Chiropractors Discuss Multiple Sclerosis

00:03-04:36What is Multiple Sclerosis?
04:42-07:07Multiple Sclerosis Risk Factors
07:10-11:14Discussing the Symptoms of MS
11:15-14:44Chiropractic Exam MS
14:45-19:32Diagnosing MS
19:33-31:54How Can Chiropractic Help Those with MS

What is Multiple Sclerosis?

Dr. Ben Boudreau: [00:00:03] MS What is it? I guess that’s probably a good place to start. So it is a chronic autoimmune disease and so it’s an autoimmune disease. And that means that the body, the body’s immune system begins to attack itself. And so chronically it can happen acutely as well and in the beginning. But normally you catch MS in the later stages when it becomes chronic. And so it’s an autoimmune disease of the central nervous system. In the central nervous system are your brain and your spinal cord. Anything outside of the column becomes a peripheral nervous system.

And so the brain and spinal cord are where MS will commonly affect and it will commonly start in the brain first attacking the white matter more commonly and then the gray matter, which is around the outside of the brain there. So when it begins to attack the body, it attacks the nerves and it causes demyelination. Now, demyelination means like there’s a big neuron, big cord, and it’s wrapped in like this big tubing, like this big insulating tubing. And what that tubing does is helps the neural impulses travel down the nerve. And if it doesn’t have that myelin, the neural impulses, the speed that it moves is then slowed down Dr. Roach do you want to elaborate on that a little bit?

Dr. Clayton Roach: [00:01:32] One thing that I’ll add is that MS affects the brain, spinal cord and more commonly as well as the optic nerve. Right. So there’s definitely that extra piece there. You can like you mentioned, the myelin is basically the glue covering that you will see here. And I put it over here and over here, it’s like insulation. Basically, in order for the message to go from the body here of the neuron down this way, the only way the message travels is by help, by being helped by the insulation, and the insulation is called myelin. But what happens with MS you start to see these holes within the myelin and now the neuron is no longer insulated properly. So that starts to affect the way the message can be transmitted from the body of the neuron all the way down.

So what happens the time that it takes for the message to go from one end to the other has now been altered. And as we all know, the nervous system runs in a very timely fashion and everything needs to be coordinated. So now all of a sudden, you’ve got messages that are kind of making it in a different time frame than it used to. So now the muscle doesn’t contract the way it should be. And you have it’s almost like listening to you know, you want to listen to 104.3 on the radio and you’re on one of 104.1. And there’s this static that’s happening and the message is now starting to get a little bit skewed. Right? That’s the best way that I can explain it in a layman’s layman’s terms.

Dr. Ben Boudreau: [00:03:13] Mm hmm. Yeah. And so things that you’ll notice in the beginning and we’ll jump into this in a little more detail, but you’ll definitely notice weaknesses in the upper and lower extremities into the limbs. Their vision loss, like Dr. Roach, said, with the optic nerve, it’s commonly one of the first symptoms to come to that you can really feel first when you have MS. But we’ll jump into that in a minute there when we get to the next slide.

Dr. Clayton Roach: [00:03:37] I want to mention that in Canada, Canada has one of the highest MS rates in the world. Right now, as of today, there are about 90,000 people that have been diagnosed with MS and there are about 12 new diagnoses every single day. It is pretty rampant. Ben. Do you want to mention what you mentioned with the hemispheres and what they’re thinking?

Dr. Ben Boudreau: [00:04:02] And so there’s this correlation between being closer to the equator. Not developing, MS. And then as you progress further north from the equator, the cases of MS seem to bump up dramatically. And this is sort of just this observation that researchers have made over the course of the year. So there seems to be this correlation between what’s going on at the equator and what’s happening north.

Multiple Sclerosis Risk Factors

Dr. Clayton Roach: [00:04:37] So if you guys have learned something so far, we’re only I know, 10 minutes. Just give us some thumbs up here. So we picked this topic because it is so prevalent here in Canada.

Dr. Ben Boudreau: [00:04:46] Yeah. And speaking of prevalence, it tends to affect women three times more than it does men. And even the most recent research is still saying this. The most recent demographic study that was done was in 2017. And they’re still saying that it’s affecting women more than it is affecting men. Commonly you’ll notice the rise in MS. You should know like you’ll experience the symptoms enough before the age of 50 that you’re able to get a proper diagnosis. And so they usually find it between the ages of 20 and 50 years old. And then, of course, people who are further from the equator tend to develop it more commonly.

Dr. Clayton Roach: [00:05:30] Yeah, family history. You told me this Ben that in the first degree of a relative, there’s an increased risk if they had it, two to four percent. Probably surprising to you guys that there’s a really low hereditary factor there. Relatively speaking, two to four percent is not high when you’re talking about, comparatively speaking, something like rheumatoid arthritis, which’s very much more hereditary and you’re more predisposed to it if you have a family member that has it. So I was actually surprised by that.

Dr. Ben Boudreau: [00:06:06] And I was surprised, too, because whenever we talk about names, always talk about all you have to watch out for the family history. And so when I read the stats, I thought it was going to be a lot higher than that. You know, it may depend on the type of research that you see. But from the research that I was looking at when I did this presentation, I saw two to four percent.

Dr. Clayton Roach: [00:06:29] So, yeah, and I will confirm and I’m pretty sure on this, they’re not really sure why it affects more women than men.

Dr. Ben Boudreau: [00:06:38] No, and that’s correct. They’re not sure. And they also don’t exactly know the cause of the autoimmune disease yet. There have been some associations with certain blood factors and the development of MS. However, they don’t have a direct cause yet. Yeah. Well, yeah, so this is you know, this is essentially just saying the evaluation and things that we’d be looking for. Right, are things that you can look out for in yourself, depending on where the MS located. And so if it is located in the spinal cord, you’ll see more peripheral issues.

Discussing the Symptoms of MS

Dr. Ben Boudreau: And so that’s like limb weakness. So like upper and lower limb like arm weakness, leg weakness. You also see, like, sensations that are abnormal. Right. And so our pins and needles sensations, numbness and then difficulty going to the washroom. Right. So either stopping or starting or losing control of your bowels and bladder.

Dr. Clayton Roach: [00:07:52] I don’t know if you remember when you were taking your boards a lot of times, you know if you had a multiple-choice that didn’t make sense and your symptoms were all over the board, then, you know, urinary problems, pins and needles, if MS was a choice, guess what you picked.

Dr. Ben Boudreau: [00:08:10] It was it was MS right.

Dr. Clayton Roach: [00:08:13] So the reason I say that is because MS can do all kinds of things. And when you’re looking at limb weakness, numbness, pins and needles, all that stuff, it could be on both sides. It could be on one side. It’s not one of these diseases that presents itself on one side or the other because it depends on where the lesions are. We’re going to talk about that.

Dr. Ben Boudreau: [00:08:35] If it wasn’t MS, it was probably another condition cauda equina. It depends on where it’s affecting the body. As Dr. Roach said at the beginning of this presentation, it can affect the optic nerve as well. One of the first symptoms that people with MS will begin to develop is visual abnormalities and visual issues. And so it can happen in one or both eyes. One may start right in the beginning. You may notice that the left is beginning to bother you and then the right starts to bother you and then the left doesn’t anymore.

It’s one of these very inconsistent diseases, double vision. Now, if the issue begins to happen in the brainstem, we have our cerebellum very closely related to this area. So people will oftentimes have difficulty walking poor coordination, vertigo. You’ll oftentimes see tremors and people with MS facial muscle weaknesses and reduce facial sensations. And so you can have issues right from the spinal cord and periphery to the eyeballs and then as much with your coordination there as well.

Dr. Clayton Roach: [00:09:45] It causes like with seems like with the optic nerves called optic neuritis. One of the symptoms that you’ll see is when you move your eye, you’ll actually cause pain. So that’s one possibility like pain with eye movement, you could have blurred vision what they call dimmed vision or loss of colour vision. Everything starts to look kind of grayish, which could be one of the symptoms that could affect the eyes and how it would display itself. Maybe we can explain the brainstem.

So what we’re talking about is the lower part of the brain. You know, there’s there are three parts, right, so those parts where a lot of the information comes in the brainstem is really important because there’s a lot of functions there. So if the lesions are in that area, it’s going to be a different presentation than if the lesions are in the brain or there are different functions depending on where the lesions are.

Chiropractic Exam MS

Dr. Ben Boudreau: [00:10:45] Yeah, exactly. And so we’ll talk more about the diagnosis after. But as you can tell, it’s already it’s a very complicated disease to diagnose and to find out. And so because there are just so many other conditions that can cause very similar symptomatology and so very important to have it assessed as quickly as possible and get the right diagnosis as fast as you can. So during our exam. Right. So we’ll do neurological examinations as well. And so what we will do is we’ll look for the signs of spinal cord inflammation.

So we’re looking for muscle weakness during our exam flaccid muscle tone, which is a very soft sort of muscle tone, not very strong. This usually happens in the acute setting of MS and then spasticity. So more of a spastic muscle during the chronic setting and then abnormal sensations like we talked about at the beginning of the presentation with pins and needles and numbness. And so you’ll expect a chiropractor if we do suspect something sinister like this to do a neurological examination.

Dr. Clayton Roach: [00:11:59] So one of the things that you guys are probably noticing is that up to now, the examination is no different than we would with any patient. Right. We’re checking for weakness associated with muscles. Remember, we went through these on other conversations where you C5, C6, seven, eight, T1, T2. We got to check all of those. The thing that does happen with MS though when you see weakness and then you tie that in with your health history, that they have vision problems. Now, things start to look a little different than this, your typical neck pain going down the arm.

Dr. Ben Boudreau: [00:12:34] And so signs of spinal cord involvement, right. So we break them up into the three areas that can be involved, signs of the brainstem. So we’re looking for nystagmus in the eyes. Right. So looking for the flickering facial numbness and weaknesses. And so we’ll check all of our cranial nerves and make sure that we can figure out if we can determine, OK, which cranial nerves are involved in it in the brainstem or spinal cord and then the cerebellum. So the cerebellum is involved with basically your coordination.

So you want to do all of your coordination testings. Chiropractors will do rapid alternating movements. So things like this where you’re flipping your hands up and down or bringing touching my hand and touching your nose, little things like that that will do in the office has to check things like that and then postural tremors. We also have a few tests as well that we do special tests that help determine if the spinal cord is inflamed.

Dr. Clayton Roach: [00:13:30] Yeah, what they will say with nystagmus if you guys don’t know what that means, is that if you’re looking at a row of cars going by, you’ll watch the first cargo by and then your eyes catch up to the next car and then you watch the second car, your eyes go to the third car. Basically, it’s your eyes going back and forth that’s nystagmus. That is a sign that your brain stem and also in coordination with your cerebellum can coordinate the eyes. So that’s one sign for sure. So, guys, up to now, you know, we’re going through the examination. We’re picking up some of the subtleties in the exam that could correlate with our health history with something that potentially is in front of us with MS.

And now they’re a woman and they’re between 20 and 40, and now it’s starting to make a little bit more sense. And what do we do with that? Right. So if you’re enjoying this so far, just give us a heart here. And if you know somebody with MS, you know, maybe say yes in the comments section because, you know, we’ll probably see that there are a few yeses even though we don’t have a thousand people live right here.

Diagnosing MS

Dr. Ben Boudreau: [00:14:44] So, yeah, the diagnosis of MS as chiropractors, we can’t diagnose MS, but what we do is we can do the physical exam and refer you to the medical doctor with suspected multiple sclerosis. And so we can suspect an issue based on her physical exams, submit the information for the medical doctor, and then they can go over that examination, ensure that they come up with consistent results. And so from that point, your medical doctor may or may not order a blood test. Right. Like I was saying before, they are seeing a correlation between Ms. Certain findings and these blood tests. And so they may or may not order a blood test and then they will refer to a neurologist or refer to get an MRI taken at that point of the brain and spinal cord.

Dr. Clayton Roach: [00:15:34] And we’ll see here in Nova Scotia, typically there will be a referral to a neurologist first who will then order the MRI. And there are a few neurologists that basically specialize in MS. By the way, there were five yeses there. So it just the people that are living right now, five people know somebody with MS. That’s pretty amazing.

Dr. Ben Boudreau: [00:15:56] Oh, OK. It’s definitely a debilitating condition and can certainly impact the life lives of early people who are who are diagnosed early. You want to be more cautious of the things that you’re doing your life to inflame that the nervous system and decrease your immune function. OK, yes, so this is the MRI we wanted to be able to show you guys what these little tumours look like when you have MS and what they look like on MRI. So the picture up to the left there is a cut through the brain if you were looking at the head down. And so, as you can see, there is these white radial, opaque or resonant. Right on the left-hand side of the brain, there

Dr. Clayton Roach: [00:16:46] And over here as well. Yeah. So what you need to to to understand here is whatever function of the brain. That where the plaquing is, is what you’re going to see display itself in terms of symptoms, right? So if the plaquing is in the occipital lobe, there might be vision issues. If the plaquing is in the frontal lobe, there might be emotional issues. Depending on where it is, it could be sensory, it could be motor, strength, it could be feeling. That’s what makes MS is so different for everybody because it depends where the parking is. So here on the right-hand side, you can see a cross-section.

So here you can see there’s parking over here where all the arrows are. Now, this is where the brain is now. If it’s in the brainstem down here, then there’s going to be different issues. If it’s in the cerebellum over here, which controls your balance here, some of the finite movements, then there’s going to be different issues over here as well. So what determines the presentation is where exactly these plaques are and are they in the spinal cord? So typically people that have M.S. will get a full spine MRI, so the brain and spinal cord so can see where these lesions are.

Dr. Ben Boudreau: [00:18:20] And so, yeah, that they’ll basically refer you to the neurologist, get the MRI performed and done, figure out, OK, do we have any of these tumours? Are they found in the brain here? And this is what they will do. This is the gold standard. And then based on the MRI findings, they go through something called a McDonald diagnostic criteria. And so they’ll run through criteria based on symptoms that you have and the MRI findings to make an accurate diagnosis of M.S. at that point.

Dr. Clayton Roach: [00:18:55] Then we have 11 we have people in right now that are like we have people that know 11 people that have MS, that’s crazy.

Dr. Ben Boudreau: [00:19:05] Yeah, I mean, it’s one of these conditions where we want to be able to learn more and more about it, which is why there are foundations here in Canada that are funding research projects to help the people that are living with this condition because it is a debilitating condition and it impacts the lives of the people who have it and the people that are around them. So how does chiropractic fit into this? Right. So I think one thing that can be said already is we can do the physical examination and so we can get to the bottom.

How Can Chiropractic Help Those with MS

Dr. Ben Boudreau: If you have a really good chiropractor who takes the time to do their physical examinations, we can do that. We can come up with a diagnosis, an accurate diagnosis to help determine, OK, you know, at least rule out that, you know, you’re not a candidate for chiropractic right now. Also, we can have you sent to get the proper care immediately and promptly. I think right there, the value of chiropractic is already established.

Dr. Clayton Roach: [00:20:17] And I mean, the chiropractor may be the first one pointing it out because, you know, depending like if you had separate visits to your M.D. one time with numbness, you know, MD could have said, well, you know, at this point, it looks like it’s your neck. Go see a chiropractor or go see a massage therapist. The next time you`ve got, you know, little vision issues and you go to the optometrist, but nobody’s ever putting it together. Maybe by that point, you’re at a chiropractic office and there are two, three or four different symptoms. Now the picture becomes a little more evident versus what it was maybe a year before.

And now the chiropractor with the exam says, oh, my gosh, this doesn’t add up very well. We’re going to send you to your M.D. It might not be a chiropractic case right now. Let’s explore this a little bit further because there are a few things that aren’t adding up in my mind. Deep down, we probably have an intuition that it’s probably MS and then we can go from there. Right.

Dr. Ben Boudreau: [00:21:14] So and as far as you know, looking beyond diagnosis, once there already is a clear diagnosis of multiple sclerosis, we can help manage the symptomatology of the issue. And so, for example, and I have it here, if the MS causes a foot drop and so if you have weakness in your feet and you can’t walk properly in your gait is altered, the altered gait may cause hip and lower back pain. And so the chiropractor is here to help restore that alignment and take the pressure off of the nerves in the low back and the pressure off the nerves and the cervical spine and neck to help move properly and help some of the spasticity.

Right. Because we already know that chronic inflammation and chronic issues and musculature can cause that tightness and specificity in people with arms. And so the chiropractors here to take the load off of those structures. Yeah.

Dr. Clayton Roach: [00:22:12] One of the things, too, that I’ll mention, you know, one of my patients comes in and she’s got MS and she actually comes in an on a scooter. So she can’t walk because of the spasticity in her legs. But she tells me many times how appreciative she is of chiropractic care because it allows her to the next point here in terms of her daily activity. These are that much better and less painful to do. Because of some of the symptoms that we manage that sometimes you can assume are MS, that they might just be musculoskeletal in nature, that sometimes people come in, they have MS, they say, well, they think everything is caused by their illness?

Right. And then you start treating them and some things go away that were caused by M.S. at all. So now you’re deleting something that they don’t have to deal with every day and then you really get to figure out what really is MS Well, that spasticity didn’t go away. So that’s probably division, the vision that`s MS. And so you get to really differentiate what’s M.S. and what isn`t.

Dr. Ben Boudreau: [00:23:16] Sort of like clearing the air and finding some clarity there. I was having a discussion with someone earlier today because I had sort of spilled the beans a little bit about what we would be talking about tonight. I’m saying, you know, sometimes people come in with things that are, you know, initially, it was the MS and then things tend to get worse. But, you know, it’s because nothing was being done to manage some of those issues and. Exactly. You can’t really clear the air. We were having the same sort of discussion. And she thought, well, I mean, you know, really, it should be managed as it goes on.

Whenever you have something that’s affecting the nervous system, that’s affecting your daily activities and your lifestyle, it’s going to have an impact on your nervous system. You become way more stressed because you can’t do the things that you want to do anymore. And so we just want to be able to give that back to you the best that we can. Right. So and that’s why my third point here is to reduce the stress on the nervous system. So we want to be able to breathe life back into your spine and give you the motion that the range of motion that you need to get your daily activities done so you feel happy and healthy about it.

Dr. Clayton Roach: [00:24:27] Well imagine a condition that is also altering the nervous system. Well, the last thing you want is added stress to that system that is being altered and being stressed upon. Right. So being able to help gain better range of motion when you have a leg that’s not spastic or if you have an irritated nerve that’s creating that numbness, then to alleviate that, to figure out that numbness wasn’t a mess. What a relief. Right. So you’ll be dealing with enough symptoms. M.S., you don’t need any more that aren’t really MS that could be solved by a chiropractor and just maintaining that mobility because, you know, we’re all on a downward spiral, to begin with of that downward spiral is accentuated by the fact that you’re not managing.

Everyday stressors with chiropractic in your spine, it’s almost like never brushing your teeth while you’re going to get bad teeth quicker than somebody who does, right? So same thing with your spine. So you’re far better at dealing with MS with a healthier nervous system. Same thing with Parkinson’s. Same thing with ALS. Doesn’t really matter what it is. You’re always better off with a healthy nervous system. So that’s why I always tell my patients. So continuing on exercise, maintaining healthy body weight. You can touch on that Ben. And I’ll talk a little bit about nutrition as well.

Dr. Ben Boudreau: [00:25:49] Sure. Yeah. So so the reports are that people with MS who are physically fit have less brain atrophy than people who are inactive. And so the whole thing with MS is the demyelination of the myelin sheath and the neurons. Right. The same thing in the brain. People who are active, physically fit, have less of that brain atrophy. And so they’re also finding the same thing with Alzheimer’s and dementia as well. People who are physically fit have stronger, healthier brains. I’m not necessarily saying like physically fit as I can like, you know, somebody who runs like 30 K a week. We’re just talking about a little bit of moderate-level physical activity, get the blood flowing to the brain and proper health, proper, healthy nutrients there.

Dr. Clayton Roach: [00:26:37] And that’s a good point for chiropractic. So let’s say you’ve got M.S. and you’ve got back pain in the back. Pain doesn’t allow you to be active, which would allow you to better manage your emotions. Right. So, you know, back pain is a secondary thing to the most that we can help get rid of more than likely so that you can go back to being active, which is going to serve you for a longer period of time in order to manage that. And so that’s a great example.

Dr. Ben Boudreau: [00:27:04] Yeah. And also it’s and you’re going to touch on nutrition. I want to talk about smoking before nutrition. We know that nonsmokers are healthier than the non than smokers. The same is told for MS here. And so people who do smoke have faster brain atrophy, are less healthy than people who are non-smokers. If you are a smoker and you do have M.S. and it’s time to think about it seriously, think about your health over the short term and the long term and determine what are your goals and who do you want to be there for.

It’s worth having more years of a happy life, being able to do the things you want to do than than than picking up that pack of cigarettes. Yeah. So that’s the only point that I want to say about smoking and know how to smokers just giving the information out there. So, you know.

Dr. Clayton Roach: [00:28:11] Yeah. With nutrition. One thing I will say in general with autoimmune disorders is you want to limit the amount of inflammation in your diet. OK, inflammatory foods in your diet, inflammatory foods for a lot of people would be anything that’s white. So the rice, the potatoes, the flour, gluten is an anti-inflammatory food for a lot of people. The albumin, which is the protein in eggs for some people to dairy, for some people it could be nightshade vegetables, it could be lentils. So one of the things that need to be done with autoimmune disorders is identifying what those immune triggers are.

Because when you have inflammatory reactions to foods that you eat, inflammation triggers the immune response. And when the immune system is always working, it gets tired. And with a condition like M.S. that attacks the immune system already, then you have a two-pronged approach to your demise. So definitely limit the number of inflammatory foods in your diet. One of the things you can do that helps to kind of reset the immune system and stop it from working is to do what’s called intermittent fasting or block eating. So definitely begin to do that in your routine. And even if you don’t have a mess, it’s a very healthy thing to do. If your last meal at six o’clock, your first meal the next day should be around 10:00, which means you’re going to fast 14 to 16 hours.

And what that does is it allows your body to go into the fat storage and access fat for fuel instead of always using carbohydrates and sugars. So it actually, in the end, ends up decreasing your wants and your addiction to sugar because it doesn’t necessarily depend on the sugar for energy. So that is very important and eating a whole lot of anti-oxidants so antioxidants can be found in your diet through blueberries, which, by the way, should be organic because any berries that are sprayed are very hard to be cleaned because it just absorbs it.

Dr. Clayton Roach: [00:30:32] There’s no big rind around the fruit or vegetable in the case of blueberry or strawberry, but antioxidant, very important ginger is very high on the ORAC scale, which is a measurement of how good an antioxidant that food is. So ginger is very high. Koku 10 is also a very, very great antioxidant as well. Fish oils are also a good source of fish oils. Some of the common things that we all should be doing, whether or not you have a mess, are going to be important with M.S. Let’s just take a break right now, guys, knowing that we have in a very small group, a lot of people that have M.S. maybe do us a favour and share this episode so that it can reach some of the people that may not know about this.

Now, I know a lot of people who haven’t met are educated about M.S., but I guarantee you it’s not common knowledge within the MS. Society to send people to a chiropractor, because the assumption is that while chiropractors don’t treat M.S. and we understand that. But there are many other things that your body might be going through that could benefit from seeing a chiropractor, that you can then take off your plate and just deal with the MS, let alone the advice you might get from a chiropractor like we’ve talked about tonight. So just give us a little thumbs up and a few hearts that you’re going to do that and just share this episode with your circle of friends.

Dr. Ben Boudreau: [00:31:56] Supplement of the month, just like Dr. Roach just said, CoQ10, right on, right on the dot. Yeah, and we’re talking about antioxidants. This is one of the best ones you can get. You can get a CoQ10, which you can produce from our clinic. These are very high, potent products as well. And so you’re sure to get the absorption rate that you need from these products as well. They lower the bad cholesterol, right? Systolic blood pressure, reduce cardiovascular heart disease, systemic inflammation. And so when we talk about the immune system and inflammation, we want to be able to reduce that, promote healthy blood flow and prevents atherosclerosis. And so whenever we talk about heart disease, we always talk about CoQ10

Dr. Clayton Roach: [00:32:42] Yes and CoQ10 again, you of. Hit it again that if you’re on a statin drug and those would be Crestor or Zocor or Lipitor, you should be on CoQ10 because of a specific thing that happens metabolically when you’re on statin drugs that depletes a certain part of your mitochondria, which is the part of the cell that produces your ATP, your energy for the cell that CoQ10 has the ability to replenish. So very known in science that you should be on CoQ10 if you’re on statin drugs. Was this a useful conversation?

Let us know. Yes or no? Yes. As a thumbs up. I think what blew me away is 90,000 people in Canada have M.S. and a new diagnosis is made 12 times every single day. So definitely a prevalent condition here, specifically in Canada, where we have some of the worst rates in the world for MS. And yeah, so I think it was a great thing. OK, any closing remarks Ben?

Dr. Ben Boudreau: [00:33:51] But thank you guys so much for tuning in. Again, this is Humpday conversation number twenty-four. We’ve done this twenty-four weeks in a row almost. I think we took one week off. And so we really love doing this for you guys. And it’s kind of funny. I was telling Madison before this Humpday conversation number twenty-four before May two-four weekend. So happy long weekend to all those that get the Monday off. Yeah. So thank you so much.

Dr. Clayton Roach: [00:34:21] Take care, guys. Have a great long weekend. See you later.

Dr. Clayton Roach: [00:34:27] What’s up? Listen, if you like this episode, you’ll probably like the other ones, chances are pretty good. So here’s what you need to do. You need to like us and follow us on Facebook. Following means, you get notified when these two guys are alive. Next, family, friends, you need to share these episodes because you never know. You might help them because they need this information as well. And guys, if you ever miss an episode, make sure you subscribe to us on YouTube. That way, you can watch the episode over and over and over again. Guys, we love you and appreciate you. Take care.