- 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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Speaker 1 (00:00):
All right south these texts in radio listeners, Welcome to
another edition of The Doctor Leavine Medical Hour. I'm your host,
Doctor Levigne, coming to you live from the pseudos of
kov I hear in Boma, Texas, cross street from Parkdale
mal Tech and your phone calls and answering questions about Yes,
as the theme song suggests, how to stay alive, I
never get tired of that song as Yeah. Every day,
(00:22):
serving as a primary career healthcare professional, we're trying to
help patients figure out what it is they need to do,
what it is their family needs to do to try
and stay alive as long as possible and be healthy
as long as possible. Remember, it's no fun being sick
and ill all the time, being in the hospital, having
to take a lot of medications, and having on a
(00:43):
doctor's office every week every two weeks, or just be
lined up with doctor Visit's unfortunately sometimes it happens even
though you did everything right. But we're trying to lower
your risk of that happening to you. So that's the
genesis of the show. And also just to filter all
of the information that you're getting every single day about
and what is the best thing or the right thing
(01:04):
or the wrong thing to do in terms of your
habits in staying healthier and staying alive as long as possible.
So it can be confusing out there. We're getting a
lot more information that is given to us about that.
So we're here to try and help you figure that out.
Phone line to open eight nine to six kelvy I
one in one hundred and three three zero kilva I.
(01:27):
We would love to talk with you. Love to chat
with you. It's two way radio. And give us a
bus so we can help you and figure out what
it is is on your mind. Remember, we're big believers
in vaccines, so those vaccines are still out there, more
so than before. And again the technology has changed. They've
(01:49):
gotten better, cleaner, and more effective. So it's the weekend.
I know you've been putting off getting your vaccine, so
you can take this opportunity to go to your pharmacy
and get your vaccines. They normally have good records in there.
Remember you can still get the infection when you get
the vaccine, it just lessens the severity of the infection
(02:12):
if you get it. We talk a lot about cancer,
we talk a lot about cardiovascular disease.
Speaker 2 (02:17):
On the show.
Speaker 1 (02:17):
But remember infections is a big cause of morbidityter mortality.
As we all get older, that term called sepsis, sepsis
most common. Folks are getting used to that term and
it strikes fear in most people's concerns, most people's hearts
(02:40):
when they hear that term sepsis, and it should. But again,
just a medical term that we use to describe what
happens when someone gets an infection, just to help everyone
sort of categorize what is helping so that we can
have a more systematic approach two SEPs is if you
(03:03):
do not know, but certainly when I came out, it
wasn't as orchestrated as it is now with the treatment
of sepsis, as is well with cardiovascuses and strokes, meaning
the healthcare system is always working on getting better and
smoother and more efficient. If you've ever had a heart attack,
you know there is a systematic approach to managing that
(03:27):
from the time ems gets to your house to the
time you get to the hospital and beyond. Same thing
with strokes. They call those stroke alerts as well as
cardiac alerts. They have those in all just about all
major hospitals. That's sort of the standard of care, and
they have that same approach with sepsis and treating sepsis.
(03:49):
Not that they're calling sepsis alerts, but there is an
understanding from the time you hit the door, from the
nurse that trioges you, to the er doctors, to the
doctors that take you and the hospital, there's sort of
an understanding about the importance of getting on top of
sepsis and treating it as aggressively as possible. Bearing in
(04:10):
mind that again certain infections, depending on the patient and infection,
can be just an overwhelming situation. Meaning everything was done
in a timely manner, they got the right testing, they
saw the right doctors, but yes, sometimes the severity of
the sepsis episode can be overwhelming to the human body.
(04:33):
And again it's something else I always try to remind
my elderly patients sixty five and above, or anyone who's
getting older for that matter.
Speaker 2 (04:44):
The immune system.
Speaker 1 (04:45):
Yeah, we don't really think about it that much until
we get sick, but the immune system is one big
system that unfortunately weakens as we get older. It's programmed
into our program and it leaves us vulnerable for all
sorts of infections, which is why the risk of infection
(05:07):
starts to climb as you get older. I mean, all
sorts of things can just sort of go wrong. I
have conversations with patients in the hospital all the time
trying to figure out, you know, why did this happen
to me? I feel like I've been doing everything I
can to stay out of the hospital. I've listened to
everything you've told me, and I do it religiously every
(05:27):
single day. You know, why did I end up here
in the hospital with an infection? What did I do wrong?
And again, the answer to that a lot of times
is you didn't really do anything wrong. Just unfortunately you
are seventy seventy five and infections is just common. We
don't really have vaccines for bladder infections or skin infections,
(05:48):
you know what I'm saying. So it's just a strong
possibility that as one matures and gets older, you might
get a pneumonia, you might get a skin infection, you
might get a infection of your colon.
Speaker 2 (06:03):
We call that colitis.
Speaker 1 (06:04):
That's a very common condition that we do see often
as one gets older, you're just growing about your day,
then all of a sudden you have this severe down
on pain. Maybe it's associated with some diarrhea or some
blood in your stool. You feel pretty bad, you feel weak,
and maybe you might have some nausea, vomiting, los your appetite,
(06:27):
and you go in to get checked out and waym
there it is, you know, some colitis, So you want
to try and do what you can to lessen the
possibility of that. And if you do get that infection,
you're as strong as possible without a lot of what
we call comorbid illnesses, meaning when you start stacking all
these chronic medical problems on top of each other. Yeah,
(06:50):
everything is fine and dandy as long as you're not
acutely sick, you don't have some acute medical crises, everything
is fine. But once you get an acute medical crisis
or as I say, medical trauma on your system, it
will stress your system out. And if it's already chronically
(07:12):
ill or chronically stressed out, again, it's just not prepared.
It's just not ready. It's just not strong enough a
lot of times to handle even more physiological and medical
stress and can cause a lot of collateral issues once
you get into the hospital. Which I hear family say
(07:32):
this a lot, and I have to answer this question
a lot in the hospital. You know, patients come in
with one thing and then by day three or four
they've already been diagnosed with four or five things, or
things kind of keep happening, and it's sometimes hard to
get the disease or the crises to turn off and
start getting better, even though we're trying everything that we
(07:54):
know to try at any hospital. Just sometimes the condition
is severe enough that the patient's bot it's just not
strong enough, and it continues to decline, it continues to.
Speaker 2 (08:05):
Have collateral issues.
Speaker 1 (08:07):
We do see this a lot of times with stepsis,
or even if you go to a hospital for a
heart attack or stroke or dehydration, whatever you're going to
the hospital for, sort of like opening up the Pandora's
box as it pertains to the human body. You want
to try and alleviate the medical crises as quickly as possible,
(08:27):
and that's really the job of most of the hospital
healthcare professionals that treat you, is what can we do
to kind of turn this off asap, because you just
don't want it to last too long. In doing so,
it just sort of stresses the body out even more
and leaves you more vulnerable for all sorts of things
to start happening once you get in there. We're doing
(08:50):
our best to try and turn off that interaction with
your the disease and the human body with the use
of iv antibiotics or fluids or other more specific medications
that we use there in the hospital. So go get
your vaccines as soon as possible so we can keep
(09:11):
you out of the hospital anyway. Phone lines are open
eight nine six kalvy out one hundred three to three zero. Kaleva.
We're going to our first prey. Give us a call,
all right, welcome back to the doctor Lovelean Medical. Our
phone lines are open eight nine six kov out one
one hundred three three zero ko v. I again sitting
(09:33):
here chatting about getting your vaccines. But certainly, as we know,
the country is dealing with issues of weight gain and
how to get it off. That's a constant conversation we're
having every single day trying to help adults figure out
how to get their weight down. And the truck that
has really allowed most Americans to do that that's out
(09:54):
there in the market now, these GLP one agonists, you
know it as ozimpig or. We're go v Jaro zip
bound trulicity will go vy. These are, in my opinion,
blockbuster medications that help in so many different ways to
get you through the day without thinking you have to
eat three times a day, which, again, in my opinion
(10:17):
as a physician, based on my reading about sickness and
disease and treating patients with sickness and disease, what we
are taught, you know, at a young age, I remember
the food pyramid, and just in general, how our society
is set up, you know, in terms of its eating intervals,
(10:40):
you know, breakfast, noonish, lunch twelve one o'clock, and then
some sort of big massive dinner at six pm, seven
pm once you get home from work, in my opinion,
is just too much eating, in my opinion, as compared
to the types of foods and beverages that are now
available to us, which normally what we call high calorie,
(11:02):
are what we call obesogenic, meaning if you consume these
foods and beverage items, as on the average most people do,
it will tend to generate weight gain. An idea of
going all day without eating is a strange idea for
a lot of patients, just because again society, our society
(11:24):
is sort of set up to kind of consume three
times a day a meal, either at home or a
restaurant or at work, and the idea that if you
don't get that meal in, then something bad is going
to happen. I mean, that's sort of an understanding of
most people. And so when they wake up, they're looking
(11:45):
to break the fast. That's where breakfast comes up. Right,
You're breaking your fast because you just slept for what
six seven eight hours. Fasting is just a medical term
we use for not eating any solid food or not
drinking any beverages that have any calorie content in it.
You're fasting, so your body is having to sort of
(12:06):
generate its own energy. And in my opinion, based on
what I've read and based on what I see, it
is a healthy way to get control of your health
is to give you your body a break from consuming
or having a breakdown food or beverages in terms of calories.
(12:28):
Give your bodies a break in doing that. And again,
I think if you look at some of the intervals
if you want to do a fasting program, I think
twelve hours are sort of the average fast time or
interval that most people choose. What would probably be one
maybe eating a solid meal once a day, and then
(12:49):
throughout the throughout the day drinking beverages that have no
calories in them, water, coffee or tea. You know, I
talk about that all the time. And again there's a
lot of flavor coffees, a lot of flavorite teas out there,
and again a lot of times they contain other nutrients
that are anti inflammatory, that are good for your digestive system,
(13:12):
your immune system. Again, just go to the major supermarkets
here in town, HB, Walmart, Target, wherever you get your food,
Brookshire Brothers, and go down the tea owl. And it's
not just a few little varieties. I mean, there are
just several varieties of coffee and teas, and then there's
(13:35):
all of these devices that you can brew them in.
So you can drink coffee warm, you can drink it cold,
same thing with iced tea, same thing with water.
Speaker 2 (13:43):
Right, you can.
Speaker 1 (13:45):
Sort of do certain things to the water to kind
of liven it up a little bit. It can't get
a little boring when it comes to all these other
beverages that are out there that are fizzy and have flavor,
and there's sort of this experience and drinking and so
it's kind of fun to do it. The packaging looks cool,
(14:05):
the bottle looks cool, so you know, you purchaser, there's
more of this emotional connection or attachment to the beverage
gives you a certain experience. You know, water, it's just
kind of bland and boring. There's no taste to it.
It's just there's no color, there's no fizz, there's no story.
Just with all the competition out there, it just sort
(14:25):
of gets pushed to the back. But again, if you're
in a position or situation where you're trying to get
control of your health, that's one thing that you need
to do is look and see what you're drinking, Look
and see what you're eating. And again, this idea of
giving yourself some time in between eating and drinking does help,
in my opinion, and can help resolve a lot of
(14:47):
the physical issues that you might have in terms of
being overweight. But again, it's tough just because there's so
many opportunities to eat and drink every day, whether it
be at work or whether it be at home. It's
just hard to say know. Once that hunger pain starts
to get to you, are the food noise as they're
now calling it, the food is just sort of in
(15:08):
the background calling your name. You know, while you work,
things slowed down, it's nothing to do, and somebody brought
some pastries, or there was a party yesterday, and it's
just that nice piece of chocolate cake that's sitting there
waiting for you.
Speaker 2 (15:21):
Are those chips that you.
Speaker 1 (15:23):
Brought from home the previous day, or whatever the case
may be. You know what I'm talking about. These medications,
the golp one agonists such as Monjaro or go vi
et cetera zep bound allow you really to comfortably ignore
the food noise and go many hours without eating. And
(15:44):
basically all that means is that you're not consuming the
calories and your body is in a fasting state. There's
just been multiple studies and multiple experts looking at this,
and metabolically your body works better in a fact statement,
meaning your immune system works better, your cardiovascular system works better.
(16:05):
So if you can find a way to introduce fasting
into your lifestyle, it typically is a positive in terms
of getting your weight down treating pain, because if you
do not know, as you gain weight normally you will
start to experience pain somewhere, whether it be and your
(16:26):
supporting joints like your knees or your ankles, your feet,
and your lower back, the lumbar spine. Man it gets
a lot of beating a lot of times.
Speaker 2 (16:37):
When you start.
Speaker 1 (16:37):
Gaining weight, typically weaightgain will introduce some sort of pain
experience that you might have to deal with, meaning just
doing normal activity. You might wake up with joint pain
or with some normal activity like moving furniture or cutting
the grass or just working around your house. Because be
(17:00):
and because weight pain tends to turn on the inflammatory system,
these parts of your body, your joint system, your muscular
skeletal system, will start to generate pain. A lot of
patients come to the office complaining of sort of back
pain or chest pain. Normally, when sort of they twist
their torso or they're bending forward, or they're sort of
(17:21):
trying to reach around and grab something, they start getting
pain in their back area, around their chest area. Sometimes
it comes to the front of their chest. That's a
common complaint. Also, sort of the upper back area is
another common area where we start. Patients start having pain
in that area. But you know, no, certainly you cannot
ignore the knees or even the shoulders or the neck.
(17:45):
You wake up with that crick in your neck, like
what did I do? But you have to understand the
power of weight gain and what it does to the
human body in terms of affecting how it behaves metabolically.
Speaker 2 (17:59):
A lot of.
Speaker 1 (18:00):
Abnormal milieu hormones start getting released into your system, which
then impact your cholesterol, impacts your sugar, impacts your blood pressure.
Like I said, your immune system, your joint system. Yes,
gaining weight will normally lower the immune system and certainly
put you at risk for all sorts of infections, especially
(18:22):
skin infections. We see a lot of skin infections and
patients who are overweighted, such as cellulitis, are getting fungal infections.
That's very common for ladies, especially if you have pendulous breast.
Just underneath the crease there there's just a lot of
moisture and friction.
Speaker 2 (18:41):
We see this a lot.
Speaker 1 (18:42):
If you have a large abdominal area, just the abdominal
folds folds a lot of times will trap heat, moisture,
and fungus loves to grow in that area. You might
get that sort of red, itchy rash or there's a
certain scent when you start getting a fungal infection that
you can experience and it's all, like I say, just
(19:05):
because of what happens when your body gets heavier and
the immune system cannot work, your skin becomes under attack,
and you can get these cellulotis infections, that redness, that
deep redness sort of that comes on your legs, that's
very common, or on your arm, your torso you get
(19:27):
these infections that happen all the time. Another condition, which
we've talked about a lot, is called venus insufficiency, where
the amount of blood float in the lower legs is
not very efficient and blood starts to pool there in
the lower legs. That generates sort of a low grade
(19:47):
amount of swelling. So your feet get a little bit swollen,
your ankles get a little bit swollen. And all that
does is disturb the normal environment of the skin in
the lower extreme remities, so that they might hurt, they
might itch, they might start to become inflamed to the
sense that it starts to discolor the skin. Maybe it's red,
(20:10):
maybe it's dark. But again it's just from the constant
presence of fluid and decreased blood flow in the legs.
And because of that, the skin is very vulnerable to
infection and a lot of our patients get say, lights
in that area, again all being generated by weight and
just the hormonal milieu that happens when you gain weight,
(20:33):
which is why when these things start happening, it's sort
of a systemic dysfunction brought on by the weight gain
that we're trying everything to help patients get their weight down,
and these GLP one agonists is a way to go,
and they are becoming more affordable and more available to you.
(20:53):
Just ask your healthcare professional about if this is the
right drug for you and see if you can get
a prescription for that, because in my opinion, these are
you know, blockbuster medications and most people should be trying
to get one of them again to try and help
them get throughout the day and ignore all the food
(21:14):
noise that's out there so that you can get your
intermittent fasting program. Start it so you can get better,
feel better. Energy level normally comes back, a joint pain
goes down, I mean, just things typically start functioning better.
You're staying out of the doctor's visit. You can reduce
the number of medicines you take. And you see this
(21:34):
a lot when patients have surgeries like the gastric sleeve,
which is the most popular barriatric surgery out there. They
get their gastric sleeve, they figure out a way to
not eat as much, They drop about forty to fifty pounds,
and normally that experience is very very positive. Meaning, like
I said, they're blood pressure falls, there are sugar falls.
(21:58):
They again just no longer and as much pain. Their
energy level comes back. I mean, that's another common complaint
in primary care physicians offices, health care providers offices, is
I just don't have the energy that I want. I
feel like I should be more energetic, I should have
more stamina. There seems to be a brick wall in
(22:19):
my way. I just I just don't feel right. I
don't feel strong like I used to when I was young.
And again it's up to the health care provider's job,
or it is. Our main job is to see if
there's a disease that is causing the fatigue, and then
fix the disease, and then in fixing the disease, that
(22:40):
fixes the fatigue. But a lot of times and again
it's hard to tell them upfront, so I normally kind
of reserve that conversation until I have done lab work.
I have done X rays, because again that's really where
most healthcare provider's mind is when someone says, I'm tired, Well,
what is the cause of it? And you have to
(23:03):
be sure that you're not overlooking a serious medical disease, which, again,
a serious medical disease, its first symptom could just be
I'm tired, you know, just don't feel well. So sometimes
it's not a good idea for a doctor or a
healthcare provider to jump over all these other possibilities and
just say, oh, you need to eat better. There is
(23:25):
sort of a list of diseases that we kind of
need to check off the list before we.
Speaker 2 (23:31):
Can say that.
Speaker 1 (23:32):
But a lot of times, ultimately in my experience, when
someone comes to I'm just tired, I don't feel good,
my energy's not good, a lot of times it is
a result of the diet and the beverages and just
being overweight.
Speaker 2 (23:49):
That is the cause of it.
Speaker 1 (23:50):
And again, these GLP one agonists are a very good solution.
Speaker 2 (23:55):
So ask your.
Speaker 1 (23:56):
Healthcare provider about getting on one of these drugs. That again,
no drug is one hundred percent safe, right, I mean
we talk about that a lot with any medication, even
though over the counter stuff talinol and motrin advil. It's
over the counter right now, you can go get it.
You don't need a prescription. But hey, guess what, it
(24:18):
can cause harm, just like the antibiotics antabotics would give you,
which is why we try not to prescribe these antibotics.
It can cause harm. I'm sure you may have seen
something about the golp one agonist on your feed in
terms of some of the potential issues with that, and
we have seen them. But in general, overall it is
(24:41):
a great drug and most of the time the risk
benefit ratio favors the benefit and not the risk. Again,
most healthcare providers are prescribing medications that tend to give
them the least amount of callbacks in terms of problems.
This is something you learned over time which met medication
and am I going to keep prescribing to my patients
(25:03):
And it's normally the ones that work very well with
the minimal issues of side effects, and this has been
my experience with these gop one agonists. Yes, we get
a few patients that get the adverse reaction, and normally
what we see of the gastro intestinal side effect issues
just abdominal bloating, maybe nausein vomiting, diarrhea, painkor titis sometimes
(25:26):
a condition called an ilias when sort of your bile
function slows down enough that the foods and beverages and
just a gash of contents start to go the other way,
meaning they're coming up instead of going down. It's in
my experience, been rare, it's not common. So for the
most part, patients tolerate the medicines, they get their weight
(25:49):
laws and their health improves. And for me, I try
to keep the dose on the low end, just because
what I've mainly seen is as you start cranking up
the dose, that's when the side effects start to come in.
So I try to find the low as those possible
that a pacing can stay on six months a year
to keep that momentum going so that they can just
(26:12):
get into better habits. A lot of times, again, because
you've sort of been taught I gotta eat breakfast, I
gotta eat lunch, I gotta eat dinner, that it's hard
to break that cycle, that mentality of just the eating
experience throughout the day in this country, and once you
can sort of break that mentality and experience not eating
throughout the day, even though you at work, You're doing
(26:33):
your normal activity, taking care of your kids, You're doing
everything you've normally done, but it does not involve this
big meal in the morning, big meal at noon, big
meal at night. When you can get break that cycle,
that mentality that you have to eat so much, it
a lot of times you don't need the medicine after
a while because you just get into a habit, a routine,
(26:55):
and the medicine can allow you to achieve that, even
with all the food noise out there. Phone lines are
opened eight one six Kalvy. I want one hundred three
to three zero Kalfey. I'll be back in two minutes.
All right, welcome back to the Doctably Medical. Our phone
lines are open. Eight one six Kelvy, I want one
hundred three three zero kalf chatting about JP one agonist
which are some diabetes medication has been out for a
(27:18):
long time, a long time seven eight years even maybe
even a little bit longer. That help you go throughout
the day without having to eat or experience that angry
episode when you've not had anything to eat all day,
especially when you're sitting in the ear trying to get
fixed up. You go several hours without eating, you know,
(27:38):
you can't eat anything they tell you right until the
doctor sees you and you get that headache and you
get fidgety and just kind of want something to eat.
So these medications are blockbuster in my opinion, So talk
with your healthcare provider about getting you a prescription for that.
Just because people are looking for ways to try and
(28:00):
improve their health and again, trying to find a way
to not eat as much throughout the day, in my opinion,
is one simple free freeway to do that, right, doesn't
cost any money to do it. Just again, the idea
that you need to go several hours without eating a
(28:21):
food substance that has calories or drinking a beverage that
has calories. You need to go several hours give your
body a break from having to process all of this food.
And again the other note that we try to make
us try and eliminate or reduce your exposure to ultra
processed foods. Right, try to eat more healthy foods that
(28:45):
are as fresh as possible with minimal processing.
Speaker 2 (28:49):
Right.
Speaker 1 (28:49):
They talk about looking at the ingredients on most of
the packaged foods out there, and if it's more than
three ingredients, then probably it's ultra processed. And not that
good for you. Again, sometimes we are in certain situations
where that's all we can get, that's all we can afford,
as ultra processed foods tend to be cheaper versus fresh foods.
(29:12):
And so you have a family to feed, you have
to feed yourself, and sometimes we just don't have a
whole lot of options. So it can get kind of
difficult out there to do those things. But certainly I
think it's a good strategy. Sort of a simple strategy
if you're trying to feel better is just don't eat
as much food throughout the day, give your body a break.
(29:34):
And certainly if you are trying to monitor yourself, again,
there's more monitoring equipment out there, which we do recommend
her to all of our patients, especially if you have
certain diseases, especially blood pressure dobeties. You really can't monitor
your cholesterol, but those are sort of the three or
four variables that we want you to monitor as much
(29:56):
as possible. Cholesterol you have to monitor with the blood test.
And again, if you're unaware, the medical world, just publish
some new guidelines as it pertains to doctors and how
they approach the treatment of cholestero Again, just year after year,
they're getting more strict and want the cholesterol levels lower
(30:18):
and lower compared to the previous recommendations, especially if you
have certain disease processes. They want the cluster to be lower,
which a lot of times means most people need to
be a little bit more medication than they were before.
Not a good idea, not a good thought, but that
is what the medical literature and medical research says out there.
(30:40):
Especially like I said, if you've had cardiovascular disease already,
you've had a stroke, you've had a heart attack already,
they want that cluster to be pretty low. And the
good thing is that there's again we always talk about diet,
we talk about exercise again, can be difficult sometimes fitting
that into your routine, your lifestyle. There's more medications available
(31:02):
for this particular issue with the cholesterol and getting it
down that yes, just like with blood pressure or diabetes,
that you might need to be on two or even
three cholesterol medicans. I haven't come across that patient yet,
but something tells me I will at some point come
across a patient who's on two or three just four
(31:23):
cholesterol alone to get that cholesterol down less than seventy, right,
that what they call the LDL or the bad cholesterol.
They wanted to get that down less than seventy in
patients who have known corn or artery disease, or maybe
you have plaque in various locations of the human body.
And again I primarily see that in smokers and poorly
(31:47):
controlled diabetics also sort of the two categories that I
see as a doctor, that tend to develop sort of
this vascular issue everywhere.
Speaker 2 (31:56):
In their bodies.
Speaker 1 (31:57):
So they have plaque in their brain, they have in
their heart, plaque in their legs, plaque in their intestinal vasculature.
It's just sort of everywhere in multiple locations. That's normally
this scenario I see it. It's just smokers and poorly
controlled diabetics. Yeah, every now and then we get someone
(32:18):
maybe with some strong family history. They have cholesterol problems.
It's sort of a genetic issue, and they have high
cholesterol from day one. They might even eat the perfect diet,
but still their cholesterol stays high. And plague tends to
develop in those particular patients as well, and they have
(32:39):
a normally early onset heart disease. Maybe their father had
a heart attack in their forties, or their mother did,
so we see that collection of people too, but for
the most part, it's the smokers and the diabetics who
don't get control of their disease process where we see
a lot of this plaque and so they tend to
(32:59):
have to be treated more aggressively for the cholesterol. But
these continuous glucose monitors that I've mentioned before, I want
to keep bringing that up because it's kind of the
new way to monitor your blood sugar if you do
have diabetes. It's very easy, it's convenient.
Speaker 2 (33:18):
You know.
Speaker 1 (33:18):
Again, before you sort of had to have this little
pack with you that contain your all of your equipment
so that you can check your sugar. But now the
way it is with these monitors, you just sort of
put this little sensor on your arm and it communicates
with your phone and you know, your sugars live all
day long and just look at your phone and it
(33:39):
just tells you what your sugars are doing. It gives
you that information that you need to make better decisions
about what to eat what not to eat. I mean,
that is the power of knowledge, And in my experience,
these devices do help patients figure that sort of thing out,
because before they were eating a certain food item that
they thought was healthy for them, at least that's what
(34:01):
they were told, that's what the packaging said, that's what
their family told them, and so they're eating it, and
then when they get their sensor and they look and
see what happens after they eat, they are surprised or
shocked to find out that it spikes or sugar. And
that's really all it is. It's just knowledge in terms
of figuring out what it is food item wise that
causes me this person, what is good for me and
(34:25):
what's not good for me. So this is how you
figure this out. And all you have to do is
avoid these food items to keep your sugar from spiking.
That that's really the simple version of that. And these devices,
like I said, the technology has gotten better.
Speaker 2 (34:42):
Before it was sort of a hit or miss.
Speaker 1 (34:45):
Sometimes the phone didn't communicate with the device, or the
sensor didn't stay on, or it just didn't work the
ten or fourteen days. It was supposed to just little
kinks right in this new technology. But it's been for
a longer period of time that they've been able to
work on all that, and it's a pretty good deal.
(35:06):
And so I'm trying to promote this. CGM is the
short acronym for that continuous glucose monitor. If you do
have diabetes, ask your health care provider about it, if
I'm sure they've already mentioned it to you. But this
is sort of the new way of checking your blood
sugar because you can graft it and you can look
at the history, and it's just a cool way for
(35:27):
you to get that information that you need so that
you can say no to this or say no to
that and just sort of smoothing out that blood sugar
level because you know what you shouldn't be eating and
what you should not be eating, and the GOLP one
agonists certainly help you achieve that goal. And again several
different varieties. Now a couple of them come in tablets.
(35:50):
If you don't like the injection, the GOVI comes in
a tablet. The right Bels's has been out for a
long time. That's the one for ozempic. So get with
your health care provider and get your CGM and get
your gop one. Achnist on board phone lines are open
eight nine six kof I one one hundred three three
zero kova. I'll be back in two minutes.
Speaker 2 (36:18):
All right, Welcome back to the DOCAVN.
Speaker 1 (36:19):
Medical phone lines are open eight nine to six ko
if I one hundred three three zero ko if guy
here in a last break.
Speaker 2 (36:26):
Remember, if there's a topic.
Speaker 1 (36:27):
That you would like me to talk about, you can
call the radio station. You can call my office three
four seven three six two one and drop down that
note and we can certainly discuss the topic that you
would like. Again, this show is for you, trying to
help you figure out what is good, what is bad,
and how to make things will be easier for you. Today,
we did spend some time again promoting this not a
(36:50):
new category, but the category of diabetes medicines that have
really revolutionized America in trying to help it get its
waisted down just because of all of the eating and
drinking that we do just naturally right, just all the
food that's available, all the beverages that are available. We
(37:11):
just sort of constantly consuming some food items, some beverage
item throughout the day that tends to generate obesity and
tends to generate sickness and illness. So you have to
find a solution to try and achieve that. In my opinion,
based on my experience with all of the other previous
weight loss drugs out there, which there still are a
(37:34):
few other weight loss medications available, but in my opinion,
this category, this golp one, sort of checks most of
the boxes, meaning you can take it long term, it's
relatively safe, it's very effective, most people tolerate it. Whereas
all of the previous other medicases something was missing, whether
(37:57):
or not it wasn't tolerated, it wasn't strong enough, or
just most people couldn't do it, maybe had to take
it multiple times a day, just sort of little issues
that came up that just didn't make it as good
as it needed to be. But this new category coincidentally
has really helped, and the pharmaceutical company is trying to
(38:20):
make it more affordable. The reps are coming by dropping
off samples. The pricing has gone down to a more
reasonable level. Again, I have seen some pricing down to
the low one hundred range per month. Again, most patients,
again with economy and inflation, still might be out of
(38:42):
their reach, but it is getting closer for the common
person to be able to afford that. And again, you're
talking about your health, right. If your health is poor, man,
you're going to be spending a lot of money. You know,
on other medications, you're going to be missing work. Sometimes
it impacts your employment, so there is a financial hit
a lot of times if your health is poor. And
(39:05):
especially our retirees out there, they're looking forward to being
off from work and not having to go to work.
And in my opinion, the one thing that should be
prioritized is your health because you don't want to spend
your retirement just being sick all the time and going
to doctor's visits and taking a bunch of medications. And again,
you've got to get that routine down when you get older,
(39:28):
and it gets a lot easier. Right when you don't
have to go to work, you don't have all these distractions.
The kids are grown out of the house now and
it's really just you and maybe your wife, or you
and your husband, maybe your pet.
Speaker 2 (39:40):
There's a lot of.
Speaker 1 (39:40):
Time to get back to on your health and not
a lot of distractions. You can really spend your time
eating the right foods, preparing your foods, maybe getting a
little exercise, and again not a whole lot. So one
thing I try to promote on this show and in
my office is again, exercising does not mean you have
(40:01):
to join a gym doesn't mean you have to go
run a marathon. You don't have to do it for
an hour at a time. You don't have to lift
a whole bunch of weights. We're talking about just some
light activity like pelling a bicycle leisurely in your neighborhood
or getting a bike in your house and make it
more convenient and pedal that for ten or fifteen minutes,
(40:25):
maybe in the morning, maybe in the at nighttime. It
doesn't matter when you do it. I think we get
so bogged down the details, right, same thing with the diet.
You know, it's got to be this, it's got to
be that, when really we just got to keep it
simple and we just need you to kind of engage
in that activity at some point throughout the week. I
(40:46):
Norman try to break it down in the seven day period.
We normally just ask you to do two or three
sessions in a seven day period. I think if you
listen to the experts, you hear one hundred and fifty
minutes of exercise per seven day week is sort of
what they recommend. I feel like the bar is a
little bit too high when it comes to that. I
think most Americans just are not going to do one
(41:08):
hundred and fifty minutes per week, and in my experience,
that's okay. I think again, ten minutes, fifteen minutes is plenty.
You just want to kind of get the heart rate
up for a sustained period of time in whatever activity
that you want to do. A brisk walk that's cheap,
that's free. Most people can do that. I've seen these
little devices being advertised on TV with a little pedal
(41:32):
system where you're kind of you're pedaling as you're sitting.
I think for some of our elderly patients who maybe
have muscular schedule problems, maybe unfortunately, if I already had
a stroke and exercising is just not something that they
can do, that certainly can be an alternative. Right Again,
you just want to keep your body in motion and
(41:53):
as opposed to just kind of sitting around not doing anything.
That's really where it's at. But it all arts with
eating the right food items and avoiding the wrong food items.
And unfortunately, a lot of the food items that we
are exposed to that we see that we put in
our grocery cart a lot of times are ultra processed.
(42:15):
And again, all the experts agree with this situation that again,
consuming ultra processed foods will tend to generate some poor
health in some way, whether it generates the diabetes, high pertension,
maybe it turns on your inflammatory system because these chemicals
that the food manufacturers have to put in it to
(42:37):
preserve it so that it can be packaged and sit
on a shelf for weeks months until you purchase it,
and then you bring it home and then you store
it at your house and then you know, the month
goes by and then you eat it. I mean we
have to sort of adulterate the food so it can
last that long. You have all been to the store
and you've bought fresh food and it spoils within two
(42:59):
of the three three days, right, that's fresh fruit, no preservatives.
Speaker 2 (43:04):
But again commersome.
Speaker 1 (43:05):
You have to run back and forth at the store
all the time, and it can be combersome anyway. Thank
you for joining me for another edition of the show.
Don't drink and drive. Drink some water.
Speaker 2 (43:14):
We'll see you guys next week. Thank you. Have a
good day.
All right south these texts in radio listeners, Welcome to
another edition of The Doctor Leavine Medical Hour. I'm your host,
Doctor Levigne, coming to you live from the pseudos of
kov I hear in Boma, Texas, cross street from Parkdale
mal Tech and your phone calls and answering questions about Yes,
as the theme song suggests, how to stay alive, I
never get tired of that song as Yeah. Every day,
(00:22):
serving as a primary career healthcare professional, we're trying to
help patients figure out what it is they need to do,
what it is their family needs to do to try
and stay alive as long as possible and be healthy
as long as possible. Remember, it's no fun being sick
and ill all the time, being in the hospital, having
to take a lot of medications, and having on a
(00:43):
doctor's office every week every two weeks, or just be
lined up with doctor Visit's unfortunately sometimes it happens even
though you did everything right. But we're trying to lower
your risk of that happening to you. So that's the
genesis of the show. And also just to filter all
of the information that you're getting every single day about
and what is the best thing or the right thing
(01:04):
or the wrong thing to do in terms of your
habits in staying healthier and staying alive as long as possible.
So it can be confusing out there. We're getting a
lot more information that is given to us about that.
So we're here to try and help you figure that out.
Phone line to open eight nine to six kelvy I
one in one hundred and three three zero kilva I.
(01:27):
We would love to talk with you. Love to chat
with you. It's two way radio. And give us a
bus so we can help you and figure out what
it is is on your mind. Remember, we're big believers
in vaccines, so those vaccines are still out there, more
so than before. And again the technology has changed. They've
(01:49):
gotten better, cleaner, and more effective. So it's the weekend.
I know you've been putting off getting your vaccine, so
you can take this opportunity to go to your pharmacy
and get your vaccines. They normally have good records in there.
Remember you can still get the infection when you get
the vaccine, it just lessens the severity of the infection
(02:12):
if you get it. We talk a lot about cancer,
we talk a lot about cardiovascular disease.
Speaker 2 (02:17):
On the show.
Speaker 1 (02:17):
But remember infections is a big cause of morbidityter mortality.
As we all get older, that term called sepsis, sepsis
most common. Folks are getting used to that term and
it strikes fear in most people's concerns, most people's hearts
(02:40):
when they hear that term sepsis, and it should. But again,
just a medical term that we use to describe what
happens when someone gets an infection, just to help everyone
sort of categorize what is helping so that we can
have a more systematic approach two SEPs is if you
(03:03):
do not know, but certainly when I came out, it
wasn't as orchestrated as it is now with the treatment
of sepsis, as is well with cardiovascuses and strokes, meaning
the healthcare system is always working on getting better and
smoother and more efficient. If you've ever had a heart attack,
you know there is a systematic approach to managing that
(03:27):
from the time ems gets to your house to the
time you get to the hospital and beyond. Same thing
with strokes. They call those stroke alerts as well as
cardiac alerts. They have those in all just about all
major hospitals. That's sort of the standard of care, and
they have that same approach with sepsis and treating sepsis.
(03:49):
Not that they're calling sepsis alerts, but there is an
understanding from the time you hit the door, from the
nurse that trioges you, to the er doctors, to the
doctors that take you and the hospital, there's sort of
an understanding about the importance of getting on top of
sepsis and treating it as aggressively as possible. Bearing in
(04:10):
mind that again certain infections, depending on the patient and infection,
can be just an overwhelming situation. Meaning everything was done
in a timely manner, they got the right testing, they
saw the right doctors, but yes, sometimes the severity of
the sepsis episode can be overwhelming to the human body.
(04:33):
And again it's something else I always try to remind
my elderly patients sixty five and above, or anyone who's
getting older for that matter.
Speaker 2 (04:44):
The immune system.
Speaker 1 (04:45):
Yeah, we don't really think about it that much until
we get sick, but the immune system is one big
system that unfortunately weakens as we get older. It's programmed
into our program and it leaves us vulnerable for all
sorts of infections, which is why the risk of infection
(05:07):
starts to climb as you get older. I mean, all
sorts of things can just sort of go wrong. I
have conversations with patients in the hospital all the time
trying to figure out, you know, why did this happen
to me? I feel like I've been doing everything I
can to stay out of the hospital. I've listened to
everything you've told me, and I do it religiously every
(05:27):
single day. You know, why did I end up here
in the hospital with an infection? What did I do wrong?
And again, the answer to that a lot of times
is you didn't really do anything wrong. Just unfortunately you
are seventy seventy five and infections is just common. We
don't really have vaccines for bladder infections or skin infections,
(05:48):
you know what I'm saying. So it's just a strong
possibility that as one matures and gets older, you might
get a pneumonia, you might get a skin infection, you
might get a infection of your colon.
Speaker 2 (06:03):
We call that colitis.
Speaker 1 (06:04):
That's a very common condition that we do see often
as one gets older, you're just growing about your day,
then all of a sudden you have this severe down
on pain. Maybe it's associated with some diarrhea or some
blood in your stool. You feel pretty bad, you feel weak,
and maybe you might have some nausea, vomiting, los your appetite,
(06:27):
and you go in to get checked out and waym
there it is, you know, some colitis, So you want
to try and do what you can to lessen the
possibility of that. And if you do get that infection,
you're as strong as possible without a lot of what
we call comorbid illnesses, meaning when you start stacking all
these chronic medical problems on top of each other. Yeah,
(06:50):
everything is fine and dandy as long as you're not
acutely sick, you don't have some acute medical crises, everything
is fine. But once you get an acute medical crisis
or as I say, medical trauma on your system, it
will stress your system out. And if it's already chronically
(07:12):
ill or chronically stressed out, again, it's just not prepared.
It's just not ready. It's just not strong enough a
lot of times to handle even more physiological and medical
stress and can cause a lot of collateral issues once
you get into the hospital. Which I hear family say
(07:32):
this a lot, and I have to answer this question
a lot in the hospital. You know, patients come in
with one thing and then by day three or four
they've already been diagnosed with four or five things, or
things kind of keep happening, and it's sometimes hard to
get the disease or the crises to turn off and
start getting better, even though we're trying everything that we
(07:54):
know to try at any hospital. Just sometimes the condition
is severe enough that the patient's bot it's just not
strong enough, and it continues to decline, it continues to.
Speaker 2 (08:05):
Have collateral issues.
Speaker 1 (08:07):
We do see this a lot of times with stepsis,
or even if you go to a hospital for a
heart attack or stroke or dehydration, whatever you're going to
the hospital for, sort of like opening up the Pandora's
box as it pertains to the human body. You want
to try and alleviate the medical crises as quickly as possible,
(08:27):
and that's really the job of most of the hospital
healthcare professionals that treat you, is what can we do
to kind of turn this off asap, because you just
don't want it to last too long. In doing so,
it just sort of stresses the body out even more
and leaves you more vulnerable for all sorts of things
to start happening once you get in there. We're doing
(08:50):
our best to try and turn off that interaction with
your the disease and the human body with the use
of iv antibiotics or fluids or other more specific medications
that we use there in the hospital. So go get
your vaccines as soon as possible so we can keep
(09:11):
you out of the hospital anyway. Phone lines are open
eight nine six kalvy out one hundred three to three zero. Kaleva.
We're going to our first prey. Give us a call,
all right, welcome back to the doctor Lovelean Medical. Our
phone lines are open eight nine six kov out one
one hundred three three zero ko v. I again sitting
(09:33):
here chatting about getting your vaccines. But certainly, as we know,
the country is dealing with issues of weight gain and
how to get it off. That's a constant conversation we're
having every single day trying to help adults figure out
how to get their weight down. And the truck that
has really allowed most Americans to do that that's out
(09:54):
there in the market now, these GLP one agonists, you
know it as ozimpig or. We're go v Jaro zip
bound trulicity will go vy. These are, in my opinion,
blockbuster medications that help in so many different ways to
get you through the day without thinking you have to
eat three times a day, which, again, in my opinion
(10:17):
as a physician, based on my reading about sickness and
disease and treating patients with sickness and disease, what we
are taught, you know, at a young age, I remember
the food pyramid, and just in general, how our society
is set up, you know, in terms of its eating intervals,
(10:40):
you know, breakfast, noonish, lunch twelve one o'clock, and then
some sort of big massive dinner at six pm, seven
pm once you get home from work, in my opinion,
is just too much eating, in my opinion, as compared
to the types of foods and beverages that are now
available to us, which normally what we call high calorie,
(11:02):
are what we call obesogenic, meaning if you consume these
foods and beverage items, as on the average most people do,
it will tend to generate weight gain. An idea of
going all day without eating is a strange idea for
a lot of patients, just because again society, our society
(11:24):
is sort of set up to kind of consume three
times a day a meal, either at home or a
restaurant or at work, and the idea that if you
don't get that meal in, then something bad is going
to happen. I mean, that's sort of an understanding of
most people. And so when they wake up, they're looking
(11:45):
to break the fast. That's where breakfast comes up. Right,
You're breaking your fast because you just slept for what
six seven eight hours. Fasting is just a medical term
we use for not eating any solid food or not
drinking any beverages that have any calorie content in it.
You're fasting, so your body is having to sort of
(12:06):
generate its own energy. And in my opinion, based on
what I've read and based on what I see, it
is a healthy way to get control of your health
is to give you your body a break from consuming
or having a breakdown food or beverages in terms of calories.
(12:28):
Give your bodies a break in doing that. And again,
I think if you look at some of the intervals
if you want to do a fasting program, I think
twelve hours are sort of the average fast time or
interval that most people choose. What would probably be one
maybe eating a solid meal once a day, and then
(12:49):
throughout the throughout the day drinking beverages that have no
calories in them, water, coffee or tea. You know, I
talk about that all the time. And again there's a
lot of flavor coffees, a lot of flavorite teas out there,
and again a lot of times they contain other nutrients
that are anti inflammatory, that are good for your digestive system,
(13:12):
your immune system. Again, just go to the major supermarkets
here in town, HB, Walmart, Target, wherever you get your food,
Brookshire Brothers, and go down the tea owl. And it's
not just a few little varieties. I mean, there are
just several varieties of coffee and teas, and then there's
(13:35):
all of these devices that you can brew them in.
So you can drink coffee warm, you can drink it cold,
same thing with iced tea, same thing with water.
Speaker 2 (13:43):
Right, you can.
Speaker 1 (13:45):
Sort of do certain things to the water to kind
of liven it up a little bit. It can't get
a little boring when it comes to all these other
beverages that are out there that are fizzy and have flavor,
and there's sort of this experience and drinking and so
it's kind of fun to do it. The packaging looks cool,
(14:05):
the bottle looks cool, so you know, you purchaser, there's
more of this emotional connection or attachment to the beverage
gives you a certain experience. You know, water, it's just
kind of bland and boring. There's no taste to it.
It's just there's no color, there's no fizz, there's no story.
Just with all the competition out there, it just sort
(14:25):
of gets pushed to the back. But again, if you're
in a position or situation where you're trying to get
control of your health, that's one thing that you need
to do is look and see what you're drinking, Look
and see what you're eating. And again, this idea of
giving yourself some time in between eating and drinking does help,
in my opinion, and can help resolve a lot of
(14:47):
the physical issues that you might have in terms of
being overweight. But again, it's tough just because there's so
many opportunities to eat and drink every day, whether it
be at work or whether it be at home. It's
just hard to say know. Once that hunger pain starts
to get to you, are the food noise as they're
now calling it, the food is just sort of in
(15:08):
the background calling your name. You know, while you work,
things slowed down, it's nothing to do, and somebody brought
some pastries, or there was a party yesterday, and it's
just that nice piece of chocolate cake that's sitting there
waiting for you.
Speaker 2 (15:21):
Are those chips that you.
Speaker 1 (15:23):
Brought from home the previous day, or whatever the case
may be. You know what I'm talking about. These medications,
the golp one agonists such as Monjaro or go vi
et cetera zep bound allow you really to comfortably ignore
the food noise and go many hours without eating. And
(15:44):
basically all that means is that you're not consuming the
calories and your body is in a fasting state. There's
just been multiple studies and multiple experts looking at this,
and metabolically your body works better in a fact statement,
meaning your immune system works better, your cardiovascular system works better.
(16:05):
So if you can find a way to introduce fasting
into your lifestyle, it typically is a positive in terms
of getting your weight down treating pain, because if you
do not know, as you gain weight normally you will
start to experience pain somewhere, whether it be and your
(16:26):
supporting joints like your knees or your ankles, your feet,
and your lower back, the lumbar spine. Man it gets
a lot of beating a lot of times.
Speaker 2 (16:37):
When you start.
Speaker 1 (16:37):
Gaining weight, typically weaightgain will introduce some sort of pain
experience that you might have to deal with, meaning just
doing normal activity. You might wake up with joint pain
or with some normal activity like moving furniture or cutting
the grass or just working around your house. Because be
(17:00):
and because weight pain tends to turn on the inflammatory system,
these parts of your body, your joint system, your muscular
skeletal system, will start to generate pain. A lot of
patients come to the office complaining of sort of back
pain or chest pain. Normally, when sort of they twist
their torso or they're bending forward, or they're sort of
(17:21):
trying to reach around and grab something, they start getting
pain in their back area, around their chest area. Sometimes
it comes to the front of their chest. That's a
common complaint. Also, sort of the upper back area is
another common area where we start. Patients start having pain
in that area. But you know, no, certainly you cannot
ignore the knees or even the shoulders or the neck.
(17:45):
You wake up with that crick in your neck, like
what did I do? But you have to understand the
power of weight gain and what it does to the
human body in terms of affecting how it behaves metabolically.
Speaker 2 (17:59):
A lot of.
Speaker 1 (18:00):
Abnormal milieu hormones start getting released into your system, which
then impact your cholesterol, impacts your sugar, impacts your blood pressure.
Like I said, your immune system, your joint system. Yes,
gaining weight will normally lower the immune system and certainly
put you at risk for all sorts of infections, especially
(18:22):
skin infections. We see a lot of skin infections and
patients who are overweighted, such as cellulitis, are getting fungal infections.
That's very common for ladies, especially if you have pendulous breast.
Just underneath the crease there there's just a lot of
moisture and friction.
Speaker 2 (18:41):
We see this a lot.
Speaker 1 (18:42):
If you have a large abdominal area, just the abdominal
folds folds a lot of times will trap heat, moisture,
and fungus loves to grow in that area. You might
get that sort of red, itchy rash or there's a
certain scent when you start getting a fungal infection that
you can experience and it's all, like I say, just
(19:05):
because of what happens when your body gets heavier and
the immune system cannot work, your skin becomes under attack,
and you can get these cellulotis infections, that redness, that
deep redness sort of that comes on your legs, that's
very common, or on your arm, your torso you get
(19:27):
these infections that happen all the time. Another condition, which
we've talked about a lot, is called venus insufficiency, where
the amount of blood float in the lower legs is
not very efficient and blood starts to pool there in
the lower legs. That generates sort of a low grade
(19:47):
amount of swelling. So your feet get a little bit swollen,
your ankles get a little bit swollen. And all that
does is disturb the normal environment of the skin in
the lower extreme remities, so that they might hurt, they
might itch, they might start to become inflamed to the
sense that it starts to discolor the skin. Maybe it's red,
(20:10):
maybe it's dark. But again it's just from the constant
presence of fluid and decreased blood flow in the legs.
And because of that, the skin is very vulnerable to
infection and a lot of our patients get say, lights
in that area, again all being generated by weight and
just the hormonal milieu that happens when you gain weight,
(20:33):
which is why when these things start happening, it's sort
of a systemic dysfunction brought on by the weight gain
that we're trying everything to help patients get their weight down,
and these GLP one agonists is a way to go,
and they are becoming more affordable and more available to you.
(20:53):
Just ask your healthcare professional about if this is the
right drug for you and see if you can get
a prescription for that, because in my opinion, these are
you know, blockbuster medications and most people should be trying
to get one of them again to try and help
them get throughout the day and ignore all the food
(21:14):
noise that's out there so that you can get your
intermittent fasting program. Start it so you can get better,
feel better. Energy level normally comes back, a joint pain
goes down, I mean, just things typically start functioning better.
You're staying out of the doctor's visit. You can reduce
the number of medicines you take. And you see this
(21:34):
a lot when patients have surgeries like the gastric sleeve,
which is the most popular barriatric surgery out there. They
get their gastric sleeve, they figure out a way to
not eat as much, They drop about forty to fifty pounds,
and normally that experience is very very positive. Meaning, like
I said, they're blood pressure falls, there are sugar falls.
(21:58):
They again just no longer and as much pain. Their
energy level comes back. I mean, that's another common complaint
in primary care physicians offices, health care providers offices, is
I just don't have the energy that I want. I
feel like I should be more energetic, I should have
more stamina. There seems to be a brick wall in
(22:19):
my way. I just I just don't feel right. I
don't feel strong like I used to when I was young.
And again it's up to the health care provider's job,
or it is. Our main job is to see if
there's a disease that is causing the fatigue, and then
fix the disease, and then in fixing the disease, that
(22:40):
fixes the fatigue. But a lot of times and again
it's hard to tell them upfront, so I normally kind
of reserve that conversation until I have done lab work.
I have done X rays, because again that's really where
most healthcare provider's mind is when someone says, I'm tired, Well,
what is the cause of it? And you have to
(23:03):
be sure that you're not overlooking a serious medical disease, which, again,
a serious medical disease, its first symptom could just be
I'm tired, you know, just don't feel well. So sometimes
it's not a good idea for a doctor or a
healthcare provider to jump over all these other possibilities and
just say, oh, you need to eat better. There is
(23:25):
sort of a list of diseases that we kind of
need to check off the list before we.
Speaker 2 (23:31):
Can say that.
Speaker 1 (23:32):
But a lot of times, ultimately in my experience, when
someone comes to I'm just tired, I don't feel good,
my energy's not good, a lot of times it is
a result of the diet and the beverages and just
being overweight.
Speaker 2 (23:49):
That is the cause of it.
Speaker 1 (23:50):
And again, these GLP one agonists are a very good solution.
Speaker 2 (23:55):
So ask your.
Speaker 1 (23:56):
Healthcare provider about getting on one of these drugs. That again,
no drug is one hundred percent safe, right, I mean
we talk about that a lot with any medication, even
though over the counter stuff talinol and motrin advil. It's
over the counter right now, you can go get it.
You don't need a prescription. But hey, guess what, it
(24:18):
can cause harm, just like the antibiotics antabotics would give you,
which is why we try not to prescribe these antibotics.
It can cause harm. I'm sure you may have seen
something about the golp one agonist on your feed in
terms of some of the potential issues with that, and
we have seen them. But in general, overall it is
(24:41):
a great drug and most of the time the risk
benefit ratio favors the benefit and not the risk. Again,
most healthcare providers are prescribing medications that tend to give
them the least amount of callbacks in terms of problems.
This is something you learned over time which met medication
and am I going to keep prescribing to my patients
(25:03):
And it's normally the ones that work very well with
the minimal issues of side effects, and this has been
my experience with these gop one agonists. Yes, we get
a few patients that get the adverse reaction, and normally
what we see of the gastro intestinal side effect issues
just abdominal bloating, maybe nausein vomiting, diarrhea, painkor titis sometimes
(25:26):
a condition called an ilias when sort of your bile
function slows down enough that the foods and beverages and
just a gash of contents start to go the other way,
meaning they're coming up instead of going down. It's in
my experience, been rare, it's not common. So for the
most part, patients tolerate the medicines, they get their weight
(25:49):
laws and their health improves. And for me, I try
to keep the dose on the low end, just because
what I've mainly seen is as you start cranking up
the dose, that's when the side effects start to come in.
So I try to find the low as those possible
that a pacing can stay on six months a year
to keep that momentum going so that they can just
(26:12):
get into better habits. A lot of times, again, because
you've sort of been taught I gotta eat breakfast, I
gotta eat lunch, I gotta eat dinner, that it's hard
to break that cycle, that mentality of just the eating
experience throughout the day in this country, and once you
can sort of break that mentality and experience not eating
throughout the day, even though you at work, You're doing
(26:33):
your normal activity, taking care of your kids, You're doing
everything you've normally done, but it does not involve this
big meal in the morning, big meal at noon, big
meal at night. When you can get break that cycle,
that mentality that you have to eat so much, it
a lot of times you don't need the medicine after
a while because you just get into a habit, a routine,
(26:55):
and the medicine can allow you to achieve that, even
with all the food noise out there. Phone lines are
opened eight one six Kalvy. I want one hundred three
to three zero Kalfey. I'll be back in two minutes.
All right, welcome back to the Doctably Medical. Our phone
lines are open. Eight one six Kelvy, I want one
hundred three three zero kalf chatting about JP one agonist
which are some diabetes medication has been out for a
(27:18):
long time, a long time seven eight years even maybe
even a little bit longer. That help you go throughout
the day without having to eat or experience that angry
episode when you've not had anything to eat all day,
especially when you're sitting in the ear trying to get
fixed up. You go several hours without eating, you know,
(27:38):
you can't eat anything they tell you right until the
doctor sees you and you get that headache and you
get fidgety and just kind of want something to eat.
So these medications are blockbuster in my opinion, So talk
with your healthcare provider about getting you a prescription for that.
Just because people are looking for ways to try and
(28:00):
improve their health and again, trying to find a way
to not eat as much throughout the day, in my opinion,
is one simple free freeway to do that, right, doesn't
cost any money to do it. Just again, the idea
that you need to go several hours without eating a
(28:21):
food substance that has calories or drinking a beverage that
has calories. You need to go several hours give your
body a break from having to process all of this food.
And again the other note that we try to make
us try and eliminate or reduce your exposure to ultra
processed foods. Right, try to eat more healthy foods that
(28:45):
are as fresh as possible with minimal processing.
Speaker 2 (28:49):
Right.
Speaker 1 (28:49):
They talk about looking at the ingredients on most of
the packaged foods out there, and if it's more than
three ingredients, then probably it's ultra processed. And not that
good for you. Again, sometimes we are in certain situations
where that's all we can get, that's all we can afford,
as ultra processed foods tend to be cheaper versus fresh foods.
(29:12):
And so you have a family to feed, you have
to feed yourself, and sometimes we just don't have a
whole lot of options. So it can get kind of
difficult out there to do those things. But certainly I
think it's a good strategy. Sort of a simple strategy
if you're trying to feel better is just don't eat
as much food throughout the day, give your body a break.
(29:34):
And certainly if you are trying to monitor yourself, again,
there's more monitoring equipment out there, which we do recommend
her to all of our patients, especially if you have
certain diseases, especially blood pressure dobeties. You really can't monitor
your cholesterol, but those are sort of the three or
four variables that we want you to monitor as much
(29:56):
as possible. Cholesterol you have to monitor with the blood test.
And again, if you're unaware, the medical world, just publish
some new guidelines as it pertains to doctors and how
they approach the treatment of cholestero Again, just year after year,
they're getting more strict and want the cholesterol levels lower
(30:18):
and lower compared to the previous recommendations, especially if you
have certain disease processes. They want the cluster to be lower,
which a lot of times means most people need to
be a little bit more medication than they were before.
Not a good idea, not a good thought, but that
is what the medical literature and medical research says out there.
(30:40):
Especially like I said, if you've had cardiovascular disease already,
you've had a stroke, you've had a heart attack already,
they want that cluster to be pretty low. And the
good thing is that there's again we always talk about diet,
we talk about exercise again, can be difficult sometimes fitting
that into your routine, your lifestyle. There's more medications available
(31:02):
for this particular issue with the cholesterol and getting it
down that yes, just like with blood pressure or diabetes,
that you might need to be on two or even
three cholesterol medicans. I haven't come across that patient yet,
but something tells me I will at some point come
across a patient who's on two or three just four
(31:23):
cholesterol alone to get that cholesterol down less than seventy, right,
that what they call the LDL or the bad cholesterol.
They wanted to get that down less than seventy in
patients who have known corn or artery disease, or maybe
you have plaque in various locations of the human body.
And again I primarily see that in smokers and poorly
(31:47):
controlled diabetics also sort of the two categories that I
see as a doctor, that tend to develop sort of
this vascular issue everywhere.
Speaker 2 (31:56):
In their bodies.
Speaker 1 (31:57):
So they have plaque in their brain, they have in
their heart, plaque in their legs, plaque in their intestinal vasculature.
It's just sort of everywhere in multiple locations. That's normally
this scenario I see it. It's just smokers and poorly
controlled diabetics. Yeah, every now and then we get someone
(32:18):
maybe with some strong family history. They have cholesterol problems.
It's sort of a genetic issue, and they have high
cholesterol from day one. They might even eat the perfect diet,
but still their cholesterol stays high. And plague tends to
develop in those particular patients as well, and they have
(32:39):
a normally early onset heart disease. Maybe their father had
a heart attack in their forties, or their mother did,
so we see that collection of people too, but for
the most part, it's the smokers and the diabetics who
don't get control of their disease process where we see
a lot of this plaque and so they tend to
(32:59):
have to be treated more aggressively for the cholesterol. But
these continuous glucose monitors that I've mentioned before, I want
to keep bringing that up because it's kind of the
new way to monitor your blood sugar if you do
have diabetes. It's very easy, it's convenient.
Speaker 2 (33:18):
You know.
Speaker 1 (33:18):
Again, before you sort of had to have this little
pack with you that contain your all of your equipment
so that you can check your sugar. But now the
way it is with these monitors, you just sort of
put this little sensor on your arm and it communicates
with your phone and you know, your sugars live all
day long and just look at your phone and it
(33:39):
just tells you what your sugars are doing. It gives
you that information that you need to make better decisions
about what to eat what not to eat. I mean,
that is the power of knowledge, And in my experience,
these devices do help patients figure that sort of thing out,
because before they were eating a certain food item that
they thought was healthy for them, at least that's what
(34:01):
they were told, that's what the packaging said, that's what
their family told them, and so they're eating it, and
then when they get their sensor and they look and
see what happens after they eat, they are surprised or
shocked to find out that it spikes or sugar. And
that's really all it is. It's just knowledge in terms
of figuring out what it is food item wise that
causes me this person, what is good for me and
(34:25):
what's not good for me. So this is how you
figure this out. And all you have to do is
avoid these food items to keep your sugar from spiking.
That that's really the simple version of that. And these devices,
like I said, the technology has gotten better.
Speaker 2 (34:42):
Before it was sort of a hit or miss.
Speaker 1 (34:45):
Sometimes the phone didn't communicate with the device, or the
sensor didn't stay on, or it just didn't work the
ten or fourteen days. It was supposed to just little
kinks right in this new technology. But it's been for
a longer period of time that they've been able to
work on all that, and it's a pretty good deal.
(35:06):
And so I'm trying to promote this. CGM is the
short acronym for that continuous glucose monitor. If you do
have diabetes, ask your health care provider about it, if
I'm sure they've already mentioned it to you. But this
is sort of the new way of checking your blood
sugar because you can graft it and you can look
at the history, and it's just a cool way for
(35:27):
you to get that information that you need so that
you can say no to this or say no to
that and just sort of smoothing out that blood sugar
level because you know what you shouldn't be eating and
what you should not be eating, and the GOLP one
agonists certainly help you achieve that goal. And again several
different varieties. Now a couple of them come in tablets.
(35:50):
If you don't like the injection, the GOVI comes in
a tablet. The right Bels's has been out for a
long time. That's the one for ozempic. So get with
your health care provider and get your CGM and get
your gop one. Achnist on board phone lines are open
eight nine six kof I one one hundred three three
zero kova. I'll be back in two minutes.
Speaker 2 (36:18):
All right, Welcome back to the DOCAVN.
Speaker 1 (36:19):
Medical phone lines are open eight nine to six ko
if I one hundred three three zero ko if guy
here in a last break.
Speaker 2 (36:26):
Remember, if there's a topic.
Speaker 1 (36:27):
That you would like me to talk about, you can
call the radio station. You can call my office three
four seven three six two one and drop down that
note and we can certainly discuss the topic that you
would like. Again, this show is for you, trying to
help you figure out what is good, what is bad,
and how to make things will be easier for you. Today,
we did spend some time again promoting this not a
(36:50):
new category, but the category of diabetes medicines that have
really revolutionized America in trying to help it get its
waisted down just because of all of the eating and
drinking that we do just naturally right, just all the
food that's available, all the beverages that are available. We
(37:11):
just sort of constantly consuming some food items, some beverage
item throughout the day that tends to generate obesity and
tends to generate sickness and illness. So you have to
find a solution to try and achieve that. In my opinion,
based on my experience with all of the other previous
weight loss drugs out there, which there still are a
(37:34):
few other weight loss medications available, but in my opinion,
this category, this golp one, sort of checks most of
the boxes, meaning you can take it long term, it's
relatively safe, it's very effective, most people tolerate it. Whereas
all of the previous other medicases something was missing, whether
(37:57):
or not it wasn't tolerated, it wasn't strong enough, or
just most people couldn't do it, maybe had to take
it multiple times a day, just sort of little issues
that came up that just didn't make it as good
as it needed to be. But this new category coincidentally
has really helped, and the pharmaceutical company is trying to
(38:20):
make it more affordable. The reps are coming by dropping
off samples. The pricing has gone down to a more
reasonable level. Again, I have seen some pricing down to
the low one hundred range per month. Again, most patients,
again with economy and inflation, still might be out of
(38:42):
their reach, but it is getting closer for the common
person to be able to afford that. And again, you're
talking about your health, right. If your health is poor, man,
you're going to be spending a lot of money. You know,
on other medications, you're going to be missing work. Sometimes
it impacts your employment, so there is a financial hit
a lot of times if your health is poor. And
(39:05):
especially our retirees out there, they're looking forward to being
off from work and not having to go to work.
And in my opinion, the one thing that should be
prioritized is your health because you don't want to spend
your retirement just being sick all the time and going
to doctor's visits and taking a bunch of medications. And again,
you've got to get that routine down when you get older,
(39:28):
and it gets a lot easier. Right when you don't
have to go to work, you don't have all these distractions.
The kids are grown out of the house now and
it's really just you and maybe your wife, or you
and your husband, maybe your pet.
Speaker 2 (39:40):
There's a lot of.
Speaker 1 (39:40):
Time to get back to on your health and not
a lot of distractions. You can really spend your time
eating the right foods, preparing your foods, maybe getting a
little exercise, and again not a whole lot. So one
thing I try to promote on this show and in
my office is again, exercising does not mean you have
(40:01):
to join a gym doesn't mean you have to go
run a marathon. You don't have to do it for
an hour at a time. You don't have to lift
a whole bunch of weights. We're talking about just some
light activity like pelling a bicycle leisurely in your neighborhood
or getting a bike in your house and make it
more convenient and pedal that for ten or fifteen minutes,
(40:25):
maybe in the morning, maybe in the at nighttime. It
doesn't matter when you do it. I think we get
so bogged down the details, right, same thing with the diet.
You know, it's got to be this, it's got to
be that, when really we just got to keep it
simple and we just need you to kind of engage
in that activity at some point throughout the week. I
(40:46):
Norman try to break it down in the seven day period.
We normally just ask you to do two or three
sessions in a seven day period. I think if you
listen to the experts, you hear one hundred and fifty
minutes of exercise per seven day week is sort of
what they recommend. I feel like the bar is a
little bit too high when it comes to that. I
think most Americans just are not going to do one
(41:08):
hundred and fifty minutes per week, and in my experience,
that's okay. I think again, ten minutes, fifteen minutes is plenty.
You just want to kind of get the heart rate
up for a sustained period of time in whatever activity
that you want to do. A brisk walk that's cheap,
that's free. Most people can do that. I've seen these
little devices being advertised on TV with a little pedal
(41:32):
system where you're kind of you're pedaling as you're sitting.
I think for some of our elderly patients who maybe
have muscular schedule problems, maybe unfortunately, if I already had
a stroke and exercising is just not something that they
can do, that certainly can be an alternative. Right Again,
you just want to keep your body in motion and
(41:53):
as opposed to just kind of sitting around not doing anything.
That's really where it's at. But it all arts with
eating the right food items and avoiding the wrong food items.
And unfortunately, a lot of the food items that we
are exposed to that we see that we put in
our grocery cart a lot of times are ultra processed.
(42:15):
And again, all the experts agree with this situation that again,
consuming ultra processed foods will tend to generate some poor
health in some way, whether it generates the diabetes, high pertension,
maybe it turns on your inflammatory system because these chemicals
that the food manufacturers have to put in it to
(42:37):
preserve it so that it can be packaged and sit
on a shelf for weeks months until you purchase it,
and then you bring it home and then you store
it at your house and then you know, the month
goes by and then you eat it. I mean we
have to sort of adulterate the food so it can
last that long. You have all been to the store
and you've bought fresh food and it spoils within two
(42:59):
of the three three days, right, that's fresh fruit, no preservatives.
Speaker 2 (43:04):
But again commersome.
Speaker 1 (43:05):
You have to run back and forth at the store
all the time, and it can be combersome anyway. Thank
you for joining me for another edition of the show.
Don't drink and drive. Drink some water.
Speaker 2 (43:14):
We'll see you guys next week. Thank you. Have a
good day.
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