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September 5, 2023 20 mins

Dr Puma stops by Cardio Health Risks, Innovative Screening Technology and more.

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Episode Transcript

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Speaker 1 (00:00):
Wake that answer up in the morning. The Breakfast Club Morning.

Speaker 2 (00:05):
Everybody is the j n V. Charlamagne the guy. We
are the Breakfast Club. We got a special guest in
the building, doctor Joseph Puma.

Speaker 3 (00:13):
Welcome, Welcome, Thank you for having me here. I appreciate it.

Speaker 4 (00:17):
Doctor Joseph Puma, I've been telling you all about this
souring medical scan. I didn't know. That's not what it's called.
It's souring heart skin heart skink at Soorn Medical. But
tell people what sorring medical is first, Doctor Pumer.

Speaker 5 (00:29):
Soren Medical is a cardiovascular medical practice. We have offices
throughout four of the five boroughs UH. Generally we provide
care in underserved communities where what often called health deserts.
There's no hospitals or not many physicians around, and we
try and meet patients who need out care where they live.

Speaker 4 (00:53):
And I told y'all I've had every cardiovascular test there
is to have over the past few months. I had
name some of them. That was the EKGs. What are
some of the tests?

Speaker 3 (01:03):
I think you had stress tests before you came to us.
You had a calcium score.

Speaker 4 (01:11):
Calcium score and yours absolutely not only was the best,
it's the one that put my mind at ease the most. Well,
thank you, especially after I got those results back.

Speaker 1 (01:21):
But why are they.

Speaker 4 (01:22):
Important for people of color to get their heart tested regularly?

Speaker 5 (01:25):
So it's important for people of color to get their
heart tested period and not regularly because one of the
challenges is they're not regularly getting they're heart tested.

Speaker 3 (01:37):
People of color.

Speaker 5 (01:38):
Have a almost one and a half to two times
the rate of death from heart disease. They get the
risk factors for heart disease, high blood pressure. They often
develop high blood pressure at an earlier age. It's more
difficult to treat. They have diabetes at a higher rate,
also a risk factor for heart disease. When they have

(02:01):
heart attacks, their outcomes are worse. They have a forty
percent increased chance of dying from a heart attack as
compared to whites in America, and they often have much
higher rates seventy percent higher rates of congestive heart failure,

(02:22):
which is very disabling, and they developed that often at
an earlier age.

Speaker 2 (02:26):
Well, how can people get tested? Not how can they
test it? Of course, but you know they tell you
at forty five years old, you get a colonoscopy. They
tell you at this age you do this At what
age should people be checking their heart? And you know,
I go to my doctor, you know, twice a year
for checkups, and that one time has he said, all right,
well you need to check out your heart or there
as certain signs where maybe.

Speaker 1 (02:47):
People say you should check out your heart.

Speaker 2 (02:49):
Are certain signs where they should do certain things, or
should they be at a particular age where this is
where you should start doing it more and more and more.

Speaker 3 (02:55):
Yeah, So that's a great question.

Speaker 5 (02:56):
So the answer to that question, I think depends on
whether you have symptoms or no symptoms. If you have
symptoms of discomfort in your chest, shortness of breath, more
easy fatigue, not able to do the usual level of exercise, dizziness, lightheadedness,
doesn't matter what age you are, you should be tested

(03:17):
because let's you remember, heart disease is the number one
killer in America. And even though over the last forty
years the rate of death from heart disease has come down,
it has not come down for the black community. All
those gains have been in the white community. So second,
if you're not necessarily symptomatic, okay, overall, you're working, you

(03:39):
feel good, but you're forty and older as a man
or fifty year older as a woman, and you've smoked,
have a family history of heart disease, have high blood pressure, diabetes,
are high cholesterol, then you should be tested prior to
the soaring heart scan or cats scanning in general of

(04:01):
the heart. The only test we had to determine if
you had heart disease was a stress test, but that's
not nearly as accurate and doesn't define the heart arteries
as Charlemagne. When you came in, we sent you images
of your heart arteries. We gave you a risk assessment,
but and it's costly. Stress testing almost ten times the

(04:22):
course of a cat skin. But cat scanning now takes
four minutes or less. If you come into our office
less than fifteen minutes of your total time, and you
have a fully accurate, greater than ninety seven percent accuracy
of your heart anatomy, whether there's blockage, calcium, any disruption

(04:42):
that could potentially cause a problem later on in life.

Speaker 2 (04:46):
Well, I was going to ask, So you know, you
go to the dentist, you have a cavity, they can
fix it right, flaus it whatever, colonoscope they clean your
butt out right, So now they know you know what
he knows what I mean. You know, they clean it out,
they cut off the polyps.

Speaker 1 (04:59):
You know what it is.

Speaker 2 (05:01):
So if there is a problem with your heart, what
are the procedures to can it be done right then?

Speaker 1 (05:06):
And there?

Speaker 4 (05:06):
Talk that talk doctor Pumber, This is good. Just just
move me away when you told me.

Speaker 3 (05:09):
Yeah.

Speaker 5 (05:10):
So, nationally, Medicare is now approved putting heart stents right
in the office in appropriate facilities. Uh. New York State
has not yet approved that, but our center down in
Lower Manhattan is built for that, and we have the
latest technology and cardiac cathization labs where you could have

(05:31):
a stent put right in at that time.

Speaker 3 (05:34):
So a stent, a stent is a.

Speaker 5 (05:37):
Metal scaffold that when you have a blockage in your
artery through an artery in your wrist, we put a
catheter up into the heart and then over a wire
through the catheter, we can pass a metal stent over
a balloon and dilate it and clear.

Speaker 3 (05:52):
Away the blockage.

Speaker 1 (05:53):
So the stint doesn't stay inside of it was just
it just cleans out.

Speaker 3 (05:56):
It stays inside you. It does stay and becomes part
of the artery wall.

Speaker 2 (06:00):
Okay, so you have a piece of metal in you
so every time you go through tsa metal detector you.

Speaker 3 (06:04):
It won't go off.

Speaker 1 (06:05):
Okay, it doesn't.

Speaker 3 (06:06):
It doesn't go off.

Speaker 5 (06:08):
It's it's very it's very small, three and a half
millimeters usually, but no, it doesn't set off metal detectors.

Speaker 3 (06:16):
You can use your microwave.

Speaker 5 (06:18):
But it's the most common treatment for blocked arteries in
the world.

Speaker 4 (06:22):
Can you explain to people what causes heart attacks and strokes?

Speaker 3 (06:26):
Sure, that's a that's a great question.

Speaker 5 (06:29):
And I think and I think that it's not only
a great, great question, great question in general, because it's
the leading cause of death, but in the black community,
the risk of it is so much higher. I know, Charlomage,
you're you're from South Carolina. I told you my family.
I raised in North Carolina, and in that part of

(06:51):
the world, we called it the stroke belt from North
Carolina down to Alabama. Primarily because black men in particular
have high blood pressure at such an early age, so
difficult to control, less likely for African Americans to control
their blood pressure than white that the risk of stroke

(07:11):
from that elevated pressure over time causes either a blood
clot in one of the arteries to the brain, or
it just ruptures.

Speaker 3 (07:22):
Same thing with heart.

Speaker 5 (07:23):
Attacks or similar At least over time, the body builds
up plaque in the arteries. Plaque is just cholesterol and calcium.
Some of it's from our diet, some of it's genetic,
some of it is accelerated if you have diabetes. In fact,
if you have diabetes, you have a three times higher
risk of dying from a heart attack than someone who

(07:47):
doesn't have diabetes. So if you have diabetes, that ought
to be like a flashing neon sign, I need to
see a cardiologist. And in communities of color, when they
have high blood pressure and they have diabetes, when they
end up with a heart attack or a stroke, they
usually have worse outcomes, a higher risk of dying from it,

(08:10):
and if they survive, they're more likely to have a
lower functional status, to be in congestive heart failure, or
to have physical abnormalities that they're not able to do
their activities of daily living.

Speaker 2 (08:24):
I was going to ask it, you know, so for
people that's listening right now, and a lot of people
don't know some of the symptoms and some of the
things that you're talking about. So when you talk of diabetes,
high blood pressure, high cholesterol, or there's symptoms besides going
to the doctor's something that people should look out for.
A lot of people in our community are scared to
go to the doctor or can't afford to, don't have insurance.

(08:44):
So what are some of the signs that they should
look at. Let's start with diabetes. What is a sign
of diabetes that people should look out for.

Speaker 5 (08:50):
Yeah, so that's a great question.

Speaker 3 (08:53):
DJ Envy. First of all, I would say.

Speaker 5 (08:57):
Healthcare should not be just for or people will well
off for people who have insurance.

Speaker 3 (09:03):
Healthcare should be a right in this country.

Speaker 5 (09:04):
There's no reason are There's just no reason why we
should treat any not treat any human being that needs
our help. Right, and if you come to any one
of our offices, we take care of everyone, regardless of
their ability to pay.

Speaker 3 (09:19):
So that's number one. Number two.

Speaker 5 (09:23):
High blood pressure and diabetes both when we're in medical
school where taught, they're called the silent killers because they
often don't have symptoms. Okay, but when they do. If
you have high blood pressure, you might feel flushed sometimes
during the day in your face. You might get headaches, okay,
you might have chest discomfort, you might get short of breath,

(09:44):
all right, you don't.

Speaker 3 (09:45):
Need to go to a doctor.

Speaker 5 (09:46):
You can go to any pharmacy even and they have
a blood pressure cuff there usually yep, and they'll check
your blood pressure. So simple screening for that. And remember
something blood pressure diagnoses often it peaks in our thirties
or in our fifties, So if you're in communities of
color and you're in your thirties, you should at least

(10:07):
get a screening for blood pressure. Diabetes also very elusive
in terms of symptoms. Often the first symptoms a diabetic
will feel is that they're very thirsty or they're urinating
a lot, and that's because their sugar levels are high
and it's making them urinate, which then makes them thirsty.
They often feel weak, have a brain fog, they just

(10:30):
never feel clear. And again simple pinprick of your finger
can tell you if your sugar is high or low
that you probably do need to go to a doctor
to have that check. Where simple blood tests. But the
bigger point is simple screening things or just self awareness.

Speaker 3 (10:50):
You bring up fear. Fear is a big issue. Fear
is a big issue for many people. People don't come
to me.

Speaker 5 (11:01):
It's it's not like I don't know if you're married
or you have kids, but you know.

Speaker 4 (11:05):
You remember when you both married, you met my wife.

Speaker 3 (11:10):
I can't bring that up again.

Speaker 1 (11:12):
Wow, Carolinas, Okay.

Speaker 3 (11:15):
I can't bring that up again.

Speaker 5 (11:17):
But anyway, but you remember, like the first time you're
pregnant and you go to the doctor, everyone's happy and
it's an exciting time. When people come to me, they're scared.
I'm not sure what's going on. They may not feel well,
they may have a family history.

Speaker 3 (11:30):
So we have we have to deal with that fear.

Speaker 5 (11:32):
One of the ways you deal with that fear is
by bringing health care to them, as opposed to saying, here,
I'm in a big, fancy building, come to me.

Speaker 3 (11:40):
I'm really smart.

Speaker 5 (11:42):
We go to them, we want to be in their community,
and then if there is an issue where they need.

Speaker 3 (11:47):
A test, make it easy for them.

Speaker 5 (11:50):
Okay, explain talk. You know, people are a lot smarter
than sometimes we give them credit for. And understanding where
they're from and and trying to learn about them and
their family can help kind of bring people together and
have an honest conversation.

Speaker 4 (12:05):
I think people want you to talk to about the
You know, when I asked you what causes the heart
attacks of scrips. I want you to talk about like
the blockage and how the plaque breaks off and that stuff.

Speaker 5 (12:15):
So in the carnery artery, so for strokes, if you
have high blood pressure, just the high blood pressure, right,
It's the same as if you have high blood pressure
in your water heater at home.

Speaker 3 (12:25):
If it gets to a certain level, boom, it just pops.
But in the hard arteries.

Speaker 5 (12:29):
You can even have a mild to moderate plaque in
your arteries and then some stressor you're smoking a cigarette
one day, you're in an argument with someone, you're having
stressful time at work, it can cause that plaque to
rupture and then causes a blood clot And that's a
big challenge. The reason when when you ask DJ Envy

(12:52):
about who should have the scan or you know, and
we said, even in people who are not symptomatic, if
they have risk factors, they should have a scan. Because
one in three people that have a heart attack find
out they're having they have heart disease the day they
have their heart attack.

Speaker 3 (13:08):
And out of those, one in three die the day
they have their heart attack.

Speaker 5 (13:12):
So it's it's often unpredictable. So unless you know you
have some plaque, then there are strategies as we discuss,
whether it's statin medications, aspirind counseling to help you maybe
stop smoking if you smoke, weight reduction, things of that

(13:32):
nature that can help. But heart attacks are I like
to think of it this way. You know, if you're
having if you're lucky enough to have symptoms, it's kind
of like when you're driving your car and the little
light goes on, says the tires run and low right. Usually,
if you're having symptoms or you see that light, you'll
attend to it so that you don't end up with

(13:53):
a blowout, let's say, on the on the highway.

Speaker 3 (13:56):
That's like a heart attack.

Speaker 5 (13:57):
But many people don't have symptoms until the day they
have their heart attack.

Speaker 2 (14:01):
I was going to ask, you know, a lot of
people feel like there's a difference between smoking weed and
smoking cigarettes. Is there is there a big difference between
the two or is it still putting smoke in your lungs.

Speaker 3 (14:12):
It's still putting smoke in your lungs.

Speaker 5 (14:14):
Different agents that's causing you causing the addiction, right, we
get a different feel. You know, you get a high,
let's say, from smoking weed, whereas nicotine is giving you
a different kind of addiction.

Speaker 3 (14:29):
But it's the tar. It's the junk that's going.

Speaker 5 (14:32):
In the lungs that adversely affects you and eventually affects
the arteries in the heart.

Speaker 4 (14:38):
What if I smoke joints, are smoking a bong, and
I'm not using tobacco products.

Speaker 5 (14:44):
So non tobacco products are better than tobacco products. But
as we saw, for instance, just with vaping, right early
on with vaping, I actually encourage folks that I took
care of that we're having trouble stopping cigarettes the vape
because it gave them the nicotine, but it didn't give
them the junk. But I don't think we have enough

(15:06):
studies or really understand enough. What about edibles that has
no effect, no significant effect from a cardiac standpoint.

Speaker 4 (15:19):
What if a pation doesn't have insurance. That's the other
thing I found very impressive about Soeign Medical.

Speaker 5 (15:25):
So we take care of anybody we're in the community,
whether we're in Inwood, Upper Manhattan, Harlem, Crown Heights, Brownsville,
we have offices in all these communities. We have great physicians,
and we take care of everybody. If they don't have insurance,
at least testing in our office. We basically do for

(15:46):
free quite honestly, even though we're not a free clinic
per se, but we'll help patients to get them the
care that they need. Either you're part of the community
or you're not. Is really it's a buying every thing.
There's really no in there's no in between.

Speaker 1 (16:03):
And y'all take insurance as well.

Speaker 3 (16:04):
We tell yeah, of course.

Speaker 5 (16:06):
We taken We take insurance and and we have a
team to to get the prior authorizations. I mean, you
know today insurance, it just happened. Just because you have
a card doesn't mean you get great health care. There's
a lot of work behind it. But but that's why
we try and build loyalty with the people we take
care of. We try and take time with them, and

(16:28):
you know.

Speaker 3 (16:28):
We're there to help.

Speaker 4 (16:29):
And I want to read my results that that doctor
Sorn sent me, because y'all send five things after you
have the test. It's to images of your coronary heart arteries,
your heartflow analysis of the arteries, right, what is that exactly?

Speaker 5 (16:42):
So the heartflow analysis is if there is any plaque
in the artery. It's a Heartflow is a company based
in California that has proprietary AI software that can actually
assess the flow to determine if that plaque, that blockage
is obstructive needs to be treated with a stent or bypass,

(17:02):
or non obstructive needs aggressive medical therapy. It's amazing software.
We use it on all our patients. And it's that alone,
That software alone has been proven to make you to
reduce mortality, increases survival by having cat the soreing heart
scan with heartflow.

Speaker 4 (17:23):
And so y'all and y'all send the sore and heart
scan final report. You send your blood work report. And finally,
which I really loved, the ten year risk of cardiovascular
events which is heart attack, stroke of death. Now this
is what put my mind at ease. Overall, your results
are excellent. Despite a high calcium score for your age,
there is only minimal plaque in your heart arteries. Furthermore,
your lipid cholesterol profile. Your cholesterol profile is excellent and

(17:47):
well below goal on your current statin medication and aspirin,
which I would continue. Your blood pressure and heart rate
are those of a man twenty years younger. All these
factors contribute to a very low ten year cardiovascular risk
of only three point five percent optimal for men of
your age would be three percent, So you are in
very good shape. That put my mind at ease more
than all of the tests I did prior to come

(18:08):
into sovereign medical.

Speaker 3 (18:10):
And how long did it take, I.

Speaker 4 (18:14):
Mean four minutes to do this skin. I was looking
at my heart within the next fifteen and I think
I got those results the next day.

Speaker 3 (18:20):
That's correct. Yeah, yeah, that's that's that's correct. So I
flipping it back to you.

Speaker 1 (18:25):
I need this.

Speaker 2 (18:26):
You need to sign me up. You know, I'm kind
of upset. We do everything together. We got a colonosc
compete together.

Speaker 4 (18:29):
That's not true.

Speaker 1 (18:31):
That is true. That is true. And he didn't call
me for this one, which is fine.

Speaker 3 (18:35):
That is not true.

Speaker 4 (18:36):
I told you I was going to get it. You
didn't say hey, I didn't know how to explain it.
I was like, I'm going to get my heart looks
at It's like I told you that I'm going to
get one. You knew what that was.

Speaker 2 (18:47):
But yeah, So I need you to sign me up, doc,
because I definitely want to check. I'm one of those
people that I use my health insurance so if there's
a problem of feeling I go some of the times
it's very stupid. But my doctors looking me like, why
are you back? Like I have tennis elbow and I
don't even know what tennis elbow is. I haven't played
tennis in ten years, but my elbow is still kind
of rickety, rickety, rickety. But I would definitely like to

(19:08):
sign up because I definitely would like to make sure
that I'm here for my kids.

Speaker 1 (19:11):
I have six kids, so I want to make sure
I'm here for my kids.

Speaker 5 (19:14):
You'd be welcome to come, and again, I just think
the access making it easy, right.

Speaker 3 (19:21):
You know, you all are people.

Speaker 5 (19:23):
Of means and you know, but it's for everybody, and
you can and you can really make a great impact
for people who may have some fear, aren't sure what
the entry point is, aren't sure what to do.

Speaker 3 (19:36):
So I appreciate you inviting me.

Speaker 5 (19:39):
I appreciate thanks taking the time and talking about it,
and I hope we can help some people.

Speaker 4 (19:45):
And where can they get more information? I'll reach you directly.

Speaker 5 (19:48):
On our website soor in medical ny dot com. We're
on Instagram.

Speaker 3 (19:55):
I've never been on any of these things.

Speaker 5 (19:56):
I've been practicing for over thirty years, but in the
past year, all the young folks in our practice.

Speaker 3 (20:01):
Have us on Instagram and.

Speaker 5 (20:04):
On the website now and they can call the office
or send us an email.

Speaker 3 (20:10):
As you saw, we respond right away.

Speaker 5 (20:12):
We get you in right away, and we give you
comprehensive results, and if we think there's something more, we
make sure that we shepherd you through your health care
journey to good health.

Speaker 4 (20:23):
Everybody needs to go do this, man, I've had too
many friends, you know, either having heart attacks or having
strokes over the past few years, are dying of heart
attacks and strokes. So you should definitely go to us
soron medical and get the soroing hearts can.

Speaker 2 (20:35):
Absolutely, I'm going as soon as I can, and I
appreciate you so much for joining us.

Speaker 1 (20:39):
Thank you very much, doctor Joseph Pumer. It's the Breakfast Club.
Good morning, wake that answer up in the morning.

Speaker 4 (20:45):
The Breakfast Club.

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