February 3, 2025 • 41 mins
- 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, good morning, Southeast texts Internet radio listeners. Welcome
to another edition of The Doctor Lavine Medical Hour. I
never get tired of hearing that introductory soon, because that's
what you should be trying to do every day, stay alive.
How can I stay alive as long as possible and
be as healthy as possible?
Speaker 2 (00:19):
Right?
Speaker 1 (00:21):
Who wants to be alive and not doing well? I'm
sick and going to doctors all the time, going to
hospitals all the time. That is no fun. So how
can I stay alive be help at the same time.
That's the genesis of the show. And welcome and thank you,
and hopefully you're having a wonderful Saturday morning. It is
beautiful outside. No snow, unfortunately, but we did have fun
(00:45):
with our little flurry of snow for a couple of
days and talking with all the patients, seems like everybody
had a blast and not a whole lot of issues
with that came and it went. You know, it's not
here for a week two weeks, which some cities get.
We just got it for a couple of days and
(01:06):
it was fun. And now we're back to Southeast Texas
bipolar weather. Right, it's hot it's cold, it's cold, it's hot,
but it's beautiful outside today. So get outside and maybe
take a brisk wall, get that blood flowing and feel better,
get off that couch and work towards staying live. Because
(01:31):
it is the new year, and normally the new year,
it's how can I get better? How can I get healthy?
I'm going to eat right, I'm going to lose that
weight right, And as we get into February and in March,
it's like, oh, maybe next year. Because it is tough
out there. Doesn't make a bad person. It's tough to
(01:53):
eat right and be healthy and keep that weight down.
Too many goodies that were exposed to every day. That's
in our face. Man, it's it's hard to say. No
phone lines open though eight nine to six Kova, I
went one hundred and three to three zero Kalovia. We'd
love to hear from you and talk with you and
(02:14):
get your question and see if we can answer it.
I'm not perfect. I'm just a doctor a human being
as well, but we certainly are pretty good at trying
to get to the bottom of a particular set of
physical problems or one physical problem. And we'd love to
(02:35):
hear from try to help you out, just get you
some answers to lead you in the right direction. Is
the genesis of the show. Phone lines are open, and
certainly also trying to give some advice about what's the
best way to do things, what's your opinion? And I
get asked that a lot. Obviously in the office as well,
(02:56):
it's in the hospital, in the general public. I run
into a lot of the listeners, and yeah, I get
asked a lot of questions about various things. And one
thing I get asked about is artificial sweeteners. You know,
we have a lot of those on the market. I
(03:18):
think when I grew up it was the the pink
package and the yellow package, right, it was sweet and
low and I can't remember the name of the other one.
I hadn't used it in a long time, but those
were out when I was growing up. Artificial sweetners. You know,
a country is sort of inundated with sweetness, and sweetness
(03:44):
is a powerful sensation. And again, the food industry is
in the business right of selling food, just trying to
keep America fed, and they have ways of, you know,
trying to encourage you to continue to choose their product
(04:05):
and to buy their product. Again, they're not bad people.
They're they're just in business of selling food. And you know,
it's choice if you want to buy it or not.
But man, it's so strong. It seems like the desire
and the sensation is so strong you almost can't even
help yourself. What does Lays say? You can't even need one?
(04:27):
You know, lace potato chips. That was the the commercial
when I grew up. You just can't eat one. Now
they have man a plethora of potato chip options out
there on the market. I mean, go down the potato
chip I remember when I was growing up, it was
kind of like Dorito's and Cheetos and Lays and maybe
(04:47):
barbecue flavors and Fredo's. That was about it, you know.
But my god, you go down the chip aisle. Now
it's a poof. You have so many varieties, you know
which when they get but they all taste good and
they look good. The packaging is fresh. But is it
(05:07):
good for you? You know, it's just it's what they
call a snack. Just maybe every now and then once
a week is sort of the frequency that most snacks
should be consumed with. But sometimes we find ourselves at
night we're kind of bored, and the hungry grimlin is
(05:28):
on our back, and we just can't resist that fresh
bag of potato chips that our wife purchased or our
husband purchased, and we just going and we'll attack it.
We can't even hardly stop. Right. Maybe if you could
go in there and just get your hand full of chips,
(05:50):
close the bag and be done with it, it'd be fine,
But that's hard to do. So you end up eating
half a bag or even the whole bag, and it's
just you know, refined starches and sugars. You hear that term,
a lot refined processed, And again it's unfortunately a lot
(06:12):
of the products that we consume every day, just in
a routine sort of way. A lot of times we
grew up eating these same products and nothing happened, and
we just have a hard time understanding. Yeah, my wife
texted me it was Splendor. That was a yellow package,
(06:32):
so sweet and low and splenda. That's right. I was
a waiter at several restaurants back in the day. I
was a waiter at the old Crazy Jose's here at
the corner of College in the freeway. I worked there
during the summer, and man, we served a lot of
iced tea, and a lot of people like the yellow
(06:56):
package or the pink package to sort of eating their tea,
make it sweet. And that's the thing is that a
lot of us confuse sweetness as flavor. But there's so
many other flavors out there that have nothing to do
with sugar or calories. And that's what you have to understand,
(07:16):
is there's other things that you can make. Are put
in the tea or the water are your chosen beverage
to kind of kick it up a little bit? Yeah,
water is a little boring after a while. And again
that's another market that has exploded. If you go to
the aisles of the convenience stores or the supermarkets, it
(07:38):
just just a lot of options as it pertains to
these water beverages that have flavor, they have fizz, they
have different colors. I mean, the sky's the limit. Leonard
from Houston, How can we help you?
Speaker 2 (07:54):
I'll call them cash out blood sugar.
Speaker 1 (07:56):
Numbers, Yes, sir, how can we help you?
Speaker 2 (08:01):
Last month I was on a thousand milligrams, I met
forman and fourteen units of insulin and I was getting
bood sugar numbers one hundred and thirty one hundred and
thirty three, one hundred and thirty nine, one hundred and
forty numbers that make me happy. When I went into
the doctor about a month ago for my six month
(08:24):
routine checkup, he switched me from mcforman to Farsega, and
almost immediately my numbers went from one hundred and thirty two,
one hundred and seventy two, one hundred and seventy one,
one hundred and seventy seven, one hundred and seventy three.
And I called a complaint about that, and I said, look,
(08:46):
Farsga takes some time to get active, and you know,
working increase your insulin from fourteen to twenty two units
a day, and I've done that and it hasn't done
any good. I'm still getting numbers one twenty three, two fifty.
This morning it was two oh five. The other day
(09:06):
it was two twenty nine. But these numbers are not
acceptable to me. What do I do about it?
Speaker 1 (09:14):
Well, certainly, well, you know, with diabetes and all the
different options out there, there's a lot of ways to
do this, and everybody's medication regimen certainly is different from
the next guy. And Leonard, as you may or may
not know, doctors and healthcare providers who prescribe these medications
(09:38):
sort of get a familiarity with certain medications, and they
like using certain medications because the medicines have worked for
their patients and they like the medicine, so they use them.
But that's going to be different from the guy down
the street. Their experience is going to be different that
you just can't help that. And at the end of
(09:59):
the day, the healthcare providers are really trying to help
you reach your target numbers for your diabetes, and again
they have sort of an idea of how to do
that in their mind a lot of times based on experience.
So any adjustments they make, they really feel like, hey,
(10:23):
this is going to help you. But we're not always right, Okay,
And I've been doing this for over twenty years, and
I'm here to say doctors are just not always right,
and our healthcare providers is not always right. They'll be
nurse practitioners, physicians, assistants, so sometimes the decisions would make
don't generate the outcome that we're looking for. I talk
(10:46):
about surgery a lot and informed consent just because a
lot of times surgeries don't work out the way you
want them to. There's just these unforeseen issues complications that
come up that the surgery was done inappropriately. Just these
are the issues that come up anytime you perform surgery.
(11:08):
This is no different from medications, meaning I may use
a certain medicine in my patients, and for most of
the part it works very well, and so you want
to use it more often. But for some patients it
doesn't work or they have a problem with it. So
(11:29):
I would certainly you get back with your healthcare provider
and say, hey, my sugars are even higher, I'm going
in the wrong direction. We need to make another adjustment.
A lot of times I'll go back to where you
were how it all start it because it seems like
you're doing okay with a certain group of medicines and
(11:52):
you might need to get back to that original medicine
or the way you were taking it before the numbers
start going up. I would just call them back and
let them know, or get an employment to go in
and do a visit. Because a lot of doctoring is
still sort of done over the phone or virtually through
(12:14):
the computer system without you having to actually physically be
there in the office. So I would not let your
sugar stay high like this without letting your healthcare provider knows.
So get back with them on Monday and let them
know that your sugars are staying high.
Speaker 2 (12:33):
When I went in for the test six month check
out and all that six months ago, they did a
blood draw and my AEC number came back at seven
point one. And I consider that a reasonable number. Is that?
Speaker 1 (12:48):
Okay, Yeah, I know you're up up in age a
little bit, and then I think seven point one is
a good target. I think a lot of Americans, well,
I should say some Americans the number to be as
low as possible, like a six point five or six,
and that's that's a if. That's a good goal for anyone.
But our current understanding of the management and treatment of
(13:12):
type two diabetes is that an A one C of
seven seven one is about right.
Speaker 2 (13:19):
Okay, Sure, I just on my met forum and I
take a thousand milligram tablet and court in half take
half in the morning, half in the evening. Should I
go back and start taking half a met forman every
day added to the for CITYGA.
Speaker 1 (13:36):
Well, that that probably might be a good idea. But again, Leonard, Uh,
you need to involve your health care provider and let
them know what's going on. I'm not sure, doctor, And
and you know, I've never met you, I've never examined you.
So these are you know, what I'm saying is just
sort of general stuff that happens in the minds of
(13:57):
health care providers. So yeah, it sounds like you need
to make an adjustment and but but you need to
talk with your healthcare provider on Monday. But that's probably
what what happened, is they would make an adjustment. I'm
not quite sure what they're going to do, but that
is a reasonable option in most cases.
Speaker 2 (14:20):
So doctor told me he swished me from Farmanto Farsigo
because it was easier on my kidney. Does not sound
right to you.
Speaker 1 (14:28):
Well, yeah, you have understand these uh far Sega Chardients
and in Volcana. These are the brand names of three Medica.
Well it's there's a there's a couple of other ones.
Stiglatro is another one. These are brand name medicines that
(14:49):
describe a class called s g l T two inhibitors, right,
and they are very good medications. They're new. They've been
out for probably five or six years, maybe a little
bit longer, but they're new medications. And their powerhouse medicines,
meaning they really make a huge difference in the management
(15:13):
of diabetes, the progression of diabetes, and sort of protecting
you from future events like kidney failure, cardiovascular events. So
these are strong mads. They work really well. We love them,
and so yeah, the current understanding is that if you
(15:34):
have type two diabetes, you probably should be on s
CLT two inhibitor. I mean, that's just you have it.
These medicines work, you need to be on one because
they work that well. They help in so many good ways.
And yes, most practitioners are trying to get all their
patients who have diabetes type two on these medications because
(15:59):
they offer so much protection against a lot of things.
They don't just help with your sugar going down. They
help you hemodynamically, they help with your fluid balance, they
help with your kidney function because ultimately these medicines act
like what we call a diuretic, and a diuretic is
(16:19):
a medicine we use primarily for hypertension management and heart
failure management to keep fluid off of your system. And
what that does in general is it it keeps the
amount of pressure and your blood vessels down. It keeps,
like I said, your heart functioning better, and it just
kind of makes sense. You know that it's going to
(16:40):
protect you cardiovascally if it's generating what we call a diuresis,
so it has a lot of good downstream impact on
your cardiovascular system by the mechanism of action. So we
like to use the product. But again, I've had patients
that they don't like the medicine. It makes them feel bad.
(17:03):
They have complications. And the biggest, I guess tacky issue
that comes up with these medicines is yeast infections. Either
it'd be a vaginal yeast infection or the one that
you have when you're urinating, and it's very irritating. It burns,
(17:24):
so men can get yeast infections as well. That's the
big irritating part about these medicines, and that's because it's
spilling sugar in your urine, so the surface of that
area gets irritated with all the constant sugar, and yeast
loves sugar, so it generates a lot of YaST infections
(17:47):
in the genital area for men and women. And that
is the hardest thing getting over the hump with that medication.
But if you can get over it and you can
stale it. We love that medications. It's a power house.
Speaker 2 (18:00):
Yes, I've been on the Farsiga for about a month.
Is that enough time to find out if Farshega is
going to work for me?
Speaker 1 (18:10):
Yeah? A month is long enough.
Speaker 2 (18:14):
No, it's not working for me.
Speaker 1 (18:16):
Yeah. And if if I were your physician and you
came in with that complaint, I'd try to increase the dose.
Farsiga comes in a five and a ten, so if
you're taking five, I would increase it to ten.
Speaker 2 (18:31):
I think I'm a ten now. Yeah.
Speaker 1 (18:34):
If the ten's not working, I would probably jump to
a different SLT two inhibitors. So if you're in Farsiga,
I'd probably give you a Jardiance. Let's say here, try
this and Chardians comes in a couple of doses, a
ten and a twenty five, so I'd probably give you
twenty five milligrams once a day. Stop the Jardians, give
(18:56):
you another I'm sorry, stop the Farsiga, and then give
you another a month and see how you do.
Speaker 2 (19:02):
Sure, should I visit with the doctor before I go
back to the half of Matt Foreman?
Speaker 1 (19:07):
Absolutely call Monday. Now you know some doctors have on
call coverage on the weekend.
Speaker 2 (19:17):
I don't know if your doctor, it's not that important. Okay, yeah, okay,
thanks big.
Speaker 1 (19:24):
Guy, appreciated, Leonard. Happy New Year to you. Phone lines
are open eight nine six kVA one one hundred three
three zero kV. I'll be back in two minutes. All right,
(19:45):
Welcome back to stock Clavi and mad Our. Phone lines
are opened. Eight nine six KVY one one hundred three
three zero ko v I. And you know, that's what
I do all day long. I love it. I love it,
absolutely love it. Greatest profession in the world is just
talking with patients and trying to get them to a
point where they're taking a medication but they don't feel
(20:09):
like they're taking a medication, but it's helping them feel
better and function better. And the pharmaceutical outlayout there is
so huge, and it gets bigger and bigger every day
and every year. Good products that they work on, good
safe products. That is that's a big topic in the
(20:32):
healthcare world, is safety. We're trying not to cause any
home with all these chemicals, all these products that we're
prescribing to you. But again, just like any sort of
surgery or anything that we recommend to you, there can
be some unforeseen adverse reactions with the medication that we
have to deal with, and a lot of people go
(20:53):
to the er or even have to be hospitalized because
of adverse reactions for medication. It's just simple things like
blood pressure medicines or even cholesterol medications. We have several
on the market now. They were not available when I
became a physician. That's only because we have recognized that again,
(21:13):
cardiovascular disease being at the top of the list in
terms of what causes morbidity mortality in our country. We're
just trying to hammer these risk factors and in doing so,
we appear to be able to keep patients out of
the hospital and keep their cardiovascular risk profile to a minimum.
(21:34):
So these medications have are being brand new to the market,
even though they've done their due diligence, the FDA has
released them and given them approval to use these medications.
I understand that when they study these drugs, you know,
they have a large enough population of patients that they
study it, but it's sort of a control study. They
(21:57):
have a lot of do's and don'ts with these studies,
and so when you put it out in the open market,
and put it out in the community. Certainly there're going
to be some unforeseen issues that come out with these medicines,
but they do their due diligence and there's always this
sort of this active surveillance with all these medications, and
if they see a trend, just like when we had
(22:19):
COVID and the vaccines hit the market, and there was
an issue with one of the vaccines, you know, they
stopped it or posited and until they can investigate. And
they do the same stuff with all these medicines that
our practitioners are prescribing to you. I know that you're
getting more and more information handed to you from the pharmacy,
(22:42):
from your healthcare provider to sort of educate you about
the potential impact or potential adverse reaction with any medication
that's prescribed to you. Same thing with stuff that's over
the counter, not so much so, because you're kind of
on your own in that situation a lot of times,
or beware if you will, but even using the computer
(23:04):
and websites, I mean, it's just tons and tons of information.
It can get very overwhelming and confusing a lot of times.
I have a lot of my patients that I prescribe
a medication to them for a reason, for a purpose,
they go home, they read about it, and you know what,
they elect not to take the medication, even though it
(23:28):
was prescribed by their provider or their healthcare advisor. Which
is sort of the way I see myself today is
I'm just sort of trying to advise you on your
health and these are the current understandings guidelines about whatever
it is we're talking about, and so this is what
they recommend that we prescribe to you. But there are
(23:48):
patients who, after doing their own research, doing their own
investigation and getting their own information, elect not to take
the medication, which is truly purely American, right. That's what
we love about this country's the ability to have personal
choice and choose what we like, choose what we don't like,
and if we decide not to do something, it's our choice.
(24:11):
And that's the way why we like it in this country.
We don't sort of like this one way of doing things.
And same thing with the medications. We have so many
options now that sometimes it's not the right idea to
ask your buddy or your friend or your mom or
what are you taking? Because I get that a lot too.
(24:32):
Patients come in like, hey, my friend's taking this, my
uncle's taking that. I want to try it, which is
fine a lot of times if it's within a safe
boundary and it makes sense to me. I'm really on
board with trying to help my patients find success in
whatever we're trying to treat, whether it be diabetes or
(24:52):
high pretension or high cholesterol, even though it may not
be my most favorite medicine or because of experience, if
my patients want to try because I want them to
be happy, I want them to be engaged, as most
providers do, then we'll prescribe the medication as long as
we sort of stay within a safe boundary and let
(25:15):
them see how they like it or dislike it, and
then bring them back within a week or so. Well,
let me say a month, give them some time to
try the medication on and see if they like it,
and you know what, surprisingly sometimes it works and the
patients are happy because they feel like they were involved
with helping make those decisions. We still have patients that
(25:37):
just trust the physician, trust the healthcare provider. Whatever you
tell them, I'm going to do it. We still have
that sort of population, but more and more especially the
younger generations coming up and they're sort of more savvy
with the internet and the computer and just sort of
the idea that they have power as well and they
(25:58):
can investigate their own health and the encouragement of again
being more involved with your health and having a more
one on one conversation with your health care provider. But
it's you know, again, if you don't do it every day,
if you don't see these terms every day, you just
really unfamiliar with all these concepts. Even though the information
(26:20):
is in front of you, it's still difficult to figure
out what's the right thing to do because it's a
lot of information. And you know, even for US health
care providers, we struggle on some medical decisions because maybe
it's a it's a rare decision. We think in scenarios.
(26:41):
Healthcare providers, we get comfortable with certain medical scenarios. We've
maybe made that decision one hundred, two hundred and three
hundred times before, and our success rate is ninety five
ninety nine percent in making certain decisions with this particular
medical scenario. Again, it's all about that exposure for health
(27:01):
care providers. It's exposure, more exposure you get to these
medical scenarios, the better your decision making get in terms
of the fine tuning of which medicine to start with, first, second, third,
the dosing, the frequency, how you combine it with other
medications again at the end of the day, to make
(27:22):
the patient feel neutral, like they're not taking medications. I
think in starting medicine, that's always a big concern or question.
I mean, I see fear in some of my patients,
pure fear in some of my patients. When they come in.
They know they're overweight, they know the blood pressure is high,
(27:45):
they might even know that the sugar is high. But
I can sit on their face. Their body language is
telling me they don't want to make any changes. They
don't want to take any medicine. They don't want to
increase any medicine because they've heard, they've seen what sometimes
can happen when you take a lot of medications, when
(28:07):
you get exposed to new medications, and they don't want
to be that person. You know, they're busy, they don't
have time to have to deal with adverse reaction for medications.
They don't have time to come back and forth to
the doctor's office, and they just want to sort of
keep things the same, and I see that a lot,
(28:28):
and that's unfortunate because a lot of times, just keeping
it the same means your disease is progressing. It's slowly
kind of damaging your cardiovascal system, slowly damaging your neurological system.
Because again, neurological injury, neurological inflammation is very, very common
(28:51):
in our country, such as what we call neuropathy. A
lot of people are suffering all forms of neuropay thief
for various reasons, but a lot of it, again is
just the lifestyle changes that we've made or not made
injures that nervous system, and the long it goes, the
(29:12):
more permanent injury occurs. You've heard me talk about how
the body is trying to just be balanced all the time.
That's the way it's engineered, just like any vehicle or
any machine. It's just trying to stay within that neutral
position and trying to stay away from extreme situations like
(29:34):
a elevated blood pressure, elevated sugar, elevated cholesterol, even your weight.
When you gain more weight than what your body is
designed for, you just don't feel well. It's a slow
progression of not feeling well, but one day you're waking
like man, I just don't feel good. I don't have
any energy. I'm in pain all the time. Just something's wrong.
(29:56):
I go to doc Levine and get a little checkup.
But really it's just the fact that that weight is
a little high and we need to get it down
and eat a little bit better. Phone lines are opened
eight nine six kal v I win one hundred three
three zero Kalva. I'll be back in two minutes. All right,
(30:46):
welcome back. Talk to my mac. Our phone lines are open.
Eight nine six kvy I won one hundred three three
zero k o v I. And I was just talking
about those new class of type two diabetes medications. If
you have type two diabetes, you know you should review
your list. And if you're not on one of these medications,
certainly ask your healthcare provider about being placed on these medications.
(31:09):
Doctors and healthcare providers are just like everyone else where,
creatures of habit and if something is going well and
there's no complaints, and I mean when we interact with
our patients, come to the office, how you're doing, everything's fine.
We review the information, the numbers look fine. You know,
we're more than likely not going to make any changes, right,
(31:30):
just because anytime you change something, you could potentially aggravate
the situation. And we might take a month, two months,
even you know, half a year to sort of get
you back in line as it pertains to your medication.
So most healthcare providers are really reluctant to make a
change if everything is going well. But again, that's why
(31:53):
you go to your doctor's office, right to have a
conversation about your health and your diseases that are noted,
to see if there's been any updates on the plan
of care or what the medical community recommends in terms
of the treatment of particular diseases. New medicines come out,
(32:14):
new thoughts come out about how to manage certain things,
and you sort of don't want to be left behind
in a sense concerning medications are the way we're managing
things like the management of certainly our diabetes, cholesterol hypertension.
Over the years, it's got more and more aggressive. Right,
(32:36):
every time we look at our medical journals are saying
get those numbers down low and law and lore, because
that tends to keep the patients out of the hospital,
it tends to keep the diseases from progressing, and That's
what I do all day is primary prevention is what
we call that. Primary care, primary prevention sort of first
on the scene sort of guy. Not always, it's sometimes,
(32:59):
you know, we run out of time too, and we're
happy for our other healthcare workers that provide that after
our care or that care that is provided. When you
can't get to your health care provider, you call the office,
Hey we don't have any openings, but hey, I feel sick,
something's wrong. I need to be evaluated by someone asap,
(33:21):
right now. And you can go to these minor cares
and these free standing emergency departments. They provide awesome immediate
care and normally just amazing buildings and amazing places. You know,
it's brighten, it's computers everywhere, and it just looks great,
right to provide health care for you, But yeah, you
(33:45):
want to make sure you're getting sort of the latest
medications for your disease process. And yes, yes, yes, I understand,
and I agree medications. The expense of medicine in this
country is a big issue and certainly something we all
need to work on, and it's hopefully something that we
(34:06):
can work on in the future, just because I mean,
these medicines work and can keep you out of the hospital.
But yeah, when you go into your health if your
type two diabetic, you go into your doctor's office see
if you're on these medicines and have a conversation with
your healthcare provider about being placed on these medicines. Because
(34:27):
you know, there's certain groups of medicines we use every
day in healthcare world that really make a huge difference.
And in my experience, this class of medications makes a huge,
huge difference, just like taking an aspirin day in some
patients are taking these statin cholesterol medication in my experience,
(34:49):
makes a huge difference in patients who have risk factors
for cardiovass disease and they sort of look at diabetes
as a big cardiovascular risk factor in and of itself,
and so that's a patient we want to aggressively manage
with the available medications. And these sg l T two inhibitors,
(35:11):
you know them as in Volcana, Jardiance, and Farsiga. There's
also the Glottro, maybe a couple of others out there,
but these are the more popular medications that are written
every day to normally once a day. Product works fairwell
to get that sugar down I mean, I'd say it
(35:34):
gets it down pretty quickly. I'd say within a week
or so, and in doing so a lot of times
because it behaves. It's mechanics, behave like a diuretic. It
helps keep your blood pressure down as well, and we
all know if we can keep your blood pressure down,
we can keep your sugar down. You know, that's two
(35:56):
hits on your cardiovasco system that are under control. And
it just makes sense. I mean, I don't even know
if we need to research that, but nonetheless they do
research it. It makes sense that you'll be in a
better position cardiovascularly to not have any sort of events.
But you still need to do your part. You know,
it's not all about the medications all the time. We
(36:19):
are so sort of medication oriented. Just let me go
to my dog, let me get a script and start
taking that medicine. And that's it. It's all I have
to do, honestly, honestly, honestly, if you can do your
part a little bit, your body will thank you for that.
And I'll discuss that when we come back on the
(36:40):
last break. Phone lines are open eight nine six Scalvy
I won one hundred and three three zero kayovy, I'll
be back all right, welcome back top with the medical
(37:07):
phone lines. I open eight nine six klv I one
hundred and three three zero kov. I want to thank
all the callers and the listeners of the Doctoraviv Medical Hour. Remember,
if there's a certain topic that you would like me
to discuss or get into, just let us know, give
us a call, or you can call my office before
seven three six y two one aeric code four to
nine here in Beaumont, Texas and let us know. Drop
(37:31):
off the question at my office and we can try
and handle that for you. Again, we're trying to just
deliver some basic, basic information for you to make better
decisions about your health. As it is extremely complicated out there,
a lot of misinformation and disorienting information out there. It's
(37:55):
kind of hard to figure out what to do. Again,
we were talking about artificial sweeteners, is how I started
to show. And I think a lot of people are
consuming sweet things, whether it be food or beverage, but
they know they need to get off and they're trying
to transition away from sugar, and artificial sweetness can provide
(38:15):
that bridge. In my opinion, it's only needed or only
be used as a bridge to get off of the
real thing. Experts are saying, it's not supposed to spike
your sugar, right, these artificial sweetness because it's not sugar.
It's just a chemical compound that generates a sweet experience
(38:36):
when you consume it. So it's artificial sweeteners as they
call them. And is that good? Is that bad? And
there are a lot of experts that have shown that yes,
it can spike your sugar and that it can cause
weight gain even though it's not supposed to. It's supposed
(38:56):
to be calorie free, sugar free. But again a lot
of people will start to consume these products every day
in large amounts, and I think most people get them
from diet sodas or diet beverages. And the market has
been hit with like sugar free candy and sugar free
(39:16):
ice cream and sugar free can you know these sort
of products that you know are bad for you. But hey,
you see sugar freen it's like, oh, I can just
eat that and be healthy and be lean and feel good.
And I think that's just sort of a fantasy. Yes,
that's what I'm going to call it, a fantasy. I
(39:36):
think eating it and drinking it periodically. As we all say,
moderation can't beat that understanding everything in moderation. But when
I talk to my patients about those artificial sweetness my
message to them is you probably, if you really truly
want to be healthy, is to find a way to
(39:57):
not consume those products on a regular basis that you
can't think that you're being healthier than the guy who's
not or the girl who's not. I just don't buy
into that. And yes, it can sometimes be hard to
get off sugar, get sweetness sort of out of your palate,
but once you do, once you get over that hump,
(40:19):
it's a piece of cake. It really is. Because some people,
once they've not had sugar for a while, they go
back to sugar and they can taste how strong it
is and the reaction they get from their body when
they consume it. It's real, and they don't want to
feel that way. It makes them feel bad, and so
they naturally avoid it after all that time. But it
(40:41):
does take time sort of releasing your body from the
sweetness and the sugar. But artificial sweetness, in my opinion,
are just a transition and ultimate to get off of it.
It's not considered healthier than not sweetness. Thank you for
joining another show. Have a good dat on drink and
Driver seen next week.
All right, good morning, Southeast texts Internet radio listeners. Welcome
to another edition of The Doctor Lavine Medical Hour. I
never get tired of hearing that introductory soon, because that's
what you should be trying to do every day, stay alive.
How can I stay alive as long as possible and
be as healthy as possible?
Speaker 2 (00:19):
Right?
Speaker 1 (00:21):
Who wants to be alive and not doing well? I'm
sick and going to doctors all the time, going to
hospitals all the time. That is no fun. So how
can I stay alive be help at the same time.
That's the genesis of the show. And welcome and thank you,
and hopefully you're having a wonderful Saturday morning. It is
beautiful outside. No snow, unfortunately, but we did have fun
(00:45):
with our little flurry of snow for a couple of
days and talking with all the patients, seems like everybody
had a blast and not a whole lot of issues
with that came and it went. You know, it's not
here for a week two weeks, which some cities get.
We just got it for a couple of days and
(01:06):
it was fun. And now we're back to Southeast Texas
bipolar weather. Right, it's hot it's cold, it's cold, it's hot,
but it's beautiful outside today. So get outside and maybe
take a brisk wall, get that blood flowing and feel better,
get off that couch and work towards staying live. Because
(01:31):
it is the new year, and normally the new year,
it's how can I get better? How can I get healthy?
I'm going to eat right, I'm going to lose that
weight right, And as we get into February and in March,
it's like, oh, maybe next year. Because it is tough
out there. Doesn't make a bad person. It's tough to
(01:53):
eat right and be healthy and keep that weight down.
Too many goodies that were exposed to every day. That's
in our face. Man, it's it's hard to say. No
phone lines open though eight nine to six Kova, I
went one hundred and three to three zero Kalovia. We'd
love to hear from you and talk with you and
(02:14):
get your question and see if we can answer it.
I'm not perfect. I'm just a doctor a human being
as well, but we certainly are pretty good at trying
to get to the bottom of a particular set of
physical problems or one physical problem. And we'd love to
(02:35):
hear from try to help you out, just get you
some answers to lead you in the right direction. Is
the genesis of the show. Phone lines are open, and
certainly also trying to give some advice about what's the
best way to do things, what's your opinion? And I
get asked that a lot. Obviously in the office as well,
(02:56):
it's in the hospital, in the general public. I run
into a lot of the listeners, and yeah, I get
asked a lot of questions about various things. And one
thing I get asked about is artificial sweeteners. You know,
we have a lot of those on the market. I
(03:18):
think when I grew up it was the the pink
package and the yellow package, right, it was sweet and
low and I can't remember the name of the other one.
I hadn't used it in a long time, but those
were out when I was growing up. Artificial sweetners. You know,
a country is sort of inundated with sweetness, and sweetness
(03:44):
is a powerful sensation. And again, the food industry is
in the business right of selling food, just trying to
keep America fed, and they have ways of, you know,
trying to encourage you to continue to choose their product
(04:05):
and to buy their product. Again, they're not bad people.
They're they're just in business of selling food. And you know,
it's choice if you want to buy it or not.
But man, it's so strong. It seems like the desire
and the sensation is so strong you almost can't even
help yourself. What does Lays say? You can't even need one?
(04:27):
You know, lace potato chips. That was the the commercial
when I grew up. You just can't eat one. Now
they have man a plethora of potato chip options out
there on the market. I mean, go down the potato
chip I remember when I was growing up, it was
kind of like Dorito's and Cheetos and Lays and maybe
(04:47):
barbecue flavors and Fredo's. That was about it, you know.
But my god, you go down the chip aisle. Now
it's a poof. You have so many varieties, you know
which when they get but they all taste good and
they look good. The packaging is fresh. But is it
(05:07):
good for you? You know, it's just it's what they
call a snack. Just maybe every now and then once
a week is sort of the frequency that most snacks
should be consumed with. But sometimes we find ourselves at
night we're kind of bored, and the hungry grimlin is
(05:28):
on our back, and we just can't resist that fresh
bag of potato chips that our wife purchased or our
husband purchased, and we just going and we'll attack it.
We can't even hardly stop. Right. Maybe if you could
go in there and just get your hand full of chips,
(05:50):
close the bag and be done with it, it'd be fine,
But that's hard to do. So you end up eating
half a bag or even the whole bag, and it's
just you know, refined starches and sugars. You hear that term,
a lot refined processed, And again it's unfortunately a lot
(06:12):
of the products that we consume every day, just in
a routine sort of way. A lot of times we
grew up eating these same products and nothing happened, and
we just have a hard time understanding. Yeah, my wife
texted me it was Splendor. That was a yellow package,
(06:32):
so sweet and low and splenda. That's right. I was
a waiter at several restaurants back in the day. I
was a waiter at the old Crazy Jose's here at
the corner of College in the freeway. I worked there
during the summer, and man, we served a lot of
iced tea, and a lot of people like the yellow
(06:56):
package or the pink package to sort of eating their tea,
make it sweet. And that's the thing is that a
lot of us confuse sweetness as flavor. But there's so
many other flavors out there that have nothing to do
with sugar or calories. And that's what you have to understand,
(07:16):
is there's other things that you can make. Are put
in the tea or the water are your chosen beverage
to kind of kick it up a little bit? Yeah,
water is a little boring after a while. And again
that's another market that has exploded. If you go to
the aisles of the convenience stores or the supermarkets, it
(07:38):
just just a lot of options as it pertains to
these water beverages that have flavor, they have fizz, they
have different colors. I mean, the sky's the limit. Leonard
from Houston, How can we help you?
Speaker 2 (07:54):
I'll call them cash out blood sugar.
Speaker 1 (07:56):
Numbers, Yes, sir, how can we help you?
Speaker 2 (08:01):
Last month I was on a thousand milligrams, I met
forman and fourteen units of insulin and I was getting
bood sugar numbers one hundred and thirty one hundred and
thirty three, one hundred and thirty nine, one hundred and
forty numbers that make me happy. When I went into
the doctor about a month ago for my six month
(08:24):
routine checkup, he switched me from mcforman to Farsega, and
almost immediately my numbers went from one hundred and thirty two,
one hundred and seventy two, one hundred and seventy one,
one hundred and seventy seven, one hundred and seventy three.
And I called a complaint about that, and I said, look,
(08:46):
Farsga takes some time to get active, and you know,
working increase your insulin from fourteen to twenty two units
a day, and I've done that and it hasn't done
any good. I'm still getting numbers one twenty three, two fifty.
This morning it was two oh five. The other day
(09:06):
it was two twenty nine. But these numbers are not
acceptable to me. What do I do about it?
Speaker 1 (09:14):
Well, certainly, well, you know, with diabetes and all the
different options out there, there's a lot of ways to
do this, and everybody's medication regimen certainly is different from
the next guy. And Leonard, as you may or may
not know, doctors and healthcare providers who prescribe these medications
(09:38):
sort of get a familiarity with certain medications, and they
like using certain medications because the medicines have worked for
their patients and they like the medicine, so they use them.
But that's going to be different from the guy down
the street. Their experience is going to be different that
you just can't help that. And at the end of
(09:59):
the day, the healthcare providers are really trying to help
you reach your target numbers for your diabetes, and again
they have sort of an idea of how to do
that in their mind a lot of times based on experience.
So any adjustments they make, they really feel like, hey,
(10:23):
this is going to help you. But we're not always right, Okay,
And I've been doing this for over twenty years, and
I'm here to say doctors are just not always right,
and our healthcare providers is not always right. They'll be
nurse practitioners, physicians, assistants, so sometimes the decisions would make
don't generate the outcome that we're looking for. I talk
(10:46):
about surgery a lot and informed consent just because a
lot of times surgeries don't work out the way you
want them to. There's just these unforeseen issues complications that
come up that the surgery was done inappropriately. Just these
are the issues that come up anytime you perform surgery.
(11:08):
This is no different from medications, meaning I may use
a certain medicine in my patients, and for most of
the part it works very well, and so you want
to use it more often. But for some patients it
doesn't work or they have a problem with it. So
(11:29):
I would certainly you get back with your healthcare provider
and say, hey, my sugars are even higher, I'm going
in the wrong direction. We need to make another adjustment.
A lot of times I'll go back to where you
were how it all start it because it seems like
you're doing okay with a certain group of medicines and
(11:52):
you might need to get back to that original medicine
or the way you were taking it before the numbers
start going up. I would just call them back and
let them know, or get an employment to go in
and do a visit. Because a lot of doctoring is
still sort of done over the phone or virtually through
(12:14):
the computer system without you having to actually physically be
there in the office. So I would not let your
sugar stay high like this without letting your healthcare provider knows.
So get back with them on Monday and let them
know that your sugars are staying high.
Speaker 2 (12:33):
When I went in for the test six month check
out and all that six months ago, they did a
blood draw and my AEC number came back at seven
point one. And I consider that a reasonable number. Is that?
Speaker 1 (12:48):
Okay, Yeah, I know you're up up in age a
little bit, and then I think seven point one is
a good target. I think a lot of Americans, well,
I should say some Americans the number to be as
low as possible, like a six point five or six,
and that's that's a if. That's a good goal for anyone.
But our current understanding of the management and treatment of
(13:12):
type two diabetes is that an A one C of
seven seven one is about right.
Speaker 2 (13:19):
Okay, Sure, I just on my met forum and I
take a thousand milligram tablet and court in half take
half in the morning, half in the evening. Should I
go back and start taking half a met forman every
day added to the for CITYGA.
Speaker 1 (13:36):
Well, that that probably might be a good idea. But again, Leonard, Uh,
you need to involve your health care provider and let
them know what's going on. I'm not sure, doctor, And
and you know, I've never met you, I've never examined you.
So these are you know, what I'm saying is just
sort of general stuff that happens in the minds of
(13:57):
health care providers. So yeah, it sounds like you need
to make an adjustment and but but you need to
talk with your healthcare provider on Monday. But that's probably
what what happened, is they would make an adjustment. I'm
not quite sure what they're going to do, but that
is a reasonable option in most cases.
Speaker 2 (14:20):
So doctor told me he swished me from Farmanto Farsigo
because it was easier on my kidney. Does not sound
right to you.
Speaker 1 (14:28):
Well, yeah, you have understand these uh far Sega Chardients
and in Volcana. These are the brand names of three Medica.
Well it's there's a there's a couple of other ones.
Stiglatro is another one. These are brand name medicines that
(14:49):
describe a class called s g l T two inhibitors, right,
and they are very good medications. They're new. They've been
out for probably five or six years, maybe a little
bit longer, but they're new medications. And their powerhouse medicines,
meaning they really make a huge difference in the management
(15:13):
of diabetes, the progression of diabetes, and sort of protecting
you from future events like kidney failure, cardiovascular events. So
these are strong mads. They work really well. We love them,
and so yeah, the current understanding is that if you
(15:34):
have type two diabetes, you probably should be on s
CLT two inhibitor. I mean, that's just you have it.
These medicines work, you need to be on one because
they work that well. They help in so many good ways.
And yes, most practitioners are trying to get all their
patients who have diabetes type two on these medications because
(15:59):
they offer so much protection against a lot of things.
They don't just help with your sugar going down. They
help you hemodynamically, they help with your fluid balance, they
help with your kidney function because ultimately these medicines act
like what we call a diuretic, and a diuretic is
(16:19):
a medicine we use primarily for hypertension management and heart
failure management to keep fluid off of your system. And
what that does in general is it it keeps the
amount of pressure and your blood vessels down. It keeps,
like I said, your heart functioning better, and it just
kind of makes sense. You know that it's going to
(16:40):
protect you cardiovascally if it's generating what we call a diuresis,
so it has a lot of good downstream impact on
your cardiovascular system by the mechanism of action. So we
like to use the product. But again, I've had patients
that they don't like the medicine. It makes them feel bad.
(17:03):
They have complications. And the biggest, I guess tacky issue
that comes up with these medicines is yeast infections. Either
it'd be a vaginal yeast infection or the one that
you have when you're urinating, and it's very irritating. It burns,
(17:24):
so men can get yeast infections as well. That's the
big irritating part about these medicines, and that's because it's
spilling sugar in your urine, so the surface of that
area gets irritated with all the constant sugar, and yeast
loves sugar, so it generates a lot of YaST infections
(17:47):
in the genital area for men and women. And that
is the hardest thing getting over the hump with that medication.
But if you can get over it and you can
stale it. We love that medications. It's a power house.
Speaker 2 (18:00):
Yes, I've been on the Farsiga for about a month.
Is that enough time to find out if Farshega is
going to work for me?
Speaker 1 (18:10):
Yeah? A month is long enough.
Speaker 2 (18:14):
No, it's not working for me.
Speaker 1 (18:16):
Yeah. And if if I were your physician and you
came in with that complaint, I'd try to increase the dose.
Farsiga comes in a five and a ten, so if
you're taking five, I would increase it to ten.
Speaker 2 (18:31):
I think I'm a ten now. Yeah.
Speaker 1 (18:34):
If the ten's not working, I would probably jump to
a different SLT two inhibitors. So if you're in Farsiga,
I'd probably give you a Jardiance. Let's say here, try
this and Chardians comes in a couple of doses, a
ten and a twenty five, so I'd probably give you
twenty five milligrams once a day. Stop the Jardians, give
(18:56):
you another I'm sorry, stop the Farsiga, and then give
you another a month and see how you do.
Speaker 2 (19:02):
Sure, should I visit with the doctor before I go
back to the half of Matt Foreman?
Speaker 1 (19:07):
Absolutely call Monday. Now you know some doctors have on
call coverage on the weekend.
Speaker 2 (19:17):
I don't know if your doctor, it's not that important. Okay, yeah, okay,
thanks big.
Speaker 1 (19:24):
Guy, appreciated, Leonard. Happy New Year to you. Phone lines
are open eight nine six kVA one one hundred three
three zero kV. I'll be back in two minutes. All right,
(19:45):
Welcome back to stock Clavi and mad Our. Phone lines
are opened. Eight nine six KVY one one hundred three
three zero ko v I. And you know, that's what
I do all day long. I love it. I love it,
absolutely love it. Greatest profession in the world is just
talking with patients and trying to get them to a
point where they're taking a medication but they don't feel
(20:09):
like they're taking a medication, but it's helping them feel
better and function better. And the pharmaceutical outlayout there is
so huge, and it gets bigger and bigger every day
and every year. Good products that they work on, good
safe products. That is that's a big topic in the
(20:32):
healthcare world, is safety. We're trying not to cause any
home with all these chemicals, all these products that we're
prescribing to you. But again, just like any sort of
surgery or anything that we recommend to you, there can
be some unforeseen adverse reactions with the medication that we
have to deal with, and a lot of people go
(20:53):
to the er or even have to be hospitalized because
of adverse reactions for medication. It's just simple things like
blood pressure medicines or even cholesterol medications. We have several
on the market now. They were not available when I
became a physician. That's only because we have recognized that again,
(21:13):
cardiovascular disease being at the top of the list in
terms of what causes morbidity mortality in our country. We're
just trying to hammer these risk factors and in doing so,
we appear to be able to keep patients out of
the hospital and keep their cardiovascular risk profile to a minimum.
(21:34):
So these medications have are being brand new to the market,
even though they've done their due diligence, the FDA has
released them and given them approval to use these medications.
I understand that when they study these drugs, you know,
they have a large enough population of patients that they
study it, but it's sort of a control study. They
(21:57):
have a lot of do's and don'ts with these studies,
and so when you put it out in the open market,
and put it out in the community. Certainly there're going
to be some unforeseen issues that come out with these medicines,
but they do their due diligence and there's always this
sort of this active surveillance with all these medications, and
if they see a trend, just like when we had
(22:19):
COVID and the vaccines hit the market, and there was
an issue with one of the vaccines, you know, they
stopped it or posited and until they can investigate. And
they do the same stuff with all these medicines that
our practitioners are prescribing to you. I know that you're
getting more and more information handed to you from the pharmacy,
(22:42):
from your healthcare provider to sort of educate you about
the potential impact or potential adverse reaction with any medication
that's prescribed to you. Same thing with stuff that's over
the counter, not so much so, because you're kind of
on your own in that situation a lot of times,
or beware if you will, but even using the computer
(23:04):
and websites, I mean, it's just tons and tons of information.
It can get very overwhelming and confusing a lot of times.
I have a lot of my patients that I prescribe
a medication to them for a reason, for a purpose,
they go home, they read about it, and you know what,
they elect not to take the medication, even though it
(23:28):
was prescribed by their provider or their healthcare advisor. Which
is sort of the way I see myself today is
I'm just sort of trying to advise you on your
health and these are the current understandings guidelines about whatever
it is we're talking about, and so this is what
they recommend that we prescribe to you. But there are
(23:48):
patients who, after doing their own research, doing their own
investigation and getting their own information, elect not to take
the medication, which is truly purely American, right. That's what
we love about this country's the ability to have personal
choice and choose what we like, choose what we don't like,
and if we decide not to do something, it's our choice.
(24:11):
And that's the way why we like it in this country.
We don't sort of like this one way of doing things.
And same thing with the medications. We have so many
options now that sometimes it's not the right idea to
ask your buddy or your friend or your mom or
what are you taking? Because I get that a lot too.
(24:32):
Patients come in like, hey, my friend's taking this, my
uncle's taking that. I want to try it, which is
fine a lot of times if it's within a safe
boundary and it makes sense to me. I'm really on
board with trying to help my patients find success in
whatever we're trying to treat, whether it be diabetes or
(24:52):
high pretension or high cholesterol, even though it may not
be my most favorite medicine or because of experience, if
my patients want to try because I want them to
be happy, I want them to be engaged, as most
providers do, then we'll prescribe the medication as long as
we sort of stay within a safe boundary and let
(25:15):
them see how they like it or dislike it, and
then bring them back within a week or so. Well,
let me say a month, give them some time to
try the medication on and see if they like it,
and you know what, surprisingly sometimes it works and the
patients are happy because they feel like they were involved
with helping make those decisions. We still have patients that
(25:37):
just trust the physician, trust the healthcare provider. Whatever you
tell them, I'm going to do it. We still have
that sort of population, but more and more especially the
younger generations coming up and they're sort of more savvy
with the internet and the computer and just sort of
the idea that they have power as well and they
(25:58):
can investigate their own health and the encouragement of again
being more involved with your health and having a more
one on one conversation with your health care provider. But
it's you know, again, if you don't do it every day,
if you don't see these terms every day, you just
really unfamiliar with all these concepts. Even though the information
(26:20):
is in front of you, it's still difficult to figure
out what's the right thing to do because it's a
lot of information. And you know, even for US health
care providers, we struggle on some medical decisions because maybe
it's a it's a rare decision. We think in scenarios.
(26:41):
Healthcare providers, we get comfortable with certain medical scenarios. We've
maybe made that decision one hundred, two hundred and three
hundred times before, and our success rate is ninety five
ninety nine percent in making certain decisions with this particular
medical scenario. Again, it's all about that exposure for health
(27:01):
care providers. It's exposure, more exposure you get to these
medical scenarios, the better your decision making get in terms
of the fine tuning of which medicine to start with, first, second, third,
the dosing, the frequency, how you combine it with other
medications again at the end of the day, to make
(27:22):
the patient feel neutral, like they're not taking medications. I
think in starting medicine, that's always a big concern or question.
I mean, I see fear in some of my patients,
pure fear in some of my patients. When they come in.
They know they're overweight, they know the blood pressure is high,
(27:45):
they might even know that the sugar is high. But
I can sit on their face. Their body language is
telling me they don't want to make any changes. They
don't want to take any medicine. They don't want to
increase any medicine because they've heard, they've seen what sometimes
can happen when you take a lot of medications, when
(28:07):
you get exposed to new medications, and they don't want
to be that person. You know, they're busy, they don't
have time to have to deal with adverse reaction for medications.
They don't have time to come back and forth to
the doctor's office, and they just want to sort of
keep things the same, and I see that a lot,
(28:28):
and that's unfortunate because a lot of times, just keeping
it the same means your disease is progressing. It's slowly
kind of damaging your cardiovascal system, slowly damaging your neurological system.
Because again, neurological injury, neurological inflammation is very, very common
(28:51):
in our country, such as what we call neuropathy. A
lot of people are suffering all forms of neuropay thief
for various reasons, but a lot of it, again is
just the lifestyle changes that we've made or not made
injures that nervous system, and the long it goes, the
(29:12):
more permanent injury occurs. You've heard me talk about how
the body is trying to just be balanced all the time.
That's the way it's engineered, just like any vehicle or
any machine. It's just trying to stay within that neutral
position and trying to stay away from extreme situations like
(29:34):
a elevated blood pressure, elevated sugar, elevated cholesterol, even your weight.
When you gain more weight than what your body is
designed for, you just don't feel well. It's a slow
progression of not feeling well, but one day you're waking
like man, I just don't feel good. I don't have
any energy. I'm in pain all the time. Just something's wrong.
(29:56):
I go to doc Levine and get a little checkup.
But really it's just the fact that that weight is
a little high and we need to get it down
and eat a little bit better. Phone lines are opened
eight nine six kal v I win one hundred three
three zero Kalva. I'll be back in two minutes. All right,
(30:46):
welcome back. Talk to my mac. Our phone lines are open.
Eight nine six kvy I won one hundred three three
zero k o v I. And I was just talking
about those new class of type two diabetes medications. If
you have type two diabetes, you know you should review
your list. And if you're not on one of these medications,
certainly ask your healthcare provider about being placed on these medications.
(31:09):
Doctors and healthcare providers are just like everyone else where,
creatures of habit and if something is going well and
there's no complaints, and I mean when we interact with
our patients, come to the office, how you're doing, everything's fine.
We review the information, the numbers look fine. You know,
we're more than likely not going to make any changes, right,
(31:30):
just because anytime you change something, you could potentially aggravate
the situation. And we might take a month, two months,
even you know, half a year to sort of get
you back in line as it pertains to your medication.
So most healthcare providers are really reluctant to make a
change if everything is going well. But again, that's why
(31:53):
you go to your doctor's office, right to have a
conversation about your health and your diseases that are noted,
to see if there's been any updates on the plan
of care or what the medical community recommends in terms
of the treatment of particular diseases. New medicines come out,
(32:14):
new thoughts come out about how to manage certain things,
and you sort of don't want to be left behind
in a sense concerning medications are the way we're managing
things like the management of certainly our diabetes, cholesterol hypertension.
Over the years, it's got more and more aggressive. Right,
(32:36):
every time we look at our medical journals are saying
get those numbers down low and law and lore, because
that tends to keep the patients out of the hospital,
it tends to keep the diseases from progressing, and That's
what I do all day is primary prevention is what
we call that. Primary care, primary prevention sort of first
on the scene sort of guy. Not always, it's sometimes,
(32:59):
you know, we run out of time too, and we're
happy for our other healthcare workers that provide that after
our care or that care that is provided. When you
can't get to your health care provider, you call the office,
Hey we don't have any openings, but hey, I feel sick,
something's wrong. I need to be evaluated by someone asap,
(33:21):
right now. And you can go to these minor cares
and these free standing emergency departments. They provide awesome immediate
care and normally just amazing buildings and amazing places. You know,
it's brighten, it's computers everywhere, and it just looks great,
right to provide health care for you, But yeah, you
(33:45):
want to make sure you're getting sort of the latest
medications for your disease process. And yes, yes, yes, I understand,
and I agree medications. The expense of medicine in this
country is a big issue and certainly something we all
need to work on, and it's hopefully something that we
(34:06):
can work on in the future, just because I mean,
these medicines work and can keep you out of the hospital.
But yeah, when you go into your health if your
type two diabetic, you go into your doctor's office see
if you're on these medicines and have a conversation with
your healthcare provider about being placed on these medicines. Because
(34:27):
you know, there's certain groups of medicines we use every
day in healthcare world that really make a huge difference.
And in my experience, this class of medications makes a huge,
huge difference, just like taking an aspirin day in some
patients are taking these statin cholesterol medication in my experience,
(34:49):
makes a huge difference in patients who have risk factors
for cardiovass disease and they sort of look at diabetes
as a big cardiovascular risk factor in and of itself,
and so that's a patient we want to aggressively manage
with the available medications. And these sg l T two inhibitors,
(35:11):
you know them as in Volcana, Jardiance, and Farsiga. There's
also the Glottro, maybe a couple of others out there,
but these are the more popular medications that are written
every day to normally once a day. Product works fairwell
to get that sugar down I mean, I'd say it
(35:34):
gets it down pretty quickly. I'd say within a week
or so, and in doing so a lot of times
because it behaves. It's mechanics, behave like a diuretic. It
helps keep your blood pressure down as well, and we
all know if we can keep your blood pressure down,
we can keep your sugar down. You know, that's two
(35:56):
hits on your cardiovasco system that are under control. And
it just makes sense. I mean, I don't even know
if we need to research that, but nonetheless they do
research it. It makes sense that you'll be in a
better position cardiovascularly to not have any sort of events.
But you still need to do your part. You know,
it's not all about the medications all the time. We
(36:19):
are so sort of medication oriented. Just let me go
to my dog, let me get a script and start
taking that medicine. And that's it. It's all I have
to do, honestly, honestly, honestly, if you can do your
part a little bit, your body will thank you for that.
And I'll discuss that when we come back on the
(36:40):
last break. Phone lines are open eight nine six Scalvy
I won one hundred and three three zero kayovy, I'll
be back all right, welcome back top with the medical
(37:07):
phone lines. I open eight nine six klv I one
hundred and three three zero kov. I want to thank
all the callers and the listeners of the Doctoraviv Medical Hour. Remember,
if there's a certain topic that you would like me
to discuss or get into, just let us know, give
us a call, or you can call my office before
seven three six y two one aeric code four to
nine here in Beaumont, Texas and let us know. Drop
(37:31):
off the question at my office and we can try
and handle that for you. Again, we're trying to just
deliver some basic, basic information for you to make better
decisions about your health. As it is extremely complicated out there,
a lot of misinformation and disorienting information out there. It's
(37:55):
kind of hard to figure out what to do. Again,
we were talking about artificial sweeteners, is how I started
to show. And I think a lot of people are
consuming sweet things, whether it be food or beverage, but
they know they need to get off and they're trying
to transition away from sugar, and artificial sweetness can provide
(38:15):
that bridge. In my opinion, it's only needed or only
be used as a bridge to get off of the
real thing. Experts are saying, it's not supposed to spike
your sugar, right, these artificial sweetness because it's not sugar.
It's just a chemical compound that generates a sweet experience
(38:36):
when you consume it. So it's artificial sweeteners as they
call them. And is that good? Is that bad? And
there are a lot of experts that have shown that yes,
it can spike your sugar and that it can cause
weight gain even though it's not supposed to. It's supposed
(38:56):
to be calorie free, sugar free. But again a lot
of people will start to consume these products every day
in large amounts, and I think most people get them
from diet sodas or diet beverages. And the market has
been hit with like sugar free candy and sugar free
(39:16):
ice cream and sugar free can you know these sort
of products that you know are bad for you. But hey,
you see sugar freen it's like, oh, I can just
eat that and be healthy and be lean and feel good.
And I think that's just sort of a fantasy. Yes,
that's what I'm going to call it, a fantasy. I
(39:36):
think eating it and drinking it periodically. As we all say,
moderation can't beat that understanding everything in moderation. But when
I talk to my patients about those artificial sweetness my
message to them is you probably, if you really truly
want to be healthy, is to find a way to
(39:57):
not consume those products on a regular basis that you
can't think that you're being healthier than the guy who's
not or the girl who's not. I just don't buy
into that. And yes, it can sometimes be hard to
get off sugar, get sweetness sort of out of your palate,
but once you do, once you get over that hump,
(40:19):
it's a piece of cake. It really is. Because some people,
once they've not had sugar for a while, they go
back to sugar and they can taste how strong it
is and the reaction they get from their body when
they consume it. It's real, and they don't want to
feel that way. It makes them feel bad, and so
they naturally avoid it after all that time. But it
(40:41):
does take time sort of releasing your body from the
sweetness and the sugar. But artificial sweetness, in my opinion,
are just a transition and ultimate to get off of it.
It's not considered healthier than not sweetness. Thank you for
joining another show. Have a good dat on drink and
Driver seen next week.
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