May 3, 2026 • 42 mins
Dr. Galati starts the program with a friend who reached out looking for a specialist to help a relative who has multiorgan involvement. He also explains the need for the ten to fifteen percent of sicker patients that need to get in and be checked out. Dr. Galati has Dr. Joseph Rogers join the show to talk about cholesterol. He ends with the emphasis on sleep with May being Sleep Awareness Month.
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Speaker 1 (00:01):
Initial life sequency.
Speaker 2 (00:04):
Coming to you live from Houston, Texas, home to the
world's largest medical center.
Speaker 3 (00:08):
He approach base everything looking.
Speaker 2 (00:19):
This is Your Health First, the most beneficial health program
on radio with doctor Joe Gillotti. During the next hour,
you'll learn about health, wellness and the provention of disease.
Now here's your host, doctor Joe Bellotti. Well a good
(00:49):
Sunday evening to everybody. Doctor Joe Galotti, I'm glad you're
spending a little bit of time with us Tonight's the
name of the program is.
Speaker 1 (01:00):
Your Health First, and the goal is to make you
better consumers, raising your Health IQ, and the goal is
to make everybody well. We cannot snap our fingers and
(01:22):
cure cancer. No, we cannot do that, nor are we
claiming to do that. But I would say that you
have to have the tools to have the understanding of
what causes cancer, what causes heart disease, complications of smoking,
(01:45):
excess alcohol, not exercising enough, not getting enough sleep. So
if if you have those tools with you and that
you could share with your family, many of the chronic
conditions that we see, the conditions that you may have
(02:06):
or a parent or a spouse or child or best
friend has can be mitigated. That is the whole idea here. No,
we're not saying we're going to snap our fingers and
everybody's going to be healthy and lived to one hundred
and five. That's not it. But in all the years
that I've been doing this to feedback from not only
(02:28):
listeners like you, but my own patience, it is the
information that they have to make the proper decision. That's
really where it's at. Our website very simple, doctor Joegalotti
dot com, d R J O E G A L
A t I dot com and when you're there, sign
(02:50):
a for our newsletter. Yesterday Saturday, the newsletter went out
and it was all about garlic. Now. The one right
before that was about olive oil, and people wrote to
me and they said, well, we like this one about
olive oil. Can you tell us about garlic. And so
we sent out the newsletter with everything you need to
(03:12):
know about garlic garlic one oh one I titled it.
And all of our social media is there, ranging from TikTok. Yes,
we put stuff on TikTok, content that you could use, Instagram, YouTube, Facebook,
our practice website, which is Liver Specialists of Texas Texasliver
(03:36):
dot Com coming on in a little while. Doctor Joseph Rogers,
he is a friend of your health. First, he is
a renowned cardiologist, and he is the director of the
Texas Heart Institute at Baylor College of Medicine, right here
(03:56):
in the world famous Texas Medical Center. And the ask
I'm going to give doctor Rogers is how do all
of you address the cholesterol issue? Now? I see patients
every day with high cholesterol, and I know the cholesterol
(04:19):
for me is important because what I see is something
called fatty livid disease. You've heard me talk about this,
I'm teen times. But where there is fatty livid disease,
there is obesity, there's high blood pressure and diabetes, and
there are cholesterol issues. And when a new patient comes
(04:43):
in and where really breaking apart their history and risk
factors and why is this happening? Why is that happening?
How did you get here? The cholesterol issue always comes up,
and nominally they will say we're watching it. Now there again,
(05:06):
there again. I've talked about this many, many times. How
I am not a fan of the term watching it
because in my experience, and this is strictly my experience,
thirty five years, watching it means don't worry about it.
Kick it to the side of the road. We'll check
(05:27):
in when you come back next bob. Oh, in a year, Okay,
in a year, we'll look at it, and then another
year goes by and we're gonna look at it again
and we'll see you next year. So if you're watching
it with active intervention, last week we had doctor Eguaman
talking about just watching things, and his episode is linked
(05:51):
on our podcast. So if you want to see what
we were talking about last week, go back to our podcast,
which is on doctor Joeglotti dot com, or you could
get the podcast anywhere podcasts are found. But so a
lot of the times people are coming in with yes,
my cholesterol were watching it, Well, it's pretty elevated and
(06:14):
you've got pre diabetes. Oh, we're watching that too, And
so it sort of drives me a little nuts to
tell you the truth, where you have to try and
explain to patients that watching it is not necessarily the
(06:35):
answer when there is so much cardiovascular disease and people
with faty liver are dying of heart disease. That is
the central issue. So if they were not dying of
heart disease. Maybe you could get a pass, but they're
dying of heart disease. What's the root cause of heart disease?
You know, typically cholesterol and plaque build up and inflammation
(06:55):
in your arteries. So doctor Rogers, a real expert, is
going to come on and chat about cholesterol. And I
would say, at the end of his discussion, conversation with me.
(07:16):
All of you should be armed with a conversation to
have with your doctor, be it your internest, your primary
care physician, family practitioner, you're gynecologist, whoever you're seeing, your
PA or nurse practitioner that you may be seeing. So
(07:38):
sharpen a pencil, get a clean sheet of paper, and
be ready to take action. That's what I would say,
all right. So a friend of the show reached out
over the weekend about a relative. I don't know the relation.
(08:00):
I know the family, but I don't know the relative.
Speaker 4 (08:04):
And.
Speaker 1 (08:06):
They were asking for a little bit of direction on
some specialists to see what did they think of the situation,
et cetera. And certainly one of the hats I wear
is being a connector as best I can connecting a patient,
(08:31):
a family member, or friend with somebody else that can
truly address the problem at hand, and so hearing about
this relative who had, you know, a multitude of problems,
we would say multi organ involvement. So there may be
(08:52):
and I'm not saying this is this particular case, but
when we say multi organ involvement, it may be anything
from heart and kidney, her kidney, liver, various glands, thyroid, adrenal.
Many times it will involve the digestive tract and the kidney.
(09:15):
So there are a lot of diseases that are multi organ. Okay,
So just trying to get the lay of the land
with this individual person and how I might be able
to help or steer them in the right direction. But
you know, the thought that came up in one of
(09:38):
the messages that I received is that number one, they're
concerned about this relative. Number two, they are very symptomatic
and they're sick. They're not feeling well, but yet getting
into a specialist's office either a new visit, consultation or
(10:03):
a follow up. So somebody that's established with doctor X,
you need to follow up either to follow up on labs, scans,
test results. You have to get in and say, okay,
what is the plan now? And in medicine. We set
up a you could say, in a sense, a series
of decision decision nodes. If this test is positive, then
(10:27):
we're going to go in this direction. If this is abnormal,
you need to see a surgeon, get a biopsy, and whatever.
So at every turn, decisions have to be made, and
people cannot live in limbo just simply going along. And
so the message was, yes, she needs to see a
(10:52):
specialist or two, but the appointments are not until July,
latter part of July, I believe. So here we are
the beginning of May, all of May, all of June,
and let's say two weeks of July. That is ten weeks,
(11:17):
ten weeks waiting to get the next step, the next plan,
the next therapy. And I find it absolutely unacceptable. Now
you may say, well, people are busy, and you can
only you can only see so many people. You can't
(11:41):
you can't be at the office seeing patients twenty four
hours a day. And I understand that. I understand that.
And even with my own practice, we have a schedule,
and it is it fills up right. You You cannot
make water out of a rock. If you're filled, you're filled.
(12:04):
But physicians' offices, and really it is the physician themselves. Now,
if you're a physician, some sort of health care provider
out there, you may say, uh, doctor Galotti, you don't
know what you're talking about. Well, I think I do
know what I'm talking about because I deal constantly with
(12:28):
sick people that are complicated multi organ I take care
of patients with livid disease. But you show me a
patient with liver disease and they have nutrition issues, GI issues,
neurologic issues, kidney issues, brain issues. Okay, So the physician
(12:51):
has to realize I am in a specialty that may
see sick patients. Maybe it is ten percent of your
patient population, maybe it's sixty percent of your patient population,
maybe it's more. But they have to figure out a
(13:12):
strategy of sort how they get these sick patients in
to provide the care. And I'm sorry, ten weeks is
too long. I'm gonna take a break right now. We'll
(13:32):
follow up on this because I do think for you,
the consumer, the patient, these are some good points on
how to navigate all this. All right, Doctor Joe Glotti,
Your Health First, What a perfect name for a radio
program broadcasting from our home station seven forty k TRH
(13:55):
in Houston, Texas and across the iHeart Radio app. Stay tuned,
We'll be right back. Welcome back, everybody, Doctor Joe Golotti.
Every Sunday between seven and a PM. I'd love for
you to all be here sharing the good word on
health and wellness, making you better consumers of healthcare, and
(14:19):
allowing you to have the tools to navigate the healthcare
system which does get a bit unruly. Doctor Joglotti dot
com is our website, all right. Coming up shortly, doctor
Joseph Rogers from the Texas Heart Institute at Baila College
of Medicine talking about cholesterol. So as I was saying
(14:43):
in the last segment, the physician is the leader of
the practice. He or she has to have let's say, disciples,
people that are like minded on the mission. We're going
to take care of sick people with kidney disease, sick
people with neurologic disease, sick people with lung issues, whatever
(15:05):
it may be, so that everybody is on board to
say that while most of our patients, let's say seventy
percent are pretty healthy, nothing immediately life threatening or nearly
life threatning. I will say immediately life threatening, like you're
going to die tonight, less critical chronic. You're going to
(15:30):
have to have a mechanism to see that ten fifteen
percent of the sicker patients that are symptomatic, they're not
doing well. They're not thriving when somebody is not well,
they are not thriving in one form or another. They're
(15:52):
not thriving like they're not gaining weight. They're not thriving
like they cannot walk, they cannot sleep, they cannot digest
food or mentally, they're just not thriving. So you have
to look and say, how are we going to approach
the ten percent? Well, yes, we all have schedules, but
(16:18):
I would say a day does not go by, and
I'm not here to get some sort of purple heart
to say, oh look at me, look how good I am,
because I know plenty of physicians that this is the
way their practice is. They fit you in and the
staff doesn't give pushback to say, doctor Johnson, do you
(16:45):
know you're full? And we're already have one overbooked patient
or whatever the case may be, and doctor Johnson says, oh, well,
oh okay, okay, let's kick it, kick it down another
week or two there has to be that a spree
to core that everybody involved is rowing in the same
(17:06):
direction and wants to help these ten percent of the
sick patients. And so now what do you do? So
you're there with a relative or yourself, your wife, your brother,
whatever it may be, and you have to really really
examine the practice to say, why can I not get
(17:27):
in if I am sick and not thriving. Now you're
not going to say they don't care, No, I'm not
going to go that far. But there's something systemic within
the practice that does not allow for the sicker patients
to get in. So, as I've said many times, you
have to find a practice, a provider that understands and
(17:54):
appreciates that ten or fifteen percent that are the sick patients.
What are we going to do with them? And as
I had said earlier, a data does not go by
where I will get a call from somebody or a
patient or a friend a neighbor that will say, hey,
I've got this friend of mine that really seems sick,
(18:16):
and I'll give them a call get the information. I'll say, yes,
you are sick, you cannot wait another week to get in.
I'll alert my staff, We get them in and we
take care of it. Do we sometimes have to stay
a little later? Yes, does it take a little bit
more time? Yes, we put ourselves out. So for all
(18:37):
those that are in this limbo of trying to get
into see somebody, you have to look and say, is
this the right practice for me? And do I need
to change practices to a practice that can accommodate me
or my relative when they are more sick. And sometimes
(18:59):
it means going to another city, It may mean having
to drive an hour to get to somebody on that's
on the edge of town, or whatever the case may be.
So I believe that as consumers we cannot tolerate this
idea that it takes ten weeks, eight weeks to follow
(19:20):
up when somebody is not is not thriving. Hopefully I
got my point across, all right, Doctor Joe Golotti, thanks
for tuning in on this very lovely Sunday evening. Doctor
Joeglotti dot com is our website. Don't forget suner for
our newsletter so that you never miss a step of
(19:40):
what we're doing. Doctor Joseph Rodgers is coming up talking cholesterol.
Stay tuned, Welcome back, everybody, doctor Joe Galotti on Sunday evening.
The name of the program is Your Health First. Don't
forget doctor Joeglotti dot com is our website, And as
I was saying earlier, it is real treat to have
(20:01):
doctor Joseph Rogers on the line. He is the director
of the Texas Heart Institute at the Bailey College of Medicine,
right here in the world famous Texas Medical Center. Doctor Rogers,
thanks for coming on and having a chat about cholesterol tonight.
Speaker 4 (20:17):
Well, doctor Gladia, thanks for inviting me. It's always always
my pleasure.
Speaker 1 (20:21):
Well, I had said to everybody earlier, get a sharp pencil,
a clean sheet of paper, take notes, because I believe
the conversation we're going to have now should be able
to serve as a guide for next time patients go
to the doctor to have a conversation about their cholesterol
(20:43):
and really make sure that they're getting the right care.
My sense is that there's a little bit of misunderstanding
about cholesterol. Who needs to be treated, who could be watched,
who needs a statin? So you're the expert, doctor Joe Rogers,
how about you just start off with how should everybody
(21:03):
look at their cholesterol readings in the blood that they get.
Speaker 4 (21:09):
Yeah, so Joe, that's a great place to start. So
there's a reading that will be your total cholesterol, and
that's made up a variety of different sub categories of cholesterol.
So the HDL cholesterol is your good cholesterol, and you
would like the good cholesterol obviously to be as high
as it possibly can be. And there aren't many things
(21:31):
that change your HDL or your good cholesterol. Exercises one
of them, but it's probably a little bit more genetically determined.
The LDAL cholesterol is the bad cholesterol, and you want
that to be as low as it possibly can be.
And then the triglycerides are a particle that represents sort
(21:53):
of it's a little bit complicated, but sort of fat
in the blood and it's influenced by blood sugar. But
you also would like your triglycerides down in a good.
Speaker 3 (22:05):
Range, in a normal range.
Speaker 4 (22:07):
So a lot of people talk about this ratio of
good to bad cholesterol. And because we don't have any
drugs that raise good cholesterol and there's not much you
can do about it, what we're really left with is
lowering bad cholesterol. Okay, there's one other thing I think
we should point out to your listeners tonight, and that
is that the American Heart Association has just released some
(22:28):
new lipid guidelines. Not ever your doctor will read these,
but I think there's some really important take home messages.
And the thing I want your listeners to do is,
when you're online, go to the prevent Risk Calculator. And
what that does is it allows you to enter a
little bit of your demographic information like your age and
(22:50):
your sex, your blood your typical blood pressures. You can
put in your lipid profile. There's one measurement of kidney
function that you can get off most blood tests that
starts to tell you what your tenure risk of having
a cardiovascular event is. And I think, armed with that,
next time your listeners go to talk to their physicians,
(23:12):
they can say, listen, I did this, Here's what my
risk is, and here's what the guidelines tell me to do.
So there's you know what a couple of the key
take homes from the Heart Association. One is we should
be treating people much earlier than we have them. You know,
if you start treating early, you're much more likely to
(23:35):
either decrease the severity or prevent the development of corner.
Speaker 3 (23:38):
Artery disease, which is what we'd like to do.
Speaker 4 (23:41):
The current recommendations from the Heart Association are that if
you have a ten year risk of having an event
of between three and five percent, treatment could be considered,
but if your risk is between five and ten percent,
you should.
Speaker 3 (23:58):
Be put on lipid lower in drug.
Speaker 1 (24:01):
Right.
Speaker 4 (24:02):
There's one other thing, sure, and I know that a
number of the people that are listening have diabetes. Yes,
but if you have diabetes, if you have stage three
or four chronic kidney disease or HIV positive patients, the
new guidelines are you should be treated with a statin
regardless of what your LDL cholesterol is.
Speaker 3 (24:24):
Yes.
Speaker 1 (24:25):
Now, being a cardiologist, you're seeing patients that come in
that let's just say, they are not being managed per
the guidelines the latest research. What do you say to
them and what do they say to you with regard
to or you may look, you're you're a great physician,
(24:45):
and you're not going to say, are you kidding me?
You're not on a statin? But what may be in
a bad moment, doctor Rodgers may say that.
Speaker 4 (24:54):
But.
Speaker 1 (24:56):
You know you're you're going to be looking there and
it's somebody with diabetes and high cholesterol and other risk hypertension,
and you're going to you might say, or this is
what I would say, did anybody talk to you about this?
And is it that nobody talked to you? Or you refuse? Right,
so it's okay to refuse, But what are people what
are people saying in the real world.
Speaker 4 (25:19):
Yeah, I mean we still see a lot of people
who are uninformed about their risk.
Speaker 3 (25:25):
And you know.
Speaker 4 (25:28):
It's the wrong answer to this test is to wait
until you have an event, right, you know, you want
to prevent that. And this is this is one of
the hard things about treating cholesterol. It's much like treating
blood pressure. Right, most people don't feel those things. You
don't feel better because you start taking a medicine to
(25:48):
ower your cholesterol or your blood pressure. You're trying to
prevent an event from occurring, you know, years.
Speaker 3 (25:55):
To decades down the road. So it's a little bit
harder sell some.
Speaker 4 (26:00):
Times, you know, to get patients to understand risk reduction, right,
That's really what this is all about, is trying to
get your risk down so that you don't have a
heart attack or a stroke or develop blockages in the arteries.
Speaker 3 (26:16):
To your legs.
Speaker 1 (26:17):
Or your kidneys exactly, and I would rephrase what you
just said that we talk about high blood pressure and
this cholesterol issue about being a silent killer. You don't
want to find out that you have a problem when
the left side of your body goes limp, you know,
having a stroke. Now, the other issue is there are
(26:41):
a lot of new and innovative tests that are being
done with either whole body scans will literally you go
into a scanner from head to toe, or things like
the carnary calcium scan that can be done. And so
people come back and they will say, hey, I had
(27:02):
a score of zero on the on the calcium score,
which is normal, but yet they're overweight and diabetic. Does
that give them license to not worry about their heart?
And then at the same time, they're those that have
risk factors with a high calcium score that are being
(27:23):
slightly undertreated. So where does all this new technology come
in to, either you know, promote more aggressive care or
a greater awareness.
Speaker 4 (27:36):
Yeah, so it's I think it's a The cornary calcium
score is really a game changer, I think in terms
of stratifying patients risk and the just so against your
listeners understand typically when patients begin to get cholesterol deposits
in the walls of their arteries, we can't see that,
(27:57):
but you also get calcium with the cholesterol, and we
can see that on a cat scan. So that's really
what we're measuring, is to see if you're getting blockage,
you're starting to get cholesterol deposits inside the wall of
the artery. It's recommended in these new guidelines that it's
completely reasonable to do that and men over the age
(28:19):
of forty and the women over the age of forty five.
And the reason for that difference, of course, is that
women have some protection from estrogen, the female hormones, and
their athosclerosis manifests later. There's one other caveat to this, Joe,
and that is not everybody lays down calcium. So some
(28:39):
people have these things that we call soft plaques and
they get cholesterol deposits in the arteries without getting calcium,
and we can't see that. To the patient that you
just described, somebody who's obese and diabetic, Well, if you're diabetic,
you know where you and I just started. You said,
be on a lipid lowering drug. So you don't get
(29:01):
a pass even if you're cholesterol even if your calcium
score is zero, right, you probably still are going to
need to You still should be on something, according to the.
Speaker 1 (29:09):
Guy right now. A lot of the times patients have
this really fear of getting on a statin. Either it
is the muscle cramps that people develop. There are again,
I think it's more online and in social media that
(29:30):
it causes dementia, it causes blindness, it causes this and that,
and they just have a real aversion for trying to
get on a statin. And they will come in and
they will say, please, doctor Rogers, give me more time.
I promise I will exercise. I promise I will shift
(29:53):
from a barbecue diet to a Mediterranean diet. How much
wiggle room do you give patience when you really know
that their risk is high or higher than it should be.
Speaker 3 (30:10):
Yeah, so, Joe.
Speaker 4 (30:11):
So lifestyle modification is always the first step. The challenge
is that so few people are actually able to accomplish that,
but some do so. Usually when I see someone for
the first time, if they've not tried a healthy lifestyle,
I'll give them six months and I'll retest their cholesterol,
and I have just very honest conversations. Say, listen, if
(30:34):
it's not down in six months. We really should talk
about more seriously about a medication. And you know, and
I agree, the muscle side effects of statins are real.
Some statins are better than others in terms of keeping
that from occurring. There's some new drugs that don't have
the muscle side effects, but today they're injectable. Right there's
(30:56):
one that's there's a pill that's going to come out
that does the same thing, but right now, those are
the injectable drugs. The dementia thing that you raised, and
you know that you hear this a lot in the office. Yes,
we have never been able to show that there's an association.
And I can tell you so many people have talked
about it, and like you said, it's all over social
(31:18):
media and the internet. It's just we we've done huge studies,
retrospective studies of tens of thousands of people.
Speaker 3 (31:28):
We cannot demonstrate that association, right.
Speaker 1 (31:31):
And you know, on the same point, everybody there is
this discussion of my liver numbers may go up, I
may develop a liver problem. But the truth is, as
a liver specialist here I rarely and I if there's
words smaller than rarely, let's find it. I see patients
(31:52):
with a true bona fide liver problem related to a statin.
But yet even though I tell them that, they're like, well,
you know, my doctor told me it might affect my liver,
and so we I think part of the work we
have is to overcome misunderstandings, people getting information from the
wrong space. But I would I would say that for
(32:14):
the most part, these drugs are safe and the risk
benefit is huge.
Speaker 4 (32:18):
Correct. No, I agree with that completely, And it's that's
no surprise, right. You know, I can tell you what
I do, and I suspect you do the same thing.
And that is when I start a stat and I
go back and remeasure the cholesterol and liver tests three
months later. Uh huh, just to make sure you know
that nothing changed with the with the liver function studies, right,
(32:40):
And like you said, you almost never see it, yes,
And if they if those liver numbers go up just
a little bit, you stop the medicine and they tend
to come right back down to normal.
Speaker 3 (32:50):
And you say, well, maybe you can't take that drug.
Speaker 1 (32:53):
Right right, and there are other options, But not to
throw your arms up and say I'm walking away, So
to to summarize what we would like everybody to know tonight,
to take a few notes to go to their doctor
in a nutshell, addressing total cholesterol, the HDL, the good
(33:13):
cholesterol we want to try to get up, and the
LDL we want to really drive down. And those that number,
the new recommendation is what below fifty five?
Speaker 4 (33:24):
Yeah, So if you have if we if you've had
an event, if you've had a heart attack, the recommendation
is to get your LDL down under fifty five.
Speaker 1 (33:34):
Right now. Suppose now, I was going to say, suppose
that they're, you know, they have some blood pressure issue
and they are fifteen pounds overweight, they're not quite diabetic yet,
but they go and their LDL cholesterol is high. Yeah,
(33:55):
then then what do they do?
Speaker 3 (33:59):
Yeah?
Speaker 4 (33:59):
You know, then I would what I would do, Joe,
is I would I would rely on the prevent calculator
that we talked about at the top of the secondment,
and that is if your risk is between if it's
more than five percent for a ten year event, you
should be on a drug to lower your cholesterol.
Speaker 1 (34:16):
Right, And so I think the take home for tonight,
Joe is if you see again, so much of this
is emotional that you want to try to take the
emotion out and just get to the facts as far
as is my risk low, intermediate, or high, and then
act accordingly, right, correct, right.
Speaker 4 (34:39):
And it's it's it's never the right thing with this
disease to ignore risk, right because as you say, you know,
you said something earlier and I don't want to pass
it by where you said this is the silent killer.
Speaker 3 (34:52):
Yes, yes, just remember the last word.
Speaker 1 (34:55):
I mean yes. Yeah.
Speaker 4 (34:57):
Cardiovaski disease remains the number one cause of death in
the United States, and a lot of it is preventable.
If we can get people's cholesterol down, get their blood
pressure down, get them to stop smoking exactly, let them
to have a normal body weight, treat diabetes, et cetera.
Speaker 1 (35:13):
Exactly. One more time, could you give everybody the website
for the Prevent score.
Speaker 3 (35:20):
Yeah.
Speaker 4 (35:21):
So all you need to do is put in your
web browser Prevent Calculator.
Speaker 1 (35:27):
And that's it. Prevent Calculator.
Speaker 3 (35:28):
That's that's all you have to do.
Speaker 4 (35:30):
And then it'll pull up a page and there'll there's
a little subsite that says online calculator.
Speaker 3 (35:35):
You can enter all your own data.
Speaker 1 (35:37):
Wow, all right, that's that's that's the take home for tonight,
Doctor Joseph Rodgers, director of the Texas Heart Institute at
bail To College of Medicine. Joe, until we meet again.
I really appreciate you coming on tonight. Oh Joe, it's
a pleasure, Thanks very much. All Right, have a great
night now, all right, Doctor Rogers the best. All right,
(35:58):
Doctor Joe Goltti. Final segment coming up. We'll be right back.
Final segment of this week's your Health First. I hope
you're getting ready for a great coming week. I can
tell everybody I think we need to use Sunday evening
(36:19):
as time to prep for the coming week. What's for dinner?
What's the exercise schedule? What does a kid's schedule look like?
Do they have lunch? Don't have them go to the
cafeteria at school. Make them a healthy lunch that doesn't
(36:41):
include cold cuts, luncheon meats, deli meats, stuff, it's poison.
But yeah, I mean, you know, good health doesn't come
by a haphazard approach. And again, Doctor Joeglotti dot com
sound a Ford news letter all things related to health
and wellness. And again we'll be talking about it a
(37:02):
little bit more in the week's come. But a new
book is coming out that I wrote, and the of
course the radio program, but also the newsletter is going
to be the best way that we'll be communicating with
everybody regarding pre ordering and different book events that we're
going to have. So doctor Joeglotti dot com signer for
(37:23):
the newsletter at the top tab. And again I want
to thank doctor Joe Rogers at the Texas Hard Institute
at Baylor College of Medicine right here in the world
famous Texas Medical Center. Always enlightening to hear what he
has to say. All right, final few minutes here. The
(37:44):
month of May is Sleep Awareness Month, and I would
say over ten years fifteen years, the emphasis on sleep
as being a big component of overall health has really
been on the rise, and the research has clearly shown
(38:08):
if you're not getting enough sleep or quality sleep, you're
at risk for obesity. Would you believe that if you
don't get enough sleep you're going to gain weight? Has
to do with inflammation and that whole mechanism there. But
besides the obesity, it is high blood pressure, at risk
(38:29):
for stroke, diabetes, cardiac arrhythmias, accidents at work or on
the road, chronic kidney disease. So sleep is important. Now,
a recent study came out that said about thirteen to
(38:49):
fifteen percent of the population is taking a wide range
of over the counter supplements to help you sleep, changing
from smoking weed if you want to call that over
the counter, to all of these gummies that are available
(39:10):
with sort of these legal gummies with marijuana or extract
in it, to melotone in and a whole host of
herbs that are being sold and promoted as sleep aids. Now,
when you really look at the research, the vast majority
(39:33):
of them have no statistical improvement in your sleep. And
so if you are one of those individuals, you have
to proceed with caution that these things you're taking may
not be any benefit and may actually harm you. And
so at the end of the day, you have to
(39:55):
get at the root cause of the problem. While you're
having trouble sleeping, do you have sleep apnea? I would say,
if anybody is having a problem sleeping, or they wake
up exhausted or they are told that they snore, you
need to go for a sleep study. And that is
(40:19):
I would say, one area in healthcare that is just
not necessarily being promoted enough. Number two. With obesity, not
only are you at risk for a sleep apnea, but
you're at risk for acid reflux heartburn at night. A
lot of people will have what they call silent reflux
(40:41):
and contents and acid from your stomach because you're laying
down and you got this big belly pressing on your
abdomen there and stomach, you're actually aspirating acid and it
is causing you to wake up, clear your throat, and
you really don't even realize it. So you have to
look at when am I eating? Am I eating late
(41:02):
at night? Never go to bed on a full stomach.
If you do have heartburn, you really need to get
that evaluated further. And then there is the group of
patients that are watching TV on their phone, some sort
of screen time that is really disrupting their ability to
relax and fall asleep. And so when you look at
(41:27):
sleep hygiene, which is very important, you have to look
at probably anywhere from two to three hours before bedtime,
you should shut everything off. Now, again we've become ingrained
that you know this is what we do. But again,
just because we do it doesn't mean that it is
(41:50):
completely right. So we'll have more about this as the
month goes on, but do take careful stock of your
your sleep. It really is quite important. All right, that's
it for tonight. We'll end with a little music from
nineteen sixty nine. I'm doctor Joe Galotti. Thanks for tuning in.
(42:15):
It really is a pleasure, best part of my week
this hour. Doctor Joeglotti dot com is our website. Stay well,
stay healthy. Go to the website and calculate your cardiac
risk profile. We'll see you next weekend.
Initial life sequency.
Speaker 2 (00:04):
Coming to you live from Houston, Texas, home to the
world's largest medical center.
Speaker 3 (00:08):
He approach base everything looking.
Speaker 2 (00:19):
This is Your Health First, the most beneficial health program
on radio with doctor Joe Gillotti. During the next hour,
you'll learn about health, wellness and the provention of disease.
Now here's your host, doctor Joe Bellotti. Well a good
(00:49):
Sunday evening to everybody. Doctor Joe Galotti, I'm glad you're
spending a little bit of time with us Tonight's the
name of the program is.
Speaker 1 (01:00):
Your Health First, and the goal is to make you
better consumers, raising your Health IQ, and the goal is
to make everybody well. We cannot snap our fingers and
(01:22):
cure cancer. No, we cannot do that, nor are we
claiming to do that. But I would say that you
have to have the tools to have the understanding of
what causes cancer, what causes heart disease, complications of smoking,
(01:45):
excess alcohol, not exercising enough, not getting enough sleep. So
if if you have those tools with you and that
you could share with your family, many of the chronic
conditions that we see, the conditions that you may have
(02:06):
or a parent or a spouse or child or best
friend has can be mitigated. That is the whole idea here. No,
we're not saying we're going to snap our fingers and
everybody's going to be healthy and lived to one hundred
and five. That's not it. But in all the years
that I've been doing this to feedback from not only
(02:28):
listeners like you, but my own patience, it is the
information that they have to make the proper decision. That's
really where it's at. Our website very simple, doctor Joegalotti
dot com, d R J O E G A L
A t I dot com and when you're there, sign
(02:50):
a for our newsletter. Yesterday Saturday, the newsletter went out
and it was all about garlic. Now. The one right
before that was about olive oil, and people wrote to
me and they said, well, we like this one about
olive oil. Can you tell us about garlic. And so
we sent out the newsletter with everything you need to
(03:12):
know about garlic garlic one oh one I titled it.
And all of our social media is there, ranging from TikTok. Yes,
we put stuff on TikTok, content that you could use, Instagram, YouTube, Facebook,
our practice website, which is Liver Specialists of Texas Texasliver
(03:36):
dot Com coming on in a little while. Doctor Joseph Rogers,
he is a friend of your health. First, he is
a renowned cardiologist, and he is the director of the
Texas Heart Institute at Baylor College of Medicine, right here
(03:56):
in the world famous Texas Medical Center. And the ask
I'm going to give doctor Rogers is how do all
of you address the cholesterol issue? Now? I see patients
every day with high cholesterol, and I know the cholesterol
(04:19):
for me is important because what I see is something
called fatty livid disease. You've heard me talk about this,
I'm teen times. But where there is fatty livid disease,
there is obesity, there's high blood pressure and diabetes, and
there are cholesterol issues. And when a new patient comes
(04:43):
in and where really breaking apart their history and risk
factors and why is this happening? Why is that happening?
How did you get here? The cholesterol issue always comes up,
and nominally they will say we're watching it. Now there again,
(05:06):
there again. I've talked about this many, many times. How
I am not a fan of the term watching it
because in my experience, and this is strictly my experience,
thirty five years, watching it means don't worry about it.
Kick it to the side of the road. We'll check
(05:27):
in when you come back next bob. Oh, in a year, Okay,
in a year, we'll look at it, and then another
year goes by and we're gonna look at it again
and we'll see you next year. So if you're watching
it with active intervention, last week we had doctor Eguaman
talking about just watching things, and his episode is linked
(05:51):
on our podcast. So if you want to see what
we were talking about last week, go back to our podcast,
which is on doctor Joeglotti dot com, or you could
get the podcast anywhere podcasts are found. But so a
lot of the times people are coming in with yes,
my cholesterol were watching it, Well, it's pretty elevated and
(06:14):
you've got pre diabetes. Oh, we're watching that too, And
so it sort of drives me a little nuts to
tell you the truth, where you have to try and
explain to patients that watching it is not necessarily the
(06:35):
answer when there is so much cardiovascular disease and people
with faty liver are dying of heart disease. That is
the central issue. So if they were not dying of
heart disease. Maybe you could get a pass, but they're
dying of heart disease. What's the root cause of heart disease?
You know, typically cholesterol and plaque build up and inflammation
(06:55):
in your arteries. So doctor Rogers, a real expert, is
going to come on and chat about cholesterol. And I
would say, at the end of his discussion, conversation with me.
(07:16):
All of you should be armed with a conversation to
have with your doctor, be it your internest, your primary
care physician, family practitioner, you're gynecologist, whoever you're seeing, your
PA or nurse practitioner that you may be seeing. So
(07:38):
sharpen a pencil, get a clean sheet of paper, and
be ready to take action. That's what I would say,
all right. So a friend of the show reached out
over the weekend about a relative. I don't know the relation.
(08:00):
I know the family, but I don't know the relative.
Speaker 4 (08:04):
And.
Speaker 1 (08:06):
They were asking for a little bit of direction on
some specialists to see what did they think of the situation,
et cetera. And certainly one of the hats I wear
is being a connector as best I can connecting a patient,
(08:31):
a family member, or friend with somebody else that can
truly address the problem at hand, and so hearing about
this relative who had, you know, a multitude of problems,
we would say multi organ involvement. So there may be
(08:52):
and I'm not saying this is this particular case, but
when we say multi organ involvement, it may be anything
from heart and kidney, her kidney, liver, various glands, thyroid, adrenal.
Many times it will involve the digestive tract and the kidney.
(09:15):
So there are a lot of diseases that are multi organ. Okay,
So just trying to get the lay of the land
with this individual person and how I might be able
to help or steer them in the right direction. But
you know, the thought that came up in one of
(09:38):
the messages that I received is that number one, they're
concerned about this relative. Number two, they are very symptomatic
and they're sick. They're not feeling well, but yet getting
into a specialist's office either a new visit, consultation or
(10:03):
a follow up. So somebody that's established with doctor X,
you need to follow up either to follow up on labs, scans,
test results. You have to get in and say, okay,
what is the plan now? And in medicine. We set
up a you could say, in a sense, a series
of decision decision nodes. If this test is positive, then
(10:27):
we're going to go in this direction. If this is abnormal,
you need to see a surgeon, get a biopsy, and whatever.
So at every turn, decisions have to be made, and
people cannot live in limbo just simply going along. And
so the message was, yes, she needs to see a
(10:52):
specialist or two, but the appointments are not until July,
latter part of July, I believe. So here we are
the beginning of May, all of May, all of June,
and let's say two weeks of July. That is ten weeks,
(11:17):
ten weeks waiting to get the next step, the next plan,
the next therapy. And I find it absolutely unacceptable. Now
you may say, well, people are busy, and you can
only you can only see so many people. You can't
(11:41):
you can't be at the office seeing patients twenty four
hours a day. And I understand that. I understand that.
And even with my own practice, we have a schedule,
and it is it fills up right. You You cannot
make water out of a rock. If you're filled, you're filled.
(12:04):
But physicians' offices, and really it is the physician themselves. Now,
if you're a physician, some sort of health care provider
out there, you may say, uh, doctor Galotti, you don't
know what you're talking about. Well, I think I do
know what I'm talking about because I deal constantly with
(12:28):
sick people that are complicated multi organ I take care
of patients with livid disease. But you show me a
patient with liver disease and they have nutrition issues, GI issues,
neurologic issues, kidney issues, brain issues. Okay, So the physician
(12:51):
has to realize I am in a specialty that may
see sick patients. Maybe it is ten percent of your
patient population, maybe it's sixty percent of your patient population,
maybe it's more. But they have to figure out a
(13:12):
strategy of sort how they get these sick patients in
to provide the care. And I'm sorry, ten weeks is
too long. I'm gonna take a break right now. We'll
(13:32):
follow up on this because I do think for you,
the consumer, the patient, these are some good points on
how to navigate all this. All right, Doctor Joe Glotti,
Your Health First, What a perfect name for a radio
program broadcasting from our home station seven forty k TRH
(13:55):
in Houston, Texas and across the iHeart Radio app. Stay tuned,
We'll be right back. Welcome back, everybody, Doctor Joe Golotti.
Every Sunday between seven and a PM. I'd love for
you to all be here sharing the good word on
health and wellness, making you better consumers of healthcare, and
(14:19):
allowing you to have the tools to navigate the healthcare
system which does get a bit unruly. Doctor Joglotti dot
com is our website, all right. Coming up shortly, doctor
Joseph Rogers from the Texas Heart Institute at Baila College
of Medicine talking about cholesterol. So as I was saying
(14:43):
in the last segment, the physician is the leader of
the practice. He or she has to have let's say, disciples,
people that are like minded on the mission. We're going
to take care of sick people with kidney disease, sick
people with neurologic disease, sick people with lung issues, whatever
(15:05):
it may be, so that everybody is on board to
say that while most of our patients, let's say seventy
percent are pretty healthy, nothing immediately life threatening or nearly
life threatning. I will say immediately life threatening, like you're
going to die tonight, less critical chronic. You're going to
(15:30):
have to have a mechanism to see that ten fifteen
percent of the sicker patients that are symptomatic, they're not
doing well. They're not thriving when somebody is not well,
they are not thriving in one form or another. They're
(15:52):
not thriving like they're not gaining weight. They're not thriving
like they cannot walk, they cannot sleep, they cannot digest
food or mentally, they're just not thriving. So you have
to look and say, how are we going to approach
the ten percent? Well, yes, we all have schedules, but
(16:18):
I would say a day does not go by, and
I'm not here to get some sort of purple heart
to say, oh look at me, look how good I am,
because I know plenty of physicians that this is the
way their practice is. They fit you in and the
staff doesn't give pushback to say, doctor Johnson, do you
(16:45):
know you're full? And we're already have one overbooked patient
or whatever the case may be, and doctor Johnson says, oh, well,
oh okay, okay, let's kick it, kick it down another
week or two there has to be that a spree
to core that everybody involved is rowing in the same
(17:06):
direction and wants to help these ten percent of the
sick patients. And so now what do you do? So
you're there with a relative or yourself, your wife, your brother,
whatever it may be, and you have to really really
examine the practice to say, why can I not get
(17:27):
in if I am sick and not thriving. Now you're
not going to say they don't care, No, I'm not
going to go that far. But there's something systemic within
the practice that does not allow for the sicker patients
to get in. So, as I've said many times, you
have to find a practice, a provider that understands and
(17:54):
appreciates that ten or fifteen percent that are the sick patients.
What are we going to do with them? And as
I had said earlier, a data does not go by
where I will get a call from somebody or a
patient or a friend a neighbor that will say, hey,
I've got this friend of mine that really seems sick,
(18:16):
and I'll give them a call get the information. I'll say, yes,
you are sick, you cannot wait another week to get in.
I'll alert my staff, We get them in and we
take care of it. Do we sometimes have to stay
a little later? Yes, does it take a little bit
more time? Yes, we put ourselves out. So for all
(18:37):
those that are in this limbo of trying to get
into see somebody, you have to look and say, is
this the right practice for me? And do I need
to change practices to a practice that can accommodate me
or my relative when they are more sick. And sometimes
(18:59):
it means going to another city, It may mean having
to drive an hour to get to somebody on that's
on the edge of town, or whatever the case may be.
So I believe that as consumers we cannot tolerate this
idea that it takes ten weeks, eight weeks to follow
(19:20):
up when somebody is not is not thriving. Hopefully I
got my point across, all right, Doctor Joe Golotti, thanks
for tuning in on this very lovely Sunday evening. Doctor
Joeglotti dot com is our website. Don't forget suner for
our newsletter so that you never miss a step of
(19:40):
what we're doing. Doctor Joseph Rodgers is coming up talking cholesterol.
Stay tuned, Welcome back, everybody, doctor Joe Galotti on Sunday evening.
The name of the program is Your Health First. Don't
forget doctor Joeglotti dot com is our website, And as
I was saying earlier, it is real treat to have
(20:01):
doctor Joseph Rogers on the line. He is the director
of the Texas Heart Institute at the Bailey College of Medicine,
right here in the world famous Texas Medical Center. Doctor Rogers,
thanks for coming on and having a chat about cholesterol tonight.
Speaker 4 (20:17):
Well, doctor Gladia, thanks for inviting me. It's always always
my pleasure.
Speaker 1 (20:21):
Well, I had said to everybody earlier, get a sharp pencil,
a clean sheet of paper, take notes, because I believe
the conversation we're going to have now should be able
to serve as a guide for next time patients go
to the doctor to have a conversation about their cholesterol
(20:43):
and really make sure that they're getting the right care.
My sense is that there's a little bit of misunderstanding
about cholesterol. Who needs to be treated, who could be watched,
who needs a statin? So you're the expert, doctor Joe Rogers,
how about you just start off with how should everybody
(21:03):
look at their cholesterol readings in the blood that they get.
Speaker 4 (21:09):
Yeah, so Joe, that's a great place to start. So
there's a reading that will be your total cholesterol, and
that's made up a variety of different sub categories of cholesterol.
So the HDL cholesterol is your good cholesterol, and you
would like the good cholesterol obviously to be as high
as it possibly can be. And there aren't many things
(21:31):
that change your HDL or your good cholesterol. Exercises one
of them, but it's probably a little bit more genetically determined.
The LDAL cholesterol is the bad cholesterol, and you want
that to be as low as it possibly can be.
And then the triglycerides are a particle that represents sort
(21:53):
of it's a little bit complicated, but sort of fat
in the blood and it's influenced by blood sugar. But
you also would like your triglycerides down in a good.
Speaker 3 (22:05):
Range, in a normal range.
Speaker 4 (22:07):
So a lot of people talk about this ratio of
good to bad cholesterol. And because we don't have any
drugs that raise good cholesterol and there's not much you
can do about it, what we're really left with is
lowering bad cholesterol. Okay, there's one other thing I think
we should point out to your listeners tonight, and that
is that the American Heart Association has just released some
(22:28):
new lipid guidelines. Not ever your doctor will read these,
but I think there's some really important take home messages.
And the thing I want your listeners to do is,
when you're online, go to the prevent Risk Calculator. And
what that does is it allows you to enter a
little bit of your demographic information like your age and
(22:50):
your sex, your blood your typical blood pressures. You can
put in your lipid profile. There's one measurement of kidney
function that you can get off most blood tests that
starts to tell you what your tenure risk of having
a cardiovascular event is. And I think, armed with that,
next time your listeners go to talk to their physicians,
(23:12):
they can say, listen, I did this, Here's what my
risk is, and here's what the guidelines tell me to do.
So there's you know what a couple of the key
take homes from the Heart Association. One is we should
be treating people much earlier than we have them. You know,
if you start treating early, you're much more likely to
(23:35):
either decrease the severity or prevent the development of corner.
Speaker 3 (23:38):
Artery disease, which is what we'd like to do.
Speaker 4 (23:41):
The current recommendations from the Heart Association are that if
you have a ten year risk of having an event
of between three and five percent, treatment could be considered,
but if your risk is between five and ten percent,
you should.
Speaker 3 (23:58):
Be put on lipid lower in drug.
Speaker 1 (24:01):
Right.
Speaker 4 (24:02):
There's one other thing, sure, and I know that a
number of the people that are listening have diabetes. Yes,
but if you have diabetes, if you have stage three
or four chronic kidney disease or HIV positive patients, the
new guidelines are you should be treated with a statin
regardless of what your LDL cholesterol is.
Speaker 3 (24:24):
Yes.
Speaker 1 (24:25):
Now, being a cardiologist, you're seeing patients that come in
that let's just say, they are not being managed per
the guidelines the latest research. What do you say to
them and what do they say to you with regard
to or you may look, you're you're a great physician,
(24:45):
and you're not going to say, are you kidding me?
You're not on a statin? But what may be in
a bad moment, doctor Rodgers may say that.
Speaker 4 (24:54):
But.
Speaker 1 (24:56):
You know you're you're going to be looking there and
it's somebody with diabetes and high cholesterol and other risk hypertension,
and you're going to you might say, or this is
what I would say, did anybody talk to you about this?
And is it that nobody talked to you? Or you refuse? Right,
so it's okay to refuse, But what are people what
are people saying in the real world.
Speaker 4 (25:19):
Yeah, I mean we still see a lot of people
who are uninformed about their risk.
Speaker 3 (25:25):
And you know.
Speaker 4 (25:28):
It's the wrong answer to this test is to wait
until you have an event, right, you know, you want
to prevent that. And this is this is one of
the hard things about treating cholesterol. It's much like treating
blood pressure. Right, most people don't feel those things. You
don't feel better because you start taking a medicine to
(25:48):
ower your cholesterol or your blood pressure. You're trying to
prevent an event from occurring, you know, years.
Speaker 3 (25:55):
To decades down the road. So it's a little bit
harder sell some.
Speaker 4 (26:00):
Times, you know, to get patients to understand risk reduction, right,
That's really what this is all about, is trying to
get your risk down so that you don't have a
heart attack or a stroke or develop blockages in the arteries.
Speaker 3 (26:16):
To your legs.
Speaker 1 (26:17):
Or your kidneys exactly, and I would rephrase what you
just said that we talk about high blood pressure and
this cholesterol issue about being a silent killer. You don't
want to find out that you have a problem when
the left side of your body goes limp, you know,
having a stroke. Now, the other issue is there are
(26:41):
a lot of new and innovative tests that are being
done with either whole body scans will literally you go
into a scanner from head to toe, or things like
the carnary calcium scan that can be done. And so
people come back and they will say, hey, I had
(27:02):
a score of zero on the on the calcium score,
which is normal, but yet they're overweight and diabetic. Does
that give them license to not worry about their heart?
And then at the same time, they're those that have
risk factors with a high calcium score that are being
(27:23):
slightly undertreated. So where does all this new technology come
in to, either you know, promote more aggressive care or
a greater awareness.
Speaker 4 (27:36):
Yeah, so it's I think it's a The cornary calcium
score is really a game changer, I think in terms
of stratifying patients risk and the just so against your
listeners understand typically when patients begin to get cholesterol deposits
in the walls of their arteries, we can't see that,
(27:57):
but you also get calcium with the cholesterol, and we
can see that on a cat scan. So that's really
what we're measuring, is to see if you're getting blockage,
you're starting to get cholesterol deposits inside the wall of
the artery. It's recommended in these new guidelines that it's
completely reasonable to do that and men over the age
(28:19):
of forty and the women over the age of forty five.
And the reason for that difference, of course, is that
women have some protection from estrogen, the female hormones, and
their athosclerosis manifests later. There's one other caveat to this, Joe,
and that is not everybody lays down calcium. So some
(28:39):
people have these things that we call soft plaques and
they get cholesterol deposits in the arteries without getting calcium,
and we can't see that. To the patient that you
just described, somebody who's obese and diabetic, Well, if you're diabetic,
you know where you and I just started. You said,
be on a lipid lowering drug. So you don't get
(29:01):
a pass even if you're cholesterol even if your calcium
score is zero, right, you probably still are going to
need to You still should be on something, according to the.
Speaker 1 (29:09):
Guy right now. A lot of the times patients have
this really fear of getting on a statin. Either it
is the muscle cramps that people develop. There are again,
I think it's more online and in social media that
(29:30):
it causes dementia, it causes blindness, it causes this and that,
and they just have a real aversion for trying to
get on a statin. And they will come in and
they will say, please, doctor Rogers, give me more time.
I promise I will exercise. I promise I will shift
(29:53):
from a barbecue diet to a Mediterranean diet. How much
wiggle room do you give patience when you really know
that their risk is high or higher than it should be.
Speaker 3 (30:10):
Yeah, so, Joe.
Speaker 4 (30:11):
So lifestyle modification is always the first step. The challenge
is that so few people are actually able to accomplish that,
but some do so. Usually when I see someone for
the first time, if they've not tried a healthy lifestyle,
I'll give them six months and I'll retest their cholesterol,
and I have just very honest conversations. Say, listen, if
(30:34):
it's not down in six months. We really should talk
about more seriously about a medication. And you know, and
I agree, the muscle side effects of statins are real.
Some statins are better than others in terms of keeping
that from occurring. There's some new drugs that don't have
the muscle side effects, but today they're injectable. Right there's
(30:56):
one that's there's a pill that's going to come out
that does the same thing, but right now, those are
the injectable drugs. The dementia thing that you raised, and
you know that you hear this a lot in the office. Yes,
we have never been able to show that there's an association.
And I can tell you so many people have talked
about it, and like you said, it's all over social
(31:18):
media and the internet. It's just we we've done huge studies,
retrospective studies of tens of thousands of people.
Speaker 3 (31:28):
We cannot demonstrate that association, right.
Speaker 1 (31:31):
And you know, on the same point, everybody there is
this discussion of my liver numbers may go up, I
may develop a liver problem. But the truth is, as
a liver specialist here I rarely and I if there's
words smaller than rarely, let's find it. I see patients
(31:52):
with a true bona fide liver problem related to a statin.
But yet even though I tell them that, they're like, well,
you know, my doctor told me it might affect my liver,
and so we I think part of the work we
have is to overcome misunderstandings, people getting information from the
wrong space. But I would I would say that for
(32:14):
the most part, these drugs are safe and the risk
benefit is huge.
Speaker 4 (32:18):
Correct. No, I agree with that completely, And it's that's
no surprise, right. You know, I can tell you what
I do, and I suspect you do the same thing.
And that is when I start a stat and I
go back and remeasure the cholesterol and liver tests three
months later. Uh huh, just to make sure you know
that nothing changed with the with the liver function studies, right,
(32:40):
And like you said, you almost never see it, yes,
And if they if those liver numbers go up just
a little bit, you stop the medicine and they tend
to come right back down to normal.
Speaker 3 (32:50):
And you say, well, maybe you can't take that drug.
Speaker 1 (32:53):
Right right, and there are other options, But not to
throw your arms up and say I'm walking away, So
to to summarize what we would like everybody to know tonight,
to take a few notes to go to their doctor
in a nutshell, addressing total cholesterol, the HDL, the good
(33:13):
cholesterol we want to try to get up, and the
LDL we want to really drive down. And those that number,
the new recommendation is what below fifty five?
Speaker 4 (33:24):
Yeah, So if you have if we if you've had
an event, if you've had a heart attack, the recommendation
is to get your LDL down under fifty five.
Speaker 1 (33:34):
Right now. Suppose now, I was going to say, suppose
that they're, you know, they have some blood pressure issue
and they are fifteen pounds overweight, they're not quite diabetic yet,
but they go and their LDL cholesterol is high. Yeah,
(33:55):
then then what do they do?
Speaker 3 (33:59):
Yeah?
Speaker 4 (33:59):
You know, then I would what I would do, Joe,
is I would I would rely on the prevent calculator
that we talked about at the top of the secondment,
and that is if your risk is between if it's
more than five percent for a ten year event, you
should be on a drug to lower your cholesterol.
Speaker 1 (34:16):
Right, And so I think the take home for tonight,
Joe is if you see again, so much of this
is emotional that you want to try to take the
emotion out and just get to the facts as far
as is my risk low, intermediate, or high, and then
act accordingly, right, correct, right.
Speaker 4 (34:39):
And it's it's it's never the right thing with this
disease to ignore risk, right because as you say, you know,
you said something earlier and I don't want to pass
it by where you said this is the silent killer.
Speaker 3 (34:52):
Yes, yes, just remember the last word.
Speaker 1 (34:55):
I mean yes. Yeah.
Speaker 4 (34:57):
Cardiovaski disease remains the number one cause of death in
the United States, and a lot of it is preventable.
If we can get people's cholesterol down, get their blood
pressure down, get them to stop smoking exactly, let them
to have a normal body weight, treat diabetes, et cetera.
Speaker 1 (35:13):
Exactly. One more time, could you give everybody the website
for the Prevent score.
Speaker 3 (35:20):
Yeah.
Speaker 4 (35:21):
So all you need to do is put in your
web browser Prevent Calculator.
Speaker 1 (35:27):
And that's it. Prevent Calculator.
Speaker 3 (35:28):
That's that's all you have to do.
Speaker 4 (35:30):
And then it'll pull up a page and there'll there's
a little subsite that says online calculator.
Speaker 3 (35:35):
You can enter all your own data.
Speaker 1 (35:37):
Wow, all right, that's that's that's the take home for tonight,
Doctor Joseph Rodgers, director of the Texas Heart Institute at
bail To College of Medicine. Joe, until we meet again.
I really appreciate you coming on tonight. Oh Joe, it's
a pleasure, Thanks very much. All Right, have a great
night now, all right, Doctor Rogers the best. All right,
(35:58):
Doctor Joe Goltti. Final segment coming up. We'll be right back.
Final segment of this week's your Health First. I hope
you're getting ready for a great coming week. I can
tell everybody I think we need to use Sunday evening
(36:19):
as time to prep for the coming week. What's for dinner?
What's the exercise schedule? What does a kid's schedule look like?
Do they have lunch? Don't have them go to the
cafeteria at school. Make them a healthy lunch that doesn't
(36:41):
include cold cuts, luncheon meats, deli meats, stuff, it's poison.
But yeah, I mean, you know, good health doesn't come
by a haphazard approach. And again, Doctor Joeglotti dot com
sound a Ford news letter all things related to health
and wellness. And again we'll be talking about it a
(37:02):
little bit more in the week's come. But a new
book is coming out that I wrote, and the of
course the radio program, but also the newsletter is going
to be the best way that we'll be communicating with
everybody regarding pre ordering and different book events that we're
going to have. So doctor Joeglotti dot com signer for
(37:23):
the newsletter at the top tab. And again I want
to thank doctor Joe Rogers at the Texas Hard Institute
at Baylor College of Medicine right here in the world
famous Texas Medical Center. Always enlightening to hear what he
has to say. All right, final few minutes here. The
(37:44):
month of May is Sleep Awareness Month, and I would
say over ten years fifteen years, the emphasis on sleep
as being a big component of overall health has really
been on the rise, and the research has clearly shown
(38:08):
if you're not getting enough sleep or quality sleep, you're
at risk for obesity. Would you believe that if you
don't get enough sleep you're going to gain weight? Has
to do with inflammation and that whole mechanism there. But
besides the obesity, it is high blood pressure, at risk
(38:29):
for stroke, diabetes, cardiac arrhythmias, accidents at work or on
the road, chronic kidney disease. So sleep is important. Now,
a recent study came out that said about thirteen to
(38:49):
fifteen percent of the population is taking a wide range
of over the counter supplements to help you sleep, changing
from smoking weed if you want to call that over
the counter, to all of these gummies that are available
(39:10):
with sort of these legal gummies with marijuana or extract
in it, to melotone in and a whole host of
herbs that are being sold and promoted as sleep aids. Now,
when you really look at the research, the vast majority
(39:33):
of them have no statistical improvement in your sleep. And
so if you are one of those individuals, you have
to proceed with caution that these things you're taking may
not be any benefit and may actually harm you. And
so at the end of the day, you have to
(39:55):
get at the root cause of the problem. While you're
having trouble sleeping, do you have sleep apnea? I would say,
if anybody is having a problem sleeping, or they wake
up exhausted or they are told that they snore, you
need to go for a sleep study. And that is
(40:19):
I would say, one area in healthcare that is just
not necessarily being promoted enough. Number two. With obesity, not
only are you at risk for a sleep apnea, but
you're at risk for acid reflux heartburn at night. A
lot of people will have what they call silent reflux
(40:41):
and contents and acid from your stomach because you're laying
down and you got this big belly pressing on your
abdomen there and stomach, you're actually aspirating acid and it
is causing you to wake up, clear your throat, and
you really don't even realize it. So you have to
look at when am I eating? Am I eating late
(41:02):
at night? Never go to bed on a full stomach.
If you do have heartburn, you really need to get
that evaluated further. And then there is the group of
patients that are watching TV on their phone, some sort
of screen time that is really disrupting their ability to
relax and fall asleep. And so when you look at
(41:27):
sleep hygiene, which is very important, you have to look
at probably anywhere from two to three hours before bedtime,
you should shut everything off. Now, again we've become ingrained
that you know this is what we do. But again,
just because we do it doesn't mean that it is
(41:50):
completely right. So we'll have more about this as the
month goes on, but do take careful stock of your
your sleep. It really is quite important. All right, that's
it for tonight. We'll end with a little music from
nineteen sixty nine. I'm doctor Joe Galotti. Thanks for tuning in.
(42:15):
It really is a pleasure, best part of my week
this hour. Doctor Joeglotti dot com is our website. Stay well,
stay healthy. Go to the website and calculate your cardiac
risk profile. We'll see you next weekend.
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