35 Burst results for "Cleveland Clinic"
What your partner needs to know and learn about the menopause transition
"Special podcast. And this is an episode that I would love for you to share with your husbands your partners or excetera off because while I spent a lot of time helping women understand menopause, I think it's really important that we help men understand menopause and the hormonal changes that go along with menopause very commonly in my office. I see patients really distressed about the way that menopause has affected their relationships and there's no relationship. That's more important than your marriage long-term partner, especially when you live together and especially when one of you is going through a lot of changes this could even be same-sex Partners if one of you is going through menopause and what isn't yet? So this whole episode is really about what your partner needs to know about menopause. I calling it. This one's for the boys just cuz men don't really go through menopause. And so there's a lot wrong. They won't understand. So I'm going to do ten things that men should know about menopause if your dude and you're listening in thumbs up. This is going to be really helpful. That's why I want to do this song cast. I want you to know that there's many other men who are facing similar situations with their spouses and that your wife is not alone and hopefully she's sick help in some ways either by finding a doctor or maybe it's even just this podcast. That would be totally cool if it was so first thing to know is number one. I want you to educate yourself. There's no better way to educate yourself then listening to this podcast. I know I keep plugging that but that's because it's going to be pretty informative. There's lots of information on my website, which is Heather Hirsch md.com and I also really like speaking of women's health. Com, there's lots of other chatrooms and support groups, but I've gone on those as well and I'm not sure if all the information is always accurate so long Educate yourself. There's lots of books out there that I really like. There's the Cleveland Clinic guide to menopause. There's many menopause books that are on the shelves. Now. I know what you're thinking and I know the answer probably not going to go to your closest Barnes and Noble and buy a 300-page menopause book and read it from cover to cover. Maybe we'll but the majority of you won't so even just listening to this or birth listening to your wife about what she has learned will help you to educate yourself because if you know what she's going to go through and if you know that this is a physiologic and normal response to changing hormone levels, you're going to hopefully be more understanding and what she's going through the more understanding you are the easier this transition and these changes will be for you and your wife and I want you to have a long-lasting relationship in a long marriage. So understanding what both of you is going through is really helpful. I always tell my female patients that men y'all have the same thing. Steady sex hormones your whole life women are hormones go up and down every month and then in perimenopause they go wonky and then in menopause they crash and burn so it's not fair. It's kind of kind of not exactly the same for both sexes. So educating yourself Super Key. Okay on a number to call. This one is most arguably arguably me the most important but it didn't want to start with this one. Number two is understand the changes in Sex and intimacy between you and your partner and the physiologic changes in your partner. This is what I tell my patients on a daily basis at menopause, you lose all your eggs. And therefore you can't get pregnant again. Now, the the purpose of the sex drive is to reproduce and after you've had your children or maybe you haven't had children, but you've gone through menopause and you no longer can reproduce you're not going to seek that out like you do food. Her and shelter, you're just not now on top of that. There can be some changes in the vagina. I know I'm going to say it. There can be dryness and pain with intercourse a vagina and this has nothing to do with you. This is the physiologic changes of the loss of estrogen in the vagina. So if you think about those two things number one. And you don't have to drive like you used to and number two, it's painful your wife is or your partner is not going to be really motivated to engage in that activity, or maybe if she is not as much as before. She's already had her children now men, they're always trying to get pregnant. They're never going to get pregnant. They never lose their testosterone. So naturally there can be a shift in their computer change the desire for intercourse a lot of women come in super distressed saying they feel so bad for their husband they feel so guilty about it. And the thing is is some dead. Nurse don't understand. This doesn't mean they're not interested in you a lot of my patients will say my husband is a hunk and he's super sexy and I really love him and I love cuddling and I love kissing but when it comes to intercourse, sometimes it hurts. I'd rather just watch TV. I'd rather read a book or I'd rather just go to sleep. That doesn't mean she doesn't love you. And that doesn't mean she's
Going red for women and heart health, raising awareness
"Today is national Wear Red Day It's aimed at raising awareness of women's heart health. Cardiovascular disease is the number one killer of women in the U. S. And effects about 44 million people. CBS views. Senior medical correspondent Dr Terror in the ruler who's a cardiologists and a spokesperson for the American Heart Association, appeared on CBS this morning with more on women's heart health. If a woman arrives at the hospital, she's going to wait longer than a man to be seen for chest pain Less often, she's going to get aspirin or guideline directed medical therapy or diagnostic testing. This is a big problem. I have a lot of patients telling me my doctor told me I'm just anxious. I'm just stressed out when in fact they have a real problem. Alarming new survey by the Cleveland Clinic found coronavirus confront Could coronavirus concerns Rather are preventing some heart disease patients from going to the doctor?
6 Months After World’s First Successful Face, Double Hand Transplant, New Jersey Man Is Thriving With No Complications
"News A New Jersey man has new hands and a new face after undergoing the first ever successful simultaneous face and hand transplants. Joe to Mayo was in a 2018 car accident that left him just figured burns over 80% of his body. But now six months after undergoing this rare surgery at N Y U Langan health the 22 years World is recovering. You could imagine in a face transplant. If you can't smell it can't see Plus how you face the world Transplant surgeon Dr Francis Pupae of the Cleveland Clinic wasn't directly involved, but says, expect transplants like this to become more
Nuclear and Multimodality Imaging Coronary Ischemia
"Welcome back everyone. It's time for car. Dealers go nuclear with today's discussion about the multitude of clinical utilities of nuclear cardiovascular imaging within the broader context of multi modality imaging. We are just so thrilled to be joined by our imaging nerds colleagues doctors. Eric hut elbow skinny and wild jaber erica. It gives me so much joy heavy back on our audience will remember you from our cleveland clinic. Cnc are episode episode number. Seventy six on our patient with spontaneous. Pap ruptured related to vascular. Eller donald syndrome so for everyone. Erica was born and raised in costa rica where she received her medical degree from university. Costa rica she trained in internal medicine at the cleveland clinic. Where fortunately for us. She couples matched to stay here for cardiology along with mr dr. Eric hut aka jose. Aguirre truly power couple. Erdo will be staying here for cardiovascular imaging fellowship at beyond being clinical and a research powerhouse. Erica is a leader within the program as her classes fell representative erika. Thanks for joining us high. And it's a pleasure to be back. Thank you for that very kind introduction. I gotta say that. It's thanks to my mentors family and friends that i'm where i am today and i'm more than excited to introduce one of those individuals. Although skin on the cardiovascular imaging fellow at brigham and women's hospital he obtained his medical degree from Willing willingness swallow and completed his internal medicine residency including chief year at cleveland clinic and then moved on to cardiovascular fellowship at this institution although not only a spurt clinician and a researcher but also an exceptional mentor and a friend. And i actually met all during my interview at ccf when he was achieved I blame him. For recruiting me and six more latin americans to my residency class all of which actually became very close friends on one. My husband so thank you all for guiding my steps and really molding future so got. Thank you for those kind words. We have great times back into clinic. Both control mason in the work hard to try to you to the clinic somber. Happy that's the case. You're following through the path of of imaging so an amid. Thank you for the invitation diseases. Great session we're looking forward to do these for some time. So he's my to pressure to actually introduce the doco alligator book. Java's attended cardiologists at the cleveland clinic. He's director of new collapse. And director of the core lab. For the cleveland clinic. But beyond that the jerry's is is a friend of father to me as a person who has been all the way through. My journey in cardiology now could imaging in half neural networks expressed Grateful i am to have him in my life. We call him l. hefei just as a way to show him respect and gratitude and show him how we like him hale. Thank you so much for these kind words. now thank you for having a Show in guys is basically. There's no better time to spend your saturday this except of course watching boss place football but again. It's you know you look at these at yourself and you hear these words you think of yourself thank you all feel old inspect only comes with age and thank you guys old florida or not. Only keeping us always up to date but fighting us and You started shows again how you can change the way. We actually learn medicine. Cardiology from an up down up down way of delivering information. What everybody's waiting for the people in gray hair sitting in now. Beautiful offices in universities threatening us web to waiting for them to come up with a verdict every four or five years guidelines versus you taking this down to the level of practicing and cardiologists toward actually in training or early career and disseminating information. Because you can reflect. Shine the light on. The most important issues is face every day clinics and in the hospital home floors globally with the pandemic and then you can also actually at transcend all these rigid structures. We developed over the past. Maybe thousands of years cardiology and make these structures louis invade democrat. So thank you so much that and there's nobody that person actually reflect this new method or way of learning than erica. Erica is amazing amazing. Amazing human being an amazing physician. And i for the feel fuelling vitals of had in my life over the past two years have been at the cleveland clinic. It's such a pleasure to spend after
The Amish Pandemic Sewing Frolic
"It was friday april tenth. Two thousand twenty. The pandemic was really starting to roar. Ppe was scarcely in the supply chains. Were already breaking down. Every hospital was scrambling to find enough masks gowns and face shields. It was already every state every institution for itself. It was everywhere in the papers. Page one page to page three on page nine of the new york times dateline creek ohio. A headline cut on ape. Make a sewing frolic in ohio. The amish take on the corona virus. The story struck a deep chord in a state with us throughout these long months. The way this isolated centuries old self. Reliant community was rising to the occasion and collaborating with the world. Outside was something we wanted to know more about your attempt to record story. A new collaboration was born in that way that the pandemic has triggered all manner of new collaborations artists. Laurie anderson ohio born designer stacey hoover and producer. Evan jacoby all joined with the kitchen sisters to bring these voices to wear today. The kitchen sisters present. The great amish sewing frolic sugar creek. Ohio inca i. John miller manufacturer here with deep connections to the close knit amish community of central of got a call from cleveland clinic. When i get a call from purchasing cleveland cleaning at midnight i know needs. The hospital system was struggling to find protective face masks for it's fifty five thousand employees plus visitors. I thought about the fact that every amish lady in a community knows how we could then utilize the talents of the ladies into to make protective gear. Could his team so twelve thousand dollars. In two days he appealed to abe choi. Kind a local lumber neil and goods business and leader in the amish community. I called deep. Troyer and said make a sewing frolic a day later. Mr troyer had signed up sixty amish home. Seamstresses and cleveland clinic sewing from was i made patriotic ones. I think mine are also the other ones are from my sister. Sarah may meet those jeff. I am rudy Homemade candies. I'm curious sister. I am esther troyer. We had the candy store in the basement of our house. Frolic usually is using up as barn. Succumb people come from all around spectators as well as i have. Four course meal nash. Potatoes some kind of me sal desert. Some kind of dessert should be retire. But that doesn't pay the bills. So i can do this. The frolic of masks sewing is just. It's a group getting together doing a project as good. 'cause i went to egypt troyer to bring supplies. He's got three or four women in his own that console and they were cutting. The little wire knows please. That goes in the mass to conform to your nose on the kitchen table. Literally within three days the sewing machines were set up we had. I'm running in times like this. When can't have you no more than ten people in a room together you know. There's there's around. Ten thousand sewing machines in amish homes abe went and recruited sixty or one hundred sewers literally overnight and we may twelve thousand masks for cleveland clinic and forty eight hours that then turned into an order for one hundred forty thousand which scaled again. Currently we are making seven hundred and thirty eight thousand masks for the state of ohio.
Diabetes Mellitus with Dr. Dennis Bruemmer
"Take hardy and hurts summit clear so excited for this installment of our cardiovascular prevention series with the deep dive into diabetes. Which i think you'll learn by the end of the episode is so important for us. Be attention to. We're joined by a phenomenal and true. Genuine in the field. Dr dennis brumer hughes. The director of the center for cardia met about health in the section of preventive cardiology and rehabilitation. At the cleveland clinic. Dr boomer earned his md and degrees from the university of hamburg in germany following residency training in internal medicine and cardiology in berlin docker boomer completed a research fellowship as the diabetes center fellow in the department at ucla. He is board certified in internal medicine and chronology hardy vascular disease and cardiac graffiti quite a unique combination. Dr boomers research is focused on mechanisms of atherosclerosis and risk factor intervention for the prevention of coronary artery disease soccer. It's such a pleasure to invite you to the show success. have you on. And as i invite you. I'm going to just reflect on your unique training path and we were just discussing before we started recording. Here that there's going to be a probably a lot of interest. In pursuing some sort of combined die batali cardiovascular education for court in the future. But would you mind just telling us how you got interested in really devoting yourself to cardio metabolic disease and diabetes in general. Absolutely am so first of all i. I'm super thrilled to be here. And i i'm so excited to be talking to the nerds here tonight so i. I think it's phenomenal. What you guys are doing and again. I very much appreciate the opportunity here so so i was. I'm kind of bridge between endocrinology in cardiology back in germany. I did my thesis. Actually in endocrinology lie protein metabolism. And that kind of got me interested in cardiology. I went to pursue cardiology training back in germany and then research fellowship at ucla. I was supposed to go back after that to germany. But i decided to stay and then obviously being a foreign Repeated training and i was always torn between the endocrine in preventive cardiology aspect than truecar ideologies. So i ultimately decided. I'm just gonna do both so. I did endocrinology fellowship and cardiologist fellowship by the university of kentucky. I had a phenomenal time. There and kind of still even now much of what we do in cardiology is really prevention. And that much of it. This endocrinology so i think these sub specialties really are complementary in or very closely together but let me say on behalf of everyone here at the clinic. How glad we are that. You decided not to go back and stayed here. Join us over here as a faculty because you've just added tremendous value to the program and you've been such an incredible resource for all of us. Thank you for being here. Yes dr burin. And i extend that thank you. Because you know you've stayed here. We are talking to the nerds. I think this is a totally fortunate. And i am really happy to benefit from your stay here now. We are very excited to dive into cardio dive tallahassee which begs the question dr boomer we are cardio nerds why should cardiologists focus on diabetes. I mean why not. Just refer are diabetic patients to endocrinologist or leave the to their primary care doctors. Yeah i think. I think that's kind of the common theme and that is the current care. We leave it to others in cardiology. Now i think that is sub optimal. I think we as cardiologists we see these patients all the time i mean when is ever a patient. In the cath. Lab that presents with an semi or stemming that doesn't have diabetes so we do see the far spectrum of this disease of cardiovascular complications that arise of having ama- diagnosis of diabetes. So i think we have to be involved in managing this. I think to a minimum. We should referred patients to primary care or make sure that the diabetes is. What managed or console endocrinology now as as we all know as physicians quite frequently. Not even that happens so and there's good evidence for that if you look at registries just about six percent of diabetic patients with cardiovascular disease actually get appropriate care for their diabetes and cardiovascular conditions as you know that vitas says associated with the two to four fold increase in risk it is a cardiovascular risk equivalent termed many many years ago seventy percent of our acute coronary syndrome patients have diabetes. So you you could argue. Yes we leave it to primary care but or the endocrinologist but keep in mind that endocrinologists currently see about five percent of the patient population with diabetes.
Some South Florida healthcare workers get first coronavirus vaccines, Miami-area workers to follow
"Administered in South Florida. Current allotment. In fact, scenes is for the employees. The frontline employees working nice in critical care areas in the emergency department. For over our 2000 physicians that make up the memorial Family Memorial Healthcare System. President Aurelio Fernandez expects about 50% of their medical staff to receive the vaccine, which is about 7000 doses. The remaining 13,000 doses will be shared with five other Broward hospitals, including Cleveland Clinic and Broward General Medical Center. Jackson Memorial Hospital in Miami is still on standby to receive its first shipment of the vaccine. President Trump is tearing the
Americans face new COVID-19 restrictions after Thanksgiving
"Hospital systems state health officials and governors across the country are extremely concerned about the pandemic even before the impact of the thanksgiving gatherings Stacey Morris is the nurse manager of the covert unit at Cleveland Clinic you can't just snap your fingers and make more care givers appear possible systems in New York up in order to move patients from crowded hospitals to less crowded ones in their systems and to get in touch with former staffers governor Andrew Cuomo says the next several weeks are going to be really rough because of the holidays they all increase social activity they all increase mobility and they will all increase viral transmission Los Angeles county's ten million residents are understated home orders sports have been banned in the Silicon Valley and people who travelled one hundred fifty miles outside that area now quarantined until acquire
Growth of COVID-19 cases in Ohio "exponential"
"To to another another record record day day in in Ohio Ohio for for Corona Corona virus virus cases cases 11,885 11,885 new new cases cases of of covered, covered, 19 19 reported reported Monday Monday Now Now goes goes down down to to see see New New Daily Daily record record in in Ohio. Ohio. But Governor Mike DeWine explain why that number was larger, big big picture is that the high volume of these cases Is now overwhelming. The system is not only overwhelming the Department of health system, but it's also causing some problems in regard to the laboratories and getting all this information through the wind, say two of Ohio's larger lab, So a two day delay of reporting which could have contributed they were mercy Health and the Cleveland Clinic. 282 new hospitalizations in 24 new deaths were also in Monday's report. I'm Sean Gallagher. Doctors
Failed study spawns debate about fish-oil-derived drugs
"New study suggests Fish oil Doesn't offer a whole lot of protection against heart problems. Researchers at Cedars Sinai in Los Angeles say that's the bottom line After tracking more than 25,000 adults took omega three fish oil or placebo over a five year period. A second study from the Cleveland Clinic involving 13,000 Heart patients found similar results. The scientists concluded Fish oil supplements failed to lower the risk of heart attack. Or stroke.
The Food Fix
"I must admit to being exhausted. The last four years has taken a massive psychological and emotional toll that i'm only now just beginning to appreciate truthfully the struggle to keep hope that this day would arrive of alluded me the good news that we now have the opportunity to reignite democracy civility truth and move towards healing both our country and the earth. We've gone so far backwards that we need to move forward with deliberate tangible and bold steps one of the voices calling for such a revolution in thinking and action is dr mark. Hyman mark is a systems thinker and for dr. Hyman health is about connecting the soil with the farmer with the groza without diet and only when we connect all those dots. Can we begin to achieve planetary regeneration. As we'll hear in today's podcast what is truly staggering is the cost of today's broken food system. In which sixty percent of our calories in the us come in the form of ultra processed food. Dr mark hyman is head of strategy and innovation of the cleveland clinic center for functional medicine. He's the founder and director of the ultra wellness center and the board president of clinical affairs for the institute of functional medicine. Mark hosts one of the leading health. Podcast the doctors pharmacies spelled f. a. a. c. y. Pham esi marcus. The thirteen time. New york best seller author. His most recent book is called food. Fix how to save our health our economy our communities and our planet one bite. At a time i sought by ascii mark. How he got into medicine in the first place. Ming doctor was a total afterthought for me buddhist student in college. I studied buddhism. Asian studies chinese. I studied ecology. The environment systems thinking ancient systems of healing. Very eclectic and i decided after i graduated. But what am. I going do with a degree in buddhism so i took a long hike by myself in the shenandoah valley through my backpack brought a copy of moby dick. Because it was a very thick books. I could carry and read house before kindle and I just walked and thought and just kind of thought about what i wanted to do in the buddhist framework is really about healing. It's a it's a healing system. It's not really a religion it's really a system of healing of the mind and it's about the relief of suffering it's about compassion and love and service and and those were things that really called to me as a young man and i thought well. What could i do. That kind of fits all that. I could be a monk. That didn't sound like a lot of fun. But i decided i could be a doctor and it was a total afterthought i just i didn't have any science courses. I had to go back. And take some pre med courses and ended up loving. And i decided i would just keep doing as long as i liked it. And if i didn't like it anymore. I would stop and so far so good thirty years later. I mean that's great advice for anyone thinking about people. Ask me career advice. I say that like if you enjoy it if it fills you keep doing it and if it doesn't maybe think about stopping it exactly exactly chain. I've changed so many things i've been you know a small town country doctrine idaho and a native american reservation. Emergency room doctor started clinics in china ex patriots. I was the medical director. Kanye ranch i developed my own. Practice started writing books and teaching About functional medicine became the faculty of functional medicine institute and direct and the chairman of it started big center for functional medicine at cleveland clinic. And now i'm sort of moving into a different phase of thinking about how do we deal with the intersecting issues of food and health and agriculture environment which all may seem separate but are actually all one problem and if we want to solve one we have to solve them all to before we end that. What is functional medicine. What does that mean. That joke is the opposite of dysfunctional medicine. Which is what we have now. As essentially a system of thinking it's not a methodology or treatment or attests supplement is is essentially a way of thinking about disease based on systems. It's it's base c ecosystem medicine. You understand that that the environment is an ecosystem and that everything has to be imbalanced in nature. For to thrive and in madison we really created a reductionist model that allows us to focus on diseases and symptoms in drugs to target those symptoms and not really understand what is health. We never took the course in medical school. Creating a healthy human wanna one. You know we we basically learn how to diagnose and diseases functional. Medicine is the science creating health. And when you do that does goes away. The side effect if you create a healthy ecosystem for example on a farm or a natural ecosystem it becomes. Resilient disease doesn't occur.
People who eat chili pepper may live longer
"A new study says. Eating chili peppers, the spice that adds kick to your favorite kung Pao chicken and all may actually help save your life research. Chili peppers not banned but despise. They reduce the risk of death from heart disease, cancer and other causes. Scientists at the Cleveland Clinic in Ohio went over healthy dietary records of more than 750,000. People says those await peppers had a 23 2 26% reduction and death from heart disease cancer. All of the above. Says the chemical component Capt. Face in the main ingredient in chili pepper, spices, also an anti inflammatory, anti cancer and anti obesity
How We Study Alzheimer's and Potential Treatments
"We have two guests today. the first is alan pal quits. He is the senior research professor of medicine and president and ceo of the indiana biosciences research institute. Also joining us is bruce lamb. He is director of stark neuroscience institute. Welcome both of you. Thank you so we usually like to start off by asking people how they got to the position that they're in like how does one become a senior research professor of medicine allen and what is president and ceo of the indiana biosciences research institute. So if you could tell us a bit about what you do and how you got here so thank you very much earned so I think my experience has been somewhat atypical. In terms of coming into academia. I spent twenty eight years at the leeann. Company started off as a bench level. Scientists of medicinal chemist and eventually in my last eleven years woods the vice president discovery chemistry research and technologies where oversaw small molecule drug discovery across all the areas of therapeutic interests that lily so this was a very rich experience and and after being there for quite some time. I had the opportunity to make an early retirement at the end of two thousand seventeen. And i was thinking about my next steps and i had developed long relationship with a not shaker. Who the rhinos. The key leader here at a school of medicine and asked me to come over and help with the position. Health initiative than any perspective that i could provide in and input in you know things kind of transpired in i came over as a professor of medicine and eventually met bruce and you know a lot about our work together here in the past year and really create some great synergies and then as i spent some time that you another opportunity came up in in the community and this lousy indiana bioscience research institute which is an organization that really had a ton of blossomed out of a vision to really create additional note of innovative research and capabilities. That would draw the community together and diorite been around for about five or six years. And now i'm there to really help create additional bridges and create new scientific directions that really elevate The the sciences here in the mid west. And hopefully beyond great and bruce sort of what what has been your experience. How did you get to hear. Thanks a lot erin. So i'm a phd level basic scientist by training. I was at johns hopkins At case western. Reserve university. In cleveland clinic in doing science research into alzheimer's disease actually for my entire career and then I saw this unity to come to indiana in early. Two thousand sixteen to lead out this translational neuroscience research institute Stark neurosciences research institute. And it's a really unique Place that brings together. Clinicians basic scientists translational People now drug discovery as well sort of brings everybody together into one location to really do innovative and interdisciplinary research. So we wanted to talk today about alzheimer's disease. So i'd really like to start by just for our listeners. What is alzheimer's disease. Yeah so alzheimer's. Disease is obviously a brain disease And it was first described. And i think the history is important because it sort of still sort of how we've sort of you. The disease was described by a bavarian neuropathologist us alzheimer in early nineteen hundreds And he had a patient who had dementia sort of loss of memory She had paranoia clinical features that she had and then when she died Being a neuro pathologist he looked in her brain did standard stains at the time and described this unique brain pathology which still even today sort of defines the disease and that was primarily that there were two primary major neuro-pathological hallmarks that he observed in the brain tissue one where these amyloid Sort of the sticky substances which were aggregating in the brain and the other words what we currently today called neurofibrillary tangles which is another Brain pathology and even today it still sort of those two primary brain pathologies that are pathan demonic for alzheimer's disease. However i will say that as we've gotten into the modern age and in our began to understand the complexities reprieve that alzheimer's disease is a is a complex set of probably multiple disorders which are very related to one. Another but actually. There's probably not one set of alzheimer's disease out there. So is it. Is it just sort of like a neuro degenerative. Cognitive decline is we just believe is because of a few specific reasons so there's clearly a lot of neurodegenerative cognitive decline syndromes but alzheimer's is just a group where we think we know where the pathologies right sort of defines. You know one particular type and again. There's there's many different types that this is probably the most common one and it's also very much age related so you really see sort of a doubling after about the age seventy seventy five doubling every five years of of the incident so with sort if the baby boomers reaching the age of sixty five at ten thousand. A day right. Now that's why there's the big increase in number of cases is there a typical course. Does it usually hit a certain age. And last a certain amount of time. It's pretty variable You know there is a sort of a prototypical alzheimer's disease. But if you talked to the clinicians. And i'm not a clinician. But if you talked conditions they say if you've seen one case of alzheimer's disease you've seen one case of alzheimer's disease You know that really. There's so much variation in how how people present their how it progresses within those people So it's it's pretty variable. Obviously the common underlying features certainly memory loss at least at a general level but within that you have other changes sometimes with personality disorders of all variety of other things that can come along with alzheimer's
How We Study Alzheimer's and Potential Treatments
"We have two guests today. the first is alan pal quits. He is the senior research professor of medicine and president and ceo of the indiana biosciences research institute. Also joining us is bruce lamb. He is director of stark neuroscience institute. Welcome both of you. Thank you so we usually like to start off by asking people how they got to the position that they're in like how does one become a senior research professor of medicine allen and what is president and ceo of the indiana biosciences research institute. So if you could tell us a bit about what you do and how you got here so thank you very much earned so I think my experience has been somewhat atypical. In terms of coming into academia. I spent twenty eight years at the leeann. Company started off as a bench level. Scientists of medicinal chemist and eventually in my last eleven years woods the vice president discovery chemistry research and technologies where oversaw small molecule drug discovery across all the areas of therapeutic interests that lily so this was a very rich experience and and after being there for quite some time. I had the opportunity to make an early retirement at the end of two thousand seventeen. And i was thinking about my next steps and i had developed long relationship with a not shaker. Who the rhinos. The key leader here at a school of medicine and asked me to come over and help with the position. Health initiative than any perspective that i could provide in and input in you know things kind of transpired in i came over as a professor of medicine and eventually met bruce and you know a lot about our work together here in the past year and really create some great synergies and then as i spent some time that you another opportunity came up in in the community and this lousy indiana bioscience research institute which is an organization that really had a ton of blossomed out of a vision to really create additional note of innovative research and capabilities. That would draw the community together and diorite been around for about five or six years. And now i'm there to really help create additional bridges and create new scientific directions that really elevate The the sciences here in the mid west. And hopefully beyond great and bruce sort of what what has been your experience. How did you get to hear. Thanks a lot erin. So i'm a phd level basic scientist by training. I was at johns hopkins At case western. Reserve university. In cleveland clinic in doing science research into alzheimer's disease actually for my entire career and then I saw this unity to come to indiana in early. Two thousand sixteen to lead out this translational neuroscience research institute Stark neurosciences research institute. And it's a really unique Place that brings together. Clinicians basic scientists translational People now drug discovery as well sort of brings everybody together into one location to really do innovative and interdisciplinary research. So we wanted to talk today about alzheimer's disease. So i'd really like to start by just for our listeners. What is alzheimer's disease. Yeah so alzheimer's. Disease is obviously a brain disease And it was first described. And i think the history is important because it sort of still sort of how we've sort of you. The disease was described by a bavarian neuropathologist us alzheimer in early nineteen hundreds And he had a patient who had dementia sort of loss of memory She had paranoia clinical features that she had and then when she died Being a neuro pathologist he looked in her brain did standard stains at the time and described this unique brain pathology which still even today sort of defines the disease and that was primarily that there were two primary major neuro-pathological hallmarks that he observed in the brain tissue one where these amyloid Sort of the sticky substances which were aggregating in the brain and the other words what we currently today called neurofibrillary tangles which is another Brain pathology and even today it still sort of those two primary brain pathologies that are pathan demonic for alzheimer's disease. However i will say that as we've gotten into the modern age and in our began to understand the complexities reprieve that alzheimer's disease is a is a complex set of probably multiple disorders which are very related to one. Another but actually. There's probably not one set of alzheimer's disease out
Arnold Schwarzenegger says he’s feeling “fantastic” after latest heart surgery
"Arnold Schwarzenegger had a third operation to correct a heart defect. Cleveland Clinic surgeons replaced his aortic valve Now, just a couple of years ago, Arnold underwent emergency surgery to replace another heart valve that helps the blood flow to the lungs. And his very first heart surgery dates back to
Arnold Schwarzenegger undergoes heart surgery, says he's feeling 'fantastic'
"Politician had heart surgery performed in Cleveland on Ly Pain and maybe Ah heart condition Movie star and former California Governor Arnold Schwarzenegger posting on his Twitter account after undergoing a heart procedure at the Cleveland Clinic. He says he now has a new aortic valve to work with his new pulmonary valve from his last surgery. Schwarzenegger posting pictures of himself in the hospital bed and also around Cleveland, saying he feels fantastic. Jack Crumley
Arnold Schwarzenegger undergoes heart surgery, says he's feeling 'fantastic'
"Arnold Schwarzenegger just went through heart surgery, He went on Twitter to thank his doctors, nurses, thie actor and former California governor tweets that he's feeling fantastic. After undergoing heart surgery at the Cleveland Clinic. The 73 year old says he has a new aortic valve to go along with his new pulmonary valve from his last surgery. That one happened in 2018. He's been open about being born with a heart defect along with the thumbs up pick from his hospital bed. The Terminator also posted photos of himself walking around downtown Cleveland.
Rural hospitals struggling to handle virus surge
"Surgeon Corona virus case is underway in the US many hospitals around the country are overwhelmed. College campuses continue to grapple with outbreaks, CBS REPORTER Moola LINKY reports A fall surge of Corona virus cases has arrived, and it's taking a toll on hospitals across the country. In Wisconsin were about one in every five Corona virus tests is coming back positive. State health officials are warning residents to avoid all gatherings large and small, which continue to play a role in spreading the virus. A retirement parties, birthday parties, baby showers, weddings all of those things. That's why we have been encouraging here in recent weeks that people stay home as much as possible. Wisconsin was one of eight states to break its single day record for new Corona virus cases on Thursday. So is Ohio Hospitalizations. There are up nearly 50% in the last two weeks and infections are rising fast in rural and suburban counties. According to Ohio State Dr Matt Excellent, Papa fell for local regional hospitals is to send patients to the referral hospitals such as Ohio State, such as Cleveland Clinic's University of Cincinnati. But if all of these hospitals and all of these cases were coming at once, they won't have that pop off valves available. Colleges and universities continue to grapple with outbreaks. The State University of New York in Oneonta announced its president had resigned to pursue other opportunities. After more than 700 students tested positive for Cove in 19, the school switched all remote classes for the rest of the semester. Another recent spike. It's Sacred Heart University in Fairfield, Connecticut, forced the campus to temporarily suspend in person classes for some off campus students. Now their goal is to test 50% of their student body every single week, and Gerry McNamara is sacred Heart's director of public safety. We have found that students have been on campus and they don't know they have the virus. And if we don't provide the testing to know that, then we can't react to the quicker we react with the quicker we can stop this.
"cleveland clinic" Discussed on Cardionerds
"So Zach as a future advanced. Heart failure critical care cardiologists at love to hear your thoughts. If you just take ourselves back in the thick of things, the patient was just crashed on. ECM. Oh, in Pella, we're trying out really experimental therapies totalism APP and Ivig hoping for the best. But what are the different trajectories of these patients and how do you triage the next steps in your mind Yup I'm by no means. An expert in these things but I think in general whenever you're thinking about employing some sort of mechanical circulatory support approach. The question in your mind always has to be what is the exit strategy from this you can't have a patient who lives indefinitely on these pertains devices in. So having in mind what the out could be whether that's a permanent type of support like in l.. Had A heart transplant or recovery is something that needs to be in the forefront of the teams mind and I think that's the benefit of having something like the shock team where you can have true experts really discuss these things and think about it as you mentioned in Myocarditis at least in my albeit limited experience, these are some of the folks that are most likely to recover so. I think the decision to pull the trigger on early invasive support is relatively easy because we know that a lot of these people have a good shot of recovery if you're moving along and you don't have recovery, that's when you start to think of things like elder transplant, which have their own considerations, for example, keeping in mind and Elvis is only going to support the left ventricle. So. If, you have somebody who has profound RV dysfunction or high pulmonary pressures that are not going to completely resolve with supporting the LV, an may not be enough and you have to think about things like transplant although that that also gets difficult. There are ways to more objectively measure this like pappy, which is the PA pressure positively index, which helps guide how functional the right ventricle is. Really, this is a team decision I don't think there's any one person that ever make a decision like this, which is why having a heart team approach in having the surgeons, the CIC attending the failure Dr all really discuss this and see what options could be Zach really touched on two key points that took away from this case number one is the fact that the RV function is very important delineating what type of Nondurable Mechanical Sport you WANNA use. Of course, you mentioned durable and chemical sports. So his RV function being so poor as one of the key factors in helping us go straight to echo, and then the second point you mentioned is that these minute data's patients especially these young. Patients who are otherwise relatively healthy if you can just bridge them through the acute phase and maintain and organ profusion and keep their kidneys from taking too big of a hit excetera, they often do quite well absolutely. These are really great points, guys thanks for going over that and I appreciate Zach you saying that this really is a team decision because there's so many layers of complexity and additionally of complexity for this patient is how deep presence of covid nineteen illness impacts transplant candidacy in be excited to hear more about this perspective from our experts segment, which will be followed after the fellows discussion called the e CPR or expert Cardio perspectives in review not to be confused with extra corporeal. Cardiopulmonary resuscitation..
"cleveland clinic" Discussed on The Doctor's Farmacy with Mark Hyman, M.D.
"But if you were king for a day or week, or whatever, however long, it took what would be the things you'd wanna implement either from policy change or culture change or some things that would actually impact the world in a way that creates more healing and benefit. Well, first of all, I think we clearly have to move to value instead of paying for volume pay for value and be across the board. Secondly, there's a lot of things that the government can do in terms of cigarettes. We talked about that we talked about the sugar tax to begin to decrease the amount of sugar that in people's diets. And you know, we've been. Need to think about. Going back to why we're all in healthcare. And which would it be in? Really, I think if increasingly people were incentive to look after the fact that they had anything to do with health care, whether it's manufacturing products or whether and pharmaceuticals, or whether it isn't taking care of people, if they idea was the reason that you're there for people it's going to that's going to be change your in, by the way people. I I just patients for exactly that's that's that's really what we're to be about. Because you know, as we move more and more towards towards wellness and taking care of people and keeping them out of the hospital. It's going to be about people not just patients. Yeah. And you and you you've done that here clean clinic. And you've you've also done it in. We've we've done it. And okay, we've done it. And you also knowing just address patient spirits, but you also. Addressed like, for example, the food and the environment, and it's tough, and you battle against food companies and food service companies and renders, and it's not an easy path. But you took I mean, courage. It's amazing. Your one of your key leaders is CEO of Abu Dhabi's Cleveland Clinic Dhabi, and he's got even a step further because there's more ability to do that with less precious from food service companies. He got her of all things white the white flour white sugar, processed anything and create a whole organic gospel food system, which would be amazing. So I think I'm delighted that people are moving further. I think we think the first few steps, and and and it's going to be leaders in the future are going to do even better in, you know, the job of a leader is really take an organization to places they're not sure they need to go. You have to lead people. So what's the most important thing? You feel like you're you're focused on working on. Well, I I'd like to see that. You know, I'm I'm helping the organization, particularly ROY. Round bringing the new technologies, and I see new technologies and all kinds of locations. I talked about the little things I'm seeing in cloud and the technologies coming there. I've seen some incredible technologies voice recognition that can tell whether or not you're on drugs. I've seen the ability to do a scan of your retina that can make sixty diagnosis from that. I think virtual care is going to take the help take care to the patient. Yeah. From having to come to the hospital, and I think one of the leaders in that has been Kaiser Permanente which knows he's more than fifty percent of their patients for Charlie and just think about the potential of managing people's diabetes without having to come to the hospital at their blood drawn or their hypertension, the same way or the dermatologist dermatological lesion, we had an orthopedic surgeon here recently see a whole clinic of Twenty-three people from home because he had an injury. I. The potential for the sort of virtual care is going to help with rural populations where the hospitals are not big enough to be sustaining. I'm very excited about a a lot of the opportunities that are coming through the technology that I see and I wanna see them getting getting corporate mazing. Toby? Thank you so much for being part of the doctors pharmacy. You listening conversations that matter the doctors pharmacy with seat former CO clean clinic, Toby Cosgrove, if you like this podcast, please share with your friends and family and social media. Please leave a common review we love to hear from you. And we hope to hear. So you next time on the doctors pharmacy.
"cleveland clinic" Discussed on The Doctor's Farmacy with Mark Hyman, M.D.
"And I think a lot of that may be came from an experience at Harvard Medical School or our business where you were you We're were. embarrassed embarrassed by the king of no I was in barris by a student who who asked the question, Dr Cosgrove said, Dr Cosgrove, my father had mitral valve prolapse, and we know you've done more of these in anybody else in the country, but we decided not to come to your dot com. Go because we heard you don't have empathy. And I haven't any idea what I said after that. I was totally flummoxed. And then the king of Saudi Arabia burst into tears in an opening of a hospital over there because they were talking about this hospital being dedicated the body and the spirit of the soul of the patient. And so I decided that you know, I better third of examined my career. And I realized I spent my whole life trying to make the cardiac surgical safer with lorrimore, bitter D And Malloy mortality, and I'd spend all my time doing that. And not paying attention to the person as a person the person with the mitral valve, they were they were I was a technician. And so we really needed to change it. And so. When we made it a sea level commitment with a chief experience. And we've changed the whole culture. I think of the organization around the fact that the patient is the reason we're here and one of the biggest things that came out of that in terms of the chief experience, what were the things that shifted when you well. You know, we really some said, okay. What's what's called in healthcare? We'll see clearly quality and Healthcare's outcomes, and it's also about the physical experience, and it's about the emotional experience in the physical experience. We'd all kinds of things we change the architecture. We looked at more late in the facilities. We change the sort of gowned that jihad so you didn't walk around with your cheeks flapping in the first Enberg to create a new. Wrap I wrap gone. Yeah. And then we began to look at the emotional aspect of it. And we went and brought everybody in the organization some forty thousand people at that time into groups, and we talked about talked about the Cleveland Clinic experience, and as they came out of it. They got a little badges said on caregiver, so we refer to everybody knows the caregiver. Whether you drive the bus on your neurosurgeon, you're all re addresses a caregiver. So it makes a team out of everybody. Yeah. And that really has begin to change both engagement of the caregivers and also the experience of the patient. Yeah. It's broken out. Some of the hierarchy. Yes, it's here. Yeah. And you know, you are great to support us in our new center where we took that a step further and credit the first wellbeing certified facility in the in the in the clinic, which basically has filtered the air differently. The water's the best in Cleveland, the lights are are not causing fatigue and stress the all the materials carp. Are all non off gassing nontoxic, and it's quite a very amazing work environment and claim claiming the spaces here. Beautiful. It doesn't feel like attritional hospital. I had a huge influence on that everybody talks about a symbol complaint about it. It's really right fifty shades away. My. Great Toby, white the so this is really been a great conversation. I wanted to end with one last question you have the perspective of years. You have tremendous experience you've been around in all sorts of different sectors and understand the problems of health care and chronic disease, and in many problems in the world more than most. And you're quite humble about it..
"cleveland clinic" Discussed on The Doctor's Farmacy with Mark Hyman, M.D.
"But these were the beliefs of the time, and it took a long time to overturn these. How do we how do we do that? Because you know, if I if I were, you know, healthcare leader, I would want to know, I guess I am a little bit. But not like you. But I I wanna know how how do we change the educational system to bring up a new generation of doctors. How do we change the reimbursement to pay people to do these things? How do we get the technology to actually be able to think about using all this big data information systems thinking biology, together and? Actually, make sense at all. Well, we we have got. I mean think how great it would be if you had a pharmacist a nutritionist person. And a and a social worker is running with you every day seeing your patients, it would change the way you thought about put their problems where and what you can do for them. Yeah. So we have got to be more inclusive. The team is it's a team. It's no longer the doctor God it is a he's a member of the team. And he brings us specialty and technology to it. But it is going to be a huge group of people who have diverse knowledge. And that's when innovation really happens. It happens at the borders, different knowledge. Yeah. I mean think about the surgeons at back to your answers thing about servants year after year after year after year in the middle of the night operating on people with bleeding ulcers thing. It was stress and trading with ice, water and milk and maalox. And in fact, it was took up pathologists finally in a micro. Biologists to finally figure out it was bacteria that was causing. The problem is true. They didn't Shing assignment these all service, which have this bacter- call at Hilliker backtra pilot H pylori, actually that bacteria was seen there for years when people buy, but they just ignore. That was incidental. It wasn't relevant. One guy goes, well, maybe it is. And let me take a beaker of Emma swallow, it give myself an all, sir. Then she and then he bought it could see I better, and then you win the Nobel prize and they'll laugh at them, right? No. That's that's the the the start of thinking that we need to change. We have to question, and we have to bring in different specialties in different knowledge in different expertise to begin to change the paradigm. But it's tough because you know, they -cational doesn't generate the systems thinking, right? Which is we'll think about it think about how we've been selected you were selected to medical school because you got through organic chemistry. Yeah. I studied Buddhism. I'm gonna why they let me know. I'm not sure. Through. But nearly barely myself. But I mean think about how you select them you select people can memorize then you memorize for four years. Then you do what you're told through your entire residency early on into your practice medicine. So you merge at age forty five without ABN courage to have any regional thoughts. Yeah. Yeah. Sad. It is true. It's interesting. I did not do pre-med. I majored Cornell and Asian studies. I was history major. Yeah. And I talked to think to analyze it to be critical. And that was my training was and when I got to medical school, you know, a lot of people were just science driven. And they didn't know how to sort through the massive amounts of information. They were overwhelmed. They're having panic attacks Singapore now, Mike, oh, I see this is the story the narrative, this is basically what's important is stuff. I don't need to learn. I just did really really well because I was able to sort of think and be critical about what I was learning and that's very different skill. Don't questions let's go. But the systems the systems part is tricky because. You know, our definitions are blowing apart about disease. You're seeing these these themes of mitochondria and information, and the microbiome and all these things that are across diseases cross specialties and nobody's talking shutter. So I think that's what's going to shift. It's exciting. It's very exciting. I wanna come back to the patient. I because everywhere in Cleveland Clinic, we work here. You see this patients I logo, it's everywhere. Right really in front of people's minds. But you're also not only the first quarter of what she follow us officer and a wellness institute, but actually to create the chief experience officer, right?.
"cleveland clinic" Discussed on The Doctor's Farmacy with Mark Hyman, M.D.
"And it's no it's so big and so complicated in Knoller. You can kind of just the doctor, but he has to have doctors, nurses, physician and of all types, you need to have the pharmacists, you need to have the P as the dentist. Everybody pulling in the same direction. So this is the first time that they've all been educated in the same location. So we're gonna have the medical school nursing. The dental school in the PA school all in one building learning together. We're going to try to bring together new technology like Microsoft's whole interestingly, we're going to be teaching anatomy now using virtual reality. Yeah. And and I you may have heard me when I my mouth at exposures better for the doctor and that and is it going to be good for their socialize gonna smell like for melda. But but the other day I'm walking around with a headset on I'm walking around a heart. That's out in space. Yeah. And you can walk all the way around it. And they say Toby stick your head in. So I go like this my heads in the left ventricle. And I'm looking at the flow track of you that I've never had is a cardiac surgeon after twenty two thousand operations, you never saw that view happily. I never did. But it gives you a much better understanding of what the Natta me is than you know, some shriveled up cadaver does so we're not going to have cadavers anymore. And I think that this begins to apply to a whole lot of things about education. So. Thinking about the educating as a team of aunt and educating using new technology. I'm excited about that. So great. So you also our good friends the guy named LeRoy hood, who you I think we're in Vietnam with maybe or no. But I know at least back then. Yes. And he's brilliant scientists whose led the way in systems biology. Yes, he is. And you were part of this program called the pioneer one hundred which I was out your biology and create a predictive model he calls it the P for model predictive preventive personalized participatory about how do we how do we think the way we do healthcare based on systems thinking systems biology? That's really what functional medicine tries to do. How is that going to change what we do and also -education because a lot of our medical education system has been set up based on the flexner report, which isn't a twenty one hundred year old organization. And now, we're we're breaking down the walls. You've got people Cleveland Clinic here like Dr STAN Hayes in Hobe. God cast and Kerr saying we're looking at the micro bio and its role on cancer or heart disease, which is what cardiology not talking about poop. Well, maybe that's important. Right. So how do we then shake this emerging science of systems biology and take them put into medical education medical practice? How do you see that going unfolding? That's an interesting, you know. So I tried to get the health care medical school here to begin to talk about teaching genomics, and it was a long hard pull before we got them to do that. And in the same with nutrition. You know, we're going to never had a single course in nutrition as a medical nor anything about genetics genomics, and this is all new information that is going to have to be shared with medical students. So they are not thinking so much about anatomy and physiology. But thinking increasingly about the metabolic aspects of healthcare, which is tremendously exciting and brand new areas, it is huge. And it's so it's such a paradigm shift because all. The not just the Klabin between people as teams, but even like how we think about disease and autumn you disease and diabetes. These are all complexes eases that have required for a new way of thinking. And yet it's very hard for anybody in science to actually change the paradigm that was that book called the structure of scientific revolutions by Thomas Kuhn, talking about the idea of a paradigm shift in how we have this normal science where everything is the way it is. I mean, you've been around long enough, you know, that all sorts are caused by stress that autism is caused by refrigerator mothers that the things that we just now are ridiculous..
"cleveland clinic" Discussed on The Doctor's Farmacy with Mark Hyman, M.D.
"You know, what's your sense of -bility to actually change policy because we have so many disparate policies that are all at odds with each other. That are actually promoting the exact opposite of what we want, you know. And I think it's not about cutting entitlements or keeping entitlements. It's about figuring out how to change the. The value. Get people better it's really hard to change policy and in Washington. There's no question about it. We didn't take the jobs that they already. But I mean just just think about it for a second. One of the things that makes me really crazy is the fact that we are subsidising the growing sugar. Uh-huh. And sugar is in everything. And so we pay for it to help them grow it. And then we pay for it to help keep getting people well from the results of giving them sugar, right? At makes very little sense. We pay for this commodities be grown with subsidies. Hey, for food stamps like which is almost trillion dollars every ten years in foods seventy five percent, which is Junkin sugar and soda and then we pay for Medicare Medicaid on the back end triple taxing the consumer tackling. And it's it's kind of a whole screwy thing. I don't know. But would Tim Ryan and another another congresswoman and does Darius must find as the dean of tufts school of nutrition how policy we got them to get the GAO the general accountability office to do an analysis of all the different agencies policies that relate to food. How each other how the helping or subverting our health? The economy, which hopefully, we'll come out and said some light on all the nonsense going on. Well, it's it's very difficult and hit is actually wound up being a very detrimental to the health of the country. I think another area that you could begin to think about as far as policies smoking. And you know cigarettes are clearly the most reversible or preventable cause of cancer. And I don't think anybody questions that happily. We're seeing are incidents smoking going down across the country. It's still thirteen percent of the people in the United States smoke. It's a major cause of emphysema major causes of cancer of all types. And you know, it'd be very nice to just tax cigarettes right out of these events. And you could aren't they like ten dollars a pack now. Well, you don't make them twenty dollars in. And because you know, we're we're are in fact causing that 'cause the cost of healthcare. Oh, yeah. I had Larry Summers on the podcast. We talked about his new initiative with Michael Bloomberg around fiscal policies, working with fiscal leaders, and you know, fiscal secretaries ministers finance ministers treasury ministers all around the country around the world to tax junk food and soda as a way of creating these disincentives for consuming the wrong thing. I think that the, you know, texting sodas one thing, but the base problem is not just soda. It's the sugar and everything. Yeah. And and so does just one of those. And so I would I would think about getting down to the root cause which is a sugar than the actual delivery. And it's also starch starch in sugar. You know, friend of mine is professor harvest has you know, below the neck you body can't tell the newsroom a bowl of cornflakes bully sugar because the way it works metabolical is almost the same. Exactly. It's such a huge issue. So changing for a minute. Why in the world would you bring somebody crazy like me in Cleveland Clinic to functional medicine, especially I've been asking myself. No, I, you know, I think that you know, we understand that the functional medicine really built around the things that influence you which are your jeans, and the and the things in your environment, and one of the things that as in the environment is food, and that's a lot of what causes chronic disease. And you know, you are heaven dressed this very directly with functional medicine. And I think this is a capabilities that we Cleveland Clinic need to bring into our repertoire and begin to learn from and to begin to understand and the data and put it out there..
"cleveland clinic" Discussed on The Doctor's Farmacy with Mark Hyman, M.D.
"Now, interestingly the payment miles so far is not incentives to do that nor have we had the training or the expertise to do those sorts of things. So it's a whole paradigm shifts. True. It's true. You know, the biggest things Dr disease are the social determinants. And that includes the food if you address those two things you can dramatically change. And that's part of what we're doing with the pharmacies. The food insecure diabetics teaching them, you know, going to their kitchens and cleaning out their cupboards and trying to shop and cook. And you know, what Cotto and how to, you know, do the things that they need to do to actually change that and it and it works if you do it, but it's a very different model. But all of a sudden if Cleveland Clinic king care of three million diabetics, and you know, you have to pay if you don't take care of these patients, well, then incentives, change and the monetary change. So all of a sudden Clinton clinic, maybe paying for ten thousand health coaches or maybe paying. For food for houses of people to actually do this at home. So it's a very different vision. So one of the things we've done is. We started putting kitchens and a lot of the places that we've built recently that will have the ability to teach people how to cook. Yeah. And and and by the way, our new health education facilities going to have that same sort of capability to begin to teach medical students, and etc. How to prepare meals. Yeah. Imagine if everybody after the discharged from the cardiac unit had to go to a cooking class for a few days as part of their discharge, you know. It's amazing. So you you've been around a long time. I don't wanna say I have been around. And you see a lot of changes in healthcare. In terms of the biggest trends that are happening. Now, you're you have a unique view because I know you really well, and I see you go to all sorts of non medical meetings where there's technology and innovation and business and science and things that are out of the normal domain of healthcare. But informs your thinking and former way of seeing the world gives you. Ideas about where these worlds intersect, and it's led to I think some really probably very interesting insights about you know, where we're going one of the biggest things that we need to be thinking about going forward because we're in an unsustainable. Nosedive as far as I'm concerned terms of chronic disease, which is counting. I mean, just obesity and tech diabetes. According to the Milken institute accounts for three point four trillion dollars in direct and indirect healthcare costs as twenty percent of our GDP. So where where are we going? What are the trends? And what should we be thinking about? Well, clearly, we've got to do two things we've got to begin to make the healthcare delivery system for people are sick more efficient, and we've got to keep people. Well, we've talked a little bit about keeping well about food and smoking and preventing diabetes and all the things that are socio with that and the obesity that is associated with everything from heart disease cancer. So let's talk a little bit about the efficiency of the healthcare delivery system for people one of the things, that's really fascinated me his been the explosion data. Yeah. And in fact, if you look at it just for doctors, they're fifty eight hundred journals putting out eight hundred.
"cleveland clinic" Discussed on The Doctor's Farmacy with Mark Hyman, M.D.
"And if we have to have them have heart surgery, it's going to be more expensive. So we can keep them their cholesterol down under hypertension under control. We're not going to have to do so much hearts, maybe emptying out the hospital with save you a lot of money they will. But, but but at the end of the day, you know, the hospitals are turning more and more into acute care organizations, and we can't build the intensive care fast enough because we get really very sick people. But you know, we're seeing more and more people being taken care of out of the hospital and less and less invasive surgical procedures, and that's why should be. So in terms of the economics. Here is something that's going to happen because I think people are still stuck in the old model thinking in right? Individuals approach healthcare in the way, businesses even policy hasn't quite moved there. But if it does it seems like it's incentivize payment for the right things instead of just doing more things. Exactly. And you know, we've been on this journey now for almost ten years, but the Medicare is said they're going to be paying for fifty percent of what they pay us for on the basis of value by twenty twenty so half of all the reimbursed for Medicare going to be based on whether or not you're. Creating healthier people lowering costs. Exactly. And so I think that's that's one of the big payers in healthcare. And I think that's going to be a spur to having more and more people a moving to values, and what is that gonna look like in a practical way in a place like Cleveland Clinic, where it's traditionally a volume based place like everybody in healthcare, and it's it's an acute care hospital. How are you going to shift that well, I think what the way we gonna shifted as we begin to incent physicians to look after people differently right now, they're being incentive to do more. Various things happily were not as far along with on that road is other places because we're all straight salary. So it doesn't really make any difference. We do more we do less. Yeah. On a day-to-day basis as far as our pay is concerned. Yeah. But but over time we're going to be an incentive to keep people out of the hospital to manage their diabetes their weight under control all of those things instead of just being taking care of them for their cute problem. Yeah. You know, I met with the. Former chief of staff here when asked him what did he think about healthcare at Cleveland Clinic in five or ten years have looked like and he said, it's healthcare without walls. We have to rethink delivering healthcare as well. As what we're doing where we do it, and whether it's virtual care, whether it's using other tools, we're gonna talk about a minute like artificial intelligence and health care, whether it's actually community based models. You know, I know, you know, a project will working on creating a food for MRI, which would take the idea that you know, if diabetes is caused by food. Why don't we give them food instead of drugs and see what happens and give them the support in your community to actually change your behavior? Some groups have done. This guy's reduced their healthcare costs in these diabetic patients eighty percent over a year. So which is dramatic. I mean think one and three Medicare dollars on diabetes, and you can do that that's a game changer. Well, there's no question about it. We need to have more incentive to to keep people. Well, and all kinds of ways we can do it. Now. The interesting thing is at so much of what we're talking about is the social determinants. Healthcare. Yes. And traditionally we have not been involved in that as as healthcare providers and more and more were being called on to do that..
"cleveland clinic" Discussed on The Doctor's Farmacy with Mark Hyman, M.D.
"Will be cities those sorts of problems are first and foremost in our minds, and if we can stop dealing with those problems, we can have people live a lot better in a lot longer in. That's really what we're up to in this far as healthcare is concerned. Most doctors are not focused on that end of the stick their focus on the other end, which is dealing with the patient when they come the hospital. You're like, wait a minute. We we need to do something differently here. What what was the Hamam where like, oh, wait a minute. I'm not gonna just be operating people's mitral valves, I need to some bigger. Well, you know, what we really need to do is we need to move from sick care organization to a healthcare organization, and we need to try and keep people healthy. And that was the whole impetus of trying to think about how we change the organization and our incentives for doing that. And the end of the day. Everybody's headed the. Same direction. Eventually everybody's gonna get sick with some a problem other. But we want to minimize that have people live as long as possible and live great healthy lives. And you've done that here. Cleveland clinic. I mean, you took risk to see you got big trouble for trying to get rid McDonald's. Here you got rid of all the soda. I mean, this is unheard of in most in most hospital system. Well, we started out by deciding that we would not allow any smoking on our campus, and then we decided not to hire smokers. I got a lot of pushback on that. But at the end of the day, it really was the right thing to do. And now our incidence of smoking is gone from somewhere around fifteen to twenty percent down to five percent of our employees, and they're healthier, and you saved huge amounts of money within the organization on healthcare cost for the employees. Yeah. At the end will what we did is we really began to look I keeping people. Well, we didn't hire smokers. We encourage exercise. We change the food across the organization, and then we went to disease management with people who were incentive to take care of themselves. If they had. Diabetes, hypertension, hypercholesterolemia, asthma smoking, hypertension. And what we've seen is that the inflation rate of healthcare is gone from going up at seven half percent year to mean flat for the last five years. You actually said something very important you paid people to get well, our stay. Well, you incentivize them with reductions in their healthcare premiums and incentives. Right, exactly. And you paid for smoking cessation and Weight Watchers and other health programs for their Kerr's membership, or whatever it is. Yeah. We did we did do that. Because you know, the end of the day. What it did was we saw twenty percent reduction in sick days. We saw a major reduction in people coming to with diabetes, hypertension, coming to the emergency room and being minted the hospitals. It just kept people will and it's one hundred thousand people, and so we learned how to keep people well and keep them out of the hospital. So you've done that for the employees. But right now, we have to focus on the patients, and I think part of what's happening, and I want to get a little. Nerdy in this space because it's an area where I think you're passionate about is of value based care now for people who don't know what that is. It means historically medicine. Doctors got paid when they did something, right? If you did a procedure if you saw patient. Visit was like busy widgets, you know, volume the more the more money now are shifting to paying for value means getting people healthy and reducing costs tackling. And that's a very big different shift in trends. So how healthcare leader, do you think that's going to impact practice, and what are the kinds of changes? You're going to see what we're gonna do is now incent people to take care of people keep out of the hospital, keep them. Well, and you know, that's going to start with primary care initially. But the whole idea is to try to keep people. Well, and we're going to be paid, and you know, certain amount per month per individual to take care of people..
"cleveland clinic" Discussed on The Doctor's Farmacy with Mark Hyman, M.D.
"Pharmacy. I'm Dr Mark Hyman. And this is pharmacy with FA R Y A place for conversations that matter in today's conversation, really matters to all of us because my guest today is Dr Toby Cosgrove, who's my boss, or I guess he was my boss. It's retire was. And who's an extraordinary visionary healthcare leader who's gonna talk to us today about healthcare because it is one of the seminal issues of our time that determined so much about what's happening in the world today. And it's often something that people really misunderstanding. Toby is the former CEO and president Cleveland Clinic he served from two thousand and four to two thousand seventeen this eight billion dollar organization that all sorts of amazing things in terms of leading the organisation building new medical school and healthcare campus, building extensions and Dhabi and now in London, Florida and Canada and Los Vegas. He's reorganising tire clinic to be more collaborative. He's really inspired innovation is really a quite unusual guy went to Williams College university of Virginia school of medicine worked at Mass General in Vietnam as a surgeon and has done some extraordinary things with his life. And now is I would say retired. But not exactly because I don't know. He's he's he's I'm gonna say all the is. But he's a lot. Older than he looks. And he's going hard as ever transforming healthcare and keeping the mission going, so welcome to doctors pharmacy. Toby? I'm delighted here. Thank you very much opportunity. So, you know, you're kind of unusual guy we met a number of years ago. I was speaking at the World Economic Forum, and I think maybe your wife, you probably know who I was invited me to dinner at a small group of people and joking. It was very provocative. And I went up to say, hey, Toby, what if I could empty half, your hospitals and cut your angioplasties and bypasses in half. And this is the number one hospital in the world. And like that'd be a good idea. I said we're gonna you're gonna pay the bills is we'll figure it out. And then after that we began a conversation about how we need to rethink our poached, a chronic disease. But you know, you're a heart surgeon you've done twenty thousand heart operations you've pioneered fifty patents. You've done extremely career. And if led this organization away that has made it one of the best in the world, if probably not the best in most categories. So what what was it that sort of shifted you from the traditional medical paradigm to actually? Being visionary and innovative in your thinking about health and healthcare. Well, really at the end of the day, we wanna keep people healthy, and you know, while lot of the problems that we deal with every day are secondary to help people to leave their lives smoking.
"cleveland clinic" Discussed on The Doctor's Farmacy with Mark Hyman, M.D.
"Talk. Welcome to the doctors pharmacy. That's F A R M C Y A place for conversations matter. I'm Dr Mark Hyman. And I'm here for a great conversation with Dr Miguel Ribeiro who's the chair of gastroenterology at Cleveland Clinic. And we got to meet recently when he reached out as he came to clean even before. I think he started official job. He reached out to us at Cleveland Clinic and functional medicine because he saw there was some connection between what he's doing what we're doing an a different way of thinking about inflammatory bowel disease. So he's come from another major academic medical center. Do something really radical here. And I'm really excited. I had this conversation. You're focuses on inflammatory bowel disease, which affects so many people Crohn's colitis, I it's really a horrible disease. It really creates so much suffering. And we have good tools, but not great tools include clinic is arguably one of the best in the world and caring for these patients. We do a lot of care. We do a lot of surgeries. But there's another way of thinking about it that you sort of brought about not only knowing what we're doing. But also Howard delivering care your home delivery models. So he's really extraordinary scientist, doctor and humanitarian, and he's such a kind guy, and I was sort of shock when you know, somebody who's leading of the major departments Clinton clinic reached out to said, hey, I'm coming in town. Let's figure out a way to work together. And we've been concocting various strategies around that, which is pretty awesome. So as guests are all trained in traditional medicine. How was it that you came to realize that there may be some other ways of thinking about how to treat this disease? So first of all, thanks for having me on. And I think one of the aspects that I saw over the years treating Crohn's and all sort of colitis patients are they would come to me. And there would be a gap in what we could ultimately do. So as you mentioned there were fortunately, the majority of the patients where to improve with standard medications or surgery, but there was a large gap in these patients who are looking for something more and many of the patients I used to see prior to come into Cleveland with talk about died in functional medicine specifically in some of the experiences that they had so truly the patient's teaching me as the physician and over the years really understanding this. So I looked into some of your work. And when I came here I wanted to collaborate, and I think the unmet need is really that area beyond the science, and what we know biologically and this gets into the micro. Oh by on the diet, health, nutrition, and inflammation. So that's really how it came about. It's amazing. So you basically were one of the few doctors who actually listened when their patients. Yeah, I tried this thing it's a little wacky. But it worked. Yes. And you're like, well, maybe there's something there. And when you hear this enough times when people say, I changed my diet. I did this. I worked on my micro bio and my symptoms got better. My client got better, then is starts to be something that you want to think about that's right. And I think that you hit it on the head. So so many of these patients they changed their diet. They find that their improved stress plays a big role as well the environment. And again, I yes, I'm grounded in traditional medicine. But the other aspect is I listened to them and some of these patients I find we were able to de-escalate off a better seasons or change really their treatment paradigm. The remember when I first got this job actually before I got the job. I went to dinner with c o of Cleveland Clinic. At the World Economic Forum, and he had cine x Ray prominent guy from technology company and was telling him about what I was doing..
"cleveland clinic" Discussed on The Doctor's Farmacy with Mark Hyman, M.D.
"Matab ways, it makes younger. Yeah. It's impressive. So how how do you live your life? What's your routine that allows you to stay so vibrant and looking and barely having any grey hair at seventy two. Well, the key is having a great partner. So my wife is magnificent wonderful. And so that's the what I consider the keys having France. And I saw beautiful quote that you gave on an article that was about you. And how you live to be wanted it to be one hundred wake up every morning, and you kiss your wife. That's exactly right. I think that's a very good thing. So great partner, and that helps me manage stress. So do six minutes of deep breathing morning and night as my meditation if you will so that's part of my life. No, no, tobacco, obviously. But then if you will I I don't go to look at my odometer. I don't go to bed. I don't know if you can catch it on. So Bill is a superb cameraman, I don't know if he can catch this. But this is yesterday just made ten this is the day before I just made ten thousand goes the day before I don't go to bed without ten thousand if I'm close I get ten thousand steps and you have a desk I've seen in your office where you're on a treadmill on the phone on conference calls we doing your work, and it's like the slow treadmill? He's going to walk. All right. So I can I can if you will. I I. Right at one point seven miles per hour. Two degrees. I type at one point eight I read at one point nine and you can do conference calls at three point three miles per hour. So I do that routinely. Have you might be breathing? Heavy. Well, the the problem on that is is if you're doing that is if you forget, you're on the treadmill, which if you get an excited part of the conference calling one, you know, say something important, and you forget you're on the darn thing you get flipped out pretty fast. You gotta have got a chair at the end of the treadmill the catch you. But so I get to do my passion during the day, which is helping Cleveland Clinic as Cleveland Clinic patients and Cleveland Clinic, if you will we spread it wide to our communities and other companies get healthy. So I get to do the wellness program. I get to see patients a couple of days of the week in executive health and and the premier program, which I love doing. And then I get to spread this and get to do shows like yours, which you know. It's as good as it gets with you here, we really really love what you do. And one of the joys of being at the Cleveland Clinic is that the other people are so good. I had a patient last week who had a rear disease in believe there's a guy who specialize who knew more about that than anybody else in the world. That's typical. Yeah. If you find person with a problem, you can find someone who knows more about that. And it was dealt. With that more than just about anyone else. So it's a joy to be here. And you know, I refer you patients to get too complex. I worked at canyon engineers, which the health resort. So I used to call myself a resort doctor the doctor of last resort. So one of the things you've done which is remarkable is to come into a place, which is one of the best hospitals healthcare systems in the world. But it's focused on acute care like the sickest of the sick. And you should wait a minute. You know, with the leadership of Toby Cosgrove is former CEO that we need to rethink healthcare, and we need to rethink how we're going to deal with our own employees. Because now there's what one hundred thousand employees and families part of Cleveland Clinic are self insured under nine thousand but who's counting. You're always go with the number. And the remarkable thing is you took a problem seemed insoluble which is dramatically rising healthcare costs within businesses and companies and organizations that Cleveland Clinic and with a very difficult to change behaviors like diet and exercise smoking stress, and you lamented a program here, which is really a national example of what can be done around creating wellness and rotation..
"cleveland clinic" Discussed on On Point with Tom Ashbrook | Podcasts
"Welcome to on point hiring thank you yeah i just wanted to echo on that there are other options i have a genetic i have a child from ibm genetically mind with there are options where you can look into embryo donation egg donation firm donation adjust asional therapy so chilly important for those out there who might be in that ten percent baby who are not going to be able to carry or have their own genetic child that maybe there's a combination where they do egger embryo donation and oftentimes those are much more cost effective options desharnais if you had been a client at the cleveland clinic where this mishap occurred would you have been in a position to take another shot at it financially maybe not i don't know how they're compensating people emotionally i really if it didn't work for us emotionally i thought i was done i just couldn't do it anymore i have no idea how those people are feeling and i really don't know if my body would have responded even if i could have backed up emotionally to be honest so thanks a lot for your call that's where we're going to end at this hour and i just wanna be clear i was referring to a clinic in cleveland not the cleveland clinic this accident happened at university hospital with the unfortunate loss of the eggs and embryos lisa campo angle stein professor at the alden march bioethics institute at albany medical college thanks for being with us.
"cleveland clinic" Discussed on The Tony Kornheiser Show
"Amazing this is exactly the tom brady thing where i guarantee you the team doesn't want this they are sponsored by the cleveland clinic and it which is a medical operation and this guy's got his own deal that's not the cleveland clinic and that team is going to say like the the patriots said with brady will let you have a everybody else have it even though everybody else ought to have it didn't they ought to have well you would think if he wants to win he would find a way to work it in to work out whatever it is is routine is to at least his partners to it but you can understand how ownership i would be afraid that they have sponsored commitments but you know what you can still do as much you can still do as many public events for them put your face on as much of of the cleveland clinic to dissatisfy them for that you know it's not just because yeah really because it didn't say oh and by the way we don't let the cleveland clinic near this visits no i gotta think there's i gotta think if i'm the cleveland clinic and lebron commits to doing fifteen spots for commercial happy clinic i hire his trainer yeah that's the first thing i do is i make sure that guys wearing a cleveland clinic shirt well the other thing too is i don't know if it's against since i have no idea with his routine is i i wanted what what supplements he's taking does he know he sleeps in one of those hypothetic hyper chambers it's not.
"cleveland clinic" Discussed on The Chief Customer Officer Human Duct Tape Show
"The cheap customer officer hugh in duct tape show on this sea sweet network i'm just so thrilled and please that adrian boise is joining us today she is the chief experience officer at cleveland clinic high adrian hide their houria i'm great thank you so much i know how busy you are in it's probably a crazy time of the year but thank you so much i've been such an admirer of your work and the cleveland clinic or cleveland clinic i know i'm not supposed to use the word anymore of cleveland clinic so thank you so much for being on the show thank you i'm thrilled to be here let's begin with um your background because it's always so interesting for folks to understand how you walked your way through and i think it's important to to talk about the fact that you are a neurologist a physician but then have also taken on this role so let's go as far back in your history has you'd like to walk us through kind of the the steps near career that got you here while i would probably start even further back than my career great i i i grew up in a dysfunctional home i would say and a high that got me constantly thinking even as a teenager about why people do the things they do interests and in an about human behavior so i was constantly asking the why what makes what makes us behave the way we do what makes us save the things we do and i think that actually was really formative for me because i feel like even now is i look back you have to have known some degree of suffering in order to wanna ease it wound in the world in the world and that began very early for me and so that that was really important as i moved on through college i had sort of this left brain right brain thing going i was a ballerina but i also was really interested in neurology partly because of that interest in human behavior and uh i was.
"cleveland clinic" Discussed on AM 970 The Answer
"This country of education is improving when it comes to managing one's own money and there's a lot of bad advice out there as well not from eugene because i am a fan of yours on the today show and i think this book is just fabulous so age proof living longer without running out of money or breaking there's a little humor in there but it's not just humor it's really very important some final words that you want to point out to my audience in terms of managing their money or coordinating their effort of health and wealth at one of the key is although there oh why there as we like to keep our wealth and appliances private they're not so endeavor so wind blowing strongly in both a medical team including a primary care doctor include an integrated medicine 'spect when that institute at the cleveland clinic includes the financial as well as you pointed out so getting the right financial adviser is absolutely um and that both area and we tell you the criteria winging it out in a book the key word michel and jean with team put together a team whether is a moneymanager a doctor an accountant lawyer get them all to work together don't have them compete have them work with you as the quarterback congratulations on a great book once again its age proof living longer without running out of money or breaking a hip best wishes to both of you i look forward to have you back on this program at some future date and kerry okay ladies and gentlemen i hope you enjoyed that as much as i did it's right up my alley because i agree with gene and i agree with mike one of the things that i want to emphasize about that interview is what is considered safe nowadays in my opinion is not the way that you approach the decades ago years ago people would buy bonds bonds bonds bonds and the older you get the more the had you put money into bonds we don't believe in that area gobert financial services may a small amount of money on the sidelines in bonds ten percent or less we like dividend paying stocks we like managed variable annuities not the cookiecutter type but managed we we manage the annuities its unique it's very interesting and it has sir britain safeguards that.
"cleveland clinic" Discussed on Boston Herald Radio
"We interviewed i one fellow his name is craig venter and probably not a household name but he was the person that decoded the human genome and is the meeting jose canadian guy who it will affect two light and humanity so if you could toast where parents work at it added so so he in god we two two top heart surgeon who live two blocks away from each other and one of them in the cleveland clinic and great happened pitchers who were nurse there are too many views rich stories we didn't want to laugh with ted kennedy before he passed away we john kerry when he ran it of goes on and on and we we never run out of this opportunity uh on on the island it's incredible id what are you some of your favorite places that you like to go to i was just there last weekend and i always stop into crew you now say the view there with all the wall boats on the water it's just spectacular and the and the bartending staff were so friendly i loved shopping in there what are some of your favorite places that you'd like to go out with with your wife or your friends the restaurant co lola which i second part ii kitchen probably took that she would you wouldn't governor tatyana as a hotbed person she put it it's really really terrific and there are so many great rush ron and it's boat likud itself has a restaurant called at galle which is weight palm beach county dinner in a show uh this goes down in one of the break when collapse every night and it is not i wouldn't that be no shortage high quality diamond exporters whose you're one of the things we learn with the magazine is incredibly intelligent suitca did population here and the reason why magazine i think he has written to the white house speaker leadership to me i'm fit you cannot deliver lowquality material to highly intelligent people came with everything here the restaurants are.