Beyond the Checkup: Demystifying Colon Cancer Screening

[00:00:00] Pete Waggoner: Hello and welcome to Beyond the Checkup brought to you by Stellis Health where neighbors care for neighbors. I’m Pete Waggoner, ready to guide you to a healthier, happier life. Today we’re here to inspire, explore, and help you thrive in your health journey. So let’s dive right in with Dr. Dale Lawrence on today’s episode of Beyond the Checkup.

[00:00:26] Pete Waggoner: We’ve got a great topic and Dr. Lawrence, thanks for joining us here today during your busy times as always.

[00:00:31] Dr. Dale Lawrence: Sure. I’m happy to be here. Thanks.

[00:00:33] Pete Waggoner: As we know, March is recognized as National Colorectal Cancer Awareness Month. And if you people weren’t aware, it’s good to, to be aware of what we’re happening, is happening here.

[00:00:42] Pete Waggoner: So one of the things that I want to get into before we get into the specifics of this, is you’ve been in the practice as a family practitioner, doctor for 20 years. A primary care physician, and you’re one of a couple that handles these screenings for the colon screening. What I [00:01:00] want to do is break it down a little bit and debunk some of the myths.

[00:01:04] Pete Waggoner: Things have changed a lot over the years for those that may be a little scared of what they’re hearing.

[00:01:08] Dr. Dale Lawrence: Sure, absolutely. You know, even in the 20 years that I’ve been doing this, it’s changed a lot. But certainly in the 20 years before that, there were really significant changes. You know, It used to be that practitioners couldn’t see the whole colon. They could only see part of the colon because the equipment they had wasn’t long enough.

[00:01:30] Dr. Dale Lawrence: At the very beginning, the equipment they had was straight. And so it was very uncomfortable for patients, it was not very effective. And people didn’t like it. And out of that have grown all these stories about how miserable it is and it’s difficult.

[00:01:45] Dr. Dale Lawrence: And fortunately, every time there’s an advancement now, things get better. The scope gets more flexible. The drugs that they use for sedation work better. The [00:02:00] process is less uncomfortable. The prep continues to improve.

[00:02:03] Dr. Dale Lawrence: Now, even though It’s never going to be good. You still have to take all the medicine and you have to poop like a goose and get everything cleaned out of you.

[00:02:12] Dr. Dale Lawrence: it is better than it was 20 years ago. So, one of the things that I feel like being a primary care provider who provides these services is I’m providing them for the folks that I see day in and day out. And I think they feel more comfortable having somebody they know doing it.

[00:02:30] Pete Waggoner: I would think so.

[00:02:31] Pete Waggoner: And, you know, one of the things that is interesting, you brought up the prep and we’ll get into that a little bit later on in the podcast as well. When you talk to friends and people that are prepping now, it used to be an ordeal. It felt like almost a 2 day ordeal. Now it seems like it’s just sort of, ah, it’s not that big of a deal, even though they have to do what they have to do.

[00:02:53] Pete Waggoner: Was there a moment or a period over the past five years where things have changed in that regard too?

[00:02:58] Dr. Dale Lawrence: Well, to be honest, there are [00:03:00] lots of different preps available for this procedure. And depending on which provider you go to, you get a different prep. Even at the facilities that I work at, they use different preps for the different providers.

[00:03:13] Dr. Dale Lawrence: Dr. Martin and I, who do the most of the scopes for the clinic, for Stellis Health. We use a prep that is available over the counter, so you don’t have to have a prescription. It’s a one day prep. So, if you’re getting your colonoscopy on a Wednesday, the prep happens on Tuesday.

[00:03:28] Dr. Dale Lawrence: Then you’re usually able to sleep. Some of the preps that are available on the market have you waking up in the middle of the night, and doing things like that. Day of or the morning of your procedure and that can really be kind of undesirable. So we use the over the counter and we try to get everything done the day ahead of time.

[00:03:46] Pete Waggoner: How common is colon cancer, from what you’ve seen?

[00:03:50] Dr. Dale Lawrence: Well, it’s interesting you ask that. I mean, I did some checking, and the American Cancer Society estimates there are going to be over 100, [00:04:00] 000 new cases of colon cancer for 2024 in the United States. And worldwide, colon cancer is the third most prevalent type of cancer.

[00:04:10] Dr. Dale Lawrence: For men, it’s behind lung and prostate. And for women, it’s behind the breast and lung.

[00:04:16] Pete Waggoner: Why do you think that is?

[00:04:18] Dr. Dale Lawrence: Well, it is interesting. I do feel like despite all of our prevention and our testing to try to find polyps when they’re small, so that they can’t grow into bigger things, and become cancerous, we still seem to be finding more and more.

[00:04:38] Dr. Dale Lawrence: I wonder if that is, obviously, as the population increases, you know, there are just more cases that are going to be found.

[00:04:45] Dr. Dale Lawrence: The interesting thing seems to be that we’re finding colon cancer in folks who are younger and younger as time goes on. When I started doing this, even just 20 years ago, it was very rare to find [00:05:00] colon cancer in a 40 year old. Or someone in their forties, and that seems to be way more prevalent now.

[00:05:06] Dr. Dale Lawrence: For that reason, the cancer screening guidelines have changed. They used to start at age 50, and now for the general population, they’ve moved to the age 45. So there’s a lot more young people that need to be screened than were in the past.

[00:05:20] Pete Waggoner: What are some of the things you hear from your patients if there’s a trend? As to, let’s say they, they turn the meter over to 45 years old and now it gets to 50, 52. What are they saying to you? Why are they not doing it? Is it fear? Is it not wanting to know? What do you think it is?

[00:05:39] Dr. Dale Lawrence: I think there’s a component of fear. I think there is a “put it off” because it’s a headache and I don’t wanna do it today.

[00:05:47] Dr. Dale Lawrence: It’s certainly inconvenient, you know. Taking a day where you have to go to the hospital, and the day before you got to take all the prep. Yeah, it ends up being a large commitment. And I think people [00:06:00] just end up pushing it down the road. And I hope that if they’re fearful, visiting with their primary care provider in the office helps put them at ease.

[00:06:12] Pete Waggoner: Well, and I think that comes back to your very initial point of trust. And you brought that up with you. And it’s a lot better when people know who’s handling a procedure like this.

[00:06:21] Pete Waggoner: What are the different types of colon cancer screening tests that are available?

[00:06:26] Pete Waggoner: Do you utilize different versions?

[00:06:28] Dr. Dale Lawrence: Great question. We’ve been talking about colonoscopy up till now, but colonoscopy is just one type of colon cancer screening. What we’re talking about with colonoscopy is a patient going to a hospital or an outpatient center, getting sedated, a long tube is inserted in their rectum, and advanced all the way through their large intestine looking for polyps.

[00:06:52] Dr. Dale Lawrence: And if there are polyps, we have instruments with the device that we take them out. Because we know that [00:07:00] little polyps grow up into big polyps and big polyps turn into cancer. And if you take out the polyps when they’re small, they can’t turn into cancer.

[00:07:07] Dr. Dale Lawrence: So that’s one way of screening. And if you do a colonoscopy and everything is completely normal, we do a recheck in 10 years.

[00:07:15] Dr. Dale Lawrence: And so if you’re an average risk person, you have no polyps, there’s no family history of colon cancer, and you get it done, then you’re off the hook for 10 years. There are several other imaging type things. I mean, we’ve done virtual colonoscopies over the years. Those kind of don’t, those have fallen out of favor.

[00:07:33] Dr. Dale Lawrence: They don’t, they’re not the greatest. You still have to go through the prep. They do a cat scan, a fancy cat scan. And if they find a polyp in there, you still end up with a colonoscopy. So people kind of, those were in favor maybe 15 years ago. They’ve gone away. They’re not really a big thing.

[00:07:48] Dr. Dale Lawrence: A flexible sigmoidoscope is a shorter scope that looks at the left side of the colon. Those kind of procedures are primarily used in areas, either [00:08:00] for screening, if there’s no colonoscopy available, maybe you’re in a rural area. Or maybe there’s no practitioners that know how to do the colonoscopy.

[00:08:09] Dr. Dale Lawrence: Or if people have a problem maybe with hemorrhoids, or bleeding or something and they just need a short scope done. So that’s number two and those are done every five years.

[00:08:18] Dr. Dale Lawrence: Then there’s the ColoGuard, which everybody sees a little box on television that’s advertising colon cancer screening. ColoGuard is something that’s offered every three years. A stool sample is submitted, and it’s mailed to the company, and they check the stool for DNA and for blood.

[00:08:38] Dr. Dale Lawrence: And the DNA tells them if there is colon cancer present in the colon, or if there’s a polyp that is shedding cells that has cancerous potential. That test, if it is positive, you end up getting a colonoscopy. So that we can go in and find the polyp and [00:09:00] remove it, so that it doesn’t cause any problems. Again, if that’s normal, that’s done every three years.

[00:09:06] Dr. Dale Lawrence: And then finally, there’s a test that is called a fecal immuno test. It tests stool to see if there is blood in it. And if there is blood in it, then, patients often end up with a colonoscopy to see if there’s a source for the bleeding.

[00:09:23] Dr. Dale Lawrence: And if that’s normal, that’s something that’s done every year. So there’s lots of different options. Things that are less invasive. You don’t have to go to the hospital or the clinic or an outpatient surgery center. They can be done at your home. And they work really well.

[00:09:38] Pete Waggoner: So it sounds like all roads, if there’s something that leads to that colonoscopy though, once you have to start. But, there are ways you can stay ahead of the game and do this. And as far as accuracy of those things, do you feel pretty comfortable with the accuracy of those?

[00:09:55] Dr. Dale Lawrence: Yeah, all three tests. The colonoscopy obviously is the gold standard of colon cancer [00:10:00] screening, but even so, it is not 100%.

[00:10:03] Dr. Dale Lawrence: And the statistics show that even in the best of hands, I think it’s 95% sensitive. So, I mean, things do get missed. One thing that Buffalo Hospital has started offering, which is new, is is an artificial intelligence for colon cancer screening. So when we’re doing the colonoscopy, artificial intelligence is watching the screen as we’re doing it.

[00:10:25] Dr. Dale Lawrence: And it helps us identify polyps. Where you’re in a process of checking to see if we actually do find more polyps than we did before it was something that we implemented. So, there’s always some new things happening and it’s pretty cool stuff.

[00:10:43] Pete Waggoner: Well, I mean, I have a million questions right now. We only have a short period of time, but I’m going to ask this anyway.

[00:10:52] Pete Waggoner: When you are going through the process, typically, do you find several polyps or a couple? Does it [00:11:00] vary? What does that look like to you? How many?

[00:11:03] Dr. Dale Lawrence: Yeah, so if I’m doing, statistically, if I’m doing a good job as an endoscopist on a screening exam, I find pre cancerous type polyps 25 to 35 percent of the time.

[00:11:16] Dr. Dale Lawrence: So if I’m doing 10 scopes that morning, three of them, and they’re all screens, they’re all brand new people, three of them should have new polyps. So that tells you how kind of prevalent it is. When I’m doing a colonoscopy, many of them don’t have anything. Everything looks completely normal. and we’re talking about colonoscopy for colon cancer screening.

[00:11:38] Dr. Dale Lawrence: We also do colonoscopies to evaluate if people are having bleeding or diarrhea and there’s different. things we look for with those types of procedures.

[00:11:47] Pete Waggoner: So, in terms of risk factors for individuals, I heard you mentioned family history, maybe some genetic type things. Can you break that down as to what those factors would be?

[00:11:59] Dr. Dale Lawrence: Sure, the risks [00:12:00] for colon cancer are many, right? They will talk to you, they will talk about smoking, alcohol use diet, lack of exercise. If you’re more, have a sedentary lifestyle, you have a higher risk of colon cancer. All of those sorts of things though. They are risk factors, and they’re important, and you, for a healthy lifestyle, you should try to modify all those sorts of things.

[00:12:24] Dr. Dale Lawrence: But in the end, the biggest risk factor you have for colon cancer is genetics. It’s your family history, which is something you can’t control.

[00:12:33] Dr. Dale Lawrence: All of the controllable factors are very small when you compare it with the risk factors that go along with family history.

[00:12:42] Dr. Dale Lawrence: If you can pick your parents, that’s the best thing you can do to prevent colon cancer. For people who have a family history, when I’m saying family history, people will come in and they’ll say, well, my aunt on my mother’s side had colon cancer, does that put me at higher risk?

[00:12:57] Dr. Dale Lawrence: Statistically, the answer is no. The [00:13:00] people that put you at higher risk statistically are a first degree relative. So that would be a mother, father, brother, sister, or a kid. So if you have a child who’s had colon cancer, maybe they’ve been diagnosed in their 40s or 50s, and the patient or the parents is in their 60s, they’re also then at higher risk.

[00:13:20] Dr. Dale Lawrence: So people who have a family history, who are considered high risk, get screens every five years as opposed to every 10 years.

[00:13:28] Pete Waggoner: And then who determines that risk? Is that something that you as the Physician would say, yeah, you know what? You need to be every five years or do you just say basically as an individual, you know, this is in the family. I do need to do it every five years. Otherwise, it’s 10 from what I’ve heard. Correct?

[00:13:46] Dr. Dale Lawrence: Yep. It’s a 10 year window for colonoscopy anyway. Like we said, it’s three years for a ColoGuard, it’s a year for the stool testing for blood. But if you’re a high risk person, if you have a family history of colon cancer, you shouldn’t be doing [00:14:00] ColoGuard or the stool tests anyway. You should be getting a colonoscopy every five years.

[00:14:05] Pete Waggoner: So you just cut straight to the chase that way?

[00:14:07] Dr. Dale Lawrence: If we do the colonoscopy, we find polyps, then we risk based on the type of polyps. And maybe you get, maybe it’s an auto worrisome polyp at all, and you get a recheck in 10 years, or maybe it’s a precancerous type polyp, but it’s really, really small.

[00:14:21] Dr. Dale Lawrence: And so we would do a recheck in five years. Or maybe there’s a whole bunch of. pre cancerous type polyps and we would bring you back in three years. Or maybe it’s a great big polyp, and when I say a great big polyp, we’re talking about a centimeter. We’re not talking about the size of my fist or my head or anything.

[00:14:38] Dr. Dale Lawrence: But you know, a centimeter type polyp is a big polyp for things that we deal with. And so when we take those out, sometimes we have those folks come back in a year. So, the follow up is varied based on the pathology.

[00:14:52] Pete Waggoner: So let’s go inside Baseball. I’ll go a little more technical here.

[00:14:55] Pete Waggoner: So when you’re, I used to love that show. So when you’re going through the [00:15:00] scope process, do you have another device that’s with you that removes the polyps? How do you go about that part of the process?

[00:15:08] Dr. Dale Lawrence: The scope that we use is about as big around as my index finger. The scopes are about five feet long. So just so people understand, your colon or your large intestine, is anywhere from three to five feet long. It’s kind of like an accordion. So it gets bigger or smaller.

[00:15:25] Dr. Dale Lawrence: When we’re doing the colonoscopy, we put air in, so that it kind of blows up the colon so we can see the inside lining of the colon, and see if there’s anything that shouldn’t be there.

[00:15:36] Dr. Dale Lawrence: Is there a swelling or irritation? Is there a polyp? Is there something that’s bleeding? And so then we advance the scope all the way through the colon. If we find a polyp, we have some devices that feed all the way down through the endoscope, through the colonoscope, either a little pincher, or sometimes we have a little loop, a wire loop, and that goes around the polyp and just kind of shaves them off.[00:16:00]

[00:16:00] Dr. Dale Lawrence: So then people will ask, okay, does that hurt? The answer is no. You do not have pain receptors in your colon. You have stretch receptors. Some people, when we put that air in there, the stretch receptors fire and they feel it as pain. For that reason, in an effort to try to make the whole procedure painless.

[00:16:22] Dr. Dale Lawrence: Buffalo Hospital and Monticello Hospital, where we do our procedures, we use something that’s called propofol sedation. We have an anesthesiologist, administers medication and the patient sleeps through the whole procedure. I tell them that they are breathing on their own, but they are not participating in the procedure anymore.

[00:16:39] Dr. Dale Lawrence: And the medicine works pretty fast, they go to sleep, and then when they’re done, it actually wears off very fast and they wake up. And most times they say they feel really good. It’s a really good nap.

[00:16:49] Dr. Dale Lawrence: Rarely do I have somebody who is, well, they’re not necessarily worried about pain, they’re worried about actually going to sleep, it’s that loss of control. But I [00:17:00] would say most times when they wake up when they’re all done with the procedure, they’re happy that we did it that way.

[00:17:06] Pete Waggoner: So how long does a procedure take?

[00:17:08] Dr. Dale Lawrence: So that’s a good question. For me and for Dr. Martin, I think we schedule them every half hour. And the actual procedure is probably 10 to 12 minutes.

[00:17:21] Pete Waggoner: Seriously?

[00:17:22] Dr. Dale Lawrence: Yeah.

[00:17:23] Pete Waggoner: For how long? 20? 30?

[00:17:25] Dr. Dale Lawrence: Probably 20 minutes. Yeah. I usually tell people when I’m talking to them at the beginning, I say to the loved one or the spouse, whoever’s with them, say they’re going to be gone for about 30 minutes. When they come back to the room, we let the medication wear off for another 30 minutes. So once we start the procedure, if everything goes well and goes smoothly, they’re usually walking out of the department an hour later.

[00:17:47] Pete Waggoner: Boy, that’s amazing. Isn’t it?

[00:17:49] Dr. Dale Lawrence: Yeah.

[00:17:49] Pete Waggoner: That’s incredible. I had a procedure for a kidney stone where I was out. And I’m curious to ask this, if this is what it’s like, somebody to ask me what my favorite music was, I told them the [00:18:00] cure. And I was like dreaming, I was like dreaming this music, you know, it was weird. It was like, I was there, but not there. Is that kind of like what it’s like?

[00:18:11] Dr. Dale Lawrence: Well, I’ll tell you for me when I’ve had this medication, it kicks in and I’m just, it’s black. There’s nothing, and then all of a sudden the medicine wears off, and then I’m back again.

[00:18:22] Dr. Dale Lawrence: Oftentimes people will be talking to the anesthetist as they’re drifting off. And then when they wake up, they restart the conversation again. It’s just like that whole 15 minutes was just gone. Other people will wake up and they’ll say, wow, I was dreaming about being in Tahiti on vacation, or I was in Hawaii.

[00:18:43] Dr. Dale Lawrence: And other people are like me and I just, nothing happens. It’s just gone.

[00:18:47] Pete Waggoner: Enjoy our podcasts and blogs? Stay updated. Sign up for our latest content tailored just for you. Pick only the information you want to receive and visit us at [00:19:00] stellishealth.com/enewsletter and never miss a beat now back to the show.

[00:19:04] Pete Waggoner: I know we touched a little bit on the prep and, you know, you mentioned some over the counter products and how it all comes together. From that perspective, can you kind of walk us through what a typical prep would look like?

[00:19:18] Dr. Dale Lawrence: Sure.

[00:19:18] Dr. Dale Lawrence: So let’s say patients getting scheduled for a colonoscopy on Monday morning, Sunday morning, they would start drinking. They would have stopped eating, Saturday night at midnight. So no more solid food sat at all on Sunday. Sunday, people maybe will have jello or juice or broth.

[00:19:40] Dr. Dale Lawrence: Anything that you can see through is fine. Typically before noon, we have the person take four Dulcolax tablets. Sometimes that gets things rolling and people start going to the bathroom right away. Sometimes nothing happens. Usually in the afternoon then, we ask people [00:20:00] to start taking Miralax mixed with Gatorade.

[00:20:03] Dr. Dale Lawrence: We do a couple of 32 ounce bottles of Gatorade. So 64 ounces total. Miralax kind of pulls water into your colon and makes you poop. So you start drinking that, about a cup every 15 to 20 minutes. But there’s no magic in that. Sometimes if people get nauseated or they feel full, we’ll just tell them to hold off for a little bit, and then start drinking again when they can handle it.

[00:20:26] Dr. Dale Lawrence: We tell people, don’t be too far from the bathroom because you’re going to end up going to the bathroom a lot. Hopefully, everything’s all cleaned out by bedtime and you can go to sleep and have no problems. Sometimes, if your colonoscopy is after noon, you’ll do half the Miralax prep the day before, and you’ll do half of it early morning the day of the procedure.

[00:20:52] Pete Waggoner: So, what would you say the most advantageous time would be to do it then?

[00:20:56] Dr. Dale Lawrence: Usually a morning colonoscopy is probably the best. [00:21:00] We offer them between 7:30 and 3:00 in the afternoon. So I think the preferred time is to do it before noon, but it varies from person to person. Some people really like splitting the prep cause they don’t have to do all that volume all at one time.

[00:21:13] Pete Waggoner: Sounds like a plan to me. Absolutely fair. Another topic we touched on are some of the risk factors and lifestyle. And you mentioned those that are moving a lot more are, you know, a little less at risk perhaps.

[00:21:27] Pete Waggoner: But what type of lifestyle things can people do to mitigate the risk in terms of exercise? Is that just walking, strength training? What is it?

[00:21:37] Dr. Dale Lawrence: Yeah, I would say the biggest thing people can do is walk. The recommendations are to do 150 minutes a week, which is 30 minutes, five times a week.

[00:21:46] Dr. Dale Lawrence: It’s not like you have to do a marathon training or triathlon training. I’m just talking about walking the dog. If you got the dog, take the dog for a walk, go for a walk with your loved ones. Just [00:22:00] move, and that makes a huge difference. And that’s true with many types of cancer. As well as heart disease and diabetes.

[00:22:09] Dr. Dale Lawrence: Just moving. I don’t remember which one of the insurance companies, but one of their, one of their models at one point. It was just move. So.

[00:22:17] Pete Waggoner: That was a really good campaign. Absolutely. I remember that. I think a lot of people saw and got that message very clearly. In terms of, we know obviously that the removal of the polyps are important.

[00:22:29] Pete Waggoner: Do you have to send those off to get tested? How long does that process take for you?

[00:22:33] Dr. Dale Lawrence: Oh, that’s a good question. Yeah, so any polyps or anything we remove or biopsy out of the colon, does go to the Pathologist and the pathologist will look at them. When the pathologists look under the microscope, they’re looking, I tell patients, I tell people that when the pathologists are looking at slides, they’re looking to see how funny looking the cells are.

[00:22:54] Dr. Dale Lawrence: If the cells look normal, then it’s not cancerous. Really, really funny looking [00:23:00] cells, way over here, those are cancerous. And in between, we have all kinds of ways we grade. We grade how funny looking the cells are. We call that dysplasia, and most people don’t need to know about that. But know that when we’re talking about cell types, it really is how funny looking they are.

[00:23:19] Dr. Dale Lawrence: And if they’re really funny looking, then it’s cancerous. If they’re sort of funny looking, it’s dysplastic. If they’re not funny looking, then it’s normal. And that usually takes a week for the pathologist to kind of put things together.

[00:23:33] Dr. Dale Lawrence: Sometimes they have to consult with other places, so it can take a little bit longer. What we’ll do then is send a letter to the patient letting them know what kind of polyps we found, if they’re worrisome or not, and what their follow up is. So, typical letter may say turns out it was a normal polyp, or normal tissue. You don’t need to be rechecked for 10 years.

[00:23:56] Dr. Dale Lawrence: Or it may say you had several adenomatous type [00:24:00] polyps and those polyps are at higher risk for cancer. So we would like to recheck you again in three years. And so, we’ll send that to the patient and to their provider so that they know, they can update their computer records and make sure that the patient gets reminded in a set amount of time when they should be doing their procedure again.

[00:24:19] Dr. Dale Lawrence: You know, I should also say that once you’ve had polyps, you probably aren’t a good candidate for the stool tests and the Cologuard anymore. Your colon cancer screening is going to need to be done through a colonoscopy. You’re now a higher risk person. So then, those other types of tests are for low risk people.

[00:24:38] Pete Waggoner: Great stuff here today, Dr. Lawrence, and I’m going to ask you one more question here as we wrap up today’s podcast.

[00:24:46] Pete Waggoner: What would be the most important thing you would say, or what do you say to your patients really about this month and what it’s all about with the National Colorectal Cancer Awareness Month?

[00:24:59] Pete Waggoner: What’s your [00:25:00] message?

[00:25:00] Dr. Dale Lawrence: The baseline message is get screened. And if you’re scared, or worried, or you’re fearful for some reason of doing a colonoscopy, then do one of the other tests. The most important thing is to get screened. And if you don’t know how to do that, talk to your provider, talk to your relatives, talk to your neighbors, because somebody knows how to do it and they’ll help you find somebody that can get you screened.

[00:25:28] Pete Waggoner: So get started, right? Just please do that.

[00:25:31] Pete Waggoner: Great stuff today. Once again, we were joined by Dr Dale Lawrence here today. And we appreciate your time on a very fascinating and important topic for all of our health. And hopefully we’ve inspired a few people along the way. We’ll listen to this to say, yeah, I’m going to continue along my path. I’m going to get there and I’m going to do what I need to do. And I think that’s just the name of the game. So thanks for joining us here today.

[00:25:56] Dr. Dale Lawrence: Thank you for having me. It was a lot of fun.

[00:25:58] Pete Waggoner: Thank you. That’s a wrap for [00:26:00] today’s episode of Beyond the Checkup, brought to you by Stellis Health, where we believe in neighbors care for neighbors. I’m Pete Waggoner and thank you for joining us on this journey to better health.

[00:26:10] Pete Waggoner: Remember, your journey to wellness doesn’t stop here. We’re always here to support, guide, and inspire you. Be sure to reach out to your Stellis Health provider for personalized care and advice.

[00:26:20] Pete Waggoner: Don’t forget to subscribe to Beyond the Checkup. For more health insights and stories, share this episode with friends and family, and let’s spread the word on living healthier, happier lives together. Until next time, stay healthy, stay connected, and continue to thrive. Thanks for listening.