The National Clinic Group 'Rounds'

The trials and tribulations of chiropractic student life. An interview with two second year CMCC students.

• Dr. Erik Klein • Season 1 • Episode 8

Share episode

Use Left/Right to seek, Home/End to jump to start or end. Hold shift to jump forward or backward.

0:00 | 1:01:15

We speak with Ellie and Sophie, two students from the Canadian Memorial Chiropractic College.  We discuss student life, their motivations, the positives and negatives and what lies ahead for their future.

We also discuss how they're spending their summer with the Canada East Spine Center, working alongside orthopaedic surgeons doing research and learning how patients navigate the surgical pathway.

SPEAKER_03

All right. Well, this is very exciting. We're here with Ellie and Sophie. We're on the National Clinic Group's rounds and we're talking about everything from business to clinical work. And you know, it's not all about people who've been practicing for five or for 10 or 20 years. You know, there's people that are just starting their journeys and they want to learn and they want to take it all in. So I am so far away from that, but I remember what I was like. And so we're here on today's podcast to talk to Ellie and Sophie, their CMCC students that's finishing them the first year. They're working with the Canada East Spine Center. We're going to talk about that. And we'll talk about everything. Nice and easy going, but I thought this would be fun to chat with some fresh faces, and we're going to have a good time, no pressure. Um, and uh it's a it's a beautiful day. Although it's supposed to be hotter today, but I guess whatever. Anyway, so we'll welcome the podcast. We're the eight millionth most popular podcast on Spotify. Maybe after this will be 7,999,000. Who knows? We'll see. Uh anyway, can always only go up. So, all right. So, Ellie, tell me about yourself.

SPEAKER_00

Uh well, Eric, I'm from New Brunswick. Yep. Woodstock. I'm going into my second year at CMCC, uh, Canadian Memorial Chiropractic College. Uh, did my undergrad at UMB Frederton. I'm really excited to come home and practice. I love working out, love working with people. I've also done a little bit of personal training. I love working with athletes and in my spare time.

SPEAKER_03

And long walks to the beach?

unknown

Oh, of course.

SPEAKER_00

Of course, long walks on the beach. Uh Sophie and I actually just went to Fundy. Uh, we did a lot of hiking. So we like to be outside.

SPEAKER_03

Yeah, yeah. Fundy is awesome. Fundy's a great spot. Yeah, it is. All right. How about you, Sophie?

SPEAKER_01

Well, I'm from um Northern Ontario. It's a small town called Capus Gasing. Um, so I grew up there and then I went to go do my undergrad um at Trent University in psychology. And then now I'm in my second year at the uh Canadian Memorial Chiropractic College. Um, yeah, I also love working out. I am also a personal trainer. Um yeah, and I love being outside in nature and yeah. Excellent.

SPEAKER_03

Perfect. Well, you came to the right spot. I was actually uh I do an annual hike every year, and I went down to um we went to uh Pucasa National Park on Thunder Bay. I'm sorry, we went we we flew into Thunder Bay and then we went to Puka Sab, which is like two and a half hours east, and it was beautiful, wild, rugged coastline, and it was a beautiful spot. Uh so I really I really enjoyed that. Actually, one of our partner clinics is in Thunder Bay uh in uh standing chiropractic. So that was pretty cool. Um excellent. So, you know, I've been doing this for 22 years, so I I really relished the opportunity to talk to you guys and see how things change and and so on. So tell me about your first year at CMCC. How was that? How much of a shock was it? Uh how different was it from university, you know, the people you're with, your classmates, the profession. You know, and here's the thing: this it doesn't need to be whitewashed, like you're welcome. You know, there's there might be things you didn't expect or things you you didn't like or things you know you love. You know, it's okay to just be just to be honest and and whatever. It's all it's very therapeutic, you know, you can get it out. So I'll start with you. What's CMCC like?

SPEAKER_01

Uh I loved my first year. It was a bit of a shock coming in with like um also having like a psychology background. I did have some background in anatomy, but not as in-depth as we we went in. Um the personal training background also kind of helped with that. But yeah, I really liked uh our first year went through like musculoskeletal anatomy. Um radiology was great to get into, but that's definitely something that I had never seen before.

SPEAKER_00

So that one's a bit of a shock. Yeah.

SPEAKER_01

Um yeah, I really liked how hands-on we get, like first month in, we were already palpating and like starting to learn some techniques.

SPEAKER_03

Getting those ham hands.

SPEAKER_01

Yeah.

SPEAKER_03

I remember trying to like feel the facets in the neck. It's like I don't feel anything. I feel a neck. And I got, you know, and they try to explain it, and it's just like, I don't know what you expect me to do here. It's a facet. It's like, I don't know what a facet, I don't barely even know what it is. Yeah, yeah, it's just a textbook, but you eventually get there. Have they ever one of the tricks that we used to like to do is you take a this is kind of old, my leagues I'm old, um, but it's still uh you can you can apply it. Uh take a phone book. We used to do this at parties, and you take a hair, typically like a woman's hair because it's it's longer, and you and you uh put it under uh you you put it in between a random set of pages, and then you know it's blinded. So you have people say, okay, how many pages can you feel through to feel the hair? So it's a palpation exercise. So, you know, some people could do 20, some people aren't very good, and they they did like five. I can't feel it. Uh so yeah, that's an interesting exercise to be able to tell because your fingers, the worst thing they could do to a chiropractor would be take tin slips and take the tips of your fingers off. That would that would be unfortunate because the receptors in your fingers they do become a major part of what you can do, and eventually you can just touch somebody and and and you can you can feel the differences, but that comes with practice, you know, in the beginning.

SPEAKER_00

Even from the beginning of the year, they'd be like, Can you feel this? I thought I have no idea what I'm talking about. And then at the end of the year, we go back, we review some of the material, and they're like, Oh, hold on. I think this is the you said the facet. Oh, I can feel all the SP.

SPEAKER_02

Yeah, yeah, yeah.

SPEAKER_00

Feel the difference, I can count them. Yeah, uh, your fingers can just tell what's going on better now than they could even a couple months ago.

SPEAKER_03

Yeah, yeah, yeah. Yeah, no, for sure. So you guys should try that. You go to a party next year, you know, get the phone book out, uh though people don't really have phone books, but the what it is, the phone book pages were were thin, and that's why it was good. That's why it was good. Uh, what was your favorite part about the year? Oh, you know what? Is it intramural sports? Oh, yeah, that's right. You're very much, yeah.

SPEAKER_00

100%.

SPEAKER_03

I went to the final in hockey one time in the rec hockey. Yeah, that was fun. And in the old schools, just sit, they would sit on top of the lockers because the school was was run down at that time. Anyway, but it was fun. Uh, so I imagine now the gym and everything is is just I've only been in a school, the new school once, and uh yeah, so I forget what it looked like to be honest.

SPEAKER_00

You gotta come again and see our new gym. It's all updated.

SPEAKER_03

Okay.

SPEAKER_00

We have oh, it's such a nice gym, all new equipment. There's like new turf down, then turf. Yeah. Really? Like sled pushes, no way, stuff, I think. Okay. There's a yoga room. Uh, and then we also have like a basketball court, and that's where we do all our internal sports. So we've done like soccer, handball, basketball, badminton. Uh, we went to the park and did softball. There was hockey. I didn't participate at campaign, but yeah, yeah. But it's so much fun, it just brings the whole school together.

SPEAKER_03

No, absolutely. Uh, if you could talk to yourself before this, like before you start, if you can go back in time and give yourself one one hint or one tip about how to prepare yourself, what would it be?

SPEAKER_00

I think be prepared to try everything. And if someone asks if you want to do something, just say yes. Yeah, if you're uncomfortable, it doesn't matter, just do it, it's gonna be fun. Everyone else is uncomfortable too. Yeah, yeah. That's how you're gonna like make strong connections and you're gonna have a blast.

SPEAKER_02

Yeah. Yeah, yeah.

SPEAKER_01

I think like going into grad school, you you're very stressed and you're like, you want to be studying. I think like it's really important to kind of still have fun and like get into those events, get into the community, and not be so like uh just like not be so stressed and still let yourself have fun.

SPEAKER_03

For sure, for sure. Is there there must be car how many car bars are in campus casing?

SPEAKER_01

Um, we have one clinic at the moment that I know. There's three working there. Okay. Yeah. Yeah. But they they're pretty busy, like we have a it'd be quite a catch an area, I suspect.

SPEAKER_03

What is the population of the town and what is the population of the area?

SPEAKER_01

We're under 10,000 in the town now. I'm not too sure, like it's the whole James Bay area. I'm not I'm not too sure of the exact population. We do have a lot of like um right on James Bay. No, no, we're a bit uh more south. Okay, but we have like a paper mill, we have a lot of um mines around.

SPEAKER_03

So a lot of yeah. So there's very good paying jobs. Yeah, it's you know, but it's out there.

SPEAKER_01

Yeah.

SPEAKER_03

Can you drive there? Do you have to fly?

SPEAKER_01

Uh I drive there from Toronto. It's a nine-hour drive. Nine hour drive straight north, eh? Yeah. If I fly, I have to fly into Timmins and then still drive two hours. So it's just better to Yeah, yeah, yeah.

SPEAKER_03

Oh, yeah, yeah, yeah. Fair enough. Fair enough. Yeah, yeah. No, that's that's cool. And um so your class, you had about 225 in your class, but there's actually a fair decent number of people who dropped out, eh? Yeah.

SPEAKER_00

Yeah, they were. Uh I think a lot of people just decided it wasn't for them. Or some people it was returning students that hadn't been in school for a while, and they just decided it was a little bit too hard on the brain to keep going.

SPEAKER_03

It is, it's intense. Like I remember I came out of McGill, I took a year off. I I graduated in 1999, and then I I spent a year in Japan and came back, and then we said I actually was accepted to school, but I was able to get deferred because I thought that would be kind of fine. I said, you know what? I could use a year off, you know what I mean? Like, why not? Right. I assume you guys went straight in, did you? Yeah, yeah. Yeah. And uh it's it's a lot, it is a lot, you know what I mean? And uh, I'm happy I did get the year off. It kind of helped me to reset my brain and have some fun. And I made a made a few bucks. I know Japan's an expensive place to live, but it was all good. So I gotta ask the big something people would be shocked about would be how much tuition costs. So, how much is tuition now?

SPEAKER_00

25 grand. Yeah, yeah. For your first, I think. Well, your one's the most expensive because you also have to buy your diagnostic kit. Yeah, and that's iPad as well. If you don't have one, oh yeah, they require iPad because we do all our exams on uh exam stuff, which is on our iPads.

SPEAKER_03

You do exams on iPad, okay.

SPEAKER_00

Yeah, so like for diagnostic imaging, they can give us a picture of an x-ray and they can do like a bunch, and it's so easy for them, and we can zoom in on the pictures.

SPEAKER_03

Sure. Yeah, yeah, yeah. Super useful. Yeah, yeah, no, that's good. And so, how do you like so I assume they give you multiple choice questions and you just have to tap on it and away you go, right?

SPEAKER_00

Yeah, they can do some uh like short answer because a lot of people have keyboards that hook onto their iPad. Yeah, but for the most part it is multiple choice or like hot spots. So find the abnormality and then you click on the picture.

SPEAKER_03

Yeah. Okay, excellent. So it's for so for anatomy, for histology, everything is through this program, eh?

SPEAKER_00

Yes, yeah, yeah.

SPEAKER_03

Excellent.

SPEAKER_00

And most people keep all their notes on their iPads too. Yeah. I remember going to school and I bought a bunch of binders and like highlighters because that's what I was used to in university. And I because I didn't have an iPad at university, and I didn't use any of it. Not at all. Everything's on the iPad.

SPEAKER_01

Some of the things I didn't even have to like open or anything. Like everything's on the iPad, yeah.

SPEAKER_03

So you can't lose this. That'd be bad. And do they give out notes? We we used to have what's called um note service. Do they have or do the professors now just give out the notes? Or do you guys have an organized note service thing still?

SPEAKER_01

Yeah, we have note service, so a student applies for it and then they take the notes for the class. Okay. Yeah. And we still like we get quite a bit of notes from the professors as well. But yeah, they'll like take in-depth notes in class, and then it's available to all of us, which is really nice.

SPEAKER_03

So I understand a lot of classes are actually online now. Is that how do you guys feel about this? And that sometimes there isn't even like I've seen schedules where you have two classes at once, so you now have to take other times to do to watch the other other class. Like, how much is virtual and how much is in in class? Assume technique, you have to be there.

SPEAKER_00

You can almost go to everything in person, yeah, and then record it and put it online. Yeah, now there's like a handful of classes, and I don't know how they pick and choose because it's not like one full class will be online, it's like certain lectures of a class will be online.

SPEAKER_03

Yep.

SPEAKER_00

Um, but you can always go back and watch your live lectures, which I've never done. If I see a lecture, I'd never go back. I'd just look at my notes. But sometimes it's nice because you actually you're like you're sick or you can't go, and that's really the only times I've used online lectures because I find that I get the most out of it if I go in person, except for histology because it goes so fast that I always find I need to pause it and go back.

SPEAKER_02

Yeah.

SPEAKER_00

So in classes where professors will go through things really quickly, it is nice to have the option to slow them down or go back.

unknown

Yeah.

SPEAKER_01

I did find it really helpful with uh radiology as well, just watching those sometimes. Just sometimes you miss some little things and then you can see her drawing it out again. So that's very helpful.

SPEAKER_00

Yeah, and that's true. In person, Dr. Flumbus will be like, Do you see this, this, this, this? And it'll be all circled, and then she'll go, next slide, and then it's all gone. And you're like, Oh no, I don't know what just happened.

SPEAKER_03

Yeah, I actually did. So, Dr. Dennis Liu is the neuroscience professor, and I believe he like it starts in the second year, so you guys have that next year. So, so he and I did a guest lecture together. Uh so hopefully you'll get a chance to see that next year, you know, and that'll be kind of fun. So I enjoy doing that kind of thing. We're talking about like CT and concussion and stuff, some some pretty cool stuff. Um excellent. So um what percentage of in an online lecture, what percentage of the class will be there? Just say, let's say for biochemistry.

SPEAKER_00

It really depends on who is lecturing or how many people go, because there are some people who talk really slow and no one will go, and everyone will watch it on like 1.5 speed.

SPEAKER_03

Okay.

SPEAKER_00

Or there are some classes that people find less applicable or they don't really want to focus on, and again, they won't go and they'll do that all online. Uh I know for for diagnostic imaging, a lot of people don't go because they find she goes so fast.

SPEAKER_02

Yep. But then slow down.

SPEAKER_00

Yeah. So there's times where you go in and like half the class is there or more, and there's other classes where you go in, and it's like two people. It really depends. I always feel bad for the professors when only two people go. So I try to go as much as I can.

SPEAKER_02

Yeah, yeah.

SPEAKER_01

Yeah, that's one thing they recommend for your course here. They say definitely try to go to every class, just or like you'll start getting used to where like how you learn and like if it's worth going in person or worth going online, but definitely like recommend going in person as much as possible. Because I feel like you get so much more out of it, and yeah.

SPEAKER_03

No, absolutely. So uh Al Ellie, where did you do your undergrad in?

SPEAKER_00

I did mine, I took a Bachelor of Science in Kinesiology to the pre-med version at UMB Fredericton. I found they did a really good job preparing me for what was coming because they did quite a few types of testing where it's like in-person, the bell ringers, which we have at CMCC, and some students had never done that before. Just having the pressure on and know that it was timed, and you had only so much time for each question. Uh and we actually did some like patient interactions and mock scenarios, which again, like a lot of people hadn't had exposure to yet. And I found that honestly helped a lot for the ASCII because I had experience just going into a situation, not knowing what it was, and having people evaluate how you're uh performing. And if I hadn't, I think I would have been a lot more nervous for the ASCII.

SPEAKER_02

Yep.

SPEAKER_00

Yeah, so UMB would definitely recommend doing the kinesiology program.

SPEAKER_03

Bell ringers are I remember, you know, it it is stressful. You know, it's uh that thing, and you switch and say, uh, you know, it's nostalgia to anatomy, and the little pin. You put the pin in the you know, the most tiny little structure, and like, yeah, what is that? Yeah, but you know, you get it, you get through it, you get through it. If it's not pleasant, you get through it. How about yourself, Sophie?

SPEAKER_01

Uh so I went to Trent University. I did a bachelor's in arts um in psychology. For me, it was a bit of a shift. Like I had done introduction to anatomy and physiology. Um, and then I had like a lot of I had experience in personal training and I also worked in like clinical settings. Um, so I worked like as a physiotherapist assistant for a while in long-term care.

SPEAKER_02

Yeah.

SPEAKER_01

So I find those interactions really helped me out at school. But it was definitely like a a bit of a like adjustment period, but yeah.

SPEAKER_03

Yeah, yeah. Oh, absolutely. Yeah, no, it's it is a big deal. And and you know, how do you guys find the environment and the academic workload from your undergrad degrees to CMCC?

SPEAKER_01

Yeah, a big difference for especially the last year. I had two courses in the semester, and then I was doing my um uh honors thesis. Yeah, so I was working a lot, like doing a lot of independent work, um, a lot on my like own time. And then when we came to school, there was such like a like a structure. Sure.

SPEAKER_03

Hello. Oh, well, you're interrupting our podcast, Jenna. But you know what? I guess I'll allow you to get some water to nourish yourself. No, go get some water, it's okay. Jenna is the uh admin for rising tides. She's she's there's that's the counseling group that's that's here. Uh they've been absolutely phenomenal. Actually, mental health is like the glue to everything. You will be running into mental health issues all the time. You're for lots of people up there. And anyone with chronic pain, like real chronic pain, that's ongoing. Um, these people, they they in many cases there's an emotional component. They also have like gut issues, and they'll get in you, it really affects the HPA axis, hyper uh hypothalamitura axis. And that's where we have um Celeste, the naturopathic doctor, and and so people come in. Typically, it is uh they're female, just talking averages here, female, usually 40s and 50s, really run down, like just kids, kids, kids. Maybe they've had a sick parent, just a lot on their shoulders, very typical for you know mom world, you know what I mean? Um, and they just haven't been able to take care of themselves. They haven't been able to put that energy in, they they're overwhelmed themselves, and their adrenals get get burned out, and then suddenly everything, it's like dominoes, it starts to fall. And by the time they come in, so my back hurts, my neck hurts, like everything hurts, actually. Uh, and I'll sit them down and say, you know, there's things we can do, but I need you to go see Celeste first. We're gonna get your gut healthy, we send them your setting inflammatory response, and maybe get it through the gut, we're gonna get your stress levels uh in check, we're gonna look at all those things, and then bit by bit get you doing some exercises, and then we're gonna be able to help. So that's why having uh access to a team is so important. So, because beyond besides the basics, anything outside of six months, usually you need an interactive care team. I mean, it works so much better. And then the science backs us up on that. Um, so yeah, no, naturopathic doctors are are phenomenal, counselors are phenomenal. Uh, so it's really helpful to have around. Um, okay, cool. So it was really hard. CMC was really hard compared to your undergrad, eh?

SPEAKER_00

The workload was a lot more.

SPEAKER_03

Yeah.

SPEAKER_00

Like I my daily schedule. Yep. And it's pretty much I do this five days a week. I get up at 5 45. Yep. I work out six to seven. I do class from eight, eight thirty uh till whenever it's done. And then I'll study until dinner time. So it's usually 7 p.m. But then I always take the time after to just let my brain rest. Because by 7 p.m. or 6 p.m., whatever it is, brain's usually sizzling.

SPEAKER_03

Oh, no doubts. No doubts.

SPEAKER_00

I don't know if you find found that too. Like it's a lot, you have to study a lot more. However, I also took the time to do the things I want to do, like go to the gym.

unknown

Yep.

SPEAKER_00

Took my nights off. Uh, a lot of weekends, I would study just a little bit, just in case we had like projects due. But again, you gotta take the time and relax or do whatever you want to do. For me, it's a way pickleball. I love pickleballing with my roommates.

SPEAKER_03

Um pickleball is fun. My wife and I went, we try to do a date night every Tuesday night. And uh she she and my daughter are off to drive in Montreal for cheerleading. Uh, so I'm I'm I'm I'm flying up on Thursday afterwards. Work, but we won't be doing that today. But pickleball's fun, you know. I mean, it's a hoot. We went, we did that like what two weeks ago. It was a real hoot. Oh, yeah. And it we got a great sweat on.

SPEAKER_00

What else do you need? There's a couple courts, like four courts, couple minute walk from CMCC, and everyone goes. There's students there all the time. Yeah, it is so much fun.

SPEAKER_03

Yeah, that's cool. Excellent. Well, it's a good question. So, besides exercise, what do you do to maintain mental health balance in school?

SPEAKER_00

I think living with my roommates is the biggest thing. Uh they're good roommates. My roommates are great. Uh socializing with people. Uh, I watch a lot of movies. Yep. Read a little bit, uh, mental health walks. I think I've got so many steps this year just from like, okay, I need a break, need to go on a walk. Uh, and if you bring someone with you, it's just even better.

unknown

Yeah.

SPEAKER_01

Very similar for me, like finding a good friend group, like right at the beginning. Like, I could really like be have each other's backs, like step forward. Um, yeah, that was like the biggest difference for me, like the social life. Um, yeah, there was a huge shift, I think, from mod one from being so like stressed and like you're feeling like I'm getting so much thrown at me, like 13 courses. Yeah. Um, and then you like switch that perspective and being like, you know, I'm gonna prioritize like working out, taking walks, um, hanging out with my friends, and then also doing like like kind of like work almost, like you just study all day like a like a shift, like a normal job.

SPEAKER_02

Yeah, yeah.

SPEAKER_01

And then you take the time to do that. And that that did a big, big change for like my academics, really.

SPEAKER_03

Absolutely. It's just you gotta invest in yourself. You gotta invest in this stuff. So, all right, so the Canada East Spine Center is uh Southern New Brunswick's orthopedic uh spine center. Um, and they do all sorts of different things. And and you were talking about you guys are here to kind of collaborate with the surgeons and the medical students and and everyone else who comes and goes. So, how did you guys find out about the program? Uh, and and how uh how are you finding it so far? What have you seen? What have you done?

SPEAKER_01

I've I've heard from you already on this one, but uh yeah, so we had um it's kind of just like an ad that I saw at school and we got a couple emails. Um, and like just seeing like, oh, working with surgeons, orthopedic surgeons, I thought that was like an amazing opportunity. And then for me, it's kind of like an adventure as well, because I'm not from here, but I I do love the East Coast. Where's where are you staying? Where what kind of accommodation do you get? I'm staying at the UNB residences. Okay, yeah, but it's so close to the hospital, like it's perfect. Yep. Yeah, yes, it's been like um yeah, a really good experience so far. I really like working with the surgeons and being able to like you can kind of think, okay, like when I s if I saw this patient after, like how would I kind of approach the like the rehab and all of that, the treatment? Yeah.

SPEAKER_03

What's the most surprising thing you picked up from from watching, you know, from the consultation process, the surgical post op? What what really struck you as as being kind of out in the left field that you did not expect? Are you surprised? How about the number of referrals who aren't um they're not surgical candidates? Are you surprised by that?

SPEAKER_01

Yeah, there's quite a bit of like cases where it's more like situations that could be like sent to like a chiropractor or therapist. Um Yeah, there's quite a bit of cases actually that you see that it's not surgical and the the surgeons really have to like do it's really similar really to like when they do their physical tests and all of that. Very similar tests and they like get to weave out if it's like if it's surgical or not surgical. So yeah, yeah, yeah. I think that was that was pretty surprising, yeah.

SPEAKER_03

Yeah, yeah. No, that's good. That's good. How about yourself? What what's the biggest surprise that you found or actually let's go another question? What's what's the biggest clinical pearl you've picked up from uh from this experience so far?

SPEAKER_00

It's been really cool seeing how all the different uh orthopedic surgeons treat their patients. And I have my book here and I have something that I've learned from all of them. Yep. Uh it was really cool to see I was with Dr. Gaznowski and she was talking to me about rotator cuff tears and then frozen shoulder.

SPEAKER_02

Yeah.

SPEAKER_00

And she said that she gets a lot of people that will be referred to her for frozen shoulder, and it's just a rotator cuff tear of some sort.

SPEAKER_03

Okay. You know what's amazing? I could talk with this all day long. And uh frozen shoulder is way overdiagnosed by therapists. Way overdiagnosed. They don't seem to understand a true frozen shoulder, you can't move, it can't be moved. Like, you know, you can it'll stop, you know what I mean? Whereas, you know, uh they'll go to a therapy clan and say, well, oh well, they don't have full abduction. They go, oh, you know, you get to maybe 100 degrees of abduction, and they're like, oh, well, you have frozen shoulders. Like, you don't have frozen shoulder, you have a rotary cuff problem, or you've got impingements. You know, I'm a big impingement guy. Yeah, pretty much everyone's got impingement. Anyway, um, but yeah, that's wild that they don't seem to understand. Like a true frozen shoulder means that the capsule has ceased and you can't move it passively. It's not an active issue or restraint, it's it's a passive thing.

SPEAKER_00

That's exactly. She was reminding me to always check for passive because they'll stop because of pain. But if they can relax and then you can keep moving it, then that's not frozen shoulder. No, no.

SPEAKER_03

I can't believe we're still having this conversation. Like, this is insane to me. This is not a hard test. I'm not splitting the atom here. You either move it or you can't move it. It's simple, it's very binary. Anyway, that is that is uh a pet peeve of mine. Dan would hear he'd be laughing because I'm always talking about that. Yeah, the number of people came in, oh, I got frozen shoulder. Ah, here we go. Yeah, and there's that one person that actually does something like that. Okay, so then we deal with now. Actually, treating frozen shoulder therapeutic is a long process, like a proper frozen shoulder, it's about a year. Takes it's and it's it's painful. You have to go into that pain zone. There was a clinic in Toronto. Um, maybe I shouldn't advertise it, but I won't name any names, but I don't even know if they exist anymore. There used to be a clinic, operate a bit of a gray area, and it was they'd have a medical doctor and a chiropractor. And the medical doctor prescribed the strongest like benzos that he could, really like make the person as loopy as possible. And then the chiropractor would just go to town, uh, and they would just go to town on the shoulder, and you'd be tearing the capsule essentially, and it has to reheal. That's what they would do surgically if they have to, they don't want to because you worry about the integrity of it. Um, but actually, I had a frozen knee. I had adhesive capsulize of not me. I had an adhesive capsulize of the knee. I mean shockwave to get into it. It took a lot of time. This person I came about due to an autoimmune disorder that person had, and you know what? I'd love to do a paper on that. That's a very interesting case, but um, unfortunately, it's just life. I gotta get out of all that it's hard. Maybe eventually we'll do it. He's signed, he's keen, but it's just a matter of doing it. Um, I did publish another study. You guys might actually, I'm pretty sure it's in the curriculum actually in radiology. When I was a student, and this is my own student, probably the highly of my student, academic highly of my student experience. Like this is a social parts, a big, big thing. And uh it was a fella walked in, he's probably like 60, 65 years old. He woke up, he sat up, he heard a pop, and he had neck pain, but didn't refer anywhere, just stayed put. So uh I was with Dr. Chris DeGrove, he was my my clinician, came in and all the ortho tests were negative, except traction, neck traction was was positive. We didn't like the whole presentation, we didn't like the whole thing, so we sent him for x-rays, and he had a uh a burst fracture at C4, which obviously you guys know the whole thing is gone. So you know the difference between a compression fraction and a burst fracture, compression fracture is stable, the front end has collapsed, it looks like a wedge. A burst fracture, the whole thing is is like a pancake. Now you got bony fragments in the spinal canal and the whole shebang. Not a good situation. Um hit multiple myeloma. So when we found that I was like, well, this fellow's probably not gonna live very long. So fast forward 10 years, and Chris actually got a hold of me. And then uh, I don't know if you guys have any experience with Jill Cox, uh, Dr. Cox, she did her clinical sciences uh residency. I don't know if she's still teaching at the school or not. Anyway, so she uh she wanted to do a paper. He and I he and her talk said, you know what, I got a paper for you. So reached out to me and he said, Do you want to collaborate? And I said 100%. So we did, and the kind of the method to the matter, we said we should make it have a message rather than just be like, okay, here's a neat study. Let's have a message. And the message was orthopedic and neurological testing is largely garbage, it's very insensitive. So not garbage, but like I'm I guess I'm being sati, but um, essentially they're it'll only pick up a case 20% of the time, right? So you got sensitivity and you got specificity. So sensitivity will pick it up 20% of the time. Specificity is if you have it, it's gonna be there, right? Essentially, what do they call it? Uh oh. The acronym was uh snout and snout. Yeah. Snout is the sensitivity is the rule it in, the specificity is to rule it out. It's been a while since I've used this link out and coming out. They still use that though. Do they? Yes, uh snout and snout? Okay, all right, perfect. Well, it makes sense. It makes sense. It is hard. These tests, it's it's not a good idea to rely solely on the orthopedic testing to rule things in simply because it's only picking up one in five. But specificity tends to rule something out that if you do the test, it's probably not there. The specificity is a lot higher for these tests, so you have to use it as part of everything else a good history, a good functional exam, um, palpation. So I usually recommend you want to use three, four, or five different tools to be able to get to where you where you want to get. One of the challenges that we've we've had was I've worked with so many different new graduates, and it's it's a real pleasure of mine to be able to help people start their careers and stuff. Is you find that they have trouble recreating people's pain in a real world environment. Because everything is very you're in a petri dish at school, right? And so it's like, okay, well, here's this test, they they they here's a cherry-picked case, so here it is, but that's not how it is. You not everyone has a meniscal tear, they might have a meniscal bruise, and so they can still walk and might not look, but then they get intermittent swelling in the joint capsule. The joint line teariness might be weaker, it might not look like a lot, but they have pain. So these spectrums that that people have as a as a pain or a function, it you it takes a lot of time to kind of sluice through us. Not everything is textbook, actually, very few things are textbook for sure. You can have sciag type pain. Um, you can have a disc issue with no straight leg raise. They got a full straight leg raise, and then two weeks later, then then they do, but they've already they've already had the pain, right? So they get sciag pain, no straight leg raise. Actually, you need to look at where are the compression points? Is it the piriformis? Is it in the in the pelvis? Is it the deep pelvis? Isn't the hip capsule itself where that is inflamed cosmic? So you're a detective. You'll be a detective. I mean, um, so yeah, so that's been a really good experience for you guys. Um, you know, how many surgeries have you guys watched so far?

SPEAKER_01

Uh I've seen two, one open and one uh minimally invasive.

SPEAKER_03

Yeah, yeah. Cool. Was that fusion or dyscectomy or laminectomy or both fusions? Yeah.

SPEAKER_00

Yeah, the one we I saw the same minimally invasive, yeah, and it was a fusion with a decompression of the L five. Yeah.

SPEAKER_03

I always thought it was cool how they get the rods into the pedicle screws. Did they have that? It looks like a wine corker where they put the pedicle screws in and then the the rod has to be slipped into the hole in the pedicle screw, and they attach the bottom one and it slips and then pop pops it in. It's like a closed system. I thought that was really cool. Yeah, I didn't know that existed.

SPEAKER_00

That and just all of the tools they use is just like I'd find in my dad's garage. Yeah, it's kind of shocking. It is, yeah, yeah, yeah. They you know they'll hammer it in and then they use like a torque wrench to get the screw in, and like this is yeah, like aggressive too that you would expect.

SPEAKER_01

Like it's not very like gentle. Like it's oh yeah, absolutely.

SPEAKER_00

There's times where they're very gentle and perse uh, they're always precise. But you'd think it'd always be gentle, and it's not at all. They have to use a lot of force to get those things in there.

SPEAKER_03

Oh, I know. Oh yeah, the whole body was shaking, was trying to get this in. Um, yeah, no, it it is really, really cool. And and uh how do they find what where do they tell you about the outcomes with different procedures? Like, you know, are people doing well?

SPEAKER_00

They always talk about risk and uh prognosis and before every single surgery like in clinic that I've seen, they've always talked about like you know, 90% of people or 80% of people are gonna get better, 10% of people are gonna get better, like 100% and love it, almost as good as new. 10% of people they say aren't gonna like me, or it might not go as well as they want, and they always manage expectations. Now, a lot of people come in when we're with the spinal orthopedic surgeons and they have you know neurological problems going down their legs and back pain. Yeah, and the surgeons are almost always up front and they'll say, Look, we're trying to help you, you know, walk better or get this burning and tingling away. Yep, but the back pain isn't the focus of the surgery. Yes, so they do a good job of managing expectations. I think still patients will come in and think, Oh, this is gonna take all my pain away. And that's just not the case.

unknown

Yeah, yeah.

SPEAKER_03

No, people don't understand it. It treats leg pain, not back pain. Because back pain is a lot of it. Once you start getting, you know, a lot of the connective tissues around like the tracholumbar fascia and the ligamental structures, when you start removing pieces, like the it's the signals getting to the brain, you know, are changed. And you know, Nelly and I were talking about this today. And you know, once you change the brain getting the signals, those compensations with the erectors and multifida and so on will change as well. And you know, sometimes that's okay. And sometimes, depending on how aggressive the procedure is, like you are suddenly you you you have changed things, but you had no choice because you had the steering pain down the leg, or maybe you lost ball bladder function, and you know, it sometimes you gotta rub here pay ball, yeah, for sure. Um, how many stenosis patients have you guys seen? Old dude, 75 years old, locks on the cart in the shopping, you know, can walk forever in the in the grocery store. How many of those have been assessed?

SPEAKER_00

I've seen a lot. So if you've seen a lot of scoliosis, yeah, yeah. Uh so I've seen a lot of people with different stenosis of like different time, different types, whether that's from you know par fracture or the generation of the facet or different types of disc bulging and just causing that, like either like central stenosis, yeah. Um a lot of shopping cart signs, like you said. Yeah, and I know the hospital the regional hospital here is trying to get GLAD spine in place, they haven't done it yet, but they're trying to. Uh so the orthopedic surgeons will be able to refer their stenosis case in cases out.

SPEAKER_02

Yep.

SPEAKER_00

Uh they don't operate on all of them, it depends. Yep, and sometimes they'll say, you know, this is progressive. You will tell me when you need the surgery. Yeah, yeah, exactly. They say, like, as long as you can put it off as long as you can. Exactly. Yeah, exactly.

SPEAKER_03

And they just do laminacin, they take they create a uh essentially turn the spine into a convertible. It's this interesting, just take the top off and so yeah, done. That's crazy. I think it's interesting. Uh cool. So as students in this professor heading on only your second year, do you have any thoughts on what you expect your careers to look like? Or do you have any ideas, at least starting point ideas? What would you like to do?

SPEAKER_01

I would really like to open my own clinic. Um, my mom is a physiotherapist. Okay. And then my sisters are all kind of in the healthcare. I have a sister that wants to be a naturopath, the other one's in pre-med. Yeah. So I kind of want to take that approach like a family clinic. It's very multidisciplinary. Um, yeah, and I really do want to practice like a very good balance of like passive and active care. Yeah. Um, maybe more leaning towards active, you think. Yeah, that's kind of my my ideas. Do you want to go back back home, do you? Or somewhere else? I'm still considering it, but I do like it down south. I find like up north sometimes is a little too isolated. Yeah. Yeah.

SPEAKER_03

Cool. And and uh how about how about yourself? You you said something similar, mass the family connections, but you you like to own your own own clinic someday?

SPEAKER_00

Yeah, I definitely want to come back to New Brunswick and uh work for a couple years, chat to some chiropractors and see how their business are running. And then again, open my own clinic. Uh, it would be the dream is to have you know uh a family doc with us that we can collaborate with. I'd love to collaborate more with the orthopedic surgeons for all of their patients that they're not gonna operate on, or even after for rehab or prehab. Uh having other physios, chirows, uh, dietitians, the whole shebang. Yeah, because I'd really like this. I would really like to provide a holistic approach to healthcare uh and work with everyone and refer out to the best possible practitioner for one of patients.

SPEAKER_03

It's about having the right tool for the right person. You guys won't be the right person for everybody. It's just the same way I'm not the right person for everyone, but having access to that and being able to maintain that circle of communication, so I can refer to say Laura and a physio or just less an astrophot or even another chiropractor, we can maintain that conversation and we can we can make sure they stay together. And people really like that. And I always say, check your ego out the door. You know, a good referral is part of the treatment plan. So if for whatever reason, and you know, you can kind of take sway and stick in the back of your head, you know, new grads are often have difficulty with this, is you know, if you get to say visit five and the person is like really not getting anywhere, a good referral out, and you always try to refer internally in the in the clinic if you can. Um, but maybe it's extra, maybe there's someone who's really good at this particular thing, then you know that you will get credit for that. So they will remember that, be like, you know what, Ellie or Sophie, you know, made this great referral, it worked out really well, and they will refer back to you. So having competent and genuine decision making is a very powerful clinical and a practicability tool, actually. So just being honest and genuine, rather than trying to squeeze in one more visit to pop and pray kind of thing, it's it's best to manage things, manage things well. Um, so yeah, having having the right people around is is so, so important. And something that they don't teach you in school, and I cannot stress enough, and we did a podcast about this, is patient management, patient education, communication, and building that trust, that rapport with the patient. Going in, the patient doesn't care about all the technical language. You need to get enough across they know what's going on, but you know, most of it goes right over their heads, and that's another thing that that students in the grads will do is they'll over-explain the technical stuff. People are not absorbing any of this. So being able to explain it, dumb it down, explain it well, and then being genuine and creating that rapport with the patient is massive. It's not a small feature. If it is almost, it's almost as important as the treatment you're going to provide them and the decisions you make. It's crazy. It took me a long time to figure that out. But if you're gonna help, if you're gonna be successful in helping people, dealing with that element of of things is incredibly important. And you already will have people in mind who say they're they're too technical. Or whatnot, or they may they may struggle with that. And you know how they're successful in practice is you have to embrace this whole approach, the biopsychosocial approach is so important from not just the mental health perspective, but again, the patient management's perspective. Um cool. You guys have any questions for me? I'm just yammering on about whatever pops in my head that I thought might might be kind of helpful, you know. But you know, I've been doing this for 20 years. I I I I have mostly bad answers, but you know, uh from you know, um, you know, being in here, hanging out with Norm, hanging out with Dan and I, kind of what's um do you have any questions about like real-world practice, the first five years of building a practice or anything like that? You know, I know you're not a hundred percent thinking about that yet, but at some point you know it'll come up.

SPEAKER_01

What's kind of been your pathway? Like how did you start kind of in so without getting into too much craziness?

SPEAKER_03

So we started the word town came. I started in Hampton, so that's 20 minutes east of here. I started out in my basement. I had no social media. Uh, I started in 2004, I had no social media, I had no mentor, I had nothing. Um, now Norm actually, who you hung out with, was uh he kind of got me started in the profession, but really kind of like uh I went to the school hard knocks. That was my residency. And you know, I was always very hard on myself, actually. I thought I should have grew faster, even though I did do well. Um, but I was in a small community, and you know, the the debt payments are there, and you're paying rent and stuff like that. So it was a stressful time. I just got married uh in the same time we built a house. So then I started going and I went to St. George and St. Stephen's. I drove a lot, I was really nomadic. So I do like a day and a half in Hampton, a day and a half in St. Stephen, and I did all that. Then we grew those up, started getting some help. Uh, Dan joined me in 2012, and we uh we started St. John and then I was able to opportunity I was able to buy some the buildings I operate on. This is New Brunswick, it's not you know, it's not Toronto, so that's a little more manageable, right? Um, because you don't have any retirement plan, there's no pension plan. So uh being able to buy the buildings you're in, if you can pull that off with like say a partner or whatnot, it it's it's not a bad, it's not a bad angle. But not everyone is keen on that. And I I do I do get that. It's worked out for us. Um, but we you know, my wife's a teacher, so that's helpful. She's in the public sector, she's very happy there. I I don't know if I can handle that. I like being an entrepreneur, so I did a lot of running around while I learned, and you know, and then you like, for example, I kept going to St. Steven longer than I probably needed to because I liked this and I like the patience. And you do develop a rapport, and I do have a large maintenance space, so I do lots of acute and subacute, but I also uh enjoy seeing people I've seen for years and keeping them healthy and helping them live their lives. Um, so yeah, I I had to be patient, just being patient. The greatest mistake you can make when you start is to jump from clinic to clinic to clinic. Like you mentioned a lot, Ellie, about um you know, shadowing lots of people, go and see as many different people as possible and lots of time in clinics, everyone's a little bit different. And you your practice will be a responsibility. When you start, so do your due diligence, make sure there's a good fit and talk to people who've been in those clinics before. Before you start, and if you start as an associate, let's say, or a contractor, um, at the end of the day, your practice will be your practice, and you know, um uh you know, it doesn't always come down to advertising and so on. Like you you have to do good work and and get your hands on people and and be the best provider you can. That's how you're gonna, that's how you're gonna build. Obviously, social media and having a presence is is important, and everyone will do that. And I always see some some students start like Cairo pages and stuff like that to kind of get that ball rolling, which is which is cool. But yeah, don't jump from clank to clank to clank. I I like to say everyone gets one switch in the first three years. Um, because again, it's like a it's like a first marriage, you don't even know, right? It's like everyone gets one divorce too. I I I have I've avoided that, I have to admit, but um, everyone gets one because you know there's there's no there's no playbook. Um but don't jump from clinic to clinic. Once you make your second change within three years, it it starts to not look great. Once you switch clinics three times, you're on the verge of exiting the profession. Yeah, that it's that's like make sure you make the right decisions early on because it it makes you look bad. It makes you look bad with um you know other carbs out there, it makes you look bad with your colleagues, and you know, the patients who kind of pick up on this, they say, like, you know, there's there's no consistency, there's no patience, and you know, consistency is huge. Yeah, make sure you make the right decision, you'll win change. That's my opinion, but I've been watching people for a long time. Yeah.

SPEAKER_00

How do you maintain such a positive environment here? Because I've even just talking to a couple people that work here, they all seem to speak so highly of the workplace that they're in. But I've been in other clinics where that's not the case.

SPEAKER_03

Well, you fake it till you make it. No, it's about people. It's you know, I know it's a bit of a commonly used trope. It's about people, but for us, I might, you know, to me, let's put it this way, as a business owner talking pure business, I perpetually leave a lot of potential revenue and money on the table to have the right people. Have you ever heard the story for uh Tom Bray's last Super Bowl? He actually took a pay cut so that they could afford to bring in the right receiver, the right team. He like he's like, I need a new line, O lineman, I need an I need a new receiver. And he goes, I'll take a pay cut to bring them in. And that's kind of like I I respect that. You know what I mean? Like I respect taking out the whole team's like, I make enough money. And although he came back to Tampa Bay, so maybe he blew it all. Who knows? I have enough gambling addiction or something. But anyway, it's about having the right team and the right pieces. Um then you're it's low drama. If you're just pushing for money, if you're very revenue driven, it's gonna be stressful. It's you're if you're there's too many spreadsheets and you're pushing people for too many quotas, and there's too many numbers, it's it's hard. It's hard. Proper business management requires a lot of those things, but it can't be the most important thing. You know what I mean? So if everyone's having fun when they come to work, it's gonna be low stress, low trauma, and patients feed off us, they do really well. Uh, and they sense that and the number of people. I had a guy who won a set of orthotics and never treated him. I gave him some orthotics, we did an auction. He came in, got fitted for the orthox, and he left, he turned, he came back, goes, You know, I've seen a lot of businesses, and he goes, I've been involved in a lot of businesses. He goes, the vibe in the culture here is really, really good. And to and that that's a that's a really good cover. I really like that. Um, and it's something we've yearned to do. We've yeah, I feel if you do things for the right reason, the money will follow. If you're nickel and diming, you know, you're gonna run into trouble. And but if you just do things right, guess what? You're you're gonna be fine. You're gonna make money, people are gonna be happy, they're gonna make money. So from a purely revenue standpoint, it's just good business to make people happy. Simple as that. Yeah, I know it sounds hard, it's not that hard. It really isn't that hard, but yeah. Just don't be a douchebag. Yeah, yeah. So um what uh so what what do the professors say? What is the word on the street at CMC? And we'll tie up here shortly. What's the word on the street at CMCC about the tips they're giving you for the next phase of your career? Like, are they saying beware of this or look for that? Like, what are some of the things that that they try to tell you as you're kind of maturing along in in school?

SPEAKER_00

I think a big thing that they push is understanding what you're testing for orthopedic testing, what structures are being used. Yeah, or if you're doing a physical test, like don't just not think when you're using these orthopedic testing and be like, oh, this is always gonna be super spinatus. No, well, what else am I moving when I'm doing this test? Because there's other things that can be causing pain to make something like not a true positive. Uh so they talk about that a lot, like using your brain, they push people's skills like crazy. They're always uh teaching us to look at it from a different perspective and like pull from different cultures and respect different cultures because that's how you're gonna respect all your patients. And another thing is just like being adaptable in the future. Because we've had some classes talked about like business, and they're like, it's gonna be hard, things are changing. You always have to stay on top of it, stay on top of the science, stay on top of the people you work with in a good way. Yeah, yeah. Um yeah, I think that's really what I've taken from it.

SPEAKER_01

Yeah, very similar to in like in terms of like physicals too. It's like when you're doing a history, you're not just asking questions, like you really have to you're interviewing the you're getting to know the person really. Yeah. Um, and like a good history will really like tell you the diagnosis if you really like ask the right question. Yeah, you're just doing the physical to like double make sure you're right.

SPEAKER_03

Yeah, yeah, absolutely. It does take time. And you know, someone put this way, and I I kind of love this. Um, I've I've always remembered it's like uncommon signs of common conditions are more common than common signs of uncommon conditions. So even though something might look weird or be presenting weird, and people describe things differently too, remember, especially kids. Um, it doesn't mean that it's something crazy. It doesn't mean that it's metastatic disease or some weird like gamberay or some weird neurological disease, uh, or or worse, you know, those things certainly come and you have to be ready for it. But nine times out of ten, when you see something weird, it's actually fairly common, but that's why you do your due diligence. But don't overreact. You can put in a referral for something and still treat it, unless it's glaringly inappropriate. And the mistake that people will make, be like, okay, well, here in our Canadian health system, unfortunately, we do have some issues with referral timelines and stuff like that. It's it can be a long wait. So to tell someone, I can't help you because you might have this, you need to go this way. You're really doing them a disservice because now you're setting them in limbo for two years, maybe, when they came to you for help. You know what I mean? So there's no shame being, okay, I'm gonna refer you. I uh, you know, we we just got the rights to refer maybe a year and a half ago here to ortho. Um, and so ortho and neuro and in physiotry and so on. Um, but like you can still manage this, you know what I mean? And you just say, listen, I want to clear this out and I, you know, have this, but we have things we can do to make you comfortable in the meantime, you know what I mean? And so that is that's really important. But just cutting them loose is a practice killer, and that person is probably not gonna be happy with you because they're gonna be like, I never nothing happened. They kicked me out. That's that's and that's what they're gonna tell me. I got kicked out. So you can identify even crazy things, make the referral, but like like I was telling you, Ellie, we'll have terminal cancer patients who will be at the end of their life and will seek us out because they're in pain. And like, I know I'm dying, I've made peace with that, I'm okay with that, but if I could just get this hip to stop hurting, I would be happy with that. And you know, and yes, they could have be riddled with mastic disease, or who knows, maybe breast cancer has gone similar vice or whatnot. Um, and they deserve to be comfortable, and you can treat these people, like these are they're not they're not made of porcelain, they're not porcelain dolls, of course. You change how you treat them, you know what I mean? And there's lots that you can do. And frankly, they appreciate the opportunity to kind of rant sometimes, they appreciate the opportunity to be listened to and to have because their families, they don't want to burden their families with their negative emotions. Um even though they have every right, they're in a place in their life that's unfortunately not that will end soon. But not everybody, it's an interesting psychology. They don't want to be a burden to people psychologically with their friends and family. If they spend time with friends, they want to be happy, they don't want to be dwelling on the fact that they're dying. And if they're spending time with their kids, they don't want to be dwelling on the fact that they're dying. So, in a lot of cases, yes, they might have a mental health counselor, which we certainly encourage, but when they're with you, they can chop it all down. It's a safe place, they're getting care, they can cry, they can scream, they can be angry, and they can be thankful at the same time. It's a really emotional and powerful piece to be able to do that. So you can treat people who are at the end of their life and they're comfortable, and it's still very appropriate as a chiropractor. So, um, so yeah, no, lots of stuff out there. Your education is amazing. You'll be able to do so many things. Don't pigeonhole yourselves. Open the aperture wide open. There's so many cool things you can do. It's an awesome profession because, frankly, I'll finish with this. Uh, when someone with MSK pain goes to see a family doctor, they can refer, they can prescribe. They see a physiological do primarily like 90% of the time, it's gonna be strength training, exercise, and read. All good stuff. Massage is 100% passive. With us Cairo, we can diagnose more. Uh, we're really good at the tricky things, we're really good at finding those discreetations, neurological conditions, really good at finding the patterns and the how things are related. You're gonna have a hip problems coming from the from the ankle issue. All those things really opening up a wide net. Our diagnostic skills are great. We know when to refer, we can read x-rays. Um, and you know, you will get further for MSK than frankly any profession because the surgeons they do surgery. And as we know, only 8% of referrals need surgery for spines, you know. So they're spending 92% of their time in these consults saying, I can't help you, or I'm not the primary option for you, which is a real time suck. Um, so yeah, we have a wonderful profession. We have a wonderful profession. Don't ignore the adjusting. It is a very helpful tool. I know there's there's a lot of folks that said I'm just gonna do strength training, which is fine, but I'm telling you, you if you adjust and then do strength training, they're gonna do better. They're gonna do better. So, yeah, anyway, that's my rant. That's my rant. All right, any closing comments? You guys having fun? Yeah, did you have a good day? Yes, yeah, you have a good day? Okay, I apologize for being so ravishly handsome. I know I was throwing you guys off. Uh so I'll I'll try to do better next time. Anyway, okay, so thank you very much. It's awesome to talk to Sophie and to talk to Ellie. Uh, you know, they're heading in the grid into second year CMCC. It's a wonderful journey. Uh, I'm jealous. I remember those days. There was a lot of fun. And um, you know, you guys are gonna be so successful, you're gonna have a blast. And anyway, we're always available if you have any questions or you have any thoughts or anything like that, uh, or you want to rant about something, uh, you know, our our lines are open. So, yeah, thank you very much, folks. We loved it, love having you. I'm not gonna make sure how do I stop this recording here. Um this is where my um this is where my age starts showing. Okay, there we go. All right, thanks for joining us on the podcast. Hopefully, you guys found this interesting. You guys just share with your friends, uh, and we'll uh we'll see you on the other side. Cheers.