Let's talk about vaping as the new health crisis...

On this week's episode of the Lunch and Learn with Dr. Berry we have Dr. Andrew Berry, a Gastroenterology Fellow to discuss one of the most talked-about current public health crisis which is Vaping. As we have moved the public needle in regards to the harmful effects of cigarette smoking, e-cigarettes/vaping has become the alternative but unfortunately, that has come with consequences.

Dr. Berry gives some amazing facts about how this craze first began, just how many deaths are attributed to vaping and what to expect for the future of the industry.

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Download Episode 130 Transcript

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Episode 130 Transcript...

Introduction

Dr. Berry:
Welcome to another episode of the Lunch and Learn with Dr. Berry. I'm your host, Dr. Berry Pierre, your favorite Board Certified Internist. Founder of drberrypierre.com, as well the CEO of Pierre Medical Consulting. Helping you empower yourself for better health with the number one podcast for patient advocacy, education and affirmation. This week we are going to be talking with Dr. Andrew Berry who is a Board Certified Internist and also a second year GI fellow, gastroenterology fellow. But we are going to be talking about a topic of vaping because that's something that's right along his alley as known as the GI fellow. But he is very well versed in lots of different academic related topics. And we got together thinking, you know what, let's talk about a subject at hand that if you are a smoker, if you know a smoker and you've heard about this this new, this trend. I would say new, but this trend of e-cigarettes and vaping, let's talk about vaping.

Let's talk about what we're hearing in the news about vaping. Whether it's harmful, whether it's good for you. Who should be vaping? So we're gonna be talking about vaping on this episode today and I think it's a good one because it is something that, again, I listened to this episode and I was getting so much education from it and I know you will too. So again, Lunch and Learn community and like always, if you have not done so, please subscribe to this podcast. Leave us a five star review especially from my Apple podcasts users. Your help is greatly appreciated and like always, if you remember to share with not one but maybe 10 friends and let them know how much of an amazing episode this was today. So we're talking about vaping. Get ready to sit back for another amazing episode here on the Lunch and Learn with Dr. Berry.

Episode

Dr. Berry Pierre:
Alright Lunch and Learn community, you just heard another amazing introduction for a topic that I think you are really in for a treat for. Again, when you turn on your TV, read the blogs. This is definitely something that has been really on front page news now. Especially, I work in a hospital setting and people keep asking me about it. People keep asking me vaping, vaping, vaping. What is vaping? How dangerous is vaping? Why are so many people dying from vaping? And I figured, hey, you know what, let's get someone who knows what they're talking about on the subject.

So again, I want to thank, I like to call the real Dr. Berry to talk about a topic. It's so funny because I call myself Dr. Berry but it's a funny thing. People like be able to call me by my first name some weird reason. I'm not sure why. But I like be able call my first name, but I still want it to attach the doctor to it. So alright, sure. I'll be Dr. Berry. But we have the real Dr. Berry - Dr. Andrew Berry who's going to be really educating us today Lunch and Learn community on just what vaping is and just why we should be really, really worried about it. So, Dr. Berry, thank you for joining the podcast today.

Dr. Andrew Berry:
Thanks for having me. I appreciate it. This is definitely a topic that's hot and we want to hit the hot topics that are relevant to all markets. I appreciate you having me on.

Dr. Berry Pierre:
So Dr. Berry before we get into this amazing topic, tell the Lunch and Learn listeners about yourself, who you are, why this topic is such a hot button topic for you and that way we can get into the meat of it.

Dr. Andrew Berry:
Actually a GI fellow currently. So basically one more year of training and then I'm out in the practice, treating all your stomach problems. But right now I'm still in training. Internal Medicine Board Certified, so obviously something that you're familiar with. You deal with people all the time and training the next wave of internal medicine physicians, which is highly appreciated. Also did my training, medical school. Some of my rotations were actually in West Palm Beach where you were.

Dr. Berry Pierre:
So funny because first of all Lunch and Learn community, Dr. Berry sent me a CV, I think 20 plus pages. So I'm already impressed at a CV and I'm seeing some of my former residents. Amongst some of the persons, I'm like, how does he know Dr. Kaplan? I tried to figure out. And then I'm trying to be like, hold on. Now it's called JMP North campus, then we'll see at the time when I was there? And then I was trying to go back and I was like, I couldn't remember. I couldn't remember if you were there at the same time I happened to be there. I definitely, because I heard name, just for some reason it was so crazy because I was seeing all of these publications. Her name just stood out. How she get there?

Dr. Andrew Berry:
I think it's a small world. But I think you were there when I was there, just like vaguely. So I saw you in passing, I didn't have the privilege to work with you.

Dr. Berry Pierre:
Yes. I saw some of the posters that are like 2014 so I wasn't sure if, because that would have been my last year, uh, as, as a residence. I wasn't sure where you were your student that year or wasn't sure we just hadn't crossed there or was just that in passing.

Dr. Andrew Berry:
Yeah. I'm not sure, who knows? Probably both.

Dr. Berry Pierre:
So definitely well-read. And like I said again Lunch and Learn community I'm not joking. The CV really is like 20 plus pages. Just amazing story. And especially for someone who, as a person who does academic medicine, I'm loving it. Oh wow, okay. This is a person who is really, really well-read. So definitely a person I want to make sure that we get to try to touch on a whole bunch of different topics as we can. And so today we're talking about vaping. Just for those maybe someone who does not know what would vaping is. What is vaping, just so for the general community?

Dr. Andrew Berry:
Everybody knows smoking taking off big time in the last couple of decades, middle of 1950s, 1960s. The big social stigma. But ever since let's say 2012, there's been a trend for this new thing called vaping, which is electronic cigarettes. So instead the smoke you get the tobacco coming out, you just get to smell the vape. It is a little shot of a smoke in the air, disappears and dissipates. And it's not like tobacco, it's usually nicotine based and nowadays they're becoming more THC, cannabis based also. But now it's becoming a little bit more of an issue because there's more illnesses and patients having symptoms that are arriving from these vaping products.

Dr. Berry Pierre:
What's interesting because I love how you touched on the fact that it is nicotine based because I think sometimes people think that if they do the vaping or is it, first of all, question, is e-cigarettes and vaping, is that similar from a reference standpoint?

Dr. Andrew Berry:
It’s interchangeable. So initially e-cigs you know, a way to ween known adult smokers off of tobacco products, cigarettes. But now it's becoming more cool slang term to call it vaping. And there's even more other terms for it. But that's what everybody thinks. E-cigs is what's called two years ago and an older crowd, but they think it's the trending way.

Dr. Berry Pierre:
Okay, perfect. And I love the fact that you touched on that it's nicotine based because I think some people make a fuse the fact that if they're vaping that they're not getting the nicotine aspect that they would get like in a regular cigarette?

Dr. Andrew Berry:
Yeah. In fact, they're actually getting more. Some of the studies have shown that they're actually more nicotine in these products. We're used to the patch and the gum to wean smokers off, which is FDA approved, as you probably use in your clinics and in a hospital setting. But the vaping is not FDA approved to wean smokers off. It is just a means to do so for adult known smokers. But the nicotine product content is actually in some of these products much higher than traditional cigarettes and/or patches or gum.

Dr. Berry Pierre:
Wow. So, okay. Alright. Lunch and Learn community, I always tell you guys that sometimes, I have to learn from my guests as well. So it has definitely, some really strange, but very interesting thing to hear the fact that you're not really putting it away from the nicotine because if it's not more that you're going to get in this, the vaping aspect of it. When did it all start? How long has this been around? Why is this such a hot topic now? What would you say?

Dr. Andrew Berry:
Yeah, exactly. So it's been really going relevant a little bit since 2012. But 2017 is when you noticed a huge rise up to the point that over the last three years, well currently this year is about 8 million adults using e-cigs or vape products and about 5 million children also vaping, which is crazy. Because of 2017, so it's two years ago, it's 11% of high school students admitted to vaping on a daily regular basis. However, 2019, so just in two years, it's up to 27%. So over two and a half times increase. One out of four high school students are actively vaping on a daily basis.

Dr. Berry Pierre:
Wow, that's crazy. Okay. Alright. Especially because you said kids, so I'm thinking like, is he 16, 17? So that young they're starting to vape?

Dr. Andrew Berry:
Yeah. Even in middle school. So in middle school were about 5% right now, which is one out of 20 middle school students admit to using vape products on a daily basis. And this is also people that admit to it. So as you and I both know, the numbers are actually higher.

Dr. Berry Pierre:
Exactly. If our patient says they drink two drinks a day, it's probably closer to four. So that's definitely a point I agree with wholeheartedly. For sure. When we talk about just vaping, why do you think like this I guess boom? And I don't know if we should even be calling it. Why do you think this level of popularity just exploded in such a short timeframe?

Dr. Andrew Berry:
Yeah, exactly. So it's not even much advertising was needed. Multiple hypothesis, event thrown out there. One is social media. This is something that can be spread easily in social media. The market uses social media in the last two, three, four years. It's skyrocketed. Instagram, Twitter, all the above. And they can do these tricks, these vape tricks. So there's all these YouTube videos, millions and millions of views regarding tricks with the vape, the smoke, they play it to music, EDM music to Friday night, vape night where they've smoke, vape and play music and just do stuff like that.

Dr. Berry Pierre:
Wow. When you say vape tricks, what type of tricks are you doing?

Dr. Andrew Berry:
You having some sort of fan product in the room or they huff and puff at the vape and then swirl smoke around with their hand. In addition to music and EDM and then they hold and they make music videos out of it. I mean from a third party viewer, not in my words, but it's cool.

Dr. Berry Pierre:
So funny. I've seen those videos and really never paid it any mind that that's what they were actually doing in those videos. Okay, that's weird. I'll take it back. I used to say that's cool too. I used to be like, okay that’s nice.

Dr. Andrew Berry:
Exactly. And a couple of years ago when this first started and like 2017, there's principals and high school teachers even coming out now saying, they didn't even notice these people. They thought it was a USB drive. So one of the main companies, Juul, which is one of the hottest companies in the last couple of years, worth billions of dollars. You could stick their little vape into a USB drive on your laptop and looks like you're charging a USB drive. (Wow). So no one knows people are smoking in the classroom. They're actually, the goal, it's not like a cigarette where you, let's say in 1999 you'd go in the bathroom and hide, sit there, you're faking constipation, sitting there for 10 minutes trying to smoke a cigarette and hide it and spray cologne. Now people are vaping purposely. They want, they've tried today vape. Every time the teacher turns their head, someone, their friend takes a picture, they post it and it goes viral. So it's the opposite, which is kind of, that's why it's…

Dr. Berry Pierre:
And do they even get like that smell that tends to linger? If you're smoking a cigarette, obviously there's like a cigarette type smell, but when they vaping is that just like not there?

Dr. Andrew Berry:
Yeah, exactly. Very good point. So 80% of Juul's sales and which is the best surrogate for the market because it's the best company. Biggest company sells flavored e-cigs. So when you smoke these, they actually smell like fruits, female student high schools perfume. You literally can't tell the difference. And it goes away fairly quick. So that's why this whole, we'll get to that in a second, about this whole ban, to try to ban these flavored products first and foremost.

Dr. Berry Pierre:
Interesting. Okay. Alright. Like I said Lunch and community, I am being educated along with you guys. Because again, this is a topic that again, because I'm internist so I take care of a lot of adults. And most of the time I take care a lot of older adults. So a lot of times the cigarettes and I'm trying to get out their hands. I'll never ever usually having to say like, hey, stop that vaping machine. I'm never having to say that. So this is definitely seems like a problem that's been pushed towards a younger crowd.

Dr. Andrew Berry:
Correct. And the marketing, the Juul company has specifically said they've never marketed toward young crowd. They have been, they have had some small social media promoters, some actors and all that that they sort of pay as years ago. But right now they are currently not marketing to this crowd. And that is the whole litigation legality issues currently going on with this company and all the other electronic cig vaping companies. The government is warning and trying to prevent any sort of marketing for a younger crowd. That is the number one topic right now.

Dr. Berry Pierre:
I'm naive to this topic. Are kids able to buy these things? Is there an age or how are so many of these young kids able to get this stuff?

Dr. Andrew Berry:
Exactly. So up until recently, most States had age of 16 or 18. But nowadays about 18 or about 20 of the States have now enforced new regulations saying that you have to be 21 to buy these products. Also the company which has been forced upon the company by the government is coming forth with these age verification systems where they only sell certain amount of products, certain amount of refills over certain periods for checking IDs stronger. The government is making them do this. They've had to spend a hundred a million dollars to try to give incentives to retailers to install these new age verification systems.

Dr. Berry Pierre:
So obviously with something that is so popular with a crowd that will only get older, which means there's going to be a long-term customer. Why has it been come such a problem? What has been the catalyst to say like, oh, we gotta do something about this vaping.

Dr. Andrew Berry:
Exactly. So with success of companies, these first couple of companies comes, want from other companies in third parties to create more products so they can get a share of the market. So it is these, some of these new products mainly containing THC components. And usually black market, which means they label it as one certain product, but they actually just use the label. They print it illegally from other outside the United States and they put these third party products in it that you don't even know what's in the product. And a lot of them have some sort of THC components. But mainly that's part of the answer to your question. The other half is over about in July or August this year is a little long answer, but this is their important in this content.

I'm from Wisconsin, so go figure. It all started, in Wisconsin, in July of this year. There was about six patients over a two month period that they just were wondering, they couldn't figure out their diagnosis. They are these young patients presenting to the hospital. Let's give you an example. I have the perfect example for you. July 7th, 18 year old who ran track, just graduated high school, presented at urgent care with breathing issues. She had an x-ray with some infiltrates. She was sent home with antibiotics. She never got better. She came back in a few days, a chest pain. She couldn't breathe. She had shallow to keep breathing. Give her oxygen and she actually became worse. She had been to the ICU, she became oxygen mask dependent, almost intubated.

In the end there had 6 or 5 other cases like this, about six. And the doctors were confused, wondering what's going on. They frantically reviewed all the records and the only thing that the patients had in common was a history of vaping. They're all young. In Illinois, the neighboring state had similar issues also. And the first death ever reported from vaping ruling out all other causes with full vaping history and objective data was in August in Illinois. That's what triggered it all. Once you heard the word death in vaping, then every newspaper every day since August has had multiple stories as you probably are aware.

Dr. Berry Pierre:
Well, to the point where even when I started to do a little research for this discussion. I just type in the letter V and it already knew that I wanted to talk about vaping. It was as like Google is like, oh you must want to talk about vaping real quick. Fun facts about vaping, what to worry about vaping things, everything was like, oh wow. You right almost everyone's like writing an article now about just this how has become such a problem. And I know you touched a little bit on the fact that this introduction of the THC related products. Was that always a goal in mind? Did it start out with, was it always just to be nicotine but the THC folks, hold on we can maybe get in here as well.

Dr. Andrew Berry:
Exactly. So nicotine was the original goal. But you know, the culture of America in general over the last five years has been more open to the concept of THC for different recreational or medicinal uses. It's still not approved under federal law or I believe 21 States plus or minus okay it under state law for recreational or medicinal purposes. So obviously it's a free market. The United States is a free market. People jump on it. So they're thinking, wow, we've got these vapes going. Now what about introducing THC? And we know people will try to do it because it's another way to hide or kind of disclose their use of THC product.

Dr. Berry Pierre:
Where these THC products, where they also in this flavor contraption so it didn't even smell like THC?

Dr. Andrew Berry:
Yeah, that's a tough topic actually. The flavor ones are mainly the nicotine. But I think there's some of these third party companies, newer players in the market now that are trying to introduce some sort of flavor THC product to mass that traditional smell that you may smell as a third party viewer walking in public.

Dr. Berry Pierre:
So we're now all of a sudden the microscope is on, right? And now we're like, really going in on vaping and everything else. So of course, I'm going to be the devil's advocate. Is this an overreaction? So I think we should start there because I already know that there's someone listening who vapes and are like, no, my vaping is great. No, I'm never letting the vape go. So there's going to be someone there who's like, no, no, no, they're just over-exaggerating. Is this an over exaggeration or is this something we really should be worried about?

Dr. Andrew Berry:
Very good point. I think there is a small, small component of over exaggeration because you're so tuned into this now. So you see somebody in the hospital, you rule everything else and have easy scapegoat. Oh they vape a lot. They vape daily. It must be that causing their lung illness or maybe they got an infection. I had a patient who had a mycoplasma positive infection that told me quote, I vaped more than anyone else you'll ever know, end quote. So I'm like, okay, it must be that. But yeah, so there is actually, they actually made a formal definition of probable cases of vape or probable component or for sure objectively determined this diagnosis. And it confirmed case describes someone who has vaped in the past 90 days presenting with haziness or CDs in their chest scan and no signs of infection or other plausible diagnosis.

So that's their CDC official definition. But I agree with you, this definitely going to be over reporting now and we need to find, people are frantically finding, when you do your article search over the last 24 hours, there's institutions and academic centers trying to do all these tests to figure out some sort of objective way of what is actually causing this. Is it the vape? I have a feeling it's actually the traditional Juul product may not be the issue. It's just these THC laden third party products that are being intertwined or switched over with not really a marketed and monitored products. So I think there's just something, the component of like spice, the drug, sometimes people take. It’s like a grab bag. You don't know what you're getting.

Dr. Berry Pierre:
Now, question. Especially because I know we've talked a little bit, I know we're getting on the Juul and now is Juul the same phrase when I think about iPod? There's a lot of MP3 players but then the standard we always think about is iPod. Is jewel the main maker of those devices or is there different ones? But Juul just happens to be the big dog?

Dr. Andrew Berry:
There's different ones. But Juul is the big dog. It's so big. In fact the two major tobacco companies, Altria and Philip Morris bought a huge stake in Juul last year. They paid like $12 billion for 35% stake. And Philip Morris did similar thing this year. However they were gonna merge. But because this whole new vaping issue, they called up their merger in last couple of weeks on Wall Street.

Dr. Berry Pierre:
So this topic…

Dr. Andrew Berry:
This is huge. This decision and this vaping, illnesses and deaths have actually changed stock market prices drastically to CEO, owes, have quit in the last two weeks. It's a very volatile market per se.

Dr. Berry Pierre:
So right now we don't really even have a direct causation of why it causes a problem. We know it causes lung damage, but we're not necessarily sure how it even does that?

Dr. Andrew Berry:
No, the best objective scientific as you know, something that you would be okay. You'd read in a journal, which I'm sure you do all the time, came out October 2nd in New England journal. So that's six days ago. It took 17 patients that have lung biopsies that have confirmed cases. So as of right now, today there's about 1,080 confirmed cases of vaping related illnesses or vaping related long illnesses and 19 confirmed deaths. So they took 17 patients. Most of them are men. Median average age is 35 and they all had a history of vaping and three quarters of them are with marijuana or cannabis oils and they actually got this stylogy from the lungs to see what's going on at a molecular level. And they just had a vague answer. There's no real one thing going on. There’s edema, there's a possibly organizing pneumonia and there's sloughing off of the epithelial cells at the lung level. But there's no one finding and they couldn't trace it to one product. That's the problem. The people in the CDC think it just might be one or two bad apples in the group, but that is the best like objective study today just came out in last couple of days.

Dr. Berry Pierre:
Lunch and Learn community, we'll definitely make sure we put a link to that journal article so that you can read that yourself and then you get educated. When you have something like that, when you have something that we don't even really know how it causes the problems, so of course again I'll be the patient, Dr. Berry, how do I avoid this if you can't even tell me how to avoid?

Dr. Andrew Berry:
I mean the easiest answer, you know these answers, stop. The CDC actually, they're not telling you, what they are telling you to stop by the polite way they're saying it is just stop in the meantime until we know what's going on. So a lot of these electronic cigarette users AKA vapers now, because it's cooler term. Successfully, studies have shown that they, it's been somewhat success for smokers that have weaned off as you probably you don't recommend it maybe, but you're okay with it. That's how a lot of physicians feel.

Dr. Berry Pierre:
Someone will say, well are they in totality? Are they better than regular cigarettes? Are you telling me Dr. Berry that I should go and smoke regular cigarettes again?

Dr. Andrew Berry:
Patients have said that. I had a patient today that literally said, I asked the history and I wanted to get more vaping questions and he says he was 50 pack your smoker. He's like, at least I don't vape, that's the bad thing for me.

Dr. Berry Pierre:
Unfortunately we know how we know how patients think. Because I already know I've got someone who's probably listening to this like, whoa, I think they're telling me that I should just go back to the regular cigarettes. (No). So are we saying that they should go back to your regular cigarettes until this vaping thing goes round? I wish this was a facetious question, but I'm 100% sure someone is thinking that.

Dr. Andrew Berry:
Correct. And I think the best answer to suffice all parties would be, if you're relying on this to wean off cigarettes and keep you off cigarettes, I'm not gonna adhere to or support this decision. But I would be okay with continued vaping products. However, I would highly caution against anything THC or cannabis space, vaping products, especially sold online or at small retail stores, not regulated with licensed state. But a lot of people are getting these online because no one, a lot of States don't have it. And then the demographic is the younger person, they're all online people trying to do stuff without under the radar.

Dr. Berry Pierre:
Right. Well we have their parents and guardians anyway, so what better place to a dude is than order it through the internet. So what tips would you give for now? I'm personally, I'm being educated, so what tips would you give a person in the health field that needs to understand the importance of this vaping topic and how to talk to their patients and I guess get them to quit or just getting them to stress to stay away from the THC related products, if anything?

Dr. Andrew Berry:
Very valid discussion point right there. I think you just tell them the facts. So if you tell them the facts, it's such a dynamic thing and tell them that you're staying on top of it. I feel like every physician should at least stay on top of this subject since it's so popular. I mean, I'm a GI physician and I've had cases consult cases that I think related to their THC laden vape products, after ruling out everything else. I have one or two in the last couple of months I feel. But I think telling them the truth and let them know, be honest and tell them that we don't know. So why would you want to take something that's such sketchy that you don't know what's actually happening currently? I think the best thing would be tell them they should be stay up to date and we should all just work on this together. Figure out what's actually causing the issues. Obviously you want to caution to decrease their usage overall.

Dr. Berry Pierre:
Especially the THC. I got question, is there any THC that I can do vaping? Is there any that have been federally stamped and given the okay or should I just be really staying away from all THC related products right now?

Dr. Andrew Berry:
Personally I would say there is small of them. But I think there is some states that have traditionally been selling the THC, especially the medical aspect. Physical stores that have been doing it for a while. And it's a tricky, tricky subject because it's not really regulated. So I wouldn't do it. I know the numbers are small. So you look at all the people that vape across the country in the world, you're saying, okay, only 19 deaths.

Dr. Berry Pierre:
Exactly and of course people always, well only have 19 people.

Dr. Andrew Berry:
Exactly. There's 19 people that got in a car accident today. But these are young healthy people. That's the thing. Okay. I mean these are people that shouldn't be getting sick, shouldn't in the ICU. There's gruesome photos online if you Google them of kids on ventilators, even one kid holding a sign that once you got extubated, I want to start a no vaping campaign. It went viral.

Dr. Berry Pierre:
This is definitely a topic. So I got to ask especially in your professional career, where you're at right now, where do you see vaping going from here? Because you're saying, you've got CEOs dropping out, you've got people losing a lot of money because of this, I don't want to call it a roadblock, but definitely there's bumps in the road. Where do you see vaping going?

Dr. Andrew Berry:
Well, on September 11th this year, President Trump wanted to ban vaping. Everybody's talk on banning flavored vapes because that's targeting those younger people. That’s the main target of their goal.

Dr. Berry Pierre:
Younger people aren't doing the non-flavored ones or is it just most of the time if it's flavored?

Dr. Andrew Berry:
I think they're getting a hook. I think a lot of them start on the flavor and then they advanced or progressed to the THC one. 80% of Juul sales are flavored, so the government is trying to hit the Juul market by stopping their flavored and they think if they can do that, they can stop the overall trend. My personal opinion from an economic standpoint is that this whole regulation, they'd probably will find some trace it to a couple companies, maybe a couple of chemicals, and that will wean out those companies and chemicals. And I think it actually may make Juul stronger because they don't have any THC products. It's all nicotine. So once they prove that their product is safe, I feel like a lot of kids will go back to it. (Wow). And it may get a little bit worse. That's my own opinion though.

Dr. Berry Pierre:
And I know especially because I know you talked about the almost three quarters of it being THC related. So we still got like that 25% that the nicotine related issues that are kind of still happening as well too.

Dr. Andrew Berry:
Correct or inhalational issues. I think some of these are having heat or caustic burns to the lung, sort of like a chemical pneumonitis. So that's on the differential. So the heat is, might be an effect also, but three quarters of them it is sure fire three quarters, I've checked all the numbers. Three quarters are usually men. Three quarters are usually younger under the age of 35 and three quarters. Usually THC is some sort of derivative. So those are the unhappy triad of things to avoid.

Dr. Berry Pierre:
Dr. Berry I wanted to thank you for really educating us and educating, especially me on a topic that is, like I said, as popular as it has been. Again, I felt like it just popped up out of nowhere. And then all of a sudden I see this crisis and almost every article that I read, I'm like, okay, alright. Write down my favorite again. I typed the vape again, nope. I typed the vape again, Nope. Read article. Everything just pop that in over. Thank you for helping enlightening us for such an important topic at hand that really does not seem to be, I guess by your words, does not seem to be going away anytime soon.

Dr. Andrew Berry:
No, I think it's just heating up literally.

Dr. Berry Pierre:
So before I let you go, I always love to really spotlight a guess. And like I said, I, I talked about it a little bit, especially in the beginning the fact that you got CV that's 24 pages. But tell people about just about yourself and where can they find you and what's next for you. Because like I said, I know you've got about a year and some change before you're out here, but clearly you're doing some things that I would love for our Lunch and Learn community, be able to follow it along. Tell us about your social media, any other ventures you may have coming up.

Dr. Andrew Berry:
I appreciate you letting me on. Basically, I'm not sure. Open mind. Just like the stock market, diversify your portfolio. You never know what opportunity you're going to get or were going to happen. Obviously, you never know. Obviously I'm set for medicine. I'd probably gonna do private practice, but academic twist to it. I like to publish on a lot of topics. A lot of my publications are not on the same topic.

Dr. Berry Pierre:
Yeah, which I know. I was like, wow, you were very wide range with it too. I know my fellows typically hyper focused, GI stuff, and I'm like, oh no, no, that's not even the case.

Dr. Andrew Berry:
Yeah. Some of the hot topics I like to hit because I think, well I talk about men to a syndrome when you're gonna see five this year. Might talk about vaping when you're gonna see five this hour. So I don't know, a social media, I like to follow a lot of things. An Instagram doctor pub med, and just something funny fitting. I guess Twitter I use sometimes mainly just to catch up on literature, but mainly Instagram. It's a great story. People want quick things as you do on your page. You've got a lot of links, a lot of quick things people are. It’s an inpatient market out there.

Dr. Berry Pierre:
Yeah. You right. Especially for attention. You gotta snatch their attention like, hey stop real quick.

Dr. Andrew Berry:
You've got to mix out audio, video, you gotta mix links. I don't know. You just got to keep it hot. No one wants to read about the same stuff. So that's the fact that you do all these podcasts and different people, different subjects keep the viewers on their toes, you know.

Dr. Berry Pierre:
Perfect. We would definitely appreciate your efforts. Remember Lunch and Learn community, all of his links will be in the show notes as well. Definitely follow him. I know you were talking about a YouTube page as well too. You have a YouTube as well?

Dr. Andrew Berry:
I have a YouTube page. I have a lecture that I gave a similar topics. I put it on YouTube. It's got video, audio. I got a little bit everything. You gotta hit all the markets.

Dr. Berry Pierre:
And remember Lunch and Learn community, if you want to watch videos, he's got stuff for you. If you want to just read, he's got a lot of stuff to read, I'm telling you. That's all I get. I'm not being facetious. There's a lot of stuff to read if you want to read. In fact, I was very interested and I have to get a read on the online symptom checker, I was like, oh, that's a topic.

Dr. Andrew Berry:
That's one of the topics I really like too. I have done some TV stuff with that and some of the vaping, it's a hot topic.

Dr. Berry Pierre:
What made you do that before I let you go? What made you like thinking, oh, you know what, we tackle there.

Dr. Andrew Berry:
Everybody, just like you and I know. Everyone, every day you're going to see somebody that comes and says, well, I looked it up online web MD, this and this, and we all have the same reaction internally, a little different externally. It just made me want to do it and I just checked the accuracy of these symptom checkers and let's just say it's not good.

Dr. Berry Pierre:
Not good. I love it. Here Lunch and learn community, please don't go to web MD and all these other places and click a couple of buttons and then come and tell me you have cancer. I don't want to hear it because web MD is always gonna sell high because they don't want to be the ones who say like, oh whoa, whoa we told them they had cancer and they didn't believe me. It was just a migraine. I guess that's all it was.

Dr. Andrew Berry:
Exactly. And now I guess right now a new study we could do, hopefully one of your viewers maybe wants to do this. You can check these injectors now for vaping. See if that's in a differential.

Dr. Berry Pierre:
It's so funny because as we've talked about it, I have not had one of my residents like throw it out in a different ritual.

Dr. Andrew Berry:
We can tell who's listening your podcast now so hopefully whoever does it definitely a listener.

Dr. Berry Pierre:
Exactly. So again Dr. Berry, thank you for really putting us on game. Putting the word out there. This is something that everyone needs to know and we'll make sure that happens. Such an important topic of vaping as it is.

Dr. Andrew Berry:
Thanks for having me. I appreciate your time.