Latest / Gladden Longevity Podcast / Unlocking the Secrets of Kidney Health - Episode 296

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Unlocking the Secrets of Kidney Health - Episode 296 · Gladden Longevity Podcast

• 0:28
  Welcome everybody to this edition of the Gladden Longevity Podcast.
• 0:31
  I'm your host, Dr.
• 0:32
  Jeffrey Gladden, and we're here answering life's biggest questions.
• 0:37
  Things like how good can we be?
• 0:38
  How do we make 100 a new 30?
• 0:41
  How do we live well beyond 120?
• 0:43
  How do we live young for a lifetime and how do we develop a 300 year old mind?
• 0:48
  And today I'm going to be joined by a physician from Hawaii, Robin Rose, whom I've met.
• 0:55
  couple of years ago and we've had several conversations.
• 0:58
  She's really a fascinating person.
• 1:00
  You're gonna love this conversation about kidney health.
• 1:03
  She has her own story of kidney cancer and nephrectomy, very compromised kidney function, complete restoration essentially of her kidney function.
• 1:13
  And uh it's a fascinating story.
• 1:16
  She's involved with some really, really interesting bioregular peptides and I think you're gonna really enjoy
• 1:21
  it.
• 1:21
  this podcast.
• 1:23
  Welcome everybody to this edition of the Gladden Longevity Podcast.
• 1:26
  I'm your host, Dr.
• 1:27
  Jeffrey Gladden.
• 1:28
  And as previously mentioned, I'm going to be joined today by Dr.
• 1:32
  Robin Rose.
• 1:33
  She's a woman that I've looked forward to speaking with on the podcast for probably over two years.
• 1:39
  So don't know why it took us so long to get together, Robin, but welcome.
• 1:43
  Welcome to the podcast.
• 1:46
  So, yeah.
• 1:50
  yeah.
• 1:50
  It took a while, but you know.
• 1:52
  Hehehe
• 1:53
  good things happen.
• 1:54
  So she's coming to us from, uh, the beautiful, beautiful Island of Molokai, uh, in the Hawaiian islands.
• 2:01
  And, uh, you can't see her background, but it's, uh, it's quite stunning.
• 2:06
  So, um, so tell us a little bit about, um, how you got into being, uh, focused on the kidney, which is obviously, uh, you know, with the kidney damage I had when I was five
• 2:17
  from post-drop chlamyral nephritis, uh, is,
• 2:22
  sort of near and dear to my kidney as well as my heart.
• 2:25
  So how did you get intrigued by optimizing kidney function?
• 2:30
  Well, I'm a family physician and knew as little about kidney as I found out most of my non-nephrology colleagues know.
• 2:40
  um getting older in my practice, I kind of had slowed down, um had a number of utterly crazy life events.
• 2:52
  You when you add up all those points, it was awesome.
• 2:57
  Terrible, actually, but...
• 2:59
  you know, many stresses.
• 3:00
  And to make a long story short, I tagged myself, Health Food Hannah.
• 3:06
  How does Health Food Hannah get kidney cancer?
• 3:10
  All of a sudden, after being on Molokai for about five months, we ended up buying our house, planning to go back to Oregon.
• 3:19
  I practiced in Aslan, Oregon for many, many, many years, holistic practice.
• 3:23
  And
• 3:24
  started spiking blood pressures of 220 over 110.
• 3:27
  Like, uh-oh, what?
• 3:31
  And, you know, with a baseline of 90 over 50 blood pressures for years and concerningly too low at times.
• 3:39
  And so I was clear, I want this out, had an infractomy, no problem.
• 3:45
  You can live with one kidney was the meme.
• 3:49
  So just take people through the steps.
• 3:51
  So your blood pressure spiked and then you got worked up and they did probably an MRI scan.
• 3:56
  Is that what it was?
• 3:57
  uh
• 3:59
  I like to tell this story is I went to see a physician who was a pulmonologist who had done Andrew Wiles integrative medicine program.
• 4:09
  And I thought, okay, you know, we can, we can have a bigger platform.
• 4:14
  And I realized that those who have not had primary care training and education may not understand that
• 4:23
  what walks in your office is vague.
• 4:27
  You don't know.
• 4:28
  A specialist gets it all packaged up.
• 4:30
  At least you know what body system you're dealing with.
• 4:33
  But we don't.
• 4:34
  And so I saw this woman who, first of all, started going, have you ever considered meditation?
• 4:41
  I've been teaching meditation for probably 50 years.
• 4:44
  OK, that was a little bit of a red flag.
• 4:46
  And then got in my face, and this was two people.
• 4:49
  I've told you about the other one.
• 4:51
  Repeat after me.
• 4:52
  I am healthy, I am healthy, over and over in my face, like almost spitting in my face.
• 4:59
  And I was like, used that word and said, either you order the CAT scan or I'll order it myself, thinking I had an adrenal tumor actually.
• 5:07
  And so I'd visualized exactly the right place.
• 5:11
  was a left upper pole renal cell carcinoma, a rare one, but neither here nor there.
• 5:18
  acting crazy, mean, knew physiologically I was not normal.
• 5:23
  And so, you know, I saw various people who were like, you know, you should go see some healer in Portland or blah, blah, blah.
• 5:30
  I like, want an nephrectomy.
• 5:32
  I was really clear.
• 5:33
  I just want this out and then I'll do the work.
• 5:37
  And what I learned, this was 2013.
• 5:42
  Okay.
• 5:43
  So.
• 5:44
  2013, somewhere right around now, I started acting crazy and finally went in and was like, I need to figure this out.
• 5:52
  So just put that in perspective for the audience.
• 5:55
  So GFR, which is glomerular filtration rate, which basically is a measure of kidney function.
• 6:01
  And ideally your kidney would be filtering.
• 6:03
  It's really a measure of kidney filtering, if you will, filtering capacity.
• 6:07
  um And it should be above 90 milliliters or cc's equivalents, milliliters and cc's are equivalent.
• 6:15
  So 90 mls of
• 6:18
  blood should be filtered every minute.
• 6:19
  We consider between 1690 to be kind of stage one or kidney disease, if you will, although a lot of people are well, OK.
• 6:30
  to 90.
• 6:30
  And I, because it's a platform that I have, which I've been going stage two is not normal.
• 6:37
  you can, you can, you can correct me if I'm wrong, but traditionally stage one would be considered above 60.
• 6:44
  Um, and then it drops off under that.
• 6:47
  people really kind of start to consider dialysis, if you will, when they get down to a GFR of around, you correct me if I'm wrong, around 10 or 12 is kind of maybe get on a
• 6:56
  transplant list, but people at 14, 15, or maybe getting dialysis, things like that.
• 7:01
  So you were at 30 is what you said.
• 7:03
  30 and felt like stuff that comes out of the dog.
• 7:07
  I mean, it was really interesting because I was getting, on one hand, don't be surprised if you lose 5 % a year.
• 7:14
  At GFR of 30, in my mind, is about 25 % function.
• 7:20
  Lose 5 % a year, that gave me a five-year death sentence.
• 7:24
  And I, at my age, absolutely had no interest in dialysis and I was being told I wasn't really eligible for a transplant.
• 7:31
  Okay.
• 7:32
  give me something.
• 7:35
  there are papers written about this that as soon as a kidney comes out, that's chronic kidney disease.
• 7:42
  You go behind doors in an exam room and it was kind of alarming to me the lack of insight about what do I do?
• 7:52
  Doc, what do I do?
• 7:54
  What do I do?
• 7:54
  Over and over I saw five nephrologists and got
• 7:57
  really useless information from you're going to die or or don't worry.
• 8:03
  Yeah, it's looking at it through the disease lens, right?
• 8:07
  So looking at it through the disease lens, well, you don't need dialysis, so what are we gonna do for you, right?
• 8:12
  Come back when you need dialysis, right?
• 8:14
  So that's looking at it through the disease lens, but looking at it through the health optimization, life optimization lens, it's like, no, what do I need to do to actually
• 8:23
  improve my kidney function?
• 8:24
  So you're asking a different question than they were focused on answering a question, and they're in lay the disconnect.
• 8:31
  That being said,
• 8:33
  You were disappointed in that, but that wasn't the end of the story because you obviously, that was the beginning of the story.
• 8:39
  So, so take us down the path of what you figured out.
• 8:43
  Leaned over my table, picked up a Townsend letter.
• 8:46
  opened it to an article by Jenna Henderson, the naturopath who's only working with kidney.
• 8:52
  Called her up.
• 8:54
  She was amazing.
• 8:55
  mean, she asked a gazillion questions, incredible history, and then basically offered me a pathway to recovery.
• 9:04
  And she herself has had a transplant, has been on dialysis, you know, so she got it.
• 9:11
  And I sat here and just started looking stuff up.
• 9:14
  I mean, my...
• 9:15
  potassium was elevated.
• 9:17
  All right, what do I do?
• 9:20
  I learned an incredible amount, you know, in this decade of doing this.
• 9:25
  And so I started doing changes in diet.
• 9:28
  I understand the role of protein.
• 9:32
  wanted 0.8 grams of protein per kilo of optimal body weight, which meant I was too skinny.
• 9:40
  I based it on 100 pounds instead of the 82 I was weighing.
• 9:46
  I started learning about safe supplementation, safe botanicals, kept going until I got my GFR up to 51 that way, basically the nephrologist, the last nephrologist I saw told me,
• 10:11
  Hmm.
• 10:13
  Yeah, but the numbers are improving, right?
• 10:15
  Exactly.
• 10:15
  Yeah.
• 10:16
  I what I'm doing.
• 10:17
  Would you like references?
• 10:18
  No, you're going to hurt yourself.
• 10:20
  So, you know, I had to I really was on my own and found some functional medicine folks who at least would have the conversation with me.
• 10:28
  And then at that point, I discovered peptides.
• 10:32
  I heard about BPC and nitric oxide is something that goes very askew with kidney disease.
• 10:41
  And of course, we know.
• 10:42
  know, the endothelial damage in CKD causes the heart disease that kills most kidney patients.
• 10:48
  And so ultimately I ended up using BPC, falling in love with it, and then continuing on learning about other peptides.
• 10:57
  And then I learned about the bioregulator peptides, which led to, I can't help it, putting this book together, which we'll talk about.
• 11:06
  So she's just held up a book called Renology Peptides, which is very cool.
• 11:11
  So BPC 157 is body protection compound 157, which we make, we actually all make it in our gut.
• 11:19
  And when we, when we inject it, it basically sets off a healing cascade inside the body is the way I tend to think about it.
• 11:26
  Whereas pharma goes into kind of interrupt a biochemical pathway.
• 11:30
  Peptides actually
• 11:31
  set off a cascade of dominoes to kind of bring forward healing.
• 11:37
  And they, are a number of different peptides, they kind of line up at different points at the head of the domino stack, so to speak, but they all have a tendency to want to push
• 11:48
  healing forward.
• 11:50
  so BPC157 is the one, probably that's most
• 11:55
  recognized as the most overall general utility of almost any peptide and it combines, it plays well with others also, right?
• 12:04
  So you were using BPC157 and were you doing that on a daily basis or?
• 12:10
  At first, at first I did it for, I don't even remember at this point, it's been some years now, probably a few months, and then started spreading it out.
• 12:20
  And the thing that I really wanna say for people to understand is there is no pill for ill with kidney disease.
• 12:29
  It really is about having, first of all, belief in healing.
• 12:33
  Do you believe you can get better is the first question to ask.
• 12:37
  Are you willing to do what it takes?
• 12:40
  And because we don't have, you know, the magic elixir for kidney, it really takes willingness to find out what for me is healthy.
• 12:50
  there's diet is an enormous conversation, exercise, unremitting.
• 12:55
  are high protein diets.
• 12:57
  Just so you know, for the audience, they're hard on the kidneys.
• 13:00
  High protein diets are hard on the kidneys, Excuse me.
• 13:06
  each person's unique, so it kind of takes figuring out what is this person in this moment of time.
• 13:13
  But my list, and I call this harvesting the low-hanging fruit from the kidney tree of lifestyle.
• 13:20
  Because that's first.
• 13:23
  Peptides and other things are placed on top of that.
• 13:26
  If you eat bad,
• 13:28
  You're not sleeping, you're stressed, you're toxic loaded.
• 13:32
  And none of this stuff's gonna work.
• 13:34
  Yeah.
• 13:35
  foods that are high in phosphorus, potentially high in potassium, and even sodium.
• 13:40
  You've got to keep track of your electrolytes a little more carefully.
• 13:43
  You also have to make sure, because the kidneys are responsible for sending out a molecule to the bone marrow to tell it to make more red blood cells, you need to make sure that
• 13:51
  you're not becoming anemic as well.
• 13:54
  So there's lots of interplay here.
• 13:56
  And then nitric oxide production.
• 13:57
  And importantly,
• 13:59
  There's a longevity protein that's made in the kidneys called Clotho that actually keeps the kidneys healthy as well as the blood vessels, as well as your heart and your brain.
• 14:08
  So these are all things that need to be considered.
• 14:12
  So I'm curious beyond the BPC 157 and the lifestyle changes that you made paying attention to nutrients and total calorie input, muscle mass, et cetera.
• 14:22
  I'm curious what other peptides you
• 14:25
  discovered were particularly useful for you or other regenerative technologies potentially.
• 14:30
  mitochondrial support important, so the mitochondrial peptides.
• 14:36
  SS31 has been my go-to.
• 14:39
  I used ModSC at first and then started reacting to it.
• 14:43
  The other interesting thing is, um, senescence is something that I heard about but really leaped into because it's a cool thing in a way.
• 14:54
  It's like our bodies...
• 14:56
  are trying to protect us from getting cancer.
• 15:00
  So there's this strategy that cells actually just become what they call zombie cells.
• 15:05
  They stop doing what they're supposed to, but continue eating.
• 15:08
  And unfortunately, those cells become toxins and start putting out cytokines to the neighboring cells.
• 15:15
  And all of a sudden, an organ is working poorly.
• 15:18
  And there's a lot of strategies for senolytic
• 15:25
  repair, some of the peptides do this, but there are actually specific senolytic strategies and so that needs guidance from an educator existing.
• 15:36
  Yeah, I think we've been looking for ways to measure senescent cell burden.
• 15:42
  And there's a molecule called beta-galactosidase that can be measured, which is interesting in and of itself.
• 15:50
  There's a new test that we recently got a hold of.
• 15:57
  uh It's made, it's called SAPIR, S-A-P-E-R-E, SAPIR P16.
• 16:04
  And it's looking at another marker of senescence essentially, particularly in the immune system.
• 16:09
  I recently had it done and very interesting to see that my immune system was so young.
• 16:14
  So that was encouraging, right?
• 16:16
  Because immunosenescence loss of immune cell function is, or immune system function is.
• 16:21
  is difficult, but I was really like a 30 year old, someone in their thirties, right?
• 16:25
  So that was, so that was great.
• 16:28
  So there are senolytics.
• 16:29
  So testing to understand the point is testing to understand what your senescent cell burden is becomes important.
• 16:35
  And then you can modulate it with things like Fisatin, Desatinib and Cursatin as a combination individually.
• 16:43
  They don't do as much as they do together.
• 16:45
  There's a peptide called Foxo for DRI, which is actually quite expensive that will take a senescent cell and instruct it to actually kill itself, right?
• 16:53
  Undergo apoptosis.
• 16:55
  So these things are out there.
• 16:56
  And then it's come out that uh SGLT2 drugs that are used now for diabetes that cause us to not reabsorb glucose through the kidney actually, you excrete it out through the urine.
• 17:10
  Turns out they have a benefit of lowering senescent cell burden also.
• 17:14
  which is interesting.
• 17:16
  then, right, so let's talk about the bioregulators.
• 17:21
  I'm just going to add in there that spermidine also as a molecule tends to impact virtually all the different hallmarks of aging, including senescence by improving
• 17:30
  autophagy and things like that.
• 17:32
  And then of course, NAD becomes important for maintaining cellular integrity, DNA repair, energy production, which you need to have.
• 17:40
  So there's a lot of interplay here around the different hallmarks and senescence.
• 17:46
  And now let's talk about the bioregulator peptides.
• 17:49
  So.
• 17:50
  Great.
• 17:50
  So first of all, I want to say I was told by my integrative oncologist, don't use the word failure.
• 17:58
  You're not in failure.
• 18:00
  So that's an important limbic system piece of it.
• 18:04
  And so I saw evidence that nephrology was saying, we don't want to use the word renal anymore.
• 18:10
  People don't know what it means.
• 18:12
  So I said, I'll take it.
• 18:14
  So that's where I took the word renal, coined renalogy.
• 18:19
  Mm-hmm.
• 18:20
  the art and clinical science of kidney success.
• 18:24
  Okay.
• 18:25
  love it.
• 18:26
  how the mind changed just saying that.
• 18:28
  I mean, it's really important.
• 18:29
  so bioregulators come along in that conversation.
• 18:34
  And that's why I call the book Rhinology Peptides, because it really is kidney success with bioregulator peptides.
• 18:40
  And so basically, they're tiny little molecules.
• 18:44
  Proteins are big, huge things.
• 18:47
  But bioregulators are two to four, basically sometimes seven amino acids.
• 18:53
  That's teeny weeny weeny.
• 18:55
  If you take them orally, the stomach doesn't break them down.
• 18:58
  It's already broken down.
• 19:00
  And so they are able to get into the cell without a whole bunch of mechanism that most things need to get in the cell.
• 19:08
  They just have easy transport.
• 19:09
  They can get into the nucleus and they also then get into the DNA and stretch it open and hook up to the histones and influence the methylation so that
• 19:22
  That which has been damaged by life, epigenetics, the genes are there, but life can kind of tweak them.
• 19:29
  And so what's happening is reverse to factory settings.
• 19:36
  And which peptides do you like for this?
• 19:38
  Well, the whole conversation of the book is the whole array of bioregulators have a role in the syndrome of chronic kidney disease.
• 19:48
  Sometimes I like to call it chronic kidney decline because disease also kind of, you know, it's like I, and just for the audience, by the way, at this point in time, my GFR is up to
• 20:01
  68.
• 20:02
  Nice.
• 20:03
  I love that.
• 20:04
  my paradigm, stage three is 30 to 60.
• 20:08
  A lot of pathology starts happening.
• 20:11
  That's when, okay, we better start calling this kidney disease and do something.
• 20:16
  In my mind, stage two is already a lot of down-regulated pathways.
• 20:23
  There's dysbiosis, there's endothelial damage, there's mitochondrial damage, there's...
• 20:30
  chemical toxicity susceptibility, the kidney tubules are starting to decline and they're the discernment.
• 20:38
  In other words, what do I keep and what do I excrete?
• 20:41
  And when that's broken, there's a lot of distress on all the systems.
• 20:46
  I mean, you mentioned, you know, like the bone marrow gets affected because there's anemia, the brain function goes down.
• 20:52
  I mean, the cardio renal conversation is enormous.
• 20:56
  the cardio renal metabolic, you there's a risk for diabetes and the pancreas is affected.
• 21:02
  So basically what I've done with this book is look at every single body system in its axis with kidney decline.
• 21:11
  And so sure, you want to do the, the, the kidney bioregulator.
• 21:15
  I'm in love with that molecule.
• 21:17
  It's an incredible tool.
• 21:20
  Again, if you're eating stupid and you're sleeping bad and you're not
• 21:24
  hydrating and yada yada, it's not really going to help.
• 21:28
  So it's a synergy that we're looking for.
• 21:31
  Yeah, that's a good point.
• 21:33
  That's a really good point.
• 21:34
  If you these peptides as powerful as they are, can be superseded by, you know, let's call it poor lifestyle choices.
• 21:41
  um They can't they can't rebuild you while you're actively tearing yourself down.
• 21:46
  All right.
• 21:48
  They can they can be a major asset when you're constructing an environment that's also a constructive environment, let's say.
• 21:56
  So that's that's really a key piece.
• 21:59
  That being said, they add something to lifestyle can that's dramatic.
• 22:05
  Because if you, like in our world, what we've become big fans of is actually doing plasma for recess for people.
• 22:11
  uh Because it enables us to sort of clear out the senescent associated inflammatory markers that tend to make it very difficult for the body to regenerate.
• 22:23
  The body can't regenerate in a toxic soup environment.
• 22:26
  And when there's kidney function, that's not optimal yet.
• 22:31
  That in itself adds to the toxic soup of the body because it's not clearing out the toxins that normally does right.
• 22:38
  In addition to the senescence, cell formation, et cetera, et cetera.
• 22:41
  So clearing all that out, my point is along with the lifestyle changes, now you put in the peptides or other rejuvenation factors.
• 22:49
  Now they have their best opportunity to work.
• 22:52
  Um, so yeah.
• 22:54
  And so, you know, I look at it like what's happening.
• 22:58
  Blood vessels are very much at risk with the kidney decline.
• 23:04
  Many molecules, TMAO and ADMA and homocysteine are things we can measure, then you know, uh-oh, something's going on.
• 23:12
  More people die of heart-related kidney disease than kidney-associated changes.
• 23:20
  In other words, the statistics
• 23:22
  from stage three to stage four is dramatic.
• 23:26
  And so, you know, so I like to use the heart bioregulator and the blood vessel bioregulator.
• 23:32
  You mentioned phosphorus, which in the cardio conversation is an enormous thing.
• 23:38
  I mean, I personally have had an elevated phosphorus, partly because I had damage to my distal colon from my surgery.
• 23:48
  Okay.
• 23:49
  And so, you know, there's a gut kidney conversation that's enormous.
• 23:56
  But the phosphorus thing is huge and diet can improve that.
• 24:02
  Alkalinizing the diet in many ways does, but it can help with phosphorus.
• 24:07
  There's so many strategies to help with that.
• 24:09
  But Bono Thirk, which is the parathyroid bioregulator, they're funny Russian names.
• 24:16
  actually helps with this calcium-phosphorus balancing.
• 24:20
  And so it's the parathyroid bioregulator.
• 24:25
  Okay, got it.
• 24:26
  And so that, to me, that has a really important place.
• 24:30
  Those who have glucotoxicity with kidney issues, there's a pancreas bioregulator.
• 24:38
  And these aren't things you take constantly.
• 24:41
  You know, there's, it's personalized.
• 24:44
  Some people, I might give them a bioregulator for three months and then start doing it every few months for 10 days a month.
• 24:51
  With some people, it's just 10 days every three months.
• 24:55
  It's personalized every time.
• 24:58
  So do you use these bioregulators sequentially or use them congruently or how do you typically orchestrate that?
• 25:08
  They call them bundling them.
• 25:10
  So you bundle them together and it makes sense.
• 25:13
  mean, if you think about it, kidney, the Russians have done a lot of research with this kidney, isn't just kidney tissue.
• 25:20
  There's actually a hundred different cell types in the kidney.
• 25:24
  And so there's cartilage.
• 25:26
  So there's the cartilage bioregulator.
• 25:29
  There's blood vessels, there's nerves.
• 25:31
  And so we address all of that so that the organ itself can...
• 25:35
  and reclaim its ability to hold its homeostasis.
• 25:41
  Right.
• 25:42
  And where do you get the, where do you get your peptides from?
• 25:45
  Do they come out of Russia or out of the Europe someplace or where are you able to get?
• 25:49
  My preferred source is through a company called Profound Health.
• 25:54
  out of England.
• 25:56
  The pharmacist from that particular company wrote a book with Professor Hovenson, was the one who discovered all of this.
• 26:06
  And so I trust that there's purity.
• 26:10
  And that's something is, I mean, you can find cheap bioregulators all over the place online.
• 26:15
  But do you know what they've done to cleanse heavy metals, which is an issue, or prion diseases?
• 26:24
  Because a lot of these are animal-based.
• 26:26
  And so that all matters, whether you're adequately purifying them.
• 26:31
  And there are a few companies out of Russia as well.
• 26:34
  Right.
• 26:34
  So I pulled up some things from your book.
• 26:38
  You have a Pylotax kidney specific peptide, Vent-Fort microcirculation peptide, an Endolutin circadian antioxidant master peptide, Glandacort, Superfort, and then BPC and
• 26:51
  occasionally KPV is kind of what came up.
• 26:54
  It sounds like you're kind of stacking these in.
• 26:57
  I'm just curious, was there a trial and error for you to figure out how to
• 27:00
  fit these together or how did that work out?
• 27:03
  Well, you know, there's a fellow who was an attorney who saw all of his family aging and dying in their 50s, went off and got a PhD in nutrition and somehow managed to navigate
• 27:18
  himself to Russia.
• 27:19
  And he's doing a study to replicate their longevity.
• 27:26
  aspect of using these bioregulators because there's the longevity aspect and there's treating pathology.
• 27:31
  Personally, I see it.
• 27:33
  If you treat pathology, longevity is one of the benefits.
• 27:37
  But anyway...
• 27:38
  I actually think that the antidote to all diseases is staying youthful.
• 27:44
  Yeah, exactly.
• 27:45
  And so the longevity aspect of these really offers reversal of damages that cause pathology and vigor and vitality that gives you the energy to do the things that you would
• 27:59
  have done in your 20s.
• 28:00
  So anyway, this is Dr.
• 28:03
  Bill Lawrence, who I hopped on his study.
• 28:07
  He was doing it at that point with just health professionals.
• 28:11
  And so I learned
• 28:13
  how he sequenced.
• 28:14
  takes a medical history and then sequences them.
• 28:17
  And so by doing that, I got a sense of it and then started offering similar consults for patients who were reaching out to me.
• 28:26
  And so for my own self, now I kind of do it intuitively because I'm done with the study.
• 28:31
  They told me, oh, you know, your longevity markers are showing you in your 30s.
• 28:36
  Yay.
• 28:38
  When you've gotten a death sentence in your 60s, it's nice to know.
• 28:41
  OK, I have.
• 28:42
  I have stability here.
• 28:44
  And so basically, you know, I take a very thorough history and I'm doing that with myself as well.
• 28:52
  What's going on?
• 28:53
  You know, and all of it has, has a place, you know, there's a stomach bioregulator, there's I, there's thymus and pineal, which to me are two exquisite contributions of
• 29:06
  peptides to medicine because
• 29:09
  We don't, you know, what do we talk about the pineal?
• 29:12
  And yet it's a huge piece of staying well and healthy and youthful as is the thymus and they're both influenced by kidney.
• 29:21
  gland because you you think about the pineal gland, it uh calcifies as we age.
• 29:26
  It's a source of melatonin and circadian rhythm control.
• 29:33
  The melatonin actually keeps stem cells alive in the walls of the third ventricle of the brain that are responsible for sending out exosomes to keep us young.
• 29:42
  And so all those are interrelated.
• 29:45
  It's also the, uh you know, in uh spiritual traditions, the pineal gland is the third eye, right?
• 29:51
  It has a spiritual construct associated with it as well, right?
• 29:55
  So I'm just curious, tell us a little bit about the pineal gland from your perspective.
• 30:00
  We know that kidney decline is associated with a melatonin decline.
• 30:09
  As in the melatonin decline is causal to kidney function loss or kidney function loss accelerates melatonin or they're intertwined or how does that work?
• 30:17
  kind of one of those vicious cycles, but uh you know, the final packaging of melatonin happens in the kidney.
• 30:24
  there's actually, I need to research this a little bit further, but there's this specific renal melatonin.
• 30:31
  And I don't want to address it too much further than that's really interesting to me because there's some unique stuff with kidney.
• 30:39
  I I call it a quirk because people with CKD end up having
• 30:47
  circadian upside down.
• 30:49
  I found this out personally.
• 30:51
  My blood pressure was fine in the morning.
• 30:54
  I was like, great, 120 over 70, I'm good.
• 30:57
  One evening I didn't feel good.
• 30:59
  Around 11 o'clock I took my blood pressure, 160 over 90.
• 31:04
  Like, that's weird.
• 31:06
  Started taking it more regularly and found out there's this thing called non-dipper blood pressure.
• 31:12
  That's typical in CKD.
• 31:15
  Do we tell people to take their blood pressure at 11 at night?
• 31:18
  We need to.
• 31:19
  Worth it.
• 31:19
  Because now I'm addressing that more aggressively, more intensively anyway.
• 31:26
  And so there's also other stuff.
• 31:28
  Sleep gets very messed up.
• 31:33
  You're thirsty not during the day, thirsty at night.
• 31:37
  How many times do you have to get up to pee at night?
• 31:40
  I'm not doing it during the day.
• 31:42
  crazy.
• 31:43
  And so you add some pineal support and some of that balances back out.
• 31:48
  And I still encourage people to supplement melatonin when they have CKD for the immune system, for the brain function.
• 31:56
  You know, it's not a sleeping pill as it's been marketed, but it does help with sleep.
• 32:01
  you know, so there's that aspect to it.
• 32:05
  And in combination with thymus, I mean, the Russians have done
• 32:09
  lots of studies looking at the combination of these two bundled.
• 32:13
  you know, cancer rates were way less and, you know, sense of well-being and, you know, cardio status way more controlled.
• 32:22
  And so, you know, it doesn't make sense to ignore it.
• 32:26
  You know, from a wellness perspective, it's not we're treating kidney disease like pill for ill.
• 32:33
  And yet, to support all of the tissues affected by the downstream decline in filtration is an important thing.
• 32:40
  And we really fail in stage two to address what's happening with those tubules.
• 32:46
  And tubules to me are spiritual because discernment.
• 32:50
  What do I do in my life?
• 32:52
  We discern what's okay and what isn't.
• 32:54
  And that's exactly what the tubules do.
• 32:56
  And as that declines, a lot of chaos can happen.
• 33:00
  emotionally as well as physiologically.
• 33:04
  I've just started ordering beta-2 microglobulin for people to recognize tubular damage when the GFR and or cystatin C, which is another way to monitor kidney, are perfectly
• 33:20
  normal.
• 33:23
  And yet, you know, wait a minute, I don't think this person has normal kidney functioning, yet the numbers aren't supporting my opinion.
• 33:31
  Beta two microglobulin, and I'm seeing some of them showing up abnormal.
• 33:35
  It's like, okay, let's now look at how we can support the tubules.
• 33:40
  And that's a whole nother conversation and lecture that I've actually been preparing to do.
• 33:47
  interesting.
• 33:47
  So we haven't really talked about how to measure kidney function.
• 33:50
  We talked about GFR early on.
• 33:53
  We should probably mention creatinine and BUN, blood urea and nitrogen and creatinine.
• 33:58
  Creatinine is a muscle mass dependent measure of kidney function.
• 34:04
  Creatinine is basically released from muscles.
• 34:06
  And it turns out the level is a function not only of muscle mass, but muscle utility.
• 34:10
  And also if you take creatine, you can bump up your creatinine without actually impacting your GFR.
• 34:17
  And then there's cystatin C, which is a muscle mass independent measure of kidney function, which we measure in every one.
• 34:24
  And then there are 24 hour urine collections where you can look at protein and you can look at a regular blood sample or urine sample.
• 34:32
  You can look at microalbumin creatinine ratios, which is a good measure of.
• 34:36
  integrity of blood vessel function and also kidney function, but then you can measure macroscopic amounts of protein in the urine and collect it for 24 hours and see how much
• 34:46
  is being lost.
• 34:46
  And that translates into the level of kidney disease and also the need for at least amino acids to help build protein back for the individual.
• 34:55
  But the beta two macroglobulin is interesting.
• 34:59
  That's one we're not measuring currently.
• 35:02
  It's new to me and here's the caveat.
• 35:07
  Again, I've just recently started diving into this.
• 35:10
  There is tubular protein urea that is different than glomerular protein urea.
• 35:17
  Not everybody with kidney disease has protein in their urine.
• 35:21
  So, gee, you're fine.
• 35:23
  in the tubules, it is low molecular weight proteins, smaller things that get through.
• 35:31
  It's registered on the urinalysis.
• 35:34
  So there are three molecules that I found, beta-2 microglobulin, which is more readily available.
• 35:41
  There's alpha-1 microglobulin, another low molecular weight protein, and retinol binding protein.
• 35:48
  Those are three things that you can use to ascertain that this tubular discernment is not working.
• 35:58
  Okay, so you think if you're finding those that you're actually finding tubular proteinuria if you find those?
• 36:05
  Okay.
• 36:06
  And so, you know, again, this is something that is more likely to be happening in stage two, which, like Dr.
• 36:15
  Robin says, is not normal.
• 36:17
  You know, and what I was told is, well, we don't really have a drug for stage two, so we'll just, you know, we'll wait.
• 36:23
  And, you know, my Jersey girl, when I was really sick, was like, what are you waiting for?
• 36:29
  You know, I mean, like what?
• 36:31
  What are you waiting for?
• 36:32
  Let's get on with this.
• 36:33
  There must be something to do and there is.
• 36:36
  And there really is.
• 36:38
  I I first learned that...
• 36:40
  you find different peptides address the tubular protein area as opposed to the glomerular?
• 36:46
  And we haven't talked about the structure of the nephron for people either, right?
• 36:50
  How the blood comes in through the glomerulus.
• 36:53
  And the glomerulus, think of it as a goblet with blood sort of flows through the goblet.
• 36:58
  tubes that go in there and through that the blood is filtered into the stem of the glass and those are the tubules and it's in the tubules at different ions are exchanged some
• 37:07
  things are reabsorbed things some things are concentrated and Excreted out into the bladder so you can have a problem at the at the glomerulus Which is the goblet of the
• 37:17
  glass so to speak and also you could have a problem in the stem of the of the glass where and that's what we're differentiating between are you losing protein?
• 37:26
  up top in the glomerulus or are you losing it along the stem of the glass, so to speak?
• 37:31
  exactly.
• 37:32
  And one of the things that I've learned is almost all kinds of kidney disease, and there's many approaches to get there, many causes, start in the tubules.
• 37:43
  Even diabetic nephropathy doesn't start in the glomerulus.
• 37:48
  Although we consider it a glomerular disease, it actually is starting with tubular dysfunction.
• 37:53
  And so that's become a bit of an obsession for me.
• 37:57
  looking at how you do that.
• 37:59
  And to answer, I think using the bioregulators offers repair at all of these levels.
• 38:05
  And no, I haven't taken the effort or had access to doing, I mean, it would be an interesting study to see if tubular dysfunction alone is repaired by using this array of
• 38:20
  bioregulators and peptides.
• 38:22
  would be super interesting.
• 38:23
  um Well, that's a really nice differentiation.
• 38:29
  I appreciate you sharing the beta 2 microglobulin, alpha 1 microglobulin.
• 38:34
  I think it was retinal binding protein.
• 38:36
  Yeah, so we'll check that out for sure and see.
• 38:41
  um
• 38:43
  one of the things that you think about is because of this abnormality in the tubules, there becomes a status of oxidative stress in many of our conversations, which then leads
• 38:56
  to inflammation.
• 38:58
  And that leads to fibrosis, meaning these delicate little structures of kidney become scarred, at which point they're really way more dysfunctional.
• 39:10
  The party line is you cannot reverse that.
• 39:12
  don't agree.
• 39:13
  think that you can.
• 39:15
  Whether it's easy, that's another conversation.
• 39:18
  you know, understanding that there's a process and that if you step in and do some things, you know, an anti-inflammatory diet, supplements, know, resveratrol and CoQ10, I mean, you
• 39:31
  there's a whole long list of stuff that I've been told I take too many things and...
• 39:36
  I still take them and have found myself better and better.
• 39:40
  You know, I mean, it really is deciding, do I believe I can get better?
• 39:46
  Yeah, think, well, I think, you know, we, we stress the fact that it comes down to the questions that you're asking, right?
• 39:52
  If you're asking, how do I manage my kidneys until I need dialysis?
• 39:56
  And those are the answers you'll get.
• 39:57
  But if you're asking the question, how do I actually have normal kidney function so I can live my life free of kidney dysfunction?
• 40:04
  Well, those are the answers that you'll find.
• 40:06
  Right.
• 40:06
  So really.
• 40:09
  Yeah.
• 40:09
  Just have to be sure what questions you're actually asking, because that's, that's those are the answers you will get.
• 40:14
  So.
• 40:14
  Yeah, so that's that's super, super cool.
• 40:17
  Yeah, very, very interesting.
• 40:18
  And so apart from the peptides, have you used other things, any things related to exosomes, stem cells, placental or core blood tissue or any of these kinds of things for
• 40:29
  rejuvenation in the kidneys or not so much you haven't needed them?
• 40:32
  I recommend it to other people where I live It's not it's not a reality to say to say the least and so and and Personally, I realized I am better when I don't Which is which is
• 40:48
  which is why you know, I have a book that I should be promoting at conferences I'm doing it this way with with podcasts.
• 40:54
  I
• 40:55
  I saw myself and my mother-in-law was still alive.
• 40:58
  We were going back and forth to see her.
• 41:01
  Every time I didn't feel good and it really is that commitment.
• 41:05
  I am getting rid of what's toxic to me.
• 41:07
  If it's banging on me and I have a choice, God willing, I will make the choice to support myself and my health, including getting rid of some people who were toxic to me.
• 41:19
  Every time I engaged, I would get alarmed.
• 41:22
  My blood pressure would go uh-uh.
• 41:25
  You know, and so, you know, it really is quite an adventure.
• 41:29
  And one thing to know is there is what I call the kidney-demic.
• 41:33
  The statistics are alarming and they only start at stage three.
• 41:37
  So if you include stage two, which I'm saying is, okay, you don't have to call it disease, but you know, we deal with pre-angina, we deal with pre-diabetes.
• 41:48
  I want to deal with early kidney because we can reverse it.
• 41:53
  That's right.
• 41:53
  I think it's a great point.
• 41:54
  So what we're talking about here is above 60, GFR above 60, between 60 and 90 is a time to actually start diagnosing what's going on, using some of the more refined markers we just
• 42:07
  discussed here.
• 42:08
  And then also, you know, looking at all the lifestyle factors that could be impacting it.
• 42:13
  And then also,
• 42:14
  leaning into some of these peptides.
• 42:16
  That's kind what I'm hearing.
• 42:18
  And one of the things that we haven't addressed that I have this story, I've been ridiculed.
• 42:23
  I was ridiculed about thinking phosphorus mattered and it does.
• 42:26
  I have a big chapter on it in the book.
• 42:28
  um It's toxins.
• 42:31
  yeah, massive.
• 42:32
  Yeah.
• 42:32
  I mean, I've been ridiculed.
• 42:33
  was part of the Facebook physician community.
• 42:36
  I talk about toxins and I would get ridiculed.
• 42:40
  Where'd you go?
• 42:41
  To Google University?
• 42:42
  And I'm like, hello, remember toxicology?
• 42:45
  Did you like skip out on those lectures?
• 42:47
  And with kidney, it's an enormous conversation.
• 42:50
  And so.
• 42:51
  detox organ, right?
• 42:52
  The liver, the kidney and the skin.
• 42:54
  Those are basically your three primary.
• 42:58
  And I guess the colon or the intestine, right?
• 43:00
  So those, that's it for detox pretty much.
• 43:05
  Well, and the mind.
• 43:07
  Yeah.
• 43:07
  No, that's well, I love that.
• 43:09
  Yeah.
• 43:10
  So completely the mind.
• 43:12
  Yeah, I get that.
• 43:13
  Yeah.
• 43:14
  you know, I mean glyphosate in our food.
• 43:17
  I mean, my next blog post I'm working on is about this unappealing stuff called a peel that is being dumped on our food.
• 43:25
  And you can't even hardly tell that it's there because the labeling obligation isn't being followed.
• 43:31
  And so, you know, all of these.
• 43:34
  get good organic food wherever you are on Molokai?
• 43:36
  I would suspect there's agriculture going on over there.
• 43:40
  know there's cattle and stuff.
• 43:41
  I don't know about if they're growing.
• 43:44
  there's a big move on Molokai.
• 43:46
  have a food hub and you order online and then you go get it.
• 43:51
  so local growers who have committed to not using toxins, we fly in food from Maui from Whole Foods, which I'm now a bit alarmed because they're supporting a peel.
• 44:02
  It's called Organapeel.
• 44:04
  Okay, it's a little bit less toxic oils that they're using for the organic versus the non-organic.
• 44:12
  It's wax.
• 44:13
  It's basically di and triglycerides that are dumped on your food.
• 44:17
  you know, read my blog post, it'll probably come out in the next week.
• 44:21
  It's nasty for the gut.
• 44:23
  It's nasty for the blood vessels.
• 44:26
  You know, there's heavy metals in it.
• 44:27
  It's like, what is this craziness that we've allowed to happen?
• 44:31
  And so it really takes this fierceness, you know, this like, I am not going to allow this.
• 44:37
  I mean, I'm a bit of a wimp, so I've had to be like, I'm not going to let this happen to myself.
• 44:44
  Water needs to be pure.
• 44:46
  You need an air purifier if you're in a moldy, toxic situation.
• 44:52
  Being in nature with your bare feet on the ground, mean, there's so much that we can do.
• 44:58
  And you don't have to be perfect.
• 45:00
  That's a piece of it.
• 45:01
  have to be perfect.
• 45:02
  You don't have to be perfect.
• 45:03
  And I think it's impossible to be, it's actually impossible not to be exposed to toxins.
• 45:08
  It's literally impossible.
• 45:10
  Right.
• 45:10
  And so it's probably always been the case.
• 45:13
  Yeah.
• 45:14
  favorite things since I've gotten into all of this is carnosine, not carnitine, which I think actually shouldn't be used with CKD because of the TMAO that harms blood vessels.
• 45:27
  You can get a blood test to know that.
• 45:30
  But um carnosine.
• 45:32
  is an amazing detox.
• 45:34
  And every time I look up, does it work for this?
• 45:37
  Does it work for that?
• 45:38
  Does it help with mold?
• 45:39
  Yeah.
• 45:39
  Does it help with heavy metals?
• 45:40
  Yeah.
• 45:41
  Does it help with, I had an ozone specialist staying at my house, yelling at me for using iron cookware.
• 45:49
  I said, take some carnivore and you'll be okay.
• 45:52
  It actually, you know, somewhat chelates or helps you eliminate these things.
• 45:57
  You know, so there's ways to be imperfect.
• 46:00
  that's right.
• 46:01
  corticine is amazing molecule.
• 46:03
  also, decreases senescent cells and muscles, and it also, um, decreases glycation where sugar, either exogenous sugars, the ones you eat or endogenous sugars, the one that your
• 46:15
  body manufactures attached themselves to protein.
• 46:19
  and that's a sign of aging also.
• 46:21
  Um, so, uh,
• 46:23
  with, you know, we recommend people are plant-based in their protein.
• 46:28
  Well, carnasine comes from meat.
• 46:31
  So right away, that's a knee-jerk for me.
• 46:35
  And if I'm going to tell somebody back off on the animal food you're eating, add carnasine.
• 46:41
  The idea of backing off on animal food is actually kidney disease leads to an acidic body.
• 46:49
  metabolic acidosis is so common.
• 46:52
  you look on your lab and CO2 is actually bicarb and the higher it is, the better.
• 47:01
  I'll see people who are like 21, 22.
• 47:03
  Okay, it looks like the normal range, but it isn't, not with kidney.
• 47:08
  25 to 30, closer to 30, safer.
• 47:11
  It lowers potassium that's elevated.
• 47:14
  It helps with phosphorus, uric acid, parathyroid hormone, all things that get
• 47:19
  messed up with kidney decline and have serious consequences of suffering.
• 47:26
  So we step in.
• 47:27
  a minute about TMAO.
• 47:29
  Talk to us about TMAO.
• 47:31
  I know a few things about TMAO, but I'm curious to get your take on it.
• 47:36
  It really is a consequence of uremic dysbiosis.
• 47:41
  So what does that mean?
• 47:42
  know, dysbiosis we all know these days, know, the intestines have an enormous population of bugs that either hurt us or help us.
• 47:55
  And so having a healthy microbiome means that vitamins you need and...
• 48:04
  hormones and molecules that are necessary are being produced.
• 48:07
  And the ones that make you sick need to be dealt with.
• 48:12
  And there's lots of ways to do that.
• 48:13
  But when kidney disease comes along, there's a uremic dysbiosis.
• 48:18
  So there's unique, weird things like different toxins that are consequence of
• 48:27
  the metabolism of some amino acids.
• 48:30
  So again, here we go.
• 48:32
  Plant-based protein theoretically helps with that, but a lot of people have gut damage, me included.
• 48:39
  mean, the surgery messed up the way my bowel was shaped.
• 48:44
  So all of a sudden on a lab test, see a high TMAO and what, so what?
• 48:52
  Atherosclerosis, heart attacks and strokes.
• 48:55
  not trivial and the incidence of these cardiovascular outcomes is somewhere between 30 to 100 times riskier when one has chronic kidney decline.
• 49:07
  That's a big deal.
• 49:10
  it's tied together to nitric oxide production, the glycocalyx being destroyed that keeps arteries healthy, et cetera.
• 49:18
  Yeah, TMAO can also be lowered with, I remember reading previously, could be lowered with high quality extra virgin olive oil and also balsamic vinegar can lower TMAO.
• 49:29
  So if you're listening to this and if you can...
• 49:32
  dressing.
• 49:33
  Yeah, yeah, exactly.
• 49:34
  And so you can take that into account as well.
• 49:37
  Well, really fascinating.
• 49:39
  I congratulate you on having a GFR in the high 60s, right from I don't know if the if the listeners really appreciate that.
• 49:46
  to go from 30 to 68 is it's it's almost unheard of, quite honestly, particularly with one kidney.
• 49:54
  Right.
• 49:54
  You only have one kidney.
• 49:56
  Right.
• 49:57
  And so that's really remarkable.
• 49:59
  I think it's fabulous.
• 50:00
  Yeah.
• 50:00
  Really great stuff.
• 50:02
  So if people want to learn more, where do they go to learn more about you?
• 50:06
  I have a website now, I'm a bit of a newbie, I'm still learning how to drive it.
• 50:10
  It's called, all one word, Rhinology is KidneySuccess.com.
• 50:16
  There's a way to reach out to me.
• 50:18
  Okay, Rhinology is kidney success.
• 50:21
  um
• 50:23
  right in your face, which was how come we started this.
• 50:28
  And this is gorgeous.
• 50:30
  The artwork is from a Ukrainian artist and I love this artwork.
• 50:36
  I didn't, I'd like to have one like you have behind you.
• 50:39
  I would love that.
• 50:41
  He just sent it to me as a graphic online.
• 50:43
  And so I have started doing blog posts.
• 50:47
  The book is not cheap.
• 50:49
  It's close to 800 page.
• 50:51
  Reference book really and so I still look stuff up in it and I'm not doing it as an ebook I just decided, you know, I'm old-fashioned textbook, but I'm writing blogs as I'm
• 51:04
  thinking of things and so they're basically as free content and there's Every time I do one of these talks those are on there slowly learning how to add some you know resources
• 51:17
  the resource for how to find the bioregulators is there and
• 51:21
  I'm happy to dialogue with people.
• 51:23
  not doing a load of patient care.
• 51:27
  I'm actually looking for other doctors who want to be Rhinology associates so that we can guide people.
• 51:33
  There's so many people who need this help.
• 51:37
  And what I encourage people to do is start looking at yourself.
• 51:43
  What am I eating that's stupid, basically.
• 51:46
  I grew up in New York and New Jersey.
• 51:47
  That's like, what are you doing?
• 51:49
  That's stupid.
• 51:50
  You know, it's self-serving to diagnose yourself.
• 51:56
  You know, I'm eating too much chocolate.
• 51:58
  You got to get rid of sugar, soda, you know, any kind of packaged foods.
• 52:04
  Uh-uh.
• 52:05
  You know, simple, simple, simple.
• 52:08
  you know, everybody's different, whether you get kidney disease because of an autoimmune problem, whether it's from cancer, diabetes.
• 52:17
  high blood pressure, all these things lead to some vicious cycles.
• 52:21
  know, the high blood pressure gets worse, the kidneys worse.
• 52:24
  It keeps going round and round until you make a decision to change it.
• 52:30
  And, you know, it's really about choosing and choosing lovingly.
• 52:34
  There's a self-love involved in this.
• 52:36
  You have to love yourself like you would your little baby.
• 52:39
  You know, what would I do if my baby was sick?
• 52:42
  And so we, we
• 52:44
  We tend to be sloppy in our culture.
• 52:47
  What's that going to hurt you?
• 52:49
  And I got really strict about it.
• 52:52
  I go to people's houses.
• 52:55
  I bring my own food.
• 52:56
  I hardly go out to eat anymore.
• 52:58
  don't know what inflammatory oils I put in.
• 53:02
  There's always too much salt.
• 53:04
  And I'll bring food and order a salad.
• 53:07
  And I really believe organic food is absolutely essential.
• 53:12
  I'm putting it in Google, Renology is kidney success.com.
• 53:17
  I love showing off my book cover.
• 53:19
  Okay, there it is.
• 53:20
  Maybe I misspelled something and it just popped up.
• 53:22
  Okay, great.
• 53:23
  So it's R-E-N-O-L-O-G-Y is kidney success.
• 53:29
  All one word, Renology is kidney success.
• 53:31
  Okay, great.
• 53:32
  That's Rose Garden Medicine.
• 53:34
  So beautiful.
• 53:35
  All right.
• 53:35
  I just want the audience to be able to access your book because you're, you you're not on every platform.
• 53:41
  So this way they can get to you.
• 53:42
  Well, thanks, Robin.
• 53:43
  I really appreciate you taking the time to chat with us.
• 53:45
  I know you had to get up a little bit early in the morning to do it, but thank you for that.
• 53:50
  Yeah.
• 53:50
  Glad the dogs.
• 53:52
  Yeah.
• 53:52
  A beautiful Friday.
• 53:54
  Beautiful.
• 53:55
  All right.
• 53:56
  Well, enjoy your weekend there.
• 53:57
  Thank you so much.