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John Malanca and Dr. Jordan Tishler discuss the ins and outs of anxiety, sleep and cannabis.
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To learn more, visit: https://inhalemd.com
John Malanca and Dr. Jordan Tishler discuss the ins and outs of anxiety, sleep and cannabis.
Visit us at: https://www.unitedpatientsgroup.com
Follow our YouTube: https://www.youtube.com/channel/UCn_Rews_k-L0_0F73JSBDxg
Follow us on Twitter: https://www.twitter.com/upatientsgroup
Facebook: https://www.facebook.com/UnitedPatientsGroup/
John Malanca 0:03
John Malanca Here with United Patient Group, Be Informed. Be Well. and I'm here with friend and colleague, Dr. Jordan Tischler, how are you doing doc?
Dr. Jordan Tishler 0:12
Well, thank you. It's always a pleasure and an honor to be on the show with you.
John Malanca 0:16
Oh, you know, we do we do a lot together. So it's okay. I talk to you more than anybody in this industry.
Dr. Jordan Tishler 0:25
You know what I think so too, and that's fine with me.
John Malanca 0:28
Cool. Cool. Cool. So what we're going to discuss, you know, here United pastry, we receive a lot of call their demographic, you know, pretty much 40 to 240. And so, but we have a lot of elderly that, trust us to help. Where do we go? What do we do? You know, does this work for that? Does it work for this. And you know, first to say cannabis is not a one size fits all, I truly believe we're not 20 anymore. And I truly believe that a medical professional should be involved. What I'm seeing not only in with my mom, you know, my dad passed away a few years ago, and my mom's 85 is still very active, but I'm seeing some anxiety come in, I always shared her I said, Mom, you're not old. Get that out of your mindset she has. Thank you so much. Thank you so much. Thank you for reminding me about that. Because, you know, she's very active. And if I and I'm very fortunate that if she wanted to go visit my brother down in Santa Barbara, she can drive by herself. And I'd feel 100% confident, you know, and she has some other friends that even drive to drive into churches is it brings out a lot of anxiety, not only for them, but for my mom if my mom's driving it, and so but you know, and you you being a an MD, and specializing not only with patients of all ages, shapes and sizes, but you work with a lot with the elderly, and that's why I wanted to have you on, I'm gonna go right to the question here is what causes anxiety in the elderly?
Unknown Speaker 1:55
Oh, boy.
Dr. Jordan Tishler 1:58
I think that that's the million dollar question. Or maybe it's a million dollar question with inflation.
John Malanca 2:05
There is I don't mean to stump you. And the reason I say that, because what I'm seeing, and I'll use my mom and her friends, as an example, memory problems, you know, they're forgetful, oh, my god, I forgot about that, or I have to do this, or I'm worrying about did the male candidate, my Mom, don't worry about the mail in the mail. So those are the types of things that come up. And I even think with COVID, I'm seeing more and more with her and her girlfriends like that. And so that that's why I asked you that question, is it something that causes losing a spouse and knowing, okay, you know, everyone's going on with their lives. And now, all of those things, yes,
Dr. Jordan Tishler 2:41
problem. And sort of, to your point, about one size doesn't fit all, I think that, you know, the reasons anyone individual might have anxiety are going to be partially aging and partially individual issues. You know, as we age, we tend to perhaps have some greater memory issues, other cognitive issues, not just memory come into play, but also, you know, things like the world is moving quickly. And at some point, we seem to be less interested in keeping up. So you know, I think that in every generation, there comes a point in technology, where it's no longer of interest to keep up and then you feel befuddled, and and when when my grandparents were older, the issue was that they couldn't figure out the remote for their television, right? Which now seeing I
John Malanca 3:35
still receive those calls, right, John? What do you do I go, mom just hit reboot, or do this, she's, oh, my God, what would I What would I do without you. So it's always a decrease in like an ability to perform perform daily activities, can you know, I feel I can't reach up I, you know, I don't want her climbing on a ladder, you know, that's like, Ah, I've been so active and independent my whole life.
Dr. Jordan Tishler 3:58
There's also the fact that as we age, we tend to get less sleep and less quality sleep. And that impacts our daytime alertness and our feelings of competence, and in fact, may, in fact, are, in fact, our actual competence. So there are a lot of factors that are going on. And then I think we also probably have to address the elephant in the room, which is that, you know, none of us as my father would have said, escape life alive. And but as you get older you that comes into sharper and sharper focus. You know, I have a 19 year old daughter, and thankfully, God, God willing, she doesn't think about this at all. And, you know, here I am at the ripe old age of 55. And I don't sleep that well because I wake up in the middle of the night and thinking about how much I miss my father who died a little over a year ago and how I need to take care of my mom who's 83 and she's doing well. Ha, she's still at three, you know. And so you know, you get into this place where now you're the middle generation, then you start to have some anxiety, and then you get to be the older generation. And I, I personally think I'm gonna be tearing my hair out with anxiety. So I'm very sympathetic.
John Malanca 5:19
I'm right behind you on age, but also with sleep. And I truly believe sleep is like a domino effect. If you miss this piece, the domino effect happens with anxiety, maybe depression, you know, you're eating,
Dr. Jordan Tishler 5:37
right? All of these things are connected. Pain leads to anxiety, sleep, poor sleep leads to anxiety leads to little pain seeming like bigger pains. I mean, they're all connected into this horrible ball of wax.
John Malanca 5:52
So let's talk about cannabis, and anxiety. And I know Can you still hear me because I know I know, my thing popped up that internet connection was a little slow. Sorry. But let's talk about cannabis cannabis, not an elderly cannabis not being a one size fits all. And it's becoming a household conversation, not only around with my mom and her girlfriends, also at church, the bridge, their flower, you know, clubs or whatever, you know, garden clubs, you know, and she says it, everyone's talking about it. And knowing knowing that I'm in the industry, I get a lot of questions about John, does it work with this? Does it work with that? And I'm sure many of you have heard on my show, before that I still receive calls from friends from high school and they say, Man, my mom listened to you. And I want to thank you. And I said, What do you mean? It's like we've been trying to tell mom for this. But sometimes it takes an outside person to have that discussion. And you know what, she's sleeping better she's doing this she's off her medications, or she's she's titrated off off of these are? And can you talk about that you being an MD, and what you see with your patients, or what you recommend to your patients, not only to have a conversation with a doctor, and feel comfortable and confident doing so but also a conversation with your family. So they don't look to you like what are you doing? Mom? You know,
Dr. Jordan Tishler 7:14
I think thankfully, for most older folks, the younger family members are attuned enough that they're not so much the issue as the older persons fear that, that the younger people will look at them funny, but that conversation actually seems to generally go pretty well. And that many of my older patients are actually sort of prodded by by their children or grandchildren into coming to me. And ultimately, I think that that's a good thing, too. You know, I think it's important that we view this as a medication. And so we don't want to dabble with it, there are a lot of ways that we can do this that are not ideal. And there are a few ways that are sort of the best practices. I think everybody should be talking about these issues with their doctors. And then I know that a lot of people, particularly older folks are concerned that their doctors will say, you know, oh, tisk tisk, this isn't medicine, it's bad for you that sort of thing. My best advice is have that conversation anyway, you may be surprised that the your doctor is much more open minded than you think. And if they come at you with all of that sort of baloney, then it's time to think about finding somebody else who can help you doesn't necessarily mean you have to leave their practice completely. But rather, you need to find somebody like a specialist like myself, who's not only open minded, but has a lot of experience with this sort of thing so that we can get you to where you need to be.
Unknown Speaker 8:50
And you just froze. Where would
John Malanca 8:51
they start with cannabis with you? I mean, what would you recommend, you know, a first time had a lot a lot of these. I'll say patients and the elderly demographic that we work with on a regular basis. They say, John, I've never tried cannabis. You know, my mom was a perfect example. You know, she's never tried it. And I remember one time she, you know, it's gonna say good morning, good night. You know, good morning, good afternoon. Good night here. And remember crewnecks called her one night Say goodnight. Mom said, I have to ask, you know, now by this point, all her girlfriends had been coming to us and you know, and getting some information. And mom said, can I ask you something? I said, Yeah, she says, Just can't cannabis help with sleep and pain because she's an ex tennis player as well as you my shoulder than hurt. And I've been taking a little cannabis every night to go to sleep. And I was silent and Corinne hits me. She's like, Be supportive, be supportive. That's the last thing I thought my mom and I said, yeah, she's like, it's amazing. She was you know, after your father passed. I may have looked at this for help. It was sleep as well. And to hear my mom say that, you know, it's funny, and I didn't share that with my brother for about three or four months. And he came to me. So, you know, Mom's doing this. I see. I said, Why don't you tell me?
Unknown Speaker 10:10
Tell you, I told you, but so she's seen
John Malanca 10:21
so for a patient, like my mom, or anyone that's listening right now, you know, their question is Doctor tissue, where do I start?
Dr. Jordan Tishler 10:29
And I think that that's exactly the right question. And the answer to it depends a little bit on what's going on. So I don't certainly mean to be being vague about this. But for example, if somebody comes to me and they say, Doc, I'm just having some anxiety, then I might turn to cannabis by inhalation. And when I say inhalation, what I mean is using a sorry, hang on a sec, a flower vaporizing machine like this one, which avoids the whole smoking thing, because smoking isn't very good for us, number one, and I think rightfully, most older people are loath to go in that direction. But that doesn't necessarily mean that inhalation is an inappropriate approach. Inhalation is rapid in its onset, relatively short in his duration of action. And this allows us to sort of be very precise and surgical in our approach to the anxiety. And this is one of the things where the cannabis industry and cannabis users really get things wrong. If you ask some of our stoner friends how you treat anxiety, the response you'll get is, well, when you wake up in the morning, the first thing you do is smoke up some weed. And anytime you feel anxious, you just continue to smoke. And we know that that's not the right answer. We know that that actually can negatively impact school and work performance. And it can actually make anxiety worse, then you can get into this catch 22 where you use cannabis for anxiety and it provokes anxiety to use more cannabis, you get worse anxiety. We don't want that that's that's completely the wrong direction. However, a small low dose given around bedtime is ideal because it will wear off while you're asleep, the intoxication part will wear off. But it's not the intoxication that is fundamentally helpful for the anxiety. It is some other effect of the cannabis that that is helpful. And the intoxication is sort of a side effect that we get in in the process. So we don't need that intoxication throughout the day. What we need is a little dose at bedtime and then that lasts throughout the day, even though we're no longer intoxicated.
John Malanca 12:51
You make you made a good point there about intoxication because a lot of the patients we work with, they say I want the medical portion of cannabis not the recreational portion. And when they say that they look at THC being the recreational portion CBD and other cannabinoids mean the non psychoactive the medical portion. And they all play a role in it. I use you were in California, you know you and I go wine tasting, we take little sips here feeling great. We drink three bottles of wine, we're going to be intoxicated. And the same thing with THC. You can have success with one milligram, two milligram doses of THC combined with other cannabinoids as well. What I'm finding and correct me if I'm wrong, you being a medical doctor, a lot of the seniors that we work with prefer a tincture or an edible anything from a piece of popcorn or peanut or gummy, because they're used to taking a one pill, you know, they can take one, one. And so and I know a lot of medical professionals don't really recommend that thing is your eating sugar and doing that way, you know.
Dr. Jordan Tishler 14:03
So there's so many questions embedded in that let me try to take out a few of them. The first is Yeah, I mean, I don't recommend that people go out and get a bunch of brownies are a bunch of rice krispie treats because that's just more food and sugar than we need but a little tiny gummy has almost no sugar in it. And so that's that's a better approach to the whole food calories side of things. Yeah, I think that you know, when we're talking about anxiety, the edibles can be used, but they're a little tricky because as you know they have a delayed onset and a longer time of action. So for many people, it's actually easier to use the inhalation in the safe approach compared with the edibles even though we you're right people think an animal is you know, a little gummy is kind of more akin to taking a pill. It's it's easier to take but it's harder To time appropriately, and the inhalation is kind of the opposite, which is it's, you don't have to kind of get used to the to the mechanics of it. But once you do, it's much more precise about what it's going to do when it's going to do it. So in some ways for anxiety, it's perfectly okay for us to sort of use either or, on the other hand, because of the ways they're different, there are other conditions that may go along with the anxiety where we need to pick one or the other. And a fine example of that would be insomnia. If somebody has anxiety and trouble getting to sleep, then we really do want to use the inhaled stuff, because it's going to work before they need to go to sleep. If they are the kind of person who has anxiety and they wake up early in the morning, and can't get back to sleep, then the edibles better because it has that longer duration, and helps keep them asleep. And then if we're throwing pain management into that mixture, then then the edibles tend to be better in general, but not all the time. So again, to you're not one size doesn't fit all, you know, we have to kind of see what the total picture is here, and then hone in. But I tend to tell my patients, we want to use cannabis by the means that's going to be most effective, rather than sort of picking, you know, the thing that's sort of most familiar to
John Malanca 16:23
us. You know, even with a doctor involved, which I I cannot express enough how important that is having a doctor involved because cannabis is not a one size fits all. I always say age, weight, current health condition sensitivities, what you've eaten, what you're trying to try to treat, but also and also drug to drug interactions should be just because you're a senior male, you know, 85, you experience anxiety doesn't mean that your buddy, Tom over here, senior male 85 is a have the exact same dose as you two things one, I will talk about safety, but also finding that sweet spot, you know, my mom, you know, has found her sweet spot over the years of knowing exactly, she takes it about 45 minutes before she gets in bed, takes it brushing her teeth gets ready to bed, boom, you know, slowly just fall asleep and wakes up. No hangover No, nothing like that, which a lot of people sounds ideal. And so she has found what her perfect sweet spot is when she takes it and how long it takes and then just kind of don't dozes off back to safety. Because my mom lives alone. Of course, now my father had passed away and a lot of seniors I work with, unfortunately, you know, are in the same boat being a widow. And so that's the one thing I was talking about is safety first. Have you tried cannabis before? Yes, no. Do you live by yourself? Yes, no? And can you share some of the safety precautions just in case if you take too much, or if you live alone, and this is the first time you're you're trying to treat anxiety or sleep or anything?
Dr. Jordan Tishler 18:07
Well, so a couple of things. The first is that many of my patients come with no previous cannabis experience, or Yeah, you know, back in the 60s or the 70s. I did a little but you know, it was a long time ago. So I try to kind of explain to them in terms that are familiar, what kind what level of intoxication or fuzzy head we're expecting. And I usually say, look, it's somewhere between half a glass and a glass of wine. And I think people can relate to that, that, you know, that's enough of a range that the people who get pretty tipsy on half a glass understand that people who actually drink a full glass of wine understand, but the point is that it's may be a little tipsy may be a little fuzzy, but we're not expecting sort of drooling on the on our feet or locked in the couch or any of those horrible expressions that people use. So what we're what we're aiming for is very small doses with very minimal, you know, side effects. So I think that that's hugely important. I often encourage people to try it the first time with people around call up their son, you know, have them come over for dinner and then we can try this stuff out that sort of thing. But generally speaking, I also you know, I don't I don't worry about it too much. One of the good things is we you all know is cannabis cannot kill you. So we really only need to worry about not getting too much in the sense that it can make us uncomfortable. You mentioned a few paragraphs ago that people like tinctures. And I'm actually generally speaking not a fan of tinctures. And one of the reasons for that is because it's a liquid, and as a liquid, it's very easy to make a mistake with the dose and the dose is the crucial element. And then on top of that at the dispensary, they tell you stupid things like drip it into your mouth and put it under your tongue and None of that turns out to be true or a particularly good way of making sure you know how much you're getting. So when I do use a tincture, I have people drop it onto a spoon and then swallow like a cough medicine. But in general, I don't do that I favor those little gummies because you know what, if each gummy has five milligrams in it, you either took it or you didn't take it, right. I mean, there's like not a lot of in between. And I think that helps with not making mistakes.
John Malanca 20:32
measurements on the dropper, the actual dropper itself,
Dr. Jordan Tishler 20:37
yeah, these are woefully inaccurate. It's tough to also because a lot of cannabis companies don't know scientific standards. So it turns out that there is a standard that from a dropper 20 drops should equal one ml. But you can find cannabis products out there that are used 20 drops per ml or 30 drops per ml or who knows what. So again, you have to kind of really be a little cautious that between the industry not knowing what they're doing and the patient being new to this, that you have to kind of spell it out carefully.
John Malanca 21:16
You just brought up a point here, cannabis products. I'm confused, you're confused. We're in this industry and it's confusing on how many products are out there, what to believe what to trust, what to look out for. And so for a first time patient doesn't matter if you're 20 year old or 120 years old. Going into a dispensary for the first time is quite confusing because you have just a wide variety of things. Can you share you spoke about dosing? Can you talk about what you're generally seeing a safe doses? And or what type of cannabinoid Are you recommending? For your patients? THC versus CBD. I know CBD. You can go anywhere from CVS to Walmart to your local gas station and pick up a CBD product these days. And it's frustrating because I think there's a lot of misinformation out there. And I get that quite a bit. Well, I just bought this over here. I bought it here. No, I mean, there's some great companies out there. So please, if you need to have any questions, you know, contact Dr. Tischler or myself, and we can direct you to some retro companies and what we're and or what to look out for. One is a tested, USDA certified, I'm a big fan of organic I'm big fan of, but make sure number one thing is it tested as well. But can we talk about dosing, as you've mentioned a couple times, but also in your definition of dosing is a dosing what can what can ammonoid thc CBD CBN CBG.
Dr. Jordan Tishler 22:49
So, you know, I tend to follow the data, we've got 70 years worth of great data on THC being useful for pain management, anxiety, sleep, that sort of thing. So I tend to focus on low doses of THC. Understanding that one of the things that makes cannabis different from from the pharmaceutical THC is that we're getting a range of chemicals along with the THC, even if we're only measuring the THC portion. I have patients who are doing well, sort of on average, between five and 10 milligrams of THC, some of them need a little bit higher 1520, very few above 20, and very few below five. So really, five to 20 is kind of the ideal range, either once or twice a day, depending on what we're treating. And, you know, I should say that even when we're using this by inhalation, there are ways that we can be very precise about the dose, so that we know that people are getting five or 10 or whatever milligrams of the THC. And that works out really well. And that's important because that allows us then if things need to be adjusted to know what was being done and how much you're getting, and it's not just kind of like okay, take some more, you know, we can be very specific about it. And we can also be very cognizant of where that safety range is. One of the things you would want to talk about about safety is the other cannabinoids. I would say to anybody listening, that you should not buy any cannabinoid or a cannabis related product at this time in any state of the United States without it's coming through a state regulated medical cannabis program. And the reason for that is that there are companies out there that are manufacturing CBD products. They're manufacturing Delta eight THC products or delta 10 ch c products. There's a you know, if you're a chemist, you can take CBD from him and manufacture it in all manner of things. Are you still yes, you're still on And the problem is, it turns out that the process of changing CBD and other cannabinoids requires some very sophisticated chemistry, because it uses some very dangerous chemicals. And it can produce multiple outcomes, meaning, if you want Delta eight, and you start with CBD, you're going to get some delta eight, and you're going to get some other stuff that are related to, but not delta eight. And many of these things are not easily detected by the testing that you're talking about. And as a result, those contaminants persist throughout the process and actually make it to the shelf. One of our association of cannabinoid specialist members, and I wrote a paper on this, which hopefully will get published in the next few months. And it was really fascinating for me to go through all of this information with him. Because basically, it comes down to a whole lot of really bad news that even the manufacturers aren't aware of yet. And so we need better testing. And we need more regulation to enforce the better testing. So for the moment, you know, when you go down to the Whole Foods or the corner gas station to get some CBD, I think there's a high likelihood of that being contaminated with one thing or another that we really don't want to expose ourselves to.
John Malanca 26:27
So just so we don't scare our audience that completely newbies, you know, ask questions, don't be afraid to ask questions. And we're here for that. If you have any questions or any products that you may have been referred to, or recommended by one of your friends, you know, and ask questions, make sure it's tested. And I'm a fan of us grown, if you can find a USDA certified, but ask question. And I'm a fan of starting starting low, start low go slow, you know, some for some
Unknown Speaker 27:09
I lost you.
John Malanca 27:13
five milligrams, I think two milligrams, five milligrams. So are we so there?
Dr. Jordan Tishler 27:17
We were off for a second. But I think we're back now there. Yeah. Okay. I think I like the expression start low and go slow. And I think that it's an arguable but the problem is that it doesn't give people really enough guideposts. Gotcha. What is low? And where is the upper limit? After I've been going slowly? And I think those are exactly the kinds of things that I addressed with patients. So that, you know, we can say, all right, we're going to start at five milligrams, oh, no, you have some sensitivities. All right, we're going to start at two and a half milligrams, and we're going to advance over such and such a period of time, we're going to communicate back and forth through the process, so that your questions are answered, and any adjustments that we need to make we make together in a thoughtful manner, but also that we don't end up you know, at 50 milligrams, which is just way too much. And, you know, the, the start low and go slow over enough period of time. And I've seen people end up at very high doses, because we didn't say, you know, if you get to x, milligram stop and give me a call. So you know, whenever I give somebody a prescription, and I do write this out for people, it says something like five to 10 milligrams, and then I have an instruction sheet that says, start this way, using five milligrams, do it for this long at this time. And then if things are going well keep doing it, if things are not going, if it's not being effective, then go to 10 milligrams, and do that for a while. And then let me know right, so that there's always this kind of connecting the dots again. And, and what we really don't want is people to say, oh, you know, I'm just going to go slowly, but I'm going to keep going. And then pretty soon, you know, there are 100 milligrams.
John Malanca 28:59
Yeah. One thing another colleague of ours in the industry says is, pick a body check first. Take a deep breath to see where you are on a scale of one to 10. If it's if you're if you're having anxiety, use your cannabis wait for it to kick in however long that may be if it's depending on how you're ingesting via inhalation or inedible, and after you feel that, take another deep breath and just take another body check to see where your anxiety is on a scale of one to 10 that is to attend or is it down to two. And I'm a big fan of journaling. Write down what you've taken so you know exactly where you are in that sweet spot. Before we finish up here, can you talk about the dangers of pharmaceuticals or drug to drug interactions?
Unknown Speaker 29:50
Absolutely.
Dr. Jordan Tishler 29:52
Well, for one thing I want to say that, you know, as a doctor, I don't have any particular fears of pharmaceuticals. I think that pharmaceuticals, you know, do great things for us in general if they're used wisely and appropriately. And it's unfortunate to me that that many people have gotten shy of them. And also, particularly in this field where people are, are looking at cannabis, it's sort of like, you know, cannabis is a substitute for, you know, where I want to get away from the pharmaceuticals. So I want to go to cannabis. To me, it's all medicine, right. And so they all come with benefits, and they all come with risks. And we our job is to use them wisely, to maximize the benefit, minimize those risks. However, to your point, there are certain cannabinoids and in particular CBD, which as we've talked about is kind of everywhere at the moment, that through the way that they're processed through your liver can interact with many conventional medications that are also processed through the liver. And so you know, there's sort of only so much that the liver can do at one time. And so if we have a pharmaceutical, which is doing fine on its own, but if it's too much, or too little can be risky, and then we add CBD into the mix, then we may actually start to affect the level of the pharmaceutical medicine without thinking about it, because we're only thinking about the CBD. And so we've seen this and there are a bunch of medicines that are sort of, you know, fairly dangerous unless they're used carefully where this can interact. So amiodarone, which is a common heart medication, warfarin, which is a blood thinner, Plavix, a different kind of blood thinner. The bunch of immunosuppressant medicines that people who've had organ transplants would be on all interact with CBD. And if you're not thinking about it, or you're not talking to your doctor about the CBD, then we can get into significant risk. The one that has been most concerned at the moment is good old Claritin, loratadine, right, that's freely available over the counter across the country. And that's just fine. But if you overdose on loratadine, you can actually cause fatal heart rhythms, right. So we only give 10 milligram tablets. And that works fine for most people, but CBD with that, and suddenly that 10 milligrams is no longer 10 milligrams, functionally, it's much higher. And I think that there's a significant risk that this is going to happen to people.
John Malanca 32:38
Again, the reason why I say a doctor should be involved, you know, going over your, what you're currently taking, and what your potential outcome is what you would like to get from using cannabis. As a as you and I both are fans of the the, the benefits of this miraculous plant. I also a lot of times direct people away from cannabis, and I'm a big fan of for anxiety, which I do for my personal anxiety is you know
Unknown Speaker 33:20
breathing your anxiety, not
John Malanca 33:21
even breathing. Take some time, take some deep breaths, you know, five to 10 My internet's going in and out. So hopefully you can hear me still Can you hear me? So? Yeah, you were out for a little bit. Oh, but even even breathing, taking deep breath.
Unknown Speaker 33:36
In, we're gonna nose out,
John Malanca 33:38
do that 510 15 times, and you'll be surprised to see how your anxiety will drop down. If you're able to move and walk out in the garden, work in the garden, get outside, get some vitamin D, get some fresh air. And I don't care what age you are getting outside for five minutes or an hour is really important. And even stretching if you're able to stretch. You know a lot of these elderly communities have some yoga but sit down you have where you're in a chair. And you can stretch and I think it's great to get
Dr. Jordan Tishler 34:12
demonstrate live Tai Chi,
John Malanca 34:13
I do Tai Chi did it this morning. And I just find that that that lowers my anxiety level down as well. But anyway, Dr. Tischer, always a pleasure working with you as we do on a daily basis. But can you share with my audience? How they can find you?
Dr. Jordan Tishler 34:32
Oh, yes, absolutely. So my clinic is called inhale MD. And so you can go on over on the web to inhale md.com and you can reach me through the website but also I want to point out that we have over 200 articles written for normal people, not doctors, but normal people on a very wide range of these topics that about cannabis, the benefits the risks And there's a search bar. So if you want to put in something specific, you can find exactly the right article. So again, inhale md.com and and the phone number is there as well. We welcome phone calls and emails, anything that will help.
John Malanca 35:15
I'll put it down in the in the description as well. Awesome. Everyone Thank you very much for for being with us here and Dr. Tishler always great being with you as well. Likewise, I will see you soon John Malanca with United patient group be informed and be will have a great day everyone.
Unknown Speaker 35:31
Bye bye