February 8, 2026 • 38 mins
Tonight, On Your Health First, Dr. Galati tells us how February is American Hearth Month. He has good friend of the show Dr. Joe Rogers join to discuss cardiovascular health and symptoms associated with it. Dr. Galati also has Physician Assistant Natalie Oliver join the show to talk about fatty liver disease.
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Speaker 1 (00:01):
Initial life Sequencing coming to you live from Houston, Texas,
home to the world's largest medical.
Speaker 2 (00:08):
Center, and he approach raises everything looking.
Speaker 1 (00:09):
At This is your Health First, the most beneficial health
program on radio with doctor Joe Gillotti. During the next hour,
you'll learn about health, wellness and the provention of disease.
(00:30):
Now here's your host, doctor Joe Galotti.
Speaker 3 (00:41):
Well a good Sunday evening to everybody. Doctor Joe Gallotti.
We're here every Sunday between seven and eight pm raising
your health i Q making you better consumers of healthcare
and allowing you and guiding you you to better understand
(01:04):
how your magnificent body works and having that knowledge to
understand your risk factors for certain diseases, understanding symptoms that
will basically alert you to check in and get the
care you need, and also understanding your Really a very
(01:28):
important part of healthcare and wellness is really understanding your
family history. What did mom die of? What did Dad
die of? Grandma, grandpa, uncles can be a little bit
of a reflection and mirror into your own life, which
is really really very important. Don't forget to contact us
doctor Joe Galotti dot com, d R J O e g.
(01:50):
A L A T I dot com. Go there, sign
up for our newsletter. All of our social media is there.
There's a tab that says contact us, and you could
send me a message and certainly have a two way
conversation with us and our team, the uroalth Fare's team
available to help all of you. So the month of
(02:11):
February is American Heart Month, and it's I mean, we
talk a lot about heart disease because it's so common here.
But we have doctor Joseph Rodgers coming up. He's the
director of the Texas Heart Institute at Baylor College of Medicine.
And doctor Rodgers really when we started the program twenty
(02:32):
three years ago, he was really one of the first
handful of guests that I called upon, not only because
he's a great physician, but he's a great communicator and educator.
And the thing about the idea of American Heart Month,
where we focus on women's heart disease, which is very important,
and heart disease and man adults, adolescence, it's very important.
(02:59):
You really have to stand the numbers that in you know,
twenty twenty three, which is a few years ago, there
was close to a million people that died from cardiovascular disease,
which is equivalent to one out of every three deaths.
Someone dies every thirty four seconds from cardiovascular disease. One
in twenty adults have cardiovasc you know, carnary arter disease,
(03:23):
which is a cholesterol build up and plaque in your arteries.
Heart attack. Every year, about eight hundred thousand plus people
have a heart attack. All right, doctor Joe Glatti.
Speaker 2 (03:36):
We're here every.
Speaker 3 (03:38):
Every single Sunday between seven and eight regardless of Super
Bowl Sunday. So all the Super Bowl widows and widowers
that are looking for alternative entertainment, Your health first is
the place stay tuned. We're burright back every Sunday evening
between seven and eight pm. We are glad you're here,
(04:02):
raising your health i Q, making you better consumers of
healthcare and doing your best to stay out of the hospital,
out of the er, because we would always say that
knowledge is really the most important thing all of you
can have as consumers. And as we were saying earlier
on the program, the month of February is American Heart Month,
(04:26):
and it's an opportunity, even though I think every day
should be American Heart Month, talking about heart disease and
some of the sobering facts about heart disease. Number one
is the leading cause of death for men and women.
One person dies every thirty four seconds of cardiovascular disease.
So during this segment, unfortunately a number of people are
(04:48):
going to die. And in twenty twenty three, close to
a million people died from cardiovascular disease. And who better
to talk about this is doctor Joseph Rodgers. He is
the director of the text Heart Institute at Baylor College
of Medicine. A dear friend and colleague, doctor Rogers, welcome
back to your health first.
Speaker 2 (05:08):
Well, doctor Glotti, it is always my pleasure to join
you on a Sunday to talk about cardiovascular health.
Speaker 3 (05:14):
I know, and at Super Bowl Sunday, and so we're
both taking breaks from the game. But that's it's a
job we've got to do, Joe, it's a job.
Speaker 2 (05:22):
We got to do.
Speaker 1 (05:24):
I know.
Speaker 3 (05:25):
So the numbers you know very well, and that is
you know your mission and you and all of your
colleagues to combat such a big disease that we we face.
But like so many times we've talked about, it is awareness,
it is understanding, and so here it is. It's the
(05:47):
twenty eight days of February American Heart Month. What what
would you say just for this month? Is your objective
as a leading cardiologist leading the Texas Heart Institute, a
world renowned center that everybody tonight needs to know and
hopefully whoever we reach tonight, they tell a person and
(06:09):
then they tell another person. So what's what's your take
on this whole notion of American Heart Month?
Speaker 2 (06:15):
Well, so, I first, I love so many of the
things that you just said as a way to introduce
the importance of cardiovascular disease and understanding it. And I
think the thing I would love for people to walk
away from our conversation this evening is to feel empowered
to ask questions about your cardiovascular health, right And you
(06:37):
know there, we know that there are modifiable risk factors
for the most common form of cardiovascular disease, which is
which is athrosclerosis or hardening. The art reces are just
different names for the same process, sure, but that's the
most common, you know, sort of preventable cardiovascular disease, and
(06:57):
the risk factors haven't changed in any appreciable way, with
a couple of exceptions which we can talk about, but
it's the things that we've talked about. It's high blood pressure,
it's high cholesterol, it's diabetes, it's obesity, and we are
now developing even more effective treatments for these pre morbid
(07:19):
conditions that will help people prevent. The other thing, Joe,
is that that the Heart Association, I think wisely and
based on data, is beginning to change the thresholds by
which we which which tell us to treat. And what
we're realizing is that we were way too liberal in
(07:39):
our recommendations at the beginning. You know, we were telling
people that they could get by with blood pressure that
was higher than we would acknowledge today is acceptable. Same
with cholesterol. And I think that's the thing that we
should be talking about today is what are those current
guidelines and and and sort of so that people when
they go to their doctor, they can say, Okay, well listen,
(08:00):
my blood pressure seems to be a little bit higher
than the guidelines would recommend, or my cholesterol seems to
be higher than the guidelines would recommend. What can I
do to lower my risks? Yeah?
Speaker 3 (08:11):
And these are great things because number one, we both
believe in having a dialogue with your physician and your
care team. You have to ask questions, you need to
take the lead. But the other thing, like so many
other disease states and including liver a disease that I
(08:32):
take care of, people will get a false sense of
security if I had heart disease, well, you know, gee,
I would know it. So I think I am okay,
And that is probably mistake number one. I feel good,
I'm working, I'm going on vacation, everything is just hunky dory.
(08:53):
How could I have a heart problem. So, you know,
let's stop talking about it. Address that for a moment.
Speaker 2 (09:01):
Joe. Yeah, no, you're you're right, Joe. The hard part
about especially acquired heart disease like atherosclerosis, is that it's
most of the time asymptomatic, and tell it's a major problem.
At that point, it's hard to reverse it, right, So
it's all about prevention. It's all about preventing those plaques
(09:24):
from forming inside the arteries, because by the time you
get symptoms, you probably have at least a seventy percent blockage, right,
and getting those to they can regress over time with
very aggressive treatment. But what better strategy than to keep
it from ever getting to be you know, a seventy
percent blockage.
Speaker 3 (09:44):
Yeah again, And I tell people that it's like, look,
we put smoke detectors in our house to pick up
the earliest sign of a fire, not until the whole
damn place is, you know, in a flame engulf, to say, oh, hey,
we've better call the fire apartment.
Speaker 2 (10:00):
It's really early warning.
Speaker 3 (10:02):
So get to really I think the two biggest things
the numbers on high blood pressure or a normal blood pressure,
and the cholesterol story, because that patients still will say, eh,
you know, my cholesterol is just a touch elevated. So
where as an expert, where do we go with this?
Speaker 2 (10:19):
Right? So, most people who are listening and who have
you been thinking a little bit about blood pressure probably
recall that you know, in decades past we said, well
we think the right blood pressure should be under one
forty over ninety. I think what we're recognizing is that
there is an important reduction in cardiovascular events even with
(10:44):
blood pressure, as we lower blood pressure below one forty
over ninety. And so, Joe, the current guidelines really tell
us to try to get that blood pressure closer to
one twenty over eighty. Now here's the hard part for patients,
and if that's it's not easy. So once you've done
all of the things that you can do to modify
(11:05):
your risk of high blood pressure, like getting down to
a normal body weight, taking the salt out of your
diet as much as you possibly can, you know, treating
sleep apnea. So many people have sleep apnea that drives
high blood pressure. Once you get through all of those
steps that are in our control, then it often takes
(11:28):
a couple of medicines to get the blood pressure down
in that range. It's oftentimes not just one pill, but
in terms of the things you can do to lower
your risk getting your blood pressure down into that one twenty,
maybe as high as one thirty, but not higher than
that range on the top number, that's important. The same
(11:49):
with cholesterol. You know, we used to sort of look
at the risks of cholesterol and we used to say, well,
we'd like to get your total cholesterol ought to be
down under two hundred, and your bad cholesterol, which is
the LDL cholesterol, ought to be down under one hundred.
There's some really compelling new data that what we ought
to be doing is driving bad cholesterols down into the
(12:12):
forty or fifty ran that's your LDL cholesterol. And so,
you know, like you said, many people say, well, you
know my cholesterol is just a touch high. Well, those
people's cholesterol is actually too high. And if we're going
to so so anyway. And then there's one other lipid
thing I think that's important to sort of get out
in the public's awareness, and that is we've realized recently,
(12:35):
and it's probably since the last time you and I
spoke on the show. There's a there's a new lipid
particle that is sort of coming into focus. It's called
LP little A and it's sort of a it's the
bad cholesterol molecule that's wrapped in a couple of different proteins.
But there is a very clear relationship between LP little
(12:55):
A elevated levels and your risk of cardiovascular disease. It
seems to be principally genetically determined, and we now have
tests for it. Now. The tricky part is we don't
have great drugs yet, but there's probably one that will
be out, could be this year, to treat that problem.
And it's a one time test, so the next time
(13:16):
people get their lipid levels tested with their primary care
doctor or their cardiologist, whoever you see, you're endochronologist, you're hepatologist,
You ought to get and you ought to get an
LP ask for an LP little A just so you
understand what that level is. And when we have therapies
we'll be I'm sure we'll be using that as a target,
(13:39):
another target to lower people's risk.
Speaker 3 (13:42):
Okay, So here's the challenge in the scenario, A fifty
five year old patient has been told by his primary
care doctors and a chronologist maybe even as cardiologists hopefully
not that you know, your cholesterol is a little elevated,
(14:02):
it's not that bad. And you go in saying I
want this LP little A and it's like, why it's
you don't need it. I'm telling you your cholesterol looks okay.
What is the comeback to the physician or nurse practitioner
to say, no, I really want to have this done.
Speaker 2 (14:25):
Yeah. I mean, I think your question is a really
incredibly insightful question because I think there are a lot
of practitioners out there who aren't thinking yet about LP
little A. Right, it can be distinguished. It can be
measured differently than LDL cholesterol. You can have a fairly
normal LDL cholesterol but a high LP little A and
(14:48):
your risks are higher. So so again this idea that
you started with that knowledge is power, right. I think
that people should be aggressive and proactive. It's it's a
one time it's not anything today that we understand that
you need to keep measuring over and over again, right,
But I would I think I would recommend people start,
(15:10):
you know, sort of thinking about getting an LP little
A right.
Speaker 4 (15:14):
Right.
Speaker 2 (15:14):
The other thing that I think has been really revolutionary
is the use of cornary calcium scoring, which is a
it's a five minute test and a cat scan and
we look for early deposition of calcium in the walls
of the blood vessel. And what that tells us is
that people are starting to get hardening of the arteries
(15:35):
or ath those sclerosis. And if you have a positive
cornary calcium score, it tells it should tell all of
us that you're starting to get the disease, and we
need to be much more aggressive about risk factor modification
and especially lowering your cholesterol.
Speaker 3 (15:50):
And again, the key thing is people that are asymptomatic
that they feel good, they may be exercising, but it's
one of those things that you you get these results
and you have to say, despite how I feel, I
really need to take action, and that I think if
there's any message here that really is what we need
(16:12):
to do. The other thing is a lot of people,
probably for the past twenty five years, people have had
this almost hysterical reaction to statins. Statins are bad. I
had a friend that couldn't walk after they took a statin,
and so I want no part of that. How do
you talk that person off off the off the ledge.
Speaker 2 (16:36):
Yeah it so there's no I mean, there is no doubt.
And I think you and I will completely agree about this,
Like all drugs have side effect, sure, and so, but
if you look at the majority of people and you
look at the net benefit that people get from the statins, right,
it outweighs the adverse events. Now, that doesn't mean that
(16:58):
as an individual person, you're not going to get muscle
discomfort from a statin. The other thing people always talk
about is that it's there and it's sort of prevalent
on the internet.
Speaker 4 (17:09):
You know that.
Speaker 2 (17:09):
It's that statins are linked to early neurocognitive changes like
early dementia. I'll tell you, like we have, we have
done everything we possibly can to understand if there is
a linkage between statins and neurocognitive decline, and we are
unable to prove that. So, so I think statins remain
(17:31):
the foundational therapy for high cholesterol. There's a new class
of drugs called the PCSK nine inhibitors. Today. Those drugs
are injectable. They work a little bit differently, they have
a different adverse event profile, and they really lower cholesterol
and can get the LDL cholesterols down in the range
(17:52):
that we just talked about a few minutes ago. But
up until now injectable drugs, they have to be injected
every couple of weeks. But there is a new pill
that will probably come out this year that's an oral form.
Speaker 3 (18:09):
Now your colleagues didn't one of your colleagues at Texas
hartwork on.
Speaker 2 (18:12):
That, Yeah, Christy Balentine was the principal author on that paper.
It just came out in the New England Journal of
Medicine this week. Yes, but it's I think it's going
to be one of those game changing therapies. Now, of course,
we'll have to understand and as we test more people,
we'll have to understand what the adverse events are that
are associated with that medicine. And there certainly will be
(18:33):
something because it's a medicine and every medicine has side effects.
Speaker 3 (18:37):
Right, and yes there are, and we have to be careful.
Patients need to be aware. Physicians and care providers need
to know, and you know, certainly inform patients, but at
the same time you have to look at the risk
benefit doing nothing about your high cholesterol and your elevated LDL.
We know you could tell me in five years the
(19:00):
risk of me having a stroke or a heart attack,
But which is real and life changing or life ending
versus a smaller risk associated with a side effect. You
have to weigh that in and not say the side
effect is as bad as not taking it and dying
of a stroke.
Speaker 2 (19:22):
I agree with you, you know, And this is why
drugs go through the rigors of clinical trials, right. And
the question always for the food and drug administration is
the benefit more than the risk? Right? And so with statins,
you know, we've probably I don't even know how many
people we've tested in clinical trials where we follow them
(19:42):
very closely for the side effects of those drugs. And
what we found is you test large populations of patients,
the benefits outweigh the risks. Right now, Once again, if
you're one of those people that has an adverse EVENTTHM.
You should talk to your physician or your advanced practice
provider it and make a switch, right. But most of
(20:02):
the side effects are not permanent, you know, so stop
the drug the side effect goes away, right, and then
come up with plan B and and and come up. Yeah.
Speaker 3 (20:11):
All right, with that said, we're going to take a
quick break. We have doctor Joseph Rodgers on the line.
He's the director of the Texas Heart Institute at Baylor
College of Medicine.
Speaker 2 (20:22):
Out doctor Joe Glotti.
Speaker 3 (20:23):
Don't forget doctor Joegalotti dot com. Stay tuned more part
talk in a minute, you know. The last the last
thing to touch on. And this gets into everybody tonight
and our patients being good consumers or good stewards of
your your human body here and it's awareness of symptoms.
(20:46):
I am sure you see patients that have been the
best of intentions. They come and see you for the
first time. Doctor Rogers, my family doctor said I need
to see a cardiologist because I have high blood pressure.
And when you see hit them down and you start
hearing they have had palpitations, they have shortness of breath,
(21:06):
their legs are swollen, etc.
Speaker 2 (21:09):
Etc.
Speaker 3 (21:10):
You scratch your head and say, you know, you're a
year too late. Not that you can't be salvaged, but
if you had known these symptoms, you could have gotten
in earlier. So what are the symptoms the outward signs
that somebody maybe not definitely, but maybe having a heart
or cardiovascular type issue that needs attention.
Speaker 2 (21:34):
Yeah, so I think this is another really important question
that you've asked. And there's one caveat which I'll explain
at the end. But the things I think that I
would be really thoughtful about are any sort of exertional
discomfort in your chest. Women sometimes don't have the same
(21:54):
kinds of pain that men do. They'll get gi upset.
Sometimes that pain isn't in your it's in your neck
or traditionally in your left arm. I think breathlessness, which
is increasing when you exercise, is another important symptom to
look for. As you said, palpitations or irregular or racing heartbeats.
(22:16):
Pain in your legs when you walk, you know, can
be a sign.
Speaker 5 (22:20):
Of blockage and the leg arteries, which also can be
a tip off. And you know that may be a
tip off in somebody, for example, who's diabetic. And the
challenge that you just pointed out, is a lot of
these symptoms come on and they're very insidious.
Speaker 2 (22:38):
Yes, right, So they start slowly you sort of say, well, gosh,
you know, I used to be able to walk six
blocks and now I can only walk five and a
half blocks. And then a year later it's down to
four and a half blocks, and you start to people
start to accommodate and they don't realize actually that there
are exercise performance for examples changing. So having a high
degree of awareness of symptoms, think, you know, my recommendation
(23:01):
is not to calendard, but maybe take an inventory, yes,
every six months and say has something changed relative to
what I was doing six months ago? And if something's changing,
I think that's the time to get in and have
an evaluation.
Speaker 3 (23:16):
Right, And that is that self awareness. But also what
people will say is yeah, I And I'll ask them
those kinds of questions and they'll say, you know what, Yeah,
I am more short of breath, or I can't walk
as far, but doctor Galotti, I turned sixty five last month.
Or I have a bad hip and it's my hip
(23:37):
and I'm cock eyed and I walk funny and I
can't walk as far. You naturally, I think it's just
a human defense mechanism that you attribute the symptoms that
you just talked about to something completely unrelated to the heart.
Speaker 2 (23:52):
Yes. No, I think you're right, and I think and
maybe it is your hip, you know, but maybe it's not.
And I think that what it should do again is
just sort of set off an alarm that it's time
to get it checked. And if you go through all
the cardiovascular testing and it's all negative, great, it's your
hip in order. So I actually think that you know,
(24:22):
there's nothing to be frightened of in terms of going
in and seeing Listen, this is changing for me. I
recognize that there are a lot of things that could
cause this, but I do also recognize that these symptoms
could be related to your heart. Yeah, so I think
i'd be good for us to at least start some
testing to rule that out.
Speaker 3 (24:39):
Absolutely well, Joe, it is always a delight to have
you on. You are so articulate and knowledgeable, but you
are an expert in heart disease. Doctor Joseph Rodgers, director
of Texas Heart Institute at Baylor College of Medicine, my friend,
thank you always for coming on. Joe, Thanks so much,
(25:00):
all right, thanks a million now all right, we are
gonna follow up here. It's always a pleasure having doctor
rogers on such a great educator, great clinician, but a
great educator. All Right, stay tuned, we will all right back.
All right, final segment of this week's Your Health First
(25:23):
Super Bowl edition. For all those that don't like football
or have a dislike for the England Patriots, We're glad
you here. Don't forget Doctor Joeglotti dot com is our website,
sign up for our newsletter, and all of our social
media is available there, but you have to go to
(25:44):
doctor Joglotti dot com.
Speaker 2 (25:46):
All right.
Speaker 3 (25:46):
So the on the phone here wrapping things up for
the night is Natalie Oliver, one of our physician assistants
at our practice, Liver Specials of Texas and no stranger
to the program, and we were having a conversation earlier
in the week about fatty liver, very common thing that
we see in our practice, very thing, very common disease
(26:10):
in the community, with about one hundred million people in
the United States having fatty liver. So Natalie, why don't
you share our conversation and the sort of the epiphany
you had regarding this conversation around fatty liver disease.
Speaker 4 (26:27):
All right, absolutely, So, first of all, thank you so
much for having me back. It's great to be here.
But yeah, so all day at work we're talking about
fatty liver disease. We're talking with our patients, and it's
so great to get to come on here to educate
more people because I will tell you fatty liver diseases
is alive and well.
Speaker 2 (26:47):
Yes.
Speaker 4 (26:47):
And this question that kept circulating in my head was
is mash contagious? You know, you look around our waiting
room and so many people have MASH and it's a
little bit of a silly question.
Speaker 2 (27:00):
And I will say now first before you get too far.
Speaker 3 (27:03):
And we've talked about the define mash m A s H.
Speaker 4 (27:09):
So MASH is metabolic dysfunction associated's diado hepatitis, which only
makes sense that we say mash instead. But that is
the inflammatory version of fatty liver disease, and fatty liver
with metabolic syndrome, you know, plays into your pre diabetes, diabetes,
high blood pressure, cholesterol weight, a little bit of thyroid disease,
(27:33):
but again metabolic driven a lot of lifestyle there. And
when you look around again our waiting room, it seems
that so many people this question kept hitting me. Is
mash contagious? Right, and in the sense of can you
cough and give your your neighbor mash?
Speaker 2 (27:50):
No?
Speaker 4 (27:50):
And the obvious answer is no. But the more I
thought about it, you know, it is so common to
see mash within or again fatty liver within a family
or within people who live in close quarters that I
think the question almost started to make more sense to me.
And when you think about it, so in the same household,
(28:11):
we are eating the same we have similar meal timings.
You know, the spouse is getting home late from work,
so we're all eating at eight pm. Or you know,
someone's tired, so that means no one in the family
goes for the family walk, right, or you know, we
you know again, we start to eat the same and
we could have some of the same health complications. And
(28:32):
so you know, in in our office, I can't tell
you how many times I'm sitting, you know, with our
patient and we have the husband or wife in the
corner of the room and we're talking about their risk
factors and I'm like, your is your husband okay? They're
like sweating in the back of the room, and they
asked the question could I have this too? You know,
(28:53):
could I potentially have fatty liver? You know, I know
we're here for my wife and I want to stay
on topic, but you know, most of what you've mentioned,
I also have this right, and they're so right, and
you know, I love that we you know, within our
practice we try. I care so much about my patience,
(29:14):
but by doing that, you also have to care about
their family. Yes, and to have the privilege to identify
more people with fatty liver, treat more fatty liver, and
prevent the devastating complications of it. We it's it's so important,
so again knowing the risk factors so we can screen
their family members too.
Speaker 3 (29:34):
Yeah, and I think the the idea that this disease,
fatty liver, is contagious. We think of things like COVID contagious,
the flu, r measles, pneumonia, different skin infections that you
have contagious. But here it's really a play on words
(29:57):
to say it is contagious in the sense that everybody
around you has this disease. And you and I both
have seen a grandparent or let's say the seeing your
patient in the family, so the grandmother is brought in
by their daughter who has fatty liver. And the next visit,
(30:22):
the granddaughter comes in. They've got fatty liver and they
have a child. So you could literally see four generations
have the same disease. And that is I believe what
you're getting at.
Speaker 4 (30:37):
Yeah, and we know that when you have a bloodline
family member who has fatty liver, you are also at
a twelve times increased risk. So by all means, if
you're out there and you have fatty liver, have your
mom screen, have your daughter's screen. But also you know
the husband or the wife, people who aren't blood and
living within the same house are also at risk and
(31:02):
need to be identified too.
Speaker 3 (31:04):
Yeah, and I would say that certainly the old saying
that you know, a family that sticks together, eats together,
et cetera, et cetera. But so much of the driving force,
the fuel that is creating all of this metabolic syndrome
and diabetes and obesity. And you know, of course the
fatty livery we see is driven by diet and lifestyle.
(31:28):
So you're married, I'm married. We do things together with
our spouse, significant other, family or children. So it makes
sense that if you are eating a bad diet process
foods you're eating out drive through. There's a good chance
the other two or three people in your family or
(31:49):
household are doing the same thing.
Speaker 2 (31:50):
And here we go.
Speaker 4 (31:52):
Yeah, and you know, in our practice, when we start
having these conversations and uncovering that everyone's eating the same way,
and we'll actually do a fibro scan the same day
for that patient. You know, again, care about the patient,
we care about their family, and we uncover, Wow, they
actually had more advanced disease than you did. These come
(32:13):
with no symptoms. And it's also, you know, on the
flip side, such a great opportunity to then treat it
so it doesn't progress and you know, impact the patient
and the family. But yeah, it's it's it's so important
to know your risk factors and share this.
Speaker 3 (32:33):
With your family, right and I and I would say
that the million dollar question, or the million dollar hurdle
for us is how do we break this really really
vicious cycle of of uh, you know, sort of poor
lifestyle choices, diet, lack of exercise, not enough sleep. Because
(32:55):
where you really can impact the other people in your
house by you you're eating better, You're putting on your
sneakers and trying to exercise, you could bring people with you.
So what would you say, oh that two or three
easier steps to get people to break this really cycle
of chronic disease.
Speaker 4 (33:15):
Yeah, and it is the million dollar question. And the
beautiful flip side of this is that couples and families
who are eating well together or who are exercising together,
also we're seeing the lack of chronic disease, right. And
I think the biggest thing is starting small, setting small
goals so where it doesn't feel so impossible that you know,
(33:38):
you have this great visit and then you're like, hey,
that's not practical and you go home and don't change
a thing. But tangible small goals. So if you're eating out,
you know, for every meal, maybe you can commit to
making your meals at home. You commit to and I
think that's when you start to take control of the
ingredients you're using, you know what you're eating. And then
(34:02):
exercise movement. You don't have to start turning for a marathon,
but you commit as a family and you sit down
and you say, you know what, four days a week,
we are going to do something active. And if you
hate running, don't run. But maybe y'all all get bikes
or you get a stationary bike, or you know, you
you swim something, so you have you know, making meals
(34:25):
at home, your exercising, and then in particular at home Michael,
so making meals at home. You could also make poor meals.
But I would say focus in Mediterranean style meal planning
is the name of the game. With fatty liver, high
fiber in your in your diet, high protein in your diet.
(34:46):
And then you see just whole real foods and making
it fun. You know, you find recipes that you're not
going to like and don't make them again, but you
may find some some really good recipes that start to
you keep the family cookbook for and you pass these down.
And it's all about a little trial and error.
Speaker 2 (35:06):
It really is.
Speaker 3 (35:06):
And I don't believe some families that we see are
so ingrained in a certain pattern that they eat a
certain style, but they have to really break out to
say I need to expand and eat more vegetables. I
need to expand and have different kinds of fruits and exercise.
And we're saying this not to force a certain lifestyle,
(35:30):
the lifestyle of Natalie or the lifestyle of Joe or
anybody else. But because we know these are families, this
contagious family, they are on a collision course with chronic
disease and a lot of sufferings. So last thirty seconds, Natalie,
how do you really wrap up this crazy but really
(35:54):
great theme that this is a disease, fatty livery is contagious.
Speaker 4 (35:59):
Yeah, I mean in that you joke that we have
a crystal ball in the people's lives. And with that,
it's we know what can happen if MASH is not
identified and if it's not treated. We treat patients with
really devastating liver disease. And if we can just take
the conversations we have today with patients, if I could
(36:19):
have these with our patients in the hospital, and if
we could go back in time, they would and we
are faced with this privilege to have conversations with the
patient that then transcend into conversations they have with their
kids and their families. And if we can treat fatty
liver in one I believe we can treat it in
a generation of people and their family And that's what
(36:42):
I want to focus on. And every it's a challenge
every day, and it's a great place to be and
I hope people listening now will go get their their
family members screen because we want the family to be healthy.
Speaker 3 (36:52):
Absolutely absolutely support healthy families.
Speaker 2 (36:56):
Natalie.
Speaker 3 (36:56):
All right, we do, Natalie Oliver with our Practice Liver
Specialists of Texas Physician Assistant, really really very thoughtful idea
and it's going to be provocative. So you know, you
want somebody listening tonight to go to their family doctor
and say I heard on the radio that my fatty
liver is contagious. You know, I think we would both
(37:18):
be so happy if that started and have some doctor
callis and say, what the hell are you saying? You're
fatty liver is contagious. I'm like, wait a second.
Speaker 2 (37:27):
You have to understand.
Speaker 3 (37:31):
I think that Natalie, you you came up with the idea,
and I think we have to keep supporting you on that.
So well, Natalie, have I have a great night, appreciate
you coming on.
Speaker 4 (37:44):
Thank you so much for having me.
Speaker 3 (37:46):
We'll set time, all right, all right, so you know
here here we are. I mean, this is this is
just great, great dialogue. All right, So thanks to doctor
doctor Joe Rodgers talking about heart disease, Natalie Oliver talking
about the contagious nature of fatty liver, wink wink, and
uh of course go to doctor Joegalotti dot com and
(38:08):
next Sunday we'll see you back for more health and
wellness and a few laughs.
Speaker 2 (38:13):
Take care, you've.
Speaker 1 (38:14):
Been listening to Your Health First with doctor Joe Galotti.
For more information on this program or the content of
this program, go to your health First dot com.
Initial life Sequencing coming to you live from Houston, Texas,
home to the world's largest medical.
Speaker 2 (00:08):
Center, and he approach raises everything looking.
Speaker 1 (00:09):
At This is your Health First, the most beneficial health
program on radio with doctor Joe Gillotti. During the next hour,
you'll learn about health, wellness and the provention of disease.
(00:30):
Now here's your host, doctor Joe Galotti.
Speaker 3 (00:41):
Well a good Sunday evening to everybody. Doctor Joe Gallotti.
We're here every Sunday between seven and eight pm raising
your health i Q making you better consumers of healthcare
and allowing you and guiding you you to better understand
(01:04):
how your magnificent body works and having that knowledge to
understand your risk factors for certain diseases, understanding symptoms that
will basically alert you to check in and get the
care you need, and also understanding your Really a very
(01:28):
important part of healthcare and wellness is really understanding your
family history. What did mom die of? What did Dad
die of? Grandma, grandpa, uncles can be a little bit
of a reflection and mirror into your own life, which
is really really very important. Don't forget to contact us
doctor Joe Galotti dot com, d R J O e g.
(01:50):
A L A T I dot com. Go there, sign
up for our newsletter. All of our social media is there.
There's a tab that says contact us, and you could
send me a message and certainly have a two way
conversation with us and our team, the uroalth Fare's team
available to help all of you. So the month of
(02:11):
February is American Heart Month, and it's I mean, we
talk a lot about heart disease because it's so common here.
But we have doctor Joseph Rodgers coming up. He's the
director of the Texas Heart Institute at Baylor College of Medicine.
And doctor Rodgers really when we started the program twenty
(02:32):
three years ago, he was really one of the first
handful of guests that I called upon, not only because
he's a great physician, but he's a great communicator and educator.
And the thing about the idea of American Heart Month,
where we focus on women's heart disease, which is very important,
and heart disease and man adults, adolescence, it's very important.
(02:59):
You really have to stand the numbers that in you know,
twenty twenty three, which is a few years ago, there
was close to a million people that died from cardiovascular disease,
which is equivalent to one out of every three deaths.
Someone dies every thirty four seconds from cardiovascular disease. One
in twenty adults have cardiovasc you know, carnary arter disease,
(03:23):
which is a cholesterol build up and plaque in your arteries.
Heart attack. Every year, about eight hundred thousand plus people
have a heart attack. All right, doctor Joe Glatti.
Speaker 2 (03:36):
We're here every.
Speaker 3 (03:38):
Every single Sunday between seven and eight regardless of Super
Bowl Sunday. So all the Super Bowl widows and widowers
that are looking for alternative entertainment, Your health first is
the place stay tuned. We're burright back every Sunday evening
between seven and eight pm. We are glad you're here,
(04:02):
raising your health i Q, making you better consumers of
healthcare and doing your best to stay out of the hospital,
out of the er, because we would always say that
knowledge is really the most important thing all of you
can have as consumers. And as we were saying earlier
on the program, the month of February is American Heart Month,
(04:26):
and it's an opportunity, even though I think every day
should be American Heart Month, talking about heart disease and
some of the sobering facts about heart disease. Number one
is the leading cause of death for men and women.
One person dies every thirty four seconds of cardiovascular disease.
So during this segment, unfortunately a number of people are
(04:48):
going to die. And in twenty twenty three, close to
a million people died from cardiovascular disease. And who better
to talk about this is doctor Joseph Rodgers. He is
the director of the text Heart Institute at Baylor College
of Medicine. A dear friend and colleague, doctor Rogers, welcome
back to your health first.
Speaker 2 (05:08):
Well, doctor Glotti, it is always my pleasure to join
you on a Sunday to talk about cardiovascular health.
Speaker 3 (05:14):
I know, and at Super Bowl Sunday, and so we're
both taking breaks from the game. But that's it's a
job we've got to do, Joe, it's a job.
Speaker 2 (05:22):
We got to do.
Speaker 1 (05:24):
I know.
Speaker 3 (05:25):
So the numbers you know very well, and that is
you know your mission and you and all of your
colleagues to combat such a big disease that we we face.
But like so many times we've talked about, it is awareness,
it is understanding, and so here it is. It's the
(05:47):
twenty eight days of February American Heart Month. What what
would you say just for this month? Is your objective
as a leading cardiologist leading the Texas Heart Institute, a
world renowned center that everybody tonight needs to know and
hopefully whoever we reach tonight, they tell a person and
(06:09):
then they tell another person. So what's what's your take
on this whole notion of American Heart Month?
Speaker 2 (06:15):
Well, so, I first, I love so many of the
things that you just said as a way to introduce
the importance of cardiovascular disease and understanding it. And I
think the thing I would love for people to walk
away from our conversation this evening is to feel empowered
to ask questions about your cardiovascular health, right And you
(06:37):
know there, we know that there are modifiable risk factors
for the most common form of cardiovascular disease, which is
which is athrosclerosis or hardening. The art reces are just
different names for the same process, sure, but that's the
most common, you know, sort of preventable cardiovascular disease, and
(06:57):
the risk factors haven't changed in any appreciable way, with
a couple of exceptions which we can talk about, but
it's the things that we've talked about. It's high blood pressure,
it's high cholesterol, it's diabetes, it's obesity, and we are
now developing even more effective treatments for these pre morbid
(07:19):
conditions that will help people prevent. The other thing, Joe,
is that that the Heart Association, I think wisely and
based on data, is beginning to change the thresholds by
which we which which tell us to treat. And what
we're realizing is that we were way too liberal in
(07:39):
our recommendations at the beginning. You know, we were telling
people that they could get by with blood pressure that
was higher than we would acknowledge today is acceptable. Same
with cholesterol. And I think that's the thing that we
should be talking about today is what are those current
guidelines and and and sort of so that people when
they go to their doctor, they can say, Okay, well listen,
(08:00):
my blood pressure seems to be a little bit higher
than the guidelines would recommend, or my cholesterol seems to
be higher than the guidelines would recommend. What can I
do to lower my risks? Yeah?
Speaker 3 (08:11):
And these are great things because number one, we both
believe in having a dialogue with your physician and your
care team. You have to ask questions, you need to
take the lead. But the other thing, like so many
other disease states and including liver a disease that I
(08:32):
take care of, people will get a false sense of
security if I had heart disease, well, you know, gee,
I would know it. So I think I am okay,
And that is probably mistake number one. I feel good,
I'm working, I'm going on vacation, everything is just hunky dory.
(08:53):
How could I have a heart problem. So, you know,
let's stop talking about it. Address that for a moment.
Speaker 2 (09:01):
Joe. Yeah, no, you're you're right, Joe. The hard part
about especially acquired heart disease like atherosclerosis, is that it's
most of the time asymptomatic, and tell it's a major problem.
At that point, it's hard to reverse it, right, So
it's all about prevention. It's all about preventing those plaques
(09:24):
from forming inside the arteries, because by the time you
get symptoms, you probably have at least a seventy percent blockage, right,
and getting those to they can regress over time with
very aggressive treatment. But what better strategy than to keep
it from ever getting to be you know, a seventy
percent blockage.
Speaker 3 (09:44):
Yeah again, And I tell people that it's like, look,
we put smoke detectors in our house to pick up
the earliest sign of a fire, not until the whole
damn place is, you know, in a flame engulf, to say, oh, hey,
we've better call the fire apartment.
Speaker 2 (10:00):
It's really early warning.
Speaker 3 (10:02):
So get to really I think the two biggest things
the numbers on high blood pressure or a normal blood pressure,
and the cholesterol story, because that patients still will say, eh,
you know, my cholesterol is just a touch elevated. So
where as an expert, where do we go with this?
Speaker 2 (10:19):
Right? So, most people who are listening and who have
you been thinking a little bit about blood pressure probably
recall that you know, in decades past we said, well
we think the right blood pressure should be under one
forty over ninety. I think what we're recognizing is that
there is an important reduction in cardiovascular events even with
(10:44):
blood pressure, as we lower blood pressure below one forty
over ninety. And so, Joe, the current guidelines really tell
us to try to get that blood pressure closer to
one twenty over eighty. Now here's the hard part for patients,
and if that's it's not easy. So once you've done
all of the things that you can do to modify
(11:05):
your risk of high blood pressure, like getting down to
a normal body weight, taking the salt out of your
diet as much as you possibly can, you know, treating
sleep apnea. So many people have sleep apnea that drives
high blood pressure. Once you get through all of those
steps that are in our control, then it often takes
(11:28):
a couple of medicines to get the blood pressure down
in that range. It's oftentimes not just one pill, but
in terms of the things you can do to lower
your risk getting your blood pressure down into that one twenty,
maybe as high as one thirty, but not higher than
that range on the top number, that's important. The same
(11:49):
with cholesterol. You know, we used to sort of look
at the risks of cholesterol and we used to say, well,
we'd like to get your total cholesterol ought to be
down under two hundred, and your bad cholesterol, which is
the LDL cholesterol, ought to be down under one hundred.
There's some really compelling new data that what we ought
to be doing is driving bad cholesterols down into the
(12:12):
forty or fifty ran that's your LDL cholesterol. And so,
you know, like you said, many people say, well, you
know my cholesterol is just a touch high. Well, those
people's cholesterol is actually too high. And if we're going
to so so anyway. And then there's one other lipid
thing I think that's important to sort of get out
in the public's awareness, and that is we've realized recently,
(12:35):
and it's probably since the last time you and I
spoke on the show. There's a there's a new lipid
particle that is sort of coming into focus. It's called
LP little A and it's sort of a it's the
bad cholesterol molecule that's wrapped in a couple of different proteins.
But there is a very clear relationship between LP little
(12:55):
A elevated levels and your risk of cardiovascular disease. It
seems to be principally genetically determined, and we now have
tests for it. Now. The tricky part is we don't
have great drugs yet, but there's probably one that will
be out, could be this year, to treat that problem.
And it's a one time test, so the next time
(13:16):
people get their lipid levels tested with their primary care
doctor or their cardiologist, whoever you see, you're endochronologist, you're hepatologist,
You ought to get and you ought to get an
LP ask for an LP little A just so you
understand what that level is. And when we have therapies
we'll be I'm sure we'll be using that as a target,
(13:39):
another target to lower people's risk.
Speaker 3 (13:42):
Okay, So here's the challenge in the scenario, A fifty
five year old patient has been told by his primary
care doctors and a chronologist maybe even as cardiologists hopefully
not that you know, your cholesterol is a little elevated,
(14:02):
it's not that bad. And you go in saying I
want this LP little A and it's like, why it's
you don't need it. I'm telling you your cholesterol looks okay.
What is the comeback to the physician or nurse practitioner
to say, no, I really want to have this done.
Speaker 2 (14:25):
Yeah. I mean, I think your question is a really
incredibly insightful question because I think there are a lot
of practitioners out there who aren't thinking yet about LP
little A. Right, it can be distinguished. It can be
measured differently than LDL cholesterol. You can have a fairly
normal LDL cholesterol but a high LP little A and
(14:48):
your risks are higher. So so again this idea that
you started with that knowledge is power, right. I think
that people should be aggressive and proactive. It's it's a
one time it's not anything today that we understand that
you need to keep measuring over and over again, right,
But I would I think I would recommend people start,
(15:10):
you know, sort of thinking about getting an LP little
A right.
Speaker 4 (15:14):
Right.
Speaker 2 (15:14):
The other thing that I think has been really revolutionary
is the use of cornary calcium scoring, which is a
it's a five minute test and a cat scan and
we look for early deposition of calcium in the walls
of the blood vessel. And what that tells us is
that people are starting to get hardening of the arteries
(15:35):
or ath those sclerosis. And if you have a positive
cornary calcium score, it tells it should tell all of
us that you're starting to get the disease, and we
need to be much more aggressive about risk factor modification
and especially lowering your cholesterol.
Speaker 3 (15:50):
And again, the key thing is people that are asymptomatic
that they feel good, they may be exercising, but it's
one of those things that you you get these results
and you have to say, despite how I feel, I
really need to take action, and that I think if
there's any message here that really is what we need
(16:12):
to do. The other thing is a lot of people,
probably for the past twenty five years, people have had
this almost hysterical reaction to statins. Statins are bad. I
had a friend that couldn't walk after they took a statin,
and so I want no part of that. How do
you talk that person off off the off the ledge.
Speaker 2 (16:36):
Yeah it so there's no I mean, there is no doubt.
And I think you and I will completely agree about this,
Like all drugs have side effect, sure, and so, but
if you look at the majority of people and you
look at the net benefit that people get from the statins, right,
it outweighs the adverse events. Now, that doesn't mean that
(16:58):
as an individual person, you're not going to get muscle
discomfort from a statin. The other thing people always talk
about is that it's there and it's sort of prevalent
on the internet.
Speaker 4 (17:09):
You know that.
Speaker 2 (17:09):
It's that statins are linked to early neurocognitive changes like
early dementia. I'll tell you, like we have, we have
done everything we possibly can to understand if there is
a linkage between statins and neurocognitive decline, and we are
unable to prove that. So, so I think statins remain
(17:31):
the foundational therapy for high cholesterol. There's a new class
of drugs called the PCSK nine inhibitors. Today. Those drugs
are injectable. They work a little bit differently, they have
a different adverse event profile, and they really lower cholesterol
and can get the LDL cholesterols down in the range
(17:52):
that we just talked about a few minutes ago. But
up until now injectable drugs, they have to be injected
every couple of weeks. But there is a new pill
that will probably come out this year that's an oral form.
Speaker 3 (18:09):
Now your colleagues didn't one of your colleagues at Texas
hartwork on.
Speaker 2 (18:12):
That, Yeah, Christy Balentine was the principal author on that paper.
It just came out in the New England Journal of
Medicine this week. Yes, but it's I think it's going
to be one of those game changing therapies. Now, of course,
we'll have to understand and as we test more people,
we'll have to understand what the adverse events are that
are associated with that medicine. And there certainly will be
(18:33):
something because it's a medicine and every medicine has side effects.
Speaker 3 (18:37):
Right, and yes there are, and we have to be careful.
Patients need to be aware. Physicians and care providers need
to know, and you know, certainly inform patients, but at
the same time you have to look at the risk
benefit doing nothing about your high cholesterol and your elevated LDL.
We know you could tell me in five years the
(19:00):
risk of me having a stroke or a heart attack,
But which is real and life changing or life ending
versus a smaller risk associated with a side effect. You
have to weigh that in and not say the side
effect is as bad as not taking it and dying
of a stroke.
Speaker 2 (19:22):
I agree with you, you know, And this is why
drugs go through the rigors of clinical trials, right. And
the question always for the food and drug administration is
the benefit more than the risk? Right? And so with statins,
you know, we've probably I don't even know how many
people we've tested in clinical trials where we follow them
(19:42):
very closely for the side effects of those drugs. And
what we found is you test large populations of patients,
the benefits outweigh the risks. Right now, Once again, if
you're one of those people that has an adverse EVENTTHM.
You should talk to your physician or your advanced practice
provider it and make a switch, right. But most of
(20:02):
the side effects are not permanent, you know, so stop
the drug the side effect goes away, right, and then
come up with plan B and and and come up. Yeah.
Speaker 3 (20:11):
All right, with that said, we're going to take a
quick break. We have doctor Joseph Rodgers on the line.
He's the director of the Texas Heart Institute at Baylor
College of Medicine.
Speaker 2 (20:22):
Out doctor Joe Glotti.
Speaker 3 (20:23):
Don't forget doctor Joegalotti dot com. Stay tuned more part
talk in a minute, you know. The last the last
thing to touch on. And this gets into everybody tonight
and our patients being good consumers or good stewards of
your your human body here and it's awareness of symptoms.
(20:46):
I am sure you see patients that have been the
best of intentions. They come and see you for the
first time. Doctor Rogers, my family doctor said I need
to see a cardiologist because I have high blood pressure.
And when you see hit them down and you start
hearing they have had palpitations, they have shortness of breath,
(21:06):
their legs are swollen, etc.
Speaker 2 (21:09):
Etc.
Speaker 3 (21:10):
You scratch your head and say, you know, you're a
year too late. Not that you can't be salvaged, but
if you had known these symptoms, you could have gotten
in earlier. So what are the symptoms the outward signs
that somebody maybe not definitely, but maybe having a heart
or cardiovascular type issue that needs attention.
Speaker 2 (21:34):
Yeah, so I think this is another really important question
that you've asked. And there's one caveat which I'll explain
at the end. But the things I think that I
would be really thoughtful about are any sort of exertional
discomfort in your chest. Women sometimes don't have the same
(21:54):
kinds of pain that men do. They'll get gi upset.
Sometimes that pain isn't in your it's in your neck
or traditionally in your left arm. I think breathlessness, which
is increasing when you exercise, is another important symptom to
look for. As you said, palpitations or irregular or racing heartbeats.
(22:16):
Pain in your legs when you walk, you know, can
be a sign.
Speaker 5 (22:20):
Of blockage and the leg arteries, which also can be
a tip off. And you know that may be a
tip off in somebody, for example, who's diabetic. And the
challenge that you just pointed out, is a lot of
these symptoms come on and they're very insidious.
Speaker 2 (22:38):
Yes, right, So they start slowly you sort of say, well, gosh,
you know, I used to be able to walk six
blocks and now I can only walk five and a
half blocks. And then a year later it's down to
four and a half blocks, and you start to people
start to accommodate and they don't realize actually that there
are exercise performance for examples changing. So having a high
degree of awareness of symptoms, think, you know, my recommendation
(23:01):
is not to calendard, but maybe take an inventory, yes,
every six months and say has something changed relative to
what I was doing six months ago? And if something's changing,
I think that's the time to get in and have
an evaluation.
Speaker 3 (23:16):
Right, And that is that self awareness. But also what
people will say is yeah, I And I'll ask them
those kinds of questions and they'll say, you know what, Yeah,
I am more short of breath, or I can't walk
as far, but doctor Galotti, I turned sixty five last month.
Or I have a bad hip and it's my hip
(23:37):
and I'm cock eyed and I walk funny and I
can't walk as far. You naturally, I think it's just
a human defense mechanism that you attribute the symptoms that
you just talked about to something completely unrelated to the heart.
Speaker 2 (23:52):
Yes. No, I think you're right, and I think and
maybe it is your hip, you know, but maybe it's not.
And I think that what it should do again is
just sort of set off an alarm that it's time
to get it checked. And if you go through all
the cardiovascular testing and it's all negative, great, it's your
hip in order. So I actually think that you know,
(24:22):
there's nothing to be frightened of in terms of going
in and seeing Listen, this is changing for me. I
recognize that there are a lot of things that could
cause this, but I do also recognize that these symptoms
could be related to your heart. Yeah, so I think
i'd be good for us to at least start some
testing to rule that out.
Speaker 3 (24:39):
Absolutely well, Joe, it is always a delight to have
you on. You are so articulate and knowledgeable, but you
are an expert in heart disease. Doctor Joseph Rodgers, director
of Texas Heart Institute at Baylor College of Medicine, my friend,
thank you always for coming on. Joe, Thanks so much,
(25:00):
all right, thanks a million now all right, we are
gonna follow up here. It's always a pleasure having doctor
rogers on such a great educator, great clinician, but a
great educator. All Right, stay tuned, we will all right back.
All right, final segment of this week's Your Health First
(25:23):
Super Bowl edition. For all those that don't like football
or have a dislike for the England Patriots, We're glad
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(25:44):
doctor Joglotti dot com.
Speaker 2 (25:46):
All right.
Speaker 3 (25:46):
So the on the phone here wrapping things up for
the night is Natalie Oliver, one of our physician assistants
at our practice, Liver Specials of Texas and no stranger
to the program, and we were having a conversation earlier
in the week about fatty liver, very common thing that
we see in our practice, very thing, very common disease
(26:10):
in the community, with about one hundred million people in
the United States having fatty liver. So Natalie, why don't
you share our conversation and the sort of the epiphany
you had regarding this conversation around fatty liver disease.
Speaker 4 (26:27):
All right, absolutely, So, first of all, thank you so
much for having me back. It's great to be here.
But yeah, so all day at work we're talking about
fatty liver disease. We're talking with our patients, and it's
so great to get to come on here to educate
more people because I will tell you fatty liver diseases
is alive and well.
Speaker 2 (26:47):
Yes.
Speaker 4 (26:47):
And this question that kept circulating in my head was
is mash contagious? You know, you look around our waiting
room and so many people have MASH and it's a
little bit of a silly question.
Speaker 2 (27:00):
And I will say now first before you get too far.
Speaker 3 (27:03):
And we've talked about the define mash m A s H.
Speaker 4 (27:09):
So MASH is metabolic dysfunction associated's diado hepatitis, which only
makes sense that we say mash instead. But that is
the inflammatory version of fatty liver disease, and fatty liver
with metabolic syndrome, you know, plays into your pre diabetes, diabetes,
high blood pressure, cholesterol weight, a little bit of thyroid disease,
(27:33):
but again metabolic driven a lot of lifestyle there. And
when you look around again our waiting room, it seems
that so many people this question kept hitting me. Is
mash contagious? Right, and in the sense of can you
cough and give your your neighbor mash?
Speaker 2 (27:50):
No?
Speaker 4 (27:50):
And the obvious answer is no. But the more I
thought about it, you know, it is so common to
see mash within or again fatty liver within a family
or within people who live in close quarters that I
think the question almost started to make more sense to me.
And when you think about it, so in the same household,
(28:11):
we are eating the same we have similar meal timings.
You know, the spouse is getting home late from work,
so we're all eating at eight pm. Or you know,
someone's tired, so that means no one in the family
goes for the family walk, right, or you know, we
you know again, we start to eat the same and
we could have some of the same health complications. And
(28:32):
so you know, in in our office, I can't tell
you how many times I'm sitting, you know, with our
patient and we have the husband or wife in the
corner of the room and we're talking about their risk
factors and I'm like, your is your husband okay? They're
like sweating in the back of the room, and they
asked the question could I have this too? You know,
(28:53):
could I potentially have fatty liver? You know, I know
we're here for my wife and I want to stay
on topic, but you know, most of what you've mentioned,
I also have this right, and they're so right, and
you know, I love that we you know, within our
practice we try. I care so much about my patience,
(29:14):
but by doing that, you also have to care about
their family. Yes, and to have the privilege to identify
more people with fatty liver, treat more fatty liver, and
prevent the devastating complications of it. We it's it's so important,
so again knowing the risk factors so we can screen
their family members too.
Speaker 3 (29:34):
Yeah, and I think the the idea that this disease,
fatty liver, is contagious. We think of things like COVID contagious,
the flu, r measles, pneumonia, different skin infections that you
have contagious. But here it's really a play on words
(29:57):
to say it is contagious in the sense that everybody
around you has this disease. And you and I both
have seen a grandparent or let's say the seeing your
patient in the family, so the grandmother is brought in
by their daughter who has fatty liver. And the next visit,
(30:22):
the granddaughter comes in. They've got fatty liver and they
have a child. So you could literally see four generations
have the same disease. And that is I believe what
you're getting at.
Speaker 4 (30:37):
Yeah, and we know that when you have a bloodline
family member who has fatty liver, you are also at
a twelve times increased risk. So by all means, if
you're out there and you have fatty liver, have your
mom screen, have your daughter's screen. But also you know
the husband or the wife, people who aren't blood and
living within the same house are also at risk and
(31:02):
need to be identified too.
Speaker 3 (31:04):
Yeah, and I would say that certainly the old saying
that you know, a family that sticks together, eats together,
et cetera, et cetera. But so much of the driving force,
the fuel that is creating all of this metabolic syndrome
and diabetes and obesity. And you know, of course the
fatty livery we see is driven by diet and lifestyle.
(31:28):
So you're married, I'm married. We do things together with
our spouse, significant other, family or children. So it makes
sense that if you are eating a bad diet process
foods you're eating out drive through. There's a good chance
the other two or three people in your family or
(31:49):
household are doing the same thing.
Speaker 2 (31:50):
And here we go.
Speaker 4 (31:52):
Yeah, and you know, in our practice, when we start
having these conversations and uncovering that everyone's eating the same way,
and we'll actually do a fibro scan the same day
for that patient. You know, again, care about the patient,
we care about their family, and we uncover, Wow, they
actually had more advanced disease than you did. These come
(32:13):
with no symptoms. And it's also, you know, on the
flip side, such a great opportunity to then treat it
so it doesn't progress and you know, impact the patient
and the family. But yeah, it's it's it's so important
to know your risk factors and share this.
Speaker 3 (32:33):
With your family, right and I and I would say
that the million dollar question, or the million dollar hurdle
for us is how do we break this really really
vicious cycle of of uh, you know, sort of poor
lifestyle choices, diet, lack of exercise, not enough sleep. Because
(32:55):
where you really can impact the other people in your
house by you you're eating better, You're putting on your
sneakers and trying to exercise, you could bring people with you.
So what would you say, oh that two or three
easier steps to get people to break this really cycle
of chronic disease.
Speaker 4 (33:15):
Yeah, and it is the million dollar question. And the
beautiful flip side of this is that couples and families
who are eating well together or who are exercising together,
also we're seeing the lack of chronic disease, right. And
I think the biggest thing is starting small, setting small
goals so where it doesn't feel so impossible that you know,
(33:38):
you have this great visit and then you're like, hey,
that's not practical and you go home and don't change
a thing. But tangible small goals. So if you're eating out,
you know, for every meal, maybe you can commit to
making your meals at home. You commit to and I
think that's when you start to take control of the
ingredients you're using, you know what you're eating. And then
(34:02):
exercise movement. You don't have to start turning for a marathon,
but you commit as a family and you sit down
and you say, you know what, four days a week,
we are going to do something active. And if you
hate running, don't run. But maybe y'all all get bikes
or you get a stationary bike, or you know, you
you swim something, so you have you know, making meals
(34:25):
at home, your exercising, and then in particular at home Michael,
so making meals at home. You could also make poor meals.
But I would say focus in Mediterranean style meal planning
is the name of the game. With fatty liver, high
fiber in your in your diet, high protein in your diet.
(34:46):
And then you see just whole real foods and making
it fun. You know, you find recipes that you're not
going to like and don't make them again, but you
may find some some really good recipes that start to
you keep the family cookbook for and you pass these down.
And it's all about a little trial and error.
Speaker 2 (35:06):
It really is.
Speaker 3 (35:06):
And I don't believe some families that we see are
so ingrained in a certain pattern that they eat a
certain style, but they have to really break out to
say I need to expand and eat more vegetables. I
need to expand and have different kinds of fruits and exercise.
And we're saying this not to force a certain lifestyle,
(35:30):
the lifestyle of Natalie or the lifestyle of Joe or
anybody else. But because we know these are families, this
contagious family, they are on a collision course with chronic
disease and a lot of sufferings. So last thirty seconds, Natalie,
how do you really wrap up this crazy but really
(35:54):
great theme that this is a disease, fatty livery is contagious.
Speaker 4 (35:59):
Yeah, I mean in that you joke that we have
a crystal ball in the people's lives. And with that,
it's we know what can happen if MASH is not
identified and if it's not treated. We treat patients with
really devastating liver disease. And if we can just take
the conversations we have today with patients, if I could
(36:19):
have these with our patients in the hospital, and if
we could go back in time, they would and we
are faced with this privilege to have conversations with the
patient that then transcend into conversations they have with their
kids and their families. And if we can treat fatty
liver in one I believe we can treat it in
a generation of people and their family And that's what
(36:42):
I want to focus on. And every it's a challenge
every day, and it's a great place to be and
I hope people listening now will go get their their
family members screen because we want the family to be healthy.
Speaker 3 (36:52):
Absolutely absolutely support healthy families.
Speaker 2 (36:56):
Natalie.
Speaker 3 (36:56):
All right, we do, Natalie Oliver with our Practice Liver
Specialists of Texas Physician Assistant, really really very thoughtful idea
and it's going to be provocative. So you know, you
want somebody listening tonight to go to their family doctor
and say I heard on the radio that my fatty
liver is contagious. You know, I think we would both
(37:18):
be so happy if that started and have some doctor
callis and say, what the hell are you saying? You're
fatty liver is contagious. I'm like, wait a second.
Speaker 2 (37:27):
You have to understand.
Speaker 3 (37:31):
I think that Natalie, you you came up with the idea,
and I think we have to keep supporting you on that.
So well, Natalie, have I have a great night, appreciate
you coming on.
Speaker 4 (37:44):
Thank you so much for having me.
Speaker 3 (37:46):
We'll set time, all right, all right, so you know
here here we are. I mean, this is this is
just great, great dialogue. All right, So thanks to doctor
doctor Joe Rodgers talking about heart disease, Natalie Oliver talking
about the contagious nature of fatty liver, wink wink, and
uh of course go to doctor Joegalotti dot com and
(38:08):
next Sunday we'll see you back for more health and
wellness and a few laughs.
Speaker 2 (38:13):
Take care, you've.
Speaker 1 (38:14):
Been listening to Your Health First with doctor Joe Galotti.
For more information on this program or the content of
this program, go to your health First dot com.
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