The Impact of Hearing Loss on the U.S. Armed Forces

A recent study by the American Journal of Audiology found rates of tinnitus within the U.S. Army to be much higher than the general population. In this episode, Dave talks with Dr. Brandon Rawlings, an audiologist and an active member of the U.S. Army Reserves about the hearing health of our service men and women, and resources for treatment and support.

Link to full transcript

Transcript

SPEAKER_00 0:01

Welcome to Starkey Soundbites. I'm your host, Dave Fabry, Starkey's chief innovation officer. We've long known that veterans and active duty military suffer from hearing loss and tinnitus at higher rates than the general population. A new study published in the American Journal of Audiology provides new numbers that help illustrate that stark contrast. The paper that was published at the end of March in 2023 showed that self-reported prevalence of bothersome tinnitus in the U.S. Army is substantially higher at 17% than that of the general population, which is around 6.6%. The hearing health of our service men and women is very important to us here at Starkey. And since it is Better Hearing Month, we've dedicated this episode to raising some awareness to talking about those solutions. Our guest is uniquely qualified to dive into this topic. Dr. Brandon Rawlings is an audiologist and an active member of the U.S. Army Reserves. He worked as an audiologist in the VA, and we'll talk a little bit about his experience. And now he's on the staff here at Starkey, working directly with audiologists in the VA, DOD, and in Indian Health Service. Dr. Rawlings, thank you for joining us today on this uh edition of Starkey Soundbites.

SPEAKER_01 1:28

Thanks, Dave, for having me. I'm excited to be on here with you.

SPEAKER_00 1:32

Well, I love that you are very patriotic today in your dress. I I got some of the colors mixed here, but not all of them. I've got the blue. But uh, you know, uh, I think really first of all, I want to thank you for your service uh in the military um and uh and your continued service, given that you still are an active member uh member of the reserves in the army. But let's talk a little bit about first uh what drew you uh to a career in audiology. Sure.

SPEAKER_01 2:02

So it's interesting. I was one of those interesting ones that um originally was going into becoming a speech language pathologist and uh and started the courses. And as I was going through my undergraduate degree, I I was realizing I was enjoying the audiology courses much more than the SLP classes. In fact, I had a I had a teacher, and this is, you know, you know, SLPs, I I have so much respect for them. And uh, but I just had a teacher that that uh an audiology teacher that really just shined for me and and made made me excited about the field of audiology. And what's interesting though is that it's also kind of nice because called them out.

SPEAKER_00 2:43

I think one of the things I always say is tip your waiters and thank your mentors. So this is an opportunity for you that to recognize them.

SPEAKER_01 2:51

Yeah, so so I I had I had an audiology professor in in uh went to Brigham Young University in Utah, and I had a great uh professor's name was Dr. Harris, and uh his name was Dr. Richard Harris, and he was great, he got me excited about it, and uh and then I did go on and get my AUD and had wonderful professors at Missouri State University as well.

SPEAKER_00 3:10

Fantastic. But I know Richard, and he is a stellar human being and a great uh professor of audiology as well.

SPEAKER_01 3:18

Yeah, yeah. He was he was a great, he was great, and and like I said, got got us all excited about him. So that's one of the reasons why I am why I'm uh in in the field of audiology. But one of the interesting things is my wife, her her cousins, they have a family of of people all that all have hearing loss as well. And so it's been it's been that having uh nice to have that connection with them as well, even in the family.

SPEAKER_00 3:40

So when you went into speech path and then ultimately audiology, had did you know your wife already at that time? Was it a chicken and egg thing, or had you met her and then developed uh the relationship and then learned of the hearing loss in her family?

SPEAKER_01 3:56

Yeah, so I I we were already married when I when I made the move over to to SLP, and it was actually technically communication disorders, was my undergraduate degree, but uh we were already married. Um, but during that transition, that was one of the things is that she said she's you know, you know, my cousins are all are all have you know pretty significant hearing loss. And so that was something that's been fun with me whenever we've been at her family reunions and stuff, being able to to talk hearing aid technology with them. And and uh and it's been a it was a nice way for me to be able to get them, get to know them better, which was which is pretty cool.

SPEAKER_00 4:29

So now the real kicker is have you worked with any of them clinically? I don't want you to violate HIPAA, but um one of the most challenging things in my career is when I've worked with family members as patients, because I want to make sure, I mean, obviously with every patient, you want to give them everything you've got, but when it's family, there's a little extra motivation and a little extra burden there.

SPEAKER_01 4:52

Yeah, you know, I have I I I have given a lot of guidance and a lot of of professional opinion in in a lot of their decisions.

SPEAKER_00 4:59

So I'll put about um and so then when did you your your active duty? You've been uh US Army Reserves for what about five years now? Yep, yeah. I'm just coming on five years, yep. So what prompted you? Um, so now um you're an audiologist already. Yep. Uh did you start? What was your first job as an audiologist?

SPEAKER_01 5:24

So my first job as an audiologist. So I I after finishing my fourth year, I actually went to uh moved to Las Vegas and worked as in a in a private practice in in Las Vegas. And uh so I was there for about four years, and then I left there and went and worked at a VA in Texas for a while.

SPEAKER_00 5:42

Okay. And was that the moment in time when you started thinking about joining the U.S. Army Reserves?

SPEAKER_01 5:50

It was. It's actually when I was in Texas. So one of my so I've been thinking about joining the military for a while now. In fact, my brother-in-law, who just recently retired from the military, he was a recruiter for the Army, Army National Guard. Now, when we look at National Guard, what's interesting about National Guard is is they don't actually have audiologists in the National Guard. And uh, and so you can't you can't join the National Guard as an audiologist. And so, um, and so, but he was a recruiter for a while and he had talked with me, and but but it whenever whenever he would talk with me, it just didn't the time wasn't right. And anyway, when we were living in Texas, I have a friend of mine that's an anesthesiologist who's in the Army Reserves, and he said, you know, Brandon, the Army is look, the Army Reserves are actually looking for audiologists. And um, so I reached out to him and and uh kind of got the ball rolling there.

SPEAKER_00 6:41

That's awesome. Well, and um, you know, I certainly have had a lot of friends and colleagues over the years who um joined the military first and then became an audiologist. And I know several who've gone all the way through to get not only their AUD but their PhD uh because of that demand. And we'll we'll pivot to this in a moment, but with the need, um hearing loss and tinnitus are uh the two most uh uh frequently listed disability uh suffered by soldiers when um they are giving uh their ears in this case. You know, they always say uh all give some, some give all. And uh hearing loss is is very much a part of service for many uh veterans. And certainly the army is uh an area where they uh frequently are exposed to uh high decibel levels. So uh, you know, I think your story is is very interesting in the sense of um uh starting out as an audiologist and then working first in a private practice and then for the VA and then and then feeling the call um to serve. And again, I say thank you to that, but it sort of gives you a unique vantage point in terms of your role now. Describe a little bit what what you do with Starkey uh in your present role.

SPEAKER_01 8:04

Yeah, absolutely. No, and I agree that that I think the experiences I've had working at the VA and working in the in in in the army really has helped me in this position because I am uh I'm a government services rep, uh field rep for Starkey. And I so I cover kind of a lot of the mid-part of the country. I actually cover 12 states, and so 12 wonderful states of the US. And uh, but that's really my job is is going out and meeting with um now. When I say government services, that's that's obviously referring to the VA, DOD, and Indian Health Services as well, are really those three. And even on the side of that, we also have the wonderful private practice uh people out there that are also community care providers, that are also um for the veterans that can't necessarily get into the VA in a in a specific amount of time, or maybe it's just easier access for them uh to go to the community provider provider. We work with them as well. And that's my job is to go out and meet with them to make sure that that their patients are being taken care of, making sure their patients are are hearing well with with the wonderful Starkey technology that we have.

SPEAKER_00 9:12

Yeah, and uh I don't know that we've ever discussed this, but my first job after I finished my PhD, I uh worked at Walter Reed Army Medical Center as a civilian uh working in the Army uh speech and hearing research group. Wow. And uh when it was still a standalone at Walter Reed in the in the northwest suburb, northwest part of the district. And uh it was there really where I really learned the rich history of uh audiology in the military and specifically in the Army branch. Uh, Forrest Glen, really, by by by all regards, is uh the birthplace of a lot of what we've done after World War II uh with veterans uh for developing a lot of the best practice protocols, a lot of the ways that we treat sensory neural hearing loss uh really can be found not only in the military, but in that uh uh Forest Glen Hospital, which then sort of grew into Walter Reed and is now part of Walter Reed at Bethesda. And so um we we owe a debt of gratitude for uh our profession uh due to treating veterans uh dating back to those 30s and 40s at the at the the the early part of our career. And it's sort of a who's who as to uh uh some of the uh the the the founding fathers and mothers of audiology and uh and their service to this country in the military. So you're part of a long train of tradition here. Yeah, you're exactly right.

SPEAKER_01 10:41

You know, what's interesting is even when I when I fulfill my role as an audiologist in the army, so many resources uh of of ours come from Walter Reed. It's you know, it's like you know, though, this protocol came from Walter Reed. So you're exactly right. It's it's uh we owe a lot of debt of gratitude to to them for the setting standards.

SPEAKER_00 11:01

Well, um, so let's turn a little bit to the patients that you served when you were working in the VA. Yep, um, and then now in your role. Um, did you see that recent study published in the American Journal of Audiology? I did, yeah. Yeah, did it surprise you that disparity?

SPEAKER_01 11:21

To be honest with you, it doesn't. And uh, and that's because I have seen this myself in both the VA and in uh as a role of playing an audiologist. Now I mean playing, I mean it's not like a I mean a play, but but being an uh audiologist in the army as well. What's interesting is that I just returned home from a mobilization. So I was I was mobilized at Fort Bliss in El Paso, Texas. And my job over there was was just I was as in a in an audiology clinic and I was the lone audiologist. And for all of the soldiers that were getting deployed and coming back from deployment, every one of them, it's it's part of your readiness of being able to be deployable. They have to go through our clinic and get here their hearing tested. And so we had some sometimes up to 500 people coming in per day for hearing tests. And for and I had technicians that were doing most of the testing, but for those of failed twice, they saw me for more diagnostic testing. And uh, and it was interesting just having that experience because I saw there were there were so many uh soldiers who uh are constantly shooting, I had just come back from deployment, and man, so many of them had that noise notch, right? A 4K. And so many of them reported that tinnitus. And uh, and so when I see those that study, just from my personal experience, it doesn't surprise me at all because I'm seeing it firsthand. I'm seeing the effect that the military that being in the military does on the hearing and on the auditory system.

SPEAKER_00 12:57

Yeah, and it really begs the question because you're seeing a lot of these young soldiers, presumably many of them were only a few years into their term of service, and they already had that noise notch because, as you say, of that um exposure to uh uh weaponry, gunfire, et cetera. And um, you know, one of the issues, it would seem strange for a hearing aid company to be concerned about preventing hearing loss before it occurs, but but it seems like in the military in particular, there is an opportunity to ensure that those veterans, to the degree that they can be, uh, are protected against noise-induced hearing loss. And wondering a little bit about, you know, the attitude. I know when I was 20 years old, 25 years old, I kind of thought my ears were bulletproof. Uh I was a drummer, I'm a drummer, uh, rode motorcycles. And I can remember before very early days before I really started thinking about audiology, um, just hitting the cymbals until my ears rang. And I thought that was really cool. And now they never stop. But um, you know, I thought I was kind of bulletproof because in many cases it was a temporary threshold shift that I was experiencing. But over time, lo and behold, that's turned into a permanent uh hearing loss that I now have in the high frequencies in particular, due to that noise exposure. What when you were counseling some of these young soldiers about that they already had a noise notch, um you know, did you encounter any any sort of like, yeah, well, you know, that's part of part of what I'm I'm doing. I I know that it's an occupational hazard. Or were they genuinely concerned about losing their hearing when you're, like you said, young and feel bulletproof?

SPEAKER_01 14:45

You know, it's interesting because I saw some of both. And uh these soldiers, so obviously, you know, when I make reference to them having those noise notches from shooting, um, certainly there's going to be other loud noises they're exposed to too. They, you know, there's all kinds of there's grenades, there's bombs, there's just so many different loud noises. And so you get these young, young soldiers coming back from deployment. And some of them you tell them they have a they have a noise notch, and then some of them, you're, you know, I mean noise notch, hearing loss. And some of them are like, okay, that doesn't surprise me. And then some of them are very concerned. And and some of the reasons why they're very concerned is that in order to stay deployable, in order to stay in the military and stay deployable, you have to be able to have still have somewhat good of hearing. And so one of my roles as an audiologist in the army is to run several tests to determine is this soldier still deployable? So if this soldier was out in combat, would they be able to hear the commands being yelled to them by their by their leader out there, right? By their commander. And uh and it was it was sad because I had soldiers. In fact, I had one young, young soldier, early 20s, just got back from deployment, and he had he had been exposed to multiple IEDs and just he came back and his hearing was just shot. And I ran several tests and and he he failed most of them. And I had to be the bear bad news to tell him that he was going to have to be essentially kicked out of the army in, you know, in one sense or another, because he just he his hearing was so poor. And uh and so there are some soldiers that that were so nervous when I was testing them because they were like, Well, am I gonna be able to stay in the army? And and so it's you know, and then but then there are all the those others too that that when they find out that they have hearing loss in general, they're like, What? You know, and so it's just I I saw just several different reactions to me telling these soldiers that they have hearing loss. And and once again, it was I had to, it's hard sometimes to be that the be have to be the one who tells them those things, but we just have to be up frank and honest with them, and especially kind of you know, telling them the you know, some of this is is preventable. So, yeah.

SPEAKER_00 16:53

I mean, I think a lot of uh the audiologists who work uh with civilians exclusively don't really consider. I mean, we talk about stigma, we talk about accessibility and affordability. Well, any veteran that has lost his or her hearing due to noise exposure appropriately can receive hearing aids at no cost. So that affordability isn't an issue. The accessibility to a professional, we know because of that increased prevalence of hearing loss and tinnitus in the military, is sometimes hard and challenging to get in to see a professional. But I know the VA is staying on top of that to provide, as you mentioned, those community-based as well as hospital and clinical-based uh access to veterans so that they can be seen as soon as possible. But I think a lot of times you don't think about that individual worried about their livelihood if they have hearing loss as being an issue. You know, similarly to uh uh police officers and firefighters in some areas, it's the ability to hear sounds um uh and uh to prevent loud sounds from becoming uncomfortable. But then also the spatial awareness. I think for the military, that's particularly important. For those of us in civilian life, it can be sort of a nuisance, but for a soldier, that can be the difference without any hyperbole at all between life and death. Yeah, absolutely. Absolutely, you know, so the the issue is certainly uh going back to my period um when I was at Walter Reed, I was fortunate to serve on the selection committee that would help select those products that would be offered to veterans uh and other uh government service employees at the time. And um, you know, we've seen tremendous advances in the past decades for technology that can not only help uh uh individuals hear better, uh, they can be connected to their phones so they can stream, they have a host of other features. Um, and uh Genesis AI is now on uh the contract, government services contract. And I know that you've uh been waiting for this product, like we have, to be developed and introduced. And this really the latest technology we have available is now available to veterans on the contract. Talk a little bit about some of your favorite features um that uh are available now for uh veterans, for DOD, for Indian Health Service, et cetera.

SPEAKER_01 19:27

Thank you, Dave. I I can't begin to tell you how excited we are to have this available now for all the government services audiologists, because it is an exciting time to be at Starkey. And uh these the the Genesis guy hearing aids are just unbelievably cool. And uh and they can just give the uh these veterans so much, so much benefit, and not only veterans, but active duty and and in health patients as well. Some of my some of my favorite features is number one, starting with that, with the sound quality. I mean, I just uh every time I put the Genesis AI hearingings on my ears myself, I just think it's such a fantastic sound quality. Uh, when we were at uh JDVAC in in March, um we had the opportunity. We we went to dinner and I had the opportunity to to put the Genesis AI hearingings on, and that was in Las Vegas. That was a really, really noisy environment. And it they they were just phenomenal, especially when I activated the edge mode. Yeah, and then it was even better. And uh, and so it that that's that's one of the exciting things is about about the this Genesis AI. It's it's a it's a refresh. And this sound quality is new and it's so crystal clear. And and I I just love it. And so, really, that sound quality, the the the patients are gonna get such a great benefit and improvement in their quality of life utilizing these hearing aids. Um, but also you can't beat the sound quality, Dave. The sound or sorry, the sound quality, you can't beat the battery life. Yeah, the battery life of these hearing aids, 51 hours on a full charge. And especially the the thing that seems to be the one of the biggest eye-openers is when I is when I tell the audiologist about our bicrust system. Yeah, you know, even on a with a bicrust that's on a full charge, 29 hours of battery life. That's just that's incredible. And uh, and that that can really so looking back at our veterans, we have so many that that have maybe had an explosion on one side, and maybe one side is a lot lot worse than the other one. And so that's that's an area by cross system, it can be hugely beneficial for them. And with 29 hours of of battery life, that's the that that's exciting. It's exciting time to be a starky.

SPEAKER_00 21:45

Yeah, you hit on a a couple of really important points. I mean, the military um does see more than its fair share of cross and by cross, contralateral rounding of signal and bilateral, uh, you know, amplification on. On a better ear, even if there is some hearing loss, and then routing it over from that other side. IED explosions are unfortunately a perfect example of when that might occur. And 29 hours for a bycross uh solution is nothing short of phenomenal. 51 hours out of the RT, the RIC with a telecoil uh in a rechargeable battery, um, is a again, people are saying, well, why so much? I mean, you guys, you you you you're blowing it out of the park, but but I think one of the important things that we all know, whether it's a cell phone or a computer battery, or frankly, any piece of uh electronic equipment that uses rechargeable batteries, we know over time those lithium-ion batteries do decr degrade somewhat. And uh, we didn't build this just for today for 29 hours of streaming, more hours than there are in a day for most people, unless they're um you know traveling or they're being deployed somewhere and going those days can become very long. But um, even three to four years from now within the service life of hearing aids that will be provided for active duty veterans, i.h. uh Indian Health Service as well, even after three, four years, you're gonna still get all day battery life, all day streaming on a cross or by cross solution. And so that's really the ticket is we wanna provide that peace of mind and comfort for both the professional and for the patient that they're going to be able to get all day use regardless of their circumstance now and in the future.

unknown 23:36

Absolutely.

SPEAKER_00 23:37

The other thing I think that you know, um uh people should be aware of is that we've made important improvements in the tinnitus functionality on Genesis AI. Do you want to talk a little bit about that? Have you tried that uh yourself or had any feedback so far uh from uh uh audiologists?

SPEAKER_01 23:56

I have, yeah. So I've tried that out and I've done person, uh use that that personalization uh feature in there and been able to personalize the tinnitus uh masking to the patient. I've assisted some some audiologists with that, and it's just it's just awesome. You're right. It's improved, it's improved. And uh, and what's interesting though, Dave, is a lot of people don't realize that we have that feature available within the within the software. And that's one of the things that's really good to educate everyone on. Everybody knows that most manufacturers have the tinnitus masking in there, but they don't realize we have the ability to personalize that to the patients, which is very beneficial for them.

SPEAKER_00 24:32

Yeah, they can change it to their audiogram, use white noise or another personal stimulus, and then even vary the rate at which there is some temporal fluctuation, slow, medium, fast. And I think being able to change that, um, uh the the end user can change it as well within the app. We like to say with Genesis AI, it's all new everything. Um, and with the new fitting software, we call it ProFit. Uh, there are some important uh advancements for ease of use and really considering the uh uh audiologists working in these facilities, streamlining that process to get from the box to a first fit in four clicks. And that minute fit functionality really, I think, was built specifically for the VA audiologist to get them to that starting point from the box to the patient's ears with that first fit in just as little as four clicks. I think um that's a really important functionality that I think they'll find. And yet we didn't throw the baby out with the bathwater. I think a lot of people said, Well, wait a minute, uh I I really liked Inspire as it was, but I think that minute fit is an important one. Can you think of any other features that we incorporated in Profit? I've got a couple, but I'll give you an opportunity to say some of your favorite features in the fitting software.

SPEAKER_01 25:55

You know, it's the the fittings, then the new Profit fitting software is just awesome. And you're right, it really is built for for the VA in order to help them. If there's anything that VA audio autists tell me, is so they want they want to be able to get through these these faster and and and easy, want to make it easier. And uh, and so for those that like you said, that that were worried about inspire, we still have that that pull out menu that you the on the side of it. So it's just like the inspire. So for those that are that like that, they can still do that. Um, but there are a lot of great features that are gonna help the the patient. So uh especially at the VA. So a couple of them. Number one is look, let's look at Estat 2.0. And that's one of the things that that is really important to audiologists, at the especially at the VA, um, but all the all just all around the country is that ability to be able to provide good sound quality, but also to be able to run the real ear uh and have and do it in somewhat of a reasonable amount of time. And that's one of the two of the features we have that are going to help with that patient, help the audiologists to help their patients and get through an appointment even faster, is number one, the improvement with the Estat 2.0. And so the the improvement we're getting with their the the bumps in in the in those uh uh lower tones as well as the high frequencies, and it's taking them even closer to to meeting those real error targets. But also one of the things that's really catching on that people are loving is that audio auto uh REM target matching that we can do right through the software in and of itself, that's allowing them to run the realer even faster in there as well.

SPEAKER_00 27:29

But half the time, right? Half the time, half the time, and yet you can still go in and fine-tune beyond that if you wish.

SPEAKER_01 27:36

Absolutely, yeah, absolutely. But you're exactly right. That the the ability to do fitting in only four clicks, that's incredible. And uh where we really are saving these audiologists time, and that's really what it's about. And the other thing that I want to mention along with that is just the fact that our hearing aids with the genesia hearing aids are even more durable than they've ever been. They now have that eight eight layers of protection in there that are gonna make those hearing aids even more durable, protecting them from the moisture. They're not gonna be seeing the the patient's back as much at all anymore because they're being so protected so well. And so this is this huge advances advancements that we're giving to the audiologist here that we're really excited about.

SPEAKER_00 28:21

Yeah, it's really beyond IP68, which is the highest rating that a hearing aid can achieve. And a couple other points that I think of uh the uh snapfit 2.0 um and really it's a smart ID, so that now when they attach the receiver to the RIC device, receiver in the canal uh device, and and fulfill that component with the appropriate length and power of the receiver, and for the left ear and the right ear, um, those will automatically be read up and incorporated in the fitting so that they don't have to go and read the serial number, which gets increasingly difficult for me to do and saves time. And then, as well within the feedback initialization, um, I encourage uh professionals to use that, initialize it on every patient, do it in their ears, not on the table, because it takes into consideration and personalize and optimizes the venting parameters with the length and the the depth of the uh insertion in the patient's ear to really ensure that that first fit is getting there in those four clicks when they're running through this uh through the steps. And then the last thing I'll point to as a particular favorite of mine is self-check because it helps us uh triage whether the patient has had a change in their hearing, whether they need to come in to see uh in the in the facility, whether they need to get a new audiogram to determine that there's been a change, whether there's a need of a repair for the device, or whether it's simply wax that needs to be removed and rerun the self-check feature. And I think that's a way to really empower that end user to know a little bit about what treatment they need next, whether it's a repair, a cleaning, or an assessment. And um, like I said, I think there's so many features that um we could go on another hour on that alone. But I think so many features that are tailored to the veteran in terms of better hearing and tinnitus during better hearing month, as well as catering to the professionals so that they can see more patients more efficiently with greater outcomes throughout the day.

SPEAKER_01 30:32

Absolutely. And I want to add to this too, Dave, is that one of the things that we have to remember too is that, you know, at Starkey, we we really do such a good job at emphasizing on treating our veterans and treating our military. But we also have such great resources as well, as far as being able to help prevent a lot of this hearing loss as well. And that's why we're the one of the greatest resources we have available is also our sound gear line. And uh, and those can that can be such a huge asset for our our uh for our veterans, for our military, for our Indian health patients, on being able to even prevent that hearing loss from the beginning. I know that when I was doing that mobilization, a lot of these soldiers they revealed to me later that gosh, this this hearing loss probably happened when I didn't wear my hearing, my hearing protection on the range. And and uh we as audiologists, that's certainly within our scope of practice to be able to help prevent the hearing loss as well. And that's another another uh thing that the VA has uh available to them, as well as our sand gear line, to be able to even help prevent it in the first place, along with being able to treat it as well.

SPEAKER_00 31:46

For sure. And uh and even post-military service um if they're engaged in noisy hobbies, uh, preventing that hearing loss from continuing or accelerating is uh and thanks for making that uh that point about sound gear. So as usual, uh, with the conversation between you and me, at the time just flies by. And I thank you so much uh during Better Hearing Month for sharing your story, your journey. And also uh thank you for your your service to the country. Thank you for your role with Starkey. And um I hope to have you on soon again to talk a little bit more about um your journey as it continues forward. And for those of you listening, uh, if you enjoyed this episode of Sound Bites, please like and subscribe, share with your colleagues if you would, your networks. Um, if we also want to hear from you if there are any topics that you'd like us to discuss and bring on other experts like Brandon to uh talk about their experience and solutions to some of the questions that you might have. So uh, Brandon, thank you again for being here today. And I look forward to seeing you again soon. Thank you, Dave. Thank you, thank you for inviting me on. It's been my pleasure. It's my pleasure. And to our listeners, thank you for uh listening to this podcast and continuing to support us. Uh, we look forward to seeing and hearing you again very soon.