Dr. Michael R. Sesemann:
I think working actually forced me to recover better than if I would've retired and gone home and just had my defects to think about and surround myself with. And so I had to learn how to talk again. I had to learn how to do all the things that my business demanded.
Dr. Kim Kutsch:
On Contrary to Ordinary, we explore the motivation, lives, and character of the innovators who see limitless potential around them, the people behind some of the largest paradigm shifts in the practice of dentistry and beyond. My name is Dr. Kim Kutsch, and I spent over 20 years in dentistry before creating CariFree. We offer a range of dental products to the industry and the public that promote the health and wellness of people suffering from the disease of dental caries. Head and neck cancer is the seventh most common cancer globally.
Symptoms may include a lump in the neck, a sore in the mouth, or a sore throat that doesn't go away. During Oral Cancer Awareness Month, we want to take some time to spotlight the extraordinary dentists and practitioners who have taken on this little-understood cancer and survived. Today's guest is Dr. Michael R. Sesemann, a dentist, educator, and founder of the Nebraska Institute of Comprehensive Dentistry. Michael has been described as the best dentist you've never heard of. I agree with this assessment, and you would, too, if you were to just take a glance at his resume.
Michael served as a president of the American Academy of Cosmetic Dentistry between 2009 and 2010, is a member of seven American Dental associations, and is currently an adjunct faculty member at the Kois Center. In 2018, Michael found a lump on his neck. When he found out that it was cancerous, he began a long and hard journey to recovery. Michael's origins are from a small farm in Omaha, Nebraska. He was the first in his family to go to college and came to find that he had a real passion for education. So that's where I want to start here today. Why does education mean so much to Michael?
Dr. Michael R. Sesemann:
The statutes that are in place for people to get their dental licenses renewed, which are like 30 hours every two years in Nebraska and various other states, are abysmally low. And I never did buy into that, and I just really enjoyed education. And there comes a time when I've been given all these gifts, and I feel like I had a responsibility to give back. Some of it was going to be things that I learned from other people. Some of it might've been innovative from me that spawned up in my years of practice. But being able to get up, I never wanted to speak in front of people.
I had to fight that fear at first with beta-blockers and stuff like that. But once I got comfortable speaking with people and communicate with them, seeing them be presented with information that was going to help them in their lives and seeing the light go off in their eyes when they got it and could put the pieces of the puzzle together made you just get all tingly all over because you were feeling it the same way as you felt it the first way you learned it. And so giving back and being part of education is just, it's not all about giving. It's about receiving as well.
Dr. Kim Kutsch:
Yeah. Michael, when you talk about that, the way your face lights up, I wish everybody could see your face right now when you talk about that. We mentioned that you were the best dentist that you've probably never heard of. You have done some amazing things. And so when I look at all the... that whole list of things that you've done and been involved in, Michael, I go, "Here is an extraordinary person." Do you see yourself as extraordinary?
Dr.Michael R. Sesemann:
I see myself as hardworking. I'm a hard worker, which came from my indoctrination in the Truck Farms. I know I can outwork just about anybody. And if I could find, like I did in dentistry, I found something that I could be good at and passionate about, then the work really wasn't work. It was just living. And so I just did those things. I don't see myself as being extraordinary. I just see myself as being a hard worker, I think.
Dr. Kim Kutsch:
So just what you were talking about, Michael, about it just not being work, but just being your life. In the dental profession, did you ever feel like you had a job, or did it never feel like a job to you?
Dr. Michael R. Sesemann:
Certainly, the first 15 years out of school were about survival, about finding my way. I opened up a small office. I was supposed to associate with my family dentist at the time, but he had a heart attack my senior year of dental school. So he sold. And so I'm left with this little office of 650 square feet that I'm renting next to him, and, all of a sudden, I'm going to be graduating and I opened it up, an office, from scratch.
Dr. Kim Kutsch:
Oh, man.
Dr. Michael R. Sesemann:
And it just so happened that the road we were on was going to be closed for two years. We'd have one of those temporary gravel roads to get there. It was tough times, and we just grew. And the important part about it was finding the right people who I was going to add to our team. At first, it was just me and my one person who joined me, who became our office manager and just recently retired after 42 years of being with the practice.
And then our community had a wonderful thing. It had this Metro Community College, and it had a Dental Assisting Program. So I went down there and regularly took flowers and gifts and good things to eat and said, "If you send me your students, I will give them practical experience." I wanted to do that, but I also wanted to live interview them. And so I picked up some perfect people who fit into our vision of what we wanted to be. And over those 15 years, I picked up some dental assistants, one of which has been with me 38 years, one of which has been with me 36, and another one that's been with me 26 years.
Dr. Kim Kutsch:
The fact that Michael's team has stayed working for him for so long says a lot about him as a leader. Indeed, every great leader needs an equally great team around them if they want to achieve excellence. In his 2014 book, Leaders Eat Last: Why Some Teams Pull Together and Others Don't, Author an Inspirational Speaker Simon Sinek says, "Leadership is not about being in charge. It's about taking care of those in your charge."
This, of course, could mean many different things. In Michael's case, caring for his team involved taking an active interest in their career development and encouraging a number of them to pursue accreditation. I think his commitment to his staff is one of the many things that makes him extraordinary. Being an incredible leader is busy work. This is partly why when Michael is attending an industry meeting in 2018, he dismissed the small lump in his jaw.
Dr. Michael R. Sesemann:
We were in a small room on a table, and I leaned my hand... my elbow on the table and put my hand up to... underneath the border of my mandible. And I felt this lump, and I thought, "Oh my God, that's not right. That's never been there before." And to put things in context, this is 2018 and not much was known about the association of human papillomavirus with oropharyngeal cancer at that time.
So I was concerned about the lump, and I'm at the Chicago Midwinter, so I have access to a lot of dentists in a couple different organizations. People I really respect. I'd say, "What do you think about this lump?" And they all felt it, and they said, "Oh, you look in good shape. It's probably just allergies or something." They're probably making me... trying to make me feel-
Dr. Kim Kutsch:
Right.
Dr. Michael R. Sesemann:
... good. But unfairly, a lot of us didn't know anything about oropharyngeal cancer and its relationship with HPV at the time. And so I bought that advice. I went into denial. And so it's February, and I'm thinking, "Oh, it's just allergies. I'll let it go. It'll go away in a couple of months." February turns to March, April. I get a couple physicians or a couple dentists in my chair during dental procedures here at my office, and I set them up, and I say, "What do you think about this lump?" And they say, "Oh, you look in good shape. That's probably just allergies."
Or one person told me it was an inflamed submandibular gland. And finally, I did it to an ear, nose, and throat person in May. February to May, I'm in denial. I'm letting this swollen lymph node on my neck, which is the number one telltale sign of perhaps there being cancer in the pharyngeal area. And I set this ear, nose, and throat physician up, and I said, "What do you think about this lump?" And he goes, "Well, I don't like lumps in adults at all." And he goes, "You need to come in and see me." I said, "Okay. Yeah, I'll make an appointment." So I'm a busy guy. I'm on the road. I'm doing my practice. I'm doing education.
Dr. Kim Kutsch:
Right.
Dr. Michael R. Sesemann:
I got places to go and things to do. And he calls me back in two weeks, and he says, "Have you made that appointment?" I said, "Yeah, I made an appointment. Our schedules matched up in August." And he goes, "No, that isn't going to do." And I go, "Well, I'm headed to the airport. I'll call your staff when I return on Monday." And he goes, "Okay." And so we hung up. I head to the airport, he calls back and talks to my staff and says, "He needs to come in at 7:00 AM on Monday. I'm going to have my staff here. We're going to do a fine needle biopsy."
And he had his staff text me and say, "We're coming in early to see you, so you better be here." And so I go in and had a fine needle biopsy and thought, "Yeah, I'll go through the steps," and kind of forgot about it. And then Wednesday night, this was Monday morning, so Wednesday night, get the phone call. I had even forgotten that I did the fine needle biopsy, and it was the doc, and he says, "Michael, it's squamous cell carcinoma." Your mouth drops open, your mind goes blank, wondering how all this is going to affect your loved ones and the people you care about or your business and how you're going to carry on.
Then you're thrown into the vortex. And the vortex is cancer treatment, and so many people know it, hundreds of millions of people around the world. We live in a toxic environment, and cancer is a great business to be in right now. So many people have it. My heart goes out to them. But you get thrown in the vortex, and all of a sudden you're doing doctor's appointments, CTs, contrast CTs, or PET scans, and you're getting seen by about four different doctors from radiation to chemo to surgery to various things, and you gather all the information, and you make some tough decisions.
Dr. Kim Kutsch:
Michael, you made a couple of comments there that I think are really important to know. There's 18 million cancer survivors in the United States. 18 million. I mean, this is not an insignificant number. That's all types of cancer, but it's not an insignificant number, right?
Dr. Michael R. Sesemann:
No.
Dr. Kim Kutsch:
Was there any advice in the early stages that you wish that you had gotten that you didn't get?
Dr. Michael R. Sesemann:
It was a little late for that. I think what we know about HPV is it's a sexually transmitted disease.
Dr. Kim Kutsch:
Yeah.
Dr. Michael R. Sesemann:
And those of us who lived in the 60s and the 70s, the era of free love and things like that because the way HPV exacts its revenge is that most people clear it and aren't going to be affected, but 10% of the people retain the virus, and the virus does DNA damage to a squamous cell, and it in particular damages a couple factors that are responsible for destroying the cell, kind of a self-timed, self-destructive device.
The E6 and the E7 mechanisms, it alters those mechanisms so that the cell does not destroy itself. What we're seeing is that people who were teenagers or in their 20s, when they contrived HPV, that remains latent in them until they're in their 50s, 60s, and 70s, and that's when a lot of us have found the cancer. Our immune systems maybe start to wane a little bit, and lo and behold, this altered DNA sequencing allows a cell to start dividing and create a cancer, in this instance, squamous cell.
So could I have done anything? Obviously, another way of getting squamous cell is smoking and alcohol. If you're going to have squamous cell carcinoma of the throat or in the pharynx, having an HPV one is good because you have an 80 to 90% chance of survival after five years. If your squamous cell is caused by alcohol or smoking, that five-year survival goes down to 30 to 40.
Dr. Kim Kutsch:
Right. That's a huge change, right. I was just at the IADR meeting, and a cancer specialist came and was one of the keynote speakers, and they actually have... with early diagnosis on the HPV oral pharyngeal cancer, they have survival rates up at 93% now. But that was with a mix of different types of therapies. So it wasn't just one particular. But when they mixed a bunch of different therapies, they were getting these results up to like 93%, which is phenomenal and really good news for people.
Dr. Michael R. Sesemann:
That's one of the unconcerting things about cancer therapy. You get diagnosed, and you think that there should be a protocol to follow and everything all laid out as to what you're going to do. But it becomes this smorgasbord or this buffet of treatment options, and it becomes partly on the patient to decide which ones are you going to do or accept and whose advice are you're going to take in order to exact your particular path.
If I was a young person today, as I tell my parents a lot in here, I question all my young kids and their parents as to whether they've had the Gardasil vaccination, which is good for dozens upon dozens of different HPV viruses, particularly HPV 16 and 18, that are the ones responsible for pharyngeal and also 22, 16 and 18, which are responsible for cervical. And my conversation with these patients, I really want to make it known. Obviously, I want to tell the patient or the parent that it's not about their parenting skills.
It's not a reflection upon whether they've been a good parent, a bad parent, or anything like that, upon whether their child, when they become sexually active in their teens or 20s or whatever. It's all about giving your child the benefit of an anti-cancer vaccine. And people are very receptive to that. People that are really against vaccines, maybe in this day and age every now and then, but all of a sudden, gentleman calls me and says, "I appreciated our talk. I called my wife and said we're reversing on this particular instance, and our kids are going to get Gardasil."
Dr. Kim Kutsch:
Did you know that human papillomavirus HPV is the most common and widespread sexually transmitted disease globally, with unprotected oral sex as the root cause? Approximately 73% of oropharyngeal cancers, OPC in the US are associated with HPV, and 80% of those occur in men. But here's the good news. The HPV vaccination is changing the game. Recent research reveals that vaccination before becoming infected with HPV has the potential to prevent 90% of the cancers from ever occurring.
The HPV vaccination series, Gardasil-9, is recommended to begin at age 11 or 12, but if you miss the opportunity, don't worry. Now, the vaccine is covered as a benefit for men and women up to age 45. Vaccination is not just about protecting yourself. It's about preventing the spread of HPV infection and HPV-related cancers. If you or someone has been affected by any of the issues raised in this podcast, head over to the Oral Cancer Foundation's website for help and support.
You can find a link to that in this episode's show notes. Thanks so much for listening. And now, back to our conversation. Michael, you talked about that whole smorgasbord of options for treatment. Here we're in 2024, and you sit and think, "Well, there should just be this exact protocol that we know exactly that we're going to follow," and it is not like that in cancer for almost any cancer treatment. You opted for intensely modulated radiation therapy over chemo. What made you make that decision?
Dr. Michael R. Sesemann:
So the three choices, main choices are usually chemo type of protocol of some type, usually cisplatin, and cisplatin has some side effects that I thought were going to possibly lead to me having to retire as a dentist-
Dr. Kim Kutsch:
Okay. Right.
Dr. Michael R. Sesemann:
... to which I didn't really want to do. And you know...
Dr. Kim Kutsch:
Michael, are you still practicing?
Dr. Michael R. Sesemann:
I'm still practicing full time. Yeah.
Dr. Kim Kutsch:
God bless you.
Dr. Michael R. Sesemann:
And so yeah, time flies.
Dr. Kim Kutsch:
Yeah, I know.
Dr. Michael R. Sesemann:
I didn't want to do chemo, but I wanted the cancer out of my body. Mine was on my lingual tonsil, something I couldn't see, something I couldn't feel. It was pretty small. Even though my lymph nodes were affected, my cancer itself was small, so I opted to have TORS, transorbital robotic surgery, in order to remove that. I just wanted it out of my body.
Dr. Kim Kutsch:
Yeah, I don't blame you.
Dr. Michael R. Sesemann:
And had a young surgeon that felt confident about doing that, that was teamed up with a radical neck dissection where they took 36 lymph nodes, and six of them had cancer in them. But the key thing that I read from the Path Report, first, the doctors came to me, and they said, "Oh, too bad it's six because if it was five, you wouldn't have to do chemo." And I said, "So where's the data on the differential between five and six? Is there any data? Well, there's no data, but that's the way we feel."
I said, "Well, when I'm reading the Path Report, I see that my lymph nodes, even though they were affected, they weren't... the encapsulation wasn't broken. That's good, right? Yeah, it is good." And I said, "So if I'm having that and I'm going with radiation, the electron approach with the spread of the spray as it does in electron radiation, that should cover a lot of those fatty tissues and things that you haven't removed." They thought so too. So we decided to go with the surgery and the radiation option.
Dr. Kim Kutsch:
Wait, did you work through that whole process?
Dr. Michael R. Sesemann:
Yeah. I was gone a week after the surgery, and I felt pretty good after the surgery outside of some neck stiffness. And the tough part was they took a three-by-two-centimeter by one-centimeter specimen off of the back of my tongue. And the difficult thing about that is that's where your glutition starts.
That's where you get this suction to start your swallowing mechanism. So it took me a good couple of years. I'd eat food in my room and stuff like that. I just couldn't go out to eat with people because I was just a moment away from a choking event. But it took me a while to regain my confidence to be able to eat and speak.
Dr. Kim Kutsch:
I remember talking to you while you were going through that at a meeting, and you were telling me you were having to learn how to swallow again.
Dr. Michael R. Sesemann:
Yeah. So that was tough. And speaking, they hit a couple nerves there that made it difficult. So I had read the newspaper aloud and try and get my articulation back and get my tongue working again and stuff like that. And so you heal up from surgery, and six weeks later, you start radiation. So they make you a mask where they bolt you down to the table, which is extremely uncomfortable. You feel locked in, and then this machine goes around you, and it took two minutes and 18 seconds. I counted them.
After a while, I realized that watching the machine wasn't a healthy thing to do, so I would just take my mind somewhere else. But you go through 60 to 70 grays as the protocol deems, and it pretty much burns you up externally, internally, your vocal cords or pharynx. It's a tough thing. And the radiation people, I don't think they were just saying it for my accord, but they said head and neck cancer is the worst radiation therapy that they deliver because of what they... how they see us go downhill after that.
Dr. Kim Kutsch:
Well, and quality of life, I mean, eating, drinking, speaking, swallowing, everything starts in the mouth, right.
Dr. Michael R. Sesemann:
Yeah.
Dr. Kim Kutsch:
And so it's like you take that away or you complicate that, and... Yeah.
Dr. Michael R. Sesemann:
The coordinated neurologic and muscular activity of those six inches between your oral cavity and your esophagus-
Dr. Kim Kutsch:
Well, breathing.
Dr. Michael R. Sesemann:
... yeah, with your trache and your epiglottis gets burned up. You have trouble with taking things in, but it comes back. I mentor a lot of people with cancer, and I had a call just a few weeks ago from someone. He's been out a year, and he was having a tough time. He retired from dentistry, and I said, "It's only been a year. You got to have some patience and some faith" because he was really down, really depressed as to how these effects were doing it.
And you asked if I'm still working. I think working actually forced me to recover better than if I would've retired and gone home and just had my defects to think about and surround myself with. And so I had to learn how to talk again. I had to learn how to do all the things that my business demanded. Radiation took me down for a couple of weeks. So I missed a couple of weeks after that because my neck was so erosive that I had to put Saran wrap on it so it wouldn't just slough onto my scrubs and such.
Dr. Kim Kutsch:
Oh, man. You brought up a good point about the radiologist radiation therapy being... in the head and neck region being the worst that they deliver. And interestingly enough, of all the cancers, all cancer treatment of all cancers in the body, of the 20 post-op complications to all cancer treatment, 16 of those are in the mouth.
Dr. Michael R. Sesemann:
Yeah.
Dr. Kim Kutsch:
Doesn't matter where your cancer is, if you go through chemo, you go through immunotherapy, radiation, whatever surgery, the complication, 16 of those 20 happen in the mouth anyway, right?
Dr. Michael R. Sesemann:
Right.
Dr. Kim Kutsch:
And so it is such a quality of life issue. It's like this person that called you and was really down. What kind of things are they asking you?
Dr. Michael R. Sesemann:
He was just thanking me and because, "All these doctors," he said, "Told me this and that, and you were the only one that laid it out as to what was actually going to happen, and you prepared me for this." And so he was grateful for that.
Dr. Kim Kutsch:
Uh-huh.
Dr.Michael R. Sesemann:
What my mission was at that time was just to give him a little hope for the future because in cancer therapy, you hear this thing about the new normal, and sometimes it can be thrown around. Definitely if you have cancer and you have a new normal, you despise that term. But he threw that term out and said that he didn't like his life the way it was now.
And I said, "You got to be patient. You got to work towards this, and you've only been out for a year." And I said, "Some of these things," and I checked off a list of different things. I said, "That took me two years to get back, or that took me then, or it's been five years, and I'm just starting to put on weight, and I got a muffin top now, and it's the most beautiful muffin top I've ever felt in my life."
Dr. Kim Kutsch:
Total different perspective, isn't it?
Dr. Michael R. Sesemann:
Yeah, because I've done gaunt, and gaunt isn't a good look on you. Having a little belly fat, I've never felt so good about it. But I just needed to give him hope that what he was experiencing was normal and that there are good times ahead, and that they're not going to be as extreme as they are currently.
Dr. Kim Kutsch:
The Poet Emily Dickinson famously called hope, "A thing with feathers that perches in the soul." We all have this little bird within us, and it can be heard faintly, even in the darkest of times. Oncologist Dr. Harmesh Naik said in a 2022 article that, "As a physician, you learn the science of cancer, but as a human being, you learn the art of cancer, which focuses on hope." Cultivating the art of hope in such tough circumstances is difficult, but focusing on living day by day may help. Dr. Naik suggests that cancer patients should create short-term goals for themselves and celebrate when they reach them.
This helps to create a sense of progress and small wins that can chart path forward. Sometimes, the thing that gives us hope in trying times is hearing a truthful and realistic assessment of what we're going through. That was certainly the case with a man who reached out to Michael. Next, in our conversation, Michael and I are going to be talking about screening for head and neck cancer. He has a comprehensive YouTube tutorial on this subject that we've included in this show notes.
Dr. Michael R. Sesemann:
First, visually, I'm looking at them usually from the 12 o'clock position, so I'm looking at their neck. And every single dentist should be doing a lymph node examination, and it shouldn't take more than 45 seconds, probably. I have one on YouTube, and since I'm demonstrating it, I take a pretty, fairly long time to do that.
Dr. Kim Kutsch:
Can patients do these screenings for themselves? And if so, how do they do that?
Dr. Michael R. Sesemann:
I actually tell them to do that, and I tell them where the chains of the lymph nodes are, particularly if they're 50 or 60 or 70-year-old males.
Dr. Kim Kutsch:
Uh-huh.
Dr. Michael R. Sesemann:
Usually, the expression 80 to 90% of pharyngeal cancers are male, and they express mostly in the 50s, 60s, and 70s. So I teach them. I say, "Every so often, at least once a week when you're showering, and everything's slippery and soapy, you need to just be cognizant of how your neck feels and run your hand down this muscle, as we know the sternocleidomastoid muscle, and run your hand down there. And if you ever feel something unusual or something like a ping pong ball, you be sure to call me right away."
Dr. Kim Kutsch:
Yeah.
Dr. Michael R. Sesemann:
They appreciate that. I think they... those that saw me in the shape I was in, I know they're checking their necks regularly.
Dr. Kim Kutsch:
Well, I'll tell you, Michael, I've made this comment so many times. We hear about oropharyngeal cancer and, of course, being a dentist, and I diagnosed a handful of cancers over my 40-year career, but we hear about it, but it's kind of abstract. It's kind of out there. It's like, "Oh, yeah, it doesn't happen. It's pretty rare. It's just one of those things."
It is kind of in the background. And then it happens to somebody that you know, like you and a couple of our colleagues, and suddenly it was a wake-up call. "This is real. This happens to us." It happened to you. And if we can do anything to get this message out and protect the kids, it's so easy with this Gardasil vaccine just educating parents and trying to get that out there. And it is never too late. I mean, I think insurance now covers it up to age 45, but you can get it anytime if you're willing to pay for it.
Dr. Michael R. Sesemann:
Yeah, I've heard that too.
Dr. Kim Kutsch:
Michael, I really appreciate this today. So how are you feeling now? You're out five, almost six.
Dr. Michael R. Sesemann:
Years. Yeah, I'm out five and a half years. I'm feeling pretty good. I was pretty raspy for a few years, particularly if I got dry, but we've been talking now for about an hour, and my vocal cords are staying okay, but they're continuing to get stronger.
Swallowing's better, becoming more automatic as opposed to a learned skill that I had to have to exercise pretty profoundly. But I'm doing well, and a lot of that's thanks to you. I definitely use some of your products. My saliva has been cut down to 15%, maybe of what it used to be.
Dr. Kim Kutsch:
Wow.
Dr. Michael R. Sesemann:
All I get is a little bit from the products and then minor salivary glands. So I would be in difficult shape, but your CariFree xylitol spray... Here's my regimen. I do your 5,000 parts per million toothpaste at night to clean. Try not to rinse out too well. I go to the xylitol spray, do about five sprays in my mouth, and then I use 3M sensitive skin tape, and I tape my lips closed.
I put about an inch and a half to two inches on either side running vertically, and I can wake up in the morning with a moist mouth with one that's been fighting bacteria all night long, thanks to the xylitol. And my teeth have been doing well, which is a tough deal. You need to keep things. Now, I have some periodontal things like gingival changes, recession, and things that are alarming for somebody in our profession to all of a sudden see your dentition go through. But everything's pretty good.
Dr. Kim Kutsch:
Oh, I'm glad to hear that. So what do you do for fun these days, Michael?
Dr. Michael R. Sesemann:
I'm just having a ball working. I took myself off the road after 25 years of being on the road and lecturing and education. The only place I go is a Kois Center with John on Occlusion 2, and I'm comfortable with that because traveling's gotten to be such a bear. Fun. I'm having a ball with my staff, my patients. I'm a real 24/7 dental nerd. There's no one that has to feel sorry for me because this doesn't work for me. This is enjoyable stuff. I love this stuff.
Dr. Kim Kutsch:
I'm so glad that Michael's been able to continue doing what he loves throughout his battle with cancer. His work is where he found his hope, but this path is different for everyone. I'd like to close out this episode by encouraging you to check out Michael's screening on YouTube and to investigate the Gardasil-9 HPV vaccination if you haven't already. Thank you so much, Dr. Michael Sesemann, for joining me today.
And thank you for going on this inspiring journey with me. Around here, we aim to inspire and create connections. We can't do it without you. If this conversation moved you, made you smile, or scratched that little itch of curiosity today, please share it with the extraordinary people in your life. And if you do one thing today, let it be extraordinary. Bye for now.