April 2, 2025 • 34 mins
Judith Abbey, DNP, shares her journey from medical student in Ghana to healthcare entrepreneur in Florida, where she founded On the Go Drip, a mobile IV therapy service delivering treatments directly to patients' homes. Dr. Michael Koren asks her about her history and business, and the two of them dive into some of the controversy surrounding supplement treatments.
Helpful Links:
Research Methods class at University of North Florida
The Book Clinical Decision Analysis
Be a part of advancing science by participating in clinical research.
Have a question for Dr. Koren? Email him at askDrKoren@MedEvidence.com
Listen on Spotify
Listen on Apple Podcasts
Watch on YouTube
Share with a friend. Rate, Review, and Subscribe to the MedEvidence! podcast to be notified when new episodes are released.
Follow us on Social Media:
Facebook
Instagram
X (Formerly Twitter)
LinkedIn
Want to learn more? Checkout our entire library of podcasts, videos, articles and presentations at www.MedEvidence.com
Music: Storyblocks - Corporate Inspired
Thank you for listening!
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Announcer (00:00):
Welcome to MedEvidence!, where we help you
navigate the truth behindmedical research with unbiased,
evidence-proven facts Hosted bycardiologist and top medical
researcher, Dr Michael Koren.
Dr. Michael Koren (00:11):
Hello, I'm Dr .
Michael Koren, the executiveeditor of MedEvidence! And I'm
really looking forward to thissession.
I have Dr.
Judith Abbey here with me andDr.
Abbey is a medical entrepreneurin our community here in
Florida and I'm reallyfascinated to know about your
journey, how you got there andtalk about why you chose a bit
(00:33):
of an unconventional way toserve the public, tell us about
your business and, importantly,tell us about how we use
evidence-based medicine andscience to make things better
for patients in our community.
Thank you, Dr.
Koren.
It's an honor to be here withyou and they may not see, but we
(00:53):
have additional people in thestudio here with us who are
making this episode wonderful,so just want to give a shout out
to them A little bit about me.
Don't flatter them too much because they may
ask for a pay raise which wereally can't afford at this
point.
But I appreciate you reachingout to the listeners may
actually help Okay well, therewe go.
Judith Abbey, APRN, DNP (01:10):
But I'm originally from Ghana, so, born
and raised in West Africa,Ghana moved to the United States
in December 2011.
So I have been here a while Noworiginally, when I moved here,
I was under the impression ofcontinuing med school.
So back home in Ghana, I wasenrolled in medical school and
(01:33):
that was the vision I'd alwayswanted to be a physician, and I
think, culturally, part of itbeing that you become a doctor,
and I think this is commonacross certain cultures.
So you're either a doctor oryou're a lawyer or an accountant
, and I think it's because,knowing that those professions
(01:54):
you end up doing well, you cantake care of yourself and your
family.
But for me, it felt more like itwas a calling for me, and so
during my whole education, myplan was I was going to become a
physician at that, and that wasgoing to be the way for me to
be a conduit for healing and forhealth for people.
(02:16):
I wanted to help people makethem feel better, and so when I
was in first year of med schoolback home in Ghana, I was told I
was moving to the United States.
I was like, ok, how'd thathappen?
My brother, my oldest brother,was here with his wife and I.
You know, I can't say for surewhat their plan was, only maybe
(02:39):
you know they wanted me to havea better life and a better
education.
Of course, there is moreopportunities in and a better
education.
Dr. Michael Koren (02:48):
I see.
More opportunities in the USversus Ghana
Judith Abbey, APRN, DNP (02:50):
Of course you know the United
States.
It's a great country and we cansee many people often want to
travel here for betteropportunities.
And so when I moved here I wasunder the impression that, ok,
because this is the trajectoryI'm on, that's what I was going
to continue on.
I was informed I was doingnursing.
I was like okay, but I did notunderstand what that meant.
(03:14):
I think for my brother and hisfamily it came from a place of
okay.
Nursing is the route where mostpeople do nursing and the
career opportunities for nursing, and the career opportunities
for nursing is just unending.
And I did come to understandlater that there is a financial
(03:35):
component to it when you look atwhat the nursing training model
is compared to what the medicalmodel is vast difference, and
so I remember distinctly mybrother saying to me you can go-
.
Dr. Michael Koren (03:46):
And what does your brother do, by the way?
Judith Abbey, APRN, DNP (03:48):
He is a phenomenal guy.
He currently works at Vystar.
He is the SVP for enterpriserisk management.
Dr. Michael Koren (03:54):
Oh, very nice ,
Judith Abbey, APRN, DNP (03:55):
he is super smart
Dr. Michael Koren (03:56):
so he's in the banking industry for
everybody.
Banking industry, bankingindustry.
And your parents?
Were they professionals?
Judith Abbey, APRN, DNP (04:11):
Mom was an assistant principal to a
high school in Ghana, one of themost prestigious high schools.
She voluntarily retired.
Dr. Michael Koren (04:14):
They have a great private educational system
in Ghana.
Judith Abbey, APRN, DNP (04:17):
They do , they really do,
and your dad was?
Dad is into social development, social
advocacy.
He's gone working with theUnited Nations.
He's worked with the AfricanUnion, lots of international
development organizations-
Dr. Michael Koren (04:27):
very nice
Judith Abbey, APRN, DNP (04:27):
So that was that background, okay.
Dr. Michael Koren (04:29):
Do they still live in Ghana?
Judith Abbey, APRN, DNP (04:30):
They're here.
Dr. Michael Koren (04:31):
Okay,
Judith Abbey, APRN, DNP (04:32):
They're here, we are a-
Dr. Michael Koren (04:35):
The whole family moved, yeah.
Judith Abbey, APRN, DN (04:36):
Majority of us.
Dr. Michael Koren (04:37):
Okay
Judith Abbey, APRN, DNP (04:37):
So still have one brother back home
with his wife.
We were saying earlier that onepart of the family is missing
and we always miss them, butit's a big, it's a big family.
It's a big family.
Dr. Michael Koren (04:48):
Sorry to interrupt, go ahead, yeah,
Judith Abbey, APRN, DNP (04:50):
Nursing school
That was the decision.
You know, not doing medicine,you're going to nursing school.
I'm like, ok, didn't questionit.
In hindsight I know that wasGod's leading and that was God's
doing.
But I went to University ofWest Florida for my nursing
degree.
So my bachelor's in nursinggraduated magna cum laude and
(05:11):
won a couple of awards while Iwas there and from there I
started working at a localcommunity hospital and that was
Santa Rosa Medical Center.
So I started on MedSurg, gettingused to all the different
patient populations, and reallythat's where my experience
started from.
So while I was at Santa RosaMedical Center just trying to
(05:35):
figure out you know, where nextdo I go?
What does the future look likefor Judith?
And so I enrolled at Universityof South Alabama and the reason
I went to that particularschool was they offered a dual
family and emergency medicinetrack, which I thought that was
(05:55):
wonderful, because once I hadstarted in med-surg I had jumped
around to ICU, I had done PACU,I had done all sorts of things,
ended up in the emergency room,which I thought I would never
be in ER, because ER is justcrazy but loved emergency
medicine.
And so I thought my trajectorywas going to be an ER nurse
(06:19):
practitioner and this programwas just perfect for that,
because if I end up not likingemergency medicine for some
reason, I could always fall backand do family practice.
So I went to South Alabama andgraduated with my NP.
That's where I pursued mydoctorate also.
Dr. Michael Koren (06:36):
Nurse practitioner degree
Judith Abbey, APRN, DNP (06:38):
Yes sir .
Nurse practitioner degree, andso the doctoral part of it
really was translating evidenceinto practice.
So really that's what broughtme to where I am currently.
So I was working in Orlando atthe height of COVID, in the
emergency room, and there was alot of anxiety going into work
(06:58):
because we got to really seewhat the frailties of our health
care system is, and oftentimespatients do not realize how
tragic or how difficult it is,as medical providers, what we go
through having to navigate thishealthcare system.
And so these are all thingsthat contribute to healthcare
(07:19):
practitioners always talkingabout burnt out, burnt out,
burnt out, and I certainly feltburnt out, that anxiety.
I had never felt anxiety orknown what anxiety felt like,
but I was at a point where I'mlike Lord, I don't know what
anxiety is, and really this wasliterally my conversation with
God, that I don't know whatanxiety feels like.
(07:41):
But I'm pretty sure that's whatI'm feeling right now and if
you do not send me in adifferent direction, I don't
know what's going to become ofmy career, because at that point
I didn't feel like I was goinginto work and giving my best
self to my patients.
And we go into this fieldwanting to make a difference and
(08:01):
wanting to make them feelbetter and being there for them
at their worst, and especiallyas a nurse, the core of what we
do is to be patient-centered andto be there for them, and we're
not only focusing on you, thepatient, we're focusing on your
family as well, and Judith wasgoing to work and Judith never
felt like she was giving herbest self to the reason why she
(08:26):
wanted to help here, and so thatwas my prayer to God to send me
a different direction.
And I chanced into this field, Ithink by accident, I think in
God's grand scheme it was not anaccident.
For now, the trajectory of whatI do it's very personable, not
(08:46):
traditional in the sense thatI'm not in a physical
environment, but I get to beright where my patient is.
Dr. Michael Koren (08:56):
So explain your business a little bit for
people.
So it's On the Go Drip, Sotell us how you came up with
that name.
Number one and number two, tellus how your business model
works.
Judith Abbey, APRN, DNP (09:07):
So number one On the Go Drip came
about from my mom.
My mom said I was going throughher face trying to figure out
what to call this business andwe're throwing all kinds of
names around.
Dr. Michael Koren (09:18):
So you committed to not work for an
institution.
Not work in ER.
You wanted to do something foryour own
Judith Abbey, APRN, DNP (09:23):
wanted to do something for my own
Dr. Michael Koren (09:24):
Even though your parents weren't
entrepreneurs necessarily, butmaybe your brother had a little
influence to say, hey, start abusiness.
Judith Abbey, APRN, DNP (09:33):
I feel like it came from when I was
working with this other companydoing the same thing and excuse
me I realized that every time Iwould go into a patient's home,
they appreciated that I wasthere.
I actually felt like I wasdoing something, like I felt
like I was making them feelbetter.
(09:54):
So, in comparison with what mytraditional ER setting was,
where you hear all these bellsand sirens going off, the radio
constantly going off becauserescue is bringing in a patient,
or you're back in the room witha Baker Act patient and there's
six security guards in theretrying to hold this one patient
(10:16):
down and you cannot.
We've given him everything wepossibly can.
He is throwing poop on thewalls.
Very different setting.
I had instances where a patientliterally would throw their cup
of water at me because it tookme a long time to bring them
water, knowing that in traumaroom 37, we just had to
(10:36):
resuscitate a patient.
And so it was very differentgoing into these people's homes
and they appreciated that I wasthere and actually felt like I
was healing, like I was doingsomething, and that feeling or
that fulfillment for which Iwent into healthcare it was
there again.
Dr. Michael Koren (10:55):
So by starting your own business, you
had a sense that you were makinga difference in people's lives.
Judith Abbey, APRN, DNP (11:00):
That's correct.
Dr. Michael Koren (11:01):
And did not get that sense when you were in
the institutional setting
that is correct.
So that was a big motivator for you.
Judith Abbey, APRN, DNP (11:06):
That was a big motivator.
Dr. Michael Koren (11:07):
And so starting a business is hard.
There's a lot of things youhave to do.
Who helped you with that?
Judith Abbey, APRN, DNP (11:12):
God.
God and also the right peoplereally.
Dr. Michael Koren (11:16):
I can use God's help, I think, for my
business.
Judith Abbey, APRN, DNP (11:20):
I highly recommend it.
I highly recommend it.
Dr. Michael Koren (11:23):
Okay, well, I know God can do accounting and
legal work and everything else.
Judith Abbey, APRN, DNP (11:29):
He works through people and he
sends the right people, and Ithink that has been what's been
driving me forward, because Ican speak specifically to my
training.
There was not a single iota ofentrepreneurship or business in
there.
I knew how to take care of aperson.
Dr. Michael Koren (11:46):
You were not driven at all by the financial
side.
Nothing like that you were juston the personal side and the
connectivity with the patients,and you figured out the
financial side.
Judith Abbey, APRN, DNP (11:54):
This is for learning on the fly.
Dr. Michael Koren (11:55):
Got it but.
Judith Abbey, APRN, DNP (11:55):
God has sent the right people to me
every single time to help makeit work.
Dr. Michael Koren (12:00):
Well, that is important because the wrong
people can create huge problems.
Judith Abbey, APRN, DNP (12:03):
Oh my gosh, Lots of problems, lots of
problems.
Dr. Michael Koren (12:06):
Okay, so tell us a little bit about your
business model and then we'llget into some of the type of
patients that you help.
Okay, so I want to get you tobecome part of my medical team.
So how do I go about that?
To become part of my medicalteam?
So how do I go about that?
How do I pay you?
How does this all work?
Judith Abbey, APRN, DNP (12:19):
So this is strictly cash pay Insurance
does not cover this yet, and howthis works is I will pick a
case of food poisoning.
So if there is somebody who atesomething bad and they're
having food poisoning or theygot the stomach flu in certain
(12:39):
instances, you go to theemergency room or you go to
urgent care because it's comingup out from up here and down
there.
You're both sides and andyou're absolutely horrible
feeling, miserable,
Dr. Michael Koren (12:50):
like norovirus.
Judith Abbey, APRN, DN (12:51):
Terrible .
We've been seeing lots of thosecases the past couple of weeks.
Yeah.
And we're trying to prevent thatwith vaccine studies.
By the way, here we are.
Judith Abbey, APRN, DNP (12:59):
And that would encourage people to
definitely pursue that route,and so they go to the emergency
room for these conditions.
One, there's that whole waittime, and this is something I
saw a lot practiced in theemergency room, because already
we have like 50 people in thewaiting room, everybody feels
that they're there for anemergency, sure, but for
somebody who is puking andhaving diarrhea at the same time
(13:19):
, they do not want to be there,right?
Dr. Michael Koren (13:22):
And so let's mention the fact the triage
nurse calls you and says MrJones, can you come out?
And Mr Jones is in the bathroom.
So he misses his turn.
Judith Abbey, APRN, DNP (13:33):
Exactly , and Mr Jones comes out not too
happy at all.
And so what we do for Mr Jonesis Mr Jones, instead of you
going to the emergency room, youreach out to us, you stay home,
because it's easier for you togo to the bathroom.
While you're home, right, andyou're right in your own
environment, it's comfortablefor you.
We will come to you, we'll takeall that hassle out.
You're going to get the samemedical care you would at the ER
(13:55):
or the urgent care, and this isin the comfort of your home.
So, really, that is what amodel is.
It's very patient-centric.
Dr. Michael Koren (14:02):
That's beautiful.
Yeah, and again, what are theygoing to do for you in the
emergency room?
There's no magic cure for anorovirus.
You're going to get hydrated,get your electrolytes.
and it's going to run its courseover a few days, right?
Judith Abbey, APRN, DNP (14:14):
So, we're going to hydrate you and
we're going to give you somePepcid if it's necessary.
Sometimes we do an anti-emetic.
Depending on how bad it is, wecall in prescriptions for you.
So it is a whole medical process
Dr. Michael Koren (14:28):
and how much would that cost somebody?
So that's always important forpeople is the economics of it.
Judith Abbey, APRN, DNP (14:32):
So on average, it's going to cost you
about $300.
If we're going to do additionsto it, then the prices could
fluctuate.
Dr. Michael Koren (14:39):
Right, and a lot of insurance companies have
co-pays of $250 or $300 or morewhen you go to the emergency
room Right.
Judith Abbey, APRN, DNP (14:44):
Right.
So if you would consider thattime of you having to get in
your car and the drive time, gosit in the waiting room, wait
for hours on end before you'repulled back and then you're
there forever before thephysician comes to see you and
yeah,
Dr. Michael Koren (14:56):
and is it just you at this point, or do
you have people that help you?
Judith Abbey, APRN, DNP (14:59):
We're a small team, so I have a small
team of three plus me, so we'regrowing.
Dr. Michael Koren (15:04):
Okay, and how do you get the word out other?
than this podcast.
Judith Abbey, APRN, DNP (15:08):
Word of mouth has been very essential.
Google reviews have beenphenomenal too.
We're also doing some ads hereand there on social media and
also Google.
Dr. Michael Koren (15:17):
So you mentioned acute diarrheal
illnesses.
How about other things that youdo for people?
What other services do youprovide?
Judith Abbey, APRN, DNP (15:22):
So I often like to categorize this
into we have the sick care.
So we know, with the foodpoisoning or somebody who's
really hangover, they have allkinds of symptoms from it.
We see patients for migraine.
Dr. Michael Koren (15:34):
Hangover cures.
I think that might be a bigbusiness.
Judith Abbey, APRN, DNP (15:42):
It is.
I really the the the hangoverpart is what has popularized
what IV therapy is over the lastcouple years, because people
like going to all these, likeparties, and they get drunk and
you know they get hung over andlike, oh, I need a banana bag,
you know.
So that has definitelypopularized IV therapy is, and
so
Dr. Michael Koren (15:57):
the other cure for hangovers was to give
more alcohol.
Judith Abbey, APRN, DNP (16:01):
I didn't know about that.
Dr. Michael Koren (16:03):
Is that part of your protocol?
Judith Abbey, APRN, DNP (16:04):
No, unfortunately not.
Dr. Michael Koren (16:06):
Okay, well, I don't think that's
evidence-based.
Judith Abbey, APRN, DNP (16:08):
It's not.
Dr. Michael Koren (16:09):
Okay.
Judith Abbey, APRN, DNP (16:11):
And so the sick component part of it,
we deal with those minor, acutethings.
And there's the other part, forwellness, where we have
individuals who they're not sick, you would say.
However, they understand theimportance of nutrients or
nutrition in their lifestyle.
So we have some patients wework with who have chronic
(16:32):
conditions, especially those whohave like gastrointestinal
things, either malabsorption,crohn's, where they're not
necessarily getting all thenutrients they need.
This becomes a way for them tosupplement that.
So a big part of it is doinglab work to identify what the
gap is, what their ranges are,and then that helps us to tailor
a treatment plan for them.
(16:54):
So those are the two categoriesand I always want to educate
that there is a maintenancetherapy and then there's a
replacement therapy.
So in instances where we'redoing maintenance therapy, it's
okay.
We know there are like maybesomewhat of abnormalities or
we're not within range where ourbody needs to be, and so we do
maintenance therapy to get ourbody maintenance really what it
(17:15):
means.
If we're do maintenance therapyto get our body maintenance
really what it means If we'redoing replacement therapy.
I'll illustrate this with apatient that I worked with.
So she had a completethyroidectomy.
Her thyroid's gone.
It's been months trying toregulate her calcium levels and
she's tried everything.
Her team had her on everythingshe reached out to us.
(17:36):
We rechecked those levels OfTried everything.
Her team had her on everythingshe reached out to us.
We rechecked those levels.
Of course she was hypocalcemic.
So we came up with a plan, dida couple of treatments
specifically replacing hercalcium.
Dr. Michael Koren (17:46):
Intravenous calcium
Judith Abbey, APRN, (17:47):
Intravenous calcium, and then after that we
rechecked labs, Boom, she'sback within range.
So then that becomesreplacement therapy.
So for some people after we'vedone replacement therapy then we
cycle back to maintenancetherapy.
But then there's always thatlab work component, trying to
make it evidence-based anddirect care.
Dr. Michael Koren (18:05):
Right.
So I think those are importantpoints and I think it's fair to
say that not everybody in thisquote less regulated space of
bringing healthcare to patients'homes is as evidence-based as
you're describing.
So you and I were just talking,before we got started, about
vitamin C therapy, which is alittle bit controversial.
(18:26):
So we know, for example, thatif you are vitamin C deficient,
that vitamin C replacement canhelp, just like we learned about
scurvy, for example.
But giving very high doses ofvitamin C has never really been
proven to do a lot of good,although some people advocate
that without evidence, and we'llpost what's called a forest
(18:47):
plot of a lot of studies thatwe're doing specifically to see
if high doses of vitamin Cprevent cold symptoms, and the
truth is is that they reallydon't, even though some people
will take the data and try tosay, oh well, that one study, it
was trending in the rightdirection.
And this gets into some of thetechnical elements of analyzing
the evidence which we'll show inthe show notes, but I love the
(19:09):
fact that you're veryevidence-based and you're
helping people resolve theirsymptoms and you're lab-directed
, and these are very importantdistinction factors to show that
you're doing a really nice jobwith evidence.
Judith Abbey, APRN, (19:21):
Absolutely , you hit the nail right on the
head and usually when it comesto vitamin therapy you hear that
, oh, this is expensive pee oryou hear all these kinds of
labels for it.
And often in our medical worldor when it comes to research,
sometimes it's hard to quantifyor really lend much credibility
to anecdotal evidence.
So we hear all these patientstories, success stories, but it
(19:45):
can be quite hard to really sayI'm going to do a randomized
control study specifically forvitamins.
Now I have seen some studieswhere they are talking about
high-dose IV vitamin C forcancer care, not as their
primary, and we always wantpatients to understand that you
should be working with yourmedical team and going with what
(20:07):
they recommend and making surethat the evidence supports that.
Dr. Michael Koren (20:12):
Or doing a clinical trial.
Judith Abbey, APRN, DNP (20:13):
Or doing a clinical trial
Absolutely
A clinical trial where you'resystematically setting up an
experiment where you'll learnthe truth,
Judith Abbey, APRN, (20:17):
absolutely , absolutely.
Right, and so you did talk aboutcolds and vitamin C.
And yes, taking vitamin Cduring a cold is not going to
cure it.
We do know that vitamin C maymake your symptoms lower or
reduce how long you have thecold for, or even zinc.
Dr. Michael Koren (20:38):
And, in fairness, that's debatable.
That's debatable and we canshow the actual evidence.
So again, with things like that, there's no harm in taking
vitamin C, no, no but whatconcerns me is when people try
to oversell it, and the fact isthat the studies that have
looked at it have not beenconsistent and meta-analyses
(20:59):
have shown that it's probably awash quite frankly, and a lot of
other stuff.
Looking at vitamins in general,show that using vitamins when
you're deficient is great.
It's helpful Right, it'shelpful
, but using vitamins when you're not
deficient probably doesn't do awhole lot Right.
So, again.
I think that's a general sense,and other things should be done
, in my opinion, in clinicaltrial settings.
Judith Abbey, APRN, DNP (21:19):
Right, right.
And also it's interesting toknow that the majority of what
the American diet is, mostpeople are deficient in certain
things and they have no idea.
So magnesium is a very commonone that most people tend to be
deficient and not knowing thatthey're deficient in magnesium.
So I think that's key for usdoing that blood work, to know
(21:40):
where do you fall at and thenthat really helps guide care.
Dr. Michael Koren (21:43):
Yeah, I love that.
So I'm a cardiologist andyou're absolutely right, a lot
of people are on diuretics.
That waste magnesium.
And a lot of people don't knowthat magnesium is hard for a lot
of people to absorb.
Unless you test it, you don'tknow if people are deficient,
and for magnesium in particular,you have the blood test, which
is not the perfect way ofknowing if you're full body
deficient, and so you have to doa cellular test to determine
(22:07):
that, and sometimes that'sexpensive and we don't do that.
Except in rare circumstances.
So sometimes you have to have alittle index of suspicion.
And again, we know that peoplethat are deficient in magnesium
will have more palpitations, forexample.
They may have othercomplications that are very,
(22:27):
very subtle that you don'treally get to until you replace
the magnesium.
And what's interesting is, ifyour kidneys work, that you
don't really get to until youreplace the magnesium.
And what's interesting is, ifyour kidneys work, you can't
really overdose the magnesium.
So you always have to look atthe safety elements of it.
Judith Abbey, APRN, DNP (22:38):
That's very true because when we work
with individuals who have coremorbidities and they have a
whole list of other conditionsthey're dealing with, then we're
very particular wanting to knowwhat their kidney function is
conditions they're dealing withthen we're very particular
wanting to know what theirkidney function is and that lab
work really really becomesimportant because, yes, it could
be benign for a healthyindividual who just needs to
(23:00):
replace their magnesium, butthen for somebody who's in
kidney failure or they haveother things going on, it's very
critical to know how you'retreating them.
Dr. Michael Koren (23:08):
That's right.
So any solution that works forone person may not work for
somebody else.
Judith Abbey, APRN, DNP (23:12):
You have to individualize it 100%,
and I think that's one thing wetry to really push is going back
to.
Oftentimes people see what IVtherapy is and they're like, oh,
I can just pick this or I canpick that, or I can pick that.
No, it really should bepersonalized to you and there
has to be a conversation withyou and your provider, or even
(23:34):
before the nurse or theparamedic, whoever actually does
that infusion for you.
You, as the patient, need tohave a conversation with either
a nurse practitioner, aphysician assistant or a
physician in some sort, so theyknow if they get a thorough
history of really who Mr Jonesis, and then that should guide
what the treatment is going tolook like, because at the end of
(23:56):
the day, it is still a medicalprocess.
Dr. Michael Koren (23:58):
Right, it's interesting.
I happen to have an interest inmagnesium.
It's one of the firstinvestigator-initiated studies
that I did when I first got intopractice over 30 years ago got
into practice over 30 years ago,and magnesium is a particularly
fascinating area for youbecause we actually use high
doses of IV magnesium to treatarrhythmias.
So in an arrhythmia calledtorsades we use very high doses
(24:22):
of IV magnesium.
Judith Abbey, APRN, D (24:23):
Obviously , you shouldn't be dealing with
torsades in somebody's home,which is a life-threatening
problem.
Dr. Michael Koren (24:28):
But the concept of getting the magnesium
level up quickly and having aneffect on the heart is
well-known, but you have toagain individualize it.
So there may be some caseswhere taking the pills is going
to be okay, but the truth is youcan get your levels back to
normal much quicker by using IVmagnesium, compared with pills
which some people just can'tabsorb very well,
Judith Abbey, APRN, DNP (24:49):
no, and we always want to advocate for
food.
Food should always be the go-towhere we're getting all these
nutrients from, but for whateverreason, sometimes food does not
meet those requirements, sothis is a good way for you to
supplement that.
But then, going back to themagnesium conversation, you do a
basic Google search and youfind different kinds of
magnesium for different things.
(25:09):
So sometimes patients find ithard to figure out.
Okay, find different kinds ofmagnesium for different things.
So sometimes patients find ithard to figure out.
Okay, what is the rightmagnesium for me?
And so people understandingthat, yes, magnesium, but then
that second part of themagnesium is really going to
tell you what that magnesium isgoing to do for you and how
beneficial it is going to be foryour baby.
We can circle back to that
Dr. Michael Koren (25:29):
and sometimes it's a little bit of trial and
error.
Some people absorb onemagnesium salt better than
another.
They do better with magnesiumoxide versus chloride versus
something else Right.
All right.
Well, that's really helpfulinformation.
So what other patient typeshave you been able to help?
Just for the audience tounderstand where they might want
to call your service.
Judith Abbey, APRN, DNP (25:51):
There is a particular direction that I
feel like the functional space,or buzzword anti-aging
longevity, is going towards, andthere's this molecule called
NAD, or nicotinamide adeninedinucleotide.
Dr. Michael Koren (26:05):
Antioxidant.
Judith Abbey, APRN, DNP (26:06):
So NAD is a coenzyme or cofactor, and
NAD is found in every cell inour body.
And so we are beginning to havesome sort of evidence that is
given as a causal link betweenlow levels of NAD and certain
conditions or certain diseases.
And for which reason?
It's because, like, NAD isimplicated in all of these
(26:28):
metabolic processes.
The theory is, as our NADlevels decrease, if we're able
to replenish that NAD, maybe wecould reverse some of these
conditions, maybe we could livea bit healthier, maybe we could
live a bit longer.
And so what we're using NADtherapy for?
And again, you know, NAD ismostly concentrated in those
(26:49):
mitochondrial cells, where, or Ishould say organ systems, where
there's a high concentration ofmitochondrial tissue, so your
heart, your brain, reproductivetissue, and so NAD tends to be
quite pronounced.
Or, for the patients we workNAD, tends to be very beneficial
for them in those regards.
Over time I say to people allthe time you can't just take one
(27:12):
thing, you can do one time.
And that's not how you knowresearch.
You try for a while so we cancollect some information and see
what the improvement is.
Has anything changed?
Has it not changed?
Dr. Michael Koren (27:24):
Yeah, and this, in fairness, is a little
bit more controversial than someof the other things you brought
up.
So you know, the wholeantioxidant hypothesis is
something that has been outthere for quite a number of
years.
I actually worked in a lab whenI was in college that was
working on some of these thingsand unfortunately, for whatever
reasons, supplements haven't hadthe effects that we had hoped.
(27:47):
That doesn't mean that thefuture won't be different, and
it doesn't mean that there isnwon't be different, and it
doesn't mean that there isn't aglimmer of truth in the
hypothesis, but we don't reallyknow exactly how to deal with it
at this moment.
So one of my first actually myfirst scientific publication was
showing the antioxidant effectsof free radicals that were
(28:08):
generated when you use the,chemotherapeutic drug called
Adriamycin, and the simplest wayof getting rid of the free
radicals is just introducingoxygen to the system.
So no one really thinks thatthat is going to solve the
problem but, it does change thefree radicals, so it gets very
(28:29):
complicated in terms of thiswhole concept of what to do with
these free electrons that cancause tissue damage, and how do
you manage that, which is reallywhat the whole NAD hypothesis
is looking at Right.
Are you familiar with the workof Dr.
McCord from Duke?
No, I'm not.
Yeah, he was one of theoriginal pioneers of this.
I don't know if he's stillaround.
I haven't checked his workrecently.
How pioneers of this?
(28:50):
I don't know if he's stillaround.
I haven't checked his workrecently.
Judith Abbey, APRN, DNP (28:52):
How long ago is that?
Dr. Michael Koren (28:53):
This is when I was in college.
Judith Abbey, APRN, DNP (28:54):
Oh boy,
Dr. Michael Koren (28:54):
It's probably more fingers and toes than I
have to count that far back, butanyhow, it's some interesting
stuff, but I would put that morein the unproven category, more
hypothesis generating.
So why don't you tell peoplehow we get your service, how you
get in touch with you and yourteam?
Judith Abbey, APRN, D (29:12):
Wonderful .
So we have a wonderful websiteOn the Go Drip.
I feel like On the Go it justrolls right off your tongue.
I like it.
So you go to www.
OnTheGoDrip.
com On the Go Drip.
That was a mouthfulOnTheGoDripcom.
One word?
Judith Abbey, APRN, DNP (29:28):
All one word yes.
Dr. Michael Koren (29:29):
On the go drip.
Judith Abbey, APRN, DNP (29:29):
Yes, onthegodrip.
com.
And we have all the informationyou need on there
Dr. Michael Koren (29:35):
so you can just work online and then
you can work online.
You can give us a phone call,you can send us a text message
whatever is convenient for you.
Why don't you tell everybody what your phone
number is?
Judith Abbey, APRN (29:42):
904-544-5010 .
Excellent.
Dr. Michael Koren (29:46):
Excellent.
Judith Abbey, APRN, DNP (29:47):
That's our phone number.
Dr. Michael Koren (29:48):
And what's your typical response time if
somebody calls?
Judith Abbey, APRN, DNP (29:51):
About 30 minutes.
Dr. Michael Koren (29:52):
Wow, okay, well, that's better the ER
Judith Abbey, APRN, DNP (29:53):
In 30 minutes.
Way better Between 30 minutesto one hour.
We would have somebody at ourlocation, .
Dr. Michael Koren (29:59):
That's amazing.
Yeah, well, thank you for nowthat I know that I might send
some patients your way.
Judith Abbey, APRN, (30:03):
Absolutely .
Dr. Michael Koren (30:06):
Any last words for the MedEvidence
audience?
Judith Abbey, APRN, DNP (30:09):
I have a question for you.
Sure, because, staring likesitting right across from you,
there is this book behind you.
That's just like staring rightat me.
Dr. Michael Koren (30:17):
Yes, and I wonder, or I just want to know,
what the story behind that bookis.
Well, let me see which bookyou're talking about.
Judith Abbey, APRN, DNP (30:23):
It's very prominent.
This one, that one, that one,okay, wow, this, that one, that
one.
Dr. Michael Koren (30:28):
Okay, wow, this was not a setup, by the way
, no, you just happened to askabout this book.
So when.
I was in medical school, I tookcourses at the Harvard School of
Public Health and Dr.
Weinstein and Dr.
(30:48):
Feinberg led this course ondecision analysis and this is a
book that they wrote togetherwith some other authors.
Back in the 1980s, when I wentto medical school, Dr.
Feinberg was my medical schooladvisor.
He became the dean of theHarvard School of Public Health
while I was there and obviouslyit was nice to have a mentor
that became the dean, but heactually also became the head of
the Institute of Medicine someyears later.
(31:10):
So he was one of my teachers andmentors and tremendous.
I learned so much from him.
Dr.
Weinstein was the primary guy.
He was a physician, he was anon-physician.
He was the primary guy that ranthe course teaching about how
to use quantitative analysis tomake medical decisions.
So my claim to fame is that Itook their course and it was
probably the fourth year or sothat they did the course you did
, I did I took the course andthis was the book from the
(31:32):
course.
I was the first student to get aperfect score on the final exam
, including the extra creditquestion.
That's my biggest claim to fame, so thank you for bringing that
up.
Judith Abbey, APRN, DNP (31:43):
No way, that is unbelievable.
Dr. Michael Koren (31:48):
Anyhow, it's a great book that helps you
analyze how to make.
That is unbelievable, butanyhow, it's a great book that
helps you analyze how to makemedical decisions, and my
medical school thesis was aboutwhether or not to neutralize the
acid content of pregnant womenbefore they deliver to prevent
the acid aspiration syndrome,and that was my first major
medical presentation on that.
Judith Abbey, APRN, DNP (32:08):
What were your findings on that?
That sounds.
Dr. Michael Koren (32:11):
Well, I have my thesis in my office, if you
want to read it.
Judith Abbey, APRN, DNP (32:13):
I would love to read it.
Dr. Michael Koren (32:15):
It's only 150 pages of light reading, and
you're probably the first one toask to read it.
Yeah.
Judith Abbey, APRN, DNP (32:22):
I would love to.
Dr. Michael Koren (32:23):
Other than my mom who read the introduction
and liked that didn't read anyof the paper, but anyhow, we
basically found that it wasimportant to neutralize the acid
content of pregnant women andthat if you had the ability to
predict when the delivery wasgoing to occur, you should use a
histamine blocker like Tagametin those days or Zantac more
(32:47):
recently, and that was actuallyhelpful to neutralize the pH of
the stomach content.
So, god forbid, the pregnantwoman vomits and aspirates.
They're much less likely to getsevere lung damage.
So that was the finding and weactually looked at how much it
costs.
So back then Tagamet was a drugyou had to pay for.
It wasn't a cheap generic, itwasn't that much, but it wasn't
(33:09):
a cheap generic.
And wasn't that much, but itwasn't a cheap generic.
And do you spend, does thesystem spend a million dollars
to protect a certain number ofwomen?
So we actually brought it downto the financial parts, which is
why I'm always interested inbusiness and how people in the
medical field develop theirbusiness models.
Judith Abbey, APRN, DNP (33:23):
Right, wow.
So if you could predict or youknew exactly when the mother was
going to deliver, Then youwould give the histamine blocker
how far out before delivery.
Dr. Michael Koren (33:36):
Typically you would want to do it within a
few hours, so you know, two to12 hours before.
Judith Abbey, APRN, DNP (33:41):
Right, that is pretty cool.
Dr. Michael Koren (33:44):
So that's what we discovered, but thank
you for the question.
Judith Abbey, APRN, (33:46):
Absolutely .
It was just there, like it'squite, and it's placed
differently from the rest of thebooks in your collections.
I was like it must really meansomething to you.
There's a story behind it.
Dr. Michael Koren (33:58):
There is a story behind it and, again, it's
the way we should be thinkingabout medicine in terms of
quantitative decision analysis.
That is definitely one of thepoints we make on MedE vidence,
and people should findphysicians or nurse
practitioners or other medicalproviders that think in those
terms.
We think in terms of analytics.
We think in terms of what'sproven and we're not just trying
(34:18):
to make up stuff as we go along.
We don't know everything andsometimes we have to make
decisions based on uncertainty,but for the things that we do
know, we need to leverage thosethings and it's an important
part of what we do.
Judith Abbey, APRN, DNP (34:29):
Wow, that's phenomenal.
So, Judith, you've been adelight.
Thank you for joining us onMedEvidence and we'll have you
back again.
and good luck on your business.
Thank you.
Thank you very much.
Dr. Michael Koren (34:41):
Thanks for joining the MedEvidence podcast
To.
Welcome to MedEvidence!, where we help you
navigate the truth behindmedical research with unbiased,
evidence-proven facts Hosted bycardiologist and top medical
researcher, Dr Michael Koren.
Dr. Michael Koren (00:11):
Hello, I'm Dr .
Michael Koren, the executiveeditor of MedEvidence! And I'm
really looking forward to thissession.
I have Dr.
Judith Abbey here with me andDr.
Abbey is a medical entrepreneurin our community here in
Florida and I'm reallyfascinated to know about your
journey, how you got there andtalk about why you chose a bit
(00:33):
of an unconventional way toserve the public, tell us about
your business and, importantly,tell us about how we use
evidence-based medicine andscience to make things better
for patients in our community.
Thank you, Dr.
Koren.
It's an honor to be here withyou and they may not see, but we
(00:53):
have additional people in thestudio here with us who are
making this episode wonderful,so just want to give a shout out
to them A little bit about me.
Don't flatter them too much because they may
ask for a pay raise which wereally can't afford at this
point.
But I appreciate you reachingout to the listeners may
actually help Okay well, therewe go.
Judith Abbey, APRN, DNP (01:10):
But I'm originally from Ghana, so, born
and raised in West Africa,Ghana moved to the United States
in December 2011.
So I have been here a while Noworiginally, when I moved here,
I was under the impression ofcontinuing med school.
So back home in Ghana, I wasenrolled in medical school and
(01:33):
that was the vision I'd alwayswanted to be a physician, and I
think, culturally, part of itbeing that you become a doctor,
and I think this is commonacross certain cultures.
So you're either a doctor oryou're a lawyer or an accountant
, and I think it's because,knowing that those professions
(01:54):
you end up doing well, you cantake care of yourself and your
family.
But for me, it felt more like itwas a calling for me, and so
during my whole education, myplan was I was going to become a
physician at that, and that wasgoing to be the way for me to
be a conduit for healing and forhealth for people.
(02:16):
I wanted to help people makethem feel better, and so when I
was in first year of med schoolback home in Ghana, I was told I
was moving to the United States.
I was like, ok, how'd thathappen?
My brother, my oldest brother,was here with his wife and I.
You know, I can't say for surewhat their plan was, only maybe
(02:39):
you know they wanted me to havea better life and a better
education.
Of course, there is moreopportunities in and a better
education.
Dr. Michael Koren (02:48):
I see.
More opportunities in the USversus Ghana
Judith Abbey, APRN, DNP (02:50):
Of course you know the United
States.
It's a great country and we cansee many people often want to
travel here for betteropportunities.
And so when I moved here I wasunder the impression that, ok,
because this is the trajectoryI'm on, that's what I was going
to continue on.
I was informed I was doingnursing.
I was like okay, but I did notunderstand what that meant.
(03:14):
I think for my brother and hisfamily it came from a place of
okay.
Nursing is the route where mostpeople do nursing and the
career opportunities for nursing, and the career opportunities
for nursing is just unending.
And I did come to understandlater that there is a financial
(03:35):
component to it when you look atwhat the nursing training model
is compared to what the medicalmodel is vast difference, and
so I remember distinctly mybrother saying to me you can go-
.
Dr. Michael Koren (03:46):
And what does your brother do, by the way?
Judith Abbey, APRN, DNP (03:48):
He is a phenomenal guy.
He currently works at Vystar.
He is the SVP for enterpriserisk management.
Dr. Michael Koren (03:54):
Oh, very nice ,
Judith Abbey, APRN, DNP (03:55):
he is super smart
Dr. Michael Koren (03:56):
so he's in the banking industry for
everybody.
Banking industry, bankingindustry.
And your parents?
Were they professionals?
Judith Abbey, APRN, DNP (04:11):
Mom was an assistant principal to a
high school in Ghana, one of themost prestigious high schools.
She voluntarily retired.
Dr. Michael Koren (04:14):
They have a great private educational system
in Ghana.
Judith Abbey, APRN, DNP (04:17):
They do , they really do,
and your dad was?
Dad is into social development, social
advocacy.
He's gone working with theUnited Nations.
He's worked with the AfricanUnion, lots of international
development organizations-
Dr. Michael Koren (04:27):
very nice
Judith Abbey, APRN, DNP (04:27):
So that was that background, okay.
Dr. Michael Koren (04:29):
Do they still live in Ghana?
Judith Abbey, APRN, DNP (04:30):
They're here.
Dr. Michael Koren (04:31):
Okay,
Judith Abbey, APRN, DNP (04:32):
They're here, we are a-
Dr. Michael Koren (04:35):
The whole family moved, yeah.
Judith Abbey, APRN, DN (04:36):
Majority of us.
Dr. Michael Koren (04:37):
Okay
Judith Abbey, APRN, DNP (04:37):
So still have one brother back home
with his wife.
We were saying earlier that onepart of the family is missing
and we always miss them, butit's a big, it's a big family.
It's a big family.
Dr. Michael Koren (04:48):
Sorry to interrupt, go ahead, yeah,
Judith Abbey, APRN, DNP (04:50):
Nursing school
That was the decision.
You know, not doing medicine,you're going to nursing school.
I'm like, ok, didn't questionit.
In hindsight I know that wasGod's leading and that was God's
doing.
But I went to University ofWest Florida for my nursing
degree.
So my bachelor's in nursinggraduated magna cum laude and
(05:11):
won a couple of awards while Iwas there and from there I
started working at a localcommunity hospital and that was
Santa Rosa Medical Center.
So I started on MedSurg, gettingused to all the different
patient populations, and reallythat's where my experience
started from.
So while I was at Santa RosaMedical Center just trying to
(05:35):
figure out you know, where nextdo I go?
What does the future look likefor Judith?
And so I enrolled at Universityof South Alabama and the reason
I went to that particularschool was they offered a dual
family and emergency medicinetrack, which I thought that was
(05:55):
wonderful, because once I hadstarted in med-surg I had jumped
around to ICU, I had done PACU,I had done all sorts of things,
ended up in the emergency room,which I thought I would never
be in ER, because ER is justcrazy but loved emergency
medicine.
And so I thought my trajectorywas going to be an ER nurse
(06:19):
practitioner and this programwas just perfect for that,
because if I end up not likingemergency medicine for some
reason, I could always fall backand do family practice.
So I went to South Alabama andgraduated with my NP.
That's where I pursued mydoctorate also.
Dr. Michael Koren (06:36):
Nurse practitioner degree
Judith Abbey, APRN, DNP (06:38):
Yes sir .
Nurse practitioner degree, andso the doctoral part of it
really was translating evidenceinto practice.
So really that's what broughtme to where I am currently.
So I was working in Orlando atthe height of COVID, in the
emergency room, and there was alot of anxiety going into work
(06:58):
because we got to really seewhat the frailties of our health
care system is, and oftentimespatients do not realize how
tragic or how difficult it is,as medical providers, what we go
through having to navigate thishealthcare system.
And so these are all thingsthat contribute to healthcare
(07:19):
practitioners always talkingabout burnt out, burnt out,
burnt out, and I certainly feltburnt out, that anxiety.
I had never felt anxiety orknown what anxiety felt like,
but I was at a point where I'mlike Lord, I don't know what
anxiety is, and really this wasliterally my conversation with
God, that I don't know whatanxiety feels like.
(07:41):
But I'm pretty sure that's whatI'm feeling right now and if
you do not send me in adifferent direction, I don't
know what's going to become ofmy career, because at that point
I didn't feel like I was goinginto work and giving my best
self to my patients.
And we go into this fieldwanting to make a difference and
(08:01):
wanting to make them feelbetter and being there for them
at their worst, and especiallyas a nurse, the core of what we
do is to be patient-centered andto be there for them, and we're
not only focusing on you, thepatient, we're focusing on your
family as well, and Judith wasgoing to work and Judith never
felt like she was giving herbest self to the reason why she
(08:26):
wanted to help here, and so thatwas my prayer to God to send me
a different direction.
And I chanced into this field, Ithink by accident, I think in
God's grand scheme it was not anaccident.
For now, the trajectory of whatI do it's very personable, not
(08:46):
traditional in the sense thatI'm not in a physical
environment, but I get to beright where my patient is.
Dr. Michael Koren (08:56):
So explain your business a little bit for
people.
So it's On the Go Drip, Sotell us how you came up with
that name.
Number one and number two, tellus how your business model
works.
Judith Abbey, APRN, DNP (09:07):
So number one On the Go Drip came
about from my mom.
My mom said I was going throughher face trying to figure out
what to call this business andwe're throwing all kinds of
names around.
Dr. Michael Koren (09:18):
So you committed to not work for an
institution.
Not work in ER.
You wanted to do something foryour own
Judith Abbey, APRN, DNP (09:23):
wanted to do something for my own
Dr. Michael Koren (09:24):
Even though your parents weren't
entrepreneurs necessarily, butmaybe your brother had a little
influence to say, hey, start abusiness.
Judith Abbey, APRN, DNP (09:33):
I feel like it came from when I was
working with this other companydoing the same thing and excuse
me I realized that every time Iwould go into a patient's home,
they appreciated that I wasthere.
I actually felt like I wasdoing something, like I felt
like I was making them feelbetter.
(09:54):
So, in comparison with what mytraditional ER setting was,
where you hear all these bellsand sirens going off, the radio
constantly going off becauserescue is bringing in a patient,
or you're back in the room witha Baker Act patient and there's
six security guards in theretrying to hold this one patient
(10:16):
down and you cannot.
We've given him everything wepossibly can.
He is throwing poop on thewalls.
Very different setting.
I had instances where a patientliterally would throw their cup
of water at me because it tookme a long time to bring them
water, knowing that in traumaroom 37, we just had to
(10:36):
resuscitate a patient.
And so it was very differentgoing into these people's homes
and they appreciated that I wasthere and actually felt like I
was healing, like I was doingsomething, and that feeling or
that fulfillment for which Iwent into healthcare it was
there again.
Dr. Michael Koren (10:55):
So by starting your own business, you
had a sense that you were makinga difference in people's lives.
Judith Abbey, APRN, DNP (11:00):
That's correct.
Dr. Michael Koren (11:01):
And did not get that sense when you were in
the institutional setting
that is correct.
So that was a big motivator for you.
Judith Abbey, APRN, DNP (11:06):
That was a big motivator.
Dr. Michael Koren (11:07):
And so starting a business is hard.
There's a lot of things youhave to do.
Who helped you with that?
Judith Abbey, APRN, DNP (11:12):
God.
God and also the right peoplereally.
Dr. Michael Koren (11:16):
I can use God's help, I think, for my
business.
Judith Abbey, APRN, DNP (11:20):
I highly recommend it.
I highly recommend it.
Dr. Michael Koren (11:23):
Okay, well, I know God can do accounting and
legal work and everything else.
Judith Abbey, APRN, DNP (11:29):
He works through people and he
sends the right people, and Ithink that has been what's been
driving me forward, because Ican speak specifically to my
training.
There was not a single iota ofentrepreneurship or business in
there.
I knew how to take care of aperson.
Dr. Michael Koren (11:46):
You were not driven at all by the financial
side.
Nothing like that you were juston the personal side and the
connectivity with the patients,and you figured out the
financial side.
Judith Abbey, APRN, DNP (11:54):
This is for learning on the fly.
Dr. Michael Koren (11:55):
Got it but.
Judith Abbey, APRN, DNP (11:55):
God has sent the right people to me
every single time to help makeit work.
Dr. Michael Koren (12:00):
Well, that is important because the wrong
people can create huge problems.
Judith Abbey, APRN, DNP (12:03):
Oh my gosh, Lots of problems, lots of
problems.
Dr. Michael Koren (12:06):
Okay, so tell us a little bit about your
business model and then we'llget into some of the type of
patients that you help.
Okay, so I want to get you tobecome part of my medical team.
So how do I go about that?
To become part of my medicalteam?
So how do I go about that?
How do I pay you?
How does this all work?
Judith Abbey, APRN, DNP (12:19):
So this is strictly cash pay Insurance
does not cover this yet, and howthis works is I will pick a
case of food poisoning.
So if there is somebody who atesomething bad and they're
having food poisoning or theygot the stomach flu in certain
(12:39):
instances, you go to theemergency room or you go to
urgent care because it's comingup out from up here and down
there.
You're both sides and andyou're absolutely horrible
feeling, miserable,
Dr. Michael Koren (12:50):
like norovirus.
Judith Abbey, APRN, DN (12:51):
Terrible .
We've been seeing lots of thosecases the past couple of weeks.
Yeah.
And we're trying to prevent thatwith vaccine studies.
By the way, here we are.
Judith Abbey, APRN, DNP (12:59):
And that would encourage people to
definitely pursue that route,and so they go to the emergency
room for these conditions.
One, there's that whole waittime, and this is something I
saw a lot practiced in theemergency room, because already
we have like 50 people in thewaiting room, everybody feels
that they're there for anemergency, sure, but for
somebody who is puking andhaving diarrhea at the same time
(13:19):
, they do not want to be there,right?
Dr. Michael Koren (13:22):
And so let's mention the fact the triage
nurse calls you and says MrJones, can you come out?
And Mr Jones is in the bathroom.
So he misses his turn.
Judith Abbey, APRN, DNP (13:33):
Exactly , and Mr Jones comes out not too
happy at all.
And so what we do for Mr Jonesis Mr Jones, instead of you
going to the emergency room, youreach out to us, you stay home,
because it's easier for you togo to the bathroom.
While you're home, right, andyou're right in your own
environment, it's comfortablefor you.
We will come to you, we'll takeall that hassle out.
You're going to get the samemedical care you would at the ER
(13:55):
or the urgent care, and this isin the comfort of your home.
So, really, that is what amodel is.
It's very patient-centric.
Dr. Michael Koren (14:02):
That's beautiful.
Yeah, and again, what are theygoing to do for you in the
emergency room?
There's no magic cure for anorovirus.
You're going to get hydrated,get your electrolytes.
and it's going to run its courseover a few days, right?
Judith Abbey, APRN, DNP (14:14):
So, we're going to hydrate you and
we're going to give you somePepcid if it's necessary.
Sometimes we do an anti-emetic.
Depending on how bad it is, wecall in prescriptions for you.
So it is a whole medical process
Dr. Michael Koren (14:28):
and how much would that cost somebody?
So that's always important forpeople is the economics of it.
Judith Abbey, APRN, DNP (14:32):
So on average, it's going to cost you
about $300.
If we're going to do additionsto it, then the prices could
fluctuate.
Dr. Michael Koren (14:39):
Right, and a lot of insurance companies have
co-pays of $250 or $300 or morewhen you go to the emergency
room Right.
Judith Abbey, APRN, DNP (14:44):
Right.
So if you would consider thattime of you having to get in
your car and the drive time, gosit in the waiting room, wait
for hours on end before you'repulled back and then you're
there forever before thephysician comes to see you and
yeah,
Dr. Michael Koren (14:56):
and is it just you at this point, or do
you have people that help you?
Judith Abbey, APRN, DNP (14:59):
We're a small team, so I have a small
team of three plus me, so we'regrowing.
Dr. Michael Koren (15:04):
Okay, and how do you get the word out other?
than this podcast.
Judith Abbey, APRN, DNP (15:08):
Word of mouth has been very essential.
Google reviews have beenphenomenal too.
We're also doing some ads hereand there on social media and
also Google.
Dr. Michael Koren (15:17):
So you mentioned acute diarrheal
illnesses.
How about other things that youdo for people?
What other services do youprovide?
Judith Abbey, APRN, DNP (15:22):
So I often like to categorize this
into we have the sick care.
So we know, with the foodpoisoning or somebody who's
really hangover, they have allkinds of symptoms from it.
We see patients for migraine.
Dr. Michael Koren (15:34):
Hangover cures.
I think that might be a bigbusiness.
Judith Abbey, APRN, DNP (15:42):
It is.
I really the the the hangoverpart is what has popularized
what IV therapy is over the lastcouple years, because people
like going to all these, likeparties, and they get drunk and
you know they get hung over andlike, oh, I need a banana bag,
you know.
So that has definitelypopularized IV therapy is, and
so
Dr. Michael Koren (15:57):
the other cure for hangovers was to give
more alcohol.
Judith Abbey, APRN, DNP (16:01):
I didn't know about that.
Dr. Michael Koren (16:03):
Is that part of your protocol?
Judith Abbey, APRN, DNP (16:04):
No, unfortunately not.
Dr. Michael Koren (16:06):
Okay, well, I don't think that's
evidence-based.
Judith Abbey, APRN, DNP (16:08):
It's not.
Dr. Michael Koren (16:09):
Okay.
Judith Abbey, APRN, DNP (16:11):
And so the sick component part of it,
we deal with those minor, acutethings.
And there's the other part, forwellness, where we have
individuals who they're not sick, you would say.
However, they understand theimportance of nutrients or
nutrition in their lifestyle.
So we have some patients wework with who have chronic
(16:32):
conditions, especially those whohave like gastrointestinal
things, either malabsorption,crohn's, where they're not
necessarily getting all thenutrients they need.
This becomes a way for them tosupplement that.
So a big part of it is doinglab work to identify what the
gap is, what their ranges are,and then that helps us to tailor
a treatment plan for them.
(16:54):
So those are the two categoriesand I always want to educate
that there is a maintenancetherapy and then there's a
replacement therapy.
So in instances where we'redoing maintenance therapy, it's
okay.
We know there are like maybesomewhat of abnormalities or
we're not within range where ourbody needs to be, and so we do
maintenance therapy to get ourbody maintenance really what it
(17:15):
means.
If we're do maintenance therapyto get our body maintenance
really what it means If we'redoing replacement therapy.
I'll illustrate this with apatient that I worked with.
So she had a completethyroidectomy.
Her thyroid's gone.
It's been months trying toregulate her calcium levels and
she's tried everything.
Her team had her on everythingshe reached out to us.
(17:36):
We rechecked those levels OfTried everything.
Her team had her on everythingshe reached out to us.
We rechecked those levels.
Of course she was hypocalcemic.
So we came up with a plan, dida couple of treatments
specifically replacing hercalcium.
Dr. Michael Koren (17:46):
Intravenous calcium
Judith Abbey, APRN, (17:47):
Intravenous calcium, and then after that we
rechecked labs, Boom, she'sback within range.
So then that becomesreplacement therapy.
So for some people after we'vedone replacement therapy then we
cycle back to maintenancetherapy.
But then there's always thatlab work component, trying to
make it evidence-based anddirect care.
Dr. Michael Koren (18:05):
Right.
So I think those are importantpoints and I think it's fair to
say that not everybody in thisquote less regulated space of
bringing healthcare to patients'homes is as evidence-based as
you're describing.
So you and I were just talking,before we got started, about
vitamin C therapy, which is alittle bit controversial.
(18:26):
So we know, for example, thatif you are vitamin C deficient,
that vitamin C replacement canhelp, just like we learned about
scurvy, for example.
But giving very high doses ofvitamin C has never really been
proven to do a lot of good,although some people advocate
that without evidence, and we'llpost what's called a forest
(18:47):
plot of a lot of studies thatwe're doing specifically to see
if high doses of vitamin Cprevent cold symptoms, and the
truth is is that they reallydon't, even though some people
will take the data and try tosay, oh well, that one study, it
was trending in the rightdirection.
And this gets into some of thetechnical elements of analyzing
the evidence which we'll show inthe show notes, but I love the
(19:09):
fact that you're veryevidence-based and you're
helping people resolve theirsymptoms and you're lab-directed
, and these are very importantdistinction factors to show that
you're doing a really nice jobwith evidence.
Judith Abbey, APRN, (19:21):
Absolutely , you hit the nail right on the
head and usually when it comesto vitamin therapy you hear that
, oh, this is expensive pee oryou hear all these kinds of
labels for it.
And often in our medical worldor when it comes to research,
sometimes it's hard to quantifyor really lend much credibility
to anecdotal evidence.
So we hear all these patientstories, success stories, but it
(19:45):
can be quite hard to really sayI'm going to do a randomized
control study specifically forvitamins.
Now I have seen some studieswhere they are talking about
high-dose IV vitamin C forcancer care, not as their
primary, and we always wantpatients to understand that you
should be working with yourmedical team and going with what
(20:07):
they recommend and making surethat the evidence supports that.
Dr. Michael Koren (20:12):
Or doing a clinical trial.
Judith Abbey, APRN, DNP (20:13):
Or doing a clinical trial
Absolutely
A clinical trial where you'resystematically setting up an
experiment where you'll learnthe truth,
Judith Abbey, APRN, (20:17):
absolutely , absolutely.
Right, and so you did talk aboutcolds and vitamin C.
And yes, taking vitamin Cduring a cold is not going to
cure it.
We do know that vitamin C maymake your symptoms lower or
reduce how long you have thecold for, or even zinc.
Dr. Michael Koren (20:38):
And, in fairness, that's debatable.
That's debatable and we canshow the actual evidence.
So again, with things like that, there's no harm in taking
vitamin C, no, no but whatconcerns me is when people try
to oversell it, and the fact isthat the studies that have
looked at it have not beenconsistent and meta-analyses
(20:59):
have shown that it's probably awash quite frankly, and a lot of
other stuff.
Looking at vitamins in general,show that using vitamins when
you're deficient is great.
It's helpful Right, it'shelpful
, but using vitamins when you're not
deficient probably doesn't do awhole lot Right.
So, again.
I think that's a general sense,and other things should be done
, in my opinion, in clinicaltrial settings.
Judith Abbey, APRN, DNP (21:19):
Right, right.
And also it's interesting toknow that the majority of what
the American diet is, mostpeople are deficient in certain
things and they have no idea.
So magnesium is a very commonone that most people tend to be
deficient and not knowing thatthey're deficient in magnesium.
So I think that's key for usdoing that blood work, to know
(21:40):
where do you fall at and thenthat really helps guide care.
Dr. Michael Koren (21:43):
Yeah, I love that.
So I'm a cardiologist andyou're absolutely right, a lot
of people are on diuretics.
That waste magnesium.
And a lot of people don't knowthat magnesium is hard for a lot
of people to absorb.
Unless you test it, you don'tknow if people are deficient,
and for magnesium in particular,you have the blood test, which
is not the perfect way ofknowing if you're full body
deficient, and so you have to doa cellular test to determine
(22:07):
that, and sometimes that'sexpensive and we don't do that.
Except in rare circumstances.
So sometimes you have to have alittle index of suspicion.
And again, we know that peoplethat are deficient in magnesium
will have more palpitations, forexample.
They may have othercomplications that are very,
(22:27):
very subtle that you don'treally get to until you replace
the magnesium.
And what's interesting is, ifyour kidneys work, that you
don't really get to until youreplace the magnesium.
And what's interesting is, ifyour kidneys work, you can't
really overdose the magnesium.
So you always have to look atthe safety elements of it.
Judith Abbey, APRN, DNP (22:38):
That's very true because when we work
with individuals who have coremorbidities and they have a
whole list of other conditionsthey're dealing with, then we're
very particular wanting to knowwhat their kidney function is
conditions they're dealing withthen we're very particular
wanting to know what theirkidney function is and that lab
work really really becomesimportant because, yes, it could
be benign for a healthyindividual who just needs to
(23:00):
replace their magnesium, butthen for somebody who's in
kidney failure or they haveother things going on, it's very
critical to know how you'retreating them.
Dr. Michael Koren (23:08):
That's right.
So any solution that works forone person may not work for
somebody else.
Judith Abbey, APRN, DNP (23:12):
You have to individualize it 100%,
and I think that's one thing wetry to really push is going back
to.
Oftentimes people see what IVtherapy is and they're like, oh,
I can just pick this or I canpick that, or I can pick that.
No, it really should bepersonalized to you and there
has to be a conversation withyou and your provider, or even
(23:34):
before the nurse or theparamedic, whoever actually does
that infusion for you.
You, as the patient, need tohave a conversation with either
a nurse practitioner, aphysician assistant or a
physician in some sort, so theyknow if they get a thorough
history of really who Mr Jonesis, and then that should guide
what the treatment is going tolook like, because at the end of
(23:56):
the day, it is still a medicalprocess.
Dr. Michael Koren (23:58):
Right, it's interesting.
I happen to have an interest inmagnesium.
It's one of the firstinvestigator-initiated studies
that I did when I first got intopractice over 30 years ago got
into practice over 30 years ago,and magnesium is a particularly
fascinating area for youbecause we actually use high
doses of IV magnesium to treatarrhythmias.
So in an arrhythmia calledtorsades we use very high doses
(24:22):
of IV magnesium.
Judith Abbey, APRN, D (24:23):
Obviously , you shouldn't be dealing with
torsades in somebody's home,which is a life-threatening
problem.
Dr. Michael Koren (24:28):
But the concept of getting the magnesium
level up quickly and having aneffect on the heart is
well-known, but you have toagain individualize it.
So there may be some caseswhere taking the pills is going
to be okay, but the truth is youcan get your levels back to
normal much quicker by using IVmagnesium, compared with pills
which some people just can'tabsorb very well,
Judith Abbey, APRN, DNP (24:49):
no, and we always want to advocate for
food.
Food should always be the go-towhere we're getting all these
nutrients from, but for whateverreason, sometimes food does not
meet those requirements, sothis is a good way for you to
supplement that.
But then, going back to themagnesium conversation, you do a
basic Google search and youfind different kinds of
magnesium for different things.
(25:09):
So sometimes patients find ithard to figure out.
Okay, find different kinds ofmagnesium for different things.
So sometimes patients find ithard to figure out.
Okay, what is the rightmagnesium for me?
And so people understandingthat, yes, magnesium, but then
that second part of themagnesium is really going to
tell you what that magnesium isgoing to do for you and how
beneficial it is going to be foryour baby.
We can circle back to that
Dr. Michael Koren (25:29):
and sometimes it's a little bit of trial and
error.
Some people absorb onemagnesium salt better than
another.
They do better with magnesiumoxide versus chloride versus
something else Right.
All right.
Well, that's really helpfulinformation.
So what other patient typeshave you been able to help?
Just for the audience tounderstand where they might want
to call your service.
Judith Abbey, APRN, DNP (25:51):
There is a particular direction that I
feel like the functional space,or buzzword anti-aging
longevity, is going towards, andthere's this molecule called
NAD, or nicotinamide adeninedinucleotide.
Dr. Michael Koren (26:05):
Antioxidant.
Judith Abbey, APRN, DNP (26:06):
So NAD is a coenzyme or cofactor, and
NAD is found in every cell inour body.
And so we are beginning to havesome sort of evidence that is
given as a causal link betweenlow levels of NAD and certain
conditions or certain diseases.
And for which reason?
It's because, like, NAD isimplicated in all of these
(26:28):
metabolic processes.
The theory is, as our NADlevels decrease, if we're able
to replenish that NAD, maybe wecould reverse some of these
conditions, maybe we could livea bit healthier, maybe we could
live a bit longer.
And so what we're using NADtherapy for?
And again, you know, NAD ismostly concentrated in those
(26:49):
mitochondrial cells, where, or Ishould say organ systems, where
there's a high concentration ofmitochondrial tissue, so your
heart, your brain, reproductivetissue, and so NAD tends to be
quite pronounced.
Or, for the patients we workNAD, tends to be very beneficial
for them in those regards.
Over time I say to people allthe time you can't just take one
(27:12):
thing, you can do one time.
And that's not how you knowresearch.
You try for a while so we cancollect some information and see
what the improvement is.
Has anything changed?
Has it not changed?
Dr. Michael Koren (27:24):
Yeah, and this, in fairness, is a little
bit more controversial than someof the other things you brought
up.
So you know, the wholeantioxidant hypothesis is
something that has been outthere for quite a number of
years.
I actually worked in a lab whenI was in college that was
working on some of these thingsand unfortunately, for whatever
reasons, supplements haven't hadthe effects that we had hoped.
(27:47):
That doesn't mean that thefuture won't be different, and
it doesn't mean that there isnwon't be different, and it
doesn't mean that there isn't aglimmer of truth in the
hypothesis, but we don't reallyknow exactly how to deal with it
at this moment.
So one of my first actually myfirst scientific publication was
showing the antioxidant effectsof free radicals that were
(28:08):
generated when you use the,chemotherapeutic drug called
Adriamycin, and the simplest wayof getting rid of the free
radicals is just introducingoxygen to the system.
So no one really thinks thatthat is going to solve the
problem but, it does change thefree radicals, so it gets very
(28:29):
complicated in terms of thiswhole concept of what to do with
these free electrons that cancause tissue damage, and how do
you manage that, which is reallywhat the whole NAD hypothesis
is looking at Right.
Are you familiar with the workof Dr.
McCord from Duke?
No, I'm not.
Yeah, he was one of theoriginal pioneers of this.
I don't know if he's stillaround.
I haven't checked his workrecently.
How pioneers of this?
(28:50):
I don't know if he's stillaround.
I haven't checked his workrecently.
Judith Abbey, APRN, DNP (28:52):
How long ago is that?
Dr. Michael Koren (28:53):
This is when I was in college.
Judith Abbey, APRN, DNP (28:54):
Oh boy,
Dr. Michael Koren (28:54):
It's probably more fingers and toes than I
have to count that far back, butanyhow, it's some interesting
stuff, but I would put that morein the unproven category, more
hypothesis generating.
So why don't you tell peoplehow we get your service, how you
get in touch with you and yourteam?
Judith Abbey, APRN, D (29:12):
Wonderful .
So we have a wonderful websiteOn the Go Drip.
I feel like On the Go it justrolls right off your tongue.
I like it.
So you go to www.
OnTheGoDrip.
com On the Go Drip.
That was a mouthfulOnTheGoDripcom.
One word?
Judith Abbey, APRN, DNP (29:28):
All one word yes.
Dr. Michael Koren (29:29):
On the go drip.
Judith Abbey, APRN, DNP (29:29):
Yes, onthegodrip.
com.
And we have all the informationyou need on there
Dr. Michael Koren (29:35):
so you can just work online and then
you can work online.
You can give us a phone call,you can send us a text message
whatever is convenient for you.
Why don't you tell everybody what your phone
number is?
Judith Abbey, APRN (29:42):
904-544-5010 .
Excellent.
Dr. Michael Koren (29:46):
Excellent.
Judith Abbey, APRN, DNP (29:47):
That's our phone number.
Dr. Michael Koren (29:48):
And what's your typical response time if
somebody calls?
Judith Abbey, APRN, DNP (29:51):
About 30 minutes.
Dr. Michael Koren (29:52):
Wow, okay, well, that's better the ER
Judith Abbey, APRN, DNP (29:53):
In 30 minutes.
Way better Between 30 minutesto one hour.
We would have somebody at ourlocation, .
Dr. Michael Koren (29:59):
That's amazing.
Yeah, well, thank you for nowthat I know that I might send
some patients your way.
Judith Abbey, APRN, (30:03):
Absolutely .
Dr. Michael Koren (30:06):
Any last words for the MedEvidence
audience?
Judith Abbey, APRN, DNP (30:09):
I have a question for you.
Sure, because, staring likesitting right across from you,
there is this book behind you.
That's just like staring rightat me.
Dr. Michael Koren (30:17):
Yes, and I wonder, or I just want to know,
what the story behind that bookis.
Well, let me see which bookyou're talking about.
Judith Abbey, APRN, DNP (30:23):
It's very prominent.
This one, that one, that one,okay, wow, this, that one, that
one.
Dr. Michael Koren (30:28):
Okay, wow, this was not a setup, by the way
, no, you just happened to askabout this book.
So when.
I was in medical school, I tookcourses at the Harvard School of
Public Health and Dr.
Weinstein and Dr.
(30:48):
Feinberg led this course ondecision analysis and this is a
book that they wrote togetherwith some other authors.
Back in the 1980s, when I wentto medical school, Dr.
Feinberg was my medical schooladvisor.
He became the dean of theHarvard School of Public Health
while I was there and obviouslyit was nice to have a mentor
that became the dean, but heactually also became the head of
the Institute of Medicine someyears later.
(31:10):
So he was one of my teachers andmentors and tremendous.
I learned so much from him.
Dr.
Weinstein was the primary guy.
He was a physician, he was anon-physician.
He was the primary guy that ranthe course teaching about how
to use quantitative analysis tomake medical decisions.
So my claim to fame is that Itook their course and it was
probably the fourth year or sothat they did the course you did
, I did I took the course andthis was the book from the
(31:32):
course.
I was the first student to get aperfect score on the final exam
, including the extra creditquestion.
That's my biggest claim to fame, so thank you for bringing that
up.
Judith Abbey, APRN, DNP (31:43):
No way, that is unbelievable.
Dr. Michael Koren (31:48):
Anyhow, it's a great book that helps you
analyze how to make.
That is unbelievable, butanyhow, it's a great book that
helps you analyze how to makemedical decisions, and my
medical school thesis was aboutwhether or not to neutralize the
acid content of pregnant womenbefore they deliver to prevent
the acid aspiration syndrome,and that was my first major
medical presentation on that.
Judith Abbey, APRN, DNP (32:08):
What were your findings on that?
That sounds.
Dr. Michael Koren (32:11):
Well, I have my thesis in my office, if you
want to read it.
Judith Abbey, APRN, DNP (32:13):
I would love to read it.
Dr. Michael Koren (32:15):
It's only 150 pages of light reading, and
you're probably the first one toask to read it.
Yeah.
Judith Abbey, APRN, DNP (32:22):
I would love to.
Dr. Michael Koren (32:23):
Other than my mom who read the introduction
and liked that didn't read anyof the paper, but anyhow, we
basically found that it wasimportant to neutralize the acid
content of pregnant women andthat if you had the ability to
predict when the delivery wasgoing to occur, you should use a
histamine blocker like Tagametin those days or Zantac more
(32:47):
recently, and that was actuallyhelpful to neutralize the pH of
the stomach content.
So, god forbid, the pregnantwoman vomits and aspirates.
They're much less likely to getsevere lung damage.
So that was the finding and weactually looked at how much it
costs.
So back then Tagamet was a drugyou had to pay for.
It wasn't a cheap generic, itwasn't that much, but it wasn't
(33:09):
a cheap generic.
And wasn't that much, but itwasn't a cheap generic.
And do you spend, does thesystem spend a million dollars
to protect a certain number ofwomen?
So we actually brought it downto the financial parts, which is
why I'm always interested inbusiness and how people in the
medical field develop theirbusiness models.
Judith Abbey, APRN, DNP (33:23):
Right, wow.
So if you could predict or youknew exactly when the mother was
going to deliver, Then youwould give the histamine blocker
how far out before delivery.
Dr. Michael Koren (33:36):
Typically you would want to do it within a
few hours, so you know, two to12 hours before.
Judith Abbey, APRN, DNP (33:41):
Right, that is pretty cool.
Dr. Michael Koren (33:44):
So that's what we discovered, but thank
you for the question.
Judith Abbey, APRN, (33:46):
Absolutely .
It was just there, like it'squite, and it's placed
differently from the rest of thebooks in your collections.
I was like it must really meansomething to you.
There's a story behind it.
Dr. Michael Koren (33:58):
There is a story behind it and, again, it's
the way we should be thinkingabout medicine in terms of
quantitative decision analysis.
That is definitely one of thepoints we make on MedE vidence,
and people should findphysicians or nurse
practitioners or other medicalproviders that think in those
terms.
We think in terms of analytics.
We think in terms of what'sproven and we're not just trying
(34:18):
to make up stuff as we go along.
We don't know everything andsometimes we have to make
decisions based on uncertainty,but for the things that we do
know, we need to leverage thosethings and it's an important
part of what we do.
Judith Abbey, APRN, DNP (34:29):
Wow, that's phenomenal.
So, Judith, you've been adelight.
Thank you for joining us onMedEvidence and we'll have you
back again.
and good luck on your business.
Thank you.
Thank you very much.
Dr. Michael Koren (34:41):
Thanks for joining the MedEvidence podcast
To.
Popular Podcasts
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
On Purpose with Jay Shetty
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!