- Listen Saturday mornings at 8 as Dr. Msonthi Levine discusses medical issues and takes your calls on News Talk 560 KLVI. Dr Levine is board certified in Internal Medicine and Geriatrics. His office is located at 3080 Milam in Beaumont, Texas. He can be reached at 409-347-3621.
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Episode Transcript
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Speaker 1 (00:00):
All right, welcome South these sex and Not radio listeners. Welcome, Welcome,
Welcome in. Happy New Year, Belated Lee, Happy New Year's
our first segment of the year twenty twenty five. I
was off last week, had to take care of some business,
but I'm back. Thank you for joining us in the
edition of the show the first of this year. Hopefully
(00:22):
so far your twenty twenty five year has been going well,
and thank you for joining us this morning. The weather's great.
You know, it's cool and cold like it was past
couple of days. I was loving it. Not everybody, but
I was. As you know, I like this sort of weather.
(00:43):
I don't like all that heat and humidity that we
get year after year in the Golden Triangle, so I
always like our little coldness. Break my jackets out and
my hats and my toboggans and I have fun, had
the fireplace going. It was great. So I loved it.
And hopefully we can get some more cold weather that,
(01:05):
you know, for the sort of holiday year. We don't
want any snow that just really shuts things down here
in South Throught, Texas. We don't really know how to
act when it's snowing out there, and the ice on
the roads and it just gets becomes a mess. No
longer any fun. Now we have to sort of shut
(01:26):
down everything. Accidents, slipping and falling and breaking ankles and legs,
so we don't really want any of that stuff. So
we just like some cold weather every now and then,
so we appreciate the weather God's out there and give
us a call. Another edition of the show, first one.
We've been doing this for a long time. We appreciate
(01:46):
everyone's support and we'll continue to be here every Saturday
between eight and nine as long as you would like
us to provide this information to you again, just you know,
basic medical and just trying to help things or help
you guys figure out what's good for you and your
family and what you're hearing out. There's a lot of
(02:10):
advice out there about what to do and what not
to do, and we're here every Saturday, cross the street
from Park Tow Mall to sort of answers some questions. Hopefully, yeah,
make things better and easier because it is confusing out there.
Phone lines are open eight nine to six kVA. That
number hasn't changed one one hundred three three zero kov I.
(02:32):
It's been the same for a long time, so we'd
love to hear from give us a call. Thought, some
prayers grow out to those suffering those terrible burned houses
and there's all the burning there in California. Thought, some
prayers grow out to them. I hope everything works out
for them. Man, we know how that can be with
(02:53):
our hurricane situation here and just the immediate catastrophic devastation
of losing a house and losing your neighborhood, and just
all the confusion that generates disorientation about you and your family.
God thoughts and prins go out to them, and we
certainly hope for the best for them. And that's why
(03:17):
it's always a good idea to not be sad about
what you don't have, but what you do have, because
in a minute and a second and a day and
an hour, things can change for the worst. So always
be thankful for a good day and your life and
your health and your family because you just never know
(03:38):
out there. So we will be watching and supporting them
as much as we can. So as you know, always
at the New Year, Oh I forgot, don't forget about
your vaccines were still in that time of year, although
flu seasons sort of winding down, and in my experience,
it wasn't a really big flu sea. And I want
(04:01):
to thank all the folks out there for getting their
flu vaccines and getting their COVID vaccines. Pretty much ask
all my patients that come into the office about their
vaccine status and remind them about vaccines because I feel
like they're very important, and I talk about it as
much as I can on this show and in my
(04:23):
office because we're in the business at least, I am
of trying to prevent or lower your risk of something
happening to and the key word is lower, because no
doctor can really prevent something from happening. We can talk
(04:45):
with you and guide you in a direction that should
reduce your risk, that should lower your chances of having
a bad outcome with a certain disease, a certain illness.
But again it's not perfect. There is that degree that
things can happen on their own. It's same thing with vaccines.
(05:07):
I guess we talk about adverse reaction issues, but the
technology is getting better and those medicines are getting better
as well. I'm still waiting for the pill form of
vaccines that would be revolutionary. Maybe they're working on that,
maybe they've tried it it doesn't work. But I think
most Americans are sort of accustomed to just tablets and
(05:29):
capsules injacsons are a little scary, you know, needles and
it's going to hurt, and it's being directly injected into you.
So those are just that visual cue is a little
concerning for some people and they're more comfortable with a
tablet or capsule doesn't seem as harsh, are as aggressive,
(05:51):
But for now, yes, it's injections, So be sure and
get your vaccines if you're still haven't gotten those. But yeah,
every time at the beginning of the year it's a
new year, we talk about the new year's resolutions. How
am I going to get better in the year twenty
twenty five versus twenty twenty four, always trying to get better.
(06:12):
I learned that concept as an athlete, as you know.
I played high school football here for Westbrook four years
and went on to play for Rice and a Versuity
Houston for five years and learn a lot about life
skills and just the aspect of trying to get better
every day. And that's your goal to success and just
(06:35):
your life goal is you have a new day and
you wake up and how can I get better, how
can I make things more efficient? And at the beginning
of the year, we kind of focus on that, probably
for a month or so, and then we get busy
and distracted with everything else that's happening. But we always
talk about weight loss because, as you know, America is
(06:57):
still struggling actively with its weight and how to accomplish that.
And I have patients who in the office that successfully
found a way to get their weight down, but we
still have those that struggle with getting their weight down.
(07:18):
So I thought we'd just chat a little bit about that,
and if you have any questions about that, give us
a buzz. The one thing that's helped over the past
few years are these diabetes medications. And I've mentioned them
last year a few times, but it's very popular right now,
these injectable medications. Most people are familiar with the term
(07:40):
ozipic or semiglutide. Patients are coming in more and more
over the past several months sort of asking for it.
They're familiar with it. Maybe a coworker a family member
is on this and they have successfully gotten their weight down,
I mean pretty drastic weight loss, and we're talking about
(08:04):
a good thirty forty pounds, which is incredible for us
because sometimes it's hard to just get five pounds or
ten pounds because it seems like you're stuck with a
certain sort of weight status and you're looking for something strong,
you know, to really shut things down. And we've struggled
(08:28):
over the years in the medical community to provide a
medication that works but doesn't cause harm, that's you know, affordable,
and that you can take a long term, right, And
a lot of these medications that we've had over the years,
unfortunately didn't really meet all those requirements. Maybe it met one,
(08:54):
but not all of them. There were sort of these
limitations that they had, and you know, just it was
hard to use it on everybody, right, there was just
a small population that we could use these medications. But
these diabetes medications, in my opinion, they check a lot
of the boxes that we're looking for as it pertains
(09:15):
to a weight loss product. And the only thing that
is incredibly irritating is just the issue with the cost.
It's still financially a lot of times hard for someone
to get these medications because of the cost, and again
(09:38):
depending on the person's insurance and deductible and all these
other factors. Personal factors, and everybody's factors are different variables.
I should say it can cost this or cost that,
meaning that the cost is different for everyone. It's hard
for a doctor or a healthcare professional to know at
(09:59):
the end of the day how much it's going to
cost an individual with most of these medications. As far
as I know, most healthcare professionals don't have systems or
mechanisms in place that allow them to determine when they
prescribe something to you, they don't really know how much
(10:20):
it's going to cost you. The pharmacists and the pharmacis
tend to have a better mechanism and a better system
in place to figure this out, and I guess they
interact with in trends companies more efficiently than we do
in terms of the pricing and the charging and the
building of medications. They haven't really introduced that to the
(10:43):
healthcare providers that you interact with at your doctor's office
or an er or an emergency department. Those two systems
are kind of disconnected, which is why sometimes when you
get to the pharmacy there's a sticker shock issue, then
you have to call the practitioner back and ask for
(11:03):
different medicine, and even under those circumstances, again you're left
with the issue that most healthcare providers do not know
how much a particular product is going to cost you.
I've mentioned to you over the years that when healthcare
professionals are trained, we sort of get the same core,
(11:28):
basic exposure to a core body of information knowledge at
the time of what's right and what's wrong in healthcare
in terms of how do I treat hypertension, how do
I treat diabetes, what do I do when someone presents
with chest pain or headache? We all sort of get
exposed that same body of information, same body of knowledge.
(11:49):
We take tests, the same tests to make sure that
we have retained a certain amount of that knowledge. So
some practitioners make high scores, some practitioners make low scores,
but they sort of pass are there over the cutoff
(12:10):
margin for what has passed and what has failed, And
then we go out and we start working wherever that is.
And in my experience, the most important aspect of what
that practition will ultimately prescribe to you is their experience
(12:30):
using the medication in terms of does it work for
my patients, does it work for me? Do I have
a lot of callbacks. Have I experienced a lot of
adverse reaction issues with the medication? Is it cheap?
Speaker 2 (12:44):
Like?
Speaker 1 (12:45):
Do I get a lot of phone calls back? In
terms of the pricing of the medication, And that is
really ultimately what dictates what a practitioner will prescribe to
an individual person. That's it. So that, yeah, these two
systems that we have where we have practitioners prescribing things
(13:06):
and then we have pharmacies that are giving it to you.
That world needs to blend better because it's it's not
where it needs to be. And that's why a lot
of times you go to the doctor. Yes, doctor, I
want semigluetite, I want ozempic, I want with go V,
(13:26):
I want some munjaro. Okay, that's fine. I'll write that
prescription for you. We want you to be successful in
weight loss. We want to get that way down. You've
struggled over the years, and now this great product has
hit the market. It's working for most people. And here's
your prescription. Take it to the pharmacy, sticker shock and
(13:49):
then you call back to the doctor's office or healthcare professional. Well,
that one's too expensive. I need another option, Okay, I'll
prescribe this one then to you. Again. Problem, Do I
know if it's going to be expensive for you when
it hits the pharmacy. I do not. Most practitioners don't know.
They don't have very easy mechanisms in place to know
(14:12):
exactly how much it's going to cost you. I think
the systems are there, are should say, the technology is
there to implement that sort of thing for doctors to
figure that out, but has not been implemented in most
health care providers electronic medical records programs. I'm sure it
(14:33):
could be, but it hasn't. And so that's a sort
of frustrating aspect of our current healthcare system is sort
of this disconnect and it's super frustrating for patients because
it's it's cumbersome when and I know this, and we'll
apologize for this, you go to the pharmacy and then
back to the provider, and then back to the pharmacy
(14:54):
and back to the provider, and just man, it could
take a whole week, two weeks to fill one medication
because of this disconnect and this confusion about the pricing
and which medicine does your insurance company pay for? And
you know, last year they pay for this, but this
year they're paying for another thing and now it's deductible,
(15:16):
and you know, super confusing, right, It's the same for us.
And again we're not trying to make it confusing. Again,
it all depends for the provider what works best for
my patient. And then really sometimes cost is a part
of that equation, but a lot of times it isn't.
(15:36):
Because we really want you to be successful. We want
the problem to be fixed, and we sort of learn
after prescribing so many meds which ones work and which
ones don't, and that's what we focus on. But your
pharmacy may not, I'm sorry, your insurance company may not
care about that, and the cost will be the cost
(15:58):
depending on their finance, which we have no control over.
You have no control. So that's just one of those issues.
But if you can get one of these medications from
your healthcare provider and you can afford it, it is
one of the medicines that we are endorsing in the
past year because it seems to check all the boxes
(16:19):
and it can get you some significant weight loss and
phone lines are open eight nine and six KELVA at
first edition of the doc Lava Medical Our year twenty five,
We're going to our first break. Give us a call.
We'll be back in two minutes. All right, welcome back
(17:01):
to OK to ME Medical. Our phone lines to open
eight to nine to six kV I one hundred and
three to three zero klvy. Beginning of the year. Right,
weight loss is always at the top of the list.
Gotta get these pounds down, got to get this weight off.
How do I do it? And as we talked about
in the first segment, these new diabetes medicines called GLP
(17:24):
one agonists, which have been out for many, many years. Actually,
the first one of these GLP one agonists that was
sort of promoted for weight loss is called sax Cinda
sax Nda, and that was years ago, but for whatever reason,
it didn't catch traction, it didn't become popular, and it
sort of was out there, and you know, costs was
(17:45):
certainly a issue with that, and that's, in my opinion,
been the issue with this class of medications. But it
is getting more affordable as the generic version of ozepic,
which is called semiglutide, is now available or has been
available for several months maybe the past year, from compound
(18:06):
pharmacies and other healthcare providers. Are offering these generic versions
of the ozimbic. We have the same product and our
office have a weight loss program, but other providers as
well Southeast Texas have availability to this medication sort of
for a cash based price, which is reasonable pricing in
(18:27):
my opinion, to get you some weight. And these medicines
work very well. And the way they work at the
end of the day is they allow you to not
eat for several hours without getting uncomfortable, and even when
it's time to eat, you're unlikely to eat a large
portion of your meal or not eat as frequently throughout
(18:51):
the day because yes, we are snacking and eating frequently
throughout the day in this country. Again, we've talked a
little bit about why that happens. There's just a lot
of messaging from day to day in terms of what
we hear, see visualized that sort of puts us in
a position where we just kind of kind of drink
(19:12):
and eat all day. Just all these restaurants everywhere, all
these food outlets everywhere, convenience stores everywhere, the grocery stores everywhere.
They're big, they're bright, they're fancy, and it's just hard
to say no to that stuff. And there's food at
the job, and you know, so we're just around it
(19:34):
all day long, and if you get a little hunger pain,
for most of it, it's an uncomfortable sensation. We don't
like to be hungry, right at least that's the way
we've been conditioned to think that when you're hungry, you know,
churn that hunger sensation off. We have this, We have that,
and again from day one, I remember having classes when
(19:56):
I was in elementary about the food pyramid and the
four basic food groups. I think it's for maybe it's
changed now, but nonetheless sort of ingrained in you that
there's a sort of a eating periods throughout the day
in the morning and at noon and in the evening
(20:16):
that you're supposed to eat right because it's at dinner
time and I'm at home and I've worked all day
and so it's time for dinner. And we sort of
had this prototypical view of what a dinner is. You know,
it's a bread, it was a salad, it was a
meat and vegetables, it was a beverage, and sometimes it
(20:37):
dessert in there, right, depending on who you were. So
this is sort of how we were ingrained to think.
And this is just sort of what we did. But
because of society's advancements and because of modern machinery and
just modern developments in our world, we're not that physically
(21:01):
active each day. The average person is just not that active.
Not that they're not trying to be, but they just
don't have to be. You know, we have cars, and
we have electric bicycles, and we just have all these
modes of transportation, and we just have machines and computers
sort of doing everything such that you know, we just
(21:23):
don't need to be physically active every day. But we're
still sort of consuming, and we're exposed to foods and
beverages that have a lot of calories in them, a
lot of energy in them, which is again at the
end of the day, that's why we eat and drink, right,
It's just energy that our body needs so that all
of our sales work, our heart works, our nervous system,
(21:44):
our immune system. They need sugar, protein fat, I say carbs.
They need carbs, protein fat. Those are the three what
they call macro nutrients that the body utilizes to make
itself work, so that the immune system works, your muscles work,
and the way that we sort of eat now and
(22:09):
our mentality now is that we're sort of consuming things
all day long, when really because we're not that physically active,
because we're not really using a lot of energy every day,
which just don't need to consume that much energy every day,
even though that's just sort of how our society is
(22:30):
set up. So it takes time to change your mentality.
And a lot of times, like I say, man, because
it's so mental, you need something to help you to
go throughout the entire day without consuming anything. We've all
been familiar with the term angry when it's been a
(22:52):
few hours and that stomach's growling and you just get
a little edgy and a little anxious, snippy and start
snapping because you haven't had anything to eat. As you know,
I do a lot of hospital work for Baptist Hospital
and then talking to you guys every day, and that's
one thing I hear a lot in the hospital is
(23:14):
when am I going to eat? I haven't eaten in
a day, haven't eaten in two days, and I'm hungry.
I want to eat. If I'm not going to get
that test, if I'm not going to get that surgery,
I want to eat right now. I'm hungry. So I
get that it's a very uncomfortable sensation when you haven't
had something to eat. And so this medication is class creatie.
(23:37):
I'm sorry, Oh simpic Why Govi munjaro rybelsis, which is
a tablet form of this medication. It allows you to
be comfortable when you take this medication and not eat.
I mean you can go an entire day and be
very comfortable. And I think for most people it's a
weird thing considering the fact that man, I haven't had
(24:01):
anything to eat all day, and I feel okay. And
so you sort of get on this routine where you
don't eat that much every day, you don't feel bad,
and your mentality kind of changes where your body is
still functioning and you understand that your body actually knows
what to do when you eat minimal amounts of food.
(24:21):
It has energy reserves and it knows how to generate
energy if you're not putting it in there to sort
of buy you some time until you can consume some energy.
And our fat stores is really where energy is stored
for most of us, and so it burns that fat,
(24:42):
turns it into the energy that we need, primarily glucose,
and that's how a lot of people lose weight when
they have the ar say they start this what they
call intermittent fasting. That's been another popular concept in the
past year or two is intermitt and fasting where basically
(25:03):
you're choosing a period of time in a twenty for
hour period where you don't eat, and I think for
most people it's twelve hour period. Sometimes they push it
up to a fourteen hour period, but that's the basic
idea is you kind of pick a time where you
don't eat, which makes sense, right, And it's all what
(25:24):
I'm saying here today is that you are we really
don't need to eat that much every day to exist.
We just don't. We don't have to, even though that's
what we're sort of coached to and it's promoted to us.
A lot of these foods, these processed foods that we love,
(25:46):
especially a lot of the starches that we love, like
a lot of the pastries and the breads and the
crackers and the rices and those sorts of starchy items
are very what we call calory dentse meaning they pack
a lot of calories energy and when you consume them,
(26:08):
if you're not burning that energy, if you're not using
that energy, it will be stored. It gets stored as fat.
And I'm being really really basic with this sort of
process versus when you really don't eat, you're not putting
a lot of energy in your body will burn that
excess energy, that energy in storage, and that's how sort
(26:29):
of you lose weight. And if you've ever spoken to
someone who's lost weight, who's ever found a way too fast?
Because fast thing's hard for some people to go several
hours without eating for the reasons I just mentioned. But
if they find that solution either using them and it's
nothing to be embarrassed about. I sometimes patients are like, well,
(26:52):
they're kind of a little embarrassed that they're using the
medication and help them lose weight, Like, who cares? We
just want you to get the weight down and keep
it off, because in my experience, patients feel so much
better when they're carrying less weight and they don't have
to be skinny, right, We're not trying to make you skinny.
(27:14):
We're just trying to get some poundage off of you.
I say, fifteen pounds is a good amount of poundage
to get off. Patients always feel better. The one complaint
I get often from patients is they want energy, they
want to feel energetic. And one thing that happens when
(27:34):
you gain weight is you lose your energy. You get tired,
and again that has to do with the metabolic changes
that occur when you have more weight on it. I mean,
your body knows. There's a term I learned when I
first started taking health classes in high school is homeostasis,
(27:55):
which means a body is just trying to be balanced
every single day. It's its goal every day is to
be in balance, and it has all these fel safe
mechanisms in place to try and get it in balance
if you allow it, and if you do allowed, it
will put itself in balance. But when you're inactive, when
(28:19):
you're consuming a lot of high density foods, processed foods
number one, that contain a lot of additives and adulterance
and sort of man made chemicals that again a lot
of experts are raising awareness that this stuff is not
good for us. When you smoke, when you drink, the
(28:40):
body cannot get itself in balance, and so you'll start
to develop physical symptoms from imbalance of your health, high pretension, diabetes, cholesterol,
joint pain, rashists, stiffness, mental fogginess, whatever the case may be,
(29:01):
those are normally symptoms of sort of a imbalance of
your health. And when you're consuming these foods every day,
it's really hard to do that. And if you can
find a way to avoid that, your body loves you
and you feel better, your energy comes back, you have
no joint pain. All of a sudden, you can bend
(29:22):
down and stand up and not get dizzy and not hurt.
That's how that works. Phone lines are open eight nine
six kvy I won one hundred and three to three
zero Kova. I'll be back in two minutes. All right,
(29:50):
welcome back to talk with me a medical Our phone
lines are open eight nine six Kalvey I w one
hundred three three zero Kaloviall talking about weight loss? Right,
we all need to lose a few pounds? How do
I do it? And these diabetes medications that are out
the GOLP one agonist, if you can get your hands
on them, I certainly am in agreeance with trying to
(30:13):
use that. Do you need to be diabetic to use
these medications?
Speaker 2 (30:16):
Not?
Speaker 1 (30:16):
In my opinion. I know some providers are a little
bit afraid to use these medications as a result of that.
Because it's indicated for diabetic patients, right, and when you
sort of go off the script and you start prescribing
these medications for those who are not diabetic, sometimes it
can cause adverse reaction. And yes, no medicine is free
(30:39):
of adverse reaction, and these medications, its biggest issue is
it can upset the gas intestinal system because of the
way it works chemically in your body. And that's why
you a lot of times can be satisfied are you
not hungry again? Because of the way it works in
(31:01):
the JA system. The JAS system, the nervousness, and the
brain work in tandem to coordinate all of that in
terms of hunger and the growling that you get, and
it's all connected. And these GOLP one agonists, these medicines
sort of interfere with that system and what is considered
(31:22):
a relatively safe way, so that yes, even though you
may not have eaten, your body is comfortable with that,
and you can go several hours without eating, and then
when you do eat, you only eat a little bit.
You know, that's a new experience, right to eat a
small amount of food, not the salad, bread, dessert, meat,
(31:43):
vegetables and beverage that sort of signifies a prototypical dinner
in this country are a breakfast, which for most is bacon, eggs, sausage, ham,
some sort of bread, orange juice, toad pancakes. You know,
just real, real high startchy, real, real calorie dense foods, syrup, jelly.
(32:10):
I mean that stuff is super dense, high calorie. And
again most of us would get up, we eat, and
then we'd go sit at a job and we sit
there for several hours, not really burning any energy. But
you've just consumed a normally a thousand calorie meal, because
that's how much energy is normally in these big breakfasts
(32:32):
that you see advertised. It tastes delicious, right, but again,
when you consume that amount of energy, you don't need it.
That body racks negatively to that. But certainly, yes, the
side effects that would be abdominal discomfort. Sometimes abdominal bloating.
Nausea is sort of the big issue. We get into
(32:54):
some slight nausea. Tony from LaBelle, how can we help you?
Speaker 2 (33:00):
Yes, sir, thank you for taking a call. I have
been taken semaglutide for about six months. I've lost about
twenty pounds and I'm thinking about getting off of it,
but I recently visited a cardiologist in the cardiologists recommend
(33:22):
it staining on it permanently, So just want to know
your thoughts on that, because there's a cardiovascular risk reduction
associated with the medicine as well, So should I use
a smaller dose but long term? Just want to get
your thoughts on long term.
Speaker 1 (33:40):
Use, Tony. Yes, thank you for the thank you for
calling in Happy New Year to you. Yeah, you know,
that's what's cool about this medication is it can be
taken long term because at the end of the day,
it's a diabetes medicine, and most diabetes medicines are engineered
to be taken long term. And that's why these metas
since are very popular and successful at helping patients lose
(34:04):
weight and keep the weight off, meaning you can keep
taking a lot of the medicines. In the past, the
weight loss medicines, it was just a certain time period
that you could take it and you had to stop
the medication, and normally that would introduce the weight gained
back because we sort of fall back to our usual
habits again. So much pressure to eat and drink all
(34:25):
day long, it's hard to get around that we would
eventually just again start eating. And again, most people are
not physically inclined or physically intellectual, meaning they don't kind
of know what to do in terms of exercise to
get the weight off. They just they don't do it
every day. They're not athletes. I was blessed with the
(34:47):
fact that I was an athlete. I've been around weights
and training for years, and I sort of know what
to do for me. But most people don't have that experience.
They they just don't know. So that weight comes back act.
So these products semaglue tie the GLP one agonists. That's
why they're so success. One reason is you can take
(35:08):
it long term if your cardiologist recommends that and you
and your cardiologists have a relationship. You trust your cardiologists.
You believe you're cardiologists. They are skilled at having the
insight of cardiovast disease and they want you to not
(35:28):
have a heart attack. They want to stabilize that disease process.
And if he's he or she is recommending that you
stand this medication, and especially if you're not having any
side effects, then I would probably stand on the medication
because yes, you want to keep things controlled all the time.
(35:50):
Doctors hate rocking the boat, and if we don't have to,
we want to keep things the same because when you
start messing around with medicines, it can sometimes throw things
off significantly. So again, I'm not your doctor, I'm just
talking to you on the radio.
Speaker 3 (36:05):
Yeah.
Speaker 1 (36:05):
If I were you, and if medicines are working no
side effects, yes, I would stay on the medication for now.
That's what your cardiologist is recommending. And if you're not
having side effects, absolutely, because we want to keep that
weight down. And that's the thing that's changed over the
past year two is cardiologists are now prescribing these diabetes medications,
(36:30):
the gop one agonist as well as the SGLT two
inhibitors like Farseega, Jardiance in Volcana that you might know
those names. They are now prescribing these diabetes medications, been
doing it for about a year or two. They've gotten
more comfortable with that because when it first hit the scene,
(36:50):
they were extremely uncomfortable because that's a diabetes medicine and
I don't do their diabetes. That's their primary care physician
or the intercronologist. I don't want to you prescribe medicines
that are really outside of my scope of practice, if
you will, But now they feel like it's within their
scope of practice because of the research that has shown
(37:12):
that these medications really benefit the cardiovascular system. So it's
pulled in the cardiologists to prescribe these medicines, and they
are prescribing them because they believe in them, especially for
patients who have what they call heart failure or congestive
heart failure, which a lot of times is a direct
result of untreated or poorly controlled hypertension, diabetes, high cholesterol.
(37:38):
Over time, it just wears your heart out and so
your blood flow starts becoming congested. And these medications, the ozipics,
the farsigas, have been shown to have significant cardiovascular benefit.
So cardiologists are also in a preventive stance and they're
trying to find medications to help you. And so, yes,
(38:01):
these medicines are very helpful and very good. I would
say blockbuster medications. I would say that because they work.
I see it, and they're prescribing it and it works,
So stay on it anyway. Phone lines open eight, nine
to six, scale of you. I have one one hundred
through three zero, Okay, I'll be back in two minutes.
(38:21):
All right, welcome back to the doctor pan medical Leonard
real Quick.
Speaker 3 (38:26):
Two years ago, I called my insurance county had to
recommend a gash or anrologists to treat a diarrhea problem.
That doctor has been remarkably unsuccessful in fixing my problem.
Should I call them back and ask for a different
kind of doctor.
Speaker 2 (38:41):
Yeah.
Speaker 1 (38:41):
I think anytime you have an acute problem and you
sought medical attention and they have gone through their process
of elimination and have not been able to find out
what's wrong with you, you still have the medical problem.
Speaker 2 (38:56):
Yeah.
Speaker 1 (38:57):
By all means, that's what we love in this country.
You get a second opinion from a different physician, and
I think that physician that's working with you, if he's
or she has exhausted all their efforts, I think they
would recommend it as well. At least that's what I do.
If a patient has been patient with me and allowed
me to go through my process of elimination and I
(39:17):
get to that end and they're still sick, they're still
not feeling well, by all means, yes, we get another
colleague to come help us out. Because this stuff is
sometimes difficult. So that is built into our system. So
by all means. Yes, asked to be sent or go
to another gaslogist for a second opinion.
Speaker 3 (39:37):
No question, Well I was really asking. Sure I asked
for another discipline instead of a gaslogist.
Speaker 1 (39:45):
Not No, Not for diarrhea that is primarily a GI issue.
And yes, I would just ask for another gash in
trologist is what I would do.
Speaker 3 (39:55):
Good night, Thanks big guy.
Speaker 1 (39:57):
Appreciate an inn Happy year to you as well. Diarrhea, yes,
you know there's constipation as diarrhea, two ends of the spectrum.
I think I would prefer diarrhea. Too much information right
conspace makes you feel bad anyway, This is the beginning
of the new year twenty twenty five talking about weight loss,
(40:22):
and yes, I do fully endorse these medications. Again, talk
with your healthcare providal provider, Lord, have mercy provider to
see what's right for you. But if you can get
your hands on some of these diabetes medicines GLP one agonist, Munjaro, trulicity,
(40:44):
y go vi semaglutide, Ribelsis, I think it can be
really really effective for you. And as far as I know,
they're being used for patients who do not have diabetes
very successfully with minimal adverse reaction, which a lot of
times it's gash intestinal such as bloating, constipation. Worst case
(41:05):
scenario what I've seen is pancreatitis when the pancreas gets inflamed,
which causes a severe abdominal pain issue. Normally have to
be hospitalized for that. I have seen that occasionally, but honestly,
a lot of people are taking these medicines. I mean,
really don't see the pancre titus that often. We do
(41:26):
see it, but not that often, so I think it's
a great product. But there are others out there which
I didn't cover on this show, but certainly talk with
the healthcare provider about that and again try to some
intermitt fasting. That's another way that patients have lost weight
in the year twenty twenty four. And remember, drink that
(41:48):
water right, don't drink sugar. Have a good day, Happy
New Year to you. We'll see next week. Doing t
All right, welcome South these sex and Not radio listeners. Welcome, Welcome,
Welcome in. Happy New Year, Belated Lee, Happy New Year's
our first segment of the year twenty twenty five. I
was off last week, had to take care of some business,
but I'm back. Thank you for joining us in the
edition of the show the first of this year. Hopefully
(00:22):
so far your twenty twenty five year has been going well,
and thank you for joining us this morning. The weather's great.
You know, it's cool and cold like it was past
couple of days. I was loving it. Not everybody, but
I was. As you know, I like this sort of weather.
(00:43):
I don't like all that heat and humidity that we
get year after year in the Golden Triangle, so I
always like our little coldness. Break my jackets out and
my hats and my toboggans and I have fun, had
the fireplace going. It was great. So I loved it.
And hopefully we can get some more cold weather that,
(01:05):
you know, for the sort of holiday year. We don't
want any snow that just really shuts things down here
in South Throught, Texas. We don't really know how to
act when it's snowing out there, and the ice on
the roads and it just gets becomes a mess. No
longer any fun. Now we have to sort of shut
(01:26):
down everything. Accidents, slipping and falling and breaking ankles and legs,
so we don't really want any of that stuff. So
we just like some cold weather every now and then,
so we appreciate the weather God's out there and give
us a call. Another edition of the show, first one.
We've been doing this for a long time. We appreciate
(01:46):
everyone's support and we'll continue to be here every Saturday
between eight and nine as long as you would like
us to provide this information to you again, just you know,
basic medical and just trying to help things or help
you guys figure out what's good for you and your
family and what you're hearing out. There's a lot of
(02:10):
advice out there about what to do and what not
to do, and we're here every Saturday, cross the street
from Park Tow Mall to sort of answers some questions. Hopefully, yeah,
make things better and easier because it is confusing out there.
Phone lines are open eight nine to six kVA. That
number hasn't changed one one hundred three three zero kov I.
(02:32):
It's been the same for a long time, so we'd
love to hear from give us a call. Thought, some
prayers grow out to those suffering those terrible burned houses
and there's all the burning there in California. Thought, some
prayers grow out to them. I hope everything works out
for them. Man, we know how that can be with
(02:53):
our hurricane situation here and just the immediate catastrophic devastation
of losing a house and losing your neighborhood, and just
all the confusion that generates disorientation about you and your family.
God thoughts and prins go out to them, and we
certainly hope for the best for them. And that's why
(03:17):
it's always a good idea to not be sad about
what you don't have, but what you do have, because
in a minute and a second and a day and
an hour, things can change for the worst. So always
be thankful for a good day and your life and
your health and your family because you just never know
(03:38):
out there. So we will be watching and supporting them
as much as we can. So as you know, always
at the New Year, Oh I forgot, don't forget about
your vaccines were still in that time of year, although
flu seasons sort of winding down, and in my experience,
it wasn't a really big flu sea. And I want
(04:01):
to thank all the folks out there for getting their
flu vaccines and getting their COVID vaccines. Pretty much ask
all my patients that come into the office about their
vaccine status and remind them about vaccines because I feel
like they're very important, and I talk about it as
much as I can on this show and in my
(04:23):
office because we're in the business at least, I am
of trying to prevent or lower your risk of something
happening to and the key word is lower, because no
doctor can really prevent something from happening. We can talk
(04:45):
with you and guide you in a direction that should
reduce your risk, that should lower your chances of having
a bad outcome with a certain disease, a certain illness.
But again it's not perfect. There is that degree that
things can happen on their own. It's same thing with vaccines.
(05:07):
I guess we talk about adverse reaction issues, but the
technology is getting better and those medicines are getting better
as well. I'm still waiting for the pill form of
vaccines that would be revolutionary. Maybe they're working on that,
maybe they've tried it it doesn't work. But I think
most Americans are sort of accustomed to just tablets and
(05:29):
capsules injacsons are a little scary, you know, needles and
it's going to hurt, and it's being directly injected into you.
So those are just that visual cue is a little
concerning for some people and they're more comfortable with a
tablet or capsule doesn't seem as harsh, are as aggressive,
(05:51):
But for now, yes, it's injections, So be sure and
get your vaccines if you're still haven't gotten those. But yeah,
every time at the beginning of the year it's a
new year, we talk about the new year's resolutions. How
am I going to get better in the year twenty
twenty five versus twenty twenty four, always trying to get better.
(06:12):
I learned that concept as an athlete, as you know.
I played high school football here for Westbrook four years
and went on to play for Rice and a Versuity
Houston for five years and learn a lot about life
skills and just the aspect of trying to get better
every day. And that's your goal to success and just
(06:35):
your life goal is you have a new day and
you wake up and how can I get better, how
can I make things more efficient? And at the beginning
of the year, we kind of focus on that, probably
for a month or so, and then we get busy
and distracted with everything else that's happening. But we always
talk about weight loss because, as you know, America is
(06:57):
still struggling actively with its weight and how to accomplish that.
And I have patients who in the office that successfully
found a way to get their weight down, but we
still have those that struggle with getting their weight down.
(07:18):
So I thought we'd just chat a little bit about that,
and if you have any questions about that, give us
a buzz. The one thing that's helped over the past
few years are these diabetes medications. And I've mentioned them
last year a few times, but it's very popular right now,
these injectable medications. Most people are familiar with the term
(07:40):
ozipic or semiglutide. Patients are coming in more and more
over the past several months sort of asking for it.
They're familiar with it. Maybe a coworker a family member
is on this and they have successfully gotten their weight down,
I mean pretty drastic weight loss, and we're talking about
(08:04):
a good thirty forty pounds, which is incredible for us
because sometimes it's hard to just get five pounds or
ten pounds because it seems like you're stuck with a
certain sort of weight status and you're looking for something strong,
you know, to really shut things down. And we've struggled
(08:28):
over the years in the medical community to provide a
medication that works but doesn't cause harm, that's you know, affordable,
and that you can take a long term, right, And
a lot of these medications that we've had over the years,
unfortunately didn't really meet all those requirements. Maybe it met one,
(08:54):
but not all of them. There were sort of these
limitations that they had, and you know, just it was
hard to use it on everybody, right, there was just
a small population that we could use these medications. But
these diabetes medications, in my opinion, they check a lot
of the boxes that we're looking for as it pertains
(09:15):
to a weight loss product. And the only thing that
is incredibly irritating is just the issue with the cost.
It's still financially a lot of times hard for someone
to get these medications because of the cost, and again
(09:38):
depending on the person's insurance and deductible and all these
other factors. Personal factors, and everybody's factors are different variables.
I should say it can cost this or cost that,
meaning that the cost is different for everyone. It's hard
for a doctor or a healthcare professional to know at
(09:59):
the end of the day how much it's going to
cost an individual with most of these medications. As far
as I know, most healthcare professionals don't have systems or
mechanisms in place that allow them to determine when they
prescribe something to you, they don't really know how much
(10:20):
it's going to cost you. The pharmacists and the pharmacis
tend to have a better mechanism and a better system
in place to figure this out, and I guess they
interact with in trends companies more efficiently than we do
in terms of the pricing and the charging and the
building of medications. They haven't really introduced that to the
(10:43):
healthcare providers that you interact with at your doctor's office
or an er or an emergency department. Those two systems
are kind of disconnected, which is why sometimes when you
get to the pharmacy there's a sticker shock issue, then
you have to call the practitioner back and ask for
(11:03):
different medicine, and even under those circumstances, again you're left
with the issue that most healthcare providers do not know
how much a particular product is going to cost you.
I've mentioned to you over the years that when healthcare
professionals are trained, we sort of get the same core,
(11:28):
basic exposure to a core body of information knowledge at
the time of what's right and what's wrong in healthcare
in terms of how do I treat hypertension, how do
I treat diabetes, what do I do when someone presents
with chest pain or headache? We all sort of get
exposed that same body of information, same body of knowledge.
(11:49):
We take tests, the same tests to make sure that
we have retained a certain amount of that knowledge. So
some practitioners make high scores, some practitioners make low scores,
but they sort of pass are there over the cutoff
(12:10):
margin for what has passed and what has failed, And
then we go out and we start working wherever that is.
And in my experience, the most important aspect of what
that practition will ultimately prescribe to you is their experience
(12:30):
using the medication in terms of does it work for
my patients, does it work for me? Do I have
a lot of callbacks. Have I experienced a lot of
adverse reaction issues with the medication? Is it cheap?
Speaker 2 (12:44):
Like?
Speaker 1 (12:45):
Do I get a lot of phone calls back? In
terms of the pricing of the medication, And that is
really ultimately what dictates what a practitioner will prescribe to
an individual person. That's it. So that, yeah, these two
systems that we have where we have practitioners prescribing things
(13:06):
and then we have pharmacies that are giving it to you.
That world needs to blend better because it's it's not
where it needs to be. And that's why a lot
of times you go to the doctor. Yes, doctor, I
want semigluetite, I want ozempic, I want with go V,
(13:26):
I want some munjaro. Okay, that's fine. I'll write that
prescription for you. We want you to be successful in
weight loss. We want to get that way down. You've
struggled over the years, and now this great product has
hit the market. It's working for most people. And here's
your prescription. Take it to the pharmacy, sticker shock and
(13:49):
then you call back to the doctor's office or healthcare professional. Well,
that one's too expensive. I need another option, Okay, I'll
prescribe this one then to you. Again. Problem, Do I
know if it's going to be expensive for you when
it hits the pharmacy. I do not. Most practitioners don't know.
They don't have very easy mechanisms in place to know
(14:12):
exactly how much it's going to cost you. I think
the systems are there, are should say, the technology is
there to implement that sort of thing for doctors to
figure that out, but has not been implemented in most
health care providers electronic medical records programs. I'm sure it
(14:33):
could be, but it hasn't. And so that's a sort
of frustrating aspect of our current healthcare system is sort
of this disconnect and it's super frustrating for patients because
it's it's cumbersome when and I know this, and we'll
apologize for this, you go to the pharmacy and then
back to the provider, and then back to the pharmacy
(14:54):
and back to the provider, and just man, it could
take a whole week, two weeks to fill one medication
because of this disconnect and this confusion about the pricing
and which medicine does your insurance company pay for? And
you know, last year they pay for this, but this
year they're paying for another thing and now it's deductible,
(15:16):
and you know, super confusing, right, It's the same for us.
And again we're not trying to make it confusing. Again,
it all depends for the provider what works best for
my patient. And then really sometimes cost is a part
of that equation, but a lot of times it isn't.
(15:36):
Because we really want you to be successful. We want
the problem to be fixed, and we sort of learn
after prescribing so many meds which ones work and which
ones don't, and that's what we focus on. But your
pharmacy may not, I'm sorry, your insurance company may not
care about that, and the cost will be the cost
(15:58):
depending on their finance, which we have no control over.
You have no control. So that's just one of those issues.
But if you can get one of these medications from
your healthcare provider and you can afford it, it is
one of the medicines that we are endorsing in the
past year because it seems to check all the boxes
(16:19):
and it can get you some significant weight loss and
phone lines are open eight nine and six KELVA at
first edition of the doc Lava Medical Our year twenty five,
We're going to our first break. Give us a call.
We'll be back in two minutes. All right, welcome back
(17:01):
to OK to ME Medical. Our phone lines to open
eight to nine to six kV I one hundred and
three to three zero klvy. Beginning of the year. Right,
weight loss is always at the top of the list.
Gotta get these pounds down, got to get this weight off.
How do I do it? And as we talked about
in the first segment, these new diabetes medicines called GLP
(17:24):
one agonists, which have been out for many, many years. Actually,
the first one of these GLP one agonists that was
sort of promoted for weight loss is called sax Cinda
sax Nda, and that was years ago, but for whatever reason,
it didn't catch traction, it didn't become popular, and it
sort of was out there, and you know, costs was
(17:45):
certainly a issue with that, and that's, in my opinion,
been the issue with this class of medications. But it
is getting more affordable as the generic version of ozepic,
which is called semiglutide, is now available or has been
available for several months maybe the past year, from compound
(18:06):
pharmacies and other healthcare providers. Are offering these generic versions
of the ozimbic. We have the same product and our
office have a weight loss program, but other providers as
well Southeast Texas have availability to this medication sort of
for a cash based price, which is reasonable pricing in
(18:27):
my opinion, to get you some weight. And these medicines
work very well. And the way they work at the
end of the day is they allow you to not
eat for several hours without getting uncomfortable, and even when
it's time to eat, you're unlikely to eat a large
portion of your meal or not eat as frequently throughout
(18:51):
the day because yes, we are snacking and eating frequently
throughout the day in this country. Again, we've talked a
little bit about why that happens. There's just a lot
of messaging from day to day in terms of what
we hear, see visualized that sort of puts us in
a position where we just kind of kind of drink
(19:12):
and eat all day. Just all these restaurants everywhere, all
these food outlets everywhere, convenience stores everywhere, the grocery stores everywhere.
They're big, they're bright, they're fancy, and it's just hard
to say no to that stuff. And there's food at
the job, and you know, so we're just around it
(19:34):
all day long, and if you get a little hunger pain,
for most of it, it's an uncomfortable sensation. We don't
like to be hungry, right at least that's the way
we've been conditioned to think that when you're hungry, you know,
churn that hunger sensation off. We have this, We have that,
and again from day one, I remember having classes when
(19:56):
I was in elementary about the food pyramid and the
four basic food groups. I think it's for maybe it's
changed now, but nonetheless sort of ingrained in you that
there's a sort of a eating periods throughout the day
in the morning and at noon and in the evening
(20:16):
that you're supposed to eat right because it's at dinner
time and I'm at home and I've worked all day
and so it's time for dinner. And we sort of
had this prototypical view of what a dinner is. You know,
it's a bread, it was a salad, it was a
meat and vegetables, it was a beverage, and sometimes it
(20:37):
dessert in there, right, depending on who you were. So
this is sort of how we were ingrained to think.
And this is just sort of what we did. But
because of society's advancements and because of modern machinery and
just modern developments in our world, we're not that physically
(21:01):
active each day. The average person is just not that active.
Not that they're not trying to be, but they just
don't have to be. You know, we have cars, and
we have electric bicycles, and we just have all these
modes of transportation, and we just have machines and computers
sort of doing everything such that you know, we just
(21:23):
don't need to be physically active every day. But we're
still sort of consuming, and we're exposed to foods and
beverages that have a lot of calories in them, a
lot of energy in them, which is again at the
end of the day, that's why we eat and drink, right,
It's just energy that our body needs so that all
of our sales work, our heart works, our nervous system,
(21:44):
our immune system. They need sugar, protein fat, I say carbs.
They need carbs, protein fat. Those are the three what
they call macro nutrients that the body utilizes to make
itself work, so that the immune system works, your muscles work,
and the way that we sort of eat now and
(22:09):
our mentality now is that we're sort of consuming things
all day long, when really because we're not that physically active,
because we're not really using a lot of energy every day,
which just don't need to consume that much energy every day,
even though that's just sort of how our society is
(22:30):
set up. So it takes time to change your mentality.
And a lot of times, like I say, man, because
it's so mental, you need something to help you to
go throughout the entire day without consuming anything. We've all
been familiar with the term angry when it's been a
(22:52):
few hours and that stomach's growling and you just get
a little edgy and a little anxious, snippy and start
snapping because you haven't had anything to eat. As you know,
I do a lot of hospital work for Baptist Hospital
and then talking to you guys every day, and that's
one thing I hear a lot in the hospital is
(23:14):
when am I going to eat? I haven't eaten in
a day, haven't eaten in two days, and I'm hungry.
I want to eat. If I'm not going to get
that test, if I'm not going to get that surgery,
I want to eat right now. I'm hungry. So I
get that it's a very uncomfortable sensation when you haven't
had something to eat. And so this medication is class creatie.
(23:37):
I'm sorry, Oh simpic Why Govi munjaro rybelsis, which is
a tablet form of this medication. It allows you to
be comfortable when you take this medication and not eat.
I mean you can go an entire day and be
very comfortable. And I think for most people it's a
weird thing considering the fact that man, I haven't had
(24:01):
anything to eat all day, and I feel okay. And
so you sort of get on this routine where you
don't eat that much every day, you don't feel bad,
and your mentality kind of changes where your body is
still functioning and you understand that your body actually knows
what to do when you eat minimal amounts of food.
(24:21):
It has energy reserves and it knows how to generate
energy if you're not putting it in there to sort
of buy you some time until you can consume some energy.
And our fat stores is really where energy is stored
for most of us, and so it burns that fat,
(24:42):
turns it into the energy that we need, primarily glucose,
and that's how a lot of people lose weight when
they have the ar say they start this what they
call intermittent fasting. That's been another popular concept in the
past year or two is intermitt and fasting where basically
(25:03):
you're choosing a period of time in a twenty for
hour period where you don't eat, and I think for
most people it's twelve hour period. Sometimes they push it
up to a fourteen hour period, but that's the basic
idea is you kind of pick a time where you
don't eat, which makes sense, right, And it's all what
(25:24):
I'm saying here today is that you are we really
don't need to eat that much every day to exist.
We just don't. We don't have to, even though that's
what we're sort of coached to and it's promoted to us.
A lot of these foods, these processed foods that we love,
(25:46):
especially a lot of the starches that we love, like
a lot of the pastries and the breads and the
crackers and the rices and those sorts of starchy items
are very what we call calory dentse meaning they pack
a lot of calories energy and when you consume them,
(26:08):
if you're not burning that energy, if you're not using
that energy, it will be stored. It gets stored as fat.
And I'm being really really basic with this sort of
process versus when you really don't eat, you're not putting
a lot of energy in your body will burn that
excess energy, that energy in storage, and that's how sort
(26:29):
of you lose weight. And if you've ever spoken to
someone who's lost weight, who's ever found a way too fast?
Because fast thing's hard for some people to go several
hours without eating for the reasons I just mentioned. But
if they find that solution either using them and it's
nothing to be embarrassed about. I sometimes patients are like, well,
(26:52):
they're kind of a little embarrassed that they're using the
medication and help them lose weight, Like, who cares? We
just want you to get the weight down and keep
it off, because in my experience, patients feel so much
better when they're carrying less weight and they don't have
to be skinny, right, We're not trying to make you skinny.
(27:14):
We're just trying to get some poundage off of you.
I say, fifteen pounds is a good amount of poundage
to get off. Patients always feel better. The one complaint
I get often from patients is they want energy, they
want to feel energetic. And one thing that happens when
(27:34):
you gain weight is you lose your energy. You get tired,
and again that has to do with the metabolic changes
that occur when you have more weight on it. I mean,
your body knows. There's a term I learned when I
first started taking health classes in high school is homeostasis,
(27:55):
which means a body is just trying to be balanced
every single day. It's its goal every day is to
be in balance, and it has all these fel safe
mechanisms in place to try and get it in balance
if you allow it, and if you do allowed, it
will put itself in balance. But when you're inactive, when
(28:19):
you're consuming a lot of high density foods, processed foods
number one, that contain a lot of additives and adulterance
and sort of man made chemicals that again a lot
of experts are raising awareness that this stuff is not
good for us. When you smoke, when you drink, the
(28:40):
body cannot get itself in balance, and so you'll start
to develop physical symptoms from imbalance of your health, high pretension, diabetes, cholesterol,
joint pain, rashists, stiffness, mental fogginess, whatever the case may be,
(29:01):
those are normally symptoms of sort of a imbalance of
your health. And when you're consuming these foods every day,
it's really hard to do that. And if you can
find a way to avoid that, your body loves you
and you feel better, your energy comes back, you have
no joint pain. All of a sudden, you can bend
(29:22):
down and stand up and not get dizzy and not hurt.
That's how that works. Phone lines are open eight nine
six kvy I won one hundred and three to three
zero Kova. I'll be back in two minutes. All right,
(29:50):
welcome back to talk with me a medical Our phone
lines are open eight nine six Kalvey I w one
hundred three three zero Kaloviall talking about weight loss? Right,
we all need to lose a few pounds? How do
I do it? And these diabetes medications that are out
the GOLP one agonist, if you can get your hands
on them, I certainly am in agreeance with trying to
(30:13):
use that. Do you need to be diabetic to use
these medications?
Speaker 2 (30:16):
Not?
Speaker 1 (30:16):
In my opinion. I know some providers are a little
bit afraid to use these medications as a result of that.
Because it's indicated for diabetic patients, right, and when you
sort of go off the script and you start prescribing
these medications for those who are not diabetic, sometimes it
can cause adverse reaction. And yes, no medicine is free
(30:39):
of adverse reaction, and these medications, its biggest issue is
it can upset the gas intestinal system because of the
way it works chemically in your body. And that's why
you a lot of times can be satisfied are you
not hungry again? Because of the way it works in
(31:01):
the JA system. The JAS system, the nervousness, and the
brain work in tandem to coordinate all of that in
terms of hunger and the growling that you get, and
it's all connected. And these GOLP one agonists, these medicines
sort of interfere with that system and what is considered
(31:22):
a relatively safe way, so that yes, even though you
may not have eaten, your body is comfortable with that,
and you can go several hours without eating, and then
when you do eat, you only eat a little bit.
You know, that's a new experience, right to eat a
small amount of food, not the salad, bread, dessert, meat,
(31:43):
vegetables and beverage that sort of signifies a prototypical dinner
in this country are a breakfast, which for most is bacon, eggs, sausage, ham,
some sort of bread, orange juice, toad pancakes. You know,
just real, real high startchy, real, real calorie dense foods, syrup, jelly.
(32:10):
I mean that stuff is super dense, high calorie. And
again most of us would get up, we eat, and
then we'd go sit at a job and we sit
there for several hours, not really burning any energy. But
you've just consumed a normally a thousand calorie meal, because
that's how much energy is normally in these big breakfasts
(32:32):
that you see advertised. It tastes delicious, right, but again,
when you consume that amount of energy, you don't need it.
That body racks negatively to that. But certainly, yes, the
side effects that would be abdominal discomfort. Sometimes abdominal bloating.
Nausea is sort of the big issue. We get into
(32:54):
some slight nausea. Tony from LaBelle, how can we help you?
Speaker 2 (33:00):
Yes, sir, thank you for taking a call. I have
been taken semaglutide for about six months. I've lost about
twenty pounds and I'm thinking about getting off of it,
but I recently visited a cardiologist in the cardiologists recommend
(33:22):
it staining on it permanently, So just want to know
your thoughts on that, because there's a cardiovascular risk reduction
associated with the medicine as well, So should I use
a smaller dose but long term? Just want to get
your thoughts on long term.
Speaker 1 (33:40):
Use, Tony. Yes, thank you for the thank you for
calling in Happy New Year to you. Yeah, you know,
that's what's cool about this medication is it can be
taken long term because at the end of the day,
it's a diabetes medicine, and most diabetes medicines are engineered
to be taken long term. And that's why these metas
since are very popular and successful at helping patients lose
(34:04):
weight and keep the weight off, meaning you can keep
taking a lot of the medicines. In the past, the
weight loss medicines, it was just a certain time period
that you could take it and you had to stop
the medication, and normally that would introduce the weight gained
back because we sort of fall back to our usual
habits again. So much pressure to eat and drink all
(34:25):
day long, it's hard to get around that we would
eventually just again start eating. And again, most people are
not physically inclined or physically intellectual, meaning they don't kind
of know what to do in terms of exercise to
get the weight off. They just they don't do it
every day. They're not athletes. I was blessed with the
(34:47):
fact that I was an athlete. I've been around weights
and training for years, and I sort of know what
to do for me. But most people don't have that experience.
They they just don't know. So that weight comes back act.
So these products semaglue tie the GLP one agonists. That's
why they're so success. One reason is you can take
(35:08):
it long term if your cardiologist recommends that and you
and your cardiologists have a relationship. You trust your cardiologists.
You believe you're cardiologists. They are skilled at having the
insight of cardiovast disease and they want you to not
(35:28):
have a heart attack. They want to stabilize that disease process.
And if he's he or she is recommending that you
stand this medication, and especially if you're not having any
side effects, then I would probably stand on the medication
because yes, you want to keep things controlled all the time.
(35:50):
Doctors hate rocking the boat, and if we don't have to,
we want to keep things the same because when you
start messing around with medicines, it can sometimes throw things
off significantly. So again, I'm not your doctor, I'm just
talking to you on the radio.
Speaker 3 (36:05):
Yeah.
Speaker 1 (36:05):
If I were you, and if medicines are working no
side effects, yes, I would stay on the medication for now.
That's what your cardiologist is recommending. And if you're not
having side effects, absolutely, because we want to keep that
weight down. And that's the thing that's changed over the
past year two is cardiologists are now prescribing these diabetes medications,
(36:30):
the gop one agonist as well as the SGLT two
inhibitors like Farseega, Jardiance in Volcana that you might know
those names. They are now prescribing these diabetes medications, been
doing it for about a year or two. They've gotten
more comfortable with that because when it first hit the scene,
(36:50):
they were extremely uncomfortable because that's a diabetes medicine and
I don't do their diabetes. That's their primary care physician
or the intercronologist. I don't want to you prescribe medicines
that are really outside of my scope of practice, if
you will, But now they feel like it's within their
scope of practice because of the research that has shown
(37:12):
that these medications really benefit the cardiovascular system. So it's
pulled in the cardiologists to prescribe these medicines, and they
are prescribing them because they believe in them, especially for
patients who have what they call heart failure or congestive
heart failure, which a lot of times is a direct
result of untreated or poorly controlled hypertension, diabetes, high cholesterol.
(37:38):
Over time, it just wears your heart out and so
your blood flow starts becoming congested. And these medications, the ozipics,
the farsigas, have been shown to have significant cardiovascular benefit.
So cardiologists are also in a preventive stance and they're
trying to find medications to help you. And so, yes,
(38:01):
these medicines are very helpful and very good. I would
say blockbuster medications. I would say that because they work.
I see it, and they're prescribing it and it works,
So stay on it anyway. Phone lines open eight, nine
to six, scale of you. I have one one hundred
through three zero, Okay, I'll be back in two minutes.
(38:21):
All right, welcome back to the doctor pan medical Leonard
real Quick.
Speaker 3 (38:26):
Two years ago, I called my insurance county had to
recommend a gash or anrologists to treat a diarrhea problem.
That doctor has been remarkably unsuccessful in fixing my problem.
Should I call them back and ask for a different
kind of doctor.
Speaker 2 (38:41):
Yeah.
Speaker 1 (38:41):
I think anytime you have an acute problem and you
sought medical attention and they have gone through their process
of elimination and have not been able to find out
what's wrong with you, you still have the medical problem.
Speaker 2 (38:56):
Yeah.
Speaker 1 (38:57):
By all means, that's what we love in this country.
You get a second opinion from a different physician, and
I think that physician that's working with you, if he's
or she has exhausted all their efforts, I think they
would recommend it as well. At least that's what I do.
If a patient has been patient with me and allowed
me to go through my process of elimination and I
(39:17):
get to that end and they're still sick, they're still
not feeling well, by all means, yes, we get another
colleague to come help us out. Because this stuff is
sometimes difficult. So that is built into our system. So
by all means. Yes, asked to be sent or go
to another gaslogist for a second opinion.
Speaker 3 (39:37):
No question, Well I was really asking. Sure I asked
for another discipline instead of a gaslogist.
Speaker 1 (39:45):
Not No, Not for diarrhea that is primarily a GI issue.
And yes, I would just ask for another gash in
trologist is what I would do.
Speaker 3 (39:55):
Good night, Thanks big guy.
Speaker 1 (39:57):
Appreciate an inn Happy year to you as well. Diarrhea, yes,
you know there's constipation as diarrhea, two ends of the spectrum.
I think I would prefer diarrhea. Too much information right
conspace makes you feel bad anyway, This is the beginning
of the new year twenty twenty five talking about weight loss,
(40:22):
and yes, I do fully endorse these medications. Again, talk
with your healthcare providal provider, Lord, have mercy provider to
see what's right for you. But if you can get
your hands on some of these diabetes medicines GLP one agonist, Munjaro, trulicity,
(40:44):
y go vi semaglutide, Ribelsis, I think it can be
really really effective for you. And as far as I know,
they're being used for patients who do not have diabetes
very successfully with minimal adverse reaction, which a lot of
times it's gash intestinal such as bloating, constipation. Worst case
(41:05):
scenario what I've seen is pancreatitis when the pancreas gets inflamed,
which causes a severe abdominal pain issue. Normally have to
be hospitalized for that. I have seen that occasionally, but honestly,
a lot of people are taking these medicines. I mean,
really don't see the pancre titus that often. We do
(41:26):
see it, but not that often, so I think it's
a great product. But there are others out there which
I didn't cover on this show, but certainly talk with
the healthcare provider about that and again try to some
intermitt fasting. That's another way that patients have lost weight
in the year twenty twenty four. And remember, drink that
(41:48):
water right, don't drink sugar. Have a good day, Happy
New Year to you. We'll see next week. Doing t
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