March 8, 2026 • 42 mins
Dr. Galati talks about March being Colon Cancer Awareness Month and what you need to know about it. He also has his sister Celeste Galati join the show to explain DNR (Do-Not-Resuscitate) and the spiritual side of Hospice. Dr. Galati also tells the story of a patient who had chronic liver disease and the importance of addressing any chronic disease you may have.
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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 in the approach rades everything looking at.
Speaker 1 (00:19):
This is your Health First, the most beneficial health program
on radio with doctor Joe Bellotti. During the next hour,
you'll learn about health, wellness and the prevention of disease.
Now here's your host, doctor Joe Bellotti.
Speaker 3 (00:48):
Well, it's Sunday night again in America. That means you're
turning into your health First every Sunday between seven and
eight pm. Broadcasting from our world headquarters here in Houston,
Texas and broadcasting really around the world on the iHeartRadio
(01:11):
app bringing you all the best in health and wellness,
making you better consumers of healthcare. I say this every
show at the beginning because that is at the most
granular level, what all of us are trying to do,
(01:32):
making you better consumers. So you might be saying yourself, well,
where do you come off saying that we're bad consumers
of healthcare? Well, I can say that, not in a
punitive way, in a caring way because taking care of
(01:53):
patients you get a window of sort as to speaking
with them and listening to their symptoms and how long
this has been going on for and we see patients
that have all kinds of complaints symptoms. They have blood
(02:18):
in their stool, they have shortness of breath, they're gaining
weight despite thinking that they're eating better. They have diabetes.
They're on seven different medications. And if they were good consumers,
(02:41):
they would understand the implication of having diabetes, high blood pressure,
and high cholesterol. That is a prescription for a shortened life,
chronic disease, heart attack, stroke, kidney failure, liver failure. But
yet people are sort of willing to just follow directions,
(03:07):
take their pills, go to Walgreens every ninety days and
get refills. But being that better consumer, you'll say, wait
a second, why do I have to take another medicine
for my blood pressure? What can I do differently? Diet, exercise,
have a conversation with the doctor. And that's where we
(03:29):
want you to be better consumers, to speak up. But
like anything in life, if you're going in to talk
to your boss about a raise, you'll want to have
the facts as far as how you've done your productivity,
how much you've added to the company, instead of just
(03:50):
walking in there and saying, hey, I just want more money.
And your boss says you stink at what you do.
So I get it. A lot of people are truly
in intimidated to talk to the doctor question why something's
going on. But that is where the more you know,
(04:10):
the more secure you'll be and you can be that
better consumer of healthcare. Raise your Health IQ all right,
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(04:33):
could get a copy of my book Eating Yourself Sick,
available in audible, hardcover, softcover kindle. We're in the process
of finishing up a new book. It's going to be
a book that is going to highlight about fifteen really
(04:57):
true life patience of mind that I've had just unbelievable stories.
Now a few of them did not survive, but despite that,
they have amazing stories. And I'll also be sharing a
little bit about myself and my journey through life and
(05:17):
the influences I had really as a young child that
have carried with me today. So it should it should
really be a very good read. And we're in the
final sort of final touches of it. It's taken a
little bit longer than I had thought. But like anything
(05:40):
that's good, you have to put some some thought into it,
all right, So uh, doctor Joeglotti dot com? All right,
So the month of March is colon cancer Awareness month.
I was watching the Today Show the other day. It
was on at the hospital, and they really had an
(06:02):
extended segment on colon cancer, which I thought was very good.
But what is it that all of you need to know? Well,
first of all, it is the third leading cause of cancer,
so this is not a minor, rare cancer. It's pretty
common and last year there were about about one hundred
(06:28):
and sixty thousand new cases and about fifty five thousand deaths.
Now you can look at this and say, is this
a preventable disease? Well, I would say a lot of
them could have been prevented with screening, being a better consumer.
(06:50):
The incidents is about one in twenty four people in
their lifetime will get colon cancer. Survival rate is ninety
one percent for local stage limited disease. It drops to
fourteen percent for patients in the late stage. And there
are about four hundred cases diagnosed every day now. There
(07:14):
is something very interesting going on with colon cancer and
there have been a number of articles about this. It's
happening in younger individuals. So for a very long time,
colon cancer screening started at fifty years old. It was
sort of the butt of a lot of jokes, no
(07:35):
pun intended that, how Bob's turning fifty and it's time
to go for your kolonoskoby. There are actually colonoscopy birthday
cards for fifty year olds. Well those are no longer
any good because colon cancer screening starts at age forty
five now. And the reason it was rolled back by
five years is that a number of younger people was
(07:59):
showing up with colon cancer and nobody is really quite
clear why. Lots of candidates, lots of ideas, as you
can imagine. Is it the diet. Is it something about
processed food, artificial colors, artificial sweeteners that could be Is
(08:24):
it part of the obesity crisis. Well, we do know
that obesity leads to chronic inflammation throughout the whole body,
so why can't you have increased inflammation in your colon?
They are suspecting maybe inactivity. So where there's obesity there's inactivity,
(08:47):
and I think everybody would agree. In the last twenty years,
with the rise of handheld devices, computers, screen time, bulk
watching television, we're not moving around as much and that
may have been a contributing factor. And they're also floating
the idea of microplastics. Micro Plastics they're causing everything from
(09:12):
Alzheimer's to cancer, to heart disease and stroke. So this
whole microplastic story is now sort of bleeding into colon cancer.
So that is it third leading cause of cancer, about
(09:33):
fifty five thousand deaths each year, one hundred and fifty
two thousand, one hundred and fifty five thousand new cases
every year, and it's happening in younger people. This is
something we need to be careful about when we come back.
What I what I would probably say, let's we'll talk
(09:53):
about some of the symptoms of colon cancer so that
you're a better consumer and you really do not get
fooled by symptoms you may have or somebody in your family.
I would say, everything you learned tonight, yes, apply to yourself,
(10:16):
but what about the other people in your house, your children,
your own brothers and sisters, your wife or husband, boyfriend,
significant other, your best friend, Bob, the guy that sits
next to you at work. This information can be spread widely.
All right, I'm doctor Joe Galotti. Always a great pleasure
(10:38):
to be here on Sunday evening spending a little time
with all of you. Stay tuned, o' breight back, Welcome back, everybody,
doctor Joe Galotti. Every Sunday between seven and eight pm.
Your Health First is on the radio. Don't forget doctor
Joegalotti dot com. Doctor Joe Galotti ga la TI dot com.
(11:01):
Everything you need to know about the program, past programs,
podcast blog posts, lots of health and wellness information as
well as well certainly links to all the health and
wellness information that we post YouTube. But also our medical practice,
(11:23):
which is Liver Specialists of Texas Texasliver dot com. We
take care of people with liver disease, digestive disorders, zorosis, alcoholism,
alcoholic zorrosis, liver transplant, liver cancer, gallbladder issues, anything with
your gut and your liver, guts and liver, we take
(11:45):
care of it. Liver Specialists of Texas. All right, So
we were talking about colon cancer last segment. Colon Cancer Awareness
Month and what do you need to know? All right,
So colon cancer does not normally just jump out and
bite you on the nose and you say, WHOA, I
(12:07):
got colon cancer.
Speaker 1 (12:08):
Today.
Speaker 3 (12:10):
It's very insidious, meaning you may have some vague symptoms.
Now it is for you to interpret these vague symptoms.
You have to say, this ain't right, this is different,
(12:31):
something is going on here. I have to act up.
I have to act I have to talk with somebody
and get some assistance. So what are some of the
symptoms related to colon cancer? Now let me just back
up here for a second. The key to colon cancer
(12:54):
is prevention. It is prevention. So prevention is avoiding excess alcohol.
It is avoiding red meat. It is avoiding processed meats,
the salamis, the pepperonis, the deli meats, the cured meats.
(13:14):
It is avoiding processed foods. It is maintaining a healthy
adequate weight. If you're overweight or obese, you have to
set up a strategy to lose weight smoking. So those
are the lifestyle type things. Now, as far as screening goes,
(13:43):
we said earlier forty five years old is when you
start screening. Now, there are different tests that you could
do at one end of the spectrum. The gold standard.
The best test is a colonoscopy. Now you can look
at a colonoscy and say, well, I have to take
the bowel prep the day before, I would say it
has gotten better. It tastes better, and you don't have
to drink as much. Number two, the procedure itself is
(14:07):
done under sedation with anesthesia. It is safe and you
will get the information you need. Looking for polyps, that
is screening. We're not looking we don't. We don't do
Kolonoskoby's looking for cancer. We do Kolonoski's looking for polyps
that may be pre cancerous. Other studies are screening strategies
(14:34):
would be you know, they're really in this stool category
where you submit a specimen, a stool specimen, and it
is sent off to a dedicated lab looking for some
of the genetic characteristics of either polyps or colon cancer.
(14:56):
Colon cancer colon polyps give off a particular chemical signature
in your stool. This test is able to detect it
all right. Now, if that test like cola guard is positive,
you are obligated to get a colonoscopy. Little hint here
(15:16):
if you have a family history of colon cancer, you
are yourself high risk for colon cancer with different conditions,
or you've had polyps in the past, colon gard is
not the proper test for you. But if it's screening
no symptoms, never had polyps, colon guard is okay as
(15:38):
a first step. So that typically is the screening part.
It's a stool test or a colonoscopy flexible sigmoidoscopy where
they only look at about a quarter to a third
of your colon. That really is nineteen eighties technology. Why
would you look for colon cancer or polyps and say
(15:59):
I'm only going to look at a third of your colon?
What are you going to do keep your fingers crossed
and hope that the part you don't see has no polyps?
It makes no sense. The main thing here is symptoms
that would alert you that something is wrong. You may
have none, you may have all, you may have multiple.
(16:20):
It may be something as simple as just abdominal discomfort,
some bellied discomfort. You may describe it as cramps or bloating,
maybe a little nausea, maybe a little loss of appetite,
maybe even heartburn or indigestion. Bloating that in itself, that
does not mean you have colon cancer. I think it
(16:40):
means you need to get this checked out. Do not
go to chat GPT so so very vague general GI symptoms.
The other would be a change in your bowels that
we say so change in bowels would be becoming increasingly
constant pay or having more diarrhea, either one of those.
(17:05):
If it's if it goes on for more than a
few days or a week, you have to really say,
why am I constipated all of a sudden. It's a change.
Why do I have diarrhea? I never have diarrhea? Why
do I have it? Is there something wrong? It may
be colon cancer, It may be an infection, it could
(17:25):
be anything. But you have to get it looked down.
But one of the things on the list is maybe
colon cancer, especially if you're over forty. The other thing
is blood in your stool. Now a lot of people
will say they have blood in their stool.
Speaker 1 (17:42):
I have a.
Speaker 3 (17:43):
Hemorrhoid, I strain, I'm constipated. I've been sitting on an
airplane for thirty six hours. I drive a truck. Whatever
the case may be. All right, everybody is allowed to
have hemorrhoids. Millions of people have hemorrhoids. Hemorrhoids don't kill you.
But if you have blood in your stool and you
(18:08):
are thinking, ah, it's a hemorrhoid, but you're also having
more constipation, more abdominal pain, maybe losing weight, something is wrong.
Don't don't just say it's it's those darn hemorrhoids. My hemorrhids.
Get some preparation. H That's not That's not the answer.
Speaker 1 (18:27):
And so.
Speaker 3 (18:30):
You have to really be in tune with your body.
The other thing is with the constipation. Constipation is one thing.
The other thing to you look out for is if
your stool, the caliber of your stool, the size of
your stool gets very narrow. People will say it's like
a ribbon, or people will say it's like a pencil.
(18:54):
Remember Plato when you were a kid and you take
this big lump and you'd squeeze it through these different
shit apes had come out like a little worm. But
that's what somebody's stool could look like. So it is
not only more constipation, but is the character of the
stool different, i e. Narrow, ribbon like, pencil like. And
(19:18):
people will come in having no idea that we described
this as pencil like, and they will say, yeah, you know,
my stool's coming out like a pencil. And we're like, okay,
something's wrong here. So I ask all of you to
really really pay attention for yourselves or those around you.
(19:39):
A lot of people talk health around the water cooler,
and if a colleague of yours fifty year old, fifty
sixty year old guy, he's like, man, I've had this
abdominal pain. I've been constipated. You can say, hey, has
the shape of your stool changed? Is it pencil like?
Is it ribbon like? And they're like, yeah, you know,
that's exactly what it's like. Then you accompany them to
(20:03):
the gastro neurologists to get evaluated. All right, So this
is a family affair. We have to talk to each
other about our health, all right, News, traffic, weather coming
up in moments. I'm doctor Joe Galotti. This is your
health first, making you all better consumers of healthcare. I'm
(20:25):
telling you that is what we're doing every weekend. Well,
very back, Welcome back everybody, Doctor Joe Glotti, thanks so
much for tuning in on this Sunday evening. You know,
the weather has been a little rough this weekend. Lots
of rain yesterday in the Houston area's drizzling tonight. But
(20:47):
it's a chance to recharge over the weekend, and I
hope you're getting looking forward to the coming week and
planning out your exercise, your diet, your nutrition and phototing
your best foot forward with regard to health and wellness.
Don't forget doctor Joegalotti dot com is our website. So
(21:08):
right now we have on the phone my sister Celeste Galotti,
and we've had her on before. She is a nurse,
but really she has spent a large, large part of
her career in the hospice arena. Celeste. Welcome to the
program tonight and thanks for taking a few minutes to
(21:28):
come on tonight.
Speaker 2 (21:30):
Hey jam Me again.
Speaker 3 (21:33):
Always happy to have you on as an expert. So,
you know, the one topic that we were talking about
is DNR do not resuscitate. And I believe a lot
of people have heard that term, but they're not quite
sure what it is. Could you explain as simple as
you can what that means and really what does everybody
(21:55):
need to understand about DNR.
Speaker 2 (21:58):
So dn R is the term, Yes, I think everybody's
heard what dn R the term, but it really means,
like you said, do not resuscitate. And basically what a
dn R is it is a legally binding medical document
that needs to be signed by a physician, by the
patient's primary care doctor or their hospice physician, and it
(22:21):
basically is instructing any healthcare professional, whether it be nursing staff,
hospital staff, ems responders, not to perform CPR if the
heart stops. So that is something that I think a
lot of people lack in obtaining because it's a hard
thing to talk about. You don't want to talk about
the what ifs. What if I die, what if mom dies,
(22:45):
if somebody is sick with the terminal illness. It is
something that the reality is you need to discuss it
personally and as a family. It doesn't affect any other
forms of treatment. You could still receive therapies, chemotherapy or
any other treatment that you adoptors have you on, but
it just really allows for that natural death to occur
(23:08):
and not have to undergo cardiopulmonary resuscitation.
Speaker 3 (23:12):
Right or anything else that's uncomfortable to make you survive.
And I would say that where I see it as
a problem and you on your end is when the
conversation never takes place, and when the person is most critical,
most likely to pass away. Somebody on the healthcare team
(23:35):
will come up to a family member and say do
you want to sign this DNR? And they may say
I want to do everything. I don't know what my
mother would have said. So the message really is for
the patient ahead of time to have all of these
documents in order. What's your thought on that.
Speaker 2 (23:58):
I totally agree with you there. Initially it should be
a voluntary decision. Whoever the patient is, they should have
a say in what the decision is. So I advise
patients like you said, I'm a hospice nurse, so a
lot of times I'll go into a patient's home where
the patient is still able to communicate their needs and
(24:18):
their wants, and we have that frank discussion with the patient,
with the family around explaining exactly what a DNR means.
It gives the patient the right to make their own decisions.
If the patient isn't sure, if the family members aren't sure,
we give them a little bit of leeway because basically
(24:39):
it's voluntary, so you don't have to sign a DNR.
People have the misnomer of when you're on hospice care
that you have to have a DNR. No, I have
a lot of patients that do not have a DNR,
But we try to educate our patients as best as
possible to let them know that this is your decision.
More than likely, most patients will sign the DNR because
(24:59):
they're tired and their disease processes brought them to a
point where they're ready to go, and they've accepted the
fact that they're dying. Yeah, but yeah.
Speaker 3 (25:08):
Do you do you find that? And and I think
this is this is something uh, people dislike for lots
of different reasons, talking about their their the finality of
their life. Talking about death is not something that people
(25:30):
routinely feel comfortable about. They'd rather talk about anything other
than the thought that they may become ill and die.
And so I think because of that, naturally we just
don't want to address the topic.
Speaker 2 (25:46):
Yeah, we ignore it. We push it, push it, push it.
And I find that sometimes you push it to the
point where now you have to talk about it.
Speaker 3 (25:55):
Right, So which is which is of course the worst
time to make a decision under under pressure?
Speaker 2 (26:01):
Yeah, exactly, emotions are flying, you have family members, but
that may not agree. So that's why I think it's
good to bring in your doctors, bringing your nurses to
have that third party discuss and really educate because most
people don't experience it, so they don't have the full understanding.
So it's always good to talk to your doctor. And
(26:22):
it's those difficult conversations that are hard to have, but
they're necessary. Yeah.
Speaker 3 (26:26):
Now at the flip side, we are putting some of
the onus on the patient and family members to in
a sense, force the conversation or bring it up. But
at the same time, we are both healthcare professionals. I
am going to say that the physician since this is
really a physician driven process, but certainly nurses like yourselves
(26:50):
are in the process too. I am going to say
that physicians themselves shy away from these tough conversations, and
then what do we do about that if the patient
is not being led by their doctor.
Speaker 2 (27:06):
That is a very tough situation because I know a
lot of doctors look at it if they've done everything
they could for their patient, but then they're at the
end of the rope. It's almost like they fail their patients,
which they have not. It is just the disease taking over.
You've done everything that you can to get this patient
(27:27):
to at this point in their life, then the disease
takes over. So that's why I think it is important
to have that conversation among family members. It's a fact
of life. We're all going to die, right, So.
Speaker 3 (27:40):
Are you kidding me?
Speaker 2 (27:43):
Yes, it is true. So if you have that elderly
parent that maybe they're in good health, or maybe they've
just said a little cardiovascular disease or something. I think
it's important for the children of the family. If they're
lucky enough they have children to discuss it, somebody has
to bring up and be courageous. Those courageous conversations have
to take place to say, hey, Ma, what do you
(28:05):
want to do? What are your thoughts? Because then if
something happens and the patient can't make that decision, you
all could say, I know mom doesn't want the heroics,
I know mom wants the DNR, even if in fact
she hasn't signed the DNR or agreed to it. At
least the family can make that decision with some education,
(28:26):
knowing that this is what mom or dad wanted exactly.
Speaker 3 (28:29):
Now, the other phrase that makes me cringe a little bit.
Is when you have a patient that is critically ill,
maybe they're not able to make those decisions like you
had said, and you're talking to the family and they
just categorically would say, we want everything done for mom.
(28:51):
And then you're left there and you're like, well, wait
a second, doing everything for mom means what that you're
going to get a liver transplant, a heart transplant? What
do you mean I want everything done? And I think
that is where when when people will say I want
everything done, that is almost that they're having difficulty making
(29:15):
a decision. So instead of saying, you know what, this
is a futile situation, let's go that path, they just
rebound one hundred and eighty degrees. Opposite of that is
let's just do everything. What are your thoughts on that?
And what do you tell everybody tonight? On not really
(29:35):
coming around to say I just let's just do everything
for her. It's almost let me just say this, it's
almost a people feel guilty to say, well, I don't
want to be responsible for pulling the plug on mom.
Let's just do everything.
Speaker 2 (29:49):
That's exactly what it is. And that's such a broad term.
Let's do everything there's so many different levels of care.
So if you're talking about specifically, specifically answer patient, people
say I want everything done, I want mom to go
for chemo radiation. But that's where the family and the
patient need to rely on their healthcare providers when they
(30:10):
say there's really not much more where you could do
and your mom needs to go home on comfort care.
At that point, you have to listen to your doctors
and your nurses, right, you have to, And it's a
hard decision. I've been putting that decision. I've been put
in that situation with families where they feel like they're
(30:30):
giving up on their loved one. But once we get
them on hospice care and we provide that beautiful care
that we provide with our spiritual counselors and our nurses,
they see, Okay, we are doing everything for our mom
now because we're making her comfortable. And then it's just
that switching the way you look at.
Speaker 3 (30:52):
Things right right, And again, I'm very sensitive to that
term I'm going to do everything where some of the
things that come under the category of everything, I'm going
to do everything for us. It's very uncomfortable for the patient,
be it you know, certain procedures, needles and intravenous catheters procedures.
(31:15):
This is you know, it's it. I will always tell
my families the the the number one importance is the
patient and how they feel and or suffering or lack thereof.
And you know.
Speaker 2 (31:31):
I'd no, I was gonna say, I don't forget. I'm
so passionate about that.
Speaker 3 (31:35):
No, no, no, I don't want to do or subject
your mother, brother, sister, husband to a procedure just to
make you feel better that you have a lot of
guilt and a lot of the times there are families
that come together they haven't spoken to their mother in
six months or a year, they never had a great
relationship to have that, and now all of this guilt
(31:58):
of you know, family dynamics is coming to a head
and they're like, well, I don't want to be the
one that likes not resuscitates, so let's do everything. So
what do you? What do you say? And I know
how passionate you are, and it's great to see.
Speaker 2 (32:10):
Yeah, and I am faced with that. I don't want
to stay on a daily basis, but with a lot
of situations and I'll have a very sick hospice patient
that let's say is end stage liver cancer or whatever
the case may be, and they've you know, they've whittled
away there. They've lost you know, forty pounds in their
skin and bones, and they're not eating and their nutritional
(32:33):
status is tanked and they're they're very sick. So you
can almost imagine what this patient looks like. But the
family decides we're going to do CPR on my dad
because we want to keep them alive. That's when I
will go into the home and say, okay, you have
the right to want to perform CPR on your dad.
But when AMS comes in, they're going to perform CPR.
(32:56):
His ribs are going to crack. And you have to
be almost very very graphic, but very graphic about it
because that puts things in perspective. You have a patient
that is you know, five foot eleven and one hundred pounds,
they're going to come in and perform CPR, ribs are
going to crack, You're going to put the tubes down
the nose and throat. Is that really what you want
(33:19):
for your your family, your right your family member who
is ultimately going to die from the disease, So you
have to put it in perspective sometimes and that usually makes
people at least think about it. I've had patients that
have families that have said, oh my goodness, I didn't
think of it that way. Yes, let's sign the DNR.
(33:40):
Others decide not to sign the DNR. And usually those
patients just die peacefully in their sleep and thank God
you don't have to put them through that torture.
Speaker 3 (33:49):
And I think a lot of this and this is
such a multi faceted conversation and problem is that. And
again not to sound overly preachy or righteous about this,
but there are people that are very spiritual in nature.
It doesn't matter what religion or what their beliefs are,
(34:12):
but they're very, very faithful type people, and they understand
they don't want their loved one to suffer, and they
understand that it's more, it's more than just them. It
is about focusing on the patient. And those are the
families that are far easier to have this conversation with
(34:34):
rather than people that aren't really speaking in that spiritual tone.
Because much of hospice, like you said, is very spiritual,
sort of non denominational, but it is spiritual.
Speaker 2 (34:48):
Yeah, And when we admit a patient to hospice. They
absolutely have to have their nurses, but we do as
spiritual counselors that they don't have to see. But I
always advise my families to see them. They're not gonna
make you become a Catholic or Jewish, you know, they
just are in there to talk about the dying process, right,
(35:09):
and to make it an easier transition. And it's the
patients and families that talk to my spiritual counselor are
far better off, right, and it's an easier process for them.
Speaker 3 (35:23):
And I think that you and I, as my sister,
we have gone through several of these personal situations. As
we've talked about before. We lost our sister at a
relatively young age with a severe illness and we had
to make that decision to not, you know, pursue further therapy,
and both of our parents we had to make that decision.
(35:46):
So there's nothing better than going through this firsthand, and
then for us, you and I and our colleagues to
share these stories of just how to do it properly
rather than having a big commotion at the end, which
is really horrible for everybody, it really is.
Speaker 2 (36:03):
And and you're absolutely correct, because I find the families
that I provide care to, the ones that have said,
oh I went through hopsice with hospice with my mother
in law, and you guys were angels. They have a
better perspective on what's to come, and it's a much easier,
smoother transition.
Speaker 1 (36:23):
Right.
Speaker 2 (36:23):
So knowledge is everything right in life. That's you know,
is whether it's medical knowledge or whatever, it's you got.
Speaker 3 (36:31):
It, it really is.
Speaker 1 (36:32):
All right.
Speaker 3 (36:33):
Well, Celeste Galotti, thank you very much for coming on tonight.
It's uh, you know, this is a topic that really
we can never hear enough about, and I think you
are certainly a great voice and advocate for patience, and
so it's great to have you on.
Speaker 2 (36:49):
Well, thanks Joe, all right for having me.
Speaker 3 (36:50):
All right, have a great rest of the Sunday. Okay,
all right, all right, bye now you bet all right?
That is that is my dear sister shedding some good information.
All right, final segment coming up. We just got a
few minutes left, doctor Joe Glotti. Don't forget doctor Joeglotti
dot com. We will be back in just a minute.
(37:13):
All right, final segment of this week's Your Health. First,
I want to thank my dear sister Celeste Galotti again
for coming on talking about DNR really hospice and having
these tough conversations around this, and really for the final
(37:33):
few minutes here, we had a patient within the past
month or so. It was a woman that was I
think she was about sixty, and she had chronic livid disease,
(37:56):
and I've known her for a good number of years,
and we had been talking with her about the inevitable
and that's why it ties in with you know, do
not resuscitate and end of life type conversations, and we
had talked with her regarding the need to get her
(38:17):
to really pay attention to her health with regard to diet,
being compliant with her medications. Alcohol was not a big
factor in her ultimate demise, but it played a minor role.
(38:37):
But even that minor role, we had been telling her
literally for years to discontinue the small amount of alcohol
that she was consuming because it really was flaming her
underlying livid disease, getting on a diet, trying to lose
weight and exercise, and ultimately she developed cancer and it
(39:02):
was so widespread that she was not a candidate for
really for chemotherapy, surgery could not be done liver transplantation.
She was out of criteria, and she became critically ill, hospitalized.
And this is when her entire family, much of which
we had never met before, These mysterious relatives, just come
(39:25):
out of the woodwork and they are asking us, pleading
with us, do this, do that, do everything, as I
was saying with Celesti earlier, do everything for my mother.
And you'd have to look back to say, I don't
think she seriously took her disease as if anything was
(39:50):
going to happen to her. And so the message here
tonight is that while you may have a chronic disease,
and you could fill in the blank, it may be
chronic high blood pressure or chronic diabetes, you are chronically
overweight or chronically obese, you have chronic lung disease, and
(40:10):
you are not addressing it because you know what you're
doing pretty okay. You're still working, you're still able to travel,
still able to show up at the Saturday afternoon family
get together. But eventually this is going to catch up
with you, and it could happen very quickly. So somebody
(40:33):
that had been sick for this woman's situation, she had
been chronically ill, just sort of bopping along smoldering. In
a matter of i'd say a month, she became really
critically ill, and even having conversations with her, I don't
think she realized even though we have said it, we
(40:55):
told her it's documented in her chart, these lengthy conversations,
family meetings, how sick she could potentially get. And so
we don't want our patients, and it is horrible for
the patient and their family the suffering, but those of
(41:16):
us that have invested years taking care of somebody, it
is equally hard on me and my team and everybody
that pours all the time into wanting to help somebody.
So if you were out there with some sort of
chronic disease and you think it's not going to happen
(41:37):
to me, I hate to say, think again, it may
happen to you. So with that said, thank you again
for tuning in tonight. Don't forget Doctor Joegalotti dot com
is our website, and certainly send me a message you
have any thoughts on DNR Colon cancer Awareness mouth, make
sure you get tested if you're at risk or you've
(41:58):
got symptoms, don't blow off the symptoms, and as usual,
we'll be back Sunday evening, have a great rest of
the weekend.
Speaker 1 (42:07):
You've been listening to Your Health First with doctor Joe Bilotti.
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 in the approach rades everything looking at.
Speaker 1 (00:19):
This is your Health First, the most beneficial health program
on radio with doctor Joe Bellotti. During the next hour,
you'll learn about health, wellness and the prevention of disease.
Now here's your host, doctor Joe Bellotti.
Speaker 3 (00:48):
Well, it's Sunday night again in America. That means you're
turning into your health First every Sunday between seven and
eight pm. Broadcasting from our world headquarters here in Houston,
Texas and broadcasting really around the world on the iHeartRadio
(01:11):
app bringing you all the best in health and wellness,
making you better consumers of healthcare. I say this every
show at the beginning because that is at the most
granular level, what all of us are trying to do,
(01:32):
making you better consumers. So you might be saying yourself, well,
where do you come off saying that we're bad consumers
of healthcare? Well, I can say that, not in a
punitive way, in a caring way because taking care of
(01:53):
patients you get a window of sort as to speaking
with them and listening to their symptoms and how long
this has been going on for and we see patients
that have all kinds of complaints symptoms. They have blood
(02:18):
in their stool, they have shortness of breath, they're gaining
weight despite thinking that they're eating better. They have diabetes.
They're on seven different medications. And if they were good consumers,
(02:41):
they would understand the implication of having diabetes, high blood pressure,
and high cholesterol. That is a prescription for a shortened life,
chronic disease, heart attack, stroke, kidney failure, liver failure. But
yet people are sort of willing to just follow directions,
(03:07):
take their pills, go to Walgreens every ninety days and
get refills. But being that better consumer, you'll say, wait
a second, why do I have to take another medicine
for my blood pressure? What can I do differently? Diet, exercise,
have a conversation with the doctor. And that's where we
(03:29):
want you to be better consumers, to speak up. But
like anything in life, if you're going in to talk
to your boss about a raise, you'll want to have
the facts as far as how you've done your productivity,
how much you've added to the company, instead of just
(03:50):
walking in there and saying, hey, I just want more money.
And your boss says you stink at what you do.
So I get it. A lot of people are truly
in intimidated to talk to the doctor question why something's
going on. But that is where the more you know,
(04:10):
the more secure you'll be and you can be that
better consumer of healthcare. Raise your Health IQ all right,
So to be part of the program, Doctor Joegalotti dot com,
d R J O E G A L A t
I dot com, sign up for a newsletter at the homepage.
There is a tab for newsletter sign up. There you
(04:33):
could get a copy of my book Eating Yourself Sick,
available in audible, hardcover, softcover kindle. We're in the process
of finishing up a new book. It's going to be
a book that is going to highlight about fifteen really
(04:57):
true life patience of mind that I've had just unbelievable stories.
Now a few of them did not survive, but despite that,
they have amazing stories. And I'll also be sharing a
little bit about myself and my journey through life and
(05:17):
the influences I had really as a young child that
have carried with me today. So it should it should
really be a very good read. And we're in the
final sort of final touches of it. It's taken a
little bit longer than I had thought. But like anything
(05:40):
that's good, you have to put some some thought into it,
all right, So uh, doctor Joeglotti dot com? All right,
So the month of March is colon cancer Awareness month.
I was watching the Today Show the other day. It
was on at the hospital, and they really had an
(06:02):
extended segment on colon cancer, which I thought was very good.
But what is it that all of you need to know? Well,
first of all, it is the third leading cause of cancer,
so this is not a minor, rare cancer. It's pretty
common and last year there were about about one hundred
(06:28):
and sixty thousand new cases and about fifty five thousand deaths.
Now you can look at this and say, is this
a preventable disease? Well, I would say a lot of
them could have been prevented with screening, being a better consumer.
(06:50):
The incidents is about one in twenty four people in
their lifetime will get colon cancer. Survival rate is ninety
one percent for local stage limited disease. It drops to
fourteen percent for patients in the late stage. And there
are about four hundred cases diagnosed every day now. There
(07:14):
is something very interesting going on with colon cancer and
there have been a number of articles about this. It's
happening in younger individuals. So for a very long time,
colon cancer screening started at fifty years old. It was
sort of the butt of a lot of jokes, no
(07:35):
pun intended that, how Bob's turning fifty and it's time
to go for your kolonoskoby. There are actually colonoscopy birthday
cards for fifty year olds. Well those are no longer
any good because colon cancer screening starts at age forty
five now. And the reason it was rolled back by
five years is that a number of younger people was
(07:59):
showing up with colon cancer and nobody is really quite
clear why. Lots of candidates, lots of ideas, as you
can imagine. Is it the diet. Is it something about
processed food, artificial colors, artificial sweeteners that could be Is
(08:24):
it part of the obesity crisis. Well, we do know
that obesity leads to chronic inflammation throughout the whole body,
so why can't you have increased inflammation in your colon?
They are suspecting maybe inactivity. So where there's obesity there's inactivity,
(08:47):
and I think everybody would agree. In the last twenty years,
with the rise of handheld devices, computers, screen time, bulk
watching television, we're not moving around as much and that
may have been a contributing factor. And they're also floating
the idea of microplastics. Micro Plastics they're causing everything from
(09:12):
Alzheimer's to cancer, to heart disease and stroke. So this
whole microplastic story is now sort of bleeding into colon cancer.
So that is it third leading cause of cancer, about
(09:33):
fifty five thousand deaths each year, one hundred and fifty
two thousand, one hundred and fifty five thousand new cases
every year, and it's happening in younger people. This is
something we need to be careful about when we come back.
What I what I would probably say, let's we'll talk
(09:53):
about some of the symptoms of colon cancer so that
you're a better consumer and you really do not get
fooled by symptoms you may have or somebody in your family.
I would say, everything you learned tonight, yes, apply to yourself,
(10:16):
but what about the other people in your house, your children,
your own brothers and sisters, your wife or husband, boyfriend,
significant other, your best friend, Bob, the guy that sits
next to you at work. This information can be spread widely.
All right, I'm doctor Joe Galotti. Always a great pleasure
(10:38):
to be here on Sunday evening spending a little time
with all of you. Stay tuned, o' breight back, Welcome back, everybody,
doctor Joe Galotti. Every Sunday between seven and eight pm.
Your Health First is on the radio. Don't forget doctor
Joegalotti dot com. Doctor Joe Galotti ga la TI dot com.
(11:01):
Everything you need to know about the program, past programs,
podcast blog posts, lots of health and wellness information as
well as well certainly links to all the health and
wellness information that we post YouTube. But also our medical practice,
(11:23):
which is Liver Specialists of Texas Texasliver dot com. We
take care of people with liver disease, digestive disorders, zorosis, alcoholism,
alcoholic zorrosis, liver transplant, liver cancer, gallbladder issues, anything with
your gut and your liver, guts and liver, we take
(11:45):
care of it. Liver Specialists of Texas. All right, So
we were talking about colon cancer last segment. Colon Cancer Awareness
Month and what do you need to know? All right,
So colon cancer does not normally just jump out and
bite you on the nose and you say, WHOA, I
(12:07):
got colon cancer.
Speaker 1 (12:08):
Today.
Speaker 3 (12:10):
It's very insidious, meaning you may have some vague symptoms.
Now it is for you to interpret these vague symptoms.
You have to say, this ain't right, this is different,
(12:31):
something is going on here. I have to act up.
I have to act I have to talk with somebody
and get some assistance. So what are some of the
symptoms related to colon cancer? Now let me just back
up here for a second. The key to colon cancer
(12:54):
is prevention. It is prevention. So prevention is avoiding excess alcohol.
It is avoiding red meat. It is avoiding processed meats,
the salamis, the pepperonis, the deli meats, the cured meats.
(13:14):
It is avoiding processed foods. It is maintaining a healthy
adequate weight. If you're overweight or obese, you have to
set up a strategy to lose weight smoking. So those
are the lifestyle type things. Now, as far as screening goes,
(13:43):
we said earlier forty five years old is when you
start screening. Now, there are different tests that you could
do at one end of the spectrum. The gold standard.
The best test is a colonoscopy. Now you can look
at a colonoscy and say, well, I have to take
the bowel prep the day before, I would say it
has gotten better. It tastes better, and you don't have
to drink as much. Number two, the procedure itself is
(14:07):
done under sedation with anesthesia. It is safe and you
will get the information you need. Looking for polyps, that
is screening. We're not looking we don't. We don't do
Kolonoskoby's looking for cancer. We do Kolonoski's looking for polyps
that may be pre cancerous. Other studies are screening strategies
(14:34):
would be you know, they're really in this stool category
where you submit a specimen, a stool specimen, and it
is sent off to a dedicated lab looking for some
of the genetic characteristics of either polyps or colon cancer.
(14:56):
Colon cancer colon polyps give off a particular chemical signature
in your stool. This test is able to detect it
all right. Now, if that test like cola guard is positive,
you are obligated to get a colonoscopy. Little hint here
(15:16):
if you have a family history of colon cancer, you
are yourself high risk for colon cancer with different conditions,
or you've had polyps in the past, colon gard is
not the proper test for you. But if it's screening
no symptoms, never had polyps, colon guard is okay as
(15:38):
a first step. So that typically is the screening part.
It's a stool test or a colonoscopy flexible sigmoidoscopy where
they only look at about a quarter to a third
of your colon. That really is nineteen eighties technology. Why
would you look for colon cancer or polyps and say
(15:59):
I'm only going to look at a third of your colon?
What are you going to do keep your fingers crossed
and hope that the part you don't see has no polyps?
It makes no sense. The main thing here is symptoms
that would alert you that something is wrong. You may
have none, you may have all, you may have multiple.
(16:20):
It may be something as simple as just abdominal discomfort,
some bellied discomfort. You may describe it as cramps or bloating,
maybe a little nausea, maybe a little loss of appetite,
maybe even heartburn or indigestion. Bloating that in itself, that
does not mean you have colon cancer. I think it
(16:40):
means you need to get this checked out. Do not
go to chat GPT so so very vague general GI symptoms.
The other would be a change in your bowels that
we say so change in bowels would be becoming increasingly
constant pay or having more diarrhea, either one of those.
(17:05):
If it's if it goes on for more than a
few days or a week, you have to really say,
why am I constipated all of a sudden. It's a change.
Why do I have diarrhea? I never have diarrhea? Why
do I have it? Is there something wrong? It may
be colon cancer, It may be an infection, it could
(17:25):
be anything. But you have to get it looked down.
But one of the things on the list is maybe
colon cancer, especially if you're over forty. The other thing
is blood in your stool. Now a lot of people
will say they have blood in their stool.
Speaker 1 (17:42):
I have a.
Speaker 3 (17:43):
Hemorrhoid, I strain, I'm constipated. I've been sitting on an
airplane for thirty six hours. I drive a truck. Whatever
the case may be. All right, everybody is allowed to
have hemorrhoids. Millions of people have hemorrhoids. Hemorrhoids don't kill you.
But if you have blood in your stool and you
(18:08):
are thinking, ah, it's a hemorrhoid, but you're also having
more constipation, more abdominal pain, maybe losing weight, something is wrong.
Don't don't just say it's it's those darn hemorrhoids. My hemorrhids.
Get some preparation. H That's not That's not the answer.
Speaker 1 (18:27):
And so.
Speaker 3 (18:30):
You have to really be in tune with your body.
The other thing is with the constipation. Constipation is one thing.
The other thing to you look out for is if
your stool, the caliber of your stool, the size of
your stool gets very narrow. People will say it's like
a ribbon, or people will say it's like a pencil.
(18:54):
Remember Plato when you were a kid and you take
this big lump and you'd squeeze it through these different
shit apes had come out like a little worm. But
that's what somebody's stool could look like. So it is
not only more constipation, but is the character of the
stool different, i e. Narrow, ribbon like, pencil like. And
(19:18):
people will come in having no idea that we described
this as pencil like, and they will say, yeah, you know,
my stool's coming out like a pencil. And we're like, okay,
something's wrong here. So I ask all of you to
really really pay attention for yourselves or those around you.
(19:39):
A lot of people talk health around the water cooler,
and if a colleague of yours fifty year old, fifty
sixty year old guy, he's like, man, I've had this
abdominal pain. I've been constipated. You can say, hey, has
the shape of your stool changed? Is it pencil like?
Is it ribbon like? And they're like, yeah, you know,
that's exactly what it's like. Then you accompany them to
(20:03):
the gastro neurologists to get evaluated. All right, So this
is a family affair. We have to talk to each
other about our health, all right, News, traffic, weather coming
up in moments. I'm doctor Joe Galotti. This is your
health first, making you all better consumers of healthcare. I'm
(20:25):
telling you that is what we're doing every weekend. Well,
very back, Welcome back everybody, Doctor Joe Glotti, thanks so
much for tuning in on this Sunday evening. You know,
the weather has been a little rough this weekend. Lots
of rain yesterday in the Houston area's drizzling tonight. But
(20:47):
it's a chance to recharge over the weekend, and I
hope you're getting looking forward to the coming week and
planning out your exercise, your diet, your nutrition and phototing
your best foot forward with regard to health and wellness.
Don't forget doctor Joegalotti dot com is our website. So
(21:08):
right now we have on the phone my sister Celeste Galotti,
and we've had her on before. She is a nurse,
but really she has spent a large, large part of
her career in the hospice arena. Celeste. Welcome to the
program tonight and thanks for taking a few minutes to
(21:28):
come on tonight.
Speaker 2 (21:30):
Hey jam Me again.
Speaker 3 (21:33):
Always happy to have you on as an expert. So,
you know, the one topic that we were talking about
is DNR do not resuscitate. And I believe a lot
of people have heard that term, but they're not quite
sure what it is. Could you explain as simple as
you can what that means and really what does everybody
(21:55):
need to understand about DNR.
Speaker 2 (21:58):
So dn R is the term, Yes, I think everybody's
heard what dn R the term, but it really means,
like you said, do not resuscitate. And basically what a
dn R is it is a legally binding medical document
that needs to be signed by a physician, by the
patient's primary care doctor or their hospice physician, and it
(22:21):
basically is instructing any healthcare professional, whether it be nursing staff,
hospital staff, ems responders, not to perform CPR if the
heart stops. So that is something that I think a
lot of people lack in obtaining because it's a hard
thing to talk about. You don't want to talk about
the what ifs. What if I die, what if mom dies,
(22:45):
if somebody is sick with the terminal illness. It is
something that the reality is you need to discuss it
personally and as a family. It doesn't affect any other
forms of treatment. You could still receive therapies, chemotherapy or
any other treatment that you adoptors have you on, but
it just really allows for that natural death to occur
(23:08):
and not have to undergo cardiopulmonary resuscitation.
Speaker 3 (23:12):
Right or anything else that's uncomfortable to make you survive.
And I would say that where I see it as
a problem and you on your end is when the
conversation never takes place, and when the person is most critical,
most likely to pass away. Somebody on the healthcare team
(23:35):
will come up to a family member and say do
you want to sign this DNR? And they may say
I want to do everything. I don't know what my
mother would have said. So the message really is for
the patient ahead of time to have all of these
documents in order. What's your thought on that.
Speaker 2 (23:58):
I totally agree with you there. Initially it should be
a voluntary decision. Whoever the patient is, they should have
a say in what the decision is. So I advise
patients like you said, I'm a hospice nurse, so a
lot of times I'll go into a patient's home where
the patient is still able to communicate their needs and
(24:18):
their wants, and we have that frank discussion with the patient,
with the family around explaining exactly what a DNR means.
It gives the patient the right to make their own decisions.
If the patient isn't sure, if the family members aren't sure,
we give them a little bit of leeway because basically
(24:39):
it's voluntary, so you don't have to sign a DNR.
People have the misnomer of when you're on hospice care
that you have to have a DNR. No, I have
a lot of patients that do not have a DNR,
But we try to educate our patients as best as
possible to let them know that this is your decision.
More than likely, most patients will sign the DNR because
(24:59):
they're tired and their disease processes brought them to a
point where they're ready to go, and they've accepted the
fact that they're dying. Yeah, but yeah.
Speaker 3 (25:08):
Do you do you find that? And and I think
this is this is something uh, people dislike for lots
of different reasons, talking about their their the finality of
their life. Talking about death is not something that people
(25:30):
routinely feel comfortable about. They'd rather talk about anything other
than the thought that they may become ill and die.
And so I think because of that, naturally we just
don't want to address the topic.
Speaker 2 (25:46):
Yeah, we ignore it. We push it, push it, push it.
And I find that sometimes you push it to the
point where now you have to talk about it.
Speaker 3 (25:55):
Right, So which is which is of course the worst
time to make a decision under under pressure?
Speaker 2 (26:01):
Yeah, exactly, emotions are flying, you have family members, but
that may not agree. So that's why I think it's
good to bring in your doctors, bringing your nurses to
have that third party discuss and really educate because most
people don't experience it, so they don't have the full understanding.
So it's always good to talk to your doctor. And
(26:22):
it's those difficult conversations that are hard to have, but
they're necessary. Yeah.
Speaker 3 (26:26):
Now at the flip side, we are putting some of
the onus on the patient and family members to in
a sense, force the conversation or bring it up. But
at the same time, we are both healthcare professionals. I
am going to say that the physician since this is
really a physician driven process, but certainly nurses like yourselves
(26:50):
are in the process too. I am going to say
that physicians themselves shy away from these tough conversations, and
then what do we do about that if the patient
is not being led by their doctor.
Speaker 2 (27:06):
That is a very tough situation because I know a
lot of doctors look at it if they've done everything
they could for their patient, but then they're at the
end of the rope. It's almost like they fail their patients,
which they have not. It is just the disease taking over.
You've done everything that you can to get this patient
(27:27):
to at this point in their life, then the disease
takes over. So that's why I think it is important
to have that conversation among family members. It's a fact
of life. We're all going to die, right, So.
Speaker 3 (27:40):
Are you kidding me?
Speaker 2 (27:43):
Yes, it is true. So if you have that elderly
parent that maybe they're in good health, or maybe they've
just said a little cardiovascular disease or something. I think
it's important for the children of the family. If they're
lucky enough they have children to discuss it, somebody has
to bring up and be courageous. Those courageous conversations have
to take place to say, hey, Ma, what do you
(28:05):
want to do? What are your thoughts? Because then if
something happens and the patient can't make that decision, you
all could say, I know mom doesn't want the heroics,
I know mom wants the DNR, even if in fact
she hasn't signed the DNR or agreed to it. At
least the family can make that decision with some education,
(28:26):
knowing that this is what mom or dad wanted exactly.
Speaker 3 (28:29):
Now, the other phrase that makes me cringe a little bit.
Is when you have a patient that is critically ill,
maybe they're not able to make those decisions like you
had said, and you're talking to the family and they
just categorically would say, we want everything done for mom.
(28:51):
And then you're left there and you're like, well, wait
a second, doing everything for mom means what that you're
going to get a liver transplant, a heart transplant? What
do you mean I want everything done? And I think
that is where when when people will say I want
everything done, that is almost that they're having difficulty making
(29:15):
a decision. So instead of saying, you know what, this
is a futile situation, let's go that path, they just
rebound one hundred and eighty degrees. Opposite of that is
let's just do everything. What are your thoughts on that?
And what do you tell everybody tonight? On not really
(29:35):
coming around to say I just let's just do everything
for her. It's almost let me just say this, it's
almost a people feel guilty to say, well, I don't
want to be responsible for pulling the plug on mom.
Let's just do everything.
Speaker 2 (29:49):
That's exactly what it is. And that's such a broad term.
Let's do everything there's so many different levels of care.
So if you're talking about specifically, specifically answer patient, people
say I want everything done, I want mom to go
for chemo radiation. But that's where the family and the
patient need to rely on their healthcare providers when they
(30:10):
say there's really not much more where you could do
and your mom needs to go home on comfort care.
At that point, you have to listen to your doctors
and your nurses, right, you have to, And it's a
hard decision. I've been putting that decision. I've been put
in that situation with families where they feel like they're
(30:30):
giving up on their loved one. But once we get
them on hospice care and we provide that beautiful care
that we provide with our spiritual counselors and our nurses,
they see, Okay, we are doing everything for our mom
now because we're making her comfortable. And then it's just
that switching the way you look at.
Speaker 3 (30:52):
Things right right, And again, I'm very sensitive to that
term I'm going to do everything where some of the
things that come under the category of everything, I'm going
to do everything for us. It's very uncomfortable for the patient,
be it you know, certain procedures, needles and intravenous catheters procedures.
(31:15):
This is you know, it's it. I will always tell
my families the the the number one importance is the
patient and how they feel and or suffering or lack thereof.
And you know.
Speaker 2 (31:31):
I'd no, I was gonna say, I don't forget. I'm
so passionate about that.
Speaker 3 (31:35):
No, no, no, I don't want to do or subject
your mother, brother, sister, husband to a procedure just to
make you feel better that you have a lot of
guilt and a lot of the times there are families
that come together they haven't spoken to their mother in
six months or a year, they never had a great
relationship to have that, and now all of this guilt
(31:58):
of you know, family dynamics is coming to a head
and they're like, well, I don't want to be the
one that likes not resuscitates, so let's do everything. So
what do you? What do you say? And I know
how passionate you are, and it's great to see.
Speaker 2 (32:10):
Yeah, and I am faced with that. I don't want
to stay on a daily basis, but with a lot
of situations and I'll have a very sick hospice patient
that let's say is end stage liver cancer or whatever
the case may be, and they've you know, they've whittled
away there. They've lost you know, forty pounds in their
skin and bones, and they're not eating and their nutritional
(32:33):
status is tanked and they're they're very sick. So you
can almost imagine what this patient looks like. But the
family decides we're going to do CPR on my dad
because we want to keep them alive. That's when I
will go into the home and say, okay, you have
the right to want to perform CPR on your dad.
But when AMS comes in, they're going to perform CPR.
(32:56):
His ribs are going to crack. And you have to
be almost very very graphic, but very graphic about it
because that puts things in perspective. You have a patient
that is you know, five foot eleven and one hundred pounds,
they're going to come in and perform CPR, ribs are
going to crack, You're going to put the tubes down
the nose and throat. Is that really what you want
(33:19):
for your your family, your right your family member who
is ultimately going to die from the disease, So you
have to put it in perspective sometimes and that usually makes
people at least think about it. I've had patients that
have families that have said, oh my goodness, I didn't
think of it that way. Yes, let's sign the DNR.
(33:40):
Others decide not to sign the DNR. And usually those
patients just die peacefully in their sleep and thank God
you don't have to put them through that torture.
Speaker 3 (33:49):
And I think a lot of this and this is
such a multi faceted conversation and problem is that. And
again not to sound overly preachy or righteous about this,
but there are people that are very spiritual in nature.
It doesn't matter what religion or what their beliefs are,
(34:12):
but they're very, very faithful type people, and they understand
they don't want their loved one to suffer, and they
understand that it's more, it's more than just them. It
is about focusing on the patient. And those are the
families that are far easier to have this conversation with
(34:34):
rather than people that aren't really speaking in that spiritual tone.
Because much of hospice, like you said, is very spiritual,
sort of non denominational, but it is spiritual.
Speaker 2 (34:48):
Yeah, And when we admit a patient to hospice. They
absolutely have to have their nurses, but we do as
spiritual counselors that they don't have to see. But I
always advise my families to see them. They're not gonna
make you become a Catholic or Jewish, you know, they
just are in there to talk about the dying process, right,
(35:09):
and to make it an easier transition. And it's the
patients and families that talk to my spiritual counselor are
far better off, right, and it's an easier process for them.
Speaker 3 (35:23):
And I think that you and I, as my sister,
we have gone through several of these personal situations. As
we've talked about before. We lost our sister at a
relatively young age with a severe illness and we had
to make that decision to not, you know, pursue further therapy,
and both of our parents we had to make that decision.
(35:46):
So there's nothing better than going through this firsthand, and
then for us, you and I and our colleagues to
share these stories of just how to do it properly
rather than having a big commotion at the end, which
is really horrible for everybody, it really is.
Speaker 2 (36:03):
And and you're absolutely correct, because I find the families
that I provide care to, the ones that have said,
oh I went through hopsice with hospice with my mother
in law, and you guys were angels. They have a
better perspective on what's to come, and it's a much easier,
smoother transition.
Speaker 1 (36:23):
Right.
Speaker 2 (36:23):
So knowledge is everything right in life. That's you know,
is whether it's medical knowledge or whatever, it's you got.
Speaker 3 (36:31):
It, it really is.
Speaker 1 (36:32):
All right.
Speaker 3 (36:33):
Well, Celeste Galotti, thank you very much for coming on tonight.
It's uh, you know, this is a topic that really
we can never hear enough about, and I think you
are certainly a great voice and advocate for patience, and
so it's great to have you on.
Speaker 2 (36:49):
Well, thanks Joe, all right for having me.
Speaker 3 (36:50):
All right, have a great rest of the Sunday. Okay,
all right, all right, bye now you bet all right?
That is that is my dear sister shedding some good information.
All right, final segment coming up. We just got a
few minutes left, doctor Joe Glotti. Don't forget doctor Joeglotti
dot com. We will be back in just a minute.
(37:13):
All right, final segment of this week's Your Health. First,
I want to thank my dear sister Celeste Galotti again
for coming on talking about DNR really hospice and having
these tough conversations around this, and really for the final
(37:33):
few minutes here, we had a patient within the past
month or so. It was a woman that was I
think she was about sixty, and she had chronic livid disease,
(37:56):
and I've known her for a good number of years,
and we had been talking with her about the inevitable
and that's why it ties in with you know, do
not resuscitate and end of life type conversations, and we
had talked with her regarding the need to get her
(38:17):
to really pay attention to her health with regard to diet,
being compliant with her medications. Alcohol was not a big
factor in her ultimate demise, but it played a minor role.
(38:37):
But even that minor role, we had been telling her
literally for years to discontinue the small amount of alcohol
that she was consuming because it really was flaming her
underlying livid disease, getting on a diet, trying to lose
weight and exercise, and ultimately she developed cancer and it
(39:02):
was so widespread that she was not a candidate for
really for chemotherapy, surgery could not be done liver transplantation.
She was out of criteria, and she became critically ill, hospitalized.
And this is when her entire family, much of which
we had never met before, These mysterious relatives, just come
(39:25):
out of the woodwork and they are asking us, pleading
with us, do this, do that, do everything, as I
was saying with Celesti earlier, do everything for my mother.
And you'd have to look back to say, I don't
think she seriously took her disease as if anything was
(39:50):
going to happen to her. And so the message here
tonight is that while you may have a chronic disease,
and you could fill in the blank, it may be
chronic high blood pressure or chronic diabetes, you are chronically
overweight or chronically obese, you have chronic lung disease, and
(40:10):
you are not addressing it because you know what you're
doing pretty okay. You're still working, you're still able to travel,
still able to show up at the Saturday afternoon family
get together. But eventually this is going to catch up
with you, and it could happen very quickly. So somebody
(40:33):
that had been sick for this woman's situation, she had
been chronically ill, just sort of bopping along smoldering. In
a matter of i'd say a month, she became really
critically ill, and even having conversations with her, I don't
think she realized even though we have said it, we
(40:55):
told her it's documented in her chart, these lengthy conversations,
family meetings, how sick she could potentially get. And so
we don't want our patients, and it is horrible for
the patient and their family the suffering, but those of
(41:16):
us that have invested years taking care of somebody, it
is equally hard on me and my team and everybody
that pours all the time into wanting to help somebody.
So if you were out there with some sort of
chronic disease and you think it's not going to happen
(41:37):
to me, I hate to say, think again, it may
happen to you. So with that said, thank you again
for tuning in tonight. Don't forget Doctor Joegalotti dot com
is our website, and certainly send me a message you
have any thoughts on DNR Colon cancer Awareness mouth, make
sure you get tested if you're at risk or you've
(41:58):
got symptoms, don't blow off the symptoms, and as usual,
we'll be back Sunday evening, have a great rest of
the weekend.
Speaker 1 (42:07):
You've been listening to Your Health First with doctor Joe Bilotti.
For more information on this program or the content of
this program, go to your health First dot com.
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