September 3, 2025 • 23 mins
(Sept 03, 2025)
China’s military display shows it has the might to back up Xi’s vision of a new world order. More older Americans are aging alone… who will take care of them? 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.
China’s military display shows it has the might to back up Xi’s vision of a new world order. More older Americans are aging alone… who will take care of them? 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):
You're listening to Bill Handle on demand from KFI AM
six FORTYFI.
Speaker 2 (00:08):
Handle here Moday, Wednesday, September the third. The new world
has changed, or the old world has changed. Yesterday, there
was a military parade through central Beijing.
Speaker 1 (00:23):
Man, if you look at the.
Speaker 2 (00:25):
Video of that, whoa fifty thousand troops, every high end
weapon that China has. You talk about the hardware going
through the thoroughfare Avenue of Eternal Peace. And there was
a huge intercontinental ballistic missile and it was carried on
an eight track eight AXL truck. And those are almost
(00:49):
impossible to defend around or defend because they just travel
around and you can put them anyplace. Vehicles with hypersonic
glide vehicles.
Speaker 1 (01:01):
You have.
Speaker 2 (01:03):
Warheads on top of intercontinental missiles that are hypersonic five
times a speed of sound. Drones all the way from
these extra large unmanned submarines to aircraft, and they look
if you saw a video, man, they look just like
our fighters accept no pilots. And so what is going
(01:28):
on with that? Well, China is now raising its hackles.
China has decided it is going to become a world power,
not only economically, which is on its way but militarily,
we're going back to the days when the US and
China where at odds accept the difference is China is
(01:49):
quickly approaching the military prowess that we have now not
as much, but man, they are getting close, and some
experts are saying they're going to exceed what we're doing.
On top of that, look at the leaders who were there.
Kim Jong Un, no surprise, Modi of India, that's a surprise.
(02:13):
Wait a second, wasn't isn't India an ally of ours?
Well it used to be. But here's the problem. Trump
has just hit India with a fifty percent tariff. And
why because it's buying resources, is buying natural gas, is
buying fossil fuels, is buying oil from Russia. And we
(02:37):
don't want people or countries buying from Russia. So therefore
it's a secondary boycott. We're going to hit the countries
that are buying from Russia. Now, how about Russia itself
that sells these these natural resources, fossil fuels. Why aren't
they getting hit because they're the ones that are selling it.
Speaker 1 (03:00):
We're only going to hit the countries that are buying it.
Speaker 2 (03:03):
Well, there were terrorifts are sanctions, except Trump won't use
those against Russia. They just won't because we're going to
Russia in the US. Of course, a relative to Ukraine.
What happened two and a half weeks ago. Putin comes
in Alaska, shakes hands with Trump, their best friends. Putin
(03:24):
goes into the presidential libousine. They laugh, and they're going
to be great friends. And of course two weeks later,
or a week and a half later, Putin says, no,
not interested in any peace. I mean is he is
playing Trump like a fiddle and we all know that,
and it is well, it's a shame. So we've got
(03:47):
tariffs that are going crazy, and the Chinese are not
afraid of tariffs. They're going take it on. And one
other point I want to make in terms of President
g if you look at the video when he did
his speech, did you notice what he was wearing. He
(04:07):
wasn't wearing a coat and tie. He was wearing a
Mao jacket. Take a look at the video. What does
that tell you? And he is saying, you know what,
you're the West were the opposite. We are North Korea,
(04:30):
we are India, we are China, and a whole bunch
of other countries and it's breaking down east and West
like it hasn't since the Cold War. And the difference
is when NATO was created, it wasn't even close in
terms of Russia other than atomic weapons, which Russia was
(04:50):
not going to use because at this point, no leader
is going to use atomic weapons, not even Kim Jong un,
who's genuinely nuts, because it at this point, whatever leader
uses that knows that his country will be obliterated.
Speaker 1 (05:08):
So you're not going to go there.
Speaker 2 (05:10):
But how about a conventional war, Yeah, that may happen,
all right.
Speaker 1 (05:15):
Now.
Speaker 2 (05:16):
I have often said, and I agree with the concept
of America is the greatest country in the world in
some instances. There are plenty of instances where we are
far from the greatest country in the world. Opportunity absolutely, education,
higher education, yes, lower education, No. We have a very
(05:39):
high illiteracy rate relative to other countries. I think we're
number twenty one, twenty two something crazy like that. Taking
care of older Americans, man, we're not very good at all.
To be old in this country is not to have
fun unless you have money, or you have family that
you can live with, or family that will take care
(06:01):
of you. That's the problem with the United States, and
that is old people are just not treated very well.
In many countries, old people are at home. They live
at home, so you have kids, they don't move out,
grandparents don't move out, and it becomes generational, generational Europe
(06:26):
Eastern European is like that. Certainly the Asian countries are
like that. Like that, so older people are taken care of.
In the United States, man, don't be poor, don't be alone,
don't get old. And that is a huge problem because
(06:47):
the numbers are growing and it is not fun. When
you think about that aspect of America and you argue
it's the greatest country in the world, it is not.
Speaker 1 (07:02):
So who takes care of them? That's the million dollar question.
Speaker 2 (07:06):
Susan Brown, co director of the National Center for Family
and Marriage Research at University of Ohio, says, this is
a huge issue. Norton, which is a city in the
Mountain Empire region. I think Ohio, fifty four percent of
people sixty five and older live alone and they need assistance.
(07:33):
And her organization serves about three thousand people sixty years
and older providing meals, transportation, personal care, and there's a
huge waiting list because you know what old people do
as they get older. They need a lot of help.
They need help bathing, they need help dressing, they need
help being taken to the doctor. And there's nobody there
(07:55):
at all. And right now, thank goodness, federal and state
fund has not decreased. The Trump administration has not taken
money away from these programs, but it also hasn't kept
pace with rising costs in demand, it has not kept
pace with inflation. And given the future of budget cuts,
(08:18):
and no one knows now what ends up happening with
older people. This organization that she has, Mountain Empire. Actually
in Virginia, here's what personal care aids make. They started
twelve dollars and seventy five cents an honor an hour,
(08:39):
and after ten years it's fifteen dollars and twenty two
cents an hour. Lighthousekeeping, prepare meals, shop for groceries. And
the jobs aren't easy either, not only because old people
are difficult to.
Speaker 1 (08:54):
Take care of.
Speaker 2 (08:56):
You know, old people can get really obnoxious, they can
be belligerent. You've got a huge number dementia hits old people,
and that's no fun. And when we talk about living alone,
women outlive their husbands by five or six years or
(09:16):
eight years statistically, and so they're by themselves social Security,
their husbands have disappears and they end up getting half
of it, and there it's harder and longer to take
care of them. Is there an answer? Well, do you
(09:38):
change a culture? Do you change the way Americans feel
about themselves? Man, I'd love to my kids going to
take care of me when I'm old and decrepit. And
I ask them that question, they laughed by face.
Speaker 1 (09:58):
I guess that means no.
Speaker 2 (10:01):
My grandmother lived with us, my family until she ended
up dying because we have a culture we East European
background where old Europe where old people stayed at home,
and my grandma, who was a psycho bitch extraordinaire, lived
(10:24):
with us until she died at the age of eighty something.
It's tough, Okay, let's have a good time now. Doctor
Jim McKinney is with us. Doctor Jim chief medical officer
for Dignity Saint Mary Medical Center in Long Beach. So, Jim,
first of all, thanks for being with us and that
(10:45):
you take the time to do it, and I appreciate it.
You take the time so instead of killing people like
I asked you to do you come aboard and tell
us how people are going to die? So, with that
one hundred thousand California potentially have fatal kissing bug disease,
we start with how do you kiss a bug?
Speaker 1 (11:04):
Where do you kiss a bug?
Speaker 3 (11:09):
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. It's also called shagas disease, and it's
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.
(11:31):
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 they've had fifty cases
reported and a certain percentage have symptoms, then we know
that not this is not mandatory reporting, so not all
cases get reported. They have to extrapolate out well, we
(11:54):
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
can cause pretty severe, you know problems in rarely where
you have it can cause heart attacks or stroked because
it increases blood fighting and inflammation.
Speaker 1 (12:14):
All right, So a couple of questions.
Speaker 2 (12:15):
First of all, the number one hundred thousand Californias potentially.
Speaker 1 (12:19):
Have it or we'll get it. Do you buy that number?
And number two?
Speaker 2 (12:25):
I mean, it's one of those tropical diseases that come
up from the jungle. And have you ever seen one?
And is there a test for it? I mean, someone
walks in and it's fever, aches, pains, same stuff, no
matter what you get.
Speaker 3 (12:44):
Yeah, I mean, so that's right. 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, but it's
a big number, right, 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
(13:07):
of these wooded areas have shaugust 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, body aches. Some people
get swelling right at the site of the bite, so
(13:28):
it's shaugust disease. It's called the shagoma below the swelling
at the bite site. And then they sometimes get eyelid 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 shaugust disease. You skip all the other multiple choices
and you go right to shaugust disease.
Speaker 1 (13:49):
How do you know?
Speaker 2 (13:50):
How can you guess? I mean, how often have you
seen this? And you were in the er for thirty years?
Speaker 3 (13:57):
But these are the things, like that's why they put
them on the test, yes, right, So like you know
Rocky Mountain 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 these things
(14:18):
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 shagus to these
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. Yeah, yeah, there are tests for it,
(14:39):
and again it's like it's very rare. That first stage
that's when you have high parasites in the blood and
you know you're more likely to 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 all up serious complications
(15:01):
like heartridden as cardiomyopathy, digestive problems like an enlarge 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
(15:25):
we just can give those. It's not anti biotic, it's
not anti viral's anti parasitic and that helps. And some
people end up needing pacemakers or heart transplants because of cardiomyopathy,
and so it does have some serious complications.
Speaker 2 (15:41):
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 dummer.
Speaker 1 (16:00):
Let's go through that.
Speaker 2 (16:01):
Yeah.
Speaker 3 (16:02):
So okay, so a lot of people don't know this
question asked their GI doctor when you're going to colonoscopy,
is what's your detection rate? Right? We know there's a
certain amount of hall ups and adnomas and people it's
about it should be close to thirty percent, like twenty
eight percent or so. And if your doctor has a
lower detection rate than that, so for every colonoscopy he does,
(16:22):
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 do these procedures. So
what they looked at was, we now have AI assisted
(16:44):
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 that close to
the twenty eight percent mark. But then now we that
same doc and we put them on a machine that
doesn't have AI assistance, and his detection rate will drop
(17:06):
to twenty two percent. So, you know, not a huge difference,
but still it sounds like it is dropping something about
the way the doctor are doing the workflow. Maybe their
brains kind of turning off a little bit to some
of these things after relying on AI and they lose
some of that skill.
Speaker 2 (17:23):
So let me ask you, how do you know which
doctor and what the percentage of detection is. It's not
like you go to this doctor on a regular basis.
Your general practitioner refers you to a doctor who performs
a kolonospy, or it's 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 or not.
Speaker 3 (17:47):
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 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.
Speaker 1 (18:06):
Uh.
Speaker 3 (18:06):
They also have some standards, right, You're supposed to the
minimum withdrawal time, like you put 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
(18:28):
your course. So if you wanted to look at your records,
you could. You could see when he started and when
he ended, and it was that six minutes. Uh, the
detection time, the detection rate, you just have to ask him.
I mean I don't know, I don't know that's affordable number.
Speaker 1 (18:41):
And are they going to tell you the truth? You know?
And what how do you then check on the doctor?
Speaker 2 (18:48):
Right? I mean, I know you were at Mission Hospital
for a whole bunch of years. Uh. Does Mission Hospital
still offer a coupon book for colonoscopies?
Speaker 3 (19:00):
Yeah? No, we actually offer the tickets like Disneyland, you know,
the old ones. It's an e ticket to get a colonoscopy.
Speaker 2 (19:06):
Yeah, Jim, I'll do the jokes, Okay, I just want
to let you know how the show works.
Speaker 3 (19:11):
But when you talk about it.
Speaker 2 (19:13):
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 col colo rectal cancers. Uh that
you're talking came out uh literally, I mean, you know,
graphically speaking obviously. Uh, the scope goes inside of you
(19:39):
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 3 (19:49):
Yeah, that's when they read it. And and you mean basically,
even if if somebody's detection rate is a little bit
lower getting a colon, 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 snip off that pollup,
(20:12):
the cancer won't grow. And if you wait until the
pollup turns cancerous and then grows down the pollup, the
pullup 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 of your colon. So so preventable if
you just get routine colonoscopies. And that's and because it's
(20:34):
so slow growing, that's why they only recommend them every
five years or so.
Speaker 2 (20:37):
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 3 (21:00):
No. I mean we've always used beta blockers for situational anxiety,
especially performance anxiety, so a lot of it. Performed Doctors
have been writing performers prescriptions for beta blockers for when
you go up on stage for decades. That's nothing new.
I think it's just become more popular ever since Rachel
Senate stood up in front of the you know, the
(21:23):
oscars and said, all right, you know, take that beta
blocker and lock it in, and you know it is
helpful for situational anxiety. It really does work. 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. It's not It does have some effects
(21:45):
on the brain, but not like 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
that exact opposite of a beta blocker or what we
use to treat asthma, So this will negate your treatment
(22:05):
for your asthma, and you can have a bad asthma
attack 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
(22:26):
beta blockers too. Okay, men, are you running out of time?
Speaker 2 (22:31):
Yeah, we're out of time. So we'll probably pick it
up next week. And the story that we want to
do is flu shot time. That's important, and we'll pick
that up next Wednesday. Jim, take care and as always,
go kill someone today. Okay, take care?
Speaker 1 (22:45):
All right?
Speaker 2 (22:45):
Goodbye, And Jim, you know we did a better job
of that when he was in the ar running the
Digney Saint Mary medical centers. He's cheap medical officer. He
doesn't have a chance to do that as much as
he should. All Right, guys, we are done. Gary and
Shannon up next and tomorrow morning we do it all
over again. Wake Up Call with Amy and Will Neil
(23:09):
and I jump up at six o'clock until now, and
of course KNO and Ann always here to make the
show run. I was about to say run well, but
run all right. We're back everybody.
Speaker 1 (23:24):
This is KFI Am six. You've been listening to the
Bill Handle Show.
Speaker 2 (23:29):
Catch my Show Monday through Friday, six am to nine am,
and anytime on demand on the iHeartRadio app
You're listening to Bill Handle on demand from KFI AM
six FORTYFI.
Speaker 2 (00:08):
Handle here Moday, Wednesday, September the third. The new world
has changed, or the old world has changed. Yesterday, there
was a military parade through central Beijing.
Speaker 1 (00:23):
Man, if you look at the.
Speaker 2 (00:25):
Video of that, whoa fifty thousand troops, every high end
weapon that China has. You talk about the hardware going
through the thoroughfare Avenue of Eternal Peace. And there was
a huge intercontinental ballistic missile and it was carried on
an eight track eight AXL truck. And those are almost
(00:49):
impossible to defend around or defend because they just travel
around and you can put them anyplace. Vehicles with hypersonic
glide vehicles.
Speaker 1 (01:01):
You have.
Speaker 2 (01:03):
Warheads on top of intercontinental missiles that are hypersonic five
times a speed of sound. Drones all the way from
these extra large unmanned submarines to aircraft, and they look
if you saw a video, man, they look just like
our fighters accept no pilots. And so what is going
(01:28):
on with that? Well, China is now raising its hackles.
China has decided it is going to become a world power,
not only economically, which is on its way but militarily,
we're going back to the days when the US and
China where at odds accept the difference is China is
(01:49):
quickly approaching the military prowess that we have now not
as much, but man, they are getting close, and some
experts are saying they're going to exceed what we're doing.
On top of that, look at the leaders who were there.
Kim Jong Un, no surprise, Modi of India, that's a surprise.
(02:13):
Wait a second, wasn't isn't India an ally of ours?
Well it used to be. But here's the problem. Trump
has just hit India with a fifty percent tariff. And
why because it's buying resources, is buying natural gas, is
buying fossil fuels, is buying oil from Russia. And we
(02:37):
don't want people or countries buying from Russia. So therefore
it's a secondary boycott. We're going to hit the countries
that are buying from Russia. Now, how about Russia itself
that sells these these natural resources, fossil fuels. Why aren't
they getting hit because they're the ones that are selling it.
Speaker 1 (03:00):
We're only going to hit the countries that are buying it.
Speaker 2 (03:03):
Well, there were terrorifts are sanctions, except Trump won't use
those against Russia. They just won't because we're going to
Russia in the US. Of course, a relative to Ukraine.
What happened two and a half weeks ago. Putin comes
in Alaska, shakes hands with Trump, their best friends. Putin
(03:24):
goes into the presidential libousine. They laugh, and they're going
to be great friends. And of course two weeks later,
or a week and a half later, Putin says, no,
not interested in any peace. I mean is he is
playing Trump like a fiddle and we all know that,
and it is well, it's a shame. So we've got
(03:47):
tariffs that are going crazy, and the Chinese are not
afraid of tariffs. They're going take it on. And one
other point I want to make in terms of President
g if you look at the video when he did
his speech, did you notice what he was wearing. He
(04:07):
wasn't wearing a coat and tie. He was wearing a
Mao jacket. Take a look at the video. What does
that tell you? And he is saying, you know what,
you're the West were the opposite. We are North Korea,
(04:30):
we are India, we are China, and a whole bunch
of other countries and it's breaking down east and West
like it hasn't since the Cold War. And the difference
is when NATO was created, it wasn't even close in
terms of Russia other than atomic weapons, which Russia was
(04:50):
not going to use because at this point, no leader
is going to use atomic weapons, not even Kim Jong un,
who's genuinely nuts, because it at this point, whatever leader
uses that knows that his country will be obliterated.
Speaker 1 (05:08):
So you're not going to go there.
Speaker 2 (05:10):
But how about a conventional war, Yeah, that may happen,
all right.
Speaker 1 (05:15):
Now.
Speaker 2 (05:16):
I have often said, and I agree with the concept
of America is the greatest country in the world in
some instances. There are plenty of instances where we are
far from the greatest country in the world. Opportunity absolutely, education,
higher education, yes, lower education, No. We have a very
(05:39):
high illiteracy rate relative to other countries. I think we're
number twenty one, twenty two something crazy like that. Taking
care of older Americans, man, we're not very good at all.
To be old in this country is not to have
fun unless you have money, or you have family that
you can live with, or family that will take care
(06:01):
of you. That's the problem with the United States, and
that is old people are just not treated very well.
In many countries, old people are at home. They live
at home, so you have kids, they don't move out,
grandparents don't move out, and it becomes generational, generational Europe
(06:26):
Eastern European is like that. Certainly the Asian countries are
like that. Like that, so older people are taken care of.
In the United States, man, don't be poor, don't be alone,
don't get old. And that is a huge problem because
(06:47):
the numbers are growing and it is not fun. When
you think about that aspect of America and you argue
it's the greatest country in the world, it is not.
Speaker 1 (07:02):
So who takes care of them? That's the million dollar question.
Speaker 2 (07:06):
Susan Brown, co director of the National Center for Family
and Marriage Research at University of Ohio, says, this is
a huge issue. Norton, which is a city in the
Mountain Empire region. I think Ohio, fifty four percent of
people sixty five and older live alone and they need assistance.
(07:33):
And her organization serves about three thousand people sixty years
and older providing meals, transportation, personal care, and there's a
huge waiting list because you know what old people do
as they get older. They need a lot of help.
They need help bathing, they need help dressing, they need
help being taken to the doctor. And there's nobody there
(07:55):
at all. And right now, thank goodness, federal and state
fund has not decreased. The Trump administration has not taken
money away from these programs, but it also hasn't kept
pace with rising costs in demand, it has not kept
pace with inflation. And given the future of budget cuts,
(08:18):
and no one knows now what ends up happening with
older people. This organization that she has, Mountain Empire. Actually
in Virginia, here's what personal care aids make. They started
twelve dollars and seventy five cents an honor an hour,
(08:39):
and after ten years it's fifteen dollars and twenty two
cents an hour. Lighthousekeeping, prepare meals, shop for groceries. And
the jobs aren't easy either, not only because old people
are difficult to.
Speaker 1 (08:54):
Take care of.
Speaker 2 (08:56):
You know, old people can get really obnoxious, they can
be belligerent. You've got a huge number dementia hits old people,
and that's no fun. And when we talk about living alone,
women outlive their husbands by five or six years or
(09:16):
eight years statistically, and so they're by themselves social Security,
their husbands have disappears and they end up getting half
of it, and there it's harder and longer to take
care of them. Is there an answer? Well, do you
(09:38):
change a culture? Do you change the way Americans feel
about themselves? Man, I'd love to my kids going to
take care of me when I'm old and decrepit. And
I ask them that question, they laughed by face.
Speaker 1 (09:58):
I guess that means no.
Speaker 2 (10:01):
My grandmother lived with us, my family until she ended
up dying because we have a culture we East European
background where old Europe where old people stayed at home,
and my grandma, who was a psycho bitch extraordinaire, lived
(10:24):
with us until she died at the age of eighty something.
It's tough, Okay, let's have a good time now. Doctor
Jim McKinney is with us. Doctor Jim chief medical officer
for Dignity Saint Mary Medical Center in Long Beach. So, Jim,
first of all, thanks for being with us and that
(10:45):
you take the time to do it, and I appreciate it.
You take the time so instead of killing people like
I asked you to do you come aboard and tell
us how people are going to die? So, with that
one hundred thousand California potentially have fatal kissing bug disease,
we start with how do you kiss a bug?
Speaker 1 (11:04):
Where do you kiss a bug?
Speaker 3 (11:09):
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. It's also called shagas disease, and it's
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.
(11:31):
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 they've had fifty cases
reported and a certain percentage have symptoms, then we know
that not this is not mandatory reporting, so not all
cases get reported. They have to extrapolate out well, we
(11:54):
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
can cause pretty severe, you know problems in rarely where
you have it can cause heart attacks or stroked because
it increases blood fighting and inflammation.
Speaker 1 (12:14):
All right, So a couple of questions.
Speaker 2 (12:15):
First of all, the number one hundred thousand Californias potentially.
Speaker 1 (12:19):
Have it or we'll get it. Do you buy that number?
And number two?
Speaker 2 (12:25):
I mean, it's one of those tropical diseases that come
up from the jungle. And have you ever seen one?
And is there a test for it? I mean, someone
walks in and it's fever, aches, pains, same stuff, no
matter what you get.
Speaker 3 (12:44):
Yeah, I mean, so that's right. 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, but it's
a big number, right, 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
(13:07):
of these wooded areas have shaugust 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, body aches. Some people
get swelling right at the site of the bite, so
(13:28):
it's shaugust disease. It's called the shagoma below the swelling
at the bite site. And then they sometimes get eyelid 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 shaugust disease. You skip all the other multiple choices
and you go right to shaugust disease.
Speaker 1 (13:49):
How do you know?
Speaker 2 (13:50):
How can you guess? I mean, how often have you
seen this? And you were in the er for thirty years?
Speaker 3 (13:57):
But these are the things, like that's why they put
them on the test, yes, right, So like you know
Rocky Mountain 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 these things
(14:18):
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 shagus to these
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. Yeah, yeah, there are tests for it,
(14:39):
and again it's like it's very rare. That first stage
that's when you have high parasites in the blood and
you know you're more likely to 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 all up serious complications
(15:01):
like heartridden as cardiomyopathy, digestive problems like an enlarge 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
(15:25):
we just can give those. It's not anti biotic, it's
not anti viral's anti parasitic and that helps. And some
people end up needing pacemakers or heart transplants because of cardiomyopathy,
and so it does have some serious complications.
Speaker 2 (15:41):
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 dummer.
Speaker 1 (16:00):
Let's go through that.
Speaker 2 (16:01):
Yeah.
Speaker 3 (16:02):
So okay, so a lot of people don't know this
question asked their GI doctor when you're going to colonoscopy,
is what's your detection rate? Right? We know there's a
certain amount of hall ups and adnomas and people it's
about it should be close to thirty percent, like twenty
eight percent or so. And if your doctor has a
lower detection rate than that, so for every colonoscopy he does,
(16:22):
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 do these procedures. So
what they looked at was, we now have AI assisted
(16:44):
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 that close to
the twenty eight percent mark. But then now we that
same doc and we put them on a machine that
doesn't have AI assistance, and his detection rate will drop
(17:06):
to twenty two percent. So, you know, not a huge difference,
but still it sounds like it is dropping something about
the way the doctor are doing the workflow. Maybe their
brains kind of turning off a little bit to some
of these things after relying on AI and they lose
some of that skill.
Speaker 2 (17:23):
So let me ask you, how do you know which
doctor and what the percentage of detection is. It's not
like you go to this doctor on a regular basis.
Your general practitioner refers you to a doctor who performs
a kolonospy, or it's 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 or not.
Speaker 3 (17:47):
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 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.
Speaker 1 (18:06):
Uh.
Speaker 3 (18:06):
They also have some standards, right, You're supposed to the
minimum withdrawal time, like you put 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
(18:28):
your course. So if you wanted to look at your records,
you could. You could see when he started and when
he ended, and it was that six minutes. Uh, the
detection time, the detection rate, you just have to ask him.
I mean I don't know, I don't know that's affordable number.
Speaker 1 (18:41):
And are they going to tell you the truth? You know?
And what how do you then check on the doctor?
Speaker 2 (18:48):
Right? I mean, I know you were at Mission Hospital
for a whole bunch of years. Uh. Does Mission Hospital
still offer a coupon book for colonoscopies?
Speaker 3 (19:00):
Yeah? No, we actually offer the tickets like Disneyland, you know,
the old ones. It's an e ticket to get a colonoscopy.
Speaker 2 (19:06):
Yeah, Jim, I'll do the jokes, Okay, I just want
to let you know how the show works.
Speaker 3 (19:11):
But when you talk about it.
Speaker 2 (19:13):
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 col colo rectal cancers. Uh that
you're talking came out uh literally, I mean, you know,
graphically speaking obviously. Uh, the scope goes inside of you
(19:39):
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 3 (19:49):
Yeah, that's when they read it. And and you mean basically,
even if if somebody's detection rate is a little bit
lower getting a colon, 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 snip off that pollup,
(20:12):
the cancer won't grow. And if you wait until the
pollup turns cancerous and then grows down the pollup, the
pullup 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 of your colon. So so preventable if
you just get routine colonoscopies. And that's and because it's
(20:34):
so slow growing, that's why they only recommend them every
five years or so.
Speaker 2 (20:37):
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 3 (21:00):
No. I mean we've always used beta blockers for situational anxiety,
especially performance anxiety, so a lot of it. Performed Doctors
have been writing performers prescriptions for beta blockers for when
you go up on stage for decades. That's nothing new.
I think it's just become more popular ever since Rachel
Senate stood up in front of the you know, the
(21:23):
oscars and said, all right, you know, take that beta
blocker and lock it in, and you know it is
helpful for situational anxiety. It really does work. 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. It's not It does have some effects
(21:45):
on the brain, but not like 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
that exact opposite of a beta blocker or what we
use to treat asthma, So this will negate your treatment
(22:05):
for your asthma, and you can have a bad asthma
attack 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
(22:26):
beta blockers too. Okay, men, are you running out of time?
Speaker 2 (22:31):
Yeah, we're out of time. So we'll probably pick it
up next week. And the story that we want to
do is flu shot time. That's important, and we'll pick
that up next Wednesday. Jim, take care and as always,
go kill someone today. Okay, take care?
Speaker 1 (22:45):
All right?
Speaker 2 (22:45):
Goodbye, And Jim, you know we did a better job
of that when he was in the ar running the
Digney Saint Mary medical centers. He's cheap medical officer. He
doesn't have a chance to do that as much as
he should. All Right, guys, we are done. Gary and
Shannon up next and tomorrow morning we do it all
over again. Wake Up Call with Amy and Will Neil
(23:09):
and I jump up at six o'clock until now, and
of course KNO and Ann always here to make the
show run. I was about to say run well, but
run all right. We're back everybody.
Speaker 1 (23:24):
This is KFI Am six. You've been listening to the
Bill Handle Show.
Speaker 2 (23:29):
Catch my Show Monday through Friday, six am to nine am,
and anytime on demand on the iHeartRadio app
The Bill Handel Show News
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