Turo Virta: 1:08

So today's conversation is about something I hear all the time. I know what to do, but I just don't do it. I know I should move more, I know I should eat better, go to bed earlier. I know another glass of wine or another snack won't really help, but still, when real life happens, everything feels harder, you feel tired, foggy, overwhelmed, stressed, emotionally loaded, and then you start blaming yourself, you think you are lazy, you think you have no discipline or motivation, but what if sometimes the problem is not motivation, what if your brain and nervous system are overloaded, that's why I'm excited for today's guest, Dr. Michael Bagnell. Dr. Pagnell is a functional neurologist, brain health educator, podcast host, and clinical innovator. He has spent more than 30 years helping people understand the connection between the brain, nervous system, movement, balance, focus, emotional well-being, and everyday function. So, in this episode, we talk about brain fog, stress, sleep, emotional overload, decision making, training, readiness, and why healthy habits can feel so hard when your brain is tired. Then, my goal with this conversation is to keep neuroscience practical, not complicated or overwhelming, but something you can understand and apply in real life. So, if you have ever felt, I know what to do, but I just can, can't seem to follow through, this episode is for you. So, let's get into it. So, Dr. Pegnall, first of all, thank you so much for coming to my soul. And before we go into practical tools, could you share a little bit about who you are and what led you into functional neurology and brain health?

Unknown: 3:05

Yes, and of course, please call me Mike, yes, or Michael. So, yeah, it.. I've had an interesting journey. I have a similar journey, I would say, in your background in physical medicine. So, I started out in chiropractic medicine in the United States, and when I got into that, is because I had a background in athletics, and so it was a natural fit. How does the body move? How do the biomechanics and the kinesiology, and I did a lot of study in that realm. How does the body work in a way that you can get the best performance out of it in everything, right? In work, in play, for us, for me it was athletics. I know you work with the women's hockey team, so the highest level of athletics. So that was the background, but I was always interested in the why behind the what, and what do I mean by that? Why the things we would do to the body would have an effect on the nervous system and about the brain, and so I always had questions, what about the brain, and we had a course in our, in our graduate school on central nervous system, where we did dissection back in those days, you still did dissection, so we dissected the brain and the spinal cord all the way down, every muscle had to be delineated, it was quite details, a year, one year course, so I was so fascinated by central nervous system understanding that I started to realize there's more to what we do in chiropractic medicine, or physical medicine, or physical therapy. There's more effects above the neck than I realized before, and so that began me on a journey. And at the same time, my father, back in the 70s, had had a brain injury, and he had been dealing with now at this time it's many years ahead. I'm in chiropractic university, been dealing with early onset dementia and mood disorders and different regulation problems and self medicating, and you understand, so the interest for me about the brain really moved ahead quite fast over the years, it went from just understanding the brain and neurology to 30 years later neuroscience, clinical neuroscience, right. We're very advanced now, and we still say we don't know that much. We're just beginning to understand. So, now what's fascinating is that people that you work with, the ladies and people that I work with, and even people who are biohacking, they're trying to understand how to improve brain and body function, right? And so our work is to help them better understand that, to understand many of the symptoms or questions that you had when you open the show, brain fog, fatigue, my motivation, my willpower, all these different elements, sleep. How is that a part of the brain? So, the way we summarize it here is, we say we practice brain-based healthcare, brain-based healthcare. So, even in my training, I'm thinking about a little bit about how is this impacting my brain. And I can talk more about that later, in terms of brain regulation for your patients, for your ladies. So, the whole journey into clinical neuroscience, also known as functional neurology, really took me into a fellowship training in brain injury rehab, rehabilitation, and training also in hyperbaric oxygen therapy or hyperbaric medicine, biofeedback, neurofeedback. So I had to have different aspects of training, and of course, functional medicine, because I know one of the things we talked about in your questions preliminarily is when my labs are normal and I don't feel normal. What is that? What do we do? This is where we look at the functional medicine side, so that we can really get underneath what is supposedly normal, but yet a person is not. So that's the short story, and it's really been a wonderful journey now. And we, we brought in some amazing things, which I'm sure we'll talk a little bit more about.

Turo Virta: 7:02

Yeah, is there something like, because I'm always curious to know, like someone like with your experience, or over 30 years working with the brain and nervous system, is there what if there would be one thing that, or not one, but maybe even few, what you have learned that most people still don't understand what is kind of like not talked enough, or or something like that. Do you have something?

Unknown: 7:32

I would say just the first thing is that people, we, me, even myself, need to realize how important my sleep really is to brain health. Sleep is really should be part of our job. Now we have much more awareness on sleep. There's podcasts on sleep, and there are Ted used to be Ted Talks on sleep. Now there's podcasts that explain all the different aspects of sleep, and we know what the environment should be like, right? Cooler environment, darker, no light, no little lights plugged in, charging things, all these different aspects true, but are we doing it to the degree that we realize your sleep, which is every single day, right? I don't even exercise every day, but I have to sleep every day, and so does every other human being, and the ladies also, is really, I would say, in my opinion, one of the elements that's going to tie together a healthy brain function and losing healthy brain function, especially as we age, so sleep would be the thing I would say you need to make sleep almost like a job for yourself, not in the way of something negative, but like I have to put attention to this, so that I, I, I cultivate a good way, quality sleep, and I know how to get back once I'm from off, for some reason. Sleep is pivotal, and we can dig into that a little bit more.

Turo Virta: 8:58

Yeah, absolutely. Because this is, it's something like I'm, I have been focusing, like, really, sleep is, it's so crucial, it's for my own. If I think, my like you said, it's I might not train every day, but I try to make sure that I get best possible quality sleep every single night, and it's, it's funny, like I don't know, is it just that because I'm more aware of it, but also at the same time, like when you, when I recognize just an example, latter week we had a very hot season, we didn't have any air con, we had like my bedroom was so hot I couldn't feel, or my sleep quality was suffering several nights in a row, and then what happens exactly after one of those nights, I go play tennis, I get insured, and then you feel you have a low energy all the time. Obviously, that's not a surprise, but that injuries happen. It's maybe it's bad luck, maybe there is something else, but somehow I think that there is so much connection between sleep, whatever is happening, and still people like my wife, my nephews, who are younger, like they are laughing at me. That's why I go, old man is going to sleep at 10pm like every single day. It doesn't matter if it's weekend or something, that's why you don't stay long, as I know that this is, it's important for me. I wait a little bit, maybe when you are 15, you maybe don't recognize it that much, but wait once you get your 40s, 50s, or even above, and it starts to make such a big difference. And I'm more than happy to go back to that topic a bit later.

Unknown: 10:48

Yeah, I 100% agree with you, and I'm in the past, the 40 past, I'm in the now the 60s. So I also try to arrange my sleep to get to bed earlier, because I also, well, this is not the right one, but I have a Garmin that I sleep with. My wife uses an oral ring, which I recommend for ladies, an oral ring or Fitbit, because. Because they have better women's algorithms, right. You know this for their health, but I watch every night this, not in an obsessive way, because I like to see what is my sleep architecture look like, right. I look to see, did I have enough REM, did I have enough deep sleep, how much was I awake, what was the length of time, how long it took me to fall asleep, and these measurements then relate to my HRV, my ability of my nervous system to handle what I want to do that day, and so these are really vital things, and I agree with you. I, you know, younger people tend to be up later, we know that, right? We probably were as well. Teenagers, that doesn't mean that's healthier for them, because we work with a lot of young people here, and often I will have them, for a short period of time, look at their sleep architecture for me, and I'll look at it on their phone if they're using some wearable device, and it's in a word, terrible, and so they may be doing that, and they may be a little more resilient, but maybe not so, because we see a lot of anxiety, a lot of depression, a lot of issues with them, and so sleep is pivotal, you know, and so our sleep process is going to help us process the emotions of the day in REM sleep, which is theta brain waves, and our deep sleep is going to be in our delta wave, which helps our body to recover, and the third thing I would say is that the glymphatic system is really going to be cleansing, to a degree, some of the metabolic toxins from the brain. So, if we don't have these things in order, it's one of the first places we talk with all of the ladies that come to us, and men, more ladies, actually, but we'll talk with them about sleep re-regulation and helping them to get on board with that.

Turo Virta: 12:53

Yeah, no, it's.. it's.. I had a couple very interesting podcast episodes about sleep, and exactly about Archie HRV with other guests and doctors and sleep specialists, and it's so interesting, like, obviously, like you said, that it's so important to track, or to be aware at some point what. How is your sleep? Obviously, not to get too obsessed with those trackable things, because you know they are not always 100% accurate, but you get the point, if you use any data, it says that you get a little bit an idea what is actually going on. What are is there some long-term effects, like how it's affecting if you have, if you like. My personal example was now that I, we had a very hot season here in Italy, and and I took, I bought the air conditioner for my, my bedroom, and got cut it down to around 2019 20 degrees, which is obviously eight degrees below it was earlier, and all of a sudden my sleep quality improved a lot, not necessarily how long I was sleeping, but quality, and that changes everything, and it's just a small thing, it's just regulating your sleeping temperature. There could be some other things for somebody, like, you know, maybe if you are having stress PCCs, and it's not all even you try to optimize everything, it's not going to help anyway, or but, or those changes are so small, but if you have a trench and how to use those data, what you are collecting, and then trying to find some kind of small improvements here and there, and it makes such a big difference, especially in the long term, like now, couple nights doesn't probably make that big difference in in a long period of time, but if that continues for weeks, months, or years, or even decades, for some people, you will pay the price at some point.

Unknown: 14:56

Yes, it's true. It's 100% true. We know that there are correlations between long-term deficits, or say dysregulation of sleep, and cognitive decline in older populations. Absolutely, we know that there are correlations between sleep disruption in younger people and mood disorders. Absolutely, so we also have good data so far that disrupted sleep will affect hormone patterns. So now when we talk about hormones, I mean, of course, you and I are affected by hormones and testosterone going down, but ladies, let's say, are probably a bit more affected because they have more, a multiple cascade going on there, and so sleep dysregulation and stress are pivotal to hormone function and to brain function, so all these things we look at a systems approach when it comes to the body, rather than just an individual symptom approach, so again, someone may come in with, let's say, a concussion. You've worked with the women's hockey team, that's got to be very fascinating work. We've worked with people who've had concussions of all types, whether it's sport, auto, or even just had a fall, or children, pediatric, and when. We look at them, one of the questions, or we consider how to help them. How's the sleep? And someone might say, "Well, no, I have problems with headache because of the concussion, or with my visual system, or I feel dizzy. And we want to know,"How's your sleep? Because sleep is going to help them to recover. So it's one of the things we build back into their healthcare, and so that's why I say we look at a systems approach rather than just a symptom approach.

Turo Virta: 16:33

That's very smart. I wanted to talk a little bit like I mentioned at the beginning, when there is something like many people who are listening, probably they already nowadays you know what you supposed to be doing, but you are not doing it, so you know people know that you should move more, you should eat better, maybe sleep more, like we talked, drink more water, but they are still struggling to follow through from a brain perspective. Why does that happen?

Unknown: 17:07

It's a good question, you, you remind me of, as you're talking, you know, we'll say, even in, in the New Testament, in the Bible, Saint Paul says, Why do I do the things I don't want to do, and the things I want to do I don't do, even there we see that all the way back 2000 years, right, but for us today, you know, I was considering this yesterday. There's something called motivation and something called willpower, right? So, we have even some scientific data - we really do - we have data on so many things, it's wonderful, but motivation is like that spark, right? I have a goal I want to do, I'm setting myself, and I have this spark that's the beginning of it, right, but the willpower is what's going to need to be to carry it through to resist temptations of foods or things we don't want to do or not training, and to push through. So it's kind of like the engine, I say. I even made a note here, so I thought it was so good, though the motivation can be affected by things like our emotions, and if we're, you know, that area, but the willpower is more of a finite battery, and this is interesting. It's more like a battery, and so your willpower tends to run down as you push against friction resistance, right? So, as I'm training, who you're training or playing tennis. I love that. That's even more long-term healthcare, playing tennis for a lifetime. But we're pushing against something, we're having to exert a force and energy and a desire to do it. So, at by the end of the day, this tends to diminish, or when we're under a lot of stress, right? We're at work, and we have - we'll call it friction. We're pushing against friction at work, in the sense of not physically, emotionally, psychologically. We're handling things, deadlines. We're trying to keep our - we've prepared our foods, or eating that in a very systematic way, because we want to get to this goal, but it starts to get drained by the end of the day, the willpower, and so that's something we have to realize that I think the largest thing personally, and that has crossed over, and I think maybe you find this as well, what you do for yourself, you start to learn to help other people in your environment, your clients, you try it on yourself, you work with it, or you, you have a breakthrough. Let me, let me impart this to you. One of the things that I've seen is that I'm not as hard on myself as I used to be, right, in training in recovery. So, I'll look at my Garmin, and it says, you know, your recovery last night was like a 65 I'll just use a number out of 100 when it's 7080, 90, and I want to train, but sometime when it's 65 and I want to train, but my body's saying no, I'll just go for a walk, I'll learn to adjust in the moment and to back off, and that will give my even my willpower kind of a chance to recharge itself, so I don't get too harsh with myself. Conversely, I've been in that, that stage of life where it's push, push, push, push, no matter what, and I find that that was not so good, because, like, you had mentioned earlier, with the sleep issue, I get injured, I get injured, or something disrupts that whole ultimate goal, so the willpower is kind of like a battery, we would say that the willpower is more involved with the midline of the brain, the limbic system, your emotional connection to something. You want a glass of water, you're not that thirsty, the willpower is low, the emotional activity is lower. I'm not that thirsty, but okay. But when you're so thirsty that you're, you're dehydrated, your emotional charge to make you move is much higher, so your willpower is higher. So we know that the limbic system, the emotional strip in the middle of the brain, also called the cingulate, is really the driver for willpower, the frontal lobe. And the cingulate, so if our frontal lobe is overstressed from too much work stress at home, whatever it might be, financial stress, and our emotions are low because I'm burned out, our willpower is going to be low too. So we have to take care of these things, and there's ways to do that, and I think we'll probably dig into them, but does that help a little bit in what kind of giving an overview, motivation, willpower? Absolutely,

Turo Virta: 21:34

absolutely. So, when, like, you mentioned those situations when someone is under stress, so what happens in the brain and nervous system under those conditions when somebody is under a chronic stress,

Unknown: 21:50

that's good, that's good. So we can think about the nervous system, right, the brain and the rest of the nervous system, the spinal cord and the peripheral nerves as the operational system, the operating system, like in a computer, and this system has in our body has one that operates at a higher level of production, sympathetic, and one that we can say operates at a lower level of, like, recovery, the parasympathetic, and many people are aware of this, they can Google this, and they can read about it, the sympathetic and parasympathetic, what they do not do, it's not one or none, they're both on simultaneously. Okay, so this is not well understood by a lot of people I have come to know, so they're operating simultaneously, but one will be more in, more involved. So, okay, so let's say right now my sympathetic system is a little more involved. I'm sweating a little bit because I'm excited. My pupils are larger because I'm communicating cognitively with you, and I'm listening, and so my digestion is not really as active, because I'm on the sympathetic side. So, the sympathetic is drive and motivation and activity, right? Exercise, training, high-level thinking. The parasympathetic is rest and digest and recovery and slow down. Okay, so we have these these two systems working simultaneously, the difficulty with stress, which is completely normal. We get, we're under stress day to day, physical, mental, spiritual, psychological, is that we get stuck up here in this sympathetic, and we're going, going, going in this sympathetic system too much, or we like that feeling, and it's not stressful, you know, caused from stress, but we push ourselves there, too much caffeine, too much go, go, go, and drive, you know, that type, we used to call it the type A, we're going too much, you get your system stuck up here, so the loop should be kind of, I'll make it instead of this, these kind of two scales, I'll make it kind of like a loop, sympathetic, and then parasympathetic, sympathetic, parasympathetic. So, what if the sympathetic loop is just like this? We're just going and going and going, and we don't really take the time to allow our body to go parasympathetic. This is also going to create cardiovascular issues that are negative, hypertensive issues, potentially immune suppression issues, and it creates neurologic cortisol function, which is inflammatory, so stress that continues right more than a day, week, two weeks, three weeks, and we're under this chronic, we'll call it chronic stress, is going to increase cortisol levels, increase sympathetic drive activity in the brain and the body, gonna, it's like driving, well, I don't have a Ferrari, but if you had a Ferrari, I'll use an Italian car. If you had a Ferrari, and you're driving it at 120 all the time, it's too much for the system. So that's going to create the frontal lobe disengaging, and what I mean by that is that the frontal lobe is where we can control impulses. Right, I'm driving the car, someone cuts me off, and I, I just go, okay. Well, you know, just let it go, Mike, let it go. Rather than if my frontal lobe disengages, I might be like, I can't believe it. And now I'm steering after them in a way that I'm out of control. So, the frontal lobe is your impulse control. So, if you're under stress for too long and you're in that sympathetic state chronically, and your cortisol is going off the off the chart. Your frontal lobe is going to disengage, and you're going to lose impulse control on some level. So, now maybe you're going to eat the thing you don't want to eat, or you're going to say the thing you don't want to say, or you're going to not have the willpower, which we just talked about, to carry out what you actually want to do, that's the problem with chronic stress, and not having an outlet to discharge it from your brain and your body.

Turo Virta: 25:34

Yeah, and it was my next question, was what you kind of follow a little bit touched with your answer, that how does then that stress affect decision making and self control? Like,

Unknown: 25:47

yeah, it's not going to be good. You're going to lose impulse control. So, when we have people that come to us, we're going to check the areas of their brain that control impulse control, and it's mostly called, pardon me, the dorsolateral prefrontal cortex in an area right out here on the lateral side, and so we do an exercise with. Which is very interesting. We have very specialized goggles that they put on. I wish I could show you here that we can analyze eye movements very precisely. And in analyzing eye movements, we understand things about their brain. The eyes tell us about the brain. So, and of course, you know this, working with the hockey team, I imagine with concussion or potential, they're going to look at eye movements. This is a standard of care, so we're analyzing their eyes, and they're going to see a target in the middle, which is quite interesting. This is called an anti-saccad task. Saccades are fast eye movements, and an anti-saccad is to check the impulse control mechanism of the brain. Isn't that something we can actually test it? So we have a.in the middle, they'll look at it, and the command is, "Look at the dot. When the dot disappears, it'll show up either on the right or the left. Don't look at where it shows up, and I can see how many errors they make, right? And based on the errors, I can tell them, "Oh, the right dorsolateral prefrontal cortex is not working, or the left is not working, or they're both in an inhibited state, so why is this conversation helpful? Stress will decrease your frontal lobe activity, decrease your, your control over impulses, which would affect many things in your life, potentially, but we can now determine right or left, or both. How do we actually train them to get stronger. Yes, we want to help lower some of the stress levels. Yes, we might want to alter nutrition in the diet and sleep patterns, but can we exercise those areas to increase your impulse control? And I'm going to tell you, in a word, the answer is yes, you can. We can strengthen them, isn't that something

Turo Virta: 27:48

that's amazing, and it is. It is. This is something like this is so exciting stuff, especially for me, and I hope for listeners, also like, because in my coaching, like, I see this all the time, that someone has a plan, for example, in the morning, that you know you have planned your day ahead, you, you have good intention to work out, eat healthy, but by the evening stress takes over and the plan disappears. So, what is happening there?

Unknown: 28:19

Well, I mean, could be many things, right? It could be many, many things, but let's, let's pick on a few. As we said, we'll go back to our example, the willpower, so fatigue is going to come in, fatigue mentally, fatigue will come in, so as the mental fatigue comes in, the ability of this willpower to sustain the things I need to do, like you said, for the goal, whatever it might be, is diminished, and now I start making some bad choices, or not such good choices, for what I want to achieve, so mental fatigue, psychological fatigue. So, I think we need to identify that with a person first. Where, where do we feel that the person is dealing with the friction in their life that's lowering their battery? Is it my work? My work is so stressful. You've heard that. I've heard that patients come in, you know they're having problems, but their work is tremendously stressful, stressful, but they cannot just quit their job. Okay, so we need to learn about that, or they might say, my relationship, my relationship is terribly stressful, and we know that we have people in our family that even have struggled with things like that. So, is it interpersonal, is it work, and maybe that's financial, is it children, you know, issues with other family members that create so much stress. So, what can we do in all those cases? Well, we may want to look at helping them to have a coping mechanism that works with the brain. So, I'll give you my personal example, and one I've given to really hundreds of patients for a number of years, and I like to train hard. I have a background in American football, soccer, and track and field, decathlon, and so forth. So, I had a lot of training background in my life, physical training, and I like fast training. I like to sprint on the track. I like 200 meters, you know. I like fast-paced activity and strength, but my wife was asking me, 'Come to the yoga class with me, come to do yoga with me, and it was hot yoga. I'm not so sure. We live in Miami, right? So your hot summer is our hot, like, all the time. I'm not so sure if I want to do yoga. It's slower, it's, you know, etc. etc. I had my concept. Well, the first time I went, I felt when that class was over, this is what I thought inside. This is what I need to do. This is the thing I need to do, because it calmed my nervous system down so much, Dodo. I couldn't believe how calm I was internally. I enjoy running and sprinting and training and jumping and all these different things, but that calmed my nervous system more than anything I ever did. Everything else I was going towards fatigue and feeling. Like, oh, I'm really relaxed. That means no, I was fatigued, but this one brought me mental calmness, which was neurologic. So, I think I would have to recommend for people in a coping mechanism many times yoga positions and yoga. I'm not too involved in the other practices of yoga. There's many different forms and styles and flows and different language on it's not my area of expertise, but I would say because we know how that works on areas in the brain, the limbic system, the amygdala, it really can lower the threshold when we're dealing with stress, so it could be many types of training, but that one in particular can be very effective.

Turo Virta: 31:50

Wow, no, it makes so much sense. Like, at the.. to have something in yoga is.. I personally, I think I have tried it once or twice, and I, for me, I didn't enjoy it. Like, I'm probably the same kind of person as you, and I didn't give it chance more often, but at this point, like, for me, that calming activity is just simply walking and talking with my wife, that is for me what gets me, my nervous system to go down, and, and that is, but I guess that that is for every individual is is a different, and definitely, for someone like, probably like, what it's not what you enjoy the most, but what you, what your brain actually needs, and that is

Unknown: 32:36

correct. Yeah,

Turo Virta: 32:36

that is. I agree

Unknown: 32:37

with you, though. Walking with my wife, that is a very calming activity for me, and it's helpful. It's a different, different time of my life, where I'm going for. I never was walking, but it's pleasant to walk with her and talk like you said. I agree with this 100% Yeah, I believe you have to find the right way. So, offering different ways for people and experiences, they might go, 'Hm, I might give that a try. And I do some yoga periodically in my house, maybe once a week or every other week. I do it. I have a mat. It's not quite the same as being in that hot room, though. There's something different about that, the heat of it, and the, of course, the breathing patterns, and the struggle that I was pushing to. There was friction, quote, involved with it, because it was things I'm not familiar with. So, this, this had a great value, and so does walking, so does being out. I wish I could be out in the mountains, like where you are, that would be beautiful.

Turo Virta: 33:32

Yeah, no, it is. It is, and there is other thing in addition, like if you want to, you are, we are lucky to be living a place, various mountains, it's a beautiful place. So, it's kind of, there are so many other benefits with that activity, so then I wanted to talk a little bit about that brain fog, because it's something that so many people talk about, especially women over 40. So, first of all, What is brain fog from your perspective?

Unknown: 34:05

So, yeah, I want to let me ask you first, so you, you hear this from a lot of ladies in that, that middle age area, for you know, yeah,

Turo Virta: 34:13

it's it's pretty common, like in, like it's usually related with with the menopause or after 40s,

Unknown: 34:24

yeah, I would say that's what I had written down here is that it's primarily thought to be among the ladies that we work with in that age group, and my wife does a lot of coaching as well with ladies in that age group, that its first thought is it's hormones, right, they're in an age when the hormones are shifting, it's hormones, and it can very well be involved with hormones, 100% agree, so we want to consider that and look at that, because as estrogen drops and testosterone, ladies, as estrogen and testosterone drop, especially the estrogen, the brain tends to have an easier inflammatory process going on, so you know, a little bit of a headache might be more of a headache, a little bit of fatigue might be more fatigue, so estrogen protects from inflammation in the brain in ladies, but the hormones are something to consider. And, as I said, we were a systems-based approach, a brain-based approach. So, we're going to consider their hormones, and we're going to look at that. Also, of course, if we're going to look at their hormones, we're going to look at what is their diet like, and then, of course, what is their lifestyle and their sleep patterns, but when we talk about brain fog, and we just take that to the side, because all of those things I just mentioned could contribute to brain fog, hormones, sleep disruption, and your diet, 100% can contribute to this brain fog condition. So, brain fog can be described in a number of different ways, and it is in the literature. There's a cloudiness- someone feels like there's a film over their, their frontal area, their eyes - they just disconnected from what's going on, not sharp, not sharp, not clear. Feel like, is it fatigue, is it dizziness? Some people. Even feel like it's a little bit of unsteady dizziness in their head, so there's a lot of ways to describe it. Yet brain fog, we'll call it - it's like an umbrella. So, in order to dissect it, we have to look at different things in the lifestyle and in the brain function. So, we might say, and my wife says this very well, like the hardware and the software in a way, and we're just going to call the software the things in your life. We're going to call that the hardware, is what we look at. We're looking at how is the frontal lobe functioning. So, we're going to look at things like reaction times of the eyes, reaction times of the hands, because reaction time has a lot to do with your frontal lobe, and we're going to look at impulse control, like I mentioned before, that's the frontal lobe, and so one way we can go about doing that is through the eye movements, right? And so eye movement testing can tell us about is it frontal lobe, what else could that be going on with the brain stem, that's the autonomic center, the brain stem is where we control so many different things, like our neuro neurochemistry. So, are the neurotransmitters low? Because people will come in with brain fog, and they're, they're trying different vitamins and supplements, and some of them are trying to optimize their hormones, but they're not looking at the hardware. So, if I came to you to train, and I said, Doo, do I want to, I want to lose body fat, and I want to increase muscle. You wouldn't just say to me, 'I don't believe, drink, drink this protein shake. Wait, don't you want me to work out? No, no, just drink the protein shake. No, no, no. We have to go in, and we have to fire those systems, so that they will develop strength and capacity, and grow potentially, and maybe shed fat, as an example. So, in the brain, it's very similar. Determine what the source of brain fog is. Is it disrupted brain waves? We do that with an EEG. Is it areas of the brain that are not firing properly? We do that through eye tracking and other testing, vestibular testing in a very unique chair. And I want to invite you. If you ever make it to Miami, first of all, you're going to come to dinner at our house, but second of all, I want you to see these, the technology, because this is the most cutting-edge technology for understanding brain function and to rehabilitate it. So it's a more complex question about brain fog than is given a simple answer, because I would say anyone who gives a simple answer for that is making it too easy. It requires a proper evaluation of where in the brain and where in the lifestyle it might be emanating from. Right, is it inflammatory? Is it is it metabolic? Right, you could have low iron and have brain fog, and someone else, it could be hormonal imbalance, and it's brain fog, and it's brain fog. Someone else could have had a concussion, their hormones are fine, or maybe they didn't have a concussion, but they've impacted their head a few times through their life, and they have brain fog. Someone else, it might be from post infection or vaccine that they developed brain fog that they never had before, so we have different causations, and so we have to look at things very carefully. I'm very much a proponent of understanding why a person has it, rather than, oh, just give me the pill or the portion of the vitamin, but why do you have that right? Why do you have ADHD? What's going on in your brain? Why do you have depression? What's happening in the brain, and we have the tools to really look at it in a way that's different, and that can help us sometimes find something that someone else didn't see, because they're not using that kind of, it's a different, a different view, right, a different bias. So, instead of using this kind of glasses, I'm using this kind of glasses, so that it doesn't make me better. Special, I just been very fortunate to train with some very insightful people that think outside the box. Yeah, and that has helped me look at things from a different view.

Turo Virta: 40:02

Oh, there's.. it's so well said, like, like you said, I love that, because it's, it's often now when you talk with someone, like, you say this is the solution, here is a pill, you take it, okay, it might help for that moment, but thinking, like, like you said, outside of the box, going behind what is causing those things, because it's not the goal, it's not that you get the symptoms away for a week or month, and then they come again, so you really need to go deeper and understanding that where it is coming from, and then once you find that fix, how to actually train, because there are, like you said, I believe I would love to visit there and see what is all possible, and then once you get that kind of that long term solution, it's same thing with the weight loss or fat loss, you know, it's not, it's not hard thing, like as many women, I believe they have experiences like that with the weight loss, that you know, you just eat as little as you can and try to train as hard as you or as much as you. Can, and you will get some long, short-term results, but it's not gonna - they are not gonna last forever. But instead, if you find actually a way, what actually works in the long term, then it's not only about finding solution for this moment, but actually to be able to maintain it for also longer. So,

Unknown: 41:27

yes,

Turo Virta: 41:28

we What is, because there are like, we talked a lot about brain and nervous system, and is there an also like recovery from those things? Is there some signs what you would say that that now brain and nervous system need more recovery?

Unknown: 41:47

Yeah, yeah, I mean, HRV is one of the best HRV, and I use that again with my, my wearable Garmin, but Fitbit and Aura Ring gives you an idea of your HRV, and then doing things to improve your HRV, so what lowers, and what is HRV? Let's just kind of help the person who doesn't understand, you know, as our heart beats, and we have that beat in between each beat, is called the HRV, and what it is a measure of, in a very simple sense, is how resilient is your body right now. Let me say it a different way. When we have not slept well, like you said, with the very high heat that was there, and you're not sleeping well, maybe you have a little bit of illness, and you're not sleeping well. You feel like, oh, I don't feel very resilient, I'm weak, so to speak. This is probably because your HRV is going down. So many things impact our ability to have resilience in our autonomic nervous system, and that's our ability to respond to a lot of things, like we said, the sympathetic parasympathetic, the autonomic system of your nervous system, which is the kind of the automatic system. So, the HRV is a brief measurement of how well your autonomic nervous system is reacting and responding and telling you how much resilience you have. So, if your HRV is low, you probably don't want to train that day. If your HRV is low, you might want to figure out what happened over the past few days or yesterday that maybe is lowering my HRV, and how do I start to improve my HRV? Breathing is one of the key ways. So, any kind of box breathing, there's different methods of methodologies of breathing and helping to improve vagal nerve function, so the vagus nerve is well, it's not in the neck, it's in the brain stem, but we do vagal stimulation many times through the neck. Some people do it through the ear, there's different reasons for different branch that comes out, but the vagal nerve system, or the vagal complex, is the system that helps to bring in parasympathetic. It also lowers systemic inflammation. It also affects the brain stem, the autonomic center, so that it affects neurotransmitters. So we

have so many beneficial effects: 43:58

gut health, calming to the body. There's studies going on with PTSD, and how people might improve with that, sleep issues, so we use vagal stimulation, so breathing would improve vagal activity, and this would help your heart, your HRV to start to recover, and also managing your sleep. Alcohol is a big thing. Alcohol is definitely going to disrupt sleep mechanisms, your REM sleep, it's going to lower HRV and recovery, and so this is important as well. So, the question was, what the question was, but HRV is really a crucial measure for people to know how their day-to-day function is, and they can do things to hack that. One other way that we have people do things at home for their vagal system, vagus nerve system, if they don't have a device to do that in the states, you can buy these devices that are cleared, FDA cleared, so people can use them on themselves, but going in the shower, if you have enough water pressure, not too much, but if you have enough water pressure, letting the water hit you in the back of the throat, and gargling it out, you know, gargling is good for the vagal system, but it's not strong enough, necessarily. But if you, if you, if your neck is okay, and you could do that, and the water can get in here, and you can gargle the water out, because it's messy, right? The water is everywhere, that's a very strong stimulus for the back of the throat, the pharynx, and that will activate that vagal system, or you could sing. So, I'm not sure how good your voice is. No, not so good,

Turo Virta: 45:35

mine, either.

Unknown: 45:38

So, these kinds of activities that really strongly affect the back of the throat can help the vagal system, which would potentially help the HRV function better.

Turo Virta: 45:48

Yeah, so it's the question was like, but you kind of answered that. What was the some signs that the brain and nervous system need more recovery, and it's the arts HRV looking at that data, and then you already mentioned in. How to actually get it, or at least have some tools to how to improve it. You also mentioned about alcohol, so why, in your opinion, people reach for food, alcohol, scrolling, or other habits when they feel overloaded? It

Unknown: 46:28

gives them, you know, it's what we connect things to, right? I know that when we have a meal, you know, a glass of wine, nice glass of wine, it's kind of like it all kind of fits together, but sometimes we're going to these things to is a coping mechanism for stress, the stress we feel reality, right? So every day we come home, okay? We have the drink, or we get on the phone, and we start scrolling. Now, one is more chemical, of course, right? The other one, you say, 'Well, that's not chemical. Scrolling through the phone, vertical scrolling. This is quite interesting. So we have vertical eye movements, and we have horizontal eye movements, and they activate different areas of the brainstem. The vertical eye movements activate higher up, and they activate the area that is involved with dopamine production. The horizontal eye movements are involved little lower, the control involved with serotonin. So, anyone who knows a bit about dopamine realizes that if you activate dopamine over and over and over, it's going to create a loop, which we can consider addictive. So, the constant or chronic vertical scrolling - I'm not talking about for a couple of minutes - I'm talking about, like, we see a person, we look at their screen time, and you know, one of these young people that we were six hours a day, and I know they're not on emails because they're 14 years old and they're not in their work, right? They're scrolling and scrolling, and it's driving vertical eye movements, and it's driving the dopamine pathways, and they say, my child has attention deficit hyperactivity disorder. I say maybe, but maybe not, because you're driving the pathway that's driving inattention, that's a problem. So this was actually something that came to my attention some years ago. There is a television show in the United States that's like a news show where they reveal different insights, journalism, and this show was about social media addiction. Now this is going back 10 years, and they talked about a tech company in California that was building algorithms with neuroscientists for the tech companies, and it was called Dopamine Labs, and so I think this person might have been like what we call a whistleblower, where they were saying we were doing that, knowing that it was driving dopaminergic pathways in the brain, which does create addictive behaviors going back and forth, so a lot of times we get into it for a little relaxation, it's like me, me, in the past we would flip open a magazine at the end of the day, right. So now we're going on the phone. I don't think we're going to stop that, but realizing that there are algorithms that are designed to keep our brain engaging, there is not really relaxing our brain the way we would think, right. It's more, we might be a little mindless, you might look on recipes and things, so it might be even productive, but walking outside to your point earlier and having divergence in your eyes rather than convergence on your phone is actually lowering the threshold of stress in the brain, divergence of the eyes rather than convergence, convergence increases activity, vertical scrolling increases activity. So, if you're stressed, you might feel, and I'm not going to deny it, more relaxed scrolling for two hours, but I can tell your brain is going to relax if you go outside and move and open your eyes up 100% There's data to prove that.

Turo Virta: 50:05

Yeah. No, and it, this is such a great example and explanation. Thank you so much for explaining it so well. Like, what is the difference? Because there are so many people who just kind of switch off and use phone of doing it, you might get that kind of feeling that it's relaxing, you don't do anything, but like you said, that those algorithms, they are trained people, they get, they are, they don't get, they are not, they don't care. Their only goal is to keep you in that app, whatever you are looking, if you are playing, or you are watching some social media channels, their goal is, they don't give you information what you need, they give you information that keeps your attention, that you keep doing it more, so they can show you more ads, or whatever. This, that's the way how they get date, is that longer you are spending, or more time you are spending in that app, whatever you are using, better it is for their business, and and that is the ultimate goal, and not to give you the pay. Possible recipes or or useful stuff. What you can use, obviously, you will see that also, but, but most of the time they, and they probably.. it's, it's actually scary from, in my point of view. How good those algorithms are, they know you better than probably you know yourself.

Unknown: 51:25

Oh yeah, they're very aware of all the different behaviors that we have, because these neuroscientists are working with them, and I ended up calling Dopamine Labs after that show I watched. I just said, "Let me just call there, and someone answered the phone, and I talked to them. It was quite interesting.

Turo Virta: 51:41

So, is can the brain then learn to use food or alcohol essence of sweets,

Unknown: 51:50

as a what

Turo Virta: 51:51

of sweets, like that, you know, when you come, like what I hear, like you know, you come after a stressful day, you are having a glass of wine or two or bottle or whatever, or some food, is it is it possible for brain to learn to use it as an off switch, like that, you know, you get kind of in that relaxation state.

Unknown: 52:15

I think that probably that's that's a correct statement, as use it as an off switch. Yes, I would say yes, it's probably not the healthiest, though it's not the healthiest off switch to no, absolutely

Turo Virta: 52:31

not right

Unknown: 52:32

within a margin. If I come home and my habit is to at the end of the day, I say, okay, I'm going to have three ounces, four ounces of wine, and then I'm going to have some olives, or I'm going to have some avocado, or I'm going to have some sardines, or I'm going to, you know, this is very different than chips, right? Chips and two glasses of wine of six ounces, eight ounces. This is very different, these two behaviors. So, there's, there's, you know, that, that sound, I prefer the other one, but we don't always have those things in our, in our home. But I think that we have to, I think, what you're saying is having the awareness about it, and realizing probably not the ideal thing, is the first start. And then trying to do, I like this, the language my wife uses, swaps. What are swaps? We can do, and I know in the past she's done something we don't drink too much, as we enjoy a glass of wine, and but I know she's mentioned to people having a, like, a mocktail. If they were someone who drinks a cocktail, do a mocktail, and there's some different types of companies that make things that help have, like, a CBD in it, or something. This, that helps to lower some of the stress level in the system, and it's more healthful, right? So, there's different things like that that might be a swap that could be a helpful way to also tell your brain this is an off switch, also

Turo Virta: 53:54

that's a very well said. So then I want to talk a little bit about exercising and how Nico's like I'm asking for myself and for many other people I work with, so how should someone think about exercise when they feel stressed, tired, or mentally overloaded?

Unknown: 54:16

Well, you gave the answer to that earlier, and that is adapting your workout. You didn't say it this way, but the walking with your wife, so being flexible is really crucial, having a flexible mentality. Now, I've been training, probably like yourself, I've been working out training since I was 13 or 14 years old, and I'm 62 almost 63 So, I have a lot of experience, and where I've come to experience now, or in my experiences, being more flexible with myself and doing different things, they used to call it cross training some years ago, but I do different things. I walk the other day, I did some easy jogging at the park, and then I, I mean, I'm in my workout today with weights, and I'm doing a little yoga, and so it's I'm adjusting based on my HRV, and how I'm not just how do I feel today, but how am I feeling, and what's my schedule? My day today, I have a lot of things on my plate, and my HRV. Okay, I'm going to adjust down. Maybe I'll just go for a walk, maybe I'll just do the walk today. Even though I had planned this, I'm going to adjust. I feel like being flexible with yourself and being strong with yourself sometimes is good, finding the way, maybe that's more years of maturity, but I don't know, it's something someone can hear from us and say, ah, I don't have to beat myself to death, I can be flexible,

Turo Virta: 55:40

yeah, no, because that is, that is, it's so true, like what you said, I try to do it, it's not always working, like I'm kind of more person who need to do something, regardless of, like, of course, if I feel like that, okay, today is maybe like I'm tired, I didn't sleep well, or my recovery is not there, then I understand to take it easier, but when, in your opinion, is exercise helpful for the nervous system, and when. It, when can it become another stressor? Because this is, I feel like that this is the hardest thing to do, like that. You know, you should, you know, that you should exercise, but on the other hand, you should also put, get your nervous system down and your stress down. So, and you don't want to, that exercise should be like relieving stress and not creating even more stress.

Unknown: 56:30

I think if a person doesn't have any measurements, I think they're running, they're flying blind, right? If they have no measurements, like, okay, yeah, I don't know if I'm pushing too hard or I should, okay, get a, get some kind of wearable device, something, a Fitbit, an aura ring, get a Garmin watch, get the lower cost, get something where you can get some data. You must have data. We are notoriously, and this is based on data, poor judges of our sleep and fitness. Many times now, sometimes we over, like, oh no, I'm great, no, but personally, they've done studies, especially with sleep, and people are very poor in analyzing their sleep metrics and latency, and these things, so it crosses over into fitness as well, where just get a wearable device, and you won't start to know, are you really over training, or are you not? Other than that, you're going by your feeling, and feelings many times can be, as you know, very, very flexible, not flexible, very untrustworthy, right? I don't feel like working out. How many times in all these years have I not felt like working out? More than I can count. And I worked out, so we have our feeling, we acknowledge our feeling. Okay, this is how I'm feeling. What's my goal? What are my numbers? And if your numbers are saying maybe you shouldn't today, then then then opt for an easier. So we learn about ourselves. We're studying ourselves physiologically. We're starting to use the tools we have that are inexpensive and non-invasive and get the best out of our brain and body.

Turo Virta: 58:10

Yeah, that's it's it's complete topic, and I think we could go even longer, but I wanted to still ask you about what you mentioned earlier about breathing exercises, and I was like giving some kind of practical tools and our breathing exercise is useful from a neurological perspective.

Unknown: 58:33

Yes, very much so. I mean, our respiratory system is intricately linked the control to the brainstem, so we have these respiratory centers in the brainstem, and so when we're training it, we're actually synchronizing. There's many things that synchronize with breath, blood flow synchronizes with breath, heartbeat, right? So we have a lot of this cardiovascular aspect of our survival is linked to breath. Now, the oxygenation of our system, of course, we use hyperbaric oxygen therapy in our clinic here as well, but my wife is actually very more expert than I am in helping people train people with their breathing. She practices that more regularly than I do. I need to practice that more. The last time I went out with a friend of mine who's a trainer for tactical pistol shooting, he says you need to learn how to breathe better. You don't relax when you're shooting. I get to, so he's like, he stops everything, and I put down the firearm, and and we do some breathing exercises. See how important it is, right, to calm the nervous system, because it's a, it's a direct link. So we talked about sleep being every day, breathing is every minute, right, even our eating is not every minute or drinking, but breathing is every minute linked to everything about you as a human being, and your brain, and your nervous system. So, breathing is crucial. Oxygen to the brain is vital for proper thinking, for oxygenating the brain. The brain runs on, you know, carbohydrates, blood sugar, and oxygen. You lose those two, or you don't have enough of those two, or not the right quality, you're going to have problems with the way your brain functions. And to go back to sleep and breathing, sleep, many, many people snore. I tend to snore. So, a number of years ago, and I don't have sleep apnea, it's not that severe, but I do have, I snore, so I went some years ago, and I read about mouth taping, and I started to do it, and it was a game changer, game changer. So, ladies who might be listening to your podcast, if their husbands snore, buy them some mouth tape, because it's actually better for their brain that they wouldn't snore, because they're probably lowering their oxygen threshold levels in their brain as they do that, or of course, if they have sleep apnea, but this is very important, see, so even in sleep I'm trying to stay properly oxygenated and my breathing, so breathing. Thing you can is vital practicing breathing has dramatic effects on many systems. The brain would be probably the foremost because it helps to lower the sympathetic level in the brain, and I actually have a an iPad that has a free app called Breathe, Breathe Plus, or Breathe, and it has a beautiful image on it, where you can set the time, how many, how long you want to inspire, how long you want to hold that, and then how long to expire, and you can set it whatever you want, so you can set it a little lower when you're in the beginning and longer, and it has a beautiful color, and it has a certain instrument sound, so you can choose piano or guitar or cello, and it'll have that sound and hold, and it goes, so if you need a visual feedback to help get into the rhythmic aspect of that. I know my wife uses maybe the Calm app also for that, so she's quite the guide on many of these things for our clients and myself, and I absolutely recommend those for your, your listeners.

Turo Virta: 1:02:06

Yeah, so I, I, I'm exactly same as you, and I, I guess this is giving me also reason to try at least mouth taping, like I don't have sleep apnea, but my wife tend to say that I'm, I snore every once in a while, so that might be, might be, or I will try it, I promise, for you, that's a, that's a great tip. So, then, like you already mentioned about that a little bit, everything. So, how does sunlight movement or time outside affect brain function?

Unknown: 1:02:42

Well, the sunlight we know is very important. Low angle sunlight is very important in the early in the morning and in the afternoon because of the frequency, the wavelength, excuse me, the wavelength of the light, how it affects your retina. So I think it's important to say that the eyes have two functions and the ears have two functions when it comes to the brain. We know that the ears are for hearing, but also your vestibular system in there for coordination of balance, stability of your body, memory, cognition, the vestibular system, the eyes, of course, for vision and seeing, but also setting your circadian rhythm. So this is where light comes in. So, as light comes into the retina, it stimulates activity through the nervous system to set your circadian rhythm or your time clock, so that you can go to bed and you can wake up and go to bed in a proper fashion, like you were saying, and you're training, you're keeping yours trained in that way, and so the light exposure is important, and for people who live in places where they don't have the same light all the time, that level of light, I'm sure the light in your area is beautiful. Some of the most beautiful light, actually, that I've ever experienced seeing was in Florence, Fridenzen. That was the light reflecting, I couldn't believe it, something, everything was like a painting to me, so beautiful, the light there. But to go back, is you can purchase these lights, like, for if you live in the northern area, where you can actually give yourself a degree of healthy light exposure if you don't have it outside, so, but light exposure is vital for the brain function through the eyes and setting the circadian rhythm. We also know that red light, we use a lot of red light and laser therapy for the brain, people use it for their skin, that that red wavelength of light is very important to the mitochondria, so the biology of the whole system, not only the skin but also to the brain. We use transcranial laser therapy, or it's a cold laser, so it doesn't heat up, but that's right through the skull over a period of time that we'd give the dose for the brain, and then movement. We talk about it all the time. There's more research about the brain and movement and exercise than anything else. There's more research on that. So, if you want a healthy brain, you got to move. It's important. You got to move, and if you can't move a lot, and I was thinking of you with this yesterday, I was thinking that even some of our older clients who can't move a lot because they've had some kind of injury or isometric, isometric because it's firing to that system, firing into the brain, so isometric, not moving the joint because maybe it's been injured or it's been repaired, but isometric work can really be helpful.

Turo Virta: 1:05:29

Yeah, that's that's so true. And thank you for pointing it out. So, time is flying. I think I could, I would have like 2030 questions for sure. We would do another hour, but I have to respect our timing. So, last couple questions, what is one? one thing you wish every woman over 40 understood about her brain?

Unknown: 1:05:56

What is the one thing I wish every woman over 40 knew about her brain? I would, I would add to their thinking, because they're going through a very difficult change. That we don't, I mean, we have some andro pause, but it's nothing like ladies' experience. I would say that to start considering or giving them an additional thought, and that is that your brain, with some attention and some evaluation, may operate better, even as you're thinking about hormones and optimizing those, which you should do, and there's ways to do that with the proper clinicians and functional medicine people, but thinking about the brain also, and that would be my hope that they would say, huh, maybe there's ways to evaluate my brain that I could train my brain that would make it stronger, because chemistry doesn't make things well, I shouldn't say that, because some chemistry makes things stronger, right? Like steroids, but generally chemistry for the brain doesn't make it stronger, right? Antidepressants and antianxiety meds and anti-inflammation, they don't make it stronger, they're dealing with a problem, but you can strengthen brain connections, you can strengthen areas even that control your hormones, because your hormones are controlled from the brain down to the ovaries and the adrenals, so there's vital links and connections, so what would I tell them that you can strengthen your brain and there's ways to do that,

Turo Virta: 1:07:23

and then this last question is that what is one daily habit that supports brain health more than people realize.

Unknown: 1:07:33

Well, we did start out by saying sleep, so I will reiterate that, but the other one would be the daily habit. Well, we hit, we hit some of the ones that they have in their, in their back pocket, so to speak. They got to be able to breathe well, got to be able to readjust their sleep, and they may need to get help with that. There's certainly enough out there, I'm sure, in your podcast some of the methodologies you bring forward, and I think the other one is regulate their nervous system. One of the key things for people, this is written by in a book by Dr. Dale Bredesen out of UCLA about reversing Alzheimer's dementia, right? And so many women are concerned with not developing Alzheimer's, which is more common in females, obviously, and so that's a debilitating form of dementia at the most common, and so stress, lowering stress levels, he talks about in your book, or coping mechanisms for stress. So, if we can learn that in our 30s and 40s and 50s, even in our 60s, if a lady can start to learn and develop new ways to have it stack, to put things together that might help them cope with and deal with the effects of stress, they're going to do better longer for their brain.

Turo Virta: 1:08:50

Awesome. So, where people can find you or learn more about your work

Unknown: 1:08:56

in South Florida. Yes, we are available at Bagnell Brain Center. You see it back there, it's probably reversed, but Bagnell Brain Center on the internet, right. So, there's actually some wonderful things people can download there that are complimentary, that they can download a brain map where they can, they can analyze symptoms they have, and it can tell them regions that may be out of balance. That's quite interesting, and they can do that right off the website, but also on social media at Bagnol Brain Center, Instagram, TikTok, etc. etc. Facebook, all those things, depending on your age, but yes, we're available on all these things, Bagno Brain Center, and we're, and YouTube, and really trying to give people understanding about their brain, brain-based healthcare, and what we like to say when we end, my wife and I, our shows, we say let people know with genuine, genuine thought they can heal, and we can help.

Turo Virta: 1:09:49

Awesome, that is so nice from you. And I feel like that you are so passionate with this. So, thank you so much, Michael. I really, really enjoyed this conversation. Learned to cut some practical tips, and I will put all links to show notes. So, thank you so much for sharing all your wisdom, and if people who are listening, please go to check Dr. Pagnils Sciotherapy, his clinic website, social media, reach out to him, and thank you so much for listening. If you enjoyed the conversation, please leave five star reviews. Those are helping so much. So, thank you so much. And talk to you in the next episode.