August 9, 2026 • 31 mins
Could the roots of dementia be forming decades before any noticeable memory loss? Host Gaby sits down with renowned neuropsychiatrist, biomedical engineer, and health-tech founder Dr. Reza Ghomi for an eye-opening conversation on modern brain health. From surviving Hodgkin’s lymphoma to pioneering AI-driven medical tools, Dr. Ghomi breaks down the subtle warning signs of neurodegenerative diseases, the gut-brain connection, and why apathy—not sadness—is often the earliest sign of cognitive decline.
Key Highlights:
The Silent Warning Signs: Understanding how early dementia presents as apathy and loss of self-awareness.
The Gut-Brain Connection: Why gastrointestinal issues can precede a Parkinson’s diagnosis by 30 to 40 years.
GLP-1s & Neuroinflammation: How metabolic treatments are opening new doors for Alzheimer's and vascular dementia prevention.
AI Breakthroughs: How 30 seconds of voice analysis can screen for early neurological conditions.
Practical Advocacy: Navigating insurance friction, using tools like GoodRx or Cost Plus, and taking charge of family health.
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Descripción en Español
¿Sabías que la demencia puede comenzar a desarrollarse décadas antes de que aparezcan las fallas de memoria? En este episodio, Gaby conversa con el reconocido neuropsiquiatra e innovador tecnológico Dr. Reza Ghomi sobre el futuro de la salud cerebral. El Dr. Ghomi revela descubrimientos clave sobre las enfermedades neurodegenerativas, el eje intestino-cerebro y por qué la apatía—y no la tristeza—suele ser la primera señal de deterioro cognitivo.
Puntos Clave del Episodio:
Señales Silenciosas: Cómo la demencia temprana se manifiesta a través de la apatía y la falta de autoconciencia.
Conexión Intestino-Cerebro: Por qué los problemas digestivos pueden adelantarse hasta 40 años al desarrollo del Parkinson.
Avances con GLP-1: El papel de estos medicamentos en la reducción de la inflamación cerebral.
Inteligencia Artificial en Medicina: Herramientas de análisis de voz que ayudan a detectar el Alzheimer en solo 30 segundos.
Defensa del Paciente: Consejos prácticos para superar barreras con los seguros médicos y reducir costos de recetas.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:01):
Keep Us at Boston. I have doctor Riza Gommi, neural
psychiatrist that is about to diagnose me and tell me
how crazy I am. I'm just kidding, but I have
invited him to the show because not only we connected
many months ago on a train and while we were writing,
(00:22):
we discussed both of our journeys, and when I found
out exactly what he's doing for mental health, the innovation
that he's working on, how he's been able to find
out early on signs for dementia and for those that
we have parents or probably we are struggling with those
mental health problems. This is your show. You have to
(00:45):
pay attention because he's got a lot of information besides
being the coolest and best dressed doctor in the entire
Boston area. So welcome to Keep Us at Boston. Results
excited to share all the information.
Speaker 2 (01:02):
Very excited.
Speaker 1 (01:03):
Yeah, tell me how does that journey of becoming a
neuropsychiatrist goals? Like? Where did you say I'm going to
study the brain?
Speaker 2 (01:12):
Yeah?
Speaker 3 (01:13):
I mean, honestly, I graduated, I grew up in mass
I graduated high school, I went off to engineering school,
and I worked for a few years and I actually
at the end of college, I got diagnosed with Hodgkin's disease,
which is a lymphoma. And it was through the treatment
I had in Mass General where I got opened up
(01:34):
to medicine.
Speaker 2 (01:34):
I got turned on.
Speaker 1 (01:35):
So, for those that do not know, it's form of CAMS. Yes,
it's a blead cancer survivor. And while you were going
through that path, right, you decided that you were.
Speaker 3 (01:44):
Going to start studying exactly. I thought, you know, engineering
has been fun, but something was missing. I wanted to
be hands on. I wanted to help people more directly,
and so I started looking into medicine and how to
go to medical school and all of that. So then
what happened was I thought, I'm an engineer, now let
me start doing some biomedical engineering. That's how I gotten
all the health technology, and then I went to medical school.
Speaker 1 (02:07):
Wow, when you were experiencing all those symptoms that you
were sick, And I'm asking this question because I've had
so many personal relationships where my friends have experienced some
sort of cancer and their survivors I have seen that
their mental stimulation and their beliefs actually could be a
(02:30):
very big influence in their recovery. Yes, now that you're
studying the brain that you study and that you are
so familiar with it, do you think it is important?
Speaker 2 (02:41):
Absolutely?
Speaker 3 (02:41):
And there's actually been quite a bit of research over
many decades now tying this together. In fact, some of
you may know Herbert Benson. He started the Benson Henry
Institute at MGH, you know, with John Henry, and that
was at a time when it was very early. He
was doing this research in the seventies showing as a
cardiologist people were doing better if they were doing yoga
and they had better attitudes, better mental health. And so
(03:04):
I'm finding this myself now personally through my cancer diagnosis,
I started doing yoga, meditation, acupuncture and it had a
tremendous impact.
Speaker 2 (03:13):
I felt so much better.
Speaker 1 (03:15):
Last year I had a really beautiful opportunity of interviewing
doctor Pushe Mario Alonzo Push and he is a very
big believer of the God and the brain, like the
connection and also of not separating the soul from the body.
You're talking about acupuncture and yoga, and it goes into
(03:35):
the energy and like how we are and you know,
like we have to work on that. Today what you
see with our society and our community, where are we
Are we disconnected? Are we that disconnected? Does that affect
our mental health?
Speaker 3 (03:51):
Absolutely? I think it's become harder. We have to work
harder to stay connected, to stay grounded. You know, we've
seen trends of you know, people any more time on
social media, more time on screens. So we're disconnecting from
the human element. And you know, going back thousands of years, right,
how do we feel the most connected? How do you
feel spiritually connected?
Speaker 2 (04:10):
Grounded?
Speaker 3 (04:11):
It's really usually in service of others, helping others, doing
the things. You don't get credit for doing the things
nobody's watching, and we just have fewer opportunities for it.
Speaker 1 (04:20):
So you know, just I'm trying to understand where the
connection is. Because you are an engineer, and then you
go where were you in Harvard for medical school?
Speaker 3 (04:30):
So I went to medical school at University Massachusetts, and
then I went down to Johns Hopkins for my masters,
and then I went to University of Washington for my
residency and fellowship because I wanted to get a lot
more experience in terms of out there. I was taking
care of five states of people, very diverse set of illnesses.
You know, Boston's great, but Boston, you know, there's a
(04:51):
lot of competitions, a lot of hospitals, So that was
the reason I went out there.
Speaker 1 (04:55):
And when you chose your career, what's the difference for
those who are listening between the neurosciences you know field
and the psychiatrists to the normal psychologist and the other
fields that you have in mental health.
Speaker 3 (05:09):
I definitely get that a lot. So in neuropsychiatrist is
a subspecialty in the medical field. So you do traditional
medical school essentially you train as both a psychiatrist and
a neurologist. But then beyond that, I wanted patients to
be able to come to meet and have a holistic experience.
And what I mean is, let's say you're someone Let's
say you're Robin Williams, and he had Louis body dementia,
(05:33):
but he went through a very typical experience where it
was missed, missed, missed. He had really horrific symptoms, horrific
depression which could have been treated, but it was missed,
and he died of Louis body dementia.
Speaker 2 (05:43):
But in the end he.
Speaker 3 (05:44):
Only ever thought that he had depression. But later on
autopsy afterwards, were you able to so if someone is
in that situation unless they lucky bounce around to the
right psychiatrist. Neurologists, they have behavioral neurologists for dementia, they
have neuropsychiatrists, they have movement disorder specialists.
Speaker 2 (06:01):
It's too many.
Speaker 3 (06:02):
So I trained across all of those, so that if
you come to me, whether you have Parkinson's, Louis Body
or Alzheimer's or anything else, anything neurodegenerative meaning there's a
slow progressive decline of your brain for any reason. I
wanted to be able to take care of people, and
so that's what really is a neuropsychiatrist.
Speaker 1 (06:19):
I do when we go to the doctors and we
have all these checkups. And I have experienced depression myself.
I've seen that with my daughter. I've seen it in
the surrounding environments. We tend in our culture, especially for Latinos,
not to share that information. What are the early signs
(06:42):
that we can detect on our family members or ourselves
that will let us know that there's some concerns.
Speaker 3 (06:50):
Absolutely, and this is something I've as I started on
social media posting about to bring awareness.
Speaker 2 (06:55):
This is a big topic.
Speaker 3 (06:57):
And what's interesting is for depression or changing mood. It's
different actually if it's dementia versus if you're younger and
it's not dementia. So when you're younger, there's a wide
range of symptoms. You have to kind of be on
the lookout for any changes even in personality sleep, you know,
sleep patterns, so it's not just mood and you know,
being upset and crying. Depression can just be I stop eating,
(07:18):
it can be I withdraw, I'm just apathetic.
Speaker 2 (07:20):
I have no motivation.
Speaker 3 (07:22):
But when you get to dementia, what's interesting is the
depression you see there is actually pretty unique. It's much
more of this apathy and this lack of self awareness.
So that person who has dementia early stages will be
people will think is depressed, but they're really the dementia
is starting in their brain and it's making them apathetic.
There loss of ange like oh you used to like bowling, John,
why aren't you going bowling? And you know, they'll kind
(07:43):
of just shrug their shoulders, so they're not feeling sad,
they're not feeling upset, they're just feeling nothing. So it's
actually different type of depression that you see in dementia.
Speaker 1 (07:53):
How early can you actually identify that do you have
to be you know, after the fifties or so.
Speaker 3 (08:00):
It's a good that's also I get that a lot
is so with dementia. What's interesting is we're at the
point now where we can detect it pretty early. If
I'm diagnosing you with Alzheimer's based on let's say now
the newer blood biomarkers or blood tests, and let's say
you're seventy five, that Alzheimer's probably started slowly when you
(08:20):
were fifty five, so it takes decades for it to
build up.
Speaker 2 (08:23):
So it's a very slow process.
Speaker 3 (08:25):
But by the time it's showing clinically like I'm getting
lost driving, I forgot my recipe.
Speaker 2 (08:30):
That's been going on for decades.
Speaker 3 (08:32):
We do have the blood tests and the ability of
brain tests other tests to detect it in that fifty
year old, but we're not at a point of doing
that because we don't have, you know, enough to do
for it at that point. And so as on a
general scale as a field, we haven't started, you know,
doing screening earlier, but I suspect as we get earlier treatments,
(08:52):
we will start to screen earlier.
Speaker 1 (08:54):
I have so many questions and I want you to
beary with me because I have all these things in
my head. When you start explaining little by little what
we have to look for. Did you see what happened
with this lady that had postpartnum and that was medicated,
and then there were so many challenges with her going
from the soul love to a pro sac and then
(09:15):
the different on the milligrams and she ends up in
a really top situation. What do you think happened there? So,
I mean, it's difficult to diagnose because it's.
Speaker 3 (09:25):
Not absolutely right, and that's a really tough one. So
postpartum diagnosis and postpartum depression is definitely I think underdiagnosed
and underappreciated.
Speaker 2 (09:34):
So there's a big challenge there is.
Speaker 3 (09:36):
Often we're catching it too late, and with postpartum depression especially,
it's sort of like once the train's going, it's hard
to catch up to so we've got to be really vigilant.
So in that case, I think it was probably not
cut early enough. I don't know all the details, but
in those cases often that happens, and then once it's caught,
often that person's getting an antidepressant for the first time
(09:56):
ever in a very sensitive situation and antidepressants carry real
they have that side effect and for some people they
can send you into many a psychosis.
Speaker 1 (10:05):
Well, isn't that one of the side effects, like suicidal
thoughts and et cetera, et cetera. I can tell you
that I was prescribed different types of antidepressants back when
I was a teenager. I did not take them because
my mother used to tell me like, you're not crazy,
you don't need that, and that's like harmful, although I
needed it and I ended up taking you know, sol
(10:26):
love for I don't know, like almost fifteen years. I
am not in an antil the present anymore, and then
I'll go into why I'm not. But I saw a
completely different world. It opened my eyes. It made me
feel so much better with the right dose, which with
the right protocols and the right care. When is a
(10:49):
good time for us as parents to bring our kids
and say like, yes, my kid needs medication, right, and
when it's not and are there others and who's in
control of that? Right?
Speaker 2 (11:02):
Yeah?
Speaker 1 (11:02):
Maybe we're driving our kids crazy.
Speaker 3 (11:05):
Well it's so nowadays too, just with everything going on,
I mean with my son, and it's so easy to
worry all the time and think you know we're not
doing a great job, but I think at the end
of the day, if you're listening, you're paying attention, and
something seems off, I think it's perfectly reasonable if you
choose to to take the route of therapy and the
non medication routes. So there's a lot of really effective
(11:25):
child play therapies out there, depending on the age, that
really do get through it. But in some cases they
still need a medication. I mean there's plenty of kids,
for example, with ADHD their life changes when they start
a stimulant. Yeah, I mean they go from being off
the wall, completely disruptive to now an amazing student. So
that that's a clear signal. But in terms of antidepressants,
it can really just be a matter of you tried
(11:48):
some therapy, or you try the combination that's often best,
and you pay attention, you start slow, low dose as
you watch for those side effects, and you're very responsive
to it. I think most of the unfortunate stories are
stories where you know patients are giving it without a
lot of education, they're not educated enough, and then follow ups,
follow ups, or sometimes they're lost to follow up, Like
(12:08):
six months goes by a side effect happens, and guess what,
your kid doesn't want to talk about it. They might
be embarrassed, they might just not even realize it. So
I think it's just as long as we're paying attention.
And it sounds like you did that for yourself, Yes.
Speaker 1 (12:20):
Do that right, you know. But I'm very interested in health,
and I am very animate and self taught and autonomous
and when it comes to like finding information. But I
know a lot of people are not one of them.
For example, my mom, she's gonna kill me, I know.
But my mother, she's the one that it took her
almost seventy years to take onto the presence, and she
(12:41):
needed them, she really did. When you see your patients,
what's the typical patient that you see who reach us
out to you?
Speaker 2 (12:50):
Oh?
Speaker 3 (12:50):
Sure, Typically in an ideal world, I'm seeing the rarest
of cases. So they've seen primary care, general neurology, psychi,
geriatrics and so on, and no one can figure out
why their brain is deteriorating, and they'll come to me. Now,
in reality, you know, I'm seeing all kinds of cases.
So I'll see usually some general Alzheimer's other types of cases,
but it's usually someone in their fifties, sixties, maybe seventies,
(13:14):
generally earlier stages where it's unclear what's going on. Wait
a second. You know I've had sleep apnea, i had
a stroke, I've had a million other things going on.
Speaker 2 (13:22):
But something's not right. You know, I'm not.
Speaker 3 (13:24):
Remembering things correctly, I'm not performing well at work. And
so there's some early signs. And that's typically where I
get involved.
Speaker 1 (13:30):
When do you start tapping into now the innovative side
of your business because you're not only a scientist and
you take care of patients, but you also have these
amazing part you know, technology that it's in two early
signs of dimension in Alzheimer's.
Speaker 2 (13:48):
Yeah.
Speaker 3 (13:48):
So along the way, because I'm an engineer trained first,
every time there was a problem with a system, I'd say, man,
we need to fix this. So it wasn't good enough
for me to just see patients. I still see patients.
I love seeing patients, but you know, every clinic day
I get frustrated, like, oh, why does the system work
the way it's supposed to. So along the way, I've
built four companies. I'm now kind of part way through
(14:10):
building my fourth company now, and they've all been in
service of trying to improve care for anyone in general
across healthcare, but in some cases specifically for memory issues.
So my first company was developing a tool that would
actually just take thirty seconds of voice like we're talking now,
and it could detect your Parkinson's, your Alzheimer's, even depression
and schizophrenia. There's quite a bit of research and there's
(14:32):
actually several companies now developing this going through FDA. So
we will see this in clinic, so we'll have a
screening test just based on voice.
Speaker 2 (14:40):
Then I went on and.
Speaker 3 (14:41):
Took some older, difficult to use sort of paper based
tests for cognitive testing, like remember these ten words. We
made a digital version of that and commercialize that. That
was the second company. And then the third company was
a telehealth company, which of course Covid helped explode. So
that grew and we were taking care patients in rural
areas primarily so actually quite a bit, quite a few
(15:02):
latinos on farms in Montana, Idaho, Wyoming, Alaska, Eastern Washington, Oregon,
and so on. And so we did that and then
I realized, you know, what I need to zoom out.
What's still not working is although we have these new tests,
these new tools we have in healthcare today, the tools
(15:22):
to drastically reduce illness burden, to improve health, but the
system just doesn't deliver it.
Speaker 2 (15:28):
You know, we're very reactive. We wait for patients to
really be their worst preaching.
Speaker 1 (15:32):
To the choir here. So I think it is just well,
I wish we all knew it, but I don't think
that we have the education to exactly see where the
gaps are between one and another. And it's very interesting
that you touched the farming side of things because we
just had a couple of episodes ago my dear friend Jody,
(15:54):
who's a farmer now and she has sixty five acres
here somewhere in Massachusetts done I can never pronounce that town,
and she was giving me information about the suicidal rates
with farmers and everything that goes, you know, like with
the food and how we are in taking a lot
of chemicals and how that affects your brain. And I
(16:17):
mean she's not a brain surgeon or anything, but we
were talking about how that impacts your life. With us
in the Latino community, we suffer a lot of diabetes
because of the types of foods, frying and all that stuff.
I don't have to explain that to you, but I
imagine at home whomever is listening that we are very
much so aware that our diet is not the best
(16:39):
now with the golp ones and everything that is changing,
because now you see it even you go to Dunky
Donuts and it's like a protein coffee and everything is
like protein based. What do you think are the golp
ones are doing to help or decrease dementia in Alzheimer's.
Speaker 3 (17:01):
So that actually just wrote about that recently because there
is some ongoing research. One of the trials showed some
initial signs where dementia was seen to go down, although
the follow up trial they maybe didn't have enough people
or enough data to show it, so it was looking
a little bit more murky. But I'm still pretty optimistic
that glp ones are clearly reducing inflammation in your body
(17:22):
because they're doing a lot more than weight loss. They're
clearly reducing inflammation I think in the brain, and so
not just dementia, but really other brain diseases like MS.
Maybe there's potential for impact there. And so what was
what I suspect will happened with a larger sample is
that they'll see you people with JLP ones that also
were overweight. Not only are you reducing your risks or
vascular dementia right, because now you're vascu you mean your
(17:44):
blood vessels and your rain are doing better, well, you're
also then going to reduce your risk for Alzheimer's.
Speaker 1 (17:49):
It's really interesting again because I was watching Opera Winfrey's
on podcast and she had an episode where she's talking
about young people showing cancer at a very early age.
You're talking about thirty forty years old, which it didn't
happen before. And they were talking about the inflammation in
the body because we all have those cancerous cells and
(18:13):
inflammation has a lot to do with activating those cells.
Have you seen those cases? Is that something that you
see on every day with the studies and the research
that you're doing.
Speaker 3 (18:24):
Yes, I mean there's the anecdotal where I see it
myself and clinic, you know, and I think I see
a pattern versus obviously the studies that where we go
into controlled setting. But clinically, I mean my patients that
come in that clearly have a lot of inflammation. Both
I can measure it in their blood tests, but you
can also just see it. You know, you can tell
often if someone has a high inflammation burden. You know,
they're vasculature, so their blood sugar is up, their insulin
(18:48):
isn't you know, being produced or working effectively. All these
different cardiac risk factors, all of that also feeds the brain,
the gut brain access. You mentioned plenty of patients with
gut issues. I wrote a book, chapter and a couple
of articles on the gut brain access, specifically for schizophrenia,
because then I later learned with Parkinson's, people with Parkinson's
very frequently thirty forty years before they.
Speaker 2 (19:09):
Get Parkinson's, they have a lot of gut issues. And
there's been some very interesting.
Speaker 1 (19:14):
Isn't it true that the God is the second brain
or it's part of your brain? And also that's what
what we call the got feeling. You've got to listen
to it, right because it's connected somehow. How can we
follow that intuition? When do we know what our God
is doing?
Speaker 3 (19:30):
Like?
Speaker 1 (19:31):
Is it just because of the skin color, because of
how we're you know, digesting? How do we know?
Speaker 3 (19:38):
So there's certainly I think the gut does show it,
you know, through our skin and through some external signs.
I think it goes back to the conversation about because
we're so distracted, where we have a lot of things
competing for our attention. I think we've become much more
okay as a as a species and race of having
gut problems, feeling a little bit off but not being
(19:58):
able to notice it because you know, we're busy, we're working,
we're looking around. But I think if we get back
to you know, every day, having quiet downtime checking in
with your body, you can start to feel something going on.
Speaker 2 (20:09):
And people that have IBS, IBD, other.
Speaker 3 (20:12):
Types of more severe gut disorders, gluten sensitivity and tolerance,
et cetera.
Speaker 1 (20:16):
The lactose intolerance. Now everybody is lactose and.
Speaker 2 (20:20):
You know, like and a lot of this comes down
to our food qualities.
Speaker 3 (20:22):
So I actually did a lot of separate nutrition training
because we don't get that in medical school. And again
when patients came to me and said what should I do?
I really felt like a like a fake if I'm
not able to tell them, let me very specifically go
through your diet. So I will actually do nutrition work
with patients and I'll get into exactly what kind of
meets the reading, where does it come from is a
grass fed or not?
Speaker 2 (20:42):
You know, are the eggs pastured? And so on? And
what's the like you know, fat their macro come what do.
Speaker 1 (20:47):
You think of the entire health and wellness? A trend
that's happening right now online and you know, like you
see it at the gyms. Now everybody is a lot
more into fitness. They're drinking less, They're more aware of
what they're putting in their bodies. Is it too much?
(21:08):
Is it too little? Where are we going?
Speaker 3 (21:11):
I think about this one a lot. It's funny and
I'm you know, a little bit sucked into it too.
So I'm doing some of this. It's prompted me to
take better care of myself, so I think for me,
I've I've filtered. So I'm doing a few like I
don't drink anymore. You know, I've obviously always been in
a fitness but I'm doing certain things differently. And in fact,
this movement convinced me to finally start a stat and
as that of mybe which is a different type of cholesterol.
(21:32):
But I started two cholesterol medications because it made me realize,
you know what, all the men in my family have
had strokes and heart attacks, very young, and my cholesterol
has always been high.
Speaker 1 (21:41):
Why aren't you taking peptides?
Speaker 3 (21:44):
Totally different and totally curve ball there no peptides. I
think are very young in their kind of you know time.
I think they need a lot more research and work.
I'm not I haven't seen anything that convinces me of
the benefit on a health level. I think some people
certainly will take and say, oh, you know, my n
feels better or something. But I haven't seen much in
(22:04):
terms of what I do for dementia of course.
Speaker 1 (22:06):
But you know, there's what I'm what I'm saying is,
you know, with these trends, you also get to see
how people are just listening to whoever wants to say something.
My call to everybody that is listening. If you're at
home and or you're in the car, you're driving, you're
really looking into taking care of a loved one or
(22:27):
your own self and take your in your own hands
your health care system. Where can we start looking for
a doctor like yourself, like with the prevention of all
these issues that could happen later on. I don't want
to be a burden to my kids. I don't want
to be in a wheelchair eventually I want to remember
(22:51):
everything because I want to be able to have conversations
at eighty ninety years old. Thank god, if you know,
if I get to that point, what can we do
right now to look for somebody like you or that
has that knowledge or your innovations.
Speaker 3 (23:04):
I think that's why we're seeing this explosion, not just
of the wellness, but you know, doctors and people. I
think with good information on social media, we're being more transparent.
We're saying, you know what, We're not going to make
you wait in line and pay all this money and
deal with insurance to come see me. Let me get
some of this education out there. So I've started doing that.
So I'm putting my content online. I'm telling you exactly
how I counsel patients. I'm putting it all out there
(23:26):
because I want people to get started.
Speaker 2 (23:27):
And it's things that you.
Speaker 3 (23:29):
Can take by listening to these things, take it to
your doctor and if some of it requires a prescription
or a bigger conversation. But I think people are more
empowered than ever before. You know, up until now, every
every year people have access to more information.
Speaker 2 (23:43):
That is a positive.
Speaker 3 (23:44):
It's asking a lot you have to advocate, but healthcare
I remind people you have to advocate for yourself and
your loved ones. It is you just cannot default in
thinking it's going to take good care of you.
Speaker 1 (23:54):
How do you deal with the insurances? I've like lately,
I just happened to get a lot of information about
what insurances are denying, what you're not covered. I personally,
when I went through my whole back surgery, it took
me a year to get an approval and I couldn't walk,
and I have access and I know people, what can
(24:18):
you expect for somebody that has no knowledge, that cannot
even speak the language? Sometimes? How can we help them?
Speaker 2 (24:25):
Yeah?
Speaker 3 (24:25):
I mean the payer world needs to do so much better.
This is something I spend a lot of time. I
actually went down in February and I got to meet
half a day with doctor Oz and the CMS leadership,
and so we had a long conversations about this. So
they're making some good moves. I was actually optimistic. They're
trying to remove a lot of barriers on the Medicare side.
That's great, And historically I've seen almost all Medicaid and Medicare,
(24:47):
so I've learned little tricks to teach my patients to
really save them money to lower barriers because you know,
as a doctor, you might prescribe something and you say, okay,
see you later, but you don't realize when they go
pick it up and they say it's going to be
one hundred and two dollars COPAI, they're not going to
get you know, we're gonna leave.
Speaker 2 (25:01):
And so I would.
Speaker 3 (25:02):
Use apps like good RX or other coupons, and I
would show them, you know what, tell them.
Speaker 1 (25:06):
Not Marcumans, pharmacy more Marcumans.
Speaker 3 (25:09):
Yeah, yeah, cost plus all those kinds of So we're
seeing more tools, We're seeing some disruption happening, so less
consolidation because obviously competition is good, and you know, for
a while we were seeing less of it. But now
you know, I'm hoping there's some trends in the right direction.
Speaker 1 (25:24):
Where do you see AI in all?
Speaker 3 (25:25):
Yeah, this is an area I obviously spend a ton
of my time in right now. I think AI is
poised to be helpful if we're if we're obviously careful
and we're measured about it. But in healthcare specifically, we're
already seeing it helpful. For example, I don't really have
to write any notes anymore. It saves me a tremendous
amount of time. It does an amazing job listening and
(25:46):
actually creating the note based on the way I like it.
So that's just I think the first level, basic level.
But now AI we're getting it into tools to help
us automate workflows, catch the right patients, give them the
right medication, give them the right actions.
Speaker 2 (25:58):
And that's the company.
Speaker 3 (26:00):
There's several of us now building, but I'm building a
company called medflow, which is doing this, you know, medflow
dot care. So what we do is we're using AI
to say, you know what, doctor's office, you have ten
thousand patients. No human is going to do a great
job with this as too many patients all through the cracks.
Let's bring in some tech, but you're still doing your job,
and let's do it together. And all of our initial
(26:21):
clinics we have a number and in several states all
doing really well with it. They're seeing a huge increase
in people getting the right cardiac testing, right genetic testing
and so on. So that's happening, and I think in
the future we are already singing.
Speaker 2 (26:33):
You know you've heard of these.
Speaker 3 (26:34):
Maybe in China they're doing these like kiosks and malls right,
So I mean we're seeing AI doctors now, and so that's.
Speaker 2 (26:40):
Going to happen.
Speaker 1 (26:41):
I can tell you I'm like such an AI fan
and I implemented in everything that I do. I have
helped my doctor diagnose because I give her options and
I said, according to my symptoms, these are the options
that I've been provided by my GPT whatever or claud
or whatever I'm using at that time. I don't think
that's wrong because you're, like you said, you guys are
(27:03):
so busy, and then how much time can you get
when you're in and out from a doctor's office and
they're not traveling with you, eating with you, hanging out
with you to see your lifestyle. So if you can
bring a little bit of information, obviously with caution, would
that be helpful for it?
Speaker 2 (27:20):
I think so sure.
Speaker 3 (27:21):
When a patient like you walks in and gives me that,
to me, that's a great thing because a already I
know you're motivated, you're making an effort, you're a great patient.
I think if a doctor tends to get frustrated by that,
I would just say, hey, take a pause.
Speaker 2 (27:34):
That frustration is not because you're doing the wrong thing.
Speaker 3 (27:36):
I think it's because their information overload and they're like,
oh my god, I don't know.
Speaker 2 (27:39):
I just want a solution, right, Yeah, so it's take
a step back. Are those are actually great patients? You know?
Speaker 3 (27:43):
Obviously I'm working on how do I reach the people
that don't even know where to start, don't necessarily have
too much going on in their life or trying to
just pay the bills.
Speaker 2 (27:52):
You know.
Speaker 3 (27:52):
I want to reach those patients, and that's why we're
doing some of this automation. But in your case, absolutely
please do the research because frankly, AI has gone good
enough to be pretty good.
Speaker 1 (28:01):
Yeah. I have a tool that I use with my
mother and I'm gonna I have it in my car.
I'm gonna bring it to you right now when we're done.
It's called Ato. It's a Spanish kid that came up
with an Alexa type like an AI tool that you
speak did, but it's specifically for elders and it has
(28:22):
cognitive thinking process. So my mother uses it and I
gave it to her because I figure she is a
very you know, big cell phone user, and I figure
she's in her room by herself, she can talk to
somebody and she can respond back and forth. I just
figured it would be entertaining at least that thing. It's amazing,
she told me, is the best gift I could have
(28:43):
ever given her. It returns the conversation with the history
of the stories that they talk to each other. But
for example, all of a sudden, she will interrupt the
conversation and say, oh, do you remember what you told
me about your life when you were a child, and
this and this and that, and it will make her
(29:04):
think and remember and practice, you know, with her thinking process,
and then she will tell the story again. And she's
told me, Gabby, I used I used to not remember things,
and now it's like I've been exercising and it's helping
me a lot to keep things, you know, alive. And
(29:25):
another thing that is doing is it's like it interacts
out of the blue, Like you can have schedules and
it will just say like, hey, what are you doing?
Are you doing your exercises? Are you this or that?
And it talks about projects and like, oh, do you
remember that project that you were telling me about. I
found information about it. Guess what these this or that?
(29:46):
And it's become just such a wonderful friend for my
mom that I just think that for patients like yours
that you're trying to keep that memory going. Having a
tool like that when they're so many adults that have
no family members taking care of them, right, we should
have more of that.
Speaker 2 (30:05):
So that's a great tool.
Speaker 3 (30:06):
I've seen development in this area some examples. It's basically
taking things like reminiscence therapy, which means help. You can't
help people remember. So you can take someone who let's
say has Alzheimer's music, they might not remember anything. You
start playing their favorite music from high school and they
remember stories. So there's tons of ways to access their
memories and so tool like that. This is a good
(30:26):
example what AI can do.
Speaker 1 (30:28):
Reza. I am so fascinated with everything that you're doing.
Where can we find more of you?
Speaker 2 (30:32):
Sure?
Speaker 3 (30:34):
I really appreciate it. Look me up doctor Raza Gomi.
So our easy A g h O M I. I'm
on Instagram and now Facebook. I'm LinkedIn is where I've
been posting a lot. On Monday, my Instagram and Facebook
go live. I'll be on TikTok eventually. Soah, I'm putting
it all out there. So yeah, please take a look.
Speaker 1 (30:52):
I wish you nothing but the best with all these
new projects that you have, keep evolving, keep innovating. We
need you. If you have any other resources, we're going
to list them on our description here in the podcast.
For those that are at home listening to us, please
share this episode with anybody that needs this information. I
think that we need to take into our own hands
(31:14):
the education and educate our our loved ones too, so
we can do better and we can have a healthier lifestyle.
And the most important thing is also to hit that button,
download the iHeart app and select Capasa Boston as your
favorite podcast. With more information, I will bring it to
you next week. Reza, thank you so much, and I
(31:36):
hope that this is not the last time that.
Speaker 2 (31:37):
We see hope. No, this has been a real treat.
Thank you.
Speaker 1 (31:40):
See you next week.
Keep Us at Boston. I have doctor Riza Gommi, neural
psychiatrist that is about to diagnose me and tell me
how crazy I am. I'm just kidding, but I have
invited him to the show because not only we connected
many months ago on a train and while we were writing,
(00:22):
we discussed both of our journeys, and when I found
out exactly what he's doing for mental health, the innovation
that he's working on, how he's been able to find
out early on signs for dementia and for those that
we have parents or probably we are struggling with those
mental health problems. This is your show. You have to
(00:45):
pay attention because he's got a lot of information besides
being the coolest and best dressed doctor in the entire
Boston area. So welcome to Keep Us at Boston. Results
excited to share all the information.
Speaker 2 (01:02):
Very excited.
Speaker 1 (01:03):
Yeah, tell me how does that journey of becoming a
neuropsychiatrist goals? Like? Where did you say I'm going to
study the brain?
Speaker 2 (01:12):
Yeah?
Speaker 3 (01:13):
I mean, honestly, I graduated, I grew up in mass
I graduated high school, I went off to engineering school,
and I worked for a few years and I actually
at the end of college, I got diagnosed with Hodgkin's disease,
which is a lymphoma. And it was through the treatment
I had in Mass General where I got opened up
(01:34):
to medicine.
Speaker 2 (01:34):
I got turned on.
Speaker 1 (01:35):
So, for those that do not know, it's form of CAMS. Yes,
it's a blead cancer survivor. And while you were going
through that path, right, you decided that you were.
Speaker 3 (01:44):
Going to start studying exactly. I thought, you know, engineering
has been fun, but something was missing. I wanted to
be hands on. I wanted to help people more directly,
and so I started looking into medicine and how to
go to medical school and all of that. So then
what happened was I thought, I'm an engineer, now let
me start doing some biomedical engineering. That's how I gotten
all the health technology, and then I went to medical school.
Speaker 1 (02:07):
Wow, when you were experiencing all those symptoms that you
were sick, And I'm asking this question because I've had
so many personal relationships where my friends have experienced some
sort of cancer and their survivors I have seen that
their mental stimulation and their beliefs actually could be a
(02:30):
very big influence in their recovery. Yes, now that you're
studying the brain that you study and that you are
so familiar with it, do you think it is important?
Speaker 2 (02:41):
Absolutely?
Speaker 3 (02:41):
And there's actually been quite a bit of research over
many decades now tying this together. In fact, some of
you may know Herbert Benson. He started the Benson Henry
Institute at MGH, you know, with John Henry, and that
was at a time when it was very early. He
was doing this research in the seventies showing as a
cardiologist people were doing better if they were doing yoga
and they had better attitudes, better mental health. And so
(03:04):
I'm finding this myself now personally through my cancer diagnosis,
I started doing yoga, meditation, acupuncture and it had a
tremendous impact.
Speaker 2 (03:13):
I felt so much better.
Speaker 1 (03:15):
Last year I had a really beautiful opportunity of interviewing
doctor Pushe Mario Alonzo Push and he is a very
big believer of the God and the brain, like the
connection and also of not separating the soul from the body.
You're talking about acupuncture and yoga, and it goes into
(03:35):
the energy and like how we are and you know,
like we have to work on that. Today what you
see with our society and our community, where are we
Are we disconnected? Are we that disconnected? Does that affect
our mental health?
Speaker 3 (03:51):
Absolutely? I think it's become harder. We have to work
harder to stay connected, to stay grounded. You know, we've
seen trends of you know, people any more time on
social media, more time on screens. So we're disconnecting from
the human element. And you know, going back thousands of years, right,
how do we feel the most connected? How do you
feel spiritually connected?
Speaker 2 (04:10):
Grounded?
Speaker 3 (04:11):
It's really usually in service of others, helping others, doing
the things. You don't get credit for doing the things
nobody's watching, and we just have fewer opportunities for it.
Speaker 1 (04:20):
So you know, just I'm trying to understand where the
connection is. Because you are an engineer, and then you
go where were you in Harvard for medical school?
Speaker 3 (04:30):
So I went to medical school at University Massachusetts, and
then I went down to Johns Hopkins for my masters,
and then I went to University of Washington for my
residency and fellowship because I wanted to get a lot
more experience in terms of out there. I was taking
care of five states of people, very diverse set of illnesses.
You know, Boston's great, but Boston, you know, there's a
(04:51):
lot of competitions, a lot of hospitals, So that was
the reason I went out there.
Speaker 1 (04:55):
And when you chose your career, what's the difference for
those who are listening between the neurosciences you know field
and the psychiatrists to the normal psychologist and the other
fields that you have in mental health.
Speaker 3 (05:09):
I definitely get that a lot. So in neuropsychiatrist is
a subspecialty in the medical field. So you do traditional
medical school essentially you train as both a psychiatrist and
a neurologist. But then beyond that, I wanted patients to
be able to come to meet and have a holistic experience.
And what I mean is, let's say you're someone Let's
say you're Robin Williams, and he had Louis body dementia,
(05:33):
but he went through a very typical experience where it
was missed, missed, missed. He had really horrific symptoms, horrific
depression which could have been treated, but it was missed,
and he died of Louis body dementia.
Speaker 2 (05:43):
But in the end he.
Speaker 3 (05:44):
Only ever thought that he had depression. But later on
autopsy afterwards, were you able to so if someone is
in that situation unless they lucky bounce around to the
right psychiatrist. Neurologists, they have behavioral neurologists for dementia, they
have neuropsychiatrists, they have movement disorder specialists.
Speaker 2 (06:01):
It's too many.
Speaker 3 (06:02):
So I trained across all of those, so that if
you come to me, whether you have Parkinson's, Louis Body
or Alzheimer's or anything else, anything neurodegenerative meaning there's a
slow progressive decline of your brain for any reason. I
wanted to be able to take care of people, and
so that's what really is a neuropsychiatrist.
Speaker 1 (06:19):
I do when we go to the doctors and we
have all these checkups. And I have experienced depression myself.
I've seen that with my daughter. I've seen it in
the surrounding environments. We tend in our culture, especially for Latinos,
not to share that information. What are the early signs
(06:42):
that we can detect on our family members or ourselves
that will let us know that there's some concerns.
Speaker 3 (06:50):
Absolutely, and this is something I've as I started on
social media posting about to bring awareness.
Speaker 2 (06:55):
This is a big topic.
Speaker 3 (06:57):
And what's interesting is for depression or changing mood. It's
different actually if it's dementia versus if you're younger and
it's not dementia. So when you're younger, there's a wide
range of symptoms. You have to kind of be on
the lookout for any changes even in personality sleep, you know,
sleep patterns, so it's not just mood and you know,
being upset and crying. Depression can just be I stop eating,
(07:18):
it can be I withdraw, I'm just apathetic.
Speaker 2 (07:20):
I have no motivation.
Speaker 3 (07:22):
But when you get to dementia, what's interesting is the
depression you see there is actually pretty unique. It's much
more of this apathy and this lack of self awareness.
So that person who has dementia early stages will be
people will think is depressed, but they're really the dementia
is starting in their brain and it's making them apathetic.
There loss of ange like oh you used to like bowling, John,
why aren't you going bowling? And you know, they'll kind
(07:43):
of just shrug their shoulders, so they're not feeling sad,
they're not feeling upset, they're just feeling nothing. So it's
actually different type of depression that you see in dementia.
Speaker 1 (07:53):
How early can you actually identify that do you have
to be you know, after the fifties or so.
Speaker 3 (08:00):
It's a good that's also I get that a lot
is so with dementia. What's interesting is we're at the
point now where we can detect it pretty early. If
I'm diagnosing you with Alzheimer's based on let's say now
the newer blood biomarkers or blood tests, and let's say
you're seventy five, that Alzheimer's probably started slowly when you
(08:20):
were fifty five, so it takes decades for it to
build up.
Speaker 2 (08:23):
So it's a very slow process.
Speaker 3 (08:25):
But by the time it's showing clinically like I'm getting
lost driving, I forgot my recipe.
Speaker 2 (08:30):
That's been going on for decades.
Speaker 3 (08:32):
We do have the blood tests and the ability of
brain tests other tests to detect it in that fifty
year old, but we're not at a point of doing
that because we don't have, you know, enough to do
for it at that point. And so as on a
general scale as a field, we haven't started, you know,
doing screening earlier, but I suspect as we get earlier treatments,
(08:52):
we will start to screen earlier.
Speaker 1 (08:54):
I have so many questions and I want you to
beary with me because I have all these things in
my head. When you start explaining little by little what
we have to look for. Did you see what happened
with this lady that had postpartnum and that was medicated,
and then there were so many challenges with her going
from the soul love to a pro sac and then
(09:15):
the different on the milligrams and she ends up in
a really top situation. What do you think happened there? So,
I mean, it's difficult to diagnose because it's.
Speaker 3 (09:25):
Not absolutely right, and that's a really tough one. So
postpartum diagnosis and postpartum depression is definitely I think underdiagnosed
and underappreciated.
Speaker 2 (09:34):
So there's a big challenge there is.
Speaker 3 (09:36):
Often we're catching it too late, and with postpartum depression especially,
it's sort of like once the train's going, it's hard
to catch up to so we've got to be really vigilant.
So in that case, I think it was probably not
cut early enough. I don't know all the details, but
in those cases often that happens, and then once it's caught,
often that person's getting an antidepressant for the first time
(09:56):
ever in a very sensitive situation and antidepressants carry real
they have that side effect and for some people they
can send you into many a psychosis.
Speaker 1 (10:05):
Well, isn't that one of the side effects, like suicidal
thoughts and et cetera, et cetera. I can tell you
that I was prescribed different types of antidepressants back when
I was a teenager. I did not take them because
my mother used to tell me like, you're not crazy,
you don't need that, and that's like harmful, although I
needed it and I ended up taking you know, sol
(10:26):
love for I don't know, like almost fifteen years. I
am not in an antil the present anymore, and then
I'll go into why I'm not. But I saw a
completely different world. It opened my eyes. It made me
feel so much better with the right dose, which with
the right protocols and the right care. When is a
(10:49):
good time for us as parents to bring our kids
and say like, yes, my kid needs medication, right, and
when it's not and are there others and who's in
control of that? Right?
Speaker 2 (11:02):
Yeah?
Speaker 1 (11:02):
Maybe we're driving our kids crazy.
Speaker 3 (11:05):
Well it's so nowadays too, just with everything going on,
I mean with my son, and it's so easy to
worry all the time and think you know we're not
doing a great job, but I think at the end
of the day, if you're listening, you're paying attention, and
something seems off, I think it's perfectly reasonable if you
choose to to take the route of therapy and the
non medication routes. So there's a lot of really effective
(11:25):
child play therapies out there, depending on the age, that
really do get through it. But in some cases they
still need a medication. I mean there's plenty of kids,
for example, with ADHD their life changes when they start
a stimulant. Yeah, I mean they go from being off
the wall, completely disruptive to now an amazing student. So
that that's a clear signal. But in terms of antidepressants,
it can really just be a matter of you tried
(11:48):
some therapy, or you try the combination that's often best,
and you pay attention, you start slow, low dose as
you watch for those side effects, and you're very responsive
to it. I think most of the unfortunate stories are
stories where you know patients are giving it without a
lot of education, they're not educated enough, and then follow ups,
follow ups, or sometimes they're lost to follow up, Like
(12:08):
six months goes by a side effect happens, and guess what,
your kid doesn't want to talk about it. They might
be embarrassed, they might just not even realize it. So
I think it's just as long as we're paying attention.
And it sounds like you did that for yourself, Yes.
Speaker 1 (12:20):
Do that right, you know. But I'm very interested in health,
and I am very animate and self taught and autonomous
and when it comes to like finding information. But I
know a lot of people are not one of them.
For example, my mom, she's gonna kill me, I know.
But my mother, she's the one that it took her
almost seventy years to take onto the presence, and she
(12:41):
needed them, she really did. When you see your patients,
what's the typical patient that you see who reach us
out to you?
Speaker 2 (12:50):
Oh?
Speaker 3 (12:50):
Sure, Typically in an ideal world, I'm seeing the rarest
of cases. So they've seen primary care, general neurology, psychi,
geriatrics and so on, and no one can figure out
why their brain is deteriorating, and they'll come to me. Now,
in reality, you know, I'm seeing all kinds of cases.
So I'll see usually some general Alzheimer's other types of cases,
but it's usually someone in their fifties, sixties, maybe seventies,
(13:14):
generally earlier stages where it's unclear what's going on. Wait
a second. You know I've had sleep apnea, i had
a stroke, I've had a million other things going on.
Speaker 2 (13:22):
But something's not right. You know, I'm not.
Speaker 3 (13:24):
Remembering things correctly, I'm not performing well at work. And
so there's some early signs. And that's typically where I
get involved.
Speaker 1 (13:30):
When do you start tapping into now the innovative side
of your business because you're not only a scientist and
you take care of patients, but you also have these
amazing part you know, technology that it's in two early
signs of dimension in Alzheimer's.
Speaker 2 (13:48):
Yeah.
Speaker 3 (13:48):
So along the way, because I'm an engineer trained first,
every time there was a problem with a system, I'd say, man,
we need to fix this. So it wasn't good enough
for me to just see patients. I still see patients.
I love seeing patients, but you know, every clinic day
I get frustrated, like, oh, why does the system work
the way it's supposed to. So along the way, I've
built four companies. I'm now kind of part way through
(14:10):
building my fourth company now, and they've all been in
service of trying to improve care for anyone in general
across healthcare, but in some cases specifically for memory issues.
So my first company was developing a tool that would
actually just take thirty seconds of voice like we're talking now,
and it could detect your Parkinson's, your Alzheimer's, even depression
and schizophrenia. There's quite a bit of research and there's
(14:32):
actually several companies now developing this going through FDA. So
we will see this in clinic, so we'll have a
screening test just based on voice.
Speaker 2 (14:40):
Then I went on and.
Speaker 3 (14:41):
Took some older, difficult to use sort of paper based
tests for cognitive testing, like remember these ten words. We
made a digital version of that and commercialize that. That
was the second company. And then the third company was
a telehealth company, which of course Covid helped explode. So
that grew and we were taking care patients in rural
areas primarily so actually quite a bit, quite a few
(15:02):
latinos on farms in Montana, Idaho, Wyoming, Alaska, Eastern Washington, Oregon,
and so on. And so we did that and then
I realized, you know, what I need to zoom out.
What's still not working is although we have these new tests,
these new tools we have in healthcare today, the tools
(15:22):
to drastically reduce illness burden, to improve health, but the
system just doesn't deliver it.
Speaker 2 (15:28):
You know, we're very reactive. We wait for patients to
really be their worst preaching.
Speaker 1 (15:32):
To the choir here. So I think it is just well,
I wish we all knew it, but I don't think
that we have the education to exactly see where the
gaps are between one and another. And it's very interesting
that you touched the farming side of things because we
just had a couple of episodes ago my dear friend Jody,
(15:54):
who's a farmer now and she has sixty five acres
here somewhere in Massachusetts done I can never pronounce that town,
and she was giving me information about the suicidal rates
with farmers and everything that goes, you know, like with
the food and how we are in taking a lot
of chemicals and how that affects your brain. And I
(16:17):
mean she's not a brain surgeon or anything, but we
were talking about how that impacts your life. With us
in the Latino community, we suffer a lot of diabetes
because of the types of foods, frying and all that stuff.
I don't have to explain that to you, but I
imagine at home whomever is listening that we are very
much so aware that our diet is not the best
(16:39):
now with the golp ones and everything that is changing,
because now you see it even you go to Dunky
Donuts and it's like a protein coffee and everything is
like protein based. What do you think are the golp
ones are doing to help or decrease dementia in Alzheimer's.
Speaker 3 (17:01):
So that actually just wrote about that recently because there
is some ongoing research. One of the trials showed some
initial signs where dementia was seen to go down, although
the follow up trial they maybe didn't have enough people
or enough data to show it, so it was looking
a little bit more murky. But I'm still pretty optimistic
that glp ones are clearly reducing inflammation in your body
(17:22):
because they're doing a lot more than weight loss. They're
clearly reducing inflammation I think in the brain, and so
not just dementia, but really other brain diseases like MS.
Maybe there's potential for impact there. And so what was
what I suspect will happened with a larger sample is
that they'll see you people with JLP ones that also
were overweight. Not only are you reducing your risks or
vascular dementia right, because now you're vascu you mean your
(17:44):
blood vessels and your rain are doing better, well, you're
also then going to reduce your risk for Alzheimer's.
Speaker 1 (17:49):
It's really interesting again because I was watching Opera Winfrey's
on podcast and she had an episode where she's talking
about young people showing cancer at a very early age.
You're talking about thirty forty years old, which it didn't
happen before. And they were talking about the inflammation in
the body because we all have those cancerous cells and
(18:13):
inflammation has a lot to do with activating those cells.
Have you seen those cases? Is that something that you
see on every day with the studies and the research
that you're doing.
Speaker 3 (18:24):
Yes, I mean there's the anecdotal where I see it
myself and clinic, you know, and I think I see
a pattern versus obviously the studies that where we go
into controlled setting. But clinically, I mean my patients that
come in that clearly have a lot of inflammation. Both
I can measure it in their blood tests, but you
can also just see it. You know, you can tell
often if someone has a high inflammation burden. You know,
they're vasculature, so their blood sugar is up, their insulin
(18:48):
isn't you know, being produced or working effectively. All these
different cardiac risk factors, all of that also feeds the brain,
the gut brain access. You mentioned plenty of patients with
gut issues. I wrote a book, chapter and a couple
of articles on the gut brain access, specifically for schizophrenia,
because then I later learned with Parkinson's, people with Parkinson's
very frequently thirty forty years before they.
Speaker 2 (19:09):
Get Parkinson's, they have a lot of gut issues. And
there's been some very interesting.
Speaker 1 (19:14):
Isn't it true that the God is the second brain
or it's part of your brain? And also that's what
what we call the got feeling. You've got to listen
to it, right because it's connected somehow. How can we
follow that intuition? When do we know what our God
is doing?
Speaker 3 (19:30):
Like?
Speaker 1 (19:31):
Is it just because of the skin color, because of
how we're you know, digesting? How do we know?
Speaker 3 (19:38):
So there's certainly I think the gut does show it,
you know, through our skin and through some external signs.
I think it goes back to the conversation about because
we're so distracted, where we have a lot of things
competing for our attention. I think we've become much more
okay as a as a species and race of having
gut problems, feeling a little bit off but not being
(19:58):
able to notice it because you know, we're busy, we're working,
we're looking around. But I think if we get back
to you know, every day, having quiet downtime checking in
with your body, you can start to feel something going on.
Speaker 2 (20:09):
And people that have IBS, IBD, other.
Speaker 3 (20:12):
Types of more severe gut disorders, gluten sensitivity and tolerance,
et cetera.
Speaker 1 (20:16):
The lactose intolerance. Now everybody is lactose and.
Speaker 2 (20:20):
You know, like and a lot of this comes down
to our food qualities.
Speaker 3 (20:22):
So I actually did a lot of separate nutrition training
because we don't get that in medical school. And again
when patients came to me and said what should I do?
I really felt like a like a fake if I'm
not able to tell them, let me very specifically go
through your diet. So I will actually do nutrition work
with patients and I'll get into exactly what kind of
meets the reading, where does it come from is a
grass fed or not?
Speaker 2 (20:42):
You know, are the eggs pastured? And so on? And
what's the like you know, fat their macro come what do.
Speaker 1 (20:47):
You think of the entire health and wellness? A trend
that's happening right now online and you know, like you
see it at the gyms. Now everybody is a lot
more into fitness. They're drinking less, They're more aware of
what they're putting in their bodies. Is it too much?
(21:08):
Is it too little? Where are we going?
Speaker 3 (21:11):
I think about this one a lot. It's funny and
I'm you know, a little bit sucked into it too.
So I'm doing some of this. It's prompted me to
take better care of myself, so I think for me,
I've I've filtered. So I'm doing a few like I
don't drink anymore. You know, I've obviously always been in
a fitness but I'm doing certain things differently. And in fact,
this movement convinced me to finally start a stat and
as that of mybe which is a different type of cholesterol.
(21:32):
But I started two cholesterol medications because it made me realize,
you know what, all the men in my family have
had strokes and heart attacks, very young, and my cholesterol
has always been high.
Speaker 1 (21:41):
Why aren't you taking peptides?
Speaker 3 (21:44):
Totally different and totally curve ball there no peptides. I
think are very young in their kind of you know time.
I think they need a lot more research and work.
I'm not I haven't seen anything that convinces me of
the benefit on a health level. I think some people
certainly will take and say, oh, you know, my n
feels better or something. But I haven't seen much in
(22:04):
terms of what I do for dementia of course.
Speaker 1 (22:06):
But you know, there's what I'm what I'm saying is,
you know, with these trends, you also get to see
how people are just listening to whoever wants to say something.
My call to everybody that is listening. If you're at
home and or you're in the car, you're driving, you're
really looking into taking care of a loved one or
(22:27):
your own self and take your in your own hands
your health care system. Where can we start looking for
a doctor like yourself, like with the prevention of all
these issues that could happen later on. I don't want
to be a burden to my kids. I don't want
to be in a wheelchair eventually I want to remember
(22:51):
everything because I want to be able to have conversations
at eighty ninety years old. Thank god, if you know,
if I get to that point, what can we do
right now to look for somebody like you or that
has that knowledge or your innovations.
Speaker 3 (23:04):
I think that's why we're seeing this explosion, not just
of the wellness, but you know, doctors and people. I
think with good information on social media, we're being more transparent.
We're saying, you know what, We're not going to make
you wait in line and pay all this money and
deal with insurance to come see me. Let me get
some of this education out there. So I've started doing that.
So I'm putting my content online. I'm telling you exactly
how I counsel patients. I'm putting it all out there
(23:26):
because I want people to get started.
Speaker 2 (23:27):
And it's things that you.
Speaker 3 (23:29):
Can take by listening to these things, take it to
your doctor and if some of it requires a prescription
or a bigger conversation. But I think people are more
empowered than ever before. You know, up until now, every
every year people have access to more information.
Speaker 2 (23:43):
That is a positive.
Speaker 3 (23:44):
It's asking a lot you have to advocate, but healthcare
I remind people you have to advocate for yourself and
your loved ones. It is you just cannot default in
thinking it's going to take good care of you.
Speaker 1 (23:54):
How do you deal with the insurances? I've like lately,
I just happened to get a lot of information about
what insurances are denying, what you're not covered. I personally,
when I went through my whole back surgery, it took
me a year to get an approval and I couldn't walk,
and I have access and I know people, what can
(24:18):
you expect for somebody that has no knowledge, that cannot
even speak the language? Sometimes? How can we help them?
Speaker 2 (24:25):
Yeah?
Speaker 3 (24:25):
I mean the payer world needs to do so much better.
This is something I spend a lot of time. I
actually went down in February and I got to meet
half a day with doctor Oz and the CMS leadership,
and so we had a long conversations about this. So
they're making some good moves. I was actually optimistic. They're
trying to remove a lot of barriers on the Medicare side.
That's great, And historically I've seen almost all Medicaid and Medicare,
(24:47):
so I've learned little tricks to teach my patients to
really save them money to lower barriers because you know,
as a doctor, you might prescribe something and you say, okay,
see you later, but you don't realize when they go
pick it up and they say it's going to be
one hundred and two dollars COPAI, they're not going to
get you know, we're gonna leave.
Speaker 2 (25:01):
And so I would.
Speaker 3 (25:02):
Use apps like good RX or other coupons, and I
would show them, you know what, tell them.
Speaker 1 (25:06):
Not Marcumans, pharmacy more Marcumans.
Speaker 3 (25:09):
Yeah, yeah, cost plus all those kinds of So we're
seeing more tools, We're seeing some disruption happening, so less
consolidation because obviously competition is good, and you know, for
a while we were seeing less of it. But now
you know, I'm hoping there's some trends in the right direction.
Speaker 1 (25:24):
Where do you see AI in all?
Speaker 3 (25:25):
Yeah, this is an area I obviously spend a ton
of my time in right now. I think AI is
poised to be helpful if we're if we're obviously careful
and we're measured about it. But in healthcare specifically, we're
already seeing it helpful. For example, I don't really have
to write any notes anymore. It saves me a tremendous
amount of time. It does an amazing job listening and
(25:46):
actually creating the note based on the way I like it.
So that's just I think the first level, basic level.
But now AI we're getting it into tools to help
us automate workflows, catch the right patients, give them the
right medication, give them the right actions.
Speaker 2 (25:58):
And that's the company.
Speaker 3 (26:00):
There's several of us now building, but I'm building a
company called medflow, which is doing this, you know, medflow
dot care. So what we do is we're using AI
to say, you know what, doctor's office, you have ten
thousand patients. No human is going to do a great
job with this as too many patients all through the cracks.
Let's bring in some tech, but you're still doing your job,
and let's do it together. And all of our initial
(26:21):
clinics we have a number and in several states all
doing really well with it. They're seeing a huge increase
in people getting the right cardiac testing, right genetic testing
and so on. So that's happening, and I think in
the future we are already singing.
Speaker 2 (26:33):
You know you've heard of these.
Speaker 3 (26:34):
Maybe in China they're doing these like kiosks and malls right,
So I mean we're seeing AI doctors now, and so that's.
Speaker 2 (26:40):
Going to happen.
Speaker 1 (26:41):
I can tell you I'm like such an AI fan
and I implemented in everything that I do. I have
helped my doctor diagnose because I give her options and
I said, according to my symptoms, these are the options
that I've been provided by my GPT whatever or claud
or whatever I'm using at that time. I don't think
that's wrong because you're, like you said, you guys are
(27:03):
so busy, and then how much time can you get
when you're in and out from a doctor's office and
they're not traveling with you, eating with you, hanging out
with you to see your lifestyle. So if you can
bring a little bit of information, obviously with caution, would
that be helpful for it?
Speaker 2 (27:20):
I think so sure.
Speaker 3 (27:21):
When a patient like you walks in and gives me that,
to me, that's a great thing because a already I
know you're motivated, you're making an effort, you're a great patient.
I think if a doctor tends to get frustrated by that,
I would just say, hey, take a pause.
Speaker 2 (27:34):
That frustration is not because you're doing the wrong thing.
Speaker 3 (27:36):
I think it's because their information overload and they're like,
oh my god, I don't know.
Speaker 2 (27:39):
I just want a solution, right, Yeah, so it's take
a step back. Are those are actually great patients? You know?
Speaker 3 (27:43):
Obviously I'm working on how do I reach the people
that don't even know where to start, don't necessarily have
too much going on in their life or trying to
just pay the bills.
Speaker 2 (27:52):
You know.
Speaker 3 (27:52):
I want to reach those patients, and that's why we're
doing some of this automation. But in your case, absolutely
please do the research because frankly, AI has gone good
enough to be pretty good.
Speaker 1 (28:01):
Yeah. I have a tool that I use with my
mother and I'm gonna I have it in my car.
I'm gonna bring it to you right now when we're done.
It's called Ato. It's a Spanish kid that came up
with an Alexa type like an AI tool that you
speak did, but it's specifically for elders and it has
(28:22):
cognitive thinking process. So my mother uses it and I
gave it to her because I figure she is a
very you know, big cell phone user, and I figure
she's in her room by herself, she can talk to
somebody and she can respond back and forth. I just
figured it would be entertaining at least that thing. It's amazing,
she told me, is the best gift I could have
(28:43):
ever given her. It returns the conversation with the history
of the stories that they talk to each other. But
for example, all of a sudden, she will interrupt the
conversation and say, oh, do you remember what you told
me about your life when you were a child, and
this and this and that, and it will make her
(29:04):
think and remember and practice, you know, with her thinking process,
and then she will tell the story again. And she's
told me, Gabby, I used I used to not remember things,
and now it's like I've been exercising and it's helping
me a lot to keep things, you know, alive. And
(29:25):
another thing that is doing is it's like it interacts
out of the blue, Like you can have schedules and
it will just say like, hey, what are you doing?
Are you doing your exercises? Are you this or that?
And it talks about projects and like, oh, do you
remember that project that you were telling me about. I
found information about it. Guess what these this or that?
(29:46):
And it's become just such a wonderful friend for my
mom that I just think that for patients like yours
that you're trying to keep that memory going. Having a
tool like that when they're so many adults that have
no family members taking care of them, right, we should
have more of that.
Speaker 2 (30:05):
So that's a great tool.
Speaker 3 (30:06):
I've seen development in this area some examples. It's basically
taking things like reminiscence therapy, which means help. You can't
help people remember. So you can take someone who let's
say has Alzheimer's music, they might not remember anything. You
start playing their favorite music from high school and they
remember stories. So there's tons of ways to access their
memories and so tool like that. This is a good
(30:26):
example what AI can do.
Speaker 1 (30:28):
Reza. I am so fascinated with everything that you're doing.
Where can we find more of you?
Speaker 2 (30:32):
Sure?
Speaker 3 (30:34):
I really appreciate it. Look me up doctor Raza Gomi.
So our easy A g h O M I. I'm
on Instagram and now Facebook. I'm LinkedIn is where I've
been posting a lot. On Monday, my Instagram and Facebook
go live. I'll be on TikTok eventually. Soah, I'm putting
it all out there. So yeah, please take a look.
Speaker 1 (30:52):
I wish you nothing but the best with all these
new projects that you have, keep evolving, keep innovating. We
need you. If you have any other resources, we're going
to list them on our description here in the podcast.
For those that are at home listening to us, please
share this episode with anybody that needs this information. I
think that we need to take into our own hands
(31:14):
the education and educate our our loved ones too, so
we can do better and we can have a healthier lifestyle.
And the most important thing is also to hit that button,
download the iHeart app and select Capasa Boston as your
favorite podcast. With more information, I will bring it to
you next week. Reza, thank you so much, and I
(31:36):
hope that this is not the last time that.
Speaker 2 (31:37):
We see hope. No, this has been a real treat.
Thank you.
Speaker 1 (31:40):
See you next week.
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