November 10, 2023 • 29 mins
The Philadelphia Department of Public Health’s IF I CAN QUIT, SO CAN YOU campaign is designed to stop tobacco-use among all smokers, but particularly those in high-risk groups including:
● Those in recovery from substance use, including opioid use
● Pregnant or new moms ● Identify as LGBTQIA+
● Individuals who work at places where tobacco use and exposure are high (e.g., food service, hospitality industry, trade professions, etc.)
● Active duty members and veterans of the armed forces Hispanic and Latino communities
I speak to Ryan Coffman, Tobacco Policy and Control Program Manager, Philadelphia Department of Public Health about the campaign that features real Philadephia who are former smokers to encourage and inspire other Philadelphians to quit. Coffman also discusses the resources available including the PA Free Quitline 1-800-QUIT-NOW. as well as the Great American Smokeout November 16th.
The AACR Philadephia Marathon Weekend is just around the corner. I speak to 1. Dr. John Luksch Sports Medicine Physician at Rothman Orthopaedics about important advice for seasoned and novice runners as they get ready to race. Rothman Orthopaedic Institute AACR Philadelphia Marathon
● Those in recovery from substance use, including opioid use
● Pregnant or new moms ● Identify as LGBTQIA+
● Individuals who work at places where tobacco use and exposure are high (e.g., food service, hospitality industry, trade professions, etc.)
● Active duty members and veterans of the armed forces Hispanic and Latino communities
I speak to Ryan Coffman, Tobacco Policy and Control Program Manager, Philadelphia Department of Public Health about the campaign that features real Philadephia who are former smokers to encourage and inspire other Philadelphians to quit. Coffman also discusses the resources available including the PA Free Quitline 1-800-QUIT-NOW. as well as the Great American Smokeout November 16th.
The AACR Philadephia Marathon Weekend is just around the corner. I speak to 1. Dr. John Luksch Sports Medicine Physician at Rothman Orthopaedics about important advice for seasoned and novice runners as they get ready to race. Rothman Orthopaedic Institute AACR Philadelphia Marathon
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
Good morning, and welcome to what'sgoing on? A show about making a
difference in our lives and our communities. I'm Lorraine Balla Tomorrow. I was
never a runner, but when theopportunity arose to raise money for the American
Association for Cancer Research the AACR,the first and largest cancer research foundation in
the world, funding breakthroughs in cancer, I couldn't resist. I never liked
(00:25):
running, but the cause was apowerful one considering all the family and friends
in my circle touched by cancer.So I laced up my sneakers and have
been running on behalf of the AACR. Not the full marathon or even the
half, but I'm proud to saythat I've completed the Rothman eight k I
was hardly the fastest and thankfully notthe slowest, but since twenty sixteen I
(00:47):
have run on behalf of the AACR. Sadly, I threw out my knee,
so I won't be running this year. But for those seasoned runners and
novices, I'll be speaking with doctorJohn Lutsch, it's medicine physician at Rothmann
Orthopedics, who has some great prerace advice. First, quitting smoking,
(01:07):
one of the toughest things. Ever, in fact, some people have considered
that tobacco can be even more addictivethan heroin, which makes quitting very challenging.
To tell us more about how wecan quit and what the resources are
that can get us there. RyanKaufman, Tobacco Policy and Control Program manager
for the Philadelphia Department of Public Health. Thank you so much for joining us
(01:29):
today. It's pleasure to be here. Thanks for having me. Well.
First of all, people don't oftenthink of it this way, but tobacco
is a drug, right, Yeah, you're right. I think far too
often we frame tobacco use as ahabit, and so when you really study
tobacco use disorder, it's really achronic disease, just like diabetes, hypertension,
or asthma, and a substance usedisorder. So it is all the
(01:49):
characteristics of other illicit substances in termsof tolerance withdrawal. I think it's really
important to see tobacco use in thatlight. It really underscores the import whortance
of becoming tobacco free and the challengesthat can exist. I think that's a
good way of reframing it because Ithink in the past we never really thought
of it as being a disorder ofany kind. We always thought, oh,
(02:10):
yeah, you made a choice,you started smoking, and now you've
got the consequences of that. Justquit. Well, it's not that simple,
because tobacco or nicotine in particular,is very friendly with certain receptors in
our brains, right, that's right. So a lot of the same receptors
that are influenced by alcohol, heroin, cocaine are also influenced by by nicotine.
(02:32):
So it releases much of the samebrain chemicals dopamine, serotonin, which
affect how we feel and even howwe think. So yeah, very very
similar. Everyone is potentially a tobaccouser, but there's certain populations that are
more prone to pick up the habit, and I wonder if we can talk
about what those populations are and whatare some of the reasons why. Yeah,
(02:54):
it's a great question. So tobaccouse rates have declined very sharply overall
around the nation and even in citieslike Philadelphia, but there are certain populations
that still use tobacco much higher ratesoverall, and those are the very same
populations at the campaign we're going totalk about today focuses on so folks with
behavioral health challenges. LGBTQA plus individuals, folks that work in the bar,
(03:16):
hospitality, food service industry, veterans, and new mothers used tobacco much higher
rates. And the reason for thatis really the tobacco industry. Through marketing
and advertising and a variety of deceptiveand manipulative practices, they've created cultures of
tobacco use in those communities where tobaccois seen is more common, normal and
(03:37):
acceptable, and the rates correspondingly arevery, very high. I think you
make a very good point about thetobacco industry. I know that they had
specifically targeted low income communities to putbillboards, for instance, for tobacco use.
That's right. I mean any strategyfrom philanthropic giving to discounting, couponning
billboards, marketing and advertising. Theyhave a whole playbook deceptive manipulative practices they've
(04:00):
used for decades in these communities.Well, we can't talk about tobacco use
without talking about the consequences because weknow that smoking tobacco can lead to so
many different health issues, including heartdisease and cancer. Tell us a little
more about that. What are theconsequences of smoking? So tobacco use is
still the leading cause of preventable deathand disability in the nation and kills upwards
(04:23):
of almost four thousand Philadelphians a year. And that is a very very important
message, and there still can besome misconceptions about just how deadly tobaccu us
is. I think a really importantcompanion message is that when people become tobacco
free, your body begins healing inas little as twenty minutes after your last
tobacco use, and over time,your risk of heart disease, cancer stroke
(04:44):
all go down pretty dramatically in shortorder. So I think there's a two
sided coin that deserves discussion around thisissue, both the negative health impacts but
also how quickly your body recovers asa result of being tobacco free. And
the Great American Smokeout can be animportant forward for folks in that way.
Well, let's talk about some ofthe ways that we can start to support
people quitting the habit. You mentionedthis American Great American Smokeout, and we'll
(05:09):
get to that in just a second, because that's one national event that really
brings awareness smoking and quitting. Butlet's talk about what are some of the
strategies for quitting smoking because we've gotsome new technologies these days. Back in
the old days, it really wasall about cold turkey. But now we
have different tools and medicines that wecan use. Tell us more, far
(05:30):
more is available than us previously tomake the journey of becoming tobacco free both
easier but then also more successful.So what I really suggest, and this
is what I tell my patients directlywhen I meet with them, is really
setting recovery start date, usually withinthe next two to four weeks, to
target becoming tobacco free, and thenhaving a plan to back that data up
and get you ready. Building upyour social support among your loved ones,
(05:51):
friends and co workers, including externalresources right like the Pennsylvania Freequent line,
which provides free medications and free coachingone hundred quit Now people can also use
text, messaging and web based applicationsto get that additional sense of social support.
Then developing coping skills for your triggers, stress, boredom, other smokers,
(06:11):
driving, whatever that might be.Then creating tobacco free environments in your
home, workplace if that applies inyour vehicle, and then talking to either
your physical health and or your behavioralhealth provider about medications which are available to
treat tobacco withdrawal symptoms. That's reallythe plan that I work on with patients
that I serve here in Philadelphia.What are some of the medications that are
now available. There's about seven FDapproved medications that are largely covered by private
(06:35):
and public insurance under the Affordable CareAct. But that resource that I mentioned
earlier when intered quit now provides severalfree weeks of medications that they mail directly
to your house, so patches,gum, and lozenges that are available for
any caller in Pennsylvania, and that'spromoted pretty regularly through the media campaign that's
running right now that we'll discuss.You talk about how it's important to have
(06:57):
a network of supporters also made perhapsputting yourself in conditions that where you can
notice what your triggers are and beable to find different coping mechanisms. But
I do want to mention that howimportant it is to have support because there
are people, just as there arein the substance use disorder community, there
are those in the tobacco use disordercommunity. I never smoke, so I
(07:21):
can speak from someone who's never smoked, but for those who have smoked,
they have seen people put packs ofcigarettes down in front of that person who's
trying to quit and engage in otheractivities that really put that person back in.
It's weird, but it's real,right right. I mean, just
the site and smell of tobacco productscan be a cue or a trigger for
(07:44):
an individual that is trying to beginor maintain their recovery from tobacco use.
And so really we use a lotof the same strategies that we use for
other substance use disorders right in thatrecovery process. So that means moods,
persons, places things like it doesfor perhaps cocaine, we use those same
strategies to apply to tobaccuous because ultimately, as I mentioned, tobacco used disorder
(08:07):
is business substance use disorder. Absolutely. Now the Great American Smoke can tell
us more. Yeah, So thisis a long standing holiday through the Great
American smokeout through the American Cancer Society, and the real goal is recognizing that
every single person among the millions andmillions of people that have become tobacco free
in this nation, that everyone startedwith one day, that one thousand mile
journey beginning with the first step,if you will, and so really encouraging
(08:30):
individuals through the resources and supports thatare available through the American Cancer Society,
but also those that I mentioned,like the PA fre quit Line, to
really utilize those resources to attempt oneday tobacco free and experience that day and
what life is like right not usingtobacco after that meal or when you're driving,
or when you're in the company ofyour coworker, and then seeing it
(08:52):
that day can be a stepping stoneor a jumping off point towards a lifetime
of being tobacco free as well.And I think it's one of the more
well known advocacy awareness days around tobaccouse. So it's an important day coming
up very soon on November sixteenth,So definitely encourage anyone listening in to make
use of the resources we're talking abouthere today, share those with your loved
ones and people you care about,and encourage them to take that first step.
(09:15):
Yes, this is a very strongaddiction, but so are people.
I've personally worked with people that werefive packs a day people at smoke for
seventy years. So if you hearanything I'm saying today, it's no matter
how long you've been on this roadof tobacco use, there's always an off
ramp or an exit. If you'vetried before, there's almost always stone's unturned
that we can explore, or theseresources can help you to explore to be
(09:37):
tobacco free and remain tobacco free andremind us what those resources are. So
Smoke Free Philly. Our website forour program has extensive amount of resources available,
tips and tricks to really help beginthat process. One eight hundred Quit
now provides free medications and free behavioralcoaching, as well as one's insurance both
(09:58):
private and public insurance is largely coveredring these medications and resources. And then
the campaign that we're talking about heretoday is also important because we're showing individuals
where there's a strong societal perception thateveryone who works in the hospitality industry or
everyone who served in the armed forceswants to use tobacco, has no interest
(10:18):
in tobacco recovery or even needs touse tobacco in those communities, and we're
doing this campaign to show that everyonedeserves the opportunity to be tobacco free,
and these communities, even with higherrates of tobacco use have just as much
interest as everyone else in becoming tobaccofree. So we're hoping that people at
home or on the bus or listento the radio will see these individuals and
(10:41):
see themselves within that story or testimonialand say, if that person can quit,
so can I This possible for them? It's possible for me too.
And as you mentioned earlier, theuse of tobacco is down, and so
for those who continue to use tobacco, there are a lot of lifestyle issues
that you need to remember. Iffor instances, so people will not date
someone who smokes, or someone willnot want to be around have their children
(11:05):
be around someone who smokes. Sothere are lots of lifestyle issues that people
can take into consideration, other additionalreasons outside of just the simple fact that
it can kill you. There arelots of other reasons related to your circle,
your community that really are compelling reasons. Not to mention the expense.
Because tobacco use has gotten super expensive, right, yeah, it has.
(11:28):
And I always when I'm meeting withpatients or i'm your training providers, I
always really emphasize the message that whateveran individual's reasons are, they're the right
ones you know. So if anyonefeels like Tobacqueo's is taking from them more
than it's giving them back, maybetheir time, their health, their money,
their relationships. We tend to thinkthat the reasons always have to be
(11:48):
related to physical health impacts. Butyes, there's a lot of people that
I work with and I've spoken towhere they're concerned of their child taking up
tobaccos from seeing them use tobacco,or they're concerned about the cost, or
it could be just how their relationshipsare a strain where they're the last person
at that barbecue that's using tobacco offon the periphery while everyone else is enjoying
(12:09):
that event. So whatever an individual'sreasons are, they are the right ones
for either them to move forward orfor a provider or a support to help
that individual take that step forward.So for anyone who's listening and you are
ready, today is day one.What's that number again? One eight hundred
quit now. Ryan Kaufman, TobaccoPolicy and Control Program manager at the Philadelphia
(12:31):
Department of Public Health, Thank youso much. Have you ever wanted to
go above and beyond for your community, volunteering for your local fire or ems,
department is your opportunity join a familythat will serve with you, always
have your back, and train youto be the best version of yourself.
As a volunteer, you will meetnew people, learn new skills, and
(12:54):
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That's make me a Firefighter dot org. Do you know someone in need of
an organ transplant you want to helpit, but don't want to be a
living organ donor, We ask youto consider becoming a designated deceased organ donor.
A federal law called the Uniform AnatomicalGift Act allows you to leave your
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organ to someone you know when youpass on. To find out more,
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an organ transplant and raise awareness aboutthis option. Visit www dot loio dot
org to find out more. ThisNovember, here's some mustaches in all their
(13:37):
glory. To the first peach fuzzones, the lopsided ones, the unexpectedly
sexy ones, to the black,brown and red ones, to the stately
salt and pepper ones, to theones grown by the men we love,
the ones grown for the men.We love those with us today and those
never forgotten. A mustache in Novemberis a power. It helps raise funds
(14:01):
and awareness for men's mental health andsuicide prevention, prostate cancer, and testicular
cancer. So rally crew, friends, family, co workers, and take
on November together. And there areplenty of ways to get involved in November
even if you can't grow mustache.Help us change the face of men's health.
Go to November dot com and let'sget this Harry party starting. That's
(14:26):
November with an m as in mustachedot com. November is a registered five
oh one C three organization. Thetwenty twenty three aac R Philadelphia Marathon,
held right here in the city ofBrotherly Love, is coming up around the
(14:46):
corner. Thousands of participants from manydifferent backgrounds, some who are longtime marathon
runners and runners in general, andthose who are fairly novice at it get
together for the most scenic, reallyamazing marathon in the world. And we're
going to talk about getting ready forthe marathon with doctor John Lush, who
(15:07):
is a sports medicine physician at RothmanOrthopedics. Thank you so much for joining
us here today. And while I'venot run the marathon, i have run
the Rothman eight k on behalf ofthe AACR. So it was quite an
accomplishment for me to get up andstart running and getting into the race.
And for a lot of people.There are some longtime runners who are very
(15:31):
seasoned and know exactly what to do, and then there's some that are kind
of new to the game. Sotell us what advice would you give too
runners getting ready for the marathon andfor all the races that are coming for
this marathon weekend, what do theyneed to do in the weeks coming up
for the races. First of all, thank you for having me. I'm
very happy to be here. I'mvery happy to be serving in this role
(15:54):
as the medical director for our upcomingmarathon weekend, which is November eighteenth and
nineteen. For those of you whoare not signed up to participate, definitely
please come out cheer on your fellowrunners. It's a great environment for any
runner who's going to participate in anysort of distance endurance event like this.
The most important thing once you decidethat you want to do it is to
(16:18):
have a plan, and that planincludes how far in advance to begin your
training, how quickly or slowly toincrease your mileage, what's a good pace
to go at, what's a goodregiment of exercise to kind of cross train
and keep your your muscles strong tohelp prevent injury. And once you commit
and you follow your plan, it'spretty bread and butter. A lot of
(16:42):
these marathon training plans are pretty welllaid out. So as long as you
can commit the couple of days aweek that it requires to effectively train,
then you know, especially as youget into those last couple weeks, you
should be at a good point withkind of knowing sort of your own limits
(17:03):
and how much you can do andhow good you feel. But even now,
as we get to you know,this is the point where really people
should be starting to pull back.So you don't want to plan to be
running thirteen or twenty six miles,depending on if you're doing the half of
the fall. At this point,you've kind of already worked up to that.
Now we're going to start to scaleback so that you sort of lower
(17:27):
some of the stress on the bodyas you're getting closer and closer to racing.
As someone who's both prepared to runin an eight k and eight k
not, I haven't done the halfor the full yet and also having the
experience of not training that hard beforedoing the last race that I did.
I can tell you that it reallyhelps to train over a period of time
(17:49):
because I finished I did. Iagree, you know, I crawled through
to the finish line. But itreally does make a difference. Really,
you really do need to spread outthe training so that if you're waiting till
the last minute to start training andrunning, it's going to be a very
painful experience. Let me tell youI can testify to that. So,
(18:11):
now, what about shoes? BeforeI started running, I was you know,
I had kids, I had,you know, nothing special. So
what is a good pair of shoesfor running in a marathon? And what
are the ways in which you needto break into wearing those shoes. You
can't just put a new pair ofshoes on and start running, right,
(18:32):
correct. Yeah, so footwear obviouslyis super important for a runner. That
is the tool of the trade.You want to make sure that you're running
in the right type of shoe.Now, you could go online, you
could go to a store and youcould see wide variety of running shoes,
(18:53):
right, different brands, different colors, designs, and some of them are
fun and flashy. Some of themlook kind of mundane and boring. But
the most important thing is getting theright type of shoe for you, and
that will depend on things like what'sthe shape of your foot. So are
you somebody who has a pretty goodarch or somebody who has a real flat
(19:18):
foot, or somebody who has areally high arch or it may not look
flat, but when you stand,do you kind of collapse down and roll
your foot in or out? Sodepending on like the mechanics of your foot
and ankle and the shape of yourfoot, there are certain running shoes that
are better than others. Ones thatmight have more cushioning, ones that might
(19:38):
be a little more rigid in themiddle, and then also too understanding what
they call kind of your foot strike. So when you take your running stride
and your footland's on the ground,do you land right on your heel and
then kind of push off on yourtoes? Do you land on your toes?
Do you land kind of more onthe midfoot, Because certain shoes might
(20:00):
be more beneficial than others. Honestly, the best place to get running sneakers
is a specialty running store. There'squizzes you can take online to try to
figure out what might be the besttype or brand of running sneaker for you,
but having somebody who does this prettyroutinely, look at the shape of
(20:21):
your foot, have you walk aroundthe store or even run on a treadmill,
and then based on that, recommenda certain brand or certain type,
and then obviously looking for fun colorsand designs and stuff as long as it's
the appropriate type of shit, andthen also making sure that you don't over
use them. Running sneakers typically havea lifespan of anywhere from about three hundred
(20:41):
to five hundred miles. If you'refalling within that range, it's a good
idea to get a new pair.Like anything new, right, they take
time to break in, As youwere asking, so I wouldn't get a
new pair of running shoes the weekbefore the race and then try to wear
those. They're probably going to bea little too new and a little too
(21:02):
uncomfortable. You want to make surethat you're in a shoe that's not too
new but also not too worn.Right, as you get closer to race
day, if you're running in apair of shoes that you've had for a
while, you're starting to get newapes or pain in the knees, paining
the shins, pain in the ankles, your feet especially they're extra sore after
you're running, you're starting to getblisters, then those might be signs that
(21:25):
the shoes are kind of nearing theend. You're on site at the marathon,
right and I'm sure I'm sure youencounter quite a few injuries. Tell
us what are some of the typicalinjuries that you see in that you have
to treat on race day. Iwill be one of the people in our
main medical tent right at the finishline, and we have a wide variety
of injuries. You know, we'llsee things such as simple scrapes and cutts
(21:48):
because somebody bumped into somebody else andthey fell down to the ground. We've
had people kind of have trip andfall episodes and they've sustained fractures and springs
of joints and injuries to ligaments.But those are a little more rare,
you know. Obviously you get concernedabout people collapsing out on the course.
Thankfully, this time of year youdon't have to worry too much about heat
(22:11):
being a major factor, although evenif the temperature the start of the races
in the high thirties low forties andonly gets up to the lower mid fifties
during the day. You can stilldevelop heat related injuries where the body's core
temperature rises to you know, sometimesconcerning your dangerous levels. But the majority
(22:32):
of the things we encounter are moreminor musculoskeletal things. Your cuts, your
bruises, a lot of blisters,a lot of chafing, which having run,
can be quite uncomfortable. We're fortunatetoo that the Philadelphia Fire Department and
some local emergency physicians are on siteas well for any of the more scary
(22:56):
dangerous kind of things, because whensomebody collapses, especially if they collapse close
to or right after the finish line, it could be something as innocuous as
well. Their muscles were working hardfor the last couple hours. They're used
to pump in all this blood throughoutthe body, and then you suddenly stop
and slow your page dramatically when youcross the finish line. Well, now
(23:18):
all that blood kind of pools inyour legs, you get light edited and
dizzy, you go down, Butthose people usually pop back up pretty quickly.
It's the ones who go down andstay down where you have to really
be concerned, and that's why I'mfortunate to have some of our emergency medical
personnel president as well. On theday of I've heard such conflicting advice about
(23:38):
what to eat. Do you eatlots of carbs, do you eat lots
of protein? What do you dothe times I've run races, the two
half marathons that I've done, Idid the carbo loading the night before the
Big Bowl apasta and then in themorning cup of black coffee and maybe you
know, two hard boiled eggs.You really kind of have to base it
(24:00):
on you individually, and because partof the training program, a lot of
these kind of marathon training guides thatyou can follow. Do you have a
nutrition component as well, so makingsure you're hydrated and not just drinking an
extra glass of water the night forthe race, but making sure you're well
hydrated in a days and a coupleof weeks leading up to it. I'm
(24:21):
more a fan of carbolode the nightbefore and then little protein in the morning.
Yeah. One of the most thrillingparts of the race is when it
ends, and you know, yougo in there and you're raising, you
know, the rocky style. You'vegot your arms waving in the air.
So at the end of the race, what do you do? Do you
(24:42):
jump into a hot tub afterwards?Do you just meet with your friends and
drink lots of beer? What doyou do you what are your recommendations?
So all of the above certainly triedoptions that all sorts of runners have engaged
in upon completing their race. Ithink the most important thing when you cross
that finish line is number one,give yourself major kudos, because you just
(25:06):
completed either an eight k or ahalf marathon or a full marathon, which
is not an easy feat, youknow, even for the people who do
multiple ones throughout the year. Likeit's hard, right, It's physically demanding,
it's a challenge, And so Ithink the first thing you need to
do is kind of appreciate all thework you put in, celebrate your own
victory there and and just kind oflook around and enjoy the moment. Then
(25:27):
wrap yourself up in a space blanket, grab a banana if you want to,
if you want to, go havea beer and a pretzel. You
know, like it's actually a prettygood beverage to rehydrate with after you know
you can you can do your gatoradebut definitely don't stop moving right away.
(25:48):
You know I alluded earlier to youknow, people's blood kind of pooling,
they get sort of lightheaded or dizzy. But also too, you know,
you don't want your muscles to immediatelycramp and seize up. So definitely keep
moving. Definitely stretch out, giveyourself some kind of cool down, even
if it's just a walk down andback up a little section of the Ben
Franklin Parkway before you meet your friendsand family to celebrate. Well, we're
(26:11):
very appreciative that you'll be on sitefor those people who are going to need
your help, and I'm sure there'sgoing to be more than one person,
I assume. But the AACR Marathonweekend the eighteenth and nineteenth. The marathon
is on the nineteenth. The halfmarathon I believe, is on the eighteenth,
as well as the Rothman eight k, which I have done and which
(26:33):
is actually doable. Maybe someday I'lldo that half marathon, but in the
meantime, well, I'm back.AK is more of my speed. If
people want more information about Rothman Orthopedics, how do they find out more about
what you guys do over there?They're definitely encouraged to go to our website
(26:53):
www dot Rothmanortho dot com and then, like most places, we are present
on social media as well Rothman Orthoon Facebook, Instagram, Twitter, Great
and also if you want to knowmore about the aac R Philadelphia Marathon,
you can go to Philadelphiamarathon dot com. And just a reminder that not only
(27:14):
is this one of the world classmarathon, it also is a benefit for
the American Association for Cancer Research,which is the first and oldest cancer research
foundation in the world based right herein Philadelphia. So I want to thank
you so much for joining us heretoday. I'm sure it's going to be
another gorgeous day. We've had somegreat luck in the last couple of years
for the a marathon. Yes one, it keeps up absolutely. Doctor John
(27:38):
Lux, who is a sports medicinephysician at Rothman Orthopedics who will be on
site helping those out there who mightneed some medical assistance during the AACR Philadelphia
Marathon, thank you so much forjoining us today. Thank you thanks for
having me learning. You can listento all of today's interviews by going to
our station website and typing in keywordcommunity You can also listen on the iHeartRadio
(28:02):
app yey Words Philadelphia Community Podcast.Follow me on Twitter and Instagram at Lorraine
Ballard. I'm Lorraine Ballard MOREL andI stand for service to our community and
media that empowers. What will youstand for? You've been listening to what's
going on, and thank you
Good morning, and welcome to what'sgoing on? A show about making a
difference in our lives and our communities. I'm Lorraine Balla Tomorrow. I was
never a runner, but when theopportunity arose to raise money for the American
Association for Cancer Research the AACR,the first and largest cancer research foundation in
the world, funding breakthroughs in cancer, I couldn't resist. I never liked
(00:25):
running, but the cause was apowerful one considering all the family and friends
in my circle touched by cancer.So I laced up my sneakers and have
been running on behalf of the AACR. Not the full marathon or even the
half, but I'm proud to saythat I've completed the Rothman eight k I
was hardly the fastest and thankfully notthe slowest, but since twenty sixteen I
(00:47):
have run on behalf of the AACR. Sadly, I threw out my knee,
so I won't be running this year. But for those seasoned runners and
novices, I'll be speaking with doctorJohn Lutsch, it's medicine physician at Rothmann
Orthopedics, who has some great prerace advice. First, quitting smoking,
(01:07):
one of the toughest things. Ever, in fact, some people have considered
that tobacco can be even more addictivethan heroin, which makes quitting very challenging.
To tell us more about how wecan quit and what the resources are
that can get us there. RyanKaufman, Tobacco Policy and Control Program manager
for the Philadelphia Department of Public Health. Thank you so much for joining us
(01:29):
today. It's pleasure to be here. Thanks for having me. Well.
First of all, people don't oftenthink of it this way, but tobacco
is a drug, right, Yeah, you're right. I think far too
often we frame tobacco use as ahabit, and so when you really study
tobacco use disorder, it's really achronic disease, just like diabetes, hypertension,
or asthma, and a substance usedisorder. So it is all the
(01:49):
characteristics of other illicit substances in termsof tolerance withdrawal. I think it's really
important to see tobacco use in thatlight. It really underscores the import whortance
of becoming tobacco free and the challengesthat can exist. I think that's a
good way of reframing it because Ithink in the past we never really thought
of it as being a disorder ofany kind. We always thought, oh,
(02:10):
yeah, you made a choice,you started smoking, and now you've
got the consequences of that. Justquit. Well, it's not that simple,
because tobacco or nicotine in particular,is very friendly with certain receptors in
our brains, right, that's right. So a lot of the same receptors
that are influenced by alcohol, heroin, cocaine are also influenced by by nicotine.
(02:32):
So it releases much of the samebrain chemicals dopamine, serotonin, which
affect how we feel and even howwe think. So yeah, very very
similar. Everyone is potentially a tobaccouser, but there's certain populations that are
more prone to pick up the habit, and I wonder if we can talk
about what those populations are and whatare some of the reasons why. Yeah,
(02:54):
it's a great question. So tobaccouse rates have declined very sharply overall
around the nation and even in citieslike Philadelphia, but there are certain populations
that still use tobacco much higher ratesoverall, and those are the very same
populations at the campaign we're going totalk about today focuses on so folks with
behavioral health challenges. LGBTQA plus individuals, folks that work in the bar,
(03:16):
hospitality, food service industry, veterans, and new mothers used tobacco much higher
rates. And the reason for thatis really the tobacco industry. Through marketing
and advertising and a variety of deceptiveand manipulative practices, they've created cultures of
tobacco use in those communities where tobaccois seen is more common, normal and
(03:37):
acceptable, and the rates correspondingly arevery, very high. I think you
make a very good point about thetobacco industry. I know that they had
specifically targeted low income communities to putbillboards, for instance, for tobacco use.
That's right. I mean any strategyfrom philanthropic giving to discounting, couponning
billboards, marketing and advertising. Theyhave a whole playbook deceptive manipulative practices they've
(04:00):
used for decades in these communities.Well, we can't talk about tobacco use
without talking about the consequences because weknow that smoking tobacco can lead to so
many different health issues, including heartdisease and cancer. Tell us a little
more about that. What are theconsequences of smoking? So tobacco use is
still the leading cause of preventable deathand disability in the nation and kills upwards
(04:23):
of almost four thousand Philadelphians a year. And that is a very very important
message, and there still can besome misconceptions about just how deadly tobaccu us
is. I think a really importantcompanion message is that when people become tobacco
free, your body begins healing inas little as twenty minutes after your last
tobacco use, and over time,your risk of heart disease, cancer stroke
(04:44):
all go down pretty dramatically in shortorder. So I think there's a two
sided coin that deserves discussion around thisissue, both the negative health impacts but
also how quickly your body recovers asa result of being tobacco free. And
the Great American Smokeout can be animportant forward for folks in that way.
Well, let's talk about some ofthe ways that we can start to support
people quitting the habit. You mentionedthis American Great American Smokeout, and we'll
(05:09):
get to that in just a second, because that's one national event that really
brings awareness smoking and quitting. Butlet's talk about what are some of the
strategies for quitting smoking because we've gotsome new technologies these days. Back in
the old days, it really wasall about cold turkey. But now we
have different tools and medicines that wecan use. Tell us more, far
(05:30):
more is available than us previously tomake the journey of becoming tobacco free both
easier but then also more successful.So what I really suggest, and this
is what I tell my patients directlywhen I meet with them, is really
setting recovery start date, usually withinthe next two to four weeks, to
target becoming tobacco free, and thenhaving a plan to back that data up
and get you ready. Building upyour social support among your loved ones,
(05:51):
friends and co workers, including externalresources right like the Pennsylvania Freequent line,
which provides free medications and free coachingone hundred quit Now people can also use
text, messaging and web based applicationsto get that additional sense of social support.
Then developing coping skills for your triggers, stress, boredom, other smokers,
(06:11):
driving, whatever that might be.Then creating tobacco free environments in your
home, workplace if that applies inyour vehicle, and then talking to either
your physical health and or your behavioralhealth provider about medications which are available to
treat tobacco withdrawal symptoms. That's reallythe plan that I work on with patients
that I serve here in Philadelphia.What are some of the medications that are
now available. There's about seven FDapproved medications that are largely covered by private
(06:35):
and public insurance under the Affordable CareAct. But that resource that I mentioned
earlier when intered quit now provides severalfree weeks of medications that they mail directly
to your house, so patches,gum, and lozenges that are available for
any caller in Pennsylvania, and that'spromoted pretty regularly through the media campaign that's
running right now that we'll discuss.You talk about how it's important to have
(06:57):
a network of supporters also made perhapsputting yourself in conditions that where you can
notice what your triggers are and beable to find different coping mechanisms. But
I do want to mention that howimportant it is to have support because there
are people, just as there arein the substance use disorder community, there
are those in the tobacco use disordercommunity. I never smoke, so I
(07:21):
can speak from someone who's never smoked, but for those who have smoked,
they have seen people put packs ofcigarettes down in front of that person who's
trying to quit and engage in otheractivities that really put that person back in.
It's weird, but it's real,right right. I mean, just
the site and smell of tobacco productscan be a cue or a trigger for
(07:44):
an individual that is trying to beginor maintain their recovery from tobacco use.
And so really we use a lotof the same strategies that we use for
other substance use disorders right in thatrecovery process. So that means moods,
persons, places things like it doesfor perhaps cocaine, we use those same
strategies to apply to tobaccuous because ultimately, as I mentioned, tobacco used disorder
(08:07):
is business substance use disorder. Absolutely. Now the Great American Smoke can tell
us more. Yeah, So thisis a long standing holiday through the Great
American smokeout through the American Cancer Society, and the real goal is recognizing that
every single person among the millions andmillions of people that have become tobacco free
in this nation, that everyone startedwith one day, that one thousand mile
journey beginning with the first step,if you will, and so really encouraging
(08:30):
individuals through the resources and supports thatare available through the American Cancer Society,
but also those that I mentioned,like the PA fre quit Line, to
really utilize those resources to attempt oneday tobacco free and experience that day and
what life is like right not usingtobacco after that meal or when you're driving,
or when you're in the company ofyour coworker, and then seeing it
(08:52):
that day can be a stepping stoneor a jumping off point towards a lifetime
of being tobacco free as well.And I think it's one of the more
well known advocacy awareness days around tobaccouse. So it's an important day coming
up very soon on November sixteenth,So definitely encourage anyone listening in to make
use of the resources we're talking abouthere today, share those with your loved
ones and people you care about,and encourage them to take that first step.
(09:15):
Yes, this is a very strongaddiction, but so are people.
I've personally worked with people that werefive packs a day people at smoke for
seventy years. So if you hearanything I'm saying today, it's no matter
how long you've been on this roadof tobacco use, there's always an off
ramp or an exit. If you'vetried before, there's almost always stone's unturned
that we can explore, or theseresources can help you to explore to be
(09:37):
tobacco free and remain tobacco free andremind us what those resources are. So
Smoke Free Philly. Our website forour program has extensive amount of resources available,
tips and tricks to really help beginthat process. One eight hundred Quit
now provides free medications and free behavioralcoaching, as well as one's insurance both
(09:58):
private and public insurance is largely coveredring these medications and resources. And then
the campaign that we're talking about heretoday is also important because we're showing individuals
where there's a strong societal perception thateveryone who works in the hospitality industry or
everyone who served in the armed forceswants to use tobacco, has no interest
(10:18):
in tobacco recovery or even needs touse tobacco in those communities, and we're
doing this campaign to show that everyonedeserves the opportunity to be tobacco free,
and these communities, even with higherrates of tobacco use have just as much
interest as everyone else in becoming tobaccofree. So we're hoping that people at
home or on the bus or listento the radio will see these individuals and
(10:41):
see themselves within that story or testimonialand say, if that person can quit,
so can I This possible for them? It's possible for me too.
And as you mentioned earlier, theuse of tobacco is down, and so
for those who continue to use tobacco, there are a lot of lifestyle issues
that you need to remember. Iffor instances, so people will not date
someone who smokes, or someone willnot want to be around have their children
(11:05):
be around someone who smokes. Sothere are lots of lifestyle issues that people
can take into consideration, other additionalreasons outside of just the simple fact that
it can kill you. There arelots of other reasons related to your circle,
your community that really are compelling reasons. Not to mention the expense.
Because tobacco use has gotten super expensive, right, yeah, it has.
(11:28):
And I always when I'm meeting withpatients or i'm your training providers, I
always really emphasize the message that whateveran individual's reasons are, they're the right
ones you know. So if anyonefeels like Tobacqueo's is taking from them more
than it's giving them back, maybetheir time, their health, their money,
their relationships. We tend to thinkthat the reasons always have to be
(11:48):
related to physical health impacts. Butyes, there's a lot of people that
I work with and I've spoken towhere they're concerned of their child taking up
tobaccos from seeing them use tobacco,or they're concerned about the cost, or
it could be just how their relationshipsare a strain where they're the last person
at that barbecue that's using tobacco offon the periphery while everyone else is enjoying
(12:09):
that event. So whatever an individual'sreasons are, they are the right ones
for either them to move forward orfor a provider or a support to help
that individual take that step forward.So for anyone who's listening and you are
ready, today is day one.What's that number again? One eight hundred
quit now. Ryan Kaufman, TobaccoPolicy and Control Program manager at the Philadelphia
(12:31):
Department of Public Health, Thank youso much. Have you ever wanted to
go above and beyond for your community, volunteering for your local fire or ems,
department is your opportunity join a familythat will serve with you, always
have your back, and train youto be the best version of yourself.
As a volunteer, you will meetnew people, learn new skills, and
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make a meaningful impact. Learn moreat make Me a Firefighter dot org.
That's make me a Firefighter dot org. Do you know someone in need of
an organ transplant you want to helpit, but don't want to be a
living organ donor, We ask youto consider becoming a designated deceased organ donor.
A federal law called the Uniform AnatomicalGift Act allows you to leave your
(13:16):
organ to someone you know when youpass on. To find out more,
contact Living on in Others, whosemission is to help those in need of
an organ transplant and raise awareness aboutthis option. Visit www dot loio dot
org to find out more. ThisNovember, here's some mustaches in all their
(13:37):
glory. To the first peach fuzzones, the lopsided ones, the unexpectedly
sexy ones, to the black,brown and red ones, to the stately
salt and pepper ones, to theones grown by the men we love,
the ones grown for the men.We love those with us today and those
never forgotten. A mustache in Novemberis a power. It helps raise funds
(14:01):
and awareness for men's mental health andsuicide prevention, prostate cancer, and testicular
cancer. So rally crew, friends, family, co workers, and take
on November together. And there areplenty of ways to get involved in November
even if you can't grow mustache.Help us change the face of men's health.
Go to November dot com and let'sget this Harry party starting. That's
(14:26):
November with an m as in mustachedot com. November is a registered five
oh one C three organization. Thetwenty twenty three aac R Philadelphia Marathon,
held right here in the city ofBrotherly Love, is coming up around the
(14:46):
corner. Thousands of participants from manydifferent backgrounds, some who are longtime marathon
runners and runners in general, andthose who are fairly novice at it get
together for the most scenic, reallyamazing marathon in the world. And we're
going to talk about getting ready forthe marathon with doctor John Lush, who
(15:07):
is a sports medicine physician at RothmanOrthopedics. Thank you so much for joining
us here today. And while I'venot run the marathon, i have run
the Rothman eight k on behalf ofthe AACR. So it was quite an
accomplishment for me to get up andstart running and getting into the race.
And for a lot of people.There are some longtime runners who are very
(15:31):
seasoned and know exactly what to do, and then there's some that are kind
of new to the game. Sotell us what advice would you give too
runners getting ready for the marathon andfor all the races that are coming for
this marathon weekend, what do theyneed to do in the weeks coming up
for the races. First of all, thank you for having me. I'm
very happy to be here. I'mvery happy to be serving in this role
(15:54):
as the medical director for our upcomingmarathon weekend, which is November eighteenth and
nineteen. For those of you whoare not signed up to participate, definitely
please come out cheer on your fellowrunners. It's a great environment for any
runner who's going to participate in anysort of distance endurance event like this.
The most important thing once you decidethat you want to do it is to
(16:18):
have a plan, and that planincludes how far in advance to begin your
training, how quickly or slowly toincrease your mileage, what's a good pace
to go at, what's a goodregiment of exercise to kind of cross train
and keep your your muscles strong tohelp prevent injury. And once you commit
and you follow your plan, it'spretty bread and butter. A lot of
(16:42):
these marathon training plans are pretty welllaid out. So as long as you
can commit the couple of days aweek that it requires to effectively train,
then you know, especially as youget into those last couple weeks, you
should be at a good point withkind of knowing sort of your own limits
(17:03):
and how much you can do andhow good you feel. But even now,
as we get to you know,this is the point where really people
should be starting to pull back.So you don't want to plan to be
running thirteen or twenty six miles,depending on if you're doing the half of
the fall. At this point,you've kind of already worked up to that.
Now we're going to start to scaleback so that you sort of lower
(17:27):
some of the stress on the bodyas you're getting closer and closer to racing.
As someone who's both prepared to runin an eight k and eight k
not, I haven't done the halfor the full yet and also having the
experience of not training that hard beforedoing the last race that I did.
I can tell you that it reallyhelps to train over a period of time
(17:49):
because I finished I did. Iagree, you know, I crawled through
to the finish line. But itreally does make a difference. Really,
you really do need to spread outthe training so that if you're waiting till
the last minute to start training andrunning, it's going to be a very
painful experience. Let me tell youI can testify to that. So,
(18:11):
now, what about shoes? BeforeI started running, I was you know,
I had kids, I had,you know, nothing special. So
what is a good pair of shoesfor running in a marathon? And what
are the ways in which you needto break into wearing those shoes. You
can't just put a new pair ofshoes on and start running, right,
(18:32):
correct. Yeah, so footwear obviouslyis super important for a runner. That
is the tool of the trade.You want to make sure that you're running
in the right type of shoe.Now, you could go online, you
could go to a store and youcould see wide variety of running shoes,
(18:53):
right, different brands, different colors, designs, and some of them are
fun and flashy. Some of themlook kind of mundane and boring. But
the most important thing is getting theright type of shoe for you, and
that will depend on things like what'sthe shape of your foot. So are
you somebody who has a pretty goodarch or somebody who has a real flat
(19:18):
foot, or somebody who has areally high arch or it may not look
flat, but when you stand,do you kind of collapse down and roll
your foot in or out? Sodepending on like the mechanics of your foot
and ankle and the shape of yourfoot, there are certain running shoes that
are better than others. Ones thatmight have more cushioning, ones that might
(19:38):
be a little more rigid in themiddle, and then also too understanding what
they call kind of your foot strike. So when you take your running stride
and your footland's on the ground,do you land right on your heel and
then kind of push off on yourtoes? Do you land on your toes?
Do you land kind of more onthe midfoot, Because certain shoes might
(20:00):
be more beneficial than others. Honestly, the best place to get running sneakers
is a specialty running store. There'squizzes you can take online to try to
figure out what might be the besttype or brand of running sneaker for you,
but having somebody who does this prettyroutinely, look at the shape of
(20:21):
your foot, have you walk aroundthe store or even run on a treadmill,
and then based on that, recommenda certain brand or certain type,
and then obviously looking for fun colorsand designs and stuff as long as it's
the appropriate type of shit, andthen also making sure that you don't over
use them. Running sneakers typically havea lifespan of anywhere from about three hundred
(20:41):
to five hundred miles. If you'refalling within that range, it's a good
idea to get a new pair.Like anything new, right, they take
time to break in, As youwere asking, so I wouldn't get a
new pair of running shoes the weekbefore the race and then try to wear
those. They're probably going to bea little too new and a little too
(21:02):
uncomfortable. You want to make surethat you're in a shoe that's not too
new but also not too worn.Right, as you get closer to race
day, if you're running in apair of shoes that you've had for a
while, you're starting to get newapes or pain in the knees, paining
the shins, pain in the ankles, your feet especially they're extra sore after
you're running, you're starting to getblisters, then those might be signs that
(21:25):
the shoes are kind of nearing theend. You're on site at the marathon,
right and I'm sure I'm sure youencounter quite a few injuries. Tell
us what are some of the typicalinjuries that you see in that you have
to treat on race day. Iwill be one of the people in our
main medical tent right at the finishline, and we have a wide variety
of injuries. You know, we'llsee things such as simple scrapes and cutts
(21:48):
because somebody bumped into somebody else andthey fell down to the ground. We've
had people kind of have trip andfall episodes and they've sustained fractures and springs
of joints and injuries to ligaments.But those are a little more rare,
you know. Obviously you get concernedabout people collapsing out on the course.
Thankfully, this time of year youdon't have to worry too much about heat
(22:11):
being a major factor, although evenif the temperature the start of the races
in the high thirties low forties andonly gets up to the lower mid fifties
during the day. You can stilldevelop heat related injuries where the body's core
temperature rises to you know, sometimesconcerning your dangerous levels. But the majority
(22:32):
of the things we encounter are moreminor musculoskeletal things. Your cuts, your
bruises, a lot of blisters,a lot of chafing, which having run,
can be quite uncomfortable. We're fortunatetoo that the Philadelphia Fire Department and
some local emergency physicians are on siteas well for any of the more scary
(22:56):
dangerous kind of things, because whensomebody collapses, especially if they collapse close
to or right after the finish line, it could be something as innocuous as
well. Their muscles were working hardfor the last couple hours. They're used
to pump in all this blood throughoutthe body, and then you suddenly stop
and slow your page dramatically when youcross the finish line. Well, now
(23:18):
all that blood kind of pools inyour legs, you get light edited and
dizzy, you go down, Butthose people usually pop back up pretty quickly.
It's the ones who go down andstay down where you have to really
be concerned, and that's why I'mfortunate to have some of our emergency medical
personnel president as well. On theday of I've heard such conflicting advice about
(23:38):
what to eat. Do you eatlots of carbs, do you eat lots
of protein? What do you dothe times I've run races, the two
half marathons that I've done, Idid the carbo loading the night before the
Big Bowl apasta and then in themorning cup of black coffee and maybe you
know, two hard boiled eggs.You really kind of have to base it
(24:00):
on you individually, and because partof the training program, a lot of
these kind of marathon training guides thatyou can follow. Do you have a
nutrition component as well, so makingsure you're hydrated and not just drinking an
extra glass of water the night forthe race, but making sure you're well
hydrated in a days and a coupleof weeks leading up to it. I'm
(24:21):
more a fan of carbolode the nightbefore and then little protein in the morning.
Yeah. One of the most thrillingparts of the race is when it
ends, and you know, yougo in there and you're raising, you
know, the rocky style. You'vegot your arms waving in the air.
So at the end of the race, what do you do? Do you
(24:42):
jump into a hot tub afterwards?Do you just meet with your friends and
drink lots of beer? What doyou do you what are your recommendations?
So all of the above certainly triedoptions that all sorts of runners have engaged
in upon completing their race. Ithink the most important thing when you cross
that finish line is number one,give yourself major kudos, because you just
(25:06):
completed either an eight k or ahalf marathon or a full marathon, which
is not an easy feat, youknow, even for the people who do
multiple ones throughout the year. Likeit's hard, right, It's physically demanding,
it's a challenge, And so Ithink the first thing you need to
do is kind of appreciate all thework you put in, celebrate your own
victory there and and just kind oflook around and enjoy the moment. Then
(25:27):
wrap yourself up in a space blanket, grab a banana if you want to,
if you want to, go havea beer and a pretzel. You
know, like it's actually a prettygood beverage to rehydrate with after you know
you can you can do your gatoradebut definitely don't stop moving right away.
(25:48):
You know I alluded earlier to youknow, people's blood kind of pooling,
they get sort of lightheaded or dizzy. But also too, you know,
you don't want your muscles to immediatelycramp and seize up. So definitely keep
moving. Definitely stretch out, giveyourself some kind of cool down, even
if it's just a walk down andback up a little section of the Ben
Franklin Parkway before you meet your friendsand family to celebrate. Well, we're
(26:11):
very appreciative that you'll be on sitefor those people who are going to need
your help, and I'm sure there'sgoing to be more than one person,
I assume. But the AACR Marathonweekend the eighteenth and nineteenth. The marathon
is on the nineteenth. The halfmarathon I believe, is on the eighteenth,
as well as the Rothman eight k, which I have done and which
(26:33):
is actually doable. Maybe someday I'lldo that half marathon, but in the
meantime, well, I'm back.AK is more of my speed. If
people want more information about Rothman Orthopedics, how do they find out more about
what you guys do over there?They're definitely encouraged to go to our website
(26:53):
www dot Rothmanortho dot com and then, like most places, we are present
on social media as well Rothman Orthoon Facebook, Instagram, Twitter, Great
and also if you want to knowmore about the aac R Philadelphia Marathon,
you can go to Philadelphiamarathon dot com. And just a reminder that not only
(27:14):
is this one of the world classmarathon, it also is a benefit for
the American Association for Cancer Research,which is the first and oldest cancer research
foundation in the world based right herein Philadelphia. So I want to thank
you so much for joining us heretoday. I'm sure it's going to be
another gorgeous day. We've had somegreat luck in the last couple of years
for the a marathon. Yes one, it keeps up absolutely. Doctor John
(27:38):
Lux, who is a sports medicinephysician at Rothman Orthopedics who will be on
site helping those out there who mightneed some medical assistance during the AACR Philadelphia
Marathon, thank you so much forjoining us today. Thank you thanks for
having me learning. You can listento all of today's interviews by going to
our station website and typing in keywordcommunity You can also listen on the iHeartRadio
(28:02):
app yey Words Philadelphia Community Podcast.Follow me on Twitter and Instagram at Lorraine
Ballard. I'm Lorraine Ballard MOREL andI stand for service to our community and
media that empowers. What will youstand for? You've been listening to what's
going on, and thank you
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