Healthy Living by Willow Creek Springs
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Healthy Living by Willow Creek Springs
Unraveling Complex Illness With Dr. Michael Scoma
When medicine gets messy—overlapping symptoms, normal labs, no clear path—most systems fall back on short visits and narrow playbooks. We went the other way. With Dr. Michael Scoma, an infectious disease and immunology specialist, we explore how long COVID, post-vaccine syndromes, POTS, mast cell activation, ME/CFS, and chronic tick-borne infections often collide in the same patient, and why solving them demands patience, pattern recognition, and care that doesn’t end at the 15‑minute mark.
Dr. Scoma shares a practical framework for treating complex illness: start with a deep history, map trends over time, test thoughtfully, and iterate based on results—not rigid protocols. We dive into hypotheses around persistent spike or viral fragments in tissues, the limitations of current diagnostics compared with conditions like HIV, and why some of the sickest patients need two-hour intakes, one-hour follow-ups, and access between visits. He explains how telemedicine and concierge-style availability help stabilize bedbound or homebound patients and how “old-school” medicine—listening, observing, adapting—still outperforms a rush to more tests.
We also wade into the nuance around vaccines, schedules, and public trust. Dr. Scoma acknowledges life-saving benefits while highlighting unanswered questions about long-term effects for a subset of patients and the need for better biomarkers, larger trials, and honest risk-benefit conversations. Beyond labels like “integrative,” he argues for whole-person infectious disease care that bridges gut, immune, autonomic, and environmental factors—because complex illness rarely respects specialty lines.
If you’ve been told “your labs are normal” but your life isn’t, this conversation offers clarity, validation, and a working roadmap. Subscribe, share with someone who needs a thoughtful clinician’s perspective, and leave a review to help more listeners find the show.
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Well, hello, and welcome back to the Healthy Living Podcast. I'm your host, Joe Grumbine, and today we've got a very special guest. His name's Dr. Michael Scoma, and he's an infectious disease doctor, distinguishing himself as one of New York's most sought-after practitioners. After completing his training at the prestigious Yale-New Haven Hospital, Dr. Scoma manages a vibrant inpatient and outpatient practice dedicated to the diagnosis and treatment of an extensive array of complex, infectious, and immunologic conditions. And that's just the tip of the iceberg. Dr. Skoma, welcome to the show. I really just want to jump into our conversation. It sounds like you're dealing with a lot of things that affect a lot of people today and maybe don't have clear answers. That's something that came to me recently with somebody who had lupus.
SPEAKER_01:Joe, thank you very much for having me. It's a pleasure to be here. To your point, there's a lot that I deal with on a daily basis as an infectious disease immunology doctor. And that's what still drives me so much with respect to my passion towards it, is uh when you had mentioned that really is just the tip of the iceberg. I deal with a lot of very varied um scenarios and presentations on a daily basis, both in the hospital, outside the hospital. Um, you know, infectious disease and immunology are very all-encompassing. Different organ systems, different types of patients, immunocompromised patients, post-surgical patients, neurosurgical, orthosurgical, plastics, cardiothoracic, uh, all of the medicine specialties, uh, profoundly immunocompromised patients, as well as what is kind of my biggest passion is more of the outpatient landscape, um, which I deal with a lot of uh they shouldn't be esoteric. I mean, everybody should know about these things, Joe. But the thing is, is they're not very well understood and kind of, I, to my opinion, um have the validation that they, that they and the urgency that they require in the conventional medical setting. And those are, to your point, what you had mentioned, uh disease entities like post-COVID syndrome, i.e., long COVID, post-vaccination related issues, uh, myalgic encephalamyelitis, chronic fatigue syndrome, uh, downstream events due to the inflammation, such as mast cell and autonomic dysfunction, um the chronic neurological tick-borne illnesses and uh uh parasites are another one that are certainly not limited to just endemic areas and things of that nature. They're they're very present here. Uh, and these are things that cause a tremendous degree of um not necessarily mortality, but morbidity and diminished quality of life in a lot of the people that are afflicted. Because many of these people in the outpatient setting, many are young and otherwise fairly healthy. And they're just struck down by these horrible, you know, neuroimmune autonomic processes with not a lot to go on in terms of FDA authorized treatments and the proper uh uh randomized double-blind placebo-controlled studies, um, the way uh other more conventional, quote unquote conventional aspects of medicine uh are are equipped to deal with. So it's a challenge. It's a challenge.
SPEAKER_00:You you've taken on this gigantic um problem, which which is multifaceted and and multi-pronged, and you almost in some ways have to step back and look at it from a big picture to to see certain patterns, I would imagine. And then in other cases, you got to jump deep into the middle of it to you know to to wade through the trenches and see what's really going on. Um, I know that with Lyme disease, it seems like it's become uh more prevalent as these ticks are spreading around and or maybe it's just being more diagnosed, you know. I think we have a lot of symptoms or or conditions that you've mentioned that you know, it seems like they're increasing in numbers, but again, were they just previously misdiagnosed?
SPEAKER_01:I think it's a couple of different things, Joe. I think one, um there's I believe since since COVID has been about, um, I do think that as pertains to some of these issues, as pertains to uh uh uh mast cell or chronic fatigue syndrome, myalgia encephalamyelitis, um, recrudescent tick-borne infections, you know, a lot of these things end up being uh downstream byproducts andor reactivated by COVID. So, you know, there was a New York Times piece that had that that basically referred to uh the incidence of what we call POTS, P O T Shield orthostatic tachycardic syndrome.
SPEAKER_00:I recently met a few people suffering with that, and it's it's extremely common.
SPEAKER_01:If you just talk to anyone, they'll tell they'll give you the history. It's not, you don't need a toll table test in some instances. It's really just given by history. And all of the incidences of these things have, you know, quintupled in terms of uh increased incidences. I I think that it's to some degree an increased awareness, better diagnostics, despite them not being where they need to be. Um, but at the same time, it's to your point, um, it's very nuanced because a lot of these disease patterns, a lot of you do look for patterns. That is a hallmark of infectious disease in general. You know, you can get some patient in the hospital that's been hospitalized for three months, and you're asked to consult on them on hospital day number 90. You know, you're looking at the general pattern of things, what's going on, uh, what's their, you know, what's the, what's, you know, what's what's been going on and things like that. But uh essentially, um uh many of these outpatient issues that I deal with, uh, they overlap uh a lot. Uh so that's why it is somewhat um nuanced with respect to uh differing out what is really just long COVID, what is long COVID plus reactivated uh Bartonella, or um what is how much is possible mast cell contributing. It's very nuanced, but that's why when I deal with these patients in the outpatient setting, um, you know, I'm very readily reachable. I really much run it kind of like a concierge type practice. Um because I've I have not joked, but I have, you know, said to these patients, you know, the complexity of these patients, they really kind of do need their own personal doctor because they're so complicated and it's so nuanced. And there's nothing FDA approved. And, you know, some of the people I have, they're more mild to moderate. You know, they can function, they can hold down a job, a career, a family. They're struggling, but they can do it. But then there's that other pretty large amount of people where, you know, they've seen 20, 30 people prior to me. And when they're coming to me, they are uh bedbound, homebound. Um, and it's it's devastating. I mean, it bothers me. It's absolutely devastating. And the most concerning aspect is that we don't have the answers that we truly do need. You know, we have not defined discrete mechanisms, what's the on-off switch in these patients? What is the specific defined treatment for these patients? Um, and that's what's so difficult as well. Um, it entails a lot of creativity and a lot of ingenuity. And that's what I do pride myself on, in particular with respect to the outpatient setting and dealing with these patients. And the, you know, fortunate, I've been fortunate because of telemedicine and and uh X and what have you. My reach is able to extend far beyond New York City, where I'm based. Um, however, to across the country as well as to other countries. I treat a lot of patients in the EU, the UK, Saudi Arabia, New Zealand, Australia, uh, Singapore, they could be reached anywhere. So it's it's it's pretty pretty interesting.
SPEAKER_00:You created a very um effective position because with your type of practice the the blood work and the scans and the you know the diagnostic tools are really integral to your treatment, much more so than sitting in a room with them, where in some cases being in a room with somebody makes all the difference in the world and not so much the other way around. And I suspect with you know the technology we have today, you're able to start collecting huge amounts of data from the different um cases you're working with, and and maybe you know you're in a position to be making breakthroughs, I would imagine.
SPEAKER_01:That's the ultimate hope. Uh, I have been able to, I mean, with respect to data, there's a lot of data to analyze. People come to me, you know, sick for many, many, many years. They've amassed a tremendous amount of data. The question is how to synthesize it and what to do with it. Knowing, though, that all the data that we can have with a lot of these outpatient conditions that I deal with, it's only so good. You know, we're not 100% where we really need to be. You know, for example, with long COVID, for example, we have a strong hypothesis that is very biologically plausible that this is probably due to viral persistence and persistent spike that's embedded itself, whether it's in the central nervous system or the small blood vessels, the vascular endothelium or the gut or what have you. Um, however, at the same time, um we um at the end of the day, we really kind of don't know fully uh, you know, it we're we're we really don't have the markers that we need to have, the same way we do, for example, such as HIV, where we're not able to measure viral load, we're not able to measure a re a reputable um uh spike level circulating in the blood, or we're not able to take tissue samples and measure the amount of spike that's in the tissues. So while there is a lot of data, it's got to be looked at appropriately and with a with it with a grain of salt, because at the end of the day, a lot of these things are kind of clinical based. Um and in terms of, I mean, I'm a results-driven guy, I'm a results-driven person for again many things that in conventional wisdom is well, there's nothing to do, right? There's nothing FDA approved, there's no trials, too bad. Just be in bed for another five years and lose out on the rest of your life. I wish you to obviously accept that. Um, so that said, uh it's a lot of clinical sense, a lot of history taking and seeing what is the trend in this patient, what has worked on them in the past, what is not, what are their worst symptoms, what uh, you know, things of that nature. Um so it actually really it's it's extremely, it's extremely nuanced and and and um and very interesting. Um, but at the same time, it's almost a little primitive. It really takes you back to like your medical school days where you're told to do a full history in physical, we lose a lot of that medicine because especially in the hospital, number of patients that you see, the volume, the metrics. Now, fortunately, that doesn't apply to me so much because I'm a private practitioner. So I'm not a I'm not a systems-based guy. Um, I do round at a couple of large hospitals, but as an affiliate, not an employee. So, with respect to the outpatient setting, I'm allowed to be able to spend the amount of time that is required for these patients because 15 minutes is not going to cut it. It's more like two hours for an initial consultation, an hour for follow-ups, uh, being available in between when we run into any issues. And that's really how you kind of get to um, I mean, in terms of the best results possible with respect to these types of patients.
SPEAKER_00:I couldn't agree with you more. I, you know, in going through working with oncologists, and I finally found one that this guy takes the time and he spends time with me. And we've we've we've come up with solutions that you know the the the big industry didn't come up with. And you know, you mentioned um, you know, FDA-approved treatments and you know, standard of care and all of these things that you know insurance is gonna cover or not, um, that hospitals can allow. Um, do you consider yourself to be an integrative practitioner?
SPEAKER_01:So integrative is interesting because I I personally I'm an allopathic MD. However, the and which is you know largely prescribing you know medications, maybe recommending supplements, but I will say a lot of people that have seen me, they've been there, done that in every type of supplement, every type of naturopathic or homeopathic regimen. To me, integrative means what really every doctor really should be. You need to look at the whole person, you need to look at every system. Um, I understand that there's the allopathic MDs, which these are the guys that just synthesize the data and prescribe, you know. Um, and then there's the integrative that does more of like the self-pay uh exams in terms of looking at the uh oat tests and the gut microbiome tests and the mycotoxins and utilizing different types of um herbals or hyperbarics or ozone or this or that. Um, to me, again, these are just these kind of defined, but I think probably albeit incorrectly defined niches. Any really good physician, in my opinion, should be integrative by way of just how they uh practice and look towards things. And yes, I think one of the fields that lends itself most to that is infectious disease, because you really are looking at the whole person, every organ system, whether it's my septic patients that are in the hospital, in the ICU, in in multi-system failure, versus my outpatients, you know, 20-year-old with long COVID, autonomic dysfunction and mast cell, who can barely stand for five minutes a day because of the severity of the disease. So I I I draw um, there's actually a lot of similarities to it, to be honest with you.
SPEAKER_00:Okay. All right. Well, I again I I I'm I deeply respect what you're doing because you're doing things the way that I I wish more physicians would. And I I I understand that, you know, there's the the medical school and the business part of it and and the politics and the insurance and all the it's way more complicated than people think, you know, you can group people into groups, but yet I know some people are willing to, you know, go outside of that and and do it the way it needs to be done. And you know, spending time with people, um taking time to to review the data, to even just to talk to people. Like if you have a five-minute consultation with somebody, you can only ask them so much. You only have so much to work from. Uh your snapshot is focused on whatever.
SPEAKER_01:Very limited, very limited.
SPEAKER_00:You've got a 20-minute or an hour or two hours, you're able to fill in a lot of those little spots and maybe see a thing that you wouldn't see with that brief consultation. You know, the old days, like you talked about, you know, doctors used to come to your house, they'd they'd they'd have a meal with your family, and you know, maybe that's revealing my age a bit, but you know, it was it was still a thing when I was a kid. And um that's so long in the past now. So even finding a doctor that will, you know, have a private practice not bound by the you know, the the like you say, the metrics of this whole thing. You gotta get these amount of people in, you gotta, here's your caseload today, you gotta do it. And it's up to you. Well, that's you know, insurmountable for most people. And you know, doctors are some of the most uh overworked people in the world. So I I'm I'm really um impressed with that.
SPEAKER_01:Um, you know, you know, I I I have done I have done house call ho house visits to patients. You know, if you have a patient with severe MECFS or long COVID and it's a it's a it's a young patient, and they're that you know, they are simply not able to be out to an office set setting or what have you, or if they expend their energy to to to to too much of a degree, they will be crashed out for weeks. I have gone to people's residences to do those consultations. Again, it's a balance between how much time I have or whatnot, but have I done it? Yes. And when you talk about like it is really what I'm a generally younger guy, um, you know, I've got you know two young kids, wife, I'm a younger guy as a whole, but in terms of my approach, it's very old school, much like my father before me, who did infectious disease. Um, it's more of an old school mentality that especially with these outpatients that I take care of, it's really just it's a therapeutic relationship that you're harboring over time. Because there are things that I continue to find out about these patients, maybe something they left out, something that comes to light from how they're behaving upon implementing treatment. These are like real-time things that um can only be harbored with uh a close working therapeutic relationship. But you know, it's very time consuming and it's a it's it's long days than a lot of hours. And it's not it's not for everyone. And to your point about medical school and and education, they don't teach you those types of things with respect to um running a running a business, running a private practice, you know, having you know, building up building a building a niche, building a patient following, dealing with insurance, dealing with prior authorizations. It's a it's it's it's a lot. Dealing with other family members, it's a lot.
SPEAKER_00:I I get it. My dad was a surgeon, so I I I learned a lot about the politics of hospitals and the the the nightmares of insurance and all this stuff. And uh, you know, I um I I I have awareness beyond what a lot of people do without having a medical background. And and talking about, you know, influences, I think that's important. Um I think that people talk about a lot of things. There's a lot of information out there now in ways that there didn't used to be. A lot of misinformation on all sides. And I think that people um are driven by their feelings and their proclivities more than um looking at data and looking at at evidence-based uh answers. Um, and they don't do the research as much as you know, they hear a thing from somebody they believe. Um, we've got huge swings back and forth. You know, you've got uh pharmaceutical companies that, you know, spend huge amounts of monies uh influence curriculums of medical schools, and you know, they're they're driven by making money. I mean, that's their that's their business, is to, you know, they're a business. Um, granted, they they are responsible for discovering medicines that save lives. And so there's this you know sort of double-edged sword to everything. Then you've got politics, and you've got, you know, um you got um presidents and their cabinets that are very deeply connected to healthcare and others that you know seem to not be so interested. We've got one right now um that's very deeply um involved. And you know, what do you think about all of this RFK stuff that you know, I think he's got some good ideas and some terrible ideas all wrapped up into a bowl of soup. And that's just my thoughts. What are your thoughts?
SPEAKER_01:Uh I think RFK, RFK, I think RFK's uh proclivity uh towards calling out more or bringing attention to more uh uh preventative measures, healthier living, uh dietary issues, um, environmental exposures, chronic diseases. Um I think obviously, specifically somebody who deals with a lot of these kind of more chronic complex uh issues, um, uh that is something that I think is uh rather refreshing. You know, I have a lot a lot of my patients. Um, they may be, you know, quite politically oriented to either end of the aisle. I tend to just wait in the center. Um, but um, you know, many no matter what their leanings were, I think everybody the sentiment was they were very excited about RFK because particularly in his Senate confirmation hearing, you know, he brought about terms such as chronic Lyme disease and long COVID and uh, you know, things of that nature that are not going to typically be uttered by many in the realm of government because I mean it gets it's bigger than me, but I just think that on a whole, there may not be a whole ton of money to kind of be made on these types of things. And I think that they kind of just go by the waist side. I mean, why we don't have a hundred clinical trials, you know, multiple, multiple, you know, billion-dollar funded clinical trials on some of these uh disease processes, where you look at the metrics of the quality of life and these processes, such as the MECFS, the myolgic encephalamitis chronic fatigue syndrome, is ranked the highest in the in the lowest quality of life, even beyond that of stage four cancers. I have had patients tell me, doctor, I would rather have stage four pancreatic cancer than have then be dealt with a Bell score zero to 10 severe MECFS where I can't move, I can't speak, I can't have the the the the shades, the the the shades open uh because of the light sensitivity, they can't eat, they can't, it's very very very horrible. Um, so I think that he does uh shine a light on um a lot of these processes that do need uh to be brought about. Um, I think as pertains to uh some other aspects with respect to vaccinations and things of that nature, um I don't know. I think that's probably more of a personalized decision more than anything else, uh, in my in my opinion. And again, I'm dealing with I'm dealing with people who are uh very concerned about some of the vaccines, particularly the mRNA vaccines. Not that the mRNA technology is new, those have been around for decades, but um this is a definitely an evolving thing as pertains to the mRNA COVID vaccines because uh we just don't have long-term data points on any of these things. And there was a study that came out a couple of years ago that irked a lot of my patients. It came from Yale, which is where I did my fellowship training. They do a lot of research there for long COVID. Uh, there's some top people there, uh MDs as well as PhDs. And they did a sampling of healthy controls. So, not people with long COVID or anything, just healthy patients that had received an mRNA vaccine. And they looked at their accurate measured blood levels of spike and they quantified it year by year by year over four years. And the levels, Joe, just increased and increased and increased and increased. That irked a lot of my a lot of my patients in particular, being that we think that possibly spike protein is the thing that drives a lot of these illnesses. This was something that was supposed to be like every other virus uh uh respiratory vaccine. You take it, it wanes after six months, get another one. This is very, very different. I've not seen anything like this in 20 years of practicing. I never saw anything like COVID in 20 years of practicing. When they first came into the hospital, I'd never seen any sort of a pathogen like this. Right. So I'm not surprised that we're getting all this downstream sequelae with the vaccines and and post-COVID sequele and post-vaccine injury. It doesn't unfortunately doesn't surprise me at all.
SPEAKER_00:And I I think a lot of it had to do with, you know, the the seriousness of the disease. So they had to respond with uh frankly a rushed solution, and there wasn't the time to get all that data because there just wasn't the time. They had to had to come up with something and and yeah, I can't I can't fault, I can't fault them.
SPEAKER_01:I mean, when you have a respiratory when it when you have something that's a virus, you know, we don't have a great uh r arsenal of medications against viruses, the way we do bacteria or fungi or mycobacterium. So it's gonna be very unlikely you're gonna come out uh in the setting of a world of a of a of a once-in-a-lifetime pop, you know, probable pandemic with an effective antiviral that's going to target these things. It's gonna keep mutating and it's not gonna happen. So naturally, the the inkling is gonna be towards um, or the tendency is gonna be towards coming up with a vaccine. Um and, you know, they did go uh more of the mRNA route. I'm not 100% exactly sure why, but their intention was to basically target uh what was thought to be with the limited research available, but which is has proved to be correct, the most virulent aspect of the COVID virus, which is the spike protein. Um, it's just a question of what have we kind of gotten ourselves into with giving vaccinations to people where it has been responsible for longer-term production of the spike protein, which could be. I say could be because we don't know, of course, no, more than we know could be could be causing issues. I say to my patients, I know enough to know, I know a lot, but I certainly do not know everything. And that pertains obviously to all of medicine, but particularly as pertains to these more uh nuanced uh uh issues that I deal with in the outpatient uh setting.
SPEAKER_00:Well, on the topic, I I know we're gonna run short on time again. And I as I told you from the beginning, I I think we we we have a ability to have several conversations over this stuff in the future. But vaccines in general, you know, I I grew up in the 60s and 70s, and we had, I don't know, a half a dozen vaccines that we were all finished by the time we were, I don't know, 10 or 11 years old. Um, you got your boosters, I think, when you were, I don't know, nine or ten years old, and you were done. And that was it. There was no more vaccines. Um and then all of a sudden now you fast forward to you know 50 years later, and kids are getting 20, 30 vaccines, and I know that I'm not in any way saying vaccines are not effective because they are. They've they've they've eliminated diseases, they've saved millions of lives, but every disease is an a lethal disease, and there are diseases that you know historically the body has you know overcome. You you get it once, you get through it, and you're okay. Um, what are your thoughts just generally about the the trend of you know, this everybody's getting a million vaccines and boosters are forever?
SPEAKER_01:I mean, it's it's like you said, there's there's definitely a massive increase in the vaccination schedule. Um, I think that it is probably geared uh more to, you know, again, more towards uh, you know, prevention, uh, you know, uh uh a uh prevention of of these uh uh uh you know uh illnesses which are coming about. Um but at the same time, um, you know, we are seeing at the same time, you know, increased incidences of uh autism and increased, not not not to, you know, I can't obviously completely draw a parallel, but we are seeing increased incidences of a lot of these problems. And again, uh we don't have a uh I think the amount of data that we necessarily need um to really fully exclude exclude uh such such relationships. Um I know, you know, personally from for my children, you know, I may be a doctor, but I my wife absolutely functions as you know, doctor for the for the for our two kids. Absolutely. And and definitely um when we have gone to our pediatrician, and for example, my little one was scheduled to get four in one session, she's like, there's no way. Of breaking it up into, you know, at least a couple of sessions is just too much. Um I I do I yeah, I do I do definitely see that as a as a significant trend. Um I guess the question is is where we're gonna go looking forward in terms of is this something that's gonna basically stay or is this something that's gonna be scaled back a little bit? And I think that's gonna have ultimately probably come from uh the healthcare agencies and government policies and things of that nature. The problem is it's just very nuanced. I don't think we have the best uh answers to a lot of these questions.
SPEAKER_00:Agreed. Agreed. Well, uh Dr. Skoma, this has been a riveting conversation, and like I said, I think we just barely touched bullet points. I would love to have you back and and go deeper into a number of these topics. Um, is there sort of a uh a thought that you want to leave our listeners with um with regards to your work and your practice?
SPEAKER_01:You know, I am basically uh I mean, I'm somebody who basically I'm doing what I love to be doing. Um this is something I think we need to, I think we need to bring med, I mean, if it's possible, I think medicine, I think there's gonna be a tide where medicine is gonna go. Uh the systems are always gonna be there, but there's gonna be this drive more from less uh system-based medicine to more uh, I believe, private practice, more individualized, personalized medicine, uh, because I just believe that the two are very incomparable in terms of the healthcare and the attention that can be provided to these patients. So I'm thinking that we may see some degree of a shift. And if I could be, for example, an uh you know, an example of that shift, um, then then so be it. Um, but uh by all means, I think that um, you know, we need to look at these things uh very uh, you know, uh uh through uh an appropriate lens uh uh and and comprehensive. And um I'm just very happy to be obviously doing what I'm doing, and I certainly appreciate uh having been uh on your program.
SPEAKER_00:Wonderful. I I certainly hope you're right. I I I agree. I believe that's what that's what the community needs, that's what that's what humanity needs are are private practice doctors that are able to we just need more doctors, probably, that are qualified because that's really sort of a dynamic of you got all these people that need treatment and only so many people that can offer it and and all of that. But meanwhile, you're on the right side of things. How does somebody get a hold of you? How does somebody reach out? You know, this is you're somebody that literally anybody that's listening here um might be able to help.
SPEAKER_01:Yeah, so I can um I it can be reached on my website. It's um Michael R Scoma MD, just like it's spelled basically.com. Um, I'm very easily searchable on Google. I post on X, um, very readily reachable. My numbers, uh, office uh office uh email address are readily available on the website, uh online. Um uh but that would be the easiest way to reach me in terms of the website. It has my office numbers available on it.
SPEAKER_00:Beautiful. Well, thank you so much for joining us today. And again, I welcome you to come back. I've got so much more I'd like to talk about. And um just grateful that you could join us.
SPEAKER_01:Thank you so much. That'd be great. Thank you again, Joe.
SPEAKER_00:Beautiful. This has been another episode of the Healthy Living Podcast. I'm your host, Joe Grumbine, and I want to thank all the listeners for making the show possible, and we will see you next time.
