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A few items from the transcript
- Grady (where he works) is one of the busiest Level 1 trauma centers in the entire United States
- He works between 80 to 100 hours a week
- 98.8% of our ICU patients were vitamin D deficient
- Interviewer: So vitamin D works sort of across the board in helping you survive whatever it is that is wrong with you
- I've had to go as high as like 70 to 80 on some patients to get the proper response
- UN presentation – They had never heard anything, how vitamin D can affect the whole nation, the country, the world, or the world health organizations. So they had no clue
- US…can probably save over $800 Billion a year if we got everybody's vitamin D level above 40
- Vitamin D is “most common nutritional deficiency in the world”
- Many blacks believe that they get more VItamin D from the sun, rather than 5X less
- Vitamin D, glutathione, and heat shock protein to treat concussions, etc. – US Patent Dec 2019
- UN invited Dr. Matthews to speak about Vitamin D in both Sept and Oct 2018
- FDA decided to double vitamin D in milk after talking 4 times with by Dr. Matthews – July 2016
- US Army learning about benefits of vitamin D to trauma – Dec 2013
- Hospital ICU added high dose vitamin D - malpractice lawsuit costs dropped from 26 million dollars to ZERO - Oct 2016
- Congressional Black Caucus Foundation (Wash D.C) invited Dr. Mathews to speak to them on Vitamin D – Sept 2018
- Army Training trying performance readiness bars with 1400 IU of Vitamin D (Dr. Matthews) – Sept 2018
- Fastest US High School sprinters are both at the school taking lots of vitamin D (Matthews) May 2016
- Surgeon on a mission to promote vitamin D - Dec 2012
- Trauma and Surgery category listing has
287 items along with related searches
- Skin - Dark category listing has
433 items along with related searches
- Includes names of studies which are in both categories Dark skin and: Diabetes, Genes, Cardiovascular, Intervential trials, etc.
- Overview Dark Skin and Vitamin D
- Dark skin births are much riskier due to lack of vitamin D
- Overview Loading of vitamin D
Items in both categories Trauma Surgery and Loading Dose are listed here:
- Taking Vitamin D just before and after surgery helps (open-heart in this case) – RCT Feb 2021
- Half as many problems if take Vitamin D (300,000 IU) before thyroid surgery – RCT Jan 2021
- Fewer days in hospital if 300,000 IU of vitamin D before brain surgery - RCT Feb 2021
- Those getting an injection of 300,000 IU Vitamin D got out of the ICU a week sooner – RCT Dec 2020
- ICU patients greatly helped by Vitamin D loading doses – if gut-friendly – Oct 2020
- Fewer days in ICU after 300,000 IU of vitamin D, but not 540,000 – meta-analysis Aug 2020
- 3X less Septic Shock in children with sepsis getting 150,000 IU of Vitamin D - RCT June 2020
- 100,000 IU daily of Vitamin D for 5 days increased Hemoglobin in Mechanically Ventilated adults – RCT Jan 2018
- Traumatic Brain Injury – 120,000 IU of Vitamin D resulted in 3 fewer days on ventilators – RCT March 2020
- Hip surgery with multiple doses of 50,000 IU of vitamin D weekly both before and after – RCT 2023
- Use of Vitamin D in a trauma surgery - Dr. Matthews on Facebook – Jan 2020
- Surgeries often deplete Vitamin D - 300,000 IU resulted in no benefit (only 22 ng) – Nov 2018
- 10 fewer days of ICU Mechanical Ventilation 300,000 IU injection of vitamin D – RCT March 2019
- Intensive Care (ICU) helped by Vitamin D – review of past and on-going studies – Dec 2018
- ICU adults getting 540,000 IU of Vitamin D were 2X more likely to be alive 30 days later – RCT June 2019
- Traumatic Brain Injury recovery helped by injection of 100,000 IU of Vitamin D – March 2019
- Rapidly restore Vitamin D levels with 10,000 IU per kg for children in ICU – RCT 2024
- Esophageal Cancer surgery helped by 300,000 IU of Vitamin D – RCT Sept 2018
- Severe sepsis may be prevented by 400,000 IU of vitamin D – RCT 2023
- Critically ill children – randomized clinical trial to give single doses of up to 400,000 IU of vitamin D – 2019
- Vitamin D loading doses reduce ICU mortality by 30 percent – meta-analysis April 2017
- Children in Intensive Care need Vitamin D loading dose of 10000 IU per kg (nearing a consensus) - Oct 2016
- Vitamin D Loading dose - 20,000 IU daily is not enough if obese, etc. (Cancer) great table and chart – Oct 2016
- Rapid Normalization of Vitamin D in Critically Ill Children (10,000 IU per kg) – clinical trial
- VITdAL-ICU - AMA RCT Sept 2014
- Critically ill need vitamin D – how much and which test to use is TBD – Nov 2014
- ICU survival increased with vitamin D single 540K IU loading dose - JAMA Sept 2014
- 540000 IU before ICU raised vitamin D by 25 ng in 2 days – March 2011
- Hip surgery followed by 100000 IU then 1000 IU of vitamin D daily – June 2010
- 600,000 IU intramuscular D3 helped BMD after pancreatic surgery – June 2010
- Every single Taekwondo (indoor) Korean teen had low Vitamin D – Sept 2019
- NCAA athletes – one third had low levels of vitamin D, 19X more likely if black race – March 2015
- Dark skinned NCAA basketball players were 15X more likely to have low vitamin D – Feb 2014
- Vitamin D Helps Atlanta High School Athletes - Feb 2012
- Vitamin D bed used 4 minutes daily by dark skin members of UK sports team – Jan 2011
- Low vitamin D in teens: especially black or overweight – June 2010
- Vitamin D levels dropped after training for white, but not black females April 2010
[music] 00:53 Carol Moulton: Greetings. Greetings. Come on in. I'm pouring the tea. Once again, this is Carol Moulton, your host of TEA Time with Carol, and we are here once again on Saturday, maybe snowing where you are. Hopefully, you're in and nice and cozy, and comfortable. But in any event, I'm pouring the tea today and fluffing the pillows and want you to come in and really put your listening ears on because we've got a special, special guest today. We've got Dr. L. Ray Matthews and this one is gonna be really good. This one's gonna be really, really good. If you've been with me for a while, you know that we've spent a lot of time talking about fear and all the different ways that that can come up in your life. And we're gonna maybe touch on that a little bit as we talk to Dr. Matthews. Growing up in Mississippi is probably not the easiest place in which to grow up and decide you wanna become a doctor, but we're gonna get to all of that.
02:04 CM: But I just want to ask you, first of all, last week we were talking about the two things that you need in order to keep your New Year's resolutions and I really wanna know how you're doing with those. So, if you'd be so kind to give me a hit on Facebook, on TEA Time, or on the Empowerment Radio station on site and just let me know if you've fallen off the wagon, or if you're still on the wagon, or just where you are in keeping those resolutions. But I don't wanna belabor it. I wanna bring our guest in because this is gonna be a really, really, really fast, fast, fast hour.
02:51 CM: Dr. Leslie Ray Matthews, and I'm only gonna say that first name once 'cause I know he doesn't like it. But Dr. L. Ray Matthews is a native of Indianola, Mississippi. And just now, we were trying to figure out how long we've known each other, and we figure it's somewhere between 13, 15, 16 years. And since the day I met him, he has been talking about vitamin D and its benefits. And the interesting thing is that when I first met him, nobody was really talking about vitamin D. That was something that was kinda unheard of. If you went to your doctor to get a physical, they really weren't testing for vitamin D. Now everybody's testing, everybody's looking at vitamin D levels and that has to do in no small way to the efforts and the work of Dr. Matthews.
03:48 CM: Dr. Matthews is, I know he won't do it, so I'm gonna toot his horn for a minute. He is a scholar and a researcher, and has used his research on his patients in Grady Hospital in Atlanta, Georgia where he has saved countless lives. People who were clinically dead, people who were in really, really bad accidents, he's been able to have them recover and not only recover, but walk out of the hospital by using vitamin D and the other items that God has given to him that is really a miracle. I mean is really nothing short of that. I've seen a lot of the research and a lot of the documentation concerning the work that he's done, and it's not only in this country but also overseas.
04:43 CM: Dr. Matthews has been inducted into the Royal Society of Medicine which, top, top, top, we're talking Louis Pasteur, and Charles Darwin, and scientists of that caliber who were members of that society. He has been inducted into that. He's been invited to speak at the United Nations, he did that I think last year. He's spoken before at the Black Congressional... Black Caucus. He's been invited to speak in overseas, Dubai, and probably just about every country you can think of. But very, very humble brother, very, very humble, but he's got an incredible story. So I'm not gonna belabor it, I just wanted to give you kind of a little bit of the parameters of who we're gonna be talking to today and I just wanna bring him and welcome, welcome Dr. Matthews into TEA Time with Carol.
05:43 Dr. L. Ray Matthews: Hi Carol. Thank you for inviting me.
05:46 CM: Oh sure. Thank you. It's my pleasure. I'd like to start at the beginning and give people a little bit of an idea of who you are and what made you decide to become a medical doctor? Are you the first doctor in your family? And why did you decide you wanted to be a doctor in the first place?
06:12 Dr. Matthews: Well, medicine and minister seems to run in my family... My father is a, he was a Baptist minister, my uncle was a Baptist minister who went to school with Martin Luther King at Morehouse, my cousin Fred Matthews was a Baptist minister, so from a family of Baptist ministers and my great grandmother and grandmother in Mississippi were both midwives. So I wanted to be a physician since I was 4-years-old, it's all I ever wanted to be. So I knew what I was destined to do from the time I was 4-years-old.
06:43 CM: Wow. Well, I mean, but what made you... I mean midwives I can kinda see, Baptist ministers, um, maybe not so much. But what was it that kind of sparked it for you that said, "Yeah, I wanna do that"?
07:00 Dr. Matthews: I think it's just God-given. Some people are predestined even before you're born, and you just know from an early age, what you're supposed to do.
07:08 CM: That's interesting, that's really interesting. So I take it you studied, went all through undergrad, where did you go to medical school?
07:16 Dr. Matthews: I went to medical school at the University of Mississippi in Jackson, Mississippi, which is Ole Miss basically. So I went to undergrad at Ole Miss, graduated with a degree in chemistry and like I said, Medical School at the University of Mississippi in Jackson, Mississippi.
07:33 CM: And I know you've done, kinda work all over, including at the Mayo. You wanna talk a little bit about, about that and how all that came to be too?
07:43 Dr. Matthews: Yes, I did my fellowship in surgical critical care at the Mayo Clinic in Rochester Minnesota and I was on staff for a couple of years as a senior consultant, associate consultant, and then I moved to Atlanta, Georgia in 2007.
08:03 CM: Okay, alright so... And so now what do you do? I know that you are at Morehouse School of Medicine and you're also at Grady. Can you talk a little bit about what that looks like for you? What's a typical day?
08:22 Dr. Matthews: Sure, Grady is one of the busiest Level 1 trauma centers in the entire United States. Last year we admitted over 4500 trauma patients, and about 30% of those trauma patients have penetrating injuries, knife wounds and gunshots. A full professor in the Department of Surgery at Morehouse School of Medicine, and also the Co-interim Director of Surgical Intensive Care Unit, a Senior Clerkship Director for fourth year medical students that take the SICU Rotation, and I teach nursing students, nurse practitioner students, medical students, and we train young doctors to be surgeons.
09:05 CM: That's a lot [chuckle]
09:06 Dr. Matthews: Yeah quite a bit, keeps me busy. I work between 80 to 100 hours a week.
09:11 CM: Oh, [09:13] . That is soul crushing. So I hope you're taking your vitamin D.
09:18 Dr. Matthews: Yes, every day. That's the first thing I do in the morning.
09:20 CM: Well speaking of that, can you tell us a little bit about how that came to you because you were really the face of vitamin D. So how did that even begin? Where does that come from?
09:37 Dr. Matthews: Okay. As far back as Medical School, I remember a nutritional lecturer, so the doctors don't get a lot of lectures on nutrition, so one of my professors said that, "All you have to do is eat three meals a day and you'll be healthy." And I was like, "Well how you gonna eat three meals a day when healthy meals and be healthy when 90% of vitamin D is produced by the sun striking your skin. You only get 10% of vitamin D from your diet". So I said, "I'm gonna prove that one day." And so, as far back as medical school I've always been interested in vitamin D. But you know you have to go through residency and a lot of other things. So I had to kinda put it on the back burner until I got time in the early 2000s to actually start working with vitamin D.
10:20 Dr. Matthews: Well, actually it's not a vitamin it's a true hormone. So that's what makes it different from the other vitamins. And actually it's the most powerful hormone in your body. You have 30,000 genes in the human body and vitamin D controls 3000 out of 30,000 genes. Or 10% of your DNA. So anything that controls 10% of your DNA is very powerful. So I figure if this stuff controls 10% of your DNA, what can you do if you learn how to really use it or understand the concepts of it?
10:50 CM: And so you started working... So what did that look like? How did you study it? What form did that take?
11:00 Dr. Matthews: Okay. First of all, I read about a thousand articles on it, everything I could get my hands on I read about vitamin D. So I knew everything, learned everything about its molecular structure, what it does, the actions that it does, the genes that it works on. And then I just started diagramming, "Okay, if it works on that, it should be able to affect this." For example, one thing that vitamin D does, it increases your immune response system or how well your body responds to infections and cancers, and bacteria and viruses. So as a surgeon, we are worried about wound infections all the time, we're worried about patients getting pneumonia, and so that's one of the things. I say, if it works on that, I can get my patients out of the hospital faster, lower my mortality rate, and there is less suffering among the patients and you can lower hospital cost. And so those are one of the things. Another thing it does, it decreases your inflammatory response. Inflammatory response to things that causes arthritis, to swelling, the phlegm that you get when you get bronchitis and all that. So if you can decrease that, you can help patients to do better. So if you can control those two arms, the immune response and inflammatory response system, you can do a lot of different things with it.
12:14 CM: So how did you begin testing this after you read these thousands of articles and concluded that it affected these two areas? What was the next step for you?
12:29 Dr. Matthews: Okay. The next step you have to get IRB approval or Internal Board Review, or in any institution you work in, you have to get approval from your medical school and hospital to do research. So that's a long, tedious application [chuckle] that you have to fill out in order to get IRB approval and you have to state specifically what you're going to do, what are your aims, patient population you're wishing to target, what are your primary outcomes, what are your secondary outcomes gonna be? Then this application has to be reviewed by your IRB Board, it's your medical school and it's your hospital. So after you get approval, it's closely monitored. You wanna design research that does not harm patients at all first of all. So I knew what the dosages was and learned everything I possibly could about potential side effects or toxicity of it if that happens and how to treat it. And so that is how I initially got started.
13:27 Dr. Matthews: So first thing we did was tested everybody in our ICU and we found out 98.8% of our patients were vitamin D deficient. That's almost 100% in sunny Atlanta where there's a plenty of sun. However, we live in a technology society, so people do not go outdoors anymore and everybody wears sunscreen. So we've made a deal with the dermatologists, just go outdoors 15 minutes and then put your sunscreen on, because you have to worry about skin cancers or being unexposed too long. And you only get 10% of vitamin D from the diet, so you cannot eat enough food to satisfy how much vitamin D you need on a daily basis.
14:09 CM: And so, what was the next step? You got the approval...
14:13 Dr. Matthews: True.
14:13 CM: And you tested everybody, and I know the rule is first do no harm.
14:18 Dr. Matthews: Yes. Correct.
14:19 CM: So how did you start testing it on people, on patients?
14:24 Dr. Matthews: Alright. So once we knew exactly, we checked the levels on everybody too. So the average levels in our patients, I looked at the different demographics, the lowest vitamin D levels were in
- African-American women, which had a level of about 9.8 nanograms per milliliter.
Federal Government states that normal vitamin D level is 30 nanograms per milliliter.
- So the average African-American lady was 9.8, that's nowhere near 30.
- The next lowest group is African-American males, they're about 12, and then the
- other two groups were the Caucasian males and females, they're around 18.
So we know from previous research that once your vitamin D level gets below at 18 nanograms per milliliter, your risk of death goes up 30% from all causes. So if you come in a hospital, you have a stroke or heart attack, you have a traumatic brain injury, you have sepsis, if your vitamin D level is below 18 and stays there, your risk of death goes up 30% just from that alone. So I said, you can basically lower some of those mortality rate 30% just by getting a vitamin D level above normal. And so we also applied a graph to our chart where we looked at the different effects of vitamin D.
15:34 Dr. Matthews: So we know that from our research that when people's vitamin D levels got below 13, between that 18 to 13 range, that mortality rate just went up through the roof regardless of what the cause was. And so after our patients got above 18 and started getting above 30, the mortality rate went down tremendously. And so we knew for a fact that the stuff is associated with increased mortality rate when your vitamin D level is real low and longer hospital stays, longer ICU stays and just a whole bunch of other problems and complications. So we plotted a graph and then we know once your vitamin D level gets above 40, you basically almost have zero mortality. I don't think we've had a single person in our ICU to die with a vitamin D level less than 30 over the like 12 years we've been doing research.
16:28 CM: Wow. That is amazing. So let me see if I understand what you're saying. You're saying when people come in, regardless of the reason or why they're coming to the hospital, or how sick they are, if their vitamin D level is below 13, it...
16:48 CM: Their chances of dying from whatever cause is much higher than if...
16:54 Dr. Matthews: Yes. Correct.
16:54 CM: They have a higher vitamin D level when they come in. So vitamin D works sort of across the board in helping you survive whatever it is that is wrong with you.
17:08 Dr. Matthews: That's totally correct. Yes, when at 13-18 range, it helps you survive whatever disease process that you may have. 'Cause remember it stimulates your immune system, so you need a strong immune system so basically it makes your immune system a lot stronger, so your immune system can fight off any type of infection, viruses, bacterial, cancer or whatever disease that you may have and it decreases the inflammatory response, 'cause everything, all diseases mostly are associated with inflammation. You have acute inflammation and you have chronic inflammation. Acute inflammation is what helps a wound or surgeon wound heal when you operate on a patient. You notice initially the wound is angry red and then over period of time, it gets back to normal looking in about a year. So acute inflammation is good, but chronic inflammation is bad. So, most of diseases that we know of mankind are associated with chronic inflammation.
18:02 CM: Like what diseases are you talking about?
18:06 Dr. Matthews:Any diseases, aging, heart attacks, strokes, cancers, arthritis, joint swelling, joint problems, dementia, Alzheimer's, basically, chronic kidney disease, almost any disease that you can think of.
18:21 CM: Wow, is the result of inflammation? Wow.
18:24 Dr. Matthews: Yes, inflammation and free radical formation. Once your body metabolizes food, and just going through the daily processes every day, you produce a lot of free radicals. Free radicals are unpaired electrons on the outer shell of molecules, little, small, at molecular level. So molecules are like human beings, they like to be paired, so when these electrons have unpaired electrons they go out and steal electrons from your DNA and from your mitochondria, which is a powerhouse of the cell. It's sort of like when you bite an apple and you place that apple on a desk, what happens to that apple? You come back several hours later that apple has rusted, that's oxidation. So that's what happens to our body with the free radicals produced in terms of the apple, it turns that apple brown, and whereas with humans, it turns us grey. We start greying as we age 'cause of oxidation basically.
19:19 CM: Hmm, I never knew that.
19:20 Dr. Matthews: Yeah. Chronic inflammation, oxidation, are the two worst culprits in your body. So you wanna keep those under wraps. It's kinda like washing your car. If you put two Ferraris outdoors and just left them there and washed one and waxed it every week, and you did nothing to the other one, just left it to the elements, the snow, the rain, which one of those cars is gonna look better a year later? Even though they're the exact same age, one of them cars is gonna look brand new, the other car is gonna look aged, because you're didn't have any wax on it or you didn't wash it. So basically, wax serves as kinda... That's what vitamins kinda do, kinda serves as a protective coat or layer or keeps things from aging as fast. We're all gonna age but you just don't age as fast. Once you take antioxidants and things that decrease chronic inflammation.
20:04 CM: Well, we certainly wanna slow it down, that's for sure. [chuckle] That's certainly true. So, now you mentioned 13 and 18 as being kind of bad numbers. What's a good number that we should should strive to be at? I mean, I'm not talking about when you're sick but just to maintain being healthy, where should our levels be?
20:28 Dr. Matthews: Well, it depends, each person is different, number one. And so... I think the problem, or the debate they're having with vitamin D research, most people do not, most physicians don't understand that that level is different for each person, because each person has different height, weight, sizes, and it depends on your metabolism of things and what disease process you have. For example, just to be normal, healthy walking around, you need to have your vitamin D level at least 40 at the minimum. And the federal government level, is at 30 nanograms per milliliter, but at 40 nanograms per milliliter, you get maximum bone density. So that would be important for a patient with what, osteoporosis. So if I have weak bones or frequent fractures, I'd definitely need to keep my level above 40, and you get maximum muscle contraction at 40 nanograms per millimeter also. So if I'm a person that's falling all the time in the nursing homes, I need stronger muscles. I've gotta make my muscles stronger and my bones stronger so I should have less frequent falls.
21:29 Dr. Matthews: Also that's important for athletes also because if I'm an athlete I want maximum muscle contraction which means I should be able to run faster, jump a little higher and sustain prolonged muscle activity over a longer period of time and I should get injured less, and my bones should be stronger and I should have fewer fractures, fewer sprains and all of that. At 50 nanograms per milliliter you get maximal stimulation of your immune system and you decrease your inflammatory response system, so your immune system really doesn't kick in until you get above 50. So if I have a bad infection or something I definitely need my immune, my vitamin D level above 50. And then in some disease processes I've had to go as high as like 70 to 80 on some patients to get the proper response. So you just can't say there's one magical number. But the lowest number I would suggest would be 40 to 50 range.
22:24 Dr. Matthews: And so, all animals in nature, if you look at, everything makes vitamin D should tell you how important it is. All plants make vitamin D, they make D2 and all animals make Vitamin D, we make D3. So all plants and animals, every living thing on this planet needs vitamin D to live or survive. So that should tell you how important it is, or hormone D. And all animals in nature, if you went out on the Serengeti and captured a giraffe or something and check his vitamin D level, they, all the animals use around between 50 to 55. So, I think mother nature is a lot smarter than us. So therefore a healthy individual that's not sick, 50 to 55 is out, but if you're sick or injured or something, sometimes you have to push it a lot higher. So there is no one magical number, you just need to know the ranges, and what you need it for.
23:13 Dr. Matthews: So it does different things at different concentrations. So at above 40, you have maximum bone density but it doesn't affect your immune response system. So if I did research and said "Well vitamin D doesn't work," and all my patients' vitamin D level's at 30, it's not gonna work 'cause it's not at 50, so it's not stimulating the immune response system. I may not have as many fractures but it's not gonna do anything for the immune response system.
23:36 CM: I see. So now, what do you recommend, now you mentioned D2 and you also mentioned D3. So what's the difference, what do I need, and what should I be taking? I don't mean the dosage necessarily but should I be taking D2 or D3 or... You know?
23:54 Dr. Matthews: Well we're humans, we're animals, so we make the D3 form. Plants make D2. So the D3 is, you absorb that 87% better than you do the D2. Usually the people with low D2 are the people who don't eat any meat products.
24:11 CM: Okay, vegan?
24:12 Dr. Matthews: Yeah. Mm-hmm. And so I explained to 'em that it's not as, you don't get the same absorption as you would with the D3.
24:19 CM: I see. I see. So is it enough to take supplements from wherever, Walmart or Kmart or whatever?
24:29 Dr. Matthews: Yes, that's what I do, I take supplements, first thing what I do when I get up in the morning I take a multivitamin and a vitamin D3 'cause you need it, you need it every day. And it's important, like I say it controls like 10% of your DNA. That's very important. So anything that controls my DNA, if I'm low in it that means my DNA is not functioning proper.
24:52 CM: Wow. That's interesting. Now, I know that you spoke at the United Nations recently, was there an interest in other countries about your research or tell me about that?
25:09 Dr. Matthews: I think they were mesmerized or shocked, 'cause it's like they had had no idea. They had never heard anything, how vitamin D can affect the whole nation, the country, the world, or the world health organizations. So they had no clue And so if you're a poor developing country and you have a lot of infectious diseases, just by getting the vitamin D levels up you can cut out a lot of sickness, a lot of illness, 'cause remember I said, once your vitamin D level gets in the 13-18 range, your immune response system doesn't work, your inflammatory response system is out of control, and so you have healthier bones and stronger muscles, so, healthy people costs the government less.
25:49 Dr. Matthews: Unhealthy people cost the government, state city or institution or organization more money. And so there's been research that's shown that people that have low Vitamin D levels are sick and have more days absent from work a year, and so, actually, your insurance is gonna be higher. So basically, I've estimated just by... If we got everybody's vitamin D level to just above 40, we can probably save like a trillion dollars, worldwide every year. And that's a conservative estimation.
26:21 Dr. Matthews: So in the United States alone, we can probably save over $800 Billion a year if we got everybody's vitamin D level above 40. You will see decreased re-admissions to hospitals, you'd see decrease falls, decreased infections and a lot of things. So we can save a lot of money with that alone. So, you cut healthcare costs then you could use that money build up your industry, hire people to do jobs, build an infrastructure and do a whole host of things. So healthy people pay taxes, they are working, they're not as injured, they're not as sick, you can cut your Medicare or Medicaid bills and you have more people paying into Social Security, so the system will feed itself and it's a relatively cheap or inexpensive way to solve a lot of issues or problems we're facing today.
27:04 CM: Wow. Well, from the time that you started to now, where do you see us, and I mean not just United States, but everybody at in terms of vitamin D? Do you think that there's a lot more interest or are we still lagging behind like, "Oh, we need to do more research." Where do think things are now?
27:30 Dr. Matthews: I think we're still lagging behind. The World Health Organization just released a report in which they stated that up until 2050, they still expect to see a lot of mineral and vitamin deficiencies because we're lagging behind. Out of all the things that they listed that should be targets, I think there is not a single nation on the planet, that's reaching all of those targets for minerals and vitamins and stuff. So we still have a lot of work to do and a long ways to go, so we need to explain to our elected officials and at every level of state, national, international level that this is a major problem. This is the 800-pound elephant in the living room. You cannot have a healthy society without addressing the most common nutritional deficiency in the world. So by a conservative estimation, over a billion people on the planet are vitamin D deficient, and that's a conservative estimation. We're using 30 nanograms per milliliter, but we know 30 nanograms per milliliter is not where you should be, you should above 40 or 50 ranges just like other animals. I think mother nature's a lot smarter than human beings and governments.
28:36 CM: Right. So we should listen, right? [chuckle]
28:38 Dr. Matthews: Yes, we should. [chuckle]
28:41 CM: [28:41] . Well, believe it or not, we're almost at the halfway mark. So we're going to take a quick pause for station identification, and when we come back, I wanna ask you about your work with athletes and some of the other cases that you've seen at Grady that have received a lot of national and international attention. So we will be back in one minute and a half.
29:11 Dr. Matthews: Okay.
29:11 CM: Alright, thanks.
29:12 Dr. Matthews: Thanks. [music]
30:49 CM: We are back with... This is Carol Moulton, TEA Time with Carol, and we are back with Dr. L. Ray Matthews where we are dissecting vitamin D and finding out what the big deal is about vitamin D and why it is so necessary for us to really keep up, have our levels checked and really be on top of this if we wanna be in optimal health. Not just for right now, but preventing things that can occur as we age. So Dr. Matthews, I wanted to ask you about... You mentioned athletes.This page was renamed Jan 22, 2019.
31:28 Dr. Matthews: Yes.
31:29 CM: And I know you did... Well, first of all let me say this. I know that there has been a lot of attention lately on professional athletes and the concussions and the... Really traumatic injuries. When somebody breaks their leg now on the field, they don't just break their leg, the bones are now coming out of their leg, you know?
31:57 Dr. Matthews: Yes, yes.
31:58 CM: Really, really horrible. Is any of that attributed to a low vitamin D levels?
32:04 Dr. Matthews: Yes, it is, because you need vitamin D to make strong bones. What vitamin D does, it absorbs calcium into the body. You can't absorb as much calcium if you're vitamin D deficient. So calcium is needed to make strong bones. We also need phosphorous and mag and other things, but calcium is the main thing. So if you're vitamin D deficient, you gonna have weak bones. And so I call the athletes of today, I say they have big muscles and weak bones and your skeletal system is used for locomotion. So without a good strong skeletal system you're not good for anything. So remember that your skull is also a bone. And what the rams do, they butt heads all day. They don't get concussions and they don't get headaches. They keep butting heads. So the thicker your [chuckle] skull is or the thicker your bone is, that energy or kinetic energy gets transmitted through the bone and then reach the soft tissue of your brain.
33:00 Dr. Matthews: I remember when we were kids growing up, we used to play football in the streets without helmets and knee pads, and yet we would play and keep playing all day and our vitamin D levels were higher 'cause we were outdoors all day and it was before the days of sunscreen. So we did not get injured as much in terms of bones sticking out of the skin because we had stronger bones and higher vitamin D levels. Over the last 30 years, Vitamin D levels has declined, so as they've declined the number of concussions has gone through the roof.
33:28 CM: Wow. That's terrible. But I understand, you did a study with a school in... I think it was in Mississippi.
33:37 Dr. Matthews: It was in Atlanta, Martin Luther King Junior High School in Lithonia, Georgia, suburb of Atlanta.
33:45 CM: Okay. Would you talk a bit about what you did in that study and what the results were?
33:54 Dr. Matthews: Okay. I started in 2011, working with the parents at Martin Luther King Junior High School. At the high school level you have to... And whatever level you're at when dealing with kids, you have to go through the parents and the coaches and everything in the administration. So I did vitamin D lecture to the parents of the football team and the athletic department over there, the coaches and administrators. And so the parents helped design and lead this program, and they basically help administer and do things and then they have to sign a consent form and they were explained all the risk and benefits and everything and stuff. And so showing them how it helps kids, 'cause 58 million kids in the United States are vitamin D deficient, and we're seeing more kids with all these concussions even at the high school, junior high level are getting concussions. And recently, even with autopsies in a few high schools, they've found out they have stage one CTE.
34:52 Dr. Matthews: So you do not have to get a concussion that totally knocks you out in order to have damage, just repetitive hitting of the head produces a chronic inflammation I was talking about earlier, and so over period of time your brain ages from that of like an 18-year-old to like a 60 or 70-year-old. Then by the time you're 30-years-old, you got the brain of a 89-year-old. So what vitamin D does, it's one of the most powerful anti-inflammatory agents on the planet and it's also an anti-oxidant. So it decreases chronic inflammation, it decreases the swelling in your brain, and so therefore, remember I told you, it's like the two cars, one with the wax on it and the other one without the wax, which one'll age faster? So the brain that's been taking vitamin D is gonna have a stronger skull and less inflammation and it's gonna not as age as fast as another kid the exact same age that has been getting hit, but is not taking vitamin D.
35:48 CM: Wow. And you mentioned CTE stage one. What is that?
35:53 Dr. Matthews: Chronic traumatic encephalopathy. That's a basic like repetitive hits to the head over... Most kids start playing football at what? Five, six years old, and then if you make it all the way to the NFL, 35 years old. That's 30 years of getting hit or getting sub-concussive hits to the head. So imagine a brain that has been hit 30 times and thousands of times a year. You gonna have all type of problems and so it is a diagnosis that can only be made by autopsy. So you can't diagnose it. Yeah. So you can see the symptoms of it, like a person with multiple concussions we know they start having memory loss, some of them have blurred vision, they have mood changes, they have headaches, and those are some of the symptoms, but this is a diagnosis. We do not have any markers or any blood test or any x-rays that we can do to diagnose it. It has to be diagnosed by autopsy.
36:44 CM: Wow. I think they mentioned that in the autopsy of that, I can't remember his name, but he played for the Patriots and he ended up in prison because...
36:57 Dr. Matthews: Yeah. The tight end from Miami. His name is escaping me at this moment.
37:03 CM: I can see.
37:03 Dr. Matthews: Yeah. But I know who you're talking about exactly.
37:06 CM: Yeah.
37:06 Dr. Matthews: Yeah. He did have stages of CTE.
37:09 CM: Wow. So it seems a little barbaric that we are willing to sacrifice our young men for this sport. What... Where are you on this? And what should we be doing?
37:30 Dr. Matthews: That's why I started the vitamin D. I'm a trauma surgeon, so we're into prevention, so that's what I do. My patients are usually, in the hospital, are usually a lot worse. I see people that have been shot in the head, brain tissue oozing out and all kinds of things, or a lot of blood in the head. So a concussion is nothing but a mild form of a traumatic brain injury. So I usually see 'em on the other end of the scale, just the worst of the worst.
37:55 CM: Got it.
37:56 Dr. Matthews: So we started using the vitamin D in our trauma patients with these severe brain injuries, and these were people that most of them the neurosurgeon said had no chance of survival, and a lot of them walked out of the hospital, and after being on courses of vitamin D. So I said, "If it works in the severe traumatic brain injuries, it should also work in the mild traumatic brain injuries or concussions that football players are getting." So on the question of football that you asked about, I grew up playing football, I'm from Mississippi, the deep south, so it's like a religion in the deep south, football, and if you...
38:32 CM: I know at Ole Miss it is.
38:34 Dr. Matthews: Huh, what's that?
38:34 CM: I said, I know at Ole Miss it is.
38:36 Dr. Matthews: Oh yeah, definitely, I'm an Ole Miss grad, SEC football, so it's like a religion. And so my thing is, I don't think football is going anywhere, I love football. And so my thing is, let's make it safe. So basically, by giving these kids vitamin D and even adults taking vitamin D, it lessens the symptoms. Will it totally eliminate it? No. It just lessens the risk of you getting it as severely or as bad or as early. And so it makes a big difference, 'cause kids that I work with at MLK, they were more concerned about playing time than they were about a concussion. I think the first year I worked with them they didn't have any concussions, period. Zero. So there were 85 football players, they played I think 13 games that year plus summer practice, and so you're talking about a football team that goes a whole year with no concussions, and out of that over the six years I worked with them over 100 kids got scholarships to play football at the college level, over $100 million in total scholarships. And right now there are currently six kids from MLK that are in the NFL.
39:44 CM: Wow, that's amazing.
39:47 Dr. Matthews: Yep.
39:48 CM: That is amazing. So, well, I see it just pays to get on it early and stay on it. You know?
39:55 Dr. Matthews: Yeah, definitely.
39:56 CM: Yeah, I'd like to ask you about a couple of cases that you had. I know that there was... Fox News did a segment on this young woman that I think she was 17 years old, cheerleader, who was in a very, very bad car accident and recovered, she was one of your patients. Can you talk a little bit about that and what happened, and I know her mother was on... They interviewed her mother as well who was a nurse.
40:29 Dr. Matthews: Yes.
40:30 CM: And she had quite a bit of response to that as well. Can you talk a bit about that?
40:35 Dr. Matthews: Yes. Yeah, that was a very special case, her mother was actually a pediatric ER nurse, so she very well understood what was going on here. So the young lady who was 17 years old, she had just won like the head cheerleader, she was driving home in her SUV, hit a pothole at approximately 70 miles an hour, she was ejected from the vehicle. And so when she hit the ground, she had a seatbelt on but she still ejected, she hit the ground and started seizing, and so she was airlifted to Grady by helicopter. So when she arrived in emergency room, she was in bad straits and stuff, not moving, not doing anything. Basically, a coma type, and she had had seizure, those were the bad signs. So after we scanned her head she had an injury called diffuse axonal injury. So diffuse axonal injury is like she might take some shears and start cutting some hedges and just don't cut them evenly.
41:30 Dr. Matthews: And so, basically, what diffuse axonal injury is like your brain cells or neuron cells are just ripped, or they just sheared, or severed, like you just severed some cords. So 90% of these patients, or 50% of these patients die at the scene, the other 50%, 90% of them were kinda like in a vegetative state, and then the other 10% are like cerebral palsy. So it's usually no good outcome when they have severe diffuse axonal injury. So this was... She was the only child, her parents had her by artificial insemination, so she was a miracle child. And to be told that your only child has no chance for survival, it was devastating, and you had to work so hard to have her. And so I convinced the neurosurgeons to just put a boat in her head so we can relieve some of that pressure. But they told them it was no chance. So we started on our vitamin D protocol, three days she was opening her eyes, in about a week and a half we had transferred her to rehab, and this young lady basically also had ACL injury, she needed that fixed and had a breastbone fracture, and so she had a whole host of other things.
42:45 Dr. Matthews: And so fast forward, now she's actually graduated from college, University of Georgia, I think she was a straight A student and she's actually working with I think children, helping children that have been through traumatic events like she has. So it was a remarkable story, so she had to learn how to walk again, basically learn how to talk again, but she was a courageous young lady and very strong. Never complained, always had a positive attitude. So actually, I learn a lot from my patients, and they teach me that some things that you think are problems are not problems.
43:18 CM: Wow. That's amazing that she was able to come back from that, well, miracle, I think of all the way around, but... And it was a blessing that she ended up at Grady as well 'cause it doesn't sound like the outcome would have been quite so positive otherwise. You know?
43:39 Dr. Matthews: Yeah. It could have been different.
43:40 CM: Yeah. Wow. There's another one that you've mentioned, someone when we talked before, I've heard you speak about. This was, I can't remember how this gentleman was injured, I don't know if he parachuted and the parachute didn't open, or if he fell off of a building. But he ended up meeting his wife in this weird kind of way. This was another patient of yours. Do you remember that one?
44:11 Dr. Matthews: Yes. He's actually a paratrooper in the military, so he was re-certifying to parachute. His parachute did well, but when he reached 500 feet, the parachute got entangled and so he tumbled from 500 feet to the ground. So he hit the ground about 80 miles an hour, went in cardiac arrest immediately. And it was tragic 'cause both of his kids were there and they were taking pictures. They were like 7 and 6 or something like that. And so he went in cardiac arrest, but fortunate there was a paramedic standing next to his children and they started CPR, and he got airlifted to Grady.
44:49 Dr. Matthews: Basically, he was like Humpty-Dumpty, broke almost everything in his body. And so he arrived in Grady in cardiac arrest and so we were able to get him back, get a strong heartbeat and we had to take him to the operating room immediately to fix and repair a lot of things. And we started him on vitamin D, 'cause he had broken a lot of bones and he was in ICU for three months. And he basically walked out of the hospital. Also, he had to go to rehab for three to six months and he had a bad traumatic brain injury also. With my traumatic brain injury patients, in addition to being on vitamin D, I recommend they do puzzles on internet and word games to get their memory back and stimulate those neurons. So he met this young lady in England, while he's playing on his computer. She had never been married, and she had given up hope that she would ever get married.
45:39 Dr. Matthews: So they start communicating [chuckle] on the internet and she came to United States to visit him. And behold, they got married and 10 years later she just sent me a Christmas card saying, they're doing great. She also stated in the card, she said, had not we saved her husband before she knew him, she never would have gotten married.
45:57 CM: Wow.
45:58 Dr. Matthews: And so... Yeah. So we get success stories sometimes. It's a lot of bad stuff, but every now and then we see some good stuff.
46:04 CM: Well, that's a sweet one, that one is really, really sweet. You know I'm like...
46:07 Dr. Matthews: Oh, definitely.
46:09 CM: After something so traumatic, his children being there and all those things, but it just seemed like there were so many good things in his favor. The paramedic being right there, and...
46:21 Dr. Matthews: Oh, definitely.
46:22 CM: Being airlifted to Grady, again, and that's wonderful, that was such a great outcome.
46:29 Dr. Matthews: Oh yeah.
46:30 CM: There was another one that you mentioned. I don't know if this guy was using a saw? And...
46:39 Dr. Matthews: Oh yes. He was using a saw. [laughter]
46:42 CM: Okay.
46:44 Dr. Matthews: Yeah, this gentleman, was an interesting gentleman, he was using a saw and the saw kicked back and severed all the blood vessels and all the muscles on the right side of his neck down to his vertebrae.
46:56 CM: Wow.
46:57 Dr. Matthews: And so you're sitting there and looking at his vertebrae. He went into cardiac arrest, and once again, had to be airlifted to Grady by helicopter. He went into cardiac arrest on the helicopter. He had lost practically his entire blood volume. The average person has five liters of blood in your system, so he had lost all five liters and had been replaced. And they got him back after the first cardiac arrest and then he went into cardiac arrest a second time. So when he arrived at Grady, he has a blood clot about the size of a beach ball on the stretcher as a nurse was doing CPR. And they took him in the operating room, put him on the operating table, and... But they noticed he did not have a pulse, or his pupils were fixed and dilated and heart was not beating anything. So they stopped everything, called it or pronounced him dead, had covered him up with the sheets. And so... Actually, I had come out of another operating room and this is exactly five minutes after he arrived. I was finishing up another case, I was at the sink scrubbing in for his case, so the nurse told me they had pronounced him and so I still kept scrubbing in to go and look at him.
48:06 Dr. Matthews: And soon as I got in the room, the nurse told me she saw the sheet move a little bit, and so I thought she was being facetious and she said, "No, I actually saw his arm move." I said, "Well, maybe it was reflex," I said, "But give me a unit of blood anyway." I transfused him a unit of blood. His heart started beating, and so he started pouring out blood through his wounds. He had bled out all of his blood. And I had to get my operative team back in and we repaired all the vessels and muscles and everything else in the right side of his neck and started him on vitamin D once again and this gentleman walked out of the hospital about a week and a half later also.
48:41 CM: That is amazing. A week and a half, I thought you were gonna say months or he had to go to rehab for six months. Wow. That is...
48:52 Dr. Matthews: Yeah. He did have to get a little rehab in terms of speech therapy and stuff like that, but he was still able to walk.
48:58 CM: Yeah, that in itself, after such a traumatic injury. Wow!
49:04 Dr. Matthews: Yeah, we saw a lot of things at Grady. [laughter]
49:08 CM: Yeah, I'm sure, I'm sure. Well, those are very memorable, all of those are very there memorable cases and glad to know that the paratrooper is still doing well, and you hear from him and his wife on a regular basis. And I guess it also goes to show you just never know how things are gonna turn out. You know?
49:29 Dr. Matthews: No, you don't.
49:30 CM: You just never know what blessing may be on the other side of something that looks really, really bad. So...
49:37 Dr. Matthews: A lot of times when I'm taken to a patient like that, I'll tell my residents, "This patient's gonna survive." They look at me like I'm totally crazy. [laughter]
49:44 CM: Well, I guess you've been doing it long enough that you can... You kind of... But do you think a person's outlook has something to do with the outcome as well? How does that play into it?
50:01 Dr. Matthews: Well, I'm sure it does. Your outlook on life, and having a supportive network helps a lot also. I trained at Mayo Clinic, and they use music therapy, they have dog therapy, and I'm a big proponent on all that. You'd be amazed if you bring a dog in with somebody that's depressed, and how it lifts their spirit, because dogs just love everybody. They don't judge anybody, and just wagging their tail, excited to meet everybody. You'd be amazed at how some of these depressed patients just start smiling and they actually look forward to the dogs coming back to visit them, the dog therapy dogs. And so yeah, all that goes into making their spirituality, all that makes a big difference on whether you survive or not.
50:43 CM: Wow, wow. So many variables.
50:45 Dr. Matthews: Yes, definitely.
50:46 CM: So many variables.
50:47 Dr. Matthews: So it's multi-factorial.
50:49 CM: Yeah, wow, that's amazing. Well, what would you... If I'm listening so that... And this is the first time I've heard anyone talk about vitamin D, and I don't know where to start. And I don't know what to do. This sounds really interesting, but and I wanna make sure that I'm in optimum health and everything. What would you suggest? Where should I start? Should I go and load up on... He said go to Walmart, load up on vitamin D? Yeah, so...
51:21 Dr. Matthews: No.
51:21 CM: What should I do?
51:23 Dr. Matthews: I would suggest you inform or educate yourself about vitamin D first. You can Google my name, L Ray Matthews, and you'll pull up a lot of articles on vitamin D alone. So always education knowledge is powerful, and so educate yourself about anything, and so educate yourself first, and then start conversations with your physician or your healthcare provider and ask them to check your levels and see where you are, and that is probably where I would start.
51:52 CM: Well, that's a good one.
51:54 Dr. Matthews: Yeah.
51:55 CM: And well, any... I can't think of any other questions for you. I really appreciate the time, 'cause I know that you've been traveling, and I know that this was unplanned, not on your schedule for today, so I really appreciate you taking the time to spend and share.
52:18 Dr. Matthews: Sure.
52:20 CM: And I think that I know I got a lot out of it, and I'm sure our listeners did as well. Anything that you would wanna add to what we've covered in terms of outlook or the future of vitamin D or... You know, any... We're...
52:37 Dr. Matthews: Yes, it's gonna be around for a long time. It's not going anywhere. [chuckle]
52:42 Dr. Matthews: It's a worldwide problem. It's the most common nutritional deficiency in the world, not just the United States. 97% of African-Americans are vitamin D deficient, so it's a big, bigger, bigger, big problem worldwide with everybody, but it's a bigger problem with African Americans, since we have pigment or melanin in our skin that serves as a natural sunscreen. So melanin and sunscreen blocks about 98% of vitamin D production, so darker skinned people have to stay in the sun 3-10 times longer than lighter skinned people to produce the same amount of vitamin D. So African Americans usually have a vitamin D level 30% lower than Caucasians usually. So that's why you see more heart attack, more strokes, more renal failure, kidney failure, and a lot more chronic diseases in African Americans and stuff, and so it would behoove us to get our vitamin D levels checked.
53:41 Dr. Matthews: Also a big area that we're really suffering in is pregnant women. Pregnant ladies have low vitamin D levels, 'cause they're trying to feed two people number one, and then we all know that the African American women have one of the highest mortality rates of all industrialized nations in terms of pregnancy, in terms of fetal death, and maternal death 'cause their vitamin D levels are so low, so you need normal vitamin D levels to sustain a healthy pregnancy. And so it makes a difference. So if you want optimal health, you need to take vitamin D, and it helps in everything. So you cannot have optimum health with low vitamin D levels is the bottom line, and it's a hormone, number two.
54:21 CM: Right, right. So can we go back to what you said for a minute? 'Cause I think it's counter-intuitive for a lot of folks. I think a lot of folks, me included, would assume that when you're darker, you absorb more vitamin D from the sun, and what I hear you saying is that is not the case?
54:41 Dr. Matthews: Yes, it's totally different. You absorb less. So we have to stay in the sun three to 10 times longer, because we have more melanin or pigment in our skin, and so that protects us. If you're on the Equator, having dark skin protects you from skin cancers and skin burn and sunburn, but the offset of that is, it takes you longer to make the same amount of vitamin D as somebody with a lot lighter skin.
55:05 CM: Okay, I see.
55:06 Dr. Matthews: So darker skinned people make it at a slower rate and then their levels are usually 30% lower.
55:10 CM: Wow! Now that is so interesting, because I think I'm not the only one who's always assumed the opposite...
55:18 Dr. Matthews: No, no.
55:19 CM: Has been true, but that is... That's really, really good to know. And so it's all the more reason why we really need to keep up on what our levels are and making sure that we're in that good 40 to 50 range. I'm... And just about everybody I've talked to, my friends who had physicals lately, they've all been talking about vitamin D and it seems like that is really, really cutting edge and I cannot... 10 years ago, I know people were not into vitamin D the way it is such... It has become such standard. It's become almost standardized now. We...
56:01 Dr. Matthews: And I was laughed at [laughter] 10, 15 years ago. [laughter]
56:05 CM: Right. Well, you know. They laughed at a lot of brilliant people, a lot of geniuses, they have been laughed at, but the point is who gets the last laugh? You know?
56:18 Dr. Matthews: Yeah.
56:19 CM: And I think you definitely do because you've really been in service with respect of this. I think a lot of folks would have walked away from... Folks who just thought, "This is ridiculous. You don't know what you're talking about." And a lot...
56:36 Dr. Matthews: I got told that too. "You don't know what you're talking about." [laughter]
56:40 CM: But you persevered. You continued. You didn't let any of that dissuade you. For all the people that you've helped, me included, just thank you for continuing to be there, and always being available. It's much appreciated.
56:54 Dr. Matthews: You're welcome. Sure, sure.
57:01 CM: You know well, that's about our time.
57:03 Dr. Matthews: Okay.
57:03 CM: I can't believe how fast this hour has gone, but this has been really critical information that you provided. And I don't know if you know, but we're heard in 167 countries, our program is...
57:20 Dr. Matthews: Wow. I did not know that.
57:22 CM: Yeah. So hopefully, a lot of this information will be shared and people will begin to make the connection and oh, next time they go to the doctor, to get their vitamin D levels checked and start eating maybe a little bit healthier, maybe paying a little bit more attention to that and will really, really help a lot of people in the long run.
57:45 Dr. Matthews: Oh definitely, definitely will.
57:47 CM: Yeah. So Dr. L. Ray Matthews, I wanna thank you sincerely for being a guest and I wanna keep the light on and the door open that you can come back any time and talk and I really wanna keep up with where you're going, what you're doing. I know you've got some big things on the way and as those begin to manifest, I'd like to have you back and talk a bit more about vitamin D 'cause I know that's your passion.
58:17 Dr. Matthews: Okay. Definitely, it is, really is.
58:19 CM: I know.
58:19 Dr. Matthews: Thanks again for having me [laughter]
58:22 CM: Yeah. Well, thank you so much and we'll talk again soon, and to all of our listeners of Tea Time with Carol, thank you so much for hanging with us once again. And remember as we always tell you everything you want is on the other side of fear. You all be blessed. We'll see you next week. God bless you. Bye bye.
58:44 Dr. Matthews: Bye bye.
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