Episode Transcript
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Erin Brinker (00:00):
Erin,
welcome everyone. I'm Erin
(00:05):
Brinker, this is the making hopehappen radio show and podcast.
So glad to have you with me onthis beautiful day. I hope you
are enjoying it. I know that Iam before we get started. Have a
great guest for you today, butbefore we get started, I wanted
to talk about, as I often do,what I'm grateful for. And I
probably talked about thisbefore, but I'm pretty grateful
for it, so I'm going to say itagain. I'm grateful for
(00:27):
community. I'm grateful for thepeople I work with. I'm grateful
for the people on my street. I'mgrateful for the people I see at
the grocery store or at the postoffice, not that I go there very
often, or at whatever place I'mI'm visiting. When I'm visiting,
you know, there's a lot ofcraziness in the world, right?
And we hear that people are ateach other's throats,
(00:48):
essentially, that if I'm on thisside, I don't like you on that
side, and vice versa. But Igotta tell you, when you're out
in the community, when you'reout with people, they still
smile, they still say hello,they still say How you doing,
or, if you're from the south,how y'all doing.
And yeah, reminds me that thatwe're all okay, let's focus on
(01:10):
the good stuff. Let's Be kind toone another, and I'm grateful
for that kindness.
All right, it's time to getstarted on our All right. With
that, it's time for our guestWell, I am very pleased to
welcome to the show. Dr RobertSalas, clinical professor of
family medicine at KaiserPermanente Bernard J Tyson
(01:32):
School of Medicine. He is alsothe chief medical officer for
the Los Angeles Football Club.
He's a team physician for the LAClippers and Program Director
Emeritus of sports medicinefellowship at Kaiser Permanente
Fontana Medical Center. He isjoining us today to talk about
all things men's health. We'vetalked about women's health and
the show a couple of times, andnow it's time to talk about
(01:52):
men's health. Dr Salas, welcometo the show.
Dr. Robert Sallis (01:59):
Thank you.
Erin, it's a pleasure to behere.
Erin Brinker (02:01):
So So tell me
about, you know, going way back,
what led you to go to medicalschool, and then why did you
decide to specialize in sportsmedicine?
Dr. Robert Sallis (02:15):
Yeah, well, I
did my undergraduate work at the
at the US Air Force Academy,where I was recruited to play
basketball, and I played fouryears of basketball there, and
during that time, I wasstruggling a bit my first year,
and the coaches actually got mea tutor in my chemistry class
who turned up, turned out to bethe pre med advisor, and an off
(02:39):
chance, mentioned to him that Ialways thought I wanted to go to
medical school. He would not letgo, and just kept encouraging
me, pushing me. He happened tobe in charge of pre med at the
Air Force Academy, and the nextthing you know, I'm applying for
medical school, and wasaccepted, and ended up coming to
Kaiser to do my residency, and Inever left. So did my residency
(02:59):
in family medicine, but with mysports background, I was very
much interested in sportsmedicine as well, and helped
start one of the, you know, oursports medicine program at
Kaiser, which is one of thefirst in the country.
Erin Brinker (03:10):
Oh, my goodness, I
didn't know that. That's great.
So did you pass that chemistryclass?
Dr. Robert Sallis (03:16):
I did. I
actually did quite well. And he
kept encouraging me, and reallyit was I always thought I'd be a
basketball coach, and kind oftook a sidetrack into medicine,
but it was kind of amazing forme doing my training in family
medicine. I really did not enjoybeing in the operating room, so
I really was not interested insurgery. I loved Family
(03:40):
Medicine, diversity of it, thebreadth of knowledge that you
had to have, but then combiningit with sports for me, sports
medicine is really just doingfamily medicine on athletes. And
I've been taking care of teamsmy whole career, so it's been
quite a fun run. So I love thebreadth of it. I really in my
sports medicine training. Becamefascinated with the effect of
exercise on health. And the moreI learned, the more I had to
(04:04):
question, why is this all aboutpills and procedures health
care? You know? Why isn't aboutgetting people to do, to adopt a
healthy lifestyle? And at thecenterpiece of that, in my
opinion, should be regularphysical activity, you know,
obviously diet and sleep, andthere's other things that are
important, but I think they allpale in comparison to just being
physically active and getting 30minutes of moderate to vigorous
(04:26):
physical activity each
Erin Brinker (04:27):
day. Now, you
know, we think about physical
activity, especially, you know,I have two brothers who are
CrossFit like they're they dothe Spartan Races. They do all
of those. And for them, when youtalk about being active, this is
not taking a walk or parkingextra far from Costco or
whatever. This is hardcore eatnails for breakfast kind of
(04:48):
exercise. But it doesn't have tobe that, right?
Unknown (04:51):
Absolutely. And what
we're finding is there's sort of
a sweet spot for how muchexercise you need. Really a
brisk walk is perfect. Doing itfor 30 minutes, you know where
you get a little bit winded, andI like to say you should walk at
a pace fast enough that youcan't sing, but not so fast you
can't talk. Doing that for 30minutes today really gets the
(05:13):
majority of the benefits. Now,to be sure, if you do, you know,
Spartan Races, intense physicalactivity, you get a little more
benefit, but the curve reallystarts to flatten out. And
what's interesting, what we haveseen in studying extreme
endurance athletes, you know,those that are doing marathons
and Iron Man distancetriathlons, there may actually
be a little loss of thatprotective effect. It may
(05:35):
actually be a little moreharmful. And I'm not saying it's
dangerously harmful, but youknow the old adage, everything
in moderation, you know, if, ifa glass of red wine a day is
good, the whole bottle isn'tbetter, you know, so why are we
surprised that doing extremeamounts of exercise may actually
be a little detrimental to yourhealth?
Erin Brinker (05:53):
Yes, and if, I
mean, there are people who are
athletes and that are, that's,that's man, that what keeps them
going, but you don't have to bethat. And if that's not, if
you're not wired that way, it'sit's nothing to be sad about.
It's nothing to be ashamed of.
Dr. Robert Sallis (06:08):
Well, you're
not getting extra health
benefit. Don't kid yourselfthat. You know, if walking 30
minutes a day, doing an hour anda half a day, you're not getting
a lot more benefit. You know,anything, anything beyond about
100 minutes a day of exercise.
You're doing it for reasonsother than health. It's it's
done more because you just, youlike doing it. You didn't even
become addicted to it. There arelots of reasons people do these
(06:30):
extreme amounts of exercise, butyou're kind of kidding yourself
if you think that's just goingto protect you and be so much
better for your health. And justdoing the small amounts, like
any I like to compare exerciseto a medication. Like any
medication, there's an optimaldose, you know, there's a sub
therapeutic, which doesn'treally help, and then there's a
toxic dose, which, taking toomuch of a medicine can actually
(06:52):
cause harm, where, when you takethe right amount, that's when
you get the benefit.
Erin Brinker (06:59):
So let's talk
about men's health. There's a
lot of stuff in the in the news.
We hear about women's health andwomen's women's mental health
all the time. That's a topicthat people talk about or the
mental health for youth. Butreally it's it's focused on
women and girls. You don't heara lot about men, because they
typically are not the ones to goseek out help when they when
they're not feeling good, theysuck it up and move ahead. But,
(07:20):
and I think that's reachinganecdotally, my opinion is
that's reaching a crisis level.
What are you seeing in yourpractice?
Dr. Robert Sallis (07:30):
Yeah, I think
the biggest concern for me is
sort of an exploding epidemic ofdiabetes and pre starting with
pre diabetes, the type twodiabetes that is entirely
preventable by appropriatelifestyle interventions, being
regularly active and eating aproper diet, keeping your weight
down. And the problem with withprediabetes and type two
(07:52):
diabetes, they start outasymptomatic, essentially, and
it takes its toll, veryinsidiously, affecting all your
major organs, from, you know,your eyes to your kidneys to
your heart. And then eventuallythe blood sugar begins to rise
so much that we can't evencontrol with medications. And so
(08:13):
that, to me, is one of thescary, you know, silent killers
that sort of exploding thesedays. Is this seems like
everybody these days is prediabetic, and it could be
entirely fixed by appropriatelifestyle modifications. And
then stemming from that iscardiovascular disease, the
major killer, both men andwomen, but in particular men, is
(08:35):
is atherosclerosis of thearteries all around the body,
but particularly the coronaryarteries that can lead to early
myocardial infarctions andsudden death, and the number one
killer is is heart disease. Andso those two sort of go hand in
hand, in my mind, that menreally need to pay attention to,
because if started early, youknow, managing the risk factors,
(08:58):
being regularly active, keepingyour weight down, monitoring
your cholesterol and your bloodpressure, not smoking, those
kind of things, you know,appropriate amounts of rest,
sleep and avoiding excessiveamounts of stress. All of those
are the contributors that we canwe have under our control to
sort of manage that can helpprevent this stuff. So
Erin Brinker (09:18):
you mentioned
sleep. What is, you know, what's
a good amount of sleep for agrown man and and how do you how
does he what kind of habitshould he develop to support
good sleep hygiene?
Dr. Robert Sallis (09:31):
Yeah, that's
a tough question to answer,
because I think it varies witheach individual. I don't think
there's one size fits all. Youknow that you need to sleep this
amount. I think as we go, if youpay close attention, you kind of
figure out what amount of sleepis good for you. I mean, I talk
to a lot of patients that if Idon't get nine or 10 hours, I
feel terrible. Others do reallywell on six seven hours. I mean,
(09:54):
the data suggests that youprobably ought to be sleeping at
least seven, maybe eight. Hours.
Maybe that's the sweet spot, butagain, I just find so much
variability in that. I thinkit's hard to assign an actual
number. You need to payattention. The way, what makes
you feel good? The mostenergetic, the clearest
thinking. When I get this amountof sleep, I think most of us, if
we're paying attention, can sortof gage what is the optimal
(10:15):
amount of sleep, but the otherfactor in there that you need to
gage is the quality of the sleepAm I getting into REM sleep, the
really refreshing, replenishingsleep that that we need to
function at our optimum, andthat can be interrupted by
things like sleep apnea as weget older. That's another big
(10:36):
crisis in men's health, is thedevelopment of sleep apnea,
which really closely correlateswith your weight. And the
heavier you get, the more likelyyou are to stop breathing at
night that it doesn't allow youto get into that REM sleep. And
you wake up feeling unrefreshedfrom sleep, and you find your
stuff falling asleep when you'redoing simple tasks. You sit down
(10:58):
to watch TV, and you're dozingoff. You're in a they turn out
the lights in a movie theater,and you're out, in, out, out,
and often snoring loudly. Andthen often a spouse will notice
that you suddenly stop breathingand make kind of cough and snort
and then start breathing again.
That's that's something that wethat can interrupt sleep, that
(11:21):
is linked to heart disease anddiabetes and a bad health
outcomes as you age.
Erin Brinker (11:27):
So, you know, I
this is all. This is all
incredibly importantinformation. And I'm thinking
about, you know, somebody hegets older, maybe he was more
active, more athletic when hewas younger. Maybe he played
pickup basketball at his churchonce a week or whatever. And now
he's in his 50s, he's slowingdown. He puts on some weight, he
(11:48):
starts to snore, he's, you know,all of those things. You know.
Maybe he doesn't have that.
Maybe his knees aren't as goodanymore, you know, how does
somebody like that take care ofhis needs? In his metabolism
slowing. What does he do? What?
How does he start this wholeprocess? Because it can be
daunting. With an informationout there is seems contradictive
(12:09):
or contradicting, it is just,it's really overwhelming.
Dr. Robert Sallis (12:15):
Yeah, it can
be tough. Certainly, all of
these things can make physicalactivity and getting the proper
amounts of physical activitymore difficult. More difficult,
but there are ways to do it. Youknow, as your knees become more
worn, it's harder to get out andcertainly run or even walk, but
things like a stationary bike,pool, workouts, resistance
(12:37):
training, I think, is really thebest exercise one can do. As we
age, we lose lean muscle mass,and lean muscle mass is really
critical to maintaining bloodsugar. Insulin sensitivity
really depends on that, and it'sessentially an organ system,
your muscle, that that helpsmaintain your sugar levels. So
(12:58):
that's particularly important.
Doing resistance training alsostrengthens the bones. We always
worry as we age the developmentof osteoporosis, thinning of the
bones, and resistance training,lifting weights, even just doing
body weight exercises, those aregreat alternatives to actually
getting out and walking. But Ithink a combination of those,
(13:19):
and then things like poolworkouts, where you can unload
the joints a bit. You know,swimming is a great exercise.
It's a little more difficult,obviously, because you have to
have access to a pool,especially in the winter. That
can be that can be a challengeand and certainly in California
when it gets cold, but it'simportant to figure out how to
get that exercise you need. Andso I think that's where really
(13:43):
connecting individuals, as weage, men and women with
opportunities to exercise.
That's why I think, you know,getting a personal trainer, or
being able to join the YMCA,there's some cost effective
options that we can utilize tohelp our patients get the
activity they need to behealthy.
Erin Brinker (14:04):
So is that, if you
have muscle loss, you know
people, and I've heard thatbefore, that as we age,
especially over 50, there's acertain amount of muscle loss
that happens every year. Can youget that back? If you started
exercising, Could you could youget that
Unknown (14:17):
back? Absolutely, we
know that resistance training at
any age can restore muscle lastretard, muscle loss that comes
with aging. We refer to it assarcopenia. You know, we always
worry about osteopenia, and Ithink we're so worried about
osteopenia and osteoporosisbecause we have drugs for it,
and the companies that marketthose drugs really push those
(14:39):
but I think more concerning issarcopenia, the loss of the
muscle sarcomere, you know, theloss of muscle mass that occurs
as we age, and particularly ifwe become very sedentary, and it
causes a loss of strength, whichaffects it is a daily living
(14:59):
and. The opportunities to enjoythings that we, a lot of us, to
do. If you drank, you do themmore prone. So it really then,
and as I mentioned, the keyreally is with muscle
maintaining insulin sensitivityand blood glucose, blood sugar
control, those go hand in hand,and that's why resistance
(15:19):
training as we age is reallyimportant.
Erin Brinker (15:22):
So let's talk diet
a little bit. Because I have
heard, you know, we should allbe vegan. I've heard we should
all eat keto. I've heard thatit's more No, paleo, no. It's
this other thing you have tooverload on, on on protein. What
is, what is the right diet? Howdo you find the right diet for
yourself?
Dr. Robert Sallis (15:44):
Well, you
know, that's a tough question,
because diet is so tied to yourupbringing, your ethnicity, you
know, the foods that you kind ofgrew up loving as a kid, it's
hard to get, you know, to changesome of those habits. But the
interesting if you start lookingat different diets, and what is
the best diet? I get thatquestion all the time. I think
(16:05):
there are lots of healthy diets,and you can look at things like
the DASH diet, the Mediterraneandiet, plants based diet, all of
those virtually identical. Ifyou go from somebody who's
eating an extremely poor diet,really high in processed foods,
and you change them to strictlyfall one of those diets that we
(16:27):
often think are just great, thatthey that does lower the
mortality risk, but it lowers itby maybe, you know, 15 to 20,
2015, to 25% or so improveimprovements in mortality. You
know, if you increase your fiberfrom somebody who has basically
the lowest amount of fiber intheir diet, and you make them on
(16:49):
a high fiber diet, yeah, itreduce your risk of premature
premature mortality about thesame, about 25% but it's
interesting, if you compare thatto exercise, if you compare
taking somebody who's notgetting any physical activity to
those who are doing, you know,meeting or exceeding the regular
physical activity guidelines.
150 minutes per week of moderateto vigorous activity, that
(17:10):
reduction in the hazards ratiois about 50% as much as 50% Oh,
wow. Compare the highest to thelowest exercises. Now I'm not
saying that diet is important,you know, certainly food is
medicine, but I tell you,exercise is a stronger medicine.
And so if you're going to workon one thing, adopting a really
aggressive diet, I'm not goingto argue with that, but the
(17:35):
better thing to focus on ismeeting the physical activity
guidelines. But you know, again,I would get back to the point
that all of those diets workfine. There is no evidence that
a plant based diet is betterthan a Mediterranean diet or a
DASH diet that increasing fruitsand vegetables, those things all
help more fiber in your diet.
(17:55):
Whole grains, all of thosethings, really, though, they
pale in comparison to whatgetting regular physical
activity is
Erin Brinker (18:02):
so if a, if a a
man comes to you for the first
time, he's been a couch potatofor, let's make up 20 years, and
he's got, he's maybe he'sdiabetic and he's got high blood
pressure, how would you tell himto start his exercise regime?
Unknown (18:18):
Very with a graduated
walking program. I think that's
the best thing, assuming thathe's able to do that. And I
would start him off verygradually, because we know even
small chunks of exercise 10minutes a day, and it does. It
can be in bounce. It doesn'thave to be in bouts 10 longer
than 10 minutes, any type ofactivity during the day is
cumulative, and so justachieving, working towards that
(18:41):
goal of 30 minutes, and startingout maybe at 10 minutes a day,
and at a lower intensity, andslowly ramping up the intensity,
that moderate amount, thatmoderate intensity, which,
again, I gage with what I callthe sing talk test, you should
walk fast enough that you can'tSing, but not so fast. You can't
(19:02):
talk, starting off 510 minutesand adding it up each week, and
at 30 minutes of moderate tovigor. And then I would throw in
some body weight exercises, youknow, some some push ups, pull
ups, sit ups, maybe some lightarm weights to work your biceps
and your triceps and overheadpresses with those light
weights. And I'd like to uselighter weight with higher rep,
(19:24):
and just sort of graduallyworking into it
Erin Brinker (19:27):
so he doesn't jump
in and do
Dr. Robert Sallis (19:28):
helpful. If
somebody has a I'm sorry now I
would go very slowly into that.
But then those sort of totalbody burpees and, you know,
squat thrusts and all those kindof things you can throw in based
on as needed. But you know, thefew resistance body weight
exercises combined with justwalking, it's pretty simple.
Erin Brinker (19:50):
So let's talk
about community. A lot of a lot
of men women, I think, connectmore easily than men do men. And
correct me, if I'm. Wrongbecause I'm not a man, but men
connect over doing thingstogether, whether it's playing a
sport or in their club or ahobby or whatever it is. And you
know, not a lot of men have timefor that, and so they're missing
(20:12):
that, that they're missing thefriendships that that go with a
healthy lifestyle, kind of talkabout that side of men's health?
Dr. Robert Sallis (20:22):
Yeah, I would
totally agree with your
assessment. Assessment there. Ithink women are much more likely
to get together and doactivities than men are, and
when men get together to doactivities, maybe it's going to
a bar and having some beers andwatching games. It's maybe not
quite as healthy on average. Imean, obviously there are
exceptions to that rule, but Ithink in my perception and my
patience, i i It feels like thewomen are are easier to get
(20:45):
together and do activity. And,you know, I find it fascinating
that, you know, if you ask me,what was my favorite, if you
would ask me, when I was inelementary school, what's my
favorite subject, I would haveprobably said PE, you know,
closely followed by recess. Imean, that was my favorite thing
to do, to go out on theplayground, play, run around.
How did we get from where thatwas your favorite part of the
(21:06):
day as a kid to now it's it'sdrudgery. I don't want to do it.
I'm trying to talk patients intodoing physical activity when it
was the favorite thing to dowhen they were little. How did
that happen? And I really thinkwe sort of engineered all the
fun out of physical activity. Itused to be so true. I was out on
the playground with my friends,playing sports, running around,
(21:28):
playing tag, tug of wars,whatever it was, climbing trees.
You know, we did all this stuffthat we enjoyed, and now it's
put headphones on, go to thegym, stand on the treadmill or
elliptical and for try to sweatfor 30 minutes. That sounds
totally unappealing. You know?
Why Can't We? I think that isthe key to solving the physical
activity inactivity problem issocializing it. You know, we
(21:50):
need a Facebook for exercise.
There's how do we get thesepeople connected to doing
because there's so many ways tomeet the physical activity
guidelines, even if we justsocialized it so you're
accountable to friends. I thinkthat's the optimal way to solve
it. The alternative to that, tome, that I have found very
helpful for my patients, is itis a pet, particularly a dog,
(22:13):
that likes to go out and walk.
And I see so many people thatthey'll, they'll walk the dog,
but not for themselves. Beforethe dog they they tend to care
of their pet, do it themselves.
And it was interesting. Yearsago, CDC put on a meeting that I
spoke at that was very fasting.
We had a group of group ofphysicians, and when you heard
(22:38):
the veterinarians talk, it wasastounding. The same problems
they have with their pets arethe same problems I'm dealing
with in my patient. You know,they eat crappy diet. They eat
too much, they don't exerciseenough, they don't get enough
sleep. It was virtuallyidentical. And you know, I just
think when you explain, if,hopefully the vets are telling
(22:59):
you need to get your dog out fora walk, because I think a lot of
people, men in particular,they'll do it for the dog, but
they won't do it fromthemselves. And so I think
that's another greatalternative. And we know from
studies that that people whohave animals have dogs, or, you
know, other pets, thatparticularly ones they can walk.
I think they live longer and andmaybe, you know, it's all not,
(23:21):
it doesn't all have to do, whichis being more physically active,
because we know that people whohave pets are more physically
active than those who don't. Butthere's also a component of
companionship and all that stuffthat probably plays into why
people with with animals livelonger.
Erin Brinker (23:35):
You know, it's,
it's so interesting. We have
engineered the fun out ofeverything. And, and I think
that that Fitbits, and I wearone, and it gives you all the
metrics, but then your healthbecomes a matter of metrics,
right? So did I hit all themarkers that I'm supposed to
meet, meet to hit? Not did I goon a hike? And it was beautiful,
(23:57):
and the payoff was this VISTAthat was incredible. It was, Did
I hit? Did I get enough steps?
Did I climb enough elevation, if
Dr. Robert Sallis (24:05):
I exercise
and I didn't have my watch on?
Did it even, did I even get
Erin Brinker (24:10):
exactly that's
crazy, but it's so true, and I
do it too, and I'm not a guy,yeah, yeah, you know. And it's
Dr. Robert Sallis (24:17):
but I can
also find that very helpful. I
mean, I do look at my stuffcounts, you know, on my phone.
And if I, you know, I'm at, youknow, 8500 I'll go out and walk
a little bit to get it up to,you know, 10,000 steps a day,
because
Erin Brinker (24:30):
you want to meet
that well, and that's good,
yeah, that's good. I mean, ifit's, if it, if you gamify it,
that's different than if it's,you know, I have to do this. I
have to it becomes, you don'twant it to be compulsive. You
want it to be
Dr. Robert Sallis (24:42):
fun. Yeah,
sure. I think it's a lot easier
to maintain that for thatreason, that it's fun than it
is. I'm just trying to meet thisbut you know, I'll do it
whatever way works. I think isuseful.
Erin Brinker (24:55):
So let's talk
about things like that that
happened to men as they age,like prostate cancer and other
kinds of. Answers. You talked alittle bit about about snoring
and sleep apnea. You know youneed to get yourself checked for
these things. At what age shouldyou start showing up and saying,
Hey, Doc, I need to check thisout.
Dr. Robert Sallis (25:14):
Well, I think
all along, you ought to be
checking in with your physicianregularly. You keeping an eye on
things like blood pressure,cholesterol, your blood sugar,
as we measure through thehemoglobin, a 1c test. These are
all things that can start sortof silently early on that begin
to set the stage for, you know,problems with insulin
(25:35):
sensitivity, pre diabetes andcardiovascular development of
cardiovascular disease early on.
You know, we ought to be tryingto head those risk factors off
before it gets to the pointwhere the arteries are clogged.
So hopefully that's going to beearly on. But as we get older,
you know, cancer goes updramatically as we age. And I
tell you, regular physicalactivity, the effects on cancer
(25:57):
prevention both the primaryprevention that is, you know,
you get that first colon cancer,but secondary prevention. Once I
have it, how much longer can Ilive? Once I've had it removed,
it's got a dramatic effect. Andif you look at physical
activity, it's hard to find acancer where there isn't data,
(26:17):
where it helps. But I tell you,colon cancer, breast cancer, in
women, prostate cancer, lungcancer, those all have clear
connections to your physicalactivity. And it just seems that
when we exercise, it ramps upour immune system, and it helps
not only cancers, but butinfections are are lower. And
you know, I was involved in oneof the first studies during the
(26:41):
COVID epidemic that showedpeople who did regular physical
activity were dramatically lesslikely to be admitted to the
hospital if they got COVID andor die from it. And in fact,
they were two and a half timesthose who are meeting the US
physical activity guidelines of150 minutes a week or more were
two and a half times less likelyto die of COVID when they
(27:03):
contracted it, and it took us along time to convince the CDC to
put that on their website. Youknow, it was all about all of
these other harder things,things that you want medicine to
control, just simply getting outand walking was probably the
best pill we had. Fact, therewas no bigger risk factor for
dying of COVID than yourexercise level. The only bigger
(27:23):
one was age. You know,particularly when you got over
the age of 60 and a history ofan organ transplant, that those
were the two things when welooked at, we did a multivariate
analysis where we look atdifferent variables, diabetes
was not a bigger risk factor,obesity was not a big, bigger
risk factor heart disease wasnot a big, bigger risk factor
during the COVID epidemic, thebiggest modifiable risk factor
(27:45):
for dying from COVID Was yourphysical activity level. If your
gene guidelines, you were twoand a half times less likely to
die.
Erin Brinker (27:57):
So even if you're
a big guy, if you are getting
exercise every day,
Dr. Robert Sallis (28:02):
then you're
okay, absolutely, even morbid.
You know, extreme levels ofobesity, significant obesity was
not a bigger risk factor thanbeing physically inactive.
Erin Brinker (28:13):
So some of this,
you know, as it's really easy to
give the community or give thepublic knowledge about how we've
got knowledge coming out ourears, what we don't have, what
it's hard to do is changeattitudes and to change
behavior, because it's socultural, it's so familial. And
you know, it's cultural on abroader perspective, but it's
cultural in your family too. Youknow, how do you change hearts
(28:36):
and minds? How do you changeyour own heart and mind?
Dr. Robert Sallis (28:40):
You know, it
starts in the schools, and I've
been dismayed the way schoolshave handled physical education.
You know, we used to havemandatory PE, we did regular
exercises every day. It was partof the school curriculum, and
it's been engineered out of kidsas well. I think the activity I
knew when I was a kid recess,and PE, you know, we did some
(29:03):
intense physical activity, andthat's just not happening today
like it used to. And I think weknow, you know, as if you're
active as a kid, you're muchmore likely to be active in in
college and then go on to beactive as an adult, so I think
(29:23):
it's imperative that we get kidsactive early and we keep them
active.
Erin Brinker (29:28):
And again, that
can be anything from riding your
bike all day long, and we usedto do that as kids. You hop on
your bike in the morning andyou're gone until the street
lights come on absolutely and Iknow that kids don't do that for
a host of different reasons, butthey don't do that anymore.
There's no, you're not, they'renot out all day long. They're
playing video games. And I don'tthink video games are
(29:48):
necessarily horrible. They hadthem when I was a kid too. It
was Atari, but, you know, westill played, but it's, it's the
absence of anything else that'sthe problem.
Dr. Robert Sallis (29:59):
Yeah. Sad is,
is we have lots of studies to
show that the physical activityis getting in school today. Can
they can't even count, becounted towards the 60 minutes
of recommended physical activitythat kids get, because it's so
(30:20):
often, just not You're notstressing the body at all with
it. It sets light and irrelevantactivity. The recommend,
recommendations for physicalactivity that the extra, the
guidelines call for, oh my God,that's a sad commentary on the
state of physical education inAmerica.
Erin Brinker (30:36):
Oh my gosh, wow.
So let's talk about some somestatistics. You know, what
percentage of men have ourhypertension? What percentage
would be are classified asobese, etc? Well, I
Dr. Robert Sallis (30:53):
don't have
those numbers right in front of
me, but if I had to guess, I'msaying it's maybe two thirds
depends on the community,depends on the racial, ethnic
background, the socioeconomicsplay a big role there as well.
But I would say at least half totwo thirds are overweight or
obese, and with that, thediabetes probably is. You know,
(31:14):
30% of Americans probably arepre diabetic. Of adults, I would
guess maybe even more, maybe upto 50% those are, they're big
numbers. It's becoming whereit's going to be. The
preponderance of people aregoing to be overweight and
diabetic or pre diabetic,
Erin Brinker (31:30):
and even kind of
the same, even thin people can
have diabetes and beunhealthful. They just happen to
look leaner than their obesecounterparts,
Dr. Robert Sallis (31:40):
absolutely.
And there's this whole, youknow, kind of, you know, thin
and unfit, you know,metabolically, you know you're
thin, but you're actually, froma metabolic standpoint, you're
not healthy and and I it's muchmore than what your BMI shows.
And for the same token, it'sinteresting. If you can look at
what BMI our body mass index,for those of you that know, it's
(32:01):
the ratio of your height to yourweight. So obviously, the taller
you are, the more you wouldlikely weigh. So the idea is
that the lower the BMI you'retall, that's the numerator and
the denominator, then is yourweight. So the and so the the
more the BMI goes up, the moreconcerned we are about that. But
(32:26):
the interesting the BMI,typically, we say is normal, is
between 18.5 and and 25 isconsidered normal weight
overweight would be a BMIbetween 25 and 30, and then
obesity. Class One, obesitywould be 30 to 35 and then 35 to
40. Class Two, we start talkingabout morbidly obese when you're
(32:50):
over 40. But the BMI that'sassociated with the longest
lifespan is a is in theoverweight range 25 to 30. That
doesn't get talked about a lot.
Actually, the most dangerous BMIis between 15 and 20, and
particularly as you age, peoplewho are really skinny as they
(33:12):
age, don't do as well. Who'speople who who weigh a little
more, and we don't really know,we're pretty astounded to see
the correlations between beingskinny and bad health outcomes
as we age. They refer to it asthe obesity paradox, that it's
sort of counter to what we'vealways thought, that I want to
be real skinny, but there aretimes when that's not healthy.
(33:35):
And so I think, you know, kindof, as we age, looking at what's
my best weight, it's often, youknow, in that slightly
overweight range is probably theone that's associated with the
best longevity, huh?
Erin Brinker (33:49):
I had no idea that
seems counterintuitive,
Dr. Robert Sallis (33:53):
yeah. Now,
when you start getting but
what's interesting, you know,you start getting up into class,
class two, obesity, morbidobesity, you know, then the
risks start to ramp up, but theystill aren't better than much,
you know. It's probably moreconcerning to have those really
skinny, you know, less than 18BMI. So as we get older, that's
(34:16):
a risk
Erin Brinker (34:18):
interesting. I
that is that surprising to me?
I've not heard that before. So,looking ahead, you know, kind of
what innovations, you know, sortof talking about research that
not everybody has heard. Whatare some interesting things
going on in men's men's health?
And what are you excited aboutright now?
Dr. Robert Sallis (34:39):
You know, I
am kind of excited about the
devices, you know, the AppleWatch that can show so many
measures. You know, not onlyjust your physical activity, but
your sleep, your you know thingsyour like, your blood pressure,
your heart rhythm. You know itcan detect heart rhythms. I've
had a number of patients come inbecause their Apple Watch told
them they were in an abnormal.
Heart rhythm. And sure enough,they were, they were in atrial
(35:01):
fibrillation in the watch reallysaved them by causing them to
come in because of what theywere seeing there. So I think
that there's some tremendousopportunities there for
monitoring folks and encouragethem when they should be going
in, reminding of that andpicking up things that they
might not have noticed. And so Ithink that's probably of all the
(35:24):
innovations, I think that'sthat's a big one. Some of the
things that I think are overhyped, I really think, like
supplements and vitamins, thoseare way overdone. I you know,
you the best way to get what'sin a supplement and what's in a
vitamin is by eating the foodsthat contain it, healthy
portions of the foods thatcontain it, not taking a pill.
(35:46):
And I think that's way over,hyped and overdone. And
hopefully, you know, people willwork on just a healthy diet to
get all the the vitamins,minerals and things that they
need, and not take supplementsto do it. It's interesting as we
age, prostate health in men isalways one of the first things
(36:06):
we pick up. But what's reallyinteresting is we've more and
more gone away from testing forPSA. What we have found is that
doing regular screening of theprostate specific antigen, the
blood test for an enlargingprostate, and for prostate
cancer, will cause the PSA to goup over. Doing that for a good
you know, 30 years, what we havefound is we're not really
(36:28):
changing the outcomes of peoplewe screen catching a high PSA
most of the time is the canceris not aggressive, and you don't
die from it. You tend to diewith it. And in fact, if you
look at the prostates of mostmen over 80, the vast majority
will have prostate cancer. Inthere will have cells of
prostate cancer. And again, theydon't die from it. They die with
(36:50):
it. So I think we've got alittle bit over aggressive
thinking that early detection ofprostate cancer saves lives,
when in fact, it may cause moreproblems than it helps, because
a lot of the things we do whenthe PSA is high and our patient
has prostate cancer, you know,taking the prostate out, you
know, treating with radiationor, you know, medications to
(37:14):
shrink it, that they can causemore problems than the than the
than solving the issue that theoriginal prostate cancer would
have been. So I think we have toapproach that very carefully
with how we use PSA testing andhow aggressively we treat when
it's elevated and the patienthas prostate cancer.
Erin Brinker (37:33):
So I know that
most prostate cancers are slow
growing, but I have heard ofsome that have metastasized into
the bone or some of the otherorgans you know are, is that
rare and absolutely
Dr. Robert Sallis (37:45):
well, no. I
mean, you know prostate cancer,
you certainly is a leadingkiller of men. The question is
is, can we do anything to alterthat course? And sometimes, when
you have very aggressiveprostate cancer, you catch it
early, you treat it with aprostatectomy, you radiate, you
do all these things, and it'syou still die from it. It seems
(38:06):
that there are some forms thatare just so aggressive, no
matter what we do, or catchingit early doesn't change the
outcome in a lot of cases, andthat's why the US Preventive
Services Task Force has nowchanged the recommendation to
only screen for prostate cancer.
It's supposed to be a shareddecision with the patient,
knowing that we often don'tchange the outcome. They've
(38:26):
looked at groups of men who getregular PSA testing compared
with groups who don't, and theones who don't get it are really
no more likely to die fromprostate cancer, the cancer,
than the ones who get it, whichis really distressing when that
came out. But I think we have tobe really careful, because there
are complications that can occurwhen we aggressively treat
prostate cancer well,
Erin Brinker (38:47):
and it's and it it
can dramatically impact
somebody's intimate life in avery negative
Dr. Robert Sallis (38:53):
way.
Absolutely from, you know,difficult with with sexual with
erection, and certainlycontinents and things like that
are big issues in people who areaggressively treated for
prostate cancer,
Erin Brinker (39:05):
and that's
something that you just you have
to work with your physician.
Yeah,
Dr. Robert Sallis (39:10):
you know,
that takes a lot of thought and
discussion, what we call shareddecision making, where it's not
just the physician telling youwe're screening your for your
PSA and it's elevated, and we'regoing to biopsy, and then we're
going to do this, you know? Dothis, you know, because there
are a lot of nuances in therewhere, in a lot of cases, the
better choice is just to monitorit. I think intuitively,
(39:31):
everybody thinks I have cancer.
The earlier I cut it out, thebetter off I'll be. That's not
always the case, particularlywith prostate cancer.
Erin Brinker (39:41):
So, you know the
discussion about people who
realized that they were havingan irregular heartbeat and came
into to see you, if you, if you,if your tracker is saying that
you have an irregular heartbeat,do you go to the ER? Do you make
an appointment with your
Dr. Robert Sallis (39:56):
GP? I think
it depends on how you're
feeling. If you're feeling.
Light headed, you're feelingsuddenly out of breath, and it
says you're in an abnormalrhythm. Yeah, you should go to
the the emergency room, or atleast an urgent care to be seen
quickly. If it's somethingthat's picking up and you're
having no no feeling, you don'tfeel bad at all, then I think
it's reasonable to I wouldn'twant to wait too long, but
(40:16):
especially if it says thingslike atrial fibrillation, I
wouldn't want to miss that so.
But I think you gotta couplethat with how you're feeling,
what symptoms you're
Erin Brinker (40:26):
having, because an
atrial fibrillation could could
cause a blood clot, which couldcause a stroke or heart attack,
right?
Unknown (40:32):
Exactly, that's the
concern, and we typically need
to put those patients on aanticoagulant, you know, to thin
the blood to reduce the risk ofa stroke.
Erin Brinker (40:44):
So do you
recommend that all your patients
wear some sort of fitnessdevice?
Dr. Robert Sallis (40:51):
You know, I
think they're helpful. I don't
think it's the end all be all,but I think for certain people
who respond well to getting allthat information. And like
having that, it's, it's a greatoption, you know, at the end of
the day, though, I just want to,I want to do whatever gets them
out, moving, you know. And Ithink the focus more on, on
finding something you enjoy thatyou'll repeat and doing it
(41:15):
again, like you mentioned,because you enjoy it and it
makes you feel good, not becauseyou're, you know, Activity
Monitor says you need moreexercise. I think you got to
look at each patient and seewhat will optimally motivate
them. And
Erin Brinker (41:28):
sometimes it'll
tell me, get up and do so many
more steps for this hour to meetyour goal. And in my mind, I'm
internalizing, hey, fat, so getoff, off your butt. Get moving
Dr. Robert Sallis (41:37):
well, you
know, I think everybody's
different. You got that's,that's the art of medicine,
trying to figure trying tofigure out what motivates people
and what's likely to get them todo the right thing and the
things they they need to do.
That's not always easy.
Erin Brinker (41:51):
So, so let's talk
about some cultural and racial
disparities. Because if you'refrom a low income community,
which typically impacts peopleof color in this nation, if
you're in a low incomecommunity, you may not have a
safe place to take a walk. Whatare some things? What are some
things that you're seeing inyour practice for people who
maybe live in an area wherethat's not getting out and
(42:13):
getting active in theirneighborhood is not possible?
Dr. Robert Sallis (42:16):
Yeah, those
are tough questions. And you
know, if you distill down thesocial determinants of health,
you know, which you know, youryour ethnicity and income and
those types of things, youdistill them down. Really, to
me, it has to do with, you know,access to healthy foods and a
place to be physically active.
To me, really, that's it. Andthen you maybe can throw in
(42:37):
some, you know, other high riskbehaviors like smoking and
alcohol, those impact. Butreally, diet and exercise, to
me, are the biggest things, thesocial determinants, effect and
and, you know, those, to me, arethings we can we can change. I
mean, there's just no excuse forhaving, you know, these, these
(42:57):
nutritional deserts, you know,where the healthy food is just
not to be found, and people arehaving to buy food from a liquor
store. That's insane, that wecan't fix that. And then places
to exercise Absolutely it'sdifficult in a lot of
neighborhoods, particularly inLos Angeles, it's not safe to go
out, particularly if you havekids and you're going to take
(43:20):
them with to exercise. But thereare some things out there that I
some examples of things thatI've seen work really well. And
one of the biggest is walking inthe mall or shopping centers
where it's safer, and especiallyI visited a mall on the east
coast where it was an incrediblegroup of elderly people that
walked every Saturday in themall. And then, actually, three
(43:43):
days a week, the mall would openearly for these walkers, and it
was good for the mall. Itbrought people in there, and as
they walked, they often thenshopped after they were finished
with their walk. But that was anexample in sort of a lower
socioeconomic neighborhood wherethe it wasn't safe to walk
outside, but they could do it inthe mall. You know, those are
(44:04):
examples. And I think it'simperative that we we have
lights and parks and guards ifwe need them to make it safe for
people to get out in theseneighborhoods. Those are things
I think that are really fixable,that I wish we would put more
focus on.
Erin Brinker (44:20):
You know, I know
that here in San Bernardino,
where the making hope happenfoundation is the mall that's
here, the inland Center Mall,they do open up early, and
especially seniors, get outthere and walk for the exact
reason that you're talking aboutis they feel safe. They can,
they their friends are there. Sothey congregate when the mall is
open, they can grab a cup ofcoffee and, you know, buy
something in the stores. And sothere's that real social
(44:43):
connection as well as thephysical connection. And I think
those things go hand in hand,
Dr. Robert Sallis (44:47):
absolutely.
Erin Brinker (44:49):
So I think it's
important you talked about the
social determinants of health,and in in in many places in the
country, in San Bernardino andRiverside counties, i. Are no
different. There's this vitalconditions. And there are seven
vital conditions, and one ofthem is civic belonging. You
know, if there's somethingthat's not happening in your
neighborhood that you want,like, you want the schools to be
(45:11):
open so you can use thebasketball courts. You want the
lights to work so you're notplaying in the dark, etc, it's
completely you have the power togo to your school board or to
your city council or to whereverto ask for those things to
happen for you, because it'sthey serve you. And I think it's
important that people hear thatand know that that they can
(45:31):
impact those things in theircommunity to create what they
need to be successful andhealthy.
Dr. Robert Sallis (45:37):
Wow, those
are great points. And yeah, we,
we certainly these are problemsthat are not even close to being
insurmountable. You know, we'renever going to solve income
distribution and things likethat, but we could solve this.
We could make sure that thereare access to healthy foods
everywhere in the US, in everybig city, there's no excuse for
(45:58):
not having access to foods, noexercise, yes, that ought to be
the minimum that we get for ourtax money, that that is
guaranteed that everyneighborhood has access to
healthy food and a place toexercise. How could we say we
couldn't achieve that
Erin Brinker (46:14):
in the in the most
the wealthiest country in the
history of the world?
Dr. Robert Sallis (46:19):
Yes, with
what I see us spend money on why
would we not go for that? Thatis, that's low hanging fruit,
Erin Brinker (46:24):
indeed. And so,
you know, it's interesting,
because now we're getting intothe into the area of purpose.
And I think purpose dramaticallyimpacts health and wellness and
well being. I think everybodyneeds to have to feel a purpose.
And if your purpose is creatinga community that meets the needs
of the people who live there.
So, you know, I live in SanBernardino, and it, for me, it's
important that this communitymeets the needs of the people
who live here. They're myneighbors, they're they're my
(46:46):
family, and that, and that hasgiven me purpose. And I know
that. You know, if you're if, ifyou're used to sitting on the
couch and not doing anything,having a reason to get up off
that couch can make a hugedifference, absolutely. So what
are some we have about aboutnine minutes left for people who
might be interested in goinginto sports medicine, and maybe
(47:07):
they're thinking about, theywant to work for a team, or
they're just, you know, thinkingabout maybe doing physical
therapy or athletic training orthat sort of thing. What would
you tell that student about howto do that job or how to get to
that place? Yeah,
Dr. Robert Sallis (47:23):
there's,
there's so many ways to get into
the sports medicine field. Youknow, so many different angles,
not just as a physician,obviously, in medicine, as
physicians generally, you wouldcome about as a primary care
physician with additionaltraining in sports medicine, or
an orthopedic surgeon withadditional training in sports
medicine. Now, obviously theorthopedic surgeons are their
(47:45):
surgeons, and they're primarilyin the operating room, operating
on those sports injuries,whereas the primary care sports
medicine physicians are moreoften on the sidelines, early
on, making the diagnosis,putting the patient in and
collaborating with a physicaltherapist, often for appropriate
rehab for their sports injury.
So that's another way to come tothe field, is through physical
therapy. And then, you know, oneof the if you think about what
(48:09):
is besides the musculoskeletalsystem, exercise also stresses
the heart, and there's a hugecomponent of cardiac disease.
You know, cardiovascular sports,cardiology is another area to
kind of work with athletes tohelp optimize performance and
health. Those are sort of theways that you could get into it.
And then, you know, I've alwaysloved being a team physician. I
(48:30):
always thought I'd be abasketball coach, and I love
being on the sidelines, beingable to take care of the
athletes, watch the games andand so it's been exciting to me.
I actually taking care of the LAClippers, being on the being at
the games, taking care of theplayers. I take care of mostly
their medical needs. I have apartner who's orthopedic surgeon
that takes care of most of theorthopedic injuries. And so it's
a combination of those, youknow, it's a, you know, it's,
(48:51):
it's everything you would see inthe general population these
athletes get Now, obviously theyput a lot of stress on their
ankles and knees. So we see alot of ankle injuries. That's
the most common reason for aplayer to miss a game. But you
know, knee knee injuries aswell. There's a lot of stress on
the lower extremities and thenupper as well. You know, when
they're rebounding and, youknow, going up to block a shot
(49:14):
or shooting with overheadactivity, they can have shoulder
issues. The soccer players ismostly lower extremity, you know
that I see in them. And we get alot of soft tissue in soccer. We
see a lot of hamstring quadmuscle, not only strains, but
contusions from getting hit. Andso kind of knowing what you're
likely to see in each and whatyou have to prepare for. The
(49:35):
other big thing is concussion.
That's that's the hot topic nowin sports medicine, particularly
in our soccer players and ourfootball players. What is the
effect of these head injuries?
That's an area that's a littleconcerning.
Erin Brinker (49:49):
Yeah, and how much
do you want to give up yourself,
of yourself, to be able to playthat game that you love? And
yes, you get paid really well,but is the cost too high? Yeah.
Know, and that's, that's aquestion. I think the NFL
especially needs to have thatdiscussion that I'm sure they're
already having it, but they needto continue Absolutely.
Dr. Robert Sallis (50:07):
Yeah, we deal
with this in our soccer players
as well. We have pretty highrates of concussion, and I have
players that have had multipleHow many is too many? We don't
really have the answer to thatquestion. I don't think any of
them are good. And the more youhave, the more concerning I get.
And then, especially when youhave persistent symptoms, how do
I convince a player, you know,at 35 now it's time to give it
(50:27):
up and and you know, you've gotthe rest of your life ahead of
you, but at the same time, I'masking them to give up their
livelihood, right? How they'vemade a living? So it's, it's a
really difficult decision anddiscussion to have with a player
trying to convince us somethingI've been through numerous
times, trying to convince them,I think, in your own self
interest, you really need toquit. That's a really hard
(50:49):
discussion.
Erin Brinker (50:50):
Oh, I bet it is.
You know, I and you went to theAir Force Academy, so obviously
you are, you are disciplined.
And one of the things that wesee in in our youth is that when
things are hard, they think, Oh,I can't do this. It's too hard
for me. But anybody who's beenin the military, or anybody
who's been a an elite levelathlete or or having a job, like
(51:12):
a physician, you know that yougot to push through the hard
because you can. You can do it.
You can get there if you work.
And I want young people to hearthat message, that the payoff is
worth it. And can you kind oftalk about your experience in
that?
Dr. Robert Sallis (51:27):
Yeah, you
know, I It's nice with the elite
level athletes, they're prettyself motivated. You know, I
don't have trouble. It's oftenI'm holding them back. But the
longer I've practiced andespecially doing sports
medicine, I have found that Itreat every patient like an
athlete. I use the sameprinciples of of that I use for
managing injuries and illnessthat I do in my athletes. I use
(51:50):
it on my regular patients.
Obviously, the goal in theathletes is getting back to
competition, and in my regularpatient is getting them back to
that physical activity that theyneed to do to stay healthy, and
if they aren't doing it,encouraging them to start doing
that activity they need to do.
So I always think of them as anathlete, helping them pick out
(52:11):
the best sport for them, helpingoptimize their training. You
know how to start it? How? Whatkind of things can you add? And
really, if they're ill orinjured, taking them out of
activity until that illnessresolves itself or the injury
heals itself, and then I putthem into graduated activity.
Follow the same protocols that Iuse in my elite athlete. I use
(52:31):
it for my regular patient. Ijust think it works beautifully.
And I really, you know, it'simportant that we look at every
patient as an athlete. In theelite athlete, it's their job.
It's even more important in thenon elite athlete, because it's
what's going to keep them alive,you know. And I've always wanted
to get an ad from, you know,someone like Joe Montana,
(52:52):
saying, you know, 20 years ago,I was working out every day to
try to win a Super Bowl. Today,I work out every day to try to
stay alive, to see my grandkids.
Erin Brinker (53:00):
Oh my gosh, that's
so great. I think in
Dr. Robert Sallis (53:03):
really saying
that now my training is so much
more important, the stakes aremuch higher. You know? I think
that we could all agree withthat,
Erin Brinker (53:11):
oh, 100% that's a
and you push through even when
it's hard, it's because, becausewhat you're fighting for is
worth it.
Dr. Robert Sallis (53:19):
Yeah, yeah. I
think Have you seen that out of
the the old man who's goes intohis his shed, and he's, he's got
some weights, and he's liftingthem above his head, you know,
he starts out with one small,little weight, and then he
slowly adds to it. And then inthe next clip, it's at
Christmas, and his grandkid isover, and he lifts the grandkid
above his head. And it was, hewas training to do that. You
(53:40):
know, I think that says it all,that we're all athletes. It's
just what we want to do, thesport we want to do, that's what
we're training for.
Erin Brinker (53:48):
Oh, well. Dr, Bob
Salas, this was absolutely
fantastic. And I want to end onthat, because it's such a high
note. How do people, or do youhave social media? How do people
find and follow you.
Dr. Robert Sallis (54:01):
I don't do a
lot on social media. I think, I
know I have a have a Facebookand Instagram, I think, but I'm
not big on there, but you canprobably search me out on
different things I've done andand get some if you're
interested in some of thestudies, the research I've done,
you can find it certainly on theinternet,
Erin Brinker (54:20):
excellent. Well,
and if people want to see the
fruits of your labor, they justneed to go to a clippers game.
Dr. Robert Sallis (54:24):
That's right.
Hopefully we're healthy that andLef see our le FC season right
now. Oh, excellent,
Erin Brinker (54:33):
excellent,
excellent. Well, thank you so
much for joining us today.
Joining me today. It's been adelight, and men and women alike
will take a lot from thisdiscussion and hopefully get out
there and get moving.
Dr. Robert Sallis (54:45):
Thank you,
Erin, I enjoyed the
conversation. Thank you.
Erin Brinker (54:52):
Well, that is all
we have time for today. Thank
you so much for listening. Ihope you enjoyed it. I know I
did, and always enjoy. Same timewith you whenever you are
listening. I am Erin Brinker,this is the making hope happen
radio show. For more informationabout the making hope happen
Foundation, go towww.makingcope.org, that's www,
(55:12):
dot makingcope, dot O, R, G, andI'll see you next week.
Noraly Sainz (55:22):
Hi, my name is
Noraly Sainz, and I am Program
Coordinator at uplift SanBernardino, a collective impact
initiative at the making hopehappen Foundation. And this is
my story in November of 2017 myhusband, our four young sons and
I moved away from our familiesto San Bernardino with the hope
of reaching our goal of homeownership in 2018 as our oldest
(55:45):
son started kindergarten, Iconnected with the school
district and learned aboutmaking hope happens. Kids
program with my oldest inkindergarten and my twins at
preschool. I had the opportunityto tote my youngest to the kids
parenting classes in January of2020, my husband and our
family's breadwinnerunexpectedly passed away. I
found myself in a pandemic withmy sons in an uncertain future.
(56:08):
It was then that that oasis thatI found at kids turned into my
support system, as the staff andfriends rallied around me while
my sons and I struggled to findour new normal. In October of
2020 after seven years as ahomemaker, I joined the making
hope happen foundation as aprogram coordinator for uplift
San Bernardino. This careeropportunity reignited my
(56:30):
family's dream of home ownershipin November of 2022 through the
mutual support of the uplift SanBernardino Housing Network, my
family was able to buy our firsthome. In my role as program
coordinator, and as I connectwith other families in our
community, I can wholeheartedlyattest to the opportunities that
the foundation is bringing toour community and truly making
(56:52):
hope happen. For
Erin Brinker (56:53):
more information
about the making hope happen
foundation and to make adonation, please visit www dot
making hope.org That'swww.makinghope.org your
donations make our workpossible.
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