April 5, 2026 • 40 mins
Dr. Galati starts the program about an article on the one muscle in your body that can add to your longevity. He talks about three independent muscles that make up your glutes. Dr. Galati also replays a previous interview with Dr. Randeep Suneja where he explains the symptoms of heart disease and the denial of a heart attack. Happy Easter Sunday!
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Speaker 1 (00:01):
Initial life sequencing coming to you live from Houston, Texas,
home to the world's largest medical center in the approach
based everything. Look, this is Your Health First, the most
(00:22):
beneficial health program on radio with doctor Joe Gillotti. During
the next hour you'll learn about health, wellness and the
prevention of disease. Now here's your host, doctor Joe Galotti.
Speaker 2 (00:44):
Well, good Sunday evening to everybody, Doctor Joe Galotti. Happy
Eastern to everybody, Happy Passover for our Jewish brethren. I
hope you're having a good holiday weekend end, which the
weather was just a tad better, but.
Speaker 3 (01:07):
It's better than some of.
Speaker 2 (01:08):
The cold weather in other parts of the country.
Speaker 3 (01:12):
Those listening.
Speaker 2 (01:16):
Sometimes it is nice to be in Texas and in
the South when this time of the year sort of
beginning of spring early April. Here in Houston especially, the
weather is just marvelous. And that's why you say, you know,
I could handle the heat of July and August and
September because we don't have winter here. That's the biggest part. Well,
(01:41):
welcome to the program. Name of the show is Your
Health First. We're here Sunday between seven and eight pm.
And as we have been saying for all the years
that we've been on the radio, there's really two objectives here.
Number one, raise your health IQ. Number two, make you
better consumers of healthcare, which means knowledge is golden about
(02:05):
your body, medicine, healthcare, diseases, things that you need to
know to be armed with the information to realize that
a certain pain or lump or symptom that you have
really should be.
Speaker 3 (02:23):
Sort of the red flag.
Speaker 2 (02:24):
That you need to get help and not sit on things.
Our website doctor Joegalotti dot com, d R J O
E G A L A t I dot com and
of course all of our social media info is there
that you could follow us. Sign up for our newsletter
right at the top of the page. There it says
newsletter sign it, sign up and never miss out. This
(02:48):
past weekend, yesterday on Saturday, we sent out a newsletter
on olive oil. A lot of patients, i'd say, in
the last month or six weeks, have been asking about
olive oil because we talk about the Mediterranean diet a lot.
In the practice. We have patients that are overweight, obese,
(03:11):
they have diabetes, they have high cholesterol, they have fatty liver,
and everybody wants to know what diet should you be
on and without the easiest thing because making things too complicated.
US physicians have a tendency to make it too complicated,
(03:31):
too much doctor talk talking about science, using big words
that nobody understands, and so without getting into all of
the nuance of diet, basically I will tell just about
everybody follow the Mediterranean diet. Now within the Mediterranean diet,
(03:51):
which we've talked about before, so you can look at
old segments of the program to find out more about
Mediterranean diet as well as things in the newsletter. A
big part is olive oil. Add olive oil to your diet.
But even that which is relatively simple at olive oil.
(04:12):
So cook with olive oil, salad, you know, make a
dressing with olive oil. You can fry in olive oil,
though we're not big fans of frying. You could add
it to your vegetables as toppings, added to your eggs.
A lot of people just are not sure about olive oil.
So with that said, yesterday's newsletter had a comprehensive outline
(04:34):
of olive oil. So go to doctor Joeglotti dot com
and sign for the newsletter, or you could send me
an email, uh and and just basically say hey, I
want the newsletter on olive oil and we can send
that off as a one off, you know, back issue.
(04:54):
All right, So lets of talk about today. But the one,
the one topic that caught my eye. It was an
r calling the newspaper about a week or so ago
talking about the one muscle in your body that can
add to your longevity. And there is so much talk nowadays,
either in the medical medical literature or online or social
(05:17):
media about longevity. Everybody wants a longevity hack. And this
particular article talks about the muscle, this one particular muscle.
You got a million muscles in the body, but what
what's the one muscle that's going to add to your longevity.
It's your gluteus muscles, it's your butt. You're behind. And
(05:42):
the reason is that when we sit down too much,
which is a hazard in its own right. People have
sedentary jobs. They sit for eight ten hours a day
and don't move. Then they drive home for an hour.
Then they get home, they said it they can table.
Then they said on the couch people are not moving.
(06:03):
Your butt will disintegrate, it will become weak. But there
are you know, basically five things to think about with
why you need a strong gluteous muscle. All right, So
it is essential for things like stability, balance, and healthy aging.
(06:31):
So it's not about having a great butt. For those
that are old enough. Back in the nineteen eighties, there
were these video programs that you would buy buns of Steel.
Anybody remember that Buns of Steel, And this was basically
a set of VHS videos that you'd pop in your
(06:53):
what was that called DVR no VHS? Oh my god,
you'd pop this in and it was, you know, probably
a forty minute, forty minute video on how to get
your butt muscles nice and strong.
Speaker 3 (07:08):
Buns of steel. Look that one up on Google.
Speaker 2 (07:12):
So it's not just having a good butt, because a
lot of people have these flat butts and that is
a sign that you're losing muscle. So they're fundamentally tied
to your body's overall stability, balance and ability to age well,
supporting a higher quality of life as you age. And
the reason is, and again it's more than looks. It
(07:35):
is an integral role in injury prevention and pain management.
And you may say, doctor Galotti, how does my butt
prevent injuries or pain management? So when you have strong glutes.
They act as natural shock absorbers as we walk, go
downstairs or upstairs. They significantly reduce the risk of common injury.
(08:00):
These are crucial to preventing and managing issues like back pain,
knee pain, ham string strings. So ham strings are the
muscles that a back of your leg, well the back
of your thigh really and ankle sprains. You need that
core strength of your glutes now independent living. And if
(08:23):
you were to look at a nursing home population, many
of the people are there because they fell. They broke
their hip, they broke their shoulder, they broke their arm.
That is a death sentence for an older person falling
and breaking your bone. So maintaining a strong butt muscle
(08:45):
ensures that you could perform these everyday activities that you
want to be able to do to live independently. This
includes all the vital movements getting out of a chair,
climbing stairs, standing upright. These are essential for long term
self sufficiency and independence. You have to be able to
get out of a chair. Instead of saying, honey, can
(09:07):
you get me out of the chair. I want to
go to the bathroom or I want to have lunch,
Just get up and move climb stairs, it's your ability
to travel, get out of an airplane seat, get out
of a train seat, a car seat. Now what happens
is when you've got bed butts, weak glutious muscles, other muscles,
(09:30):
and it's this cascade, it's this domino effect that happens.
Hamstrings and lower back are forced to overcompensate because your
butt's weak. Other muscles are going to kick in and
try to keep you balanced. Work when you stand up,
help keep you straight. And then what does this leave
to inefficient movement patterns, which causes strain, joint pain in
(09:54):
various areas and reduce confidence in your ability to move safely.
So so many of the problems. Your gait is thrown off,
you're unsteady, you may need a cane. Weak butts and
without a doubt, especially for older adults. Strong glutes and
(10:15):
overall lower body strength are directly linked to better balance
and ability to stay up right, therefore minimizing the risk
of falling. That is your goal. You have to get
up in the morning and say I'm not going to fall.
Speaker 3 (10:29):
What I have to do.
Speaker 2 (10:30):
It's not so much get a bigger walker or get
a bigger cane. It is how do you strengthen those muscles.
So we'll follow up on this in a minute.
Speaker 3 (10:44):
We will follow up on butts.
Speaker 2 (10:50):
There are a few exercises that you need to think
about with regard to strong butts. What I'll do is
I'll post some information on the Facebook page of doctor
Joglotti dot com so they have a little bit of
(11:12):
a reference on exercises and the power of having strong glutes. Okay,
doctor Joe Glotti, this is your health for our stay tuned.
Speaker 3 (11:20):
We're bright back.
Speaker 2 (11:21):
Welcome back, everybody. I hope you having a great Easter Sunday.
Time for a little bit of prayer and reflection and.
Speaker 3 (11:34):
Prayer.
Speaker 2 (11:35):
Jewish brethren, happy Passover. I think it's a time time
of the season, holiday season to be thankful for all
that we have. Spend time to pray and reflect and
be with family, which is beneficial for our mind, body
(11:57):
and soul. We all know that doctor Joglotti comes our website.
We're here every Sunday between seven and eight pm. Don't
forget send me a send me an email, send me
a message if you have any comments on topics you
want to hear about. Very much interactive as much as
(12:18):
we can, but go to doctor Joeglotti dot com under
the contact us button and signer for our newsletter. That
probably is the best way to stay in touch with us.
You see what we're doing, and then there's a way
to communicate back with us. And just like this, this
week's newsletter on olive oil. It was based on so
many people have been asking me, I want to know
(12:40):
more about olive oil. You talk about olive oil every day. Okay,
Well I put a little little essay together, little little
worksheet on olive oil.
Speaker 3 (12:53):
So that's important.
Speaker 2 (12:54):
Okay, So we've been talking about gluts and you may
not realize you look at your budget and the gluteous muscle,
your butt muscle is made up of actually three independent muscles,
the gluteus maximus, the gluteous medius, and the gluteous minimus.
(13:18):
So the gluteus minimis is the strongest muscle, is the
smallest muscle in the gluteal region. It sits under the
gluteous medius and works with it to add stability to
your lower half and to move your hip.
Speaker 3 (13:31):
So there are.
Speaker 2 (13:34):
Specific glute exercises that will focus on the maximus, the medius,
and the minimus. Now you said you might say, how
do I get strong glutes? Well, it's not so much
what do you do, it's what you don't do. You
(13:54):
don't want to spend too much time sitting down. Sitting
down causes your glutes to melt. You just use them inactivity.
And as we get older, it doesn't take much where
our muscles to atrophy or atrify or become a trophy,
(14:15):
meaning they just shrink up and they don't work. They
become weak, and then you get into this cascade of
problems that I talked about the last segment.
Speaker 3 (14:23):
Now there are let me back up. So talk to patients,
and it may be you and you go to the gym.
Speaker 2 (14:35):
You say, hey, yeah, I go to the gym three
times a week and I do strength training. Yeah, I
do strength training. All right, what is that strength training?
Some people say, oh, they just get a couple dumbbells
and they do some curls.
Speaker 3 (14:48):
Okay, that's good. They may get a.
Speaker 2 (14:54):
Lat pulled down. So it's a you know you've seen
it's a bar that hangs over your head. You sit
down on a bench and you pulled down and this
works for your latissim is dorsie muscles, which is basically
part of your shoulders and part of your your flanks,
on your on your side, you're sort of upper back
(15:14):
around the middle.
Speaker 4 (15:16):
Uh.
Speaker 3 (15:16):
They may do.
Speaker 2 (15:19):
Leg extension, Okay, they may get on the elliptical, you
may get on a bicycle. But you're really not telling
me anything you're doing specific for the gluteous muscle. Now,
part of the problem is the gluteous muscle if you're
not used to exercising it. When somebody sits you down
(15:41):
and says, okay, Bob, we're going to exercise the gluteous muscle.
If you're not used to exercising it, it hurts, it
will burn. You may be only only able to do
five or six repetitions before you you tie around. Now,
how do I know that? So? I've always been one
(16:04):
to exercise and stay active, be it cycling, weight training, aerobics, etc.
We go hiking a lot, you know that. But with
my knee issue, I had been in physical therapy for
a year and a half before my knee replacement in December,
and it was brought to my attention clearly to have
(16:28):
a well functioning knee, you need strong quadrcet muscles quads,
and you need strong glutes. And so the physical therapist
got me on the table and had me do a
number of different exercises, and these were uncomfortable, uncomfortable to
(16:49):
the point where if I was sitting at the gym
by myself, I'd give up. I'd say this, I don't
have the discipline to sit and do this where your
muscles are burning, they're hurting, and you can barely do it.
But with a physical therapist, which is I almost liken
it to having a personal trainer sitting there, We're going
to do nine reps, we're going to do ten reps.
(17:10):
We're going to do it three times, three sets. You
have somebody there forcing you, and you learn these exercises.
And then shortly after I started doing physical therapy, I
started doing all these glute exercises and I got it down.
But if you just go to Google, which I would recommend,
and I could post some recommended websites muscles to strengthen
(17:33):
your glutes.
Speaker 3 (17:35):
You look at these.
Speaker 2 (17:37):
These may be exercises you never did, and some of
them I could just read these off here. Okay, one
of them is called a soup pine bridge, so you're,
you know, a bridge exercise. You're laying on your back.
Your legs are bent and you're basically bringing your butt
up and you're squeezing your butt as you lift up again.
(17:59):
You could maybe do a few, but it's going to burn.
There's another exercise called a hip thrust. You could either
do it on a bench, you could do it on
one of those big exercise balls, and you're just throwing
your hip forward to work that back muscle. Other exercises,
this is actually a pretty good one. You should pick
(18:23):
up some bands. You could go on Amazon for ten
bucks and buy all these different bands. But they go
around your sort of around the level of your knee,
and it's sort of like a tight rubber band and
you just move left and right. So you just sort
of sort of shuffling to your left. You're taking step
(18:45):
to your left. You do about ten then move ten
steps to the right. And what you're doing is you're
stimulating that gluteous muscle.
Speaker 3 (18:54):
And so all of these.
Speaker 2 (18:55):
Muscles are very very specific for the gluteos. But I
will tell you they are challenging to do, and they
may hurt, not hurt like you know, can't go to
work the next day, but they're going to be uncomfortable
for you.
Speaker 3 (19:08):
But again.
Speaker 2 (19:09):
This is because this is a muscle that you don't
normally use. And for people that are sitting around there,
sitting at work, sitting on the couch when they get home,
bulk watching TV, it's all bad. And I'd say for
the last ten plus years, there's been plenty of research
that shows people that spend more time watching TV it
(19:33):
has a negative health impact. I would say it's tied
back to the weakness associated with the gluteus muscles. So
think about it. So pay attention to your glutes. Go
to doctor Joglotti dot com and the Facebook page and
I'll have info on the glutes.
Speaker 3 (19:53):
Sign a for our newsletter.
Speaker 2 (19:55):
All right, doctor Joe Glotti taking a break newswhether traffic.
Maybe we'll hear about the astro back in the minute.
Don't forget doctor Joeglotti dot com. I hope you're having
a great evening.
Speaker 3 (20:06):
Hope you're having a great Sunday. I'm doctor Joe Glotti.
Thank you for sharing a little bit of your weekend
with us. We hear every Sunday between.
Speaker 2 (20:15):
Seven and eight pm. I want to get right back
to doctor ran Deep Sinaja. He's a cardiologist Houston Cardiology
dot com. Is how you get in touch with this
outstanding cardiologists on to the symptoms of heart disease. And
again this is so key because many people, unfortunately they're
(20:40):
they're lumbering around with shortness of breath, chest pain, chest discomfort,
swelling in their legs, not being aware that these are
either early or later stages of heart disease and they
need to get in to be seen by somebody like you.
So just punch out the list of symptoms that people
(21:01):
may be experiencing that should have the red light go
on in their head to say I need to get care.
Speaker 4 (21:10):
No, it's an excellent question, and I think this is
very important for the listeners to understand. So when you
have heart disease, we talk about blockages corney art disease,
so that can manifest with multiple symptoms and symptoms which
are typical and somewhat atypical. Women tend to have more
atypical symptoms, so these symptoms may not be classical or typical,
(21:33):
but I will discuss both of them. So typical symptoms
of heart disease, which is angina, are a lack of
blood shoot artists because of the blockages, will typically present
with discomfort in the chest, which can be tightness, heaviness
invieiably associated with stress or exertion, and patients may experience
(21:53):
these symptoms when they try to exert and symptoms get
better when they stop. Also resertional shortness of breath or
disney and exertion that you talk about something which is
new a gentleman, a person who is experiencing At last
years they were able to climb stairs of their home
because any difficulty, and now they suddenly see that they
(22:14):
are unable to do so, provided they have not had
any excessive weight gain, because sometimes when patients gain a
lot of weight, there is symptoms of exertion distney and
that can occur. And then there is overlap of symptoms
with some ches burning sensation that patients may have refluxed.
But interestingly, the statistics tells us that angina or cornead
(22:39):
disease symptoms, you can have concurrent reflux symptoms in twenty
to twenty five percent of the population. So so many
times we have patients say dark, you know that came
because I think I'm having some heart burn, and then
I cut some tightness in the chest when I climb
these stayers. In the last three four months, so that
(22:59):
now you have are symptoms of corneat disease in China
combined with reflux symptoms and you can have overlap. Sometimes
the twenty twenty five percent not even more. So it
is very important for people to know that if they
are experiencing heaviness, tightness, pressure that may go to the arm, neck, jaw,
(23:21):
symptoms that typically occur with stress or exertion. But sometimes
symptoms may not be there at all. You know, asymptomatic
heart disease with heart attacks, may occurrent diabetic where you
have painless is skin atabeties. Tabric patients may majority half
the stabric patients may have an acute even and they
have no symptoms at all, but there are some of
(23:42):
the symptoms. Then also fatigue and women will present with
some more atypical features. Then you have shortness of breath
and then other symptoms that may experience in the form
of unusual palpitation, they're feeling some strong heartbeats, irregular beats
which may be related to PVCs or a rhythmia, and
(24:03):
you may experience shortness of then leading on to congestive
heart failure where patients is having difficulty in laying flat
in the bed, very very important sign of patient says,
you know, dog, I woke up at two o'clock in
the morning and had to sit up at the edge
of the bed and had to cough and sat up.
And this has been happening more through the signs of
(24:24):
congestor heart failure, swelling in the legs which is occurring
recently again leading to congestive heart failure symptoms. But sometimes
may patiently experience some sensation and it's just that is
lasting a second or two. Here there see symptoms of
vngina will typically last minutes. If anything is a lasting
through seconds that is not related to the heart. But
(24:47):
you may have concurrent atypical and typical symptoms. So we
always urge patients that if there is a change in
your condition, if you're feeling something new, please please consult
your doc. So because we see this so often not
realizing because once did as they are not being attention
and they having any event or heart that then the
(25:10):
damage has been done and then you know that damage
unless you do an emergency intervention. Sometimes the damage is
permanent and that produces your life plan significantly, leading to
congestive heart feeling literal alrighty.
Speaker 2 (25:24):
Final segment coming up, talking with doctor randeep Sonasia. Don't
forget doctor Joe Galotti dot com. Signer for the newsletter.
The subscribe tab is now on the website. Stay tuned,
we will be right back.
Speaker 4 (25:40):
All right.
Speaker 2 (25:40):
Final segment for this evening's your Health First. Doctor Joe Glatti.
Doctor Joe Glotti dot com is our website signer for
the newsletter the news subscribe tab. The newsletter is posted
on the top of the website. And again, it's real
pleasure having doctor Randeepsinasia on the program tonight. Visit his
(26:03):
website used in Cardiology dot com to find out the services.
Speaker 3 (26:08):
That he and his partners offer. Very important.
Speaker 2 (26:13):
Take care of your heart, that's what it's all about.
You mentioned the reflux, and the problem with that is
that there is such availability of over the counter heartburn medicine,
and if you watch TV or look at the magazines,
you would think everybody's got reflux. And so when this
(26:36):
fifty year old gentleman or sixty year old woman is
having heartburn or sort of an upset stomach, instead of thinking, well,
my goodness, I'm diabetic, i have high blood pressure, and
I'm overweight, this might be a heart attack. They in
a sense go into denial mode and will say, no,
(26:58):
it's heartburn, let me take more of purple pill. I'm
sure you see that a lot more.
Speaker 4 (27:04):
More than I realized, in the sense that you probably
see two thousands of patients who actually have symptoms of
angina will come dark. You know, I believe I've got
some heart purne going on, or they have actually been
using the medications right, and invariably there is you know,
it's a human nature, human psychology where you're going to say,
(27:24):
you know what, I believe it may be related to
GI and them seeking out for attention, but that's great.
But if they don't seek medical attention, then unfortunately they
can cause damage to the heart muscle by having an event.
And then you know then that that's not good. Because
I so much believe we have so much technology available,
(27:46):
We have so much diagnostic things available in the presence
of heart skin and calcium score where we can we
can diagnose heart disease before it has caused damage. We
have so much tools available now and the three minute
tests in the form of hearts can then diamos pre
clinical heart disease, and we can tell where do you
(28:08):
stand compared to the rest of the population. And there's
so much information available where we can help patient, but
obviously the patient has to reach out to the doctor.
Speaker 3 (28:17):
Right now.
Speaker 2 (28:17):
With that said, I know a topic near and dear
to you is the calcium score, which I'm going to
ask you to explain. I believe the importance of this
truly requires a dedicated segment, so not to in any
way cut it short, but I think give everybody an
(28:39):
introductory understanding and some insight about the calcium score, what
it means, and why they should think about it.
Speaker 4 (28:49):
That is one of the excellent questions you asked, and
I think this is I've been extremely passionate about doing
chum schools. In fact, at Houston Methodist West, I was
and we spoke to the CEO and the hospital open
ten years ago to start doing right here. I have
been doing calsium score since the year two thousand. So
(29:09):
what calcium score is. Calcium score or the Augustin score,
was first described by Robert Auguston, a cardiologist in from
in Miami, where calcium is basically a stage five B
acrosclerosis stage in the arteries of the heart. So when
(29:32):
the elder particles ultimately go inside the walls of the
vessel an ultimately, over period of time get calcified, leading
to a calcified plaque that is measured by a cat
scan called the catch score. So the catsium score is
a number that is given and we as you know
there is we have the left main artery, left descending
(29:54):
supplying the front fall of the heart, less circumplex applying
the site full of the heart, and the right corneachy
supplying the back all of the heart. So when a
patient undercourses non invasive tests, which at Houston Methodist is
done for one hundred and forty dollars because the insurances
still don't cover it. So it is literally a three
(30:15):
minute test, no contrast, no needles, nothing, a purely non
invasive test. When the patient undergoes the CT scan of
the heart or the arties of the heart, patient is
given a number called the Eggiston score. We kept the
calculator score called the Eggerston score, and the data of
the Eggiston school was published by the MESA Registry in
(30:37):
the year two thousand and six when it became there
was the largest registry multi eth aoscrootic registry of patients
in the US, we have about sixty five hundred patients
who underwent Calts in school, and then we measured the
Calton school and the classification is as follows. So zero
(30:58):
is none meaning build up a heart black in the
artists of the heart. One to ten is minimal, eleven
two hundred is mild, one hundred and one to four
hundred is mild to moderate, and four hundred being severe
and over one thousand being very severe. So when a
patient undergoes the catch in schore, we the patient will
(31:21):
get the number and then we compare that patient. It's
based on their age and gender. So we plug them
into the mass of registry and we get a number
called the percentile. And We'll have a fifty year old
male and I'll tell you these stories. A fifty year
old male came to me with shortness of breath. He's
a dark and I put on twenty pounds, twenty five pounds.
(31:43):
I retired from the marines. This is a recent story.
I've retired from the marine. I've been become with shortness
of press and you know, I think it's go I'm
going to get on some exercise program. Can you check
my heart? I said, okay. As So we did some
testing exam normally normal economable pretension that cholestered for calcium score.
Calcium score one thousand. Wow, yes, sir, you are in
(32:07):
the ninety nine percent time. He said, what do you mean?
I said, one, when you have one hundred men your
age when underwent calcium score ninety nine people are going
to have school less than you, and you are in
the top one percent time. And when you have those
kind of numbers, you know, at the score of around
four hundred, we have a statistical chance of approximately twenty
(32:29):
eight percent chance of the severe blockage in one of
the artists of the heart. And that percentage can rise
to forty to forty eight percent when the school is
one thousand. Sure enough, and I did stress tests and
did work up. He had a ninety five percent blockage
in the circles flex and a ninety five percent block
in the proximality required stenting both the vessel's normal heart
(32:52):
no damage. Only fifty years old. Now after fixing, he's
able to exercise, lost weight And just that test was
a tip off, total tip off that this patient has
got severe problems. So this small test can tell us
so much. But as in score mismeasures only hard black
and the artists are The important thing is the black
(33:14):
in the arts is the heart a twenty percent hard
and eighty percent soft. So if you have a high
amount of heart plague, it also tells you you have
a lot of soft plaque. However, a score of zero,
although statistically, if you don't have diabetes or you are
(33:35):
not a smoker, it's almost that your ten year warranty
that you cannot have any events. Whether in a patient
who is a diabetic or is a smoker, really, if
they have scored zero, they still can have heart disease.
So it is a great test. It tells us that
if you're not a smoker or non diabetic, then your
chances of having a heart attack are practically very low,
(33:56):
very low, less than one person over a ten year period.
In a diabetic or a smoker, you still can have events.
And I have had patients with zero scores having events,
so you have to see the patient as a whole.
You just cannot say you score is zero. However, it
provides us with the wealth of information. And if you
score is zero and you don't have other restractors, then
(34:19):
you don't me may not require you an aspen, but
if you are a diabetic and smoker, you still may
need an ASPEN. But if you have any built of
a plaque, then that leads to what your elderal goal
should be. So we are able to tell the patient, sir,
you are in the eightiest percentile. You're only fifty years
(34:39):
old and your score is two hundred and your stress
is normal. That's great, you don't have lack of blood flow.
But this is telling us that you are already having
premature heart disease. Now we need to make sure you're
taking your aspen. You need to take your statin l
deal should be below seventy, and you need to please
work on life cell modification can diet exercise your pre
(35:02):
diabetes diabetes. So it takes the preventive care to the
highest level and the patient starts becoming aware because you
get your report card. We give them the report and
he says, oh, my goodness, I have vulready built up
a plaques and NOM only forty five years old before us.
So it makes the patient. They become more compliant, and
(35:22):
that helps the patient and helps us because they become
very aware of their illness and fact leads to better
patient participation, and they then become more believers of lifestyle
modification with diet, exercise, all the things.
Speaker 2 (35:37):
Now, really in the last two minutes here the most
important question that I've got right now. So you get
this individual with a high concerning calcium score, which is
the analysis is you know what you're at risk for
something bad happening. Now can it be reversed? Meaning one year,
(36:02):
two years later they do another calcium score and it's better.
Can you get to that point or are we at
that point?
Speaker 4 (36:12):
So excellent question. So calcium calcium deposition is a process
that takes years, so typically we don't repeat the score
for several years, three years, five years, some years. But
the calcified plaque cannot be reversed. However, the soft plat
can be regressed. And we know that we know that
(36:34):
once you have cornea, prezzy has been reduced your acute
heart events. We know that a life cele modification with
working diet exercise will reduce statins are very very important
because we know the statans not only reduce the aldial
but they have the pleomorphic effect of stabilization of plaques
reduce the events. We have non data that fish oil
(36:56):
in the equation of pedal like acid in reduced the trial.
You know, it reduces events. And we have studies which
have shown that medical therapy with aspens statins may not
reduce the cossium score, but can reduce a THIRS crossis.
It was attudy by Steve Nisson and these irs ultra sounds,
and then they showed that these a soscotic plaque can
(37:19):
be reversed in the first thirteens that came from the
honest writing in Houston, texolks right in the nineteen ninety
six that showed reversal of heart disease. But it requires
a tremendous amount of commitment by the patient compliance. It
can be reversed to some degree, but it requires a
lot of effort and commitment on diet, exercise and medical therapies.
Speaker 2 (37:41):
Absolutely all right, Doctor ran Deep Synasia a good friend,
akl like a brilliant cardiologist and educator. Thanks for coming
on tonight, and as promised, we're going to get you
on and I think the calcium score story is important
enough to get you back and just concentrate on that
for an evening. Thanks very much for coming on.
Speaker 4 (38:04):
Thank you so much on a pleasure.
Speaker 2 (38:06):
Well, that is a wrap for tonight. I want to
thank doctor Synasia again for coming on and with it
being nearly February, an American heart month, we really do
have to take a look at ourselves. And it's not
so much to say, oh boy, heart disease is a
(38:28):
big thing, or my dad died of a heart attack
or Grandma had a stroke. You have to look inward
at yourself and take a look, and of course re
listen to this segment. It's going to be available on
the podcast that you'll hopefully see if you sign up
for the newsletter, you'll get information on this. But you
(38:48):
have to look and say, do I have risk factors
both a family risk factor and do I have a
history of smoking, high cholesterol? Am I overweight? Am I overweight?
Do I have diabetes? Or pre dive bets or the
nonsense of a touch of diabetes. Don't fool yourselves. Our
listeners are too informed to think that you're going to
(39:10):
fall for a sucker punch to say, oh, yeah, I
have just a touch of diabetes. It is not the
truth and that's what we are seeking here and so
intervene if you need to get evaluate. We talk about
the calcium score. There's all sorts of invasive or non
(39:32):
invasive diagnostic testing to find out. And again we talk
about the dashboard. We know the dashboard on our car
or truck, different things light up when something's wrong. Well,
you in your own life, your own body may have
lights and bells, buzzers and other things beeping alerting you
(39:53):
that there is a problem.
Speaker 3 (39:54):
Slow down, pull off, go in and get checked out.
Speaker 2 (39:58):
So that's it for tonight, Doctor Joe Glotti always at pleasure,
don't forget doctor Joe Glotti dot com.
Speaker 3 (40:05):
And we will of course see you next Sunday evening
Initial life sequencing coming to you live from Houston, Texas,
home to the world's largest medical center in the approach
based everything. Look, this is Your Health First, the most
(00:22):
beneficial health program on radio with doctor Joe Gillotti. During
the next hour you'll learn about health, wellness and the
prevention of disease. Now here's your host, doctor Joe Galotti.
Speaker 2 (00:44):
Well, good Sunday evening to everybody, Doctor Joe Galotti. Happy
Eastern to everybody, Happy Passover for our Jewish brethren. I
hope you're having a good holiday weekend end, which the
weather was just a tad better, but.
Speaker 3 (01:07):
It's better than some of.
Speaker 2 (01:08):
The cold weather in other parts of the country.
Speaker 3 (01:12):
Those listening.
Speaker 2 (01:16):
Sometimes it is nice to be in Texas and in
the South when this time of the year sort of
beginning of spring early April. Here in Houston especially, the
weather is just marvelous. And that's why you say, you know,
I could handle the heat of July and August and
September because we don't have winter here. That's the biggest part. Well,
(01:41):
welcome to the program. Name of the show is Your
Health First. We're here Sunday between seven and eight pm.
And as we have been saying for all the years
that we've been on the radio, there's really two objectives here.
Number one, raise your health IQ. Number two, make you
better consumers of healthcare, which means knowledge is golden about
(02:05):
your body, medicine, healthcare, diseases, things that you need to
know to be armed with the information to realize that
a certain pain or lump or symptom that you have
really should be.
Speaker 3 (02:23):
Sort of the red flag.
Speaker 2 (02:24):
That you need to get help and not sit on things.
Our website doctor Joegalotti dot com, d R J O
E G A L A t I dot com and
of course all of our social media info is there
that you could follow us. Sign up for our newsletter
right at the top of the page. There it says
newsletter sign it, sign up and never miss out. This
(02:48):
past weekend, yesterday on Saturday, we sent out a newsletter
on olive oil. A lot of patients, i'd say, in
the last month or six weeks, have been asking about
olive oil because we talk about the Mediterranean diet a lot.
In the practice. We have patients that are overweight, obese,
(03:11):
they have diabetes, they have high cholesterol, they have fatty liver,
and everybody wants to know what diet should you be
on and without the easiest thing because making things too complicated.
US physicians have a tendency to make it too complicated,
(03:31):
too much doctor talk talking about science, using big words
that nobody understands, and so without getting into all of
the nuance of diet, basically I will tell just about
everybody follow the Mediterranean diet. Now within the Mediterranean diet,
(03:51):
which we've talked about before, so you can look at
old segments of the program to find out more about
Mediterranean diet as well as things in the newsletter. A
big part is olive oil. Add olive oil to your diet.
But even that which is relatively simple at olive oil.
(04:12):
So cook with olive oil, salad, you know, make a
dressing with olive oil. You can fry in olive oil,
though we're not big fans of frying. You could add
it to your vegetables as toppings, added to your eggs.
A lot of people just are not sure about olive oil.
So with that said, yesterday's newsletter had a comprehensive outline
(04:34):
of olive oil. So go to doctor Joeglotti dot com
and sign for the newsletter, or you could send me
an email, uh and and just basically say hey, I
want the newsletter on olive oil and we can send
that off as a one off, you know, back issue.
(04:54):
All right, So lets of talk about today. But the one,
the one topic that caught my eye. It was an
r calling the newspaper about a week or so ago
talking about the one muscle in your body that can
add to your longevity. And there is so much talk nowadays,
either in the medical medical literature or online or social
(05:17):
media about longevity. Everybody wants a longevity hack. And this
particular article talks about the muscle, this one particular muscle.
You got a million muscles in the body, but what
what's the one muscle that's going to add to your longevity.
It's your gluteus muscles, it's your butt. You're behind. And
(05:42):
the reason is that when we sit down too much,
which is a hazard in its own right. People have
sedentary jobs. They sit for eight ten hours a day
and don't move. Then they drive home for an hour.
Then they get home, they said it they can table.
Then they said on the couch people are not moving.
(06:03):
Your butt will disintegrate, it will become weak. But there
are you know, basically five things to think about with
why you need a strong gluteous muscle. All right, So
it is essential for things like stability, balance, and healthy aging.
(06:31):
So it's not about having a great butt. For those
that are old enough. Back in the nineteen eighties, there
were these video programs that you would buy buns of Steel.
Anybody remember that Buns of Steel, And this was basically
a set of VHS videos that you'd pop in your
(06:53):
what was that called DVR no VHS? Oh my god,
you'd pop this in and it was, you know, probably
a forty minute, forty minute video on how to get
your butt muscles nice and strong.
Speaker 3 (07:08):
Buns of steel. Look that one up on Google.
Speaker 2 (07:12):
So it's not just having a good butt, because a
lot of people have these flat butts and that is
a sign that you're losing muscle. So they're fundamentally tied
to your body's overall stability, balance and ability to age well,
supporting a higher quality of life as you age. And
the reason is, and again it's more than looks. It
(07:35):
is an integral role in injury prevention and pain management.
And you may say, doctor Galotti, how does my butt
prevent injuries or pain management? So when you have strong glutes.
They act as natural shock absorbers as we walk, go
downstairs or upstairs. They significantly reduce the risk of common injury.
(08:00):
These are crucial to preventing and managing issues like back pain,
knee pain, ham string strings. So ham strings are the
muscles that a back of your leg, well the back
of your thigh really and ankle sprains. You need that
core strength of your glutes now independent living. And if
(08:23):
you were to look at a nursing home population, many
of the people are there because they fell. They broke
their hip, they broke their shoulder, they broke their arm.
That is a death sentence for an older person falling
and breaking your bone. So maintaining a strong butt muscle
(08:45):
ensures that you could perform these everyday activities that you
want to be able to do to live independently. This
includes all the vital movements getting out of a chair,
climbing stairs, standing upright. These are essential for long term
self sufficiency and independence. You have to be able to
get out of a chair. Instead of saying, honey, can
(09:07):
you get me out of the chair. I want to
go to the bathroom or I want to have lunch,
Just get up and move climb stairs, it's your ability
to travel, get out of an airplane seat, get out
of a train seat, a car seat. Now what happens
is when you've got bed butts, weak glutious muscles, other muscles,
(09:30):
and it's this cascade, it's this domino effect that happens.
Hamstrings and lower back are forced to overcompensate because your
butt's weak. Other muscles are going to kick in and
try to keep you balanced. Work when you stand up,
help keep you straight. And then what does this leave
to inefficient movement patterns, which causes strain, joint pain in
(09:54):
various areas and reduce confidence in your ability to move safely.
So so many of the problems. Your gait is thrown off,
you're unsteady, you may need a cane. Weak butts and
without a doubt, especially for older adults. Strong glutes and
(10:15):
overall lower body strength are directly linked to better balance
and ability to stay up right, therefore minimizing the risk
of falling. That is your goal. You have to get
up in the morning and say I'm not going to fall.
Speaker 3 (10:29):
What I have to do.
Speaker 2 (10:30):
It's not so much get a bigger walker or get
a bigger cane. It is how do you strengthen those muscles.
So we'll follow up on this in a minute.
Speaker 3 (10:44):
We will follow up on butts.
Speaker 2 (10:50):
There are a few exercises that you need to think
about with regard to strong butts. What I'll do is
I'll post some information on the Facebook page of doctor
Joglotti dot com so they have a little bit of
(11:12):
a reference on exercises and the power of having strong glutes. Okay,
doctor Joe Glotti, this is your health for our stay tuned.
Speaker 3 (11:20):
We're bright back.
Speaker 2 (11:21):
Welcome back, everybody. I hope you having a great Easter Sunday.
Time for a little bit of prayer and reflection and.
Speaker 3 (11:34):
Prayer.
Speaker 2 (11:35):
Jewish brethren, happy Passover. I think it's a time time
of the season, holiday season to be thankful for all
that we have. Spend time to pray and reflect and
be with family, which is beneficial for our mind, body
(11:57):
and soul. We all know that doctor Joglotti comes our website.
We're here every Sunday between seven and eight pm. Don't
forget send me a send me an email, send me
a message if you have any comments on topics you
want to hear about. Very much interactive as much as
(12:18):
we can, but go to doctor Joeglotti dot com under
the contact us button and signer for our newsletter. That
probably is the best way to stay in touch with us.
You see what we're doing, and then there's a way
to communicate back with us. And just like this, this
week's newsletter on olive oil. It was based on so
many people have been asking me, I want to know
(12:40):
more about olive oil. You talk about olive oil every day. Okay,
Well I put a little little essay together, little little
worksheet on olive oil.
Speaker 3 (12:53):
So that's important.
Speaker 2 (12:54):
Okay, So we've been talking about gluts and you may
not realize you look at your budget and the gluteous muscle,
your butt muscle is made up of actually three independent muscles,
the gluteus maximus, the gluteous medius, and the gluteous minimus.
(13:18):
So the gluteus minimis is the strongest muscle, is the
smallest muscle in the gluteal region. It sits under the
gluteous medius and works with it to add stability to
your lower half and to move your hip.
Speaker 3 (13:31):
So there are.
Speaker 2 (13:34):
Specific glute exercises that will focus on the maximus, the medius,
and the minimus. Now you said you might say, how
do I get strong glutes? Well, it's not so much
what do you do, it's what you don't do. You
(13:54):
don't want to spend too much time sitting down. Sitting
down causes your glutes to melt. You just use them inactivity.
And as we get older, it doesn't take much where
our muscles to atrophy or atrify or become a trophy,
(14:15):
meaning they just shrink up and they don't work. They
become weak, and then you get into this cascade of
problems that I talked about the last segment.
Speaker 3 (14:23):
Now there are let me back up. So talk to patients,
and it may be you and you go to the gym.
Speaker 2 (14:35):
You say, hey, yeah, I go to the gym three
times a week and I do strength training. Yeah, I
do strength training. All right, what is that strength training?
Some people say, oh, they just get a couple dumbbells
and they do some curls.
Speaker 3 (14:48):
Okay, that's good. They may get a.
Speaker 2 (14:54):
Lat pulled down. So it's a you know you've seen
it's a bar that hangs over your head. You sit
down on a bench and you pulled down and this
works for your latissim is dorsie muscles, which is basically
part of your shoulders and part of your your flanks,
on your on your side, you're sort of upper back
(15:14):
around the middle.
Speaker 4 (15:16):
Uh.
Speaker 3 (15:16):
They may do.
Speaker 2 (15:19):
Leg extension, Okay, they may get on the elliptical, you
may get on a bicycle. But you're really not telling
me anything you're doing specific for the gluteous muscle. Now,
part of the problem is the gluteous muscle if you're
not used to exercising it. When somebody sits you down
(15:41):
and says, okay, Bob, we're going to exercise the gluteous muscle.
If you're not used to exercising it, it hurts, it
will burn. You may be only only able to do
five or six repetitions before you you tie around. Now,
how do I know that? So? I've always been one
(16:04):
to exercise and stay active, be it cycling, weight training, aerobics, etc.
We go hiking a lot, you know that. But with
my knee issue, I had been in physical therapy for
a year and a half before my knee replacement in December,
and it was brought to my attention clearly to have
(16:28):
a well functioning knee, you need strong quadrcet muscles quads,
and you need strong glutes. And so the physical therapist
got me on the table and had me do a
number of different exercises, and these were uncomfortable, uncomfortable to
(16:49):
the point where if I was sitting at the gym
by myself, I'd give up. I'd say this, I don't
have the discipline to sit and do this where your
muscles are burning, they're hurting, and you can barely do it.
But with a physical therapist, which is I almost liken
it to having a personal trainer sitting there, We're going
to do nine reps, we're going to do ten reps.
(17:10):
We're going to do it three times, three sets. You
have somebody there forcing you, and you learn these exercises.
And then shortly after I started doing physical therapy, I
started doing all these glute exercises and I got it down.
But if you just go to Google, which I would recommend,
and I could post some recommended websites muscles to strengthen
(17:33):
your glutes.
Speaker 3 (17:35):
You look at these.
Speaker 2 (17:37):
These may be exercises you never did, and some of
them I could just read these off here. Okay, one
of them is called a soup pine bridge, so you're,
you know, a bridge exercise. You're laying on your back.
Your legs are bent and you're basically bringing your butt
up and you're squeezing your butt as you lift up again.
(17:59):
You could maybe do a few, but it's going to burn.
There's another exercise called a hip thrust. You could either
do it on a bench, you could do it on
one of those big exercise balls, and you're just throwing
your hip forward to work that back muscle. Other exercises,
this is actually a pretty good one. You should pick
(18:23):
up some bands. You could go on Amazon for ten
bucks and buy all these different bands. But they go
around your sort of around the level of your knee,
and it's sort of like a tight rubber band and
you just move left and right. So you just sort
of sort of shuffling to your left. You're taking step
(18:45):
to your left. You do about ten then move ten
steps to the right. And what you're doing is you're
stimulating that gluteous muscle.
Speaker 3 (18:54):
And so all of these.
Speaker 2 (18:55):
Muscles are very very specific for the gluteos. But I
will tell you they are challenging to do, and they
may hurt, not hurt like you know, can't go to
work the next day, but they're going to be uncomfortable
for you.
Speaker 3 (19:08):
But again.
Speaker 2 (19:09):
This is because this is a muscle that you don't
normally use. And for people that are sitting around there,
sitting at work, sitting on the couch when they get home,
bulk watching TV, it's all bad. And I'd say for
the last ten plus years, there's been plenty of research
that shows people that spend more time watching TV it
(19:33):
has a negative health impact. I would say it's tied
back to the weakness associated with the gluteus muscles. So
think about it. So pay attention to your glutes. Go
to doctor Joglotti dot com and the Facebook page and
I'll have info on the glutes.
Speaker 3 (19:53):
Sign a for our newsletter.
Speaker 2 (19:55):
All right, doctor Joe Glotti taking a break newswhether traffic.
Maybe we'll hear about the astro back in the minute.
Don't forget doctor Joeglotti dot com. I hope you're having
a great evening.
Speaker 3 (20:06):
Hope you're having a great Sunday. I'm doctor Joe Glotti.
Thank you for sharing a little bit of your weekend
with us. We hear every Sunday between.
Speaker 2 (20:15):
Seven and eight pm. I want to get right back
to doctor ran Deep Sinaja. He's a cardiologist Houston Cardiology
dot com. Is how you get in touch with this
outstanding cardiologists on to the symptoms of heart disease. And
again this is so key because many people, unfortunately they're
(20:40):
they're lumbering around with shortness of breath, chest pain, chest discomfort,
swelling in their legs, not being aware that these are
either early or later stages of heart disease and they
need to get in to be seen by somebody like you.
So just punch out the list of symptoms that people
(21:01):
may be experiencing that should have the red light go
on in their head to say I need to get care.
Speaker 4 (21:10):
No, it's an excellent question, and I think this is
very important for the listeners to understand. So when you
have heart disease, we talk about blockages corney art disease,
so that can manifest with multiple symptoms and symptoms which
are typical and somewhat atypical. Women tend to have more
atypical symptoms, so these symptoms may not be classical or typical,
(21:33):
but I will discuss both of them. So typical symptoms
of heart disease, which is angina, are a lack of
blood shoot artists because of the blockages, will typically present
with discomfort in the chest, which can be tightness, heaviness
invieiably associated with stress or exertion, and patients may experience
(21:53):
these symptoms when they try to exert and symptoms get
better when they stop. Also resertional shortness of breath or
disney and exertion that you talk about something which is
new a gentleman, a person who is experiencing At last
years they were able to climb stairs of their home
because any difficulty, and now they suddenly see that they
(22:14):
are unable to do so, provided they have not had
any excessive weight gain, because sometimes when patients gain a
lot of weight, there is symptoms of exertion distney and
that can occur. And then there is overlap of symptoms
with some ches burning sensation that patients may have refluxed.
But interestingly, the statistics tells us that angina or cornead
(22:39):
disease symptoms, you can have concurrent reflux symptoms in twenty
to twenty five percent of the population. So so many
times we have patients say dark, you know that came
because I think I'm having some heart burn, and then
I cut some tightness in the chest when I climb
these stayers. In the last three four months, so that
(22:59):
now you have are symptoms of corneat disease in China
combined with reflux symptoms and you can have overlap. Sometimes
the twenty twenty five percent not even more. So it
is very important for people to know that if they
are experiencing heaviness, tightness, pressure that may go to the arm, neck, jaw,
(23:21):
symptoms that typically occur with stress or exertion. But sometimes
symptoms may not be there at all. You know, asymptomatic
heart disease with heart attacks, may occurrent diabetic where you
have painless is skin atabeties. Tabric patients may majority half
the stabric patients may have an acute even and they
have no symptoms at all, but there are some of
(23:42):
the symptoms. Then also fatigue and women will present with
some more atypical features. Then you have shortness of breath
and then other symptoms that may experience in the form
of unusual palpitation, they're feeling some strong heartbeats, irregular beats
which may be related to PVCs or a rhythmia, and
(24:03):
you may experience shortness of then leading on to congestive
heart failure where patients is having difficulty in laying flat
in the bed, very very important sign of patient says,
you know, dog, I woke up at two o'clock in
the morning and had to sit up at the edge
of the bed and had to cough and sat up.
And this has been happening more through the signs of
(24:24):
congestor heart failure, swelling in the legs which is occurring
recently again leading to congestive heart failure symptoms. But sometimes
may patiently experience some sensation and it's just that is
lasting a second or two. Here there see symptoms of
vngina will typically last minutes. If anything is a lasting
through seconds that is not related to the heart. But
(24:47):
you may have concurrent atypical and typical symptoms. So we
always urge patients that if there is a change in
your condition, if you're feeling something new, please please consult
your doc. So because we see this so often not
realizing because once did as they are not being attention
and they having any event or heart that then the
(25:10):
damage has been done and then you know that damage
unless you do an emergency intervention. Sometimes the damage is
permanent and that produces your life plan significantly, leading to
congestive heart feeling literal alrighty.
Speaker 2 (25:24):
Final segment coming up, talking with doctor randeep Sonasia. Don't
forget doctor Joe Galotti dot com. Signer for the newsletter.
The subscribe tab is now on the website. Stay tuned,
we will be right back.
Speaker 4 (25:40):
All right.
Speaker 2 (25:40):
Final segment for this evening's your Health First. Doctor Joe Glatti.
Doctor Joe Glotti dot com is our website signer for
the newsletter the news subscribe tab. The newsletter is posted
on the top of the website. And again, it's real
pleasure having doctor Randeepsinasia on the program tonight. Visit his
(26:03):
website used in Cardiology dot com to find out the services.
Speaker 3 (26:08):
That he and his partners offer. Very important.
Speaker 2 (26:13):
Take care of your heart, that's what it's all about.
You mentioned the reflux, and the problem with that is
that there is such availability of over the counter heartburn medicine,
and if you watch TV or look at the magazines,
you would think everybody's got reflux. And so when this
(26:36):
fifty year old gentleman or sixty year old woman is
having heartburn or sort of an upset stomach, instead of thinking, well,
my goodness, I'm diabetic, i have high blood pressure, and
I'm overweight, this might be a heart attack. They in
a sense go into denial mode and will say, no,
(26:58):
it's heartburn, let me take more of purple pill. I'm
sure you see that a lot more.
Speaker 4 (27:04):
More than I realized, in the sense that you probably
see two thousands of patients who actually have symptoms of
angina will come dark. You know, I believe I've got
some heart purne going on, or they have actually been
using the medications right, and invariably there is you know,
it's a human nature, human psychology where you're going to say,
(27:24):
you know what, I believe it may be related to
GI and them seeking out for attention, but that's great.
But if they don't seek medical attention, then unfortunately they
can cause damage to the heart muscle by having an event.
And then you know then that that's not good. Because
I so much believe we have so much technology available,
(27:46):
We have so much diagnostic things available in the presence
of heart skin and calcium score where we can we
can diagnose heart disease before it has caused damage. We
have so much tools available now and the three minute
tests in the form of hearts can then diamos pre
clinical heart disease, and we can tell where do you
(28:08):
stand compared to the rest of the population. And there's
so much information available where we can help patient, but
obviously the patient has to reach out to the doctor.
Speaker 3 (28:17):
Right now.
Speaker 2 (28:17):
With that said, I know a topic near and dear
to you is the calcium score, which I'm going to
ask you to explain. I believe the importance of this
truly requires a dedicated segment, so not to in any
way cut it short, but I think give everybody an
(28:39):
introductory understanding and some insight about the calcium score, what
it means, and why they should think about it.
Speaker 4 (28:49):
That is one of the excellent questions you asked, and
I think this is I've been extremely passionate about doing
chum schools. In fact, at Houston Methodist West, I was
and we spoke to the CEO and the hospital open
ten years ago to start doing right here. I have
been doing calsium score since the year two thousand. So
(29:09):
what calcium score is. Calcium score or the Augustin score,
was first described by Robert Auguston, a cardiologist in from
in Miami, where calcium is basically a stage five B
acrosclerosis stage in the arteries of the heart. So when
(29:32):
the elder particles ultimately go inside the walls of the
vessel an ultimately, over period of time get calcified, leading
to a calcified plaque that is measured by a cat
scan called the catch score. So the catsium score is
a number that is given and we as you know
there is we have the left main artery, left descending
(29:54):
supplying the front fall of the heart, less circumplex applying
the site full of the heart, and the right corneachy
supplying the back all of the heart. So when a
patient undercourses non invasive tests, which at Houston Methodist is
done for one hundred and forty dollars because the insurances
still don't cover it. So it is literally a three
(30:15):
minute test, no contrast, no needles, nothing, a purely non
invasive test. When the patient undergoes the CT scan of
the heart or the arties of the heart, patient is
given a number called the Eggiston score. We kept the
calculator score called the Eggerston score, and the data of
the Eggiston school was published by the MESA Registry in
(30:37):
the year two thousand and six when it became there
was the largest registry multi eth aoscrootic registry of patients
in the US, we have about sixty five hundred patients
who underwent Calts in school, and then we measured the
Calton school and the classification is as follows. So zero
(30:58):
is none meaning build up a heart black in the
artists of the heart. One to ten is minimal, eleven
two hundred is mild, one hundred and one to four
hundred is mild to moderate, and four hundred being severe
and over one thousand being very severe. So when a
patient undergoes the catch in schore, we the patient will
(31:21):
get the number and then we compare that patient. It's
based on their age and gender. So we plug them
into the mass of registry and we get a number
called the percentile. And We'll have a fifty year old
male and I'll tell you these stories. A fifty year
old male came to me with shortness of breath. He's
a dark and I put on twenty pounds, twenty five pounds.
(31:43):
I retired from the marines. This is a recent story.
I've retired from the marine. I've been become with shortness
of press and you know, I think it's go I'm
going to get on some exercise program. Can you check
my heart? I said, okay. As So we did some
testing exam normally normal economable pretension that cholestered for calcium score.
Calcium score one thousand. Wow, yes, sir, you are in
(32:07):
the ninety nine percent time. He said, what do you mean?
I said, one, when you have one hundred men your
age when underwent calcium score ninety nine people are going
to have school less than you, and you are in
the top one percent time. And when you have those
kind of numbers, you know, at the score of around
four hundred, we have a statistical chance of approximately twenty
(32:29):
eight percent chance of the severe blockage in one of
the artists of the heart. And that percentage can rise
to forty to forty eight percent when the school is
one thousand. Sure enough, and I did stress tests and
did work up. He had a ninety five percent blockage
in the circles flex and a ninety five percent block
in the proximality required stenting both the vessel's normal heart
(32:52):
no damage. Only fifty years old. Now after fixing, he's
able to exercise, lost weight And just that test was
a tip off, total tip off that this patient has
got severe problems. So this small test can tell us
so much. But as in score mismeasures only hard black
and the artists are The important thing is the black
(33:14):
in the arts is the heart a twenty percent hard
and eighty percent soft. So if you have a high
amount of heart plague, it also tells you you have
a lot of soft plaque. However, a score of zero,
although statistically, if you don't have diabetes or you are
(33:35):
not a smoker, it's almost that your ten year warranty
that you cannot have any events. Whether in a patient
who is a diabetic or is a smoker, really, if
they have scored zero, they still can have heart disease.
So it is a great test. It tells us that
if you're not a smoker or non diabetic, then your
chances of having a heart attack are practically very low,
(33:56):
very low, less than one person over a ten year period.
In a diabetic or a smoker, you still can have events.
And I have had patients with zero scores having events,
so you have to see the patient as a whole.
You just cannot say you score is zero. However, it
provides us with the wealth of information. And if you
score is zero and you don't have other restractors, then
(34:19):
you don't me may not require you an aspen, but
if you are a diabetic and smoker, you still may
need an ASPEN. But if you have any built of
a plaque, then that leads to what your elderal goal
should be. So we are able to tell the patient, sir,
you are in the eightiest percentile. You're only fifty years
(34:39):
old and your score is two hundred and your stress
is normal. That's great, you don't have lack of blood flow.
But this is telling us that you are already having
premature heart disease. Now we need to make sure you're
taking your aspen. You need to take your statin l
deal should be below seventy, and you need to please
work on life cell modification can diet exercise your pre
(35:02):
diabetes diabetes. So it takes the preventive care to the
highest level and the patient starts becoming aware because you
get your report card. We give them the report and
he says, oh, my goodness, I have vulready built up
a plaques and NOM only forty five years old before us.
So it makes the patient. They become more compliant, and
(35:22):
that helps the patient and helps us because they become
very aware of their illness and fact leads to better
patient participation, and they then become more believers of lifestyle
modification with diet, exercise, all the things.
Speaker 2 (35:37):
Now, really in the last two minutes here the most
important question that I've got right now. So you get
this individual with a high concerning calcium score, which is
the analysis is you know what you're at risk for
something bad happening. Now can it be reversed? Meaning one year,
(36:02):
two years later they do another calcium score and it's better.
Can you get to that point or are we at
that point?
Speaker 4 (36:12):
So excellent question. So calcium calcium deposition is a process
that takes years, so typically we don't repeat the score
for several years, three years, five years, some years. But
the calcified plaque cannot be reversed. However, the soft plat
can be regressed. And we know that we know that
(36:34):
once you have cornea, prezzy has been reduced your acute
heart events. We know that a life cele modification with
working diet exercise will reduce statins are very very important
because we know the statans not only reduce the aldial
but they have the pleomorphic effect of stabilization of plaques
reduce the events. We have non data that fish oil
(36:56):
in the equation of pedal like acid in reduced the trial.
You know, it reduces events. And we have studies which
have shown that medical therapy with aspens statins may not
reduce the cossium score, but can reduce a THIRS crossis.
It was attudy by Steve Nisson and these irs ultra sounds,
and then they showed that these a soscotic plaque can
(37:19):
be reversed in the first thirteens that came from the
honest writing in Houston, texolks right in the nineteen ninety
six that showed reversal of heart disease. But it requires
a tremendous amount of commitment by the patient compliance. It
can be reversed to some degree, but it requires a
lot of effort and commitment on diet, exercise and medical therapies.
Speaker 2 (37:41):
Absolutely all right, Doctor ran Deep Synasia a good friend,
akl like a brilliant cardiologist and educator. Thanks for coming
on tonight, and as promised, we're going to get you
on and I think the calcium score story is important
enough to get you back and just concentrate on that
for an evening. Thanks very much for coming on.
Speaker 4 (38:04):
Thank you so much on a pleasure.
Speaker 2 (38:06):
Well, that is a wrap for tonight. I want to
thank doctor Synasia again for coming on and with it
being nearly February, an American heart month, we really do
have to take a look at ourselves. And it's not
so much to say, oh boy, heart disease is a
(38:28):
big thing, or my dad died of a heart attack
or Grandma had a stroke. You have to look inward
at yourself and take a look, and of course re
listen to this segment. It's going to be available on
the podcast that you'll hopefully see if you sign up
for the newsletter, you'll get information on this. But you
(38:48):
have to look and say, do I have risk factors
both a family risk factor and do I have a
history of smoking, high cholesterol? Am I overweight? Am I overweight?
Do I have diabetes? Or pre dive bets or the
nonsense of a touch of diabetes. Don't fool yourselves. Our
listeners are too informed to think that you're going to
(39:10):
fall for a sucker punch to say, oh, yeah, I
have just a touch of diabetes. It is not the
truth and that's what we are seeking here and so
intervene if you need to get evaluate. We talk about
the calcium score. There's all sorts of invasive or non
(39:32):
invasive diagnostic testing to find out. And again we talk
about the dashboard. We know the dashboard on our car
or truck, different things light up when something's wrong. Well,
you in your own life, your own body may have
lights and bells, buzzers and other things beeping alerting you
(39:53):
that there is a problem.
Speaker 3 (39:54):
Slow down, pull off, go in and get checked out.
Speaker 2 (39:58):
So that's it for tonight, Doctor Joe Glotti always at pleasure,
don't forget doctor Joe Glotti dot com.
Speaker 3 (40:05):
And we will of course see you next Sunday evening
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