September 3, 2025 • 12 mins
Dr. Jim Keany, Chief Medical Officer at Dignity Health St. Mary Medical Center in Long Beach, joins The Bill Handel Show for 'Medical News'! Dr. Keany talks with Bill about getting the flu shot, AI making doctors dumber, the pill women are taking to calm down, and 100,000 Californians potentially having the fatal Kissing Bug Disease.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Okay, let's have a good time.
Speaker 2 (00:01):
Now.
Speaker 1 (00:01):
Doctor Jim McKinney is with us.
Speaker 3 (00:04):
Doctor Jim chief medical officer for Dignity Saint Mary Medical
Center in Long Beach. So, Jim, now, first of all,
thanks for being with us and that you take the
time to do it, and I appreciate it.
Speaker 1 (00:15):
You take the time.
Speaker 3 (00:17):
So instead of killing people like I ask you to do,
you come aboard and tell us how people are going
to die. So, with that one hundred thousand Californians potentially
have fatal kissing.
Speaker 1 (00:29):
Bug disease, we start with how do you kiss the bug?
Where do you kiss the bug?
Speaker 4 (00:36):
Yeah, it's I don't know why they name it the
kissing bug disease or why that bug is named kissing bug,
but it is.
Speaker 2 (00:43):
It's also called shagas disease.
Speaker 4 (00:45):
And it used to be considered a rare disease, right
that was seen in Central America in places like that,
warmer tropical climates, and now you know, we're starting to
see it in California. You know, I don't know how
to make much of the significance right now, because they're
saying up to one hundred thousand people and this is
these are epidemiologic studies where they extrapolate out that if
(01:09):
they've had fifty cases reported and a certain percentage have symptoms,
then we know that this is not mandatory reporting, so
not all cases get reported. They have to extrapolate out. Well,
we estimate about one hundred thousand people may have this disease.
It is treatable if it's discovered, but it's almost never discovered,
you know, unless you have really bad symptoms, and it
(01:31):
can cause pretty severe problems. Rarely where you have it
can cause heart attacks or stroke because it increases blood
flotting and inflammation.
Speaker 1 (01:41):
All right, So a couple of questions.
Speaker 3 (01:42):
First of all, the number one hundred thousand Californias potentially.
Speaker 1 (01:46):
Have it or will get it? Do you buy that number?
Speaker 3 (01:51):
And number two, I mean, it's one of those tropical
diseases that come up from the jungle.
Speaker 1 (01:58):
And have you ever seen one? And is there a
test for it?
Speaker 3 (02:03):
I mean, someone walks in and it's fever, aches, pains,
same stuff, no matter what you get.
Speaker 2 (02:11):
Yeah, I mean, so that's right.
Speaker 4 (02:13):
The first the acute phase is so number one question,
was you know one hundred thousand? You know, again, it's
extrapolated out data so is that an exact number. I
think that what you're they're saying really is no one
really knows.
Speaker 2 (02:26):
But it's a big number, right.
Speaker 4 (02:28):
So a lot of people probably have it, we don't
know about it. They're saying up to a third of
the kissing bugs tested in some of these wooded areas
have shagas disease. So it's out there and people are
getting it. They're getting bit by the bug and they're
getting it, you know, And then how significant is that? Well,
the acute phase, it's again, it's just you know, fever, chills,
(02:50):
body aches. Some people get swelling right at the site
of the bite, so it's shagus disease. It's called the shagoma,
the little the swelling at the bite site. And then
they sometimes get eyelids swelling. This weird eyelid swelling. So
that's you know, when we're taking tests in medicine, right
when you hear somebody has a swollen bug bite and
eyelid swelling, you're supposed to think shaugusta. You skip all
(03:12):
the other multiple choices and you go right to shaugust disease.
Speaker 1 (03:16):
How do you know? How can you guess?
Speaker 3 (03:18):
I mean, how often have you seen this, and you
were in the er for thirty years.
Speaker 4 (03:24):
But these are the things, like that's why they put
them on the test, I guess, right. So, like you
know Rocky Mounted spotted fever. When on the test, they
always have the rash on the wrist or the ankles.
So as soon as you see on a test question
rash on the wrist or ankles, you think Rocky Mountain
spotted fever, and you go straight to that one on
the multiple choice questions. So you know, you learn all
(03:45):
these things by repetition and they're just embedded in your
brain because you were tortured through medical school to learn
all these things. And then when they pop up and
you see somebody with this bug bite and swellen eyelids,
you go, oh my gosh, I think this might be
shaugust disease, and you get super excited because it's the
first one you've seen in your career, and you send
out the tests for it.
Speaker 2 (04:04):
Yeah, yeah, there are tests for it.
Speaker 4 (04:06):
And again it's like it's very rare. That first stage
that's when you have high parasites in the blood and
you more likely be able to test positive for it.
It's only life threatening typically in rare cases in children,
and then you get into this chronic phase that that
lasts for years or decades, and in that case, maybe
twenty percent will develop serious complications like heart aridden me as, cardiomyopathy,
(04:32):
digestive problems like an enlarged colon, swallowing problems, those types
of things. So you know it's it's a real disease
and it has real complications. And then you said treatment.
You asked about treatment. There are anti parasitic drugs that
we give for that, and so we just can give those.
(04:53):
It's not anti biotic, it's not anti viral, it's anti parasitic,
and that helps. And some people end up meeting pacemakers
or heart transplants because of carriomiopathy. So it does have
some serious complications.
Speaker 3 (05:08):
Yeah, and I'm assuming when you talk about it, of course,
I'm going to go there, Jim. And that is when
you're talking about in large colon, you always ask has
the patient been in prison recently? Okay, let's do the
story about AI and how it's actually making doctor's dumber.
Speaker 1 (05:27):
Let's go through that.
Speaker 4 (05:28):
Yeah. So okay, so a lot of people don't know
this question. Ask their GI doctor. When you get a
colonoscopy is what's your detection rate? Right, we know there's
a certain amount of pull ups and adnomas and people.
Speaker 2 (05:41):
It's about it should be close to thirty.
Speaker 4 (05:42):
Percent, like twenty eight percent or so. And if your
doctor has a lower detection rate than that, so for
every colonoscopy he does, maybe he only finds fifteen percent
of the time finds a pall up or something. That
probably means they're not doing a real thorough job of
checking and looking. So your adnoma detection rate is an
important metric for how GI doctors are performing when they
(06:05):
do these procedures. So what they looked at was we
now have AI assisted colonoscopies where the AI views the
screen and will tell you there's a poll up there,
and it actually has been shown to add to increase
detection rates. So AI assisted detection rates will go up
to close to the twenty eight percent mark. But then
(06:26):
now we take that same doc and we put them
on a machine that doesn't have AI assistance, and his
detection rate will drop to twenty two percent. So, you know,
not a huge difference, but still it sounds like it
is dropping something about the way the docs are doing
the workflow. Maybe their brain's kind of turning off a
little bit to some of these things after relying on
(06:47):
AI and they lose some of that skill.
Speaker 1 (06:50):
So let me ask you, how.
Speaker 3 (06:51):
Do you know which doctor and what the percentage of
detection is. It's not like you go to this doctor
on regulars. Your general practitioner refers you to a doctor
who performs a kolonosopy or time for a baseline or
time five or ten years later. How do you have
any idea if the doctor is doing a good job
(07:12):
or not.
Speaker 4 (07:14):
Yeah, I mean that's you got to trust that the
doctor's doing the job at number one, because you're out
right you're not aware of the procedure. But number that's
that's the question I asked. I asked my doctor what's
your detection rate? And when he told me it was
close to thirty percent, And I said, okay, it sounds
like at least you're you're taking a good look. They
also have some standards, right, You're supposed to the minimum
(07:36):
withdrawal time, like you put that you put in the scope,
and then you're supposed to take a minimum of six
minutes from the time you start backing out to view
everything as you pull it out. So if you're going
faster than that, you're going too fast. So they have
some guidelines and they try and they follow those and
those are all documented when you, you know, during your
your course. So if you wanted to look at your records,
(07:58):
you could, you could see when he's started and when
he ended, and it was that six minutes. Uh, the
detection time, the detection rate.
Speaker 2 (08:05):
You just have to ask them. I mean, I don't know,
I don't know that afford number.
Speaker 1 (08:09):
And are they going to tell you the truth?
Speaker 4 (08:11):
Uh?
Speaker 1 (08:11):
You know, and what how do you then check up
on the doctor?
Speaker 4 (08:15):
Right?
Speaker 3 (08:16):
And then I know you were at Mission Hospital for
a whole bunch of years.
Speaker 1 (08:20):
Uh. Does Mission Hospital.
Speaker 3 (08:22):
Still offer a coupon book uh for colonoscopies?
Speaker 2 (08:27):
Yeah?
Speaker 4 (08:27):
No, we actually offer the tickets like Disneyland, you know,
the old ones.
Speaker 2 (08:31):
It's an e ticket to get a colonoscopy.
Speaker 1 (08:33):
Yeah, Jim, I'll do.
Speaker 3 (08:34):
The jokes, Okay, I just want to let you know
how the show works. But when you talk about it,
you know, I mean literally the putting in the colonoscopy,
and it is I mean, it's it's still the I'm
assuming still the gold standard in terms of uh talking
about polyps and uh colon colo rectal cancers.
Speaker 1 (08:55):
Uh that you're talking him out?
Speaker 3 (08:58):
Uh literally, I mean, you know, graphically speaking. Obviously, the
scope goes inside of you and then it's pulled out.
And I didn't know that that's where they read it
as the doctor is pulling out the machine or the scope.
Speaker 2 (09:16):
Yeah, definitely read it.
Speaker 4 (09:17):
And you mean basically, even if somebody's detection rate is
a little bit lower, getting a colon O, don't let
that stop you from getting a colonoscopy, right. Getting a
colonoscopy is so important because this is the third leading
cause of cancer death and it's the most preventable because
it grows so slow, the polyp's form, and once you
(09:38):
snip off that pollup, the cancer won't grow. And if
you wait until the pollup turns cancerous and then grows
down the pollup, the pull up looks like a mushroom,
so it has a head, it becomes cancerous, it grows
down the stalk. Now, once it's touching the actual colon lining,
you have to have a colostomy, and you have to
you have to take out a piece.
Speaker 2 (09:56):
Of your colon.
Speaker 4 (09:57):
So so preventable if you just get routine colon apiece.
That's and because it's so slow growing, that's why they
only recommend them every five years or so.
Speaker 3 (10:05):
All right, yeah, and I think I'm at ten years
the last time I had one. Now, the pill that
women are tight taking to calm them down, I'm saying,
you don't need a pill. All you have to do
is get divorced, and that's going to calm women down.
Is this new and is it something that is out
there and is just being used for this off brand.
Speaker 2 (10:27):
No.
Speaker 4 (10:28):
I mean we've always used beta blockers for situational anxiety,
especially performance anxiety.
Speaker 2 (10:34):
So a lot of it.
Speaker 4 (10:35):
Performed doctors have been writing performers prescriptions for beta blockers
for when you go up on stage for decades.
Speaker 2 (10:42):
That's nothing new.
Speaker 4 (10:43):
I think it's just become more popular ever since Rachel
Sennat stood up in front of the you know, the
oscars and said, all right, you know, take that beta
blocker and lock it in, and you know it is
helpful for situational anxiety.
Speaker 2 (10:58):
It really does work.
Speaker 4 (11:00):
It reduces all those symptoms of sweating, shakiness, you know,
the physical symptoms of anxiety. So that makes you feel
more calm and more centered.
Speaker 2 (11:10):
It's not.
Speaker 4 (11:11):
It does have some effects on the brain, but not
like an anti anxiety medicine like out of an or xanax,
so you're not sedated. I can tell you that my
concerns would be people just grabbing this stuff who have asthma,
especially because beta agonists are the exact opposite of a
beta blocker are what we use to treat asthma. So
this will negate your treatment for your asthma, and you
(11:33):
can have a bad asthma attack that it's very difficult
to fix. And then diabetics, when you get a low
blood sugar, you get sweaty, shaky, nauseous, all those symptoms,
and beta blockers stop those symptoms, so you'll have no
warning that you're going into a hypoglycemic event, and you
could just die from low blood sugar. So those are
the two categories I would not give beta blockers too. Okay, men,
(11:56):
are we running out of time?
Speaker 3 (11:58):
Yeah, we're out of time. So we'll probably pick it
up next week. And the story that we want to do,
it's flu shot time. That's important, and we'll pick that
up next Wednesday. Jim, take care and as always, go
kill someone today.
Speaker 2 (12:10):
Okay, take care,
Okay, let's have a good time.
Speaker 2 (00:01):
Now.
Speaker 1 (00:01):
Doctor Jim McKinney is with us.
Speaker 3 (00:04):
Doctor Jim chief medical officer for Dignity Saint Mary Medical
Center in Long Beach. So, Jim, now, first of all,
thanks for being with us and that you take the
time to do it, and I appreciate it.
Speaker 1 (00:15):
You take the time.
Speaker 3 (00:17):
So instead of killing people like I ask you to do,
you come aboard and tell us how people are going
to die. So, with that one hundred thousand Californians potentially
have fatal kissing.
Speaker 1 (00:29):
Bug disease, we start with how do you kiss the bug?
Where do you kiss the bug?
Speaker 4 (00:36):
Yeah, it's I don't know why they name it the
kissing bug disease or why that bug is named kissing bug,
but it is.
Speaker 2 (00:43):
It's also called shagas disease.
Speaker 4 (00:45):
And it used to be considered a rare disease, right
that was seen in Central America in places like that,
warmer tropical climates, and now you know, we're starting to
see it in California. You know, I don't know how
to make much of the significance right now, because they're
saying up to one hundred thousand people and this is
these are epidemiologic studies where they extrapolate out that if
(01:09):
they've had fifty cases reported and a certain percentage have symptoms,
then we know that this is not mandatory reporting, so
not all cases get reported. They have to extrapolate out. Well,
we estimate about one hundred thousand people may have this disease.
It is treatable if it's discovered, but it's almost never discovered,
you know, unless you have really bad symptoms, and it
(01:31):
can cause pretty severe problems. Rarely where you have it
can cause heart attacks or stroke because it increases blood
flotting and inflammation.
Speaker 1 (01:41):
All right, So a couple of questions.
Speaker 3 (01:42):
First of all, the number one hundred thousand Californias potentially.
Speaker 1 (01:46):
Have it or will get it? Do you buy that number?
Speaker 3 (01:51):
And number two, I mean, it's one of those tropical
diseases that come up from the jungle.
Speaker 1 (01:58):
And have you ever seen one? And is there a
test for it?
Speaker 3 (02:03):
I mean, someone walks in and it's fever, aches, pains,
same stuff, no matter what you get.
Speaker 2 (02:11):
Yeah, I mean, so that's right.
Speaker 4 (02:13):
The first the acute phase is so number one question,
was you know one hundred thousand? You know, again, it's
extrapolated out data so is that an exact number. I
think that what you're they're saying really is no one
really knows.
Speaker 2 (02:26):
But it's a big number, right.
Speaker 4 (02:28):
So a lot of people probably have it, we don't
know about it. They're saying up to a third of
the kissing bugs tested in some of these wooded areas
have shagas disease. So it's out there and people are
getting it. They're getting bit by the bug and they're
getting it, you know, And then how significant is that? Well,
the acute phase, it's again, it's just you know, fever, chills,
(02:50):
body aches. Some people get swelling right at the site
of the bite, so it's shagus disease. It's called the shagoma,
the little the swelling at the bite site. And then
they sometimes get eyelids swelling. This weird eyelid swelling. So
that's you know, when we're taking tests in medicine, right
when you hear somebody has a swollen bug bite and
eyelid swelling, you're supposed to think shaugusta. You skip all
(03:12):
the other multiple choices and you go right to shaugust disease.
Speaker 1 (03:16):
How do you know? How can you guess?
Speaker 3 (03:18):
I mean, how often have you seen this, and you
were in the er for thirty years.
Speaker 4 (03:24):
But these are the things, like that's why they put
them on the test, I guess, right. So, like you
know Rocky Mounted spotted fever. When on the test, they
always have the rash on the wrist or the ankles.
So as soon as you see on a test question
rash on the wrist or ankles, you think Rocky Mountain
spotted fever, and you go straight to that one on
the multiple choice questions. So you know, you learn all
(03:45):
these things by repetition and they're just embedded in your
brain because you were tortured through medical school to learn
all these things. And then when they pop up and
you see somebody with this bug bite and swellen eyelids,
you go, oh my gosh, I think this might be
shaugust disease, and you get super excited because it's the
first one you've seen in your career, and you send
out the tests for it.
Speaker 2 (04:04):
Yeah, yeah, there are tests for it.
Speaker 4 (04:06):
And again it's like it's very rare. That first stage
that's when you have high parasites in the blood and
you more likely be able to test positive for it.
It's only life threatening typically in rare cases in children,
and then you get into this chronic phase that that
lasts for years or decades, and in that case, maybe
twenty percent will develop serious complications like heart aridden me as, cardiomyopathy,
(04:32):
digestive problems like an enlarged colon, swallowing problems, those types
of things. So you know it's it's a real disease
and it has real complications. And then you said treatment.
You asked about treatment. There are anti parasitic drugs that
we give for that, and so we just can give those.
(04:53):
It's not anti biotic, it's not anti viral, it's anti parasitic,
and that helps. And some people end up meeting pacemakers
or heart transplants because of carriomiopathy. So it does have
some serious complications.
Speaker 3 (05:08):
Yeah, and I'm assuming when you talk about it, of course,
I'm going to go there, Jim. And that is when
you're talking about in large colon, you always ask has
the patient been in prison recently? Okay, let's do the
story about AI and how it's actually making doctor's dumber.
Speaker 1 (05:27):
Let's go through that.
Speaker 4 (05:28):
Yeah. So okay, so a lot of people don't know
this question. Ask their GI doctor. When you get a
colonoscopy is what's your detection rate? Right, we know there's
a certain amount of pull ups and adnomas and people.
Speaker 2 (05:41):
It's about it should be close to thirty.
Speaker 4 (05:42):
Percent, like twenty eight percent or so. And if your
doctor has a lower detection rate than that, so for
every colonoscopy he does, maybe he only finds fifteen percent
of the time finds a pall up or something. That
probably means they're not doing a real thorough job of
checking and looking. So your adnoma detection rate is an
important metric for how GI doctors are performing when they
(06:05):
do these procedures. So what they looked at was we
now have AI assisted colonoscopies where the AI views the
screen and will tell you there's a poll up there,
and it actually has been shown to add to increase
detection rates. So AI assisted detection rates will go up
to close to the twenty eight percent mark. But then
(06:26):
now we take that same doc and we put them
on a machine that doesn't have AI assistance, and his
detection rate will drop to twenty two percent. So, you know,
not a huge difference, but still it sounds like it
is dropping something about the way the docs are doing
the workflow. Maybe their brain's kind of turning off a
little bit to some of these things after relying on
(06:47):
AI and they lose some of that skill.
Speaker 1 (06:50):
So let me ask you, how.
Speaker 3 (06:51):
Do you know which doctor and what the percentage of
detection is. It's not like you go to this doctor
on regulars. Your general practitioner refers you to a doctor
who performs a kolonosopy or time for a baseline or
time five or ten years later. How do you have
any idea if the doctor is doing a good job
(07:12):
or not.
Speaker 4 (07:14):
Yeah, I mean that's you got to trust that the
doctor's doing the job at number one, because you're out
right you're not aware of the procedure. But number that's
that's the question I asked. I asked my doctor what's
your detection rate? And when he told me it was
close to thirty percent, And I said, okay, it sounds
like at least you're you're taking a good look. They
also have some standards, right, You're supposed to the minimum
(07:36):
withdrawal time, like you put that you put in the scope,
and then you're supposed to take a minimum of six
minutes from the time you start backing out to view
everything as you pull it out. So if you're going
faster than that, you're going too fast. So they have
some guidelines and they try and they follow those and
those are all documented when you, you know, during your
your course. So if you wanted to look at your records,
(07:58):
you could, you could see when he's started and when
he ended, and it was that six minutes. Uh, the
detection time, the detection rate.
Speaker 2 (08:05):
You just have to ask them. I mean, I don't know,
I don't know that afford number.
Speaker 1 (08:09):
And are they going to tell you the truth?
Speaker 4 (08:11):
Uh?
Speaker 1 (08:11):
You know, and what how do you then check up
on the doctor?
Speaker 4 (08:15):
Right?
Speaker 3 (08:16):
And then I know you were at Mission Hospital for
a whole bunch of years.
Speaker 1 (08:20):
Uh. Does Mission Hospital.
Speaker 3 (08:22):
Still offer a coupon book uh for colonoscopies?
Speaker 2 (08:27):
Yeah?
Speaker 4 (08:27):
No, we actually offer the tickets like Disneyland, you know,
the old ones.
Speaker 2 (08:31):
It's an e ticket to get a colonoscopy.
Speaker 1 (08:33):
Yeah, Jim, I'll do.
Speaker 3 (08:34):
The jokes, Okay, I just want to let you know
how the show works. But when you talk about it,
you know, I mean literally the putting in the colonoscopy,
and it is I mean, it's it's still the I'm
assuming still the gold standard in terms of uh talking
about polyps and uh colon colo rectal cancers.
Speaker 1 (08:55):
Uh that you're talking him out?
Speaker 3 (08:58):
Uh literally, I mean, you know, graphically speaking. Obviously, the
scope goes inside of you and then it's pulled out.
And I didn't know that that's where they read it
as the doctor is pulling out the machine or the scope.
Speaker 2 (09:16):
Yeah, definitely read it.
Speaker 4 (09:17):
And you mean basically, even if somebody's detection rate is
a little bit lower, getting a colon O, don't let
that stop you from getting a colonoscopy, right. Getting a
colonoscopy is so important because this is the third leading
cause of cancer death and it's the most preventable because
it grows so slow, the polyp's form, and once you
(09:38):
snip off that pollup, the cancer won't grow. And if
you wait until the pollup turns cancerous and then grows
down the pollup, the pull up looks like a mushroom,
so it has a head, it becomes cancerous, it grows
down the stalk. Now, once it's touching the actual colon lining,
you have to have a colostomy, and you have to
you have to take out a piece.
Speaker 2 (09:56):
Of your colon.
Speaker 4 (09:57):
So so preventable if you just get routine colon apiece.
That's and because it's so slow growing, that's why they
only recommend them every five years or so.
Speaker 3 (10:05):
All right, yeah, and I think I'm at ten years
the last time I had one. Now, the pill that
women are tight taking to calm them down, I'm saying,
you don't need a pill. All you have to do
is get divorced, and that's going to calm women down.
Is this new and is it something that is out
there and is just being used for this off brand.
Speaker 2 (10:27):
No.
Speaker 4 (10:28):
I mean we've always used beta blockers for situational anxiety,
especially performance anxiety.
Speaker 2 (10:34):
So a lot of it.
Speaker 4 (10:35):
Performed doctors have been writing performers prescriptions for beta blockers
for when you go up on stage for decades.
Speaker 2 (10:42):
That's nothing new.
Speaker 4 (10:43):
I think it's just become more popular ever since Rachel
Sennat stood up in front of the you know, the
oscars and said, all right, you know, take that beta
blocker and lock it in, and you know it is
helpful for situational anxiety.
Speaker 2 (10:58):
It really does work.
Speaker 4 (11:00):
It reduces all those symptoms of sweating, shakiness, you know,
the physical symptoms of anxiety. So that makes you feel
more calm and more centered.
Speaker 2 (11:10):
It's not.
Speaker 4 (11:11):
It does have some effects on the brain, but not
like an anti anxiety medicine like out of an or xanax,
so you're not sedated. I can tell you that my
concerns would be people just grabbing this stuff who have asthma,
especially because beta agonists are the exact opposite of a
beta blocker are what we use to treat asthma. So
this will negate your treatment for your asthma, and you
(11:33):
can have a bad asthma attack that it's very difficult
to fix. And then diabetics, when you get a low
blood sugar, you get sweaty, shaky, nauseous, all those symptoms,
and beta blockers stop those symptoms, so you'll have no
warning that you're going into a hypoglycemic event, and you
could just die from low blood sugar. So those are
the two categories I would not give beta blockers too. Okay, men,
(11:56):
are we running out of time?
Speaker 3 (11:58):
Yeah, we're out of time. So we'll probably pick it
up next week. And the story that we want to do,
it's flu shot time. That's important, and we'll pick that
up next Wednesday. Jim, take care and as always, go
kill someone today.
Speaker 2 (12:10):
Okay, take care,
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