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CLICK HERE for PART 1 of this 2-part interview!
Ever wonder what insights could be gained from small intestine bacterial overgrowth testing when you’ve got IBS gut symptoms?
Last week, Dr. Ken Brown and I discussed various reasons why Irritable Bowel Syndrome (IBS) is a problematic diagnosis that has become a “catch-all” for any digestive symptoms. We also spoke about how SIBO inflammation can spread to other body systems including skin rashes like rosacea.
In today’s episode, we will dive into the reason why small bacterial overgrowth testing should be run by gastroenterologists. AND how it can lead to clarity on the type of SIBO you’re struggling with (and may explain your constipation or diarrhea). Plus, SIBO constipation can lead to unwanted side effects that, unfortunately, worsen long-term constipation!
And if you are struggling with SIBO symptoms and want to know how to get better, we’ll also dive into conventional and natural SIBO treatment options.
My friend and SIBO expert Dr. Ken Brown is back for Part 2 of this interview! He’s a board-certified gastroenterologist and has been in practice for over 15 years with a clinical focus on inflammatory bowel disease and irritable bowel syndrome (IBS). Known as the host of the podcast “Gut Check Project”, Dr. Brown’s mission is to bridge the gap between medical & natural science, leading to attainable improvements in quality of life for all.
For over a decade, he conducted clinical research for various pharma companies but is now focused on natural solution product development for KBMD Health and KBS Research. Dr. Brown has a clinical and research practice based in Plano, Texas. And he is the creator of ATRANTIL, this FIRST proven solution for IBS and bloating, now available in over 20 countries.
Or, listen on your favorite app: iTunes (Apple Podcasts) | Spotify | Stitcher | TuneIn | Subscribe on Android
In This Episode:
- Methane versus hydrogen gas production (and associated SIBO symptoms)
- Can laxatives improve SIBO constipation?
- Can you become addicted to laxatives?
- Conventional and natural SIBO treatment options
- Benefits of polyphenols in a SIBO diet
- How Atrantil could help your SIBO symptoms (as an alternative SIBO treatment option)
Quotes
“If somebody comes in and they sound like SIBO, and they eat a meal, and they bloat, that tells me that there's SIBO going on in the small bowel.”
“If we were to look at what makes vegetables and fruits healthy for you, we know that they have insoluble fiber, they do have some vitamins, but the primary reason is these polyphenols, the things that make the fruits and vegetables colorful.”
Links
Find Dr. Ken Brown Podcast | Instagram | Tiktok
TRY DR. BROWN’S SIBO SUPPORT KIT
Healthy Skin Show ep. 019: SIBO-Rosacea Connection w/ Dr. Leonard Weinstock
Plant phenolics with promising therapeutic applications against skin disorders: A mechanistic review
349: Small Intestine Bacterial Overgrowth Testing + Natural SIBO Treatment Options (PART 2) w/ Dr. Ken Brown {FULL TRANSCRIPT}
CLICK HERE for PART 1 of this 2-part interview!
Ken (28:19.662)
You did, you did. So, many bacteria will break down the carbohydrates and produce hydrogen. Certain sulfide reducers, this is a whole genus of bacteria over here, they'll be like, I'll take that hydrogen and I'll make a hydrogen sulfide, which is hydrogen sulfide gas. Now, hydrogen sulfide, as it goes through the intestines, once it hits the colon, works like a laxative. So it actually stimulates colonic contraction. Then if there's hydrogen sitting around and there's archaeobacter, the archaeobacter go, you know what? I could use four of those hydrogens and I'm going to make a methane, CH4. The methane slows everything down. The beauty of this is, remember in the very beginning when I said, how in the world can you have something with opposing symptoms? Now we can. If you've got hydrogen sulfide, you're going to have diarrhea. If you've got methade, you're going to have constipation.
So the bacteria break it down and produce hydrogen, and then there's this constant flux of, if you have the archaeobacter in the small bowel or if you have these sulfide reducers, they're sharing the hydrogen and they can produce hydrogen sulfide and/or methane. And we have certain small intestine bacterial overgrowth testing that show us that. We do what's called a breath test where you can see, are you a methane producer, or a hydrogen sulfide producer, or just a hydrogen. And what we're learning is that if it's just hydrogen, it's probably being used by both types of bacteria. And that's why we're just seeing the one. It's a moving target, but it makes total sense now, where all of a sudden we're like, wow, this makes sense.
Jennifer Fugo (30:06.062)
And so for someone who is more on the methane side of SIBO symptoms, where they have constipation, you said it becomes almost like this paralytic agent, isn't the usually next step is, say, take a laxative. Do you think that laxatives are actually helpful in this case? Or in your experience, do you think it's actually not helpful and there's other things that we should consider?
Ken (30:28.366)
So if somebody comes in and they sound like small intestine bacterial overgrowth (SIBO), and they eat a meal, and they bloat, that tells me that there's SIBO going on in the small bowel. They can also have functional constipation, where it's like, how often do you get called to the bathroom? Well, I don't really have the urge for three, four, five days, I feel miserable. So there is a role of treating the small intestine bacterial overgrowth and also trying to get the movement going more in the colon to train the colon in many different ways. But many times when we treat the SIBO, then the colon will correct itself because you're not having this methane gas slowing everything down.
So there's two parts to it. It's the IBS-C, if you treat the SIBO symptoms causing the methane, then the constipation component will get better. If somebody, I get a lot of people that'll come in and the first thing they say, they're like, I'm really bloated. And were you ever normal? No, I've been this way since I was a teenager. Do you wake up bloated? Oh yeah, I wake up bloated. Those are people that I consider more functional constipation. And that's more of a pure colonic movement issue rather than a SIBO thing, because they don't have any of those other SIBO symptoms. Do you have skin issues? No. Do you have brain fog? No. You've had this since you were a teenager, this is more of a functional thing.
Now let's look at, is it pelvic floor issues? It's a whole different conversation. And so I do see a lot of people that come in saying I'm bloated, but the reality is you wake up bloated, you feel bloated all the time, it's because, we get an X-ray, and you're just completely full of stool. And you've become so accustomed to it that that is your normal. That's a different conversation than what we're talking about with methane producers that have SIBO.
Jennifer Fugo (32:09.866)
So I'm gonna ask you this question. As a gastroenterologist, do you like laxatives? Do you not? I personally think that people have a very hard time, even some of the natural ones, getting off of them, almost like the colon becomes addicted to them. But what's your thoughts on that in terms of, do you think it's worthwhile to try a laxative if you're really, really constipated?
Ken (32:34.766)
Yes, absolutely, and laxative means a lot of different things. Is it a stimulant making the colon contract? Is it osmotic, are you drawing water in? There's different types of laxatives. The way that I think about it, is that the being addicted to a laxative is a carryover from when old stimulant laxatives actually damaged the nerve cells. And once you started it, if you took it long enough, you literally could not get off of them because they damaged the nerves themselves. Fortunately, they figured it out and they don't have that agent in there. And it's so long ago, I don't even remember what was put in it. But stimulant laxatives that make the colon contract are useful in certain times. Osmotic laxatives are non-habit forming at all, but they draw a lot of water in.
Ideally what you're trying to do is train your bowel so you don't need anything, and you can take advantage of certain things. Meaning, if you have the urge to go to the bathroom, but you don't completely empty or feel fully evacuated, now we're talking about, let's work on the muscles in the pelvic floor. Let's work on that aspect so that you can have a complete full bowel movement. If you don't have the urge to go to the bathroom at all, and you tell me that you can go a really long time, what can happen is the colon itself, the muscles, actin and myosin, they have to contract. And when somebody says that they've been constipated since they were a teenager and they've been putting up with it, well, over time, the colon actually stretches and gets longer to adapt to this.
Jennifer Fugo (34:14.601)
Wow.
Ken (34:18.496)
So we will do these, I'll do a colonoscopy on somebody that's had constipation for a really long time, and they have this really long, large, redundant colon, is what we call it. Because the colon has just sort of said well, you know, if you can't beat them, join them. If you're not gonna let me out and I'm just gonna have to hold on to all this poop, I'm just going to get bigger and everything.
So knowing that, that when you have this, the colon, if it gets stretched out, it's much like a normal muscle. If you think about it, your bicep is much stronger from this to this because more of the muscle fibers are together. If you hyperextend, I'm actually weaker trying to bring it up. Same thing with the colon. So I view it as almost therapy for the colon. Let's put you on a regimen, let's get you going to the bathroom, let's get you cleaned out. A lot of times we'll do it after a colonoscopy. You're completely cleaned out now. Now let's work on a regimen. Let's decide how we're going to do this.
Because if you think about it, there's things like the gastrocolic reflex. We know that if you put something in your stomach, that there's a signal to tell your colon that it's time to move. And so many people block that due to life. I have a commute. I'm going to have my cup of coffee. Yes, I have a slight urge to go, but I'm going to suppress it because I'm on the train right now, or I'm on a bus, or I'm stuck in traffic. And those signals, the brain gets used to not listening to that.
So if you're listening to it and you're on something, so if you take something in the evening. And even natural stuff actually has, even natural, when you talk about herbal, they usually have something called a senna alkaloid in it, which is a stimulant. There was a study that just came out a few months ago that looked at taking four prunes against prescription medications, and it was as equivalent to taking super expensive drugs. But if you look at the prune, it has both an osmotic component to it and it has a stimulant component. It has erythritol, which draws water in, and it has caprylic acid, which stimulates the colonic movement. So even the foods we eat are kind of built, like your grandmother that told you to eat a prune, now there's scientific evidence for that. So once you're treating that, it's not a, you're going to be addicted. It's let's get you used to the signals. Make sure you fully evacuate, and over time, your colon will start to become normal size, where now the muscle fibers have the ability to push everything where it's supposed to go.
Jennifer Fugo (36:50.597)
So if you have done small intestine bacterial overgrowth testing and have SIBO, in addition to constipation, or maybe you're on the other side with SIBO symptoms like diarrhea, and we want to treat this, there's medications, you mentioned Xifaxan. There's also herbs that you can use as well for natural SIBO treatment, there's some great research showing that different herbs can be really helpful. What are some of your favorites?
Ken (37:15.982)
Well, I have one particular favorite for natural SIBO treatment. I mean, this is what my research was in. I don't usually have to go beyond this thing. So while I was doing the clinical research, looking at the archaeobacter producing the methane, and knowing that other types of bacteria produce the hydrogen, looking at the data that we had, then we did clinical trials by combining three large stable polyphenols. And what I mean by large stable polyphenols, one of the things that I was doing the research, knowing where the problem is, which is inside the bowel, I don't want it to be absorbed.
So one of the problems with taking antibiotics, you say, well, just take an antibiotic. Antibiotic gets absorbed systemically and disrupts your microbiome. We need it to work right where it's supposed to be, which was the concept of Xifaxan. It's poorly absorbed, so it's going to work where it's supposed to be. So I realized that if you take a large polyphenol like quebracho, which has been shown to block, or it has been shown to be able to get rid of, the archaeobacter. And you combine that with chestnut, which blocks the enzyme that the archaeobacter produces methane. And then the peppermint, which actually allows it to stay around a little bit longer, calming the area down. We had clinical results, we did two clinical trials on it, and we did have basically four out of five people get better with bloating and such. So that is the go-to, and it's called Atrantil, that's what we've been working on.
I do use Xifaxan as an adjunct. And occasionally there was some data to show that neomycin has been an adjunct to Xifaxan, so some doctors will use neomycin and Xifaxan. There are some side effects to neomycin that kind of prohibit it for some people. There's some new evidence to show that the types of bacteria causing hydrogen sulfide actually do respond to Pepto-Bismol, the Bismol component of it is an antimicrobial to those. So people are learning a lot of different things. But most of the time, we can get away with treating people with Atrantil. But, it has to be now knowing what's going on, it's not take one and walk away. Even with Xifaxan, it's really it's two 14-day, three times a day. So we do two capsules, three times a day for 30 days.
Jennifer Fugo (39:35.296)
And with this, so I think sometimes people get nervous with natural SIBO treatment like herbs, especially with the chestnut. That is not a nut, right? So there's no nut allergy issue.
Ken (39:48.334)
Correct, so chestnut is not a tree nut, there's no nut allergy. And when people look up chestnut, if you were to eat a chestnut, it's toxic, but when you take out the main component, which is called asin, or Aesculus, the asin is completely harmless and has been shown for years and years and years to be used for different things. Specifically venal health, like it's been used for varicose veins and hemorrhoids. And so it's been used forever for that. But nobody had actually realized that it actually does have the ability to decrease the methane as well. So yeah, chestnut is not a nut, and if you have a nut allergy, it's fine. And it actually has been used for many, many, many years for other reasons.
Jennifer Fugo (40:34.142)
And is there anybody, because I do use Atrantil in my practice, and I feel so grateful to have you here. Because I've known you so long, and this has been such an amazing blessing for so many people. And plus it's over the counter, I feel like you can get it in a lot of places, and obviously we'll link up to that in the show notes. But one of the big points about this is the polyphenols that can have a real, especially like for the skin component, can have a really positive impact. So you were saying the polyphenols in these particular herbs, they're like the colorful components of fruits and vegetables.
But what about the polyphenols specifically, because I feel like now we're like hearing about the carnivore diet as a SIBO diet and people are cutting, they're like afraid to eat plants because of salicylates or salicylates, or however you want to pronounce it. Or they're nervous about oxalates, and we start to get to this point where everybody's afraid of different components. And yet polyphenols, I think, historically have shown that they are healthful and have a healthful impact.
Ken (41:51.854)
So if we were to look at what makes vegetables and fruits healthy for you, we know that they have insoluble fiber, they do have some vitamins, but the primary reason is these polyphenols, the things that make the fruits and vegetables colorful. The funny part was that when I had developed Atrantil, it was strictly specific for these gut issues. And we had been working with scientists from around the world since then, because the science of what polyphenols can do is really so fascinating.
The one thing is, that not all polyphenols are created equal. So when you look at, let's take the quebracho and the chestnut together. This was a clinical study done by a PhD out of Spain, Silvia Molino. Fascinating work where she took the chestnut and the cabracho and she put it through a digestive system, and what she was able to show is that it essentially did not get digested from mouth all the way until it got to the colon. Once it was in the colon, or in basically her laboratory colon, she then put it with a microbiome. She took a sample of human feces, and then she was able to ferment the chestnut and the quebracho with this. And then she did what's called a mass spec on it, where she wanted to see what molecules were actually produced.
This is fascinating because in the paper, what she showed is that these large stable polyphenols have all these other molecules in it, molecules that you've heard of like quercetin, urolithin A, urolithin B, there's green tea extract in there. So people think of it as like a separate product. Think of it like this. When you have a large stable polyphenol, it's like a big Lego piece, let's call it a Lego castle. It goes into your digestive tract. The Lego castle stays intact till it gets to the microbiome, at which point, if you have the right bacteria, they start disassembling the castle into chunks of Legos. Those chunks of Legos do different things. These chunks of Legos then get broken down by other bacteria.
Ken (44:10.444)
And so when you take quercetin and you put a bunch of quercetin together, it becomes a flavonoid. You take a bunch of flavonoids, it becomes a proanthocyanidin. These are all sciencey words for saying, how big is the polyphenol. That is why Atrantil is so unique and so effective, is that it is the largest stable one. So when your bacteria break this down, they break it down into different metabolites. Everything about the polyphenols comes down to the metabolites, and these metabolites are the things that create the anti-aging, anti-cancer, anti-inflammatory aspects that are so beneficial.
So when we talk about the polyphenols, and you realize that having a large stable polyphenol with the right microbiome, I keep kind of saying that because when we live in a society where we take a lot of antibiotics, where we eat a highly processed food diet, think of your microbiome either like a lush tropical forest in Puerto Rico, or just kind of a smattering of just one type of weed in somebody's yard. That's a microbiome, but it is very narrow. And there's inability to actually break down these large polyphenols when you don't have the right microbiome.
So you have to feed your microbiome what it wants, which is fiber and polyphenols, and you also have to protect your microbiome. I say this because a lot of people are taking things, that they don't realize, that are specifically made to not be absorbed, but to be broken down by the microbiome. For instance, a lot of different herbs that we talk about, turmeric, curcumin, berberine, quercetin, resveratrol, I could go on and on, these are all polyphenols. They're all polyphenols that are poorly absorbed. And so everybody's trying to figure out how to make it more absorbed. But when you realize that the benefit of those polyphenols are these metabolites, urolithin A, urolithin B, you end up causing mitophagy and things like that. That's where you get these benefits. So that being said that the science of the polyphenols is amazing.
Ken (46:30.766)
I was going to tell you that an article just came out this month, June 2024, in case I come back on in 350 episodes, episode 700, and I'm referring to this, we at least have it dated, June 2024. It actually looks specifically at the role of polyphenols in skin health in a SIBO diet. And they were looking at the science of it and trying to explain exactly what happens. And we can nerd out completely on that. But all these terms that I've said before, it describes NF-κB.
On the skin level, UV radiation creates NF-κB on a local level, which creates inflammation. So these polyphenols are protective against a lot of these different things. It's really fascinating because it's strictly polyphenols and their metabolites, and what it does to the skin. Improves hydration, increases collagen, decreases these different inflammatory cytokines that end up creating different skin issues. It causes increased growth factors. It's just super cool that people are catching up to this science that, you know, I've been like, I started out in the gut and now I'm just geeking out on these polyphenols in the SIBO diet.
We haven't even begun to talk about the thing that most people know about, which is the short chain fatty acids in a SIBO diet. That's a metabolite of these polyphenols and their bacteria. Butyrate and skin health, propionate, IPA, which is indole-3-propionic acid, it does all kinds of things. These are all really cool things that get absorbed, and it can be directly related to the skin. If you have SIBO, by definition you have dysbiosis, meaning you probably don't have the right microbiome, by definition you're creating inflammation, by definition that inflammation is going to other parts of your body. And if you're not getting rid of it and then feeding your microbiome, then that inflammation goes unchecked. So that's why it's such a cool thing with these polyphenols.
Jennifer Fugo (48:37.873)
It's such a cool field that you are in. And I will say, I love listening to you nerd out about this. We had the opportunity to do this a couple months ago in person, which I deeply, deeply loved hearing many of these stories and explanations. And I really wanted you to come here to share not only the benefits of all of these different polyphenols, specifically the ones that you have used in Atrantil, because I do think it's a really great option for listeners, and it's so accessible. But also to understand the complexity of SIBO (including small intestine bacterial overgrowth testing), and to see the connections deeper and deeper of what's going on in our GI tract and the gut microbiome, the impacts that that can have in other areas that you're just, unfortunately at this point in time, if you go to your doctor, you might not hear about this. And there's so much more that you can do than just say, well, I guess I've just got to live with this.
Ken (49:40.014)
Well, you know, this is a thank you to you, for somebody like you, who has a podcast that has tremendous reach, people listen to you. I honestly feel that people are taking health into their own hands and they're realizing these kind of things. And enough people go to their doctor and say, I heard this on a podcast or I'm gonna do this, this is what I'm doing. And you know, it shifts the tides.
When I launched Atrantil and I would try and talk to doctors, and or I would try to talk about this, the knee jerk reaction is always, and everyone's busy and I understand it is, well, there's no research on it. I'll give you an example. I went to a talk and there was a doctor, he was a professor from North Carolina and he was supposed to give a talk about probiotics. Whole separate subject, but he was presenting the data and he said, look, guys, the data here on the
long-term studies, we now know that these probiotics are not, basically, he said, it's equivalent to placebo over time, over patient person years, dah, dah, dah, dah, dah. Individually, I think it affects people, and if it works for you, great, but when they're talking just gross data on everything. And he said, what we really need to do is we really need to improve the microbiome, but unfortunately, there's no data on this.
Now at the time, our group Baby Bathwater, they had asked me to give a talk on the microbiome and aging. And I was sitting with a folder with, I mean, hundreds of articles on the microbiome, aging, and what you can do. If your microbiome gets old, you get old. And this has shown that, if you look at people that are super centenarians, their microbiome is that of somebody much, much younger. And so it's chicken or the egg. But that is an example where I went, even you, this Professor Emeritus who's saying something that is kind of slapping everybody in the face, you didn't even look to see if there was data on this. And so when I would go talk to doctors and I would say, you know, we're treating this, IBS is not in their head, it's actually in their gut, it's called SIBO, then I would be told, well, there's no data on this. And as they're eating a lunch given by a drug rep. And then you realize the only data they're being exposed to is when somebody brings lunch and hands them a pamphlet, says this is the new drug that we're using here, and then you just say, okay.
So that's part of the reason, is that everyone's busy and old habits are hard to change, but hopefully when it starts with the consumer, meaning the patient, they can change it by listening to stuff like this.
Jennifer Fugo (52:14.349)
100%. That's part of the reason I started the Healthy Skin Show. I thought, well, if the drug companies can inform, we'll put that in air quotes, inform and educate on the TV, we can do the same thing. And I know that people are gonna love this because this is a conversation that I feel like you have to come back. So I'm extending the invitation now, not when I get to episode 700, before that.
Ken (52:43.118)
I'll put it in my calendar for four years. Yeah, I'll make sure.
Jennifer Fugo (52:49.837)
In case you guys don't know, we're actually friends. So it's all good.
Ken (52:54.334)
I'm sorry, we got off topic there when you said, you know, I really enjoyed listening to you geeking out. And I was going to say, I really enjoyed you being one of the few people that didn't just kind of nod and walk away, and you actually listened, because I am a nerd about this stuff.
Jennifer Fugo (53:02.085)
I did. I find it fascinating because for me, if it helps one person or two people, and the things that I start to hear, and I can direct them in a certain way that could change the course. You know, people who don't have GI issues don't get it. Until they have GI issues, and then they can't leave their house because they have SIBO symptoms like bad diarrhea, or they're so constipated they feel really uncomfortable and whatnot. You don't get it until it's so bad, and the same goes with a lot of skin issues too. A SIBO test could help.
And so for me this is the way to help others connect the dots to get their life back by trying small intestine bacterial overgrowth testing, because you don't get those moments of life back. You can't go back and go, jeez, I wish I had gone to the whole entire season of my son's soccer game, but I couldn't do it because I had really bad diarrhea, and gas, bloating, and my skin was all broken out. I couldn't do it. You don't get that time back. So for me, this is about changing the quality of people's lives and giving them back that power to be able to live them to the fullest.
Ken (54:14.348)
100%, and also allowing people to feel comfortable saying things to you and to me. I've had so many patients that sheepishly would say, well, you're going to say this. I'm like, no, I'm not. I'm not going to say whatever, because basically they'll say, you're like the fifth doctor to say I have IBS. You're going to put me on an antidepressant. And then when you ask those questions and then they realize, and it's the same thing. People have been like, I've been to the dermatologist, they gave me this, nothing helped. And they come to you and you say, well, let's do this through many different ways, lifestyle changes, things like that. So allowing people a place to keep looking.
Jennifer Fugo (54:54.121)
And that's so, so important because when you give up hope, it's not a great place to be in. I know personally. So I think that's what this is for me. It gives people hope, and a path with SIBO test, and an option forward that they didn't have before.
Thank you, Ken, for coming on the show for your first appearance, your inaugural appearance. I swear it will not, the audience can hold me accountable to this, it will not be another 350 episodes before you come back. But I will make sure to put all of the research and everything into the show notes of this episode. And if you guys wanna try Atrantil, it is available in so many places so you don't have to feel like you have to try and hunt it down. But I will put a special link where you can get discounts on the product and you can always use my discount code, Healthy Skin Show. But we'll put that all for you in the show notes so it's really easy for you to find. And yes, we'll put all the links to find Ken and all of the many things that he does everywhere on the internet so that you guys can connect if that works for you. And as you said, you don't really see patients unless it's a request, right? So like a second or a third opinion.
Ken (56:13.182)
No, no, no, I mean I still have a practice, I have a clinical practice, I love doing my job. You know Eric, Eric and I have the Gut Check Project, that's our podcast. Eric is, him and I, he was my anesthesia provider for over a decade and he put my patients to sleep, and him and I worked together at Atrantil and developing products and things like that. Now, both of us have had multiple discussions that I really do love my job. And so this is hard because we have all this stuff going on, but I really enjoy seeing people and doing this, and it helps with that.
But I do want to say that you were talking about where you can find Atrantil. Now you're kind of underselling this in the sense that, you know, I really want everybody to buy Atrantil from you, because you're making the effort to educate people, and you're doing this, and you're going to get a discount from you. If you get it off Amazon, it's going to cost you full price. If you go to wherever you live in the country, go to Sprouts or wherever place, it's going to cost full price.
Jennifer Fugo (57:03.974)
That's right.
Ken (57:11.662)
The rest of my team's gonna get angry because they're like, quit sending people to a discount, but get it, it's at the Healthy Skin Show, will be there.
Jennifer Fugo (57:19.845)
I will send everybody, I'll give them the link.
Ken (57:24.62)
Everyone, get it from Jennifer.
Jennifer Fugo (57:31.109)
It's in the show notes, it's in the show notes. Ken, thank you so much for coming, I really appreciate it.
Ken (57:33.966)
It was awesome. It was worth the wait. Worth the wait.
