to how to commercialize research discoveries. Because it seems that they've been funding a lot of research and then there's no commercialization effort. So it's not being translated into the marketplace. So they want. Why? Why is that? Maybe it's because scientists are working on things that nobody cares about. So we need to change that. So the idea is for scientists to go talk to your target consumer or patient or people who really care about the problem or who really experience the problem. And so we are forming in to teams. So my team, one of my team member, said, hey, I let's CHS because he has a product, he claims at least a product that can be used to treat CHS. So for him to really work on this, make sure that it's the proper treatment or the proper product for the his target market. The other step that we need to take, at least through the program, is to conduct customer discovery or customer development. Some people call it customer to talk to those who are really affected by the problem. So in my case, I talk to patients. It was to talk to ER physicians. I talk to pharmacists. I talk to other people who well, who might know others, who have CHS. And just recently I just talk to somebody who has CVS, and it turns out that there is Cyclic Vomiting Syndrome. Okay. Besides CHS. So that complicates things because CVS is the same symptoms. Right. But it's not due to cannabis. And in fact, in the case of this patient that I interviewed in her case, cannabis is the one that helps her with the vomiting and which makes sense to some because it's antiemetics. And that's what cancer patients use, right? For nausea.

Trevor: Like, I got to jump in on that one. We were just listening to Dr. Ethan Russo talk about CHS, and fascinating guy has done tons in the cannabis world and, and that at the moment, that is one of his biggest bones to pick is, the Journal of Gastroenterology just sort of declared that, CHS is, just a subset of CVS. And, he is not happy with that. He's written a letter to the editor saying, no, they're completely different things. And, Russo has long as well as being, a researcher sort of started his career as a neurologist. So in his mind, CVS is actually sort of a early precursor to migraines. And then where it segues nicely into what you were saying and said and for some of the CVS patients, cannabis can actually treat the nausea. Where in CHS cannabis is the problem? You know, too much cannabis, you know, the only way to make CHS better is decrease or eliminate cannabis whereas CVS so yeah, he's he, Dr. Russo has a big B in his bonnet right now about people conflating CVS or CHS or saying that, CHS is a subset of CVS, but just interesting, you interviewed a a CVS patient.

Aldwin Anterola Yes. And that's why I now believe in this customer discovery customer development process. Because I would not have thought about these things without talking to customers because I thought, as a scientist, yeah, we are, very focused on the research and maybe even the sales at the molecular level and things like that and pathways. Right. But then without talking to the patients, sometimes you are too narrow minded. And so, yeah, in her case, I talk to her about her experience and what she did and, what she has to go through before she gets a correct diagnosis. Because in her case, she was diagnosed as CHS. Right. But it was CVS. If somebody ask her that for example, that when did that condition start? Well, they would realize that their vomiting started before her cannabis consumption. Right. So so talking to patients, listening to patients is very important because we might have preconceived notions of what the disease is or the condition is. But if you don't listen to the patients that you we won't learn anything. Right. So. So yeah, the concept of development, I guess just listening is really an important part of the process I would think. So back to CHS now. So yeah  besides patients, so I'm interviewing E.R. physicians. The problem is well there are some ER positions that are already familiar with this. Like in Colorado they've had this before. Right. And probably in other states that have just started with the legalization of cannabis, they'll, they will see, an increase, a rise of CHS because, yeah they haven't had access and now they do. And then some people will just get it, some people won't. And I still don't know why. I don't know why some people have CHS and some people don't. So the ER physicians, some of them are already familiar. Some of them wouldn't be. When this probably started maybe ten years ago or even further. They don't know what to do, but some of them already know, right? And some patients would complain that they, they don't know that the ER doctors don't know. But at this point, I think we are at that stage where if only they looked at what the experiences of Colorado, for example, ER physicians, then, then they would know what to do. My hope actually is for all ER physicians to be familiar with it. So because when, when they legalize it then they'll have more influx of patients and they would know what to do. The problem for hospitals is that whenever there is vomiting and nausea they call this and, well, they have to test for other things besides CHS, because what if it's like gallbladder? What? It is kidney stones? Because these are symptoms that might indicate something else. They cannot just ignore, other things. So it becomes a cost to the hospital, right. To go through all this, radiological, diagnostics, you know, CAAT scans and MRI's and other things that they had to do. Even though they have a suspicion this might be CHS, what if it is CHS and something else they still have to see. So for them, it's an additional cost, right? That's their main problem right now. If only they can diagnose it CHS more quickly, then they probably don't have to do all these tests. But I think Best Practices, they still have to just to make sure. Because you cannot just exclude these things just because somebody has CHS. Anyway. So that's interesting because we're looking at different problems. Diagnostics for example, I think some some people, some ER physicians would be very familiar with this now that that it's out there. Okay. The complaint I guess for patients, of ER physicians, would be the patients don't believe them or they don't want to believe. So that's their challenge. The challenge is making them stop. And I do believe because, as I said, because they're CVS and there is CHS and then in the internet, they would say, yeah, it's probably not THC, it's probably the means, it's probably the pesticide or whatever. So they don't like to believe that it's THC causing this. So that's a challenge for the doctors.

Trevor: I gotta jump in because sorry was just at,  again Dr. Russo talking about, so his, much of what you, agree with much of what you're saying and you know he wrote a whole article on myths of CHS and, you know, they've shown it's not the pesticides and they show it's not the means. And now this is this is not a promote Dr. Russo segment, but his team has developed what they claim is a genetic test for we won't call it CHS, but for a propensity to get CHS. So they think they have sort of five biomarkers of, you know, people who CHS is  likely. And so their claim, similar to what you were saying from the ER docs, is typically it costs more than $100,000 to test a vomiting person to figure out what's wrong with them. So their claim is, you know, if you use their genetic test, then you can you can significantly reduce that $100,000. And and like you said, eliminate many, many, many other tests in the ER. So it's just this is really fascinating from a couple days ago listening to someone else talk about CHS.

Aldwin Anterola Yeah. Well that's my that's, that's one perspective because the, the opposite perspective is, well even as I've said, even though you know it's CHS, can you in your good conscience not test them just because they have CHS, what if they also have other conditions

Trevor: a gallbladder or something. Yeah. No, no. Absolutely.

Aldwin Anterola So, to me even though it's a positive for CHS you still have them. So, I guess there's less likely that that they would have to spend, you know, more. But in order to be more thorough, they still have to do it, you know. So yeah, that's the other argument. Yeah, sure. There is a good diagnostic, but it still doesn't save the hospital, you know, but at least, doesn't save the hospital money, but at least the hopefully the patient will believe, because I think that's the greater challenge is the patients don't believe that they have CHS. But if there's a test that says, you see, this is it. So and the other, another interview that I had is, well, he's called a CHS specialist because whenever ER physicians, these are children's hospital, right? So they do have kids. When I say kids, below 16 to 18, right. It's a children's hospital. So they will have. It's harder because they're not supposed to be using cannabis because they're not 18 or even 21, right? So it's harder. But if ER physician has, you know, are you saying. Yeah, maybe the only once, but maybe it's more than that, right? So he would send, the patient to, the minor, to the CHS specialist. And I like what CHS specialist says because what he's doing is more counseling, right? It's like. Okay. It's like. Because usually he said that what ER physician, most ER physician say, you have to quit, right? But in his case, he said you have to stop. And then I said I was confused. What's the difference? Well, quit means never, ever do this again. But in this case, you have to stop. It's like. Yes just stop for a while. And if you if you want to go back to it, you had to take it slow. But there is a possibility of  you getting it again, you know. But it's not, it's like, our goal is for you to at least have the patient on your side. Or better yet, they know that you are on their side, you know. So the way he talks to the patient is that I am not here to chastise you. I am here to support you. And I think that's also something when when dealing with CHS patients that I saw from this guy is the way he counsels, the teenagers basically into like, okay, you know, this is not a moment of you should not be doing that, you know, you, you know, or you should, you know, but more on like, okay, this is the situation, this is what we can do about this. And I think it's the approach sometimes that that actually makes the difference.

Trevor: Yeah. Oh. That's fascinating. So Aldwin the survey that you're doing now, do you have a goal about how many people you want to survey or when will, you know the survey is done and giving you the data you want?

Aldwin Anterola Well, this is not really a scientific survey. The interviews that I'm doing is really part of my assignment to understand more about CHS from different perspectives in the healthcare ecosystem, not just the patients, but ER doctors.  I'd like to, I was also doing interviews, these scheduled interviews with hospital administrators. Right. I've got parents of teens. They're involved in decision making. I've got people who claims to have a solution as well. You know, I've been interviewing somebody who said, oh, they don't have to stop. They just have to use my product. So I want to hear more about what they had to say. Right. Yeah. So yeah. So that's, that's what I've been doing now and we'll see if what I found out it's worth another interview.

Trevor: Now this has been fascinating Aldwin. I really appreciate it. And maybe you can maybe you can't, but I'lll ask any chance that when the assignments done, we could see some sort of copy or summary of what you found out. It sounds very interesting.

Aldwin Anterola That's a good suggestion. I haven't thought of writing it up, but maybe I should. Maybe in a blog somewhere, and I'll let you know.

Trevor: If it is in a blog somewhere we'd love to link to that. I just think what you found out might be very, very informative.

Aldwin Anterola I'll consider that. Thank you for that suggestion.

Trevor: Okay. So aside from the business, the other and I talked about this a little interview, but I got to jump into CVS. Let's talk CVS. So CVS is Cyclical Vomiting Syndrome which is another terrible sounding thing. I don't want that. And I'd just like 2 or 3 days before this interview, listen to Dr. Ethan Russo talk during a CHS. Talk about Cyclic Vomiting Syndrome. And basically, he was thoroughly annoyed with a gastroenterologist who, in the Journal of Gastroenterology, had just put out a position statement paper, something saying that CHS, Cannabinoid Hyperemesis Syndrome was really just a subset of CVS. And he strongly disagrees with that, that they are two completely separate entities. So it got me really excited that Aldwin interviewed a CVS patient and basically found the same thing is that, you know, just through the interview, that her vomiting pre-dated her cannabis use and cannabis was helping her vomiting. So, you know, just kind of tickled my fancy.

Kirk: Well, I find abdominal assessment, it's very subjective, right? Somebody comes in, somebody comes in with abdominal pain. You've got solid organs, you've got hollow organs. So your assessment is based on the subjectivity of it. So someone comes in with vomiting. Boy oh boy. Is it because the liver is not functioning. Is it because they've got pancreatic issues and a gallbladder problem? Do they just have gas? Have they, have they, you know, eaten bad chicken and will have diarrhea for a couple days and the vomiting. So having a test, like when Russo talks about, having a test and having, you know, Cannabinoid Hyperemesis Syndrome possibly being linked genetically, and going back, going back into Episode 107, we talked to Russo about this. I think these two episodes kind of blend because wouldn't it be nice if doctors had access to Russo's testing? Because, as Aldwin says, it's thousands of dollars. If in this day and age, in this day and age of diagnosis done by systems testing and and laboratory testing opposed to ears, hands and eyes, of the doctor or the practitioner. People can rack up the up the bills to check out why you got this Cyclic Vomiting happening. So I kind of like it. And I think, I think in today's day and age where it seems the politicians want to talk about all the emergency room visits, the few of them, but all of these increases in it because of people coming in with Cannabinoid Hyperemesis Syndrome, or I think having this test would be important. In my practice, I wish I would have had the test to say, you know what, you smoke a lot of cannabis. You may be predisposed to having this syndrome. Stop the cannabis and see what happens. Or gee whiz, when did this start before your cannabis use? Maybe cannabis might help you. So it's a good, ping pong game of diagnosis and treatment.

Trevor: Well, and I want to pick your brain a little bit. So as a pharmacist, I do not do diagnosis. So, because Aldwin brought up the counter point, which, honestly, I think for any diagnostician must be not just cannabis related, it's just be hard in general. So even if you had Russo's test or a test to say, okay, this is this is CHS, how much are you tempted or how much is a good idea to do those other tests in case they have, in case they have a gall bladder attack as well, in case they have something else as well. Like this must come up a lot just in diagnosis in general. You know, we have we're pretty sure it's this. But you know, there's always the possibility it could be 100 other rare things. But the some of those rare things might be really, really bad, you know. How, when do you stop spending money on tests? Like, even if even if you have a Russoish test, that's pretty good. And we're pretty sure it's CHS but, you know, we have a suspicion that might be a few other things, you know, to somebody at some accountant or someone say, okay, you've got X number of dollars to spend, don't blow it all on tests on this one patient.

Kirk: First of all, diagnosis. First of all, the thing to understand about doing a diagnosis, it's called a differential diagnosis. And what a differential diagnosis is, you try to determine what it's not. Right. So you go through an algorithmic thought process of bits and bytes in your brain. You go yes, no, yes, no, yes, no. As you ask questions, as you're trying to link the subjective data the patient's given you, for example, boy, my stomach hurts and it hurts right here. And I'm vomiting and I have sweats and headaches and diarrhea, blah, blah, blah. You take all that subjective stuff, subjective stuff that the patient gives you and you apply a hands on, ears, eyes, hands, sometimes your nose, to diagnose what it's not. Right? So you go through the process of what it's not. And my experience with diagnosis is in environments where we don't have a lot of diagnostic tests. In my environment we had dipstick for your urine. We had blood glucose test, and that was pretty much it in regards to diagnosis. So when when the patient gets transferred to a tertiary center where they have, you know, internists and other doctors, they would be going through the same process. But to answer your question, medical legal, I think the doctors are following their own protocols, and a lot of doctors are frustrated by the system that forces them to do the tests. So I think the answer to your question would come down to the security of the doctor's knowledge of what he what he believes it's not. And therefore I'm treating you for X and the environment in which you work. So I don't think that that's sort of like how long is the piece of string. Right. So it really depends on the patient subjectivity of illness and what you found. So I can't answer that, but I think, I think having a diagnostic test that says, hey, you're predisposed to having hyperemesis syndrome. Cannabis Hyperemesis Syndrome would be would be a good tool in your toolbox, if that makes sense. Right. So I don't know.

Trevor: No, that was good. Like I said, diagnosis not in the realm of what I do. So just thought that was an interesting little side bit.

Kirk: Yeah. There was just a couple more things I thought interesting about the interview about we've got a chemist that basically gave us a business model. He as he was talking to you, he gave away a business model that he was thinking of doing, which I thought was interesting. I also wondered if we interviewed Clay Moore, who is a friend of the show, a couple of times. And in Episode 124, Clay Moore talks about, Rare Earth Genomics. And I'm wondering if part of what he does there might help this chemist commercialize his knowledge. So I just thought there was a relationship between the two episodes.

Trevor: Yeah. No, I think so. I think so in Rare Earth Genomics is, if you have money and want some science to, you know, make, your money in your project go that sort of there end where Aldwin, Aldwin and the NHS entrepreneurial stuff is, if you've got science and want to figure out how to get money to make it go. So yeah, in general it's called translational research. How to get stuff a lab into the real world. They're both to do with translational research, but, one starting with money and the other is starting with science. And how do we get get it out into where it can be useful for the rest of us?

Kirk: Hey, I was going to tell you a story. I guess we're done with Aldwin. It was a really interesting, disjointed conversation, but I, I think I think it was I think it was interesting for the audience. I'm going to update you a little bit on 8000 Kicks episode 118.

Trevor: So in case people missed it, remind them what that is.

Kirk: Yeah. Episode 118 - 8000 Kicks - I had bought some cannabis boots some Chelsea boots, so I wore these Chelsea boots for pretty much, several months in the winter time. A lot, a lot, a lot. One day I was I was going to clean them because, you know, it was starting to melt and things get muddy. And I started cleaning them, and I noticed that there was some tares in the hemp right where the toes are. So there's a the way that the way the, the toe bends as you walk. So I got ahold of Roberto  and he said, yet these this is an issue with these boots, They have improved them for the next lot. I said fantastic. I guess what do you want to do? He said, well, I'll replace your boots for you, so I could either get the cash I paid for it because I bought those boots on a Kickstarter or I can get merchandise. I said, well, I'd rather have the boots. And of course, the Boots have gone up in price and the new boots are going to cost me a little bit more. So he replaced them very, very quickly with two sets of shoes for Michelle and I. And these are  shoes called sliders. Yeah. So so now I have, now I have, two pairs of hemp shoes that are completely different than the winter boots I was wearing. Now I have summer shoes replacing, so, I'll let you know how my sliders go. And I'm still waiting for the running shoes, so I'm going to have. And then at the end of the year, I will end up buying the Chelsea boots back again because they're very cool, very cool shoes. So anyway, so.

Trevor: So you're, you're officially a fashion model.

Kirk: I'm a fashion model of hemp boots. And I'm also just a fan of the company yet, you know, there's a flaw in the boots. They identified the flaw, the repaired the flaw, and they replaced my shoes with something else. So just an ethical company doing ethical work. I want to promote them a little bit more. 8000Kkicks, Episode 118 - Cannabis the Textile with 8000 Kick. So check that out. Yeah. So that's an update on that episode? Anything else?

Trevor: cool. Good to hear. No, I think that's all we got for today.

Kirk: Yeah. I am, Kirk Nyquist. I'm the registered nurse, and we are Reefer Medness - The Podcast.

Trevor: I'm Trevor Shewfelt I'm the pharmacist. And thanks, everybody. Thanks. Come on back and, we'll talk to you next time. All right.