May 30, 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, all right, that familiar themes song. You know
what time that is? Hello doctor Levine here, Welcome to
another distant at the Doctor Levine Medical Hour. I am
here every Saturday morning between eight and nine, crosses you
from park to them, all taking your phone calls, trying
to answer questions about how to stay alive longer and
be healthier longer. Who wants to be sick and alive again?
(00:23):
Sometimes bad things happen to good people and just can't
avoid that. But certainly, as you know, it may not
know if you listen to my show. You know, I
always say this a lot. If you want to be
health you want to stay alive, as you get older,
you certainly have to do your part and invest more
time into doing that. It's not automatic like it was
(00:44):
when you're in your twenties or when you're eighteen. You
can do whatever you wanted to and your body would
just forgive you. But as you get older, it just
doesn't happen. You got to do your part. You got
to treat it right so that it can respond to you.
And it does want to respond and it does want
to be healthy. You just have to give it an opportunity.
(01:05):
So phone lines are open eight nine to six klvy
I one hundred three three zero kilva I. We'd love
to hear from your talk with you and just see
what's on your mind this morning. It's a beautiful, beautiful
Saturday morning. It's clear, it's sunny, not crazy hot, although
we're getting into that sort of temperature. We're getting into
(01:26):
the summertime. Schools out, kids are graduating and moving off
to their next careers, or going to summer camp, or
just laying around the house and taking it easier. Remember
those days. Now it's it's all about work, work, work,
Isn't that right? That's right, work, work, work, No more
(01:48):
summer breaks, got to work through that summer. How you
doing this morning.
Speaker 2 (01:54):
I'm good, Thank you, Good.
Speaker 1 (01:56):
Morning smithus Levigne decided to roll out of bed and
comber hair, put some clothes on and care come talk
with us, chat with us. As you know, she is
a guest on the show periodically. She manages our medical
practice Golden Triangle, Tonal.
Speaker 2 (02:17):
Medicine and Jerry the years, This year, twenty years, twenty years,
this year?
Speaker 1 (02:22):
Did you get an award? Did you did we get
a plaque? Did we get a jacket? A watch? You know,
something to commemorate the fact that it's been twenty long,
hard tense years.
Speaker 2 (02:35):
Not yet, but the year's not over. We did get
a plaque yesterday actually from United health Care.
Speaker 1 (02:41):
United Healthcare that you what did they say.
Speaker 2 (02:45):
Well, they came in and they brought a plaque and
it was really nice. You were a gold Hero.
Speaker 1 (02:53):
Not me. We I mean, I can't do this by myself.
I think I've mentioned that before over and over again.
As you may or may not, I know, I was
an athlete, right, and I played high school ball here.
I played college ball at Rice in Houston. I wish
I had some videos so you could watch the old
men run and duke and score touchdowns, right, because that's
(03:15):
what I did. But nonetheless, you learn the concept of
teamwork that's extremely important in medicine these days, and especially
trying to run an office and get an award. It's
just not me, it's the whole team that is necessary
to answer those phone calls, get those refills, send referrals,
(03:36):
et cetera. We need other people helping us, and especially
if we're going to win an award or be recognized.
Let me put it that way, it's just being recognized.
That we're for now performing on a level that they like,
and these are the things that they look for in
doctor's offices, as you may or may not know. Like
(03:58):
you said, it's been over twenty years and a lot
has changed with the insurance company and the relationship between
the doctor's office and insurance company's office. I think at
one time doctor's offices where it's sort of on an island,
you could sort of run the office the way you
want it to run it. Whether it be good or bad,
it didn't matter. But and I kind of agree with
(04:22):
this sort of position insurance coms like, wait a minute,
maybe there's a lot of opportunity being lost at the
doctor's office that maybe we can clean this up, we
can help them, we can partner with them to provide
better care so that yes, maybe they can stay alive,
they can be less sick. And the insurance companies have
(04:45):
gotten more and more involved with office medicine office work.
Is that correct? Yeah, what's been your experience?
Speaker 2 (04:54):
My experience. I think they just want the best care
taken for their members and they want to put some
things in place to make sure that we're not missing anything.
And they call it quality or whatever.
Speaker 1 (05:07):
They want to call it well, yeah, I mean I
think that's kind of what it is. Quality absolutely, yeah.
I mean again, like I said, when I first started,
every physician's office was very independent. I mean you could
kind of do whatever you wanted to do, like I said,
whether or not it was deficient or on point. And again
it had lots to do with the practitioners' experience and
(05:28):
where they trained and just their ideas about how they
wanted to run their practice. Not anymore, right.
Speaker 2 (05:35):
Yeah, but it all makes sense because they want, you know,
women to have their mammograms, they want colonoscopies done, they
want a one c's frequently. They want med compliance. They
want to make sure their members are taking their medications,
you know, so that their diseases are controlled or don't
get worse, you know, diabetics, they want them to have
(05:55):
an eye exam.
Speaker 3 (06:00):
You know.
Speaker 2 (06:00):
They want patients with you know, high cholesterol to be
on lipids. So it all makes sense. And they want
their patients to be compliant, and they're sicker patients, they
want them to be seen more often of course, so
that we can stay on top of things, not behind things.
So you just have to make sure that you're in
the game. You're keeping up. You understand the reporting, you
(06:25):
know where to go to pull your reports so that
you can look at your members, look and see kind
of where they stand with the insurance companies, get them compliant.
It's a it's a lot of work, but at the
end of the day, it's the best outcome for the
patient if everybody can comply.
Speaker 1 (06:43):
Yeah, and again I think that again when I was
at training and when I got out, is a more
autonomous experience as a physician. Again, that's sort of how
you're a train and taught that you're sort of the
captain of the ship and it's your you can sort
of dictate what happens and how you want to do
(07:05):
things right. But again, over time that autonomy has been
reduced for good reason. Has sometimes irritating to a certain
degree because you have certain ideas, but how do you
want to do things? However, we have this partner call
the insurance company that has some other ideas about maybe
how they want to do things. And again it's a partnership.
(07:28):
I mean, it's been a nice cordial relationship in terms
of them coming to the office looking through your chart,
making suggestions, and I don't see that slowing down only
maybe intensifying as the time goes forward. And again for
good reason. Again, they're trying to try and keep patients
(07:50):
out of the hospital, keep their disease process controlled, maybe
limit the number of tests that they need, just because
they're not as sick. This stuff works. They even also
go to the house, right, they're sending what they call
mid levels nurse practicians, physicians assistant. Sometimes that patients get
a little, uh, get a little work, a little anxious
(08:12):
about that, right, Like, what do you you know, I
don't need another person coming into my house talking to
me about my care. That's that's what me and my
doctor and I do that, right, So sometimes they get
a little.
Speaker 2 (08:23):
Well, think in your home is invade in your privacy
a little bit, you know, as far as they don't
want a stranger in their home, they don't really know
much about that person, and maybe they don't feel safe,
And that's completely fine, you know. The only thing I
have a problem with is a lot of times they
don't communicate that note to our office. And the only
time we know that that's happened is when the patients
(08:45):
come in to visit with you and they tell you,
and it would just be really nice if they would
up their game and that provider that is in that
home just make sure that they send the note to
us and we get it so that we can read
the communication and see what was going on at that time.
That would be nice.
Speaker 1 (09:04):
Well, I think my experience is most patients bring that
little yellow sheet that they go over. Most of them
bring it. Not everybody, but most of them bring that
is legible. Yeah, it's legible. Yeah. And again it's just
a sort of a brief summation of some basic things
like you said, have you had this, have you had that?
Speaker 3 (09:26):
This?
Speaker 1 (09:26):
And this is just totally basic stuff that everyone should
be getting. I actually like the information in the packet.
It's really easy to read and it just sort of
spells out what you should be getting, what you're doing,
the gap you're paying all this this money for. Yes,
closing the gaps, as they say, And that is something
(09:47):
that the office works on all the time. Is that
correct time.
Speaker 2 (09:50):
And they do an amazing job, you know, because we
get the patients exactly what their gaps are that need close.
We get them in the office, we close the g apps,
We upload the know your documents or your visit note
for that day to them and the gaps closed.
Speaker 1 (10:08):
And a gap is basically a term that means that
they're deficient with one of these tests.
Speaker 2 (10:14):
Gotten for colonoscopy, or maybe they haven't gotten their mammogram,
maybe they didn't pick up their meds at the pharmacy
the last time that you wrote their meds, and normally
those meds they like them to be written in a
ninety day supply so that they're not having to run
back and forth to the pharmacy every twenty five days
to pick up their meds.
Speaker 1 (10:30):
So yeah, certain labs as well, I know the hemoglobe
at A one C is a big one that they
like to get cholesterol. As you may or may not know.
I know you're busy with business admin side of things,
but there have been some updates with the cholesterol management
in this country, and if you read it, the basic
(10:51):
idea is that they basically want the cholesterol even lore
than before, especially for those who have what they call
known heart disease. We already know that something's happened, maybe
you've already had a stint, maybe you've had some testing
and it's seen some plaques somewhere. They want us to
be super super aggressive with these patients and get that
what they call bad cholesterol down below seventy. They want
(11:15):
it now in the fifty fifties range. That's hard, It's
super hard. And really all that means to me as
a provider, based on my position over twenty years in
the game, is that more people are going to be
on meds. It's all that means. Right when I came out,
the statin category of cholesterol medicines was king That's primarily
(11:39):
what we used. But we had patients, a lot of
patients that we would maximize the dose of the statin
and they still were just not The cholesterol still wasn't responding.
So pharmaceutical company came to our rescue. And now at
this point we have about three we have about three
(11:59):
or four meticines right now just for cholesterol categories. Let
me let me rephrase that. We have three about three
or four different categories. Statin is a part of that,
but other categories that can reduce the cholesterol down to
a fifty because for most people are statin alone, it's
just not going to get them there like a lipatour
(12:21):
or zoc or provostat. And plus we had all the
side effect issues with that whole statin category.
Speaker 2 (12:27):
When they're a shot now like once a week or
one yes.
Speaker 1 (12:30):
Something correct. The PCSK nine an a body category REPATHA
would be a name brand medication that is in that category.
There's another one. I don't use it that often, so
there's two in that category. These are injections every two weeks,
very strong, very effective, so a lot of to get
(12:53):
to fifty, most people will need to be on that
injection right. For some yes, the statin will get them there,
but not that many. So most people to get to fifty. Again,
if you have had the heart attack of stroke, you
have other areas where there's plaque that's been seen, maybe
in your legs, you have that peripheral arterial disease periofhyle
vast disease. You know, again we personally I see it
(13:16):
more in smokers and pull the control diabetics. You need
those two components typically to get a lot of PAD PVD.
Those are the ones that are high risk for cardiovasc disease.
So those are the ones that going to need to
be in like on a statin and that injection just
to treat cholesterol alone. That's it. We didn't talk about
blood pressure, heart failure, diabetes, so the number of mats
(13:41):
can get pretty high. So that's the thing that I've
seen with the cholesterol management, and this is about two
or three months ago, where they want that level even lower.
And obviously they want to say screen sooner right close
those gaps so that again we can prevent or reduce
the development of plaque in the bloovest. Remember it's still
(14:04):
the number one issue in our country. So we're working
as aggressively as possible to get those factors control, which
is what all the gaps have to do. Your primary care,
you're the first person, the first health care provider that
can be gate keeper, the gatekeeper that can impact this.
So we want to help you manage this and follow
(14:24):
along with this. And so gaps is their method, their process,
their platform so that everybody can kind of see it
and you get graded on it. So for now, in
terms of United Health, we're doing okay, yeah, we're doing great.
Speaker 2 (14:39):
We ask you this, your big healthcare try to be
lifestyle sorry life, I mean, I like eating, So let
me ask you this. So if they want cholesterol to
a fifty, which I think is really difficult, could you
do that with diet alone, if you had a really
strict diet, because I don't see that you could do
(15:01):
that right, and you would have to exercise all the time.
Speaker 1 (15:07):
It's it's a very committed lifestyle. Absolutely, that's correct. You're right,
And are most Americans going to do that? No, they're
not bad people, It's just the country is just not
set up for that.
Speaker 2 (15:20):
You'd have to walk to work, walk home, you would.
Speaker 1 (15:23):
You would have to do a lot of things, and
it would have to be consistent. And again, listeners, let's
not believe in the fantasy. Right. You can't just go
down to the store or get your product off the
internet and then start taking this magic substance, this magic
pill that's just going to whila make you healthier, live longer,
(15:47):
correct all your ills. We we sort of believe in
that fantasy in this country. Unfortunately, you still have to
do the basic things right. So I'll yeah, I think
you're correct that to get to fifty just no medicines,
it would be super difficult, and just most people are
(16:07):
not going to do that. It's just easier to get
that that pill that will push it down. And then
these medicines are very effective. And again it's it's like
plastic surgery. It's it's like bypass surgery. It's not a
crutch necessarily, but for some it could be. If they're
(16:27):
struggling with their health, they just can't put can't put
the twinkies down, they just can't put the soda down.
And we have those patients again, very good people on
as hard working people, little debbies and all. We grew
up on that, right, twinkies, little debbies, ding dongs, what else?
Pop tarts right?
Speaker 2 (16:49):
Oreos oreo and ships ahoy, you know chips a hoy. Right,
you're such a foodie.
Speaker 1 (16:59):
I know. I loved eating all that peanut butter.
Speaker 2 (17:01):
And you'll never know that, you know, personally, because yeah,
yeah he doesn't eat, but he would love to eat.
Speaker 1 (17:07):
I eat. But I'm older now. Yeah, and this is
where I get a lot of my position, Like I'm
older now, right, so my body has changed.
Speaker 2 (17:14):
To you, it's so funny.
Speaker 1 (17:16):
Yeah, I know, I know, And that's terrible, just how
it is, how how I've been built. And I kind
of respect people who can like naturally, and I've met
these people that they're not big eaters, right, they can
they just don't eat, right, they can go all day
not eat and they're comfortable with that. Well, but I
mean before I got to this age, I mean people
I've met throughout my life college, uh, medical school, you
(17:40):
met people that could just kind of not eat and
they were fine with that. And it's I just found
that amazing. No, no, no, something like that. Just I
just always found that amazing. But it's it's hard out there.
And again, congratulations on your plaque because you work hard
at that too, getting the staff to meet those goals
(18:03):
so it keeps everybody safe and the patience. We try
to provide that service to you. It's something that we
do every day. It's not easy every day, but we're
certainly waking up every day trying to achieve those goals
of providing that service.
Speaker 2 (18:19):
To the highest quality of care as.
Speaker 1 (18:21):
Much as possible. Yes, it's a lot of work. Phone
lines are opened eight nine six kal vat one one
hundred three three zero ko for I'll be back in
two minutes. All right, welcome back to the doctor Levinia matterpower.
(18:42):
Phone lines are open eight nine six Kalfy out one
one hundred and three three zero ko for y'all sitting
here chatting with miss Lavine about food and awards and
plaques and just all of the behind the scenes that
happen when you go to your healthcare provider's office and
the partnership with insurance companies that actually has been going
(19:04):
on for many years and their desire to present a
certain level of service to you when you get to
your doctor's office. What about time spent at the doctor's office.
That's where is that on the award list in terms
of Hey, I had to I spent a whole hour
(19:26):
and a half at the doctor's office. Is that part
of the equation? I want to say, yes, right, Like
don't they call them and will not maybe like ask
how much time you spend or that's something like that, Right,
that's my hospitality aspect of that.
Speaker 2 (19:41):
That's mainly hospital They want to know did your doctor
talk to you? Did he touch you?
Speaker 1 (19:44):
They don't do that in the office. I thought they did.
Speaker 3 (19:46):
Know.
Speaker 2 (19:46):
They want to know how long did you wait in
the waiting room? Right in the doctor's office. But you know,
here's what I tell all the patients. I would not
want to go to a doctor's office to where I
walked in my money, my copey and walk straight to
my room.
Speaker 1 (20:03):
No, I think that's the idea ideal. Let me put
it that way that I mean it is. It is cumbersome.
I mean it is a lot of time. I mean
that's hour and a half of your that's a lot.
Speaker 2 (20:16):
I just don't think the patients or the insurance understands
what all goes on behind the scenes to even get
that patient processed, to even come into the office.
Speaker 1 (20:27):
I think you would need a lot of lot more people, right,
that would also be providers, the actual healthcare professional, and
then office staff so that that thing is going one
hundred miles an hour from the minute it opens in them.
Speaker 2 (20:43):
But it's it's still the same no matter what. So
you have to verify the patient's insurance, make sure that
none of their demographics has changed.
Speaker 1 (20:50):
Well, let's say you had like three or two or
three people that that's all they did verified insurance. Like
you hired three or four people and that's all they did.
That was their only job, and they did that all
day long.
Speaker 2 (21:02):
I mean, you could speed it up, right, but I
don't think the insurance verification is what slows it down.
What slows it down is patients that you know have
a lot of changes, right, So their address change, their
phone changed, their insurance changed, all these things changed when
they came last, and you know, so we have to
(21:24):
update all those things. Maybe even they were in the hospital,
went to the emergency room, saw other physicians. Those other
doctors changed a lot of their care plan, a lot
of their meds, and so we have to update that
because we're primary, so we have to stay abrust at
everything that the patient's doing in between when we saw
(21:45):
them last and when we're seeing them currently.
Speaker 1 (21:47):
Yeah, so it's not just simply I'm just going to
Doc Lavine's office and getting a little check up. There's
just a lot of paperwork.
Speaker 2 (21:54):
Or computer a lot of information that we have to know,
computer work that's you know, where they hospital, did they
go to the er?
Speaker 1 (22:02):
And this has to do with your gaps, right, Yes,
they're wanting primaries to sort of chronicle all of this activity,
and there's just time that you have to put into
the computer so that it's all there. I mean for
many years with patients becoming more familiar with interfacing with
these computer programs. What would be wonderful is if they
(22:26):
helped us out with that, like even before they got
to the office, Hey, let me update my file before
I get to the doctor's office. Let me go to
this website update my file, and then boom when they
get there, it's all in there. I mean technology does exist.
Speaker 2 (22:42):
Yeah, I'll call and see if they've updated that, because
they used to have that long ago, but it would
not migrate correctly into the computer. It kind of they
gets out there, they would try and then when they
would upload it, it would just jabble and gibbers.
Speaker 1 (22:58):
The technologies out there. I want to say, some EMRs
that doctors have in their offices, Well, we.
Speaker 2 (23:06):
Have a pretty amazing one.
Speaker 1 (23:07):
Yeah, no, we like, we've loved it. Ever since we
got it. We've not had major problems, a great ability
for us to work with them. If we have a problem,
they fix it really quickly. We've been very lucky with that.
But again, just the ability for the patient or the
family some family member to get inside their chart and
(23:30):
provide all that basic information so that when they get
to the office it's kind of most of it's there. Yes,
we still have to do some things, but again it
will cut down in the time spent just sitting there
in the office. I want to say that's probably going
to get better as time goes on. Maybe AI do
that for us. All right, we have Lawrence from Atlanta
(23:51):
to order. How can we help you me?
Speaker 3 (23:54):
And thank you so much. So. My my right leg
was swollen and I didn't have an act tight in
the fall, and so sugges it thy weird compression socks.
I just wonder how they work and are they beneficial.
Speaker 1 (24:10):
Yeah. I've had a couple of talks on low extremity
swelling or what we call peripheral edema over the years,
and a lot of times the swelling occurs because of
the change in blood flow, which is brought on by
things like heart failure, kidney failure, liver failure, and also
(24:33):
a condition called venus insufficiency where the blood vessel called
the vein, loses its stiffness if you will, and becomes
more lazy, if you will. And so when it becomes
more lazy or it's not as tight, the blood becomes
more sluggish the flow the blood flow, and then doing so,
(24:55):
it changes the dynamics of blood flow and it tends
to generate this release of fluid into your skin. And
when that happens, your skin becomes swollen because of the
fluid that's been released from the blood vessel. Because the
blood ain't flowing. So one simple way to try and
(25:16):
resolve that or mitigate that is yes to where a
compression stocking, where basically the stocking has pressure or it's tight,
and when you put it on and it squeezes the
fluid that's escaped the blood vessel, it pushes it back
into the blood vessel and that then reduces the swelling
(25:38):
that you have. It doesn't necessarily fix the problem, but
it sort of changes the hemodynamics of blood and the
mechanics of blood flow so that it's not leaking fluid
out of the blood vessel and it's keeping it in
the blood vessel, and then in doing so, it keeps
your leg down. Do they work absolutely? I think that
(26:00):
I'd like to remind patients because I don't think a
lot of patients understand this. That's probably my fault when
I'm when I'm telling them to go get compression stockings.
Is they have different sizes and different strengths. So there's
sort of a mild medium high strength gradient, if you will,
(26:21):
and I think most people are kind of in the
middle when if if you wear the stocking, the one
in the middle probably works the best because just like
what was that story the piggy and the wolf and
the bed was not right, and so we had to
go to the bigger one. Do you remember that fable
back in the day. Anyway, you kind of want to
(26:44):
just write right, because the one that's the high intensity
or a high pressure stocking is just too uncomfortable. It's
too tight, it's hard to put on a lot for
most of our elderly patients. And then the one that's
not strong was this. It doesn't work right. You put
it on and nothing happens. So most people kind of
go for that medium pressure stocking. So you have to
(27:07):
maybe try a different pair of stockings, different sizes before
you kind of hit on the one that works for you.
But they do work. I wear compression socks every day,
not because I have swelling, but because I'm on my
feet all the time and walk and the talking with
other colleagues. It's shown that if you do that, you're
(27:30):
less likely to develop this venus and sufficiency as you
get older. So they do work, and that's one of
the one of the main resolutions fixes for swellings, just
to wear some compression stockings.
Speaker 3 (27:44):
Docklavin. I wonder I'm seventy seventy years young. I just
wonder the issue you just cry, the vast close swelling,
is that some of it just naturally comes with getting
old or is it unique.
Speaker 1 (27:58):
No, it can be, and I know it's frustrating for
patients as you get older. And again this is something
I have to talk to patients all the time. It's
if you can get to eighty or eighty five, I mean,
something's bound to happen really just because your body is old.
And I'm not trying to be rude until the listeners
(28:19):
are rude to my patients. But it's just a fact
that eighty is old and your body just doesn't work
as well. I mean, your body is programmed to not work,
to have dysfunction, to have disease. It's hardwired into us.
So for some, yes, they may be completely healthy, but
(28:42):
they reach eighty, then boom, they start having swelling of
their legs because the vein doesn't work. And again, a
lot of it just has to do yes with that
aging process as the vascular system wears down. So we
do see that natural decline in the function, the physic
function of the human body. And yes, it could just
(29:03):
be a spontaneous decline spontaneous dysfunction of your venus system,
not anything that you did wrong, just you know, you
got to eighty, and unfortunately, getting to that point, you
know you're gonna have some headache, you're gonna have some
joint pain, You're gonna have fatigue, You're you're gonna lose weight,
or you can't sleep, or you get more depressed. I mean,
(29:25):
just all these things kind of start happenings as you
get older.
Speaker 2 (29:29):
Can we just say eighty is older?
Speaker 1 (29:32):
Well, eighty is older. I mean the average age for
most Americans is about seventy five, so I mean most
when they get to that age. I mean that's normally
the length of time most Americans get to. So eighty,
in my opinion, is a superstar an eighty five year
old ninety. And we have those in the practice, and
it's just wonderful talking with them, and I try to
(29:54):
talk with them as much as possible, get some hints
like how did you do it? Tell me I'm wanna
share with everyone, So you know, it's kind of really
it's exciting to see them. I feel like I'm looking
at a superstar sort of guy.
Speaker 2 (30:08):
And you get them a little sticker exactly.
Speaker 1 (30:13):
That's right, because it's hard. It's really hard to get
to eighty five.
Speaker 2 (30:19):
My late fifties and it's hard.
Speaker 1 (30:20):
Yeah, so I can only.
Speaker 3 (30:22):
Imagine Jaxavia missis. Thank you, thank you so much, thank
you so much.
Speaker 1 (30:27):
Appreciate it, Lawrence. Have a good day, brother. Yeah. Yeah,
I've been doing this for over twenty years. Right, no way,
and I'm just trying to lay it out there.
Speaker 3 (30:38):
It is.
Speaker 2 (30:39):
That's what you're hard about.
Speaker 1 (30:40):
You But it's hard. You really have to do your
part if you want to get there, and you can
do it. Phone lines are open eight nine to six
kalvy I one hundred three three zer OKV. I'll be
back in two minutes. Well that was a mistake.
Speaker 2 (30:55):
I think the doc is here with us right now,
live along with business.
Speaker 1 (31:01):
That's right. Technology, we love it. I love computers, love
computers absolutely. Phonelines are opened eight nine six kV I
won one hundred and three to three zero k l
v I. Yes, you got to eighty What does that
look like? We had a question in Star Absolute Superstar
give some stickers or maybe they can get a plaque
(31:22):
or something like that.
Speaker 3 (31:23):
Yeah.
Speaker 2 (31:23):
Absolutely.
Speaker 1 (31:24):
Yeah. We had our taping of Acid Doc yesterday and
There was one question about diet and age when one
of the callers or questions had to do with being eighty.
The patient was dognosed with prostate cancer and maybe had
not been doing their part to eat right. But now
(31:45):
what this new diagnosis. They were really interested and motivated
to change their diet. And the question was is does
it make a difference. So, you know, that's sort of
a good question, and in my experience and my understanding,
it always makes a difference. No matter how late in
the game you are, it always makes difference, especially if
(32:09):
you get diagnosed with something like cancer. Even at eighty,
it does make a difference. I think a lot of
times at eighty, maybe you can't smell as well, you
can't taste as well, and that's certainly going to impact
your eating drinking experience and sort of impact what you'd
like to eat or drink. But I think the experts
(32:31):
all agree that the diet impacts the development of cancer,
the progress of your treatment, how things go with your cancer.
And I think the villains right now in the food
world would be the sugars and the ultra processed foods
(32:53):
that we all consume.
Speaker 2 (32:55):
What's the difference between processed and ultra processed.
Speaker 1 (33:02):
Well, I think that just about all food has some
degree of processing, Like even your fresh vegetables, you know,
somebody has to pick it off of vine, put it
in a storage facility, and it's got to travel, and
it requires a little processing to protect the food, right,
so they would spray something on it, might spray something
(33:23):
on it even as it's grown in the ground. The
seeds that they use, the fertilizers that they used, nutrition,
all of that sort of has a processing to it, right,
And there's a huge industry behind that to be able
to provide us with food year round.
Speaker 2 (33:44):
So maybe a farmer's market would be a better option
rather than a grocery store.
Speaker 1 (33:48):
Well, not necessarily because they still have to protect their
produce as well. I'm not an expert on that, but
that fresh food is minimally processed, whereas ultra process be
a TV dinner, a frozen pizza, a frozen pizza, maybe
some of the canned foods that are out there where
(34:11):
they put them in a metal can and they put
it in this sort of this fluid liquid preservation, liquid
preservation fluid, if you will. It sits on a shelf
for a year or more. Or more and then you
finally decided to decide to buy it, open it up,
poor and can It's supposed to be kind of close
(34:32):
to its natural state, so just to imagine what it's
going to take to do that. And that's what a
lot of experts are saying that a lot of these substances,
even if you talk about just nuts. I like to
eat nuts, right, so a lot of the nuts out
there are sort of coated, are processed in vegetable oils,
(34:54):
and a lot of experts are just raising awareness that
vegetable oils or seed oils, panola oil, peanut oil can
sometimes cause inflammation in your system just because it's sort
of unnatural and you're eating it. So it's something to
really be aware of. It's processed, minimally processed, but nonetheless
(35:16):
process I think the only way it's zero processes if
you got in the backyard, you're growing at yourself and
you go pick it. With some of our patients, they
have gardens, not all of us, but some of them
have gardens.
Speaker 2 (35:28):
I'm in the process of making a little garden, right.
Speaker 1 (35:30):
So ultra process would be that TV dinner that's been
sitting there, maybe something canned that's been sitting on a
shelf for a long time. Ultra versus minimally processed, and
all that means is try to be as fresh as possible,
go get the ingredient yourself.
Speaker 2 (35:47):
So with vegetables, can you just wash them off and
then you get rid of.
Speaker 1 (35:51):
The to some degree? I mean we can't. We can't
avoid it completely just because again we're not out there
growing our vegetab we don't have livestock in the back
that we're processing. Right, somebody's got to do that, of course.
So we can go to a GB, right, we can
package it's packaged and you just buy it and cook it.
(36:13):
So minimally processed versus ultra process just the preservatives and
the chemicals that they're using to sort of preserve the
beverage or the food. You want to try and stay
away from that. Do things that are more wholesome for you. Anyway,
We're going to our last break. Phone lines to open
eight nine to six KLV. I wait one hundred three
three zero kV I'll be back in two minutes. All right,
(36:38):
welcome back to the Doctament Medical. Our phone lines to
open eight nine six kV I won one hundred three
three zero Kova. Any closing thoughts, missus Levine, I don't
think so.
Speaker 2 (36:49):
I mean, do you have any Yeah, if.
Speaker 1 (36:52):
You have any topics that you would like for me
to talk about, you or any of the listeners, give
the officer call four nine three four seven three six
two one, or you can call this station and leave
a list of topics medically related. We're not talked about politics,
or religion or finances. I mean, those are some big topics.
(37:15):
This is not the radio station for that. I think
I saw something like that Monday when I went to
the office. It was like topics and none of it
was medical. I'm just I'm the medical doctor, right, so
I need medical topics that we can talk about. That's
my level of expertise.
Speaker 2 (37:32):
Maybe the community looks at you as a life advisor.
Speaker 1 (37:37):
But as it pertains to probably medicine again, politics, religion, finances,
I mean those of hot topics, very sensitive topics. I
just don't do that every day. It can be kind
of messy too. And I just personally don't like tension,
to be honest.
Speaker 2 (37:52):
With you, Yeah, you are a low key, chill person.
Speaker 1 (37:55):
Yeah, the healthcare world is full of tension, especially in
the hospital so many emotions or happening in the hospital.
That's where I get most of my attention. From office
is not too bad, although sometimes it can't get tent
and the office, but less likely just the acuity is
a lot less and so you just don't really get
into that area. But the show is for you, and
(38:18):
we certainly want to talk about topics that you would
like to talk about. One that I was going to
talk about before Missus Leving decided to show up was sepsis.
Sepsis and sepsis has been sort of put on the
national scene because of the recent death of Kyle Bush.
He was a NASCAR driver that passed away unfortunately about
(38:41):
a week or two ago from pneumonia in his forties,
and the prom of his life died from sepsis and
died from pneumonia that caused sepsis, and so it sort
of put this term in the national language. And I
was going to talk about that. I'll do it next week.
We obviously don't want to miss opportunity to talk with
(39:01):
you and see what's on your mind. The brilliant mind
that you have, We want you to share that with
the general public. But I'll talk more about sepsist next time,
and people are becoming familiar with this term, and it
doesn't necessarily always mean that you're going to end up
in the hospital, but as unfortunately happened to Kyle Busch,
(39:24):
you know it did, and I heard a few things
about again, kind of a busy guy. Just looking at
my feed source, I think he was ill for several
days prior to actually going to the hospital. And that's
a lot of times how it sneaks up on you, right.
I think most of us try to just kind of
push through it, especially NASCAR driver they got a busy schedule.
(39:48):
Their athletes are tough, and that's part of the mantra
of being an athlete is you know, you're strong, You've
got a lot of endurance, and yes you're tired, but
you kind of push through it. And unfortunately, sometimes that
kind of leads you open from maybe the disease getting
a hold of you, which we talk a lot about
that here in terms of being reassessed and reevaluated. Maybe
(40:12):
you did go to the doctor, maybe you did go
to Monecare and then gave your diagnosis, but you're not better,
you're worse.
Speaker 2 (40:18):
Certainly, think the scary thing with sepsis is it has
no age limit. You can zero, you can get sepsis
at any age. But there's but there's your body kind
of tells you something's wrong. What are those symptoms? Common
symptoms of your becoming septic. Your blood pressure gets low,
your pulse gets high, you have a low grade temp.
(40:42):
You know, you feel confused.
Speaker 1 (40:43):
I mean, so there's someone who's not in the medical
world you use I know, and.
Speaker 2 (40:48):
It's a scary word.
Speaker 1 (40:49):
I mean, sepsis is it's becoming that all things like
this happen. Yes, it becomes that, but we've known about
it in the medical world for many years.
Speaker 2 (40:58):
If you just stay on top of it, as soon
as you start in those type of symptoms, you go
to the hospital, get evaluated because it's av antibotics.
Speaker 1 (41:04):
Improves your chances, no question, to be more successful. But
there are patients that they do everything right. They do
go to the doctor, they do go to the hospital,
the doctor does everything, the hospital does everything. We saw
that with COVID just the reaction is so overwhelming and
so severe that the body just can't handle it and
(41:27):
it causes permanent issues. Thank you for listening to the show.
Thank you, Miss Levine.
Speaker 2 (41:30):
You're welcome. Everyone have an awesome weekend.
All right, all right, that familiar themes song. You know
what time that is? Hello doctor Levine here, Welcome to
another distant at the Doctor Levine Medical Hour. I am
here every Saturday morning between eight and nine, crosses you
from park to them, all taking your phone calls, trying
to answer questions about how to stay alive longer and
be healthier longer. Who wants to be sick and alive again?
(00:23):
Sometimes bad things happen to good people and just can't
avoid that. But certainly, as you know, it may not
know if you listen to my show. You know, I
always say this a lot. If you want to be
health you want to stay alive, as you get older,
you certainly have to do your part and invest more
time into doing that. It's not automatic like it was
(00:44):
when you're in your twenties or when you're eighteen. You
can do whatever you wanted to and your body would
just forgive you. But as you get older, it just
doesn't happen. You got to do your part. You got
to treat it right so that it can respond to you.
And it does want to respond and it does want
to be healthy. You just have to give it an opportunity.
(01:05):
So phone lines are open eight nine to six klvy
I one hundred three three zero kilva I. We'd love
to hear from your talk with you and just see
what's on your mind this morning. It's a beautiful, beautiful
Saturday morning. It's clear, it's sunny, not crazy hot, although
we're getting into that sort of temperature. We're getting into
(01:26):
the summertime. Schools out, kids are graduating and moving off
to their next careers, or going to summer camp, or
just laying around the house and taking it easier. Remember
those days. Now it's it's all about work, work, work,
Isn't that right? That's right, work, work, work, No more
(01:48):
summer breaks, got to work through that summer. How you
doing this morning.
Speaker 2 (01:54):
I'm good, Thank you, Good.
Speaker 1 (01:56):
Morning smithus Levigne decided to roll out of bed and
comber hair, put some clothes on and care come talk
with us, chat with us. As you know, she is
a guest on the show periodically. She manages our medical
practice Golden Triangle, Tonal.
Speaker 2 (02:17):
Medicine and Jerry the years, This year, twenty years, twenty years,
this year?
Speaker 1 (02:22):
Did you get an award? Did you did we get
a plaque? Did we get a jacket? A watch? You know,
something to commemorate the fact that it's been twenty long,
hard tense years.
Speaker 2 (02:35):
Not yet, but the year's not over. We did get
a plaque yesterday actually from United health Care.
Speaker 1 (02:41):
United Healthcare that you what did they say.
Speaker 2 (02:45):
Well, they came in and they brought a plaque and
it was really nice. You were a gold Hero.
Speaker 1 (02:53):
Not me. We I mean, I can't do this by myself.
I think I've mentioned that before over and over again.
As you may or may not, I know, I was
an athlete, right, and I played high school ball here.
I played college ball at Rice in Houston. I wish
I had some videos so you could watch the old
men run and duke and score touchdowns, right, because that's
(03:15):
what I did. But nonetheless, you learn the concept of
teamwork that's extremely important in medicine these days, and especially
trying to run an office and get an award. It's
just not me, it's the whole team that is necessary
to answer those phone calls, get those refills, send referrals,
(03:36):
et cetera. We need other people helping us, and especially
if we're going to win an award or be recognized.
Let me put it that way, it's just being recognized.
That we're for now performing on a level that they like,
and these are the things that they look for in
doctor's offices, as you may or may not know. Like
(03:58):
you said, it's been over twenty years and a lot
has changed with the insurance company and the relationship between
the doctor's office and insurance company's office. I think at
one time doctor's offices where it's sort of on an island,
you could sort of run the office the way you
want it to run it. Whether it be good or bad,
it didn't matter. But and I kind of agree with
(04:22):
this sort of position insurance coms like, wait a minute,
maybe there's a lot of opportunity being lost at the
doctor's office that maybe we can clean this up, we
can help them, we can partner with them to provide
better care so that yes, maybe they can stay alive,
they can be less sick. And the insurance companies have
(04:45):
gotten more and more involved with office medicine office work.
Is that correct? Yeah, what's been your experience?
Speaker 2 (04:54):
My experience. I think they just want the best care
taken for their members and they want to put some
things in place to make sure that we're not missing anything.
And they call it quality or whatever.
Speaker 1 (05:07):
They want to call it well, yeah, I mean I
think that's kind of what it is. Quality absolutely, yeah.
I mean again, like I said, when I first started,
every physician's office was very independent. I mean you could
kind of do whatever you wanted to do, like I said,
whether or not it was deficient or on point. And again
it had lots to do with the practitioners' experience and
(05:28):
where they trained and just their ideas about how they
wanted to run their practice. Not anymore, right.
Speaker 2 (05:35):
Yeah, but it all makes sense because they want, you know,
women to have their mammograms, they want colonoscopies done, they
want a one c's frequently. They want med compliance. They
want to make sure their members are taking their medications,
you know, so that their diseases are controlled or don't
get worse, you know, diabetics, they want them to have
(05:55):
an eye exam.
Speaker 3 (06:00):
You know.
Speaker 2 (06:00):
They want patients with you know, high cholesterol to be
on lipids. So it all makes sense. And they want
their patients to be compliant, and they're sicker patients, they
want them to be seen more often of course, so
that we can stay on top of things, not behind things.
So you just have to make sure that you're in
the game. You're keeping up. You understand the reporting, you
(06:25):
know where to go to pull your reports so that
you can look at your members, look and see kind
of where they stand with the insurance companies, get them compliant.
It's a it's a lot of work, but at the
end of the day, it's the best outcome for the
patient if everybody can comply.
Speaker 1 (06:43):
Yeah, and again I think that again when I was
at training and when I got out, is a more
autonomous experience as a physician. Again, that's sort of how
you're a train and taught that you're sort of the
captain of the ship and it's your you can sort
of dictate what happens and how you want to do
(07:05):
things right. But again, over time that autonomy has been
reduced for good reason. Has sometimes irritating to a certain
degree because you have certain ideas, but how do you
want to do things? However, we have this partner call
the insurance company that has some other ideas about maybe
how they want to do things. And again it's a partnership.
(07:28):
I mean, it's been a nice cordial relationship in terms
of them coming to the office looking through your chart,
making suggestions, and I don't see that slowing down only
maybe intensifying as the time goes forward. And again for
good reason. Again, they're trying to try and keep patients
(07:50):
out of the hospital, keep their disease process controlled, maybe
limit the number of tests that they need, just because
they're not as sick. This stuff works. They even also
go to the house, right, they're sending what they call
mid levels nurse practicians, physicians assistant. Sometimes that patients get
a little, uh, get a little work, a little anxious
(08:12):
about that, right, Like, what do you you know, I
don't need another person coming into my house talking to
me about my care. That's that's what me and my
doctor and I do that, right, So sometimes they get
a little.
Speaker 2 (08:23):
Well, think in your home is invade in your privacy
a little bit, you know, as far as they don't
want a stranger in their home, they don't really know
much about that person, and maybe they don't feel safe,
And that's completely fine, you know. The only thing I
have a problem with is a lot of times they
don't communicate that note to our office. And the only
time we know that that's happened is when the patients
(08:45):
come in to visit with you and they tell you,
and it would just be really nice if they would
up their game and that provider that is in that
home just make sure that they send the note to
us and we get it so that we can read
the communication and see what was going on at that time.
That would be nice.
Speaker 1 (09:04):
Well, I think my experience is most patients bring that
little yellow sheet that they go over. Most of them
bring it. Not everybody, but most of them bring that
is legible. Yeah, it's legible. Yeah. And again it's just
a sort of a brief summation of some basic things
like you said, have you had this, have you had that?
Speaker 3 (09:26):
This?
Speaker 1 (09:26):
And this is just totally basic stuff that everyone should
be getting. I actually like the information in the packet.
It's really easy to read and it just sort of
spells out what you should be getting, what you're doing,
the gap you're paying all this this money for. Yes,
closing the gaps, as they say, And that is something
(09:47):
that the office works on all the time. Is that
correct time.
Speaker 2 (09:50):
And they do an amazing job, you know, because we
get the patients exactly what their gaps are that need close.
We get them in the office, we close the g apps,
We upload the know your documents or your visit note
for that day to them and the gaps closed.
Speaker 1 (10:08):
And a gap is basically a term that means that
they're deficient with one of these tests.
Speaker 2 (10:14):
Gotten for colonoscopy, or maybe they haven't gotten their mammogram,
maybe they didn't pick up their meds at the pharmacy
the last time that you wrote their meds, and normally
those meds they like them to be written in a
ninety day supply so that they're not having to run
back and forth to the pharmacy every twenty five days
to pick up their meds.
Speaker 1 (10:30):
So yeah, certain labs as well, I know the hemoglobe
at A one C is a big one that they
like to get cholesterol. As you may or may not know.
I know you're busy with business admin side of things,
but there have been some updates with the cholesterol management
in this country, and if you read it, the basic
(10:51):
idea is that they basically want the cholesterol even lore
than before, especially for those who have what they call
known heart disease. We already know that something's happened, maybe
you've already had a stint, maybe you've had some testing
and it's seen some plaques somewhere. They want us to
be super super aggressive with these patients and get that
what they call bad cholesterol down below seventy. They want
(11:15):
it now in the fifty fifties range. That's hard, It's
super hard. And really all that means to me as
a provider, based on my position over twenty years in
the game, is that more people are going to be
on meds. It's all that means. Right when I came out,
the statin category of cholesterol medicines was king That's primarily
(11:39):
what we used. But we had patients, a lot of
patients that we would maximize the dose of the statin
and they still were just not The cholesterol still wasn't responding.
So pharmaceutical company came to our rescue. And now at
this point we have about three we have about three
(11:59):
or four meticines right now just for cholesterol categories. Let
me let me rephrase that. We have three about three
or four different categories. Statin is a part of that,
but other categories that can reduce the cholesterol down to
a fifty because for most people are statin alone, it's
just not going to get them there like a lipatour
(12:21):
or zoc or provostat. And plus we had all the
side effect issues with that whole statin category.
Speaker 2 (12:27):
When they're a shot now like once a week or
one yes.
Speaker 1 (12:30):
Something correct. The PCSK nine an a body category REPATHA
would be a name brand medication that is in that category.
There's another one. I don't use it that often, so
there's two in that category. These are injections every two weeks,
very strong, very effective, so a lot of to get
(12:53):
to fifty, most people will need to be on that
injection right. For some yes, the statin will get them there,
but not that many. So most people to get to fifty. Again,
if you have had the heart attack of stroke, you
have other areas where there's plaque that's been seen, maybe
in your legs, you have that peripheral arterial disease periofhyle
vast disease. You know, again we personally I see it
(13:16):
more in smokers and pull the control diabetics. You need
those two components typically to get a lot of PAD PVD.
Those are the ones that are high risk for cardiovasc disease.
So those are the ones that going to need to
be in like on a statin and that injection just
to treat cholesterol alone. That's it. We didn't talk about
blood pressure, heart failure, diabetes, so the number of mats
(13:41):
can get pretty high. So that's the thing that I've
seen with the cholesterol management, and this is about two
or three months ago, where they want that level even lower.
And obviously they want to say screen sooner right close
those gaps so that again we can prevent or reduce
the development of plaque in the bloovest. Remember it's still
(14:04):
the number one issue in our country. So we're working
as aggressively as possible to get those factors control, which
is what all the gaps have to do. Your primary care,
you're the first person, the first health care provider that
can be gate keeper, the gatekeeper that can impact this.
So we want to help you manage this and follow
(14:24):
along with this. And so gaps is their method, their process,
their platform so that everybody can kind of see it
and you get graded on it. So for now, in
terms of United Health, we're doing okay, yeah, we're doing great.
Speaker 2 (14:39):
We ask you this, your big healthcare try to be
lifestyle sorry life, I mean, I like eating, So let
me ask you this. So if they want cholesterol to
a fifty, which I think is really difficult, could you
do that with diet alone, if you had a really
strict diet, because I don't see that you could do
(15:01):
that right, and you would have to exercise all the time.
Speaker 1 (15:07):
It's it's a very committed lifestyle. Absolutely, that's correct. You're right,
And are most Americans going to do that? No, they're
not bad people, It's just the country is just not
set up for that.
Speaker 2 (15:20):
You'd have to walk to work, walk home, you would.
Speaker 1 (15:23):
You would have to do a lot of things, and
it would have to be consistent. And again, listeners, let's
not believe in the fantasy. Right. You can't just go
down to the store or get your product off the
internet and then start taking this magic substance, this magic
pill that's just going to whila make you healthier, live longer,
(15:47):
correct all your ills. We we sort of believe in
that fantasy in this country. Unfortunately, you still have to
do the basic things right. So I'll yeah, I think
you're correct that to get to fifty just no medicines,
it would be super difficult, and just most people are
(16:07):
not going to do that. It's just easier to get
that that pill that will push it down. And then
these medicines are very effective. And again it's it's like
plastic surgery. It's it's like bypass surgery. It's not a
crutch necessarily, but for some it could be. If they're
(16:27):
struggling with their health, they just can't put can't put
the twinkies down, they just can't put the soda down.
And we have those patients again, very good people on
as hard working people, little debbies and all. We grew
up on that, right, twinkies, little debbies, ding dongs, what else?
Pop tarts right?
Speaker 2 (16:49):
Oreos oreo and ships ahoy, you know chips a hoy. Right,
you're such a foodie.
Speaker 1 (16:59):
I know. I loved eating all that peanut butter.
Speaker 2 (17:01):
And you'll never know that, you know, personally, because yeah,
yeah he doesn't eat, but he would love to eat.
Speaker 1 (17:07):
I eat. But I'm older now. Yeah, and this is
where I get a lot of my position, Like I'm
older now, right, so my body has changed.
Speaker 2 (17:14):
To you, it's so funny.
Speaker 1 (17:16):
Yeah, I know, I know, And that's terrible, just how
it is, how how I've been built. And I kind
of respect people who can like naturally, and I've met
these people that they're not big eaters, right, they can
they just don't eat, right, they can go all day
not eat and they're comfortable with that. Well, but I
mean before I got to this age, I mean people
I've met throughout my life college, uh, medical school, you
(17:40):
met people that could just kind of not eat and
they were fine with that. And it's I just found
that amazing. No, no, no, something like that. Just I
just always found that amazing. But it's it's hard out there.
And again, congratulations on your plaque because you work hard
at that too, getting the staff to meet those goals
(18:03):
so it keeps everybody safe and the patience. We try
to provide that service to you. It's something that we
do every day. It's not easy every day, but we're
certainly waking up every day trying to achieve those goals
of providing that service.
Speaker 2 (18:19):
To the highest quality of care as.
Speaker 1 (18:21):
Much as possible. Yes, it's a lot of work. Phone
lines are opened eight nine six kal vat one one
hundred three three zero ko for I'll be back in
two minutes. All right, welcome back to the doctor Levinia matterpower.
(18:42):
Phone lines are open eight nine six Kalfy out one
one hundred and three three zero ko for y'all sitting
here chatting with miss Lavine about food and awards and
plaques and just all of the behind the scenes that
happen when you go to your healthcare provider's office and
the partnership with insurance companies that actually has been going
(19:04):
on for many years and their desire to present a
certain level of service to you when you get to
your doctor's office. What about time spent at the doctor's office.
That's where is that on the award list in terms
of Hey, I had to I spent a whole hour
(19:26):
and a half at the doctor's office. Is that part
of the equation? I want to say, yes, right, Like
don't they call them and will not maybe like ask
how much time you spend or that's something like that, Right,
that's my hospitality aspect of that.
Speaker 2 (19:41):
That's mainly hospital They want to know did your doctor
talk to you? Did he touch you?
Speaker 1 (19:44):
They don't do that in the office. I thought they did.
Speaker 3 (19:46):
Know.
Speaker 2 (19:46):
They want to know how long did you wait in
the waiting room? Right in the doctor's office. But you know,
here's what I tell all the patients. I would not
want to go to a doctor's office to where I
walked in my money, my copey and walk straight to
my room.
Speaker 1 (20:03):
No, I think that's the idea ideal. Let me put
it that way that I mean it is. It is cumbersome.
I mean it is a lot of time. I mean
that's hour and a half of your that's a lot.
Speaker 2 (20:16):
I just don't think the patients or the insurance understands
what all goes on behind the scenes to even get
that patient processed, to even come into the office.
Speaker 1 (20:27):
I think you would need a lot of lot more people, right,
that would also be providers, the actual healthcare professional, and
then office staff so that that thing is going one
hundred miles an hour from the minute it opens in them.
Speaker 2 (20:43):
But it's it's still the same no matter what. So
you have to verify the patient's insurance, make sure that
none of their demographics has changed.
Speaker 1 (20:50):
Well, let's say you had like three or two or
three people that that's all they did verified insurance. Like
you hired three or four people and that's all they did.
That was their only job, and they did that all
day long.
Speaker 2 (21:02):
I mean, you could speed it up, right, but I
don't think the insurance verification is what slows it down.
What slows it down is patients that you know have
a lot of changes, right, So their address change, their
phone changed, their insurance changed, all these things changed when
they came last, and you know, so we have to
(21:24):
update all those things. Maybe even they were in the hospital,
went to the emergency room, saw other physicians. Those other
doctors changed a lot of their care plan, a lot
of their meds, and so we have to update that
because we're primary, so we have to stay abrust at
everything that the patient's doing in between when we saw
(21:45):
them last and when we're seeing them currently.
Speaker 1 (21:47):
Yeah, so it's not just simply I'm just going to
Doc Lavine's office and getting a little check up. There's
just a lot of paperwork.
Speaker 2 (21:54):
Or computer a lot of information that we have to know,
computer work that's you know, where they hospital, did they
go to the er?
Speaker 1 (22:02):
And this has to do with your gaps, right, Yes,
they're wanting primaries to sort of chronicle all of this activity,
and there's just time that you have to put into
the computer so that it's all there. I mean for
many years with patients becoming more familiar with interfacing with
these computer programs. What would be wonderful is if they
(22:26):
helped us out with that, like even before they got
to the office, Hey, let me update my file before
I get to the doctor's office. Let me go to
this website update my file, and then boom when they
get there, it's all in there. I mean technology does exist.
Speaker 2 (22:42):
Yeah, I'll call and see if they've updated that, because
they used to have that long ago, but it would
not migrate correctly into the computer. It kind of they
gets out there, they would try and then when they
would upload it, it would just jabble and gibbers.
Speaker 1 (22:58):
The technologies out there. I want to say, some EMRs
that doctors have in their offices, Well, we.
Speaker 2 (23:06):
Have a pretty amazing one.
Speaker 1 (23:07):
Yeah, no, we like, we've loved it. Ever since we
got it. We've not had major problems, a great ability
for us to work with them. If we have a problem,
they fix it really quickly. We've been very lucky with that.
But again, just the ability for the patient or the
family some family member to get inside their chart and
(23:30):
provide all that basic information so that when they get
to the office it's kind of most of it's there. Yes,
we still have to do some things, but again it
will cut down in the time spent just sitting there
in the office. I want to say that's probably going
to get better as time goes on. Maybe AI do
that for us. All right, we have Lawrence from Atlanta
(23:51):
to order. How can we help you me?
Speaker 3 (23:54):
And thank you so much. So. My my right leg
was swollen and I didn't have an act tight in
the fall, and so sugges it thy weird compression socks.
I just wonder how they work and are they beneficial.
Speaker 1 (24:10):
Yeah. I've had a couple of talks on low extremity
swelling or what we call peripheral edema over the years,
and a lot of times the swelling occurs because of
the change in blood flow, which is brought on by
things like heart failure, kidney failure, liver failure, and also
(24:33):
a condition called venus insufficiency where the blood vessel called
the vein, loses its stiffness if you will, and becomes
more lazy, if you will. And so when it becomes
more lazy or it's not as tight, the blood becomes
more sluggish the flow the blood flow, and then doing so,
(24:55):
it changes the dynamics of blood flow and it tends
to generate this release of fluid into your skin. And
when that happens, your skin becomes swollen because of the
fluid that's been released from the blood vessel. Because the
blood ain't flowing. So one simple way to try and
(25:16):
resolve that or mitigate that is yes to where a
compression stocking, where basically the stocking has pressure or it's tight,
and when you put it on and it squeezes the
fluid that's escaped the blood vessel, it pushes it back
into the blood vessel and that then reduces the swelling
(25:38):
that you have. It doesn't necessarily fix the problem, but
it sort of changes the hemodynamics of blood and the
mechanics of blood flow so that it's not leaking fluid
out of the blood vessel and it's keeping it in
the blood vessel, and then in doing so, it keeps
your leg down. Do they work absolutely? I think that
(26:00):
I'd like to remind patients because I don't think a
lot of patients understand this. That's probably my fault when
I'm when I'm telling them to go get compression stockings.
Is they have different sizes and different strengths. So there's
sort of a mild medium high strength gradient, if you will,
(26:21):
and I think most people are kind of in the
middle when if if you wear the stocking, the one
in the middle probably works the best because just like
what was that story the piggy and the wolf and
the bed was not right, and so we had to
go to the bigger one. Do you remember that fable
back in the day. Anyway, you kind of want to
(26:44):
just write right, because the one that's the high intensity
or a high pressure stocking is just too uncomfortable. It's
too tight, it's hard to put on a lot for
most of our elderly patients. And then the one that's
not strong was this. It doesn't work right. You put
it on and nothing happens. So most people kind of
go for that medium pressure stocking. So you have to
(27:07):
maybe try a different pair of stockings, different sizes before
you kind of hit on the one that works for you.
But they do work. I wear compression socks every day,
not because I have swelling, but because I'm on my
feet all the time and walk and the talking with
other colleagues. It's shown that if you do that, you're
(27:30):
less likely to develop this venus and sufficiency as you
get older. So they do work, and that's one of
the one of the main resolutions fixes for swellings, just
to wear some compression stockings.
Speaker 3 (27:44):
Docklavin. I wonder I'm seventy seventy years young. I just
wonder the issue you just cry, the vast close swelling,
is that some of it just naturally comes with getting
old or is it unique.
Speaker 1 (27:58):
No, it can be, and I know it's frustrating for
patients as you get older. And again this is something
I have to talk to patients all the time. It's
if you can get to eighty or eighty five, I mean,
something's bound to happen really just because your body is old.
And I'm not trying to be rude until the listeners
(28:19):
are rude to my patients. But it's just a fact
that eighty is old and your body just doesn't work
as well. I mean, your body is programmed to not work,
to have dysfunction, to have disease. It's hardwired into us.
So for some, yes, they may be completely healthy, but
(28:42):
they reach eighty, then boom, they start having swelling of
their legs because the vein doesn't work. And again, a
lot of it just has to do yes with that
aging process as the vascular system wears down. So we
do see that natural decline in the function, the physic
function of the human body. And yes, it could just
(29:03):
be a spontaneous decline spontaneous dysfunction of your venus system,
not anything that you did wrong, just you know, you
got to eighty, and unfortunately, getting to that point, you
know you're gonna have some headache, you're gonna have some
joint pain, You're gonna have fatigue, You're you're gonna lose weight,
or you can't sleep, or you get more depressed. I mean,
(29:25):
just all these things kind of start happenings as you
get older.
Speaker 2 (29:29):
Can we just say eighty is older?
Speaker 1 (29:32):
Well, eighty is older. I mean the average age for
most Americans is about seventy five, so I mean most
when they get to that age. I mean that's normally
the length of time most Americans get to. So eighty,
in my opinion, is a superstar an eighty five year
old ninety. And we have those in the practice, and
it's just wonderful talking with them, and I try to
(29:54):
talk with them as much as possible, get some hints
like how did you do it? Tell me I'm wanna
share with everyone, So you know, it's kind of really
it's exciting to see them. I feel like I'm looking
at a superstar sort of guy.
Speaker 2 (30:08):
And you get them a little sticker exactly.
Speaker 1 (30:13):
That's right, because it's hard. It's really hard to get
to eighty five.
Speaker 2 (30:19):
My late fifties and it's hard.
Speaker 1 (30:20):
Yeah, so I can only.
Speaker 3 (30:22):
Imagine Jaxavia missis. Thank you, thank you so much, thank
you so much.
Speaker 1 (30:27):
Appreciate it, Lawrence. Have a good day, brother. Yeah. Yeah,
I've been doing this for over twenty years. Right, no way,
and I'm just trying to lay it out there.
Speaker 3 (30:38):
It is.
Speaker 2 (30:39):
That's what you're hard about.
Speaker 1 (30:40):
You But it's hard. You really have to do your
part if you want to get there, and you can
do it. Phone lines are open eight nine to six
kalvy I one hundred three three zer OKV. I'll be
back in two minutes. Well that was a mistake.
Speaker 2 (30:55):
I think the doc is here with us right now,
live along with business.
Speaker 1 (31:01):
That's right. Technology, we love it. I love computers, love
computers absolutely. Phonelines are opened eight nine six kV I
won one hundred and three to three zero k l
v I. Yes, you got to eighty What does that
look like? We had a question in Star Absolute Superstar
give some stickers or maybe they can get a plaque
(31:22):
or something like that.
Speaker 3 (31:23):
Yeah.
Speaker 2 (31:23):
Absolutely.
Speaker 1 (31:24):
Yeah. We had our taping of Acid Doc yesterday and
There was one question about diet and age when one
of the callers or questions had to do with being eighty.
The patient was dognosed with prostate cancer and maybe had
not been doing their part to eat right. But now
(31:45):
what this new diagnosis. They were really interested and motivated
to change their diet. And the question was is does
it make a difference. So, you know, that's sort of
a good question, and in my experience and my understanding,
it always makes a difference. No matter how late in
the game you are, it always makes difference, especially if
(32:09):
you get diagnosed with something like cancer. Even at eighty,
it does make a difference. I think a lot of
times at eighty, maybe you can't smell as well, you
can't taste as well, and that's certainly going to impact
your eating drinking experience and sort of impact what you'd
like to eat or drink. But I think the experts
(32:31):
all agree that the diet impacts the development of cancer,
the progress of your treatment, how things go with your cancer.
And I think the villains right now in the food
world would be the sugars and the ultra processed foods
(32:53):
that we all consume.
Speaker 2 (32:55):
What's the difference between processed and ultra processed.
Speaker 1 (33:02):
Well, I think that just about all food has some
degree of processing, Like even your fresh vegetables, you know,
somebody has to pick it off of vine, put it
in a storage facility, and it's got to travel, and
it requires a little processing to protect the food, right,
so they would spray something on it, might spray something
(33:23):
on it even as it's grown in the ground. The
seeds that they use, the fertilizers that they used, nutrition,
all of that sort of has a processing to it, right,
And there's a huge industry behind that to be able
to provide us with food year round.
Speaker 2 (33:44):
So maybe a farmer's market would be a better option
rather than a grocery store.
Speaker 1 (33:48):
Well, not necessarily because they still have to protect their
produce as well. I'm not an expert on that, but
that fresh food is minimally processed, whereas ultra process be
a TV dinner, a frozen pizza, a frozen pizza, maybe
some of the canned foods that are out there where
(34:11):
they put them in a metal can and they put
it in this sort of this fluid liquid preservation, liquid
preservation fluid, if you will. It sits on a shelf
for a year or more. Or more and then you
finally decided to decide to buy it, open it up,
poor and can It's supposed to be kind of close
(34:32):
to its natural state, so just to imagine what it's
going to take to do that. And that's what a
lot of experts are saying that a lot of these substances,
even if you talk about just nuts. I like to
eat nuts, right, so a lot of the nuts out
there are sort of coated, are processed in vegetable oils,
(34:54):
and a lot of experts are just raising awareness that
vegetable oils or seed oils, panola oil, peanut oil can
sometimes cause inflammation in your system just because it's sort
of unnatural and you're eating it. So it's something to
really be aware of. It's processed, minimally processed, but nonetheless
(35:16):
process I think the only way it's zero processes if
you got in the backyard, you're growing at yourself and
you go pick it. With some of our patients, they
have gardens, not all of us, but some of them
have gardens.
Speaker 2 (35:28):
I'm in the process of making a little garden, right.
Speaker 1 (35:30):
So ultra process would be that TV dinner that's been
sitting there, maybe something canned that's been sitting on a
shelf for a long time. Ultra versus minimally processed, and
all that means is try to be as fresh as possible,
go get the ingredient yourself.
Speaker 2 (35:47):
So with vegetables, can you just wash them off and
then you get rid of.
Speaker 1 (35:51):
The to some degree? I mean we can't. We can't
avoid it completely just because again we're not out there
growing our vegetab we don't have livestock in the back
that we're processing. Right, somebody's got to do that, of course.
So we can go to a GB, right, we can
package it's packaged and you just buy it and cook it.
(36:13):
So minimally processed versus ultra process just the preservatives and
the chemicals that they're using to sort of preserve the
beverage or the food. You want to try and stay
away from that. Do things that are more wholesome for you. Anyway,
We're going to our last break. Phone lines to open
eight nine to six KLV. I wait one hundred three
three zero kV I'll be back in two minutes. All right,
(36:38):
welcome back to the Doctament Medical. Our phone lines to
open eight nine six kV I won one hundred three
three zero Kova. Any closing thoughts, missus Levine, I don't
think so.
Speaker 2 (36:49):
I mean, do you have any Yeah, if.
Speaker 1 (36:52):
You have any topics that you would like for me
to talk about, you or any of the listeners, give
the officer call four nine three four seven three six
two one, or you can call this station and leave
a list of topics medically related. We're not talked about politics,
or religion or finances. I mean, those are some big topics.
(37:15):
This is not the radio station for that. I think
I saw something like that Monday when I went to
the office. It was like topics and none of it
was medical. I'm just I'm the medical doctor, right, so
I need medical topics that we can talk about. That's
my level of expertise.
Speaker 2 (37:32):
Maybe the community looks at you as a life advisor.
Speaker 1 (37:37):
But as it pertains to probably medicine again, politics, religion, finances,
I mean those of hot topics, very sensitive topics. I
just don't do that every day. It can be kind
of messy too. And I just personally don't like tension,
to be honest.
Speaker 2 (37:52):
With you, Yeah, you are a low key, chill person.
Speaker 1 (37:55):
Yeah, the healthcare world is full of tension, especially in
the hospital so many emotions or happening in the hospital.
That's where I get most of my attention. From office
is not too bad, although sometimes it can't get tent
and the office, but less likely just the acuity is
a lot less and so you just don't really get
into that area. But the show is for you, and
(38:18):
we certainly want to talk about topics that you would
like to talk about. One that I was going to
talk about before Missus Leving decided to show up was sepsis.
Sepsis and sepsis has been sort of put on the
national scene because of the recent death of Kyle Bush.
He was a NASCAR driver that passed away unfortunately about
(38:41):
a week or two ago from pneumonia in his forties,
and the prom of his life died from sepsis and
died from pneumonia that caused sepsis, and so it sort
of put this term in the national language. And I
was going to talk about that. I'll do it next week.
We obviously don't want to miss opportunity to talk with
(39:01):
you and see what's on your mind. The brilliant mind
that you have, We want you to share that with
the general public. But I'll talk more about sepsist next time,
and people are becoming familiar with this term, and it
doesn't necessarily always mean that you're going to end up
in the hospital, but as unfortunately happened to Kyle Busch,
(39:24):
you know it did, and I heard a few things
about again, kind of a busy guy. Just looking at
my feed source, I think he was ill for several
days prior to actually going to the hospital. And that's
a lot of times how it sneaks up on you, right.
I think most of us try to just kind of
push through it, especially NASCAR driver they got a busy schedule.
(39:48):
Their athletes are tough, and that's part of the mantra
of being an athlete is you know, you're strong, You've
got a lot of endurance, and yes you're tired, but
you kind of push through it. And unfortunately, sometimes that
kind of leads you open from maybe the disease getting
a hold of you, which we talk a lot about
that here in terms of being reassessed and reevaluated. Maybe
(40:12):
you did go to the doctor, maybe you did go
to Monecare and then gave your diagnosis, but you're not better,
you're worse.
Speaker 2 (40:18):
Certainly, think the scary thing with sepsis is it has
no age limit. You can zero, you can get sepsis
at any age. But there's but there's your body kind
of tells you something's wrong. What are those symptoms? Common
symptoms of your becoming septic. Your blood pressure gets low,
your pulse gets high, you have a low grade temp.
(40:42):
You know, you feel confused.
Speaker 1 (40:43):
I mean, so there's someone who's not in the medical
world you use I know, and.
Speaker 2 (40:48):
It's a scary word.
Speaker 1 (40:49):
I mean, sepsis is it's becoming that all things like
this happen. Yes, it becomes that, but we've known about
it in the medical world for many years.
Speaker 2 (40:58):
If you just stay on top of it, as soon
as you start in those type of symptoms, you go
to the hospital, get evaluated because it's av antibotics.
Speaker 1 (41:04):
Improves your chances, no question, to be more successful. But
there are patients that they do everything right. They do
go to the doctor, they do go to the hospital,
the doctor does everything, the hospital does everything. We saw
that with COVID just the reaction is so overwhelming and
so severe that the body just can't handle it and
(41:27):
it causes permanent issues. Thank you for listening to the show.
Thank you, Miss Levine.
Speaker 2 (41:30):
You're welcome. Everyone have an awesome weekend.
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