July 12, 2026 • 41 mins
Dr. Galati starts the program with the news about Lindsey Grahams death after a sudden illness. He also talks about being on call this weekend and reflects on families having to mentally cope with a sick loved one. Dr. James Mike Wilson joins the show to talk more in depth about Lindsey Grahams sudden death. Dr. Galati also spends a few minutes on a Tic Tok video he did on whether or not physicians are examining their patients.
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Speaker 1 (00:01):
Initial life sequence.
Speaker 2 (00:04):
Coming to you live from Houston, Texas, home to the
world's largest medical center. They approach phase everything looking all.
This is Your Health First, the most beneficial health program
on radio with doctor Joe Gallotti. During the next hour,
(00:26):
you'll learn about health, wellness and the prevention of disease.
Now here's your host, doctor Joe Galotti.
Speaker 1 (00:46):
Well, that's another Sunday evening in America. Thanks for tuning in.
The name of the program is Your Health First. I'm
doctor Joe Galotti, and we're here every Sunday between San
n eight pm Central Time. We're broadcasting out of Houston, Texas,
our home station seven forty KTRH, the Great Station KTRH,
(01:13):
and broadcasting around the globe on the iHeartRadio app. So
no excuse if you are on vacation next week or
the week after and you're out of town and you say,
wait a second, it's seven o'clock Central. We got to
tune into Your Health First. You can get us no
(01:37):
excuse to miss a single episode. Our website Doctor Joegalotti
dot com, sign a for our newsletter. All of our
social media is there, our blog posting is there for
lots and lots of health and wellness information articles we've
written over the years, and our podcast is there at
(02:01):
doctor Joegalotti dot com. So uh big, well, not a
big weekend. I woke up this morning and read the
headline Lindsey Graham, Senator from North Carolina dead sudden event,
(02:21):
a very short illness. Uh yeah, pretty short. I think
they would call this cardiac arrest as the papers are reporting.
And I looked at this and I said to myself,
we need to incorporate this into the program tonight. Coming
up in a little bit, my good friend and colleague,
(02:43):
doctor Mike Wilson, cardiologist. His first name really is James.
I don't know why they call him Mike. I don't
see him as a gym or a Jimmy. He's Mike Wilson,
doctor Mike Wilson. Here in the Texas Meat Center. He
(03:03):
comes on a lot to answer these kinds of questions.
He's always very articulate and knowledgeable. So doctor Wilson's going
to be coming in a little bit to try to
shed a little bit of light on this. What you know,
he was seventy one, Lindsey Graham was seventy one, And
whenever you see these stories, you cannot help, or you
(03:28):
should self reflect and say, oh, man, I'm seventy one.
If it could happen to him, it could happen to me,
or you could be fifty one, or he could be
eighty one. So when you have these sudden death episodes,
you have to look back and you know what, I
(03:50):
don't want to say, what doesn't make sense. So everybody
over the years, they I don't want to say they brag,
but they make a point that the elected federal officials, Congress,
and the Senate representatives they have the best of healthcare. Now,
(04:11):
I don't really know what that means as far as
the best of healthcare now, I do not know if
senators go to one of the military institutions. Do they
go to Walter Reed, do they go to the naval hospital.
(04:32):
I just don't know, but I would think what they
may mean by that the best of health. If Senator
Graham calls up somewhere and he wants to be seen
by a doctor, they're going to fall all over him
and say, yes, you could come in today and if
(04:53):
you need this test, yes we will call doctor X
and we will facilitate.
Speaker 3 (04:56):
So I think.
Speaker 1 (04:56):
It's availability, but that does not always mean you're getting
the best care I have taken care of in my
nearly thirty five years. You know, I would say, well
to do people, you know, if you want to call
them celebrities or whatever, and I would say, outright, they
(05:17):
get some of the worst care because they do not.
You know, the doctors and nurses do not want to
confront mister Big or miss Big about what they're doing
or they're not doing. It's basically, don't ruffle the feathers.
Don't insult them, don't tell them they're drinking too much,
don't tell them they're overweight or they're smoking.
Speaker 3 (05:38):
Just go with the flow.
Speaker 1 (05:39):
Be nice, get an autograph and a selfie. But the
truth is a seventy one year old person as a
non cardiologist, and we'll see what doctor Wilson has to say.
What is it that causes a seventy one year old
to abruptly die? Some would call this sudden death. Well,
(06:04):
no matter how you slice and dice it, the majority
of us are going to die from cardiovascular disease. That
is the number one killer. So cardiovascular disease in the
flavor of a stroke, a heart attack, heart failure, or
(06:26):
some other valvular disease or arrhythmium where your heart just
starts beating way out of control, typically too fast, but
your heart can go into a heart block where it
just instead of beating seventy times a minute, it beats
ten times a minute, and that's not good. So you'd
(06:49):
have to think that it's one of those one of
those items. So you have to look back and for
everybody tonight, all of us and anytime, are at risk
for something like this happening. Now you have to do
the you know, the real nuts and bolts of taking
(07:11):
care of yourself is what is your family history?
Speaker 3 (07:15):
Did you have a.
Speaker 1 (07:17):
Mother or father or a brother that died prematurely from
heart disease, cardiovascular disease, arrhythmia. If that is the case,
and I'd say somebody that had serious cardiovascular disease, probably
you know, under fifty five, I would say that's a
red flag that you need to pay attention and get
(07:40):
checked out specifically with your doctor. To say, my father
passed away at fifty two suddenly of a heart attack, okay,
rather than he had a heart attack when he was
ninety eight. That's that's a completely different story. So family
history is always going to be important. And then you
get into the other risk factors. Do you smoke? Certainly
(08:03):
smoking increases your risk of cardiovascular disease, developing plaque, stiffness
of the arteries, arterial disease in your brain, and or
your extremities in your legs in particular. And then it
is cholesterol. What's your cholesterol? And I'm going to be
(08:24):
asking doctor Wilson his take on cholesterol, but would I
would say, as much discussion as there is about cholesterol,
there is still a sense a lot of the patients
I see are slightly under treated. Physicians will and it
(08:45):
may be the choice of the patient.
Speaker 3 (08:48):
They will.
Speaker 1 (08:50):
Ask, instead of getting on a statin, can we give
it some time with diet and exercise. I swear to you, doctor,
I will lose weight, will eat better. That doesn't always happen,
especially when you have a lipid profile that's staring you
in the eye that you know is not the preferred
(09:11):
set of numbers. And then there's diabetes, and pre diabetes
is almost a bigger menace than diabetes itself. There are
so many people with pre diabetes that will eventually turn
the diabetes that you want to treat it now, intervene
now through diet and exercise and potentially medical therapy, and
(09:36):
so all of these issues should give you pause to say,
what what bucket do I fit into? Am I in
the overweight or obese bucket, the high blood pressure bucket,
the diabetes or the pre diabetes bucket, the smoker's bucket?
(09:57):
Or do I have a little of everything? Sort of
a piree of risk factors. I'm overweight, i have a
bit of elevated cholesterol.
Speaker 3 (10:05):
I've got this.
Speaker 1 (10:06):
My doctor said my blood suggars were a little high,
and I smoke a pack of cigarettes once a week.
Speaker 3 (10:18):
Now.
Speaker 1 (10:18):
The other interesting thing is, and many of you know
I am a hepatologist, I'm a liver specialist. Fatty liver
disease is one of the top things that we are
seeing in liver disease. But people with fatty liver they
got there because of obesity and high blood pressure, cholesterol
(10:42):
issues and type two diabetes. So I'm seeing you for
fatty liver. Fine, we will address all of these issues separately,
risk assessing your cardiovascular disease and trying to get the
lipids under control, in a better diet and lose weight.
And there are medications for fatty liver that we can
devene with. But really, the little secret is that the
(11:04):
majority of people with fatty liver die of cardiovascular disease.
And so you may be sitting at home saying, well,
I just have fatty liver. Okay, that may be true,
but you are at risk for cardiovascular disease as well
and a sudden event like Lindsay Graham appears to have had. Now,
(11:30):
the other interesting thing is that the reports are saying
he just came back from a trip to Ukraine. Now
that has got to be I don't know, eighteen to
twenty hour flight sitting still, did he develop a clot
in his leg called a DVT deep venus thrombosis that
(11:52):
then broke loose and he developed a pulmonary embolism. A
clot goes to your lung. If that is the case,
this clot, depending on how big it is, can cause
sudden death. You may present with some chest pain, shortness
of breath which can lead to heart failure, sudden heart
(12:15):
failure literally in a matter of minutes, and or develop
an arrhythmia.
Speaker 3 (12:21):
That is fatal.
Speaker 1 (12:23):
And you could do all the CPR in the world,
it is not going to dislodge this pulmonary embolism. So
I would think that an autopsy, considering who he is
and the suddenness of it, an autopsy will be performed.
And I would not be surprised if he had a
pulmonary embolism. Now, if you're taking a wager here, those
(12:49):
a lot of people would still say this is bread
and butter. Cardiovascular. He had a heart attack, he had
a sudden arrhythmia of ventricular tacic already. But again, you know,
if EMS came and now it could have been you
don't know the time from him getting sick or going down.
(13:10):
EMS comes and they hook him up to a monitor
and they try to use a defibrillator too much. Time
may have may have passed, you just you just don't know.
But I think it'll be very interesting on the deep
venus thrombosis followed by a pulmonary embolism causing a sudden issue.
I mean, to me, just as a casual observer, the
(13:30):
guy seemed like he was everywhere, like he was not
really ill appearing. He seemed a bit overweight. But I think,
you know, a chronically ill appearing person maybe not all right,
We're going to take a break right now. Don't forget
Doctor Joegalotti dot com is our website. Go there and
(13:54):
find out what we do Center Front Newsletter and I'll
be back in one minute or two. Welcome back everybody,
Doctor Joe Glotti, thanks as always for tuning in on
this glorious Sunday evening, spending a little time with me
and all of us together, making you better consumers of healthcare,
(14:17):
raising your health IQ, all of that good stuff.
Speaker 3 (14:20):
It is all rooted in.
Speaker 1 (14:23):
Knowledge, but it is wanting the knowledge, wanting the knowledge,
and that goes for anything in life. There's a ton
of information out there for people to absorb and integrate
into their daily routine. But do you want to learn this?
(14:44):
Do you want to learn how to eat and cook better?
Learn how to exercise in a better way or in
a way that doesn't get totally monotonous, or take the
interest in a certain disease that you may have or
you may be at risk for, and having knowledge which
(15:07):
is so powerful and intervening small changes, small changes can
go a very long way. Doctor Mike Wilson is coming up.
We're going to be talking about heart disease and Lindsey
Graham seventy one year old senator from North South Carolina
that died last night some sort of sudden cardiac event,
(15:30):
cardiac arrest. We don't know the details, doctor Wilson, nor
I have anything to do with Lindsey Graham's healthcare. Just
a disclaimer, we'll have doctor Wilson on to really, you know,
have you all think could this happen to me? And
(15:50):
it doesn't matter if you're seventy one, eighty one, sixty five,
fifty eight, forty two hike. We have to be aware.
Speaker 3 (16:01):
And you know what I like to say, you.
Speaker 1 (16:06):
Plan for the best, or you hope for the best,
plan for the worst. Hope for the best, plan for
the worst. So planning for the worst is making sure
your blood pressure is under control, your diet is in
line with what you should be eating, blood pressure, diabetes,
you're exercising, et cetera. All right, doctor Wilson will be
(16:27):
coming up in just a few minutes. So this weekend
I was on call. And when you're on call, I
cover other colleagues of mine their liver patients in the hospital,
and you meet a lot of people that you did
not know, but you're dealing with patients that are in
(16:51):
the hospital, in the intensive care unit, and we have
a very sick population of patients with liver disease. They're
waiting for liver transplant, they are on life support, they're
on dialysis, they're on respirators, and the families are absolutely
beside themselves trying to mentally cope with sick a sick
(17:18):
loved one. It could be a daughter, it could be
their husband, their wife, their brother or sister. But it
is a lot to handle. And I look at these
weekends as opportunities to certainly educate all of these families
and the patients if they're awake, but also for myself
(17:42):
to reflect on, you know, what is the state of
affairs out there, And there are individuals and believe me,
I know the duress that they're under trying to, you know,
deal with the potential that a loved one may not live.
Getting a liver transplant, depending on the situation, seems like
(18:05):
a very thin opportunity, depending on how sick they are.
We're lucky at here at Euston Methodist Hospital. It's the
largest liver transplant program in the country. We have, bar none,
the most experienced team collectively in taking care of these patients,
but it's still very daunting, and what it comes down
(18:26):
to so many families, they not that they don't get it,
not that they don't understand, but their understanding of the
disease process, how they got here, how their loved one
got here, is sometimes just a big black hole. They
were living with this person, they were in maybe constant
(18:49):
contact with this person, maybe they didn't live together, but
they were intimately involved in their life. But they are
still really befuddled as to how could this have happened?
Why did this happen? And you know, we have, you know,
(19:10):
the entire case, the entire history, and we try to
explain to them that this person has had X y
Z disease for the last five years. Things were done,
things were not done, they followed directions, they did not
follow directions, or it's a disease that, no matter what,
(19:32):
will progress to this end stage point. And so there's
this look of amazement like, oh, I never knew that. Well,
they you know, we know that they've been told, but
it's just so much to sink in. So again, so
much of health and wellness and the path that we
take really depends on you, the consumer, and that's why
(19:55):
I always talk about you, the consumer in healthcare, to
really get a deep dive into your health affairs. All right, newsweather,
traffic coming up. We'll hear about sports, the astros, maybe
a little bit about World Cup. I'm doctor Joe Glati,
Doctor Mike Wilson will be up after the break. All right,
(20:16):
Every Sunday evening between seven and a pm.
Speaker 3 (20:21):
You should be tuned into your health first. I'm doctor
Joe Galotti and.
Speaker 1 (20:27):
Big news day unfortunately for our government, and as I
was talking earlier, we're going to have an expert to
try to make you think and understand what may have
happened to poor Lindsey Graham, the Senator from South Carolina
and no stranger to your health first, Doctor James Michael
(20:49):
Wilson here in the Texas Medical Center. Doctor Wilson, as always,
thanks for bailing us out and shedding a little light
on this topic.
Speaker 4 (20:59):
Yes, sir, happy to be here.
Speaker 3 (21:00):
All right.
Speaker 1 (21:01):
So I woke up this morning like many that Lindsey
Graham dead at seventy one. And you know the headline
is a brief illness. Yeah, like about thirty minutes of
cardiac arrest. That's pretty brief.
Speaker 3 (21:16):
And apparently.
Speaker 1 (21:20):
According to some reports, he called emas or somebody called
EMS chest pain. Next thing you know, people are doing CPR.
Next thing, he's deceased. So for people listening tonight, that
may be seventy one, that may be sixty, that maybe
fifty five. So when you see something like this, what
(21:42):
goes through your head as far as what may have
happened to him?
Speaker 4 (21:49):
Well, the first thing is that when somebody his death
after rapidly after onset of illness, we call that. If
it happens within twenty four hours or before you can
call anybody for help, we call that sudden death. Right,
So if you take all comers with sudden death, just everybody,
(22:12):
there's a little over fifty percent chance that heart disease
was the major precipitate. In all the studies that have
looked back at stuff like this, there's kind of two
big categories. There's the people who died suddenly and were
not resuscitated or no attempt was made and their evaluation
(22:34):
came at autopsy. And there's a whole other group and
whom EMS made it there or somebody was able to
help and get them back. And if you take the
two groups of people, the people that you get back.
Most often have heart disease, and it's usually cordinary artery
disease or heart attack, right, and the people that don't.
(22:55):
It's about a little over fifty percent of heart disease
in about twenty five percent of those are heart attacks,
and a pretty large proportion or other cardiovascular illnesses like
pulmonary embelis a big blood clot that goes to the
lungs right dis section of the order which is a
tear due to high blood pressure right and stroke is
(23:19):
actually still one of the big big causes of sudden death.
Speaker 1 (23:23):
Yeah, so when you hear the reports and again you
nor I have taken care of Lindsay Graham. I don't
believe you haven't made any nefarious trips to Washington dately,
have you South Carolina or South Carolina? But you know
it's being reported there was a problem. EMS was called
(23:45):
and CPR was started and next thing you know, the
poor man died. Could that be stroke? Could a stroke
present like this or you know, maybe not so?
Speaker 4 (23:58):
Stroke is a probably not so. Stroke that causes sudden
death is usually like a lightning bolt from the sky.
Just you are fine and all of a sudden you
collapse to the floor. Right, that's it, right, this kind
of thing where he says, I don't feel good, call
(24:19):
for help, that's going to more likely be heart related
or since we know he just returned on a long flight.
Absolutely absolutely right, Yeah, a pulmonary embolus, which is a
lot of times something that can be discovered, but it's
(24:40):
so bad that you can't be resuscitated.
Speaker 1 (24:43):
Right, right, And it could have been. A pulmonary embolism
can present with chest pain and shortness of breath and
to the untrained eye may see, oh he's having a
heart attack, right, and you can wrap deteriorate and develop
arrhythmias and all kinds of other things, and you know,
(25:04):
to your point, just not not be able to come back.
Speaker 4 (25:10):
That's correct.
Speaker 3 (25:12):
Yeah, So yeah, Well.
Speaker 4 (25:15):
The other thing is you said, well, he just came
from a long trip, this was probably pulmonary. That's true,
but he's a seventy one year old man who was
not in very good physical condition by all appearances, right,
uh huh. And statistically, the likelihood is still going to
be very high that this was a cornery event that
they had heart disease exactly.
Speaker 1 (25:37):
So for the you know, the men and women listening tonight.
And again, whether you're seventy one, you're seventy five, or
you're fifty five. The goal for all of us, and
especially those in cardiovascular disease like yourself, it is prevention,
primary prevention. So how how do people look themselves tonight
(25:59):
or tomorrow and say how does this not happen to me?
Now that that's a big ask for you, but again
we have to have this dialogue and people need to
look at their risk factors and how they feel and
really what they're doing with regard to their health and wellness.
Speaker 4 (26:17):
Right well, with a lot of forms of curdy vascular disease,
this is your way out. I mean this. You become
ill and in a very short amount of time you're
not treatable and you die right and prevention is the
only way to get around it. And there is a
reason that we hear all these same recommendations we get
(26:41):
beat over the head with don't eat too much salt,
don't eat too much, try to regulate your weight, your doctor,
measure your blood pressure, eat healthy, check your cholesterol. All these,
all these what I call chicken soup recommendations are enormously
helpful in preventing the diseases that cause or many of
(27:05):
the diseases that cause what Lindsay Graham.
Speaker 1 (27:08):
May have had.
Speaker 3 (27:09):
Yeah.
Speaker 1 (27:09):
Yeah, And so when you look at the top risk factors,
but also the things that you could potentially intervene on.
Speaker 3 (27:19):
Weight.
Speaker 1 (27:21):
We are in a sea of obesity and people that
are overweight, and it almost has become the new norm
that everybody is overweight?
Speaker 3 (27:30):
So why pick on me?
Speaker 1 (27:31):
But it has such a downstream negative effect on our health?
Speaker 3 (27:37):
How do you look at it? As a cardiologist?
Speaker 4 (27:41):
The obesity is undoubtedly an epidemic, and as you said,
it's downstream effects on your circulating cholesterol concentration, on your
blood pressure, on various and sundry things that we can
measure are enormous. And the interesting statistic that I think
(28:04):
is incredibly useful is a ten percent reduction in your
body weight if you're overweight, is a fifty percent reduction
in your risk of curdiovascular events.
Speaker 3 (28:14):
Tremendous.
Speaker 4 (28:16):
There is not any medicine that works that well, right,
So simple lifestyle measures actually go a long way. Yeah,
A little bit of walking every half an hour, walking
every day, cutting five hundred galleries at in your diet,
even a little bit of weight loss. You don't have
to become a runway model to get the benefits of
(28:39):
weight loss.
Speaker 1 (28:40):
Yeah, now, a lot of patients because of the patients
that I see, and we share many of them together
with fatty liver who have obesity and high blood pressure
and type two diabetes. The cholesterol issue, We've had other
experts on the program over the last couple of years
about how important it is to understand your cholesterol and
(29:04):
getting it down. I like to say there's no such
thing as having a touch of cholesterol elevation, but I
think and you, you know, you fill me in. It
seems like the last few years the LDL cholesterol has
been getting a lot more attention than it may have
in the past. What's your take on that.
Speaker 4 (29:26):
Well, the the truth is that we've kind of known
for many years what the physiologic range is for circulating
LDL cholesterol. It's just that most of the time we
couldn't get anybody there because the medicines that we had
available were potent enough and we didn't have enough ways
(29:47):
to get it there. Right now we do, and now
we understand a lot more of the physiology of athrosclerosis.
So there was in the past an acceptance of what
I would call a non physiologic LDL cholesterol simply because
we couldn't get most people there. Right, that's different today.
(30:10):
And the other thing is that we also understand that
the other different lipoproteins, the HDL, the VLDL one it
called IDL, they have a role in athroskerosis that's complicated
and it can't be boiled down. So simply is cholesterol
ratios and you're good versus your bad. And that's why
(30:32):
we really shine the attention on the LDL.
Speaker 1 (30:35):
But you you would say, there are and I see
these patients myself. They have a ton of risk factors.
They're total cholesterol may be I would say acceptable, but
their LDL cholesterol is very high. And you know, as
well as anybody the I guess it was the American
Heart Association. They want the LDL like less than fifty five?
Speaker 3 (30:56):
Is that right?
Speaker 4 (30:57):
Right? Well, the the thing is that, and I hear
this all the time. People will come in and say, well,
we've found evidence that athrosclerosis and one artery versus another.
And they say, but doctor, I've never had a cholesterol problem. Right, Well,
on one side of the scales, you've got your LDL
cholesterols or on the other side, you have your arteries
(31:19):
and their resistance to it. Right, and if you develop athrosclerosis,
any evidence of it, then whatever your LDL is, no
matter how good you think it is, it's too high
for you. Right And we know that if you get
that LDL under fifty five, and actually there's a lot
of accumulating data that says we ought to have it
(31:40):
a little closer to thirty, right, right, then we're going
to be getting it down to the ranges where it's
okay for everybody.
Speaker 1 (31:47):
Right right now, along those lines, and again, this is
a topic that is you know, we talk about it
a lot, and it's always great to get different opinions.
The carnary calcium score, it's widely available, it's easy, it's safe,
not too expensive. For people listening tonight and they say, well,
(32:08):
I'm a little overweight, i have some high blood pressure.
I'm just on let's say a diuretic thiazid diuretic and
that's about it. I'm not diabetic. What's the role of
getting a carninary calcium scan so that you do not
have a Lindsey Graham moment.
Speaker 4 (32:30):
I think the calcium score is an absolutely wonderful tool
to answer the question of where do I stand in
terms of my risk. When you talk to your doctor,
he's going to take your age and your other risk
factors and get a ballpark idea what your chances are
having trouble in ten years. If you're low risk, you're
(32:50):
generally in pretty good shape. But if you're not low risk,
you really don't know, right. And the calcium score is
essentially like going to Vegas and looking at the dealer's cards. Right,
So I've got sixteen? Do I here? Do I stay?
Speaker 3 (33:07):
Yeah?
Speaker 4 (33:07):
So essentially with a councium score, we get to cheat, Yes,
we get to find out what's in there.
Speaker 3 (33:12):
Yes, exactly.
Speaker 1 (33:14):
And I guess the last comment here because the the
interplay of weight and blood pressure, cholesterol and diabetes. Your
Sunday Night message to everybody on type two diabetes. And
as I've said a million times and we've laughed over
it together, Hey doc, I just have a touch of diabetes.
(33:35):
What is your take on that? And the importance in
cardiovascular health? And you know, again, I think we're going
to coin this Lindsey Graham event. It's really sad for
him and his family, but this may wake people up
on sudden death. What do you what do you think
on the on the touch of diabetes or diabetes in general.
Speaker 4 (33:56):
Yeah, so that's I too. I hear that a lot.
Well doctor, I'm pre diabetic, right, that's like being pre pregnant.
Speaker 3 (34:05):
Yeah, or prey dead.
Speaker 4 (34:07):
You are you? You or you ain't. So once the
abnormal physiology appears, then its adverse effects on your health
have begun. The reason that we have a declaration of
at this point you are now officially a diabetic is
(34:27):
that at this point we know that the medicines we're
going to give you to lower your sugars, their value
to you exceeds the risk that comes with the medicines.
But as soon as that sugar goes up, as soon
as you are quote pre diabetic, you are diabetic and
you just need to control that problem.
Speaker 1 (34:47):
Right, Well, well said all right, well, doctor Wilson, it's
always great to have you on, and maybe we'll have
you back if we hear something about Mitch McConnell in
the next week or two. So it's it's bad, all right,
doctor James Michael Wilson here in the Texas Medical Center
used the Methodist Hospital. It's always great having you on.
(35:07):
Thanks again, Thank you, all right, good by now all right,
final segment coming up on Your Health First, Doctor Joe Glotti.
Don't forget doctor Joe Galotti dot com.
Speaker 3 (35:22):
We'll be back in a minute. Welcome back, everybody.
Speaker 1 (35:24):
Final segment of this week's Your Health First. I want
to give a big thanks to doctor Mike Wilson for
coming on and shedding a fair amount of light on
the whole Lindsey Graham sudden death issue. I think it's uh,
it'll be very interesting to see what we find out
(35:45):
in the uh in the days and weeks to come.
I'm almost positive and autopsy will be done and we'll
see what happened. But again, this is a great opportunity
for all of you to take stock what are your
risk factors? And you don't want to find out that
you have a health issue when it presents itself as
(36:09):
a calamity. We we know a lot about risk factors.
Who has heart attacks, who has diabetes, who has strokes,
who develops cancer. We know people that drink too much
get cirrhosis. We know people that smoke at lung cancer
and emphysema. We know that people that have diabetes out
(36:31):
of control, high blood pressure, out of control, end up
on dialysis. So let's try and take ownership of these issues,
all right. So in the last few minutes here, so
social media. Let's talk about social media for a second.
So I have a social media presence of sort, trying
(36:58):
to communicate information to patients and the community on basically
a lot of what we talk about here. And I
did a TikTok video about been maybe about a month
ago on whether or not physicians are examining their patient. Now,
(37:18):
when you come to me as a new patient, you
will get into a gown, you'll get down to your skivies,
your undergarments, and we.
Speaker 3 (37:29):
Will examine you.
Speaker 1 (37:30):
Yes, we are a liver service, that's our specialty or
digestive issues, and there's a certain part of the abdomen
that we will be looking at. But we will look
at your eyes, we will look in your mouth, we
will take a look at your teeth. We'll feel your
neck for any lymph nodes, will listen to your lungs,
(37:51):
look at your extremities, check your pulses. So we will
do a head to toe physical exam. You come back,
we may do the exact same thing again. Now I
have seen patients that come to me and we're chatting
and we're getting to know their history, going over the records,
(38:12):
and I may say, Okay, I am going to step
out for a moment. Here is the gown you could change,
keep your onund the garments on, open the gown to
the front, and I'll come and examine you. And they
will look at me and say, doctor Galotti, what are
you going to do? And I said, well, you're here
with this problem. We're going to examine you. And they
will say why and I'm like why You're not, Well,
(38:36):
I'm a doctor and that's what we do. That's part
of the the evaluation is a physical examination. And they
then the patients by and large will say nobody else
has ever done this. And then I will very carefully ask, well,
you've been seeing these doctors, that group, that clinic, whatever,
(38:57):
and I have all the records and I'm like, I
have Have they not examined you? And they would say no.
They just sit and talk to me, maybe look at
the computer with back turned. I get a prescription, I
get a referral and that's it. And I'll say never
ever and they're like, no, never ever have I been
examined or maybe they will listen to the heart and
(39:19):
that's it. But nobody's getting into gowns and getting a
detailed physical examination. That sparked on TikTok hundreds of thousands
of visits comments. It was unbelievable, It blew up, It
sort of went viral. And so I do think that you,
(39:44):
as the consumer, want to be in a practice with
a team of professionals that are taking care of you
for your problems, whether it's a minor or a major,
that are paying attention to your physical exam. Now, there
is a lot of technology, these laboratory tests that in
a sense replace a lot of things we used to do,
(40:06):
and imaging, galore, MRI, pet scan, X rays, ultrasound, everything imaginable.
Technology is getting better, but there's still something to be
said for the physical examination and what information that gleans.
It still is very valuable. So the message tonight, if
(40:31):
you're in a situation where you have a chronic problem,
where you're seeing your doctor more than just once or
twice a year and they're not examining you, then I
think you really have to question the care you're getting.
I'll be honest, I'm not here to disrupt relationships with
patients and doctors. I don't have a solution, but you're
(40:53):
going to have to seek.
Speaker 3 (40:57):
A better quality of care.
Speaker 1 (41:00):
And the comments that everybody wrote back are doctors are busy.
They're so busy they can't take care of you, or
it's the insurance company, or they're not getting paid enough.
They have to see sixty patients a day to make
ends meet. And that may be true, but that's a
bigger part of the problem. So just a thought. You
could probably go on TikTok at doctor Joe Galotti. I no,
(41:22):
that's not it. It's I'm sure you can find me
on TikTok and take a look at that. But anyway,
we're going to close out.
Speaker 3 (41:30):
Hope you have a great rest of the week.
Speaker 1 (41:34):
Do take stock and inventory of your health and wellness,
and don't figure out. Doctor Joeglotti dot com is our website.
Stay in touch with me and my team. Have a
blessed week coming up.
Speaker 3 (41:46):
Take care
Initial life sequence.
Speaker 2 (00:04):
Coming to you live from Houston, Texas, home to the
world's largest medical center. They approach phase everything looking all.
This is Your Health First, the most beneficial health program
on radio with doctor Joe Gallotti. During the next hour,
(00:26):
you'll learn about health, wellness and the prevention of disease.
Now here's your host, doctor Joe Galotti.
Speaker 1 (00:46):
Well, that's another Sunday evening in America. Thanks for tuning in.
The name of the program is Your Health First. I'm
doctor Joe Galotti, and we're here every Sunday between San
n eight pm Central Time. We're broadcasting out of Houston, Texas,
our home station seven forty KTRH, the Great Station KTRH,
(01:13):
and broadcasting around the globe on the iHeartRadio app. So
no excuse if you are on vacation next week or
the week after and you're out of town and you say,
wait a second, it's seven o'clock Central. We got to
tune into Your Health First. You can get us no
(01:37):
excuse to miss a single episode. Our website Doctor Joegalotti
dot com, sign a for our newsletter. All of our
social media is there, our blog posting is there for
lots and lots of health and wellness information articles we've
written over the years, and our podcast is there at
(02:01):
doctor Joegalotti dot com. So uh big, well, not a
big weekend. I woke up this morning and read the
headline Lindsey Graham, Senator from North Carolina dead sudden event,
(02:21):
a very short illness. Uh yeah, pretty short. I think
they would call this cardiac arrest as the papers are reporting.
And I looked at this and I said to myself,
we need to incorporate this into the program tonight. Coming
up in a little bit, my good friend and colleague,
(02:43):
doctor Mike Wilson, cardiologist. His first name really is James.
I don't know why they call him Mike. I don't
see him as a gym or a Jimmy. He's Mike Wilson,
doctor Mike Wilson. Here in the Texas Meat Center. He
(03:03):
comes on a lot to answer these kinds of questions.
He's always very articulate and knowledgeable. So doctor Wilson's going
to be coming in a little bit to try to
shed a little bit of light on this. What you know,
he was seventy one, Lindsey Graham was seventy one, And
whenever you see these stories, you cannot help, or you
(03:28):
should self reflect and say, oh, man, I'm seventy one.
If it could happen to him, it could happen to me,
or you could be fifty one, or he could be
eighty one. So when you have these sudden death episodes,
you have to look back and you know what, I
(03:50):
don't want to say, what doesn't make sense. So everybody
over the years, they I don't want to say they brag,
but they make a point that the elected federal officials, Congress,
and the Senate representatives they have the best of healthcare. Now,
(04:11):
I don't really know what that means as far as
the best of healthcare now, I do not know if
senators go to one of the military institutions. Do they
go to Walter Reed, do they go to the naval hospital.
(04:32):
I just don't know, but I would think what they
may mean by that the best of health. If Senator
Graham calls up somewhere and he wants to be seen
by a doctor, they're going to fall all over him
and say, yes, you could come in today and if
(04:53):
you need this test, yes we will call doctor X
and we will facilitate.
Speaker 3 (04:56):
So I think.
Speaker 1 (04:56):
It's availability, but that does not always mean you're getting
the best care I have taken care of in my
nearly thirty five years. You know, I would say, well
to do people, you know, if you want to call
them celebrities or whatever, and I would say, outright, they
(05:17):
get some of the worst care because they do not.
You know, the doctors and nurses do not want to
confront mister Big or miss Big about what they're doing
or they're not doing. It's basically, don't ruffle the feathers.
Don't insult them, don't tell them they're drinking too much,
don't tell them they're overweight or they're smoking.
Speaker 3 (05:38):
Just go with the flow.
Speaker 1 (05:39):
Be nice, get an autograph and a selfie. But the
truth is a seventy one year old person as a
non cardiologist, and we'll see what doctor Wilson has to say.
What is it that causes a seventy one year old
to abruptly die? Some would call this sudden death. Well,
(06:04):
no matter how you slice and dice it, the majority
of us are going to die from cardiovascular disease. That
is the number one killer. So cardiovascular disease in the
flavor of a stroke, a heart attack, heart failure, or
(06:26):
some other valvular disease or arrhythmium where your heart just
starts beating way out of control, typically too fast, but
your heart can go into a heart block where it
just instead of beating seventy times a minute, it beats
ten times a minute, and that's not good. So you'd
(06:49):
have to think that it's one of those one of
those items. So you have to look back and for
everybody tonight, all of us and anytime, are at risk
for something like this happening. Now you have to do
the you know, the real nuts and bolts of taking
(07:11):
care of yourself is what is your family history?
Speaker 3 (07:15):
Did you have a.
Speaker 1 (07:17):
Mother or father or a brother that died prematurely from
heart disease, cardiovascular disease, arrhythmia. If that is the case,
and I'd say somebody that had serious cardiovascular disease, probably
you know, under fifty five, I would say that's a
red flag that you need to pay attention and get
(07:40):
checked out specifically with your doctor. To say, my father
passed away at fifty two suddenly of a heart attack, okay,
rather than he had a heart attack when he was
ninety eight. That's that's a completely different story. So family
history is always going to be important. And then you
get into the other risk factors. Do you smoke? Certainly
(08:03):
smoking increases your risk of cardiovascular disease, developing plaque, stiffness
of the arteries, arterial disease in your brain, and or
your extremities in your legs in particular. And then it
is cholesterol. What's your cholesterol? And I'm going to be
(08:24):
asking doctor Wilson his take on cholesterol, but would I
would say, as much discussion as there is about cholesterol,
there is still a sense a lot of the patients
I see are slightly under treated. Physicians will and it
(08:45):
may be the choice of the patient.
Speaker 3 (08:48):
They will.
Speaker 1 (08:50):
Ask, instead of getting on a statin, can we give
it some time with diet and exercise. I swear to you, doctor,
I will lose weight, will eat better. That doesn't always happen,
especially when you have a lipid profile that's staring you
in the eye that you know is not the preferred
(09:11):
set of numbers. And then there's diabetes, and pre diabetes
is almost a bigger menace than diabetes itself. There are
so many people with pre diabetes that will eventually turn
the diabetes that you want to treat it now, intervene
now through diet and exercise and potentially medical therapy, and
(09:36):
so all of these issues should give you pause to say,
what what bucket do I fit into? Am I in
the overweight or obese bucket, the high blood pressure bucket,
the diabetes or the pre diabetes bucket, the smoker's bucket?
(09:57):
Or do I have a little of everything? Sort of
a piree of risk factors. I'm overweight, i have a
bit of elevated cholesterol.
Speaker 3 (10:05):
I've got this.
Speaker 1 (10:06):
My doctor said my blood suggars were a little high,
and I smoke a pack of cigarettes once a week.
Speaker 3 (10:18):
Now.
Speaker 1 (10:18):
The other interesting thing is, and many of you know
I am a hepatologist, I'm a liver specialist. Fatty liver
disease is one of the top things that we are
seeing in liver disease. But people with fatty liver they
got there because of obesity and high blood pressure, cholesterol
(10:42):
issues and type two diabetes. So I'm seeing you for
fatty liver. Fine, we will address all of these issues separately,
risk assessing your cardiovascular disease and trying to get the
lipids under control, in a better diet and lose weight.
And there are medications for fatty liver that we can
devene with. But really, the little secret is that the
(11:04):
majority of people with fatty liver die of cardiovascular disease.
And so you may be sitting at home saying, well,
I just have fatty liver. Okay, that may be true,
but you are at risk for cardiovascular disease as well
and a sudden event like Lindsay Graham appears to have had. Now,
(11:30):
the other interesting thing is that the reports are saying
he just came back from a trip to Ukraine. Now
that has got to be I don't know, eighteen to
twenty hour flight sitting still, did he develop a clot
in his leg called a DVT deep venus thrombosis that
(11:52):
then broke loose and he developed a pulmonary embolism. A
clot goes to your lung. If that is the case,
this clot, depending on how big it is, can cause
sudden death. You may present with some chest pain, shortness
of breath which can lead to heart failure, sudden heart
(12:15):
failure literally in a matter of minutes, and or develop
an arrhythmia.
Speaker 3 (12:21):
That is fatal.
Speaker 1 (12:23):
And you could do all the CPR in the world,
it is not going to dislodge this pulmonary embolism. So
I would think that an autopsy, considering who he is
and the suddenness of it, an autopsy will be performed.
And I would not be surprised if he had a
pulmonary embolism. Now, if you're taking a wager here, those
(12:49):
a lot of people would still say this is bread
and butter. Cardiovascular. He had a heart attack, he had
a sudden arrhythmia of ventricular tacic already. But again, you know,
if EMS came and now it could have been you
don't know the time from him getting sick or going down.
(13:10):
EMS comes and they hook him up to a monitor
and they try to use a defibrillator too much. Time
may have may have passed, you just you just don't know.
But I think it'll be very interesting on the deep
venus thrombosis followed by a pulmonary embolism causing a sudden issue.
I mean, to me, just as a casual observer, the
(13:30):
guy seemed like he was everywhere, like he was not
really ill appearing. He seemed a bit overweight. But I think,
you know, a chronically ill appearing person maybe not all right,
We're going to take a break right now. Don't forget
Doctor Joegalotti dot com is our website. Go there and
(13:54):
find out what we do Center Front Newsletter and I'll
be back in one minute or two. Welcome back everybody,
Doctor Joe Glotti, thanks as always for tuning in on
this glorious Sunday evening, spending a little time with me
and all of us together, making you better consumers of healthcare,
(14:17):
raising your health IQ, all of that good stuff.
Speaker 3 (14:20):
It is all rooted in.
Speaker 1 (14:23):
Knowledge, but it is wanting the knowledge, wanting the knowledge,
and that goes for anything in life. There's a ton
of information out there for people to absorb and integrate
into their daily routine. But do you want to learn this?
(14:44):
Do you want to learn how to eat and cook better?
Learn how to exercise in a better way or in
a way that doesn't get totally monotonous, or take the
interest in a certain disease that you may have or
you may be at risk for, and having knowledge which
(15:07):
is so powerful and intervening small changes, small changes can
go a very long way. Doctor Mike Wilson is coming up.
We're going to be talking about heart disease and Lindsey
Graham seventy one year old senator from North South Carolina
that died last night some sort of sudden cardiac event,
(15:30):
cardiac arrest. We don't know the details, doctor Wilson, nor
I have anything to do with Lindsey Graham's healthcare. Just
a disclaimer, we'll have doctor Wilson on to really, you know,
have you all think could this happen to me? And
(15:50):
it doesn't matter if you're seventy one, eighty one, sixty five,
fifty eight, forty two hike. We have to be aware.
Speaker 3 (16:01):
And you know what I like to say, you.
Speaker 1 (16:06):
Plan for the best, or you hope for the best,
plan for the worst. Hope for the best, plan for
the worst. So planning for the worst is making sure
your blood pressure is under control, your diet is in
line with what you should be eating, blood pressure, diabetes,
you're exercising, et cetera. All right, doctor Wilson will be
(16:27):
coming up in just a few minutes. So this weekend
I was on call. And when you're on call, I
cover other colleagues of mine their liver patients in the hospital,
and you meet a lot of people that you did
not know, but you're dealing with patients that are in
(16:51):
the hospital, in the intensive care unit, and we have
a very sick population of patients with liver disease. They're
waiting for liver transplant, they are on life support, they're
on dialysis, they're on respirators, and the families are absolutely
beside themselves trying to mentally cope with sick a sick
(17:18):
loved one. It could be a daughter, it could be
their husband, their wife, their brother or sister. But it
is a lot to handle. And I look at these
weekends as opportunities to certainly educate all of these families
and the patients if they're awake, but also for myself
(17:42):
to reflect on, you know, what is the state of
affairs out there, And there are individuals and believe me,
I know the duress that they're under trying to, you know,
deal with the potential that a loved one may not live.
Getting a liver transplant, depending on the situation, seems like
(18:05):
a very thin opportunity, depending on how sick they are.
We're lucky at here at Euston Methodist Hospital. It's the
largest liver transplant program in the country. We have, bar none,
the most experienced team collectively in taking care of these patients,
but it's still very daunting, and what it comes down
(18:26):
to so many families, they not that they don't get it,
not that they don't understand, but their understanding of the
disease process, how they got here, how their loved one
got here, is sometimes just a big black hole. They
were living with this person, they were in maybe constant
(18:49):
contact with this person, maybe they didn't live together, but
they were intimately involved in their life. But they are
still really befuddled as to how could this have happened?
Why did this happen? And you know, we have, you know,
(19:10):
the entire case, the entire history, and we try to
explain to them that this person has had X y
Z disease for the last five years. Things were done,
things were not done, they followed directions, they did not
follow directions, or it's a disease that, no matter what,
(19:32):
will progress to this end stage point. And so there's
this look of amazement like, oh, I never knew that. Well,
they you know, we know that they've been told, but
it's just so much to sink in. So again, so
much of health and wellness and the path that we
take really depends on you, the consumer, and that's why
(19:55):
I always talk about you, the consumer in healthcare, to
really get a deep dive into your health affairs. All right, newsweather,
traffic coming up. We'll hear about sports, the astros, maybe
a little bit about World Cup. I'm doctor Joe Glati,
Doctor Mike Wilson will be up after the break. All right,
(20:16):
Every Sunday evening between seven and a pm.
Speaker 3 (20:21):
You should be tuned into your health first. I'm doctor
Joe Galotti and.
Speaker 1 (20:27):
Big news day unfortunately for our government, and as I
was talking earlier, we're going to have an expert to
try to make you think and understand what may have
happened to poor Lindsey Graham, the Senator from South Carolina
and no stranger to your health first, Doctor James Michael
(20:49):
Wilson here in the Texas Medical Center. Doctor Wilson, as always,
thanks for bailing us out and shedding a little light
on this topic.
Speaker 4 (20:59):
Yes, sir, happy to be here.
Speaker 3 (21:00):
All right.
Speaker 1 (21:01):
So I woke up this morning like many that Lindsey
Graham dead at seventy one. And you know the headline
is a brief illness. Yeah, like about thirty minutes of
cardiac arrest. That's pretty brief.
Speaker 3 (21:16):
And apparently.
Speaker 1 (21:20):
According to some reports, he called emas or somebody called
EMS chest pain. Next thing you know, people are doing CPR.
Next thing, he's deceased. So for people listening tonight, that
may be seventy one, that may be sixty, that maybe
fifty five. So when you see something like this, what
(21:42):
goes through your head as far as what may have
happened to him?
Speaker 4 (21:49):
Well, the first thing is that when somebody his death
after rapidly after onset of illness, we call that. If
it happens within twenty four hours or before you can
call anybody for help, we call that sudden death. Right,
So if you take all comers with sudden death, just everybody,
(22:12):
there's a little over fifty percent chance that heart disease
was the major precipitate. In all the studies that have
looked back at stuff like this, there's kind of two
big categories. There's the people who died suddenly and were
not resuscitated or no attempt was made and their evaluation
(22:34):
came at autopsy. And there's a whole other group and
whom EMS made it there or somebody was able to
help and get them back. And if you take the
two groups of people, the people that you get back.
Most often have heart disease, and it's usually cordinary artery
disease or heart attack, right, and the people that don't.
(22:55):
It's about a little over fifty percent of heart disease
in about twenty five percent of those are heart attacks,
and a pretty large proportion or other cardiovascular illnesses like
pulmonary embelis a big blood clot that goes to the
lungs right dis section of the order which is a
tear due to high blood pressure right and stroke is
(23:19):
actually still one of the big big causes of sudden death.
Speaker 1 (23:23):
Yeah, so when you hear the reports and again you
nor I have taken care of Lindsay Graham. I don't
believe you haven't made any nefarious trips to Washington dately,
have you South Carolina or South Carolina? But you know
it's being reported there was a problem. EMS was called
(23:45):
and CPR was started and next thing you know, the
poor man died. Could that be stroke? Could a stroke
present like this or you know, maybe not so?
Speaker 4 (23:58):
Stroke is a probably not so. Stroke that causes sudden
death is usually like a lightning bolt from the sky.
Just you are fine and all of a sudden you
collapse to the floor. Right, that's it, right, this kind
of thing where he says, I don't feel good, call
(24:19):
for help, that's going to more likely be heart related
or since we know he just returned on a long flight.
Absolutely absolutely right, Yeah, a pulmonary embolus, which is a
lot of times something that can be discovered, but it's
(24:40):
so bad that you can't be resuscitated.
Speaker 1 (24:43):
Right, right, And it could have been. A pulmonary embolism
can present with chest pain and shortness of breath and
to the untrained eye may see, oh he's having a
heart attack, right, and you can wrap deteriorate and develop
arrhythmias and all kinds of other things, and you know,
(25:04):
to your point, just not not be able to come back.
Speaker 4 (25:10):
That's correct.
Speaker 3 (25:12):
Yeah, So yeah, Well.
Speaker 4 (25:15):
The other thing is you said, well, he just came
from a long trip, this was probably pulmonary. That's true,
but he's a seventy one year old man who was
not in very good physical condition by all appearances, right,
uh huh. And statistically, the likelihood is still going to
be very high that this was a cornery event that
they had heart disease exactly.
Speaker 1 (25:37):
So for the you know, the men and women listening tonight.
And again, whether you're seventy one, you're seventy five, or
you're fifty five. The goal for all of us, and
especially those in cardiovascular disease like yourself, it is prevention,
primary prevention. So how how do people look themselves tonight
(25:59):
or tomorrow and say how does this not happen to me?
Now that that's a big ask for you, but again
we have to have this dialogue and people need to
look at their risk factors and how they feel and
really what they're doing with regard to their health and wellness.
Speaker 4 (26:17):
Right well, with a lot of forms of curdy vascular disease,
this is your way out. I mean this. You become
ill and in a very short amount of time you're
not treatable and you die right and prevention is the
only way to get around it. And there is a
reason that we hear all these same recommendations we get
(26:41):
beat over the head with don't eat too much salt,
don't eat too much, try to regulate your weight, your doctor,
measure your blood pressure, eat healthy, check your cholesterol. All these,
all these what I call chicken soup recommendations are enormously
helpful in preventing the diseases that cause or many of
(27:05):
the diseases that cause what Lindsay Graham.
Speaker 1 (27:08):
May have had.
Speaker 3 (27:09):
Yeah.
Speaker 1 (27:09):
Yeah, And so when you look at the top risk factors,
but also the things that you could potentially intervene on.
Speaker 3 (27:19):
Weight.
Speaker 1 (27:21):
We are in a sea of obesity and people that
are overweight, and it almost has become the new norm
that everybody is overweight?
Speaker 3 (27:30):
So why pick on me?
Speaker 1 (27:31):
But it has such a downstream negative effect on our health?
Speaker 3 (27:37):
How do you look at it? As a cardiologist?
Speaker 4 (27:41):
The obesity is undoubtedly an epidemic, and as you said,
it's downstream effects on your circulating cholesterol concentration, on your
blood pressure, on various and sundry things that we can
measure are enormous. And the interesting statistic that I think
(28:04):
is incredibly useful is a ten percent reduction in your
body weight if you're overweight, is a fifty percent reduction
in your risk of curdiovascular events.
Speaker 3 (28:14):
Tremendous.
Speaker 4 (28:16):
There is not any medicine that works that well, right,
So simple lifestyle measures actually go a long way. Yeah,
A little bit of walking every half an hour, walking
every day, cutting five hundred galleries at in your diet,
even a little bit of weight loss. You don't have
to become a runway model to get the benefits of
(28:39):
weight loss.
Speaker 1 (28:40):
Yeah, now, a lot of patients because of the patients
that I see, and we share many of them together
with fatty liver who have obesity and high blood pressure
and type two diabetes. The cholesterol issue, We've had other
experts on the program over the last couple of years
about how important it is to understand your cholesterol and
(29:04):
getting it down. I like to say there's no such
thing as having a touch of cholesterol elevation, but I
think and you, you know, you fill me in. It
seems like the last few years the LDL cholesterol has
been getting a lot more attention than it may have
in the past. What's your take on that.
Speaker 4 (29:26):
Well, the the truth is that we've kind of known
for many years what the physiologic range is for circulating
LDL cholesterol. It's just that most of the time we
couldn't get anybody there because the medicines that we had
available were potent enough and we didn't have enough ways
(29:47):
to get it there. Right now we do, and now
we understand a lot more of the physiology of athrosclerosis.
So there was in the past an acceptance of what
I would call a non physiologic LDL cholesterol simply because
we couldn't get most people there. Right, that's different today.
(30:10):
And the other thing is that we also understand that
the other different lipoproteins, the HDL, the VLDL one it
called IDL, they have a role in athroskerosis that's complicated
and it can't be boiled down. So simply is cholesterol
ratios and you're good versus your bad. And that's why
(30:32):
we really shine the attention on the LDL.
Speaker 1 (30:35):
But you you would say, there are and I see
these patients myself. They have a ton of risk factors.
They're total cholesterol may be I would say acceptable, but
their LDL cholesterol is very high. And you know, as
well as anybody the I guess it was the American
Heart Association. They want the LDL like less than fifty five?
Speaker 3 (30:56):
Is that right?
Speaker 4 (30:57):
Right? Well, the the thing is that, and I hear
this all the time. People will come in and say, well,
we've found evidence that athrosclerosis and one artery versus another.
And they say, but doctor, I've never had a cholesterol problem. Right, Well,
on one side of the scales, you've got your LDL
cholesterols or on the other side, you have your arteries
(31:19):
and their resistance to it. Right, and if you develop athrosclerosis,
any evidence of it, then whatever your LDL is, no
matter how good you think it is, it's too high
for you. Right And we know that if you get
that LDL under fifty five, and actually there's a lot
of accumulating data that says we ought to have it
(31:40):
a little closer to thirty, right, right, then we're going
to be getting it down to the ranges where it's
okay for everybody.
Speaker 1 (31:47):
Right right now, along those lines, and again, this is
a topic that is you know, we talk about it
a lot, and it's always great to get different opinions.
The carnary calcium score, it's widely available, it's easy, it's safe,
not too expensive. For people listening tonight and they say, well,
(32:08):
I'm a little overweight, i have some high blood pressure.
I'm just on let's say a diuretic thiazid diuretic and
that's about it. I'm not diabetic. What's the role of
getting a carninary calcium scan so that you do not
have a Lindsey Graham moment.
Speaker 4 (32:30):
I think the calcium score is an absolutely wonderful tool
to answer the question of where do I stand in
terms of my risk. When you talk to your doctor,
he's going to take your age and your other risk
factors and get a ballpark idea what your chances are
having trouble in ten years. If you're low risk, you're
(32:50):
generally in pretty good shape. But if you're not low risk,
you really don't know, right. And the calcium score is
essentially like going to Vegas and looking at the dealer's cards. Right,
So I've got sixteen? Do I here? Do I stay?
Speaker 3 (33:07):
Yeah?
Speaker 4 (33:07):
So essentially with a councium score, we get to cheat, Yes,
we get to find out what's in there.
Speaker 3 (33:12):
Yes, exactly.
Speaker 1 (33:14):
And I guess the last comment here because the the
interplay of weight and blood pressure, cholesterol and diabetes. Your
Sunday Night message to everybody on type two diabetes. And
as I've said a million times and we've laughed over
it together, Hey doc, I just have a touch of diabetes.
(33:35):
What is your take on that? And the importance in
cardiovascular health? And you know, again, I think we're going
to coin this Lindsey Graham event. It's really sad for
him and his family, but this may wake people up
on sudden death. What do you what do you think
on the on the touch of diabetes or diabetes in general.
Speaker 4 (33:56):
Yeah, so that's I too. I hear that a lot.
Well doctor, I'm pre diabetic, right, that's like being pre pregnant.
Speaker 3 (34:05):
Yeah, or prey dead.
Speaker 4 (34:07):
You are you? You or you ain't. So once the
abnormal physiology appears, then its adverse effects on your health
have begun. The reason that we have a declaration of
at this point you are now officially a diabetic is
(34:27):
that at this point we know that the medicines we're
going to give you to lower your sugars, their value
to you exceeds the risk that comes with the medicines.
But as soon as that sugar goes up, as soon
as you are quote pre diabetic, you are diabetic and
you just need to control that problem.
Speaker 1 (34:47):
Right, Well, well said all right, well, doctor Wilson, it's
always great to have you on, and maybe we'll have
you back if we hear something about Mitch McConnell in
the next week or two. So it's it's bad, all right,
doctor James Michael Wilson here in the Texas Medical Center
used the Methodist Hospital. It's always great having you on.
(35:07):
Thanks again, Thank you, all right, good by now all right,
final segment coming up on Your Health First, Doctor Joe Glotti.
Don't forget doctor Joe Galotti dot com.
Speaker 3 (35:22):
We'll be back in a minute. Welcome back, everybody.
Speaker 1 (35:24):
Final segment of this week's Your Health First. I want
to give a big thanks to doctor Mike Wilson for
coming on and shedding a fair amount of light on
the whole Lindsey Graham sudden death issue. I think it's uh,
it'll be very interesting to see what we find out
(35:45):
in the uh in the days and weeks to come.
I'm almost positive and autopsy will be done and we'll
see what happened. But again, this is a great opportunity
for all of you to take stock what are your
risk factors? And you don't want to find out that
you have a health issue when it presents itself as
(36:09):
a calamity. We we know a lot about risk factors.
Who has heart attacks, who has diabetes, who has strokes,
who develops cancer. We know people that drink too much
get cirrhosis. We know people that smoke at lung cancer
and emphysema. We know that people that have diabetes out
(36:31):
of control, high blood pressure, out of control, end up
on dialysis. So let's try and take ownership of these issues,
all right. So in the last few minutes here, so
social media. Let's talk about social media for a second.
So I have a social media presence of sort, trying
(36:58):
to communicate information to patients and the community on basically
a lot of what we talk about here. And I
did a TikTok video about been maybe about a month
ago on whether or not physicians are examining their patient. Now,
(37:18):
when you come to me as a new patient, you
will get into a gown, you'll get down to your skivies,
your undergarments, and we.
Speaker 3 (37:29):
Will examine you.
Speaker 1 (37:30):
Yes, we are a liver service, that's our specialty or
digestive issues, and there's a certain part of the abdomen
that we will be looking at. But we will look
at your eyes, we will look in your mouth, we
will take a look at your teeth. We'll feel your
neck for any lymph nodes, will listen to your lungs,
(37:51):
look at your extremities, check your pulses. So we will
do a head to toe physical exam. You come back,
we may do the exact same thing again. Now I
have seen patients that come to me and we're chatting
and we're getting to know their history, going over the records,
(38:12):
and I may say, Okay, I am going to step
out for a moment. Here is the gown you could change,
keep your onund the garments on, open the gown to
the front, and I'll come and examine you. And they
will look at me and say, doctor Galotti, what are
you going to do? And I said, well, you're here
with this problem. We're going to examine you. And they
will say why and I'm like why You're not, Well,
(38:36):
I'm a doctor and that's what we do. That's part
of the the evaluation is a physical examination. And they
then the patients by and large will say nobody else
has ever done this. And then I will very carefully ask, well,
you've been seeing these doctors, that group, that clinic, whatever,
(38:57):
and I have all the records and I'm like, I
have Have they not examined you? And they would say no.
They just sit and talk to me, maybe look at
the computer with back turned. I get a prescription, I
get a referral and that's it. And I'll say never
ever and they're like, no, never ever have I been
examined or maybe they will listen to the heart and
(39:19):
that's it. But nobody's getting into gowns and getting a
detailed physical examination. That sparked on TikTok hundreds of thousands
of visits comments. It was unbelievable, It blew up, It
sort of went viral. And so I do think that you,
(39:44):
as the consumer, want to be in a practice with
a team of professionals that are taking care of you
for your problems, whether it's a minor or a major,
that are paying attention to your physical exam. Now, there
is a lot of technology, these laboratory tests that in
a sense replace a lot of things we used to do,
(40:06):
and imaging, galore, MRI, pet scan, X rays, ultrasound, everything imaginable.
Technology is getting better, but there's still something to be
said for the physical examination and what information that gleans.
It still is very valuable. So the message tonight, if
(40:31):
you're in a situation where you have a chronic problem,
where you're seeing your doctor more than just once or
twice a year and they're not examining you, then I
think you really have to question the care you're getting.
I'll be honest, I'm not here to disrupt relationships with
patients and doctors. I don't have a solution, but you're
(40:53):
going to have to seek.
Speaker 3 (40:57):
A better quality of care.
Speaker 1 (41:00):
And the comments that everybody wrote back are doctors are busy.
They're so busy they can't take care of you, or
it's the insurance company, or they're not getting paid enough.
They have to see sixty patients a day to make
ends meet. And that may be true, but that's a
bigger part of the problem. So just a thought. You
could probably go on TikTok at doctor Joe Galotti. I no,
(41:22):
that's not it. It's I'm sure you can find me
on TikTok and take a look at that. But anyway,
we're going to close out.
Speaker 3 (41:30):
Hope you have a great rest of the week.
Speaker 1 (41:34):
Do take stock and inventory of your health and wellness,
and don't figure out. Doctor Joeglotti dot com is our website.
Stay in touch with me and my team. Have a
blessed week coming up.
Speaker 3 (41:46):
Take care
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