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Join Australia's leading comic speechmaker, Homer Papantonio, and renowned cardiologist, Dr. Ross Walker, for a podcast that blends humor and health in a way you’ve never heard before. "The Seriously Funny Wellbeing Podcast" delivers top-notch insights on wellness and well-being with a satirical twist. Get ready to laugh, learn, and live better—it's not for the faint-hearted!
Homer Papantonio (00:01.961)
Welcome people from all over the globe to our very special, seriously funny, wellbeing podcast number 14. This episode's subject is on medical checkups and screenings and with me as always is one of the world's foremost preventative health experts, Dr Ross Walker. Ross, great to be with you. You are busy, still keep...
Ross Walker (00:23.375)
Always busy, mate. Always healing the damn sick. They're always there to be healed.
Homer Papantonio (00:30.507)
So any mediocre humor to kick off this session in the light that you aren't as funny as me.
Ross Walker (00:34.549)
yeah, look, I was thinking of starting a new business, Homer, where I want to actually develop a company that makes coffins and condoms. And the slogan's going to be, we've got you covered whether you're coming or going.
Homer Papantonio (00:38.74)
Yeah.
Homer Papantonio (00:51.987)
Good one, I like that one. Okay, so let's kick off this session with an explanation to our listeners on some medical terms. Ross, you are like the, and many of the listeners have made this observation, you are like the quintessential human medical encyclopedia and you have the potential to comprehensively bamboozle people with some of the medical terms you use. And notwithstanding, I speak three or four languages, I too.
get bamboozled occasionally. So in my relentless pursuit to make you understood to our listeners, here are some popular basic medical terms and what they mean next to them. So here it goes. Artery, the study of fine paintings. Bacteria, back door to cafeteria. Barium, what doctors do when patients die. Cat scan, searching for sc-
Ross Walker (01:37.293)
Yes.
Ross Walker (01:41.666)
Nah, jeez.
Ross Walker (01:46.382)
you
Homer Papantonio (01:49.567)
for Kitty. Cauterize made eye contact with her. Coma a punctuation mark. D &C where Washington is. Enema not a friend. ER the thing on your head that you hear with. Fester quicker than someone else. Jeans, blue denim slacks. GI series, World Series of Military Baseball.
Hemorrhoid, a male from outer space.
Ross Walker (02:21.834)
jeez.
Homer Papantonio (02:23.175)
Impotent, distinguished, well-known medical staff for Drs Kane, morbid, a higher offer than I bid Nitrates, cheaper than day rates Organ transplant, what you do to your piano when you move Outpatient, a person who has fainted Pap smear, making fat fun of dad
Ross Walker (02:31.689)
gee.
Ross Walker (02:35.88)
yeah. Yep.
Ross Walker (02:41.6)
Right.
Ross Walker (02:49.855)
God.
Homer Papantonio (02:50.485)
Pathological, a reasonable way to go. Pharmacist, person who makes a living dealing in agriculture. We're almost there. Palvis, second cousin to Elvis. Post-operative, a letter carrier. Recovery room, place to do upholstery. Rectum, almost killed him. Red blood count, Dracula, secretion, hiding something.
Ross Walker (02:58.435)
Thank God.
Ross Walker (03:02.926)
Much.
Homer Papantonio (03:20.433)
seizure, Roman Emperor, terminal illness, getting sick at the airport, thorax, a Dr. Seuss character, triple bypass, better than a quarterback sneak, tumor, more than one, an extra pair of ericus, nearby, blah blah blah. You know, they were ecstatic and by your reaction, I can see you were over the moon.
Ross Walker (03:44.218)
yeah, over the moon I just had to go off and get a strong coffee to wake me up. But anyhow, that's alright, that's fine. Keep going. I digress.
Homer Papantonio (03:50.027)
So we've got this one as a lead in to this session. surgeon, an internist, a psychiatrist and a pathologist go duck hunting. Do know what ducks are? I do a great duck impersonation. I do a very good duck impersonation. I've entertained my grandkids and many infants, even corporate audiences, with my duck impersonation. Especially with the sneeze when you go...
Ross Walker (04:02.862)
Yeah, I do, I do.
Ross Walker (04:07.95)
Very good. I won't try.
Homer Papantonio (04:20.611)
They find that funny for some reason. here, two ducks fly by and the internist takes aim then puts a gun down and says, I think we need some further investigations. I'm not sure those were actually ducks. A few moments later another swarm of ducks fly over their head. The psychiatrist takes aim then puts the gun down and says those definitely look like ducks, but how do they feel about themselves?
Ross Walker (04:22.296)
Mm-mm.
Homer Papantonio (04:50.611)
A few moments later a huge swarm of birds fly by. The surgeon takes aim and starts blindly firing into the swarm in a storm of blood and feathers as several birds go down. As he puts down his gun he turns to the pathologist and says, can you go and look whether I got some ducks.
Ross Walker (05:14.383)
Hmm. Yeah, yeah, that's...
Homer Papantonio (05:16.611)
pretty ordinary punchlines and that's what they call a joke that should bomb out normally because there's all that preamble and then the punchline is quite mediocre. So let's get on to medical news Ross. Multiple surgeries and cognitive decline.
Ross Walker (05:18.382)
extremely.
Yeah, yeah, yeah, well I...
Ross Walker (05:29.251)
Yeah, yeah, and even the preamble was pretty mediocre, I've got to say, but anyhow, there we go. Let's do that.
Ross Walker (05:41.975)
Yep, yeah, this is a really interesting study that was done. Where was it done? I'm just trying to figure out exactly when this was done. I've had too many surgeries. No, I'm just getting to the page where it was done. No, no, no, no, it was actually an Australian study and basically the University of Sydney, but from data from a thing called the UK...
Homer Papantonio (05:50.857)
Just make up, make up somewhere. Did it come out of Athens or Italy or Zagreb or...
Homer Papantonio (06:03.221)
Hmm?
Ross Walker (06:10.435)
Biobank. Now the UK Biobank is this wealth of data from about 500,000 people where they've looked at all aspects of their lifestyle, what they eat, what their blood's doing, all these genetic markers, et cetera, et cetera, et cetera. And they took people between the ages of 40 to 70 with a follow-up for 20 years, did brain scans on them, do cognitive testing, and they found that the more surgeries people have over the age of 65,
the worse they score on cognitive testing and the more brain scans demonstrate loss of brain volume, brain function. So the message here is pretty simple. This is from just under 47,000 people, by the way, so very extensive studies. The message is, and I say this all the time to my patients, over the age of 65, make sure the anesthetic is absolutely vital. So reserve your general anesthesia
Homer Papantonio (07:05.077)
Yes.
Ross Walker (07:08.185)
for things that are really important. So I'll give you one great example. In my own field in cardiology, there's a very common condition called atrial fibrillation where the heart beats all over the shop. And we have a technique called atrial fibrillation ablation where you're going through the vein in the groin up into the heart. It's a very intricate procedure, but it's a three hour general anesthetic. Now I think it's a legitimate.
thing to do for a young and someone under the age of 65. But when you get over the age of 65, a three hour general anesthetic that isn't vitally necessary when you do have the alternative of being on chronic pharmaceutical therapy, that's the one I'd go for in that situation. So there are times, for example, knee replacements, hip replacements, bypass surgery, neurosurgery, gastrointestinal surgeries for major cancers or whatever, those things are vital.
if people are in agony from their knee pain or whatever. But don't go and have cosmetic procedures over the age of 65 and don't go and have procedures where there are medical alternatives. That's the message.
Homer Papantonio (08:14.699)
So there's a connection between cognitive decline and frequency of anesthesia.
Ross Walker (08:22.402)
frequency and length of anesthesia. OK?
Homer Papantonio (08:26.085)
And what about the equation if you're fitter do you tolerate that more?
Ross Walker (08:32.661)
look, I'm sure that's the same with every condition. If you're fitter, if you're fitter and you're not carrying a lot of weight, you tolerate many things better. So yes, there is a correlation there, but it's not always true. What it's saying is across the board, the more anesthesia you have, the more risk. It's not a definite thing, but the more risk there is for cognitive decline. So all I'm saying is,
Homer Papantonio (08:35.519)
Yeah. Yeah.
Homer Papantonio (08:41.93)
Yeah, yeah.
Homer Papantonio (08:53.983)
Yeah.
Homer Papantonio (08:57.451)
Okay.
Ross Walker (08:58.959)
Always ask the right questions, always seek a second opinion if you've got a condition that may require surgery, especially if that surgery is long.
Homer Papantonio (09:08.381)
Okay, future of medicine, low cost portable device to detect cancers. That's a real important one, isn't it?
Ross Walker (09:18.659)
Yeah, this is an interesting one, you see, because for years a lot of the ways of detecting cancers have been with biopsies. Now biopsies are quite invasive. For example, for us wimpy men who've had to go through childbirth or any of those dreadful things, when you get to the 60 plus age group, then the prostate cancer looms its ugly head and about one in nine men would develop prostate cancer throughout their life, probably over the age of 80.
if you ripped out the prostates of men over the age of 80 and had a careful look through them. And I wouldn't suggest you do because it creates a shocking mess on the floor. But if you did, you'd probably see traces of prostate cancer in most men over the age of 80, which should be ignored because they'll die with it rather than from it. But equally then, if people have indications of cancers, often they have to be confirmed with a biopsy.
So we're getting to the point now in medicine where we're being able to diagnose these things so much earlier and so much quicker. So this new device basically is a low cost portable device, just a pinprick. You put a little bit of blood on a blotting paper into this device and it can pick up things like prostate cancer, colorectal cancers, because how it works, Homer, this is really interesting.
When you develop a cancer, even very early on, that cancer releases what we call circulating tumor markers. So everyone's cancer has its own DNA footprint. And this DNA footprint releases little bits of this stuff into the bloodstream, which is now getting to the point where we can pick it up very, very early. So exciting stuff. Not clinically available right now, but it's not too far off.
Homer Papantonio (11:03.037)
Interesting isn't it? Body of evidence, pancreatic cancers, why are they so difficult to treat and diagnose? And just off the cuff, pancreatic cancers appear to be the most, one of the most sinister of cancers in terms of...
Ross Walker (11:09.368)
Yeah.
Ross Walker (11:19.097)
Well, I'll tell you a dreadful personal story. Well over 15 years ago, I hadn't seen my mother for about nine months because she lived up in Queensland and just hadn't been able to travel. So she came down to visit and she looked like a skeleton. And I knew straight away she had pancreatic cancer. She'd had no diagnosis made when she was living up there. And so I...
did some tests and noting what I was gonna find and found a huge pancreatic cancer, I had to make the diagnosis and tell her, which was pretty upsetting and she died about three months later. It was, I don't wanna go into that, but I don't wanna go into that. But anyhow, that aside, it was a really horrible thing. So pancreatic cancer is extremely personal to me. Now I wanna explain to people,
Homer Papantonio (11:53.619)
And why wasn't it diagnosed? Because of the rural... Okay. Yeah. Alright.
Homer Papantonio (12:06.057)
Yeah, yeah.
Ross Walker (12:08.111)
A, it's so hard to diagnose and B, why it's so hard to treat. One of the reasons it's so hard to diagnose, it's really a hidden organ. It sits at the back of the stomach away from everything and any symptoms from pancreatic cancer, a bit like ovarian cancer, presents very late. So people don't start to lose weight or don't start to lose their appetite or be nauseated until the pancreatic cancer is pretty advanced. That's the first problem.
And also with that, we don't have great screening tests for pancreatic cancer. But also with pancreatic cancers specifically, they have a very strong, what we call fibrous shield. So the fibrous tissue is really the very strong connective tissue. And these pancreatic cancers have this fibrous shield around all the cells, which make them almost invisible to the immune system. now that we understand all of these things, what's happening
is we're moving closer to getting better treatments that'll break down that fibro shield, better tests that'll be able to pick up the disease so much earlier, and also using other therapies together. So for example, a study was done on mice who were genetically primed to develop pancreatic cancer, and they found that if they put those mice on a ketogenic diet, or in other words, switched off glucose as being the major fuel for the pancreatic cancer,
and then use the substance that blocked the ability for the pancreatic cancers to use the fat from the ketogenic diet. Then they starve the pancreatic cancer and the mice actually arrested their cancers. So what we're talking about here is a comprehensive program that firstly, break down the shield so the immune system can see the pancreatic cancer, use maybe some dietary manipulations with some other drugs that go with that.
to starve the pancreatic cancer of its fuel and use some other things. So this is some interesting work with a version of folic acid called folinic acid and some B6. And I'm not saying if anyone has just been diagnosed with pancreatic cancer, I'm not telling them to start taking folinic acid and B6. I'm just saying all of these things are being used as advances in pancreatic cancer.
Homer Papantonio (14:27.883)
So as I reach for a sip of my coffee, the link between coffee and caffeine and pancreatic cancer is there a strong one? Okay.
Ross Walker (14:38.681)
There is no link. In fact, if you have a couple of cups of coffee a day, you reduce your risk for most common cancers. Now, pancreatic cancer is not a particularly common cancer. It's nothing like the common ones like breast, prostate, lung, colorectal cancer, melanoma, and the other skin cancers. But it's still getting there. It's still not rare. But if you enjoy a couple of cups of coffee a day, you reduce your risk for many diseases of which
the common cancers are one of those diseases. Yeah, yeah, the polyphenol concept, but also there is some benefits from caffeine as well. So for example, a couple of cups of coffee a day with the caffeine, there's a lesser Parkinson's disease and Alzheimer's disease as another gallstones, kidney stones.
Homer Papantonio (15:10.571)
because of the polyphenol
Homer Papantonio (15:16.725)
Yep.
Yeah.
Homer Papantonio (15:23.519)
Yeah, Controversies and vitamin D, I've been listening up a fair bit on this. Vitamin D, the sunshine vitamin, being a Southern European extraction. normally I need more vitamin D because I've got a dark colour of my skin. But there's also other elements, it's called the sunlight vitamin, but there's other...
elements to sunlight that apparently are very good for you. One of them is it helps the body secrete melatonin. So go ahead, useful or not?
Ross Walker (16:02.134)
Mmm, yeah, yeah.
Ross Walker (16:07.075)
Well, this is just focusing on it because you see, again, if you listen to conservative medicine, they'll tell you that vitamins are useless. You're basically just creating expensive urine. Now, I agree with them. What you don't need, you excrete out. But you also get expensive or valuable blood by taking vitamins as well. And there's a couple of interesting studies that have just been released, one out of McGill University in Canada.
Homer Papantonio (16:12.117)
Yeah.
Homer Papantonio (16:16.106)
Yeah.
Homer Papantonio (16:19.775)
Yeah.
Homer Papantonio (16:26.741)
Yeah.
Ross Walker (16:33.303)
looked at the fact that we've got this thing which many people haven't heard of before called the thymus gland. So the thymus gland sits in the middle of the chest and it's really vital that thymus makes your T cells. So the T cells are part of the immune system and the T cells are really the memory cells that you remember all the toxins you've been exposed to so you can mount a good immune response. But as we get older, that thymus invalutes and basically
melts away to almost nothing unless you get some sort of weird tumor, a thing called a thymoma. And that can be associated with a very unusual disease called myasthenia gravis that actually Aristotle and Nasus had, just as one excessive bit of trivia.
Homer Papantonio (17:16.075)
So if I had a thymoma, it would be a thyhoma. Yeah, yeah, thymoma. Yeah, yeah, yeah, Okay.
Ross Walker (17:19.715)
Yeah, thaihoma, thaihoma for the mymoma, yeah, that's it. So anyhow, this particular study looked at the way that the thymoma works and that if you are vitamin D deficient when you're younger, it actually increases thymus ageing too early. And so therefore, it's really important, the theme of this particular study, for children to have adequate vitamin D, which of course,
you get from the sun. But the problem with Australia, we're of course the skin cancer capital of the world. And if you expose people to too much sun, yes, you give them vitamin D, but you markedly increase the risk for skin cancers. So there's a bit of a balance there. I like, especially as we get older, but maybe even for children, for vitamin D supplementation. So I believe all of us adults, or we adults, as proper English, all we adults,
should be taking 2,000 international units of vitamin D per day. And for example, one study out of the US of 25,000 people over five years showed that if you do that, you reduce your risk for autoimmune disease by about 25%. But there is a strong link between low vitamin D, osteoporosis, heart disease, cancer, type 2 diabetes, multiple sclerosis, depression, asthma.
There's so many things that linked to low vitamin D. But the second part of this controversy is a study was just released in the American Journal of Preventative Cardiology out of the US. And this study called the STIRTI trial looked at people over the age of 70 and gave them different concentrations of vitamin D for a couple of years and found that it had no influence on markers of significant cardiac damage. So therefore, they're sort of making out that
Vitamin D doesn't prevent cardiovascular disease. No, this is just ridiculous. They're getting people over the age of 70 starting too late, giving them a 2000, I'm not saying if you're over 70, you shouldn't take vitamin D, but I'm just saying don't expect that two years of taking vitamin D will undo 70 years of damage to your arteries. It's just a ridiculous study. So.
Homer Papantonio (19:20.619)
Mm-hmm.
Homer Papantonio (19:33.419)
Yeah, yeah. So what did dermatologists feel about exposure to sunlight? Should it be for white folks especially? Should it be done gradually over time? Or should, can they have it in one?
Ross Walker (19:49.593)
Now some dermatologists feel we should go nowhere near the sun. We should work, look like vampires. Yeah, yeah, yeah. Because, I mean, this is the problem. It's called the pre-test probability. If you see a lot of one thing, then everything becomes that one thing. If everything looks like a nail, so if everybody has a hammer, everything looks like a nail. And so the dermatologists say to everyone, keep out of the sun. And look, I don't disagree with that to some extent. I mean, I think people who sunbake are absolute nuts.
Homer Papantonio (19:52.637)
Yes, and they're a bit paranoid aren't they about... yep.
Homer Papantonio (20:00.298)
Yeah.
Homer Papantonio (20:08.362)
Yeah, yeah.
Homer Papantonio (20:15.285)
Yeah.
Ross Walker (20:19.151)
But I still think before 10 and maybe after three or four o'clock, to get a bit of sunlight's probably good for you, because you are getting some vitamin D. Or if you go out in the sun at midday, stand there for five minutes, but then cover up pretty quickly. So it's the dose that's important. But also take the 2,000 units of vitamin D, and some with your skin, Homer, opposed to some with this skin. Your melanin cover is so much stronger than mine, so you don't absorb as much vitamin D as I do, so it's best to swallow the damn thing.
Homer Papantonio (20:33.791)
And if you're dark.
Homer Papantonio (20:48.075)
Thanks Ross. Ross the main topic of this week's podcast is medical checkups, screenings and what should be tested. And I'll give you a bit of a better joke than the last one. A great part of this story, when a pirate goes to the doctor and says, I have moles on my back, The doctor says, it's all key, they're benign. And the pirate says, count again, I think there'll be 10,
Ross Walker (20:53.89)
Yeah. Yeah.
Ross Walker (21:16.747)
yeah, well, let's hope they do get better. Yeah, would you? No, no, but just before just before you do, do you know what the police officer said to his belly button? You're under a vest.
Homer Papantonio (21:20.011)
So Ross, my understanding...
Homer Papantonio (21:28.927)
No.
Okay, so Ross, my understanding is a medical checkup or screening can include a variety of tests and exams. A physical exam, blood pressure, we all know this, we've got urine dipstick test, mental health, the doctor may give you a questionnaire to assess your depression, anxiety levels, cholesterol and lipid blood test, mammograms, eye exams, hearing tests, allergy tests, cervical screening. So what's the scoop with medical?
checkups and screenings.
Ross Walker (22:05.785)
Well, I say all the time, Homer, the best treatment of heart disease, cancer, Alzheimer's, osteoporosis is not to get them in the first place. It's called prevention. And the best way to prevent anything is to pick up the markers for that disease early and do something about it. And I think screening, good health screening should start around age 30. Now, why 30? Because most people in their 20s think they're bulletproof.
nothing's gonna happen to me, I can abuse my body, get myself written off on a Saturday night with alcohol and maybe illegal drugs and I can smoke cigarettes, do it. So young men, for example, go to the gym, not for good health, but to look good for the opposite sex. And so what I'm saying to you is there's not a real focus on being healthy in your 20s. Some people are, I'm not saying everyone's like this, but what I'm saying is that for most of us, we start to look at our mortality around age 30.
So when people reach 30, that's when I think it's about time they started to think about their health. really, because 30 is the peak of your life, by the way, and it's all downhill from there. Sorry to be depressing, but osteoporosis starts at 30. Sarcopenia, which a lot of people don't understand, you would know what that is. It's loss of muscle bulk. That starts at 30. No high-performance athlete is as good in their 30s as they were in their 20s because their hand-eye coordination is not as good.
and they're starting to get weaker bones and weaker muscles to some extent. I'm not saying it's that gross at 30. I'm not saying it's just boom, you stop at 30, but it just starts to slow down from there. Then you hit 50 and the hormones go south, things wear out even quicker. So what I'm saying is that for people who are health aware and health conscious without being what I call health neurotic, because there is a thing called health anxiety, and this is what does my head in when somebody walks into my practice,
with the folder under their arm with all their health details in alphabetical order and in chronological order and placemarks.
Homer Papantonio (24:10.699)
tinkering on hypochondria. Yep.
Ross Walker (24:13.231)
Yeah, we do, But the point is the study's been done on that. People who do that have a 30 % higher rate of heart disease. And I say to, you know, so worry about it. So I say to them, smell the roses, don't analyze the damn things. And that's what people have to understand. There's the fine line between being health aware and health conscious and being health neurotic. And I'm...
Homer Papantonio (24:21.995)
because they're worried about it.
Homer Papantonio (24:37.739)
But should we be pushing for functional health, for functional fitness? Being fit enough to do what you need to do in a day and doing it well instead of what you're saying with the 20 year olds, they want to look better, they need to function better.
Ross Walker (24:44.002)
What do you mean by that?
Ross Walker (24:59.698)
no, no, of course, but that's a process as you develop more maturity around your life. And so I think 30 is a good starting point. So what should you do at 30? And so here's the question. So I've written some notes on this, so I'll go through it, not to make too boring, but certainly have a clinical assessment, which you've already mentioned. Have your height, your weight, your BMI done, but also your waist circumference. I think waist circumference is much more important than
Homer Papantonio (25:05.983)
Yeah.
Ross Walker (25:27.747)
than looking at BMI, because there's a thing called relative fat mass, which is much more accurate as an indication of your total body fat, because no one wants to lose weight. They just want to lose fat. So relative fat mass is the simple equation. 64 minus, in brackets, 20 times your height divided by your waist circumference. OK, that's for a male, for a female, add 12, because women want a
a relative fat mass less than 35%, men less than 25%. So that's the way to do it. So basically have all those things done. Have your pulse checked. Have your blood pressure checked. Every time you go into a doctor, especially at the age of 30, but even before that, it takes 30 seconds to check your blood pressure. It's the most important, simple, cheap cardiovascular screening test. And probably at age 30, if you've never had one before, have an ECG.
just to make sure you have a normal pattern ECG once. You don't need to keep doing these things. This is a one-off initial assessment. Then when you have your blood, then start and have your first lot of blood tests maybe at age 30. Some people have had them before that, but I'm just saying if you've never had them before, what should you have? Well, things like a full blood count, looking at red cells, white cells, assessment of kidney function, liver function. I think it's not bad to have a thyroid check as well.
There's a thing called ferritin, which is iron stores. So the ferritin levels, the iron stores are a very good marker for a lot of different things, very simple tests. fasting blood sugar level and hemoglobin A1C. Now let me explain to what that is. Hemoglobin A1C is average three month sugar control. Now let me also say there is a test called a glucose tolerance test, which many Australian GPs order and it's two hours of your life, you'll never get back. It's a complete
Homer Papantonio (26:57.803)
Yeah.
Ross Walker (27:24.365)
waste of time that should not be done but is done too often. And when you ask the GP, why do you do this? I'm checking for diabetes. You can check for diabetes by fasting blood sugar level and hemoglobin A1C. You don't have to put someone in a pathology department, get to swallow this horrible sweet tasting stuff, and wait for two hours having blood tests. Waste the time, so don't do that. But also, at that first blood test, you need to have checked once in your life a thing called lipoprotein little a.
So that's lipoprotein, lower case A in brackets. That's the cause of one in five cases of heart disease. With that, there's a test called HSCRP, which is an indication of how inflamed things are in your system. And you want that test to be less than 1.5. And also, I'm a great believer in a thing called homocysteine. So we had a podcast, I think it was podcast seven, from memory, on the MTHFR gene, which I think everyone should have checked.
Homer Papantonio (28:18.571)
you
Ross Walker (28:22.799)
at age 30. Now why? Because 50 % of people have an abnormality in that. And so that needs to be managed. A B12 and a folic acid level, and also a urine dipstick. So you basically pass some urine. GP puts a check in it just to make sure there's no protein or blood or other stuff in your urine. And that's basically all you need at age 30. And many of those tests, apart from the lipoprotein delay, need to be rechecked about age 40.
And then at age 50, you start to need to get a bit more serious about things because that's when the diseases are really starting to rear their ugly head. So I introduced into Australia 25 years ago a thing called coronary calcium scoring. So I actually do. But all males at 50, all females at 60 should have as a routine a coronary calcium score. Now there's a but there, Homer. If you've already had heart disease, it's a waste of time and money because
It's there to diagnose your risk for heart disease. it's not a, yeah, already had a stent, it's a waste of time. It's not retrospective. You know there's a problem, needs to be treated. But what the Connery calcium score tells you is how much muck you have in your arteries, and therefore how much you need intensive treatment of that muck. So for example, many people go into the doctor with a high cholesterol level and immediately the doctor throws a statin at them, they can have a zero calcium score, they don't need the statin.
Homer Papantonio (29:19.339)
So if you've already had a stink, put in... Yeah, you know that's a problem. Yeah, yeah.
Ross Walker (29:45.806)
If your calcium score is below 100 between the ages of 50 up to about 65, 70, you don't need a statin. I don't care if your cholesterol is 10, if you've got a zero calcium score, statins are unnecessary. Even if your calcium score is 50 at age, say 60, that's nothing. Forget about it. But everybody needs to practice the five keys that we spoke about in one of the earlier podcasts. But not everyone needs to be on drugs. And that's what the calcium score tells you. But the calcium score also tells you your prognosis.
over the next many years. And I do a calcium score if it's in the low range every five years. If it's in the high range, I don't do it again because it's just like you've had a stent. You know you need treatment. So don't keep repeating calcium scores. And with Lp little a, the low prednisate, you only need it once because it's either high or it's low. It doesn't change much over life. So I've got people who misinterpret this and they track their Lp little a. And it does that and they're worried if it does that or does that, it's rubbish. It's either high or it's low.
Homer Papantonio (30:43.433)
Yeah, okay.
Ross Walker (30:44.302)
Okay, so that's, so the coronary calcium score, but, but is another but. If your father had a bypass at 50 and you're a 40 year old male, have the calcium score at 40. If you're a 40 year old female and your father had the bypass at 50, have your calcium score at 50 because the difference between men and women and heart disease is about 10 years. Women are protected by their hormones until menopause. Okay, so what else should we do?
At age 50, I think men should have a PSA test, which is the prostate cancer screening test, and have that every couple of years. But you've got to cheat for your PSA, because the PSA is very much related to sexual activity. So...
Homer Papantonio (31:27.947)
Can I just say on, not on the sexual activity but on the PCA screening, had a PSA, I had a friend of mine who was a professor in Urology and he was adamant about men not having their prostrate checked at all because he said the vast majority of them die with, outlive the breast cancer.
Ross Walker (31:33.038)
PSA, PSA, not PCA.
Homer Papantonio (31:56.499)
You wouldn't agree with that, would you?
Ross Walker (31:58.254)
No, no, I don't agree with that because look, a big study in the New England Journal of Medicine, 1500 men diagnosed with prostate cancer. A third were in the prostatectomy group, a third were in the radiotherapy group, and a third were just what we call expectant watching. They did nothing. After 15 years, 97 % were still alive. So whether they had treatment or no treatment, they were still alive. But there was three times the rate of spread in the people who did nothing.
Homer Papantonio (32:03.061)
Yeah.
Ross Walker (32:27.151)
So I think active surveillance is important for many people. But again, I don't think we should overinterpret PSA tests. I don't think we should have them too often. But if I see a trending up in PSA, I want to make sure that person doesn't have markers for more aggressive disease. Now, the professor of urology knows a hell of a lot more about urology than I do. That's his opinion. But you can speak to other people in urology who believe that PSA screening is important.
Homer Papantonio (32:30.485)
Yeah.
Ross Walker (32:55.522)
We mentioned before about the point of care test, the simple test for early cancers. We're getting better at diagnosing prostate cancer early. And it doesn't mean you need to go in and rip the thing out, but we're also getting better at managing these things as well. everyone's going to have different opinions. I've seen world leaders in any area arguing tooth and nail that they were right, and the other guy who was also a world leader, his opinion was wrong. So it's all opinions.
Homer Papantonio (33:20.981)
So do you think we'll ever get to the point where we, maybe the Microsofts of our world, the techno gurus out there come up with the B's and E's for medical screening. Where you just, they can tell within half an hour, maybe a scan of whatever ailment you've got. Whether it be blood pressure.
Ross Walker (33:41.144)
Hmm. Yep.
look, I think there'll be a blood test where you can just map all the different proteins and whatever and the different genetic make-ups that will say, yes, you're at risk, you're not. That's on the... we're not far. No, I'd say probably to that accuracy, maybe 10 years. So we're not that far. We're not talking about 30, 40 years away. So you remember the Star Trek where Bones, the doctor, is you just put this machine on go, this is the problem.
Homer Papantonio (33:55.561)
Are we close to that?
Homer Papantonio (34:02.699)
Okay.
Ross Walker (34:12.525)
We're getting close to that. We're getting close to that. So what else should happen for women? Mammography should start at 50. Now, why? There are three advantages of being over 50, Homer. Number one is wisdom. Number two is grandchildren if you've got them. And number three, you lose the cancer risk from medical radiation. So the less radiation you have up to age 50, the less risk of cancers 15, 20 years down the track. So what I'm saying is that
Homer Papantonio (34:13.547)
You're not fat? Yeah, yeah.
Homer Papantonio (34:32.776)
Okay.
Ross Walker (34:41.846)
If you start mammography at age 50 as a female, it will detect more cancers than it will induce. But if you start at age 40, it'll induce more cancers than it will detect. So you've got to get the right... So you're not going to get a breast cancer out of having mammography starting at age 50. So that's...
Homer Papantonio (34:59.083)
And that always is a concern for people that are being diagnosed for cancer and everything is the radiation exposure from the whole.
Ross Walker (35:07.266)
Yeah, but don't worry about if you're over 50. I'm not suggesting you should front up for a CT scan every day. I'm just saying to have a CT scan every five years is not going to cause a cancer in 20 years time.
Homer Papantonio (35:17.355)
So the rationale being it will take 15, 20 years.
Ross Walker (35:20.685)
No, no, no, no, no. The rationale is our cells change and become less sensitive to radiation when you hit 50 because there are so many changes in the body. But I have seen people who, for example, there's a thing called CT coronary angiography where you squirt someone full of dye and they have a CT that takes a picture of their arteries. Beautiful pictures of their arteries. But I see some people ordering this in 35-year-olds and then 20 years down the track, they've got a cancer.
Homer Papantonio (35:48.085)
Yeah, yeah.
Ross Walker (35:48.258)
possibly from the radiation. So the first line of the Hippocratic Oath, first do no harm. Now let me also say, there's a thing, the National Bowel Cancer Screening Test is a vitally important test that from the age of 50 we should all be doing. And I believe that everyone deserves one colonoscopy in their life over the age of 50. Some people I know should have one a week without the anesthetic. But what I'm saying is colonoscopies are important to have one. I'm headed for my fifth one.
Homer Papantonio (35:54.463)
Yeah.
Ross Walker (36:16.783)
pretty soon because my father died of bowel cancer. So if you've got a bowel cancer history in the family or one of the genetic conditions such as Lynch syndrome, you need to have more regular colonoscopies. But for all of us, at least one. And then finally, the DEXA scans, which are the scans for osteoporosis. Over the age of 70, they're free for everybody. But below the age of 70, if you've got risk factors, say you've had fractures or you've been on steroids or whatever, it's important.
to it's important to have a DEXA scan a bit earlier because here's the statistics. 25 % of women, postmenopausal women, will have osteoporosis. 5 % of men over the age of 65 will have osteoporosis. But a study came out the other day saying that 65 % of people over the age of 50 have some degree of osteopenia, which is the gray area before normal to osteoporosis.
So 65 % is a big number.
Homer Papantonio (37:18.227)
And that might have from an exercise perspective a lot to do with non-weight-bearing exercises. How people when they get to a certain age, they don't walk and run as much and do weights as much.
Ross Walker (37:33.667)
Look, can I say to you mate, all disease is genetic. I've said this before, osteoporosis is genetic. Regardless of that, the best non-medical, non-pharmaceutical treatment of osteoporosis is exercise, which should be two-thirds cardio or third resistance training. And so it's so important still to exercise, whether you do or don't have osteoporosis, because the benefits of exercise are just overwhelming.
Homer Papantonio (37:39.871)
Mm-hmm.
Homer Papantonio (37:48.448)
Yeah.
Ross Walker (38:00.846)
but 50 % reduction in osteoporosis for people who exercise three to five hours a week. So when should screening stop? See, that's another interesting question, because I think every 10 years you should have a set of preventative screens the way I've just said. Every five years.
Homer Papantonio (38:16.235)
Before you get onto that, when should screening actually start? So let's get back to colonoscopies. Okay, so I had my first colonoscopy 10 years ago and they detected a polyp.
Ross Walker (38:23.63)
colonoscopy after age 51.
Ross Walker (38:32.878)
well, if you've had a polyp, you should have had one five years later, depending on the size of the polyp or the type of the polyp. There are different types of polyps. Small, I'd have another one. But if you've, if just say you were 55 years old, you had a colonoscopy, no polyps, everything was fine, don't have another one. But if you've got the family history or you've had polyps, you need to have those followed up because they can regrow. Every five, well, depending on...
Homer Papantonio (38:36.689)
Okay, okay, it was a small polyp but yeah yeah
Homer Papantonio (38:56.049)
every five years.
Ross Walker (38:59.31)
the histology, when you look at the polyp, what it looks like. There are different types of polyps. So when should screening... So screening should be every 10 years up to about age 75. Now I'm not being ageist. I'm just saying if you've made it to 75 without a problem, you're probably not going to get it. So you're wasting your time, money and energy going for the screening for it. So this is something that most of my colleagues don't agree with, which is unusual for me to say stuff that people don't agree with, but that aside.
Homer Papantonio (39:03.313)
Okay, okay. Sorry.
Ross Walker (39:30.158)
I think screening cholesterol in people over the age of 75 is medical negligence if they haven't had heart disease. If you've had no vascular disease and your calcium score is low, don't have a cholesterol check over the age of 75. The worst call I ever had to my radio show, and we give shameless plugs on my radio show for this podcast, I'll give a shameless plug on this podcast for my radio show. It's on the Nine Radio Network, six to nine every...
Every Sunday night's called Healthy Living. It's a fantastic show. Thank you, Homer. Yeah, but anyhow, the worst call I ever had was this woman rang up and said, my 95 year old father's general practitioner wanted to start him on a statin because his cholesterol was 5.2. Now you're not allowed to use, or you're not allowed to swear on radio, but I certainly wanted to when I heard that. I think.
Homer Papantonio (39:59.179)
Great show,
Ross Walker (40:21.748)
if being idiot would have been the right thing to do. Why would anyone measure a cholesterol in its 95 year old? I why would you even think of doing it? And then why would you discuss statin therapy in a 95 year old? It's just nonsense. It is medical nonsense to do that. So stop screening about 75. But when you talk about the categories of screening, there's the general things we've spoken about. There's the cardiovascular screening, which is going to move to what we call metabolic screening. So it's looking at lipids, glucose.
Homer Papantonio (40:23.496)
you
Homer Papantonio (40:33.557)
Good
Ross Walker (40:49.921)
liver, kidneys, and a thing called the Omega 3 index is a good thing where you prick the fingers and it tells you what your Omega 3 index is and that's something we should talk about another time. Then we can screen for all the common cancers that I mentioned. So if you're a smoker, does anyone still smoke or a vapour, just as bad? You can screen for lung cancer with a screening CT, colorectal cancer we've discussed, breast we discussed, gynaecologic screening for other gynaecologic conditions for women.
Homer Papantonio (41:06.667)
Mmm.
Ross Walker (41:18.168)
prostate and of course everyone needs to skin checks every couple of years. Checks for bone health we've mentioned. You need your eyes checked every two years, your hearing checked and everyone should have very regular dental checkups because the mouth isn't just localised to that. It can have an effect on the rest of the body. you also alluded to mental health checks as well, cognitive screening tests for people that are starting to have some problems with their memory. And we're moving into the genetic era where we can do
genomic testing, epigenomic testing, so it's the environment's interaction with the genes, proteomics, looking at all the different protein markers in the bloodstream, metabolomics, I've already sort of alluded to that, how are your organs functioning, and then the microbiome, which is another thing. I still don't think we're right there with microbiome screening yet, but they're talking about, this is more of a future of the medicine segment, but they're talking about now,
developing smart toilets. So every time you open the bowels, the toilet will analyze your gut bacteria and give you a rating on that. So some exciting things happening. Yeah, no issue. And then there's finally, we're getting to the point of being able to assess people's immune function, not just by looking at HSCRP, but by looking at the subtypes of different immune cells, things called CD4 cells, CD8 cells.
Homer Papantonio (42:23.531)
Wow! Nice shit, yeah, okay. Yeah.
Ross Walker (42:42.424)
A lot of exciting stuff happening in the world of screening. as I said right at the start, and I'll say it again, best treatment of all these diseases is not to get them in the first place. It's called prevention.
Homer Papantonio (42:53.323)
Yeah, and you know what I was thinking, remember we were talking about the blue zones a while back and you mentioned that Greek or Italian gentleman who was diagnosed with cancer. was stermatos, sounds like one of my characters, stermatos moriartos. And remember he was diagnosed with fairly aggressive cancer and he went and joined the blue zones.
Ross Walker (43:03.668)
Stamatis Moriatis.
Ross Walker (43:09.506)
Yeah. Yeah.
Ross Walker (43:15.724)
He was lung cancer. He was a smoker.
Ross Walker (43:22.51)
Yep. Yep, yep, yep. Well, basically, age 60, I'll tell the story because it's a really interesting one. 1972, he was 65 years old and he was a smoker, heavy smoker, and was diagnosed in New York as having lung cancer. He had nine months to live. So got two more opinions. They all said, yeah, nine months to live. So he said to his married daughters, you stay here with your husbands, but your mother and I are going back to live with my parents in Ikaria.
Homer Papantonio (43:23.123)
and cured it.
Homer Papantonio (43:28.586)
Yeah.
Ross Walker (43:50.895)
So goes back to Ikaria in Greece, lives on this beautiful island, isolated island, 50 Ks off the coast of Turkey. And he's pretty sick, this guy. He's coughing blood, he's short of breath. But he starts living the Ikarian lifestyle, eating the natural foods out of his parents' backyard. He starts having a glass of wine with his friends who are coming to say goodbye to him. Childhood friends would call over, glass to... He starts having an afternoon sleep, study of 23,000 Greeks.
Homer Papantonio (44:06.731)
Mmm.
Ross Walker (44:19.534)
those who had an afternoon sleep, had a 40 % reduction in cardiovascular disease, the working greets, not many of those left, 50 % reduction in cardiovascular disease. And then he starts reconnecting with his faith, walking gingerly around the village. After three months goes to the doctors and they examine him and they go, stomatitis not too bad. You're okay, come back in three months, comes back in three months, no trace of cancer. So 25 years later, stomatitis decides to go back to New York to visit his daughters.
And she goes, he gets there, says, know, while I'm here, I'll go and see the doctors and show them how healthy I am. He couldn't, because they were all dead. They were all dead. So stomatists live to 104.
Homer Papantonio (44:54.763)
They were all dead!
So the philosophy is that the body always heals itself if it's given the right conditions.
Ross Walker (45:07.692)
Yeah, no, body has the best chance of healing itself if it's given the right condition. You can't say it always heals itself.
Homer Papantonio (45:12.683)
him in town.
Can you understand the cynicism with a lot of listeners out there? We need to get tested for everything. It's almost like the paralysis of analysis. Do we have to be tested for everything? What's just say we take a back step and eat well, exercise well, do the whole lot and not get too concerned, especially with some of the psychiatric? Yep.
Ross Walker (45:42.124)
Yeah, but look, I hear what you're saying, mate, but the reality is less than 10 % of people do exactly what you're suggesting. Less than 10 % of people come even close to living in the blue zones. So you've got 90 % of people who are abusing their body in some way, and they're the ones that are getting these diseases. So I'm not saying those people in the less than 10 % will never get the diseases. I'm saying they just don't get them as often.
Homer Papantonio (45:46.527)
You need to check.
Homer Papantonio (45:51.571)
Yeah.
Ross Walker (46:11.5)
And when they do get them, they get better quicker.
Homer Papantonio (46:13.707)
That's a huge statistic you just mentioned there, isn't it? 90 % of people listening to this are sedentary and don't do the right thing yet. Mmm.
Ross Walker (46:17.342)
Eh? Eh? Well look-
Ross Walker (46:24.864)
or eating bad food, they're unhappy, they're unhappy, they don't sleep well, they're smoking or drinking too much. And can I say to you, and this is a dreadful statistic, only 5 % of the population have two or three pieces of fruit per day, three to five servings of vegetables per day, and those who do have the lowest rates of heart disease and cancer and Alzheimer's in the community.
and it doesn't do zip to your cholesterol, it just keeps your immune system healthy. that's the, that's very, very current. 5%, 5%. It's appalling. One of the most important health innovations you can do, fruits and vegetables, only 5 % of people do it.
Homer Papantonio (46:55.605)
How current is that statistic?
Homer Papantonio (47:04.459)
You'd have to say...
Homer Papantonio (47:11.595)
So you'd have to say that health promotion programs in this country have failed.
Ross Walker (47:16.886)
No, I think they're, well, they've failed only because people don't listen to them. Look, I can tell you, mate, in my own practice, I line up 100 people, give them a program for good health. After 12 months, 50 % have stopped. And I can tell you, there's a line in the sand in my practice. There's people who listen to what I say and people who don't listen to what I say or don't follow what I say. The ones who listen to what I say and follow it,
Homer Papantonio (47:23.327)
That's why you have the Health Promotion Programme.
Homer Papantonio (47:42.208)
Yeah.
Ross Walker (47:47.0)
just become long-term mates of mine. Nothing ever happens to them. The ones who can't or won't follow the advice whittle away bits of their heart to their premature death. It's a decision you make every day. When you're standing there, there's a set of stairs, there's a set of escalators. When you go up the escalators, not the stairs. When you get there at the breakfast table and have some processed packaged crap masquerading as food, as opposed to having healthy fruits, vegetables, nuts, grains, et cetera, for your breakfast.
It's just a decision people can make every day of their life. And I say all the time, life isn't about making the big decision to be healthy. It's about making 30, 40, 50 small decisions every day of your life that takes you to good health or bad health. It's your decision, which I think is a very good way to end this podcast.
Homer Papantonio (48:34.923)
beautiful. I was going ask you a question. If we have 50 % increase in people doing the right things, would we then only need a 50 % less medical screening? Right across the board. Yep.
Ross Walker (48:49.518)
Possibly, yeah. yeah, look, if everyone followed the five keys of being healthy, I'd be twiddling my thumbs all day, but they don't. And the point is, again, even if people do have a problem and you pick up that problem relatively early, you can reverse a lot of the effects of the problems, especially if they will then change their life.
Homer Papantonio (48:55.711)
Yeah. Okay.
Homer Papantonio (49:10.045)
Okay, we've got questions from our listeners that have been emailed in. This one is from Karen. I think she's from Melbourne. Karen asks, Hey Homer and Dr Ross, love your podcast. Homer is significantly funnier than you Ross. Primarily. No, but she said I do love the Seriously Funny Podcast.
Ross Walker (49:19.022)
Karen.
Ross Walker (49:28.972)
No, she didn't say that. She did not say that. She didn't say it. She's just lying now.
Homer Papantonio (49:38.547)
It's the funniest podcast I've ever listened to. Primarily because it's the only seriously funny podcast that I've listened to. That's why she thinks it's the funniest. But seriously, I've just discovered the podcast. Love it. I'd like to ask about the supplements that you referred to but cannot publicly name. Okay, so that means I can't.
Ross Walker (49:42.454)
Is she serious?
Ross Walker (49:48.473)
Yeah.
Ross Walker (50:00.077)
Yeah, well, I still can't because it's a public podcast. OK, look, can I tell you, I basically think that everybody from age 30, this should be another segment. This is too long. let's make note. look, Karen, we'll, well, a quick snapshot. High quality multivitamin, high quality omega 3 supplement. When you hit 50, everyone should be on the BJ100 and I can't mention the name of it.
Homer Papantonio (50:13.579)
Okay, just give us a snapshot.
Ross Walker (50:29.301)
should be taking some form of vitamin K2, ubiquinol, magnesium orotate and kialic garlic and vitamin D. And they're the basic things, but I think we should have a podcast just devoted to supplements where I will not mention products, but I can mention ingredients.
Homer Papantonio (50:48.779)
Yeah, I think we have, we're talking about the adverse effect of supplement in the next podcast, aren't we? As well as medications in the next one. but yeah. So, Karen's still going on. My husband is 65. He's being prescribed blood pressure tablets and statins, although he will be requesting a calcium score. He was prescribed them purely on his cholesterol levels.
Besides that, can you please recommend a good ubiquinol brand and a good magnesium brand?
Ross Walker (51:22.806)
No, I can't, because this is a public podcast, I cannot give the brand name. Just let me say that if you buy it in Australia, you are getting a high quality product. Do not buy it on the internet from America. So it's ubiquinol, 150 milligrams a day, is the dose, and a magnesium-orotate-aspartate combination. Again, just Google magnesium-orotate-aspartate combination. It's usually around...
somewhere between four to 800 milligrams of magnesium in the compound, taken twice a day.
Homer Papantonio (51:55.411)
Is there anything else that we should be taking as a preventative measure? This is Karen still.
Ross Walker (52:00.92)
Well, again, this gets back to talking about the cardiac protocol and which I think we should focus and go through in another podcast. We should have it just devoted to why should people take supplements and what should they take?
Homer Papantonio (52:06.133)
Mm, okay.
Homer Papantonio (52:15.127)
So this is from Gloria on the Gold Coast and she asked, I have grief induced tinnitus. It came on the day after a hectic week of watching my mother slowly pass away. Sorry for making fun of that.
Ross Walker (52:24.024)
tinnitus. It's got a real ring to it.
Ross Walker (52:33.23)
poor one, so sorry to hear that, Gloria.
Homer Papantonio (52:34.827)
expected it would lessen in time but it has now been 14 months and I still have a ringing buzzing in my ears. It isn't loud during other noisy situations but as soon as noise disappears it's still there. I've been to a doctor who referred me to an audiologist who confirmed there was no physical damage with my ears on.
Ross Walker (52:43.864)
Yep.
Homer Papantonio (52:58.823)
or any issue with my hearing. I have attempted different ear piercings based on pressure points to try and ease it as well as taking certain vitamins which are said to lessen the symptoms but still no luck. Any hot tips?
Ross Walker (53:16.322)
Yeah, yeah. Look, tinnitus is a shocking problem for many people. And when she's been told there's nothing wrong with their ears, well, it clearly is because she's got tinnitus. So there's what I call the poor man's way of approaching this, which works for some people. And that's when you go to sleep, you put two little earphones into the ear, get a radio and turn the radio onto the static. So it's going.
Homer Papantonio (53:26.4)
Yeah.
Ross Walker (53:45.144)
and you turn that static up above the noise of the tinnitus, so you can't hear the tinnitus, and you sleep with that for a few nights, and after that, that can block out the effects of the tinnitus. Works for some people, doesn't work for everyone. One thing is never do that when you listen to my radio show. You've got to listen to the content, which might put many people to sleep. But that aside, there are a couple of new exciting things happening in the tinnitus world. There's a substance that's being trialed in France.
that actually can restore the sound for people. So it would stop the, take the tinnitus away, maybe improve their hearing if they've got hearing problems as well. So they're trialling that at the moment, not clinically available yet. But what is available is a thing called the Leneer system, L-E-N-A-I-R-E, I think it is, out of Ireland. And this is an intricate thing. It's a sort of weird thing. You wear headphones, you sit at a computer for a half an hour every day for about 12 weeks.
Homer Papantonio (54:32.672)
Yep.
Ross Walker (54:44.076)
and you put this thing on your tongue. So it's not painful, it just stimulates the tongue and basically has a huge benefit for the treatment of tinnitus. So LENAIRE.
Homer Papantonio (54:56.404)
Okay.
So we're winding up now, that's all we have on this week's Seriously Funny Podcast. If you'd like more information on the podcast as well as explore the amazing newly released ultimate Seriously Funny keynote speaking package that Ross and I are now offering, go to seriouslyfunnywellbeing.com. All you corporate heavyweights out there that are having a conference, don't bore your delegates to tears. Try and get two of the best
Ross Walker (55:12.95)
are you? A little extraordinary.
Homer Papantonio (55:27.627)
speakers in the country to speak in a very funny way. Too best. Okay, sorry. Okay. I was going to make it a bit modest there. Okay. So it's bye from me and Ross, it's bye from you. Thank you. There we go.
Ross Walker (55:29.036)
No, no, no, no, the two bass, not two of the bass. Get the,
Ross Walker (55:44.066)
Bye.