March 17, 2026 • 42 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, welcome Southeast Texas Internet radio listeners. This is
your host, doctor Levine, coming to you live from the
studios of KLVI here in Bauma, Texas, crossroaugh from park
to the mall, taking your phone calls, talking about healthcare
and medicine to as the theme song indicates, stay alive
as long as possible and as healthy as possible. It's
(00:22):
complicated out there. It's confusing what to do, what not
to do. You hear so many different things from so
many different resources and sources and people you just don't know.
And we have one hour ahead of us to try
and figure out how to keep you alive as long
(00:42):
as possible and as healthy as possible. Remember, phone lines
are open eight nine to six klv I one in
one hundred three three zero klv I left. Hear from me,
Talk with you, Chat with you, See what's on your
mind in terms of what happened to you this past week,
and just the question of what can I do every
(01:04):
day to stay out of the hospital. Reduce my visits
to the doctor, reduce the number of medicines that I
have to take, so they don't have a sack of medicine,
so that I'm not spending all my heart earned money
on prescription medications and going to doctor visits. It's expensive
(01:29):
out there when it comes to medications and going to
the hospital. Yeah, it can be a lot. So certainly,
as you get older, your health is your most critical
and important commodity. And somebody lied to us, they said
(01:50):
the golden years, right, when you get older, the goldens
retire and just life is wonderful and you don't have
to go to work and you can just do whatever
you want. And for some people that is their experience.
You know, they've worked for thirty thirty five years and
(02:11):
they have a good retirement financially, their health is good.
We do see those patients. I would say they're not
the majority of the patients in my experience. I would
say at least less than half of my retire You
sort of have that scenario. One of the elements is
(02:35):
a lot of times missing. But you have to really
engage and do your part if you really want to
be healthy. As you get older, you really have to.
It's not automatic anymore like when you're in your twenties,
when you could just do whatever you wanted to and
(02:58):
your body tolerated it. You could stay up all night,
you could drink, you could eat whatever, smoke doesn't matter.
Your body's still going strong.
Speaker 2 (03:08):
Right.
Speaker 1 (03:08):
You could go work a full day eight hours with
zero sleep. I used to do that in medical school,
have to study for a test, be up all night,
not get one minute of sleep, and go take a test.
Supposed to get your sleep so your mind can be
(03:31):
ready to go and rest so you can use it.
But you're so nervous. The drilling is so high doing
that stage of your life. I mean, you're drinking coffee
all night, You're taking caffeine tablets. This is what I did.
I don't know what my other colleagues did, but this
is what I did to stay up to study. And
(03:53):
it's insane that you're able to do that. But there's
no way I could do it now. I mean, even
if I try to stay up all night, your body
feels so terrible when you don't sleep. I mean you
feel bad, achey, headaches, dizziness, sometimes, blory vision, mental fogginess.
(04:17):
I mean, you need that sleep. And insomnia is such
a big issue in our country. We don't really we
don't really talk about it that much. Insomnia or the
lack of a normal sleep pattern. We don't talk about
it that much, and you know, you hear about the
diet and the exercise blah blah blah. Right, we've heard
(04:39):
it before, doctor Levine, but we don't talk about sleep enough.
You need a good night's rest to be healthy the
next day. And unfortunately, there are a lot of factors
that lead to poor sleep habits. You know, getting that
good six to eight hours of rest at night, I
(05:00):
would say, is the average amount of time you need.
Some people can operate on four They just need four
hours of sleep and they're good. But most of us
need about six to eight hours of sleep just to
feel good, and there are a lot of things that
interrupt that. Probably the most common sleep disorder that we
(05:26):
have here in this country is obstructive sleep apnear ORSA
for short, and it's something that has gotten easier to
diagnose just because now there's a little home device that
you can wear. Can take it at home, take it
home and put it on, just a few little pieces
(05:46):
to the device, and it measures and monitors the way
you sleep, and you turn it back into your doctor's
office and then they analyze it to determine if you
have any obstructive sleep apnea. Now, just like we talk
a lot about knowing your numbers. I hadn't said that
in a long time, but know your numbers right, blood pressure, cholesterol, sugar,
(06:13):
it's a barometer to your health. Basically. There's a few
other things that they're throwing out there as well. A
coronary calcium test is another one, cardiac stress test, EKG,
echoes of your heart. These are other screening tests that
we do to try and risk stratify you to see
(06:36):
how you're doing. Do we need to put you on medication,
do we need further testing. So again we're trying to
stay ahead of the game as much as possible. So
if you're overweight, and the way you can determine that
is using the index of what we call a body
(06:56):
mass index or BMI. You may have seen that somewhere
and it's a ratio of your weight and your heighth
And they have these little apps that you can download
on your phone that can calculate your body mass index.
And if your body mass index is thirty are above,
you're definitely at risk for having OSA or obstructive sleep apnea.
(07:21):
Reason being is when you gain weight, you can you
when you have extra pounds on you. There's a certain
look you have.
Speaker 2 (07:31):
Right.
Speaker 1 (07:32):
Your neck gets a little bit more full, your torso
gets a little bit more full, your face gets a
little bit more full.
Speaker 2 (07:41):
Right.
Speaker 1 (07:41):
Well, a lot of that same fullness goes to the
throat area and the soft tissue of the throat, so
that area becomes large as well. If you will, and
as all of us float to sleep and get into
the deeper stages of sleep what you call rimram rapid
(08:02):
eye movement sleep. That's just how they categorize it. I
believe the throat muscles at some point relaxed. There is
a slight paralysis or relaxation of your muscles when you
go to bed, right, your body is trying to shut
down and fix itself and repair itself. That's basically what
(08:24):
sleep introduces is the repair process of the body.
Speaker 3 (08:28):
Right.
Speaker 1 (08:29):
A lot of times you get some sort of acute
problem whatever it is, right, pain, nausey, vomiting, headache, stomach pain,
whatever it is, and you say to yourself, I'm gonna
go to sleep. It's gonna go lay down, gonna take
a nap, I'm gonna sleep to solf right, And you
(08:50):
know what, A lot of times that's all you need.
You wake up the next day or after several hours,
you feel refreshed, You're ready to go. The symptoms have resolved,
right just going to sleep. The body has healing powers,
it really does, and we sometimes forget that in this
(09:13):
culture that we have, this pharmaceutical culture where every physical
ailment that we get, there must be a pharmaceutical product
at CVS or Walmart online that I can consume or
drink or inhale or smell or inject that's going to
(09:35):
resolve that physical problem quickly, easily, cheaply. Right, that's our
line of thinking with a lot of these physical ailments
that we get. And you know, for the most part,
there is medication out there for it. God bless them.
They're trying to help everybody out and provide all these
(09:56):
products to Americans to make them feel better when they
don't feel well. But your human body has healing Potential's
got to give it a chance, and unfortunately a lot
of our habits interfere with that process, like not being
able to sleep. So when you go to sleep, your
(10:17):
body's own healing processes go into effect and try to
repair the damage of the day and get you ready
to go for the next day, so you can tolerate
the stress of the day if you will. And if
you don't give your body it's ability to do that,
(10:38):
then it starts to cause breakdown in various areas. You
don't feel as well right, your energy goes down. You
might have aches and pains like can said, headache, dizziness,
I mean your eyes are burning if you don't get
that proper ress. But with obstructive sleep APPNE, it's sort
of a problem that evolves over time and it can
(11:01):
sort of slowly creep into your life. And a lot
of times patients don't really know they have it. They
just noted, don't feel good. You know something's off. I
don't feel the way I did when I was younger.
And especially if they live alone. We have missus. Why
(11:24):
do you like creep in here? You don't have your headphones?
The producer is gonna get them, is a micone? Can
you talk?
Speaker 4 (11:31):
Can you hear me?
Speaker 3 (11:32):
Yeah?
Speaker 1 (11:32):
I can hear you. You just like to creep in
here like you find my car keys? What happened to them?
Speaker 3 (11:40):
Well?
Speaker 4 (11:40):
They I guess I came home last night.
Speaker 1 (11:42):
And can you hear yourself? No, okay, I can hear you.
The producer wants you to ask the producer to get
you some headset, a headset. Missus Levigne has entered the
premises and at the building again she like, broke my
chain of thought.
Speaker 4 (12:00):
I think you were talking about sleep apne.
Speaker 1 (12:03):
Yes, thank you. I need her by my side to
talk about that. But it's a very common disorder. And
if your B and I is thirty or above, just
put that in. But if you know you a little
bit overweight, you probably have it. It's an extremely common disorder.
Have you done your B and I yet?
Speaker 4 (12:24):
I mean it's just getting on the scale and looking
at it right.
Speaker 1 (12:27):
Yeah, you have to put your height in as well.
So thirty or above is when you should get a
sleep apnea test, and we do those in the office
and it's very easy, very simple, and it allows patience
to determine if they have sleep app Now, a lot
of times I get this story about the why or
(12:47):
the husband has seen their loved one not breathing or
stop breathing or excessive snoring, but they don't do anything
about it. They just wake up, wake up, and then
they go on and they don't ever say go to
the doctor or.
Speaker 4 (13:04):
Well, they may not know what to do about.
Speaker 1 (13:06):
It, because it's a very violent thing to watch when
you see your loved one struggling to breathe, like they're
not breathing at all, and you hear how rough the
snoring is. I mean, it's really and this is a
severe sleep apnea. I would say most of our patients
fall into the mouth to moderate sleep apnea. But nonetheless,
(13:29):
it is a disruptive way of sleeping. I mean, you
know how important sleeping is, right, Oh?
Speaker 4 (13:36):
Absolutely.
Speaker 1 (13:37):
When you don't get your rest at night, it's just
it's hard to function the next day, right, yes, I
mean did you have to when you were studying for
your nursing degree? Did you have to stay up all
night and not get any sleep at night time? Did
you ever have to do that? They call it, we
used to call it an all night.
Speaker 4 (13:56):
All night or I was young back in those days,
so I'm sure I did a lot of all nighters.
Speaker 1 (14:01):
Do you remember doing them?
Speaker 4 (14:02):
Though? Really? I mean I remember staying up and studying
all night. But then there's a point you just have
to go to bed and wing it. Not me, It's
like the more you study, the more you forgot. So
I just gave up. No, But I always made really
good grades.
Speaker 1 (14:20):
I was so nerved up that I couldn't go to sleep.
Speaker 4 (14:23):
I mean, I think your education was a little bit
more serious than mine.
Speaker 1 (14:26):
Yeah, but I had classmates of mine that they didn't
stay up all night.
Speaker 4 (14:32):
They were gifted. You weren't gifted, baby.
Speaker 1 (14:35):
I know.
Speaker 4 (14:35):
I wasn't gifted.
Speaker 1 (14:36):
I had to I had to really work hard to
get that that degree, you know. But they were I know,
I know. And I was exposed to these these guys
that and females when I went to Rice University in Houston, Texas.
I mean, you're you're working and dealing with some of
the smartest people at the time, and they were just
(14:58):
mentally gifted. They could absorb information, process it with little effort.
Not like them, not like I'm telling it was intimidating,
to be honest with you, to understand that there are
people out there like that, whether their brains just work
more efficiently processing information, knowing how to toss that information
(15:25):
around and spit it out in different ways and just
retain it. That was the thing that was important in
medical school. Medical school wasn't too tough, just a lot
of information that throwing at you. To sort of keep
it oriented then, especially for a test, you have to
just sort of recount all this information that was given
(15:46):
to you. Not that it's tough. You're not figuring out
math problems and chemistry problems that was difficult, but just
the amount of information. So yeah, the energy it took
to do that for me was higher than some of
my other colleagues. I mean they would be comfortable just
you know, peacefully going to their test and they got
(16:07):
a good night's rest.
Speaker 5 (16:09):
And maybe I just had breakfast and maybe worked out,
you know, I was like studying to the end going
into the test room.
Speaker 1 (16:20):
I'm still looking at information anyway. Phone lines are open
eight nine six kelvy I won one hundred and three
to three zero klv I'm surprised by Missus Levine. We'll
come back in two minutes. Take care, all right, Welcome
back to the doc Lavine Metical. Our phone lines are opened.
Eight nine six KELVA won one hundred three three zero Kova.
(16:41):
I was sitting here chatting with Missus Levine. We're talking
about obstructive sleep appnear or OS A for short, very
common disorder that we all should be looking out for.
We have the little device in our office is that correct?
How long we had that long time?
Speaker 4 (16:59):
But you know, well you take it home and sleep,
so mm hmmm.
Speaker 1 (17:04):
That was the problem back in the days. You had
to go to sleep lab, which they still have these
sleep labs, but it's a little commersome, right.
Speaker 4 (17:11):
It's not in the comfort of your own home. It's
in another bed and you're hooked up to probes and
people are watching you, and it's I've never done it,
but I don't think I would sleep my greatest mm hmm.
And you're supposed to sleep your greatest so that it
can measure things.
Speaker 1 (17:26):
Yeah, that's correct. And it's sometimes hard for people to
just be away from their house at nighttime. They have
responsibilities at home and it's difficult to leave that environment,
go to, like you say, yes, a foreign environment and
sleep for several hours. And that did interfere with a
lot of patients being properly diagnosed with sleep after they
(17:48):
just couldn't accomplish that kind of like we have with
colon cancer screening. How when I graduated, we were still
doing what they call flex SIGs or flex sigma, which
is basically a colonoscopy, but it only looks at half
of the colon, and then we figured out that some
cancers were on the other side of the colon and
(18:08):
they would have a normal flex SIG but then actually
have cancer we diagnosed later, so they did away with
the flex sig and now it's just a full colonoscopy.
But at one time that was really all that we
recommended for colon cancer screening. Now we have these stool kits,
right colon guard that come to your house and you
(18:31):
can sort of process it yourself. I mean a lot
of people fairly. Yeah, I mean it's it's it's more
automated than it was when it first started. Well we've
had it in the office for five six years something. Yeah,
So and they do advertising and it's it's a very simple, quick,
easy way to do colon very convenient, just because again
(18:55):
doing a colonoscopy, what that requires a referral you got it.
Speaker 4 (19:00):
First of all, you got to prep for it, so
you got to drink this stuff and clean your colon out. Yes,
then you have to have someone drive you, you have
to be put to sleep under anesthesia, and then you
have to get up and carry on about your day.
Speaker 1 (19:13):
So yeah, so it's a lot of obstacles to perform
the colonoscopy. So as a screening tool, you know, it's
it's not the best in the sense that we're not
reaching a lot of patients in terms of getting their
colon cancer screen It's got to be easy, simple, quick, fast, cheap,
(19:34):
that sort of thing. So that's what while the stool
kit works. And again just to reiterate to all of you,
if you want to do the stool kit, that's fine,
but you have to have a very low risk of
colon cancer, like it shouldn't run in your family. You
shouldn't have any physical symptoms whatsoever like anemia or rectal
bleeding or abdominal pain.
Speaker 4 (19:55):
Abnormal patterns.
Speaker 1 (19:57):
Yes, it's really got to be for the most average
risk patient, which is most Americans. Right, Most Americans don't
meet that criteria. Most Americans are low risk. But again,
colon cancer is a big issue in our country, and
we now start screening at forty five years of age,
(20:17):
whereas go ahead.
Speaker 4 (20:18):
Isn't colonoscopy the highest standard of care?
Speaker 1 (20:22):
Well, it is the if you look at everything. It
is a very good test to look inside your colon.
But again you're.
Speaker 4 (20:31):
Evasive, more risk, dangerous or whatever.
Speaker 1 (20:34):
Well, it's just cumbersome. And when you talk about a
screening test like a blood test, a PSA test, the
screening test has to be easy to do. It's got
to be affordable, it's got to be convenient if you
want to have one hundred percent compliance, So you want
(20:54):
to approach one hundred percent compliance with the screening test,
almost like vaccines. I mean, we want one hundred percent
compliance with vaccine. So we've got to make it easy, fast, cheap.
It has to be on that level. If there's there's
complications or there's obstacles to getting that, then it's just
not going to be done, and then people will miss
(21:15):
the opportunity to get screened for their colon cancer. So
that's why these stool kits are really good adjunct to
colon cancer screening. Yeah, if you have the time and
the ability, Yeah, get a colonoscopy. No, I don't think
anyone argues about that. But we're talking about all the
other people that are out there that just can't get
to the doctor's office. They can't take office kind of
(21:36):
like the sleep apnea. Now that we have the device,
you come to the office, you see your doctor and
they're like, hey, I think you have sleep appening. You're
a BMI stard of or above. Take this device home?
Is it that simple?
Speaker 4 (21:52):
Is that simple? I mean, we register the device in
their name.
Speaker 1 (21:55):
Mm hmm.
Speaker 4 (21:55):
We give them instructions. It's very straightforward. When they go
home and go to bed, they hook it up. It's
not a bunch of probes. It's not all the things
that are in a lab. And then you drift off
to sleep. You bring it to us the next day,
and then we we send it off to a company
who reads it.
Speaker 1 (22:11):
Then you have your results and may it be done
within a day or two. And then if you do,
if you are confirmed to have sleep apnea, then the
most immediate treatment is this device called a SEPAP machine
continuous positive airway pressure. And the machines have come a
long way. When you and I graduated from our medical training,
(22:34):
the devices were pretty big and loud and loud and.
Speaker 4 (22:40):
And we dry out the nose, yeah, nose bleeds and
all those.
Speaker 1 (22:44):
It wasn't the best. And so guess what, most people
didn't use them, right, even though they have had sleep apna,
they didn't use them.
Speaker 4 (22:51):
And the mask don't fit the greatest.
Speaker 1 (22:53):
You know, well, back in the day, they didn't they've
come a long way, they've gotten a lot better, so
patients are able to be more compliant with the device.
So number one, we've made it easier to be diagnosed.
And again all of the listeners out there, if you're
if you know you're of a weight. Most people know
they're of a weight, right, I would think, so just
(23:14):
look in the mirror, like, look at these jowls. Look
at my neck. It's kind of big.
Speaker 4 (23:20):
They may not go that far, but.
Speaker 1 (23:22):
Or they have to sort of loosen up that belt, right,
and they're putting on those favorite para of jeans. I
wore them a few musco Oh, it was getting a
little tight when I put them on.
Speaker 4 (23:34):
Chose. It's a little bit more of an effort to
reach down there.
Speaker 1 (23:38):
That's right. They don't see the feet anywhere. Yeah, most
people know when they're a little bit overweight. And so
if you are, just again, the test is simple. It's
just as easy as getting a blood test or an
EKG are checking your blood pressure. These are things that
we want patients to kind of keep up with, especially
as you get older. Again, you have to invest more
(23:58):
time into your health as you get older. If you
want to be healthy, you want to stay out of
the doctor's office. It's not as simple as taking a
tablet or a vitamin supplement that you see. We unfortunately
still answer those questions in the office. Our patients come
to the office and they've seen a commercial, they've seen
(24:22):
an advertisement, and they buy a box or a container
of a vitamin or vitamin supplement or diet. I mean,
there are so many out there, I would you can't
even count them with all these weird names and all
this weird packaging. And they're like, hey, I want to
(24:44):
try this for this, or I want to try this
for that, and you know I don't. I certainly want
to support them and I want them to feel good.
And if patients want to try things, I'm all ford
because most of these dietary supplements are not harmful, but
most of the time they just don't have the research
(25:05):
that they need to endorse. The main thing, like you
know and I know, is number one, you have to
have that diet right, and then number two just be
physically active. And then three, yes, sleep, so if you're overweight,
get your sleep apnea test so that you can figure
that out. And then yes, if your doc knows, get
(25:28):
your c pap machine. Phone lines are open eight nine
six Kalva at one one hundred three three zero Kalvia City.
(25:51):
All right, welcome back to the doctor. The medical phone
lines are open eight nine six Kalvy. I win one
hundred three three zero Kovia chatting with this levine sharing
sometimes Levigne Leonard from Houston. How can we help you?
Speaker 3 (26:03):
A couple of weeks ago, we talked about my low
blood sugar numbers.
Speaker 6 (26:07):
Yes, sir, and it was agreed that I would stop
all of the farsiga and stop the insulin.
Speaker 3 (26:17):
And when I did that, I got numbers of one
hundred and eighty five hundred and ninety. So I went
back to one farsga a day and that got me
down to one hundred and eighty one hundred and seventy five.
And I'm just wondering how long I should stay allowed
or stay at one hundred and eighty before I go
(26:37):
back to some measure of insulin.
Speaker 1 (26:41):
Well, then, I just want to make sure that you're
communicating with your healthcare professional. Are you working with your
healthcare professional to adjust these I.
Speaker 3 (26:52):
Tell them what I'll call and tell them what I'm doing.
They say, Okay, give it a try. You know that's
basically what they're saying.
Speaker 1 (27:00):
Okay, yeah, I'm just a radio personality. I just want
to make sure that you are working with your healthcare provider.
I'm not your physician. But in general, in these situations,
if this were my patient and the blood sugars were
still staying a little bit high in one point eighty
range in the morning, that is above our targeted goal
(27:23):
of high sugar. So we would yes, probably recommend or
agree with increasing the farciga up to its ten milligram
dose as the highest you can take a farciga and
would judge and see how that adjustment would help with
your blood sugars. And so then certainly brings is used
(27:43):
but can introduce low sugar issues. So farsiga the way
it works is it is less likely to cause hy
poke lycemia. So that's probably why I be better to
adjust to farciga before adding back on the end. So
that would be a general recommendation, but certainly, like I say,
(28:04):
we would like you to make sure that's okay with
your healthcare provider, your prescriber of these medications.
Speaker 3 (28:13):
Well, I call him on Monday. But so the recommendations
go to two farciga a day instead of one farciga
and some insulin.
Speaker 1 (28:23):
Yeah, that's a that's a general recommendation, and that is
something that we can do in these situations. But again,
I'm not your physician. I'm just a radio personality, and
you need to make sure your your doctor is okay
with that before you make that change.
Speaker 4 (28:41):
So didn't you say ten milligrams of farsigo?
Speaker 1 (28:44):
Yes?
Speaker 4 (28:44):
Is that one or two?
Speaker 1 (28:45):
That's two?
Speaker 4 (28:46):
Okay?
Speaker 1 (28:47):
Yeah, of the five milligram yes.
Speaker 3 (28:49):
So that'd be one in the morning, one and after
one at night.
Speaker 1 (28:52):
You could do it that way, or you could just
take two in the morning.
Speaker 3 (28:57):
I prefer to do one in one.
Speaker 1 (28:59):
Yeah, you can try that out.
Speaker 3 (29:02):
Gives me something to do.
Speaker 1 (29:04):
Okay, be sure and check with your doctor though first.
Speaker 3 (29:07):
Okay, Yes, all right, brother, thanks big guy.
Speaker 1 (29:10):
All right, take care and uh yeah, Farsiga belongs to
a category of diabetes medicines we call sgl T two inhibitors.
We know about gop one, right, it was zimpic and
semi glue tide. We know about that one. Do we
still do that in the office?
Speaker 4 (29:29):
Yeah?
Speaker 1 (29:30):
How's that going?
Speaker 4 (29:32):
It's going good. I mean, patients come and go because
they lose the weight they want to lose, and then
they go about their day.
Speaker 1 (29:39):
Have we figured out how successful the program has been
or if the medicine that we are prescribing works for them?
Do we know anything like that? Do we figure that out?
Or what are most patients saying? Or I don't hear
a lot about it? To be honest with you.
Speaker 4 (29:58):
Well, then that means it's doing its job. If you
don't hear a lot about it, but not really.
Speaker 1 (30:02):
A lot of times patients don't want to talk about
negative things, and when they come in, it's like I'm
just going to ignore them.
Speaker 4 (30:09):
I think it works very well. I think the patients
are happy. Most of our patients have made it to
their goal weight. So we have patients that go off
the program, then we have new patients that come on
to the program. But you know, it's working as far
as I know. I mean, I've not been told any different.
Speaker 1 (30:29):
I think the one thing I hear a lot is
that they have to come in weekly.
Speaker 4 (30:33):
But that's anywhere they go. Yeah, no matter where you go,
no matter where you get your weight loss program from,
you have to go in weekly.
Speaker 1 (30:42):
You know what sometimes to in order for patients to
tolerate the medication. Sometimes we'll have them go every two
weeks with the medication. That's something that we can do
at our program. Right They don't necessarily have to come
every week. It's recommended you come weekly. But if you
can only squeak in every two weeks, that's something that
they can do as well.
Speaker 3 (31:03):
Right.
Speaker 4 (31:04):
Well, I feel like if you're wanting to lose weight
and it's that important to you, then you make the
time to come.
Speaker 1 (31:10):
I heard that, John from Houston. How can we help you?
Speaker 3 (31:14):
Oh?
Speaker 2 (31:14):
Yes, I just want to get your opinion on getting
prescribed maybe abuse bar for the for some mile OCD strip.
Go ahead, Yes, I hear that.
Speaker 1 (31:33):
Yeah, bus spar abus sperone. It's an old school anti
anxiety medication and it's still being used today because I
guess when I finished my medical training, the benzo diazepine
category was being heavily used by practitioners. That's things like xenax,
(31:56):
our praisealam, klonipin, valum. They were using that a lot
for anxiety. And in this day and age right now,
we're trying to be safer and trying not to expose
patients to medicines that have sort of a abuse potential. Yes,
(32:16):
so abuse spar or abuse sperone is one of those
products that we've kind of reached back and started using
again because it's felt to be safer, less addicting, and
I think for someone who has a psychiatric disorder like
bipolar disorder, which can sort of go between anxiety depression,
can be used. It's not the primary medication when you
(32:39):
have bipolar disorder, but I think it can be used
in addition to some of the other mainstream frontline medications.
So yes, it can be used to help manage the
symptoms of bipolar disorder, normally as an add on.
Speaker 2 (32:57):
Or like an OCD.
Speaker 1 (33:00):
I'm sorry, I apologize OCD, yes, sir, yes, sir, so yes.
Speaker 2 (33:04):
Uh yeah, so that's that's that's good to know. Yeah,
I'm trying to stay clearer from the from the other alternative.
I just wanted to make sure if that's even effective,
you know.
Speaker 1 (33:18):
I mean, not for everyone, but again, it's still a
good product in my opinion and in my experience, and
can be used in various psychiatric disorders like OCD. It's
not probably the main medication we use for OCD, but
again can be used as an as a second line
or a third line medication if you're not responding to
(33:39):
the frontline medication and it's normally well tolerated, doesn't have
a lot of toxicity issues. So I think if yeah, yeah,
it does not have abuse, but typically no abuse potential,
you don't need a special prescription. It's again considered low risk,
(34:00):
So yes, that would be a good option for you
if you were concerned about that.
Speaker 2 (34:05):
Okay, well, I appreciate you.
Speaker 1 (34:07):
Appreciate it, John, thanks for the phone call. Don't get
a lot of psychiatric calls on this show, but mental
illness psychiatric disorders are huge in this country, and any doctor,
I don't care what you get into, normally has exposure
to psychiatric diseases such as anxiety or depression. I wouldn't
(34:32):
say insomnia is a psychiatric disorder, but certainly those two
categories anxiety depression are huge. OCD are Obsessive compulsive disorder
is certainly out there as well and has been recognized
more and more. I think most people are just a
little embarrassed when they feel like they have OCD and
(34:53):
they just kind of deal with it because they can
a lot of times get through the day, but sometimes
it gets pretty bad and because of the behaviors. They
can't function normally, like they can't just go to work
and just be at work and come home, and sometimes
even the home situation is kind of bad as well,
(35:16):
you know, just all the things that you have to
do to keep that disorder in line. But I think,
and again I'm not a psychiatric expert, and it's been
a while since I read about OCD, but I think
the what we call SSRIs like Zoloft, paxel lexapro cyitalopram,
(35:37):
these are the medications that normally are reached for when
it comes to OCD if the disease is crippling the
patient where they can't seem to function well. And I
think most people are high functioning OCD patients, there's probably
a small segment that it's so severe. Like I said,
(35:58):
they just pretty much are going in circles. They can't
really function very well, and it's it can be a
very hard disease to deal with in terms of OCD. Now,
like I said, anxiety depression. Our country, our culture is
just designed to be stressed. We see all the media,
(36:18):
we hear all the things in the radio and the TV,
and it's just very stressful and were stressed about this,
and we're stressed about that, and we're paired not about
this and paired not about that. And I hear that
a lot in my office. And yes, sometimes it can
cause some low level anxiety depression, but these are psychiatric
diseases that normally require medical therapist, especially as one gets older,
(36:43):
it does require that to be done. And again, behavior modification, Yes,
we've we've come a long way in this country recognizing that, hey,
you know, we need to really deal with this. This
is real, it's nothing to be embarrassed about. We just
need to know about it, and we want to try
and help you. And the America has really responded to
(37:04):
that and done what it can to recognize these patients
and give them therapy so that they can get better. So,
if you have any issues with OCD or anxiety depression,
you know, go talk with the healthcare provider and see
if they can get you fixed up. Phone lines are
open eight on six kalvy. I want one hundred three
three zero kovy. I'm going our last break, all right,
(37:34):
welcome back to doctor Matago. Our phone lines are open
eight one six kalvy. I want one hundred three three
zero klv I at the ended the program talk with
Missus Levine again. If you have a topic that you
would like me to talk about, call the station or
call the office and we can talk about it, because
the genesis of the show is to provide you with
information so you can help you and your family figure
(37:55):
out how to stay alive in as long as possible.
Real quick, we have some new testing in the office.
Is that correct that you wanted to share with the public.
Have No, you blew up the microphone again. No, I
think I hear you. Now, there you go.
Speaker 4 (38:16):
Can you hear me?
Speaker 5 (38:16):
Yeah?
Speaker 1 (38:17):
Hold on, Alan from Vider, How can we help you?
Speaker 3 (38:21):
Yeah?
Speaker 7 (38:21):
I had a question a week or so ago. You
were talking about gastric bypass surgeries and you know, weight
loss surgeries. That was something I was once considering. I
have a abnormally massive appetite. It's it's been my whole life,
(38:43):
all the way back to the seventies. I'm pushing sixty
now and I struggle with For me, it's not overeating.
I eat just as much as it takes to you know,
satisfy me or fill me up. But it's twice the
normal grown man. I was considering that just to reduce,
(39:04):
you know, the the intake. But one of the things
I consider is I have I think what you call hyperhydrosis,
and I do a lot of work outside and because
of my sweating, I can't really it's very difficult for
me to stay hydrated. And I was wondering if I
(39:26):
did anything like the like the weight loss surgeries with
limiting possibly my water intake, if that would just exacerbate
the hyperhydrosis. And I'm pushing heat, exhaustion and he stroke
because I can't stay hydrated. Wondering what you had to
say about that.
Speaker 1 (39:45):
I mean, Allen, that's a that's a good concern. However,
in terms of prioritizing your health, I still would recommend
trying to have surgery to get your weight down or again,
these diabetes medicines JLP one agonists are very good to
help control appetite. So if you don't want to go
(40:06):
through with the weight all surgery, trying to get your
hands on one of these products through your health care
provider can help you control your weight because at the
end of the day, we still need to get your
weight down. The body functions better when your weight is
a normal weight. When you have excessive weight, then your
body doesn't function very well. It introduces a lot of disease,
(40:29):
and so the hyperhydrosis can be a chronic issue. But
I wouldn't let that get in the way of doing
whatever it took to get your weight down, because at
the end of the day, you need to get that done,
is to get your weight down. We can deal with
hydration issues later.
Speaker 8 (40:46):
The first Yeah, I remember you were talking about the
weight loss drugs as one of the pharmaceutical companies whatever thing,
they won't get on board with that.
Speaker 7 (41:03):
I've looked at that.
Speaker 2 (41:04):
The private is cost prohibitive.
Speaker 7 (41:07):
So yeah, insurance won't cover it. You gotta pay for it.
So I'm just looking at all options. And I'm not
you know, according to the chart, I'm obese, but you
know six' one run about two fifty to forty, five,
so you, know carrying about sixty pounds over but with my,
(41:29):
appetite AND i, said it's been like this for my whole.
Life i've seen doctors they say THEY i just have
an abnormally large appetite and OVER i get the harder it.
Is my only choice is walking Around hungary all the
time beyond what normal you, know sacrifice would be them you,
(41:51):
know considered weight.
Speaker 1 (41:52):
Loss, Absolutely, Alan we appreciate your PHONE. Covid at the
end of the shows are going to have to hang.
Up good luck to. You calls back next week and
we'll see you guys next. Week take, care
All right, welcome Southeast Texas Internet radio listeners. This is
your host, doctor Levine, coming to you live from the
studios of KLVI here in Bauma, Texas, crossroaugh from park
to the mall, taking your phone calls, talking about healthcare
and medicine to as the theme song indicates, stay alive
as long as possible and as healthy as possible. It's
(00:22):
complicated out there. It's confusing what to do, what not
to do. You hear so many different things from so
many different resources and sources and people you just don't know.
And we have one hour ahead of us to try
and figure out how to keep you alive as long
(00:42):
as possible and as healthy as possible. Remember, phone lines
are open eight nine to six klv I one in
one hundred three three zero klv I left. Hear from me,
Talk with you, Chat with you, See what's on your
mind in terms of what happened to you this past week,
and just the question of what can I do every
(01:04):
day to stay out of the hospital. Reduce my visits
to the doctor, reduce the number of medicines that I
have to take, so they don't have a sack of medicine,
so that I'm not spending all my heart earned money
on prescription medications and going to doctor visits. It's expensive
(01:29):
out there when it comes to medications and going to
the hospital. Yeah, it can be a lot. So certainly,
as you get older, your health is your most critical
and important commodity. And somebody lied to us, they said
(01:50):
the golden years, right, when you get older, the goldens
retire and just life is wonderful and you don't have
to go to work and you can just do whatever
you want. And for some people that is their experience.
You know, they've worked for thirty thirty five years and
(02:11):
they have a good retirement financially, their health is good.
We do see those patients. I would say they're not
the majority of the patients in my experience. I would
say at least less than half of my retire You
sort of have that scenario. One of the elements is
(02:35):
a lot of times missing. But you have to really
engage and do your part if you really want to
be healthy. As you get older, you really have to.
It's not automatic anymore like when you're in your twenties,
when you could just do whatever you wanted to and
(02:58):
your body tolerated it. You could stay up all night,
you could drink, you could eat whatever, smoke doesn't matter.
Your body's still going strong.
Speaker 2 (03:08):
Right.
Speaker 1 (03:08):
You could go work a full day eight hours with
zero sleep. I used to do that in medical school,
have to study for a test, be up all night,
not get one minute of sleep, and go take a test.
Supposed to get your sleep so your mind can be
(03:31):
ready to go and rest so you can use it.
But you're so nervous. The drilling is so high doing
that stage of your life. I mean, you're drinking coffee
all night, You're taking caffeine tablets. This is what I did.
I don't know what my other colleagues did, but this
is what I did to stay up to study. And
(03:53):
it's insane that you're able to do that. But there's
no way I could do it now. I mean, even
if I try to stay up all night, your body
feels so terrible when you don't sleep. I mean you
feel bad, achey, headaches, dizziness, sometimes, blory vision, mental fogginess.
(04:17):
I mean, you need that sleep. And insomnia is such
a big issue in our country. We don't really we
don't really talk about it that much. Insomnia or the
lack of a normal sleep pattern. We don't talk about
it that much, and you know, you hear about the
diet and the exercise blah blah blah. Right, we've heard
(04:39):
it before, doctor Levine, but we don't talk about sleep enough.
You need a good night's rest to be healthy the
next day. And unfortunately, there are a lot of factors
that lead to poor sleep habits. You know, getting that
good six to eight hours of rest at night, I
(05:00):
would say, is the average amount of time you need.
Some people can operate on four They just need four
hours of sleep and they're good. But most of us
need about six to eight hours of sleep just to
feel good, and there are a lot of things that
interrupt that. Probably the most common sleep disorder that we
(05:26):
have here in this country is obstructive sleep apnear ORSA
for short, and it's something that has gotten easier to
diagnose just because now there's a little home device that
you can wear. Can take it at home, take it
home and put it on, just a few little pieces
(05:46):
to the device, and it measures and monitors the way
you sleep, and you turn it back into your doctor's
office and then they analyze it to determine if you
have any obstructive sleep apnea. Now, just like we talk
a lot about knowing your numbers. I hadn't said that
in a long time, but know your numbers right, blood pressure, cholesterol, sugar,
(06:13):
it's a barometer to your health. Basically. There's a few
other things that they're throwing out there as well. A
coronary calcium test is another one, cardiac stress test, EKG,
echoes of your heart. These are other screening tests that
we do to try and risk stratify you to see
(06:36):
how you're doing. Do we need to put you on medication,
do we need further testing. So again we're trying to
stay ahead of the game as much as possible. So
if you're overweight, and the way you can determine that
is using the index of what we call a body
(06:56):
mass index or BMI. You may have seen that somewhere
and it's a ratio of your weight and your heighth
And they have these little apps that you can download
on your phone that can calculate your body mass index.
And if your body mass index is thirty are above,
you're definitely at risk for having OSA or obstructive sleep apnea.
(07:21):
Reason being is when you gain weight, you can you
when you have extra pounds on you. There's a certain
look you have.
Speaker 2 (07:31):
Right.
Speaker 1 (07:32):
Your neck gets a little bit more full, your torso
gets a little bit more full, your face gets a
little bit more full.
Speaker 2 (07:41):
Right.
Speaker 1 (07:41):
Well, a lot of that same fullness goes to the
throat area and the soft tissue of the throat, so
that area becomes large as well. If you will, and
as all of us float to sleep and get into
the deeper stages of sleep what you call rimram rapid
(08:02):
eye movement sleep. That's just how they categorize it. I
believe the throat muscles at some point relaxed. There is
a slight paralysis or relaxation of your muscles when you
go to bed, right, your body is trying to shut
down and fix itself and repair itself. That's basically what
(08:24):
sleep introduces is the repair process of the body.
Speaker 3 (08:28):
Right.
Speaker 1 (08:29):
A lot of times you get some sort of acute
problem whatever it is, right, pain, nausey, vomiting, headache, stomach pain,
whatever it is, and you say to yourself, I'm gonna
go to sleep. It's gonna go lay down, gonna take
a nap, I'm gonna sleep to solf right, And you
(08:50):
know what, A lot of times that's all you need.
You wake up the next day or after several hours,
you feel refreshed, You're ready to go. The symptoms have resolved,
right just going to sleep. The body has healing powers,
it really does, and we sometimes forget that in this
(09:13):
culture that we have, this pharmaceutical culture where every physical
ailment that we get, there must be a pharmaceutical product
at CVS or Walmart online that I can consume or
drink or inhale or smell or inject that's going to
(09:35):
resolve that physical problem quickly, easily, cheaply. Right, that's our
line of thinking with a lot of these physical ailments
that we get. And you know, for the most part,
there is medication out there for it. God bless them.
They're trying to help everybody out and provide all these
(09:56):
products to Americans to make them feel better when they
don't feel well. But your human body has healing Potential's
got to give it a chance, and unfortunately a lot
of our habits interfere with that process, like not being
able to sleep. So when you go to sleep, your
(10:17):
body's own healing processes go into effect and try to
repair the damage of the day and get you ready
to go for the next day, so you can tolerate
the stress of the day if you will. And if
you don't give your body it's ability to do that,
(10:38):
then it starts to cause breakdown in various areas. You
don't feel as well right, your energy goes down. You
might have aches and pains like can said, headache, dizziness,
I mean your eyes are burning if you don't get
that proper ress. But with obstructive sleep APPNE, it's sort
of a problem that evolves over time and it can
(11:01):
sort of slowly creep into your life. And a lot
of times patients don't really know they have it. They
just noted, don't feel good. You know something's off. I
don't feel the way I did when I was younger.
And especially if they live alone. We have missus. Why
(11:24):
do you like creep in here? You don't have your headphones?
The producer is gonna get them, is a micone? Can
you talk?
Speaker 4 (11:31):
Can you hear me?
Speaker 3 (11:32):
Yeah?
Speaker 1 (11:32):
I can hear you. You just like to creep in
here like you find my car keys? What happened to them?
Speaker 3 (11:40):
Well?
Speaker 4 (11:40):
They I guess I came home last night.
Speaker 1 (11:42):
And can you hear yourself? No, okay, I can hear you.
The producer wants you to ask the producer to get
you some headset, a headset. Missus Levigne has entered the
premises and at the building again she like, broke my
chain of thought.
Speaker 4 (12:00):
I think you were talking about sleep apne.
Speaker 1 (12:03):
Yes, thank you. I need her by my side to
talk about that. But it's a very common disorder. And
if your B and I is thirty or above, just
put that in. But if you know you a little
bit overweight, you probably have it. It's an extremely common disorder.
Have you done your B and I yet?
Speaker 4 (12:24):
I mean it's just getting on the scale and looking
at it right.
Speaker 1 (12:27):
Yeah, you have to put your height in as well.
So thirty or above is when you should get a
sleep apnea test, and we do those in the office
and it's very easy, very simple, and it allows patience
to determine if they have sleep app Now, a lot
of times I get this story about the why or
(12:47):
the husband has seen their loved one not breathing or
stop breathing or excessive snoring, but they don't do anything
about it. They just wake up, wake up, and then
they go on and they don't ever say go to
the doctor or.
Speaker 4 (13:04):
Well, they may not know what to do about.
Speaker 1 (13:06):
It, because it's a very violent thing to watch when
you see your loved one struggling to breathe, like they're
not breathing at all, and you hear how rough the
snoring is. I mean, it's really and this is a
severe sleep apnea. I would say most of our patients
fall into the mouth to moderate sleep apnea. But nonetheless,
(13:29):
it is a disruptive way of sleeping. I mean, you
know how important sleeping is, right, Oh?
Speaker 4 (13:36):
Absolutely.
Speaker 1 (13:37):
When you don't get your rest at night, it's just
it's hard to function the next day, right, yes, I
mean did you have to when you were studying for
your nursing degree? Did you have to stay up all
night and not get any sleep at night time? Did
you ever have to do that? They call it, we
used to call it an all night.
Speaker 4 (13:56):
All night or I was young back in those days,
so I'm sure I did a lot of all nighters.
Speaker 1 (14:01):
Do you remember doing them?
Speaker 4 (14:02):
Though? Really? I mean I remember staying up and studying
all night. But then there's a point you just have
to go to bed and wing it. Not me, It's
like the more you study, the more you forgot. So
I just gave up. No, But I always made really
good grades.
Speaker 1 (14:20):
I was so nerved up that I couldn't go to sleep.
Speaker 4 (14:23):
I mean, I think your education was a little bit
more serious than mine.
Speaker 1 (14:26):
Yeah, but I had classmates of mine that they didn't
stay up all night.
Speaker 4 (14:32):
They were gifted. You weren't gifted, baby.
Speaker 1 (14:35):
I know.
Speaker 4 (14:35):
I wasn't gifted.
Speaker 1 (14:36):
I had to I had to really work hard to
get that that degree, you know. But they were I know,
I know. And I was exposed to these these guys
that and females when I went to Rice University in Houston, Texas.
I mean, you're you're working and dealing with some of
the smartest people at the time, and they were just
(14:58):
mentally gifted. They could absorb information, process it with little effort.
Not like them, not like I'm telling it was intimidating,
to be honest with you, to understand that there are
people out there like that, whether their brains just work
more efficiently processing information, knowing how to toss that information
(15:25):
around and spit it out in different ways and just
retain it. That was the thing that was important in
medical school. Medical school wasn't too tough, just a lot
of information that throwing at you. To sort of keep
it oriented then, especially for a test, you have to
just sort of recount all this information that was given
(15:46):
to you. Not that it's tough. You're not figuring out
math problems and chemistry problems that was difficult, but just
the amount of information. So yeah, the energy it took
to do that for me was higher than some of
my other colleagues. I mean they would be comfortable just
you know, peacefully going to their test and they got
(16:07):
a good night's rest.
Speaker 5 (16:09):
And maybe I just had breakfast and maybe worked out,
you know, I was like studying to the end going
into the test room.
Speaker 1 (16:20):
I'm still looking at information anyway. Phone lines are open
eight nine six kelvy I won one hundred and three
to three zero klv I'm surprised by Missus Levine. We'll
come back in two minutes. Take care, all right, Welcome
back to the doc Lavine Metical. Our phone lines are opened.
Eight nine six KELVA won one hundred three three zero Kova.
(16:41):
I was sitting here chatting with Missus Levine. We're talking
about obstructive sleep appnear or OS A for short, very
common disorder that we all should be looking out for.
We have the little device in our office is that correct?
How long we had that long time?
Speaker 4 (16:59):
But you know, well you take it home and sleep,
so mm hmmm.
Speaker 1 (17:04):
That was the problem back in the days. You had
to go to sleep lab, which they still have these
sleep labs, but it's a little commersome, right.
Speaker 4 (17:11):
It's not in the comfort of your own home. It's
in another bed and you're hooked up to probes and
people are watching you, and it's I've never done it,
but I don't think I would sleep my greatest mm hmm.
And you're supposed to sleep your greatest so that it
can measure things.
Speaker 1 (17:26):
Yeah, that's correct. And it's sometimes hard for people to
just be away from their house at nighttime. They have
responsibilities at home and it's difficult to leave that environment,
go to, like you say, yes, a foreign environment and
sleep for several hours. And that did interfere with a
lot of patients being properly diagnosed with sleep after they
(17:48):
just couldn't accomplish that kind of like we have with
colon cancer screening. How when I graduated, we were still
doing what they call flex SIGs or flex sigma, which
is basically a colonoscopy, but it only looks at half
of the colon, and then we figured out that some
cancers were on the other side of the colon and
(18:08):
they would have a normal flex SIG but then actually
have cancer we diagnosed later, so they did away with
the flex sig and now it's just a full colonoscopy.
But at one time that was really all that we
recommended for colon cancer screening. Now we have these stool kits,
right colon guard that come to your house and you
(18:31):
can sort of process it yourself. I mean a lot
of people fairly. Yeah, I mean it's it's it's more
automated than it was when it first started. Well we've
had it in the office for five six years something. Yeah,
So and they do advertising and it's it's a very simple, quick,
easy way to do colon very convenient, just because again
(18:55):
doing a colonoscopy, what that requires a referral you got it.
Speaker 4 (19:00):
First of all, you got to prep for it, so
you got to drink this stuff and clean your colon out. Yes,
then you have to have someone drive you, you have
to be put to sleep under anesthesia, and then you
have to get up and carry on about your day.
Speaker 1 (19:13):
So yeah, so it's a lot of obstacles to perform
the colonoscopy. So as a screening tool, you know, it's
it's not the best in the sense that we're not
reaching a lot of patients in terms of getting their
colon cancer screen It's got to be easy, simple, quick, fast, cheap,
(19:34):
that sort of thing. So that's what while the stool
kit works. And again just to reiterate to all of you,
if you want to do the stool kit, that's fine,
but you have to have a very low risk of
colon cancer, like it shouldn't run in your family. You
shouldn't have any physical symptoms whatsoever like anemia or rectal
bleeding or abdominal pain.
Speaker 4 (19:55):
Abnormal patterns.
Speaker 1 (19:57):
Yes, it's really got to be for the most average
risk patient, which is most Americans. Right, Most Americans don't
meet that criteria. Most Americans are low risk. But again,
colon cancer is a big issue in our country, and
we now start screening at forty five years of age,
(20:17):
whereas go ahead.
Speaker 4 (20:18):
Isn't colonoscopy the highest standard of care?
Speaker 1 (20:22):
Well, it is the if you look at everything. It
is a very good test to look inside your colon.
But again you're.
Speaker 4 (20:31):
Evasive, more risk, dangerous or whatever.
Speaker 1 (20:34):
Well, it's just cumbersome. And when you talk about a
screening test like a blood test, a PSA test, the
screening test has to be easy to do. It's got
to be affordable, it's got to be convenient if you
want to have one hundred percent compliance, So you want
(20:54):
to approach one hundred percent compliance with the screening test,
almost like vaccines. I mean, we want one hundred percent
compliance with vaccine. So we've got to make it easy, fast, cheap.
It has to be on that level. If there's there's
complications or there's obstacles to getting that, then it's just
not going to be done, and then people will miss
(21:15):
the opportunity to get screened for their colon cancer. So
that's why these stool kits are really good adjunct to
colon cancer screening. Yeah, if you have the time and
the ability, Yeah, get a colonoscopy. No, I don't think
anyone argues about that. But we're talking about all the
other people that are out there that just can't get
to the doctor's office. They can't take office kind of
(21:36):
like the sleep apnea. Now that we have the device,
you come to the office, you see your doctor and
they're like, hey, I think you have sleep appening. You're
a BMI stard of or above. Take this device home?
Is it that simple?
Speaker 4 (21:52):
Is that simple? I mean, we register the device in
their name.
Speaker 1 (21:55):
Mm hmm.
Speaker 4 (21:55):
We give them instructions. It's very straightforward. When they go
home and go to bed, they hook it up. It's
not a bunch of probes. It's not all the things
that are in a lab. And then you drift off
to sleep. You bring it to us the next day,
and then we we send it off to a company
who reads it.
Speaker 1 (22:11):
Then you have your results and may it be done
within a day or two. And then if you do,
if you are confirmed to have sleep apnea, then the
most immediate treatment is this device called a SEPAP machine
continuous positive airway pressure. And the machines have come a
long way. When you and I graduated from our medical training,
(22:34):
the devices were pretty big and loud and loud and.
Speaker 4 (22:40):
And we dry out the nose, yeah, nose bleeds and
all those.
Speaker 1 (22:44):
It wasn't the best. And so guess what, most people
didn't use them, right, even though they have had sleep apna,
they didn't use them.
Speaker 4 (22:51):
And the mask don't fit the greatest.
Speaker 1 (22:53):
You know, well, back in the day, they didn't they've
come a long way, they've gotten a lot better, so
patients are able to be more compliant with the device.
So number one, we've made it easier to be diagnosed.
And again all of the listeners out there, if you're
if you know you're of a weight. Most people know
they're of a weight, right, I would think, so just
(23:14):
look in the mirror, like, look at these jowls. Look
at my neck. It's kind of big.
Speaker 4 (23:20):
They may not go that far, but.
Speaker 1 (23:22):
Or they have to sort of loosen up that belt, right,
and they're putting on those favorite para of jeans. I
wore them a few musco Oh, it was getting a
little tight when I put them on.
Speaker 4 (23:34):
Chose. It's a little bit more of an effort to
reach down there.
Speaker 1 (23:38):
That's right. They don't see the feet anywhere. Yeah, most
people know when they're a little bit overweight. And so
if you are, just again, the test is simple. It's
just as easy as getting a blood test or an
EKG are checking your blood pressure. These are things that
we want patients to kind of keep up with, especially
as you get older. Again, you have to invest more
(23:58):
time into your health as you get older. If you
want to be healthy, you want to stay out of
the doctor's office. It's not as simple as taking a
tablet or a vitamin supplement that you see. We unfortunately
still answer those questions in the office. Our patients come
to the office and they've seen a commercial, they've seen
(24:22):
an advertisement, and they buy a box or a container
of a vitamin or vitamin supplement or diet. I mean,
there are so many out there, I would you can't
even count them with all these weird names and all
this weird packaging. And they're like, hey, I want to
(24:44):
try this for this, or I want to try this
for that, and you know I don't. I certainly want
to support them and I want them to feel good.
And if patients want to try things, I'm all ford
because most of these dietary supplements are not harmful, but
most of the time they just don't have the research
(25:05):
that they need to endorse. The main thing, like you
know and I know, is number one, you have to
have that diet right, and then number two just be
physically active. And then three, yes, sleep, so if you're overweight,
get your sleep apnea test so that you can figure
that out. And then yes, if your doc knows, get
(25:28):
your c pap machine. Phone lines are open eight nine
six Kalva at one one hundred three three zero Kalvia City.
(25:51):
All right, welcome back to the doctor. The medical phone
lines are open eight nine six Kalvy. I win one
hundred three three zero Kovia chatting with this levine sharing
sometimes Levigne Leonard from Houston. How can we help you?
Speaker 3 (26:03):
A couple of weeks ago, we talked about my low
blood sugar numbers.
Speaker 6 (26:07):
Yes, sir, and it was agreed that I would stop
all of the farsiga and stop the insulin.
Speaker 3 (26:17):
And when I did that, I got numbers of one
hundred and eighty five hundred and ninety. So I went
back to one farsga a day and that got me
down to one hundred and eighty one hundred and seventy five.
And I'm just wondering how long I should stay allowed
or stay at one hundred and eighty before I go
(26:37):
back to some measure of insulin.
Speaker 1 (26:41):
Well, then, I just want to make sure that you're
communicating with your healthcare professional. Are you working with your
healthcare professional to adjust these I.
Speaker 3 (26:52):
Tell them what I'll call and tell them what I'm doing.
They say, Okay, give it a try. You know that's
basically what they're saying.
Speaker 1 (27:00):
Okay, yeah, I'm just a radio personality. I just want
to make sure that you are working with your healthcare provider.
I'm not your physician. But in general, in these situations,
if this were my patient and the blood sugars were
still staying a little bit high in one point eighty
range in the morning, that is above our targeted goal
(27:23):
of high sugar. So we would yes, probably recommend or
agree with increasing the farciga up to its ten milligram
dose as the highest you can take a farciga and
would judge and see how that adjustment would help with
your blood sugars. And so then certainly brings is used
(27:43):
but can introduce low sugar issues. So farsiga the way
it works is it is less likely to cause hy
poke lycemia. So that's probably why I be better to
adjust to farciga before adding back on the end. So
that would be a general recommendation, but certainly, like I say,
(28:04):
we would like you to make sure that's okay with
your healthcare provider, your prescriber of these medications.
Speaker 3 (28:13):
Well, I call him on Monday. But so the recommendations
go to two farciga a day instead of one farciga
and some insulin.
Speaker 1 (28:23):
Yeah, that's a that's a general recommendation, and that is
something that we can do in these situations. But again,
I'm not your physician. I'm just a radio personality, and
you need to make sure your your doctor is okay
with that before you make that change.
Speaker 4 (28:41):
So didn't you say ten milligrams of farsigo?
Speaker 1 (28:44):
Yes?
Speaker 4 (28:44):
Is that one or two?
Speaker 1 (28:45):
That's two?
Speaker 4 (28:46):
Okay?
Speaker 1 (28:47):
Yeah, of the five milligram yes.
Speaker 3 (28:49):
So that'd be one in the morning, one and after
one at night.
Speaker 1 (28:52):
You could do it that way, or you could just
take two in the morning.
Speaker 3 (28:57):
I prefer to do one in one.
Speaker 1 (28:59):
Yeah, you can try that out.
Speaker 3 (29:02):
Gives me something to do.
Speaker 1 (29:04):
Okay, be sure and check with your doctor though first.
Speaker 3 (29:07):
Okay, Yes, all right, brother, thanks big guy.
Speaker 1 (29:10):
All right, take care and uh yeah, Farsiga belongs to
a category of diabetes medicines we call sgl T two inhibitors.
We know about gop one, right, it was zimpic and
semi glue tide. We know about that one. Do we
still do that in the office?
Speaker 4 (29:29):
Yeah?
Speaker 1 (29:30):
How's that going?
Speaker 4 (29:32):
It's going good. I mean, patients come and go because
they lose the weight they want to lose, and then
they go about their day.
Speaker 1 (29:39):
Have we figured out how successful the program has been
or if the medicine that we are prescribing works for them?
Do we know anything like that? Do we figure that out?
Or what are most patients saying? Or I don't hear
a lot about it? To be honest with you.
Speaker 4 (29:58):
Well, then that means it's doing its job. If you
don't hear a lot about it, but not really.
Speaker 1 (30:02):
A lot of times patients don't want to talk about
negative things, and when they come in, it's like I'm
just going to ignore them.
Speaker 4 (30:09):
I think it works very well. I think the patients
are happy. Most of our patients have made it to
their goal weight. So we have patients that go off
the program, then we have new patients that come on
to the program. But you know, it's working as far
as I know. I mean, I've not been told any different.
Speaker 1 (30:29):
I think the one thing I hear a lot is
that they have to come in weekly.
Speaker 4 (30:33):
But that's anywhere they go. Yeah, no matter where you go,
no matter where you get your weight loss program from,
you have to go in weekly.
Speaker 1 (30:42):
You know what sometimes to in order for patients to
tolerate the medication. Sometimes we'll have them go every two
weeks with the medication. That's something that we can do
at our program. Right They don't necessarily have to come
every week. It's recommended you come weekly. But if you
can only squeak in every two weeks, that's something that
they can do as well.
Speaker 3 (31:03):
Right.
Speaker 4 (31:04):
Well, I feel like if you're wanting to lose weight
and it's that important to you, then you make the
time to come.
Speaker 1 (31:10):
I heard that, John from Houston. How can we help you?
Speaker 3 (31:14):
Oh?
Speaker 2 (31:14):
Yes, I just want to get your opinion on getting
prescribed maybe abuse bar for the for some mile OCD strip.
Go ahead, Yes, I hear that.
Speaker 1 (31:33):
Yeah, bus spar abus sperone. It's an old school anti
anxiety medication and it's still being used today because I
guess when I finished my medical training, the benzo diazepine
category was being heavily used by practitioners. That's things like xenax,
(31:56):
our praisealam, klonipin, valum. They were using that a lot
for anxiety. And in this day and age right now,
we're trying to be safer and trying not to expose
patients to medicines that have sort of a abuse potential. Yes,
(32:16):
so abuse spar or abuse sperone is one of those
products that we've kind of reached back and started using
again because it's felt to be safer, less addicting, and
I think for someone who has a psychiatric disorder like
bipolar disorder, which can sort of go between anxiety depression,
can be used. It's not the primary medication when you
(32:39):
have bipolar disorder, but I think it can be used
in addition to some of the other mainstream frontline medications.
So yes, it can be used to help manage the
symptoms of bipolar disorder, normally as an add on.
Speaker 2 (32:57):
Or like an OCD.
Speaker 1 (33:00):
I'm sorry, I apologize OCD, yes, sir, yes, sir, so yes.
Speaker 2 (33:04):
Uh yeah, so that's that's that's good to know. Yeah,
I'm trying to stay clearer from the from the other alternative.
I just wanted to make sure if that's even effective,
you know.
Speaker 1 (33:18):
I mean, not for everyone, but again, it's still a
good product in my opinion and in my experience, and
can be used in various psychiatric disorders like OCD. It's
not probably the main medication we use for OCD, but
again can be used as an as a second line
or a third line medication if you're not responding to
(33:39):
the frontline medication and it's normally well tolerated, doesn't have
a lot of toxicity issues. So I think if yeah, yeah,
it does not have abuse, but typically no abuse potential,
you don't need a special prescription. It's again considered low risk,
(34:00):
So yes, that would be a good option for you
if you were concerned about that.
Speaker 2 (34:05):
Okay, well, I appreciate you.
Speaker 1 (34:07):
Appreciate it, John, thanks for the phone call. Don't get
a lot of psychiatric calls on this show, but mental
illness psychiatric disorders are huge in this country, and any doctor,
I don't care what you get into, normally has exposure
to psychiatric diseases such as anxiety or depression. I wouldn't
(34:32):
say insomnia is a psychiatric disorder, but certainly those two
categories anxiety depression are huge. OCD are Obsessive compulsive disorder
is certainly out there as well and has been recognized
more and more. I think most people are just a
little embarrassed when they feel like they have OCD and
(34:53):
they just kind of deal with it because they can
a lot of times get through the day, but sometimes
it gets pretty bad and because of the behaviors. They
can't function normally, like they can't just go to work
and just be at work and come home, and sometimes
even the home situation is kind of bad as well,
(35:16):
you know, just all the things that you have to
do to keep that disorder in line. But I think,
and again I'm not a psychiatric expert, and it's been
a while since I read about OCD, but I think
the what we call SSRIs like Zoloft, paxel lexapro cyitalopram,
(35:37):
these are the medications that normally are reached for when
it comes to OCD if the disease is crippling the
patient where they can't seem to function well. And I
think most people are high functioning OCD patients, there's probably
a small segment that it's so severe. Like I said,
(35:58):
they just pretty much are going in circles. They can't
really function very well, and it's it can be a
very hard disease to deal with in terms of OCD. Now,
like I said, anxiety depression. Our country, our culture is
just designed to be stressed. We see all the media,
(36:18):
we hear all the things in the radio and the TV,
and it's just very stressful and were stressed about this,
and we're stressed about that, and we're paired not about
this and paired not about that. And I hear that
a lot in my office. And yes, sometimes it can
cause some low level anxiety depression, but these are psychiatric
diseases that normally require medical therapist, especially as one gets older,
(36:43):
it does require that to be done. And again, behavior modification, Yes,
we've we've come a long way in this country recognizing that, hey,
you know, we need to really deal with this. This
is real, it's nothing to be embarrassed about. We just
need to know about it, and we want to try
and help you. And the America has really responded to
(37:04):
that and done what it can to recognize these patients
and give them therapy so that they can get better. So,
if you have any issues with OCD or anxiety depression,
you know, go talk with the healthcare provider and see
if they can get you fixed up. Phone lines are
open eight on six kalvy. I want one hundred three
three zero kovy. I'm going our last break, all right,
(37:34):
welcome back to doctor Matago. Our phone lines are open
eight one six kalvy. I want one hundred three three
zero klv I at the ended the program talk with
Missus Levine again. If you have a topic that you
would like me to talk about, call the station or
call the office and we can talk about it, because
the genesis of the show is to provide you with
information so you can help you and your family figure
(37:55):
out how to stay alive in as long as possible.
Real quick, we have some new testing in the office.
Is that correct that you wanted to share with the public.
Have No, you blew up the microphone again. No, I
think I hear you. Now, there you go.
Speaker 4 (38:16):
Can you hear me?
Speaker 5 (38:16):
Yeah?
Speaker 1 (38:17):
Hold on, Alan from Vider, How can we help you?
Speaker 3 (38:21):
Yeah?
Speaker 7 (38:21):
I had a question a week or so ago. You
were talking about gastric bypass surgeries and you know, weight
loss surgeries. That was something I was once considering. I
have a abnormally massive appetite. It's it's been my whole life,
(38:43):
all the way back to the seventies. I'm pushing sixty
now and I struggle with For me, it's not overeating.
I eat just as much as it takes to you know,
satisfy me or fill me up. But it's twice the
normal grown man. I was considering that just to reduce,
(39:04):
you know, the the intake. But one of the things
I consider is I have I think what you call hyperhydrosis,
and I do a lot of work outside and because
of my sweating, I can't really it's very difficult for
me to stay hydrated. And I was wondering if I
(39:26):
did anything like the like the weight loss surgeries with
limiting possibly my water intake, if that would just exacerbate
the hyperhydrosis. And I'm pushing heat, exhaustion and he stroke
because I can't stay hydrated. Wondering what you had to
say about that.
Speaker 1 (39:45):
I mean, Allen, that's a that's a good concern. However,
in terms of prioritizing your health, I still would recommend
trying to have surgery to get your weight down or again,
these diabetes medicines JLP one agonists are very good to
help control appetite. So if you don't want to go
(40:06):
through with the weight all surgery, trying to get your
hands on one of these products through your health care
provider can help you control your weight because at the
end of the day, we still need to get your
weight down. The body functions better when your weight is
a normal weight. When you have excessive weight, then your
body doesn't function very well. It introduces a lot of disease,
(40:29):
and so the hyperhydrosis can be a chronic issue. But
I wouldn't let that get in the way of doing
whatever it took to get your weight down, because at
the end of the day, you need to get that done,
is to get your weight down. We can deal with
hydration issues later.
Speaker 8 (40:46):
The first Yeah, I remember you were talking about the
weight loss drugs as one of the pharmaceutical companies whatever thing,
they won't get on board with that.
Speaker 7 (41:03):
I've looked at that.
Speaker 2 (41:04):
The private is cost prohibitive.
Speaker 7 (41:07):
So yeah, insurance won't cover it. You gotta pay for it.
So I'm just looking at all options. And I'm not
you know, according to the chart, I'm obese, but you
know six' one run about two fifty to forty, five,
so you, know carrying about sixty pounds over but with my,
(41:29):
appetite AND i, said it's been like this for my whole.
Life i've seen doctors they say THEY i just have
an abnormally large appetite and OVER i get the harder it.
Is my only choice is walking Around hungary all the
time beyond what normal you, know sacrifice would be them you,
(41:51):
know considered weight.
Speaker 1 (41:52):
Loss, Absolutely, Alan we appreciate your PHONE. Covid at the
end of the shows are going to have to hang.
Up good luck to. You calls back next week and
we'll see you guys next. Week take, care
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