Welcome back to the Ultimate Prescription. 00:00:01.36\00:00:02.70 I'm Nick Evenson here with Dr. James Marcum. 00:00:02.73\00:00:04.17 And today, we are talking about weak hearts. 00:00:04.20\00:00:06.60 And, Dr. Marcum, before the break, 00:00:06.63\00:00:08.17 we were just talking about some of the reasons 00:00:08.20\00:00:09.84 why people might have a weak heart, 00:00:09.87\00:00:12.11 how it's diagnosed, 00:00:12.14\00:00:13.78 and what some of the problems can be. 00:00:13.81\00:00:15.41 Where do we go next? 00:00:15.44\00:00:16.78 Yeah, well, again, 00:00:16.81\00:00:18.15 I wanna focus this all back on understanding the reason why. 00:00:18.18\00:00:22.15 That's the key. 00:00:22.18\00:00:24.15 And also, when a patient comes in, 00:00:24.19\00:00:27.02 that they think they might have a weak heart, 00:00:27.06\00:00:29.06 it's very important to dig out all the history, 00:00:29.09\00:00:32.79 you know, to get them to tell you things 00:00:32.83\00:00:34.66 that that you might not think is significant. 00:00:34.70\00:00:37.70 For instance, I had a gentleman 00:00:37.73\00:00:40.07 that came I guess a couple of months ago, 00:00:40.10\00:00:42.24 he had a weak heart. 00:00:42.27\00:00:43.61 He was real short of breath. 00:00:43.64\00:00:44.97 Fluid was in his lungs. 00:00:45.01\00:00:46.34 Well, we got the fluid out with some diuretics, 00:00:46.37\00:00:48.38 but we did some testing and the heart was weak. 00:00:48.41\00:00:51.18 Of course, we're gonna talk a little bit 00:00:51.21\00:00:52.55 about some of the medicals, but I wanted to understand why? 00:00:52.58\00:00:56.18 Didn't seem to have blockages in arteries, 00:00:56.22\00:00:58.12 valves, rhythm good, 00:00:58.15\00:00:59.49 hormonal things good but in exploring his history, 00:00:59.52\00:01:03.09 I found out that he was a heavy drinker. 00:01:03.12\00:01:06.29 Drank a lot of alcohol. 00:01:06.33\00:01:08.73 I mean, a lot, a lot. 00:01:08.76\00:01:10.33 Yeah. 00:01:10.37\00:01:11.70 And that is one cause of a weak heart. 00:01:11.73\00:01:13.80 In some people alcohol 00:01:13.84\00:01:15.60 literally poisons the heart muscle. 00:01:15.64\00:01:18.34 We call it an alcoholic cardio heart weakness, 00:01:18.37\00:01:22.11 alcohol cardiomyopathy. 00:01:22.14\00:01:24.31 So his cause for the weak heart was alcohol. 00:01:24.35\00:01:27.75 So I could put him on all the medicines to help the heart 00:01:27.78\00:01:30.79 in the world, 00:01:30.82\00:01:32.15 but unless I got it the cause the alcohol, 00:01:32.19\00:01:34.69 I wouldn't probably be successful long-term. 00:01:34.72\00:01:37.56 Yeah. Okay. 00:01:37.59\00:01:38.93 Another couple of years ago, 00:01:38.96\00:01:40.30 I can remember a lady that it was her thyroid. 00:01:40.33\00:01:42.76 So we checked her thyroid, replaced her thyroid, 00:01:42.80\00:01:45.33 and her heart function started to get better. 00:01:45.37\00:01:48.14 Some hearts are just weak 00:01:48.17\00:01:49.64 because they have to work too hard. 00:01:49.67\00:01:52.21 You know, and that's frequently 00:01:52.24\00:01:53.58 the cause of high blood pressure. 00:01:53.61\00:01:54.94 Remember, high blood pressure, 00:01:54.98\00:01:56.31 the heart has to pump 00:01:56.34\00:01:57.68 year in year against all that pressure. 00:01:57.71\00:01:59.05 Right. 00:01:59.08\00:02:00.42 If you were a big weight lifter, Nick, 00:02:00.45\00:02:01.78 originally the muscles would get bigger, 00:02:01.82\00:02:03.15 but if you have to lift weights all the time 00:02:03.18\00:02:04.92 you get tired and weak. 00:02:04.95\00:02:07.26 Well, if the heart has to pump against 00:02:07.29\00:02:08.72 high blood pressure all the time 00:02:08.76\00:02:10.33 that can happen too. 00:02:10.36\00:02:11.93 We call that a hypertensive weak heart, 00:02:11.96\00:02:15.06 hypertensive cardiomyopathy. 00:02:15.10\00:02:17.83 Myopathy just means weak muscle. 00:02:17.87\00:02:20.14 Okay. Okay. 00:02:20.17\00:02:21.50 So understanding the reason why is the key. 00:02:21.54\00:02:24.57 So we get back to the question, 00:02:24.61\00:02:26.47 well, how is a weak heart treated, okay? 00:02:26.51\00:02:29.81 So first understanding the reason why, 00:02:29.84\00:02:32.81 and until we can find out that reason, 00:02:32.85\00:02:35.08 we also have medications that can help. 00:02:35.12\00:02:37.59 Okay. 00:02:37.62\00:02:38.95 So when a heart is weak, 00:02:38.99\00:02:41.16 the body responds by making stress chemicals to help it 00:02:41.19\00:02:44.93 pick up the slack. 00:02:44.96\00:02:46.29 Okay. 00:02:46.33\00:02:47.66 But in the process of the stress chemistry, 00:02:47.70\00:02:50.07 the stress chemistry also makes the myocytes 00:02:50.10\00:02:53.07 which are the cells of the heart weakened as well. 00:02:53.10\00:02:56.14 So stress hurts the heart long-term. 00:02:56.17\00:02:59.07 Right. Hurts the heart. 00:02:59.11\00:03:00.81 That's why the broken heart syndrome, 00:03:00.84\00:03:02.74 you know, stress cardiomyopathy. 00:03:02.78\00:03:04.11 So high levels of stress damage the heart. 00:03:04.15\00:03:07.15 So when the heart's weak, 00:03:07.18\00:03:08.52 we don't want more stress chemistry. 00:03:08.55\00:03:10.62 Now when we talk about stress, 00:03:10.65\00:03:12.75 a lot of people 00:03:12.79\00:03:14.12 probably think of maybe only one kind of stress. 00:03:14.16\00:03:16.49 But stress can come in a lot of different forms. 00:03:16.52\00:03:18.06 Is that right? That's correct. 00:03:18.09\00:03:19.43 Good deduction. 00:03:19.46\00:03:20.80 And now you're thinking about the reason why you have stress, 00:03:20.83\00:03:23.37 right? 00:03:23.40\00:03:24.73 It could be lack of sleep. Right. 00:03:24.77\00:03:26.74 It could be mental stress. 00:03:26.77\00:03:28.34 It could be pain stress. 00:03:28.37\00:03:29.90 It could be not drinking enough water stress. 00:03:29.94\00:03:32.04 It could be nutritional stress. 00:03:32.07\00:03:34.21 It could be come from a myriad of sources, 00:03:34.24\00:03:37.25 where the body is not smart enough to figure out 00:03:37.28\00:03:39.81 when we're under stress, 00:03:39.85\00:03:41.18 what's causing it, it makes the same. 00:03:41.22\00:03:43.82 The lower part of the brain 00:03:43.85\00:03:45.19 makes all these stress chemicals 00:03:45.22\00:03:46.55 to try to compensate. 00:03:46.59\00:03:48.02 It says, "I'm in a disaster situation. 00:03:48.06\00:03:50.36 I've got to help the heart out. 00:03:50.39\00:03:51.89 Mr. Heart needs help." 00:03:51.93\00:03:53.26 So brain doesn't understand 00:03:53.29\00:03:54.63 that maybe it shouldn't do all this, 00:03:54.66\00:03:56.30 the lower part, but it does it. 00:03:56.33\00:03:57.73 So it makes adrenaline and cortisol, 00:03:57.77\00:03:59.30 and cytokines, and leukotrienes all those things 00:03:59.33\00:04:01.40 which can make the heart weaker. 00:04:01.44\00:04:02.77 Right. Yeah. 00:04:02.80\00:04:04.14 So everything based on heart failure 00:04:04.17\00:04:05.71 is to turn off the stress chemistry. 00:04:05.74\00:04:08.58 So we have medicines like beta blockers, different ones, 00:04:08.61\00:04:12.31 they block adrenaline's effect on the heart. 00:04:12.35\00:04:15.25 We have different medicines like 00:04:15.28\00:04:16.89 angiotensin converting enzyme which blocks angiotensin. 00:04:16.92\00:04:20.46 We block different other things. 00:04:20.49\00:04:22.06 We have medicine that blocks, all sorts of stress chemistry, 00:04:22.09\00:04:25.79 we have one called Aldactone, angiotensin receptor blockers. 00:04:25.83\00:04:29.80 So we try to block things that cause stress on the heart. 00:04:29.83\00:04:33.90 We also try to make the heart's life easier 00:04:33.94\00:04:37.14 by making sure the blood pressure is good, 00:04:37.17\00:04:39.91 making sure the heart has enough oxygen, 00:04:39.94\00:04:42.54 getting fluid out of the lungs, 00:04:42.58\00:04:44.58 all those things we can do to make heart rest easier. 00:04:44.61\00:04:48.28 Now also, one thing that helps the heart 00:04:48.32\00:04:50.72 quite a bit is doing something. 00:04:50.75\00:04:53.46 Another thing is getting enough rest. 00:04:53.49\00:04:55.86 And each individual treating the symptoms is important. 00:04:55.89\00:04:59.66 So even if we can't understand the reason why, 00:04:59.69\00:05:02.70 if we can slow down the stress chemistry, 00:05:02.73\00:05:05.77 we can also improve the strength of the heart. 00:05:05.80\00:05:08.67 Sometimes if you have 00:05:08.70\00:05:10.04 a stress-induced cardiomyopathy, 00:05:10.07\00:05:12.14 which is just due to too much stress, 00:05:12.17\00:05:13.98 or an infection, 00:05:14.01\00:05:15.34 just the combination of these medications. 00:05:15.38\00:05:17.61 And rest will improve the strength of your heart. 00:05:17.65\00:05:21.12 You know, is this making sense to you? 00:05:21.15\00:05:22.88 Yeah, yeah. 00:05:22.92\00:05:24.25 Less stress and understand the reason why. 00:05:24.29\00:05:27.89 It's definitely, definitely makes sense. 00:05:27.92\00:05:29.69 Yeah. 00:05:29.72\00:05:31.19 Let's move on to the broken heart syndrome. 00:05:31.23\00:05:32.89 You mentioned this earlier, 00:05:32.93\00:05:34.36 what is the cause of this and what is the result? 00:05:34.40\00:05:36.36 Well, I think 00:05:36.40\00:05:37.73 this is very important to mention 00:05:37.77\00:05:39.10 because I've seen three cases 00:05:39.13\00:05:41.07 of this at the Chattanooga Heart Institute 00:05:41.10\00:05:43.10 in the last month, the broken heart syndrome. 00:05:43.14\00:05:45.91 So it's fairly common. 00:05:45.94\00:05:47.28 Yes, more common than I would like it. 00:05:47.31\00:05:48.81 One happened after 00:05:48.84\00:05:52.31 this lady's son ran away 00:05:52.35\00:05:55.78 in the woods 10 or 11 years old 00:05:55.82\00:05:57.75 and they found him dead, okay? 00:05:57.79\00:06:00.72 So the stress from all that, she presented with chest pain, 00:06:00.76\00:06:05.59 couldn't breathe, heart failure. 00:06:05.63\00:06:07.56 And originally when she came in, 00:06:07.60\00:06:08.93 look like she was having a heart attack. 00:06:08.96\00:06:10.90 Yeah. Okay. 00:06:10.93\00:06:12.27 Well, we did all the testing, no evidence of a heart attack, 00:06:12.30\00:06:15.30 and yet her heart was very, very weak. 00:06:15.34\00:06:17.57 And so eliminating one thing after another, 00:06:17.61\00:06:19.77 we found out that she had the broken heart syndrome 00:06:19.81\00:06:23.88 or the apical ballooning syndrome. 00:06:23.91\00:06:26.68 Very, very rare. 00:06:26.72\00:06:29.28 We thought until we understand 00:06:29.32\00:06:31.55 that this world is under 00:06:31.59\00:06:32.92 a lot more stress than we think. 00:06:32.95\00:06:34.29 Yeah. 00:06:34.32\00:06:35.66 And it's interesting that some people have 00:06:35.69\00:06:37.03 a line genetically that they can cope with, 00:06:37.06\00:06:39.79 but when they get above that line, boom! 00:06:39.83\00:06:42.50 Stress... 00:06:42.53\00:06:43.87 And not only the heart, these stresses, 00:06:43.90\00:06:46.10 some people had experiences, they can't sleep at night. 00:06:46.13\00:06:49.27 Some people can't digest their food. 00:06:49.30\00:06:51.31 Some people makes their blood pressure go high. 00:06:51.34\00:06:53.51 Some people, they have heart palpitations. 00:06:53.54\00:06:56.38 Some people, their brain doesn't think right, 00:06:56.41\00:06:58.75 you know, and they down shift. 00:06:58.78\00:07:00.52 So lots of different manifestations of stress. 00:07:00.55\00:07:03.89 Unfortunately, some people 00:07:03.92\00:07:05.35 reach for bad things to deal with stress. 00:07:05.39\00:07:07.99 You know, some people drink alcohol, 00:07:08.02\00:07:10.36 some people reach for drugs. 00:07:10.39\00:07:12.13 Some people beat up their animals, I don't know. 00:07:12.16\00:07:14.90 But everyone has to deal with their body stress 00:07:14.93\00:07:17.60 in different ways. 00:07:17.63\00:07:18.97 The body wants to make a chemical called endorphin 00:07:19.00\00:07:21.67 that helps balance that. 00:07:21.70\00:07:23.61 But it's a stressful situation just talking about a little... 00:07:23.64\00:07:26.57 Yeah, you know, it makes sense 00:07:26.61\00:07:27.98 that the body doesn't react well 00:07:28.01\00:07:29.64 when you have a crazy high amount of stress 00:07:29.68\00:07:31.38 because God didn't design us to live that way. 00:07:31.41\00:07:33.01 He designed us live in peace. 00:07:33.05\00:07:34.88 And unfortunately, 00:07:34.92\00:07:36.79 the sinful world we live in causes a lot of stress. 00:07:36.82\00:07:39.45 Yeah. It's tragic. 00:07:39.49\00:07:41.82 What about medications? Yeah. 00:07:41.86\00:07:43.22 Medications that are used for weak heart? 00:07:43.26\00:07:44.59 Well, We talked about them, 00:07:44.63\00:07:45.96 the ones that block the stress chemistry, 00:07:45.99\00:07:47.63 ones like the beta blockers, ACE inhibitors, 00:07:47.66\00:07:51.57 angiotensin receptor blockers, if the fluid in the lungs, 00:07:51.60\00:07:55.44 diuretics, and there's a bunch of different ones of them, 00:07:55.47\00:07:58.34 which we sometimes don't use this as much we use a medicine, 00:07:58.37\00:08:01.61 sometimes Digoxin that can help the strength of the heart 00:08:01.64\00:08:04.71 or basically I approach it, 00:08:04.75\00:08:06.21 anything that causes stress in the body 00:08:06.25\00:08:08.88 can help the strength the heart. 00:08:08.92\00:08:10.35 Getting enough rest, not overdoing it, 00:08:10.39\00:08:12.79 not underdoing it, not overdoing it, 00:08:12.82\00:08:15.22 get enough oxygen in the body, 00:08:15.26\00:08:17.43 making sure there's not a lot of pain, that stressful, 00:08:17.46\00:08:20.76 making sure there's no infections in the body, 00:08:20.80\00:08:23.37 optimizing nutrition, 00:08:23.40\00:08:24.87 so the heart has everything it needs to work correctly. 00:08:24.90\00:08:27.97 So all these variables come into play, when we try to... 00:08:28.00\00:08:31.47 So medications are just one of the many ways 00:08:31.51\00:08:34.44 we help weak hearts, 00:08:34.48\00:08:35.81 but the key is understanding the reason why? 00:08:35.84\00:08:40.25 Yeah. 00:08:40.28\00:08:41.62 On that note, I'm thinking to share 00:08:41.65\00:08:42.98 your biblical prescription today with us. 00:08:43.02\00:08:44.35 Yeah. 00:08:44.39\00:08:45.72 And that's Psalms 103:3. 00:08:45.75\00:08:48.56 You know, 103:3 and David is just a hero of mine because, 00:08:48.59\00:08:52.79 you know, he went through so much stress in his life, 00:08:52.83\00:08:56.73 and yet he kept his eyes focused on the big picture. 00:08:56.77\00:09:01.00 And in Psalm 103:3, it says, 00:09:01.04\00:09:03.41 and it talks in the first part of the chapter, 00:09:03.44\00:09:05.87 "Bless the Lord." 00:09:05.91\00:09:07.24 It talks about, 00:09:07.28\00:09:08.61 they were talking about the Lord here. 00:09:08.64\00:09:09.98 And it says, "Who forgives all your iniquities," okay? 00:09:10.01\00:09:13.82 "Who heals all your diseases..." 00:09:13.85\00:09:17.45 So the Lord heals all your diseases. 00:09:17.49\00:09:20.26 Notice that, He forgives, and He heals in the same time. 00:09:20.29\00:09:23.86 So sometimes it makes you wonder, 00:09:23.89\00:09:26.03 you know, for, you know, when people aren't forgiven, 00:09:26.06\00:09:28.63 the stress of that can cause health problems. 00:09:28.66\00:09:32.87 You know, the stress of all the stuff we've done 00:09:32.90\00:09:35.94 and all the stuff with us. 00:09:35.97\00:09:37.31 So God can take that burden that stress off of us, 00:09:37.34\00:09:40.21 but He's gonna heal all our diseases. 00:09:40.24\00:09:42.61 Now does it tell us when He's gonna heal them? 00:09:42.64\00:09:45.68 No. No. 00:09:45.71\00:09:47.05 Sometimes if God wants to, He can use modern medicine. 00:09:47.08\00:09:50.19 He can heal you in this blink of an eye right here. 00:09:50.22\00:09:53.25 Sometimes He can empower you to maybe 00:09:53.29\00:09:55.99 exercise more to eat better, 00:09:56.02\00:09:57.79 to rest better, to think better. 00:09:57.83\00:09:59.89 But sometimes God chooses not to heal in that manner. 00:09:59.93\00:10:03.50 I think about Paul in the New Testament, 00:10:03.53\00:10:06.17 you know, he wanted to be healed, 00:10:06.20\00:10:08.14 but God uses His illness sometimes to bring us closer 00:10:08.17\00:10:11.21 and keep us close to Him, but He will heal us 00:10:11.24\00:10:13.61 when we walk with Him in His time, 00:10:13.64\00:10:16.04 and it might not be our time. 00:10:16.08\00:10:18.38 So the reason why we have disease in the first place 00:10:18.41\00:10:22.82 is because of our fallen nature, right? 00:10:22.85\00:10:25.19 Right. Yeah. 00:10:25.22\00:10:26.55 We departed from God's perfect plan. 00:10:26.59\00:10:29.86 And that's put genetic stress on us 00:10:29.89\00:10:31.73 that's been passed down 00:10:31.76\00:10:33.09 from generation to generation to generation. 00:10:33.13\00:10:36.80 Many years ago, if you had a bad genetics, 00:10:36.83\00:10:40.04 people that would not reproduce, 00:10:40.07\00:10:42.40 and that gene pool would die off. 00:10:42.44\00:10:43.77 That's right. 00:10:43.81\00:10:45.14 But now we have these, 00:10:45.17\00:10:46.51 you know, now we're able to do some things medically 00:10:46.54\00:10:47.94 and bad genes are being propagated 00:10:47.98\00:10:50.05 and we have things that we can do to help with that. 00:10:50.08\00:10:52.28 So I think that weak hearts understanding 00:10:52.31\00:10:54.82 the root reason why are very important 00:10:54.85\00:10:58.69 in treating weak hearts. 00:10:58.72\00:11:00.06 So whenever you have someone that says 00:11:00.09\00:11:02.39 there's something wrong in life, 00:11:02.42\00:11:03.99 first of all, not only ask God to help you 00:11:04.03\00:11:06.16 give you wisdom, realize that He will heal you, 00:11:06.19\00:11:08.53 but ask yourself, why is this happening? 00:11:08.56\00:11:10.47 Yeah. 00:11:10.50\00:11:11.83 And that extends to beyond just medical conditions, right? 00:11:11.87\00:11:13.57 Yeah. Yeah. 00:11:13.60\00:11:14.94 Every aspect of life. Yeah. 00:11:14.97\00:11:16.74 Well, thank you for sharing on weak hearts with us, 00:11:16.77\00:11:18.57 Dr. Marcum. 00:11:18.61\00:11:19.94 If people have questions about 00:11:19.97\00:11:21.51 where they can get more information, 00:11:21.54\00:11:22.88 where would you send them? 00:11:22.91\00:11:24.25 Well, lots of places that they go to our website, 00:11:24.28\00:11:26.61 HeartWiseMinistries.org, we answer individual questions. 00:11:26.65\00:11:32.05 We have a prayer page there where we pray for people, 00:11:32.09\00:11:34.89 we pray for each other. 00:11:34.92\00:11:36.39 And we love each other, 00:11:36.42\00:11:37.76 encourage each other a long health. 00:11:37.79\00:11:40.70 We have the new worship app that we talked about, 00:11:40.73\00:11:43.80 where people can have 10 minutes 00:11:43.83\00:11:45.40 of scientifically proven worship 00:11:45.43\00:11:48.27 that can help them improve their health 00:11:48.30\00:11:49.80 and get them on the right path. 00:11:49.84\00:11:52.27 For ultimate healing also gives us hope, 00:11:52.31\00:11:55.31 turns down the stress, 00:11:55.34\00:11:57.28 plugs us into biblical prescriptions 00:11:57.31\00:11:59.25 that help us live longer and do better. 00:11:59.28\00:12:01.78 There's just a host of things that we can also send you, 00:12:01.82\00:12:05.22 you know, and people might need specific advice 00:12:05.25\00:12:08.12 about which doctor they should see 00:12:08.16\00:12:09.56 or what little things we help in all of those things. 00:12:09.59\00:12:11.89 Yeah. Excellent. 00:12:11.93\00:12:13.26 It sounds like we got some great resources there. 00:12:13.29\00:12:15.06 And thank you viewers for tuning in today 00:12:15.10\00:12:16.80 to the Ultimate Prescription. 00:12:16.83\00:12:18.17 I'm Nick Evenson. 00:12:18.20\00:12:19.53 And if you have a moment, 00:12:19.57\00:12:21.00 I really encourage you to go 00:12:21.04\00:12:22.37 find our Biblical Prescriptions app. 00:12:22.40\00:12:24.07 It's a free download on your mobile device. 00:12:24.11\00:12:26.37 And that will really 00:12:26.41\00:12:27.74 do something there to help you get connected with God's Word 00:12:27.78\00:12:30.05 everyday through all the noise and chatter 00:12:30.08\00:12:33.21 that we have going on in our lives. 00:12:33.25\00:12:34.75 So thank you for joining us today. 00:12:34.78\00:12:36.18 And Dr. Marcum is going to end the program with prayer. 00:12:36.22\00:12:38.65 As we end our program today, I want to pause for a second 00:12:44.09\00:12:47.20 and help us each one of us to remember 00:12:47.23\00:12:49.50 the importance of prayer. 00:12:49.53\00:12:52.27 What can we do more important for our health in our lives 00:12:52.30\00:12:54.90 and for each other than pray for each other 00:12:54.94\00:12:56.91 and pray for God, 00:12:56.94\00:12:58.27 asking Him to be the center of everything for. 00:12:58.31\00:13:00.48 So let's bow our heads in prayer. 00:13:00.51\00:13:04.15 Dear Heavenly Father, 00:13:04.18\00:13:06.41 we invite You to the Holy Spirit 00:13:06.45\00:13:08.28 to create in us a new heart. 00:13:08.32\00:13:11.35 Lord, our hearts might be weak now 00:13:11.39\00:13:13.49 but we don't want them to be weak forever. 00:13:13.52\00:13:15.19 We want to invite You into a heart 00:13:15.22\00:13:16.73 to be our Lord and Savior, 00:13:16.76\00:13:18.73 to sit on our throne of our heart, 00:13:18.76\00:13:20.30 Father, and bring us into Your presence. 00:13:20.33\00:13:22.56 This is our prayer. 00:13:22.60\00:13:23.93 Amen. 00:13:23.97\00:13:26.53 I want to thank you for joining us today 00:13:26.57\00:13:28.84 on Ultimate Prescription. 00:13:28.87\00:13:30.87 I'm Dr. James Marcum. 00:13:30.91\00:13:32.37 And I want to wish you the best of health. 00:13:32.41\00:13:35.31