April 26, 2026 • 43 mins
Dr. Galati starts the program with his story telling about how being healthy is a full-time job. He also has Hepatologist Dr. Chuma Egwim on to talk about the value in taking care of yourself by maintaining your regular health checkups. Dr. Galati also spends a few minutes with a primer on hepatitis.
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Speaker 1 (00:01):
Initial life sequences. Coming to you live from Houston, Texas,
home to the world's largest medical.
Speaker 2 (00:08):
Center, and he approaching vats everything looking.
Speaker 1 (00:19):
This is your Health First, the most beneficial health program
on radio with doctor Joe Gillotti.
Speaker 2 (00:25):
During the next.
Speaker 1 (00:26):
Hour, you'll learn about health, wellness, and the provention of disease.
Now here's your host, doctor Joe Galotti. Well, a good
(00:48):
Sunday evening to everybody tuning in from across the fruited
Plains of America, Doctor Joe Galotti, and uh, this is
your Health First, every Sunday evening between the hour of
seven and a PM. I'm here, my team's here with
(01:09):
our single minded mission of making you better consumers of healthcare.
We've been saying that for twenty three years or so.
I believe that is the way to go to make
you healthier. But to be healthy, you have to have
(01:31):
knowledge and knowledge about health and wellness, disease prevention, signs
and symptoms of things that may be going wrong in
and around your body. You're not born with this, it's
an acquired knowledge. And so our program and all that
(01:52):
we try to do is to really get you up
to speed with what you need to know and be healthier.
It's it's it's it's uh. It may seem like a
very complicated task that we have, but really at the
end of the day, it's just to make you healthier,
more aware, and stay healthy so you could be happy
(02:15):
with your family, lead a happy life, do whatever you
want to do, not hamstrung by some sort of chronic
disease that really takes the juice out of your life.
So to participate in the program, our website Doctor Joegalotti
dot com, d R J O E G A l
(02:39):
A t I dot com center for a newsletter every weekend.
It goes out all of our social media. Is there.
You could pick up a copy of my book Eating
Yourself Sick And as I've been talking for oh gosh.
We started the project back in July of last year.
(03:01):
A new book is coming out pretty soon. There'll be
some pre sale information, but I would say certainly a
tune into the broadcast. Number two is go to the
website and center for the newsletter. The newsletter really is
the way that we convey information about what we're doing
(03:22):
different programs projects to everybody. Doctor Joeglotti dot com. All right,
on the program this evening, Doctor Chuma Egwam. He is
a fellow hepatologist that's a liver specialist here in the
Texas Medical Center and he and I were speaking yesterday
(03:43):
Saturday at a program on liver cancer, and it was
geared towards the general public, people that had survived or
in the midst of being treated for liver cancer, Others
that had a family member maybe they were a caretaker,
or those that were in some sort of allied field
(04:05):
related to liver disease, cancer, oncology, nutrition, things like that.
And doctor Egwam, who is a bright guy, excellent physician,
at the end of his talk, he gave a plea
of sort to the attendees on how to reproach your
(04:31):
body and staying well, and it really resonated with me,
and I reached out to him yesterday and I said, look,
this is good stuff. You have a certain way of
saying it. Let's get along the radio. So he'll be
on a little later this evening. Doctor Chuma Eggwam, all right,
You know, I do a lot of teaching to students
(04:57):
that are in medical school, nursing school, pre med, and
to my patients. I think the core requirement of a
physician is to teach, and I have a habit of
storytelling or telling stories with some sort of analogy to it.
(05:19):
Now sometimes it drives my kids nuts. They're like, Dad,
just get to the point. You don't have to tell
this whole concocted story. But for me, that's the way
I'm the most comfortable. It's really the way my brain
works in a sense storytelling. And so at the core
of what we do both here on the radio and
(05:40):
God forbid I say social media, but our day to
day practice of taking care of patients, we have to
convey what it takes to stay healthy. It's not so
much you have a disease and this is how you
treat it. It's a medicine, some sort of therapy, surgery, etc.
(06:03):
I am of the mindset of how do you prevent it,
either prevent it totally or limit the damage so that
the treatment you have is maybe better tolerated. It's not
as extreme if you need surgery, it's not a major surgery.
(06:24):
It's a minor surgery, whatever the case may be. And
one thing that I've learned in visiting with thousands upon
thousands of patients, and I think for those of us
that have been in medicine for or practicing medicine for
probably more than fifteen years. We are certified experts in
(06:47):
a certain domain that we work and I've been doing
this almost thirty five years, so I would say, yeah,
I'm an expert in what I do. But you see
certain patients that do well, and there is a common thread.
You see the patients that do really poorly, and there's
(07:07):
a common thread with those people too. And my sense
is that and this is the story. To be healthy,
free of chronic disease, Free of chronic disease, it's a
full time job. Now you say full time job. I
(07:31):
didn't sign up for that. Well, it really is. You
have to think every single day what habits are fostering
good care, what habits are preventing chronic disease. Just like
(07:53):
if you, and you know most of you do, have
a job of some kind that you have to think
in that mode. My health, staying healthy is a job.
(08:13):
Let me take a break right now, Boy that the
evening goes so damn fast. All right, doctor Joe Glotti,
We're gonna talk more about how you have to think
about your health as a job. Allow me to tell
a story, and I'll be right back, doctor Joe Glotti.
This is your Health First a tune. We'll be right
back raising your health IQ, one listener at a time.
(08:36):
That's what we do here. You're tuned into your health First.
I'm doctor Joe Glotti. Doctor Joglotti dot com is our website.
Everything you need to know about me is there, our practice,
social media, our newsletter sign up. Other health and wellness
(08:59):
information is on doctor Joeglotti dot com. Coming up in
just a small bit, Dr Chuma Eguam. He's a live
a disease specialist similar to what I do here in
the Texas Medical Center. We're going to be I don't
know what we're going to be talking about, sort of
his his wisdom on how to stay healthy and we'll
(09:25):
see where that goes. Doctor Joglotti dot com. All right,
I was talking before the break about your health and
warneness approach should be a job. Now, let's think about it.
You go to work nine to five, eight to four,
four to eleven, graveyard shift, whatever. You have a set
(09:49):
time that you're working. If you're not working full time,
it's part time, whatever the deal. But you are showing
up to work at a certain timeframe that you are
committing to work and the analogy of how this is
a job to stay healthy. You have a position at work.
(10:12):
You have a job. You're the manager, you're the boss.
You're somebody that is making something, you're calculating something, you
are supervising. But you have a more or less a
defined role within your job. And if you do your
(10:34):
job well, you get paid, you get promoted, you get rewarded,
you get accolades, and you move up. And for most people,
there are a set of directions on how you do
(10:57):
your job. You may not, you know, you may not
show up at work on Monday morning and say, okay,
well I got to open up my manual as to
how I do my job. You sort of know the
job now. There may be references of sort of operating procedures,
how you do certain things, or certain standards or what
(11:21):
is a deviation from whatever you do. But you have
in your head, if you've been doing it long enough,
a set of guidelines. If you are a car salesman,
you know exactly how to behave what's expected from you.
If you're a car salesman, you don't start talking about roofing.
(11:48):
The guy that has a job as a roofer does
that job, or you don't start taking a medical history,
practicing medical profession on the side of the Chevy dealership.
You get my point. You have a set of responsibilities,
You have a certain time that you show up. There
(12:09):
are expectations when you come, when you leave, expect expectations
about how you do your job, who you supervise. You
are evaluated from time to time. Some people are evaluated weekly, quarterly,
twice a year, every year. But you live within this framework.
(12:34):
You know what your job is. And when you try
to make that analogy to say your job is to
stay healthy, your job is to be free of chronic disease. Well,
there has to be a certain amount of time that
(12:54):
you put into this job. Is it ten minutes a day,
is it thirty minutes a day? Is it two hours?
Speaker 2 (13:04):
Now?
Speaker 1 (13:05):
Putting in time may come in the form of exercise.
You are going to commit thirty minutes a day to exercise.
Some people are committing two hours a day to exercise,
or they exercise Monday, Wednesday, Friday, and on Sunday a
little bit longer. They do a little overtime. But you're
(13:27):
showing up in some fashion. If it's not exercising, it
is ten minutes a day reviewing what you're eating, or
you spend thirty minutes a day meditating to try to
relax manage stress. You are reviewing your blood pressure, you're
(13:54):
checking your glucose, you're stepping on the scale and seeing
how much you weigh, or you do a little of everything,
but cumulatively, you're investing an hour or ninety minutes or
two hours into the job of staying well. So then
the next part is you know what to do your
(14:18):
job of staying healthy. It is not smoking, It is
not consuming excess alcohol. It is not having a double
cheese bacon sausage burrito every morning for breakfast. That's not
in the job manual. The job manual is for breakfast,
(14:40):
you're going to have a healthful breakfast, maybe high in protein,
high in fiber, getting your fruits and vegetables in there.
Ditto for lunch. What does the what does the I
Stay Healthy job manual say about lun lunch? It may
(15:02):
say you're allowed to go out to lunch and splurge
once a week twice a week, but to do that
you have to exercise five days a week. Same thing
for dinner. The job description of staying healthy says you
need to get at least seven to eight hours of sleep.
(15:27):
You need to work on healthy relationships in your life. Now,
there's really nobody policing you. Now, you could say, if
you're married, your spouse, especially the wives out there, doctor mom,
they may get on your case. They may call you
into the office to say, hey, you're drinking too much,
(15:50):
or you're smoking too much, or why did you start
smoking again? Or you're not exercising. I'm going to the
gym you're not, or why is it that there are
apps from water Burger in the backseat of your car.
Not good. So at a regular job, unless you're self
(16:11):
employed and you're the boss, you have somebody looking over
your shoulder making sure you're staying within the work guidelines.
You're following the manual. Now, I'm not a big fan
of manual readers because we get sort of zombies. You know,
we need people to be a little creative at work.
But I think if you look at it this way,
(16:36):
and if you are good at your real job, you're
a teacher, you're an engineer, you're an astronaut, whatever the
heck you are, the more time you put into it,
becoming a student of your job, you're going to be
better at it, You're going to be more successful. And
(16:58):
I would say the exact same thing goes for being
a student of health, a student of your body working
at it. You cannot expect to be in good shape
if you exercise one day a month for ten minutes,
it just isn't going to happen. Likewise, if you think
(17:20):
you're going to have a healthful diet, not developed diabetas,
high cholesterol, cardiovascular disease, fatty liver, because you're having salad
one day a week or one day a month, it's
not going to happen. And so the patients that I see,
(17:47):
and these thousands of patients and people I have met
over thirty five plus years, there is a pattern. These
are people that make their health their job different from
whatever their profession is. So if you could think in
(18:08):
those terms, yes, you have a day job, you've got
a side job, a side hustle, you're self employed, whatever
the case may be. You show up, you put in time.
There are objectives of your job, there are rules and
(18:31):
regulations as to what's in bounds and out of bounds.
You may have people that you're accountable to and you
know what the end product is. It is how many
hubcaps you make, how much money you make, how many
lives you save? Whatever, you have all those metrics built in.
(18:51):
You know that as part of the job. So with
your job of health, the metrics are is my blood
pressure under control? Is my weight under control? Am I
losing weight appropriately? Am I going to the doctor on
some sort of regular basis to get the metrics of
(19:12):
what does your kidney function look like? What does your
liver function? Your liver test look like? Do I need
a chest X ray, EKG. The same metrics that you
would look for if you were in sales. You know,
what are your sales? How many units did we sell?
So I do hope that some of this made a
(19:39):
little sense and resonated with some of you. But think
of your health and wellness as a job, a job
that you should love. All right, Coming up as doctor
Tchuma eguam hepatologist here in the Texas Medical Center talking
about his thought tho on staying well. We'll see what
(20:04):
he has to say. Don't forget doctor Joeglotti dot com.
We'll be right back. Welcome back everybody, doctor Joe Glotti.
Every Sunday between seven and eight pm, trying to raise
your health IQ. As we say all the time, and
as I was saying earlier this evening, we've got a
special guest, a friend and colleague, doctor Chuma Eggwam, a
(20:25):
fellow hepatologist with Liver Associates of Texas and Houston Methodist Hospital. Tuma,
welcome to the program, and thanks for taking a little
bit of time out of your night.
Speaker 2 (20:35):
Thank you, thanks for having me on the show.
Speaker 1 (20:37):
All right, Well, you know I was saying early in
the program that you and I yesterday were on a
program and at the end of your talk you really
got passionate and more of a plea to the audience
and you know, everybody that was listening about the value
(21:01):
of taking care of yourself, the value of knowing your
liver chemistries, knowing your blood pressure. And I thought to myself,
this is good radio to reach the masses. So if
you were call, what were you getting at at the
end of your talk yesterday.
Speaker 3 (21:22):
Yeah, So at the end of the talk, well, this
talk was specific to liver cancer. However, in talking about
treating liver cancer, the best treatment really is prevention, and
so we discussed a little bit about well, a lot
of these situations where a disease is advanced and there
(21:43):
it's difficult to treat, could be prevented by just having
our regular screenings, regular checkups with our primary care doctors.
And so this was the thing is a lot of
times we feel healthy, there may be a condition that
is underlying that has come up will all produce any symptoms.
Speaker 2 (22:02):
Until it's very late.
Speaker 3 (22:03):
That could be high blood pressure, that could be some
types of liver conditions, and the list goes on. But
oftentimes symptoms will only develop when it's in an advanced state,
more difficult to treat, and worse outcomes. And so we
as adults really have a responsibility to ourselves.
Speaker 2 (22:24):
To maintain our regular health checkups.
Speaker 3 (22:27):
Meaning we are feeling okay, we have no symptoms, no complaints,
but we do go to see at least annually our
primary care physicians, to have a regular testing, blood pressure testing,
blood glucles, our liver chemistries the liver enzymes that are
part of the lab testing. And what happens is that
(22:48):
by so doing, a condition can be picked up early,
can be treated to prevent the bad things quote unquote
from happening the more advanced stages of may illnesses.
Speaker 1 (23:00):
Yeah, and you're right. We were talking about liver cancer
in particular, and I would almost say, in you know,
eighty percent, eighty five percent of the cases, the liver
cancer in this particular population did not just come out
of nowhere. These many of these patients that we see
(23:21):
have been sick for years to decades, and so at
any point in that continuum from the day something bad
was diagnosed, backing it up three years, five years, ten years,
some telltale sign would have been noted.
Speaker 3 (23:38):
Absolutely absolutely, these are situations that rarely happen, very very
rarely happen without the underlying condition and a completely healthy person.
So to say so in the instance of liver cancer, yes,
these are patients who've had some type of inflammation in
the liver, whether it's fighty liver disease or a viral hepatitis,
(24:00):
that would have been picked up by simple routine blood tests, right,
And if that were the case, they would have been treated.
They would have been managed years before to prevent the
liver condition from getting to that advanced stage and then
the cancer developing. Also applicable to other things, people will
not just have a stroke out of nowhere.
Speaker 2 (24:19):
They may have.
Speaker 3 (24:19):
Had high blood pressure that produced no symptoms for years, right,
and then they have a stroke because it was not
diagnosed and was not treated.
Speaker 1 (24:27):
Yeah, I mean the first symptom is a stroke or
even a heart attack. Or they go to see you
and they show up and they say, oh, doctor edmum,
I was told I had you know, a fatty liver.
And you're like, okay, well let's sort of look over things,
and you're saying yourself, well, this, this poor guy doesn't
realize he has cirrhosis already, and so that's you know,
(24:49):
that's bad. So you know, do you do you think
that a lot of this, let's let's just say undermanagement
is due to people that might be in a certain
sense of denial to say, you know what, I sort
of don't feel good, I'm a little bit more run down,
my tummy is a little unsettled. Or and you know,
(25:13):
they're afraid if they show up at the PCP or
a specialist office something bad's gonna happen, or that they
really don't know. They don't put two and two together
to say I'm tired, I'm sure to breath, my digestion
is off. This might be something with the liver, gallbladder,
pancreas or gut. Where do you think that lies.
Speaker 2 (25:36):
I think there's a combination of both.
Speaker 3 (25:39):
I have had patients who present, unfortunately at an advanced
stage of some liver condition or liver cancer, and they
will admit that they have had these symptoms like you mentioned,
sure perhaps even for a couple of years.
Speaker 2 (25:54):
And yes there's that sense of oh, it could be this.
Speaker 3 (25:58):
They actually do even the thought crosses their mind that
it might be something serious, but that sense of denial.
I just don't want to sort of deal with this
or have this diagnosis, and then they put it off
and put it off until it's too late, right. And
then there are some who really don't put two and
(26:20):
two together. It's yeah, they wave it off. I've been
working hard, many hours at work, stress and things like that,
and then unfortunately it is actually something that needed to
be addressed much earlier.
Speaker 1 (26:34):
Yeah, you know, I would say those of us that
work together at Euston Methodists, on our Delivered Team, I
would say all of us have developed the approach that
we have really good relationships with our patients and our families,
let alone with each other. And sometimes you find out
(26:58):
that we have patients that because they trust you, they
have a good relationship with you. It's you know, these
relationships and sometimes you know, the public may not realize
the sacred nature of the relationships that we have. We're
a patients that they trust you so much that they
will call you not only for themselves, but for a
(27:21):
relative or a neighbor to say, hey, doctor egwam, doctor Galotti,
I've got a neighbor coworker, could you help them out?
So I wonder if patients don't quite have that really
good relationship with their care team, and you know, be
it a nurse practitioner PA, physician, that that's almost a
(27:43):
barrier to call and say, you know what, something's going
on here? I just don't know what do you think? Instead,
they just sort of stay behind a brick wall until
all hell breaks through. What do you think of that?
Speaker 2 (27:57):
Yes, I completely agree.
Speaker 3 (27:59):
It is that that relationship with the healthcare the healthcare
provider in their lives, like you said, the physician or
the nurse practitioner PA.
Speaker 2 (28:07):
Is extremely important.
Speaker 3 (28:10):
Yes, I do get those calls sometimes even to ask
questions not related to the liver, but because that trust
has been developed through the years taking care of their
liver right and you know, God, they will call and
run something by you, or at the time of their
appointment will actually bring something up that is maybe cardiovascular
(28:30):
at the heart vascular system and will go with with
the advice that you give them. I have people who
will come for their appointment and it was their routine appointment,
but took it as an opportunity to bring their spouse or.
Speaker 2 (28:45):
Their their their kid.
Speaker 3 (28:46):
Right, And you're almost doing a two for one unofficially,
because after going through their purpose of their visit, they
will actually say, oh, yes, I already introduce you. This
is my husband or my wife or so on, and
and actually almost like I want this person to hear
what you have to say as well, right, And and
that really is is just on the background of that
(29:09):
relationship that's been developed.
Speaker 1 (29:11):
Absolutely no, And I think that is we I think
we see it all where and I you know, look,
I don't think any of us are going to shun
it to say, well, you know, you have to make
an appointment come back in a month. It's like, hey,
what what what? What are your concerns? And and you know, look,
we're experienced enough that you could you could figure out
in thirty seconds what's going on here to say, you
(29:34):
know what, this is probably minor and here's some you know,
sort of straightforward recommendations. Or you have that holy smokes
moment where you're like, oh wow, this lady, this man,
this kid is in worse condition. But that makes for
a good day. You go home and say, you know
what I did something good today.
Speaker 2 (29:52):
Makes some impact.
Speaker 3 (29:53):
Definitely, Definitely, it's it's that's important, very very fulfilling that
we have that relationship where we start to see whole
families really right and can impact their care.
Speaker 1 (30:07):
Yeah. Yeah, you know. One other thought here which came
up a few times in yesterday's meeting, this idea that
you the patient. You're told by your team, your doctor
that something's wrong, you have an abnormal scan, and most
(30:28):
of what we were talking about yesterday it was liver disease.
But you have a fatty liver. Don't worry about it.
Everybody's got it or your liver chemistries are up, they're
just a touch elevated. You know, it's not a big deal.
You feel okay, let it go. And I think because
the very first thing you said, these are silent diseases.
You're not going to have a particular paint what do
(30:50):
you tell the patient? I like to say the consumer
that's listening tonight as to how do you navigate this
because a lot of the times the patients will you know?
If I see them at a later point, they're like,
will you know the doctor didn't make a big deal
out of it, and I didn't want to go against
(31:11):
him or her. What do you say?
Speaker 2 (31:15):
Yes, that's very important.
Speaker 3 (31:16):
I would say that we need to be strong advocates
for ourselves and at the end of the day, no
one's going to care about us more than we care
about ourselves. And there are many reasons things like this
can happen. It could be limited experience of a particular
you know, practitioner with a certain condition or time. You know,
(31:36):
waiting rooms are full, people get in and out and
not enough time to spend, and so we I'd encourage
anyone to ensure that you get an answer and you're
satisfied with that answer. I have seen patients who come
in and they were the drivers of the referral, you know,
to a specialist, whether it's me or they related a
(31:58):
story about how they got to see a cardist force
but only by putting some pressure, so to say, on
their primary care for providers. So if you're not satisfied,
if you don't have a good answer, there's not a
good explanation for why these numbers, for instance, are staying elevated,
then then you really should ask for maybe that second
(32:20):
opinion or specialty care ensure that you get the answer,
because in the instance of liver disease, elevated liver enzymes
are never normal and that indicates inflammation and no symptoms
cause now, but over time that inflammation is causing damage
underlying to advance disease. And so really it's it's advocating
(32:42):
for themselves and pushing and pushing so that they can
get an answer or see maybe somebody more experienced in
that area.
Speaker 1 (32:49):
Right right, And I similar to what we've been saying
here that the two words that make me nervous are
watch it. Let's watch it. You know there's there there
is There is cases where you'll see somebody'll say, hey,
we're we're going to watch this, but that's after a
thorough workup has been done where you have done an ultrasound,
(33:13):
a cat scan, supplemental blood work, and you sit with
them and you say, look, this is abnormal and it
could be an EKG. It could be a chest X ray,
it could be anything. We've done the workup everything so far, ABC, D, E,
F and G negative. You feel good. Your physical exam
is normal. Now we would say come back in a month,
(33:35):
three months, let's get another chest X ray or if
it's still abnormal, we'll do it a CT scan. Let's say,
but it's it's sort of active watching instead of let's
watch it and i'll see you next year.
Speaker 2 (33:48):
Exactly.
Speaker 3 (33:49):
There's definitely a place for watching it, sure, but like
you you you indicated after a throw evaluation, then that
that that place then arrives in terms of now we
can watch it.
Speaker 2 (34:03):
You've excluded X, Y and Z. Right, we are watching
it exactly.
Speaker 1 (34:07):
All right. Well, doctor Tuma Eggwam with Liver Associates of Texas.
This was great. I think that everybody listening tonight's going
to look at a lot of things differently. I really
do hope. So, doctor Egwam, thanks so much for coming on.
Speaker 2 (34:25):
Thank you, this is great, Thanks for having all right, all.
Speaker 1 (34:27):
Right, take care, all right, all right, final segment of
your health first coming up, Doctor Tuma Eggwam with Liver
Associates of Texas. If you want more information. I'm doctor
Joe Galotti. Stay tuned. Hope you having a great evening
raising your health IQ, Stay tuned, Welcome back everybody, Doctor
(34:47):
Joe Galotti. Final segment for this glorious Sunday evening. The
weather today has been a little gray. Yesterday was terrific.
That's why we love living in the southwest part of
Texas here. But I hope you having a great Sunday
(35:08):
evening getting prepared for Monday and the week ahead. Making
sure you got enough good nutritious food at home, so
you're going to feed your kids a healthy breakfast and
lunch and dinner and not let them just subsist on
Captain crunch. All right, Hey, thanks to doctor Egwam for
(35:32):
coming on just a few minutes ago. You know, I
didn't realize this May is Hepatitis Awareness Month. I'm a
little ashamed as a hepatologist. I wasn't talking about this earlier.
But anyway, in the four or five minutes we have
left here tonight, we'll give you a quick primer on
(35:55):
hepatitis and what everybody needs to know about. So when
when you look at Hepatitis Awareness Month, predominantly the centers
for Disease Control are talking about hepatitis A, B, and C.
But let me just back up for a second. Hepatitis
is any inflammation of the liver. So if you drink
(36:20):
too much alcohol and your liver is injured and your
liver enzymes are elevated the alt and the ast, you
will have what we call an alcoholic hepatitis. It's not infectious,
it's not contagious. You don't have the cooties, you're not
going to give it to your partner. But it's inflammation
(36:43):
due to alcohol. We have patients with too much fat
in their liver that triggers inflammation, and that is called
a steato hepatitis. So just because you go to the
doctor and they say, Bob, you think you've got hepatitis,
it doesn't mean it's the infectious type. Hepatitis is strictly
(37:05):
inflammation of the liver. And as doctor Egwan was saying,
you need to get that worked up. Inflammation of the liver,
hepatitis that goes unchecked for months, years, decades has a
very good chance of potentially putting you at risk for zorrhosis,
(37:27):
liver cancer, liver failure, the need for liver transplant really
bad stuff. But in the context of Hepatitis Awareness Month,
predominantly hepatitis A, B and C. And one thing from
the beginning. Hepatitis A does not turn into B, which
then turns into C. They are distinct viruses, all right.
(37:51):
So hepatitis A by and large is not going to
kill you unless you're very young or very old, or
have other medical problems. It's usually pretty mild short term illness.
The way you get hepatitis A is through we call
(38:12):
it the fecal oral route. So when you have hepatitis A,
so all right, let's put a let's put a case
scenario together. You're at a salad bar somewhere, okay, which
is why I really don't like to go to salad bars.
But the worker putting the salad bar together, taking the
(38:35):
let us out the cut carrots, et cetera, et cetera,
they have hepatitis A. They might not know it yet,
they're in that pre symptomatic phase, but they are shedding
the active hepatitis A virus in their stool, in their
in their bowel movements. They go to the bathroom, don't
(38:59):
wash their hand. I know this is disgusting. On Sunday, evening,
they don't wash their hands. They have a little bit
of stool under their fingernails. They don't wash their hands
the required thirty seconds hot soapy water, and they are
then putting the salad bar together. A little fleck of
that stool from their fingernail gets into the romain lettuce.
(39:21):
You go have your romain lettuce, think you're doing well.
Five days later, you get sick as a dog turned yellow.
That is fecal stool oral your mouth. Transmission typically it's
self limited. You can get pretty sick. Some have a
mild case, but that is hepatitis A. There is an
(39:42):
effective vaccine for hepatitis A. Hepatitis B different virus, typically
blood born, sexually transmitted infection many times depending on different
parts of the world. Certainly in Asia it is spread
from mother to child, and so you propagate it that way.
(40:07):
Other parts of the world, certainly Latin America, parts of Africa,
very high rates of hepatitis B. If there's a lack
of proper hygiene, sterilizing instruments, there's always the chance that
you could get hepatitis B. Tattoos, needles, things like that.
Sexual promiscuity. Hepatitis B for the most part, you'll get it.
(40:32):
You may or may not get sick, but there's about
an eighty eighty five percent chance that you will make
appropriate antibodies and you will take care of it yourself.
Your own immune system will take care of it. Probably
around fifteen percent slip through for whatever reason, their immune
system does not eradicate it and they go onto a
chronic hepatitis B, which you can imagine over time, years, decades,
(40:58):
it can lead to more damage. It can lead to
liver cancer and to cirrhosis. Similar to hepatitis A. Very
effective vaccine for hepatitis B, and many times we will
administer the A and the B vaccine together. Now, there's
various organizations around the world that talk about universal vaccination.
(41:20):
The World Health Organization just universally vaccinate everybody for appatitis
A and B, but you should, adults should, and you know,
young kids should be vaccinated for hepatitis B. It's very safe.
It's been around for thirty five forty years. Then hepatitis C,
which again is typically spread by blood, blood transfusions, intravenous
(41:48):
drug use, tattooing, far less sexually spread than hepatitis B,
but it is now very effective if therapies are available,
but you need to get screened. And several years ago,
sent Us for Disease Control other organizations have said everybody
(42:08):
eighteen and older, universally, whether you have symptoms or not,
risk factors or not, should be screened for hepatitis C.
If you find out you have hepatitis C, the treatments
are ninety five to one hundred percent cure rate. So
that is a quick update on hepatitis A, B and C.
(42:29):
We'll talk about it a little bit more next week.
Feel a little bit of rush tonight. All right, that's
it for me, doctor Joe Glotti, thanks for tuning into
your Health First tonight. Don't forget doctor Joegalotti dot com. Everybody,
have a great week. Think about your health. Put it
as a priority. Take care. You've been listening to your
Health First with doctor Joe Glotti.
Speaker 3 (42:49):
For more information on this program or the content of
this program, go to your Health First dot com.
Initial life sequences. Coming to you live from Houston, Texas,
home to the world's largest medical.
Speaker 2 (00:08):
Center, and he approaching vats everything looking.
Speaker 1 (00:19):
This is your Health First, the most beneficial health program
on radio with doctor Joe Gillotti.
Speaker 2 (00:25):
During the next.
Speaker 1 (00:26):
Hour, you'll learn about health, wellness, and the provention of disease.
Now here's your host, doctor Joe Galotti. Well, a good
(00:48):
Sunday evening to everybody tuning in from across the fruited
Plains of America, Doctor Joe Galotti, and uh, this is
your Health First, every Sunday evening between the hour of
seven and a PM. I'm here, my team's here with
(01:09):
our single minded mission of making you better consumers of healthcare.
We've been saying that for twenty three years or so.
I believe that is the way to go to make
you healthier. But to be healthy, you have to have
(01:31):
knowledge and knowledge about health and wellness, disease prevention, signs
and symptoms of things that may be going wrong in
and around your body. You're not born with this, it's
an acquired knowledge. And so our program and all that
(01:52):
we try to do is to really get you up
to speed with what you need to know and be healthier.
It's it's it's it's uh. It may seem like a
very complicated task that we have, but really at the
end of the day, it's just to make you healthier,
more aware, and stay healthy so you could be happy
(02:15):
with your family, lead a happy life, do whatever you
want to do, not hamstrung by some sort of chronic
disease that really takes the juice out of your life.
So to participate in the program, our website Doctor Joegalotti
dot com, d R J O E G A l
(02:39):
A t I dot com center for a newsletter every weekend.
It goes out all of our social media. Is there.
You could pick up a copy of my book Eating
Yourself Sick And as I've been talking for oh gosh.
We started the project back in July of last year.
(03:01):
A new book is coming out pretty soon. There'll be
some pre sale information, but I would say certainly a
tune into the broadcast. Number two is go to the
website and center for the newsletter. The newsletter really is
the way that we convey information about what we're doing
(03:22):
different programs projects to everybody. Doctor Joeglotti dot com. All right,
on the program this evening, Doctor Chuma Egwam. He is
a fellow hepatologist that's a liver specialist here in the
Texas Medical Center and he and I were speaking yesterday
(03:43):
Saturday at a program on liver cancer, and it was
geared towards the general public, people that had survived or
in the midst of being treated for liver cancer, Others
that had a family member maybe they were a caretaker,
or those that were in some sort of allied field
(04:05):
related to liver disease, cancer, oncology, nutrition, things like that.
And doctor Egwam, who is a bright guy, excellent physician,
at the end of his talk, he gave a plea
of sort to the attendees on how to reproach your
(04:31):
body and staying well, and it really resonated with me,
and I reached out to him yesterday and I said, look,
this is good stuff. You have a certain way of
saying it. Let's get along the radio. So he'll be
on a little later this evening. Doctor Chuma Eggwam, all right,
You know, I do a lot of teaching to students
(04:57):
that are in medical school, nursing school, pre med, and
to my patients. I think the core requirement of a
physician is to teach, and I have a habit of
storytelling or telling stories with some sort of analogy to it.
(05:19):
Now sometimes it drives my kids nuts. They're like, Dad,
just get to the point. You don't have to tell
this whole concocted story. But for me, that's the way
I'm the most comfortable. It's really the way my brain
works in a sense storytelling. And so at the core
of what we do both here on the radio and
(05:40):
God forbid I say social media, but our day to
day practice of taking care of patients, we have to
convey what it takes to stay healthy. It's not so
much you have a disease and this is how you
treat it. It's a medicine, some sort of therapy, surgery, etc.
(06:03):
I am of the mindset of how do you prevent it,
either prevent it totally or limit the damage so that
the treatment you have is maybe better tolerated. It's not
as extreme if you need surgery, it's not a major surgery.
(06:24):
It's a minor surgery, whatever the case may be. And
one thing that I've learned in visiting with thousands upon
thousands of patients, and I think for those of us
that have been in medicine for or practicing medicine for
probably more than fifteen years. We are certified experts in
(06:47):
a certain domain that we work and I've been doing
this almost thirty five years, so I would say, yeah,
I'm an expert in what I do. But you see
certain patients that do well, and there is a common thread.
You see the patients that do really poorly, and there's
(07:07):
a common thread with those people too. And my sense
is that and this is the story. To be healthy,
free of chronic disease, Free of chronic disease, it's a
full time job. Now you say full time job. I
(07:31):
didn't sign up for that. Well, it really is. You
have to think every single day what habits are fostering
good care, what habits are preventing chronic disease. Just like
(07:53):
if you, and you know most of you do, have
a job of some kind that you have to think
in that mode. My health, staying healthy is a job.
(08:13):
Let me take a break right now, Boy that the
evening goes so damn fast. All right, doctor Joe Glotti,
We're gonna talk more about how you have to think
about your health as a job. Allow me to tell
a story, and I'll be right back, doctor Joe Glotti.
This is your Health First a tune. We'll be right
back raising your health IQ, one listener at a time.
(08:36):
That's what we do here. You're tuned into your health First.
I'm doctor Joe Glotti. Doctor Joglotti dot com is our website.
Everything you need to know about me is there, our practice,
social media, our newsletter sign up. Other health and wellness
(08:59):
information is on doctor Joeglotti dot com. Coming up in
just a small bit, Dr Chuma Eguam. He's a live
a disease specialist similar to what I do here in
the Texas Medical Center. We're going to be I don't
know what we're going to be talking about, sort of
his his wisdom on how to stay healthy and we'll
(09:25):
see where that goes. Doctor Joglotti dot com. All right,
I was talking before the break about your health and
warneness approach should be a job. Now, let's think about it.
You go to work nine to five, eight to four,
four to eleven, graveyard shift, whatever. You have a set
(09:49):
time that you're working. If you're not working full time,
it's part time, whatever the deal. But you are showing
up to work at a certain timeframe that you are
committing to work and the analogy of how this is
a job to stay healthy. You have a position at work.
(10:12):
You have a job. You're the manager, you're the boss.
You're somebody that is making something, you're calculating something, you
are supervising. But you have a more or less a
defined role within your job. And if you do your
(10:34):
job well, you get paid, you get promoted, you get rewarded,
you get accolades, and you move up. And for most people,
there are a set of directions on how you do
(10:57):
your job. You may not, you know, you may not
show up at work on Monday morning and say, okay,
well I got to open up my manual as to
how I do my job. You sort of know the
job now. There may be references of sort of operating procedures,
how you do certain things, or certain standards or what
(11:21):
is a deviation from whatever you do. But you have
in your head, if you've been doing it long enough,
a set of guidelines. If you are a car salesman,
you know exactly how to behave what's expected from you.
If you're a car salesman, you don't start talking about roofing.
(11:48):
The guy that has a job as a roofer does
that job, or you don't start taking a medical history,
practicing medical profession on the side of the Chevy dealership.
You get my point. You have a set of responsibilities,
You have a certain time that you show up. There
(12:09):
are expectations when you come, when you leave, expect expectations
about how you do your job, who you supervise. You
are evaluated from time to time. Some people are evaluated weekly, quarterly,
twice a year, every year. But you live within this framework.
(12:34):
You know what your job is. And when you try
to make that analogy to say your job is to
stay healthy, your job is to be free of chronic disease. Well,
there has to be a certain amount of time that
(12:54):
you put into this job. Is it ten minutes a day,
is it thirty minutes a day? Is it two hours?
Speaker 2 (13:04):
Now?
Speaker 1 (13:05):
Putting in time may come in the form of exercise.
You are going to commit thirty minutes a day to exercise.
Some people are committing two hours a day to exercise,
or they exercise Monday, Wednesday, Friday, and on Sunday a
little bit longer. They do a little overtime. But you're
(13:27):
showing up in some fashion. If it's not exercising, it
is ten minutes a day reviewing what you're eating, or
you spend thirty minutes a day meditating to try to
relax manage stress. You are reviewing your blood pressure, you're
(13:54):
checking your glucose, you're stepping on the scale and seeing
how much you weigh, or you do a little of everything,
but cumulatively, you're investing an hour or ninety minutes or
two hours into the job of staying well. So then
the next part is you know what to do your
(14:18):
job of staying healthy. It is not smoking, It is
not consuming excess alcohol. It is not having a double
cheese bacon sausage burrito every morning for breakfast. That's not
in the job manual. The job manual is for breakfast,
(14:40):
you're going to have a healthful breakfast, maybe high in protein,
high in fiber, getting your fruits and vegetables in there.
Ditto for lunch. What does the what does the I
Stay Healthy job manual say about lun lunch? It may
(15:02):
say you're allowed to go out to lunch and splurge
once a week twice a week, but to do that
you have to exercise five days a week. Same thing
for dinner. The job description of staying healthy says you
need to get at least seven to eight hours of sleep.
(15:27):
You need to work on healthy relationships in your life. Now,
there's really nobody policing you. Now, you could say, if
you're married, your spouse, especially the wives out there, doctor mom,
they may get on your case. They may call you
into the office to say, hey, you're drinking too much,
(15:50):
or you're smoking too much, or why did you start
smoking again? Or you're not exercising. I'm going to the
gym you're not, or why is it that there are
apps from water Burger in the backseat of your car.
Not good. So at a regular job, unless you're self
(16:11):
employed and you're the boss, you have somebody looking over
your shoulder making sure you're staying within the work guidelines.
You're following the manual. Now, I'm not a big fan
of manual readers because we get sort of zombies. You know,
we need people to be a little creative at work.
But I think if you look at it this way,
(16:36):
and if you are good at your real job, you're
a teacher, you're an engineer, you're an astronaut, whatever the
heck you are, the more time you put into it,
becoming a student of your job, you're going to be
better at it, You're going to be more successful. And
(16:58):
I would say the exact same thing goes for being
a student of health, a student of your body working
at it. You cannot expect to be in good shape
if you exercise one day a month for ten minutes,
it just isn't going to happen. Likewise, if you think
(17:20):
you're going to have a healthful diet, not developed diabetas,
high cholesterol, cardiovascular disease, fatty liver, because you're having salad
one day a week or one day a month, it's
not going to happen. And so the patients that I see,
(17:47):
and these thousands of patients and people I have met
over thirty five plus years, there is a pattern. These
are people that make their health their job different from
whatever their profession is. So if you could think in
(18:08):
those terms, yes, you have a day job, you've got
a side job, a side hustle, you're self employed, whatever
the case may be. You show up, you put in time.
There are objectives of your job, there are rules and
(18:31):
regulations as to what's in bounds and out of bounds.
You may have people that you're accountable to and you
know what the end product is. It is how many
hubcaps you make, how much money you make, how many
lives you save? Whatever, you have all those metrics built in.
(18:51):
You know that as part of the job. So with
your job of health, the metrics are is my blood
pressure under control? Is my weight under control? Am I
losing weight appropriately? Am I going to the doctor on
some sort of regular basis to get the metrics of
(19:12):
what does your kidney function look like? What does your
liver function? Your liver test look like? Do I need
a chest X ray, EKG. The same metrics that you
would look for if you were in sales. You know,
what are your sales? How many units did we sell?
So I do hope that some of this made a
(19:39):
little sense and resonated with some of you. But think
of your health and wellness as a job, a job
that you should love. All right, Coming up as doctor
Tchuma eguam hepatologist here in the Texas Medical Center talking
about his thought tho on staying well. We'll see what
(20:04):
he has to say. Don't forget doctor Joeglotti dot com.
We'll be right back. Welcome back everybody, doctor Joe Glotti.
Every Sunday between seven and eight pm, trying to raise
your health IQ. As we say all the time, and
as I was saying earlier this evening, we've got a
special guest, a friend and colleague, doctor Chuma Eggwam, a
(20:25):
fellow hepatologist with Liver Associates of Texas and Houston Methodist Hospital. Tuma,
welcome to the program, and thanks for taking a little
bit of time out of your night.
Speaker 2 (20:35):
Thank you, thanks for having me on the show.
Speaker 1 (20:37):
All right, Well, you know I was saying early in
the program that you and I yesterday were on a
program and at the end of your talk you really
got passionate and more of a plea to the audience
and you know, everybody that was listening about the value
(21:01):
of taking care of yourself, the value of knowing your
liver chemistries, knowing your blood pressure. And I thought to myself,
this is good radio to reach the masses. So if
you were call, what were you getting at at the
end of your talk yesterday.
Speaker 3 (21:22):
Yeah, So at the end of the talk, well, this
talk was specific to liver cancer. However, in talking about
treating liver cancer, the best treatment really is prevention, and
so we discussed a little bit about well, a lot
of these situations where a disease is advanced and there
(21:43):
it's difficult to treat, could be prevented by just having
our regular screenings, regular checkups with our primary care doctors.
And so this was the thing is a lot of
times we feel healthy, there may be a condition that
is underlying that has come up will all produce any symptoms.
Speaker 2 (22:02):
Until it's very late.
Speaker 3 (22:03):
That could be high blood pressure, that could be some
types of liver conditions, and the list goes on. But
oftentimes symptoms will only develop when it's in an advanced state,
more difficult to treat, and worse outcomes. And so we
as adults really have a responsibility to ourselves.
Speaker 2 (22:24):
To maintain our regular health checkups.
Speaker 3 (22:27):
Meaning we are feeling okay, we have no symptoms, no complaints,
but we do go to see at least annually our
primary care physicians, to have a regular testing, blood pressure testing,
blood glucles, our liver chemistries the liver enzymes that are
part of the lab testing. And what happens is that
(22:48):
by so doing, a condition can be picked up early,
can be treated to prevent the bad things quote unquote
from happening the more advanced stages of may illnesses.
Speaker 1 (23:00):
Yeah, and you're right. We were talking about liver cancer
in particular, and I would almost say, in you know,
eighty percent, eighty five percent of the cases, the liver
cancer in this particular population did not just come out
of nowhere. These many of these patients that we see
(23:21):
have been sick for years to decades, and so at
any point in that continuum from the day something bad
was diagnosed, backing it up three years, five years, ten years,
some telltale sign would have been noted.
Speaker 3 (23:38):
Absolutely absolutely, these are situations that rarely happen, very very
rarely happen without the underlying condition and a completely healthy person.
So to say so in the instance of liver cancer, yes,
these are patients who've had some type of inflammation in
the liver, whether it's fighty liver disease or a viral hepatitis,
(24:00):
that would have been picked up by simple routine blood tests, right,
And if that were the case, they would have been treated.
They would have been managed years before to prevent the
liver condition from getting to that advanced stage and then
the cancer developing. Also applicable to other things, people will
not just have a stroke out of nowhere.
Speaker 2 (24:19):
They may have.
Speaker 3 (24:19):
Had high blood pressure that produced no symptoms for years, right,
and then they have a stroke because it was not
diagnosed and was not treated.
Speaker 1 (24:27):
Yeah, I mean the first symptom is a stroke or
even a heart attack. Or they go to see you
and they show up and they say, oh, doctor edmum,
I was told I had you know, a fatty liver.
And you're like, okay, well let's sort of look over things,
and you're saying yourself, well, this, this poor guy doesn't
realize he has cirrhosis already, and so that's you know,
(24:49):
that's bad. So you know, do you do you think
that a lot of this, let's let's just say undermanagement
is due to people that might be in a certain
sense of denial to say, you know what, I sort
of don't feel good, I'm a little bit more run down,
my tummy is a little unsettled. Or and you know,
(25:13):
they're afraid if they show up at the PCP or
a specialist office something bad's gonna happen, or that they
really don't know. They don't put two and two together
to say I'm tired, I'm sure to breath, my digestion
is off. This might be something with the liver, gallbladder,
pancreas or gut. Where do you think that lies.
Speaker 2 (25:36):
I think there's a combination of both.
Speaker 3 (25:39):
I have had patients who present, unfortunately at an advanced
stage of some liver condition or liver cancer, and they
will admit that they have had these symptoms like you mentioned,
sure perhaps even for a couple of years.
Speaker 2 (25:54):
And yes there's that sense of oh, it could be this.
Speaker 3 (25:58):
They actually do even the thought crosses their mind that
it might be something serious, but that sense of denial.
I just don't want to sort of deal with this
or have this diagnosis, and then they put it off
and put it off until it's too late, right. And
then there are some who really don't put two and
(26:20):
two together. It's yeah, they wave it off. I've been
working hard, many hours at work, stress and things like that,
and then unfortunately it is actually something that needed to
be addressed much earlier.
Speaker 1 (26:34):
Yeah, you know, I would say those of us that
work together at Euston Methodists, on our Delivered Team, I
would say all of us have developed the approach that
we have really good relationships with our patients and our families,
let alone with each other. And sometimes you find out
(26:58):
that we have patients that because they trust you, they
have a good relationship with you. It's you know, these
relationships and sometimes you know, the public may not realize
the sacred nature of the relationships that we have. We're
a patients that they trust you so much that they
will call you not only for themselves, but for a
(27:21):
relative or a neighbor to say, hey, doctor egwam, doctor Galotti,
I've got a neighbor coworker, could you help them out?
So I wonder if patients don't quite have that really
good relationship with their care team, and you know, be
it a nurse practitioner PA, physician, that that's almost a
(27:43):
barrier to call and say, you know what, something's going
on here? I just don't know what do you think? Instead,
they just sort of stay behind a brick wall until
all hell breaks through. What do you think of that?
Speaker 2 (27:57):
Yes, I completely agree.
Speaker 3 (27:59):
It is that that relationship with the healthcare the healthcare
provider in their lives, like you said, the physician or
the nurse practitioner PA.
Speaker 2 (28:07):
Is extremely important.
Speaker 3 (28:10):
Yes, I do get those calls sometimes even to ask
questions not related to the liver, but because that trust
has been developed through the years taking care of their
liver right and you know, God, they will call and
run something by you, or at the time of their
appointment will actually bring something up that is maybe cardiovascular
(28:30):
at the heart vascular system and will go with with
the advice that you give them. I have people who
will come for their appointment and it was their routine appointment,
but took it as an opportunity to bring their spouse or.
Speaker 2 (28:45):
Their their their kid.
Speaker 3 (28:46):
Right, And you're almost doing a two for one unofficially,
because after going through their purpose of their visit, they
will actually say, oh, yes, I already introduce you. This
is my husband or my wife or so on, and
and actually almost like I want this person to hear
what you have to say as well, right, And and
that really is is just on the background of that
(29:09):
relationship that's been developed.
Speaker 1 (29:11):
Absolutely no, And I think that is we I think
we see it all where and I you know, look,
I don't think any of us are going to shun
it to say, well, you know, you have to make
an appointment come back in a month. It's like, hey,
what what what? What are your concerns? And and you know, look,
we're experienced enough that you could you could figure out
in thirty seconds what's going on here to say, you
(29:34):
know what, this is probably minor and here's some you know,
sort of straightforward recommendations. Or you have that holy smokes
moment where you're like, oh wow, this lady, this man,
this kid is in worse condition. But that makes for
a good day. You go home and say, you know
what I did something good today.
Speaker 2 (29:52):
Makes some impact.
Speaker 3 (29:53):
Definitely, Definitely, it's it's that's important, very very fulfilling that
we have that relationship where we start to see whole
families really right and can impact their care.
Speaker 1 (30:07):
Yeah. Yeah, you know. One other thought here which came
up a few times in yesterday's meeting, this idea that
you the patient. You're told by your team, your doctor
that something's wrong, you have an abnormal scan, and most
(30:28):
of what we were talking about yesterday it was liver disease.
But you have a fatty liver. Don't worry about it.
Everybody's got it or your liver chemistries are up, they're
just a touch elevated. You know, it's not a big deal.
You feel okay, let it go. And I think because
the very first thing you said, these are silent diseases.
You're not going to have a particular paint what do
(30:50):
you tell the patient? I like to say the consumer
that's listening tonight as to how do you navigate this
because a lot of the times the patients will you know?
If I see them at a later point, they're like,
will you know the doctor didn't make a big deal
out of it, and I didn't want to go against
(31:11):
him or her. What do you say?
Speaker 2 (31:15):
Yes, that's very important.
Speaker 3 (31:16):
I would say that we need to be strong advocates
for ourselves and at the end of the day, no
one's going to care about us more than we care
about ourselves. And there are many reasons things like this
can happen. It could be limited experience of a particular
you know, practitioner with a certain condition or time. You know,
(31:36):
waiting rooms are full, people get in and out and
not enough time to spend, and so we I'd encourage
anyone to ensure that you get an answer and you're
satisfied with that answer. I have seen patients who come
in and they were the drivers of the referral, you know,
to a specialist, whether it's me or they related a
(31:58):
story about how they got to see a cardist force
but only by putting some pressure, so to say, on
their primary care for providers. So if you're not satisfied,
if you don't have a good answer, there's not a
good explanation for why these numbers, for instance, are staying elevated,
then then you really should ask for maybe that second
(32:20):
opinion or specialty care ensure that you get the answer,
because in the instance of liver disease, elevated liver enzymes
are never normal and that indicates inflammation and no symptoms
cause now, but over time that inflammation is causing damage
underlying to advance disease. And so really it's it's advocating
(32:42):
for themselves and pushing and pushing so that they can
get an answer or see maybe somebody more experienced in
that area.
Speaker 1 (32:49):
Right right, And I similar to what we've been saying
here that the two words that make me nervous are
watch it. Let's watch it. You know there's there there
is There is cases where you'll see somebody'll say, hey,
we're we're going to watch this, but that's after a
thorough workup has been done where you have done an ultrasound,
(33:13):
a cat scan, supplemental blood work, and you sit with
them and you say, look, this is abnormal and it
could be an EKG. It could be a chest X ray,
it could be anything. We've done the workup everything so far, ABC, D, E,
F and G negative. You feel good. Your physical exam
is normal. Now we would say come back in a month,
(33:35):
three months, let's get another chest X ray or if
it's still abnormal, we'll do it a CT scan. Let's say,
but it's it's sort of active watching instead of let's
watch it and i'll see you next year.
Speaker 2 (33:48):
Exactly.
Speaker 3 (33:49):
There's definitely a place for watching it, sure, but like
you you you indicated after a throw evaluation, then that
that that place then arrives in terms of now we
can watch it.
Speaker 2 (34:03):
You've excluded X, Y and Z. Right, we are watching
it exactly.
Speaker 1 (34:07):
All right. Well, doctor Tuma Eggwam with Liver Associates of Texas.
This was great. I think that everybody listening tonight's going
to look at a lot of things differently. I really
do hope. So, doctor Egwam, thanks so much for coming on.
Speaker 2 (34:25):
Thank you, this is great, Thanks for having all right, all.
Speaker 1 (34:27):
Right, take care, all right, all right, final segment of
your health first coming up, Doctor Tuma Eggwam with Liver
Associates of Texas. If you want more information. I'm doctor
Joe Galotti. Stay tuned. Hope you having a great evening
raising your health IQ, Stay tuned, Welcome back everybody, Doctor
(34:47):
Joe Galotti. Final segment for this glorious Sunday evening. The
weather today has been a little gray. Yesterday was terrific.
That's why we love living in the southwest part of
Texas here. But I hope you having a great Sunday
(35:08):
evening getting prepared for Monday and the week ahead. Making
sure you got enough good nutritious food at home, so
you're going to feed your kids a healthy breakfast and
lunch and dinner and not let them just subsist on
Captain crunch. All right, Hey, thanks to doctor Egwam for
(35:32):
coming on just a few minutes ago. You know, I
didn't realize this May is Hepatitis Awareness Month. I'm a
little ashamed as a hepatologist. I wasn't talking about this earlier.
But anyway, in the four or five minutes we have
left here tonight, we'll give you a quick primer on
(35:55):
hepatitis and what everybody needs to know about. So when
when you look at Hepatitis Awareness Month, predominantly the centers
for Disease Control are talking about hepatitis A, B, and C.
But let me just back up for a second. Hepatitis
is any inflammation of the liver. So if you drink
(36:20):
too much alcohol and your liver is injured and your
liver enzymes are elevated the alt and the ast, you
will have what we call an alcoholic hepatitis. It's not infectious,
it's not contagious. You don't have the cooties, you're not
going to give it to your partner. But it's inflammation
(36:43):
due to alcohol. We have patients with too much fat
in their liver that triggers inflammation, and that is called
a steato hepatitis. So just because you go to the
doctor and they say, Bob, you think you've got hepatitis,
it doesn't mean it's the infectious type. Hepatitis is strictly
(37:05):
inflammation of the liver. And as doctor Egwan was saying,
you need to get that worked up. Inflammation of the liver,
hepatitis that goes unchecked for months, years, decades has a
very good chance of potentially putting you at risk for zorrhosis,
(37:27):
liver cancer, liver failure, the need for liver transplant really
bad stuff. But in the context of Hepatitis Awareness Month,
predominantly hepatitis A, B and C. And one thing from
the beginning. Hepatitis A does not turn into B, which
then turns into C. They are distinct viruses, all right.
(37:51):
So hepatitis A by and large is not going to
kill you unless you're very young or very old, or
have other medical problems. It's usually pretty mild short term illness.
The way you get hepatitis A is through we call
(38:12):
it the fecal oral route. So when you have hepatitis A,
so all right, let's put a let's put a case
scenario together. You're at a salad bar somewhere, okay, which
is why I really don't like to go to salad bars.
But the worker putting the salad bar together, taking the
(38:35):
let us out the cut carrots, et cetera, et cetera,
they have hepatitis A. They might not know it yet,
they're in that pre symptomatic phase, but they are shedding
the active hepatitis A virus in their stool, in their
in their bowel movements. They go to the bathroom, don't
(38:59):
wash their hand. I know this is disgusting. On Sunday, evening,
they don't wash their hands. They have a little bit
of stool under their fingernails. They don't wash their hands
the required thirty seconds hot soapy water, and they are
then putting the salad bar together. A little fleck of
that stool from their fingernail gets into the romain lettuce.
(39:21):
You go have your romain lettuce, think you're doing well.
Five days later, you get sick as a dog turned yellow.
That is fecal stool oral your mouth. Transmission typically it's
self limited. You can get pretty sick. Some have a
mild case, but that is hepatitis A. There is an
(39:42):
effective vaccine for hepatitis A. Hepatitis B different virus, typically
blood born, sexually transmitted infection many times depending on different
parts of the world. Certainly in Asia it is spread
from mother to child, and so you propagate it that way.
(40:07):
Other parts of the world, certainly Latin America, parts of Africa,
very high rates of hepatitis B. If there's a lack
of proper hygiene, sterilizing instruments, there's always the chance that
you could get hepatitis B. Tattoos, needles, things like that.
Sexual promiscuity. Hepatitis B for the most part, you'll get it.
(40:32):
You may or may not get sick, but there's about
an eighty eighty five percent chance that you will make
appropriate antibodies and you will take care of it yourself.
Your own immune system will take care of it. Probably
around fifteen percent slip through for whatever reason, their immune
system does not eradicate it and they go onto a
chronic hepatitis B, which you can imagine over time, years, decades,
(40:58):
it can lead to more damage. It can lead to
liver cancer and to cirrhosis. Similar to hepatitis A. Very
effective vaccine for hepatitis B, and many times we will
administer the A and the B vaccine together. Now, there's
various organizations around the world that talk about universal vaccination.
(41:20):
The World Health Organization just universally vaccinate everybody for appatitis
A and B, but you should, adults should, and you know,
young kids should be vaccinated for hepatitis B. It's very safe.
It's been around for thirty five forty years. Then hepatitis C,
which again is typically spread by blood, blood transfusions, intravenous
(41:48):
drug use, tattooing, far less sexually spread than hepatitis B,
but it is now very effective if therapies are available,
but you need to get screened. And several years ago,
sent Us for Disease Control other organizations have said everybody
(42:08):
eighteen and older, universally, whether you have symptoms or not,
risk factors or not, should be screened for hepatitis C.
If you find out you have hepatitis C, the treatments
are ninety five to one hundred percent cure rate. So
that is a quick update on hepatitis A, B and C.
(42:29):
We'll talk about it a little bit more next week.
Feel a little bit of rush tonight. All right, that's
it for me, doctor Joe Glotti, thanks for tuning into
your Health First tonight. Don't forget doctor Joegalotti dot com. Everybody,
have a great week. Think about your health. Put it
as a priority. Take care. You've been listening to your
Health First with doctor Joe Glotti.
Speaker 3 (42:49):
For more information on this program or the content of
this program, go to your Health First dot com.
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