May 19, 2026 • 41 mins
- Listen Saturday mornings at 8 as Dr. Msonthi Levine discusses medical issues and takes your calls on News Talk 560 KLVI. Dr Levine is board certified in Internal Medicine and Geriatrics. His office is located at 3080 Milam in Beaumont, Texas. He can be reached at 409-347-3621.
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Episode Transcript
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Speaker 1 (00:00):
All right, welcome South these Texes. Welcome, Welcome, Welcome to
the edition of the Doctor Levigne Medical Hour. Good morning,
and hopefully you're having a wonderful morning this morning. It's
a beautiful morning, good weather, no rain, it's not really cold,
not really hot, just right, and hopefully you're having a
wonderful morning today and we'll appreciate you joining us on
(00:25):
the Doctor Levine Medical Hour to chat about how to
stay alive longer and healthier, and how to start at
the hospital, how to limit your exposure to pharmaceutical medications
and doctor visits. Just what are the ways to do that?
Phone line to open eight nine to six. Kov I
wanted one hundred three three zero Kovi ivy. Love to
(00:48):
talk with you, love to hear from you, and help
you try and answer some of your issues that you
might have or just clear up some confusion, which there
tends to be a lot of that going on every
single day in a lot of different instances, and we're
just here to try and help you out, get you
some basic information. Try to keep it basic, try not
(01:09):
to make it too complicated, so that you can figure
out what works for you and your family. Because we're
all different our bodies are all different, we respond to
medicines different, and it's sometimes difficult to look across the
street and see what someone else is doing and adopt
that for yourself just because it may not work for you,
(01:30):
just because it works someone else. So you got to
kind of figure it out, put a little time into
it to figure out what is the right plan for you.
And it does require some effort, especially as you get older.
We have this conversation a lot with my patients who
are getting older. When you're younger, you can kind of
get away with sort of the misbehavior of your lifestyle
(01:53):
in terms of what you eat and drink and just
being sedentary. You get busy with other things, your job,
your marriage, your kids, just trying to get financially settled,
and our health normally is not being prioritized. And I
get that you've never been sick before, never been in
a hospital before.
Speaker 2 (02:11):
It's just not an.
Speaker 1 (02:12):
Experience for you until you have some big medical crises
and you do end up in the hospital or doctor's
office and you have to sort of reroute or reconfigure
your priorities in terms of what's one, two, three, four.
And that is one thing that I see as the
trajectory of aging takes over as you get into the
(02:34):
later part of your life and all these other issues
have sort of been settled. You've got your financial base,
kids are off living.
Speaker 2 (02:42):
Their own lives.
Speaker 1 (02:44):
Maybe now you're retired, there's not much staring at you
other than you and your health, and now you have
time to really spend time doing the right things, all
the things that you've wanted to do over the years,
but for whatever reason, you couldn't get around to it
because of other distractions, other priorities. And now that you've
(03:04):
made it through the obstacle course and you're on the
other end, here's the time to really really dedicate or
devote to your health and maintain your health because you
typically need to do that as the body's system, as
the program that we all have in terms of the
aging process, starts to get in pretty heavy. The things
(03:27):
that you do every single day tend to be more
impactful than when you were younger, and you really have
to say no to those food items and beverage items
that you know are just not good for you. If
you want to stay out at doctor Lavine's office, you
want to stay out of the local hospitals, you don't
want to take a sack full of medications. These are
things that need to be done in order to reduce
(03:49):
that possibility. And again, it's not going to be as
simple as going to the store or going to your
favorite internet spot and ordering some magical pill or juice
or liquid or supplement that you then consume every single day.
Aren't a handful if you will if you don't do
(04:12):
the basic things right. So I keep mentioning that, and
I'll keep saying that you have to do the basic
things right otherwise this stuff will not work. Even as
it pertains to memory and prevention of dementia. We get
that question a lot in the office. Sometimes we get
it here on the show. Just how can I preserve
my memory? My memory is slipping a little bit. I
(04:35):
forgot where my keys where I forgot something the other day?
You know, is this the beginning of a more serious
disease process? And again, just to reiterate to the listeners,
last week we had a very brief conversation about Alzheimer's
dementia and some new medications and a new philosophy about
(04:57):
how to treat it. Again, just to reiterate that, because
I know that that is on the mind of a
lot of Americans as they get older, just do not
want to be in that position where they don't have
their memory or if their memory power is slipping, which
again some of that can just be aging in itself.
(05:20):
If you get to your seventies and eighties, something is
bound to not work well. I mean, you're just older, right,
And I'm not trying to be disrespectful in any way.
I'm trying to be respectful of the aging process, which
you really need to understand that that is an active
process going on all the time in the background, and
(05:42):
it gets more parent as you get up into your
older age. These things don't work as well, and unfortunately
you're bound to suffer some sort of physical ailment. We're
just trying to keep it to a minimum as much
as possible. And yes, we do meet those patients who
are in there deep eighties, and maybe they take one medication,
(06:03):
maybe they take no medication. I mean, those people do
exist out there. But for the majority of us getting
into your deep eighties, there is a price to pay
to some degree, and as I mentioned, you have to
put a little bit more time into preserving how your
body functions and being able to feel well every day.
You have to sort of prioritize that and do your part.
(06:26):
And again it can't just be going to the store
and taking a supplement and doing that. But again, just
to reiterate, there is new medication available for the treatment
of what it from my understanding, early dementia, meaning if
you catch it late and the disease is pretty heavy,
the symptoms are pretty heavy. The medication is not really
(06:50):
late or severe dementia. It's really for kind of in
the beginning early onset. And I can kind of get that.
I can kind of understand that just because dementia does
have a lot to do with injury to the brain tissue,
and I think the scientists, the researchers are trying to
figure out why it gets started and then the metabolism
(07:12):
or the metabolic pathway that forms these plaques that we've
mentioned last time. PLAQ ues plaques, which is different from
the plaque that's in your blood vessel. The one that's
in your brain is called amyloid plaque. And again, over
the years, they've sort of discovered that in the brain
(07:34):
tissue of patients who've been proven to have Alzheimer's dementia.
This is a common denominator, the presence of this amyloid plaque,
which is a description of probably what it looks like
on bopsy and when they do tests to it, that's
sort of the appearance it has amyloid ish plaque. That
appears to be a very common denominator. So eliminating that
(07:59):
in the minds of the researchers are preventing the development
of that in the minds of the researches is a
way to reduce brain injury and increase or preserve the
function of the brain cell. So normally, if you start
getting the presence of these plaques in the brain tissue,
that's when you start getting dysfunction of the brain tissue
(08:21):
because it's been injured or that present that amyl plaque
starts to mess up the internal components of the brain tissue,
almost like cancer. When it becomes present, it sort of
takes over the cell. It handicaps the cell.
Speaker 2 (08:34):
We heard a lot about that with COVID.
Speaker 1 (08:36):
How when the virus gets inside of you sort of
hijacks your immune system and sort of turns your body
against you, because that's just the way the invader, the
organism works. It gets inside and then takes over and
sort of does whatever it wants to normally generating a
lot of chaos. Same thing with this amyloid plaque. Once
it gets inside that brain cell, it starts to take
(08:58):
over the brain cell and causes massive dysfunction. So the
end resultience you don't remember new things, or your behavior changes,
or you get more paranoid, or you make poor decisions,
which we call executive function. You start to develop poor
executive functions. So if you think of an executive and
running a business, business would be just your life and
(09:23):
how you run your life. When someone has dementia, a
lot of the decisions you make are poor and end
up costing or end up causing a lot of problems.
And that could be several different things. Financial is one
of them. A lot of elder patients who do have
dementia are who do have sort of a what they
(09:45):
call MCI, mild cognitive insufficiency. That's a new buzzword for
the development potentially of Alzheimer's dementia. Mild cognitive insufficiency is
you start to make some decisions that are not so
good for you, and financial is one of them. Unfortunately,
there are a lot of predators out there just sort
(10:06):
of waiting around to take advantage of those situations. A
lot of times there's a lot of cold calling where
elderly patients are at home watching TV, are doing their thing.
They get phone calls or they're on their phone and
they get these sort of concerning messages which prompt them
to sort of unload a lot of personal information to
(10:27):
whomever's on the other side whatever the message is, and
then before you know it, their bank accounts have been
cleaned out. So this stuff kind of happens on a
regular basis, and it even happens to regular people own
a regular basis who have no MCI, but more so
in that situation. That's just one example of sort of
the decisions these patients can make when amyloid plaque is
(10:51):
built up in their brain and it starts to generate
some of this executive dysfunction is what I'll call that,
and patients up making bad decisions, and it can sort.
Speaker 2 (11:03):
Of happen under the radar. Initially.
Speaker 1 (11:05):
You don't know what's happening until there's maybe a big
blow up and something gets found out when really it's
been going on for a long time. You know, a
lot of families are kind of busy. They're not really
paying attention to their parents. And a lot of times
patients who have Alzheimer's dementure mci I can kind of
hide it for a long time. They don't necessarily want
(11:26):
to be diagnosed. It's like everything else of any disease
that we have. A lot of times patients try to
ignore the fact that they have a certain disease. Don't
want to really go on, they don't want to take medicines.
You know, they're sort of at the end of their
lives and they've lived a good life and they're happy
with the way things are. They understand they're in the
later stages of their life and they're not trying to
(11:49):
dodge that. They get that part of it. Maybe their
wives have died, their husbands have died, maybe their friends
are not around, or there have been a lot of deaths.
They maybe they're hurt, and you know, they're just they're
just kind of at the end of the road, and
they get that. So they're not trying to be too
aggressive with things, and they know something's happening, but they
(12:11):
kind of accept it, and so it just kind of
goes on. The can gets kicked down the street for
multiple months until some sort of big crisis happens, they
get found somewhere out of town an hour and a
half away, two hours away, nobody's seen them, or again
the bills stop getting paid, or various sort of catastrophies
like that that happen every single day when families are
(12:33):
busy and they can't kind of keep an eye on
their mother or their father and they're sort of existing
by themselves at the house, they can kind of get
away with it for a while until it gets discovered.
So it's a lot of different scenarios out there, But
the one thing we wanted to mention to is that, yes,
the treatment is out there, and it's sort of brand new,
(12:55):
maybe been available for on that for a year or so.
And again we don't talk about just the awareness of dementia,
but certainly if you listen to the show and you
feel like you have some issues with your memory, or
you have a family member that you're concerned, I think
the idea is, and it's with everything else, is you know,
go in early and start that process of being monitored
(13:20):
and getting the testing and just sort of following it
because a lot of times early on it's kind of
difficult to tell if someone truly has a true disease
or not, just because again, as I mentioned, could just
be kind of an aging thing for all of us.
We lose a little bit of that memory capacity to
remember new things, but it doesn't become pathological most of
(13:43):
the time. With dementia becomes a little bit more deeper,
more pathological, and you can really tell that there is
an issue. But even for all of us on a
given day, we just things just kind of slip our
minds and we forget, we're preocupt we've got a lot
of things to do, and that's kind of a normal thing.
(14:04):
Dementia normally causes a deeper issue with short term memory.
Remember that's one of the most classic symptoms of dementia.
There can be other symptoms, but that is the most classic,
well known.
Speaker 2 (14:17):
Symptom of that.
Speaker 1 (14:18):
If you are having that problem, you know someone having
a problem, don't wait, go ahead, get in with your
health care provider and start that process of trying to
figure out is it real, is it not? Is there
something we need to be doing, and just kind of
start the surveillance aspect. And then unfortunately, if you do
get diagnosed, just like with any disease, diabetes, cancer, cardiovascal disease.
(14:44):
It's always better to find it at a earlier stage,
you know, stage one, if you will, versus finding it
out of stage four, which tends to be in the
medical world, a more advanced, untreatable sort of terminal position.
Terminal meaning there's really nothing the medical world can do
to reverse it or treat it or curate. And it's
(15:08):
more about just what we call palliative attention, palliative care.
We're just going to try and manage it as best
we can, but we ultimately know the end result of
this situation, so we just don't want you to get
in that position. And it just requires a little awareness
and just some attention to that problem. So go in
(15:28):
and get checked out first so that, yes, if you
do have that, maybe you're a candidate for these new medications.
But as I mentioned to you, it's not for the
general public dementia patient, right, it's for a special collection
of patients. I'm assuming there's some exclusionary criteria, which again
(15:49):
I don't prescribe the medication every day, so I don't
have a deep knowledge about the criteria in terms of
who meets the criteria To get this medication or not.
I think again it's an infusion, as our previous call
it mentioned, and maybe every other week or once a
week or once a month, something along those lines.
Speaker 2 (16:10):
And then there's a lot of testing.
Speaker 1 (16:13):
Before and during the treatment because, as the information admits,
there are some potential side effects with the medication, some
serious side effects.
Speaker 2 (16:26):
Right.
Speaker 1 (16:26):
There was some mention of brain bleeding, some mention of
swelling of the brain. I mean, these are some pretty
concerning symptoms. And I think that was sort of the
whole controversy when these medications came out, based on my
reading of when this medicine's hit the market, and just
both sides of the fence sort of voicing their concerns
(16:50):
about the medication, that the effectiveness was a little bit questionable,
and if it's not that effective and you have these
side effects, the ratio of benefit versus harm, which and
health care providers play every single day when we're prescribing
even the most simple medication to you for one single problem,
(17:10):
whether it be your blood pressure, your diabetes, you have
a headache, you're sick, and we're prescribing an antabotic or
whatever we're prescribing. That is always on the minds of
healthcare providers, is the risk of benefit ratio? Am I
going to harm this patient? Am I going to benefit
this patient? And in general, as a healthcare provider matures
(17:34):
in their decision making, they normally stick with the medications
that cause the least amount of problems, no matter how
they were trained, no matter what they read in the articles,
their own personal experience with their own patients tends to
dictate what they write and what they don't write, which
(17:55):
is why you sort of get different opinions from different doctors.
I know patients hate that. I deal with that every
single day, more so in the hospital, not so much
in my office. Just families and patients just utterly confused,
utterly upset at the mixed messaging that they're getting from
(18:18):
the healthcare providers that are trying to take care of
them in the hospital and help them figure out why
they feel a certain way, why certain things are happening.
To explain to them their physical symptoms, Explain the labs,
the x ray results, what it means. What are we
going to do? Are we having surgery, not having surgery?
Are we having this test not having this test? Am
I going home? I'm staying just all this stuff that happens,
(18:42):
especially in the hospital. If you don't know, I spend
a lot of time in the hospital every day, so
I have this experience and I have these stories interacting
with Southeast Texans, and I know it's super frustrating, and
again it's sometimes difficult, even with the best intentions from everyone.
It's different to stay on the same page, just again
because we all have sort of a different perspective about
(19:06):
what this means, what it doesn't mean, and how to
manage it. And that's sort of how medicine operates at
this time. But we honestly try to stay on the
same page and be on the same page about what
it is you have or what it is we need
to do for you. But again, a healthcare provider's personal
(19:27):
experience is really going to be the one thing that
dominates the influence on their decision making. What has happened
to me and my patient before when I did X,
Y or Z, And that is a lot of times
why you sort of get a different position on everything,
which is why getting a second opinion if you do
have a medical problem, something is going on you can't
(19:51):
get the right answer or things are not going as
planned with your provider, Go get a second opinion. I mean,
it's built in to the system. You have the ability
to do that. Most doctors I know endorse that, including myself,
even for my own patients.
Speaker 2 (20:08):
You're not getting better.
Speaker 1 (20:10):
You want a second opinion, Let's do that, just because
I know I'm not perfect. I don't know everything, and
maybe I'm just not understanding the situation to the best
of my ability for various reasons. No mal intent, it's
just that's the way it is. Yes, just get a
second opinion from a different healthcare provider, whether it be
one that's recommended to you, buy your provider, or if
(20:32):
you do it on your own. The Internet and our
healthcare system is set up so a lot of times
patients can do their own research, found their own providers.
And yes, if you do have the capacity, you get
in your car and you drive to a baytown, you
drive to an Austin. I know that's a far away,
but these providers are out there and if you have
(20:54):
the means, and a lot of Southeast sections have done
that and found the doctor that.
Speaker 2 (20:58):
Could sort of take care of the problem.
Speaker 1 (21:01):
And get them the answers that they're looking for, especially
if the local community was unable to do that even
given its best effort, which sometimes happens. You can walk
outside of the community and try and find that practitioner
that can get that answer for you, because that's really
what all doctors are trying to do is and healthcare
providers get that information too. You make you feel as
(21:23):
well as possible, just you know, sometimes it does not
work out as planned, and getting a second panion is
nothing wrong with that.
Speaker 2 (21:30):
It's built into the system.
Speaker 1 (21:32):
But certainly, if you do have memory issues, get in
sooner rather than later so that maybe you might be
a candid for these new medications. It may help you out,
but certainly work with your neurologists to try and figure
that out whether or not you're a candidate.
Speaker 2 (21:48):
Phone lines or open eight nine six.
Speaker 1 (21:49):
Kalva one one hundred and three three zero Kyov.
Speaker 2 (21:51):
I'll be back all right, Welcome back to the dark
Living and Medical.
Speaker 1 (22:04):
Our phone lines are open eight nine to six Kova
at one hundred and three three zero Kova. I sitting
here chatting about memory laws and certainly if you do
feel like that's an issue, then get in sooner rather
than later, just because again, if there is something going
on then it needs to be figured out or remember,
(22:25):
just because you forget a few things doesn't mean you
have dementia. We really need to get better with the testing,
and as far as I know, there are few new
tests that the neurologists primarily are using to try and
just help them be more accurate with making the diagnosis
of dementia or not.
Speaker 2 (22:44):
It's not necessarily a screening test.
Speaker 1 (22:47):
It hasn't gotten to the level where when you're going
to your primary care physician like me or a healthcare provider,
you're getting sort of this test to help you figure
out if you have.
Speaker 2 (22:57):
Dementia or not.
Speaker 1 (22:58):
It hasn't gotten to that level yet, which is kind
of what we're looking for. We don't have that at
this point. I guess for most patients who do ultimately
develop dementia, just things start changing neurologically, maybe psychologically, and
it's all about that trend, right, does it continue, does
(23:18):
it deepen? Is it every day or is it once
a year. That's really the symptoms and signs that maybe
something is changing. And initially it could just be just
random aging mild, not pathological. So again it's difficult to tell.
Sometimes you can kind of blow it off and maybe
(23:39):
attributed to whatever the case would be, a new medication,
just didn't get some good sleep. But again, as it progresses,
maybe you get a few more events under your belt,
or something more deeper happens. Then yes, it seems like
it's something real and you can't get rid of it,
then go in and get tested sooner rather than later.
(24:01):
We do have the medications that have been available for years.
That's a recept and na menda, which those medicines have
been out since I was a physician years ago. Those
are good medications and I've used them over the years
and feel like they do help. But again, you have
to kind of get on top of.
Speaker 2 (24:23):
The disease earlier rather than later.
Speaker 1 (24:26):
And if you can get the medications sooner, then they
tend to preserve your memory and they can sort of
lengthen out.
Speaker 2 (24:34):
This process a lot better.
Speaker 1 (24:35):
So that's why it's just better to go in, get
the testing and maybe start some medication, start the process
of being monitored tested, just so you can stay on
top that. Especially now you're just retired, you don't know
what to do with yourself. I mean, now the world
is open to you, don't have to go to work, anymore,
and all the responsibilities that you had are gone, and
(25:00):
you want to preserve your health. You got to preserve
your health, and certainly things that you do every single
day impact your health the most. And again I just
want to remind you it cannot just be simply going
to the store and getting your magic pill or your
magic supplement.
Speaker 2 (25:20):
You first of all have to eat the right foods.
Speaker 1 (25:22):
And again, I don't mind mentioning this over and over
again because after being a physician of over twenty years
and everything I've read, everything I see, I just want
to do my best to sound the alarm to all
my patients about if you really want to be healthy,
you really want to be out of the doctor's office,
(25:44):
You don't want all those medicines, you don't want to
be in a hospital every single day.
Speaker 2 (25:50):
It all starts with.
Speaker 1 (25:51):
What you eat and drink. I mean, that is the
honest of God's truth. That is my position at this
point in my career.
Speaker 2 (26:01):
Is you got to eat right.
Speaker 1 (26:03):
It's not really about the exercising point, although we want
you to be physically active, and that's another point of
contention to me as well. Just the way it's advertised
to the American people, and just the assumption of the
American people that it's got to be sort of this aggressive,
high intensity, high impact sort of activity and if it's not,
(26:26):
then it doesn't count, you know, meaning you have to
sweat and scream and yell and you need sort of
a tutor or a coach to get you on the
right path to this. I mean, if you want to
do that, that's fine. But again my impression, based on
my understanding and what I've read, it really doesn't require
(26:47):
that much. In my opinion, you can very simply just
walk around in your neighborhood ten fifteen minutes. You're done right.
You don't even have to do it every single day.
We have leave from Lumberton. How can we help you?
Speaker 3 (27:03):
Oh, yes, I'm calling in regards to my wife. For
about eight years now, she's been having what is called
cluster headaches binger talking about neurologists and the only thing
she does is, of course, the headaches wake her up
anywhere from like two three o'clock in the morning, and
(27:27):
she gets up and drinks real strong black coffee and
takes an aspirin and waits on it to go away.
She has been to a neurologists and he gave her
about three different things. Problem is she don't like to
take medicine and she didn't want to follow that program,
(27:48):
and she is fixing to go back. But I wanted
your thoughts. This has been going on so long and interrupting,
so almost like continuously raising a newborn. Yeah, so you know,
I wanted your faults on remedies and things you know
(28:13):
about cluster headaches. And I'll hang up and listen to
what you have.
Speaker 2 (28:19):
All right, leave from Lumbington. We appreciate that.
Speaker 1 (28:22):
Don't talk a lot about headaches on this show, but
certainly a very common complaint in most primary care physicians' offices.
Probably back pain is number one, and then headache is
number two. Fatigue Maybe maybe that's another that's a one
two fatigue, just don't feel good. But cluster headaches is
a specific type of headache that normally causes, as they
(28:47):
teach us in medical school, a pain syndrome that normally
involves the eye ball or the eye area. It could
either be left or right, and it normally causes a severe, searing,
very sharp pain syndrome in the ocular eyeball area of
(29:10):
face area. That's again severe, sudden, sort of like a
very like a lightning strike, and it normally lasts for
several minutes, maybe hours, and can be very incapacitating just
because of the severity of the pain. Sometimes can cause
(29:31):
changes in your vision. But again, it's hard to function
when you have pain in your face, your eyeball, you
can't function normally, and normally it does prompt an urgent
evaluation because, especially if it's your first one, you don't
know what's causing it, right, because the pain is so severe,
it may be related to some vision loss. You want
(29:52):
to make sure you're not dying. There's no stroke, there's
no cancer. I mean, those are things that patients think
about when symptoms like this happen and then it goes away, right,
It kind of comes and then it goes but it
comes with force, and it's unpredictable when it's going to happen.
And in terms of why certain people get and certain
(30:12):
people don't, my understanding is.
Speaker 2 (30:14):
That we don't quite know that yet.
Speaker 1 (30:17):
And in terms of the mechanism of action, as we say,
you know what starts the whole chain reaction off, my
understanding is that we haven't quite figured that out yet.
Speaker 2 (30:28):
We are getting better at.
Speaker 1 (30:30):
Identifying some of the players with the development of migraines,
like this calcium gene related peptide. That's one that's known
to operate a lot in the genesis of a lot
of these migraine syndromes. I'm sorry headache syndromes. Cluster headache
is one type of headache. Migraine is a different type
(30:53):
of headache. There are a few other types of headaches,
but cluster has its own physical characteristics, which is why
it's called a cluster.
Speaker 2 (31:02):
It sort of.
Speaker 1 (31:03):
Comes in bouts and explosions like a cluster, whereas migrante
headache tints when it comes, it tends to stay all day,
can last for several days or not. But the cluster
is more of a thunderclap, a thunderstrike headache just bam right,
happens quickly, it's strong, it stays for a certain length
(31:23):
of time, and then a lot of times it'll go away,
but very incapacitating for migraine headaches. You can sort of
work through it, especially if it's mild, but sometimes can
generate some severe symptoms. But in terms of why one
person would get migraine, woman will get cluster. Again, I'm
not a headache specialist. But my understanding is that I'm
(31:44):
not quite sure why that is. But we're starting to
get a little bit more better understanding of the players
in terms of the genesis of headache development, and this
calcitonin genulated peptide is one of the identified and there
is medication on the market now that inhibits, prohibits controls
(32:07):
this calcotonin gene related peptide, and in controlling that, it
then controls the frequency and intensity of the cluster headache.
When I hit the scene as a doctor, there were
a few medications available for cluster headache management. They were okay,
but you know, weren't the best. But twenty years later,
(32:30):
again this new category of headache medications, the calcitonin gene
related peptide inhibitor, they're now out. You may know these
medicines as Ubrelvy or a q Lipta are a couple
of those, as also Neurotech. That's not the name I'm
(32:50):
blinking on that. I'll have to get that one for you.
But this is a new class of medications that's out
on the market now that really really helps control the
development of cluster headaches, migraine headaches. It's really for migrant headaches.
But again, cluster is sort of a cousin of migraine
and share some similar pathways in terms of its mechanism
(33:15):
of action and can be used to help control the
frequency and intensity of the cluster headache. So the cluster
headache gets its name from the way it behaves. Like
I said, it's very fast on set, it comes strong,
lasts for a while, and then it goes away sort
of in the sense of a cluster of cluster of
symptoms very quickly, very rapidly, and then shuts down. Sometimes, yes,
(33:40):
it can last several hours and again be very incapacitating.
And then migraine, the most common form of headache, can
also be severe, but a lot of times kind of
a dull, moderate pain. You can kind of get through
it takes them over the counter medications and get through
your day, maybe go to sleep, laid down in the
dark room. But cluster is one that tends to just
(34:04):
be very severe, very fast on set, and more incapacitating
most of the time. So hopefully that answers your questions.
Phone lines are open eight nine six Kalvy. I won
one hundred three three zero Kalva. I'll be back in
two minutes. All right, welcome back to talk with me Medica.
(34:30):
Our phone lines to open eight nine six. Kalovy I
won one hundred three three zero O kova I talking
about cluster headaches, migraine headaches, Man, you don't want to
have one of those, but a new class of medications
is out for in particular migraine headaches, and probably knowing
doctors and healthcare providers, we probably would use it for
(34:52):
a cluster headache, which again probably has a little bit
different mechanism of action in terms of what generates the symptom.
But probably, like we do with all medicines, we use
it off label just because again we're just trying to
help patients, and if we don't have a lot of options,
we will sometimes use that product for a different disease
safely based on our experience as I mentioned to you,
(35:15):
and these calcitoniningmulated peptide antagonist or inhibitors I mentioned a few.
Qu Lipta is one of them. You, Breilvy is another,
and then the other one.
Speaker 2 (35:25):
I couldn't remember. I looked it up.
Speaker 1 (35:27):
It's called nerd Tech in you are Tec that's the
brand name, and these are tablets that you can take
primarily for migraines, but again probably can be used to
off label for these cluster headaches. There's a few other
medications that I learned specifically for cluster egs and blood
(35:47):
pressure medications primarily being one of them. But we also
have Gaba pension for headaches and Lyrica for headaches. We
have medication called elevil, So we have several different meds
that we're using for the prevention and treatment of primarily
migrant headaches, but cluster headaches. Probably we're using those off label,
(36:10):
as we do with a lot of medicines that get
FT approved for one indication, then it hits the market
and we sort of do our own investigation and try
medicines for other diseases and for other indications, and depending
on what happens, you know, it might be something that
we can use for these particular patients, just trying to
get them to feel better, which can sometimes be tough,
(36:33):
and no matter which medication we prescribe to you, again,
we never know if it's going to completely work. You
might have to go through a trial of trying a
few different medications. We found this a lot with antidepressants
and anti anxiety medications. A lot of times we do
hit on the first one, meaning we give a medication, Boom,
(36:54):
it works, everybody's happy, and that's it. But there is
a significant portion of pas, especially like I say, with
anxiety depression, we might have to go to go through
two or three medications before we find one that kind
of works for you and makes you feel neutral without
causing a lot of side effects. Doesn't quite matter what
(37:16):
your friend is taking with your mother's taking. It's all
about what your system needs and how your system ranks
to these medications. So you just have to be careful.
As pertains set, I'll go on my last break. Phone
lines are open eight one six klv I one to
eight hundred and three three zero kov. I'll be back
for closing remarks.
Speaker 2 (37:42):
All right, welcome back to Talkable Matic.
Speaker 1 (37:44):
Our phone lines are open eight nine six kV I
one hundred three three zero klv I. Remember, if there's
a topic that you like me to discuss, you.
Speaker 2 (37:53):
Can call the radio station.
Speaker 1 (37:54):
You can call my office and drop that note and
we will talk about that. Remember the show with for
you to help you figure out what's good what's bad
for you, to help make this easier based on someone
who's on the inside, who sees this stuff every day,
who kind of sees what works what doesn't work. That's
the genesis of the show. So give us a buzz
(38:15):
and drop off that note and we will certainly cover that.
We had some fun today again talking about headaches, cluster migraine,
some good medications on the market. Just talk to your
healthcare provider about getting a prescription for these calcitonin gene
related peptide inhibitors or antagonists. Works very well, nerd Tech,
(38:39):
u Lipta, your Brelvy, just to name a few. Probably
being used for cluster. Not quite sure. I probably would
try it if I had a cluster headache patient. Because
these medicines are awesome, they're clean, they're once a day,
minimal side effects. I've had excellent, excellent experience with that
category of medications. I'm using it very heavily. But we
(39:02):
also talked about memory and the memory health, and again
it all balls down to what you eat, what you eat,
what you eat.
Speaker 2 (39:11):
And what you drink. Remember, you can go wrong with
drinking right sugar. Try not to drink sugar. Right.
Speaker 1 (39:16):
I'm sort of tell that's my new phrase in my office. Now,
don't drink sugar and a lot of people, my pastients
sleeping like, what, don't drink shit is it? But again,
there's sugar and a lot of the beverages that you
decide to drink, and all the health experts agree it's
very unhealthy for you. You got to give your body
a break from this exposure to all this refined, ultra
(39:39):
process sugar that's in a lot of the ultra process
foods and beverages that you're consuming. Just good old fashioned
water can get a little boring, so I get it.
Coffee tea is out there that can be more exciting.
They have more flavor profiles, flavor right flavor. A lot
of people think sugar is flavor, but different flavor profiles
(40:01):
with coffee and tea. Just go to your HB, go
to your Kroger, your market basket and look at the aisle.
It's just full of different types of varieties and you
can brew it yourself. It's a very healthy beverage.
Speaker 2 (40:15):
A lot of time.
Speaker 1 (40:15):
It contains products in it, herb spices that are antioxidants
that are good for your health, that help you fight
disease such as dabetes and arthritis. And you're drinking it
every day. Right, it's your medicine primarily, how you have
to look at that, consuming a product that is healthy
for you. It's your medicine to protect you, to boost
(40:37):
your immune system, to help decrease the development of these
amyloid plaques, again common denominator in dementia. But again if
you're starting to have some memory issues, go in sooner
rather than later. Just kind of start the process and
get on these medications. If your provider feels like this
is an issue, go get your proper testing and start it.
(41:00):
Because if you wait and wait and wait, then a
lot of times there's not much we can offer to you.
And remember it all starts with what you eat and
drink and being physically active, not running a marathon, but
just getting off the couch doing something around the house
every single day. Thank you for joining aroun the edition
of the show Don't drink and drive, eat some vegetables.
Speaker 2 (41:18):
We'll see you guys next week. Take care,
All right, welcome South these Texes. Welcome, Welcome, Welcome to
the edition of the Doctor Levigne Medical Hour. Good morning,
and hopefully you're having a wonderful morning this morning. It's
a beautiful morning, good weather, no rain, it's not really cold,
not really hot, just right, and hopefully you're having a
wonderful morning today and we'll appreciate you joining us on
(00:25):
the Doctor Levine Medical Hour to chat about how to
stay alive longer and healthier, and how to start at
the hospital, how to limit your exposure to pharmaceutical medications
and doctor visits. Just what are the ways to do that?
Phone line to open eight nine to six. Kov I
wanted one hundred three three zero Kovi ivy. Love to
(00:48):
talk with you, love to hear from you, and help
you try and answer some of your issues that you
might have or just clear up some confusion, which there
tends to be a lot of that going on every
single day in a lot of different instances, and we're
just here to try and help you out, get you
some basic information. Try to keep it basic, try not
(01:09):
to make it too complicated, so that you can figure
out what works for you and your family. Because we're
all different our bodies are all different, we respond to
medicines different, and it's sometimes difficult to look across the
street and see what someone else is doing and adopt
that for yourself just because it may not work for you,
(01:30):
just because it works someone else. So you got to
kind of figure it out, put a little time into
it to figure out what is the right plan for you.
And it does require some effort, especially as you get older.
We have this conversation a lot with my patients who
are getting older. When you're younger, you can kind of
get away with sort of the misbehavior of your lifestyle
(01:53):
in terms of what you eat and drink and just
being sedentary. You get busy with other things, your job,
your marriage, your kids, just trying to get financially settled,
and our health normally is not being prioritized. And I
get that you've never been sick before, never been in
a hospital before.
Speaker 2 (02:11):
It's just not an.
Speaker 1 (02:12):
Experience for you until you have some big medical crises
and you do end up in the hospital or doctor's
office and you have to sort of reroute or reconfigure
your priorities in terms of what's one, two, three, four.
And that is one thing that I see as the
trajectory of aging takes over as you get into the
(02:34):
later part of your life and all these other issues
have sort of been settled. You've got your financial base,
kids are off living.
Speaker 2 (02:42):
Their own lives.
Speaker 1 (02:44):
Maybe now you're retired, there's not much staring at you
other than you and your health, and now you have
time to really spend time doing the right things, all
the things that you've wanted to do over the years,
but for whatever reason, you couldn't get around to it
because of other distractions, other priorities. And now that you've
(03:04):
made it through the obstacle course and you're on the
other end, here's the time to really really dedicate or
devote to your health and maintain your health because you
typically need to do that as the body's system, as
the program that we all have in terms of the
aging process, starts to get in pretty heavy. The things
(03:27):
that you do every single day tend to be more
impactful than when you were younger, and you really have
to say no to those food items and beverage items
that you know are just not good for you. If
you want to stay out at doctor Lavine's office, you
want to stay out of the local hospitals, you don't
want to take a sack full of medications. These are
things that need to be done in order to reduce
(03:49):
that possibility. And again, it's not going to be as
simple as going to the store or going to your
favorite internet spot and ordering some magical pill or juice
or liquid or supplement that you then consume every single day.
Aren't a handful if you will if you don't do
(04:12):
the basic things right. So I keep mentioning that, and
I'll keep saying that you have to do the basic
things right otherwise this stuff will not work. Even as
it pertains to memory and prevention of dementia. We get
that question a lot in the office. Sometimes we get
it here on the show. Just how can I preserve
my memory? My memory is slipping a little bit. I
(04:35):
forgot where my keys where I forgot something the other day?
You know, is this the beginning of a more serious
disease process? And again, just to reiterate to the listeners,
last week we had a very brief conversation about Alzheimer's
dementia and some new medications and a new philosophy about
(04:57):
how to treat it. Again, just to reiterate that, because
I know that that is on the mind of a
lot of Americans as they get older, just do not
want to be in that position where they don't have
their memory or if their memory power is slipping, which
again some of that can just be aging in itself.
(05:20):
If you get to your seventies and eighties, something is
bound to not work well. I mean, you're just older, right,
And I'm not trying to be disrespectful in any way.
I'm trying to be respectful of the aging process, which
you really need to understand that that is an active
process going on all the time in the background, and
(05:42):
it gets more parent as you get up into your
older age. These things don't work as well, and unfortunately
you're bound to suffer some sort of physical ailment. We're
just trying to keep it to a minimum as much
as possible. And yes, we do meet those patients who
are in there deep eighties, and maybe they take one medication,
(06:03):
maybe they take no medication. I mean, those people do
exist out there. But for the majority of us getting
into your deep eighties, there is a price to pay
to some degree, and as I mentioned, you have to
put a little bit more time into preserving how your
body functions and being able to feel well every day.
You have to sort of prioritize that and do your part.
(06:26):
And again it can't just be going to the store
and taking a supplement and doing that. But again, just
to reiterate, there is new medication available for the treatment
of what it from my understanding, early dementia, meaning if
you catch it late and the disease is pretty heavy,
the symptoms are pretty heavy. The medication is not really
(06:50):
late or severe dementia. It's really for kind of in
the beginning early onset. And I can kind of get that.
I can kind of understand that just because dementia does
have a lot to do with injury to the brain tissue,
and I think the scientists, the researchers are trying to
figure out why it gets started and then the metabolism
(07:12):
or the metabolic pathway that forms these plaques that we've
mentioned last time. PLAQ ues plaques, which is different from
the plaque that's in your blood vessel. The one that's
in your brain is called amyloid plaque. And again, over
the years, they've sort of discovered that in the brain
(07:34):
tissue of patients who've been proven to have Alzheimer's dementia.
This is a common denominator, the presence of this amyloid plaque,
which is a description of probably what it looks like
on bopsy and when they do tests to it, that's
sort of the appearance it has amyloid ish plaque. That
appears to be a very common denominator. So eliminating that
(07:59):
in the minds of the researchers are preventing the development
of that in the minds of the researches is a
way to reduce brain injury and increase or preserve the
function of the brain cell. So normally, if you start
getting the presence of these plaques in the brain tissue,
that's when you start getting dysfunction of the brain tissue
(08:21):
because it's been injured or that present that amyl plaque
starts to mess up the internal components of the brain tissue,
almost like cancer. When it becomes present, it sort of
takes over the cell. It handicaps the cell.
Speaker 2 (08:34):
We heard a lot about that with COVID.
Speaker 1 (08:36):
How when the virus gets inside of you sort of
hijacks your immune system and sort of turns your body
against you, because that's just the way the invader, the
organism works. It gets inside and then takes over and
sort of does whatever it wants to normally generating a
lot of chaos. Same thing with this amyloid plaque. Once
it gets inside that brain cell, it starts to take
(08:58):
over the brain cell and causes massive dysfunction. So the
end resultience you don't remember new things, or your behavior changes,
or you get more paranoid, or you make poor decisions,
which we call executive function. You start to develop poor
executive functions. So if you think of an executive and
running a business, business would be just your life and
(09:23):
how you run your life. When someone has dementia, a
lot of the decisions you make are poor and end
up costing or end up causing a lot of problems.
And that could be several different things. Financial is one
of them. A lot of elder patients who do have
dementia are who do have sort of a what they
(09:45):
call MCI, mild cognitive insufficiency. That's a new buzzword for
the development potentially of Alzheimer's dementia. Mild cognitive insufficiency is
you start to make some decisions that are not so
good for you, and financial is one of them. Unfortunately,
there are a lot of predators out there just sort
(10:06):
of waiting around to take advantage of those situations. A
lot of times there's a lot of cold calling where
elderly patients are at home watching TV, are doing their thing.
They get phone calls or they're on their phone and
they get these sort of concerning messages which prompt them
to sort of unload a lot of personal information to
(10:27):
whomever's on the other side whatever the message is, and
then before you know it, their bank accounts have been
cleaned out. So this stuff kind of happens on a
regular basis, and it even happens to regular people own
a regular basis who have no MCI, but more so
in that situation. That's just one example of sort of
the decisions these patients can make when amyloid plaque is
(10:51):
built up in their brain and it starts to generate
some of this executive dysfunction is what I'll call that,
and patients up making bad decisions, and it can sort.
Speaker 2 (11:03):
Of happen under the radar. Initially.
Speaker 1 (11:05):
You don't know what's happening until there's maybe a big
blow up and something gets found out when really it's
been going on for a long time. You know, a
lot of families are kind of busy. They're not really
paying attention to their parents. And a lot of times
patients who have Alzheimer's dementure mci I can kind of
hide it for a long time. They don't necessarily want
(11:26):
to be diagnosed. It's like everything else of any disease
that we have. A lot of times patients try to
ignore the fact that they have a certain disease. Don't
want to really go on, they don't want to take medicines.
You know, they're sort of at the end of their
lives and they've lived a good life and they're happy
with the way things are. They understand they're in the
later stages of their life and they're not trying to
(11:49):
dodge that. They get that part of it. Maybe their
wives have died, their husbands have died, maybe their friends
are not around, or there have been a lot of deaths.
They maybe they're hurt, and you know, they're just they're
just kind of at the end of the road, and
they get that. So they're not trying to be too
aggressive with things, and they know something's happening, but they
(12:11):
kind of accept it, and so it just kind of
goes on. The can gets kicked down the street for
multiple months until some sort of big crisis happens, they
get found somewhere out of town an hour and a
half away, two hours away, nobody's seen them, or again
the bills stop getting paid, or various sort of catastrophies
like that that happen every single day when families are
(12:33):
busy and they can't kind of keep an eye on
their mother or their father and they're sort of existing
by themselves at the house, they can kind of get
away with it for a while until it gets discovered.
So it's a lot of different scenarios out there, But
the one thing we wanted to mention to is that, yes,
the treatment is out there, and it's sort of brand new,
(12:55):
maybe been available for on that for a year or so.
And again we don't talk about just the awareness of dementia,
but certainly if you listen to the show and you
feel like you have some issues with your memory, or
you have a family member that you're concerned, I think
the idea is, and it's with everything else, is you know,
go in early and start that process of being monitored
(13:20):
and getting the testing and just sort of following it
because a lot of times early on it's kind of
difficult to tell if someone truly has a true disease
or not, just because again, as I mentioned, could just
be kind of an aging thing for all of us.
We lose a little bit of that memory capacity to
remember new things, but it doesn't become pathological most of
(13:43):
the time. With dementia becomes a little bit more deeper,
more pathological, and you can really tell that there is
an issue. But even for all of us on a
given day, we just things just kind of slip our
minds and we forget, we're preocupt we've got a lot
of things to do, and that's kind of a normal thing.
(14:04):
Dementia normally causes a deeper issue with short term memory.
Remember that's one of the most classic symptoms of dementia.
There can be other symptoms, but that is the most classic,
well known.
Speaker 2 (14:17):
Symptom of that.
Speaker 1 (14:18):
If you are having that problem, you know someone having
a problem, don't wait, go ahead, get in with your
health care provider and start that process of trying to
figure out is it real, is it not? Is there
something we need to be doing, and just kind of
start the surveillance aspect. And then unfortunately, if you do
get diagnosed, just like with any disease, diabetes, cancer, cardiovascal disease.
(14:44):
It's always better to find it at a earlier stage,
you know, stage one, if you will, versus finding it
out of stage four, which tends to be in the
medical world, a more advanced, untreatable sort of terminal position.
Terminal meaning there's really nothing the medical world can do
to reverse it or treat it or curate. And it's
(15:08):
more about just what we call palliative attention, palliative care.
We're just going to try and manage it as best
we can, but we ultimately know the end result of
this situation, so we just don't want you to get
in that position. And it just requires a little awareness
and just some attention to that problem. So go in
(15:28):
and get checked out first so that, yes, if you
do have that, maybe you're a candidate for these new medications.
But as I mentioned to you, it's not for the
general public dementia patient, right, it's for a special collection
of patients. I'm assuming there's some exclusionary criteria, which again
(15:49):
I don't prescribe the medication every day, so I don't
have a deep knowledge about the criteria in terms of
who meets the criteria To get this medication or not.
I think again it's an infusion, as our previous call
it mentioned, and maybe every other week or once a
week or once a month, something along those lines.
Speaker 2 (16:10):
And then there's a lot of testing.
Speaker 1 (16:13):
Before and during the treatment because, as the information admits,
there are some potential side effects with the medication, some
serious side effects.
Speaker 2 (16:26):
Right.
Speaker 1 (16:26):
There was some mention of brain bleeding, some mention of
swelling of the brain. I mean, these are some pretty
concerning symptoms. And I think that was sort of the
whole controversy when these medications came out, based on my
reading of when this medicine's hit the market, and just
both sides of the fence sort of voicing their concerns
(16:50):
about the medication, that the effectiveness was a little bit questionable,
and if it's not that effective and you have these
side effects, the ratio of benefit versus harm, which and
health care providers play every single day when we're prescribing
even the most simple medication to you for one single problem,
(17:10):
whether it be your blood pressure, your diabetes, you have
a headache, you're sick, and we're prescribing an antabotic or
whatever we're prescribing. That is always on the minds of
healthcare providers, is the risk of benefit ratio? Am I
going to harm this patient? Am I going to benefit
this patient? And in general, as a healthcare provider matures
(17:34):
in their decision making, they normally stick with the medications
that cause the least amount of problems, no matter how
they were trained, no matter what they read in the articles,
their own personal experience with their own patients tends to
dictate what they write and what they don't write, which
(17:55):
is why you sort of get different opinions from different doctors.
I know patients hate that. I deal with that every
single day, more so in the hospital, not so much
in my office. Just families and patients just utterly confused,
utterly upset at the mixed messaging that they're getting from
(18:18):
the healthcare providers that are trying to take care of
them in the hospital and help them figure out why
they feel a certain way, why certain things are happening.
To explain to them their physical symptoms, Explain the labs,
the x ray results, what it means. What are we
going to do? Are we having surgery, not having surgery?
Are we having this test not having this test? Am
I going home? I'm staying just all this stuff that happens,
(18:42):
especially in the hospital. If you don't know, I spend
a lot of time in the hospital every day, so
I have this experience and I have these stories interacting
with Southeast Texans, and I know it's super frustrating, and
again it's sometimes difficult, even with the best intentions from everyone.
It's different to stay on the same page, just again
because we all have sort of a different perspective about
(19:06):
what this means, what it doesn't mean, and how to
manage it. And that's sort of how medicine operates at
this time. But we honestly try to stay on the
same page and be on the same page about what
it is you have or what it is we need
to do for you. But again, a healthcare provider's personal
(19:27):
experience is really going to be the one thing that
dominates the influence on their decision making. What has happened
to me and my patient before when I did X,
Y or Z, And that is a lot of times
why you sort of get a different position on everything,
which is why getting a second opinion if you do
have a medical problem, something is going on you can't
(19:51):
get the right answer or things are not going as
planned with your provider, Go get a second opinion. I mean,
it's built in to the system. You have the ability
to do that. Most doctors I know endorse that, including myself,
even for my own patients.
Speaker 2 (20:08):
You're not getting better.
Speaker 1 (20:10):
You want a second opinion, Let's do that, just because
I know I'm not perfect. I don't know everything, and
maybe I'm just not understanding the situation to the best
of my ability for various reasons. No mal intent, it's
just that's the way it is. Yes, just get a
second opinion from a different healthcare provider, whether it be
one that's recommended to you, buy your provider, or if
(20:32):
you do it on your own. The Internet and our
healthcare system is set up so a lot of times
patients can do their own research, found their own providers.
And yes, if you do have the capacity, you get
in your car and you drive to a baytown, you
drive to an Austin. I know that's a far away,
but these providers are out there and if you have
(20:54):
the means, and a lot of Southeast sections have done
that and found the doctor that.
Speaker 2 (20:58):
Could sort of take care of the problem.
Speaker 1 (21:01):
And get them the answers that they're looking for, especially
if the local community was unable to do that even
given its best effort, which sometimes happens. You can walk
outside of the community and try and find that practitioner
that can get that answer for you, because that's really
what all doctors are trying to do is and healthcare
providers get that information too. You make you feel as
(21:23):
well as possible, just you know, sometimes it does not
work out as planned, and getting a second panion is
nothing wrong with that.
Speaker 2 (21:30):
It's built into the system.
Speaker 1 (21:32):
But certainly, if you do have memory issues, get in
sooner rather than later so that maybe you might be
a candid for these new medications. It may help you out,
but certainly work with your neurologists to try and figure
that out whether or not you're a candidate.
Speaker 2 (21:48):
Phone lines or open eight nine six.
Speaker 1 (21:49):
Kalva one one hundred and three three zero Kyov.
Speaker 2 (21:51):
I'll be back all right, Welcome back to the dark
Living and Medical.
Speaker 1 (22:04):
Our phone lines are open eight nine to six Kova
at one hundred and three three zero Kova. I sitting
here chatting about memory laws and certainly if you do
feel like that's an issue, then get in sooner rather
than later, just because again, if there is something going
on then it needs to be figured out or remember,
(22:25):
just because you forget a few things doesn't mean you
have dementia. We really need to get better with the testing,
and as far as I know, there are few new
tests that the neurologists primarily are using to try and
just help them be more accurate with making the diagnosis
of dementia or not.
Speaker 2 (22:44):
It's not necessarily a screening test.
Speaker 1 (22:47):
It hasn't gotten to the level where when you're going
to your primary care physician like me or a healthcare provider,
you're getting sort of this test to help you figure
out if you have.
Speaker 2 (22:57):
Dementia or not.
Speaker 1 (22:58):
It hasn't gotten to that level yet, which is kind
of what we're looking for. We don't have that at
this point. I guess for most patients who do ultimately
develop dementia, just things start changing neurologically, maybe psychologically, and
it's all about that trend, right, does it continue, does
(23:18):
it deepen? Is it every day or is it once
a year. That's really the symptoms and signs that maybe
something is changing. And initially it could just be just
random aging mild, not pathological. So again it's difficult to tell.
Sometimes you can kind of blow it off and maybe
(23:39):
attributed to whatever the case would be, a new medication,
just didn't get some good sleep. But again, as it progresses,
maybe you get a few more events under your belt,
or something more deeper happens. Then yes, it seems like
it's something real and you can't get rid of it,
then go in and get tested sooner rather than later.
(24:01):
We do have the medications that have been available for years.
That's a recept and na menda, which those medicines have
been out since I was a physician years ago. Those
are good medications and I've used them over the years
and feel like they do help. But again, you have
to kind of get on top of.
Speaker 2 (24:23):
The disease earlier rather than later.
Speaker 1 (24:26):
And if you can get the medications sooner, then they
tend to preserve your memory and they can sort of
lengthen out.
Speaker 2 (24:34):
This process a lot better.
Speaker 1 (24:35):
So that's why it's just better to go in, get
the testing and maybe start some medication, start the process
of being monitored tested, just so you can stay on
top that. Especially now you're just retired, you don't know
what to do with yourself. I mean, now the world
is open to you, don't have to go to work, anymore,
and all the responsibilities that you had are gone, and
(25:00):
you want to preserve your health. You got to preserve
your health, and certainly things that you do every single
day impact your health the most. And again I just
want to remind you it cannot just be simply going
to the store and getting your magic pill or your
magic supplement.
Speaker 2 (25:20):
You first of all have to eat the right foods.
Speaker 1 (25:22):
And again, I don't mind mentioning this over and over
again because after being a physician of over twenty years
and everything I've read, everything I see, I just want
to do my best to sound the alarm to all
my patients about if you really want to be healthy,
you really want to be out of the doctor's office,
(25:44):
You don't want all those medicines, you don't want to
be in a hospital every single day.
Speaker 2 (25:50):
It all starts with.
Speaker 1 (25:51):
What you eat and drink. I mean, that is the
honest of God's truth. That is my position at this
point in my career.
Speaker 2 (26:01):
Is you got to eat right.
Speaker 1 (26:03):
It's not really about the exercising point, although we want
you to be physically active, and that's another point of
contention to me as well. Just the way it's advertised
to the American people, and just the assumption of the
American people that it's got to be sort of this aggressive,
high intensity, high impact sort of activity and if it's not,
(26:26):
then it doesn't count, you know, meaning you have to
sweat and scream and yell and you need sort of
a tutor or a coach to get you on the
right path to this. I mean, if you want to
do that, that's fine. But again my impression, based on
my understanding and what I've read, it really doesn't require
(26:47):
that much. In my opinion, you can very simply just
walk around in your neighborhood ten fifteen minutes. You're done right.
You don't even have to do it every single day.
We have leave from Lumberton. How can we help you?
Speaker 3 (27:03):
Oh, yes, I'm calling in regards to my wife. For
about eight years now, she's been having what is called
cluster headaches binger talking about neurologists and the only thing
she does is, of course, the headaches wake her up
anywhere from like two three o'clock in the morning, and
(27:27):
she gets up and drinks real strong black coffee and
takes an aspirin and waits on it to go away.
She has been to a neurologists and he gave her
about three different things. Problem is she don't like to
take medicine and she didn't want to follow that program,
(27:48):
and she is fixing to go back. But I wanted
your thoughts. This has been going on so long and interrupting,
so almost like continuously raising a newborn. Yeah, so you know,
I wanted your faults on remedies and things you know
(28:13):
about cluster headaches. And I'll hang up and listen to
what you have.
Speaker 2 (28:19):
All right, leave from Lumbington. We appreciate that.
Speaker 1 (28:22):
Don't talk a lot about headaches on this show, but
certainly a very common complaint in most primary care physicians' offices.
Probably back pain is number one, and then headache is
number two. Fatigue Maybe maybe that's another that's a one
two fatigue, just don't feel good. But cluster headaches is
a specific type of headache that normally causes, as they
(28:47):
teach us in medical school, a pain syndrome that normally
involves the eye ball or the eye area. It could
either be left or right, and it normally causes a severe, searing,
very sharp pain syndrome in the ocular eyeball area of
(29:10):
face area. That's again severe, sudden, sort of like a
very like a lightning strike, and it normally lasts for
several minutes, maybe hours, and can be very incapacitating just
because of the severity of the pain. Sometimes can cause
(29:31):
changes in your vision. But again, it's hard to function
when you have pain in your face, your eyeball, you
can't function normally, and normally it does prompt an urgent
evaluation because, especially if it's your first one, you don't
know what's causing it, right, because the pain is so severe,
it may be related to some vision loss. You want
(29:52):
to make sure you're not dying. There's no stroke, there's
no cancer. I mean, those are things that patients think
about when symptoms like this happen and then it goes away, right,
It kind of comes and then it goes but it
comes with force, and it's unpredictable when it's going to happen.
And in terms of why certain people get and certain
(30:12):
people don't, my understanding is.
Speaker 2 (30:14):
That we don't quite know that yet.
Speaker 1 (30:17):
And in terms of the mechanism of action, as we say,
you know what starts the whole chain reaction off, my
understanding is that we haven't quite figured that out yet.
Speaker 2 (30:28):
We are getting better at.
Speaker 1 (30:30):
Identifying some of the players with the development of migraines,
like this calcium gene related peptide. That's one that's known
to operate a lot in the genesis of a lot
of these migraine syndromes. I'm sorry headache syndromes. Cluster headache
is one type of headache. Migraine is a different type
(30:53):
of headache. There are a few other types of headaches,
but cluster has its own physical characteristics, which is why
it's called a cluster.
Speaker 2 (31:02):
It sort of.
Speaker 1 (31:03):
Comes in bouts and explosions like a cluster, whereas migrante
headache tints when it comes, it tends to stay all day,
can last for several days or not. But the cluster
is more of a thunderclap, a thunderstrike headache just bam right,
happens quickly, it's strong, it stays for a certain length
(31:23):
of time, and then a lot of times it'll go away,
but very incapacitating for migraine headaches. You can sort of
work through it, especially if it's mild, but sometimes can
generate some severe symptoms. But in terms of why one
person would get migraine, woman will get cluster. Again, I'm
not a headache specialist. But my understanding is that I'm
(31:44):
not quite sure why that is. But we're starting to
get a little bit more better understanding of the players
in terms of the genesis of headache development, and this
calcitonin genulated peptide is one of the identified and there
is medication on the market now that inhibits, prohibits controls
(32:07):
this calcotonin gene related peptide, and in controlling that, it
then controls the frequency and intensity of the cluster headache.
When I hit the scene as a doctor, there were
a few medications available for cluster headache management. They were okay,
but you know, weren't the best. But twenty years later,
(32:30):
again this new category of headache medications, the calcitonin gene
related peptide inhibitor, they're now out. You may know these
medicines as Ubrelvy or a q Lipta are a couple
of those, as also Neurotech. That's not the name I'm
(32:50):
blinking on that. I'll have to get that one for you.
But this is a new class of medications that's out
on the market now that really really helps control the
development of cluster headaches, migraine headaches. It's really for migrant headaches.
But again, cluster is sort of a cousin of migraine
and share some similar pathways in terms of its mechanism
(33:15):
of action and can be used to help control the
frequency and intensity of the cluster headache. So the cluster
headache gets its name from the way it behaves. Like
I said, it's very fast on set, it comes strong,
lasts for a while, and then it goes away sort
of in the sense of a cluster of cluster of
symptoms very quickly, very rapidly, and then shuts down. Sometimes, yes,
(33:40):
it can last several hours and again be very incapacitating.
And then migraine, the most common form of headache, can
also be severe, but a lot of times kind of
a dull, moderate pain. You can kind of get through
it takes them over the counter medications and get through
your day, maybe go to sleep, laid down in the
dark room. But cluster is one that tends to just
(34:04):
be very severe, very fast on set, and more incapacitating
most of the time. So hopefully that answers your questions.
Phone lines are open eight nine six Kalvy. I won
one hundred three three zero Kalva. I'll be back in
two minutes. All right, welcome back to talk with me Medica.
(34:30):
Our phone lines to open eight nine six. Kalovy I
won one hundred three three zero O kova I talking
about cluster headaches, migraine headaches, Man, you don't want to
have one of those, but a new class of medications
is out for in particular migraine headaches, and probably knowing
doctors and healthcare providers, we probably would use it for
(34:52):
a cluster headache, which again probably has a little bit
different mechanism of action in terms of what generates the symptom.
But probably, like we do with all medicines, we use
it off label just because again we're just trying to
help patients, and if we don't have a lot of options,
we will sometimes use that product for a different disease
safely based on our experience as I mentioned to you,
(35:15):
and these calcitoniningmulated peptide antagonist or inhibitors I mentioned a few.
Qu Lipta is one of them. You, Breilvy is another,
and then the other one.
Speaker 2 (35:25):
I couldn't remember. I looked it up.
Speaker 1 (35:27):
It's called nerd Tech in you are Tec that's the
brand name, and these are tablets that you can take
primarily for migraines, but again probably can be used to
off label for these cluster headaches. There's a few other
medications that I learned specifically for cluster egs and blood
(35:47):
pressure medications primarily being one of them. But we also
have Gaba pension for headaches and Lyrica for headaches. We
have medication called elevil, So we have several different meds
that we're using for the prevention and treatment of primarily
migrant headaches, but cluster headaches. Probably we're using those off label,
(36:10):
as we do with a lot of medicines that get
FT approved for one indication, then it hits the market
and we sort of do our own investigation and try
medicines for other diseases and for other indications, and depending
on what happens, you know, it might be something that
we can use for these particular patients, just trying to
get them to feel better, which can sometimes be tough,
(36:33):
and no matter which medication we prescribe to you, again,
we never know if it's going to completely work. You
might have to go through a trial of trying a
few different medications. We found this a lot with antidepressants
and anti anxiety medications. A lot of times we do
hit on the first one, meaning we give a medication, Boom,
(36:54):
it works, everybody's happy, and that's it. But there is
a significant portion of pas, especially like I say, with
anxiety depression, we might have to go to go through
two or three medications before we find one that kind
of works for you and makes you feel neutral without
causing a lot of side effects. Doesn't quite matter what
(37:16):
your friend is taking with your mother's taking. It's all
about what your system needs and how your system ranks
to these medications. So you just have to be careful.
As pertains set, I'll go on my last break. Phone
lines are open eight one six klv I one to
eight hundred and three three zero kov. I'll be back
for closing remarks.
Speaker 2 (37:42):
All right, welcome back to Talkable Matic.
Speaker 1 (37:44):
Our phone lines are open eight nine six kV I
one hundred three three zero klv I. Remember, if there's
a topic that you like me to discuss, you.
Speaker 2 (37:53):
Can call the radio station.
Speaker 1 (37:54):
You can call my office and drop that note and
we will talk about that. Remember the show with for
you to help you figure out what's good what's bad
for you, to help make this easier based on someone
who's on the inside, who sees this stuff every day,
who kind of sees what works what doesn't work. That's
the genesis of the show. So give us a buzz
(38:15):
and drop off that note and we will certainly cover that.
We had some fun today again talking about headaches, cluster migraine,
some good medications on the market. Just talk to your
healthcare provider about getting a prescription for these calcitonin gene
related peptide inhibitors or antagonists. Works very well, nerd Tech,
(38:39):
u Lipta, your Brelvy, just to name a few. Probably
being used for cluster. Not quite sure. I probably would
try it if I had a cluster headache patient. Because
these medicines are awesome, they're clean, they're once a day,
minimal side effects. I've had excellent, excellent experience with that
category of medications. I'm using it very heavily. But we
(39:02):
also talked about memory and the memory health, and again
it all balls down to what you eat, what you eat,
what you eat.
Speaker 2 (39:11):
And what you drink. Remember, you can go wrong with
drinking right sugar. Try not to drink sugar. Right.
Speaker 1 (39:16):
I'm sort of tell that's my new phrase in my office. Now,
don't drink sugar and a lot of people, my pastients
sleeping like, what, don't drink shit is it? But again,
there's sugar and a lot of the beverages that you
decide to drink, and all the health experts agree it's
very unhealthy for you. You got to give your body
a break from this exposure to all this refined, ultra
(39:39):
process sugar that's in a lot of the ultra process
foods and beverages that you're consuming. Just good old fashioned
water can get a little boring, so I get it.
Coffee tea is out there that can be more exciting.
They have more flavor profiles, flavor right flavor. A lot
of people think sugar is flavor, but different flavor profiles
(40:01):
with coffee and tea. Just go to your HB, go
to your Kroger, your market basket and look at the aisle.
It's just full of different types of varieties and you
can brew it yourself. It's a very healthy beverage.
Speaker 2 (40:15):
A lot of time.
Speaker 1 (40:15):
It contains products in it, herb spices that are antioxidants
that are good for your health, that help you fight
disease such as dabetes and arthritis. And you're drinking it
every day. Right, it's your medicine primarily, how you have
to look at that, consuming a product that is healthy
for you. It's your medicine to protect you, to boost
(40:37):
your immune system, to help decrease the development of these
amyloid plaques, again common denominator in dementia. But again if
you're starting to have some memory issues, go in sooner
rather than later. Just kind of start the process and
get on these medications. If your provider feels like this
is an issue, go get your proper testing and start it.
(41:00):
Because if you wait and wait and wait, then a
lot of times there's not much we can offer to you.
And remember it all starts with what you eat and
drink and being physically active, not running a marathon, but
just getting off the couch doing something around the house
every single day. Thank you for joining aroun the edition
of the show Don't drink and drive, eat some vegetables.
Speaker 2 (41:18):
We'll see you guys next week. Take care,
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