December 18, 2024 • 10 mins
Dr. Jim Keany, Co-Director of the Emergency Room at Mission Hospital in Mission Viejo, joins The Bill Handel Show for 'Medical News'! Dr. Keany talks with Bill about taking vitamin D and broken bones, why holding you pee is bad, and whether just going for a walk can help depression.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
As we do every single Wednesday, Medical News with doctor
Jim Keeney. Jim is chief medical officers for Dignity Saint
Mary Medical Center in Long Beach and a.
Speaker 2 (00:10):
Board certified er doctor.
Speaker 1 (00:12):
For Jim, how long did you actually practice R medicine
before you became a chief medical officer.
Speaker 3 (00:19):
Just a little over thirty years, So.
Speaker 2 (00:22):
You're pretty good at it. You got a good grip
on it.
Speaker 3 (00:24):
I would think you get the hang of it after
the first ten or fifteen.
Speaker 2 (00:28):
Yeah, exactly.
Speaker 1 (00:29):
Okay, A couple of topics I want to bring up,
and that is the whole issue of vitamin D.
Speaker 2 (00:36):
Okay, let's start with.
Speaker 1 (00:37):
We need vitamin D, and vitamin D usually is in milk,
and I understand if you go outside and you're in
the sun for thirty eight seconds, you get all the
vitamin D you need and that connects directly with the
strength of your bones.
Speaker 2 (00:53):
So a lot of people take vitamin D.
Speaker 1 (00:55):
I mean a lot of people as a matter of course,
in their daily vitamin regimen.
Speaker 2 (01:00):
How connected actually is that?
Speaker 3 (01:03):
Yeah, I mean you're right. Vitamin D we started, once
we started testing it, we realize that a large percentage
of the US population has insufficient levels of vitamin D
probably about a third or overall. If you look at
special groups like people over sixty five, it's more than
fifty percent. If you look at people with dark skin,
probably because of the ability to convert vitamin D due
(01:24):
to sun exposure, they have deficiency rates as high as
seventy or eighty percent. So you know, obese individuals are
at risk. There's a lot of different reasons you may
be at risk, and you know the best source is
ultraviolet light. But the problem is that now we all
use sunscreen. We all know don't go out in the
sun without sunscreen. So even though thirty minutes of mid
(01:45):
day sun two to three times a week would probably
get you a good amount of vitamin D because your
body uses that ultraviolet light to convert the chemical into
vitamin D from your diet, you still we probably you
don't get enough because of sunscreen. So it is still
recommended that people take vitamin D. It's just that in
(02:07):
this case, what we're talking about is people maybe think
that you know, there were fifty sixty years old and
will prevent osteoprocess by taking vitamin D and prevent bone fractures. Well,
your bones are already built by then, And so you're right,
at this point, you're not trying to add calcium to
your bones, You're trying to reduce the loss of calcium.
And it turns out that for that particular function vitamin DED,
(02:30):
there's not a ton of evidence that in the average
person it really helps you maintain reduce the risk for fracture.
Speaker 1 (02:38):
Hey, you're about as modern medicine thinking as anybody out there.
Speaker 2 (02:43):
You're not into that.
Speaker 1 (02:45):
Fruity weirdo will will medicine like people that are very
close to me are. I won't mention any names here, lindsay.
Speaker 2 (02:53):
But and I'm not into that stuff at all. What
kind of do you do vitamins every day?
Speaker 3 (02:59):
In which they Yeah, So I do multi vitamin and
vitamin D. I also do fish oil, And there was
more evidence that seemed to support fish oil, seeming to
get less support these days. But I feel like, you know,
it's a good thing to take, So I do those
three basically. That's pretty much it.
Speaker 1 (03:19):
Oh, okay, so you don't do that whole regimen of
you know, the handfuls of and so the osteoporosis. You
know that the as we get older, our bones just
get more fragile, and they lose density.
Speaker 2 (03:34):
If I'm not mistaken, right, isn't that osteoporosis.
Speaker 3 (03:37):
Yeah, osteoporosis, And then we have certain pills that will
increase the density of your bone. The problem is bone
has two parts, right, It's think of like a test
tube as a glass cylinder, and the outside is the
hard part, and then the bone to keep that from
shattering on the inside is the spongy bone, and that
has some flexibility to it. That's the part that we
(04:00):
and to lose quite a bit of, and that's the
part that these medicines that we give don't recreate. So
what you're doing is making that glass tube harder and harder,
but it's still not giving all the support that's necessary.
So ideally people get adequate calcium and vitamin D intake.
You know, I should mention, you know, because I have
(04:20):
a little bit of heartburn, I take enough calcium daily
two in the form of tombs that you know that
probably would be considered a supplement as well. But yeah,
it's so basically, you know, you want to try and
do this when you're a teenager. You want to make
sure you have adequate vitamin D and calcium intake. You
want to make sure you have adequate physical activity and
(04:41):
continue that all the way through your twenties and thirties,
and that's what's going to prevent osteoporosis really when you're
sixty or seventy.
Speaker 1 (04:49):
So it's not a question of the bones becoming weaker,
it's they become more brittle.
Speaker 2 (04:53):
Do I have that, writer? Or is it both?
Speaker 3 (04:56):
Yeah? I mean in a way, they just they become
more brittle, they become more glass like, And it's that
because it's hard. But yet glass is easily fractured. So
if you if you make that thinner, then of course
it's going to fracture easier.
Speaker 1 (05:12):
Okay, the medical questions of guardentuan proportions, why it's bad
to hold your pee?
Speaker 3 (05:22):
All right, Well let's dig into that. So you know,
I mean human beings, this is how we work, right.
Is that your bladder, you know, gets about halfway full
and you start realizing that you could probably urinate, but
you know that doesn't work. We live in a society
where you can't just you know, be like a bird
on a wire and it just falls out. So you
(05:42):
need to be able to control it and wait. And
that's normal. So I don't want anybody freaking out that
they if they wait to urinate, they're going to cause
any damage. That's that's just normal function. But you get
to a point where it gets pretty uncomfortable. And if
you're you know, trying to finish that business meeting, or
finish that movie you're watching, or you know whatever you're
doing this delaying you're finishing your Christmas shopping. You know,
(06:07):
at that point it can, over time, in extreme cases,
cause problems. You know, when you don't urinate, there's not
a good flow and you can actually start building up
bacteria and that makes you more prone to urinary tract infections.
But over time, if you keep doing this chronic overfilling
of the bladder, it can you know, it's like a
(06:28):
rubber band that you've overstretched. You just stretched the bladder
out to the point where it doesn't contract efficiently, and
then you can't fully empty your bladder and you end
up with urinary retention, which also puts you at risk
for bladder infection.
Speaker 1 (06:41):
Here's the question, because holding your pe this has happened
to me and others for a long period of time,
which you know, based on what you said, sometimes happens,
and then you start to urinate, and this is men
I assume, and it doesn't come out as as well
as it does during normal times.
Speaker 2 (07:03):
Is that a prostate thing? Mainly? I'm talking about dribbles
and drabbles.
Speaker 3 (07:07):
Yeah, yeah, yeah, So that's exactly how you can tell
the size of the prostate in any mail. So as
you're sitting in a public restroom and you listen to
the strength of the stream, you're able to judge. This
is how doctors think, right, You're able to judge every
stall and figure out who has the large prostate and
who has a small prostate.
Speaker 2 (07:29):
How often do you do that, Jim?
Speaker 1 (07:30):
I'm just curious that you go into public restrooms to
listen to guys pe in the other stalls, also guys
ping and peeing installs.
Speaker 2 (07:40):
That's a question there too.
Speaker 3 (07:42):
Yeah, I guess I simplified stalls stalls, you know, urinuls, whatever.
But either way, yeah, I know I can't not hear it,
you know. Unfortunately, I just can't go in there and
not hear the guy next if he has a large bladder.
It can very get it all over.
Speaker 2 (08:00):
I know, I get it. Thirty years into er medicine.
Speaker 1 (08:04):
Do you ever tilt your head closer so you have
better hearing.
Speaker 3 (08:10):
No, not allowed, definitely not allowed.
Speaker 1 (08:14):
Okay, all right, always a great topic, all right, walking,
walking and depression.
Speaker 2 (08:20):
How do those connect?
Speaker 1 (08:22):
Well?
Speaker 3 (08:23):
I mean this is not really new, is that exercise
and depression are connected and as in inverse lea connected.
So the more you exercise, the better off you'll be
as far as depression goes. And there's been studies that
show that the vigorous exercise thirty minutes, three or four
times a week is equal to something like prozac or
(08:44):
a lot of these antidepressants. So you know, exercise is
definitely helpful. But what I think what this really points
out is they were talking about seven thousand steps, and
so there's people out there trying to get ten thousand
steps a day, and seven thousand is not a it's
not an overly vigorous exercise that maybe somebody you know,
(09:05):
with with other physical ailments or problems couldn't do. And
so I think the point here is that you know,
really just getting some exercise will help, and don't necessarily
look to kill it. Just go find something that you
like to do that puts your body in movement, and
whether that's yoga or pickleball or walking or you know,
golf or whatever, or gardening. You know, those things all
(09:28):
are physical activities that can help you not only stay
physically fit, but mentally fit.
Speaker 2 (09:34):
All right, I consider you my doctor in many ways.
Speaker 1 (09:36):
I go to you as a go to and not
asking for a diagnosis because I know, in never mind,
we went to this whole legal thing before.
Speaker 2 (09:45):
But here's what I do.
Speaker 1 (09:46):
I walk an hour a day, I take an antidepressant
in really good dosages, and I still want to climb
up to the top of the parking structure and take
a swan dive off.
Speaker 2 (09:58):
What is that about? Well, I mean, by the way,
I'm not exaggerating, I'm.
Speaker 3 (10:03):
Still it's not really a laughing matter. But there are
different degrees obviously, of depression, anxiety, all these other conditions.
There's bipolar depression, there's different forms of depression, and some
of these more serious levels and forms. It's not necessarily
going to be simply treated with exercise. I think you'd
actually be worse off if you didn't exercise, so I
(10:27):
think it's helping you. But in your case, you know,
there are people that due to chemistry and balance in
their brain require a little more help than just exercise.
Speaker 1 (10:35):
All right, thanks Jim. A good way to end the show.
I require a little bit more because there are people
in my position. Jim, A pleasure. We'll talk again next Wednesday,
assuming I'm still alive.
Speaker 2 (10:47):
Okay, take care, take care.
As we do every single Wednesday, Medical News with doctor
Jim Keeney. Jim is chief medical officers for Dignity Saint
Mary Medical Center in Long Beach and a.
Speaker 2 (00:10):
Board certified er doctor.
Speaker 1 (00:12):
For Jim, how long did you actually practice R medicine
before you became a chief medical officer.
Speaker 3 (00:19):
Just a little over thirty years, So.
Speaker 2 (00:22):
You're pretty good at it. You got a good grip
on it.
Speaker 3 (00:24):
I would think you get the hang of it after
the first ten or fifteen.
Speaker 2 (00:28):
Yeah, exactly.
Speaker 1 (00:29):
Okay, A couple of topics I want to bring up,
and that is the whole issue of vitamin D.
Speaker 2 (00:36):
Okay, let's start with.
Speaker 1 (00:37):
We need vitamin D, and vitamin D usually is in milk,
and I understand if you go outside and you're in
the sun for thirty eight seconds, you get all the
vitamin D you need and that connects directly with the
strength of your bones.
Speaker 2 (00:53):
So a lot of people take vitamin D.
Speaker 1 (00:55):
I mean a lot of people as a matter of course,
in their daily vitamin regimen.
Speaker 2 (01:00):
How connected actually is that?
Speaker 3 (01:03):
Yeah, I mean you're right. Vitamin D we started, once
we started testing it, we realize that a large percentage
of the US population has insufficient levels of vitamin D
probably about a third or overall. If you look at
special groups like people over sixty five, it's more than
fifty percent. If you look at people with dark skin,
probably because of the ability to convert vitamin D due
(01:24):
to sun exposure, they have deficiency rates as high as
seventy or eighty percent. So you know, obese individuals are
at risk. There's a lot of different reasons you may
be at risk, and you know the best source is
ultraviolet light. But the problem is that now we all
use sunscreen. We all know don't go out in the
sun without sunscreen. So even though thirty minutes of mid
(01:45):
day sun two to three times a week would probably
get you a good amount of vitamin D because your
body uses that ultraviolet light to convert the chemical into
vitamin D from your diet, you still we probably you
don't get enough because of sunscreen. So it is still
recommended that people take vitamin D. It's just that in
(02:07):
this case, what we're talking about is people maybe think
that you know, there were fifty sixty years old and
will prevent osteoprocess by taking vitamin D and prevent bone fractures. Well,
your bones are already built by then, And so you're right,
at this point, you're not trying to add calcium to
your bones, You're trying to reduce the loss of calcium.
And it turns out that for that particular function vitamin DED,
(02:30):
there's not a ton of evidence that in the average
person it really helps you maintain reduce the risk for fracture.
Speaker 1 (02:38):
Hey, you're about as modern medicine thinking as anybody out there.
Speaker 2 (02:43):
You're not into that.
Speaker 1 (02:45):
Fruity weirdo will will medicine like people that are very
close to me are. I won't mention any names here, lindsay.
Speaker 2 (02:53):
But and I'm not into that stuff at all. What
kind of do you do vitamins every day?
Speaker 3 (02:59):
In which they Yeah, So I do multi vitamin and
vitamin D. I also do fish oil, And there was
more evidence that seemed to support fish oil, seeming to
get less support these days. But I feel like, you know,
it's a good thing to take, So I do those
three basically. That's pretty much it.
Speaker 1 (03:19):
Oh, okay, so you don't do that whole regimen of
you know, the handfuls of and so the osteoporosis. You
know that the as we get older, our bones just
get more fragile, and they lose density.
Speaker 2 (03:34):
If I'm not mistaken, right, isn't that osteoporosis.
Speaker 3 (03:37):
Yeah, osteoporosis, And then we have certain pills that will
increase the density of your bone. The problem is bone
has two parts, right, It's think of like a test
tube as a glass cylinder, and the outside is the
hard part, and then the bone to keep that from
shattering on the inside is the spongy bone, and that
has some flexibility to it. That's the part that we
(04:00):
and to lose quite a bit of, and that's the
part that these medicines that we give don't recreate. So
what you're doing is making that glass tube harder and harder,
but it's still not giving all the support that's necessary.
So ideally people get adequate calcium and vitamin D intake.
You know, I should mention, you know, because I have
(04:20):
a little bit of heartburn, I take enough calcium daily
two in the form of tombs that you know that
probably would be considered a supplement as well. But yeah,
it's so basically, you know, you want to try and
do this when you're a teenager. You want to make
sure you have adequate vitamin D and calcium intake. You
want to make sure you have adequate physical activity and
(04:41):
continue that all the way through your twenties and thirties,
and that's what's going to prevent osteoporosis really when you're
sixty or seventy.
Speaker 1 (04:49):
So it's not a question of the bones becoming weaker,
it's they become more brittle.
Speaker 2 (04:53):
Do I have that, writer? Or is it both?
Speaker 3 (04:56):
Yeah? I mean in a way, they just they become
more brittle, they become more glass like, And it's that
because it's hard. But yet glass is easily fractured. So
if you if you make that thinner, then of course
it's going to fracture easier.
Speaker 1 (05:12):
Okay, the medical questions of guardentuan proportions, why it's bad
to hold your pee?
Speaker 3 (05:22):
All right, Well let's dig into that. So you know,
I mean human beings, this is how we work, right.
Is that your bladder, you know, gets about halfway full
and you start realizing that you could probably urinate, but
you know that doesn't work. We live in a society
where you can't just you know, be like a bird
on a wire and it just falls out. So you
(05:42):
need to be able to control it and wait. And
that's normal. So I don't want anybody freaking out that
they if they wait to urinate, they're going to cause
any damage. That's that's just normal function. But you get
to a point where it gets pretty uncomfortable. And if
you're you know, trying to finish that business meeting, or
finish that movie you're watching, or you know whatever you're
doing this delaying you're finishing your Christmas shopping. You know,
(06:07):
at that point it can, over time, in extreme cases,
cause problems. You know, when you don't urinate, there's not
a good flow and you can actually start building up
bacteria and that makes you more prone to urinary tract infections.
But over time, if you keep doing this chronic overfilling
of the bladder, it can you know, it's like a
(06:28):
rubber band that you've overstretched. You just stretched the bladder
out to the point where it doesn't contract efficiently, and
then you can't fully empty your bladder and you end
up with urinary retention, which also puts you at risk
for bladder infection.
Speaker 1 (06:41):
Here's the question, because holding your pe this has happened
to me and others for a long period of time,
which you know, based on what you said, sometimes happens,
and then you start to urinate, and this is men
I assume, and it doesn't come out as as well
as it does during normal times.
Speaker 2 (07:03):
Is that a prostate thing? Mainly? I'm talking about dribbles
and drabbles.
Speaker 3 (07:07):
Yeah, yeah, yeah, So that's exactly how you can tell
the size of the prostate in any mail. So as
you're sitting in a public restroom and you listen to
the strength of the stream, you're able to judge. This
is how doctors think, right, You're able to judge every
stall and figure out who has the large prostate and
who has a small prostate.
Speaker 2 (07:29):
How often do you do that, Jim?
Speaker 1 (07:30):
I'm just curious that you go into public restrooms to
listen to guys pe in the other stalls, also guys
ping and peeing installs.
Speaker 2 (07:40):
That's a question there too.
Speaker 3 (07:42):
Yeah, I guess I simplified stalls stalls, you know, urinuls, whatever.
But either way, yeah, I know I can't not hear it,
you know. Unfortunately, I just can't go in there and
not hear the guy next if he has a large bladder.
It can very get it all over.
Speaker 2 (08:00):
I know, I get it. Thirty years into er medicine.
Speaker 1 (08:04):
Do you ever tilt your head closer so you have
better hearing.
Speaker 3 (08:10):
No, not allowed, definitely not allowed.
Speaker 1 (08:14):
Okay, all right, always a great topic, all right, walking,
walking and depression.
Speaker 2 (08:20):
How do those connect?
Speaker 1 (08:22):
Well?
Speaker 3 (08:23):
I mean this is not really new, is that exercise
and depression are connected and as in inverse lea connected.
So the more you exercise, the better off you'll be
as far as depression goes. And there's been studies that
show that the vigorous exercise thirty minutes, three or four
times a week is equal to something like prozac or
(08:44):
a lot of these antidepressants. So you know, exercise is
definitely helpful. But what I think what this really points
out is they were talking about seven thousand steps, and
so there's people out there trying to get ten thousand
steps a day, and seven thousand is not a it's
not an overly vigorous exercise that maybe somebody you know,
(09:05):
with with other physical ailments or problems couldn't do. And
so I think the point here is that you know,
really just getting some exercise will help, and don't necessarily
look to kill it. Just go find something that you
like to do that puts your body in movement, and
whether that's yoga or pickleball or walking or you know,
golf or whatever, or gardening. You know, those things all
(09:28):
are physical activities that can help you not only stay
physically fit, but mentally fit.
Speaker 2 (09:34):
All right, I consider you my doctor in many ways.
Speaker 1 (09:36):
I go to you as a go to and not
asking for a diagnosis because I know, in never mind,
we went to this whole legal thing before.
Speaker 2 (09:45):
But here's what I do.
Speaker 1 (09:46):
I walk an hour a day, I take an antidepressant
in really good dosages, and I still want to climb
up to the top of the parking structure and take
a swan dive off.
Speaker 2 (09:58):
What is that about? Well, I mean, by the way,
I'm not exaggerating, I'm.
Speaker 3 (10:03):
Still it's not really a laughing matter. But there are
different degrees obviously, of depression, anxiety, all these other conditions.
There's bipolar depression, there's different forms of depression, and some
of these more serious levels and forms. It's not necessarily
going to be simply treated with exercise. I think you'd
actually be worse off if you didn't exercise, so I
(10:27):
think it's helping you. But in your case, you know,
there are people that due to chemistry and balance in
their brain require a little more help than just exercise.
Speaker 1 (10:35):
All right, thanks Jim. A good way to end the show.
I require a little bit more because there are people
in my position. Jim, A pleasure. We'll talk again next Wednesday,
assuming I'm still alive.
Speaker 2 (10:47):
Okay, take care, take care.
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