March 8, 2024 • 63 mins
There is a saying that goes, "The mind is the Devil's playground." Though this particularly refers to thoughts, mindsets, and emotions, the organ that houses the mind also seems to be an abode to nefarious diseases that have long been regarded as death sentences. Brain tumors and cancers, like meningioma and glioblastoma, are the most-feared adversaries of the nervous system, but there is an array of brain diseases that also creep up over time and claim their power over someone's life, its quality, and even the people around them. Memory loss has long been regarded as the hallmark presentation of Alzheimer's Disease and dementia. and it leads to the question of how possible it is to evade the malady that wipes the mental records of love and happiness clear. Can one surpass the ultimatum set by brain cancer? How can one ease their mind in the face of imminent demise? Can memory loss be prevented? What does "brain health" mean? Is social interaction really necessary to keep our brains safe?
We are joined today by Joon Myung, a neuro-oncology nurse practitioner, Alzheimer's disease and dementia educator, and brain health and mental health advocate. She received her BS in Nursing from California State University in 2002 and MS in Family Practitioner Nursing from UCLA in 2005. Joon has been a nurse practitioner for almost two decades, spending the bulk of her advanced provider role in Internal Medicine and Urgent Care. Over the past six years, she has been diagnosing and treating brain cancers and providing treatment plans for post-surgical patients. Online, Joon generously shares her passion for brain health education, focused on brain-boosting, activities, meditation, mindsets, and supplements. She also shares her advocacy for Alzheimer's disease and dementia prevention, rooted in her own journey with her mother, who had the progressive brain disease.
Livestream Air Date: May 25, 2023
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
Hi friends, happy March!
(00:07):
Spring is on its way.
I cannot wait.
I'm so sorry, not sorry, to all my seasonal allergy girlies out there but I'm selfish
and I have to say that.
Just let all the flowers bloom and pollen fly in the breeze.
I'm so sorry but I'm so sick of winter.
Like literally I'm sick.
You can hear in my voice and I cannot wait for better climates and temperatures here
(00:29):
in New York City.
Thinking about the flowers of spring and summer and now the dirty white, yellow and brown
snow of winter and the 20 degree Fahrenheit weather is literally making me feel good.
My feel good hormones are all coming out and this is the topic of our episode today.
Feel good hormones, good mindset, happy brain, yes.
(00:51):
This is what we always want to hear right?
Is serotonin and dopamine rushed from our brain to our bloodstream and we walk in cloud
night and all but honestly this is not the truth when it comes to the brain.
The brain, as you may know, is so complex.
There's something new every day.
New research findings are always in the tabloids, new medicine always coming out of evolution
(01:12):
and I wish it was always happy results and news but definitely this is not the case.
As the brain and the mind are complex, so are the small functions that occur within
it.
Some people always say that the CPU of the computer is its brain.
So many wirings and electricity and functions and this is exactly how our brain looks like.
Electricity, wirings, firings.
And as all things, sometimes something goes wrong.
(01:36):
Sometimes it's more tangible in mass like a cancerous tumor or even a blood clot that
leads to a stroke.
Sometimes it's more thermal like seizures and epilepsy.
Sometimes it's more chemical like an unseen psychiatric disorders.
Sometimes it's more electrical and technical and damaged like paralysis and speech disorders
and movement disorders and sometimes it's just a mix of all things like complex things
(01:58):
like urofibularis triangles and amyloid plaques as in Alzheimer's disease and dementia.
I first witnessed Alzheimer's disease and dementia through a movie.
Do you remember the film The Notebook from the novel by Nicholas Sparks?
I mean who hasn't watched it?
But this one hell of a journey of a love story, the end scene where Noel visits Ali who's
(02:19):
now suffering from dementia, disoriented, loss of memory, unrecognizing her greatest
love.
Truly diseases of the brain is like a storm, thunder and lightning.
How do you weather through it?
How do you stay adrift above the waves and how do you glide over the vehement winds?
Can we avoid these progressive conditions?
(02:39):
Can one evade memory loss?
Can feel-good hormones just trump over the bad ones?
Can brain cancer be eradicated?
Can set-over tomatoes be extended or even better, turned back like we're starting
an hourglass?
Today, in this episode, we are joined by a good friend of mine, Joon Myungung, a neuro-oncology
nurse practitioner with over 17 years of experience as an NP who is an advocate for brain and
(03:02):
mental health and educator for Alzheimer's disease and dementia.
I bring her on to tell her stories within this torrential field of the brain and its
patients, not only as a provider but also as a loved one being a daughter whose mom
had dementia.
Truly the mind is a devil's playground and the brain can truly storm, but can the same
brain and the same mind take us from that downpour and bring upon the sunlight and rainbows?
(03:26):
This episode is such a special and heartfelt one.
Forget the medicine and the time to fick logistics.
Just listen to the humanity of the conversations that occur in this discussion.
I hope you get something out of this episode and I'm sure you will.
Thank you for tuning in.
Let me rest my voice.
(04:10):
This is a super important and very informative discussion.
You know, May is a month of many awareness days, right?
It is.
It's mental health awareness month.
It's also brain cancer awareness month.
And can I think of anyone more perfect to join you tonight than you to speak about all
of these special and super, super pertinent topics?
(04:31):
If you could just first please introduce yourself to everyone.
Thank you so much.
Yeah, of course.
First of all, I'm so excited to finally meet you officially.
We've been talking for so long and I'm just so honored that you would think of me.
I'm no expert, but I'm an advocate and I'm passionate about these topics.
So I'm really excited.
(04:52):
So my name is June Young.
I am a board certified nurse practitioner.
I'm currently working in Southern California in the department of neuro-oncology.
I've been doing this for about almost six years now and it's just kind of interesting
how I fell into this specialty that I will kind of, you know, talk about a little bit
later.
But I've been a nurse practitioner for the past, wow, I'm going to be aging myself about
(05:15):
16, no, 17 plus years now.
So I'm an expert.
I did the family nurse practitioner track at UCLA.
I graduated 2005.
So maybe for like about 12 years, I worked primarily in primary care, urgent care.
You know, honestly, I just needed some flexibility because, you know, during the whole time I
(05:38):
was either pregnant, having kids and doing all that.
So you know, the urgent care is just like a great place where you can, you know, still
work, have great experience, but you know, there's more flexibility there.
And I think after my third child, he was about three, I felt like, okay, now I can like specialize
and do something, you know, delve a little bit more deeper into something.
(06:01):
I don't want to say more interesting because, you know, primary care and urgent care definitely
is its own, you know, it's great.
I love health promotion.
I love teaching and I like all the aspects of all of that.
But I just felt like I did it for so long and I just wanted to do something different.
So why neuro-oncology?
Honestly, I don't know.
(06:22):
I just started like applying like all these different specialties and then, you know,
did all these interviews and that one kind of just like, yeah, that's one that stuck.
But I just have a little fun fact toy for you.
Guess which two subjects were my least favorite in school?
I'm going to give you a guess.
Is it neuro-oncology?
I'm not even kidding.
I've been thinking like, ugh, like neuro, it's just so hard to wrap your brain around
(06:51):
literally.
It's just so intense, right?
It's like you could do like a whole year on neurology and oncology, I was like, oh no,
I'm not going to touch that, you know.
You know, at UCLA they had like an oncology track and one of my friends was in it and
I was like, you know, you do it, you do it, you know, it's like do all that chemo and
everything like it's just, but you know, like life just kind of takes you places and yeah,
(07:15):
so that's kind of my little.
Yeah, I love it.
I mean, I must say I agree with the whole neuro part.
I think if there's one like block or subject during nursing school or whenever I'm trying
to learn something, right, like in the same biology, neuro is always the system where
I'm like, I have no idea how I'm going to remember or understand any of this.
(07:39):
There's just so many things going on at the same time.
It's not just the brain, right?
It's like also the spinal cord and all of the deep matters of the brain and you got
to like know which part does this, which part.
And then all the cranial nerves as well.
I agree with them.
But I love how you're like in neuro-oncology and your least favorite are neuro-an-oncology.
(08:01):
I just sometimes like laugh.
I'm just like, how in the world did I end up here?
But it's just been such a like amazing journey.
You know, I think it was a fear like of doing something that I didn't know that I could
like perfect, you know, after being a nurse practitioner for about like what?
12 years, like to go into like a specialty and not really be an expert and like be new
(08:26):
where I'm kind of like older.
It was really kind of scary.
But I think this just kind of proved to me that like, you know, you have to do what scares
you because that's kind of where you're supposed to be.
Yeah.
And like every time I like shy away from something that I'm afraid of, I regret it later because
I feel like I was supposed to do that.
And so why I apply, I just didn't assume they would hire me because I don't have any like
(08:50):
neuro or like, you know, acute like neuro ICU or anything like that.
They said that they hired me because I have such a strong medical background.
And I didn't understand that until like I delved into neuro oncology and I realized
how much I needed that, you know, to treat my patients because, you know, when they have
cancer and are having chemotherapy, there's so many other, you know, things that happen
(09:13):
that we have to manage.
So they wanted that part of my experience.
And you know, it's been kind of a whirlwind the last like six years, like I would say
like the first two years of it, you know, nurse practitioner, we're not like a med
school, but I was literally like in my backpack had like big books.
I was like up all night.
My husband was like, I feel like you're in med school.
(09:34):
I was like, I feel like it too.
It's just such an intense, like there's just no way that I could have prepared for it without
just learning as I go, you know, and I really appreciated my colleagues who just kind of
guided me because, you know, I'm not the physician, I'm a nurse practitioner.
So I have a different role, but just learning all about the different cancers, the brain
(09:57):
cancers and like the different types of treatment, you know, like the complications that arises
from all of that, you know, it was a really big learning curve.
The first year I felt like an imposter.
I can't imagine.
Yeah.
I mean, like neuro in itself is like so complex, right?
I mean, even our previous guests who were neuro like surgeons or like specialized neurologists,
(10:23):
even they say like, yeah, we can't even call ourselves like an experts in this expertise
because there's just something new every day, I guess about the brain.
I mean, I mean, you know, when we get to the cellular level, right?
Like our neurons, it's like just like spark things, just fire things.
You just never know what's happening, right?
Yeah.
(10:44):
Like we're learning every day.
Yeah, like we're learning something new every day.
So I can't imagine how big of a learning curve that is.
Well, I guess take our audience into that June who was there for the very first time
was like having this learning curve too.
For those who may not know, for the general public, I guess people are aware of like neuro
is and they're aware of what oncology is like in separate entities.
(11:08):
But in the life of neuro oncology, what are we really talking about?
Like what are the things that you see in neuro oncology?
And let's say, oh, I'm going to work today.
I'm a neuro oncology and peak for sugar, like top three.
These are the top reasons why my patients come to see.
OK, so it's pretty super specialized.
(11:28):
You know, you had the oncology doctor previously and that's such a huge field.
But our specialty is extremely like, you know, it's a niche.
But you know, surprisingly, we do have a wide set of diagnosis.
But I would say like the top three diagnosis is that we see the, you know, glial blastoma.
It's the most common primary malignant brain tumor, maybe meningioma and like brain metastasis.
(11:54):
We see patients who have primary cancers somewhere else and then it metastasizes the brain.
And then we have to get involved in terms of like, you know, how we perceive the treatment.
But I would break up my day like maybe like in two parts because I do inpatient and outpatient.
So inpatient, because I work at a teaching hospital, we see a lot.
(12:15):
We don't actually like admit patients.
But like, you know, in the emergency room, if someone presents with they suspect a tumor,
they do CT scan, they find something, they consult us.
So then, you know, I'll go across.
Our outpatient clinic is on the same campus.
So I'll walk over to the inpatient consult, like the new person.
And then we kind of like help them.
You know, we're basically like a team with neurosurgery, like neuro, like medicine.
(12:38):
We work together and kind of get this person if it's like something that needs to be treated
like right away.
Neurosurgery will, you know, jump in and do surgery.
And then we'll say, you know, we'll see you after you recover our outpatient clinic.
You know, when I round, it's more of just like a history and doing like a complete like
neuro exam to see where their deficits are before and after surgery just to see how they,
(13:00):
you know, how we can help them recover.
And then outpatient wise, which is kind of like, you know, the bulk of what I do, you
know, it's like an eight to five Monday through Friday clinic.
We have a couple of neuro-oncologists and there's me and another NP and we have a neuro-oncology
fellow and we have a really amazing team of nurses and medical students.
(13:21):
They're like case managers.
But my role is pre-KMO patients who have already established like their treatment plan with
the attending.
A lot of times if it's a new consult, like from another hospital or like we didn't end
up seeing them in the hospital, they'll come see us outpatient as like the first time meeting
us.
Then I'll just do like the whole, you know, history and physical and get all the information
(13:43):
and do their exam and whatnot.
And I'll see them in tandem with the attending physician.
So basically once the treatment plan is in place, then whatever it may be, like if it's
an oral chemo, an intrathecal chemo, and I'll kind of talk about that one more, or if it's
like an infusion, which we'll get like in the infusion center, then they'll see me like
for the subsequent visits for like pre-KMO visits just, you know, to see how they're
(14:06):
doing on the chemo, review their labs, if there's any issues, like any side effects
they're having and just kind of like guiding them through the process because you know,
this is a pretty, it's a hard diagnosis.
I mean all cancers are difficult, but in this case, a lot of our patients are terminal.
Unfortunately, glioblastoma, you know, there's no cure like over the past like 60 years,
(14:30):
there's no cure and there's definitely lots of research.
We do a lot of clinical trials at our facility as well.
So that's really cool to be a part of that.
But it's still like, you know, it's basically, we don't know.
I do a lot of like counseling.
I don't have any professional like training, but it's just like on the job training that
I just try to help guide my patients and also their family members because you know, and
(14:54):
it just goes so fast.
Like once they're diagnosed, then there's surgery and there's like chemo and radiation
and like labs, MRI.
It's like just, it's constant and throughout the whole process, I feel like they're in
shock still, you know, and then I think they're just like, it's just so much information that
I feel really bad for them that, you know, it's kind of like a really short, intense
(15:18):
time where they just have to like just accept it and just go, you know, we don't have time
to just like let them fit with it because it has to be kind of quick.
Yeah.
Yeah.
I can't imagine.
I mean, I think it's with all cancers, right?
Beyond like just the physical toll on the patients, right?
The whole emotional aspect involved, right?
I guess when it comes to cancer, I think a common question that either the patients or
(15:40):
their family members always ask us like, why, right?
Like why does it happen to me or to my loved ones, right?
So you experience with all of these patients that have, whether it's gliobasomas or angiomas
or even just like metastatic cancers to the brain.
What have you seen to be a commonality in their histories as to why many of these cancers
(16:02):
arise?
Like are there common risk factors that you see in these patients?
You know, I get asked that question a lot and I actually asked that question to the
director when I first started.
I was like, so what is it?
Is it genetics?
Like, is it the water?
Like, is it the food?
Like, what is it?
You know, is it like the phones, like micro?
(16:23):
Like you just like want to like, you want the answer and you want to be able to tell
people so that you can prevent this.
Fortunately, like most of them, they don't know, you know, like for glioblastoma, they
really don't know how it just kind of like, you know, from the glial cells in the brain,
how it just kind of starts.
I mean, it's more common in men and it's more common in older people.
I just, I think it's just a combination of just bad luck and like environmental things
(16:49):
and maybe just, I don't know, I can't really say, you know, I can't give the answer, which
I wish I could, because I would just, you know, be yelling it from the mountain top.
But you know, meningiomas though, they have like a previous history of like childhood
cancer and receive radiation, then that is a risk for meningiomas.
Metastatic cancer, that's just something that, you know, there's really nothing.
(17:11):
But for brain cancer, like neuro-onc issues, like there's really nothing, you know, we
can tell people like how to avoid, you know, I think just in general, like avoiding toxins,
like forever chemicals, just overall, like generally, you know, eating better and whatnot.
Like I think definitely like, you know, that comes into play.
But you know, like sometimes like when I read articles, how like there's like that one like
(17:35):
city like in the middle of United States where like, there's like a hundred people diagnosed
with like glioblastoma, then I'm like, what's going on?
You know, there's gotta be some kind of chemical that has leased into their system and it's
causing these like mutations in the cells.
So I think, you know, there are certain risk factors, but we just can't like hammer say,
it's like, oh, it's one, two, three, and just avoid it and you'll be fine.
(17:57):
Yeah.
I mean, even our previous episode with Dr. Sanjay, he's the oncologist, very funny and,
you know, very intriguing to hear that he said the same thing as you, it's just bad
luck like it's literally just a combination of just things that just go wrong and go haywire.
Right.
Yeah.
And I guess in those situations, it's really so hard not to question why, right?
(18:23):
Why does this happen?
And I think secondary to why is like, how, how do we get through this?
Right.
You know, I think brain and spinal cord cancers have gotten this reputation of, like you said,
it's like the scarier forms of cancer, right?
Like when people, especially when I watch movies, when someone says, oh, you have brain
(18:45):
cancer, my mind is like, oh, that's it.
Yeah.
You know, like, that's it.
Like, like you said, it's terminal, right?
But with our current science and medicine, what is the deal with neuro conditions and
cancers?
Is it a treatment basis?
Is it, we're just trying to improve the quality of life?
Is there in this small or probability of hope that, you know, we can actually go into remission?
(19:10):
Yeah, that's a really great question.
And I think that's actually, I wish more people would ask that because for example, like I
said, like if you have like a, you know, grade one meningioma, neurosurgeons will actually
tell their patients, oh, it's not cancer, you know, but neuro-oncologists will be like,
you know, if there's something in the brain, like it's a tumor, I never use the word benign
(19:31):
because I think that people kind of like hinge upon that because, you know, grade one can
still come back.
It's slower and it's unlikely, but actually seeing grade one meningiomas like come back
with a vengeance as well.
I mean, after surgical resection, some of the more, I guess, you know, benign cancers,
like just tumors that we like schwannomas and the two adenomas, like these are not like
(19:52):
terminal, you know, we kind of watch these patients over.
We do like serial imaging, you know, whether it's every two months, every three months,
four months, six months, and we kind of just, and some people just kind of do well.
But in terms of talking about like the terminal malignant brain tumors, like glioblastoma,
that's kind of like, you know, our heaviest population, you know, without treatment, you
(20:13):
know, studies have shown it's about like a six month overall survival rate, which is
pretty, it's pretty fast.
So with surgery and with treatment, you know, we can hopefully extend that to between like
18 to 24 months, depending on like the genetic mutations and markers that we find in the
tumor, some respond better to treatment, but sometimes it's quick and some people just
(20:36):
don't do well.
And I think like, initially, when they come and see us, we do tell them that it's malignant
and it's incurable.
So we let them know upfront, like, cause you know, they're going to Google it as soon as
they can, right?
It's going to just tell them all this terrible things.
And so we don't sugar coat it because they have to know it's their body, you know, they
have to know how to like deal with it and like with their financial situation and their
(21:01):
family situation.
But I know our neuro-oncologists don't like to hammer in like a date because like I said,
then, you know, patients tend to just like clean onto that number, you know, see like,
oh, you promised me 24 months and sometimes it's less.
We just kind of like leave it open ended because we do have these rare, rare cases where, you
(21:22):
know, some of our patients have lived like longer.
I feel like our physicians have a really hard job in kind of giving that balance of hope,
but yet reality so that they don't live the last few like weeks or days, just like wasting
away in a hospital.
And so that's actually one of the biggest struggles that I've had as a nurse practitioner
(21:45):
working in this field.
I feel like I'm kind of like, it was between me and the social worker.
We had many conversations where like, I see the doctors because they're so focused on
like treating patients.
They will give them every option.
Oh, we have this new clinical trial.
We have this new medication and it's, you know, their heart is in the right place because
they're healers.
(22:06):
They want to give them hope.
They want to help because that's why they're in this field.
And that's why the physicians that I work with currently, they're so good and I love
them and they're like the best human beings.
They're super humble.
They're super smart.
They're passionate and they're kind.
And I feel like as a neuro-oncologist, you have to have those qualities.
But sometimes like what I kind of start seeing like, oh, my patient is sleeping for 20 hours
(22:30):
a day, you know, they don't want to eat.
Like they're not responding.
Like, you know, like you kind of start to like, you know, being in this field for six
years, I kind of start seeing the end, which is really hard.
It's really hard to kind of tell the family.
But I think the patient kind of knows, but sometimes like we give them like a different
(22:50):
option.
And then, you know, I've seen some patients like when I feel like maybe the last three
months they should have just been like on hospice or just, you know, quality versus
quantity.
I think it's hard to like find that perfect balance.
And I feel like that's the struggle that I feel like I'm trying to like, you know, trying
to learn better on how to like get our people to have like an optimal treatment time.
(23:15):
Like we want to give them this quality 18, 24 months, you know.
I just hope people who are watching aren't just thinking, oh, you know, that's the time
frame.
It just could be longer, like I said, could be less.
I focus on trying to give them the quality, you know, and I do have these conversations
with them here and there.
When I start to see that their quality is not there and like they want to travel, they
(23:39):
want to like see family and I tell them, you know what, you can take a little break, like
go do that because honestly, like, don't know when the next time you'll have that chance.
But it's a tough, it's tough, Christian.
Like it's hard.
It's hard for me.
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(27:02):
I feel like in this matter, we always think of again the emotional and the psychosocial
toll on the patients and their loved ones, right?
But also takes a toll on the healthcare providers who are part of the care team or taking care
of these patients, right?
Especially when they always say you don't want a patient to just exist, right?
(27:25):
You want them to actually live, be alive, even if that means like just a piece of quality
of life, right?
I think especially for brain cancers, right, or brain tumors, for example, if it's a lung
cancer or it's a lung tumor, it's like a very localized set of, I guess, presentations
(27:46):
and the feelings that the patients feel.
But when it comes to the brain, the brain is so interconnected.
It's like, oh, you have a tumor here.
That means there'll also be a problem with your hormones because it's suppressing, I
don't know, the part of your brain that releases this hormone or it's pressing on the cranial
nerves.
So you can't actually like move this extremity anymore.
(28:07):
Your hearing is impaired.
I always think that with brain and spinal cord cancers and tumors, it's just so hard
to navigate, right?
Because so many things are involved with it.
Like it entails the whole body, right?
And I guess it's so, I can't imagine how difficult it is for you as the NPS, the healthcare provider,
(28:28):
these patients of seeing some patients just from a better word, like just to waste away,
right?
Like not being able to do what they can do before.
And you're right, patients, I feel like patients know when the time is coming, right?
How do you deal with that as the healthcare provider?
Like how do you deal with this emotional and mental toll of these heartbreaking stories?
(28:53):
Oh, I did not do well the first year, let me tell you.
You know, I've just, you know, primary care, urgent care, like, you know, you just see
different things.
They're not so like devastating.
And being, you know, I think I learned that I think I'm an empath, like so I absorb emotions.
I tend to just kind of like, I wear my heart on my sleeve, you know?
(29:14):
A lot of my patients who have these diagnosis, they're like the nicest people, you know,
I don't know what it is.
And I just feel not that like, if you're not a nice person, you know, it's any sadder,
you know, it's not a sad, but I just become kind of like intertwined in their lives because
I ended up seeing them quite a bit.
And you know, we kind of share our lives together.
(29:36):
And so it's like, kind of like a, like a surrogate family.
And so it's the first year I didn't know how to separate myself from my patients.
And in a sense that like, you know, when they, I saw them, you know, kind of taking a turn
for the worse, like it was hard for me to step back and kind of protect myself.
I think you understand what I'm saying.
It's like, you know, cause I don't have closure when they pass.
(29:59):
Cause you know, sometimes we'll just get a call over the weekend that like so and so,
you know, ended up passing.
Cause sometimes at the end, you know, there's complications, like it could be a heart attack
or a pulmonary embolism or something, not even the tumor itself, you know, that ends
up causing the issue.
So it's like, you're just kind of like, you know, you just kind of have to move on.
Right.
And so I would just kind of push that down and go see the next patient.
(30:21):
But you know, that person's smile, you know, their eyes, like it's still like in my thoughts.
And so like that first year on the weekend, I would just start like bawling in my car.
Like I'm going somewhere and I'll just be like, Oh my God, like what do I do with these
emotions?
Cause I really do.
I felt it, you know, and I just felt like I felt for them and for their family, like
(30:43):
how did they process it?
Cause it was, it's just so unfair and it's just so fast.
And I wish we could find a cure for all of this.
But my husband, you know, he knows me really well.
He told me like, you know, I didn't want to like keep myself distant because then I didn't
want to come off cold, you know, like, like, but yet he's like, you have to find that balance.
(31:06):
And he's like, you know, he did tell me like, you just have to process it.
Don't suppress it so much.
And so I started just letting my feelings happen, you know, like that day when I'm going
home, like I'll kind of like think about their lives and just, you know, it gives me peace
that like, instead of thinking that it's a life loss, which it definitely is, and there's
(31:26):
a big hole in that family's life now, because it's a hole in my heart, you know, as I've
known that person.
But when I think that impact that they made on me and this world that meant something,
you know, and I'm able to kind of bless them and just kind of like, you know, hope that
they're in a place that's better.
And also helps that, you know, a lot of my co workers, the nurses I work with, once in
(31:48):
all, we'll have like a big fencing sessions and just kind of like cry together.
Because everyone that I work with, they have big hearts.
And it's not like we're just like, okay, next person, you know, we all kind of become like
family in a sense, in a sense, right?
So it is difficult.
And I don't think I've mastered it.
Because once in a while, it'll like creep up on me.
(32:08):
Because I think like the first year to like there was patients that like just, you know,
as me as a brand new Neuro-On-College NP, like I met them, like they're like my first
patients and when they passed, that was really hard.
And I still think about them, you know, and I just feel like, like, how do I deal with
these feelings?
But I think it makes me, you know, do my job a little bit better, you know, like going
(32:31):
forward.
But like, I feel like even including my education, my experience and my emotions, I kind of like
just push it forward to the next person.
I don't know.
It's hard.
Yeah.
Yeah.
But I can feel your heart like for these patients.
And again, it is so hard, like such a field where, I mean, do we really know what goes
(32:54):
on in Neuro, right?
Like, again, like there's something, always something new going on, right?
Yeah.
And I feel like aside from just the cancer aspect, which I know comprises a lot of your
work in your very, very specialized field, right?
I think Neuro in itself, even outside of the oncology aspect, again, it's such, that's
(33:16):
why I don't like it, right?
Well, I like it, but I just can't do it.
Same.
Same.
I can't do it because there's so much.
It's okay.
I can do it.
Yeah.
Yeah.
I mean, I feel like a part of also that complex topic within Neuro in itself, which I know
that you love educating about is Alzheimer's disease or dementia, which again, I guess
(33:38):
me and I remember in nursing school, I was like, so what's the difference between these
two?
You know, I think the first time I ever heard of, I guess the concept of dementia was, have
you ever watched the movie, The Notebook?
Yeah.
Yeah.
I know.
Like in the end, I think it's like sundowning.
I was like, wait, what's going on?
(33:59):
And this is the first time I ever Googled, oh, dementia.
And then part of the search list was also Alzheimer's disease.
So can you please educate us on what is Alzheimer's disease and how is it connected to dementia?
Oh, okay.
So Alzheimer's disease, well, I started kind of like delving into like learning more about
(34:21):
Alzheimer's disease and dementia because, you know, my mom was diagnosed quite early.
She developed early onset Alzheimer's and she was like 55, I would have to say.
So I was just kind of in shock, you know, but I remember my paternal grandmother also
has Alzheimer's.
So I was like, you know what, I need to know a little bit more about this because, you
(34:41):
know, you learned a little about in school and you're just kind of like, right.
But Alzheimer's disease is a part, you know, it's dementia also, but it's basically where
it's just a description of there's like a built up of like amyloid plaques or like the
talatangles that they call, you know, crazy neuro terms, right.
(35:04):
But they build up in your brain and that's how you develop this dementia.
There's like, there's another Lewy body dementia where the Lewy bodies, you know, build up.
There's vascular dementia where it's like the breakdown of the vascular system and that,
you know, you develop dementia that way.
And there's frontotemporal dementia also, basically it's that area of the brain that
you develop.
So you just have different symptoms, you know, so dementia is just kind of like a group of,
(35:29):
you know, where you have memory loss, your personality changes.
We just lose those memories, you know, that are certain parts of your brain.
Yeah, but I'm no, I'm no expert in it.
I just, you know, every day I just try to learn a little bit more about it.
Yeah.
But, you know, I'm all about, you know, I've been excited about it lately because, you
know, like, I think what we hear is that, oh, you know, once you have it, you know,
(35:53):
that's it, right.
You can't, you know, or if you're destined to have it, you can't really prevent it.
Like I remember when I was initially looking into it a couple of years ago, they were not
really talking about any modifiable like risk factors.
So basically like, oh, you know, you're screwed if it happens, it's like hits you like a brick,
like there you go.
Right.
(36:14):
And, you know, great that there's no actual medication that's actually going to help you.
Right.
They think like some medications may slow it down, but there's still actually no, like
there's no proof that any of this actually works.
But I've been excited because there's a lot of research that happening now that shows
that there's actually you can somewhat prevent it, you know, obviously, if it's going to
(36:35):
happen and actually still happen, but you can kind of like modify it and kind of like
prolong it so that it doesn't happen sooner.
Yeah.
And I think, you know, I guess you could speak more about this because I know that in telling
your story, right.
But you can imagine how heartbreaking it is, right.
I mean, I know memory loss is not the only effect of it, right.
(36:58):
There's so much more like cognitive aspects of it as well.
Right.
And I agree that I guess this is where science is so helpful.
Right.
It's always something, you know, we can learn about it every day.
I think it was only recently, too, where people are like, oh, maybe like B12 has something
to do with it as well.
Right.
(37:18):
These things that just something new every day.
And I guess we learn more about the disease process itself.
Right.
And I guess I remember when I was first watching the movie, I was like, oh, so is it only a
memory loss?
And then I guess throughout the years, we learned that, oh, wait, there's so much more
(37:39):
to it than just like losing memory.
Right.
Or like the cognitive changes and stuff like that.
I think it also goes to a whole message of just the brain health as a whole.
Right.
Like, I guess how we can optimize like our brain health now.
Right.
Like, even if we may not have any very definite studies on, oh, these are the specific ways
(38:02):
that we can avoid or prevent Alzheimer's disease or dementia.
I guess just the whole aspect of just brain health in itself.
It's so important to know and learn about.
Right.
And I know you're a huge advocate for brain health and also mental health as well.
And as we're talking about memory loss, I wanted to know what does brain health mean
(38:26):
to you?
Is it just about memory?
Is it just about focus?
For you, how would you define brain health?
For me, I think initially it started with memory loss because I was kind of like thinking,
oh my gosh, like, what if I develop Alzheimer's?
To me, I told my husband, like, if I develop Alzheimer's, I said just kill me, you know,
because I don't want you dealing with it.
(38:47):
I don't want my kids, you know, he was like, that's kind of severe.
But to me, it was initially a memory loss.
And then I just realized it's so much more than that, you know?
And as I kind of like started delving more into how to prevent it, I realized it's just
about like just overall brain health, you know, which encompasses like the mental health
aspect of it, just like, you know, like the social interaction factor, hearing, nutrition,
(39:14):
and like exercising and just like maintaining healthy blood pressure and, you know, your
blood sugar levels and sleep, you know, all of that together.
Because basically, to me, I realized that when I didn't do certain things that was
brain healthy, like, I just didn't feel good, like, overall, like, I didn't feel good,
(39:37):
like physically, spiritually, like, you know, emotional, I just felt like really like, you
know, poopy, right?
Because I wasn't taking care of my brain, then my body wasn't being taken care of.
And so I just realized, it's like, you know, yes, like people argue like cardiovascular
health is like, oh, that's important thing, like eye health, like teeth health, all of
that, you know, like skin care, like I love, you know, skin care, you know, you're glowing
(40:00):
right now.
I'm so jealous.
Hi, Jamie.
Thank you.
Jamie, I need to go see you.
But like, I realized brain health is such a pivotal, like just just overall like living,
right?
I just realized like, you know, why not just focus on brain health so that overall, like
(40:21):
it'll improve everything I realized for me, yes, eating healthy, for sure, it's a big
thing, but for my body type, I have to exercise, or I don't feel good.
But when I learned that when you exercise the brain derived neurotrophic factor, it
increases and that goes into the hippocampus.
And that's where your memories are stored.
(40:43):
Right?
And so I was like, oh, it's no and then you know, you just feel better and your muscles
get stronger.
And so then your bones don't like fold over when you get older.
Yeah, right.
So I was like, okay, that's awesome.
And then when you eat better, it just feeds your whole system.
And so, like to me, I always ate fairly healthy, I would say.
(41:04):
But you know, like I get lazy and I'll just eat like junk, but then I'll just feel like
junk.
You're so young, you know, you have I ate so bad when I was your age.
But now like, you know, 40 something, and I don't eat good, I feel it right away.
But you know, when I learned that, like, what I eat actually affect my serotonin levels,
(41:27):
which you know, affect how I feel like mentally and physically, you know, I started kind of
looking into, you know, better foods.
And then when you sleep, you know, who knew that when you actually slept a good seven
to eight hours, you know, your, your brain is actually detoxifying.
And so sleep is so important, because you know, I used to be a night owl, and I would
(41:49):
like, you know, pride myself and getting like four hours of sleep, you know, like, I used
to be that way.
But I realized like, older now, and so it's harder.
But I'm happy like, because, you know, when you sleep more, you know, your skin looks
better.
You know, you just you're more like alert.
(42:10):
But besides the fact that detoxifies, you know, I always tell my son, like, when he
studies at night, he needs to get like the good like, you know, six, seven hours of sleep,
because actually, when you sleep, your brain actually goes over all the material again,
and kind of organizes it and puts it away.
And that's how it retains the memory.
And so, you know, if you just like cram and you sleep, you know, it's kind of it's helpful.
(42:35):
I think the whole aspect of like brain health, everything you mentioned, its effects, it's
not only like, for us, right, it's also for the people around us as well, right?
It influences how we interact with other people, how we respond to other people.
And personally, like me too, I guess it's changed over the years.
(42:57):
But when I was in high school, like I can survive, actually, even nursing school, I
could survive on two hours of sleep within like a three day period.
Not good at all.
I'm not this is not medical advice.
I'm not recommending it to anyone.
But definitely, my brain was like, your brain just stops automatically, right?
(43:20):
You will fall asleep because your body, especially your brain has this like automatic like sensor.
It's like, okay, we're going to shut down right now.
Right.
And I guess especially, especially in the long run, like it's so unhealthy to sleep
or even just constant exposure to like constant stress, right?
(43:42):
Like stressors and how have you seen like, just like stress as a whole to affect brain
health in general?
So like from my patients, going back to neuro-oncology, I have patients who obviously don't deal with
their diagnosis very well.
They tend to be on the younger ones, which is extremely unfortunate, because then they
(44:06):
have a lot of just anxiety and worries like financially, like if they have young children,
they're worried about their children and their spouse.
So needless to say, they have a lot of stress and they come into their appointments and
all like tense and like, you know, like, and I just try to, it's just so hard because you're
not in their position.
(44:26):
You can't just be like, don't worry, you'll be, you know, you can't say like, you'll be
fine.
Like you can't do that.
You can't minimize how they're feeling because you know, we have no idea how that feels,
right?
We don't ever.
But without like diminishing how they feel, I do kind of let them know that like after
getting to know them, of course, that like being actually more stress is more harmful
(44:50):
to them.
You know, like us as doctors, nurse practitioners, we can help our patients heal, like by giving
them treatments, medication or whatnot.
But you know, it's actually our own bodies and the own person that is facilitating that
feeling.
I really believe, right?
You have to create that environment for yourself.
And so I encourage them, I remind them that like, okay, they could spend the next two
(45:13):
weeks worrying about their next MRI and just waste that whole two weeks away by worrying
and it's gone.
Or they could worry, but don't just like, you know, delve in it and just sit there and
wallow for, you know, to actually do something and enjoy that time and try to like work through
their stress by going out and doing something if they're able to.
(45:36):
And when I put it in that way, they're just like, oh, that's right.
Like why would I waste that precious time that I have?
You know, actually, my patients who are more like lighter and just kind of like, you know,
living day to day to the fullest, I would say like they do tend to have less side effects.
I kind of want to say, you know, maybe not towards the end, but in the beginning, I do
(45:58):
see them kind of like manage it better and just overall, like it improves their own mental
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(49:38):
One of the last questions I wanted to ask was something so intriguing that you shared
I think a few weeks ago, which was a Harvard study on quote unquote social fitness.
And actually, since you shared that, I've been, I guess that's how the internet works.
Like my algorithm is just like all things about social fitness.
(50:01):
Oh, cool.
Yeah, what was the finding in the study that you shared on the social fitness?
And how do you think the pandemic has affected all of our social interaction, right?
And how do you think it affects our brain health in general?
You know, when I read that article too, I was kind of shocked because I thought they
(50:21):
were going to say something else.
But I guess it makes sense because, you know, we're not alone in this world, you know.
I was kind of glad that it did prove the point that we do need each other, you know, whether
physically or just like, you know, we're next to each other or, you know, communicating
via social media or whatnot.
We're just exchanging that like, I don't know what it is.
(50:42):
It's just when you see someone's face and you smile, then like, then all your endorphins,
you know, your brain happy chemicals kind of go up.
And I feel like, I think they didn't really talk about that.
But I feel like that's a big part of it, you know, that definitely during the pandemic,
you know, you saw a lot more cases of depression, suicide, and just people just like kind of,
you know, retreating.
(51:03):
And that's the part that kind of like, it was sad because during the pandemic, I think
before then, my mom was like able to recognize me and she was able to like walk and do things
and sing and interact.
But like two years into the pandemic, because you know, before the vaccine, like my dad
didn't want anybody to come over.
And so they kind of just sequester themselves inside the house, and she became bed bound.
(51:28):
You know, she wasn't able to walk and she completely like wasn't able to like she just
went downhill so fast.
She only had, you know, like one person to talk to the whole time.
And I was just like, Oh, wow, like she went down really quickly.
And I was like, you know, social interaction, social fitness is really important just, you
know, not just in Alzheimer's or like neuro-oncology, but just I think, just in general, you know?
(51:53):
Yeah, yeah.
Yeah.
I think I think it kind of like persisted the idea of no man is an island, right?
Like need that social interaction.
You know, I think last year we had a recording with one of our season two guests, she was
a pediatric speech language pathologist, Jovan.
And I asked her about the effects of the pandemic on children's ability to order progress into
(52:20):
comprehension and speaking.
She was like, the pandemic definitely took a toll on that.
Right.
And it just goes to show that even from an early age, leading that social fitness, that
social interaction, it just goes to show that we are wired for human connections, right?
We are wired for connections towards each other.
Right.
(52:41):
And I feel like it's so important that, you know, we get to speak to others, even I think
that's a beauty of social media as well.
Right.
I think during the whole lockdown and everyone was at home, right, people were at least form
connections like online.
I think that's what happened to all of us, right?
Like who could imagine that strangers online become friends because of social media, right?
(53:03):
So it's such a beautiful thing.
And that's why I feel like it's just helpful for us to have people around us, right?
And I think it's also helpful for us to also have time for ourselves, right?
To be able to do the things that make us happy as well.
Well, that's what I wanted to ask you is, I can't imagine how stressful, even though
you explained how stressful and how heartbreaking it can be working in neuro-oncology and, you
(53:29):
know, seeing patients or their terminal conditions and how do you decompress out of all of this?
How do you find peace?
What activities do you like to do to somewhat separate yourself from, you know, the heartbreaking
world of neuro-oncology?
I think Instagram.
You know what, honestly, I think I started like my account like kind of towards the beginning
(53:57):
of the pandemic, you know, and I actually met a lot of my close friends through Instagram.
I mean, I kind of half joking, but I think for me, like, if you look at me, I'm not
like an outdoors kind of girl, you know, but I love like going on like, I would say like
a moderate intense hike, like, like, like up in our neighborhood, like with my husband,
(54:19):
we'll walk for maybe like five miles.
We don't have a lot of those moments because, you know, I have three kids, high school,
junior high and elementary school, and they have full schedules.
I'm a full time working mom.
So our time is kind of limited with each other, but we try to make like maybe twice a week
or three times a week where we just kind of just drop everything and we'll just like walk
(54:40):
before dinner after dinner and whatever works.
So that's one of my favorite activities to do.
During the pandemic, I really just kind of I love doing yoga.
Because just physically, it's almost like it's very meditative.
But also, it's a it's like an actual physical workout.
I don't do that as much anymore because I just don't have the time for it.
(55:01):
But you know, I love doing yoga and just walking, think hanging out with my friends, you know,
like like we talked about, like the social fitness.
I try to make an effort to maybe like go out to dinner or like hang out, like a phone call,
maybe like at least once a week or maybe once every other week with like a friend.
And I try to like not go out with the same friends.
(55:23):
I try to like, you know, make new connections and just, you know, it's easy to kind of like
get in the rut and just kind of go out the same people over and over again.
But like, you know, when I watch your stories, I'm just like amazed at, you know, how many
social events like that you're able to go to.
I'm actually very impressed at the energy level that you have.
(55:49):
I love it, though, because I see how you just connect so well with everybody because you're
just so genuine and you're just so like wanting to know people and their stories.
And it's just it's just I love it.
And I'm actually learning from you.
I learned to just kind of like go out there more, you know, don't be so like stuck in
my ways and just meet, you know, just like the people that I know.
(56:12):
But like, like trying to, you know, even like through Instagram, too, like I've met so many
cool people.
Yeah.
And I went to like a conference last year.
We were basically strangers.
We stayed in the same room.
We're just like best friends now, you know, it's just like I would have never done that.
And I would have never had that friendship.
I think you just have to just like get yourself out there.
(56:34):
And that's a part of brain health, too, is like learning new things, doing new things,
like not doing the same things, because as you create those new synapses, then your brain
learns those new groups.
And then that's how you grow.
Because another aspect of like Alzheimer's and dementia is your brain starts to kind
of shrink, you know, and then when you get less mass, you have less neurons and you have
(56:57):
like less of that firing and everything kind of just gets smaller and smaller, you know.
But when you learn new things, like your brain's growing, you know, so that's just another
reason to.
And how can you forget our favorite K dramas?
Oh, yes.
We watch K dramas.
That's right.
I almost forgot.
For those who may not know, people wouldn't know, but me, June, and Jamie, we have a group
(57:23):
chat where we literally wait on each other to finish the episode.
We don't have a book club.
We have a K drama club where we wait for each other to watch the next episode of Singles
Inferno, first of all.
Oh my gosh, that was so fun.
It was so fun.
So I think things like that, right, like just things that you can look forward to, I think
(57:45):
brings like so much joy and just like you said, being able to spend time with a lot
of people, like I see many amazing people here watching, like Alex and Christina, who
said a child in high school, I thought you were 30 at most.
What does that mean?
She said that you look young.
Oh me?
Oh, thank you.
You know, I have a filter on because this closet, you know, I told Christian the only
(58:16):
quiet place that my kids and my husband won't bother me is my closet.
I'm literally sitting in my closet right now.
So the lighting is bad.
So I had to use a little filter, but yeah.
Oh, we love it.
You are glowing.
I mean, I feel like the amount of times, options that we had to canvass for this to happen,
(58:38):
and I was like, yeah, it will have to be 11 PM on Easter time because that is the time
when June is just a superhero.
She's like a super mom and it's just such an honor to speak with you tonight and just
learn so much about such a very specialized field that it's honestly so scary, right?
(59:03):
For me, neuro-oncology scares me.
I mean, like you said, it's like a death sentence, right?
The medicine and science now has changed that aspect, right?
Now people can actually like have hope, right?
That, oh, we can at least improve our quality of life, extend a lifeline, maybe not as long
as we want, but the ability to provide quality of life, right?
(59:26):
To these patients and their family members is such a beautiful thing.
And it's just so beautiful that you are a part of that workforce and that story that
I can't imagine how much it touches so many people's lives and such an honor and so fun
to talk to you tonight.
So, so fun.
(59:46):
I'm so bummed that we never got to hang out when we were in LA.
I would love to be back.
I'm so sad because I think we kind of for like five months and then we both, like none
of us could be, I don't know.
I really genuinely felt like horrible because I don't like flaking on people.
It just, there was literally no way I could have done it.
(01:00:09):
But man, I'm really happy.
That only means that when we finally all meet, the three of us, and also I think the NP mom
is here watching, maybe the four of us, right?
We have so much more stories to talk about.
And yeah, I am so excited and I'm just so honored that you joined me tonight and just
(01:00:30):
gave me your expertise and all of your stories and beyond all of that, just sharing your
heart because like all the way from here, I could feel like your love and like your
genuine care for your patients.
And it's such an honor to have someone like you on my platform.
Thank you so much, Christian.
I was honestly kind of nervous because you have some pretty heavy people on your podcast.
(01:00:54):
Excuse me, this is NP June Da Brain Health.
What are you talking about?
And honestly, I felt like I kind of just, you know, honestly, the topics that I picked
up, they're pretty heavy.
So I felt like I kind of glazed over a lot of it and there's so much more to delve into.
But you know, that's why you follow me and you learn a little bit every day.
(01:01:15):
Please follow June.
She posts this super amazing reels of just, you know, constant reminders of regarding
brain health and just staying, you know, just being present.
And you know, it's so easy to forget to take care of ourselves and our brains, especially
during such busy lives and busy days.
(01:01:36):
I can't imagine you're, you know, being a mom, seeing you and like working as an NP
and just, you know, just those reels are so helpful just to be reminded that take a pause
and you know, just breathe.
That makes me so happy to hear that, honestly, because sometimes I do it, like I have this
(01:01:56):
great idea and then I do it and I'm like, oh my gosh, why did I do that?
Like it probably didn't help anyone.
I'm just, I look super silly, but you know, I'm like, you know what?
It's okay.
I did it for myself.
So when I'm like 70 years old, I look back and be like, oh yeah, you know, there we go.
Yeah.
Well, Christine, I just commented saying my two brain cells.
Thank you too.
Well, I am glad that at least two of them were energized tonight.
(01:02:21):
Thank you, June.
Thank you for spending an hour and a minute with me in your closet.
You're welcome.
I had such a good time.
I feel so honored.
You just spent one hour in the closet for me.
Thank you so much, June.
Thank you.
This is not the last time that we will have a live stream.
There's so much more to talk about.
Like we said, neuro is an ever evolving field and so much research is coming out and so
(01:02:47):
much findings that we have to spread to the general public.
So this is not the end.
Next time they find a cure for Alzheimer's or glioblastoma, we're doing it.
There we go.
Bye.
Bye.
Thank you, June.
Have a great night.
Have a good night, everybody.
Be safe.
Thank you.
Hi friends, happy March!
(00:07):
Spring is on its way.
I cannot wait.
I'm so sorry, not sorry, to all my seasonal allergy girlies out there but I'm selfish
and I have to say that.
Just let all the flowers bloom and pollen fly in the breeze.
I'm so sorry but I'm so sick of winter.
Like literally I'm sick.
You can hear in my voice and I cannot wait for better climates and temperatures here
(00:29):
in New York City.
Thinking about the flowers of spring and summer and now the dirty white, yellow and brown
snow of winter and the 20 degree Fahrenheit weather is literally making me feel good.
My feel good hormones are all coming out and this is the topic of our episode today.
Feel good hormones, good mindset, happy brain, yes.
(00:51):
This is what we always want to hear right?
Is serotonin and dopamine rushed from our brain to our bloodstream and we walk in cloud
night and all but honestly this is not the truth when it comes to the brain.
The brain, as you may know, is so complex.
There's something new every day.
New research findings are always in the tabloids, new medicine always coming out of evolution
(01:12):
and I wish it was always happy results and news but definitely this is not the case.
As the brain and the mind are complex, so are the small functions that occur within
it.
Some people always say that the CPU of the computer is its brain.
So many wirings and electricity and functions and this is exactly how our brain looks like.
Electricity, wirings, firings.
And as all things, sometimes something goes wrong.
(01:36):
Sometimes it's more tangible in mass like a cancerous tumor or even a blood clot that
leads to a stroke.
Sometimes it's more thermal like seizures and epilepsy.
Sometimes it's more chemical like an unseen psychiatric disorders.
Sometimes it's more electrical and technical and damaged like paralysis and speech disorders
and movement disorders and sometimes it's just a mix of all things like complex things
(01:58):
like urofibularis triangles and amyloid plaques as in Alzheimer's disease and dementia.
I first witnessed Alzheimer's disease and dementia through a movie.
Do you remember the film The Notebook from the novel by Nicholas Sparks?
I mean who hasn't watched it?
But this one hell of a journey of a love story, the end scene where Noel visits Ali who's
(02:19):
now suffering from dementia, disoriented, loss of memory, unrecognizing her greatest
love.
Truly diseases of the brain is like a storm, thunder and lightning.
How do you weather through it?
How do you stay adrift above the waves and how do you glide over the vehement winds?
Can we avoid these progressive conditions?
(02:39):
Can one evade memory loss?
Can feel-good hormones just trump over the bad ones?
Can brain cancer be eradicated?
Can set-over tomatoes be extended or even better, turned back like we're starting
an hourglass?
Today, in this episode, we are joined by a good friend of mine, Joon Myungung, a neuro-oncology
nurse practitioner with over 17 years of experience as an NP who is an advocate for brain and
(03:02):
mental health and educator for Alzheimer's disease and dementia.
I bring her on to tell her stories within this torrential field of the brain and its
patients, not only as a provider but also as a loved one being a daughter whose mom
had dementia.
Truly the mind is a devil's playground and the brain can truly storm, but can the same
brain and the same mind take us from that downpour and bring upon the sunlight and rainbows?
(03:26):
This episode is such a special and heartfelt one.
Forget the medicine and the time to fick logistics.
Just listen to the humanity of the conversations that occur in this discussion.
I hope you get something out of this episode and I'm sure you will.
Thank you for tuning in.
Let me rest my voice.
(04:10):
This is a super important and very informative discussion.
You know, May is a month of many awareness days, right?
It is.
It's mental health awareness month.
It's also brain cancer awareness month.
And can I think of anyone more perfect to join you tonight than you to speak about all
of these special and super, super pertinent topics?
(04:31):
If you could just first please introduce yourself to everyone.
Thank you so much.
Yeah, of course.
First of all, I'm so excited to finally meet you officially.
We've been talking for so long and I'm just so honored that you would think of me.
I'm no expert, but I'm an advocate and I'm passionate about these topics.
So I'm really excited.
(04:52):
So my name is June Young.
I am a board certified nurse practitioner.
I'm currently working in Southern California in the department of neuro-oncology.
I've been doing this for about almost six years now and it's just kind of interesting
how I fell into this specialty that I will kind of, you know, talk about a little bit
later.
But I've been a nurse practitioner for the past, wow, I'm going to be aging myself about
(05:15):
16, no, 17 plus years now.
So I'm an expert.
I did the family nurse practitioner track at UCLA.
I graduated 2005.
So maybe for like about 12 years, I worked primarily in primary care, urgent care.
You know, honestly, I just needed some flexibility because, you know, during the whole time I
(05:38):
was either pregnant, having kids and doing all that.
So you know, the urgent care is just like a great place where you can, you know, still
work, have great experience, but you know, there's more flexibility there.
And I think after my third child, he was about three, I felt like, okay, now I can like specialize
and do something, you know, delve a little bit more deeper into something.
(06:01):
I don't want to say more interesting because, you know, primary care and urgent care definitely
is its own, you know, it's great.
I love health promotion.
I love teaching and I like all the aspects of all of that.
But I just felt like I did it for so long and I just wanted to do something different.
So why neuro-oncology?
Honestly, I don't know.
(06:22):
I just started like applying like all these different specialties and then, you know,
did all these interviews and that one kind of just like, yeah, that's one that stuck.
But I just have a little fun fact toy for you.
Guess which two subjects were my least favorite in school?
I'm going to give you a guess.
Is it neuro-oncology?
I'm not even kidding.
I've been thinking like, ugh, like neuro, it's just so hard to wrap your brain around
(06:51):
literally.
It's just so intense, right?
It's like you could do like a whole year on neurology and oncology, I was like, oh no,
I'm not going to touch that, you know.
You know, at UCLA they had like an oncology track and one of my friends was in it and
I was like, you know, you do it, you do it, you know, it's like do all that chemo and
everything like it's just, but you know, like life just kind of takes you places and yeah,
(07:15):
so that's kind of my little.
Yeah, I love it.
I mean, I must say I agree with the whole neuro part.
I think if there's one like block or subject during nursing school or whenever I'm trying
to learn something, right, like in the same biology, neuro is always the system where
I'm like, I have no idea how I'm going to remember or understand any of this.
(07:39):
There's just so many things going on at the same time.
It's not just the brain, right?
It's like also the spinal cord and all of the deep matters of the brain and you got
to like know which part does this, which part.
And then all the cranial nerves as well.
I agree with them.
But I love how you're like in neuro-oncology and your least favorite are neuro-an-oncology.
(08:01):
I just sometimes like laugh.
I'm just like, how in the world did I end up here?
But it's just been such a like amazing journey.
You know, I think it was a fear like of doing something that I didn't know that I could
like perfect, you know, after being a nurse practitioner for about like what?
12 years, like to go into like a specialty and not really be an expert and like be new
(08:26):
where I'm kind of like older.
It was really kind of scary.
But I think this just kind of proved to me that like, you know, you have to do what scares
you because that's kind of where you're supposed to be.
Yeah.
And like every time I like shy away from something that I'm afraid of, I regret it later because
I feel like I was supposed to do that.
And so why I apply, I just didn't assume they would hire me because I don't have any like
(08:50):
neuro or like, you know, acute like neuro ICU or anything like that.
They said that they hired me because I have such a strong medical background.
And I didn't understand that until like I delved into neuro oncology and I realized
how much I needed that, you know, to treat my patients because, you know, when they have
cancer and are having chemotherapy, there's so many other, you know, things that happen
(09:13):
that we have to manage.
So they wanted that part of my experience.
And you know, it's been kind of a whirlwind the last like six years, like I would say
like the first two years of it, you know, nurse practitioner, we're not like a med
school, but I was literally like in my backpack had like big books.
I was like up all night.
My husband was like, I feel like you're in med school.
(09:34):
I was like, I feel like it too.
It's just such an intense, like there's just no way that I could have prepared for it without
just learning as I go, you know, and I really appreciated my colleagues who just kind of
guided me because, you know, I'm not the physician, I'm a nurse practitioner.
So I have a different role, but just learning all about the different cancers, the brain
(09:57):
cancers and like the different types of treatment, you know, like the complications that arises
from all of that, you know, it was a really big learning curve.
The first year I felt like an imposter.
I can't imagine.
Yeah.
I mean, like neuro in itself is like so complex, right?
I mean, even our previous guests who were neuro like surgeons or like specialized neurologists,
(10:23):
even they say like, yeah, we can't even call ourselves like an experts in this expertise
because there's just something new every day, I guess about the brain.
I mean, I mean, you know, when we get to the cellular level, right?
Like our neurons, it's like just like spark things, just fire things.
You just never know what's happening, right?
Yeah.
(10:44):
Like we're learning every day.
Yeah, like we're learning something new every day.
So I can't imagine how big of a learning curve that is.
Well, I guess take our audience into that June who was there for the very first time
was like having this learning curve too.
For those who may not know, for the general public, I guess people are aware of like neuro
is and they're aware of what oncology is like in separate entities.
(11:08):
But in the life of neuro oncology, what are we really talking about?
Like what are the things that you see in neuro oncology?
And let's say, oh, I'm going to work today.
I'm a neuro oncology and peak for sugar, like top three.
These are the top reasons why my patients come to see.
OK, so it's pretty super specialized.
(11:28):
You know, you had the oncology doctor previously and that's such a huge field.
But our specialty is extremely like, you know, it's a niche.
But you know, surprisingly, we do have a wide set of diagnosis.
But I would say like the top three diagnosis is that we see the, you know, glial blastoma.
It's the most common primary malignant brain tumor, maybe meningioma and like brain metastasis.
(11:54):
We see patients who have primary cancers somewhere else and then it metastasizes the brain.
And then we have to get involved in terms of like, you know, how we perceive the treatment.
But I would break up my day like maybe like in two parts because I do inpatient and outpatient.
So inpatient, because I work at a teaching hospital, we see a lot.
(12:15):
We don't actually like admit patients.
But like, you know, in the emergency room, if someone presents with they suspect a tumor,
they do CT scan, they find something, they consult us.
So then, you know, I'll go across.
Our outpatient clinic is on the same campus.
So I'll walk over to the inpatient consult, like the new person.
And then we kind of like help them.
You know, we're basically like a team with neurosurgery, like neuro, like medicine.
(12:38):
We work together and kind of get this person if it's like something that needs to be treated
like right away.
Neurosurgery will, you know, jump in and do surgery.
And then we'll say, you know, we'll see you after you recover our outpatient clinic.
You know, when I round, it's more of just like a history and doing like a complete like
neuro exam to see where their deficits are before and after surgery just to see how they,
(13:00):
you know, how we can help them recover.
And then outpatient wise, which is kind of like, you know, the bulk of what I do, you
know, it's like an eight to five Monday through Friday clinic.
We have a couple of neuro-oncologists and there's me and another NP and we have a neuro-oncology
fellow and we have a really amazing team of nurses and medical students.
(13:21):
They're like case managers.
But my role is pre-KMO patients who have already established like their treatment plan with
the attending.
A lot of times if it's a new consult, like from another hospital or like we didn't end
up seeing them in the hospital, they'll come see us outpatient as like the first time meeting
us.
Then I'll just do like the whole, you know, history and physical and get all the information
(13:43):
and do their exam and whatnot.
And I'll see them in tandem with the attending physician.
So basically once the treatment plan is in place, then whatever it may be, like if it's
an oral chemo, an intrathecal chemo, and I'll kind of talk about that one more, or if it's
like an infusion, which we'll get like in the infusion center, then they'll see me like
for the subsequent visits for like pre-KMO visits just, you know, to see how they're
(14:06):
doing on the chemo, review their labs, if there's any issues, like any side effects
they're having and just kind of like guiding them through the process because you know,
this is a pretty, it's a hard diagnosis.
I mean all cancers are difficult, but in this case, a lot of our patients are terminal.
Unfortunately, glioblastoma, you know, there's no cure like over the past like 60 years,
(14:30):
there's no cure and there's definitely lots of research.
We do a lot of clinical trials at our facility as well.
So that's really cool to be a part of that.
But it's still like, you know, it's basically, we don't know.
I do a lot of like counseling.
I don't have any professional like training, but it's just like on the job training that
I just try to help guide my patients and also their family members because you know, and
(14:54):
it just goes so fast.
Like once they're diagnosed, then there's surgery and there's like chemo and radiation
and like labs, MRI.
It's like just, it's constant and throughout the whole process, I feel like they're in
shock still, you know, and then I think they're just like, it's just so much information that
I feel really bad for them that, you know, it's kind of like a really short, intense
(15:18):
time where they just have to like just accept it and just go, you know, we don't have time
to just like let them fit with it because it has to be kind of quick.
Yeah.
Yeah.
I can't imagine.
I mean, I think it's with all cancers, right?
Beyond like just the physical toll on the patients, right?
The whole emotional aspect involved, right?
I guess when it comes to cancer, I think a common question that either the patients or
(15:40):
their family members always ask us like, why, right?
Like why does it happen to me or to my loved ones, right?
So you experience with all of these patients that have, whether it's gliobasomas or angiomas
or even just like metastatic cancers to the brain.
What have you seen to be a commonality in their histories as to why many of these cancers
(16:02):
arise?
Like are there common risk factors that you see in these patients?
You know, I get asked that question a lot and I actually asked that question to the
director when I first started.
I was like, so what is it?
Is it genetics?
Like, is it the water?
Like, is it the food?
Like, what is it?
You know, is it like the phones, like micro?
(16:23):
Like you just like want to like, you want the answer and you want to be able to tell
people so that you can prevent this.
Fortunately, like most of them, they don't know, you know, like for glioblastoma, they
really don't know how it just kind of like, you know, from the glial cells in the brain,
how it just kind of starts.
I mean, it's more common in men and it's more common in older people.
I just, I think it's just a combination of just bad luck and like environmental things
(16:49):
and maybe just, I don't know, I can't really say, you know, I can't give the answer, which
I wish I could, because I would just, you know, be yelling it from the mountain top.
But you know, meningiomas though, they have like a previous history of like childhood
cancer and receive radiation, then that is a risk for meningiomas.
Metastatic cancer, that's just something that, you know, there's really nothing.
(17:11):
But for brain cancer, like neuro-onc issues, like there's really nothing, you know, we
can tell people like how to avoid, you know, I think just in general, like avoiding toxins,
like forever chemicals, just overall, like generally, you know, eating better and whatnot.
Like I think definitely like, you know, that comes into play.
But you know, like sometimes like when I read articles, how like there's like that one like
(17:35):
city like in the middle of United States where like, there's like a hundred people diagnosed
with like glioblastoma, then I'm like, what's going on?
You know, there's gotta be some kind of chemical that has leased into their system and it's
causing these like mutations in the cells.
So I think, you know, there are certain risk factors, but we just can't like hammer say,
it's like, oh, it's one, two, three, and just avoid it and you'll be fine.
(17:57):
Yeah.
I mean, even our previous episode with Dr. Sanjay, he's the oncologist, very funny and,
you know, very intriguing to hear that he said the same thing as you, it's just bad
luck like it's literally just a combination of just things that just go wrong and go haywire.
Right.
Yeah.
And I guess in those situations, it's really so hard not to question why, right?
(18:23):
Why does this happen?
And I think secondary to why is like, how, how do we get through this?
Right.
You know, I think brain and spinal cord cancers have gotten this reputation of, like you said,
it's like the scarier forms of cancer, right?
Like when people, especially when I watch movies, when someone says, oh, you have brain
(18:45):
cancer, my mind is like, oh, that's it.
Yeah.
You know, like, that's it.
Like, like you said, it's terminal, right?
But with our current science and medicine, what is the deal with neuro conditions and
cancers?
Is it a treatment basis?
Is it, we're just trying to improve the quality of life?
Is there in this small or probability of hope that, you know, we can actually go into remission?
(19:10):
Yeah, that's a really great question.
And I think that's actually, I wish more people would ask that because for example, like I
said, like if you have like a, you know, grade one meningioma, neurosurgeons will actually
tell their patients, oh, it's not cancer, you know, but neuro-oncologists will be like,
you know, if there's something in the brain, like it's a tumor, I never use the word benign
(19:31):
because I think that people kind of like hinge upon that because, you know, grade one can
still come back.
It's slower and it's unlikely, but actually seeing grade one meningiomas like come back
with a vengeance as well.
I mean, after surgical resection, some of the more, I guess, you know, benign cancers,
like just tumors that we like schwannomas and the two adenomas, like these are not like
(19:52):
terminal, you know, we kind of watch these patients over.
We do like serial imaging, you know, whether it's every two months, every three months,
four months, six months, and we kind of just, and some people just kind of do well.
But in terms of talking about like the terminal malignant brain tumors, like glioblastoma,
that's kind of like, you know, our heaviest population, you know, without treatment, you
(20:13):
know, studies have shown it's about like a six month overall survival rate, which is
pretty, it's pretty fast.
So with surgery and with treatment, you know, we can hopefully extend that to between like
18 to 24 months, depending on like the genetic mutations and markers that we find in the
tumor, some respond better to treatment, but sometimes it's quick and some people just
(20:36):
don't do well.
And I think like, initially, when they come and see us, we do tell them that it's malignant
and it's incurable.
So we let them know upfront, like, cause you know, they're going to Google it as soon as
they can, right?
It's going to just tell them all this terrible things.
And so we don't sugar coat it because they have to know it's their body, you know, they
have to know how to like deal with it and like with their financial situation and their
(21:01):
family situation.
But I know our neuro-oncologists don't like to hammer in like a date because like I said,
then, you know, patients tend to just like clean onto that number, you know, see like,
oh, you promised me 24 months and sometimes it's less.
We just kind of like leave it open ended because we do have these rare, rare cases where, you
(21:22):
know, some of our patients have lived like longer.
I feel like our physicians have a really hard job in kind of giving that balance of hope,
but yet reality so that they don't live the last few like weeks or days, just like wasting
away in a hospital.
And so that's actually one of the biggest struggles that I've had as a nurse practitioner
(21:45):
working in this field.
I feel like I'm kind of like, it was between me and the social worker.
We had many conversations where like, I see the doctors because they're so focused on
like treating patients.
They will give them every option.
Oh, we have this new clinical trial.
We have this new medication and it's, you know, their heart is in the right place because
they're healers.
(22:06):
They want to give them hope.
They want to help because that's why they're in this field.
And that's why the physicians that I work with currently, they're so good and I love
them and they're like the best human beings.
They're super humble.
They're super smart.
They're passionate and they're kind.
And I feel like as a neuro-oncologist, you have to have those qualities.
But sometimes like what I kind of start seeing like, oh, my patient is sleeping for 20 hours
(22:30):
a day, you know, they don't want to eat.
Like they're not responding.
Like, you know, like you kind of start to like, you know, being in this field for six
years, I kind of start seeing the end, which is really hard.
It's really hard to kind of tell the family.
But I think the patient kind of knows, but sometimes like we give them like a different
(22:50):
option.
And then, you know, I've seen some patients like when I feel like maybe the last three
months they should have just been like on hospice or just, you know, quality versus
quantity.
I think it's hard to like find that perfect balance.
And I feel like that's the struggle that I feel like I'm trying to like, you know, trying
to learn better on how to like get our people to have like an optimal treatment time.
(23:15):
Like we want to give them this quality 18, 24 months, you know.
I just hope people who are watching aren't just thinking, oh, you know, that's the time
frame.
It just could be longer, like I said, could be less.
I focus on trying to give them the quality, you know, and I do have these conversations
with them here and there.
When I start to see that their quality is not there and like they want to travel, they
(23:39):
want to like see family and I tell them, you know what, you can take a little break, like
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But it's a tough, it's tough, Christian.
Like it's hard.
It's hard for me.
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(27:02):
I feel like in this matter, we always think of again the emotional and the psychosocial
toll on the patients and their loved ones, right?
But also takes a toll on the healthcare providers who are part of the care team or taking care
of these patients, right?
Especially when they always say you don't want a patient to just exist, right?
(27:25):
You want them to actually live, be alive, even if that means like just a piece of quality
of life, right?
I think especially for brain cancers, right, or brain tumors, for example, if it's a lung
cancer or it's a lung tumor, it's like a very localized set of, I guess, presentations
(27:46):
and the feelings that the patients feel.
But when it comes to the brain, the brain is so interconnected.
It's like, oh, you have a tumor here.
That means there'll also be a problem with your hormones because it's suppressing, I
don't know, the part of your brain that releases this hormone or it's pressing on the cranial
nerves.
So you can't actually like move this extremity anymore.
(28:07):
Your hearing is impaired.
I always think that with brain and spinal cord cancers and tumors, it's just so hard
to navigate, right?
Because so many things are involved with it.
Like it entails the whole body, right?
And I guess it's so, I can't imagine how difficult it is for you as the NPS, the healthcare provider,
(28:28):
these patients of seeing some patients just from a better word, like just to waste away,
right?
Like not being able to do what they can do before.
And you're right, patients, I feel like patients know when the time is coming, right?
How do you deal with that as the healthcare provider?
Like how do you deal with this emotional and mental toll of these heartbreaking stories?
(28:53):
Oh, I did not do well the first year, let me tell you.
You know, I've just, you know, primary care, urgent care, like, you know, you just see
different things.
They're not so like devastating.
And being, you know, I think I learned that I think I'm an empath, like so I absorb emotions.
I tend to just kind of like, I wear my heart on my sleeve, you know?
(29:14):
A lot of my patients who have these diagnosis, they're like the nicest people, you know,
I don't know what it is.
And I just feel not that like, if you're not a nice person, you know, it's any sadder,
you know, it's not a sad, but I just become kind of like intertwined in their lives because
I ended up seeing them quite a bit.
And you know, we kind of share our lives together.
(29:36):
And so it's like, kind of like a, like a surrogate family.
And so it's the first year I didn't know how to separate myself from my patients.
And in a sense that like, you know, when they, I saw them, you know, kind of taking a turn
for the worse, like it was hard for me to step back and kind of protect myself.
I think you understand what I'm saying.
It's like, you know, cause I don't have closure when they pass.
(29:59):
Cause you know, sometimes we'll just get a call over the weekend that like so and so,
you know, ended up passing.
Cause sometimes at the end, you know, there's complications, like it could be a heart attack
or a pulmonary embolism or something, not even the tumor itself, you know, that ends
up causing the issue.
So it's like, you're just kind of like, you know, you just kind of have to move on.
Right.
And so I would just kind of push that down and go see the next patient.
(30:21):
But you know, that person's smile, you know, their eyes, like it's still like in my thoughts.
And so like that first year on the weekend, I would just start like bawling in my car.
Like I'm going somewhere and I'll just be like, Oh my God, like what do I do with these
emotions?
Cause I really do.
I felt it, you know, and I just felt like I felt for them and for their family, like
(30:43):
how did they process it?
Cause it was, it's just so unfair and it's just so fast.
And I wish we could find a cure for all of this.
But my husband, you know, he knows me really well.
He told me like, you know, I didn't want to like keep myself distant because then I didn't
want to come off cold, you know, like, like, but yet he's like, you have to find that balance.
(31:06):
And he's like, you know, he did tell me like, you just have to process it.
Don't suppress it so much.
And so I started just letting my feelings happen, you know, like that day when I'm going
home, like I'll kind of like think about their lives and just, you know, it gives me peace
that like, instead of thinking that it's a life loss, which it definitely is, and there's
(31:26):
a big hole in that family's life now, because it's a hole in my heart, you know, as I've
known that person.
But when I think that impact that they made on me and this world that meant something,
you know, and I'm able to kind of bless them and just kind of like, you know, hope that
they're in a place that's better.
And also helps that, you know, a lot of my co workers, the nurses I work with, once in
(31:48):
all, we'll have like a big fencing sessions and just kind of like cry together.
Because everyone that I work with, they have big hearts.
And it's not like we're just like, okay, next person, you know, we all kind of become like
family in a sense, in a sense, right?
So it is difficult.
And I don't think I've mastered it.
Because once in a while, it'll like creep up on me.
(32:08):
Because I think like the first year to like there was patients that like just, you know,
as me as a brand new Neuro-On-College NP, like I met them, like they're like my first
patients and when they passed, that was really hard.
And I still think about them, you know, and I just feel like, like, how do I deal with
these feelings?
But I think it makes me, you know, do my job a little bit better, you know, like going
(32:31):
forward.
But like, I feel like even including my education, my experience and my emotions, I kind of like
just push it forward to the next person.
I don't know.
It's hard.
Yeah.
Yeah.
But I can feel your heart like for these patients.
And again, it is so hard, like such a field where, I mean, do we really know what goes
(32:54):
on in Neuro, right?
Like, again, like there's something, always something new going on, right?
Yeah.
And I feel like aside from just the cancer aspect, which I know comprises a lot of your
work in your very, very specialized field, right?
I think Neuro in itself, even outside of the oncology aspect, again, it's such, that's
(33:16):
why I don't like it, right?
Well, I like it, but I just can't do it.
Same.
Same.
I can't do it because there's so much.
It's okay.
I can do it.
Yeah.
Yeah.
I mean, I feel like a part of also that complex topic within Neuro in itself, which I know
that you love educating about is Alzheimer's disease or dementia, which again, I guess
(33:38):
me and I remember in nursing school, I was like, so what's the difference between these
two?
You know, I think the first time I ever heard of, I guess the concept of dementia was, have
you ever watched the movie, The Notebook?
Yeah.
Yeah.
I know.
Like in the end, I think it's like sundowning.
I was like, wait, what's going on?
(33:59):
And this is the first time I ever Googled, oh, dementia.
And then part of the search list was also Alzheimer's disease.
So can you please educate us on what is Alzheimer's disease and how is it connected to dementia?
Oh, okay.
So Alzheimer's disease, well, I started kind of like delving into like learning more about
(34:21):
Alzheimer's disease and dementia because, you know, my mom was diagnosed quite early.
She developed early onset Alzheimer's and she was like 55, I would have to say.
So I was just kind of in shock, you know, but I remember my paternal grandmother also
has Alzheimer's.
So I was like, you know what, I need to know a little bit more about this because, you
(34:41):
know, you learned a little about in school and you're just kind of like, right.
But Alzheimer's disease is a part, you know, it's dementia also, but it's basically where
it's just a description of there's like a built up of like amyloid plaques or like the
talatangles that they call, you know, crazy neuro terms, right.
(35:04):
But they build up in your brain and that's how you develop this dementia.
There's like, there's another Lewy body dementia where the Lewy bodies, you know, build up.
There's vascular dementia where it's like the breakdown of the vascular system and that,
you know, you develop dementia that way.
And there's frontotemporal dementia also, basically it's that area of the brain that
you develop.
So you just have different symptoms, you know, so dementia is just kind of like a group of,
(35:29):
you know, where you have memory loss, your personality changes.
We just lose those memories, you know, that are certain parts of your brain.
Yeah, but I'm no, I'm no expert in it.
I just, you know, every day I just try to learn a little bit more about it.
Yeah.
But, you know, I'm all about, you know, I've been excited about it lately because, you
know, like, I think what we hear is that, oh, you know, once you have it, you know,
(35:53):
that's it, right.
You can't, you know, or if you're destined to have it, you can't really prevent it.
Like I remember when I was initially looking into it a couple of years ago, they were not
really talking about any modifiable like risk factors.
So basically like, oh, you know, you're screwed if it happens, it's like hits you like a brick,
like there you go.
Right.
(36:14):
And, you know, great that there's no actual medication that's actually going to help you.
Right.
They think like some medications may slow it down, but there's still actually no, like
there's no proof that any of this actually works.
But I've been excited because there's a lot of research that happening now that shows
that there's actually you can somewhat prevent it, you know, obviously, if it's going to
(36:35):
happen and actually still happen, but you can kind of like modify it and kind of like
prolong it so that it doesn't happen sooner.
Yeah.
And I think, you know, I guess you could speak more about this because I know that in telling
your story, right.
But you can imagine how heartbreaking it is, right.
I mean, I know memory loss is not the only effect of it, right.
(36:58):
There's so much more like cognitive aspects of it as well.
Right.
And I agree that I guess this is where science is so helpful.
Right.
It's always something, you know, we can learn about it every day.
I think it was only recently, too, where people are like, oh, maybe like B12 has something
to do with it as well.
Right.
(37:18):
These things that just something new every day.
And I guess we learn more about the disease process itself.
Right.
And I guess I remember when I was first watching the movie, I was like, oh, so is it only a
memory loss?
And then I guess throughout the years, we learned that, oh, wait, there's so much more
(37:39):
to it than just like losing memory.
Right.
Or like the cognitive changes and stuff like that.
I think it also goes to a whole message of just the brain health as a whole.
Right.
Like, I guess how we can optimize like our brain health now.
Right.
Like, even if we may not have any very definite studies on, oh, these are the specific ways
(38:02):
that we can avoid or prevent Alzheimer's disease or dementia.
I guess just the whole aspect of just brain health in itself.
It's so important to know and learn about.
Right.
And I know you're a huge advocate for brain health and also mental health as well.
And as we're talking about memory loss, I wanted to know what does brain health mean
(38:26):
to you?
Is it just about memory?
Is it just about focus?
For you, how would you define brain health?
For me, I think initially it started with memory loss because I was kind of like thinking,
oh my gosh, like, what if I develop Alzheimer's?
To me, I told my husband, like, if I develop Alzheimer's, I said just kill me, you know,
because I don't want you dealing with it.
(38:47):
I don't want my kids, you know, he was like, that's kind of severe.
But to me, it was initially a memory loss.
And then I just realized it's so much more than that, you know?
And as I kind of like started delving more into how to prevent it, I realized it's just
about like just overall brain health, you know, which encompasses like the mental health
aspect of it, just like, you know, like the social interaction factor, hearing, nutrition,
(39:14):
and like exercising and just like maintaining healthy blood pressure and, you know, your
blood sugar levels and sleep, you know, all of that together.
Because basically, to me, I realized that when I didn't do certain things that was
brain healthy, like, I just didn't feel good, like, overall, like, I didn't feel good,
(39:37):
like physically, spiritually, like, you know, emotional, I just felt like really like, you
know, poopy, right?
Because I wasn't taking care of my brain, then my body wasn't being taken care of.
And so I just realized, it's like, you know, yes, like people argue like cardiovascular
health is like, oh, that's important thing, like eye health, like teeth health, all of
that, you know, like skin care, like I love, you know, skin care, you know, you're glowing
(40:00):
right now.
I'm so jealous.
Hi, Jamie.
Thank you.
Jamie, I need to go see you.
But like, I realized brain health is such a pivotal, like just just overall like living,
right?
I just realized like, you know, why not just focus on brain health so that overall, like
(40:21):
it'll improve everything I realized for me, yes, eating healthy, for sure, it's a big
thing, but for my body type, I have to exercise, or I don't feel good.
But when I learned that when you exercise the brain derived neurotrophic factor, it
increases and that goes into the hippocampus.
And that's where your memories are stored.
(40:43):
Right?
And so I was like, oh, it's no and then you know, you just feel better and your muscles
get stronger.
And so then your bones don't like fold over when you get older.
Yeah, right.
So I was like, okay, that's awesome.
And then when you eat better, it just feeds your whole system.
And so, like to me, I always ate fairly healthy, I would say.
(41:04):
But you know, like I get lazy and I'll just eat like junk, but then I'll just feel like
junk.
You're so young, you know, you have I ate so bad when I was your age.
But now like, you know, 40 something, and I don't eat good, I feel it right away.
But you know, when I learned that, like, what I eat actually affect my serotonin levels,
(41:27):
which you know, affect how I feel like mentally and physically, you know, I started kind of
looking into, you know, better foods.
And then when you sleep, you know, who knew that when you actually slept a good seven
to eight hours, you know, your, your brain is actually detoxifying.
And so sleep is so important, because you know, I used to be a night owl, and I would
(41:49):
like, you know, pride myself and getting like four hours of sleep, you know, like, I used
to be that way.
But I realized like, older now, and so it's harder.
But I'm happy like, because, you know, when you sleep more, you know, your skin looks
better.
You know, you just you're more like alert.
(42:10):
But besides the fact that detoxifies, you know, I always tell my son, like, when he
studies at night, he needs to get like the good like, you know, six, seven hours of sleep,
because actually, when you sleep, your brain actually goes over all the material again,
and kind of organizes it and puts it away.
And that's how it retains the memory.
And so, you know, if you just like cram and you sleep, you know, it's kind of it's helpful.
(42:35):
I think the whole aspect of like brain health, everything you mentioned, its effects, it's
not only like, for us, right, it's also for the people around us as well, right?
It influences how we interact with other people, how we respond to other people.
And personally, like me too, I guess it's changed over the years.
(42:57):
But when I was in high school, like I can survive, actually, even nursing school, I
could survive on two hours of sleep within like a three day period.
Not good at all.
I'm not this is not medical advice.
I'm not recommending it to anyone.
But definitely, my brain was like, your brain just stops automatically, right?
(43:20):
You will fall asleep because your body, especially your brain has this like automatic like sensor.
It's like, okay, we're going to shut down right now.
Right.
And I guess especially, especially in the long run, like it's so unhealthy to sleep
or even just constant exposure to like constant stress, right?
(43:42):
Like stressors and how have you seen like, just like stress as a whole to affect brain
health in general?
So like from my patients, going back to neuro-oncology, I have patients who obviously don't deal with
their diagnosis very well.
They tend to be on the younger ones, which is extremely unfortunate, because then they
(44:06):
have a lot of just anxiety and worries like financially, like if they have young children,
they're worried about their children and their spouse.
So needless to say, they have a lot of stress and they come into their appointments and
all like tense and like, you know, like, and I just try to, it's just so hard because you're
not in their position.
(44:26):
You can't just be like, don't worry, you'll be, you know, you can't say like, you'll be
fine.
Like you can't do that.
You can't minimize how they're feeling because you know, we have no idea how that feels,
right?
We don't ever.
But without like diminishing how they feel, I do kind of let them know that like after
getting to know them, of course, that like being actually more stress is more harmful
(44:50):
to them.
You know, like us as doctors, nurse practitioners, we can help our patients heal, like by giving
them treatments, medication or whatnot.
But you know, it's actually our own bodies and the own person that is facilitating that
feeling.
I really believe, right?
You have to create that environment for yourself.
And so I encourage them, I remind them that like, okay, they could spend the next two
(45:13):
weeks worrying about their next MRI and just waste that whole two weeks away by worrying
and it's gone.
Or they could worry, but don't just like, you know, delve in it and just sit there and
wallow for, you know, to actually do something and enjoy that time and try to like work through
their stress by going out and doing something if they're able to.
(45:36):
And when I put it in that way, they're just like, oh, that's right.
Like why would I waste that precious time that I have?
You know, actually, my patients who are more like lighter and just kind of like, you know,
living day to day to the fullest, I would say like they do tend to have less side effects.
I kind of want to say, you know, maybe not towards the end, but in the beginning, I do
(45:58):
see them kind of like manage it better and just overall, like it improves their own mental
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(49:38):
One of the last questions I wanted to ask was something so intriguing that you shared
I think a few weeks ago, which was a Harvard study on quote unquote social fitness.
And actually, since you shared that, I've been, I guess that's how the internet works.
Like my algorithm is just like all things about social fitness.
(50:01):
Oh, cool.
Yeah, what was the finding in the study that you shared on the social fitness?
And how do you think the pandemic has affected all of our social interaction, right?
And how do you think it affects our brain health in general?
You know, when I read that article too, I was kind of shocked because I thought they
(50:21):
were going to say something else.
But I guess it makes sense because, you know, we're not alone in this world, you know.
I was kind of glad that it did prove the point that we do need each other, you know, whether
physically or just like, you know, we're next to each other or, you know, communicating
via social media or whatnot.
We're just exchanging that like, I don't know what it is.
(50:42):
It's just when you see someone's face and you smile, then like, then all your endorphins,
you know, your brain happy chemicals kind of go up.
And I feel like, I think they didn't really talk about that.
But I feel like that's a big part of it, you know, that definitely during the pandemic,
you know, you saw a lot more cases of depression, suicide, and just people just like kind of,
you know, retreating.
(51:03):
And that's the part that kind of like, it was sad because during the pandemic, I think
before then, my mom was like able to recognize me and she was able to like walk and do things
and sing and interact.
But like two years into the pandemic, because you know, before the vaccine, like my dad
didn't want anybody to come over.
And so they kind of just sequester themselves inside the house, and she became bed bound.
(51:28):
You know, she wasn't able to walk and she completely like wasn't able to like she just
went downhill so fast.
She only had, you know, like one person to talk to the whole time.
And I was just like, Oh, wow, like she went down really quickly.
And I was like, you know, social interaction, social fitness is really important just, you
know, not just in Alzheimer's or like neuro-oncology, but just I think, just in general, you know?
(51:53):
Yeah, yeah.
Yeah.
I think I think it kind of like persisted the idea of no man is an island, right?
Like need that social interaction.
You know, I think last year we had a recording with one of our season two guests, she was
a pediatric speech language pathologist, Jovan.
And I asked her about the effects of the pandemic on children's ability to order progress into
(52:20):
comprehension and speaking.
She was like, the pandemic definitely took a toll on that.
Right.
And it just goes to show that even from an early age, leading that social fitness, that
social interaction, it just goes to show that we are wired for human connections, right?
We are wired for connections towards each other.
Right.
(52:41):
And I feel like it's so important that, you know, we get to speak to others, even I think
that's a beauty of social media as well.
Right.
I think during the whole lockdown and everyone was at home, right, people were at least form
connections like online.
I think that's what happened to all of us, right?
Like who could imagine that strangers online become friends because of social media, right?
(53:03):
So it's such a beautiful thing.
And that's why I feel like it's just helpful for us to have people around us, right?
And I think it's also helpful for us to also have time for ourselves, right?
To be able to do the things that make us happy as well.
Well, that's what I wanted to ask you is, I can't imagine how stressful, even though
you explained how stressful and how heartbreaking it can be working in neuro-oncology and, you
(53:29):
know, seeing patients or their terminal conditions and how do you decompress out of all of this?
How do you find peace?
What activities do you like to do to somewhat separate yourself from, you know, the heartbreaking
world of neuro-oncology?
I think Instagram.
You know what, honestly, I think I started like my account like kind of towards the beginning
(53:57):
of the pandemic, you know, and I actually met a lot of my close friends through Instagram.
I mean, I kind of half joking, but I think for me, like, if you look at me, I'm not
like an outdoors kind of girl, you know, but I love like going on like, I would say like
a moderate intense hike, like, like, like up in our neighborhood, like with my husband,
(54:19):
we'll walk for maybe like five miles.
We don't have a lot of those moments because, you know, I have three kids, high school,
junior high and elementary school, and they have full schedules.
I'm a full time working mom.
So our time is kind of limited with each other, but we try to make like maybe twice a week
or three times a week where we just kind of just drop everything and we'll just like walk
(54:40):
before dinner after dinner and whatever works.
So that's one of my favorite activities to do.
During the pandemic, I really just kind of I love doing yoga.
Because just physically, it's almost like it's very meditative.
But also, it's a it's like an actual physical workout.
I don't do that as much anymore because I just don't have the time for it.
(55:01):
But you know, I love doing yoga and just walking, think hanging out with my friends, you know,
like like we talked about, like the social fitness.
I try to make an effort to maybe like go out to dinner or like hang out, like a phone call,
maybe like at least once a week or maybe once every other week with like a friend.
And I try to like not go out with the same friends.
(55:23):
I try to like, you know, make new connections and just, you know, it's easy to kind of like
get in the rut and just kind of go out the same people over and over again.
But like, you know, when I watch your stories, I'm just like amazed at, you know, how many
social events like that you're able to go to.
I'm actually very impressed at the energy level that you have.
(55:49):
I love it, though, because I see how you just connect so well with everybody because you're
just so genuine and you're just so like wanting to know people and their stories.
And it's just it's just I love it.
And I'm actually learning from you.
I learned to just kind of like go out there more, you know, don't be so like stuck in
my ways and just meet, you know, just like the people that I know.
(56:12):
But like, like trying to, you know, even like through Instagram, too, like I've met so many
cool people.
Yeah.
And I went to like a conference last year.
We were basically strangers.
We stayed in the same room.
We're just like best friends now, you know, it's just like I would have never done that.
And I would have never had that friendship.
I think you just have to just like get yourself out there.
(56:34):
And that's a part of brain health, too, is like learning new things, doing new things,
like not doing the same things, because as you create those new synapses, then your brain
learns those new groups.
And then that's how you grow.
Because another aspect of like Alzheimer's and dementia is your brain starts to kind
of shrink, you know, and then when you get less mass, you have less neurons and you have
(56:57):
like less of that firing and everything kind of just gets smaller and smaller, you know.
But when you learn new things, like your brain's growing, you know, so that's just another
reason to.
And how can you forget our favorite K dramas?
Oh, yes.
We watch K dramas.
That's right.
I almost forgot.
For those who may not know, people wouldn't know, but me, June, and Jamie, we have a group
(57:23):
chat where we literally wait on each other to finish the episode.
We don't have a book club.
We have a K drama club where we wait for each other to watch the next episode of Singles
Inferno, first of all.
Oh my gosh, that was so fun.
It was so fun.
So I think things like that, right, like just things that you can look forward to, I think
(57:45):
brings like so much joy and just like you said, being able to spend time with a lot
of people, like I see many amazing people here watching, like Alex and Christina, who
said a child in high school, I thought you were 30 at most.
What does that mean?
She said that you look young.
Oh me?
Oh, thank you.
You know, I have a filter on because this closet, you know, I told Christian the only
(58:16):
quiet place that my kids and my husband won't bother me is my closet.
I'm literally sitting in my closet right now.
So the lighting is bad.
So I had to use a little filter, but yeah.
Oh, we love it.
You are glowing.
I mean, I feel like the amount of times, options that we had to canvass for this to happen,
(58:38):
and I was like, yeah, it will have to be 11 PM on Easter time because that is the time
when June is just a superhero.
She's like a super mom and it's just such an honor to speak with you tonight and just
learn so much about such a very specialized field that it's honestly so scary, right?
(59:03):
For me, neuro-oncology scares me.
I mean, like you said, it's like a death sentence, right?
The medicine and science now has changed that aspect, right?
Now people can actually like have hope, right?
That, oh, we can at least improve our quality of life, extend a lifeline, maybe not as long
as we want, but the ability to provide quality of life, right?
(59:26):
To these patients and their family members is such a beautiful thing.
And it's just so beautiful that you are a part of that workforce and that story that
I can't imagine how much it touches so many people's lives and such an honor and so fun
to talk to you tonight.
So, so fun.
(59:46):
I'm so bummed that we never got to hang out when we were in LA.
I would love to be back.
I'm so sad because I think we kind of for like five months and then we both, like none
of us could be, I don't know.
I really genuinely felt like horrible because I don't like flaking on people.
It just, there was literally no way I could have done it.
(01:00:09):
But man, I'm really happy.
That only means that when we finally all meet, the three of us, and also I think the NP mom
is here watching, maybe the four of us, right?
We have so much more stories to talk about.
And yeah, I am so excited and I'm just so honored that you joined me tonight and just
(01:00:30):
gave me your expertise and all of your stories and beyond all of that, just sharing your
heart because like all the way from here, I could feel like your love and like your
genuine care for your patients.
And it's such an honor to have someone like you on my platform.
Thank you so much, Christian.
I was honestly kind of nervous because you have some pretty heavy people on your podcast.
(01:00:54):
Excuse me, this is NP June Da Brain Health.
What are you talking about?
And honestly, I felt like I kind of just, you know, honestly, the topics that I picked
up, they're pretty heavy.
So I felt like I kind of glazed over a lot of it and there's so much more to delve into.
But you know, that's why you follow me and you learn a little bit every day.
(01:01:15):
Please follow June.
She posts this super amazing reels of just, you know, constant reminders of regarding
brain health and just staying, you know, just being present.
And you know, it's so easy to forget to take care of ourselves and our brains, especially
during such busy lives and busy days.
(01:01:36):
I can't imagine you're, you know, being a mom, seeing you and like working as an NP
and just, you know, just those reels are so helpful just to be reminded that take a pause
and you know, just breathe.
That makes me so happy to hear that, honestly, because sometimes I do it, like I have this
(01:01:56):
great idea and then I do it and I'm like, oh my gosh, why did I do that?
Like it probably didn't help anyone.
I'm just, I look super silly, but you know, I'm like, you know what?
It's okay.
I did it for myself.
So when I'm like 70 years old, I look back and be like, oh yeah, you know, there we go.
Yeah.
Well, Christine, I just commented saying my two brain cells.
Thank you too.
Well, I am glad that at least two of them were energized tonight.
(01:02:21):
Thank you, June.
Thank you for spending an hour and a minute with me in your closet.
You're welcome.
I had such a good time.
I feel so honored.
You just spent one hour in the closet for me.
Thank you so much, June.
Thank you.
This is not the last time that we will have a live stream.
There's so much more to talk about.
Like we said, neuro is an ever evolving field and so much research is coming out and so
(01:02:47):
much findings that we have to spread to the general public.
So this is not the end.
Next time they find a cure for Alzheimer's or glioblastoma, we're doing it.
There we go.
Bye.
Bye.
Thank you, June.
Have a great night.
Have a good night, everybody.
Be safe.
Thank you.
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