January 5, 2025 • 31 mins
01/05/24
The Healthy Matters Podcast
S04_E06 - How to Live to be 100 (or Die Trying...)
When it comes to our longevity, there's certainly no shortage of advice out there. We'll often get an earful about the superfood du jour, fad diets, or trendy exercise routines - but what's the word from an actual MD on the subject? Are there really keys to living a longer, healthier life? And can I still eat bacon?
Well, on Episode 6 of our show, we'll be joined by an extra special guest - Dr. David Hilden! He'll share with us his learnings from over 25 years in the field and help us develop strategies for how to live healthy, and ideally, long lives. From what we can do for ourselves, to what the medical community can do for us, there's a good bit of wisdom here for all of us humans. He'll also tell us what "ditzel" is... Join us!
We're open to your comments or ideas for future shows!
Email - healthymatters@hcmed.org
Call - 612-873-TALK (8255)
Get a preview of upcoming shows on social media and find out more about our show at www.healthymatters.org.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:01):
Welcome to the Healthy Matters podcast with
Dr. David Hilton , primary carephysician and acute care
hospitalist at HennepinHealthcare in downtown
Minneapolis, where we cover thelatest in health healthcare and
what matters to you. And nowhere's our host, Dr. David
Hilden .
Speaker 2 (00:18):
Hey everybody, it's Dr. David Hilden and welcome to
episode six of the podcast. Andon this episode, we're going to
be interviewing me.
Speaker 3 (00:26):
That's right. And hey, my name is John Lucas. I'm
one of the producers on theshow. And today yeah, we do
have a very special guest. It'snice to see you again. Why
thank
Speaker 2 (00:34):
You. Thanks for having me on the show.
Speaker 3 (00:35):
It's our pleasure.
Today we're gonna be talkingabout something that I think
we're all kind of interestedin, which is our longevity,
right? How do you live to be100 or die Trying is the topic
of today's show. So it's goingto be kind of a little bit of
maybe some things that we mighthave heard, but a lot of things
you might not even be thinkingabout. So , uh, I'm gonna kind
of turn it over to you becauseyou seem to be the expert on
(00:55):
all these things.
Speaker 2 (00:57):
Thanks, John . And, you know, people sometimes ask
me, so , so what's the, what'sthe warranty on the human body?
What is it? How long can Iexpect to live? And some people
can live a great long time.
Others not quite so much. Buthow do you live as long as
possible? And I sometimes usethat phrase, how to live to be
a hundred or die trying. Butthere was a why Sage once said,
(01:18):
you can live to be a hundred,John , you can live to be a
hundred if you give up all thethings that make you want to
live to
Speaker 3 (01:24):
A hundred. Yes, I've heard that line before, and I
think you're right. It is , uh,about a sage as it could get,
you know ?
Speaker 2 (01:29):
Yeah . That it was about a sage as you can get. I
do think that sage maybe wasWoody Allen, but , uh, uh, uh,
I'm pretty sure. But I think it, it actually , um, makes some
sense and people might besurprised. The things that can
make you live the longest arenot the things that you do in
your doctor's office. Hmm .
What your doctor does, orwhoever your clinician does, is
just a small percentage of theeffect on your lifespan. Now,
(01:54):
if you're sick, I wanna startright off and say, if you're
sick, if you're having asymptom, if you're feeling some
concern about your health, youshould go to your
Speaker 3 (02:02):
Doctor. Right. Diet , exercise might not fix
Speaker 2 (02:03):
That. That might not fix that. So that's not what
I'm talking about. I'm talkingabout your average person, you
listening to this podcast, whatdo I need to do to stay
healthy? Not what to do after Iget sick. Excellent . If you
get sick, excellent. Go to yourdoctor. That's my advice on
that one. But you might besurprised at the things that
you should and should not beworried about. So that's what
we're gonna talk about today.
Speaker 3 (02:24):
Excellent.
Excellent. Well, I say we diveright in then. So how do we
kick things off here?
Speaker 2 (02:28):
I want people to know that the things that you
do in your daily life, there'sfour big areas I want you to
know about. And if you attendto these things, that is gonna
give you your best chance ofliving a longer life. And, and
again, they're not things inyour doctor's office. So the
first one is about smoking, ofcourse. And that one sounds
(02:48):
like, oh my goodness, he'sgonna preach to us about not
smoking.
Speaker 3 (02:52):
Although you and everyone else who's been on the
show, I think this is kind of atheme that seems to come up no
matter who's on mic .
Speaker 2 (02:57):
It does come up a lot. And there are something
like 16 million people in ourcountry, in the United States
living with a disease that wascaused by their smoking.
Speaker 3 (03:08):
And this isn't Europe,
Speaker 2 (03:10):
Probably even worse over there, where, you know ,
you have a cigarette withdinner . Um, there are , there
are no, and I I repeat that.
There are no redeemingqualities to cigarette smoking.
Now you might say, well, Ienjoy, okay, okay , I get that.
Sure , I get it. I get it, Iget it. You , you like it. But
there are no good healthbenefits from it. It is
something that you can stopdoing and you should stop
(03:30):
doing. And if anyone ever tellsyou otherwise they're lying,
you can and you should stopsmoking. It leads to way more
things than people know.
Everybody, everybody knowsabout lungs. Sure. Not good for
your lungs. It is the leadingcause of lung cancers. Yeah.
But it , it also causesemphysema. Everybody knows that
lung cancer is the leadingcause of cancer death, and you
(03:53):
simply don't want that. Andthat might sound obvious, but I
have been at the bedside ofpeople with lung disease at the
end of their life. And you ,uh, trust me, you'd pick
something else. Yeah,
Speaker 3 (04:04):
Yeah, no doubt. But in
Speaker 2 (04:06):
Addition to the lungs, it causes heart disease,
high blood pressure, itexacerbates your diabetes. It's
one of the leading risk factorsfor bladder cancer. In fact,
there's like 20 cancers. Itleads to bladder cancer,
leukemia, pancreas problems. Itleads to fertility
complications in men and women.
So if you're trying to have ababy uhuh, it's not good women,
(04:26):
it's not good if you arepregnant. So number one thing
you can do, I don't thinkanything else that you do
matters very much if you'resmoking. Okay. You can't take a
pill to counteract that one. SoI don't care what else you do.
If you're smoking, that's thenumber one thing you should
quit. Wow . That's number
Speaker 3 (04:40):
One in technicolor.
Okay .
Speaker 2 (04:42):
In technicolor .
Right . Okay. And so I preachedright off the bat,
Speaker 3 (04:45):
Chad . Yeah , no , you know what, that's , uh,
that's kind of what people needto hear. Yep . Yep .
Speaker 2 (04:48):
I'm not gonna sugarcoat that one. The second
thing in your life is tomaintain a healthy weight. I
know people that equate obesityor being quite a bit overweight
to be in a health risk factoralmost to the level of smoking.
Now it's not all the way there.
It is true that there are somepeople are bigger boned and,
and the body mass index thatmany of us heard of is not a
(05:09):
perfect measure. Right . Butmaintaining a healthy weight is
very likely to help you to livelonger, at least reduce your
risk. How do you do that? Youcan't exercise your weight to a
healthier weight, but you mustexercise to stay healthy. But
it's almost all in diet, whichdoes lead me to the third
thing. And that is exercise. I
Speaker 3 (05:29):
Was afraid you were gonna say that.
Speaker 2 (05:30):
So you need to move more. Whatever you're doing. I
bet you need to do it more. SoI would suggest move more and
eat less. That's probably four. Okay . So
Speaker 3 (05:37):
There's no ceiling to this exercise thing then,
huh? Oh , we can't . We can't.
We we're never out of thewoods.
Speaker 2 (05:41):
No. I suppose Jesse Diggins moves enough, you know,
Olympic athlete from our homestate of Minnesota. I mean ,
Speaker 3 (05:47):
Don't tell her that.
Speaker 2 (05:48):
Don't tell her that.
Yeah. She's, she's saying , no,I don't, I gotta work out more.
No, 30 minutes a day every day.
Wow . But that, that soundslike a lot, doesn't
Speaker 3 (05:55):
It? That's a commitment. Yeah.
Speaker 2 (05:56):
And I don't , I'm not gonna lie,
Speaker 3 (05:56):
That's uh , that's , that's an Everest of a
challenge right there. Exactly.
Speaker 2 (05:59):
For many of us. But so what I tell people, you and
somebody might be listening andsaying, well, I can't go to a
gym for 30 minutes a day . Ican't do that. That's not what
I'm talking about. I'm talkingabout moving your body. And you
don't have to do it all atonce. Do it in three 10 minute
intervals. And it can bewhatever is something you enjoy
doing anyways. Maybe it'swalking, maybe it's gardening.
(06:21):
Maybe you're a very vigoroushouse cleaner.
Speaker 3 (06:23):
I am not. Uh ,
Speaker 2 (06:24):
But so get out there and vacuum a lot.
Speaker 3 (06:26):
Okay .
Speaker 2 (06:26):
You'll be good to go if you do that. Okay . Maybe
you are a runner or maybe youwant to do a rowing machine or
a stationary bike. It doesn'treally matter to me. Just
Speaker 3 (06:34):
Something
Speaker 2 (06:34):
Seat . Yeah. Go to the mall and watch the seat .
Get off the
Speaker 3 (06:37):
Seat . Okay . Get out and get out of the chair
and, and , and get moving.
That's the
Speaker 2 (06:40):
Stage advice that is . So, so far we've talked about
don't smoke if you smoke, quit,and don't start. Uh , and
number two is maintain ahealthy weight. Number three is
move more. Right. And numberfour is about diet. And this is
one that we're learning moreand more as the years go on. So
what I'd like to tell people iseat low on the food chain. That
means as many plants as youcan, a plant-based diet is the
(07:03):
best. Okay . It's not only bestfor you, it's, it's best for
the planet. A lot of benefits.
There's a lot of benefits. ButI'm not saying never eat meat.
If you're a meat eater, maybelimit it . And fish is probably
better than fatty meats.
Poultry is relatively , uh,healthy red meats are maybe a
little less so, but Right . Butstick to lean ones. And in
smaller portions, which bringsme the portion
Speaker 3 (07:24):
Size is is kind of a big one. Exactly. The portion
size is kind of a big one. Andit's kind a need to eat a one
pound steak. Exactly.
Speaker 2 (07:30):
You never in your life should be eating a one
pound steak. I'm sorry, for nomatter
Speaker 3 (07:33):
How big you are.
Yeah,
Speaker 2 (07:34):
Exactly. I'm sorry.
Purveyors of steaks. That's nothealthy. I used to show some
pictures of what even a coffeelooks like. Even a coffee. If
you think back to, I don'tknow, the seventies or
eighties, and you went to adiner and you got a little
eight ounce cup of black coffeein a cup with a saucer. Now
when you go down to your localcoffee shop, they're giant.
(07:55):
Yeah ,
Speaker 3 (07:56):
Yeah . And it's like the 64 ounce or the grand .
Speaker 2 (07:58):
Exactly . Exactly.
. Exactly. And I don'teven know what some of the big
chain coffee shops, what halfof those mean. Um, 'cause they
have all these words for 'em ,but then they show up with this
thing that's about a foot tall.
Yeah . This cup's about a foottall. Yeah . And about two
thirds of it is calories. Yeah.
So even your coffee is
Speaker 3 (08:13):
Bigger. Right, right. And it's not always as
easy as you think, becausesooner or later you get hungry
and the only thing around youis a quickie
Speaker 2 (08:19):
Mart. Right ? Yep .
And you don't even know whatyou're eating, so you do it
outta convenience. I, I wasrecently, this is a true story.
I was recently in Washington DCand met with someone from the
US Department of Agriculturebecause they were asking
physician leaders how we canbest get the message out about
diet. And they werespecifically talking about,
remember the old food groups?
Oh yeah. That was 30, 40 yearsago.
Speaker 3 (08:39):
Yeah . Do we still have those? Well,
Speaker 2 (08:40):
Yeah. That was sort of the state of the art back in
1970. But then they moved on tothe food pyramid, and now
they're calling it My plate ,my plate . You can go to the
government site and look at myplate. Okay . And it's what
should be on your plate. Andyou'd be surprised. The meat or
the protein is a smaller littlepiece on there. The vegetables
is a giant portion of yourplate. Dairy and fats is a
(09:02):
smaller portion, but it'sreally fascinating about eating
smaller and lower on the foodchain. And then the last point
would be far fewer processedfoods.
Speaker 3 (09:12):
Processed foods.
Right. And we just touched onthis recently with Dr. Aisha
Galloway Gilliam just a coupleepisodes ago, as well as
another show in season two,episode two with Dr. Kate
Shafto . Reading the labels,understanding them is such a
big piece of the puzzle and,and can be pretty hard,
especially when the marketingdepartment is playing against
you. Uh, a little bit of atangent, but I remember I had
(09:33):
an aunt who used to say, keepyour plate colorful. And I
think that that's always kindof a nice kind of just rule of
thumb. Just add some greens toit. Keep it red, don't eat
monochromatic.
Speaker 2 (09:41):
Yep . That's a , your aunt is smart. I've heard
she's a white woman. And Ithink Dr. Schau on one of our
previous episodes right here onHealthy Matters, talked about
eating the rainbow. Yeah,
Speaker 3 (09:49):
It's true. Yeah.
Yeah, I remember that one.
Speaker 2 (09:51):
Eat the dark orange things, eat the dark green
things. You find somethingthat's purple, eat it.
. And
Speaker 3 (09:57):
Maybe I'm just getting older, but those things
taste better too.
Speaker 2 (09:59):
They do taste better. Yeah . I, I sometimes
talk about the white foods andI , you know, and I'm guilty,
I'm guilty of this, but whitepotatoes, white pasta, white
bread, white rice, those thingsare filling and it's, they're
affordable often, but they'renot your healthiest option. Eat
something dark orange, darkgreen, dark purple, dark red,
(10:20):
whatever you can find, eat therainbow. So sold. All right .
Those are the four things youshould be doing in your life.
And even if you never saw adoctor and you should ,
sure , that's , but even if younever did , if , if you never
did, these are the four biggestareas to stay healthy. And I'll
just repeat them. They are,don't smoke, maintain a healthy
(10:40):
weight exercise and move moreand eat a healthy diet. Those
four things, if you'reattending to those, you are
doing 80 to 90% of what youshould do to live
Speaker 3 (10:51):
Longer. Excellent.
Some of this, obviously we'veheard before and putting into
practice is harder, but , uh,especially when you hear from a
doctor that this might be moreimportant exactly than blood
tests or anything like that,that this might be the key to
kind of, you'll just , just toenjoying the life that you do
have all that much more.
Speaker 2 (11:06):
And there are some things you should do in your
doctor's office. Sure , therereally are. Certainly there
really are. But if you are notdoing these four things or at
least attending to these,there's nothing in a pill
bottle that's gonna fix that.
It's not gonna counteract thefact that you're smoking. If
there is no vitamin that'sgonna counteract you carrying
an extra 50 pounds or there'sno supplement that's gonna fix
(11:29):
it. If you're watching TV allday long and you never move,
right. And there's really nomedicine or thing your doctor
can do, there's no blood testthat's gonna fix the problem if
you're eating garbage. Right .
So those four things, you needto do those first, or at least
think about how those thingsare in your life. And then
(11:49):
there are some things yourdoctor can do and there are
some things you should beasking for at your doctor to
take that next step to stayingas healthy as you can. And I'd
love to talk about those afterour break.
Speaker 3 (11:59):
No doubt. I was gonna say, it sounds like we're
about to get into those, butbefore we do that, we're gonna
take a quick break and we willbe right back
Speaker 4 (12:07):
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(12:29):
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Hennepin Healthcare is here foryou and here for life.
Speaker 3 (12:45):
And we're back for part two of our show with our
very special guest, our own Dr.
David Hilton. We kind of talkeda bit about what you can do in
your daily life. Uh, there werefour things we talked about.
And just to recap the fourthings we talked about in the
first part of this show. Onemore time, don't smoke. Can't
say it that loud enough. Andfor the cheap seats, there are
no redeeming qualities ofsmoking. Number two, maintain a
(13:06):
healthy weight. This isn'talways as easy as people think
it is, but it is nonetheless anessential piece of the puzzle.
Three is move more. That issomething that most of us can
do and I think everybody shouldat least try to do. And number
four is to make healthy foodchoices, which isn't always
easy again, but the better wedo at that, the better we'll do
in general. Okay, cool. Movingon. Now, when we do all those
(13:27):
things, it doesn't mean we'reout of the woods, right? Uh ,
there is a time that we'reprobably gonna have to go to a
doctor's office and what can wedo in a doctor's office or what
can we expect from the medicalside, from the medical
community? How can they help uslive longer? What , uh, where
are we headed with this? Yeah,I hope,
Speaker 2 (13:40):
I hope there I have some role , um, in helping keep
people healthy. And there aresome pretty sure you do. Yeah .
There are some things youshould be going to your primary
care physician or advancedpractice provider. If you see a
nurse practitioner or aphysician assistant, there are
some things you should be doingat regular intervals. People
might be a little surprisedthat the intervals aren't what
you think. And the list is alittle shorter than you think.
(14:04):
Hmm . And I wanna reiterate, goto your doctor if you're sick.
What I'm talking about here isnot that. Right? If you're sick
and you've got whatever yoursymptom is, you go in, there's
things ,
Speaker 3 (14:13):
We have doctors and hospitals
Speaker 2 (14:14):
For a reason, right ? That's , that's what they're
there for. But when should yougo in for just screening and
when should you go in for yourpreventive health? Now
everybody talks about theannual physical. Sure. I'm not
gonna get into that in too muchdetail, but most things don't
need to be done every year. Ifyou are an older adult, I'd say
mid forties to fifties, I dorecommend that you go in every
(14:34):
year. Okay? If for no otherreason for a check-in on the
four things we talked about inthe first half of the show, but
also for your blood pressure,checking for diabetes,
cholesterol, those areimportant. So go to your doctor
probably every year if you'reof a certain age, maybe
fifties. If you're younger thanthat, I don't know anybody of
that age. You don't knowanybody of that age. Yeah . One
day you will, John . One dayyou will. But when you're
(14:57):
younger, it maybe doesn't evenneed to be that often . But
what should you do when you getthere? That's the important
thing. Now, a lot of peoplethink you need a slew of blood
tests. You need to do bloodtests . Blood tests , blood
tests , blood tests. And you ,I mean, how else are we gonna
know? Yeah, exactly. You'd beshocked at how few blood tests
you really need. So I'll, letme tell you about the things
that you should be considering.
First of all, screenings. Whatshould you be screened for? And
(15:20):
a lot of people aren't realsure what that means, but
screening is a test that isdone in a person who does not
have any symptoms. Okay ? Aperson who feels, well, it's
looking for an illness, it'slooking for a disease. And
people think that there's ahundred things you should be
looking for. No, there aren't. Okay. Alright .
Whittle it down. So let mewhittle it down. There are a
(15:43):
few things you should be doing.
Number one, there are somecancer screenings that you
should do, but this list isshorter than you think as well.
If you are a person, and I justmean if you are a human person
and you've hit the age of 50,you should be looking for
colorectal cancer. Okay? Men,men and women. All women . And
women is one of the top threecancers. And it is one of those
(16:06):
cancers that is perfect forscreening. And what do I mean
by that? There's something tobe done about it. If we find
something. Okay ? And , and sowe can reduce your risk of
dying, of colorectal cancer,your colon's, your large
intestine. We can reduce yourrisk by, by screening. So if
you are 50, some groupsrecommend maybe 45, but the the
usual one is 50. Do something.
(16:28):
What is that something? Somepeople get a colonoscopy. Okay
. That's sort of the mostinvasive one, but it's maybe
the most thorough one. Otherscan't stand the idea of a
colonoscopy and they wanna do,so you could do stool testing
that's legitimate colonoscopy.
If normal is only every 10years, stool testing needs to
be every year. Alright ? And sothose are the differences. But
(16:49):
colon cancer, that's the firstthing I'd say. Okay. Breast
cancer screening in women,usually at the age of 50. Some
people recommend at the age of40, you get a mammogram every
year or two next to coloncancer. Those are the two
biggest ones. Get yourmammogram if you're at average
risk. If you're at higher risk,your , your mom, your sister
(17:10):
had breast cancer, then youmight even get other tests like
MRIs or, or genetic testing.
Okay? But for sure talk to yourdoctor about breast cancer.
That those are the two bigones. There are a few others
I'm gonna touch on, but Sure .
All people, those are the two.
Okay . Third one, cervicalcancer screening in women or,
or , or people , uh, who have acervix. And that is the pap
(17:32):
smear that every woman of acertain age remembers doing
every year. And the horrors ofthe stirrups and getting up in
that thing. This is one of thebiggest success stories of
modern medicine. We have almostnever heard of cervical cancer
in the United States. It's verycommon in the rest of the
world. Wow . And that's becauseof PAP testing. Okay. And we
now know that cervical canceris a sexually transmitted
(17:54):
cancer. Hmm . It is caused inthe vast majority of the cases
by the human papilloma virus.
So if you have a teenager boyor a girl or a young adult,
there is a vaccine against acancer. Wow. It is the HPV
vaccine. I can't recommend itstrongly enough.
Speaker 3 (18:12):
And what's the age range of that vaccine?
Speaker 2 (18:14):
That is for , um, pre-adolescent, up to mid, mid
range adult or mid people intheir mid twenties. It's a
three shot series. Yep . Ithurts. It doesn't hurt as much
as cervical cancer. No ,exactly. . And so
there's lots of ways to getyour cervical cancer screening,
but if you're a woman or aperson with a uterus , uh, that
includes transgender men, youshould be getting , uh,
Speaker 3 (18:33):
Pap. Gotcha. So those are the big three. What,
what other cancers do peoplekind of need to keep on the
radar?
Speaker 2 (18:37):
There's two more.
The one of them is lung cancer.
And that is in a limited numberof people. There is a CAT scan,
a CT scan you can get if youare, if you meet these
criteria, you're a smoker oryou quit in the last 15 years,
okay? You smoked at least 20 pplus years and you're between
the ages of 50 and 80, you getan annual lung cancer
screening. That's it. Nobodyelse. Okay? Um, you don't wanna
(18:59):
get an annual CT scan and allthat radiation if you don't
meet those criteria. Okay.
Speaker 3 (19:05):
Then the
Speaker 2 (19:06):
Last one ,
Speaker 3 (19:06):
It's for those who need
Speaker 2 (19:06):
It, it's those who need it. And the last one's
prostate cancer screening. Ifyou are, if you have a
prostate, a man or atransgender woman who has a
prostate, you can think aboutit. There's no recommendation
to actually get prostate cancerscreening.
Speaker 3 (19:20):
No actual guidelines. So fifties more,
Speaker 2 (19:23):
I do it in men who wish to, I have a conversation
with them at age 50. Why isthat? Everyone says, well, why
wouldn't I do that? Whywouldn't I get a prostate test?
Speaker 3 (19:31):
Sure, why not? Just know. The,
Speaker 2 (19:32):
The current US government recommendation is to
not, not get any prostatecancer screening because on a
population level, we couldscreen every single solitary
man in this country and nobodyon a population level will live
longer. Gotcha . Nobody , itdoes not statistically change
your lifespan, but the oneperson in front of you, it
(19:54):
might change that one person'slifespan. So we, it's a blood
test individual. You canconsider
Speaker 3 (19:59):
Individual . It's a blood test. Okay,
Speaker 2 (20:00):
That's a blood test.
So tho that's it. Those are thecancers that you should look
at.
Speaker 3 (20:03):
That's a lot smaller list than I thought.
Speaker 2 (20:05):
Yeah. We don't have a screening test for pancreas
cancer, for kidney cancer, forleukemia, for liver cancer, all
the other ones. There's no testthat you need to get. Okay. But
that's not all. There's someother thing . Those are just
the cancers. There are twoblood tests, all of two that
you should be getting at yourdoctor's visits, whether you
feel healthy or not. And thatis cholesterol and a test for
(20:28):
diabetes.
Speaker 3 (20:28):
Count 'em 1, 2, 1, 2.
Speaker 2 (20:30):
Alright , that's it.
If you are between the ages oflike 20 and 50, I would get
those tests every two to fiveyears. Okay? You don't need it
every year. Your cholesterolain't gonna change that much
every year. Your diabetes riskisn't gonna change that much
every year if their normal,every two to five years is
adequate. When you get a littlebit older, sometimes people
push that to a little morefrequently. But those are the
(20:51):
two blood tests, cholesteroland
Speaker 3 (20:54):
Diabetes and two to five years. So if you've got a
health scare in your family orsomething like that, maybe does
that increase the frequency orare you still kind of sticking
to those guidelines?
Speaker 2 (21:01):
Yeah . Um , people ask all the time, I need blood
tests. You gotta find what'swrong with me. The vast
majority of blood tests, we,you might have a little bit
something wrong with it . Itdoesn't meaningfully affect
your health, but now you knowabout it. And so there's
nothing to be done. So youworry about the vast majority
of them. Now, isn't it truethat, well, why don't you get
my blood counts? You could findleukemia true in , in one out
(21:23):
of hundreds of people. It mightbe possible to find those. But
the, the, the overall benefitof getting routine blood tests
is not there. There's norecommendation to get those
blood tests. Now, if you haverisk factors or you're feeling
some symptoms, of course we getblood tests. Okay? But I'm
talking about your annualphysical, you don't need as
many as you think talking
Speaker 3 (21:42):
About just an average person, right .
Speaker 2 (21:44):
Average person. You can not worry so much about all
those things. Yeah . There aresome other things. If you are ,
uh, a human being with
Speaker 3 (21:52):
A heart , a few of those Yep . With a heart. With
a heart, okay.
Speaker 2 (21:55):
You need to have your blood pressure checked and
you need to do that every year.
Okay. That is something I wouldrecommend almost in all people
from the age of adulthood tillyou die, check your blood
pressure at least once a year.
It is probably next to smoking.
The biggest modifiable risk youcan do if your blood pressure
is high, and I'm talking ifit's higher than one 20 over
(22:17):
70. If it's one 30 over 80,certainly if it's one 40 over
90 or higher, you need to dosomething about that. Okay?
High blood pressure is a majoror leading or major cause of
heart attacks, peripheralarterial disease, stroke,
kidney disease, those are thebiggest ones. Okay ? Kidney,
heart, brain. That's , uh, youneed to get your blood pressure
Speaker 3 (22:38):
And and you're gonna want to hang onto those.
Speaker 2 (22:39):
Yep . You want to hang onto to those. So every
year. And then there's a fewothers. Women, if you're over
65, you might look for your,your , your bone health. Uh ,
men, if you're over 65 and youwere a smoker, you can look for
an aneurysm in your belly. Butthose are the only tests that
you should probably get.
There's really only those fewcancers. Your blood pressure,
couple of blood tests, you'regood to go.
Speaker 3 (22:59):
Keep an eye on a few things and otherwise take care
of yourself.
Speaker 2 (23:02):
That's right. That's right. I would refer you back
to the first half of the showfor everything else you should
be doing. Okay. I didn't, Ididn't call out vaccinations.
Right . They're in the news alot. They are vaccinations are
in the news a lot. Yeah . And,and I do wanna be crystal clear
with people that vaccinationsare probably more important
than almost anything else I'vetalked about in this second
(23:26):
half of the show. For me, italmost goes without saying. But
that is not the case in ourworld. We are gonna see polio
again. We're gonna see whoopingcough is currently in an
outbreak in the state ofMinnesota. Whooping cough is
something that we should nevertalk about. It should be gone
polio for heaven's sakes. Askanybody of a certain age what
(23:47):
polios like, and then tell themyou're not gonna get the polio
vaccine. And look at thereaction on their face.
, . So there'sother vaccines you should get
as an adult. Sure. Shingles,pneumonia, flu, covid . You
should get those at certainstages of your life. Ask your
doctor about the right time toget those.
Speaker 3 (24:03):
Gotcha . Okay. Yeah.
And the shingles vaccine, we'vetalked about it on the show. It
doesn't sound like a whole lotof fun, but neither is the
shingles.
Speaker 2 (24:08):
No, the shingles are , are not much fun. I I can
mention that one a little bit.
When you're 50, it's a two shotseries. The shingles vaccine is
highly effective. The one wehad 10 years ago wasn't, I
wrote prescriptions for it. Wegave it to people. It worked
half the time. It was pretty ,pretty good. The current one is
great. It's really good. Okay.
And,
Speaker 3 (24:25):
And when a doctor says, great, yes , that's a
heck of an endorsement. Yep .
Speaker 2 (24:27):
I'll never say anything's a miracle, but it ,
uh, it really is effective. Andyou don't wanna get the
shingles. And many of us willget shingles when you get
older. The shingles are abummer. But what's not a
bummer, but a real, it can becatastrophically bad is to have
pain for the rest of your life.
Speaker 3 (24:44):
You may not wanna live to be 100,
Speaker 2 (24:45):
You know , well then you're not gonna wanna live to
be a hundred. So I wouldstrongly consider getting the
shingles
Speaker 3 (24:49):
Vaccines. Okay.
Noted. Um ,
Speaker 2 (24:51):
So I think that those are the things you should
do at your doctor's office. I,I probably should mention that
your mental health is, isequally as important. So you
should get screened fordepression. Yeah . Talk to
your, your clinician aboutdepression. Talk to your
clinician about substance use,particularly alcohol.
Speaker 3 (25:08):
We just did a show
Speaker 2 (25:09):
On that and we just did a show with Dr. Resnikoff
couple weeks ago on alcohol. Istrongly encourage you to
listen to that episode becauseit is probably the largest
misused drug in our world.
Sure. And we don't think of itthat way because it's
complicated, but , um, at riskdrinking is a big deal. Alcohol
misuse and substance usedisorders are a big deal. So
(25:31):
you should talk about those.
Speaker 3 (25:32):
And again, mental health. Yeah. It's, you know ,
thankfully it's a conversationwe're having a lot more these
days, but , uh, I suppose wecould add that to our list of
things you might be able to beagreed kinda a , a aware of and
proactive with.
Speaker 2 (25:41):
Agreed. John ? I actually think it's one of the
more important things to talkabout with your doctor if they
don't ask you. Uh, they shouldYeah. At , at your physical,
hopefully a nurse or whoeverput you in the room or your,
your clinician, your doctor,whoever that is, asks you a
couple of screening questionsabout your mood.
Speaker 3 (25:58):
Yeah. You know, maybe that's just as important
as any blood test right
Speaker 2 (26:01):
There. As important . I would say that that is way
more important than most of theblood tests is some of these
things that we're talkingabout. Alcohol, your mood, your
blood pressure is infinitelymore important than any blood
test , daily
Speaker 3 (26:11):
Pieces of the puzzle that don't have a pretty big
impact. So we've covered a lotalready, but I'm , I'm
imagining there's a few otherthings in the orbit that might
kind of, you know, pertain tothis conversation. Anything
else? Kind of just raised tothe top for you?
Speaker 2 (26:23):
So I always tell people what else should I worry
about? Nothing. My answer isnothing. Nothing. And, and I
know that's a little tongue andcheek. Sure. Obviously ,
obviously there's
Speaker 3 (26:30):
Some comic in there.
Speaker 2 (26:31):
Yeah, exactly. Um, but what I mean by that is, in
order to live to be a hundred,if we want to live to be a
hundred, it better be fun. Itbetter be enjoyable. Okay . It
better be worth it. Right. Andso I tell people what is more
important than anything elsethat we haven't talked about is
social connections, avoidingloneliness, attending to things
(26:53):
in your family, spending timewith each other, doing things
that you enjoy. Maybe you aresomebody who doesn't wanna
spend time with all that manypeople and you never get a free
minute. Well, you should relaxand get a few free minutes to
yourself. Do the things thatyou enjoy in life. Reduce your
stress, avoid loneliness. Dohuman connections. Those are
(27:16):
the things that you should beattending to. If, if you're
worried about a hundred bloodtests or you worried that you
didn't get an x-ray ofsomething, I would suggest
don't worry about those things.
Enjoy your life. Attend to yourmental health. Have a healthy
relationship with alcohol andsubstances, and mostly make
connections in your family thatare meaningful to you or with
your friends that aremeaningful to you. And don't
(27:37):
worry about anything else.
Speaker 3 (27:38):
Yeah. So worrying is pretty much useless in general,
Speaker 2 (27:40):
But I think so worry is sort of a , a wasted , uh,
emotion. I know it's normal.
Sure It's normal. Try not
Speaker 3 (27:47):
Worrying. Yeah.
Speaker 2 (27:48):
But I get people coming and they want everything
under the sun. Well, are yougonna get an MRI of my brain? I
go, no. Why would I do that?
. Right. You're worriedabout things that haven't come
to pass and you're overlyrelying on technology to
relieve your worries. There wasa study done about physicians
one time and it says, well,what things would you get done?
(28:08):
And most doctors, that'snothing. Don't order anything
else on me. And I have apersonal story with that. So
our hospital bought a new MRImachine about six years ago and
we built a new building, builtit around this MRI machine. And
they needed to practice, youknow, you gotta practice, right
? We gotta turn the thing onand Yeah , exactly. Let's see
if it works. Take it around theblock a few times. So they
asked a bunch of us doctors tobe the, the Guinea pigs , I
(28:30):
think is the word. Right . GetGuinea pigs, get an MRI done.
And they were having troublefinding a doctor who wanted a
free head to toe. Wow . MR mri. Most ev I remember my friend
said, oh no, I do not wantthat. And so, so I did it .
Speaker 3 (28:44):
Is it just the amount of information that
comes from these things? Yes .
Or, or , because Okay. That'sthe concern. I wasn't
Speaker 2 (28:49):
Worried about anything in my body. Sure . Now
you did this. MRI you found alittle dizel that has a dizel
is the proper medical term.
Speaker 3 (28:57):
I , I , I was gonna say, could you break that one
down? For, for , for us,
Speaker 2 (29:00):
A dizel is something that they found on
there that means nothing. Itmight be a little cyst in your
liver. Okay. Or a cyst in yourkidney. You would've lived a
long life to a hundred yearsold , never known about that
little dizel. And you would'vebeen happy as a clam. Now
that's keeping you up at night.
Now you know about it . And go,oh my gosh, I got this . Its
over . I got this dizel in myliver, now what am I gonna do?
. So you're gonna getan MRI every year. You're gonna
(29:21):
worry about this thing. You
Speaker 3 (29:22):
Wear the dizel.
Speaker 2 (29:23):
So I absolutely , um, thought about that, but I
did it. Okay. I, and then Iremember the chief of
radiologist , he did head totoe, MRI , me, head to toe from
the top hair on my head to mytoenail. And I come out of the
thing and the , the chief ofradiology is standing there
with this look on his face. AndI said, don't you give me that
look on your face. What did you? And then he comes and says,
it all looks good. But, butthat, that's , it's
(29:46):
illustrative . It'sillustrative that physicians
generally don't wanna look forthings that weren't gonna be a
problem and for which there wasnothing you could do about it
anyway.
Speaker 3 (29:54):
Right. And we kind of have that line, don't pick
up a happy baby.
Speaker 2 (29:57):
Exactly. That's a great line. I'm gonna use that
one. John . Don't pick up ahappy baby. Yeah. In the
population. Everybody's gonnahave a little bit of an
abnormal test on something.
Sure . And so it, it , that's,that's kind of the , the idea
behind, don't worry about
Speaker 3 (30:09):
Everything. We'll try, you know, I , I think it's
always easier said than done,but at the same time, again,
it's like a lot of thesethings, these are goals. These
are the objectives that we'regonna try to follow.
Speaker 2 (30:17):
That's what I would leave people with is 10 to
those four areas of your life.
Get a few things done in yourphysicals at whatever interval
feels comfortable to you. Andthen don't worry about
everything
Speaker 3 (30:27):
Else. Fantastic. We are gonna take that into the
new year. Well, thanks for thetime again, doc. Uh, and again,
this is kind of an interestingway to do the show where you
are the guest Of course. Uh,and we're off to a good start
here with these. So hopefullywe'll do another one down the
road. Thanks
Speaker 2 (30:40):
For doing it with me, John , and happy New year
to everybody and thanks forlistening to the podcast.
Speaker 3 (30:44):
Thanks again, doc.
And thanks again listeners fortuning in. We will be back in
two weeks and I've been waitinga long time to say this. In the
meantime, be healthy and bewell.
Speaker 1 (30:54):
Thanks for listening to the Healthy Matters podcast
with Dr. David Hilden . To findout more about the Healthy
Matters podcast or browse thearchive, visit healthy
matters.org. Got a question ora comment for the show, email
us at Healthy matters@hcme.orgor call 6 1 2 8 7 3 talk.
There's also a link in the shownotes. The Healthy Matters
(31:16):
Podcast is made possible byHennepin Healthcare in
Minneapolis, Minnesota, andengineered and produced by John
Lucas At highball Executiveproducers are Jonathan, CTO and
Christine Hill . Pleaseremember, we can only give
general medical advice duringthis program, and every case is
unique . We urge you to consultwith your physician if you have
a more serious or pressinghealth concern. Until next
(31:38):
time, be healthy and be well .
Welcome to the Healthy Matters podcast with
Dr. David Hilton , primary carephysician and acute care
hospitalist at HennepinHealthcare in downtown
Minneapolis, where we cover thelatest in health healthcare and
what matters to you. And nowhere's our host, Dr. David
Hilden .
Speaker 2 (00:18):
Hey everybody, it's Dr. David Hilden and welcome to
episode six of the podcast. Andon this episode, we're going to
be interviewing me.
Speaker 3 (00:26):
That's right. And hey, my name is John Lucas. I'm
one of the producers on theshow. And today yeah, we do
have a very special guest. It'snice to see you again. Why
thank
Speaker 2 (00:34):
You. Thanks for having me on the show.
Speaker 3 (00:35):
It's our pleasure.
Today we're gonna be talkingabout something that I think
we're all kind of interestedin, which is our longevity,
right? How do you live to be100 or die Trying is the topic
of today's show. So it's goingto be kind of a little bit of
maybe some things that we mighthave heard, but a lot of things
you might not even be thinkingabout. So , uh, I'm gonna kind
of turn it over to you becauseyou seem to be the expert on
(00:55):
all these things.
Speaker 2 (00:57):
Thanks, John . And, you know, people sometimes ask
me, so , so what's the, what'sthe warranty on the human body?
What is it? How long can Iexpect to live? And some people
can live a great long time.
Others not quite so much. Buthow do you live as long as
possible? And I sometimes usethat phrase, how to live to be
a hundred or die trying. Butthere was a why Sage once said,
(01:18):
you can live to be a hundred,John , you can live to be a
hundred if you give up all thethings that make you want to
live to
Speaker 3 (01:24):
A hundred. Yes, I've heard that line before, and I
think you're right. It is , uh,about a sage as it could get,
you know ?
Speaker 2 (01:29):
Yeah . That it was about a sage as you can get. I
do think that sage maybe wasWoody Allen, but , uh, uh, uh,
I'm pretty sure. But I think it, it actually , um, makes some
sense and people might besurprised. The things that can
make you live the longest arenot the things that you do in
your doctor's office. Hmm .
What your doctor does, orwhoever your clinician does, is
just a small percentage of theeffect on your lifespan. Now,
(01:54):
if you're sick, I wanna startright off and say, if you're
sick, if you're having asymptom, if you're feeling some
concern about your health, youshould go to your
Speaker 3 (02:02):
Doctor. Right. Diet , exercise might not fix
Speaker 2 (02:03):
That. That might not fix that. So that's not what
I'm talking about. I'm talkingabout your average person, you
listening to this podcast, whatdo I need to do to stay
healthy? Not what to do after Iget sick. Excellent . If you
get sick, excellent. Go to yourdoctor. That's my advice on
that one. But you might besurprised at the things that
you should and should not beworried about. So that's what
we're gonna talk about today.
Speaker 3 (02:24):
Excellent.
Excellent. Well, I say we diveright in then. So how do we
kick things off here?
Speaker 2 (02:28):
I want people to know that the things that you
do in your daily life, there'sfour big areas I want you to
know about. And if you attendto these things, that is gonna
give you your best chance ofliving a longer life. And, and
again, they're not things inyour doctor's office. So the
first one is about smoking, ofcourse. And that one sounds
(02:48):
like, oh my goodness, he'sgonna preach to us about not
smoking.
Speaker 3 (02:52):
Although you and everyone else who's been on the
show, I think this is kind of atheme that seems to come up no
matter who's on mic .
Speaker 2 (02:57):
It does come up a lot. And there are something
like 16 million people in ourcountry, in the United States
living with a disease that wascaused by their smoking.
Speaker 3 (03:08):
And this isn't Europe,
Speaker 2 (03:10):
Probably even worse over there, where, you know ,
you have a cigarette withdinner . Um, there are , there
are no, and I I repeat that.
There are no redeemingqualities to cigarette smoking.
Now you might say, well, Ienjoy, okay, okay , I get that.
Sure , I get it. I get it, Iget it. You , you like it. But
there are no good healthbenefits from it. It is
something that you can stopdoing and you should stop
(03:30):
doing. And if anyone ever tellsyou otherwise they're lying,
you can and you should stopsmoking. It leads to way more
things than people know.
Everybody, everybody knowsabout lungs. Sure. Not good for
your lungs. It is the leadingcause of lung cancers. Yeah.
But it , it also causesemphysema. Everybody knows that
lung cancer is the leadingcause of cancer death, and you
(03:53):
simply don't want that. Andthat might sound obvious, but I
have been at the bedside ofpeople with lung disease at the
end of their life. And you ,uh, trust me, you'd pick
something else. Yeah,
Speaker 3 (04:04):
Yeah, no doubt. But in
Speaker 2 (04:06):
Addition to the lungs, it causes heart disease,
high blood pressure, itexacerbates your diabetes. It's
one of the leading risk factorsfor bladder cancer. In fact,
there's like 20 cancers. Itleads to bladder cancer,
leukemia, pancreas problems. Itleads to fertility
complications in men and women.
So if you're trying to have ababy uhuh, it's not good women,
(04:26):
it's not good if you arepregnant. So number one thing
you can do, I don't thinkanything else that you do
matters very much if you'resmoking. Okay. You can't take a
pill to counteract that one. SoI don't care what else you do.
If you're smoking, that's thenumber one thing you should
quit. Wow . That's number
Speaker 3 (04:40):
One in technicolor.
Okay .
Speaker 2 (04:42):
In technicolor .
Right . Okay. And so I preachedright off the bat,
Speaker 3 (04:45):
Chad . Yeah , no , you know what, that's , uh,
that's kind of what people needto hear. Yep . Yep .
Speaker 2 (04:48):
I'm not gonna sugarcoat that one. The second
thing in your life is tomaintain a healthy weight. I
know people that equate obesityor being quite a bit overweight
to be in a health risk factoralmost to the level of smoking.
Now it's not all the way there.
It is true that there are somepeople are bigger boned and,
and the body mass index thatmany of us heard of is not a
(05:09):
perfect measure. Right . Butmaintaining a healthy weight is
very likely to help you to livelonger, at least reduce your
risk. How do you do that? Youcan't exercise your weight to a
healthier weight, but you mustexercise to stay healthy. But
it's almost all in diet, whichdoes lead me to the third
thing. And that is exercise. I
Speaker 3 (05:29):
Was afraid you were gonna say that.
Speaker 2 (05:30):
So you need to move more. Whatever you're doing. I
bet you need to do it more. SoI would suggest move more and
eat less. That's probably four. Okay . So
Speaker 3 (05:37):
There's no ceiling to this exercise thing then,
huh? Oh , we can't . We can't.
We we're never out of thewoods.
Speaker 2 (05:41):
No. I suppose Jesse Diggins moves enough, you know,
Olympic athlete from our homestate of Minnesota. I mean ,
Speaker 3 (05:47):
Don't tell her that.
Speaker 2 (05:48):
Don't tell her that.
Yeah. She's, she's saying , no,I don't, I gotta work out more.
No, 30 minutes a day every day.
Wow . But that, that soundslike a lot, doesn't
Speaker 3 (05:55):
It? That's a commitment. Yeah.
Speaker 2 (05:56):
And I don't , I'm not gonna lie,
Speaker 3 (05:56):
That's uh , that's , that's an Everest of a
challenge right there. Exactly.
Speaker 2 (05:59):
For many of us. But so what I tell people, you and
somebody might be listening andsaying, well, I can't go to a
gym for 30 minutes a day . Ican't do that. That's not what
I'm talking about. I'm talkingabout moving your body. And you
don't have to do it all atonce. Do it in three 10 minute
intervals. And it can bewhatever is something you enjoy
doing anyways. Maybe it'swalking, maybe it's gardening.
(06:21):
Maybe you're a very vigoroushouse cleaner.
Speaker 3 (06:23):
I am not. Uh ,
Speaker 2 (06:24):
But so get out there and vacuum a lot.
Speaker 3 (06:26):
Okay .
Speaker 2 (06:26):
You'll be good to go if you do that. Okay . Maybe
you are a runner or maybe youwant to do a rowing machine or
a stationary bike. It doesn'treally matter to me. Just
Speaker 3 (06:34):
Something
Speaker 2 (06:34):
Seat . Yeah. Go to the mall and watch the seat .
Get off the
Speaker 3 (06:37):
Seat . Okay . Get out and get out of the chair
and, and , and get moving.
That's the
Speaker 2 (06:40):
Stage advice that is . So, so far we've talked about
don't smoke if you smoke, quit,and don't start. Uh , and
number two is maintain ahealthy weight. Number three is
move more. Right. And numberfour is about diet. And this is
one that we're learning moreand more as the years go on. So
what I'd like to tell people iseat low on the food chain. That
means as many plants as youcan, a plant-based diet is the
(07:03):
best. Okay . It's not only bestfor you, it's, it's best for
the planet. A lot of benefits.
There's a lot of benefits. ButI'm not saying never eat meat.
If you're a meat eater, maybelimit it . And fish is probably
better than fatty meats.
Poultry is relatively , uh,healthy red meats are maybe a
little less so, but Right . Butstick to lean ones. And in
smaller portions, which bringsme the portion
Speaker 3 (07:24):
Size is is kind of a big one. Exactly. The portion
size is kind of a big one. Andit's kind a need to eat a one
pound steak. Exactly.
Speaker 2 (07:30):
You never in your life should be eating a one
pound steak. I'm sorry, for nomatter
Speaker 3 (07:33):
How big you are.
Yeah,
Speaker 2 (07:34):
Exactly. I'm sorry.
Purveyors of steaks. That's nothealthy. I used to show some
pictures of what even a coffeelooks like. Even a coffee. If
you think back to, I don'tknow, the seventies or
eighties, and you went to adiner and you got a little
eight ounce cup of black coffeein a cup with a saucer. Now
when you go down to your localcoffee shop, they're giant.
(07:55):
Yeah ,
Speaker 3 (07:56):
Yeah . And it's like the 64 ounce or the grand .
Speaker 2 (07:58):
Exactly . Exactly.
chain coffee shops, what halfof those mean. Um, 'cause they
have all these words for 'em ,but then they show up with this
thing that's about a foot tall.
Yeah . This cup's about a foottall. Yeah . And about two
thirds of it is calories. Yeah.
So even your coffee is
Speaker 3 (08:13):
Bigger. Right, right. And it's not always as
easy as you think, becausesooner or later you get hungry
and the only thing around youis a quickie
Speaker 2 (08:19):
Mart. Right ? Yep .
And you don't even know whatyou're eating, so you do it
outta convenience. I, I wasrecently, this is a true story.
I was recently in Washington DCand met with someone from the
US Department of Agriculturebecause they were asking
physician leaders how we canbest get the message out about
diet. And they werespecifically talking about,
remember the old food groups?
Oh yeah. That was 30, 40 yearsago.
Speaker 3 (08:39):
Yeah . Do we still have those? Well,
Speaker 2 (08:40):
Yeah. That was sort of the state of the art back in
1970. But then they moved on tothe food pyramid, and now
they're calling it My plate ,my plate . You can go to the
government site and look at myplate. Okay . And it's what
should be on your plate. Andyou'd be surprised. The meat or
the protein is a smaller littlepiece on there. The vegetables
is a giant portion of yourplate. Dairy and fats is a
(09:02):
smaller portion, but it'sreally fascinating about eating
smaller and lower on the foodchain. And then the last point
would be far fewer processedfoods.
Speaker 3 (09:12):
Processed foods.
Right. And we just touched onthis recently with Dr. Aisha
Galloway Gilliam just a coupleepisodes ago, as well as
another show in season two,episode two with Dr. Kate
Shafto . Reading the labels,understanding them is such a
big piece of the puzzle and,and can be pretty hard,
especially when the marketingdepartment is playing against
you. Uh, a little bit of atangent, but I remember I had
(09:33):
an aunt who used to say, keepyour plate colorful. And I
think that that's always kindof a nice kind of just rule of
thumb. Just add some greens toit. Keep it red, don't eat
monochromatic.
Speaker 2 (09:41):
Yep . That's a , your aunt is smart. I've heard
she's a white woman. And Ithink Dr. Schau on one of our
previous episodes right here onHealthy Matters, talked about
eating the rainbow. Yeah,
Speaker 3 (09:49):
It's true. Yeah.
Yeah, I remember that one.
Speaker 2 (09:51):
Eat the dark orange things, eat the dark green
things. You find somethingthat's purple, eat it.
. And
Speaker 3 (09:57):
Maybe I'm just getting older, but those things
taste better too.
Speaker 2 (09:59):
They do taste better. Yeah . I, I sometimes
talk about the white foods andI , you know, and I'm guilty,
I'm guilty of this, but whitepotatoes, white pasta, white
bread, white rice, those thingsare filling and it's, they're
affordable often, but they'renot your healthiest option. Eat
something dark orange, darkgreen, dark purple, dark red,
(10:20):
whatever you can find, eat therainbow. So sold. All right .
Those are the four things youshould be doing in your life.
And even if you never saw adoctor and you should
sure , that's , but even if younever did , if , if you never
did, these are the four biggestareas to stay healthy. And I'll
just repeat them. They are,don't smoke, maintain a healthy
(10:40):
weight exercise and move moreand eat a healthy diet. Those
four things, if you'reattending to those, you are
doing 80 to 90% of what youshould do to live
Speaker 3 (10:51):
Longer. Excellent.
Some of this, obviously we'veheard before and putting into
practice is harder, but , uh,especially when you hear from a
doctor that this might be moreimportant exactly than blood
tests or anything like that,that this might be the key to
kind of, you'll just , just toenjoying the life that you do
have all that much more.
Speaker 2 (11:06):
And there are some things you should do in your
doctor's office. Sure , therereally are. Certainly there
really are. But if you are notdoing these four things or at
least attending to these,there's nothing in a pill
bottle that's gonna fix that.
It's not gonna counteract thefact that you're smoking. If
there is no vitamin that'sgonna counteract you carrying
an extra 50 pounds or there'sno supplement that's gonna fix
(11:29):
it. If you're watching TV allday long and you never move,
right. And there's really nomedicine or thing your doctor
can do, there's no blood testthat's gonna fix the problem if
you're eating garbage. Right .
So those four things, you needto do those first, or at least
think about how those thingsare in your life. And then
(11:49):
there are some things yourdoctor can do and there are
some things you should beasking for at your doctor to
take that next step to stayingas healthy as you can. And I'd
love to talk about those afterour break.
Speaker 3 (11:59):
No doubt. I was gonna say, it sounds like we're
about to get into those, butbefore we do that, we're gonna
take a quick break and we willbe right back
Speaker 4 (12:07):
When head up in healthcare says, we are here
for life. They mean here foryou, your life and all that it
brings. Hennepin Healthcare hasa hospital, HCMC and a network
of clinics both downtown andacross the West Metro. They
provide all the primary careand specialty care you would
expect to find, but did youknow they also have services
like acupuncture andchiropractic care available at
(12:29):
many of their primary careclinics and at their
integrative health clinic indowntown Minneapolis? Learn
more@hennepinhealthcare.org.
Hennepin Healthcare is here foryou and here for life.
Speaker 3 (12:45):
And we're back for part two of our show with our
very special guest, our own Dr.
David Hilton. We kind of talkeda bit about what you can do in
your daily life. Uh, there werefour things we talked about.
And just to recap the fourthings we talked about in the
first part of this show. Onemore time, don't smoke. Can't
say it that loud enough. Andfor the cheap seats, there are
no redeeming qualities ofsmoking. Number two, maintain a
(13:06):
healthy weight. This isn'talways as easy as people think
it is, but it is nonetheless anessential piece of the puzzle.
Three is move more. That issomething that most of us can
do and I think everybody shouldat least try to do. And number
four is to make healthy foodchoices, which isn't always
easy again, but the better wedo at that, the better we'll do
in general. Okay, cool. Movingon. Now, when we do all those
(13:27):
things, it doesn't mean we'reout of the woods, right? Uh ,
there is a time that we'reprobably gonna have to go to a
doctor's office and what can wedo in a doctor's office or what
can we expect from the medicalside, from the medical
community? How can they help uslive longer? What , uh, where
are we headed with this? Yeah,I hope,
Speaker 2 (13:40):
I hope there I have some role , um, in helping keep
people healthy. And there aresome pretty sure you do. Yeah .
There are some things youshould be going to your primary
care physician or advancedpractice provider. If you see a
nurse practitioner or aphysician assistant, there are
some things you should be doingat regular intervals. People
might be a little surprisedthat the intervals aren't what
you think. And the list is alittle shorter than you think.
(14:04):
Hmm . And I wanna reiterate, goto your doctor if you're sick.
What I'm talking about here isnot that. Right? If you're sick
and you've got whatever yoursymptom is, you go in, there's
things ,
Speaker 3 (14:13):
We have doctors and hospitals
Speaker 2 (14:14):
For a reason, right ? That's , that's what they're
there for. But when should yougo in for just screening and
when should you go in for yourpreventive health? Now
everybody talks about theannual physical. Sure. I'm not
gonna get into that in too muchdetail, but most things don't
need to be done every year. Ifyou are an older adult, I'd say
mid forties to fifties, I dorecommend that you go in every
(14:34):
year. Okay? If for no otherreason for a check-in on the
four things we talked about inthe first half of the show, but
also for your blood pressure,checking for diabetes,
cholesterol, those areimportant. So go to your doctor
probably every year if you'reof a certain age, maybe
fifties. If you're younger thanthat, I don't know anybody of
that age. You don't knowanybody of that age. Yeah . One
day you will, John . One dayyou will. But when you're
(14:57):
younger, it maybe doesn't evenneed to be that often . But
what should you do when you getthere? That's the important
thing. Now, a lot of peoplethink you need a slew of blood
tests. You need to do bloodtests . Blood tests , blood
tests , blood tests. And you ,I mean, how else are we gonna
know? Yeah, exactly. You'd beshocked at how few blood tests
you really need. So I'll, letme tell you about the things
that you should be considering.
First of all, screenings. Whatshould you be screened for? And
(15:20):
a lot of people aren't realsure what that means, but
screening is a test that isdone in a person who does not
have any symptoms. Okay ? Aperson who feels, well, it's
looking for an illness, it'slooking for a disease. And
people think that there's ahundred things you should be
looking for. No, there aren't
Whittle it down. So let mewhittle it down. There are a
(15:43):
few things you should be doing.
Number one, there are somecancer screenings that you
should do, but this list isshorter than you think as well.
If you are a person, and I justmean if you are a human person
and you've hit the age of 50,you should be looking for
colorectal cancer. Okay? Men,men and women. All women . And
women is one of the top threecancers. And it is one of those
(16:06):
cancers that is perfect forscreening. And what do I mean
by that? There's something tobe done about it. If we find
something. Okay ? And , and sowe can reduce your risk of
dying, of colorectal cancer,your colon's, your large
intestine. We can reduce yourrisk by, by screening. So if
you are 50, some groupsrecommend maybe 45, but the the
usual one is 50. Do something.
(16:28):
What is that something? Somepeople get a colonoscopy. Okay
. That's sort of the mostinvasive one, but it's maybe
the most thorough one. Otherscan't stand the idea of a
colonoscopy and they wanna do,so you could do stool testing
that's legitimate colonoscopy.
If normal is only every 10years, stool testing needs to
be every year. Alright ? And sothose are the differences. But
(16:49):
colon cancer, that's the firstthing I'd say. Okay. Breast
cancer screening in women,usually at the age of 50. Some
people recommend at the age of40, you get a mammogram every
year or two next to coloncancer. Those are the two
biggest ones. Get yourmammogram if you're at average
risk. If you're at higher risk,your , your mom, your sister
(17:10):
had breast cancer, then youmight even get other tests like
MRIs or, or genetic testing.
Okay? But for sure talk to yourdoctor about breast cancer.
That those are the two bigones. There are a few others
I'm gonna touch on, but Sure .
All people, those are the two.
Okay . Third one, cervicalcancer screening in women or,
or , or people , uh, who have acervix. And that is the pap
(17:32):
smear that every woman of acertain age remembers doing
every year. And the horrors ofthe stirrups and getting up in
that thing. This is one of thebiggest success stories of
modern medicine. We have almostnever heard of cervical cancer
in the United States. It's verycommon in the rest of the
world. Wow . And that's becauseof PAP testing. Okay. And we
now know that cervical canceris a sexually transmitted
(17:54):
cancer. Hmm . It is caused inthe vast majority of the cases
by the human papilloma virus.
So if you have a teenager boyor a girl or a young adult,
there is a vaccine against acancer. Wow. It is the HPV
vaccine. I can't recommend itstrongly enough.
Speaker 3 (18:12):
And what's the age range of that vaccine?
Speaker 2 (18:14):
That is for , um, pre-adolescent, up to mid, mid
range adult or mid people intheir mid twenties. It's a
three shot series. Yep . Ithurts. It doesn't hurt as much
as cervical cancer. No ,exactly.
there's lots of ways to getyour cervical cancer screening,
but if you're a woman or aperson with a uterus , uh, that
includes transgender men, youshould be getting , uh,
Speaker 3 (18:33):
Pap. Gotcha. So those are the big three. What,
what other cancers do peoplekind of need to keep on the
radar?
Speaker 2 (18:37):
There's two more.
The one of them is lung cancer.
And that is in a limited numberof people. There is a CAT scan,
a CT scan you can get if youare, if you meet these
criteria, you're a smoker oryou quit in the last 15 years,
okay? You smoked at least 20 pplus years and you're between
the ages of 50 and 80, you getan annual lung cancer
screening. That's it. Nobodyelse. Okay? Um, you don't wanna
(18:59):
get an annual CT scan and allthat radiation if you don't
meet those criteria. Okay.
Speaker 3 (19:05):
Then the
Speaker 2 (19:06):
Last one ,
Speaker 3 (19:06):
It's for those who need
Speaker 2 (19:06):
It, it's those who need it. And the last one's
prostate cancer screening. Ifyou are, if you have a
prostate, a man or atransgender woman who has a
prostate, you can think aboutit. There's no recommendation
to actually get prostate cancerscreening.
Speaker 3 (19:20):
No actual guidelines. So fifties more,
Speaker 2 (19:23):
I do it in men who wish to, I have a conversation
with them at age 50. Why isthat? Everyone says, well, why
wouldn't I do that? Whywouldn't I get a prostate test?
Speaker 3 (19:31):
Sure, why not? Just know. The,
Speaker 2 (19:32):
The current US government recommendation is to
not, not get any prostatecancer screening because on a
population level, we couldscreen every single solitary
man in this country and nobodyon a population level will live
longer. Gotcha . Nobody , itdoes not statistically change
your lifespan, but the oneperson in front of you, it
(19:54):
might change that one person'slifespan. So we, it's a blood
test individual. You canconsider
Speaker 3 (19:59):
Individual . It's a blood test. Okay,
Speaker 2 (20:00):
That's a blood test.
So tho that's it. Those are thecancers that you should look
at.
Speaker 3 (20:03):
That's a lot smaller list than I thought.
Speaker 2 (20:05):
Yeah. We don't have a screening test for pancreas
cancer, for kidney cancer, forleukemia, for liver cancer, all
the other ones. There's no testthat you need to get. Okay. But
that's not all. There's someother thing . Those are just
the cancers. There are twoblood tests, all of two that
you should be getting at yourdoctor's visits, whether you
feel healthy or not. And thatis cholesterol and a test for
(20:28):
diabetes.
Speaker 3 (20:28):
Count 'em 1, 2, 1, 2.
Speaker 2 (20:30):
Alright , that's it.
If you are between the ages oflike 20 and 50, I would get
those tests every two to fiveyears. Okay? You don't need it
every year. Your cholesterolain't gonna change that much
every year. Your diabetes riskisn't gonna change that much
every year if their normal,every two to five years is
adequate. When you get a littlebit older, sometimes people
push that to a little morefrequently. But those are the
(20:51):
two blood tests, cholesteroland
Speaker 3 (20:54):
Diabetes and two to five years. So if you've got a
health scare in your family orsomething like that, maybe does
that increase the frequency orare you still kind of sticking
to those guidelines?
Speaker 2 (21:01):
Yeah . Um , people ask all the time, I need blood
tests. You gotta find what'swrong with me. The vast
majority of blood tests, we,you might have a little bit
something wrong with it . Itdoesn't meaningfully affect
your health, but now you knowabout it. And so there's
nothing to be done. So youworry about the vast majority
of them. Now, isn't it truethat, well, why don't you get
my blood counts? You could findleukemia true in , in one out
(21:23):
of hundreds of people. It mightbe possible to find those. But
the, the, the overall benefitof getting routine blood tests
is not there. There's norecommendation to get those
blood tests. Now, if you haverisk factors or you're feeling
some symptoms, of course we getblood tests. Okay? But I'm
talking about your annualphysical, you don't need as
many as you think talking
Speaker 3 (21:42):
About just an average person, right .
Speaker 2 (21:44):
Average person. You can not worry so much about all
those things. Yeah . There aresome other things. If you are ,
uh, a human being with
Speaker 3 (21:52):
A heart , a few of those Yep . With a heart. With
a heart, okay.
Speaker 2 (21:55):
You need to have your blood pressure checked and
you need to do that every year.
Okay. That is something I wouldrecommend almost in all people
from the age of adulthood tillyou die, check your blood
pressure at least once a year.
It is probably next to smoking.
The biggest modifiable risk youcan do if your blood pressure
is high, and I'm talking ifit's higher than one 20 over
(22:17):
70. If it's one 30 over 80,certainly if it's one 40 over
90 or higher, you need to dosomething about that. Okay?
High blood pressure is a majoror leading or major cause of
heart attacks, peripheralarterial disease, stroke,
kidney disease, those are thebiggest ones. Okay ? Kidney,
heart, brain. That's , uh, youneed to get your blood pressure
Speaker 3 (22:38):
And and you're gonna want to hang onto those.
Speaker 2 (22:39):
Yep . You want to hang onto to those. So every
year. And then there's a fewothers. Women, if you're over
65, you might look for your,your , your bone health. Uh ,
men, if you're over 65 and youwere a smoker, you can look for
an aneurysm in your belly. Butthose are the only tests that
you should probably get.
There's really only those fewcancers. Your blood pressure,
couple of blood tests, you'regood to go.
Speaker 3 (22:59):
Keep an eye on a few things and otherwise take care
of yourself.
Speaker 2 (23:02):
That's right. That's right. I would refer you back
to the first half of the showfor everything else you should
be doing. Okay. I didn't, Ididn't call out vaccinations.
Right . They're in the news alot. They are vaccinations are
in the news a lot. Yeah . And,and I do wanna be crystal clear
with people that vaccinationsare probably more important
than almost anything else I'vetalked about in this second
(23:26):
half of the show. For me, italmost goes without saying. But
that is not the case in ourworld. We are gonna see polio
again. We're gonna see whoopingcough is currently in an
outbreak in the state ofMinnesota. Whooping cough is
something that we should nevertalk about. It should be gone
polio for heaven's sakes. Askanybody of a certain age what
(23:47):
polios like, and then tell themyou're not gonna get the polio
vaccine. And look at thereaction on their face.
as an adult. Sure. Shingles,pneumonia, flu, covid . You
should get those at certainstages of your life. Ask your
doctor about the right time toget those.
Speaker 3 (24:03):
Gotcha . Okay. Yeah.
And the shingles vaccine, we'vetalked about it on the show. It
doesn't sound like a whole lotof fun, but neither is the
shingles.
Speaker 2 (24:08):
No, the shingles are , are not much fun. I I can
mention that one a little bit.
When you're 50, it's a two shotseries. The shingles vaccine is
highly effective. The one wehad 10 years ago wasn't, I
wrote prescriptions for it. Wegave it to people. It worked
half the time. It was pretty ,pretty good. The current one is
great. It's really good. Okay.
And,
Speaker 3 (24:25):
And when a doctor says, great, yes , that's a
heck of an endorsement. Yep .
Speaker 2 (24:27):
I'll never say anything's a miracle, but it ,
uh, it really is effective. Andyou don't wanna get the
shingles. And many of us willget shingles when you get
older. The shingles are abummer. But what's not a
bummer, but a real, it can becatastrophically bad is to have
pain for the rest of your life.
Speaker 3 (24:44):
You may not wanna live to be 100,
Speaker 2 (24:45):
You know , well then you're not gonna wanna live to
be a hundred. So I wouldstrongly consider getting the
shingles
Speaker 3 (24:49):
Vaccines. Okay.
Noted. Um ,
Speaker 2 (24:51):
So I think that those are the things you should
do at your doctor's office. I,I probably should mention that
your mental health is, isequally as important. So you
should get screened fordepression. Yeah . Talk to
your, your clinician aboutdepression. Talk to your
clinician about substance use,particularly alcohol.
Speaker 3 (25:08):
We just did a show
Speaker 2 (25:09):
On that and we just did a show with Dr. Resnikoff
couple weeks ago on alcohol. Istrongly encourage you to
listen to that episode becauseit is probably the largest
misused drug in our world.
Sure. And we don't think of itthat way because it's
complicated, but , um, at riskdrinking is a big deal. Alcohol
misuse and substance usedisorders are a big deal. So
(25:31):
you should talk about those.
Speaker 3 (25:32):
And again, mental health. Yeah. It's, you know ,
thankfully it's a conversationwe're having a lot more these
days, but , uh, I suppose wecould add that to our list of
things you might be able to beagreed kinda a , a aware of and
proactive with.
Speaker 2 (25:41):
Agreed. John ? I actually think it's one of the
more important things to talkabout with your doctor if they
don't ask you. Uh, they shouldYeah. At , at your physical,
hopefully a nurse or whoeverput you in the room or your,
your clinician, your doctor,whoever that is, asks you a
couple of screening questionsabout your mood.
Speaker 3 (25:58):
Yeah. You know, maybe that's just as important
as any blood test right
Speaker 2 (26:01):
There. As important . I would say that that is way
more important than most of theblood tests is some of these
things that we're talkingabout. Alcohol, your mood, your
blood pressure is infinitelymore important than any blood
test , daily
Speaker 3 (26:11):
Pieces of the puzzle that don't have a pretty big
impact. So we've covered a lotalready, but I'm , I'm
imagining there's a few otherthings in the orbit that might
kind of, you know, pertain tothis conversation. Anything
else? Kind of just raised tothe top for you?
Speaker 2 (26:23):
So I always tell people what else should I worry
about? Nothing. My answer isnothing. Nothing. And, and I
know that's a little tongue andcheek. Sure. Obviously ,
obviously there's
Speaker 3 (26:30):
Some comic in there.
Speaker 2 (26:31):
Yeah, exactly. Um, but what I mean by that is, in
order to live to be a hundred,if we want to live to be a
hundred, it better be fun. Itbetter be enjoyable. Okay . It
better be worth it. Right. Andso I tell people what is more
important than anything elsethat we haven't talked about is
social connections, avoidingloneliness, attending to things
(26:53):
in your family, spending timewith each other, doing things
that you enjoy. Maybe you aresomebody who doesn't wanna
spend time with all that manypeople and you never get a free
minute. Well, you should relaxand get a few free minutes to
yourself. Do the things thatyou enjoy in life. Reduce your
stress, avoid loneliness. Dohuman connections. Those are
(27:16):
the things that you should beattending to. If, if you're
worried about a hundred bloodtests or you worried that you
didn't get an x-ray ofsomething, I would suggest
don't worry about those things.
Enjoy your life. Attend to yourmental health. Have a healthy
relationship with alcohol andsubstances, and mostly make
connections in your family thatare meaningful to you or with
your friends that aremeaningful to you. And don't
(27:37):
worry about anything else.
Speaker 3 (27:38):
Yeah. So worrying is pretty much useless in general,
Speaker 2 (27:40):
But I think so worry is sort of a , a wasted , uh,
emotion. I know it's normal.
Sure It's normal. Try not
Speaker 3 (27:47):
Worrying. Yeah.
Speaker 2 (27:48):
But I get people coming and they want everything
under the sun. Well, are yougonna get an MRI of my brain? I
go, no. Why would I do that?
to pass and you're overlyrelying on technology to
relieve your worries. There wasa study done about physicians
one time and it says, well,what things would you get done?
(28:08):
And most doctors, that'snothing. Don't order anything
else on me. And I have apersonal story with that. So
our hospital bought a new MRImachine about six years ago and
we built a new building, builtit around this MRI machine. And
they needed to practice, youknow, you gotta practice, right
? We gotta turn the thing onand Yeah , exactly. Let's see
if it works. Take it around theblock a few times. So they
asked a bunch of us doctors tobe the, the Guinea pigs , I
(28:30):
think is the word. Right . GetGuinea pigs, get an MRI done.
And they were having troublefinding a doctor who wanted a
free head to toe. Wow . MR mri. Most ev I remember my friend
said, oh no, I do not wantthat. And so, so I did it .
Speaker 3 (28:44):
Is it just the amount of information that
comes from these things? Yes .
Or, or , because Okay. That'sthe concern. I wasn't
Speaker 2 (28:49):
Worried about anything in my body. Sure . Now
you did this. MRI you found alittle dizel that has a dizel
is the proper medical term.
Speaker 3 (28:57):
I , I , I was gonna say, could you break that one
down? For, for , for us,
Speaker 2 (29:00):
A dizel is something that
there that means nothing. Itmight be a little cyst in your
liver. Okay. Or a cyst in yourkidney. You would've lived a
long life to a hundred yearsold , never known about that
little dizel. And you would'vebeen happy as a clam. Now
that's keeping you up at night.
Now you know about it . And go,oh my gosh, I got this . Its
over . I got this dizel in myliver, now what am I gonna do?
(29:21):
worry about this thing. You
Speaker 3 (29:22):
Wear the dizel.
Speaker 2 (29:23):
So I absolutely , um, thought about that, but I
did it. Okay. I, and then Iremember the chief of
radiologist , he did head totoe, MRI , me, head to toe from
the top hair on my head to mytoenail. And I come out of the
thing and the , the chief ofradiology is standing there
with this look on his face. AndI said, don't you give me that
look on your face. What did you? And then he comes and says,
it all looks good. But, butthat, that's , it's
(29:46):
illustrative . It'sillustrative that physicians
generally don't wanna look forthings that weren't gonna be a
problem and for which there wasnothing you could do about it
anyway.
Speaker 3 (29:54):
Right. And we kind of have that line, don't pick
up a happy baby.
Speaker 2 (29:57):
Exactly. That's a great line. I'm gonna use that
one. John . Don't pick up ahappy baby. Yeah. In the
population. Everybody's gonnahave a little bit of an
abnormal test on something.
Sure . And so it, it , that's,that's kind of the , the idea
behind, don't worry about
Speaker 3 (30:09):
Everything. We'll try, you know, I , I think it's
always easier said than done,but at the same time, again,
it's like a lot of thesethings, these are goals. These
are the objectives that we'regonna try to follow.
Speaker 2 (30:17):
That's what I would leave people with is 10 to
those four areas of your life.
Get a few things done in yourphysicals at whatever interval
feels comfortable to you. Andthen don't worry about
everything
Speaker 3 (30:27):
Else. Fantastic. We are gonna take that into the
new year. Well, thanks for thetime again, doc. Uh, and again,
this is kind of an interestingway to do the show where you
are the guest Of course. Uh,and we're off to a good start
here with these. So hopefullywe'll do another one down the
road. Thanks
Speaker 2 (30:40):
For doing it with me, John , and happy New year
to everybody and thanks forlistening to the podcast.
Speaker 3 (30:44):
Thanks again, doc.
And thanks again listeners fortuning in. We will be back in
two weeks and I've been waitinga long time to say this. In the
meantime, be healthy and bewell.
Speaker 1 (30:54):
Thanks for listening to the Healthy Matters podcast
with Dr. David Hilden . To findout more about the Healthy
Matters podcast or browse thearchive, visit healthy
matters.org. Got a question ora comment for the show, email
us at Healthy matters@hcme.orgor call 6 1 2 8 7 3 talk.
There's also a link in the shownotes. The Healthy Matters
(31:16):
Podcast is made possible byHennepin Healthcare in
Minneapolis, Minnesota, andengineered and produced by John
Lucas At highball Executiveproducers are Jonathan, CTO and
Christine Hill . Pleaseremember, we can only give
general medical advice duringthis program, and every case is
unique . We urge you to consultwith your physician if you have
a more serious or pressinghealth concern. Until next
(31:38):
time, be healthy and be well .
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I’m Jay Shetty host of On Purpose the worlds #1 Mental Health podcast and I’m so grateful you found us. I started this podcast 5 years ago to invite you into conversations and workshops that are designed to help make you happier, healthier and more healed. I believe that when you (yes you) feel seen, heard and understood you’re able to deal with relationship struggles, work challenges and life’s ups and downs with more ease and grace. I interview experts, celebrities, thought leaders and athletes so that we can grow our mindset, build better habits and uncover a side of them we’ve never seen before. New episodes every Monday and Friday. Your support means the world to me and I don’t take it for granted — click the follow button and leave a review to help us spread the love with On Purpose. I can’t wait for you to listen to your first or 500th episode!
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com