Burnout is not a buzzword—it's a pressing issue that's taking a toll on healthcare professionals. Together with Dr. Svetlana Chamoun, MD, PhD, DipABLM we uncover what burnout truly signifies and its impact on health care providers and patients.
Prepare to be inspired by Dr. Chamoun's upcoming books and her innovative wellness calendar. Plus, she lets us peek into her daily routine and shares her non-negotiables for meals, movement, mindset and overall health. Our conversation culminates in a powerful dialogue on the importance of positive health messages and stigma-free healthcare.
Dr. Svetlana Chamoun, MD, PhD, DipABLM
Follow Perfectly Pl@nted on Instagram
Follow Perfectly Pl@nted on YouTube
Follow Perfectly Pl@nted on Pinterest
Burnout is not a buzzword—it's a pressing issue that's taking a toll on healthcare professionals. Together with Dr. Svetlana Chamoun, MD, PhD, DipABLM we uncover what burnout truly signifies and its impact on health care providers and patients.
Prepare to be inspired by Dr. Chamoun's upcoming books and her innovative wellness calendar. Plus, she lets us peek into her daily routine and shares her non-negotiables for meals, movement, mindset and overall health. Our conversation culminates in a powerful dialogue on the importance of positive health messages and stigma-free healthcare.
Dr. Svetlana Chamoun, MD, PhD, DipABLM
Follow Perfectly Pl@nted on Instagram
Follow Perfectly Pl@nted on YouTube
Follow Perfectly Pl@nted on Pinterest
Welcome to the Perfectly Planned Podcast, where we're dedicated to growing with you on our journey towards a healthier, happier and more sustainable lifestyle. I'm your co-host, vesame Shreering, health and wellness enthusiast and loving all things plant-based. Whether you're a seasoned vegan or you're just dipping your toes into plant-based living or just curious about a healthier lifestyle, you're in the right place. Good morning, daphne. How are you?
Daphne:Good morning, vesame. I'm doing good. Thank you, it has been a busy weekend. Thanks for taking time everyone to join us today. I want to start by giving a huge shout out to the amazing women who ran the Ironman Triathlon yesterday in Kona, hawaii, and, more importantly, to Lucy Charles Barkley, who had an amazing win yesterday and set a new course record. I've been following LCB for years. Just the thought of swimming 2.4 miles and biking 112 miles and running 26 miles back to back it's an incredible feat. I just want to acknowledge the amazing women who had center stage all day and put on an incredible performance. We all look up to you and we are all aspiring to be as mentally and physically resilient as you are. Talking about mental and physical resilience, I'd like to introduce another amazing woman, which is our guest, dr Lana Shemun. Dr Shemun, welcome to the Perfectly Planted Podcast.
Vesime:Welcome.
Dr. Svetlana Chamoun:Thank you so much, Vesame Daphne. It's my pleasure to be here today.
Daphne:Well, I was looking through your bio and there are so many amazing things that you have accomplished in this industry.
Daphne:I just want to highlight a few for those who are listening or viewing, but really we're here to hear your story. Dr Shemun is an accomplished leader in the healthcare industry and she is recognized for her expertise in cardiology and lifestyle medicine, which is where I had an opportunity to meet her and get to know her. But, more importantly, as the founder and president of CardioSeed's LLC and creator and host of the CardioSeed's podcast, which I would definitely encourage you to listen to, she just combines a passion for preventive cardiology, preventive health, and a commitment to educating and inspiring others, and that's whether it's healthcare professionals or just people in the community. And I think that's core to the message. With certification in both cardiology and lifestyle medicine and also being certified as a health and wellness coach by AFPA, I think this combination of skills the health, the prevention, the focus on mental and behavioral health you've just found a core way to develop a message and connect with people, and we are so pleased to have you on the podcast today.
Dr. Svetlana Chamoun:Thank you so much, stephanie, for this kind introduction and I guess, as you said before and as Bessie said, as we all say, everybody in lifestyle medicine has a story to tell, right, and we'll be chatting today about my story and for me, as you said, blending lifestyle medicine and cardiology and my further opening. My business was not simple but it was kind of organic to me and cardiovascular prevention through stress and burnout reduction is a very personal story to me because, first and foremost, I'm a cardiologist who understands the cause effect between work-related burnout and development of cardiovascular disease and, secondly, I experience burnout firsthand, and not once but twice, and I'm equipped also with resilience, knowledge and tools to change my work-life balance. So I founded company CardioC, as you said, to help other healthcare professionals advance their cardiovascular health and overall wellness through stress and burnout reduction and other pillars of lifestyle medicine. So my story actually started in Soviet Ukraine and was filled with rich culture and adversity also, as well as triumphs and tragedies. So all those things shaped the person I am now and the professional I'm today, and I was raised in a family of professionals and intellectuals.
Dr. Svetlana Chamoun:My mom is Jewish. My mom was a professor at the university and she was very strict and she was stern strict, raise in traditional values, educate my traditional values. At the same time, my dad was sort of a free spirit. He was a journalist, a dissident journalist who stood against the government and paid the price. Actually, he was sent to Siberian Gulag and spent several years in Siberian Gulag. But before that happened he really instilled this free spirit in me and we traveled with him extensively throughout our country. He showed me so many places and he really instilled the spirit of adventure in me.
Dr. Svetlana Chamoun:And I entered medical school when I was 16 and by the age of 26, I had my medical degree and I had my PhD degree already. So, unfortunately, when I was about 24, our country plunged into the post-Soviet turmoil and when I was 26, I had to take my daughters and immigrate to first Canada and then the US, seek brighter future for myself and my daughters, because there was no future there at that time at least. And I literally you know when they say I thought it was a joke in the past when people said I came to this country with $200 in my pocket, one. For me it was literally speaking $400 in my pocket and closing on my back. This is it. I didn't even have language. I didn't speak English when I came to this country and then, you know, shortly after I came or we came, I received tragic news of my dad's passing and that shattered my world for years to come.
Dr. Svetlana Chamoun:And essentially, you know, I was equipped with this resilience and courage and young age at that time. So, and interestingly enough, my mom, who was a professor of psychoanalysis, she wrote books on self-care and resilience and she published books on self-care and resilience. So I had that knowledge with me and I persevered and despite all those years of taking care as a single mom of my daughters and you know, my mom was shattered, you know, with this, my dad's suicide and I had to take care of her, and all this single-handedly, while going through immigration and going through several years of retraining here in the United States as a resident and then as a fellow, and going through jobs as a cardiologist for 20 years, you know. You know long hours and grueling jobs and all that stuff. All of that I survived and I thrived somehow. I don't know, I don't know how I did this, but somehow, not only I did this, I sent my daughters to college, I helped my mom, I wrote books and then I realized I've been doing all this and this is all. This spirit is living in me and I'm feeding other people with my strength and my daughters started telling me mom, you've been doing all this and you are doing it differently, not like people back home, and you are inspired and asked to do some things differently.
Dr. Svetlana Chamoun:So, essentially, and then fast forward essentially to 2019, my husband I read to my colleague here to a cardiologist and fast forward 2019, he gives me brochure for the American College of Cardiology annual meeting, the American College of Lifestyle Medicine annual meeting, and that changed my life. So it changed your life problem. At some point it changed my life and this is how I got more certified in Lifestyle Medicine in addition to cardiology. Then I got certified as a health and wellness coach and essentially at that point also the COVID pandemic started and I saw how they burn out, engulfed medical community and also the fact that the pillars of Lifestyle Medicine weren't practiced among the mainstream medicine, how much it affected our patients also and their cardiovascular health and chronic diseases. How much they could have been prevented and they were not prevented and this affected the health and survivorship of our patients from COVID, so negatively affected it.
Dr. Svetlana Chamoun:And so I realized that I could contribute to the positive part of it with my knowledge of Lifestyle Medicine, my knowledge of cardiology, my knowledge of health and wellness and coaching. So I said 20 years of cardiology is enough, so I can do it differently. I left my job and I started the cardio seeds. So I started the cardio seeds podcast with that aim to dedicate my services to Lifestyle interventions, behavioral coaching and aim for cardiovascular risk reduction through stress reduction, through burnout reduction and transformative powers of Lifestyle Medicine. So this is my goal. Now I co-chair the cardiology member interest group at the American College of Lifestyle Medicine. I also started the work-life balance and cardiovascular health subcommittee within the MIG to expand the message that the earlier we prevent chronic work related stress, the earlier we address widespread burnout among the health care professionals, the more cardiovascular prevention among our health care professionals we can introduce. So this is my goal and my mission now.
Vesime:That's amazing.
Daphne:That is amazing.
Vesime:There's a little mission there, dr Shimon. Your credentials alone are incredible, but just sharing your journey just makes me put you on a completely another level. It's extremely impressive and I'm curious, through all of this, what really has driven you? What is your? Why? Why is this work so important to you?
Dr. Svetlana Chamoun:You know, at this stage of my career, I am grateful that my actions and objectives resonate deeply with my personal professional values, so they all can come together finally. So I'm far moved beyond the phase of my life when I struggled, you know, to struggle to put food on the table or caring for my mom and send my daughters to college. So I have accomplished that. I enjoy my life. I enjoy it. I'm completely financially secure, I'm comfortable with my life, so I can do what I want now and what I think is important.
Dr. Svetlana Chamoun:So I think that promoting wellness of healthcare professionals is one of the most paramount importances of our healthcare. You know of the founding blocks that our healthcare cannot live without, because we are talking about, you know about patients, investing in patients, investing in the AI, even in all of those, all of those missions that healthcare systems have. But without wellness and health care professionals, all of this cannot be done or cannot be done effectively, profoundly and whole-simily. So wellness of healthcare professionals starts on not only on the personal level but also on the system level, and if we don't address the system and personal all together, reasons for chronic stress and burnout, all this will accumulate over years and will be related to cardiovascular diseases, disturbances, cardiovascular diseases in our healthcare professionals in the long run, in the long run, h12 fibrillation, hypertension, hyperlipidemia, coronary heart disease, myocardial infarctions. All of this is it doesn't happen all together at once in one month, one week.
Dr. Svetlana Chamoun:All of this is accumulative, all cumulative and cause effect may not be, you know, obvious for many and may not be reported as much you follow me. It may not be reported as related to stress or burnout, but it's a very well-known cause effect. It's a very well-documented cause effect. So if we don't pay attention, raise awareness and reduce those stresses, reduce that burnout, this will inevitably happen, even though it may not be reported as such as a cause of those cardiovascular complications. But I think it can be done and I think it needs to start to be done.
Vesime:So, as a groundwork needs to start, yeah, no, I completely agree, and I think it's so important because as we fly on a flight, it's always your oxygen mask first and then you help the others, right? So this is correlating a bit. But you mentioned being burned out twice not once, but twice. Can you tell us a little bit more about that? I mean, you must have firsthand experience of that burnout and the stress that now you're so passionately to try and fix in the healthcare for healthcare professionals.
Daphne:And can you define what burnout is, because I think it's a term a lot of people hear but don't understand, yeah, burnout.
Dr. Svetlana Chamoun:So essentially burnout now is as a burnout syndrome is an official diagnosis. Entering that entered ICD-11 actually, and that we have to be thankful to Christina Maslak from UC Berkeley. So it's a burnout syndrome, syndrome resulting from excessive, chronic workplace stress. That has not been resolved. So Dr Maslak gave it a specific definition, she defined a classic triad of symptoms and she even developed a tool which is called MBI, the Maslak Burnout Inventory. It's like the questionnaire for medical professionals at 22 questions, and there is one for medical students, for other professionals, so there are multiple tools that one can use for different populations. So for medical professionals there's a specific tool and, interestingly enough, the burnout can present differently for female professionals and for male professionals. For women, physicians, for instance, or nurses or other professionals there is a classic triad. All three components are present the feeling of emotional exhaustion, then depersonalization and then number three is like the feeling of the lack of accomplishment, not like we're lacking any accomplishment, but we feel that we may lack accomplishment. And males, they don't feel this way. So they start with depersonalization, then emotional exhaustion, and then they always feel accomplished, they feel like the best docs ever, but people around them start noticing cynicism, if I'll let me cynicism. So this is how people around male docs know that they are burning up. So that's the key, that's the essential, the way for other people to notice, but that's the burnout definition.
Dr. Svetlana Chamoun:And it's important also to be able to distinguish between stress, chronic stress and burnout itself. So there is, dr Sellier. They found, or rather describe, this stress curve right chronic stress curve, or rather acute to chronic and then to burnout stress curve. So stress is not linear, it's like a bell shaped curve that human beings, we are very, very resilient and adaptable. So our bodies and minds have ability to adapt to stresses and chronic stresses.
Dr. Svetlana Chamoun:But so stress starts with adaptation of our physiological and mental mechanisms. So, like our bodies, you know, like the heart rate goes up, the blood pressure and the mental acuity goes up, so we adapt to optimal performance, naturally, like whether we are doing performance and exam, test exam, for instance, or we have to fight, literally speaking, this is evolutionary. You know, blood pressure and heart rate goes up to fight with a bull, for instance, or with a mammoth in the past, right, so now we don't need to fight with a bull or mammoth, but it's still the case. But when those things go for a very long time. They get exhausted. Our bodies and minds get exhausted. So this curve of optimal performance goes eventually down and down and down and down and our abilities to our resilience, abilities to adapt, go down so and burnout inevitably start manifesting as exhaustion, emotional, physical, etc. Etc. And then our ability to replenish energy. When the energy drain exceeds our ability to replenish energy, it results in complete burnout or complete exhaustion. So that's the bottom line.
Daphne:And do you? I mean again, I know you said that the correlation between this chronic stress burnout and the cardiovascular disease, just the general cardiometabolic dysfunction in healthcare providers in general nurses, physicians, I mean every care provider I think has been impacted the past four years?
Dr. Svetlana Chamoun:Pretty much. It's not only that. I mean there is statistics before COVID-19, obviously so and after and during and after. So it's not like we've been doing great before, right. So it happened that we've been just languishing before COVID-19. The statistics haven't been great across the board, it's just during COVID-19. We just spiral it down as an overall group of professionals, but we have not been doing well for a while. We have not been doing well for a while.
Dr. Svetlana Chamoun:So the thing is that that curve that we were talking about, we can say it's a stress curve or we can call it a languishing curve. So, according to sociology or sociological or like bureaus like, for instance, dill-watt, they did the studies that you know. They studied groups of people, groups of workers, for instance within the United States, and they determined that a large number of workers within our country are, you know, within the optimal maybe performance, like 60% or something like that, and then about 10% or 15% at any given time we're talking about are in the burnout stage. Okay, in the burnout stage, but what's important about 30% or so are shifting. They're shifting all the time between the burnout and the optimal performance. So they are in that orange zone between the green and the red. So, whatever you know, a small episode like you know, a bad day at work or the illness of a loved one, or a dog dies right, or something like that, can throw them into the spiraling down curve. They can throw them from optimal performance into the orange zone and, if something else happens, from the orange zone into the red zone of burnout. You follow me. So it's very important that we know how to replenish our energy and how to reduce the drain of the energy on a daily basis to prevent that shift from our optimal performance, from our optimal energy level, to that orange and that red zone of the burnout, to prevent sliding to that red zone. So yes, our medical profession slides back and forth down that curve.
Dr. Svetlana Chamoun:You know, when a pandemic starts, we are at extremes of our resilience. Our resilience gets tested so badly that we, literally speaking, go down the ski slope and then we drag ourselves up. So now we are, you know, we are much better now, two years later, three years later, because, number one, we can talk to one another. We can frankly discuss things that we could not discuss before and we are equipped with this power of discussing things. This is very important. We had shores on our on our eyes. Before that, and all the secrecy, all the we were completely you know, this empowerment was taken away from us. Now we are empowered and mentorship and collective wisdom is with us, thank God. So one thing that came out of corporate is that it opened the doors to Frank and open discussion and, thankfully, that mental health issues aren't the secret and aren't taboo anymore.
Vesime:So no, that's great. I know that you, within your cardio seeds platform, you created this platform, or pro essentially platform that can now feed into certain programs and you have a program called reclaim yes, is that? So? Maybe you could tell us a little bit about reclaim and maybe this is part of the solution where you can help the healthcare providers reclaim essentially reclaim their lives and not necessarily spiraling into that burnout stage. Is that right? Why don't we share a little bit more about the program Sure?
Dr. Svetlana Chamoun:Reclaim is very, very simple. It's very simple. It's based on simple principles. First, the idea of reclaim is reclaim and, literally speaking, your best health, wellness, whatever you want to reclaim. I ask people they are mainly healthcare professionals and now at the moment they're mainly physicians in my program. So what do you want, what are your objectives from the program? What do you want to reclaim? Some say I want to reclaim my freedom from work. I want to reclaim my best mental state, my best ability to be the best father, or my best cardiovascular health or whatever.
Dr. Svetlana Chamoun:But reclaim is also an acronym that stands for recognizing a problem, evaluating, charting the course. L stands for love that we start practicing, love for self and others, a take an action and other things, and I for doing other things. So we have the whole bunch of acronyms for each letter and for mentorship, etc. So each letter stands for the whole bunch of things. But what we do there is essentially we facilitate growth mindset and we achieve things through mainly not only through the pillars of lifestyle medicine, but also we introduce a lot of behavioral coaching. Sustainability I push that things become sustainable for them.
Dr. Svetlana Chamoun:Creativity is number one tool that I push with them. And how do I push that. I say we are short. Shores are on our eyes, put there by years and years of this focus on our goal and our tasks and medicine. So we are intrinsically people with open mind, creative. We are born creative, each person is born creative, and then years of this medical training took creativity out of us. You know, put us on this track of do like you're told to do and like be like everybody else so.
Dr. Svetlana Chamoun:But we are intrinsically very creative, we are leaders and we are very resilient. So show me your creativity. You know, write your story, write your book, write your life story, show me your future. So we are writing together. They are writing and some of them are drawing, some of them are painting, some of them are doing photography. So all of those things we are creating, a final product for each one of them. So in the final product, actually creates a shape. I mean, you know, takes a shape of either a book or a calendar or something else. So, and that stays with them as a product that shows them their journey from point A point B, where they were before the program and where they came, what they became after the program. And it's very telling for many people.
Daphne:Yeah, and I mean Dr Shimun, that program listening to where your podcast started, where you're going now, where you're doing what you're doing with Reclaim, what's next on the horizon for you? How do you expand the message? Where else are you taking this? How do you continue to foster the work that you're doing? Sure, yeah, that's a good question.
Dr. Svetlana Chamoun:I wrote two books. One of them is behind me, I'll show you. Okay. So this one. So both of them are coming out next month. So this one is called Resilience in Scrubs thriving as a woman resident physician. So I wrote this book specifically to empower women resident physicians. I think it's very important to empower our next generation of physicians to encounter challenges that often differ from our male peers. Right and despite all the advancements in medical field, we grapple with disparities and very specific pressures. So this book, hopefully, will help them to confront these challenges head on, and it's kind of a one-stop reference packed with careful, selected resources. I really took my time to select resources, put together toolkits on topics like gender dynamics and medicine, resilience and wellness Everything from my perspective, what I thought could be helpful 20, 25, 30 years ago when I was going through the residency and how I see through my eyes now, like salary negotiations, work life, family integration, embracing leadership roles, even exploring career pivots, personal wellness, much, much more.
Dr. Svetlana Chamoun:So this is I think it would be helpful. So I also wrote a book that kind of goes very close to this, but not for the residents but for women physicians. So women physicians, it's called Women Physician Essential Survival Guide. I don't have it here because it's in print now. So women physician essential survival guide tools and resources for thriving in medicine. So that would be specifically for women practice in physicians. And also I wanted to show you this.
Dr. Svetlana Chamoun:This is a proof copy, but this is a 2024, if you can see I'm not sure 2024 physician wellness calendar. This is not a final version of it. The final version is in print now. So this all will be my pictures. So this they.
Dr. Svetlana Chamoun:You know I changed the design a little bit, but the essence is the same. So I put every month will have like a motivational, the motivational theme and also personal wellness goals for physicians and professional and so what you do for yourself this is kind of you know, monthly smart goals, what you do for your wellness, for yourself and at your workplace. This are very doable doable and they change every month. This is my Yorkshire area. I took all these pictures, so and these are doable I did this. If I could do this, everybody can do this. If I'm so, I made sure that I want people to thrive. I don't want people to continue burning out. I really don't. So this is my small contribution for this year, for this upcoming year, and I'm going to bring a copy of each to Lifestyle Medicine 2023, when I'm meeting in Denver, to show to you guys, to show what we, where we're going. So this is my next step to just contribute to the wellness of physicians in real way, like this way.
Vesime:I love that and you mentioned that you, you know you've done the goals, both personal and professional, which is amazing because you have firsthand what we always love to do here on Perfectly Pinnadish. Ask our guests and I will ask you the same question really to give us a day in the life, of your life, really, when it comes to your meals, your movement, your, you know, overall health and wellness, some of the things that are non-negotiable for you and some things that are your favorite things to do. We would love to hear.
Dr. Svetlana Chamoun:Oh sure, oh, like with my okay.
Vesime:What time do you wake up? In the morning? I didn't do it.
Dr. Svetlana Chamoun:That's so cool, actually. Yeah, so I am my own boss now, so no, pressure whatsoever now.
Dr. Svetlana Chamoun:I don't get out of bed before 7.30. So 7.30 is my wake up time. In the morning my husband and we take three day weekend now, so we are Saturday, sunday and Monday. My husband and I are weekends, so in the morning we're always playtime with our 14 year old Yorkie, always, and coffee, always together about an hour. We spend time with my husband and your shirt Terrier plane. We are pescatarian. We eat fish three times a week. The rest we eat whole food, plant-based diet. We cook at home about 9.95% of meals and he takes leftovers for lunch. He works as a full-time cardiologist I mean four days a week, cardiologist at the large hospital here about six minutes away.
Dr. Svetlana Chamoun:Movement I work from home. I do all the stretches that I do what I preach essentially I swim for one hour every day. We walk the dog together for 30 minutes every week every night and on weekends we walk for one and a half hours every day. Saturday, sunday and Monday. Social connection we have our adult daughters. We have group chat with them and we chat every day at least once a day, send in pictures. We have grandchildren with them in pictures, recipes, jokes, etc. At least once a day, sometimes four, five, ten times a day. It depends and it's been consistent for the past 15 years. I actually believe that. And meeting up lunch dinner every month, sleep stress. So my bedroom, our bedroom, is free from cable TV, phones, lights or clocks. That's it, completely Weekends, no social media, complete social media and digital detox. I do daily breathing and meditation and for hobbies I do jewelry making, crafts and gardening for my husband, and those activities are completely for the sake of joy. That's all and that's all.
Vesime:That's all Two books and photography. You must be a fantastic photographer if you took those beautiful pictures on your upcoming calendar.
Dr. Svetlana Chamoun:No, just no, just, that's all. Oh, and that's, and that's my grandchildren. Oh cute, speaking of exchanging pictures all the time, I wonder if they just send it to me. Oh great.
Daphne:Dr Shimon, I just want to follow up on your first, the first book you shared, because I do think I was talking to a medical student that I've been mentoring for years and I do think we need to move these conversations upstream Because the it's easy to cultivate attitudes and behaviors, as you're going through training, that result in Not the most empathetic caring providers that we need, one not caring for themselves and two not knowing how to care for the people that we serve. So I mean, I don't know how to start to introduce that, even from a medical education perspective, but I applaud the fact that you wrote such a book because I know in training, even when we would go to our Academy meetings, there was usually a women's group that would get together and talk about how we need to show up differently and what we need to do differently as women in this profession. Women of color is a whole nother layer of stress. Yeah, but my point is that if you can start to even have conversations with ACGME or with medical schools, that would be wonderful.
Dr. Svetlana Chamoun:Yeah, that would be. That would be most important and definitely I would be happy to do. You know, to talk to anybody and everybody, because you know I am. I experienced so many things in my life that you know, short of being a woman of color, but ethnocentric things that I went through or I'm just a heart to describe that they experienced, and so I know so well things that are related to diversity and minorities and I can relate to them so well. Yeah, and empathy that we need to express to one another is very important and women women, mentorship and sponsorship and support is a paramount priority in this profession.
Daphne:Agreed, agreed, which is why we are so thankful that you are able to join us today, because you're I mean when I first heard you at the Heel Group you're just such an example for so many of us, and this is a very important message. So, thank you, we appreciate you, thank you so much for having me and, to those of you who are listening and watching, we hope that you have gained new seeds of knowledge and ideas. Again, we're here to plant seeds of positivity. If you have a healthcare professional in your life who would benefit from hearing this, please share. Please share with them.
Daphne:We'll provide you links to Dr Shumman's website, her social media links, but we need to remove the stigma of having these conversations, and this is why it's important to have all of you share the message, both as your own personal and professional journey, but to share this with others. So, thank you. If you're enjoying this podcast, please like, subscribe. We welcome your feedback and comments on other amazing speakers like Dr Shumman that we can have, so that we can continue to plant those seeds of positivity and empowerment that make this such an important opportunity for all of us to achieve our best life possible. We appreciate you, dr Shumman, we appreciate you and until next time be well. Thank you, be well.