Sawbones: A Marital Tour of Misguided Medicine - Sawbones: Warfarin

Episode Date: April 19, 2019

Sure, an episode about a common blood thinner may not sound particularly sexy. But we'd bet that once you hear the inspiring story of how moldy hay became a life saving medicine (with a detour as a rat poison) you may think differently. Music: "Medicines" by The Taxpayers

Saw bones is a show about medical history, and nothing the hosts say should be taken as medical advice or opinion. It's for fun. Can't you just have fun for an hour and not try to diagnose your mystery boil? We think you've earned it. Just sit back, relax, and enjoy a moment of distraction from that weird growth. You're worth it. All right, time is about to books. One, two, one, of Miss Guy to Medicine. Come for the mouth.

Hello everybody and welcome to Saul Bones, a marital tour of Miss Guy to Medicine. I'm your co-host, Justin McAroy. And I'm Sydney McAroy. Sydney, it's quite a mysterious episode this week. It is. Justin, we get a lot of suggestions from our wonderful listeners as to what topics we should cover on the show.

And that it's the source of, I would say at this point, the vast majority come from those suggestions. What are the people want to know? Yeah. And so I always appreciate that. And usually if I see a couple of emails with the same topic suggestion, it's because it's something that's been in the news recently. And so people have heard about it and want to know more. So when I got two emails

from two separate individuals within several hours of each other that both suggested that I talk about a medication, a blood thinner is what it's known as, although that name is sort of misleading. But war for n, I thought, I wonder what Warfriend related news has occurred. And so I googled that. And I could not find a recent Warfriend controversy happening case issue. I think it's exciting. No, but it is an interesting topic.

And I thought, well, the universe and these two listeners want me to talk about Warframe. As Boaconon says, peculiar episodes, suggestions are dancing lessons from God. So now we will do the dance of the oral anti-coagulant. So we're gonna talk about Warfarin and before you stop the recording or before you stop the show, I know that sounds boring, but it's not. I promise. No, you care.

It's Warfarin. It sounds medieval. It sounds threatening and dangerous and powerful. You probably know somebody who's been on war, it's a it's a war friend's been around for a long time and it is for for the longest time it was the only option we had to take a blood thinner in pill form. And so you I know this sounds strange, but Cuminin war friend same thing. You've probably heard of it. Several of our listeners actually want to talk about it. Matthew what their blood to be thinner, I'm going to tell you mine's great. Thank you.

Thank you, Matthew, Nikki, Lauren, Megan, Katie, Damien, and Ginger for suggesting this. It is an interesting history. I don't believe it was Nick. Poss could have been it was absolutely not. It was not Nick, you know, I don't know. Maybe she's a fan. That'd be nice.

Yeah, I mean, I like that. Anyway, so back in the 1920s, some cattle were dying mysteriously. So there was some sheep too, but the focus of this was on the cows. For whatever reason, people weren't as concerned about the sheep. It was twilight where wolves are added again. It was the cows. And people, the cattle persons, are they farmers or ranchers or cow, cowmen? Well, the farmer and the cowmen should be friends.

So I know that they are two discrete individuals. The farmer, the farmer I think keeps them in place. The farmer holds a plow and the other one has to milk a, no, the farmer keeps. The farmer I think the farmer holds a while and the other one has to milk a cat. No, the farmer keeps them in place and the cowboy takes them from place to place. He's like the driver right and the farm. Farmers like the hotel owner for cows. Sure. So I don't want it. I'm trying to avoid I'm trying to do the layman terms for you Sydney, but that's the basic idea. So the cattle persons noticed that their cows were dying and they were not just dying,

they were bleeding. And sometimes these were episodes of spontaneous bleeding. They would find that their cow had died and they'd had some sort of bleeding and they didn't know why. There was no injury, there was no trauma, there was no twilight, where will fatac. The cow was just dead and they were worried about that. And then they also found that there were these episodes of excessive bleeding following sort of a minor injury or for instance, I guess, dehorning is a thing that happens, taking horns off. Or they were castating some bowls.

Anyway, these sort of procedural things, which should not cause a great deal of hemorrhaging, caused so much that the animals were actually dying. And this was unusual, obviously. Yeah, everybody was very concerned because how can I just say it's work? No, that's not how cows work. And that's, well, it's very sad, and to like, it's their livelihood. So, it's a very concerning.

So they began to investigate. I think it's sad I would question you on because I think you're from a cow. And I like, I saw what happened to those other guys. Like, this is fine. Like, this is okay. I mean, I don't know. I don't know. I'm not a cow. I can't see their heart, but it seems like I be, you know, either way, these farmers

were concerned. Yes, it's after the farmers for sure. And so they began to try to find the burgers and sakes from a cow that mysteriously died from bleeding for no reason. You know, I don't know the rules on that, but I guarantee mysterious illness in the cow is a automatic. Yeah, it's an automatic rule that's called for eating or any other purposes other than trying to figure out what happened. Right. That would be my guess.

After some investigation, they began to connect the diets of these specific cows with the bleeding episodes. Thumbtacks. Why do we give them thumbs tags? No, not thumbs tags. They seemed to occur after the cattle had grazed on sweet clover hay and not just the sweet clover hay, but specifically sweet clover hay that had gotten wet and then somewhat moldy.

And I guess traditionally, if your, if your hay gets moldy, you don't feed it to the cows. You throw it out is at least what this is. I am not an agricultural expert. This is my understanding. That is what I'm saying. agricultural experts. This is my understanding. Is that you generally say, well, let's get some fresh hay, but it was the 1920s. It was tight. Not a lot of hay to go around. Exactly. Well, I mean, I don't think there was a hay shortage. There's a money shortage.

There's a big problem. I mean, that individual farm had to just be like on earth. I'd find it. Yes. And so the farmers were a little more inclined to use the wet hay or the moldy hay than they would have been otherwise because they needed something. You know, they got to feed them. You know, you can count. So they began to notice this connection and there were, there were some recommendations that kind of came out pretty early on saying, like, hey, maybe it's this moldy hay, maybe we should all stop using it. We don't really know why,

but we think this is a problem. But they weren't necessarily followed these recommendations, because people, I don't know, either they didn't buy it or there was no internet. So maybe they just didn't hear about it or they had to use it. But they began referring to the condition as sweet clover disease. So they knew there was a connection. They didn't know exactly why. So there were two local veterinary surgeons that were instrumental in figuring this out. One, Frank Schofield and two Lee Rodrick.

And both of them figured out pretty quickly that if you use fresh hay and not moldy hay, that fixed problem. So there was something to with the mold that was the issue. They also found that if you transfuse the cow with some blood, that fixed it. So just give them new blood and that seemed to fix the issue. Frank Schofield was a Canadian veterinary pathologist and he did some experiments at first to like replace it all with fresh hay and figure that kind of stuff out. He actually with rabbits, he

worked with rabbits and gave them moldy hay and fresh hay and figured all this out. Okay. In case you're curious. I'm asking you to spend an afternoon right now. And again, they begin to spread the word, you know, that they'd figured this out. Please stop using moldy hay. But people still weren't listening. But they love it. So, look at them go crazy for it.

So by the, and that, they even at this point had called it a, a, Roderick called it a plasma pro thrombin defect. So they knew it was something to do with the blood's ability to clot. They're, you eat moldy hay, your blood doesn't clot. We don't know exactly why yet, but we know that this is a problem. That should be good enough. Honestly, for this time period, trust, just trust us on this one. But people were still doing it. And by the 1930s, there was a Wisconsin farmer named Ed Carlson, who was just, he was fed up with this. So he loves moldy hay and his cows love moldy hay and no scientist nerd is going to get in the way of that.

So another one of his cows died from sweet clover disease. So he, he hauled the cow 200 miles. Oh, it's shoulder. No, I don't think he carried the car. You know, I don't have the, I do not have the documentation to prove that he carries the car. You know, I don't have the, I do not have the documentation to prove that you used to car, but we're going to assume there was a car involved that he did not carry the cow 200 miles to an agriculture. I also brought it on the like a cart, like a horse, John cart, maybe. I guess that's true. It's possible. There's lots of ways to carry a dead cow. Take it from me. How many would you like to list anymore? Cannon. Well-aimed cannon. Okay. Let's move on from this. So he took the cow to an agricultural experimental station. And he said there was a biochemist, their name Carl Link, and he said,

hi, this is my dead cow. Douglas. He had sweet clover disease. And this is my, this is a cow. My dog was. He had sweet clover disease. And here is a, here is a, a milk canful of unclotted blood for you to examine too from, from said cow. Please figure out what the deal is here. Please help us. So Lincoln's colleagues started working to figure out what exactly is the caught. Why, what is the association with Moli Hay? They did a lot of scientific work on it and by 1940,

it took them six years to figure this out. That cow must have stuck. No, Justin. So they figured out that in, hey, actually in a lot of plants, there's a substance called cumurin, okay? Okay. It's present in, like I said, lots of plants. It is actually what causes the sweet smell

in like freshly cut grass, or hey, you were something like that, or plants like sweet grass or sweet clover. That's where they get their name. Cumerin. Cumerin. Cumerin. Cumerin.

From this substance that is naturally in the plants and makes them smell sweet. When hay becomes moldy, the cumerin becomes oxidized. Okay. And all you need to know is that it changes into a slightly different compound, which we know mainly as di-cumeral. Di-cumeral can cause you to bleed. So this was the problem. Cumer in itself was not the issue. It was the the process that happens when the hay became moldy, turned it into something that was dangerous and would make you bleed easier and also have spontaneous bleeding episodes.

So they figured out and found the substance, dichromarol from this. And at this point, they began to figure out like dichumeral, is it the best thing to use because we could use this. Like, we found something that then's the blood. We have isolated the substance now. We've actually backed into the cure at this point versus the issue. Well, we found the issue. The issue was the moldy hay.

But then we turned it to our advantage. But then we thought, well, we could do something with this. This I like. Yes. I mean, spontaneous bleeding is a bad thing, but sometimes as we'll get into, there are medical conditions that make you wish you didn't clot so much. So maybe Di-Cumeral could be the answer. So they, they begin working on, first they got a patent for Dikumeral in 1941, then they

began working to refine it at the Wisconsin Alumni Research Foundation, which is abbreviated Wharf. And we're about to get into. Oh, my. We're about to get into what came of this. But first, let's head to the Billion Department. Let's go. So we just got into the exciting, I feel like you kind of, if you'll pardon the expression, gave the milk away for free with that last reveal of war. It's like the Paul Harvey twist happened before the break, but I am

on pins and needles still to see how this all plays out. So you may remember the Wisconsin Alumni Research Foundation war has patented. I don't remember. It was minutes ago. They have patented dichromeral, which they began to think could be used maybe as initially the idea was as a rodenticide, a rat poisoning. That was the first thought of how we could take advantage of this. But what they discovered pretty quickly is that Dikumarol itself acted very slowly and so it wasn't very practical if you were trying to rid your home of rats.

I just have to watch them sort of slip away into the twilight over the months just like a little slower in the step and just a little little more of a struggle getting back into that hole and so this slowly sort of wind down and sunset there's time for rat house business. I'm not going to go into the whatever the thought process was behind like we have a blood thinner. I want to use it to kill rats. I don't want to do something that's going to be for.

There's a piece there that is missing for me. And I cannot answer for you. You can fill that blank in on your head. But so they started working with other variations on cumerain, not just acumeral, but are there other ways we could, like other reactions that would cause a more potent anti-coagulant. That's anti-clotting, substance. And they found one on number 42 and they named the compound war for in war for in war for in war for because of the funding agency. War for and then are in because of

the ending of cumeron. So war for in is war for in a proper name or is that just what the substance is called war for an instant the generic name. Yeah, without getting into, there are dozens of brand names of Warfriend. Most commonly, you've probably heard Cuminin. I know that is the one in the US, at least in this part of the US that is most popularly used. Most people maybe haven't even heard of Warfriend

but have heard of Cuminin, which sounds like Cumaran, but isn't the same thing. Because as I mentioned of Cumardin, which sounds like Cumardin but isn't the same thing. Because as I mentioned, Cumardin is not an anti-coagulant in and of itself. No. Cumardin is, it's Warfriend. But initially, all that Warfriend was marketed as

was a rap poisoning. That was all people used it as. In 1948, it came out. And it was very highly publicized. That's like a great, great thing to use to kill rats. Nobody was considering using it in humans initially until in 1951, someone actually took multiple doses of war friend, of rap poisoning in an attempt to take their own life. And what they, when they got to the hospital, when this individual got to the hospital, they gave him doses of vitamin K to reverse it. And we already kind of knew this could work as an antidote

to the rap poisoning. And I don't know how, I don't know how interested anybody is in the mechanism of action of forefront. Are you kidding me? So just to very briefly, because I mean, if you want to know, there's a whole, your blood has multiple factors that help it, that helps it clot. It's not a one thing. It's not like, I mean, you've probably heard of platelets,

they help your blood clot. But there's a whole cascade of events that occur to help you clot when you're bleeding to help stop the bleeding and help your blood clot. Specifically, there are certain factors that depend on vitamin K. You can get vitamin K from food, specifically green leafy things. So vitamin K is in our diet. We give vitamin K to newborns to make sure they have plenty to prevent hemorrhage right away, to prevent babies from having any bleeding episodes right away. Actually, a really important thing that we do right when they're born. If you ever have somebody tell you that you shouldn't do that,

don't listen to them. You should absolutely do that. It's totally safe and it saves lives. That's one of those, it's like what the anti-vax thing people will say no to this. You can't say no in most states, but if you can, don't say yes, it's important. So anyway, there is a specific enzyme vitamin K epoxide reductase. The important thing you need to know is that this enzyme has to function in order for the vitamin K to help make all the little clotting factors that it needs to. Warpher and inhibits it. Warpher and blocks it.

So, because it works on the vitamin K, Warpher and it's easily reversed by just giving the person more vitamin K. Why would you want to reverse it practically speaking? So in this case, you wanted to reverse it because this person had taken many doses of forefront, they were bleed, I don't know if they were bleeding or they feared that they could bleed. So vitamin K will turn that around so that they won't bleed to death.

Why you would want to now is that, and we'll get into this too, Warfront is kind of a tricky medication to take and manage appropriately. And you can, there's a very narrow therapeutic range. There's a very specific range that we... You can kind of bump you back up. We have a way to push it. If you get, if you're blood, I'm going to say gets too thin or too thick, but that

is not what is happening. It's important to know with blood thinners, the viscosity of your blood is not changing. Are you kidding me? No. This is completely new information to me. No, these do not change the viscosity in any way. So it's not thickening or thinning the blood? No, it's just clotting.

I had no idea about this. You could not tell me this way. So it's not thickening or thinning the blood? No, it's just clotting. I had no idea about this. You could not tell me this would be, I've been patient all these cows with this watery blood. No. I mean, it would be watering the sense that you'd expect it to clot and it wouldn't, but it's not thinner or thicker. Okay. I know.

We use these terms because it's easier than for dum dum's like me. No, no. Then you pull the rug out from underneath and say say psych. It wasn't that at all ever. It's a good, it's a good way of explaining to people who are not in the sciences how these medications work. The life juice inside your skin bag is a thick like honey. Do you know honey? But they're not.

It has nothing to do. It has nothing to do. It has nothing to do with the viscousin. Anyway, I understand that. I understand that. I've been lied to you by the establishments. We have, it's just an easy, sometimes you have to come up with good analogies. It's sort of like your blood's tooth in.

Got it. Anyway, we got ahead of ourselves. So because of this episode, they began to do studies on the use of war-fren and humans. Would there be an amount that we could use in people? Yes, it was initially a rat poisoning, but could we use a certain amount in people that would actually be helpful? And you have to know, at this point in time, we had other blood thinners, that could be

a whole other show getting the history of blood thinners in general. But the blood thinners that we had had to be injected, we didn't have anything you could take like in a pill at home. This was a new idea. And so this was very exciting. Is there something that we could give people who have issues where they clot too much?

And these could be people who have had clots in their legs, deep vein thrombosis, like DVT. People who have had clots in their legs, deep vein thrombosis, like DVT, people who've had clots in their lungs, like a pulmonary embolus, people who have had, who have something called atrial fibrillation, which is when their heart beats abnormally and because they're the upper part of their heart kind of quivers, blood can collect and clot in there and those clots can shoot off to places like your brain and cause a stroke. So the use, some sort of medication that could prevent that clotting from happening was very useful to certain patients.

So this was very exciting because up to that point, all they had was stuff they could give you by shot. This would be a pill. So they started working with it to figure out, you know, how can we, how can we use this? And by 1954, they had started selling Cuminin, which was the original brand name for Warfront. One of the first people to receive Warfront was Eisenhower. Oh wow. He was prescribed it after he had a heart attack in 1955.

And that was used back then after a heart attack. I mentioned to you the mechanism of action, how it works, how Warfriend blocks this certain enzyme. And so the environment K isn't there, so you don't get clotting factors. You know, we actually didn't figure that out until 78. We were using it for a long time before we figured out. Yeah, before we figured out exactly. How does this work? Well, and I mean, we knew it had something to do with vitamin K because we knew vitamin K could reverse it. But beyond that, it was.

We didn't know. But then we figured it out. But all of this that I've mentioned, and this is kind of the end, the warfront story. I don't know if it's coming to a close now, at this point in medical history, but warfront as great as it was at the moment, it was such an important medical breakthrough to have something that you could take by mouth that would thin your blood, so to speak, thin your blood, and help prevent strokes and clots in your lungs and all those things. There's such an important breakthrough, but it wasn't a perfect medication. So as I mentioned, vitamin K is in your food. So you have to be very careful what you eat if you're taking more fun.

Does she get mad to do it? Yes. If you eat too much vitamin K, then the war for is not going to work. If you, let's say that you eat three salads a week and one week you decide not to eat those salads, then the war for them might be working too well because you've eaten less vitamin K. So it's that's helping by trying to warn people about salads.

You know, listen. It's not that. It's what I usually tell people is it's not that you have to avoid green leafy vegetables. I certainly don't want you to do that. It's that you have to eat pretty much the same amount of green leafy vegetables every week. You have to decide what that is, eat that every week. Well, regulate your war friend to match it and then never change. And that's hard.

I mean, I know, especially for us with our, as much as we travel, to try to predict what I was gonna eat every week, that would be a very difficult thing to do. And it is for a lot of people. It's also war friend acts differently in everybody. There are some genetic variations that can make war friend behave a little differently

in your body. So the dose that you'll need if we're friend, we don't know until we start giving you some and measure certain things and then figure out what's best for you. But what we had to do early on after we started using more friend was figure out a way to measure was it active enough in your body?

Was it doing what it needed to do? And was it too active? Was it making you too likely to bleed, and was it too active, was it making you too likely to bleed? So they started using a pro-thrombin time, which is just how, think about it as a way of measuring how fast your blood clots. But what they needed to do was kind of find a ratio, because it's not just how fast your blood clots, it's how fast that clots in comparison to the norm.

So they came up with a number eventually that we call the INR, which just stands for the International Normalized Ratio. So this is a ratio, essentially. How fast is you, a person who's on war frame, how fast is your blood clotting compared to me, a person who is not on war frame? And that number is how we keep track. It's, we'll say things like,

it's like your war frame activity level. That's, it's, we'll say things like it's like your war for an activity level. That's sort of what it is. But it's a way of measuring, are you on the right dose or not? Okay. And it's important when you're on war for and we have to keep that in that very specific range that we know is good for you. So like for most people, they need their I and R to be two to three. R's is one, by the way, around one. There's a narrow range, but that's the normal, this one. That one. But somebody would probably need it be 2 to 3. Some people need it to be 2.5 to 3.5.

These are very specific numbers. Yeah, it's like a lot of margin for error. Yes. And while there are home kits that some lucky people have, and there are places where you can go get like a little finger stick to get your eye in our checked. There are other patients who have no option but to go to a lab and get a blood draw to check this level. When you're first starting, war-friend, you could need it checked every day.

Now, once you're stable on a dose, it can be much less often than that. It can be every few weeks. Unless you get solid crazy. Exactly. Or, there are a whole variety of medications that can interfere with the metabolism of warfront. So there are a lot of antibiotics or a big culprit. So people will be doing really well in their warfront dose. And then they'll have to take an antibiotic for something and it goes, their level goes a lot of whack. And then they have to come back in

and get a monitor and we have to change things. And yes. So because of all this, Warferin in recent years is starting to be replaced by newer meds. That's hard to manage. I'm assuming. That's exactly the point. So they have found newer medications that don't have anything to do with vitamin K. So the nice thing is it doesn't matter what you eat. They are not influenced by your green leafy vegetables. So eat as many or as few as you so desire. Done. You don't have to have any levels checked. The INR is, it doesn't matter that you don't monitor that. They're fixed doses, essentially.

This is just the dose you take. This is, you know, the appropriate dose. There are fewer met interactions. So the mechanisms are completely different. That's just different. Yeah, they're just different medications. They will still keep you from clotting, but you don't have to do all that other stuff. For some patients, warfarin is still the best choice because of...

There's certain things we're not sure about, like kidney conditions and things that make warfarin a better choice. Okay, down that. Because it's been around since the 50s. Sure. So we have decades to know what it went and to say when it's not. But in many patients, they're choosing these newer agents because they're so much easier to manage.

So we may send CNN to warfront someday in terms of its use in humans just because it is cumbersome to manage. It's not a bad met. It's easily reversed, which some of the new agents don't have easy reversal the way WarFran does. But yeah, if somebody came in with an INR of like 20, that would be somebody you'd want to reverse.

You know what I mean? Like to answer that earlier question, why would you give somebody vitamin K and reverse it? Or if somebody came in and they were bleeding, let's say they got in an accident and they cut themselves and they were bleeding, you'd want to give them vitamin K to try to reverse the warframe to stop them because they're not going to clot. You know, Sid, I've only said this at the end of a handful of sawbots episodes, but thank goodness those cheap farmers gave their cows nasty hay. You know, they really all worked out in the end, didn't it? I mean, I can't have the purpose, Sid. Some dog millionaires. Do you know that we don't, I thought this was interesting. We don't really use war for in much as a rat poison anymore. Do you

know why rats eating too many salads. They became resistant. Rats are becoming or have become, for the most part, resistant to warfront. They have newer agents called super warfront. They can use, they use them with rats and I guess sometimes in places with bats where they're close to humans to try to prevent rabies. But I read more than I wanted to know about super war friends. I found it very upsetting and scary. Okay. Because they're just really dangerous to humans. Yeah, it wasn't going to eat any. I know, but how many salads? Oh my God. You have to take vitamin K for

like a year in some cases to try to reverse it if you accidentally ingest this. That's what you just said. Intentionally ingested. Anyway, yes, so there are super warfronts that scared me. And also I thought this was an interesting historical note. It is possible that warfront was used to poison Stalin, apparently. Oh, really? This is much debated among historians.

I think there are still a lot that just believe he had a brain hemorrhage because he had medical conditions that made it likely that he would have a brain hemorrhage. And so there was no foul play. He just had an unfortunate well, I don't know. Well, it's however you, whatever your feelings are on Stalin. Yeah. He had a brain hemorrhage and it just happened and it was nobody's fault. But some argue that because he also had a hemorrhage in his stomach

and some areas of hemorrhage in his heart muscle, that that seemed suspicious. Rad poison. Warfriend was very popular at that. It was being marketed very heavily all over the world at this point in history. So a lot of people would have known about it. It is odorless, it is tasteless.

It could easily be slipped into a food or beverage. Much like Iocaine powder. Pretty sick. And there are some that theorize that for five to ten days prior to his death, somebody was dosing him with warfriend on the slide. It takes three days for warfriend to start working. I don't know if anybody wants to know that. That's another reason why it's hard, because it takes three days before you even know what

it's going to do. But I'm not saying Stalin was murdered. I'm just I'm saying there is a theory. Regardless, we are dedicating this episode to his memory. No, we're not. No, I'm not dedicating an episode of Stalin. Not too soon. Stalin.

No, sometimes it's better to burn bright than it is to fade away. Stalin gone too soon. No, that's why I have this angel, that angel wings sticker on my truck. It says Stalin and then the years of which he was born and died because gone too soon. This is not true. Don't miss you, buddy. None of this is, none of this is true. Anyway, it's a very interesting thing you can read about from historians who know all things about Russia that I don't know. I just know about orphan and there it is. Are you waiting to get to heaven and ask

old Stalin himself? Well, I don't think Stalin knew. Folks, thank you so much for this. Probably would have avoided the poison. Our podcast, he knows now. Food and beverage. He's probably checked up on it at SENS for heaven. Folks, thanks for listening to Sal Barnes.

They teach you in church about happy Easter. See you having good Friday. We hope you've enjoyed this the show. Our theme song is performed by the taxpayers. And they are a great band. You can find more of their music on Bandcamp. Find a link at solbons.libs.com. I think or at maximumfund.org, you can find all the sub-bones episodes. Actually, if you go to solboneshow.com, we never mentioned that URL, but there it is.

You can... There are all kinds of places. There's all kinds of places. It goes direct to it. If you go to, I don't even think we've talked about this in the show. If you go to mackerelweemerge.com, mceel.roi, you can find a new pair of solbones pins I'm going to go to the website. I'm going to go to the website. I'm going to go to the website.

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website. I'm going to go to the website. I'm going to makes a great gift. Hey, thank you so much for listening. We hope you enjoyed this week's episode. And until next time, my name is Justin McRoy. I'm Sydney McRoy. And as always, don't draw a hole in your head. Alright! Maximumfun.org Comedy and Culture

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