19 Episode results for "David Geffen School Of Medicine"

Understanding The Gut Microbiome

Precisione: The Healthcast

44:38 min | 5 months ago

Understanding The Gut Microbiome

"Welcome to precision the health cast where you will learn how to live your best and healthiest life by precisely understanding how your body works, what it is made up of and how to optimize your health based on that information. I'm your host. Dr Marvin. Founder of precision clinic where we take a highly individualized approach to health wellness and longevity I helping amazing people like yourself understand more about their genes at genetics microbiome sensitive. Toxic exposures levels of inflammation and much much more for the purpose of creating a highly specific nutrition and lifestyle planned and is flexible and sustainable. I. Hope You enjoy this week's episode as much as I enjoyed recording it. I everyone welcome to my podcast we are dedicated to delivering the best and most accurate information regarding precision healthcare from the brightest people in the world. Today, we have amazing guests on the show. He's one of my personal friends and I had the privilege of working together with them as faculty at Ucla and as a contributing author to my book. The Textbook of Integrative gastroenterology second edition. I'm excited for everyone to hear what he has to say. It's always exciting when I can get another fellow gastroenterologist on the show to talk shop with me. So without further ado would like to introduce our guest today Dr Mayer. Dr Mayer is a gastroenterologist. and professor in the departments, of Medicine and psychiatry in the division of Digestive Diseases at the David Geffen School of Medicine at Ucla Is the executive director of the G. Openheimer, center for neurobiology of stress and resilience at Ucla and Co Director of the cure digestive diseases, research center as one of the Pioneers and leading researchers in the role of mind body interactions in health and chronic disease his scientific contributions to the US national and international communities in the broad area of basic and translational enteric neurobiology with wide ranging applications in clinical Gi diseases and disorders is unparalleled. He has published more than three hundred fifty scientific papers and Co edited three books. Published the selling book, the Mind Gut Connection, which I read it I think at least two or three times and is currently working on a second book to be published in early twenty, twenty one he is the recipient of the two thousand Sixteen David Mclean Award from the American psychosomatic society and the two thousand seventeen if smart boys metal from the German Society of gastroenterology and metabolic disease is research interest is focused on the role of brain. Gut microbiome directions in human diseases, including Alzheimer's and Parkinson's disease autism. Spectrum. Disorders of the laboratory bow. Disease. Dr Mayer has longstanding interest in healing traditions and affords them a level of respect rarely found in western medicine. He has been involved in documentary film productions about the Yen Amami people in the Orinoco region of Venezuela and the Mott people in Irian Jaya. He has recently co produced the award winning documentary in search of balance and is working on a new documentary interconnected planet. He is a strong believer in Buddhist philosophy was a member of the UCLA Zen Center for several years and got married in Tibetan monastery. By Gio key Nima Rinpoche Shea in Katmandu he regularly pursues Meditative Practices Dr Mayer has been interviewed on National Public Radio PBS and many national and international media outlets including the los. Angeles. Times Atlantic magazine and stern and Spiegel online he has spoken at Ucla Fedex on the mysterious origins of gut feelings in two thousand fifteen and his bestselling book the Mind Guy Connection was published by Harpercollins in July of two thousand sixteen and has been translated into twelve languages Amarin. Welcome to the show. Thanks Marvin great to be on the show at the thanks for the comprehensive introduction. appreciated. Thank you so much for being on the show I. Really appreciate it and I'm so excited for you to be able to chat with me. I know I have done a lot of writing myself and it is nearly impossible to write anything or research anything related to the GUT microbiome without your name POPs up somewhere. In. Between thirty five Yugoslav contributing field. So. Let's jump right into a tell us a little bit about how you came into this field and how you developed an interest in. This specific area of Research Eichel back. To you know, my my my college years. I've always for some reason I can't really explain that to you why for some reason, I've always been interested in in mind body and tractions and psychology, and it was very close call in the last minute that I decided to go to medical school. People told me because of my grades I should do that and. Then I have pursued that interest of You know mind brain body and tractions ever since this was the main interest in medical school and it was one of the main reasons that I picked made certain choices of training and and they my research. So it's been something that's been with me through my professional life. Awesome one of the most discussed topics these days is the mind got connections one of the. Most. Frequently asked questions to me when I come on podcast. So I thought why don't you? Since you're the master of the mind connection tell us in your words what this means. This is an interesting sub story to what it sold you. Line trysts has. After initially sort of pursuing him a dissertation, the brain heart connection for four years I decided. To become a gastroenterologist and obviously switched from the heart to the GI track. But kept the interest in the connection to the brain. And I'm glad I did this because it's obviously lots closer connected to the brain and the heart disease. And and then about ten years ago. So pursued his. For some time today without the microbiome because Mike was not A. A topic did anybody really discussed or or or was interested in? Until the first papers came out you know now about ten years ago from animal studies that that showed that You know you could do pretty exciting things for manipulating the GUT microbiome in mice and rats. and. Then through this manipulation change behaviors change Chemistry in the. Brain. And that caught my interest initially very skeptical. 'cause I thought. The Gut by itself is complex enough to explain many of this communication with O'Brien I mean. We have. An enteric nervous system, we have an immune system. The seventy percent of all immune cells aren't a gut. We have the biggest endocrine system into God. So I thought that's enough to communicate with rain and then. I watched the animal studies for a couple years before we decided. GonNa get involved in this field as well with Lou including the microbiome. And did our first study often quoted study where we looked at the effects of a new simple manipulation lookout microbiome with a probiotic cocktail in the form of a fermented milk product on brain circuits and when they came up positive that really you know changed my enthusiasm and. Ever since so the last. Seven eight years. All our studies focusing on brain gut microbiome attractions, and then also just sort of really interesting. has broadened the applications. So initially, it was all you know guests withdrawal achieve mainly irritable bowel syndrome. Then we we thought could display a role in inflammatory bowel disease. To display rolling obesity and. Food addiction could play a role in. In neurological disorders and To me very interestingly in with been able to get grant funding in all of these areas just it's turned me from a gastroenterologist in. In sort of a much more general brain gut microbiome expert than I ever thought it would happen yet amazing like it's almost every week or so we see a new article published in the literature about microbiome minutes connection to something else in health. MAZING. The oral microbiome is another big topic you know and A lot of discussion about these oral microbes getting into the gut microbiome in affecting health. Would you think about all that? He has this is also quite interesting in terms of So, normally the regional microbiomes on epithelial surfaces. So every time we have a surface in the body that the skin or in a surfaces like the got. Microbes. At the interface and Typically these different microbiomes and different sites that have body of clearly separated so they don't mix. Always uses uses example of the of the Dolphin Skin microbiome that is completely different from the water microbiome surrounding you know the the habitat of the Dolphin. So that gives you an example of how tightly. There are connected to their habitat. and was the oral Mike Von. That's a little bit different. Is Interaction and communication with Gut microbiome. I mean, ozzy, we swallow a lot of these allow these microbes. From, my mouth in and they say can transfer into intestine. You know they they can find. You should there. To lose an inference. The the house in UK system in in in the the gut is well so. Yeah I think this is an interesting example and and and obviously opens possibilities for. For more convenient testing of relevant microbes in our body in the future in. Much more. Feasible and practical than than these tool samples. What are some of the most important microbes we should know about because people always throw names of different microbes around? Are there particular strains that you think we should all be most familiar with or is it more important to kind of have an idea of what the general health ecosystem in the Gut microbiome is rather than focusing on individual microbes? This is I. I like the second half of your question because at that would be my answer. I'm a full believer in the ecosystem concept. So in the Michael Bonfield, there's two types of people walking in it, the to Casco microbiologist who is trained to identify and characterize certain pathogens. Develop Strategies strategies to to eliminate these these pathogens. So that's disipline focusing on one organism. Microbiology, it's bats the bad guy. And those people in the microbiome field. Now that have a similar philosophy or you know outlook on on the system, but there's other people that are. ecologists to assist them ballots to really look at the ecosystem, and in the last few years this has even become more important now because we look mainly at the function now So. We could tell this from the publications you know in the past you would. Describe certain microbes being present more in one disease than in a in a healthy person. Today this has really shifted nobody's interested in that. Any more people interested? What does an ecosystem of microbes in you got? What does that Do Produce. In terms of small molecules or univation that then signals who cells in the body. And anyone of any organ and so I would say yesterday That that a lot of attention. Like. Him Sinophilia. FA Kelly bacterium lactobacillus to if you're have. A. Their affair press because it seems that they have been fishery fixed on the old. System. With soon, feeling of. That's You know that's interesting because of plays of equal in in it loose loosen the mucus layer of the gut ten plays a big role in regulating the mucus layer. It changes with fasting. So as a lot of really interesting source around it. But nevertheless, if ones I was telling everybody that Ackerman he is one of my favorite ones yesterday you hangs. It is definitely in terms of the will be currently understand in terms of. Leaking the garden systemic immune activation all these it's it's a key player. But Yeah. So the thing happened that we look now primarily two things one is. Dean Yoon response to a certain. Certain collection of microbes and these small molecules. So metabolites that they produce and what's interesting is that. So. Just as an example, you could take ten ten microbes different microbes ten different strains of species that produce a certain pattern of. Of metabolites in have certain effects on you got on your. Body. You could take another totally different group of ten microbes that do exactly the same. So it's like it's a second orchestra. You can take five different orchestra they can play exactly the same symphony. It would matter who specifically is is in is in the orchestrates the interaction of the musicians in your Castro degenerates the the symphony. So that's one example I think that's now used to illustrate focusing on a single micro of will even. Couple microbes that may be different. Is Not that relevant and also keep in mind I mean. These. These microbes amid about four hundred thousand genes. So a lot more than we of jeans. And They can produced of. A huge ability to synthesize molecules and signaling molecules metabolites. It's a tremendous capacity to come up with. The health-promoting or. Disease. From Odeon metabolite patterns and that's something that we can measure. We can measure. Going back to the example of before. You take ten microbes and instead of looking at wisdom there in which microbes are there you look at what genes are there of what genes are being expressed by these ten microbes. And even though the microbes might be different. They might generate exactly the same. The might express executive same jeans. So I I, think there's a fundamental change in this whole field that would require rethinking of people that. Promote some of the the the products and microbes in supplements. So that is definitely changing Ama instead of probiotics will be taking some Matab, Lomax supplement or something like that. Yeah, exactly, and so the the name for that is called post -biotics what. Is An, and that's great. It's one of the ones that people are already taking. Yeah and that's difficult to be the next generation of of of supplements, and then to make the whole concept even more interesting there's this concept of quorum sensing. So tell us all about that and how that can influence what's going on in the gut. Yes. So the quorum sensing requires OBE basically describes that. Many most microbes have the have sensors in the membranes which In, accordance with without human receptors and they with their best gene pool can synthesize sixty molecules that can that can act on these receptors so they can. They can communicate with each other in a very complex language that we currently don't completely understand just as. In the microbial, world? I described in the in pathogens. and. They not only these these receptors or. Called Auto inducers in the microbe field. So they're not only respond to signal molecules from the Victoria but also to some of our human. Signal Molecules one the first examples does always fascinated me was the description that. Our main stress mediator Neupane. Efren. Is. Actually. Can can be detected in God's infinite, fairly high level during stress. In animals and then he can act on one these other user receptors on unlike roads that changes their the gene expression is micro and makes them more virulent so. You know our signaling system is very tightly. Toes connected to the microbial one day have similar evolutionary origin. So it's it is the same language. And so in this way. Our health and our states of function of vehicles tied to the microbial behavior. So if you're. Chronically stressed, you will have more virulent microbes senior got amongst many other things. and. You certainly more more prone to infection. So if you stress send. You pick up. Against Theresa's in in Mexico you likely to have a longer course of the disease and possibly the development of host infectious IBS symptoms than if you told you relaxed and you don't have these his corum sensing going on in in your gut the meantime. Described for not just annoy Ephron but for other molecules. Can Avenue it's OPIOID Aminals opioids can also turn these microbes more pathogenic. We don't know if they become more more pets trying, but they can lead to those receptors on these. You know homologue superhuman receptors they can change microbial behavior to pathogenicity has mainly being here tries nine on fifteen different microbials, species and strains. Half of them pathogens, but also commences. So. We don't really know what is interesting field and basically. I mean, what? What do they do to microbial behavior? Unexplored territory but very interesting concept. I hope everyone's enjoying today's episode and wanted to take a quick break and talk to you about Mega I G G two thousand mega g two thousand is a dairy free immunoglobulin concentrate. At supports healthy digestion and maintains healthy gut barrier function. Unlike other milk derived immunoglobulins on the market Mega I. G G. Two thousand is derived from bovine serum making it lactose free casing free and Beta lactose Globulin free. If you haven't used this as part of your gut healing protocol, go ahead and check it out. Let me know what you think. Now, let's get back to the show. What are some of the best things we can do to kind of optimize our gut health and our microbiomes so that we can feel better and So. You know before answering this question just to recapitulate. So the microbes in got the suit that the interface between the input that the gut gets from our brains, which can be in a stress mode in relaxed mode in the negative emotion motor positive. So clearly. I will say that you know the the gut milieu. Habitat of the microbes is a mirror image of our emotional state because. We have the on mommy nervous system innovating gutten changing secretion and parasol says, contractions, Matilde lot flow secretion of all kinds of molecules defense. So that's one thing to do. We have this top down influence. We also have a nature influence of our diet because clearly the microbes. In some ways or reflection of the diet that we eat with a high fiber diet to get a different microbiome than with a low fiber diet. And then we have genetics so as does a Is the third thing with the Diet also comes in chemicals or? Co -biotics. All, all the molecules winchester chemicals said, we haven't said, our bodies haven't seen in doing evolution, but on microbes are able to respond to those. To the microbes living his interface and One last thing is June forget this. So bodies during exercise also produce a large number of metabolites, some of which make it to in contact with the microbiome as well. So I've listened the three things listed the brain and the body of this The food we eat and the chemicals consumed. This is where we can start with designing a a healthy regimen for our microbes optimize. All these four influences. So it's it's quite simple as taking old. concepts. Ancient. Concepts of what's good for you health and just translating them into microbiome science. So microbiome speak. So that means you want to have a a balanced mind. You want to be able to avoid negative emotions and in a chronic way mean everybody gets upset or. stressed. But it's it's the chronicity. That to my opinion, it's important influence menu the differences that have been described in disease population. I think come really from an increased stress level in the population that like autism or like. Even, cognitive decline I mean any of these entities are associated with significant. Stress Level Negative emotions. So that's that's the one thing. The second thing which is obviously. Everybody focuses on his diet. and. As as raging debates so that the Diet field nutrition field is. It always amazes me. You know that it's time these fields to related to medicine health that. That's in some ways. The most controversial people considered. It's more a philosophy than the science. Just originally baked between you know Kito people and Halio people and vegans that that's going on now as as good example. But if you look at it objectively the number of studies that associate will be today consider healthy microbiome, which means a high diversity of different species and strains And and. A minimal state of immune activation the got there's no question in these association studies that. Largely. Plant based Diet is is the most beneficial so For certain conditions obviously and I. Get into this. Now, the to diet has some advantages. Unlimited duration of Akita Diet. But overall I think our gut. So a millions of years have evolved. Really to be vista adapted, to To largely plant based, Diet with occasional meat consumption would he tell these people that are coming out now advocating carnivorous diet eating meat only in saying that fiber is not necessary for human health what do you? What would be your response to these kinds of people who are now creating a basically a group of followers with regard to that kind of eating style Yeah, it's it's in contradiction with the science. I think there's a before this is a strange fueled that even people that are trained nutritionists have sort of really non scientifically based. Concepts, but that argument that you know five is not that important than a canoe Stasi's is optimal that just goes against any any scientific data. A plant based Diet that's high in different types of fiber with the greatest variety of of plant based foods gives you the greatest variety of microbial diversity. is clearly just again ecosystem. If you want to optimize an ecosystem, you wanna increase its its diversity. Without, comes its resilience and resistance against her today shins. So. I I think it's a nonargument. An additional argument that can now be made is this whole thing. This whole concept of one health. We shouldn't just think about our own health but the health of the planet to help the environment. And it's pretty clear that the plant based Diet with continuing increasing in populations is a very important component of combating climate change and providing nutritious food for billions of people without having any damage to the moment. People. Don't really think about this when they. You know everybody gets upset about when they see images of burning, Amazon? was. The reason for that is really the increasing meat consumption because the Amazon is being destroyed for two reasons one is have room. Growing soybeans for as feed for cattle in the second one is to have grazing land for cattle so It has pretty dramatic consequences on the ecology of the planet up just inside of our guts also outside of us and around us, it's interesting these. Carnivores seemed to have arguments against that theory as well. I don't really know based. Is it's it's quite interesting and I'm sure you've seen this film game changer. Based on a lot of questionable science But I sort of liked it and I think it's it's actually. Has Shown. How, and this was really the purpose to make this film to change the the ancient concept of the traditional concept. that. To be a real male, you have to be a carnivore. And percents somebody. Highly successful top athletes in this film. Does. Have Become Vegan that it completely destroys this argument and. It's very interesting to to see how many people that I know have changed their eating behavior. Man, particularly having seen this film, it's it's really, but it also shows I mean they they'll state you know their performance has not gone down. Some of this climate in the world. Of Formula One champion. On Schwarzenegger of Old People Either they have changed and have not noticed that of sudden. And not as healthy notice Strong Did. This film really demonstrates how much of this is in our minds in our projections on and not based on the on science. I think it's a combination of things too. It's not just one hundred percent what you're eating is going to make you the athlete. Working out in the gym for five hours a day also plays a role in how well you perform as well. You Know Young. This is something that amongst the the questions that you sent me. Food is a multidimensional eating's a multidimensional experience, and again, most of us don't think about this you know when you? Can Our proficient? When go to noon lectures and yes to focus on on on something? That's completely. So the opposite of what you Say or topic that you would want to be watching. When you eat a nice meal, you know could be a colonoscopy with the cancer guests. Particularly good in this to completely suppress any influence of the mind. On what they eat, and after after these lectures and you ask people, what did you eat would what they would sandwich states So that's a good example of fun. In a hobby can disconnect influences on. During, eating that the play role on the other hand if you in a social context. Birthday party you know winning or just with friends together with friends. which is sort of not traditional setting when people had their. Communal meals. That has a has important influence on on your gut microbes studies. Now that if Sean fuel awards social, if a different, they were city of the Gut microbiome Dan, those that. Are Not and have been social in the traditional way not by social media obviously. So I would say the components that contribute to one is. Previous memory of food intake either good or bad will have as big influence of what happens to the food that you ingest. If it's if it was a bad experience, it will trigger your stress system and will have a negative influence if it's a good memory of yielded enjoyed or. That you'll remember for the rest of your life that will have a positive influence. Than concepts about foods. So if somebody who believes that that nieces? Terrible for you or that glutinous terrible for you and you exposed to that it will trigger a major stress response and again, it will will have a negative effect on on the digestive process. So these are these mind related. Factors Then does does this also now a lot of emphasis on? On when you eat or these You, know shoe we've developed eating habits that we eat and and snacks throughout the day that is hardly a time during the day that does not something inside your track. And dead again. Just behavioral patterns will have an influence on what happens in your got towel. Genes being transcribed to some very elegant studies have shown that. How different it is when you got his empty as opposed to win when it's contained, any kind of So I would say there's a lot of dimensions to. To healthy eating that And mindful eating that I think are really important to consider. Pretty cannot fast paced lifestyle lifestyles were. I mean fast food by definition is something that is is not ideal for for our overall gut tells and some of this concept with this multidimensional eating experience, which I find very fascinating. You wrote about it in in the chapter that you contributed to our textbook. And I often refer back to it. is this where you believe some people get the feeling of comfort foods in cravings from. So if there's an experience perhaps from childhood where some food like macaroni and cheese made them feel good and perhaps when they feel sad or down later on an adult life, they feel like that's the one thing. That's GonNa help them feel better because their brain in their microbes have this memory of macaroni and cheese in the setting of something that was not a pleasant experience. Yeah absolutely. I mean also something laser this is like this imprinting like. There's a phase early in life for. These tastes I francis or being imprinted and them. So in our society, sweets are obsolete sweets and fast a two things that we. That we condition our even our children to you know. Sweets if you've done something good, you get a candy so D-? That that association or or you get an ice cream word. And that's a big problem I mean to change this this memory even from a very early age. I. Didn't know about all this stuff when I was a new father but when we had our first kid in the hospital and the baby was just born within like the first day and we're still in the hospital. And the baby would cry they would say, here's a little dextrose solution. Put It on your finger and let him suck on on your finger and get the sugar because the sugar gums down. Like what are we teaching these these kids from you know birth that sugar sugar is good. It calms you down. Yeah. Does he I mean this is kind of a you know not so bad example but. The sort of really shocking example for that is when I was once traveling Mexican giving a talk there were telling me that coke of Mexico Coca Cola of Mexico. Slipped by center Fox so previous president. So. Heavily promoted coke to mothers with young children is the first health of first intervention when their children were not happy. So it's unbelievable and. Most and and and you know that Mexico has one of the biggest obesity epidemics. This has a lot to do with shaping these early taste preferences with sugar with a high degree drink. Yeah that's crazy. As we wrap up I wanted to ask you I. Ask a lot of our guests on the show. How do you think medicine is going to be practiced in the next ten years? Are we going to be doing things differently knowing what we know now? I think we definitely going to be doing things differently I I would think there's there's different. Things. Going on I. Mean One is clearly the ascendancy of integrative medicine. We can see this. Here at Ucla we we can see it even to larger degree in many other university hospitals and community hospital settings. It's incredibly popular with the lay public in a more popular than than popping pills. So. That's definitely one thing that will keep growing wove. This going to be this is the Samoa Elliott School of Integrative Medicine at UC Irvine that you know. Really Training, people formerly, you've been trained in this direction so you're good example. Yeah. At the same time I think the certainly flowers especially the the more traditional medicine. Will Get. I would say even more extreme in the future. They will be listened this contact with the patient more and more procedures. Some of these procedures will be done by. The assisted by artificial intelligence. So needless gastroenterologist. So it's becoming a much more much less human aspect of medicine a very technical so like checking heavier car check out but I think this is going to be balanced fi the ascendancy of of integrative medicine so it will change the balance and. Yeah I I think. That is hard to predict you know menu to the diseases were Mike Obama has been implicated. It may turn out that. It's not that important as we as some people think at the moment wars in others, it may be you know we have major impact like the whole testing of metabolites and gene expression in the stool may allows to personalise. A medical interventions. microbiomes is very different young share by ten percent with each other. So, that could be revolutionary and there's some. Philly advanced commercial products that going that direction. And then ABC's scientists is moving so fast that many other changes will happen in the medical field that you know people will not be able to catch up with reading the text books fast enough because the. Developments are just too fast and science right now. Well, that's an exciting time to because we're going to learn a lot about how to optimize health. Absolutely. Yes. So it's in the most general term health will be more important than disease I think in the future. Yeah. I. One of my favorite sayings is Um that I made up is it's better to stay on top of your health rather than underneath disease and I think that kind of brings this whole concept altogether why wait until you get sick when you can understand what happens when you do and try to prevent it absolutely I mean there was a recent study in a very large number of patients I. think he came out of the Harbor Public Health School. They identified five simple things that you need to pay attention to, which can prolong healthy life. I think it was five years more in in men than in women. And this was simple things like daily moderate exercise a normal body weight healthy diet. So would five simple things that everybody can do without? The need of a doctor, you can add five healthy life ucla life. That's a good example. And Save Save billions of dollars to the healthcare system. Yeah. Awesome. What new project you have coming up that we can be on the lookout for you mentioned a a new book coming out what are the things you have cooking in the Background yes. So I'm I'm working on this on this book hopefully. We'll be with the publisher in a couple of months and. Come on nearly two thousand and twenty one. It's starting with my first soup to mind connection, but it's really expanded. into the whole health concept. So. Healthy? Gut Healthy Body. Healthy soil healthy plants in healthy planet that all of these are new intriguingly interconnected Most people don't think about this, but it's really intriguing to see these connections and we'll also working. So we have been working on this on this movie Interconnected, planet. Which shows essentially. Which focuses on the ongoing paradigm shift from a linear patriarchal, make a new seek. Worldview to one of interconnectedness. So we showed this in examples wide range of examples in society from. Health to science to agriculture politics business. And it's kind of interesting to see how. Similar trends or happening in all these dimensions. And most people on nausea really wear this. You know it's A. I think this is going to be the most revolutionary change our. World. Is going, we'll be going through. So we're very excited to to walk on the film. While I WANNA. Thank you so much for being a guest on the show I love the discussion. Always, a great time talking with you on. So honored, you're able to make some time to talk with me today. Now it's always a pleasure talking to you and. I hope your listeners will find it of interest. Thanks, and thank you to all of our listeners for tuning in today to listen to another exciting episode of precision the health cast. We hope you've enjoyed this episode of precision. The health cast the one and only podcast truly dedicated to helping you understand how to live long and personalize your health. I'm your host, Dr Marvin Sake. Until next time. I WanNa take a moment to tell you about precision clinic a unique medical clinic that I founded in two thousand nineteen precision clinic is the only practice in the United States that uses precision. Oh, mix to help optimize, health and improve jeopardy by using cutting edge science and technology to create highly personalized recommendations and protocols. No matter what your health goals may be. Give us a call and learn more about our customized and comprehensive evaluations that can all be done from the comfort of your home. By telemedicine our phone number is eight, five, eight, two, two, nine, seven, five, eight, nine or you can email me at Adleman at precision clinic DOT COM AD. M.. I N. AT P R E C I s I o N E. C L I N I C. Dot. com we're looking forward to hearing from you.

Gut microbiome Ucla Dr Mayer United States Mexico Dr Marvin Digestive Diseases Textbook of Integrative gastro Alzheimer Disorders David Mclean metabolic disease Atlantic magazine UCLA Zen Center microbiome field David Geffen School of Medicin Founder Co obesity
July 2, Hr 1  Protect Our Neighbors and politicizing coronavirus

Mornings With Gail - 1310 KFKA

32:32 min | 8 months ago

July 2, Hr 1 Protect Our Neighbors and politicizing coronavirus

"Wake Up. It's time for mornings with jalen thirteen. Ten KFI K.. Not Even Cova nine nine hundred and it's related with strict. or social unrest across the country could stop you from keeping your voice heard good on Ya as Colorado's saw the highest turnout ever for a non presidential primary election. We'll get into the details on that. In just a few six Oh eight, now thirteen ten KFI K a thirteen ten K. F. A. dot com northern Colorado's voice mornings with Gail via the auto collisions, specialist studios, but covid nineteen of course going nowhere fast, and we're seeing some of the ramifications of that continue. This as the state prepares to enter the next phase of cove, nineteen related guidelines and restrictions, not mandates I might add not enforceable, and that's going to be key to a lot of our discussion this morning, but as the state prepares to enter the protect our neighbors phase of Covid, Nineteen Colorado bars and nightclubs again will be closed for in person services statewide due to a slight uptick in corona virus cases in the state. This according to an announcement made by governor. Jared poll. This past Tuesday now pull a sad according to a piece by sadie Swanson and the Fort Collins Colorado and police said Tuesday. The public health order would go into effect within the next forty eight hours again Tuesday and expire in thirty days now the decision comes only about two weeks after bars and nightclubs reopened for limited person services statewide, the new guidelines for bars will also prohibit in person. Services allowed them to serve takeout alcohol bars that have also changed their business model in response to state guidelines and are now serving food can remain open as a restaurant. As long as they keep patrons, you know the drill. Six feet apart seated with their own. Own Groups and do not allow groups to mingle seems to me that well. It's kind of an oxymoron there. Because why do people go to bars? They go to bars to mingle, and that's why you're seeing so many bars and nightclubs close not only in Colorado, but indeed across the country it's that whole mingling type of atmosphere Right County variances. This is interesting. County variances approved by the state that allow bars to be open will remain in place. Lamoure County did not get approved for bars to reopen in their variants earlier variants request so the county will continue to follow state. Guidelines, Weld County has not and will not apply for a variance. We're GONNA. GonNa. Get into that in greater detail when we're joined this morning by weld. County Attorney Bruce Barker, at eight Oh five conversation. You don't WanNa. Miss Fullest said this decision was made based on science and data collected and analyzed by the state and from conversations he has recently had with governors in Texas and Arizona recent spikes. Cases have forced significant closers, bars and nightclubs, where named by those governors as a significant source of the spike, in cases as well as large parties and gatherings police attributes Colorado's slight uptick. In cases to well, it's standard fly behavior right in bars and nightclubs as well as some of the large outdoor gatherings have been seen statewide including. Including protests are uptick. Police said much like we've seen. Other states is largely among the younger demographic statewide transmission rate has been above one in the past week. Meaning each person with the virus has passing it to at least one other person on average. If that transmission rates sustains above one for a longer period of time, more restrictions might have to be reinstated according to Governor Jared Polis. We don't want to have the kind of setback that Arizona and Texas are having. He added Bolles again. Harped on the importance of wearing mass and applauded the nation's Republican leaders including a vice president Mike Pence who now wearing masks show in the country. That mask wearing. A partisan issue and whose fault is it that it became a partisan issue in the first place? We're GONNA. Get into that with all of the misinformation disinformation. Indeed the out now lies that we have been fed relative to Covid nineteen at six thirty five police said this is not an ideological or partisan thing. This is a science thing than the. Why did our epidemiologist and chief Dr Anthony Out? She lie about mask wearing to begin with. Why didn't they treat us like adults and tell us from the get go well, you know mass are effective, and they are very. Very useful in helping, stop the spread of covid nineteen, but at the beginning instead of telling us the truth he said done under. No, no general public doesn't have to wear masks. Don't worry about it because of concerns that there would not be enough PPI personal protective equipment, including mass to go around for our front line hospital providers, but sorry, it's kind of like a first impression. Doctor FAUCI lie to me once and well. I'm going to be skeptical of what you tell me on down the line. You know you get one chance to make a first impression. Ryan Bullets also reminded us. To celebrate the fourth of July, by well celebrating within your immediate family group. Maybe another one other group, but of course, a small group with all of those social distancing restrictions in place and and wearing masks. Now here's where it gets kind of interesting, even as cases rise in Colorado poll, US announced guidelines Tuesday for the state's third phase in the corona virus response that he said will remain in effect until there is a cure or vaccine that is the protect. Our neighbors face so beginning next week, and you have to qualify for this protect. Protect our neighbors phase or you stay in safer at home phase beginning next week. Counties or regions that fits certain qualifications will have more local control and flexibility on how to mitigate the virus in their area, rather than having to follow state ride restrictions. Those qualifications are sufficient hospital bed, capacity, superficial, sufficient, p. p. e. supply, stable or declining cases of corona virus hospitalizations viewer new corona virus, cases and sufficient testing capacity along with the ability to implement case, investigation and contact tracing protocols. Contact tasing turning into well quite the conundrum because a lot of the contact tracing is being done. By phone guess what a lot of people just start answering their phones. Documented search capacity plans for case, investigation and contact tracing of course strategies to offer testing to close contact of outbreak associated cases now the exact numbers, each county or region must mean will depend on the area's population this courting to state epidemiologist Rachel, Hurley if these areas are counties that meet the qualifications for the protect our neighbors phase have an increase in cases that causes them to no longer meet those qualifications. The state could send them back to the safer at home phase, or even back to the stay at home phase whole a said on Tuesday now meanwhile back to the waivers. Waivers. Why won't well county apply for those waivers? Well, because those public health, order's simply are not enforceable. We have all the details coming your way in just a few six, sixteen, now, thirteen ten Kfi a thirteen ten KFI, K. A. DOT COM northern Colorado's voice this time check sponsored by caring hearts home, healthcare, serving northern Colorado since two thousand, one, where patient care always comes first nine, seven, three, seven, eight, fourteen, nine or carrying hearts, H, h, dot, com, all sports story in northern Colorado state in the country tune into the whole show weekdays noon to two and thirteen ten KFI. For more on KFI programs podcasts sports scheduling. News goto thirteen ten KFI K. A. DOT COM now. Bhakta mornings with Gail. All, right working through all of those covert nineteen related wrist, restrictions and guidelines. This adds a the state prepares to enter into the next phase of Covid, nineteen related restrictions, the protect our neighbors phase, and the variances that well counties must use in order to qualify for the protect our neighbors phase, but are they seating power and control when they don't have to six twenty four now. Now Thirteen. Ten KFI, a thirteen ten K. F. A. dot com, northern Colorado's voice mornings with Gail live and local the the auto collision specialist studios all right, so we talked about how bars and restaurants closed or excuse me. Restaurants Let's rewind. Their bars and nightclubs closed for thirty days as Colorado has seen an slight uptick in the number of covid nineteen cases across the state well. This release from Jennifer Finch and the Weld County commissioners as the state continues to work through obstacles presented by covert nineteen. Well County wants to make clear that the county will not be applying for variance from the state, nor will the county develop further reopening guidelines for businesses or events, and how many times and how many well county commissioners have we talked to throughout. This time of covid nineteen said we don't open businesses, and we do not close businesses now in a memo dated. June twenty twenty. Weld County Attorney Bruce Barker. Who by the way we will talk to this morning at eight Oh five outlined the legal reasons upon which Weld County has taken its position with regard to those variances. The memo outlines the county's belief that because of the lack of adherence and we're getting into the weeds here so just. Just. Bear with me because of the lack of adherence to emergency rulemaking process as directed by Colorado State Statutes, public, Health Order, twenty twenty. Eight is not legally binding, and therefore the county will not request variance from public health order twenty, twenty eight, because it is of no legal effect that said many businesses, events, nonprofits, and even individual residents have asked the county health department for guidelines as they looked to reopen or initiate. Certain activities were confused, right? Just as well county is not applying for variance. It is not developing specific guidance or giving approval to individual plans. Rather the county is trying to support businesses with reminders reminders about common sense approaches to reduce the spread of Covid nineteen, so whether you own a mom and pop ice, cream shop or the largest restaurant in town whether you work in a small retail store or a large company whether you want to host family, reunion or a parade or festival, protecting yourself your employees, your friends, your loved ones and your customers from covid nineteen really comes down to five basic things, and we all know what they are. Wash your hands frequently. Don't touch your face clean frequently touched or use surfaces often maintain that six foot distance between individuals or family groups. Cover your cough. Stay home if you're feeling sick. How you meet, those tenants is at your discretion. Imagine that elected officials trading us as though we're adults whether you're an employee or shopper, a business owner or restaurant, diner and event, planner or festival goer implementing these tenants will help reduce the spread of covid nineteen in our communities, please note. Public Health cannot anticipate every unique situation that means we need to stay informed and act based once again. On Common Sense and wise judgment that will protect health and support economic revitalization. This release from the Weld County Commissioner says for detailed guidance. Please consult the CDC website at triple dub, CDC dot, Org and NO S. Those five key things do not include wearing a mask. That is up to your discretion. Although? I will suggest that wearing masks particularly if you are having the sniffles, if only to protect others, the most vulnerable among us might be a wise course of action particularly if you are in endorsed spaces poorly ventilated spaces. We're GONNA check in with Weld County Attorney Bruce Barker this morning at eight. Oh five, but speaking of mass says masking up becomes increasingly political well. Let's explore the corona virus, credibility gap, and how it's sewn so much distrust among us when it comes to the conflicting messages, we've been bombarded with for the past several months relative to wearing a mask and advocacy when it comes to fighting Kovic, nineteen that coming up at six thirty five closing in on six thirty, now, thirteen ten K. F. K. BASS UNC bears target game coverage lives on thirteen ten K of k after mornings with gale's stay tuned for the Dan Patrick show the whole show and the herd with Colin Cowherd. Oland thirteen ten K. K. A.. Well more good news this morning with that June jobs report that just came out. The economy added four point eight million jobs in May that was well over the expectation of three million jobs. Unemployment rate dropped to eleven point one percent. The estimate was twelve point, four percent and needless to say markets indeed are up on the news. Keith Whiteman Presidential Wealth. Management will unpack everything you need to know about. That June jobs report when he joins US this morning. Right around seven forty, six, thirty, seven thirteen ten KFI thirteen ten K., A. dot com northern Colorado's voice morning with Gail. Gail via the auto collision specialists studios all right talking about masking up and how mass have become partisan politicized indeed weaponized as a mask shaming on either side of the equation. If you're not wearing a mask if you're wearing a mask is rather rampant these days well interesting piece in the Wall Street, Journal, that I wanted to share with you this morning by Joseph a Pado Mr Lepanto, as an associate professor at Ucla's David Geffen School of Medicine. He writes the American. Public is fractured. Indeed, we are over policy responses to cove nineteen. That rift is most visible in debates about. and New rounds as we are seeing not only in Colorado, but indeed across the country new rounds of shutdowns. This governor Jared Polis has a closed bars and nightclubs for thirty days. Such disputes are common man. country's diverse and well. Outwardly opinionated as America indeed is but political leaders and health officials have sown distrust by politicizing the pandemic response. Is Anything not politicize these days? Political leaders health officials have often invoked science and use that in air quotes I refer to it as junk science to justify decisions manifestly guided by their personal preferences, and that cost them credibility. So does lying. Restoring public confidence will require acknowledging their role in politicizing the pandemic, yielding to accommodations and sensible alternatives in the areas of greatest controversy, and how about focusing on the widely supported goal of not overwhelming are hospitals rather than less meaningful metrics such as increases in covert nineteen cases. One of the earliest signs of politicisation was the broad animist directed at protesters who objected to the lockdowns now in a country where liberty and free expression are as fundamental as air and water. Isn't it remarkable? How casually political leaders and health officials disparaged and banned those activities those who were protesting because our constitutional rights were being trampled on. Protesters were even targeted. Targeted for prosecution politics was also at play when New York mayor. Bill de Blasio or police in Brooklyn to break up a crowd of mourners. Gathered for his civic, Jewish funeral warning that their actions were quote unacceptable and threatening to arrest them. Okay compare and contrast. With the approach that many of those same political leaders and public health experts took toward the protests catalyzed by George Floyd's killing. Those protesters were neither maligned nor targeted with fines and arrests based on social, saying or masks mandates. They were often joined in the streets. By politicians such as Los Angeles, Mayor Eric Garcetti New Jersey Governor Phil Murphy. The double standard and treatment. Nothing less than political all these public gatherings where led by people expressing sincerely held beliefs that they felt outweighed the risk of covid, nineteen transmission, protecting such expression, regardless of viewpoint is absolutely fundamental to the integrity of democracy. Instead. Politicians. Played favorites with this core American Tenet. Medical experts also lost the empathy that previously characterized their approach, the public health many illnesses spread as a result of personal decisions and behavior. The contemporary consensus in the medical community has been to acknowledge without judgment. That our individual preferences and circumstances there-i. This has been true even when individual decisions affect the health of others, this is why public health experts advocate. Pre Exposure. ANTIRETROVIRALS FOR HIV, prevention needle exchange programs for drug users and in the UK e cigarettes for smoking cessation. But this wisdom now it hasn't been afforded to the COVID nineteen pandemic. Little accommodation for people who avoid mass because of difficulty breathing claustrophobia or the belief that once face shouldn't be subject to public policing. Some medical ethicists have suggested that if ventilators are in short supply, patients, who religiously used mass and adhered to social distancing should receive priority. Rationing medical care to punish non-compliance and they call themselves medical ethicists. Further corroding public trust was health officials reversal about wearing mass. I. Know Some something I've been droning on for quite some time in February. They discourage their use member. They told US oh no, there's there's no evidence that mass are effective whatsoever. Yet when questioned by Representative David? McKinley Republican West Virginia on June Twenty Third Anthony found. She claimed the initial guidance was motivated by concerns about medical supply shortages not doubts about mask effectiveness. So. It's no wonder. That many US don't trust the call to wear mass. So political leaders and health experts want to restore their credibility and our confidence in them. Well. Shouldn't they begin by knowledge? Ing Politics rather than science has influenced important public health decisions and by making accommodations for dissenting perspectives. Alternatives to mass for instance includes physical distancing. And using those masks or shields while endures. And while there is more to learn about immunity, there has not been a single confirmed case of reinfection. Among the ten million cases of covid nineteen worldwide this according to a May report in the Journal of American of the American, Medical Association, and until the data says otherwise. People who have recovered from covid nineteen? Should be exempt from restrictions. The most important step political leaders and health officials can take is to base their decisions on hospital capacity, not the outlandish models, not the best and worst case cement scenarios. Not The number of cases as a result of increased testing. No, it needs to focus on hospital capacity rather than case counts. And those case counts. Will inevitably continue to increase among young people. That's where we are seeing now. The most number of cases. Policing of social distancing restrictions on personal educational and business activities. It's doing nothing more. Than fueling. Anger and indecision and uncertainty and angst and indeed. Culture wars focusing on the goal of not overwhelming hospitals is sensible. It's less vulnerable to politicization. So long as the data or public available, publicly available for our own independent analysis. Hospitals often run near capacity to maximize profits, so the promises made during shutdowns to increase capacity needs to be fulfilled or yes capacity. Will join that rather lengthy list. Of Political Weapons. Now since many of us are already opting out. Of High risk activities they want. We want to avoid. Why not let us enter bars? Enjoy the beach. Exercise at the gym. And yes, learn in school. If that is our choice, the government should intervene with mandates enclosures, only if regional hospital capacity requires it while being transparent about bed, availability, illness, severity of hospitalized patients and efforts to increase. Treatment capacity including the supply of promising medications like disappear. These steps. Would certainly make the struggle against Covid, nineteen, more, sustainable and less politicized. Less, petty squabbling and wasting of resources would absolutely mean more attention for strategies to protect the most vulnerable among us. Dr Lepanto as an associate professor at UCLA's. David Geffen School of Medicine. Finally some common sense your thoughts is warning, nine, seven, three, five, three, thirteen, ten, eight, seven, seven, three, five, three, thirteen ten. Drop me a text on thirteen ten. KFI A text line at three, one, nine, nine, six, six, forty, eight, now, thirteen ten. Hey, F K A thirteen ten. K. K. preps. Radio is northern Colorado's home for the best high school coverage. This is mornings with Gail on thirteen ten Kfi K. A. The dan Patrick! Show is on the way. Well not even Kobe nineteen. All the conflicting competing guidelines and regulations and restrictions could dampen are enthusiastic. Secretary of State Jenna griswald deemed Tuesday's election. Turn out the largest in the state for a non presidential primary in Colorado's history with more than one point, five seven million of US casting ballots, representing forty five percent of active volunteers, six, fifty, three, now thirteen, ten, Kfi, a thirteen ten KFI, K. dot com mornings, Gail via the auto collision, Specialists Studios on thirteen ten K of K, a northern Colorado's of voice. Working for peace by Michael Carr Lake out of Colorado politics. A total of ninety nine point, three percent of voters cast a mail ballot according to Miss Griswald. Great and there were not lengthy lines or wait times reported at in-person voting centers think that's because many of us took advantage of either draw dropping our ballot in the mail or those twenty four hour drop boxes that were available around the state. Despite misleading attacks disinformation and attempts to make vote by mail. Partisan Issue Colorado's election proves that male cats are the key to accessible voting during this health crisis. Now her illusion likely was in response to comments as President Donald Trump has made in recent months alleging that mail ballots lead to as he refers to them rigged elections. Colorado does indeed right as a trailblazer in mail-in ballot elections now in Weld, county, seventy, one, thousand, four, hundred and twenty nine ballots were cast handily beating returns in both the two thousand sixteen and twenty eighteen elections, and meanwhile for more than one hundred and eleven, thousand people cast ballots in Larimer County. This cording to a piece by JC Marmaduke in the Fort Collins Colorado and representing a forty seven percent of active registered voters as of May thirty first now larimer counties previous record turnout. For a state primary was a thirty six point three percent. Back in twenty eighteen, as as a secretary of state, Jenna griswold deemed at Tuesday's election turnout, the largest for a non presidential primary in Colorado's history with more than one point. Seven million of US casting ballots again representing forty five percent of active voters, six, fifty, six, now thirteen ten Kfi Kfi webre whole sports story in northern Colorado state in the country tune into the whole show weekdays noon to two and thirteen ten K. F. K.. On your Thursday. Morning Swift. The Collision Specially Studios Thirteen ten K of a thirteen ten KFI K. dot com northern Colorado's voice. Sorry, after we get all caught up on everything that you need to know at the top of the hour, stay with US got a busy busy couple of hours ahead. Three Weld County inmates have tested positive for Covid, nineteen and a second round of jail. Wide testing will have all the details on that coming your way and the Greeley, fire department and the Greeley Police. Department recommend leaving the big firework shows to the. The pros and respecting your neighbors doing during your fourth of July festivities. Are you going to celebrate the fourth of July this year? Be Interested in what your plans are, but we're gonNA, take a deep dive into primary election results right around seven five when we're joined by Sherry Pipe Sherry Pipe, award winning investigative journalists for Complete Colorado and our Weld County political insider joins us once again at seven. Oh five ABC News than local news coming your way in just a few thirteen ten K. Greeley Loveland Longmont. It's seven o'clock. To UNC bears target game coverage lives on thirteen ten KFI K.?

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The Power of Showing Up for Your Kids

Kickass News

52:52 min | 1 year ago

The Power of Showing Up for Your Kids

"This is kick ASS news. I'm Ben Mathis. Parenting is an easy. But showing up is and your greatest impact begins right where you are one of the best scientific predictors for how any child turns out in terms of happiness academic success leadership skills and meaningful relationships is weather at least one adult in their life has consistently shown up for them in an age of scheduling demands and digital distractions. Showing up for your child might sound like a tall order. But now doctors Daniel Siegel and Tina Pain Bryson. The best-selling authors of the whole brain child and no drama discipline explained that it doesn't take a lot of time energy or money and the simple quality of presence. Presence can transform a child's life. It's all in their new book titled The Power Of showing up how parental presence shapes. Who are kids become and how their brains brains get wired and today they join me on the show to offer this soon to be first time father? Some much needed advice on parenting. They explain what it means to really really show up for your children and how your interactions with your kids are shaping the course of their lives and literally altering their physical brain. They discussed the latest discoveries and attachment science some tips for encouraging the baby scientists in your kid and why sometimes with children. It's best to answer a question with another other question less. We talk about the perils of hyper parenting the difference between soothing a child and coddling them and how even people who experienced neglect and abuse from their own parents can break the cycle for the next generation. Coming up with Daniel Siegel and tina pain Bryson in just a moment. Yeah Daniel J Siegel. MD is a clinical professor professor of psychiatry at the David Geffen School of Medicine at Ucla. The founding CO director of the UCLA Mindful Awareness Research Center and the Executive Director Director of the Mind Site Institute. Tina Pain Bryson. PhD Is the founder and Executive Director of the center. For connection a multidisciplinary clinical practice us and of the Place Strong Institute a center devoted to the study research and practice of play therapy through neurodevelopmental Lens. Tina and Dan Dan or the CO authors of the best selling books the whole brain child no drama discipline and the Yes brain and now. They're out with their latest book. The power of showing up up how parental presence shapes who are kids become and how their brains get wired. Dan and Tina Welcome. Thanks so much for having us to pleasure to be here. I kind of feel like I have to warn you hear. This might be part interview in part therapy session for me. Because as I mentioned before we went on air my wife and I are expecting our first child February twenty-second coming right up and I've read books I've listened to podcast. I've watched videos. I've gone to classes. I've done all the stuff and yet I still feel like I have no idea. What's in store for me and you know my rational brain says okay? I know that this is. This is not an uncommon feeling for new parents are probably any kind of parent no matter how long they're at it and yet it's still there and it's still has to be dealt with so help me out here. Hey does that nagging feeling feeling ever go away and how does apparent cope with it. Will first of all congratulations on your birth as a set of parents parents And it is always there that feeling like Oh what's it gonna be like. How can it be better and I think what Tina and I really wanted to do? And writing writing all of these books but especially the power of showing up was to give parents what is the essence of what we need to do as parents and it actually is based on science and it's very practical and we can get into the details of it but the idea that showing up for your kid is what they really I need to thrive is with this approach is all about yeah. I think that you say in here. That if you're doubting yourself and if you're worrying a lot then you're probably doing exactly what you're supposed to do. Although of course you can probably overdo it. I'm sure definitely you can overdo it. And that's actually one of the things that so exciting about what the science says says. Is that as parents. We worry and it really doesn't stop you know. I have three Adolescent boys and we always are thinking about. What are we doing the right thing are we? What are we missing? You know we worry. Are we spending enough time with them. Are we spending too much time with them are we. Do they have enough activities. That are enriching teaching. Do they have too many activities. That are enriched gray. So we're always kind of wrestling with that tension. But what's great about what the science tells us is that most of the things we worry worry about his parents or things we can let go. And you know the the overdoing in hyper parenting. That's very much part of our current culture is actually not what our kids the need and the science is clear about that. Yeah that's interesting. You discuss hyper parenting hypo parenting. Now I think I have a grasp of hyper parenting. That's you know those parents who just fill a kids day with activities and have every minute's scheduled and no time for free play and that kind of thing but hypo parenting. I'm a little less familiar with. Can you explain. uh-huh yeah I think the hyper-parented for a long time people have talked about it as helicopter parenting but I actually think that's way too passive to describe what we actually see you know. Helicopter parenting came from the idea. That parents are hovering too much but I think the current culture is much more intrusive. They're like in doing it so it's more like a snowplow parenting or or curling parenting where we're sweeping the ice of there's no little bumps right we're not just hovering in watching we're intrusively involved and In fact when we do that it can really get in the way of giving our kids practice dealing with challenges and learning that they themselves are more resilient than they think. But the HYPO- parenting you you know is really the idea where parents are checked out distracted. Okay over committed themselves stretched too thin. You know it's really hard to parent right now. We don't have the same kinds of familial supports we did in the past redoing. It often fairly alone even if we have a partner to co parent with us but especially when we don't we can be really isolating but what happens is we. It's overwhelming to do parenting. And so we're stretched so thin and even when that's not the case are devices and our schedules can really keep fragmented distracted and checked out. So that's why this book is so helpful. The scientists helpful for those of US parents who are involved too much where we're intrusive and we're doing everything for our kids. The answer is you don't need to do all that you just need to be present show up and then for the parents who are checked out distracted not present to say. Hey your kids really need you to show up We'll let me ask ask you guys this. We're living this age where our devices are just attached to our hands and we have all kinds of influences zone. Our children from social media media instagram culture crazy access to things like pornography you know at a very young age on the Internet plus global warming and all these things you have to explain your was it easier to parent maybe fifty twenty years ago than it is today. It's a great question Ben. I think the the issue is parenting. Being has always been challenging. It's probably the hardest job that we can take on and I don't want to get you nervous a month and a half way. Hey there so it's a hard job and what we WANNA do as parents in that club is say okay. Well what is the core strategy can take so there were two hundred years ago. You wouldn't be faced with all those challenges that you're mentioning but you'd have other challenges colleges in fact you know those days you had sadly a high chance that your child would not make it into the lesson so you know we have have a lot of wonderful things that are happening now even as they're also challenges so we need to just take a deep breath and say okay. What what do we know? Well when you look at the science across across cultures it comes down to this very simple notion that the way you as a dad and your partner your wife as a mom will communicate with your soon to be born. Child is going to provide the kind of environment filled with experiences that would allow their brain that organ in their head to grow optimally. Now this isn't to put pressure on you just to say that when you learn the basics you realize you can take a deep breath and relax because the basics which we can go through come down to three fundamental fundamental S.'s that give rise to a fourth S. And if you just like the litter as you can remember these as you're going to do just fine And and those are really all about showing up. That's actually in a sense of V as you know where you want to develop a way of connecting with your child so that you see them keep them safe you sue them when they're distressed and they develop when they have that in a reliable way a sense of security and when parents really get that and they realize oh my gosh if I didn't have that my own childhood does that mean my child eldest doomed to not be able to get it in their childhood and the answer is absolutely no the fact. Is that even if you had a very challenging childhood without these S.'s. You can learn to develop this capacity to show up for your child now. And that's why Tina and I wrote this book is because parents actually can earn earn security so they learn these very simple steps to take a deep breath show up and your child will thrive and develop develop things like resilience things like grit things like kindness and compassion. And that's a new way of measuring successful. Parenting is to have your child had these ways of thriving in before we get to the four S.'s. I WanNa Kinda talk about the research that underpins this book. There's something called attachment. Science what is attachment science will attachment. Science is a branch of the field field of psychology. That studies child psychology in particular that studies human development. And it's been around for about fifty years ears so half a century and it has these fantastic ways of systematically studying how the interaction of an adult old the caregiver usually apparent with the infant leads to how that infant will be at twelve months of age at twelve years of age and even into their forties now we have launched studies so this is an amazing collection of research data and we can tease apart how they do it. But that's basically what attachment science is it studies. How relationships impact the development of the person person? Okay and and your new book as we mentioned is called the power of showing up now. You don't just mean physically showing up to a recital or baseball game. There's more a to it than that I have to assume. What do you mean by showing up? Yeah there's more to it for sure. Being physically present is important our kids WANNA see us in the stands at those games at least some of the time but showing up is really more than just physical presence. It's really about knowing our children. And being present in ways where we can see the the mind behind their actions and their behaviors to really know them and the essence of showing up is the idea that when our kids have the need we see it and respond to it quickly insensitively. At least most of the time this this idea of showing up does not mean perfect it in fact we can mess up all the time as parents. The research shows and as long as we make a repair with our kids it actually can be really beneficial and we can talk more about the idea of showing up is the where. Your child's brain has wired based on repeated relational experiences with you that says hey if I I need them. They're going to show up for me. I expect that someone's going to see and respond to my needs. And how starker the differences later in life between adults whose parents did or didn't didn't show up for them when they were children will. That's a great question. The the first thing saying for anyone listening is that if what we're about to describe the the differences strikes. You take a deep breath and know that the research gives you a very optimistic empirical so finding that if you didn't have parents show up for you when you're kid you can do certain steps which team tonight outlined in the book to actually allow Al Yourself to develop the kind of way of living in a sense the way of being the way being present so you can show up for your kids. So we'll outline these differences is but please please please keep that important research finding in mind that if you say oh my gosh. I'm that person that Tina Danner now now describing. That didn't have so much show up for me and that's the way I am. You can if you choose find a way to grow rothe through that and develop more flexible way of being so basically what happens is if you did have parents who showed up for you you develop what's called the secure attachment attachment and that securities sometimes called a mental model which is just a fancy term for inside of me I have a frame what's called a Schema Schema that you and I can ever relationship that's mutually rewarding. I can be aware of my emotions. And what means something to me and and I can share that with you and in a very open and flexible way. I can engage with you where I've shared. What's going on inside me? You you shared going on inside of you and we have a very meaningful rewarding relationship with each other that is what security is all about an basically says nothing. I'm entitled titled To Be Seen and known by you but that I'm able to be an eye in a sense it more the of that I feel good good about who I am and good about the relationships I can create that security now. There are various forms of insecurity and there are three major forms but the bottom bottom line. Each of them is. I don't feel that I need other people and I want to go. It alone is one strategy or no matter what you do. I'm going to feel really insecure and feel like wow. You don't really love me you don't really care about me. I'm not certain this is GONNA work out. Oh my God. I'm flooded with my emotions. That's the second second kind and a third kind is if I've had terrifying experiences that I haven't worked through so it's still unresolved loss or unresolved trauma then. I will have a fragmentation of mine called association where was specially when things get tough. I'm going to have a disconnection with the feelings in my body from my awareness or I might feel like suddenly filled with rage or might get filled with flashbacks of memories as of painful things that happened in the past so that I can't really show up for you as a friend or if it's my child we're talking about. I can't really show them because I'm dissociated fragmenting my mind and one of the things that I found most fascinating about this. Is You guys say that the physical brain is actually physiologically altered by our interactions children are actual physical brain changes based on our interpersonal relationships. So that means that as parents or or teachers or grandparents whoever we are influencing spending time with a child we are brain architects. And that's absolutely true. The the kinds of experiences we provide children and even each other relationship don't just influence the mind or their character or their behaviors abuse but the actual physical architecture and wiring in that rain and again I know that seems like a lot of pressure sure but the sciences so relieving in saying look if you show up for your kid when they need you if you sensitively tune into what they need and and respond you are building that architecture and really strong on positive ways and I have to say that one of the most exciting things for me this might sound kind of weird or perverse about having a baby is the experiment of raising a child child and seeing how their mind works and what she observes and what she takes to and why she takes to something or doesn't take something you guys talk about this idea of the baby scientists in the book. They're just insatiably curious. And sometimes you say that a child might for instance throw a plate of Spaghetti not to act act out but see what happens. Because they're curious How can parents foster that kind of curiosity and maybe do a little bit better at viewing child's behavior through that lens of the baby scientists at such a great question you know The idea of curiosity is something parents can really I cherish. And if they're thinking like you are like how do I keep that alive my child. That child's GonNa really benefit because sadly when kids get to school cool. Many many schools are busy just teaching about. Here's some information. There's a right way to do it as a wrong way to do it. I'm not interested in your curiosity. I just want you to know the right answer and don't give me the wrong answer so that unfortunately starting around first second grade tells kids. I'm not really valued for what I'm asking questions about. I'm only valued for when I can guess the answer right. So there's not a evaluate life skill exactly so as a parent. This is so beautiful. You're thinking about it for your child about to be born is that you can really focus on questions Questions allows to join with the child. So let's say your child is she's going to be he she's going to be three. They're out in a park and they're looking at a bug. You can get down at their level and look at the legs of the bug and she may say to you. Why does the the bug have six legs and not it To like we do and go. Oh my God that's a really interesting question. What do you think which is very different? That's a set of questions from saying. Oh well bugs have eight eight legs but actually spider nor does it spiders as the other ones have six whatever it is okay and you get an answer. No questions in developing the socratic mind signed that allows your child to see. My Dad really loves that. I'm curious. He loves that. I asked questions questions and together. We can explore the nature of reality rather than he's GonNa Download Encyclopedia the final answer. You know so this is the first thing the second thing just to say about it. Is You know you by asking. That question are showing us that you really interested in the mind of your child Because curiosity is an inner state of wonder and that is part of the mind and we have a term we use coal mine site. Parents suit tried to cultivate mindset in there by asking questions not just giving answers by exploring things like would you feeling would you wondering about what do you remembering. Those are all aspects of the mind. Not just how are you behaving. Is it right or wrong behavior. But what's going on inside of you. You join at the level of mine site and and all the studies are absolutely clear. Parents have these reflective dialogues reflecting the nature of mind. They have kids who do better. They they become more resilient more empathic with other people more insightful. They develop more grit so they say wow. That was really tough and I didn't do as well as I should have. Let me try harder. That's what you want your kid to have and you can cultivate that. That's so interesting to me because the one thing I keep telling myself is that I'm going if they have a question I'm going to give them a real answer. I'm not going to just make up after because I see so many parents especially with very young kids they ask a question every thirty seconds and and the parents you know. They're focused on something else and they'll just say well because that's the way it is something like that. Because he was telling me myself. I'm not going to do that but you're saying I should actually get them to think about battling maybe answer a question with a question exactly and you know a lot of us. Of course had curiosity trained out of us so in a way as you you are so beautifully describing heretic is adventure to continue your lifelong learning as an individual. And if you see especially especially this notion that Tina beautifully mentioned the idea of reconnecting after a break after a rupture you know. Some people call repair but repairs fair sometimes as the feeling of like something's broken but the ideas you reconnect if you aren't seeing your child or keeping them safe for all these other S.'s. You know we always mess. It's up as Ed Toronto. The wonderful researcher beautifully says you know relationships are messy and if you realize that realize okay I get an idea of what the S.. Czar Dr is going to be messy nece where this disconnections and I'm not keeping my child safe or not soothing them or not seeing them all these things. What I do is City these opportunities just like that rather than burdens of I did something wrong you see them as opportunities. Okay okay say wow. I'm going to teach my child the skill that I can apologize I was absent. I wasn't showing up. I can reconnect act and amazingly. It's those mismatches and reconnections that a lot of science suggests are the basis of your child child developing resilience because wouldn't teach her. She says I know there were times when I was a kid when my dad maybe got mad maybe he was distracting the phone and I got really upset and he goes. Oh my God. I shouldn't be my phone or I'm sorry. I got mad. And you get down at her level and you reconnect that gets embedded literally in her brain as a memory. Things can be really tough but with love and connection they can get better And and now I've learned the mismatch reconnection pattern is something so when things are hard. I don't despair that's where resilience come round. I know it's going to the okay. You've taught me that we're going to take a quick break and then we'll be back with more when we come back in just a minute. Today's podcast is sponsored by native. 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The way of deodorant should smell and it keeps me feeling fresh from early in the morning. Yeah well into the night it rose on dry and it holds up under pressure whether I'm running around two meetings or running on the treadmill for twenty percent off your first purchase just visit native deodorant dot com and use Promo Code kick during checkout. That's native Deodorant Dot Com and Promo Code kick for twenty percent off your first purchase. One more time that's native Deodorant Dot Com Promo Code kick for twenty percent off. Your kids need to feel safe not just from external threats but you say they need to feel safe from a perceived threat or anger coming from their own parents sometimes yet we still have to create boundaries. We still have to discipline our children sometimes. What's the best way to do that without breaking that bond with the kid? So let's be really clear that when we're talking talking about tuning into our child's mind and having them feel that were that we care about who they are and what they're feeling. This is not permissive parenting. So let's be really clear about that from the beginning and in fact having boundaries that our children know we've clearly communicated this is okay. Hey this is not okay That actually helps them feel safe because it creates predictability so the main piece of safety is first protecting them from harm. So that's something that is very instinctual for most parents right like we know we're going to put him in the carseat them. You know what the first trip home from the hospital or the first trip. Out of the house We really want to protect them from harm. But one of the things that often gets left out is the second piece which is really important and that is that we should not be the source of their fear and the source of their terron. Dan alluded to this before when he was talking about sort of these one of these insecure styles of attachment. And if you think about this you no the the drive to be connected in protected is very primal. It's very much part of even our our mammal brain where you know. I think about like a little bear cub and out in the forest and a Predator starts coming toward them or they get hurt or they get scared. Their biological instinct is to run to their attachment figure to to make sure that they're safe. So we have this biological drive that says go to your attachment figure to be safe but if your parent is the source of your fear the source of your tear it actually creates disorganization. How the brain tries to process that because you have one circuit that says go to where there is safety which is supposed to be your caregiver and you have another circuit? That says get the hell away from what's dangerous so that that's an important part of that now. Of course what we're talking about there is more in terms of abuse neglect. which is you know very much more common than most people realize but the second part of that is more micro ways that we might as parents be frightening because we're unpredictable? Yelling kids or are a lot of times. We're probably not even aware that we're being perceived as a threat that's right and I think that's why it's really important. You know I remember one time I was I was with my niece. Listen I was on the phone with a customer service person and I was clearly communicating that I was frustrated and she was three or four. You know they're incredibly perceptive and amazing and she said Anti Tina you you mad and you know that's a moment where if I say no I'm not mad then she she has sort of only two ways to make sense of that either one. She doesn't tell me the truth or I must not be right when I think emotion is that look so then she has to doubt herself so much better in that moment you know. I know times times and this happens particularly when you're in the car with your children and let me just warn you. There's all these moments it's hard you can't get down to I level and give a hug and all these things so you know there. There are times you know where we can. You know emotions run high. Dan has written about this idea of flipping our lives where we go to kind of more primitive ways of acting out but in those moments to even be even in those moments when our emotions are running high we can help our kids feel safer by just naming. What's happening so I could say I'm mad? You're mad you're brother's mad. We shouldn't talk to each other right now because we all are not gonNA handle ourselves in a way we would like so we're just going to take a few minutes and breathe and calm down so even them knowing that I'm aware that that's happening can help create that safety but I think the other thing that can happen is if households were. There's a lot a lot of chaos and fighting There's even a study that shows an infant who is asleep so not consciously present if their parents are arguing in the background around in a hostile ways. The baby's level stress hormones or elevate. You know our our children mirror and really absorb Our are states in. What's happening so a big piece of safety is protecting them from harm? But it's also not being the source of fear and when we do have those ruptures like Dan said to go back and repair them and you also say that children need to feel seen and this sort of gets to something that Daniel was talking about a moment ago This idea of mine site which I think is a term that you coined what is mind side and give us an example of a mine site conversation between a parent and child absolutely well might site is a term for me I made up When I was in medical school I actually dropped out of school because my professors acted as if their patients chance and even their students? which just like bags of chemicals that they could diagnose disease but not identify feelings in the meaning of things things so I dropped out of school and when I was reflecting on you know what happened to me? During those first two years of school I made up this term mindset when I decided to go back that there were two perceptual systems. One was the system that we see the physical world. Like you know doing an x ray on bones for example you need in your physical cider eyesight to do that. But if someone has a broken bone and they're an athlete. The emotion of not being able to perform their sport is really significant for that clinicians. And all about Zo. What is that? What is an emotion? What's meaning and will you had to put it somewhere so I just said well it's part of the mind? Call it subjective. You know it's the inner sense of something felt texture of life but even though the word subjective implies Oh it's not as important as the objective science has shown it's just the opposite relationships including parent Chow relationships that focus on the subjective felt texture of life of the child in this case that is that are seeing the mine mine site. It's using using a different network of perception so I call it the mindset network that you can sense what's going on subjectively another person. So when I went back to school school I studied those professors and I noticed that the patients who were with physicians who didn't see their mind didn't do as well as the others studies these later on. Which showed that even if you go with the common cold and it's a controlled study but basically one set of doctors told? Just tell the person you know. Drink lots of fluids woods and call me in the morning. Whatever the other say the same thing but they take about thirty seconds to say? Oh my gosh this May and you're a student. Yes this must be so frustrating mistreating for you to have a cold. Yes okay. Do this do this at the ones who got the empathic comment got over there. Cold Day sooner. And when you studied their immune immune response it was much more robust. What we know is relationships that have mind site in them? Basically that are involved the empathy and compassion a a feeling of what one patient mind. What's called feeling felt when you feel that the other person gets you what teen and I just use simple awards sees you that they know you? That's using your mind site circuitry to connect with your child and the studies are amazing. I could go through them them one by one but let me just summarize them for you win. Parents do that when they actually reflect to their child that they're taking in the signals from the child. Get a feeling for what the feelings are. The thoughts the intentions. The meaning the memories for that child and you can do it in the form of questions. You don't say I know your mind when you don't you say I wonder if that was scary. So he's an here's an example. A child that says three and a half. She's running down the street. She's so excited that that she's got this ball on her hand but she doesn't look and see a stone and she trips over the stone falls. Now you have a couple of ways you can respond as as a parent one might be to ignore it and just say Oh. She's three and a half. She can handle herself. She's screaming and crying and maybe she scraped her knee. You just ignore it because you think pull herself up by the bootstraps. And that's the way she's GonNa do rely teacher now rather than when she's thirty and still still living in a crib or something like that. That's one approach. Another approach is get down on the floor and cry your eyes out because your child fell and go. Oh my God got so terrible so terrible my God. How can you like Soda and you could feel the anxiety of that right okay? So that's over identified over identifying with your child's pain in another approach is where you differentiate from your child so you get down your child's level and go. Wow Sweetie are you okay. That must have been really really shocking. Because you were so excited about the ball. There's the mindset near you recognizing their excitement that you may have gotten distracted about the stone so you understand where her attention attention was again the mind and you fell and that was scary. Now that's very different from a parent who just attempted or can just as get up Right so that's another option. You just get your child you pull them up and say get up. Even if it's done nicely it's still not involving mind site. Dialogue uses Uses what's called mental state language. That is I said you were excited about the ball. You may have been surprised about the fall. You didn't see the rock because your attention somewhere else. I'm I'm teaching my child there about how her mind works that her mind is valuable to know by me and that she herself can learn about the mind for insight site for herself and then she develops empathy and compassion for others. Mrs Where Social and emotional intelligence are built upon mind site. And this is something the you can teach your child as apparent interesting so the roots of these qualities like self awareness and resilience which we think of as sort of for lack of a better word. Inner Skills are more the result of interpersonal interactions than Some kind of internal realization. Exactly well well said I said that I I'm curious. Third S is sue than I think we kind of talked about that a little bit just now but it's Kinda hard you you know. It's very easy for us to get overwhelmed or distracted and to be dismissive of kids problems or worse to get just impatient and angry about them. Do you have some tips for for how we can be more soothing and less dismissive reactionary. Yeah that's a really hard one to do a lot of times parents and it's very common in our world to have that kind of pull them up by the bootstraps mentality. Or you know we say things to kids all the time like you know. There's no monsters there's nothing to be worried about. Or you know. We kind of dismiss their internal experience. And I think that's been a theme of what we've been talking about this whole time. Is that the idea of seeing the mind behind the behavior and that's gets especially tricky when it's a discipline issue you you know so the way that we think about soothed is the idea that we are there to help. Our child go from a chaotic reactive. State back into an an integrated state or back to what we call being regulated right. And so a Lotta Times There is a fear of parents and we can do so much fear based parenting and we think Oh we if if we let them do this one thing or you know whatever you know our mind easily is like they're gonna live in a van down by the river and all that the soothing piece is really the idea of saying I'm here to help you and and when parents actually really fear that when we do that we're coddling them or indulging that sure and and really the opposite is true and because what we know is that what we're doing in soothe is really something we might call co regulation so your child's in a really reactive state state the parents steps in to help support and help them calm down. Help them feel good again and when we do that it actually gives their brain kind of like a rep like lifting a muscle right. They're getting a rep for going from a dist- regulated state back into a regulated state. So that they can do that for themselves. So you know just a quick example example. I have one of my favorite stories from one of my guys. Is You know my four year old throwing a fit about getting out of the bathtub right so my my job in the first and foremost is to stay regulated myself so that I can you know he. He's GonNa Mirror my stay so if I get really reactive and angry. He's GonNa Tantrum more so I make sure I'm grounded and then I say it's time to get out and can either help you out or you can get out by yourself. And so he doesn't get out by himself and he screaming screaming and yelling and you know so. The first thing I want to do is help him feel felt and do that. That scene piece so that once I can get clear on what he's he's experiencing. It's going to be easier to soothe him so I can say you're so disappointed. Bath Times over. You really wanted to stay in. Is that right. And as I'm saying that as I'm lifting him out and then I can say you can cry if you need to. You can yell if you need to and I'm right here with you while you do it but I think one of the ways to think about this. Is You know. I'm setting the limit. I'm still pulling him the bathtub. I'm predictable and doing what I said I was going to do. But I'm seeing his mind and I'm basically saying I'm right here with you while you do this so I'm not fixing it for him. I'm giving him practice sitting in tolerating difficult feeling with support so it's really the essence of sort of saying you're safe. I'm with you and we will figure this out together. Gather let me ask you about one thing that I see often especially with. Dad's is this tendency to want to be their child's best friend or almost like an like like an older sibling more than a parent. Sometimes is that healthy. And how does that affect the child. Well I think you know. Sometimes parents will say that. They'll say I don't want him not my child's friend I'm their parent. But if you think about what a lot of it has to do with definitions a friend someone you share things with and that you like to spend time with and all of that You can be those things to your child while still being the adult who is in charge in who is going to protect their child. So I don't think Being an authority figure you're and being a friend have to be mutually exclusive. I think what's important is that we want to build relationships. You know so much of the time when parents use that kind of saying where they say. I'm not my child friend. They're often telling their kid. Like I don't WanNa hear about it. You know if you're gonNA cry and throw a fit go to your room. I don't I don't I I don't WanNa hear about it. Sure what happens is when we say that repeatedly our children internalized that and they're like not only do they not want to hear about when I'm in distress when I'm falling coming apart. When things are hard not only do they not want to hear about it but they're not going to help me so it actually can amplify their states of distress because then they go okay? They don't get me and I'm totally on my own. So I think we can promote if you think about the idea of building relationship where you're sharing sharing your life together and you're delighting and spending time with the other person to me. Those are the two biggest pieces a friendship. I want friendships with children. But that does not mean that I am not in charge and you know I can still be the authority figure that says I will protect you and in fact when my boys. They've moved into adolescence. I don't know if you know this bat adolescent children particularly my boys I guess they do some risk taking to experiment with the limits of of things and so you know there have been times. They've made decisions that the way I come in after I've heard about something that they've done is to say you made a decision that did not keep yourself safe eighth and my job is to keep you safe. And so I'm stepping in here the parameters are coming in you have your you know you're not gonNa have as much freedom because I will keep you safe. And so that's that's definitely right and that's not a friend thing and so if you have another thought about first of all you can see why I love working with Tina uh-huh fantastic just so great you know I would just add on those magnificent things that you said Two two thanks to build on what you're saying one is attachment is the way we turn to someone to be Safe to be seeing to be soothed and that's really all about attachment. It is true that when you're an adolescent and then in your adult hood your friends close friends can be attachment figures for you So just to name that And that's a beautiful thing. Mentors tours can be an attachment figure for you but in friendships or romantic partner. You are looking to be kept safe and to be seen in suit okay. So that's where exactly you're saying Tina you know attachment and friendship aren't exclusive this second thing to say just to build on what you beautifully Flea said is you know parenting requires that we set limits when kids are in a sense designed to push against those limits so the studies are really clear and something called permissive parenting where no limits or said. It's not good for kids or The opposite some they call authoritarian parenting. which is like you're a dictator and you don't ask the questions of your kid? What are they feeling whether thinking to join with them? That's not helpful. Either the middle ground authoritative where you are an authority figure creating limits. It is really what I think teen and I've written about in our other books too that we right in the power of showing up. which is this your building? Would you can simply call an internal compass in your child. It's a set of internal skills that just like you say ben come from interpersonal relationships and and what that relationship is is from. Your point of view is apparent. is you're a skill builder. Your inner architect for sure. You are neuro sculptor where you're helping. I'm literally build these networks of an internal compass. What does that mean? It means. For example I have a twenty five year old thirty year old and we were all out to dinner with my mom sooner is ninety and there was this beautiful moment when we're talking about friends in the French she has and some of them are passing away and what friendships mean to us. And and you know one of my kids turned to me and says dad you know I would consider you one of my friends now and it was beautiful and I don't think he or she would have said that you know when they were ten which is fine because I was there attachment figure as a parent and my goal then not not so much now but then was to say how can I offer communication. That helps build skills for them so that it's a an immediate in the moment. I'm showing up for them so that I'm being present for them right yet in my mind into in addition to being there in the present moment I'm trying to build a skill that's GONNA change the networks in their brain is internal compass. So that when they're twenty five thirty as my two kids show. It's just so beautiful to watch. As they're navigating the very complex world that now exists they have an internal attornal way of governing. What are their values? What are their morals? How can they have an internally generated sense of direction how to take the challenges and have grit so that they stick to it even when things don't go the way they initially hoped they would and they just try a different way or try harder would have they're going to do and both IOS number that way and I remember when our kids were young some of our friends would say? Why do you talk to your kids so much about how they feel? Just tell them what to do. Do literally that was like the gives us come and we would say my wife and I would say because we want them to learn about their feelings. Now here's the key. Think about feelings feelings and meaning are essentially coexistent in the brain. So the reason you want to tune into your child's emotional life their feelings is because if you want to have a meaningful relationship or have your child understand what matters what has meaning so that the internal compass then when all the influencers are from social media pressing on them or mission here. My kids dialogue about that is so beautiful because they they have this internal compass. That says here's the meaning that I'm aware of because you know I've learned this and I'm not gonna just be influenced by social media or peer pressure. Whatever I'm going to have my internal compass guide me and then as apparent when you set them off and I write about this book brainstorm for adolescents? You take a deep deep breath and you go. I've given them the gift of mine site. So they have the skill of an internal compass and now they've got to make their own way. They they leave the Launching Shing Pad that we've provided them and safe harbor. We will always provide for them and they go out in the world and that's the best we can do. You can't guarantee anything but what teen and I. I really hope the power of showing up does is it gives parents these basic ways when you show up and build this internal compass. It's a skill. That's a gift that keeps on giving and and I want to end by going back to what you said earlier about how history is not necessarily destiny so often. It's very easy to perpetuate dysfunction in by repeating unhealthy patterns that we experience with our parents with their own children How do you break that cycle? How do you rewrite the narrative? Well I I think the thesis of this book comes down to what you just said there. which is that one of the best predictors for how well our kids turn out out is that they've had secure attachment with at least one person and the safe seen in soothed providing repeated experiences of those not perfect experiences but enough of them actually wires their brain so that they know to expect that if they have a need someone will show up for them right and and and be there for them they have a need? And what's so cool. So that's the most important thing we can do for our kids development and what's so cool about the research is that we can say that. The best predictor for us is being able to provide that kind of secure attachment for our kids being able to do the SS and to show up for them is not whether or not we had it which is like everybody take a deep sigh right like thank goodness but rather whether or not we have reflected on our experiences and made sense of them in the literature it's called a coherent narrative. But it's the idea that you look back and you say gosh you know. I didn't feel that safe or I felt safe. But they didn't see me. They didn't give me at all and that's that was really hard for me. I felt really alone or if I was upset about something I knew not to go to them. You know they were they. Were going to just make me feel worse. So when we we reflect on and make sense of those experiences how they impacted us then. Our brain actually starts to change to be more integrated where we're not running from are passed but we're also not flooded buyer entangled by but rather were free and that's it in the literature. It's actually called free and autonomous and adulthood where we're free not to look back at our past to make sense of it so that we are not just being driven by our past but rather we are intentional. Final people who are aware of those things so that we can make choices and Dan has a beautiful phrase which is without awareness. We don't have a choice and so we just we we just carry on those dysfunctional patterns if we're not aware of them if we haven't made sense of them and what's so great about this is that anybody can do this so if you're listening to this and you're thinking Gosh I didn't get that and I have scared my kids a lot or I don't see them and you're starting to kind of go. Goodness I didn't get that are. I'm I'm not parenting in the way I'd like like to be. The research is also hopeful there to say that as we start providing more of these predictable experiences a feeling safe and soothed our brains change and our children an impact have a positive benefit for that right away. Yeah and it's great because most people if they weren't focused on their children or didn't have children to worry about they probably wouldn't be doing all this introspection and figuring this out so it's like the kids are a great excuse to work on yourself and make your your own life. Better invite us into into that day they want you to do is opportunity. And it's an amazing thing because some parents when they first hear about the attachment story that you just said they said why would I reflect reflect on the past when the past is the past and I can't change in and I have a feeling was pretty painful so I don't WanNa do this reflection when effect would teen is saying is so parable based on the science that you cannot change the past. That's true you can change how you make sense of how the past impacted did you and change the strategies of survival so that you open yourself up and become free now to become the parent and the person that you always dreamed named. You could be great advice. Well the book is just fantastic. I highly recommend it to people. Even if you're not a parent I mean all of these skills can be applied to any kind of relationship Romantic relationships office co Workers of best friends. You name it and again. The book is called the power of showing up how parental presence presence shapes. Who are kids become an how their brains get wired? Daniel J Siegel and Tina Pain Bryson. Thanks for talking with me thank you thanks again to Daniel J Siegel and Tina Pain Bryson for coming on the show. Their new book the Power Power of showing up out parental presence shapes who are kids become and how their brains get wired is available on Amazon audible or wherever books are our sold. If you enjoyed. Today's podcast. Be Sure to subscribe to us on Apple podcasts. And rate and review US while you're there five star ratings in detailed reviews news or one of the best ways for new listeners to discover the show you can also follow us on facebook or on twitter at at kick ASS news pod in recommend us to your friends is on your social media for more fun stuff visit kick ASS News Dot Com and I welcome your comments questions and suggestions at comments at kick gas news dot com for now. I'm Ben Mathis and thanks for listening to kick ASS News mm-hmm.

Tina Dan Dan Daniel J Siegel Tina Pain Bryson S. partner founder and Executive Director Ucla US PhD Mind Site Institute Ben Mathis baseball Place Strong Institute HYPO David Geffen School of Medicin Tina Danner director MD
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37:18 min | 5 months ago

The Role of Nutrition in Gut Health

"Welcome. To precision the health cast where you will learn how to live your best and healthiest life by precisely understanding how your body works, what it is made up of and how to optimize your health based on that information. I'm your host Dr Marvin. Founder of precision clinic where we take a highly individualized approach to health wellness and longevity I helping amazing people like yourself understand more about their genes at genetics microbiome sensitive. Toxic exposures levels of inflammation and much much more for the purpose of creating a highly specific nutrition and lifestyle planned and is flexible and sustainable i. hope you enjoy this week's episode as much as I enjoyed recording it. Hi Everyone. Welcome to my podcast where we are dedicated to delivering the best and most accurate information regarding precision healthcare from the brightest people in the world. Today, we have a very special guest in I'm so excited to speak with him. He's a good friend of mine who I've known for quite a while now and they fellow gastroenterologist. Today we have Dr Leo Trays on. Actor Trayvon is an attending physician in previous clinical chief of the Division of Gastroenterology at Cedars. Sinai Medical Center. He is a board certified specialist in clinical nutrition and gastroenterology. Specializes. In the best treatment of article, Bowel Syndrome Crohn's and colitis. Gastro Soft Gel reflux. Disease. Ulcers gastritis small intestinal, bacterial overgrowth, and cancers of the digestive tract. Common symptoms he treats include abdominal pain gas bloating diarrhea constipation, anemia bleeding. He is a participating physician and researcher in the Cedar Sinai Gastroenterology Department. Atra trays on performs procedures such as Daas, copy colonoscopy, and wireless capsule endoscopy breath testing. He lectures on subjects related to the field of gastroenterology nutrition and functional abdominal pain. In Assistant, professor at the David Geffen School of Medicine at University of California Los Angeles. As an educator, he teaches medical students, residents and fellows who are training in Gastroenterology Leo Welcome to the show good morning. Thank you for having me on I'm so happy that you're able to join us. Let's jump right into it. Tell us a little bit about yourself and how you came to do what you do. Well I am for five years old and I have been practicing gastroenterology as an attending physician four eleven years. As you mentioned I work at Cedar Sinai I actually have two offices where function out of into different parts of town to try to reach people in their in their communities where they need me. But I got here through a wonderful medical education. I tell people I was in school for fifteen years before I came Dr and the road was really a fun road as you know, Marvin what our educations entail. Included four years of college for years in medical school than there is a residency in internal medicine for three years, and then we do fellowships for three or four years. Mine included a master's degree in the study of clinical. Research. And there is some. Sort of informal educational opportunities alongside increased after ships mine was in clinical nutrition and stroke battalion more about that later interested. Cool. How'd you get interested in nutrition? How did you choose that? Because you know in our I remember in my fellowship they didn't really. I mean we had. We did learn nutrition. There's nutrition on our borders but. Nothing, really kind of to the effective how we talk and what we talking about these days in this whole health and wellness circle. Mind came through an indirect path Basically I was Crohn's and Colitis type guy or I would like to research things in that field, and I was looking for an opportunity that was undeveloped in one thing that I had noticed that nutrition was very important to patients in the field of crowns in Columbus it was what they felt was going to be a key to their improve minimum recovery because they observed. So many times that we made the wrong things things got worse tried to create a program for how to understand nat from themselves the patients did but when approached their doctors, the doctors really said now it's really all about the medicine. Disease activity in biology behind it. Sudanese attrition early make difference or at least that's what they saw or set. And it was that disconnect that I recognize it. There can't be this way you know how can you out? So many people intuitive with army not have You know incitements to get that are so solid as an opportunity in then. I said, well I'M GONNA be nutrition person within I D inventory thousand sees. And then you know what nutrition in general is really cool and from there on him to obesity and weight management, and that's really where my nutritional focus was for many years and then I I did A. Unofficial fouls yet at the Department Clinical At, Ucla, it was there that my mentor David Hieber Tommy, a lot about nutrition and obesity That's half. Awesome. So how do you use in apply some of the stuff with you know this food as medicine concept that we have that a lot of us talk about how to use that in how you approach. Various gastrointestinal conditions with that kind of concept while its own integrated I. If. I don't address it at its core. So many times people will come in for weight management. A common thing is I'm just getting bigger EADS. Trying hard think I'm eating healthy food because it's all organic. and. The too frequent story that I hear and so I told them about my insights into nutritional management of common conditions. And then we try to incorporate when you don't have a disease or problem. How do you any incorporate preventative wellness principles and knowledge points into like well for the future not just to get that are now. So what I do in order to have that discussion with the context of clinical visit. Is I them what your goals for the visit and how can I help you today usually do not about about ten minutes into a visit not right away you would think that would be right away but I kind of get a sense of what people are going to talk about these four and go off into what I. You know the right pathway is at that point is. Why leak year? How can be of most value? And through there I say okay well you. Know what I think is going on but I also WANNA to talk about nutrition as one of the models for our guide you make plans to get better to what do you think about loaf odd map diet do you think you use it a lot? You Talk to all that a lot or do you think that? All the time. Tell everyone what the low fat diet is I talk about all the time but maybe it's good to hear it from somebody else shirts explained to us maybe like I'm your patient shirt. So the low fog now. On stands for fermentable Oliveros Zach Rides dies akrons, monitors at rise and polyols which are small sugar alcohols that are found in healthy food and unhealthy foods, and all foods have some degree of. Ability and the low fog map tie it is an index of foods that that are low in their fermentable capacity. In some ways, it similar to another popular diet called the low for men tation Diet but there are some differences and the content is is that this diet can help people with your spouse syndrome get better your balance Indra means chronic abdominal pain or discomfort associated with altered bowel habit we call it IBS and a group of researchers have identified that you take away these highly fermentable healthy and unhealthy foods. Patients do better. The Diet is not meant to be a diet. For Life at least not in my opinion, I use it more as a tool to hundred San. What people are sensitive to a user's that quick intervention Moore's it tests than a treatment meaning you do it for a few weeks learn that it can help you or not help you, and if it does then you reintroduce the things that you took out of your diet during the testing a and it's only through that method that you could truly understand what you're sensitive to. I don't know if you feel the same way a moving about this, but I feel that food sensitivity testing is not where it needs to be. It doesn't I don't find accurate or predictive of what what people truly improve from an. So my way of approaching food sensitivity is through an elimination of finance in effect and then a reintroduction vase, they get better than I asked them to incorporate the principles. They learned offer a lifetime healthy eating guy I often tell people that the most important food sensitivity test you can do is observing what happens when you eat something absolutely you know some of these, some of these tests detest definitely not A. Perfect Science or maybe even near perfect science. But some of them are able to help some more complicated people at least get some guidance and how to begin an elimination diet. But I just tell people to kind of use that as a guidance tool and not as like you know some commandment that came down from the heavens or anything that you cannot eat this food. I, mean. This is just kind of a guidance was really the true test is what your body tells you when you eat something. Yeah I mean I guess this is where you and I might disagree on something I. Think it's highly confusing what those tests Really. Observe and project I think. We're better off making a just guesses at what we might be sensitive to based on experience with our own ten thousand patient population or If you use pool data of Irritable Bowel Syndrome patients from literature that might be a better way to approach it you might have a different experience vs sensitivity assessments on actually experimenting when Allergy, testing to to try to understand when people have documented allergy. Is it a real allergy that there we should stay away from this is a real tricky point is there is potential severe harm from food allergy a food sensitivity don't make his. It as dangerous that all of this really needs to be challenged reevaluated in the context of clinical scenario. This is one of the areas of learning them going through right now. Would you tell people when when they when you say, Hey, you know Brussels sprouts and cabbage cauliflower these all healthy foods by you shouldn't eat them. TAX PEOPLE GET upset they're like while I'm trying to eat more plant based I'm trying to eat more vegetables and now these are you know big ones they're they're very common vegetables. A lot of people eat. So what what do I do? I can never eat these foods again how would you tell them? The wave raised it is just so great on because usually when I go through the list of my fifteen or twenty most common nance when explain the Diet most people kind of raised their eyes or they look her husband or wife when comes doing their that's exactly what I'm eating is a common response and I would say to them. That, it's not going to be this way forever if you're intolerant of these five maps, it's unlikely that you're intolerant of every single one. It's usually you that are the particular culprit. The diet is called a low fought map diet on a no fought nap diet, and a means that there's some degree of you could eat foods in a certain amount It's not a binary option in various scales of grey, but the testing phase is really about knowledge acquisition. Again, I think it's more of a test than treatment and if you devote time to a Smartly, you're really GONNA get a lot out of it when I think about what my greatest tools are for patients the common things that people come in for I would say that a low fat diet is a big big success story I would say an Osmanovic laxative like Merrill is commonly a big success story of acid suppressors for reflux patients, huge impact, those of revolutionized acid based medicine. Mike espy flex all sorts in our country for a long time. Now, I would say giving non absorbable -biotics for voters and your. Syndrome has been very helpful. And lifestyle management and stress reduction techniques have also been a big impacter. So those reviews, the things that can help me those are my tools of the Trade Marvin. Now you'll be. To people be surprised really how much lifestyle can actually lifestyle changes can impact how people feel in Their long term health the mean it's so impactful. I Rueda Chapter In our Book Integrative gastroenterology second edition that is just about lifestyle medicine. Next thing the title of the chapters lifestyle medicine. And, basically, we of go over how impactful lifestyle medicine can be on got health and how microbiome shifts can occur as a result of doing what seems so simple but it's really not that simple because I tell everyone where humans living on earth. So by definition making some changes, they're not necessarily the easiest to do, but they can be done, and if we do them and we do them, well, it can make a huge difference could be a total game changer. I agree I heard this analogy from someone that I follow where if you make hard choices, you'll have an easy life. If you make easy choices, you'll have a hard legs. Right, on it. That's awesome and and with the five maps I love it. What you said that's pretty much exactly what I say as well. So I tell people you know will eliminate them for now for a period of time, you may find when we try to reintroduce things that it might be a couple of foods in one category or maybe it's a whole category but the other categories are okay. Maybe you can have a small portion of Brussel sprouts Padania a plate of Brussels sprouts you kind of figure out the dose makes the poison as well. So if you have a little bit of cabbage, you might. Be Okay. But if you have a whole plate of cabbage might have bloating that most people might have bloating actually if they had a whole plate of cabbages well, yes, does dependent. It's what works the same for lactose intolerance. I would say in some people I I would say that the problem with the low five Makhaya for so many people is that there's different information on the web about it in getting an anchored source for guidance has been a challenge for patients. Although, trained in in Nutrition Nanhai Think I can get to it and help people with. I feel that the registered dieticians and nutritionists or doing it better than I am. Really have the time and energy get into the nitty gritty details of what people are eating. So, I usually work alongside a Dietitian or attrition at Sonora achieved. That's dot. COM A place where patients can mail and talk to email and talk to to get A. Navy Gre- hands on. To help the I totally agree they can. They're super helpful. Especially when they're knowledgeable about Gi symptoms and things like that your what would you think about? You know CBO? You're right there at cedars that's kind of like the the. The pulse of CBO in the country? A lot of the stuff of related to CBA comes out of. An institution, why do you think so many people have CBO 'cause I tell you honestly in my practice. I duNNo. At least seventy to eighty percent of the patients probably have CBO. I would say that my numbers are lower may have a little bit more of a skewed skewed numbers because I guess I do integrative medicine as well but at that is Truly that's majority of the symptoms icies bloating yeah I think we would have to separate systems from it disease or Jones from diagnosed condition. Think there's a huge overlap between functional bloating. overgrowth. Ironically, the treatments are very comparable. I think, CBO, came about in this context. people who have chronic abdominal symptoms. It goes gastroenterologist. They get a diagnosis that was called. You have ideas in its stress related, and that was a frustrating for people because the felt that independent of stress factors. There was. Known triggers like dietary or make known trigger. It things just acted up sue to the search for other explanations was augmented when researchers noticed that there's a strong relationship between abnormal breast testing and irritable bowel syndrome. and. So a offices came around that irritable bowel, syndrome is caused by this alteration in gas producing bacteria within your gut. We simple non invasive tests for which is basically a three hour broadcast tests or drank a non absorbable sugar drink in we see how you metabolize sugar drink as dawn exhaled breaths at various time points. So the problem went this testing is that indeed there is a high percentage of people that test positive so it might seem that everyone. Everyone has CBO by I think there is a wide spectrum of people who have an abnormal Ross tests that don't have clinical symptoms. And people who have clinical symptoms in out normal practice test i. think what she's always now is the clinical symptoms in Admiral. Pass. Your see people that WANNA breath test sometimes than I'm like you don't really have the clinical symptoms so I try to get them not to do the task because it can become confusing. Then I think the symptoms occur. So extensive though of what the syndrome is, I mean they're not always digestive. Brain's. Abnormal waking these could be manifestations of condition too. And so a bigger question I ask is. Do with the information. How is it going to lead to changes in management, and that's how we decide whether we want to do press tests. Depressed test is also useful as a marker and like a biomarker like a blood test has x ray when you track progression of a disease. So we use that sometimes serially order to gauge how people are doing. So why do I think it's happening more I? Think it's because we're just aware of more in it's a treatable sub entity of irritable bowel syndrome. And, in my opinion people who have an abnormal breath, thousand symptoms of bacterial overgrowth, they deserve a shot at the standard treatments for it whether it's herbal therapies or prescription non absorbable antibiotic such as reflects then. People deserve a shot because unlike other treatments or your Bowel Syndrome, it's a one and done treatment whereas everything else requires ongoing daily use of that treatment in order to achieve on this what about those who are treated in and don't respond. Yeah. Exactly, symptoms that were talking about a little bit more of a challenging situation there is. Less than one in done in that situation sometimes. I tell people. That's probably you know although I a one and done the truth is it's rarely one and done, but it might be one in done and it might be two or three time in the risk benefit savers. Has this you know the when you give people a treatment for bacterial overgrowth in the form of an antibiotic sometimes, a lifetime of suffering is rectify in just two weeks and it's really impressive. It's. You know those are some of my favorite visits when people come back in and they say I just can't believe that's what it took to get. Well, you know keep. Saying I'm cured I'm curious. And we we tell them what I'm happy that you're this is where you're at of Benin make some possible outcomes that occur in a few weeks months or years, and we come up with a strategy at our follow this. For what success looks like what reasonable outcomes you should expect, and what will happen if your wellness right now changes. Interestingly. This is rare. The Diet comes into place for me because I actually don't do the Diet unless people are unwell meaning. You expose someone to low fat Manai when they're feeling well. My Hunt. Strategy, in this might involve his I. Ask he bowl to to get well with medical therapy fact is an option, and then when symptoms recur is at that point that we could try nutritional therapy in a structured observable diet like low finance Isla from Diet. Kito died something along those lines. And it's at that point that we try dietary measures because those are so hard to do when you think it requires a lot of effort on the part of when patient usually they make decisions. You Know Ten twenty times a day when you deal with Diet. So. You have those who I see that are most successful in the long run are those who? You know may have taken a treatment, but then really took the lifestyle measures to heart and started making changes in their diet and started exercising more started sleeping better and started meditating in reducing stress. These are the people that I see years later who don't need any other treatment. So is definitely a multi pronged approach to it and I use a lot of herbs in my practice and you know there are people who don't want herbs or for some reason or the other they can't use herbs and or they prefer to tie the you know non answerable antibiotics and I see the success rate is fairly equivalent in. The study from two thousand fourteen comparing facts into a couple of different herbal regimens, and they found the results to be equivalent and I I see that in my practice as well. So. It's a IT'S A. Common thing I hear to. Me With the study you're referring to I take issue with some of the conclusions from the study, the way that it was framed but I think it's really important is an astute physicians personal experience with success rates and how it adapts to what the patient needs. You're seeing on battlefield. So to speak that, it's helpful than that's really a great thing as long as therapies are safe and consistent with what people. In the way that they want to approach their healthcare that's really a great therapy. I. Hope you're enjoying this conversation as much as I. Am let's take a quick break and talk about Sun Genomics. This is an incredible company. They are testing your gut microbial and looking at what it needs and creating a precision probiotic just for you. Check it out now by going to www dot son genomics, dot com, and just as a thank you for listening to our podcast today giving everyone my discount code. Asked to five so you can give it a try at a discounted price. Now, let's get back to the show. Let's talk about something a little bit at different. Let's talk about precision health. What does precision health mean to you a lot of talk about precision health this the precision held podcast I do a Lotta precision health in my clinic precision clinic. What does it mean to you as a gastroenterologist knowing how important the microbiome is to whole health? I would say that it's not a term that a US ally and actually I probably never. Would never come out of my mouth as A. But other people seem to be grasping at it. I would say it's how we study our genes have we study our lifestyle and our environment and come up with treatments that are personally oriented to ourselves. It tells us which in this study of precision health tells us which medicines and therapies for -ceptable to what things were likely to be addicted to sixers obedience. For example, in, it might help us understand which conditions were at increased risk for. Cancers. The idea is by knowing our Bonnie ourselves we could make the right choices early in life to prevent bad outcomes into enhance good outcomes. Do you think the way we practice medicine in the next ten years is going to be different than the next ten years twenty years, thirty years they think that this will become more prevalent Homa Gosh I think about this all the time because I wanna get ahead of where we're GONNA go off. All people try to get to the place where they envision the future gone. What I think is different is. I think algorithms and computer programs will be bigger parts of health decision making as an example, the change them seeing is that. Is that people come in more educated about conditions they kinda have an understanding of where they wanna go and on more of a tour guide in getting him there than I was the diagnostician, the examiner like the agendas are often set before I ever walk in the room. And to my surprise, people are rather insightful about what they need what they want. Might be some bias there because people seek us out because we're skilled in a certain arena by that's when I'm observing I. wonder if it's the same for you to. But wearing think we're going is computers are GONNA help people in doctors and other allied health professionals are gonna be the ones that fine tuned the delivery of that, care. Yeah I was GONNA. Say We can't forget that you know computers are going to be a huge part of this machine learning artificial intelligence all these technologies that are coming out using it to help interpret data in a certain way. Bud at the end of the day, you still need that human touch because you have to understand the patient and where they came from and how to apply that information to their specific circumstances and how to actually interpret it and utilize it appropriately and I think the job of the Doctors Never GonNa go away but the job of the doctor might shift there may be different different kind of way of practicing because of all this information. Have is an advantage that my dad is a doctor who was practicing for fifty years just having retired last month. I talked to him about principles in themes medicine all the time. But one thing that's consistent is that people do need to identify with a person not eater as they go through their health challenges. He just I don't know how well they will. They will really feel having a computer algorithm help them in the most important decisions of their life. They have a lot of the test. Now, our direct to consumer and people do them on their own. But when they come with the results to my office, they are often still confused. So there's definitely a disconnection because the computer can't really talk to you as a human computer can spit out a result in you some information attached to, but is still need the doctor and but I agree with you, there's actually a book called. The patient will see you now is written by a Eric Topol on off you know him but yeah. Is Awesome he's year in San Diego actually at scripts and He, basically wrote this book a while back about how there's gives me so much information that everybody will have their personalized information on some some sort of secure hip compliant cloud and when they go in for a doctor's appointment, he'll be able to tap into that cloud and and get the information you need. If we unified health records in genre manner makes it simple for everyone that's really a special time on seeing some of that. Happening with? Hospital sharing of information and. What apple is doing to try to get information to the simple way on sure devices I. think that'll be really cool if when it happens. If you to give somebody. I guess one or two pieces of advice that was. that. You think is the most important to optimize their health. And regain control of their lives what would those one or two things be? What would those special pearls? I would say using exercise as form of prevention is probably number one and making investments in understanding what your sensitive to is number two. Here's like. when you do exercise, well, you're probably can feel better. You're probably GONNA lose weight or keep your way down our half better lean body mass copies, other index points of success. I would say, Hey. You're GONNA, prevent a bunch of problems, but you'll never know it. Her success looks like just fewer office visits. It's hard for people to gauge that. With regard to. Investing went you're sensitive to I think he's GonNa have to be sort of like scientists where they detach things all the time in figure out what works and what doesn't work. Don't rush to judgment based on the things that you read in the things that even doctors sometimes tell you because we don't know at all either I people need to learn for themselves. With their honestly can what they dumped like two. They need a lot of sleep to be need a minimal amount asleep do they need a glasses of water or as foreign us and the run these controlled experiments for themselves? I think these things take years to learn in. But when you understand it in the context of your own body, you're probably GONNA do well. I. Love It. That's that's the personalized touch to it there too, and you know we don't live in vacuums either we have to be flexible and sustain was kind of a big. Fear of big fury concepts that I keep advocating for and things shift and change and our needs and desires shift and change just kind of continuing to stay aware and fine tuning that as you go along takes time like you said and but you can get there if you pay attention to what your body is telling you. Absolutely. So. Awesome. I had an awesome time talking with you tell Saul where we can find you somebody wants to look you up. Probably. The best way is, might website www dot trees on meg dot com. I'm starting a social media presence very soon. I would have done seen her but I've. Always been a cautious. On a personal level about a social media does to me. So that's why I haven't in present in. But I realize as I, WANNA spread my message ensure with people the things that I've learned over a relatively short career and as I continue learn orange I'm gonNA have to leverage so media do it so you need to into awesome. Awesome if you find out. What your social media handles are before the show comes out we'll put that information in the show notes. So everybody should show notes as well. We'll added in there you I'll be I'll be making a group of videos where Kinda share quick boy knowledge points and like how I predecessor in problem just haven't figured out the optimal format where share that awesome low we'll be looking forward to check those out. Thank you so much for being a guest on the show we had awesome discussion a really appreciate it. I'm sure everybody found some value in hearing from two guys chat. And, I think you're doing a great job. Marvin. Thanks for having me. Thanks appreciate it, and thank you to all of our listeners for tuning in today to listen to another exciting episode. Of Precision. Health cats. We hope you've enjoyed this episode of precision. The health cast the one and only podcast truly dedicated to helping you understand how to live long and personalize your health. I'm your host Dr Marvin Sink Until next time. I WanNa, take a moment to tell you about precision clinic a unique medical clinic that I founded in two thousand nineteen precision clinic is the only practice in the United States that uses precision nomex to help optimize, health and improve longevity by using cutting edge science and technology to create highly personalized recommendations and protocols. No matter what your health goals may be. Give us a call and learn more about our customized and comprehensive evaluations that can all be done from the comfort of your home. By telemedicine our phone number is eight, five, eight, two, two, nine, seven, five, eight, nine or you can email me at Admin at precision clinic dot com a d. m. I N. at P. R E C I s I o N E C L I, N I C. Dot Com. We're looking forward to hearing from you.

CBO food sensitivity bloating Dr Marvin abdominal pain bowel syndrome Brussels Cedars United States Ucla attending physician gastritis Bowel Syndrome Crohn Dr Leo Trays Sinai Medical Center David Geffen School of Medicin Cedar Sinai Gastroenterology D obesity Allergy
Building for The Future: Physician and Clinical Leadership with Anish Mahajan, Chief Medical Officer, Harbor-UCLA Medical Center

Outcomes Rocket

27:03 min | 1 year ago

Building for The Future: Physician and Clinical Leadership with Anish Mahajan, Chief Medical Officer, Harbor-UCLA Medical Center

"Hey comes record listeners. Thanks for tuning into the PODCAST again tired of your businesses healthcare costs unpredictably increasing every year. Healthcare costs are typically businesses second or third line-item expense and if you're like most employers lawyers it's an expense. That's growing faster than your revenue. Luckily for employers Nevada health has the Solution Nevada. Health is a full-service healthcare consulting firm with proven strategies to lower your healthcare costs by up to thirty percent or more they operate on a fee for service model and never markup any of their medical or pharmaceutical claims. None of your employees have to leave their doctor or pharmacist either their health captive and pharmacy benefit manager are the most cost effective and transparent solutions in the whole country what they do is not magic is just honest so if you're tired of overspending on health insurance and WANNA learn more visit outcomes rocket that health slash save for a free spend analysis to see how you to could save by switching to Nevada health that's outcomes rocket dot health slash save for your free spend analysis outcomes rocket dot health slash save welcome back to the podcast. Today I have the privilege of speaking with Dr a Niche Mahajan is a Chief Medical Officer at Harbor U._C._l._A.. Medical Center Associate Dean at the David Geffen School of Medicine at U._C._l._A.. He's an accomplished pushing driven physician and healthcare executive with clinical strategic data analytic and communication skills to motivate policy and practice change in the government and private sector with over ten years of experience in vanguard policy in healthcare organizations including five years leading successful initiatives at the intersection of Health Policy and system change he served one year as a special adviser on health policy at the White House Office of Management and budget during the formulation of the affordable Care Act Act his work as well as the bed practice that he's had really will offer a lot of insight to to everybody listening today and so with that. It's a true privilege to have a niche on the podcast and looking forward to the discussion on each welcome. Thank you very much. It's a privileged to have you here and I wanNA know that I leave anything out in the intro that you'd like to share with listeners. No I don't think so as a very nice introduction appreciate sure so. Tell me what what is it that got you interested in healthcare well for me early on you know I had a drive in passion to try and be of use in service for underserved communities and that really came inspired by my grandfather who was a public servants in India where my parents are from in that really drove being you know how did it become serving the public and the underserved and health you know quite simply. It's that I am of Indian the American origin there are no doctors in my family and my parents had a very strong hope that somebody would become a doctor and of course I felt that pressure and I thought I can make the best of being a doctor because at least they can also serve in Korea health for under certain people why that's fantastic <hes> Dr Mahajan and so you you've done a wonderful work and you've covered so many so many as you call it <hes> different angles of the elephant right taking look at it and it is a big elephant healthcare so I'm just curious what you believe is and should be at the forefront of health leaders agendas and how are you and in the work you do approaching it. Yeah I guess I I'll start by saying that you know my experience has taken me from the bedside. Were you know an internist. I practice <hes> on the hospital setting on the impatient side mostly at practice now a half a day week as a primary Eric Care provider and I learned clinical medicine but I quickly moved into health services or implementation science research and became a research faculty member after my training and residency <hes> U._C._l._a. and was fortunate to gain skills and analytics and research and studying health systems and trying to understand what are the possible way is in which we could create interventions and policy environments to improve the system I of course in doing that. I I also understood that academia and the production of knowledge is extraordinarily important but certainly not nearly enough to actually implement and get to the the goal of actually improving health outcomes and so I was fortunate to have the opportunity to go and work as an special advisor in health policy as White House fellow in the lead up to the affordable care act on the first year President Obama's presidency in that was a moment where I I could I thought in going to wash that I could take my understandings in my ability to understand research insights and the medical literature on what we what is rich in in the Journal of American Medical Association New England Journal could we bring those insights to bear on policy and what the new healthcare reform which eventually we ended up calling the affordable care act would do and I you know I was quickly shown. How complicated did I had a front row seat in how complicated it is to use the best available evidence and translated itchy meaningful policy and we got what we got and I believe the affordable care act was a big step that or certainly not the entire step in and so that was somewhat humbling for me about the nature of how you know research in academia can impact change thereafter? I you know my own career. I thought about it. I was in my mid thirties. At the time. Take Care Act was passed. I had opportunities to stick around in Washington on continued to contribute as a political employees to yet C._M._S. or H._H._S.. Or be where I was but I made a very deliberate a decision thinking that it would be quite a privileged to continue to work at a policy level but I felt the same way I felt in academia that Gosh how are we going to actually translate what we're doing here into actual impact and change. For how Americans access and utilize and benefit from healthcare and so I made a decision to walk away from great opportunities after my year in Washington in the Obama Administration on return to Los Angeles to seek an opportunity it'd be a health system leader and to try and understand what it means to lead as an executive in implement both insights from literature and Opportunities in policy to system change. I was very fortunate to when you have an opportunity to be a deputy director of large second largest public healthcare system the U._S. in L._A.. Here and from there I really understood that Gosh there is a whole nother layer to actually improving health care and that was us that was related to how you lead teams how you build a culture at the level of the healthcare delivery organization that could actually harness the opportunities of policy in the insights of research and so in my journey so far. I've been humbled in every arena that I've worked but I've also sort of understood or feel like because I have a global view from multiple sort of silos as it were that I can see places where whereas opportunity also places where Gosh we have a lot more work to do in a collaborative profession yeah some rich experience you've had their nation and fascinating to hear that you've done all this at really during such a young phase of your career so Kudos for you for being able to have done anat contributed so early on and now as a system executive putting things in the practice that make a difference. Can you give an example of something that you've done or things that have been implemented at your facility that have improved outcomes <unk> by doing things differently sure you know we one of the big changes that the affordable care act enabled was coverage expansion for people who are traditionally uninsured and with coverage expansion in California where I work <hes> this is the governor at the time Jerry Brown decided that coverage expansion would occur in managed care fashion and so Medicaid Insurance of medical in California. It was decided that anybody who gained new insurance in California California which they were going to be hundreds of thousands in L._A.. County areas it we serve would have to be managed care members of health plan and this was a sea change in how low income people in Los Angeles would access care and the theory as as I worked on it and promulgated in Washington and as I understood it in the academic setting is that if we made provider groups accountable in a per member per month style reputation for the lives jobs of patients we are likely to improve the delivery of the care and ultimately outcomes of care for those patients as compared to fee for service and that's the grand experiment we've been on in California since the invitation affordable care act the low income people bowl and so in our health system which is a safety net health system. We suddenly had to get our patients to understand it. They were going to have a primary care physician that they could call their own. They could identify the person that they had a place to go for clinic did not have go to urgent care or the emergency room. They're starting point of care and yet in the first year or two our patient satisfaction scores were not very good not surprisingly so on the outpatient setting and so we as a team using Toyota production action system principle the lean management approach created a steak multi disciplinary stakeholder team of nursing administrators positions in our primary care practices to figure out. How can we do better you know in one intervention that was something that people said would never could never be possible before we created collaborative teams using lean methodology was that we ought to have open access appointments are patients should be able to call their doctor and be seen that day or the next day scheduling pulling template should allow it and before our Lee measurement approach no chance of doing that because we did the hard work of doing that we implemented it and we saw our scores? Skyrocket was patient. Experience improved dramatically among among rolling come population in that was something that you know everybody in my facility should be very proud of well. That's <hes> that's amazing in also very ambitious project. It's it's difficult to do. What would you say was the reason you guys are able to execute on that particular? I'm referring to the just in time method for appointments. I mean that's that's not easy yeah well. I appreciate the question so much because you know it. It isn't because we did lean it wasn't a travel mall or it wasn't the only that we are able to throw together the people who do the schedule The I._T.. Folks control the Electronic Health Record and physicians and some patient in put it. Wasn't you know those were necessary but not sufficient efficient really what made this possible was a very long set of engagements and conversations at all levels of our organization about who we are what is our mission and can we articulate together what we call are true north and and what we did articulate I think was ended up being very powerful in that we articulated that two years prior to achieving this game which was the even though we provide care too low income people we should be providing getting care at a level that we would bring our own loved ones to our facilities and with that sort of powerful notion it became very easy at in the face of big challenges for people to feel inspired and say. Will you know when I need eight to bring my mother and her myself I have a problem I'm able to get into my own doctor's office within a day or two it shouldn't be different for our patients and so people rolled their sleeves up and did what was hard in Lo and behold I figured it out love it Yup and and you know it's a testament to the culture like you alluded to and being serious about the true north and there's also some inspiration there I think brought by you in the leadership team Doctor Mahajan to be able to knock us out so Kudos post you guys for doing this gives us an example of of a project that didn't work in something that you guys learned from that that has made you better gosh there are so many other continue to work so gosh. What should I pick? I would just give it very operational example of managing our carry operative process from patients who are screened for their risk of Perry operative risk all the way through the having their operation. Operation and their post op care we run a level one trauma center we provide everything all kinds of procedures and surgeries including robotic surgery so insofar as we do that we have you know we have over seventy surgeons on staff across multiple departments and it becomes a very complex situation in terms of managing the operations effectively managing our costs. How do we decide which supplies are absolutely we needed in the operating room? How do we budget for it and to date you know we've had very strong clinical department chair leaders who continued to be very strong but they were somewhat autonomously and we still we did not and we continue you to work on trying to manage the entire period operative process in our trauma center in a way that is more efficient more collaborative and insurance that we have the right skill sets applied for every problem long? So how did we try to address this. All you know I thought we ought to change how we govern <hes> decision making in the period operative care service line and I asked that we create a Perry operative leadership team that involves I senior nursing leader senior administrator in a senior physician surgeon physician who would represent each of the departments as you can imagine that part that last part has been a challenge. We have to pick one person because if you pick the one I it's difficult to hold anybody accountable but you know one person comes from one of the three major department of the dust surgeries in the in this service line in so we've had a lot of challenges in sort of corralling the governance but also part of that John's is because it's so complex and expensive in American medicine when you talk about all the kinds of procedures inserters we do so we don't have an answer there yet but it something that we are not doing well on where over budget of last two years and that's something that I'm being being asked about quite rightly yeah. No it makes a lot of sense and <hes> and look I think the inevitable is is is that you guys as you've done in the past Anisia you'll find a way and these <hes> operational challenges pose <unk> a challenge for really all leaders in healthcare and I appreciate your sharing this specific one as a way to connect with the listeners on on the problems that they too are having in their systems. There's no such thing as perfection but going going toward. It is definitely something that you guys doing so Kudos to you there. What about the other side of the coin? What's one of your proudest medical leadership experiences? You've had the date well. You know. I guess I I will say really should go without saying but my my achievements are really often almost always achievements of many other people who do the work so as a leader my roles in the last five seven years really been those a a setting vision helping people come come together around common purpose identifying high priority issues that we should expand our precious assets including people in their time on so you know that just I'd have to say that for everything. I'm talking about here so it's one of the things I've spent a lot of number on outside of my job. As we associate Dean and Chief Medical Officer I've served as a as really the clinical thought leader the founding member now that share of the board of directors of a new effort around Health Information Exchange Los Angeles County is you know and as many people know sharing in health health information across entities so meaning you know I'm impatient say at Kaiser but I ended up in the emergency room at U._C._l._a.. Medical Center which is not a Kaiser facility those U._C._l._A.. Doctors in the E._D.. Are Unable to know or see my medical record as an example and health information exchange of courses intended to ensure that health health information can travel seamlessly between organizations and entities that manage the healthcare needs of any given individual. We do not have an H._i.. As it's called for short era in Los Angeles and yet we have such a sprawling geography we we have so many healthcare entities and we're largely now a managed care environment for the safety net because of Medicaid being managed care product so the need for health information exchanges so paramount as it relates to health care good quality healthcare but also for controlling costs and we do if you look at the data in L._A.. We do a poor job of that across sector across health lands and sectors and so few years ago there was a lot of grant money to try Ryan Start. These initiatives and most initiatives around the country are are not successful but I had taken this on as a passion project but something that I truly believe in that in there are many appropriate naysayers I s people think experience is not good but I have taken it on and I I have personally and with a lot of help built vision and been able to convince leading health plans leading out systems in L._A.. County to take the leap invest in Health Information Shane take the risk of sharing their native people of course are quite rightly very nervous about sharing patient health information for the right reason which is to improve patient care and care coordination so our lanes health information. We call it lanes. The made celebration shaded L._A.. County it's up we have major entities connected in other entities coming and the goal is to prue and it's a it's a final one C.. Three nonprofit effort in the goal is to prove to ourselves into everyone who participates that we we can generate meaningful use cases they calm in I._T.. Meaningful ways in which information can be shared between entities to improve care outcomes and this has been like rolling a boulder up at hill and I've had a lot of the other folks believe in it with me but I think that's what I'm proudest moment man. That's exciting and definitely ahead of the time is another difficult thing to actually be able to have gotten all these health systems align on this vision. This interoperability ability problem is Kinda like the holy grail so to speak in in what we do so wow fascinating and and again you know just a big Kudos to you for for being able to do that. What's the vision there then you know in five ten years twenty years yet I think for us it's the idea that it's not simply allowing one physician at one hospital and other physicians Saint Clinic to look at each other's health record because as you know well and all of us have complained about electronic? monoculture record is almost too much information right a lot of noise and you know and it's difficult to corral. You know that's all true but rather it's it's to enable that capability but it's more than that it's really to say if I may care manager <unk> who's managing and I'm not a physician but I'm a nurse. I'm care manager who is working at health land and managing the sickest patients with the worst social challenges that are members of my health plan somebody. Let's say who has serious mental illness and diabetes will use care frequently who doesn't adhere to their medications to their social and medical challenges that whenever that person enters emergence zero the computer system H._I.. Automatically Ping's be Medicare manager and Automatically Ping the primary care providers office that the patient that you are co managing together has hit the emergency room reason for that is that then the folks that do the care coordination can ensure that when that patient is discharged from the E. D. or from the inpatient patient service they're tracking that patient within a day or two getting them into clinic so that they can make sure patient continue to take their diabetes and psychotropic medications. It's the idea that we as a society have the tools we as healthcare entities have the staffing to actually wrap around and help or most needy patients use care better and have better outcomes but what we need to do is ensure that information gets to people who need to act on it in real time and that's the kinds of functionalities pleased that we're building in a collaborative fashion listening to people who actually do this work asking them what their problems are designing the I._T.. System to meet those needs awesome I love love the direction Dr Mahajan and and I'm just thinking about the future you know it's it's definitely bright with the work you're doing here and so love that you shared that story and the directions going at will serve as inspiration for people listening today so time for the lightning round so I've got a couple of questions for you. These will be rapid fire as possible followed by favorite book that you recommend the listeners you're ready. Sure are what's the best way to improve healthcare outcomes building effective teams was what's the biggest mistake or pitfall to avoid thinking that I've identified the right metrics so then naturally we're going to beat the goal. How do you stay relevant as an organization despite constant change? I think it's being focused like a laser for on your mission. If it's a healthcare delivery organization it's it's meeting healthcare needs of your patients and if your patients or changing demographically than actually you need to change how you serve them to keep that role of meeting their needs of <hes>. What's one area focus that drives everything in your work I would say it's it really is two things it's patient satisfaction and provider and staff satisfaction outstanding and these next thanks to unleash are more on personal? What is your number one health habit while I need many more? There's some a terrible patient. I what I've been trying to do is go to the the gym four times a week Afar. I'm averaging three times a week so I guess that's my habit and goal. I love it. It's a really great one and what is your number one success habit gosh if I could keep this habit up I would probably be more accessible and that is to plan the most important thing I'm supposed to do the next day the night before and ensure that I don't allow other things to encroach on my time to accomplish those things outstanding love that one definitely a focus for for me as well on each side brought that up. What book would you recommend the listeners? I like reading novels <hes>. I believe it probably is because we're my partner. She's a professor literature but I think novels are amazing but I recommend you know what I just. Recently read was a nonfiction piece by Vallery of these sally. She's a writer for Mexico by Italy she wrote a book call was called. Tell me how it ends. An Essay in forty questions in this is a book that she served as a volunteer interpreter for Central American children migrant children when they come across the border egner taken in by the immigration services and she he wrote in two thousand fourteen actually before much of the recent political issue around this and what she did was interviewed these kids she interviewed she served as the interpreter of these kids as they answered the forty questions the intake questions we are government as for for processing these kids and it's a phenomenal story the real story it's very short. I recommended to anybody any of US Americans to read in terms of the insight it is not just about those kids but about how we as a society manage difficult social challenges as well as it really is generalize -able story about what it means to be an immigrant so ray thing great recommendation on Asian so folks for a full transcript of our discussion as well as a short links to any of the books or resources. We've discussed today just go to outcomes rocket that health and in the search bar type in Dr Amish Mahajan. That's M. A. H.. A. J. N. and you'll find all of that. They're so Nisha love if you could just leave us with a closing thought and then the best place for the listeners get in touch with or continue following your work yeah you know I get closing. This has been a great. This made a lot of fun. I really appreciate a speaking speaking with you saw and I guess my closing. What a great thing you're doing here? I can't wait to continue to listen to the others. Who had you have interviewed? I think conversations I guess my closet that will be conversations. Have conversations with people outside of your immediate expertise sided your silo because we really do need to break silence down of the experts in the delivery of healthcare. That's beyond just physicians administrators nursing includes patients an increase community health workers do that and you know in terms of getting in touch with me. Please reach out to me. My email is available on Lincoln. I love to hear from people engage with folks in healthcare outstanding in each love that call the actions the folks take it on reach out outside of your own silo and hit the rewind button and listen to this one again because it was definitely a great interview a niche just appreciate you taking the time to <hes> share your insights with us. Thanks again thank.

Dr Amish Mahajan L._A I._T California founding member Los Angeles executive Nevada Chief Medical Officer Associate Dean Washington Eric Care David Geffen School of Medicin Medical Center Toyota Harbor U._C._l._A
#129 DTC Series: Picture Genetics on At-Home, Physician-Mediated, Genetic Testing

DNA Today

33:21 min | 6 months ago

#129 DTC Series: Picture Genetics on At-Home, Physician-Mediated, Genetic Testing

"I'm happy to announce that you made it happen today. Has been nominated in the twenty twenty podcast awards for the best science and medicine show. This is our fourth year being nominated and we are up alongside big podcast like gimblett media science verses so huge thanks to all the loyal listeners. That made this happen if you did nominate dna today. Check your email to see. If you're one of the lucky few with the power to vote for the winner you can also go to podcast. Awards dot com and click on the blue box in the middle of the page that reads voting open there. You can sign it and it will tell you if you are one of the powerful people that can vote for the winner of this category among the other. So thanks again. Everyone really helps the visibility of the show and having the show grosso thank you so much always be find ourselves surrounded by such and such genes of almeida de and all made the same category. Hello you're listening to today. Genetics podcast and radio show. I'm your host cure dineen on the show. We explored genetics impact on our health through conversations with leaders in genetics. These are fellow genetic counselors researchers doctor's patient advocates and many more science communicators today are from full. Genetics sues the sponsor of our ongoing dt series with their picture genetics kits. This is the third installment of the series. So definitely go back and listen to our two previous episodes. If you haven't already so my two guess today our jessica sheils who is a genetic counselor and doctor samuel strom. Who is a geneticist. Jessica serves as fulgence. Clinical genetics marketing specialists so her main role is to provide clinical training and expertise to help develop marketing material. That's used educate support and inform the patients and providers that fulgence serves which is strong passion for patient advocacy. She also leads. Fulgence community outreach. She's a fellow. Sarah lawrence college alumni also received her masters of science in human genetics previously. Sam was an assistant professor at the ucla. David geffen school of medicine where he pioneered interpreting genomics results in the context of clinical diagnostic testing for both rare inherited. Diseases and cancer apple gent. He is continuing to forward this new science at an industrial scale. He's also an accomplished researcher in the fields of neuro genetics ophthalmology genetics and molecular diagnostics with publications in top journals such as science jama genetics medicine and human molecular genetics. Thank you so much salmon jessica for coming on the show we're gonna be diving into talking about Different kits that are provided by picture which is powered by full gent. Before we do that. I did want to get a little bit of a reference on what we're going to be talking about today with direct consumers and also the other terms that are kind of related to bat. Sam could you start us out by giving us this frame of reference to understand what a direct consumer test is and what the other terms out. There are sure. Yeah thanks for having us today. So a direct to consumer tests in service pure purest form. Something where the only interaction is between consumer or patient And the company so something like twenty three and me or ancestry dot com or you go online. You get a kit eventually. After giving him a sample they give you a report. And there's no doctor involved in that process While we're talking about today with picture is a provider supported model where there always is a healthcare provider involved a physician and also genetic counseling resources available. And so i think we kind of dive into what that means why. We're doing that way. And i think You had a previous episode in this series that went into some detail there. But what we're talking about today is all in that area of healthcare support provider supported testing. Certainly and if people are interested the first episode of the series really tease that out further. So that's to refresh everyone's memory so thank you for that and one aspect within this that i wanted to talk about was just For those that may not understand or are aware of this. What is the difference between gino. Typing and sequencing. We're gonna be talking about this during the show so in case someone doesn't understand this sam. Could you also explain this concept to our listeners. Yes this is a really important concept. i think So we talk about gino typing. You're talking about looking for a small number of very specific genetic changes so us up be. Rca one is an example here so there's one particular mutation in the brca one gene which is pretty common in certain populations of people Including ashkenazi jewish. People at places like twenty three and me Are able to get their tests verified by the food and drug administration fda for one mutation at a time so one of these changes so they have on their test one b. r. c. a. One mutation approved for testing Whereas when you do sequencing you can potentially discover any mutation and they're actually thousands and thousands of mutations and beer one which are known to cause increased risk for breast and ovarian cancer in addition to that one which is the most common but most people who are positive. Aren't going to have that one. So we do a gina typing test and it comes back negative. You've only been tested for one thing. It's like going to the grocery store and the person comes out of the grocery store and say did you get eggs. yes or no And they say no and their card is full of stuff You have no idea what's in the rest of that cart. So sequencing is looking at everything in a given gene that we know how to look for. That is an interesting analogy. Haven't heard before. I might have to use that one in the future. Credit you I think that this is a really important concept people to understand that geno. Typing is limited. It if it finds what you you're looking for great but if it doesn't that doesn't necessarily mean there isn't something else happening that is affecting the gene and the way it functions and so i think that's an important concept to understand when we're now talking about the different kits that genetic provides powered by full genetics. Here and one of those picture parenting. We're going to talk about three today. While four for including our covid nineteen tests. Little kind of tease. Now talk about the end of the show but for now the first is picture parenting so this is carrier screening Sam could you explain what carrier screening is and the types conditions that are being identified through this type of screening. Yes for carrier screening. You're looking for things where the parents are healthy. But they have soared. This ticking time bomb. That can happen in their kids where the kids can have a disease They're actually Conditions that behave this way. Some of the most famous ones are cystic fibrosis the fallacy mia's There's excellent conditions like duchenne muscular dystrophy. Where the mother is a carrier and her sons are at very high risk to have a v oliver sons. A fifty percent risk of having a muscular dystrophy disease as a carrier screening checks parents to see what they have Ideally you check both parents and compare them and see if they h- they share any Genes that are both mutated. Because that's when there's going to be a really strong risk for a kid to have the disease and jessica bringing in the genetic counseling perspective is someone that Counselors we meet with patients to discuss this type of testing and see if this fits in with their family planning and where they're at in that process. What is the most ideal time to have this carrier screening done. Yeah that's a really good question you ask. And of course my overall genetic counselor answer will be no ideal time that fits everybody Each patient's journey is definitely different. But this task can definitely be taken before during or after pregnancy and actually believe it or not. The american college of medical genetics states that carry screening is most ideal before pregnancy because it really does allow and enable couples to learn their reproductive risks and really kind of consider the whole picture to get complete range of what they're different reproductive options are and i get. This really does kind of allowing what pictures values to just in helping. Individuals really be proactive about their health and their families health so there isn't too early of time to get carrier testing from carrier screening from my understanding. I did one of the picture. Parenting kits to get an understanding of mine. I'm not trying to conceive at the moment. That's that's far off for me but it was interesting to see What conditions. I may be a carrier for and learning that Through doing it the next kit that you have is picture newborn. So we're kind of going along with the life cycle here of now When someone is actually parents and Giving birth and having a brand new baby What is this testing exactly. As sick babies were for healthy babies. A great question as well so picture. Newborn is really geared towards healthy babies. You're likely to think if there's a significantly ill baby and early on in pregnancy those will probably be identified with newborn screening They really do need that immediate care. And what picture. Newborn is there to kind of help with complementing things. Like newborn screening would be with babies. That might seem healthy at birth but might have underlying health conditions. Excuse me that might appear within first couple of days or a few months of life and a good deal of that would be like mcat or any of the fatty ox fatty acid oxidation disorders metabolic condition might not be picked up right away but periods of illness or fast these kind of conditions can arise. And if you're able to catch that and have a known risk before you can kind of change change the outcome of of these these potential symptoms that could be caused by having this condition so in a sense. It's almost an extra step to newborn screening. Most babies have newborn screening. It's opt out process and most of the states that's going to differ a little bit State by state. But this is kind of giving extra information because the newborn screening. That's more looking at its of dried blood spot that you take from the prick on the babies. He'll so you're looking at more biochemical different proteins and that sense whereas this test we're talking about genetic tests on the show today so we're looking more to see if the baby has a certain condition or is it is has a genetic marker for that. Yeah absolutely we like to kind of look at it as like a safety net. Not all the time is newborn screening in going to pick up this particular metabolites on the blood spots and And is not fully diagnostics. So by going through and doing gene sequencing and looking at the baby's actual dna is more of a diagnostic Confirmation that this child will develop or has increased risk of developing these particular disorder reported to remember that Or just a recognize that the state does with metabolic newborn screening is maybe the most successful public health initiative ever It's really been an amazing change Diseases like fennel. Keaton area used to cause severe intellectual disability Throughout the lifetime and newborn screening of the metabolites. I talking about what the heel prick the key. The key reason that works is because it's something that you can do on a large number of people you can pick up the people who might be Affected and the key there is that there's something you can do about it with. Pk you you avoid. Certain foods a lot of foods but they they will live to be completely healthy In terms of their metabolic disease so we did with the new picture. Newborn is to try to find the conditions that would be tested for by the state. If there was something in that he'll that they could test for so meeting all the same kinds of standards of about medical actionability and screening efficacy Basically we we started A room with the conference a conference of white board of. How do you pick a unseen for newborn screening. And just remove the last thing which is a metabolite that we can test for and changed into. There's a gene we test for. And that's how we kinda came up with this list. So one example is immunodeficiencies. There's one immunodeficiency test that's done for some kids in some states. But then there's about two dozen different genetic ones that you can test for the same specimen And it's the same type of disease the exact same reasoning that you'd want a test for it in a healthy warrant so i think it's a really exciting New way of thinking about this. We think eventually Should have this And right now. It's really just getting our toes in the water. As a supplement to the state of were screaming. We don't imagine it replacing newborn screening. 'cause they weren't screening as currently conceived is so effective. There's no reason to stop doing it. but this can sort of act on top of it. it's interesting that you fill in the gaps. Where newborn screening can't quite go as you said with newborn screening. You have to have certain markers really to be able to say okay. We found this in. This is elevating newborns risk for having certain condition and then they go on to do further testing. Because it's newborn screening we're screening newborns now with yours. You're talking about being more diagnostic test and able to test for other conditions so kind of between the two. You're able to cover quite a few conditions. And now linking this back to the carrier screening that we were talking about at the beginning of the show. If a couple had negative carrier screening is doing a newborn test repetitive. Is it the same conditions that are on your carrier screening as would come up on the newborn testing here. So it's it's not the same but there's some overlap they should Make ven diagram. We can put on your blog. There's there's definitely something yeah The key difference. With the newborn ones are some of these genes are ones that are autosomal dominant or even excellent dominant Or even excellent recessive. They're ones where the mutation could be a new mutation occurring. That's only in the baby. And so if you test the parents they're going to be negative But there could be a new mutation called de novo In the baby There's really no other way to test for that right now And so there are no quite a number of conditions on our newborn Because newborn genetic analysis we avoid screening because as he talked about. It's not really screening. It's a diagnostic test So there are a number here that are dominant where the child would have the mutation and the parents would be negative. And that's a really good point that a lot of these conditions when we talk about genetics i think people often think of oh being passed down through families but a lot of genetic conditions are novo so kind of randomly happen and so there's a mistake somewhere And that's not gonna show up in the parents if your screen the parents. That's not going to end up giving a diagnosis to a baby that is affected by one of these conditions. What i'm also learning with this is that you are only including early onset conditions jessica. A why is this yeah. I think that's just kind of going back to what sam was saying earlier with. Why we picked some of these genes included a lot of the times These conditions are occurring earlier on pretty much under the age of ten. And we really believed that knowing. These risks ahead of time can really help pants prepare for their child's life in the quality of their living so early identification for these disorders can help with early prevention and management really makes the parents feel empowered. They have options. They know that they're really doing everything they can to protect the future. Health of their children so That would say is one of the main reasons why we have these early onset condition and the the counting term we like to use his autonomy right. So if there's something like like me are for example That's going to be an adult onset condition where there's no risk until that person is the age of eighteen Let's just wait until that person's eighteen and then they can get. They can decide whether or not they want to be tested So you know that's something. Another thing that was on our white board at the beginning was the no medical ethics. We don't like in this to make a quick buck. We want to use the technology to improve health And in order to improve healthy have to be careful not to make things worse. I do no harm in so doing you know You know adult neurological conditions like something like parkinson's disease alzheimer's dementia. On a on a baby. I think is just wildly You know just not appropriate and and has more likely is more likely to do harm to that individual's psyche then to actually help them. And as you said you want to allow people to make that decision for themselves if it's not a condition that's going to affect them under the age of eighteen if it's not a pediatric condition or going to have an onset or have symptoms while they're still a child then usually it's something we like to save until someone is adult and can make the decisions on their own and that leads into your other kit which has picture wellness which is looking at a certain number of conditions that kind of fall more into this category of being affected. You know when you're eighteen or older this is based on the acm g fifty nine. Sam can you explain what that even means for people that have never heard this before. Yeah for sure. So the american college of medical genetics and genomics. They've added a g but everybody kind of forgets that that's the thing because acm gee-gee just sounds like you made a mistake But that's that's the medical profession the professional society that That is in charge of licensing. Jack's professionals specifically medical geneticists and laboratory geneticists like myself And so that group Came out with a list of originally fifty seven genes That they They're committee had decided sort of met several criteria First of all that they were high risk so that if you have a mutation in one of those genes you're very likely to have the condition that and that again the idea of medical actionability that there's something you can do about it on that there's You know for cancer. You can do increased surveillance for a lot of these are cardiac i. We'll talk about sort of This the seasons particular. But you know you can do things like Maybe installed pacemaker before someone has a dies of a heart attack so there is that sort of the the list is these genes where they're well established The jags community is is very confident in these genes and there's medical actionability surrounding it The the list raising now the fifty nine actually version two point. Oh so they publish that list and then Got a lot of feedback from People around the the community around the world gen-x professional saying. Hey you forgot about this gene. Or hey this actually one of these genes. We're not so sure about and so They published a sort of an updated. Version called those secondary findings. Two point oh list of fifty nine jeans And and that's that's we basically developed a laboratory tests that can evaluate exactly those fifty nine jeans and so this is not a choice that just two people sat down or like. Oh let's do these fifty nine. This has really been in the in the genetics community refined discussed and debated to see. Okay what are these final nine jeans at least for now i'm sure there will be You know in the future with more research. This'll be reevaluated. But if someone is healthy just why would they order this test. If they are healthy themselves maybe they have a good family history. Why would someone want to order picture. Wellness right yeah. I mean i just personally. I think we're in a culture where we really just want to kind of being control and being control of our health and anything that we can really kind of get our hands on that can can help with prevention management screening to do that You know we're likely gonna kind of jump onto and i mean there's just there's so many complexities and certainty in our health. And if we have the opportunity to be proactive and take a picture wellness tests to kind figure. These things out and learn our risk ahead of time a really like i keep coming back to this term but just feeling empowered and being able to be educated about yourself in your health and being able to take this information and like say i've said especially with acm g fifty nine leasings clinically. We can actually put action to to these types of results. So i mean to each their own but most of the time. We really liked to kind of have control of our health and able to be proactive about. I would say that this is probably the reason why people want to in would Order this type of testing thing. I caught him in bent to talk about and didn't about of how this list came about originally was not sort of in the context of testing healthy individuals who is actually in the context of testing People who are already getting genetic test because they have a genetic disease or a suspected genetic disease But you're doing something like an ex omer a genome sequence where you're looking. You have data for you. Know twenty thousand genes to a whole exit test There was a question about what if you found a mutation one of these genes in someone who you're testing for something else And so that's why it's called sort of a secondary incidental findings lists The the need to come up with a list of sprung from that it was okay. So we've tested this person I come back to be a million times. But i think it's it's a good one Because it people are familiar with it. What some people may not be familiar with. Is that People who have both copies of the gene. Mutated can absolutely called fanconi. Anemia which is a severe pediatric condition. has skeletal abnormalities. And and admiral is the blood So you might have a kid who has what looks like fanconi anemia. And you're doing. Xm you can find the genetic causes of their fanconi. Anemia also find a a mutation. That might be one of those. The other fanconi anemia genes. But you also find a beer see two mutation that means they're going to have increased for ovarian and breast cancer later in their life So there's there's a lot of complexity and so they ace. Acm wanted to come out with a list of say. Like if you're gonna do an xm sequence originally said you must test for all these whether the person wants it or not And there's a lot of feedback About that to say What people should be given the choice to opt out. If it's a child was a severe. We don't really need to know if they have risk for breast cancer So the the idea to opt in or opt out kind of came about the those conversations always kinda turned back towards well if you're going to test somebody with a genetic disease that's unrelated to these genes. And you're saying that that's medically necessary What about everyone else you know. Why are we testing the parents of those people. Oftentimes we are testing the parents. Those people do we tell them about their results. Got you know the served this like unraveling of the sweater. That kind a happened where it's like. Wait a second. Why aren't we doing population screening on everyone And i think as just with saying we're in a society where many people would like to have this information even if they don't have a positive personal family history It can be very difficult for them to get a test right now. If you wanna know your status for brca if you don't have a history You until recently. That'd be very very expensive tests that you maybe a physician would not just wouldn't do it for you And so The picture wellness really gives the power to the individual to say will. I'm interested in knowing this information. The technology is there We can do it and can we do it in a safe way. That's affordable You know and and so. I think we kind of resort threatening that needle. I think it's important for people to have this option as you said when they're getting say whole genome or whole excellent sequencing. I've been with patients and we're they're learning more about this and saying okay and my opting in to get this information or not and having that be an option and this is one area of genetics isn't necessarily all areas where there is a consensus on this of what these conditions are. Because they're actionable that patients can do something about him in that it is advantageous for them to learn about it if they so choose So i think that's interesting that you know that checks kuni has been able to come together For these conditions and will be interesting to see if other conditions are add list and at what point they are but before we end the show. I did want to talk about one more kit. You guys offer. And that is a recent kit due to the pandemic the covid nineteen Sam how and when did fulgence start doing cova testing. Yes oh back in february. My boss of twenty twenty. My boss started saying you know we were working on developing a test for for covid For this this virus and if you remember this this sort of before it was a big deal in the united states It had been it. Had first occurred in china and then you know there are some other countries italy and spain And i was kind of shocked Because i've you know in my training. i did some work with infectious diseases When i was a student but it's been a while and it's not something that are that i was used to doing and so You know it really became our number. One project develop a cova test And i gotta say it's just been amazing to be a part of this team to come together like this so quickly where we went from not doing any infectious disease testing. Not even really having the right equipment to having a fully operational lab We're now serving los angeles county in our local neighborhoods and also you know many other states. So we've been running a diagnostic testing for covid since Since late march of twenty twenty And you know bringing it into the onto the picture platform with something. We thought about early on and wanted to make sure that we did it right. Because you know hopefully People are able to go out and and get testing You know there's a lot of like drive throughs and stuff where you can do it Different parts of the country. But it's not. It's not like broadly available to anyone who wants it in every place and so We brought in the same types of the same type of approach. We brought to a picture wellness and picture parenting and picture newborn To be able to offer kovic testing. So it's a it's a different collection method than these. Oh for angel swab. It's at we have a video and stuff it's used it up your nose instead of in your mouth otherwise it's it's actually kinda similarly how you go online and order the test. I think just spry could do a better job explaining how that process works. Yeah yeah so. I mean it is like sam said. It's it's similar to the platform that we have set up for a picture where you know you're able to be able to order online at home safe in your home especially with the risk of infection being really high where it's at so this is in the safety of your home and not only that but it is mediated by physician so when you hop on our website at picture. Genetics dot com backslash cova. Nineteen you are able to order the tests. You take a quick eligibility questionnaire that set out by the cdc and it's approved by the third party physician company that we're working with portal is created. Everything is then mailed to you. You collect your sample. You mail it back to us. And as i mentioned there's a video with how to take the Nato fangio swab. There's written instructions provided as well and then your results are available within Your puerto within one to two days of after he sent in your sample and then following that again with this whole concept w really light at picture to be able to help guide and support throughout the entire process. You're able to call and schedule a consultation following following your results regardless of whether or not they're positive or negative and that goes to all of our picture Picture product lines with genetic counseling support. At the end i think is one of the biggest again differentiator between the direct to consumer testing versus the physician and Healthcare mediated. We really want to provide that support at the end. If you have follow up questions again whether or not your results or negative or positive to be able to provide an shed some light inside onto those things those those individuals are there to help you when you had like. Well thank you so much for offering the cova task because there are people that may not be able to drive out and get tested in person so being able to have kids into their house. I'm sure is just great for so many people and it really is very quick and easy to order one. I think i ordered one and maybe four minutes three minutes. Something like that so It was very quick and just really appreciate you guys stepping up during the pandemic to offer your part as sam had mentioned You had previously done. Infectious diseases testing. So this was a new front for you guys and kudos to you for being able to offer this test and thank you. In general for coming onto this episode we explored a lot of kits that you offer just the concepts behind them in what people should be thinking about an understanding when it comes to these kits and that at the end of the day. You also offer genetic counseling with all of your kids so even if they're not soaking everything in during this episode. that's something that they can get personalized. Genetic counseling So thanks so much. This has been a treat to explore all this with you guys. Thank you thank you. If you're interested in getting your own ca doing a giveaway so head over to our social media by searching deeny today on twitter. Instagram facebook to enter to win your own free picture genetics kit. And if you can't wait to find out if you have one or you want multiple kits had over to picture. Genetics dot com with promo code. Dna today for twenty five percent off and free shipping again. The code is dini today for that twenty five percent off and free shipping at picture genetics dot com and all the links we've mentioned today throughout the episode other episodes they're all at dna podcast dot com. Go there all the information you need. Is there including the contact form on our website. If you have questions you wanna directly. Email in email info at dna. Podcast dot com. You can send questions jessica sam. I will forward those on and thank you again for everyone that helps to get dna nominated in the podcast wards. If you're one of those people don't forget to check your email to see if you're one of the lucky few. That has the power to vote for the winner. So we've been nominated but still up for grabs of. Who's going to win the award. Now here's how it works through. Random selection five thousand listeners were selected to be able to vote. So if you're one of these people it's your job to help get the show more votes and hopefully a win for us. So if you're not sure if you're one of those people head over to podcast awards dot com and click that blue box in the middle of the page reads voting open and sign in and it will tell you if you are eligible or not so again big. Thank you another way that you can help. The show received more visibility is giving us a rating review on. I tunes are now. We call it. Cast so definitely be sure to do that. You haven't already thanks for listening and join me next time to learn discover new advances in the world of genetics. You almeida dna chemical.

american college of medical ge fulgence Sam almeida de jessica sheils samuel strom Fulgence David geffen school of medicin gino science jama genetics medicine jessica dystrophy disease fda fanconi Sarah lawrence sam parkinson's disease anemia muscular dystrophy ovarian cancer
Dr. Shaunda Grisby  Surgical Oncologist

Discover Lafayette

43:44 min | 4 months ago

Dr. Shaunda Grisby Surgical Oncologist

"Off, this is Jane Swift and you're listening to discover Lafayette a podcast dedicated to the people in Rich culture of Lafayette the gateway to sell the Louisiana. I'd like to thank our sponsors who make our podcast possible first. Iberiabank and First Horizon who are now One bank to walk relationship-driven Banks. Both leaders in the industry have officially joined forces the combination of iberiabank and First Horizon creates a leading financial services company dedicated to enriching the lives of their clients Associates and their communities. And also like to thank Lafayette General Health who has joined the Oscar Health family and is now Oscar Lafayette General as one Health System Oscar Lafayette General will provide expounded services and enhanced care from the familiar faces. You already trust Ochsner Lafayette general means more resources to help solve healthcare's toughest problems reinvesting in our communities and being further committed to health and wellness oschner Lafayette General together means more learn more today at together means more. Org today's guest is dr. Shonda risking a general surgeon who is fellowship-trained in breast Surgical Oncology with Advanced skills and treatment of breast disease has a specialized has and surgical techniques for the treatment of benign and malignant breast diseases as well as patients at high risk for breast cancer. She is with Ochsner Lafayette General wage. Dr. Grisby is joining us during breast cancer awareness month a yearly events held each October to increase awareness of the disease doctor. Grisby was recently honored wage 2020 Spirit of Hope honoree by the American Cancer Society and recognition of her work to increase breast health originally from North California doctor Grisby earned a doctor of medicine from the David Geffen school of medicine at UCLA. She recently joined the Acadiana Community from Michigan where she completed a fellowship in breast Surgical Oncology according to the city see breast cancer is the most common cancer in women aside from some types of skin cancer no matter the race or ethnicity. Unfortunately, Louisiana is ranked number three in breast cancer mortality information is powerful and we're fortunate to have an expert with us today to share the latest on breast cancer in the advancements in the field. Dr. Chandra Bose. Thank you for joining us on Discover Lafayette. All right, my pleasure. Yeah, so we're here early in the morning and you can hear the birds singing outside of my window. We're unzoom wage. It's definitely early it very kind to take time out of your day. I understand your days or packed from way before sunup to wait until sundown. Yes. Yes. Yes. Yeah, really very busy. I am I'm happy to be here and and again like you said before my goal is to just be aware and to make people aware. Yeah, so I'm happy so you joined our community in 2017 if I understand it, right and and kind of jumped right in involved very much did actually so yeah when I first got here I wanted to bring myself to the community and and let people know that I was around and and my ultimate goal was just took to to allow people to know that breast disease. Is is a big deal as you pointed out in Louisiana. It's it's one of the top three areas where mortality rate was highest and that's part of the reason why I ended up in Louisiana people always ask me you're from California you end up here and and really family's from Louisiana originally my parents and some of the north Shreveport and Monroe Area and when I was looking for areas to go after faith, my fellowship My ultimate goal was to take all the knowledge that I gained and bring it to a place or a space where I felt like it was going to be utilized. And so Monday when I looked around at different communities and I had family who lived here it piqued my interest. I looked at to the state statistics and things and I said, okay. Well, I'm I think I might be able to do some good and then came down here and if you and I and of course the culture too cold, I guess of me right away, even when I was on my plane trip down for an interview and dead. I think that the hospital system has been very supportive. Their ultimate goal was my ultimate goal and I think that was a big driving force for me because you really need that support from the community and from the hospital system went down to really put out messages of of good health. And so yeah, that's essentially what brought me down to this area and I've been moving ever since like people share off. What motivated you to go into medicine at the beginning. I know that you have a personal story that touched your heart, but I think it's interesting you're empowering for other women to here's a highly specialized field in this forever for you to get your your degree and your residency requirements and all but what what was the original impetus for you to go into medicine so actually medicine in general one day woke up when I was in my, you know early childhood and said I'm going to be doctor so that's just I didn't have any Pre-exposure, I guess I just said one day out of not sure what I saw or what speak speak speak that interest but as I got into a parts of my life, I actually spent time with several people in my community growing up and when I said it reminded me doctor so I actually spent time with I thought I want to be an Susie ologist. I don't want to make sure there's several different things and that exposure to those walls in high school, but then but really kind of peaked me my my antenna should I say is a friend's sister was just completely law school and found a breast lump and essentially he didn't live very long and that was I think very shocking to like all of us in you know, I was young and I still learning about life at that time, but I thought wow that's that's yeah. He's very much it was very much, you know in our early thirties very much like, you know, she was about to hit a primer. It's done all this hard work and and then you hit with the bombshell such as that it was it was a very enlightening for me and then I segue into surgery over over time because I I feel like I had a autistic mindset I guess and that's kind of how I thought it I think about circling I guess in general for me. I like to draw I like to paint and that way just up with my hands. And so that's really what Segway me down the surgery past I think and and then as a medical student in the combined program of Trials are in David Geffen School of Medicine in that program was meant to Foster development of Physicians who wanted to go out into the communities that had low either socioeconomic status or burdens of disease that were difficult or the community was difficult. Should I say in urban areas? And so that fostering them together made me kind of I guess part of who I am and why I'm even coming down to a place where I feel like I can log Cuz that's kind of just been my role over my path and then when I got into my residency for general surgery, I got even more honed into breast than you know, I have I have made friends from all kinds and I you know nursing staff and one of the nursing staff that I was really close with found a lump and they found I went through her whole process with her off the boxes with it went through her physical consultations with our attendings at the time and and like the whole litter surgery. I mean the whole process and today she still cancer-free and today we still have many conversations about just life and checking on one another and that is just the person that I feel like I am I think when it comes to taking care of patients with breast issues doctors breast cancer, but it's very anxiety-provoking and I feel it takes a personality to really truly try to make someone feel comfortable even when it's not going to end up. Okay, I guess but God And so I felt like I had that personality and ever since then I kind of just hit the ground running with getting experiences. I rotated at Sloan-Kettering and during my residency program cuz my mom was in a small area of Pennsylvania and I we didn't have everything all together. We had a lot of we had a lot of breast disease and I did a lot of breast surgery but getting a program together and how that structure should look up with that looks like that's what led me to go do too much rotation is Sloan-Kettering and of course, there are Powerhouse of breast Sloan-Kettering in New York City. And so that just also kind of complicated, I need to get any do the spell see if I need to make sure that I have these other things, you know, and that's that's essentially how that line of process is going and and I love all my experiences have been leading to this point. I think so. I have a question. I looked up. You know, how do you become a surgical oncologist would you explain the number of years like, you know just go to medical school and it's not just a residency. This is a a number. She was process get where you are what you explain the years and yeah, so obviously a medical schools usually for years and then following that musical into a general surgery residency and a general surgery residency can be anywhere between five years to seven years. And that's just depending on if you take yours off for research or what have you so six years is what I did for Joel surgery and then I did an additional year off focused on breast Surgical Oncology. There is Surgical Oncology general which is 2 years because they're doing everything Surgical Oncology, but I clearly wanted to focus on breasts. I took the the best route and did a page dedicated to that and during that year you are rotating with various different breast surgeons. You also are rotating with Radiology in time going through Radiology yourself going through the biopsies Gene. So you become well-versed in looking at Imaging and again, I get a lot of that already, but they were just some more to solidify that we also spent time in the pathology Labs grossing specimens looking at things. Yep. No that process very well spent time in radiation oncology looking at how that process goes. So that's you know, how can I how can I explain that to a patient before they get there? That's why I'm I'm able to do that because I've sat in those spaces. I've done those consultations. I've done all the steps that radiation oncologist would have taken and then we also rotate with medical oncology. Well and so we learned a lot about the chemotherapy the side effects of those issues with Benefits the hormone blockers as I call them or endocrine therapy all that stuff, you know how to manage bone disease and Bone like all that was encompassed in my fellowship which to me made me a very well-rounded and of course, we did a lot of plastics and I did a lot of breasts and Plastics or during my entire trouble trying so long. I I learned both of those other and pretty much all aspects of breasts as you know flaps all that kind of stuff. Do I do all the Plastics now? No, but I do have a vast knowledge and and I think that has helped me to page. Navigate patience of do a process where I'm able to kind of give them a little bit of an explanation of how that looks or what it looks like what to expect when they're making decisions about treatments because that's really the biggest point is just making decisions based off of somewhat is a little bit and how do you you know coax them through those what ifs and I still learning process for me actually because I find that it's such a abundance of knowledge is getting at one time. It could be very very they probably don't hear most of what the doctors are telling them which walk us through it was your typical page that you have one. How do people find their way to Austin or life in general and talk to Chris be like just typically through their GPS like what happens kind of people end up with you. So let's say somebody just getting their screening mammograms regularly. They can either present you the option of lots of your breast center the surrounding breast centers like breast center of Acadiana and the other ones in the community wage. And what happens is our Radiologists are all Fellowship training as well as similar to myself where they've done dedicated time outside of the general Radiology training specifically reading breasts. And so that's what I think with these type of institutions in a band changes that that's all the way y'all just are doing so they are looking at mammograms day in and day out and then if they find something generally what happens is that the radiologist will call back and we try to give them a heads up explain them why we're calling them back and do additional Imaging. So a screening mammogram is usually meant just a screen. We're not going into like dive into anything but looking to see something to dive into and so when it comes when they come back, they're getting something called a diagnostic workup now because now we're trying to see there's something to diagnose and so therefore we're going to do much more, you know, a comprehensive intensely looking at a particular spot or what have you but included ultrasound things like that and then usually happens is that if there's any indication or need for biopsy the dog But y'all just hear really good at bringing the patient in discussing that Imaging let them know what they're seeing and why they're recommending a biopsy scheduling that Bob see if it needs to be done. And then what's The Bobbsey on it takes a couple of days for that result to come back and our Radiology some really invested in we're all World changed but they try to do is make sure they give them and they speak to them about their past results before they come to see me so there should be aware and I'm at the first person telling them. Although that's also happened. And so then once they come to me, it's more. Of a of a process of kind of going through and making sure they understand what it is that they have been diagnosed with that's using my biggest Point as I want them to understand it at least enough to be able to walk to tell somebody else about it because what happens when they get out of here, someone asked him much what happens what they say and it's like they've gotten a slew of information. So I I usually tell people a very I try to bring it down to a level where they think that they can tell a story I try to tell a story and so I would say okay you have these, you know looked up some great batteries like a great and it has these big fines but the vines are like a plumbing system and so you can tell people that suck you have cancer but it's it hasn't sprung a leak. It's in the plumbing system that's considered invasive right? But if it's brings a week, then you get a little cuddle and that's what we see, you know, and so now you have and what we call an invasive cancer cuz now you have a little puddle in the bridge. It looks like Google Maps and so that's kind of how I explain it. So that way when someone just letting somebody else it comes across in a way that it's understandable. So that's my role and then obviously breaking down their options and birth Really when things get a little bit trickier because now it's this still somewhat is on the table for patients sometimes so like you asked me what type of patient comes it's usually somebody who has not felt anything but did not expect to have General mammogram. That's the usual patient that I see and so when they it wasn't like they were pumped it because there was something going on in their body so they are still in. A lot of the times so that's when I try to make sure that they are aware of what's going on and most people that we catch things over here really early stages. So like early, you know stage one stage small, you know, relatively little issue with the lymph nodes at the time on at least initial Imaging of clinical exam. But essentially it's my role at that point is just need to get them to understand where they are what their stages what options exist and then from those options giving them the risk and benefits of you know surgery at that point, but I can give a little bit of a heads up of these are still questions and out log. We need to do surgery first. There are occasions obviously what people have come later on and they have had a mass they felt or it's not to say later on because sometimes you'll find that some cancers can go faster. Right? So you'll have a have had a normal mammogram six months ago. But now you feel something so then it will something, you know, they prompt to work up and it's a much you start off with a diagnostic thing. You're not really strong anymore because there's actually a problem or does that concern? So that's what I try to go out and community and teach is that if you feel something see something something's changed not normal to you. Then you need to make to somebody's attention but not wait for your schedule screening because another screen anymore. There's a problem and we need to and I I usually do a shout back we do what a diagnostic what and I that's how I teach it to the to the community because I want them to be ingrained in their mind that is a problem needs to be a diagnostic workup and you're not waiting for your screening mammogram that happen in three months if it's already scheduled so you manage breast cancer hair and not all of your Patients end up having surgery. I know you're a surgical oncologist. But you managed here once people present with breast cancer. Correct? Correct. So sometimes you know, it gets to a point where surgeries not necessarily the first step. It may be part of the process but it's not always the first step but they using come to me first so we can kind of talk about what they I do a lot of the explaining a joke answer is and so then I say, okay. These are the ways we can go I usually have a nice diagram or a spreadsheet. I do a lot of drawing. I have a a purposely created a whiteboard wall am constantly that we use that I do a lot of drawing cuz I think drawing one helped me so down because I talk fast but it also helps the patient kind of visually follow the steps of what I'm saying, but I usually give them a little tree algorithm. Okay, this is your local things which meeting at the local level, which means we're treating your breasts in your armpit or your your lymph nodes. I have pictures and then I say these are your thoughts. Some things are treating your system is treating your head to toe that is stuff that we need. So I say, you know, these are usually a part of the treatments. What are you looking at it for a circle those ones that their candidate for sometimes we go to our female therapist first, for example, and and it's for particular reasons. Let's say someone has a large mass and that's really all that. The problem is there's no real evidence that can trust anywhere else, but they really took a smaller breast size and that mass is taking a majority of the breast but they want me to do a breast-conserving surgery which means that they want me to preserve their breasts. And so sometimes that large mass won't let me do that. But let me give somebody chemo we can sometimes shrink it down to a smaller size which would allow me to potential or the opportunity to do that for that patient. That's one way sometimes we go to chemo first other times. It's just you know, lymph nodes are involved or a type of cancer of such as one that's not hormonal morally sensitive. For example, sometimes they are that are benefited with chemo first. We found that song. Research and studies that when they do chemo first and then I bring them back to surgery that there's a good response rate roughly 60% around there that people who've had chemo first in the setting of hormone-sensitive in a negative cancer can have actually a complete response that came on which is actually a benefit to that patient. So there's different times we have those kind of conversations and or home and and so there are times where yes, sir just not happen at all as well. But it just it's always difficult conversation. Sometimes a relatively new graduate with the education. Can you kind of tell us where we are? I know there's been a lot of advancements with our high mortality rate in Louisiana. Is I guess two things doctor crispy. It seems like medicine is Advanced much. But yet you have to go to get the treatment for the medicine to help you. So, where where are we in? Like how would you compare where we are today to maybe where we were Thirty or forty years ago. Like, you know, if you can touch on that definitely I definitely have made tremendous strides in the management and care and treatment of breast cancer thirty years ago. I would tell you we would probably doing a lot more aggressive surgery which caused more to figuring out comes for women and even men who are dealing with breast cancer would take the muscle that was underlying the the breast tissue which is your chest muscle your pets loss muscle and that would cause the ribs to be disfigured people quite a bit cuz we thought we really need to get all this out. We really need to remove it surgically, but when we Advanced seating using things like radiation and when we've Advanced you using birth You know more of our biology now, we know a little bit more about the tumor biology we've developed other ways to treat these cancers and and can limit some of that surgical mortgage or disfigurement or long-term problems that exist after surgery. And so we've gone from the whole mastectomy radical what we've taken the muscles and everything underneath to just you know, just take in the breast tissue sampling of knows which we learn from the melanoma World. Actually that we can actually map a lymph node and how the body drains like infection and we learn that actually from melanomas off and then we spoke with it over to rest and now we that's what the the whole box your Sentinel lymph node biopsy came from actually and so they're now we do less surgery in the excellent because what we found is that I tell people you getting cut on your hand and you need to clear the infection the infection occurs back of the arm this direction. So if we take to lymph nodes, we don't affect the highway too much but if you cut a whole month Yeah, you just created a big gap in the highway. So how's it going back there? It doesn't it causes swelling and back up and get in college. We learn it. That was actually not a good thing cuz when somebody develops that if they if they change and develop it early for example, and they have a for certain period of time that can also increase your risk for a secondary cancer of that arm or you know, it's called Angeles. So there's there's always a catch twenty-two and and that's what I tell people we're going to try to treat something but we can potentially cause another issue down the line potential right? That's that's really but the the the risk of that is now less than it used to be because we don't do as much money. So that's kind of that's kind of how that process goes. But essentially like you're right like the we made advancements in chemotherapies. I mean people with metastatic disease which means people had cancer somewhere outside of the breastbone brain things like that and actually survive much longer because of the advancements in some of the chemotherapy drugs are not even chemotherapy drugs. It could be a pillow. That's a chemotherapy treatments. Assume that people can take but it has been a really good job of prolonging life and and people can go five ten you're you know years with with with cancer outside of the breast and but I think what you're what you're looking to to is, you know, when access to care or knowledge of the access-to-care, you know, I find that's also part of the problem. I think that's a secure is part of it, but it's also known no, Being educated about things and so that's one of my biggest things like last year. I did a lot of Education out into the smaller communities outside because I realized I work in University Hospital. Well, so I was wondering about that. Yeah, that is where I think I see what we do a lot of evaluations of numbers and what things look like stage or staged compared to other cancer wage, um centers and things and we find unfortunately chances at a later stage at University Hospital. And again, I think that leads to access to care ability to pay for treatments so or even ability to take time off and works or socioeconomic status. There's a lot of unfortunate variables that exists. Well, they're probably they're not getting mammograms. They're they're not probably taking preventive measures because I thought you said their their life circumstances don't really open it one day off is a problem one day off of them. They keep me like when they they don't go to you know, so that's just it's it's a different. You know, so I think the other you know, the other part of this is bringing those mammograms to them and I think that's our next phase of course coping, puts cameras on we do these things, but I would love for us to teach you how to get to some of these communities and try to get some of these mammograms done. But my biggest point I tell people well what happens after screening mammograms done that says a mammogram done in the community. We do all you know, I figured out there they get their mammogram done for free, but then they need additional work up. And then how does that process work for them? And that's the other part. I think we've done a good job of trying to get out there and do the screening, but how about the Financial support of the rest of that process for someone who actually has something that needs to be done, you know or prevent something from occurring, you know on the line, you know, when do women a recommended that we get mammograms when we start so I often tell people to see it a time for most of us is going to be about 40 years of age. However, if you had a family member Mama sister a daughter, for example somewhere in the first degree relative area that has had a cancer at say forty then we usually recommend that you start your marriage two years before would you be dirty but you don't want to get a mammogram before 8:30, not that you can't it's just at the breast tissue is always in and let's more developmental State and it's difficult to read a mammogram at a younger patients. So let's say somebody got diagnosed at 35 in the family. Like someone's mom died of 35. Someone's coming in to talk to me about what do I get screening wage? For that person. We don't start mammograms a 25 we might start an MRI or something like that 25 and then the mammograms would not start until 30 though, you know, so it's still ten years before but not before 8:30. So the standard time for average-risk person is forty. I wish y'all had some magic wand where you could just wave it. What is the most uncomfortable thing and I've had to go back and I'm wondering it's going to take a woman to invent some scan thing where you can just be there like going through an airport and just kind of let get scanned. You know what I'm saying? Yeah. It is yeah, you know, but yeah, I do agree. It's not it's not the most comfortable in the world originally in and it's necessary. But I have a friend. I'm just going to share loss of this friend of mine Baton Rouge said, she had a associate at work and she was getting a mammogram in the Lights Went Out in the facility. And so of course she's in the middle of the squish. Stuff. Yeah, you know what? I mean? I mean adult work now, but yeah that had to be a man that came up with that and I don't mean any disrespect but it's there's gotta be some way to improve this and there will be right you're going to be at work in progress. I'm always I'm always thinking always thinking of how can we can make this experience better? Yeah. There's definitely I have because like man, I think I got bruised just from this man right now. I know I'm curious about how close it has affected your patience. I know that with the sit-down and surgeries. It wasn't just elective surgeries. There were many surgeries that were postponed has that affected your ability and this year has it affected your ability to treat your patients that needed surgical intervention. Yes, so it did have an effect on cheese Halloween went about treating things. So essentially what was happening is because we had made so much advancements in the treatment of breast cancer the society Is would say okay. Well if someone has early-stage cancer of the breast theoretically to put them on a hormone pill if it was hormone-sensitive and Stave off usually the growth or the progression of a page ideals. And so that segue into US using that particular approach. More frequently than we normally would but and then we will follow that up with a you know, follow-up Imaging to make sure things haven't progressed in clinical exam to make nests issue is critical exams were still need needed to happen is something changed if it was something that was felt before and it would put them on there. We need to still do clinical exam. So then at the time you're trying to figure out you can't do telemedicine and then we were telling us and talks and things were going on and do we do this do we do that? And how do we and so that became very difficult to try to figure out who she need really needed to be seen physically who we can kind of see on video and the video things for some of these Pages very difficult. You know, we do have a vast range of patients and age in their technical abilities in so that also became a a factor but yes, it definitely changed some dynamics of how we did things during that time it led to some research studies that happened in the breast world as far as what if we do this first this happening and we do these things and and see what those results. Flights will be happy doing a registry for a recall the code registry because we people were treated in a certain way that was outside of our normal treatment. So it definitely had that that and I think really thought it was I think more of a scary time for the patience because well we as doctors know they'll be okay. You can't be can't really convenient. I wouldn't if I was not knowledgeable about it. You would convince me. That would be okay just sitting here with this, you know with this so that became a you know reassuring patient if they're going to be okay to things hadn't progressed in most in most patients were really aware of that understood but I'm sure in the back of their mind. They're like why me see if I can do anything you want me to see, you know, it's like it's going to be okay cuz we know all these messages to go slow and and then those cases that were little more aggressive than we said. Okay. Well, they would probably get chemo anyway, so let's give them chemo first, right? So but then the questions that come up are well if I'm on chemo my mortgage, right? It was just like on the gate code if I'm not came out cuz now I'm immunocompromised this and that and and in truth be told our consider of a of a katyana did a great job of making sure that the risk to those patients was really low. I think we you know, we make sure that everybody was spread out. I mean, I think when you look at the stats of Kuwait and cancer patients who got caught with its not they're not dead. They were in there but they're not the highest peak of the ones getting the coronavirus. I think we did the world has done a pretty good job of making sure that those patients who were going to be middle compromise in that in that way were able to walk be safe. And so we couldn't even put so when we do keep going to put a little poor tend to kind of protect we weren't even able to do that if I have to go and get his old pink lines. It's it was a different time and I would grab a piece of somewhat back to normalcy. Although obviously we're we're you know, we're still aware of the concern for you know contraction and numbers going to keep going like this. And so that's always a risky thing and and Right here. We are education that's began wiping things, you know washing our hands keeping up, you know face masks on and all those things. So I I want to get into the lifestyle and ways we can prevent cancer but as we do that, dr. Christy, I'm curious. I was thinking about the breast cancer Gene do you test for that? And most of your patients have that genetic predisposition? Like I have so many friends that have had breast cancer and unfortunately it many of them it's it's spread. Yeah, and sometimes they've been cured I'm using that are quotes which I hate and the cancer re-emerges in another Forum years down the line, but the most of your patients are you finding that they have that breast cancer Gene. Truthfully. Most people don't actually have the gene but the we do here we have a pretty organized high risk assessment that goes on during a someone with a dog Is the cancer but also for individuals who may have family histories or concerning, you know, they just going to be a see where the risk lies. And so we do a we have a high risk program that we we start here that we take on that that role too kind of screen and see what people are see who needs additional screening Imaging who meets the criteria for genetic testing and truthfully, you know, it's it's a smaller percentage of the population that actually has that gene mutation or that related to cancer gene or Baraka one or two, but there are actually other genes that exist. And so that's kind of where the brake issue lies and making sure that patients are aware of the other genes that could potentially lead to increased risk for breast cancer, but not just breast cancers have ovarian cancer and uterine cancer stomach cancer painfully anyway, so I usually do a detail history and I like to know the other cancers that people have because those are also risk factors for needing genetic assessment Beyond just the breast related genes right the rest home. Packaging everybody knows so yes, I do screen every patient for those risk factors for the necessity for genetic testing and you know, we make sure that if they meet the criteria, they have those risk factors that they we talked about it. We discuss it. Some people don't want to know that's okay and other people want to know and get tested more so for their families if they have children or other family members who are concerned, but truthfully you'll find it. Unfortunately. Most people do not have that genetic mutation and they are in that average risk of people who just decide that 12% to 12.5% off. The average risk is 12.5% for someone in the community without any other issues, but family history is still Factor, even if you're not genetically mutated, maybe there's a gene we just haven't met yet. I don't know but I would say that. Is a part of the assessment process and there are people with family histories, but unfortunately, there are people most of the people are getting cancer without right many patience. So lifestyle choices, you know what I read. It's cut back on alcohol, you know have a clean diet. What what is the best and highest things we can do like choices we can make cuz we're the ones that can take charge of our body, even if we end up with the cancer. We if we do everything we can to take care of ourselves. They shouldn't have or rats. You know, what do you recommend on it? When you go out into the community? What do you recommend that people look at in their lives that they could so having a well-balanced diet is definitely important. I think that is the one thing you kind of want. I have a You have your carbs you have your proteins you have your fat and they all need to be in diet in a certain modification protein and vegetables a very important. I preached that and obviously you need healthy carbs, not your starchy carbs, but maybe you're you're more veggie carbs are actually have carbon hydrogen and then you're healthy fats. So not cooking with you know, chicken grease per se but you know, you're you're off of oil is in your avocado oils and things like that are little bit more of a fat content. And so I try to teach all that healthy diet nutrition support. We have a good nutrition support as a gift certificate or wage and we as well as our radiation groups and so we try to make sure that people aware of that. I'm pretty well-versed at diet and the modifications myself. So I try to help them through that process. I always encourage exercise, you know, just walking stay up take the stairs. There's still a little things they can do throughout the day is still be active unfortunately in setting a cold, but if they're outside lots of trails outside and obviously, unfortunately, we've had a dog Rain and weather issues and problems. And so that really makes it a big deal but it's going to take some laps around you kitchen islands and around your house and just kind of walk back and forth throughout the house. You really want to try to stay as active as possible at least three dog days a week thirty minute exercise fans, which is too tough for some people and it became much tougher during Corona can tell you but and then obviously yes alcohol meditation and try not to be you know to drink several glasses of alcohol a day. I mean, obviously if you you know have a glass of wine it is what it is. I don't like I don't try to really cut box that too much but yes, there isn't built of association with the amount of alcohol drinks that until the more you drink obviously the the higher the risk because I think there is some messages that can be produced from that process. And so that that can increase somebody's risk and then really it's just prevention and maintaining your screening mammograms. I recommend them. Annually. I know there's some screening guidelines out there that exists that say every two years most of the best surgery World wage. Follow that we tend to follow the yearly screen recommendations because we who do best on a regular basis. We see that there's cancer that can be evolved within the year or within that 6 months band. So we don't offer I usually don't let them in Waiting 2 years in between and obviously if you're a little bit older but again, you know, even being older does not mean that you know, you can't get a progression of cancer in the short. I'm either and so that is just wrong. Usually what I put out there and then just knowing your family history. I always say the biggest part of also prevention is knowing your you when you came from so yeah, I know there was a victim in the back of the time where people can really discuss their health issues with family members, but I think it's very important. Now as we as he recognized that yes, there are some genetic predispositions at higher risk things of screenings. And so even if they aren't even if they don't have it in a mutation, they make them meet criteria for additional screening studies such as MRIs and things to be a part of their screening so that wait if God forbid they did develop one breast cancer of some kind we would find it at the most. JW find it and that's just really part of that prevention or early detection. I put out there. What about hormone replacement therapy, you know that's such a big thing. And and with that the bioidentical I don't know if there's any difference in what it does to your body. But what are your recommendations on that? Because that can cause an increased risk of breast cancer. Right? Right. That's good. Cause risk rather things right? So essentially, you know, there's a lot of research going on with that right now and if it's estrogen or progesterone or what-have-you that's works better in I think is kind of buying afternoons actually not really in a bad cold Workforce also compared to Progesterone. But again, really I tell people you only want to be on it as long as you need to be on it and get off it as quickly if you need to get off. Like I think what happened is that people just love you want and they were just on it for years and I'm like, you know, if you even needed, you know, and so cuz it wants to just try seeing how you do without it. Obviously, you know, if I should have been should now kind of be adjusted to that hormonal changes. Distance to let's see how you do if you really feel like you're not doing well then okay, we can put you back on the smallest my new bills if you can and and so it's always kind of, you know worthwhile to have that kind of conversation agency what people are and why they're on it. What happened how long they've been on and we assess all that and like you said the other office that exists out there. You're comfortable, but my ultimate goal is to try to get people off them if they don't need it and and have them only on it for the time period that it's necessary and so the sort of the time the better and that's kind of like any other advice about my asked you what you expected or there any other things you'd like to share about your role, you know in breast cancer awareness month anything that we didn't touch on. I think we you don't have quite a good amount of salient points, and I just think that Everybody just needs to know and I think the one thing I said I leave is when covid-19. It's we get out and these hurricanes have existed and there's a lot of life things going on don't neglect yourself off because it could lead to that Downstream issue of finding a chance to to late and then now you're not only dealing with the hurricane in this but now you're dealing with the fact that you can even help with it because either you have cancer in your phone now what have you so it takes a short bit of time to get the screening mammogram. Just realized still make it a priority. Yeah, that's inspirational. I have a paper. I'm supposed to get a mammogram and it's it's been like two or three years, maybe two years and years. It's so easy to put things off and we can Derek is really this year has flown by for most of us. It's a bubble that you think yes, putting off all kinds of things. Yeah, and I just came home with doing that just because we have to happen and you don't want to get to a point where we can't do anything about it Ryan and then it all just like things you're worried about become not so important back. Once you find out something serious is going on. So that's just right Doctor Sonic crispy. We're lucky to have you here. I wish people could I'm going to have a picture of your beautiful face somewhat a website and will be promoting us through social media, but I wish people could see you right now your heart like you're you're passionate about what you do and that's what we all want our doctors, you know. To know that you care. So thank you for always tell the pages of put you first, you know, I'm giving you suggestions and recommendations, but it's you know your body wash and so I often tell people who don't always do the recommended things that it's okay I much rather them still following see me and you know, we've got a lot of the holistic approaches to medicine. I'm completely okay with those things. It just seemed to go get lost and think that we're not I don't support what they're what they're what they want. And so that's the main thing also help my patients. Like if you've moved for not agreeing to make sure that you understand the risks you're taking off but understand if there's a problem I'm here. I might like this is not like me dismissing you because you don't want to do I say like, that's not how this worked as a team approach is this is not me. This is us and so let's using my approach to be discussions. Right right that's comforting to know about well, thank you for joining us and I'd like to thank Oscar Lafayette general for encouraging me to reach out to you their response review page. Now it's you know, and yeah, yeah breast cancer awareness. I'm hoping that this interview will maybe touch one heart that hasn't, you know, somebody that hasn't taken care of themselves. Maybe they'll go and get that off the ground and get some follow-up treatment if they need it, and I'd like to thank our other sponsors, of course a very bank is now 1st Rawson and Raider which makes our show possible and thought I'd like to thank our listeners. You can find Aqua Shonda Krispies interview and over 175 others at Discover Lafayette. Net. You can also subscribe to discover Lafayette on your device and you're down your cat whatever and have this delivered every Friday to your your device. We encourage you to share this with the communities on behalf of December La Piazza, this is Jan Swift. Thank you.

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Dr. Dale Bredesen on Preventing and Reversing Alzheimer's Disease

FoundMyFitness

1:14:38 hr | 2 years ago

Dr. Dale Bredesen on Preventing and Reversing Alzheimer's Disease

"Hey, friend, welcome back. Today's episode features Dr. Dale e Bredesen's a professor of neurology at the eastern laboratories for nerd Jenner of disease research at the university of California Los Angeles. He was the founding president and CEO, the buck institute for research on aging as well as an junk professor at UCSF Dr Bredesen's laboratory focuses on identifying and understanding the underlying mechanisms involved in the neurodegenerative process and the translation of this knowledge into effective treatments for Alzheimer's disease and other degenerate conditions. In particular, he is especially notable for having developed along with his colleagues and approach to identifying intriguing several sub types of Alzheimer's disease, which is the most common nerds Jenner disease and responsible for sixty to eighty percent of all cases of dementia. He refers to his book the end of Alzheimer's as a guidebook for the seventy five million Americans who carry the Aibo four gene to escape their fate Aibo he four, which maybe you've heard me talk about before is a genetic risk factor that prior research has suggested may increase the risk of Alzheimer's disease. As as much as between two to three fold in hetero. It's people that carry one wheel or up to fifteen fold in those that have two copies of the oil known as homes. I goats, sounds ominous. No doubt, but to know, is better than not knowing in my opinion because it very well may give us the opportunity to control that fate. That's especially true according to Dr Bredesen's research in his book doc Brenton paints far more optimistic picture for those of us concerned about our cognitive future. And he tells us to quote, take a deep breath and realize that cognitive decline is at least for most of us, and especially early knits course addressable despite what you may have been told, it's not hopeless or irreversible to the contrary for the first time. Hope in Alzheimer's have come together. He's not just talking about prevention either which he advocates when he likens his suite of baseline biomarkers that he suggests everyone get tested for at the age of forty five, much like a colonoscopy. He calls this ACOG, NAS copy. Instead, his clinical work indicates that his protocol can. Reverse the condition, a feat that not only is impressive, but is utterly unheard of and to my knowledge completely unprecedented this protocol, the cog NAS copy to which he is referring is known as the Recode protocol, which stands for reversal of cognitive decline and approach applicable, not to just patients with Alzheimer's disease, but also to those with mild cognitive impairment. What makes me excited about this podcast? And indeed, Dr Bredesen's work is the systematic approach describes where a baseline is established, and then the practitioner and the patient work together to interet until they're in the right place, which may be different than lab reference ranges expect when talking about biomarkers, he observes that often the Rangers were told are within normal limits may not represent what is actually optimal. We do also talk a little bit about diet today at diet, which he calls Kito flex, twelve three. So name to highlight three points of emphasis burst mild Kito service. Second Affleck's -tarian approach that treats me as a condiment instead of the main course and third, at least twelve hours of daily. Fasting starting three hours before bed that daily fasting partial sound familiar to many of you that have been listening to my podcast for a while if not catch my episodes with Dr Sachin panda. In today's episode, we also discussed three main subtypes of Alzheimer's disease described by Dr Edison, which sometimes overlap and also incorporate what he calls glencoe toxicity or insulin resistance, which in some circumstances may not even be peripherally obvious sub types include type one, which is inflammatory and associated with an overactive immune system type two, which is a trophy or said another way lacking proper signalling to promote synapse generation and preservation, and a third subtype that he calls type three. This last one is particularly important because it may have a robust environmental toxicity component and is also characterized by different presentation. That's both less amnesic but also potentially earlier onset. Alright. Well, before I give away the whole podcast, just kidding that's almost impossible to do with how much information's packed in. I'd like to make a few quick menu. For some useful resources. The first is Dr reticence book. He gets into some of the significant blood tests, and even some of the ranges he's interested in this episode, but he goes in-depth in his book, make sure to check that out. It's entitled the end of Alzheimer's, the first program to prevent and reverse cognitive decline. It's a New York Times and Wall Street Journal bestseller. It's on Amazon, and it's also linked to the show notes of this episode. I found my fitness dot com. The second resources a website called Aibo. He four dot info, which is a community website dedicated to helping April before carriers get the best information on what's next. It's a great resource and one that Dr Bredesen's speaks very highly of the third and final resource can be found at my website at foundmyfitness dot com. Forward slash genetics. If you go there, I have a basic report, basic meaning free, in this case called the Aibo report. It's a great resource. If you've used one of the consumer genetic tests like twenty three me, you can find that once again, I found my fitness dot com forward slash genetics. That's found my fitness dot com forward slash g. E e n e t ICS genetics. Okay, enough of all that now onto the podcast. Hello, everyone. I'm really excited to be sitting here with Dr Dale Bredesen's who is internationally recognized for his understanding of the mechanisms of neuro degenerative disease, particularly Alzheimer's disease. He holds faculty positions at university of California, Los Angeles and the buck institute for research on ageing. In fact, he was the founding president and CEO of the buck institute back in nineteen ninety eight. So that's really kind of cool. And he also is an author of New York Times bestselling book called the end of Alzheimer's disease, which I'm sure we're going to talk quite a bit about today. He's got a really interesting multi prong protocol for preventing and also helping treat mild cognitive dementia and Alzheimer's disease. So thank you so much Dale having me here at your place. Thanks very much Rhonda. So maybe we can start a little bit by just talking about some of the. Characteristics and pathological distinguishing features of Alzheimer's disease, and maybe what you were thoughts are what can cause Alzheimer's disease leads to it. Right. So. It's a good point because cognitive decline, very common and Alzheimer's is the most common cause of cognitive decline ultimately dementia. And by definition, this means that you have amyloid plaques in the brain and FOSS four elated tau tangles. So those those are the two main pathological hallmarks of Alzheimer's. But as you can see, that doesn't tell you why you've got it. It just is something you look at the rain, and of course you can get something that looks virtually identical without the Loyd and you can get amyloid without the cognitive decline. So it's a marker, but it's an imperfect one. Yeah, that's a really good point. You brought up and do you have any thoughts on why? There are some people that do have amyloid plaques in their brain that aren't really demented and some others that just don't seem to handle it? Yeah, it's a great point. So here's the thing that the. The whole world is turning upside down. Now when it comes to our understanding of Alzheimer's, it's been over one hundred years. Of course going back to Ellis Alzheimer's publications back in one thousand nine hundred sixty one thousand nine hundred seven, and there hasn't been a good understanding of this disease. And of course amyloid has been for years vilified and there's no question it. It is a neuro toxin. It does have toxic effects. The surprise has been that this is also a protectant. It's actually something that is made by your brain when you have specific insults. And for example, professor Rudy Tanzi and professor Robert Moyer at Harvard too few years ago show that it is an anti microbial. It also is professor Ashley Bush showed a number of years ago. It's actually quite a good binder of dive Valent metals like copper, zinc and things like that iron. And we showed a number of years ago. It is also. Response to a reduction in traffic support. So you actually get a change in signaling. So there are multiple different insults and metabolic changes that lead the brain to produce this stuff. And so I think there's been confusion because it's clear that when you produce it, you're at this increased risk for having a degenerative process. But as you indicated, there are many people that produce it and they successfully are protecting themselves. They don't actually have. The downsizing was often been stated, is those who then have inflammation on top of that seemed to be the ones that do worse. And that's a very general idea. But really it is a, it is a set of things, and we identified in published a number of years ago, thirty six different factors all contribute this, but they actually break down into just a couple of categories. So any sort of pathogens anything that's giving you inflammation, whether you have it because you have a leaky gut or because you have PG. Vallis in your brain or because you have beryllium of Lyme disease or you've been exposed to specific fungi, things like that. All of these things can engender that response. And in fact, we think more and more of amyloid as being like, napalm, you got the bad guys coming across the border. So you're now going to put down stuff that kills the bad guys the napalm. But in so doing, you're now going to reduce your air soil, you're now living in a smaller country, and that's exactly what's going on in the brain. You are downsizing the overall network. So that's what we call type one or inflammatory or hot Alzheimer's, and I should mention I, it turns out IRA Veda physicians from thousands of years ago, recognized dementia that was related to something that was hot, that was abnormally ultimately inflammatory as well as that that was related to dry us, which is what we call type two. Where you have decreased trophy support. It can be nerve growth factor. Brain derived neurotrophic factor, Estra dial testosterone, pregnenolone, progesterone thyroid vitamin d, all these things are critical to support of sonata Genesis. So we think of the signaling as being a ratio of Sanap dole blasting activity where you're actually sending signals to make and store synapses just like you think of osteo blasted activity versus Sanap dough, classic activity where you're actively pulling back and your reorganizing. And of course, this is going on all the time. You're actively forgetting the seven song that played on the radio on the way to work yesterday and you're, you're actually forgetting a lot, but you're remembering the key things where your keys are and where your son is and all that sort of stuff. And so there is a change in that ratio in Alzheimer's disease because of time. One with inflammation or type two, which we call a trophy or cold because you don't have the support for those synapses. So you're literally it's a little bit like someone saying, I've got five children and I can only feed for I can either watch all five starved slowly or I can put one in a foster home and feed for, and that's basically the downsizing that's happening when you cannot support the neural network that you have, then we have a type that's actually type one point five, which is Gleich Otok sick, and we named it that because it has features of both type one inflammatory anti to a trophy. So what happens is you develop insulin resistance. So you now have a change in signaling that actually occurs because of this chronic high end zone. So you actually phosphor late. Your IRS one has showed very nicely by professor at gets over at UCSF. So you change the ratio. Of the Syrian three Indian phosphorylation to the tyrosine phosphorylation. You're literally changing your your response to insulin. So that gives you the type to because you know, longer have insulin as the support of trophic factor to the extent it was previously. But of course, you're also Gleich eating proteins with an we measure. This of course, is hemoglobin a. one c, but you're like hating many proteins. So you get now a response to that as well. So you have an inflammation in eight trophy. And so that's why it's one point five and then type three turns out to be completely different, and that is a response to toxins. So there is a toxic form which we call toxic or vile Alzheimer's disease. In addition, there are people we call type four who have more of a vascular component and then type five, which is more of a traumatic component, but they're really both related to these other ones. It's really about, do you have inflammation? Are you fighting something off? Do you have trophy support? And are you exposed to. Specific toxins. Well, and so. All of these different types of subtypes of Alzheimer's disease. They all sort of have some of the same thing machine pathological features like amyloid beta plaques, tau tangles, right between all of them all have amyloid plaques. They all have by definition tau tangles blood, the presentation can be different. Now, there are some overlaps the type ones and the type two's are typically amnesic presentations, more common with abo four, and that's true for the type one point fives as well. The type threes. The toxic ones are quite different. They often present with anonyme nesic presentation. It's executive dysfunction problems with calculation problem with visual perception, problems with word, finding so-called primary progressive, a Faiza, all of these things. They are really by parietal presentations as opposed to buy temporal presentations essentially. So these are. Have often been called cortisol presentations which have been noted for years by people like professor Mario Mendez to be typical in younger presentations of Alzheimer's and often in April four negative individuals. I think also read one in your paper where you did this metabolic profiling. There was very prominent zinc deficiency in that. Yes. So for reasons that we don't entirely understand yet many of the people with type three, the toxic subtype have low serum, zinc high copper, zinc ratios and low triglycerides to low triglycerides may turn out to be related to Malibu option. We don't know for sure yet, but we don't really understand why the people often have these low copper zinc ratios. What does that mean? The coppers. What? By copper's in Gratiot. Low zinc. Yeah. So as you know, copper and zinc actually are competitive. For example, in there. Absorption. And so too much of one actually is often associated with two little of another untypically in our society. As you know, most of us are deficient in zinc there actually about a billion people on earth is the estimate for zinc deficiency. It's a very common problem because if you have poor gastric acidity, which is common as we age, if you're taking is for for GERD, if you're taking something for for reflux, you won't absorb the zinc very well. If you have copper piping, which most of us do the copper will often compete with zinc. And so many people have a little too much copper and a little bit too little zinc. And in fact, it was noted over thirty years ago that people with high copper, zinc ratios tended to have dementia more than those with normal copper, zinc ratios. Wow. Says this, had this have something to do with it. I know there's like. Over what three hundred, five hundred different enzymes in the body that requires zinc, right? So this copper then bind to those enzymes and then sort of mess up the function or is that like the theory? So no, the the theory is that copper is, you know, a copper is a generator of free radicals. It is copper is can act like iron. In that sense. It has a free electron in the orbital, which does not occur with zinc. So in general, as you indicated in these various enzymes in its hundreds, just as you said, it is an important structural component and it has a very specific architecture with the enzymes that it served. So it is a is a structural thing in general in copper to my knowledge doesn't actually replace that. But for example, zinc is important in many things that are related to cognitive decline. It's important in diabetes. It's important in functioning of insulin. It's important, of course, in the trophy activity of insult. On and on and on. It's important in immune responses, so actually has many effects that are related to cognition. So may even just be a biomarker for something underlying going on right in this Pat in toxic insult type of Alzheimer's disease. You're talking about. It's something to keep in mind when you see that, especially if the person presents these people tend to be very distinctive. The people who have type three. So they tend to be young and we see them in their late forties mid-fifties very commonly. We've seen him as late as starting their first symptoms in the mid sixties. But typically their first symptoms are currying in the forties and fifties. They are often women. They are often April four, negative, although not always there, certainly people are able before positive who have this as you mentioned, they often have the low zinc, and then they typically present in a non amnesic way. Interestingly, unless they are homos Aus for e four in which case they do. The present typically with an amnesty presentation, but the ones who are for negative, typically present with problems as I mentioned earlier executive dysfunction. So I always ask people, are you having trouble organizing things? We had one person, for example, who was known for her tremendous organizing capability in as she started to to get the problem. She's just lost that she could not organize things that she could do before. It's a very common complaint, or as I said, people will say, oh, I can't calculate a tip anymore, or I can't pay the bills anymore. Anything that is math related or visual perception or word finding things like that. I, you mentioned April four times. Can you talk a little bit about just for for people listening and watching? You know what? April before is and it's it's, it's a gene right? And and so why, why? It plays a major role in Alzheimer's disease. So April Leipold protein is a really fascinating story. And of course, a professor Robert Bailey discovered this decades ago and it has turned out to be the most important should network risk factor for Alzheimer's disease, seventy. Five million Americans have a single copy of April four. And when I say that what I mean by that is everybody has two copies of either two, three or four and the most common one is three so common for people to be three, three as an example, however, about a quarter of the population. So about seventy five million Americans are have one copy of Abeille four and. That's actually the primordial one. It's the one that was present for about ninety six percent of hominids evolution. If you look at a chimp for example, it does not have a four, but the hominids do and still about twenty five percent of population today then about seven million Americans have two copies, so they're homos Avis for April four. Now if you have zero copy. So if you're a, for example, a three, three, your overall lifetime risk for Alzheimer's is about nine percent. So not terribly common disease, but not zero. On the other hand, if you have a single copy of April four, your lifetime risk is about thirty percent or so if you have two copies, if you're homeless, I guess your lifetime risk is over fifty percent and in some studies as high as ninety percent. So most likely you will get. And of course, the vast majority of people. Don't know. Now in the past people said, don't check because there's nothing you can do about it, and that has completely changed. So there is a tremendous amount and the reality is Alzheimer's should be a rare disease. It should essentially decrease to a very low level with the current generation. If everybody gets checked, we recommend that everybody forty five or over get a cog, NAS copy. It's e- it's a silly term, but it's easy to remember like everybody knows when you when you hit fifty, you should get a cold Oscar. And if you hit forty five or over, you should be getting a Kadhafi's. You should be doing some testing and see where you stand. What are your risk factors? Are you able four positive? Do you have high homocysteine metallization issues, inflammatory issues, nutrient issues, toxin issues, all these things because they can all be addressed and we can decrease the overall global burden of dementia. So this, there's. Variety of biomarkers that you're suggesting people can go and get measured yesterday to this. What did you call it? The the dog boss. Cacak. NAS Coppee? Yes, that's nice term. So the including the genetic factor, April, we four seeing three, four. And then you have a righty of biomarkers on that. You kind of just mentioned. Some of those. I think you also have published on before talking about the insulin. Sensitivity is well looking at insulin sensitivity and glide kid hemoglobin. So maybe we can talk a little bit about some of those bio markers and how you have this wonderful protocol. The the men protocol, right? So it's called Rico. So men was the very first edition that was metabolic enhancement for neuro degeneration. But as we have, we've made two point zero and three point zero and we have made it more sophisticated. As I mentioned in the book, it's become Recode which is for reversal of cognitive decline, and we now have over three thousand people who are on this protocol with unprecedented, and we've published a number of the results. We actually have another thing that's that's just finishing up that that reports another fifty people who have shown improvement. So you're so the publications that I had read, you had shown that was about ten, ten, and then there was another another ten different and you show that you had you were able to basically take a person and that had Alzheimer's disease. Some of them had to leave work because of their issues and you put them on a protocol and they were not not only able to return to work, but they also seem to have brain mass returning and just so he's really phenomenal. So some of these, some of the very complex diet lifestyle intervention that you did here, maybe we can talk about some of the key ones. Sure. Starting with like this diet overhaul, and I should say it goes back to one very simple principle. We've been trying to treat this disease without knowing what causes it. So I tell people, it's it's as if you took your car into the mechanic because it wasn't working well and the mechanics said, oh Rhonda, no problem. This is. Not working syndrome, and your car is going to die, and you said, we'll wait a minute. I mean, shouldn't you figure out why? Why? Something? What went wrong with it? And he said, well, no, you know, the testing isn't reimbursed, so we're not going to do that. And that's, that's the unfortunate situation we've been in people say, we don't know what causes it. There's nothing to do about it. You know, there's nothing we're gonna do and you're going to die and medicine is changing in the twenty first century. As you know, it is becoming less about mono therapeutics and more about programmatic. And at the at the center of this is to understand why complex chronic illnesses occurred. When you have something like this, a simple hill that's like new macaca Monja you find the pneumococcus you treat the pneumococcus and all the other underlying things, alcohol, diabetes, anything that could have been contributing is less important because you got at the pneumococcal pneumonia. That's not the case with complex chronic illnesses with Alzheimer's. There are dozens of things that can be contributing. And so what we want to do. Do is address all of those? Yes. If you have pathogens many people have, for example, Brealey from Lyme disease or a lime co infection like Barton Nello or BB's EEO or Air Liquide, things like that, then those need to be addressed. And of course you need to change the underlying biochemistry. So as you indicated there are specific biomarkers, so we want to know your HSA we your, it's a marker of inflammation. Of course, we want to know your homocysteine marker of methylated if you're not methylated appropriately in your homocysteine is high, then you are at increased risk for neuro degeneration. And of course it's been published that you have a more rapid decline in your cerebral gray matter volume and hippocampal volume. If you have a high homocysteine because the vascular reasons what's what's home assisting the publication did not distinguish. It just simply followed. People over years and looked at the repetitive of the decline in volume and could show that not only was it more happen literally, you could put the the repetitive it on a on a graph with homocysteine fit very nicely. But then if you improve the homocysteine and brought it back to normal and they're looking at less than seven as being normal, not less than thirteen, which is often used in seven is being able then in fact, what happened was people actually stop their decline and leveled off. So it suggested that this has a is a causal relationship that it is a mediator of cognitive wealth of change in cerebral volumes, independent of other biomarkers. Yes. So so we want to know that we want to know whether you have Gleich Otok society, so we want to know what is your fasting insulin. And again, people will accept it way. Way off the scale. We have an unfortunate situation where classically we have accepted laboratory values as within normal limits, wwl very arbitrarily as being within two standard deviations of the mean that actually makes no sense. Physiologically, it just says that there's a distribution there. It doesn't say that that's optimal for your health. So we'd like to know what your fasting insulin is and optimally, it would be less than five or less than five. Although again, within normal limits goes much higher than that, we'd like to know your hemoglobin a. one c. which again is a marker of your of your essentially over the last two months, your serum glucose. We'd like to know your fasting glucose. These three actually give you quite complimentary pieces of information all related to this type. One point five that I mentioned the Gleich Otok sick time, and then the traffic as you can imagine. There are lots of things. We want to know your vitamin d and we get in. We wanted to see that it's optimal, not sub optimal, but within normal limits, we want to know your pregnenolone, progesterone Esther, dial testosterone, free t three. Now we'd like to know your brain derived neurotrophic factor in your engine. There's no simple way on a Clinical Lab tests today to get those. So you have to infer them from other things. You know, what is your? What is your hippocampal volume? What are what have you been doing? I if you change these various things we've been talking about, you're likely to have a decrease. Have you been exercising if you're not exercising, your beady enough is likely to be lower. So we want to look at all of the trophy support for your brain because these are critical things if you're going to make and keep a large network of synapses, you need to have that support. And again, that balance changes for many of us as we age. Especially if we are Abeille for positive, April four gives you an advantage in that you have a hair trigger essentially for inflammation you are responding. So if you live in a squalid environment, like the Indians that professor tuck finished studied, for example, or the Ghana tribe that that tuck also has studied, you're in better shape if you're Abeille four positive. But if you're not living in a pro inflammatory in an environment that's parasitic, then in fact, you have this chronic inflammation that again, good for when you're fighting things good for if you step on a nail good for situations that are that should be pro inflammatory, but in the long run counter productive. So as you know, this is, you know, this is so called antagonistic patrol. This is something that can help you when you're young, but actually can put you at risk for diseases that will shorten your lifespan. And typically cerebrovascular disease, of course, Alzheimer's disease. And as you know, April four is actually under represented in centenarians. So it has been a short jeopardy gene as it were again that is changing and Ken change to buy understanding what's what's actually being driven by this. So we wanna know all those markers and those for the type two. And then of course we want to know the markers for type three. So we want to know if there are specific toxins and especially mycotoxin. So the toxins can be metallic toxins, like mercury, relatively common one, they can be organic toxins, like DD things like that. They can be biotoxins like tricon, casinos, okra toxin, a aflatoxin glioma toxin. These are toxins produced by various mold species. Like staffy botrous an aspirin Djilas penicillin which are literally fighting us. I mean, they're literally saying, okay, I'm fighting back in. For example, one of the one of the responses has been when you have mold growing on treated wood, they're recognizing something change, mold that have been treated with fungi side. So these are things where just as we're seeing increasingly bacteria that are antibiotic resistant as professor shoemaker has pointed out, the doctor Richie shoemaker who's done so much word work over the years on mold and Mike o. toxins and describe what he calls Sirs chronic inflammatory response syndrome as we've had fun. GIS is as we've had buildings with leaks where we haven't recognized the danger from these. In fact, we've had more and more of this mold related illness. So we want to do all those things for the type threes than than of course. We also want to know, do you have a history of head trauma? We want to know if you have vascular compromise. All of those things are critical. Now you mentioned the diet. So yes, we want to start with the basics. But again, ultimately it's a program that is customized to you based on what's actually causing your cognitive decline or your risk for cognitive decline. And so the nutritional part, we call Kito flex, twelve slash three, and it's for a very simple reason. So Kito. So we want people to be in mild Kito sus because that actually turns out to work better for cognition and many people do better with their cognitive decline. Just as Mary Newport showed, of course with using coconut oil then that may or may not be the best way to do it for some people. Other people like Capri, like acid, MCAT oil. Other people can are very good at generating endogenous key tones, which if you can do it is the best way to do it. And so we want to drive you into. Mild Kito sus, which means a very low carbohydrate, high fat, good fats diet, things like avocados and nuts and seeds, and things like that. And there is a caveat for people who are able. We four and a caveat for people have very low BMI. So we can talk about that. The next piece is flexible -tarian so you can be a meat eater or not. In general, we see meet as a condiment. But you know, again, you know, as we evolved, we tend to eat relatively small amounts of meat, but that's fine. If you do, if it's going to be chicken, it should be pastured chicken. If it's going to be beef, it's should be grass-fed beef. Have fish. Great. Make sure it's wild caught, not farmed fish. You don't want to have the fish with high mercury. Those are the large mouthed long live fish tuna, shark swordfish things like that. You want to stay away from those because they can contribute to your cognitive decline. In fact, one of the people who called me a couple of years ago was a very successful businessman who had early Alzheimer's at already had pet scan proven, and they told him come back in a year because you're not doing that badly yet. You're still in the phase, but you could. You could already see the signature of Alzheimer's on his pet scan. And when I listened to his story, I said, you know you've, you've got type three and you. You need to find out if you've got exposure to any toxins and he said, no, no, everything's great. Well, he turned out it turned out that he was eating large amounts of tuna sushi and he happened to be genetically a poor excreta of mercury also happen to have. Some dental amalgams. So he had extremely high organic mercury from the seafood, extremely high. Inorganic mercury from the amalgams and then as well as we have the perfect storm and his mercury is actually seven times the ninety fifth percentile for our country just massive, massive, mercury exposure, and he's done well with removing that. So we to know those specific ones. And again for fish, you want to think about the smash vision in my wife who's a family practitioner. Reminds me about this. You know, salmon mackerel, anchovies sardines inhering and she's a real expert on the nutritional side and on the integrative medicine side, she told me twenty five years ago, whatever you guys come up with in the lab in your test tube, we spent. I spent my whole career looking at what is driving the molecular signaling that leads to neuro degeneration. She said, you know, whatever you come up with, it's going to have something to do with what you're eating and your exercise. And I said, no, no, no. It's going to be one domain over one molecule and we're going to get a drug that thing that's going to be over. And of course, I should have listened to her twenty five years ago when she was right, it does have to do with programmatic, not mono therapeutics. So then the twelve three part of Kito flex, twelve three, a minimum of twelve hour fast between when you finished dinner immune start breakfast or brunch or lunch. If you are Abeille four positive, you. Better, fat, absorb as you know. So you want to want to make that fourteen to sixteen hours if you're able four, negative twelve to fourteen hours and be careful if you have a very low BMI, you can lose weight on this Kito flex, twelve, three diet. And so you have to liberalize typically once a week, have some sweet potatoes or something that's a little more carbohydrate related. And of course, in the book, we talk about the various things that you want to do with this diet, but twelve hours that gives you time for autophagy. It gives you time essentially at night to induce your Kito sus to clean out your brain. Of course, Glenn paddock system, you actually have a change in the architecture of your brain as you're sleeping, you're actually essentially sweeping this stuff out. It's kind of amazing actually. And so if you're eating with these very small windows of sleep in very small windows of fasting, you're actually doing yourself harm in putting yourself at greater risk. And then similarly, you want three hours before bed. After you finish your dinner, you don't wanna eat right up until bedtime because you know you're insulin's high and again that that's hurting your cognition. That's again giving you the same sort of insulin resistance problem, storing fat. You're doing all the things that are not helpful. So that's the dietary approach. And of course, you wanna have organic. There are toxins in our food. It's unfortunate. We've got a tremendous lifelong exposure to toxins. Of course, Bruce Ames with whom you trained develop the Ames test, which allows us now to look at carcinogens, but nobody has ever told us, well, hey, what about dementia? Jains? You're exposed everyday to various dimensions. Things like mercury, things like some of the organics that are in some of the health and beauty aids, and things like biotoxins. If you're living in a home that has leaks, you are exposed to dimensions and you need to know about that. So that's the Kito flex. Twelve three. Wanted to be. It's a plant rich dieted, Mark Hyman coal plant rich as opposed to plant base, but either way it is a plant rich diet that can use some animal products. It's up to you. You want to be vegetarian. That's fine. You don't. That's fine too. That minimizes the toxins, you wanna have a high typically seventy percent or so calories from fat, and you can start out with using things like MCAT oil or coconut oil to get your key tones up. We're finding that people who have higher Kito levels. One point, five million molar to four Miller beta hydroxybutyrate tend to do better than those who are down lower four positive end eighty four positive or negative. Now, interestingly, for the April, we fours, what we typically suggested. This was actually originally suggest by missing gesture by Julie g who started the website, April four dot info. You you essentially start with using the oil to help. To get your Kito sus, but then switch after a month or two, two more monounsaturated polyunsaturates. Now you can essentially balanced. You had the best of both worlds you. You follow your LDL particle number, your LDL p, you wanna keep it below a thousand so you can adjust how much MCAT oil and how much of the monounsaturated and polyunsaturated. So they have the best heart out outcome. They best cardiovascular outcome at the same time, have the best Haag native outcome. Be careful if you don't use you. Don't get your key tones up and you get your carbs down, you're starving your brain. And so then people will say my gosh, I just have no energy. So you want to use that. You want to basically be changing over to a more Kitone based metabolism for your brain. And then as you indicated you want to go back more toward the monounsaturated polyester just to make it hard healthy. So for this April. Four positive people. You do recommend lowering the saturated fat intake because you get, yeah, after you become insulin sensitive. So after you want to drive yourself into insulin sensitivity, so you, you've got your able now to convert. So because it takes a few weeks as you know, to convert from a largely carbohydrate based metabolism to a largely fat based metabolism. So if you try to do it in a day, you may end up with so-called Kito flew. It takes it takes some time and you're now producing. It's a whole set of things that you're producing. It's going to be less inflammatory. You're lowering your your reliance on glucose. You're becoming metabolic flexible, and you're now essentially developing a use of the key tones and it just takes a few weeks that's helpful to do things like exercise and things at that time to help you convert. And then the fasting overnight fasting of at least twelve hours or like you said, if you're April four positive. Possibly even increase out to fourteen hours. That's interesting that you're you're talking about, you know, while you're sort of transitioning into becoming more ketogenic that you may actually have to increase your saturated fat intake because you have to really it is kind of hard to to go into Kito says without really just having a lot of fat. And so it's something I have not experimented with yet. I found out I had an ape four Lille and so I've definitely become extremely interested in Alzheimer's disease and what I can do to prevent it. Because as you mentioned, not everyone with one April before gets Alzheimer's disease, very complex diet, lifestyle interaction. We've no woman should. Yeah, that's the key this. This should the largely ended with the current generation. Everybody should get checked. Everybody should get an optimal personalized program. That is the medicine of the twenty th century. I wanted to ask you about this because so caught your colleague of yours Dr. Eric Verdon at the buck institute. I spoke with him a few months back on. Very interesting paper. He had published, they believe it with cell metabolism where he had done. He had given animals a cyclic key genyk diet, and there was just improve improvement in health span in general. But what was really, really real best was the improvements in cognitive function in bringing aging where it was just, you know, hands down like clear that this really that diet really helped delay brain aging. And so of course, those weren't April before positive mice, but this is the exact same thing we're seeing with people and especially people with early cognitive decline. Now, as you go later later, it's more and more difficult, but we have seen people even with mocha scores of zero show improvement. So yes, this I think the the work that you quoted supports that notion than in fact, having you know, having ki- tones is actually quite helpful cognition. Do you think here's a couple, of course. Related to that, and that is, you know, is that probably multiple things but one because you know, you're, you're obviously going to have improved insulin sensitivity. You're not gonna have high blood glucose levels and all the inflammatory processes associated with that. Also, the key tones as you mentioned are used by the brain quite nicely. And interestingly, it actually spares, are you familiar with the glucose bearing? What happens with the? Yes, a glucose get spare to make any HR precursor, frequented theon. So that helps repair damage. But I'm wondering if people like myself, I don't. I don't really practice a ketogenic diet, but I also don't eight a very healthy diet. You know, I definitely try to make sure I don't anything refined carbohydrates or processed foods, things like that. But. The thing is, is that my my, my fasting insulin is really good and my blood glucose and all. That's really good. So for me going on a diet, do you think there would still be more benefit even though the whole insulin sensitivity thing, maybe it would still improve? I'm not sure. Well, I think the only way you're going to notice to try try and you know, you can even do all sorts of online evaluations for your own cognitive ability. I do think that many of us are sub optimal in our metabolism and we know this, you know, we're one of the problems, of course, is that there have been a lot of assumptions made during the twentieth century. Yes, it's fine to have processed foods is just as good. You know, it's fine to have more sugar, you know, on and on and on, which just simply have turned out to be wrong. And. Has to do with sleep. It has to do with exercise all sorts of things we were built as as human creatures to do certain things well, and to do other things we weren't built for. If we all were jumping out of third story windows as something to do that would be fun that would not go over well for us. And to some extent, we're doing the same thing with the way we're living. So obviously you've managed to stay fit and to have a good fasting insulin and all these sorts of things. However, a little bit will depend on how you know what you're actually doing. For example, you know, do you have? Where is your hemoglobin a. one c, for example, is there some inflammation there or not? The bottom line is that we were not made as human organisms to consume the amount of simple carbs that we typically are exposed to. So to some extent, just as we're being exposed to all these other talk. Sons, of course, shoulder is one of them and whether you try to be exposed to it or not. Often we are exposed to it from all sorts of different foods and things like going out to eat. You don't out you don't listen there and there's also the whole issue of leaky gut. So many people in this wasn't even known as as a problem when I was in medical school, but it's become very clear that it's very common. It does contribute to chronic inflammatory conditions like arthritis and like cognitive decline. So I think that you know, having a high fat diet has been helpful for many people, but what you can suggest is look if you ever have any cognitive decline get in as early as possible and then consider this in your case, of course, as you indicated you're interested in prevention because you already know that you're April before positive, so it might be worth trying it just to see. But you know, obviously you're doing a lot of other things right? Curl. Early and measuring a lot of different. You know, other cardiovascular rated biomarkers is also good. So you're going to measure things like LDL particles number in size and triglycerides and all those things as well to make sure that the changes you're making are actually indeed good for you. I think that's very important. Absolutely. So the diet and exercise and the sleep is really important. You mentioned the lymphatic system. You know, there's to my knowledge really. Is there two major ways that amyloid beta plaques cleared from the brain. One is the paddock system will there, of course, there are multiple is the ratio of formation clearances critical. And of course you're going to be forming more and keeping more if you actually have a state of inflammation or of responding to a pathogen. So they actually, you know, there was a really interesting test developed by professor meal on Allah at UCLA developed about almost ten years ago now and what he was looking at was taking. In peripheral blood mono- nuclear cells. So you're essentially taking the blood macrophages and you're now simply challenging them. He would give them amyloid and just look to see how good are they at phagocytes hosting at eating and getting rid of the Loyd. And the surprise was all the people who have Alzheimer's are very poor at eating and getting rid of this Emily it. It was as if they're literally trying to keep the amyloid around and we realized, yeah, this is a state. So you know, as you as you know, it's become clear that you change your cells change states. You know, you have the metabolic flexibility. You have burning this burning that for fuel. One of the states you change back and forth between a pro inflammatory state, essentially, an NF Capela be mediated state and on the other hand and anti inflammatory state that is involved more with, Sir, Ti one, these two actually. We have multiple sites of mutual inhibition. So you're literally flipping back between these different states and the people who had cognitive decline are poor at getting rid. They're literally keeping this amyloid around. And if he looked at their m one to end to ratios, essentially inflammation to resolution, he saw two patterns, the people who don't eat the amyloid who have the cognitive decline, either have a pro inflammatory state where they have a lot of them one and very little m-2, or he found that they literally had an eight trophy state the same thing we saw as type two where they simply could not produce enough of this to resolve. So they literally have very low levels. And so in fact, getting the right level about two and a half to one was associated with the best outcomes. So you do have this phenomenon and so yes, you're, you know, as you know, you've got everything from insulin. Grading enzyme Knepper Lisin macrophage clearance gloom fatty system and on and on and on their multiple ways. But as long as you're in that state where you're using multiple mechanisms to keep this stuff around, you're not going to be very good at metabolising it this, this paper that you've referred to idea. Remember reading a paper that you had published years ago where you had you had taken this essentially. I guess you can use it as a biomarker, right? The people without some Reggie's are not clearing amyloid beta plaques via Vegas, Saito suspend their with their monocytes effectively. This sort of kind of a surrogate marker for what's going on in the brain, potentially. Right. And this is professor Fiallos test, right? And you had done a small study where you would give people some three supplements along with some antioxidants and vitamin d and improved their Vegas at hostess amyloid plaques and the periphery, and also. So I think they're cognition. Some some individuals had improved cognition eight, four negative ones. And so that was a so I was a co author on that paper with professor Fiala. So he invented the test and he's now doing the small number of things that you described there. What we're doing is a much larger set where we're doing more of a program, but clearly that is an important part of it. And of course, professor sear hand from Harvard has shown that resolution is a critical part. You have the inflammatory part, but then you have to have the resolution part. And if you don't have that resolution part, again, a change in mode, then you're stuck with this chronic inflammatory state. And so things like omega threes and omega three derived, Marie Sens and things like that are actually involved with the resolution Resolven for named for that very event. Resolving inflammation, right. Remember that paper and as I've also done some some reading on this because I have, I have a paper that hopefully will be published quite soon on on April. We four related Alzheimer's disease and particularly with respect to a mega three. So there's some evidence that for whatever reason fish when when when people that have before given fish or fish, they, they're protected against Alzheimer's disease, but DHA supplementation, it's not the same. At least for AP we positive individuals, and it's kind of been a mystery. As to why that is employed. By the way Paul, Clayton from Oxford has has discussed this numerous times and written about this in his argument is that of course, fish have much more than just DHA and EPA and things like that. So they have a antioxidants, things like Seco irritates and things like this, whether you find them in plants or animals that actually are protective because you have to remember, you know, you're looking at something with multiple sites of de saturated, so it's very sensitive to oxidation. And so you have to protect that and you're absolutely right this again, this idea that we had in the past that fish, hey, it's just as good just to get that oil out. It's not just as good, and although the oil can be helpful, you better make sure that it's not oxidized and you know better to get it in its appropriate setting. It very interesting. Some some interesting papers had come out from a few labs. One one from. Salem, Norman, Norman, Salem. Sorry, he had. He had shown in animals if you take animals and give them human, but we three four, two, that there was a then feed them DHA orally. There was a transport defect in DJ across the blood brain barrier. And so I kind of review this work on a variety of other papers as well talking. You know where where there's a couple of major mechanisms by which Jay's transported across the brain. Are you familiar with some of those one is through a free fatty acid and the other one's through an actual transporter called the MFS Adrian's porter which is actually in a phospholipid form phospholipid form. And so it appears that there may be different ways. These DHA gets across the brain. And one of the ways is potentially not working quite as well in April four individuals, but at least that's my my, my my theory, but once. Papers accepted. I'll send you a copy. So I, it's super, super interesting. You know, I mean, professor Werthmann from MIT has spent years looking at what is it actually take nutritional nutritionally to make synapses in his point was you need the DHA and you need city choline as well. And so again, if you're going to be helping people to change that balance toward the plastic, you wanna make sure that they have plenty of those precursors as well as the appropriate signals reduction of inflammation. All these other things that are actually part of an overall orchestrated event. The other interesting thing is that DHA and I didn't know this previously until I had been digging into the literature is also seems to be important for some of the glucose transporters on the blood brain barrier. And so if you don't, if you're DHA deficient, those glucose transporters aren't working as well, and you're not getting Lucas into the brain, which is another real hallmark of Alzheimer's disease absolute. Without that. That's another interesting thing. So the other a couple of interesting things I wanted to ask you about were. Kind of off topic, but not particularly. You mentioned this type three subtype. Would would the herpes virus fall into that. So so herpes virus could give you type one or type three depending on what you're actually responding to. If it's just a chronic inflammation that it would be a little bit more like a type one, chronic inflammatory, but you're right. We get many groups of said, okay, it's about herpes. Okay. It's about p. Jinja Vallis. It's about few, so 'Bacterial nuclear. It's about Candida, and the reality is all of these are capable of inducing the signal this change where you're making the amyloid as part of a protected. It's part as you know, it's part of your essentially part of your innate immune system. So if you're responding in that way, it can be any of those things. It's not just one every single time as far as anyone knows. So yes. You alluded to the recent work on. Herbie's and especially of course of six and seven in. So, yes, not surprisingly, you know, the one of the things we see frequently with various patients is a chronic exposure, chronic presence of the various herpes family viruses see him the HSP age, HP, all those things. The last thing I kind of wanted to mention just just because I wanted you to know about in case you weren't aware of it. There's there's some really interesting research coming out of Finland. Are you familiar with the with the saunas and the worst? Oh, okay, dramatic effects. It's very interesting. It's very beautifully with everything we've been talking about, and certainly. What happens when you have a sauna? Yes, you Baidu some heat shock protein. Great. That's important. And you can be important in folding of proteins. But what also happens, of course, is that you detox and these people who are doing this repeatedly, you know, some nice work by a doctor genuis from from Canada who showed that if you look at composition of sweat compared to the blood, there are certain toxins that are very high, cadmium being the big one over a thousand times increase in sweat. So a good way to get rid of cadmium, but a good way to get rid of other things as well. I think I think you're right worke BPA especially the the hydrophobic toxins that did not hydrophobic stuff tends to be very good in the sweat, so, but others as well. And so that's why it is very helpful in in many of us don't do. Enough of that sort of thing. And as has been pointed out whether you're doing it through sweat and exercise or whether you're doing it through saunas, whether you're doing it through other mechanisms? Yes, it's good to get, and then you wanna use a non emollient soap immediately thereafter things like Casteel soap or whatever you like that's not emollient and get rid of this stuff so that you don't get re penetration. The other thing is that cardiovascular effects on with with on and not may also be related to -absolutely dementia as well. So is that so is that something that you're you consider using in your protocol who it's part of the mortar? Oh, absolutely. We recommend that people and especially if someone has type three, that's even more important. But as a general rule, you know, part of this is. As again as my wife says resilience. Part of this is resilience. We're taking people who are sub optimal in their metabolism in their inflammation and their toxic status in their lifestyle status in their sleep in their stress levels. These are surprisingly important. One of the first people who came through was a very intelligent physician, and as we went through each thing, he said to me, will you know, I don't believe that that that's that's not a cure for Alzheimer's. That's not a cure for also and he had well documented. Early Alzheimer's. Pets can prove an amyloid pet positive f. t. g. pet positive, hippocampal atrophy, the whole nine yards. And is we went through each thing. You know, he was telling me, well, I don't believe this and said, look, this is not about one thing. This is about a program that is awful for you, and actually he's done extremely well, and he's now four years into the program and still doing very, very well. So it is. It is about changing. Signaling within your scenario blasting this and after classic ratio providing the right support for that DHA insideh choline in vitamin d, inappropriate hormones and Bedia and all these things and making sure that you don't have chronic exposure. And as you mentioned sauna is actually a very powerful way to help reduce overall toxic burden. It is surprising how much toxic burden. Most of us are living with talking about how the importance of, you know intervening in multiple ways because there's so many different pathways that lead to inflammation that can lead to insulin resistance that can lead to talk burden. That one of the really something that's made major headlines over the past few years is the failed clinical trials. Targeting amyloid beta plaques multiple clinical trials just one after the other. So actually we've had a number of people who have. Tried to remove their amyloid with antibodies who've actually gotten worse with that happening. So you have to go back to why is it there? And it's tough because yes, it is both part of the mediator. It's not the cause of Alzheimer's. It's a mediator, and I think that's been one of the problems. People want to say it's the 'cause it's a mediator and there are many upstream things contributing to that. So on the one hand, it's a mediator of the pathophysiology. On the other hand, it's also a protectant. It's a response to things like pathogens and so there's a double edged sword there. It's fine. I think in the long run, it'll be fine to remove the Loyd, but you've got to remove the cause of it first. Now, of course, people have just tried to go earlier earlier earlier in, can we actually see some improvement. So I think it won't be surprising if you can get a little improvement early on. But again, it's a little bit like saying, if we fire the CFO, we can all spend a little more for a while. Well. Well, if if we're still going to go into the red, we wanna know wanna make sure that we're spending for the right things. We want to know why you're why you're amyloid. Is there to begin with. We want to remove all those things. Then remove the amyloid as opposed to just blindly removing this mediator and leaving the various inducers right, and with Alzheimer's disease it. So you know, there's as you've been talking about for the last hour there. So many different things that can lead to so many causes so many things in the environment in our diet, things that are not present in our diet, that it's just it's difficult to just find that one monotherapy and target, you know, and things are always much more complex. It seems like we'll amyloid plaques in your brain. Of course you want to get rid of those. They're destroying synapses and well, as you mentioned, has a function has a really important function and for the longest time I remember I was trying to some years ago. I was trying to understand. What the normal function of amyloid beta even amyloid precursor protein. Like, what? What is it doing? Why is it? They're like, obviously, we have this whole elaborate system. We have these enzymes at Cleveland in this right position. It forms this forty two amino acid fragment. I mean, that's all happening for a reason. It's not. It doesn't seem like it would be program into our biology to to happen to to cause dementia, you know. And so I think it really is important understand what the normal function is of amyloid beta and also with the towel phosphorylation tile tau protein as well. Is that something that you find. Quite often in in the people that have the amyloid burden and are affected. The often also have tau tangles in still tau. Imaging is still kind of in its infancy. So most people, we don't know. So they may have amyloid positive skin, but they haven't had house game. However, they are clearly in Alzheimer's. Say, we do know that many of them do from sui was final food. So these people that we've reported. I mean, these people have the low a. t. ATI that is associated amyloid tau index. So they have low a. beta forty two in the half, and they have the high phosphorus towel and total tau in the CSF the ones that have been evaluated so indirectly from that, we can say they definitely had a tau. They likely to have phosphor tangles it again. If you look at what this is doing, it makes a lot of sense. When you are trying to pull back on a connection, then you need to collapse the superstructure. And what is the phosphorylation of tau? Do it allows it to pop off the micro tubular? So you have a rapid collapse of the structure. So no surprise when you're in this when you're in this mode of you're trying to fight this off, you're trying to change your trying to pull back on your structure. You're gonna fos for tau, pop it off the Mike, the micro tubular and you're gonna, you know, you're going to die back and that's what Zafy what you see. So again, it's not that you know the towel is not the cause of the problem. It is a mediator based on what's going on genetically with pathogens with toxins with metabolic changes with a native moon system and with trauma. So the things that are driving, this are the things that we want to target. What percentage of people would you say is? Is it more common to have your some type of one one point? Five to the inflammation and insulin resistance and the neurotrophic. Are those the most common? Would you say types of Alzheimer's? Really. Good point. So initially what we saw was that many people had this type. One point, five play co toxicity is so common. In fact, again, professor gets whole from UCSF had a nice paper a few years ago showing that everyone he evaluated using excess OMO analysis had the signature of insulin resistance in the nervous system, whether they had peripherally or not. It was really striking now. So this was x. OEMs that he analyzed and specifically he selected the neural excess OEMs, which represented about ten percent of the overall x. OEMs and showed that they all had the signature. This was this change in phosphorylation of IRS one. So clearly that's a very common thing. But what we're finding is rarely. Do people have purely type one point, five one or two. So although type three, this toxin type represented only about fifteen or twenty percent of all of the of all of the pure over fifty percent. So typically in the sixty to seventy percent range had at least some suggestion of the type three. So in fact, most people have some sort of toxin exposure pathogen exposure, and that sort of thing. So the so what it's turning out is that they're, they're, it's more about what's your mixture? Are you predominantly the type three with a little mixture of one point five. And by the way, the easiest to deal with type one in one point, five, you can improve that as you can imagine zones inflammation and like, oh toxin, you could improve diet, exercise, sleep, stress, stuff like that. Improving the traffic is a little harder. You've gotta get all the right things. You've got. Many people have to go on bio, identical hormone replacement. You've got to optimize the support for your brain, and then the hardest of all is the type of because you're having to find out. For example, some people have very high Ernie scores that's EPA relative mold index. If you've got micro-toxins being produced and you're living in them, you need to get out of there or if you're working in them, you need to get out of there and until you do that, you've got this chronic exposure at task. People can do to see if they've got the second. There's an easy test. In fact, you could go on the government has set up this so-called EPA relative mold index, and you want to get a score that's less than two again as Dr shoemaker recommended years ago and you can easily get go on Mike o. metrics dot com. They literally send you some little cloths and you can go around and take areas that are that you are concerned about send it in, and they will actually do by our analysis. Looking for evidence of these various species. And if you've got species that happened to produce a lot of toxins, it's a concern then you can actually measure the toxins in urine tests so you can get an idea. And then again, you can actually see without a product that you. Yes, you can. You can. You can get there a couple of companies now that do that make urinary mycotoxin does. Okay. And so for people that don't, let's say they don't have the toxin exposure and they don't think they do, but they don't. If they've done this test, the things that they can do in their diet and lifestyle to prevent the Alzheimer's disease would be the major things to reduce inflammation, which are a lot of things, diet, lifestyle, exercise, sleep. And then again, a lot of overlap there with improving insulin sensitivity, and he goes and fast in glucose levels and then you're anyone see down. Yeah, all those things are getting on a plant based. And by the way, you probably know that Dr Terry walls. Published a lot and actually has done a lot of studies now on using a similar sort of approach for multiple sclerosis and has seen excellent results including in herself with taking this sort of an approach. So again, looking at the drivers and looking at what, what are we actually responding to an? Are we having more of an auto immune response? Like with them ask or we having more of a innate immune system response with Alzheimer's, these are critical for dealing with these complex. You get marker for markers for gut health because you're absolutely. I mean, gut health is one of the most common things flam toy markers, or you know, is there like an actual marker for gut health more to, right? Oh, yeah. So there are a couple of ways to go. There's a, you know, Genova test doctors, data test their different tests that are like stool analysis sort of thing. But you can also do Cyrus for example. So Cyrus array to. Cyrus has a whole set of different markers for different antibodies. So if you have a leaky gut, you're often going to respond to things like l. p. s. coming from your gut, then there's a Cyrus array three that looks at various of the domains of gluten in gladden. And so you can look at that and then there are various auto antibodies, etc. So, yeah, these are very helpful to spell. Yeah, it's why r e x is the company that developed these excellent nap. And you heard of that one for the diagnostics. Is that the metabolic metabolism test or is there there's a, there's a, there's a gut health last option guy affects and then so yeah. So in Dr Aristo Vos Donnie. He was the one who developed these various essays for Cyrus that are not now being used by the Cyrus company and that knowledge. And that's what they lable. Yeah. Excellent. I'll definitely check those out. So the reality is it's an era in which just like you gonna take an Uber, for example, you don't necessarily have to call a taxi anymore. In this era, we could actually get a lot more data. You know, the quantified self is becoming more and more popular and more and more common, and it's something to some extent, the responsibility for our longevity in four, our health is resting more and more with us. If you want to learn more about the particle, please go take a look at the book and it's called the end of Alzheimer's and from Random House. And the other thing you can do is you can go to the website Dr. Bredesen's dot com. Look at it there and we are responding to their lot of comments on the first book that is coming out now twenty six different languages. A lot of comments saying, we want more specifics about what you are else. Do we use, where do we go? So we're actually now putting that in a second. That will be out next year. Excellent. Well, thank you so much for this conversation, Dr. Partisan for your wings. Run search. Yeah, thanks very much. Then. Good luck with your with your work. Thank you. Hey, guys, you made it all the way through. Thanks for listening and a huge things Dr Bredesen's for coming on to learn more about Dr. Bredesen's work, even information on how to actually get a baseline cog, NAS copy or how to become a practitioner. If you're a healthcare professional head over to Dr Bredesen's dot com. That's d. r. b. r. e. e. s. e. n. dot com. Have you taken a consumer available genetic test like those offered by companies like twenty three and me, you can run the April. We report on my website. Depot, we report is one of the basic reports which is just another way of saying free. So make sure to check that out at foundmyfitness dot com. Forward slash genetics that's found my fitness dot com board slash g. e. n. e. s. genetics finally, does this podcast in its lineup of deaths. Knock your frigging socks off hug a supporter today. Thanks to the generous monthly support people. Just like you. Yes, the kind of person that even listens to these kinds of episodes, which let's face it aren't for everyone that I can even do this and not only just record the interviews but take the time to provide extra resources with every episode that many of you may enjoy right on my website. Yes, you too can be a part of the community of outstanding individuals that nurture the very existence of this podcast by making a pay what you can pledge. 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What Is The Tea with Vaccines, Hunty? with Dr. Nina Shapiro

Getting Curious with Jonathan Van Ness

54:21 min | 2 years ago

What Is The Tea with Vaccines, Hunty? with Dr. Nina Shapiro

"This episode is sponsored by the podcast terrible. Thanks for asking. And each episode Nora mcgurn, he talks to people with the prising honesty heart and humor about their experiences with terrible things the Atlantic named it. One of the best podcasts of twenty eighteen. And the New York Times calls it a gift to listen. You can find terrible things were asking wherever you listen to podcasts. Welcome to getting curious. I'm Jonathan Venice. And every week as it down for thirty minutes or forty minute or fifty minute conversation with a brilliant expert torn all about something that makes me curious. So usually guys when I recorded an episode, and then when it comes out there closer together. This gorgeous episode on vaccines. We actually recorded on January twenty first so I've had it in the Bank for a little bit. But here's the thing when this code was recorded. I had just heard the beginning of what was becoming the measles outbreak in Washington and New York on the news, but we really didn't know yet because it wasn't that it hadn't proliferated so much. It's interesting now that two months later, we find that these outbreaks are still happening, and there continues to be like legislation that's been proposed and come out, and there's been a lot of controversy around it. So obviously vaccines are always controversial there. It's a thing. So today, I'm joined by Dr Nina, Shapiro director a pediatric ear nose and throat at the Mattel children's hospital UCLA and professor at the David Geffen school of medicine at UCLA to come and tell us a little bit about this hype around back scenes in medicine, and what is the tea with axes Punti. Hey, look into getting curious this Jonathan van s I'm very excited to welcome. Dr Nina Shapiro, author of hype. Honey, I love this book. I love the title. It's a doctor's guide to medical myths exaggerated claims and batted by and how to tell what's real. And what's not I need to inscribe that on the know how I'm gonna learn from this book between my eyeballs, it's a tattoo right there. I need. So tell me let's qualify a little bit about what made you will not qualify. But what made you want to write the book tell me about it? So the book was a long time coming and it was really based on a lot of my experiences. I live in Los Angeles. I have friends in New York. So I'm very aware of what we're hearing socially, and I take care of families. So I hear a lot of nonsense and I've been in medicine for two decades. So you're. Intern assed ear nose and guy your nose and throat, and so you work with families, I work with families because I see I see kids and a lot of the things that I'm hearing in the questions that I'm getting are good questions because people care about their health and they want health for their families. But I feel that they're more and more buzzwords coming in their natural organic GMO free vaccine free. You name it, and it's all this nonsense. That's not scientifically based it's no there's no evidence for any of this, but people are incorporating it into their lifestyles thinking that it's healthier. And actually a lot of it the nonsense that we're get getting as far as information for our health is bad for our health and dangerous. Well, so I mean, I think when I think of. News. And like things like really scare me. When I read on the news, like there's I like click bait is that thing like, you know, creating headlines that stick, and you know, kind of poke the bear of people's feelings on whatever topics. It drives the conversation. Right. It's like when I see a new story of a tragic accident or something with a young person. Like, I always I don't want to click on it. But I find myself clicking on it. You know what? I mean. I I read the story. And I think there was nations. It's like one of the similar one of those things that you like click on that, you know. Right. And and I have also seen like even just right now. Like today there was there is a outbreak of something sizzles. Yes. In Italy or something it's all this a lot of local stuff. Oh, yeah. Told me about the local stuff. So the local stuff, you know, measles has been back. Measles was something that we didn't see for many many years because everyone was getting immunized. And then the means. Measles vaccine got vilified because it was a mar- 'em are the dreaded MR causes autism. And that was really everybody's terror. And so people started stopped immunizing their kids. And so now we were seeing for the last five to ten years, we see these pockets, and now the pockets are getting bigger and more frequent of these measles outbreaks, and some of a lot of it's deadly and certainly very dangerous, and it's very very contagious. And we haven't really seen. I don't think I've seen measles in my life. Like not in not that I knew of right? So what does it look like does it look like, chicken pox? It looks a little worse than she can pass because it's usually like chicken pox, you think of those spots randomly all over your body. And then we'll talk about that. Because now, there's a chicken pox vaccine. So we don't see chicken pox as much anymore and measles looks more like head to toe red spots all over and it has this kind of quality to it a little bit bumpy. And the kid is usually pretty sick little sicker than chicken pox. A really high fever lethargic. Bright red is. So it's usually a much sicker child than a child was with chicken pox was this era of. Oh, yes. Of course. Yes. Is was this era of was this latest round of like anti vacs? Sentiment. The first time since we've had vaccines that they've had that it's happened. Like, if people been leery of vaccines and say, I started, and that's all that. That's a great question. So anti vaccine Damant is old as axioms. So the first vaccines were in the seventeen hundreds. And it was this guy Edward Jenner who found out that the milkmaids didn't get smallpox. Remember smallpox was that old, but old illness that we don't even immunize because it's radically ended and he tried vaccine on a on a little farm boy just on his own. There was no hip of violation is no consent. Just here. Try this try this thing I'm making up and it worked, and so people started wanting to get an innocuous it was a it was a little bit of cowpox virus that he would give to this child. And which is really what vaccines are. It's a part of the vacs of the virus. So in the seventeen hundreds Honey their smallpox, and that's like that one that you really look messed up with all box. Hawks so badly mess. Yeah. You are. So messed up like, it's everywhere. Like, you really probably don't live. If you get it. Right. Like don't most people die. Because not one HBO special about John Adams, these people pox. And I was like. I could not it was. So you guys let me tell you them on some Sunday morning when you have a nice strong, trusting chest of a man that you can lay your head into. Honey, you go on that HBO now app, and you pull up that John Adams dock? It is so good. It's like eight episodes long or six, but it's so good anyway. So you're probably going to die from her which is not good. If you get the smallpox, so, but he, but so he noticed that the may didn't get it because they milked the cows with cowpox 'cause they were getting exposed to cowpox, and they were getting this milder form of it, and that actually protected them from smallpox is pretty amazing back, then there was no real science going on to the degree that it is now, and he figured this out any gave it a try and it worked. So there were some people who said, hey, gimme some of that stuff. I don't wanna get that nasty disease. And some people said I don't want to be injected with cowpox. Oh, he injected it. Yeah. Well, it was like a little bit of a scrape under the skin back, then not an injection like we would think of now but like under. The skin. So and this is if you read some of the Hamilton books from Alexander Hamilton, and the and Elisa was going around giving smallpox inoculation or she was a good girl. Yeah. That's true. So so people didn't trust a Honey plenty of people didn't trust it. So antitax has been around for for as long as vaccines have been around. And then later in the eighteen hundreds when they realized in England in Massachusetts, you know, these these educated pockets that all the school children needed to be immunized, then you can be conscientious objector the same term that we used to use for the military or that we used for the military you can use then two hundred and something years ago against vaccines. So not as new as Hollywood anti vaccine. It's a whole new thing in Hollywood that we have these anti vaccines, and it really is. We are kind of a hub of it here in Hollywood. But it's been around as long as. Axes have been around. Okay. So this is I'm taking 'em veering. Right. Because there's an taking this to me. And why I'm scared Honey what if you get the flu shot, but then you still die of the flu? That happens every year every year at this time of year. They always mentioned like the people who pass away the flu that year. And then I'm always like fuck like it's gonna be me. I am not spoiler alert. But if you haven't seen down now be it's your own fault. But I see down now. And I'm like, oh my God. Like, oh my God. And yeah, like, oh my God. But so, but so even at the vaccines, another eight strain, it'll lessen your ability to get the flu. And then the other heart rate that I will go from that question as clams getting it all out because I just can't even handle it. Only at escaped me, right? Is. I was about to ask it something about vaccines. And if it doesn't work for you. I can't remember the flu. So yes, we get that all the time. I the only time I get the flu is when I get the flu shot that's complete nonsense. So you can't get the flu from the flu shot. That's the first thing. A lot of people say I don't want to get the flu shot because every time I get it. I get sick. And it gives me the flu. And so that's not true. You can't just feel able within terms or something for show you usually get the flu shot around flu season. It takes about two to three weeks to start working. So you can get exposed to the flu got the flu shot, and then you can get the flu, but it's not from the flu shot. So that's first of all you're not gonna get the flu from the flu shot. They don't know. Exactly. What strains they're going to protect each year because they base it on the prior years, and what has been shown, and these are looking at millions of people is that even if you do get the flu a year you've gotten the flu shot. It'll be a less severe case of the flu. Yes. People die from the flu. People died this year from the flu. And actually this year of all years. There's been an uptick in number of flu vaccines, and there has been a downturn in hospitalizations for the flu. So. Yeah. Two thousand eighteen two thousand nineteen we're getting better Gu's really God last year. I feel fine. Terrifying. I mean, I can't imagine is this sort of like the same idea. Like, well, you know, I don't wanna cross the street without health insurance. Because what if I get hit by a car? I don't wanna I don't wanna day to go by without being protected from the flu with a flu shot. I can't imagine walking around here not being protected. Right. People are more afraid of the vaccines than they are of the onus. Which is I don't understand that. So as an EMT and someone who works with families. What the things that you hear that? You're like, oh, my mic can't handle it. Like, you got to like kind of like when people tell me that like why they have to wash their hair every day. And I'm like, oh my God. Get it together girls up over washing your hair. Do I don't wash my hair every day? So that's great. But like what's your version of that? You know what I mean? Yeah. We've got a lot of specifically related to vaccine. Yeah. So I mean, one of them is the flu because people don't want to get the flu shot. And and another thing is, you know, some of the illness is that I treat unite to ear infections and sore throats. There are actually vaccines that kids get that protect them from a lot of the childhood illnesses. So I'm really big on that chicken pops lollipop parties we hear about this, really popular. Oh, you know when you when everyone gets them. Yeah. And it was that bad bad because chicken pox. Although for the most part those of us who had the composites. Yeah. It was a couple of days. It was no big deal. It can be deadly. And you know, kids can die from the chicken box. So why not be protected from this? Well, what if you look back saver everything? And then your little immune system never had to fight anything off. And then you have a go poopie little immune system. Or is that not a thing is nothing because there are so many there, plenty of other, viruses and bacteria for you to be exposed to. So it's not like taking too many antibiotics, and it knocks out your gut and knocks out your protection. And you can't take other antibiotics. It's not like that. So you not gonna knock out your immune system and doing too many vaccine. And then another question, I get is. I don't wanna get too many vaccines too soon for my precious fragile sterile child, and I wanna spread them out. And and it's actually, you know, they're more. They get more bacteria and viruses from a kiss on the cheek in from being born, certainly or nursing. There's so many more bacteria and viruses that they're exposed to just being out in the world that that these these immunizations are actually a lot less. So I get a lot of I don't want to get them to quickly. It's gonna make them sick there too. Fragile in his. Actually, more protective and much safer to do it that way. So what about your mouth? Okay. So most people don't even know what it stands for genetically modified organism. No. I know you. I would hope he does. Yeah. Most people don't even know what it stands for. And what that even means. An and just by the terminology. It implies something bad. Right. So it sounds genetic genetically modified. So that's something I don't want. But actually some times in some reasons for Jim genetic modification is for good, right? So for instance, if you're modifying crop, so they don't need pesticides. Well, that's a good thing. Which would you rather have those quote, unquote, toxic cancer causing pesticides, most of them, don't cause cancer, very, very safe. But but GMO's sometimes minimize the need for pesticides or maximize the health benefit or strengthen the crops or something like that. So it's not always a negative for GMO's. Okay. Question not to cut you off. But this is the literal question one time we had a guest on getting curious who had done a documentary with. This amazing artist named Chow and the documentary covers basically affects it caused in his life due to exposure from Agent Orange. And I understand that like, but I'm just trying to say that like there is an also I'm accented for everything. So I am. But like there is there has to be a fear for why people do feel so canfield feel so ardently antibac- or whatever and anything Agent Orange case. Like, you had a government saying that there was like no harm. No foul. It's no big deal. It's absolutely safe. All the scientists say it's tote safe. No big deal. Take a bath in it. No big deal to this day. Like, there are people whose parents American parents who are veterans of you know, like they can't even get support for like their exposure to Agent Orange and not to mention the people in Vietnam that like continued to struggle with it. So like has there ever been any like really horrific things other than Agent Orange gave people reason to be scared kuenz? Sure, of course, and a lot of these things, you know, the GMO thing is one example, but you know. Let's say remember the the drug solidified which was a drug that was given to pregnant women to to help with nausea, just like out. Now, we have so Fran or Benadryl or something, but solidified it was a great drug and got people through pregnancy until they're started to become solidified babies, where they would have limb problems would be born without arms, or, you know, severely, you know, abnormal arms and legs and things like that. And so, but this was a drug that we thought as a medical community was a safe drug and ineffective drug and harmless drug. So certainly looking back. There are a lot of things that we can say, oh, this was actually horrible doctors Easter recommend cigarettes. So you know, there's a lot that we have to step back and say, wow, we were wrong. So I feel like that is a gorgeous say Guay for our first break. So just deal with me saying like an ad or two it's probably going to it could be an accent. You know and could be me with an accent on the attic could not be. I'm not quite sure. Sure. But we're going to get through this together. We'll be back with Morgan curious and more Dr Nina Shapiro right after the break. Hey, pure for men is an all-natural cleanliness supplement designed to help you bottom with confidence. No amount of last minute. Prep Animas, douching, etc. Sorry, mom. We'll keep you one hundred percent clean. If you have a crappy diet, the Chia flaxseed silly an elevator inside of each capsule work to safely pass through your digestive tract, biting food, particles and anyways left along the way pure for men's proprietary blend is all natural the friendly and works like a sponge to clean your little poopie bottom. There's also pure for her with extra aloe. Vera. So here's the thing. I've been using pure for men for like the last couple months, and I just take three with me. And I charged a lot of water, and then I continue drinking water. And Honey, I'm just feeling so much more secure and confident and don't even get me started on their bum. Bums grub? It is gorgeous. She is clean. She's frisky. And we're all human and. I didn't get taught how to deal with my bum bum. And I just want people to love their Bumba GMs. Okay. So don't judge me? Mom shop now. Pure for men dot com and use promo code JV end to receive twenty percent off your first purchase. That's pure for men dot com. Promo code JVM for twenty percent off pure for men, hashtag stay ready grove is your one stop shop for household pet and personal cast applies m makes it easy to get products. You can feel great about. Hi, it's Harry, Larry from Lara's weather corner. 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Sign up for the grove collaborative at grove dot co slash JV in and you'll receive a thirty dollars. Mrs my gift set for free with your order of twenty dollars or more. That's grove dot CO, not grove dot com slash JV. A and I want to tell you about a brand new streaming service that allows you to work out from the comfort of your living room in as little as ten minutes a day open pit takes all the complexity out of finding a place to work out and getting fit and getting up of that. Ouch. Any just press play on your computer your web able TV tablet smartphone. Andro coup and workout on your schedule. Honey, I live for my little BB open. She's working great one of my favorites is the yoga fifty two because when I need to stretch and is needed to do a quick. And I don't have time to go to the yoga studio that schedules now working on my schedule on busy boy, busy girl. Do not have time. I can just do it. Right. When I get up a right before I go to bed healthy stretch out that figures dating back in Honey, I'm feeling great. So open pit his changed the way I work out and with my code JV. N you can join me on a fitness or any personalized just for you again. Use my co J B N and start using open fit for your journey to a more gorgeous active life listeners of getting curious. Get a special extended thirty day free trial membership to open fit just text JV on to thirty thirty thirty. You'll get full access to open fit all the workouts. And all the nutrition information, totally free again, just text JV N to thirty thirty thirty and get that little baby open-access, Honey. Hey, welcome back to getting curious. This is Jonathan Vanessa. We were just kind of painting the picture for what I think is. So great about the book that you wrote which is like what is the difference between good science. Maybe something you shouldn't mess with. How do we use our critical thinking skills? I'm really big on critical thinking, Honey, I think it is really important to be able to like take the information and be able to disseminate between what is fake news. And what is true for you? You know, but true for you. And like a real way, you know. So what do we learn about this gorgeous book without giving away all the info to the children? But because I want them to buy it. But what were some of the things that you cover in this book, and how do you use your gorgeous critical thinking brain, so one of the things that I start out with and I think it's really important. And I think this is important as you say the children, so this I think should start in school early as a child has a computer is how to do an internet. Search is especially when it comes to your health. I mean what? What do we do when we have a symptom? I web MD night freak out because I'm like, oh my God. I look crazy. It's this right. Is that no one was supposed to do the box. Yes. So or we Google and Google is now a verb. So you we Google are symptoms or we being are symptoms or however, Yahoo whatever whatever search engine using. That's the first thing we do doctors do it too. And if it's something out of our specialty we freak out too. So if I have a headache, I'm having a stroke if I have an armed pain, I'm having a heart attack. So that's it. There's nothing in between. And so it just teaches people how to do a web search how to identify since ational ISM advertisements in advertisements aren't necessarily wrong. But they you have to understand that. It's an advertisement. Insatiable ISM children. If you don't know what sensational than means done since. No break it down for them. Tell them how do you? What is like a way that you can they can spot it. So anything that is incredible groundbreaking earth shattering the most amazing results is not true. It doesn't mean it's false. But it's probably not accurate, and it's. Exaggeration. And that's what a lot about the book is about exaggeration. Not that it's wrong. Not that is false not that it's fake news. Although there's a lot of fake news in health as well. It's just this exaggeration. And that's what sensationalism is is blowing something up taking a story and people will their heartstrings will be pulled at some amazing terrible story about some horrible event that happened. But what about the other nine hundred ninety nine thousand nine hundred ninety nine people were it didn't happen with that seem event. Right. So, but that, but what's gonna make it onto the internet is something, you know, some amazing sensationalized story, and that's what pulls readers in. That's what pulls your is in. Because that's you wanna read about one person. You don't wanna look at a boring graph of some data. You're going to read about some horrible tragedy. But your goal is to kind of power people with those thinking skills so that your day to day life than derailed with like worrying or being ridden. Things -iety over like, whatever that like that. I looked at the eclipse for like two long. Oh my God. I I did pull a Trump. I did look at it for two seconds. But then I was like, oh, my Khan. And you're okay. And you're okay. And then once was six Bill asked him, we had an eclipse. I did the same thing with that time. I was like convinced I was going blind like convince tariff very, much terrifying. Yeah. So I think that's a really important thing to be able to spot. And then what else do you talk about things that we worry about, you know, we all worry, and it's human nature. I have one I have on all of last year. I was convinced that I was getting the beginning of Parkinson's because I like sometimes I twitched like my little hand will like twitch like that or like middle finger. And so then it was telling everyone about it. That would listen frankly for months because I was really becoming worried about I was worried. But then my fringe Buki said girl you drink like eighteen coffees a day, and you only drink three cups of water. And when I used to drink that much caffeine the guy you'll get a little like an ever since. Then I was like oh my God. I feel better much better. And it goes away. It does go away. Yeah. Yeah. Power of suggestion. Yes. So yeah there, but there's a lot to worry about. And and what I talk about also is. Yes, there are things you should worry about and things that you really shouldn't worry about or things you should just be aware of you know, when two thousand fourteen what happened in two thousand fourteen Ebola right everyone everyone had e Bala because that's what was hitting the airwaves. Right. We were all seeing evola. It was all over the news. News. Did he bullet just begin to exist in two thousand fourteen it had been there for decades before that was the biggest outbreak that we'd just outbreak? But how so how many cases have you Bulla were there in the cutting? Well, I think the thirteen thousand nine thousand right, and I'm gonna new cases of HIV where they're they're more two million. So what are we talking about HIV in two thousand we definitely should be. And we shall be old news, but in others newel boulevard outbreak this year to right, and they'll be more. And it's it's a horrible. It's a deadly disease. But people will really, you know, what do we do at home in our home in Kansas or wherever because we heard that somebody in some airport had he bowl. And again, it's not that we shouldn't worry about it. We should be aware about it. But because it's in the news in its front page news. That's all we worry about. And we don't wear seatbelts. Well, yeah. Because it does kind of feel like well that a bullet thing felt like it could be like the beginning scene of like the Walking Dead, or like, you know, sort of Armageddon ish, this is how the world will end. Yes. This is this is the end of human. Kind. And then you're kind of saying more like what my dad says to me when I'm freaking out about something like, which is like if you're in Wyoming, and you hear hooves think horses, not zebras. That's right. That's right. We say that a medicine to well. That's my dad and my dad's dad is a doctor. So I like to my dad's favorite thing to say is I'm a doctor, son. And then my other favorite thing to say. I'm a doctor's grandson knows even better still. Okay. So that's kinda starts off. And you like sensationalism spotting your I like not being like. Kind of thrown around so much like some of the information that we take in especially when it comes out because we are naturally scared, and as we should be about keeping ourselves, healthy, etc. So then what happens gorgeous? I talk about. Also that people, you know, in a lot of people have asked me like, well, I'm not in medicine. I don't have to find a good website. I don't have access to all this medical nonsense. But it's you know, it's also to empower people and say, no that's not true if you can read, and you can read a website, you can figure this out. You don't have to be in medicine to decipher when a headline says groundbreaking study. And then you look that it involves three people. So it's a lot of it is empowering, I talk a lot about diet. So GMO is in there definitely supplements. You know, what does it mean to be taking supplements? Do we need supplements? Yeah. Let's deal with that. Yeah. So for the most part, not really, right? Most people are very very well supplemented with enormous healthy, well rounded diet. That's why I I don't know if I. When it include this. I could be shooting myself in the foot here you guys. But I guess I'll go ahead and say that I going to say that's why I have never endorsed a hair vitamin because say, that's my vitamins for your people that take I've never I've never endorsed it. Because I had a lot of people have told me over the years, it, it's it's not that they don't work 'cause but you have to take it every day at least for three months, and you might grow like a little teeny bit faster hair. Like, you it might work a little bit. But it's not like you're gonna all if you've had twenty-seven here's on your head your whole life. You're not all of a sudden going to have waist length share center, part hair because of this hair, vitamin, you know, and a lot of the people that do market it. It's not the case. I thought a lot of flack for a lot of upset in this because I did a partnership with looked in an I and I love Lipton, but one of the teeth because they have like a wellness t range and one of them with the detox tea, but it had like dandelion and like grapefruit it was like nothing like it didn't have. We didn't have any of those like, you know, diarrhea chemicals in it. It was literally just you know, a light t just had like it like literally it was dandelions Nedal in grapefruit that was yet. There's there's no chemicals in it was just a t. But in the comments people were like Bish coming for blood Jonathan how could you promote something like this? We expect more from you this body. This is body just Morphing how could you possibly endorse a brand like this in with your followers? Expect better from you of all the things that it's like if people knew the amount of endorsement and money that you turn down day in and day out because earliest for me, I know a lot of people that don't like that. I haven't done gummy sugar hair bear vitamins because I don't believe that. I think that you can Dudley have like, you know, you're salmon or get your spinach or wherever else those little like, those omega czar and get it that way like that certainly has been what I've done now have been taking propecia once a day since I was nineteen out the fucking Lutely and it works. It works like a Charney really works. That's a supplement. That's different. She. Yeah. I love me, some pro PIX. Yeah. That's fine. Because they may hairline is just he's not giving up on me. She's yeah. She's hanging in there. Your lips to God's. Here's Jonathan I already because every man in my family's bald is a bat. Like, I'm on borrowed time. Man. That's better. Well, you know, where pieces she's the pill. But I've just I'm just doing joining it while I and then when I need to be bought I'll be ball eight. I'll be fine see their way. I'll just pull a lace front out of the closet, and it'll be fine. Just so. In your you said you've been in medicine for two decades. I now I'm like twelve years. No. But have you noticed an uptick in the in our catastrophe ising or in our in general level of anxiety? Like, his it always been this way. Do you think it's kind of just more of the same like the climate that we're in? Now, I think I think just that we have so much more quick access to information. And so we're so freaked out because we look on our Twitter feed or we look on our Instagram when we see something right away. And then you look again, your thumb is so Warren and in the past we didn't have that we had the newspaper. We had the radio we had the television and everything was so much slower. So the news would travel so much more slowly than it does now. So I think everyone is like what's next? What's next what's next, and I need to I can't fall behind. Whereas whereas the latest outbreak was it was in Italy. Or was it in Washington while they were both. So so I think because we have so much more ready access to information earlier and earlier younger and younger, so kids know what's going on. Now that we're free. Kicked out all the time because we know so much more. So you're minding your own business came you're at I don't know where you are. Maybe you're at like a basketball game of your children's or something, and you, and you know, and you and you overhear an anti vaccine conversation. Do you attempt to talk to them? Do you not do you like do like, this is not necessarily you individually, but in our world like do we like do we need to protect our herd immunity by like telling people like Lee, what do you think? I mean, I think I do have the advantage of saying, you know, if it's something like that where I feel like that, you know, if I hear people saying, well, you know, I really and they give their reasons why they don't want to vaccinate their kids or their family. Then I can certainly turn around and say, well, listen, you know, I'm a doctor, and I have had this experience. And I understand your concerns. Maybe can talk to me about. I don't wanna say you idiot. You know, feel like saying you wanted to is your kids. But I would I would probably approach them if you know, if people are talking about, oh, I don't eat GMO, or I'm vegan or I have this special diet, you know. Is their business? It's fine. But I feel like for something like that vaccines where it's not just a personal decision. It's a public health decision and what they do for their family affects every other family. They just don't even realize it. I think it is important to say something it's like saying, oh, I think it's fine for my kids to smoke cigarettes. It's a personal problem. But it's also affecting the people around them. What is there ever a reason to knock accented or something? Yes. Such as so. And this is the reason why the healthy people have to get vaccinated. So if somebody is on immune suppressant medication if they are getting cancer therapy or chemotherapy or any other sort of medication where they can't get vaccinated. The reason why we are heard and we rely on her immunity is that everyone else around them. We'll be protected and that actually physically as like a herd for them in protects that person who can't get him United. So that's what herd immunity mean. That's what hurt immunity means. It's protecting the people. Who can't get vaccinated which is like maybe babies like literally brand new babies elderly like, right? So or like babies who get their vaccines? Let's say it's a tiny little baby and they go to that basketball game. And they haven't gotten all of their vaccines yet because they're still so young. They can get something like whooping, cough or measles because they could be exposed to some unimmunized kid. But if the kids around them are protected that protects that little baby. Oh, so nice. So it really is kind of it is it is a decision you're making to it is decision that you're making to not. I mean is your is your family, and it's more than it's more than just a decision for your family where can people really go to find their own research to determine if it is safe for them or not or if it's a government conspiracy or not like, right? So the first one I would say would be the CDC site. But if that's government people are are uncomfortable with that. And I can understand they're certainly concerned with a government funded website, but the CDC centers for disease. Control has all of the vaccine information, the American Academy of pediatrics so that's a little less government d because it's dot org. And and it's a medical organization that has all of the information about vaccines. And so those are probably the two biggies the NIH also has has good. But that's that's true. All right man, England, which we love which is this ain't well National Institute for health is also American it is well, you're of NHS. Yeah. Health service? Oh, an agent QA. Yes. They're yeah. They're really something. So, but the NIH the national institutes of health in Bethesda, that's based here. So but those are government funded. So if you're if you're uncomfortable with that new feel like there's a conspiracy and actually most vex antibac- vaccine also anti are conspiracy theorists. So kind of goes together. But if you have the concern the American Academy pediatrics eight AP dot org is a great site for vaccines. And it just gives the information. How concerned are you about like, the anti vaccine, and and and the threat that poses to like public health? It's a huge problem. I mean, we've just seen it blossom over the last five to ten years. It's it seems it seems like it's relatively new now. But because we have loud voices, and we have voices that people listen to and it's growing, and there's more and more sort of anti-government concern. Some of that anti-government is for good reason, certainly nowadays. But this anti-government that that the scientists are out to get you is a little bit crazy. So it so the anti vaccines are it's exploding. Well, that's why fake news. I'm white so problematic for Donald Trump to like paint such a distressing picture of like journalists and scientists, and you have those those seven words at the CDC's and allowed to use in their research. And I think that is problematic because it does breed this idea that you can cherry pick your facts and cherry pick like what works for you. And what doesn't work for you? And that is not with public healthy. No. And we saw this with how the HIV aids crisis was handled like that can cost lie and not only HIV aids abortion for that matter like when you politicize health issues and put them next to like, moral and religious things which a lot of antibodies. It's also like it can be a religious thing. It's like that is dangerous. Yes. You know? And it's just completing. Yeah. I think that's just like a completion of of many things. It's confusing. What else that goes on in gorgeous hype that people really need to know about? Well, I think you know, we talked about detox is. You mentioned that t-. So you know, detox is well, that's actually I just thought of one another thing. I'm really sorry. You mentioned vegan. 'cause I was actually militant begin for like four years. I relative vegan is that different from regular. Why didn't even wear leather? Honey, I was really worried about it. And then I realized that like tires have like a horse stuff. And it's only got like not drive a car from really going to go all out, but I didn't wear leather. I was really I read this book called skinny bitch. I was really really moved by felt really really good. I didn't think I was protein deficient or anything in that time. But do you think that being begins like too extreme like? I think it's again, I think it's fine. It's a personal decision. I think is long as especially because they are a lot of kids now, better vegan. I think as long as you're getting enough protein and enough of a balanced diet. It's fine. Anything wrong with it. Get your rice and beans. Now, it's it used to be oh, you're a vegetarian now. It's kind of editor, Ian, because there's so many different kinds of again. And there's soya, and there's so, you know, I think, but I think if people are doing it for let's say, you know, a so-called allergy because a lot of people think they have gluten intolerance or lactose intolerance can't dairy. I can't have this that and then they put that on their kids, and it's actually just like maybe they're kid had an upset stomach, and it's not necessarily an allergy. I think that's a negative because first of all you're making your kid Krazy and second of all they could be missing on some nutrients for the wrong reasons. So what what is that? Like, what is it that some people have that thing where it's like, oh, I have a, but then they really really don't. But they're convinced that they do like is that like a really mild case of like that one thing really mom's saying that their kids sick. And then they like that much houses thing is that like a really? Not quite the much Hume or or just like, human nature or something. So sometimes it's you know, sometimes it's true. So gluten intolerance is a real thing, and they're seal EAC disease, which is an absolute real thing. Where to get really really sick. If you have any gluten, and that's absolute real thing. But we all have that brand who said that they're gluten intolerant or silly. And then they make you go to all those special restaurants. But then at like eleven o'clock at night you find them face down in a box of Pizza Hut. And you know, and then the next day, they're not swollen their ankles or not blue thereby. Yeah. So that's the other thing. That's what if you eat too much pizza. You're gonna feel sick. And that doesn't mean you're gluten intolerant of too many bagels. Or if you have too much of all, you know, any sort of carb or Brad you're going to feel sick. That's not gluten in Arizona, really steadfast education to my through. My gluten intolerance. I've had you know, pizza cookie after pizza cookie after pizza after pizza after Taco Bell. Then chapter Taco Bell bench at night after night, and they keep coming back for more. I'm not going to claim that sort of, you know, I'm just saying, okay? Yeah. Just kidding. But yeah. No. So it's you know, some of it's real and some of it is just not real. And it's it's just it's lumped into this whole area of oh, well, I can't tolerate XYZ. So I have this special special special special and. It's a personal thing. It makes it makes it gives people control. I think a lot of that is whether it's control over your kid or control over yourself, but I can feel my infants part just pull just tripping up right now. Like, I am you know, soy intolerant. Whatever for the people right now that are fuming are like this woman is a bucking bit that I'm used to I take. So you know, I know, but so what do we say to them? I mean because like we're how do we bring some JV like loving compassionate? It's like, look I understand like you're stressed out. I understand like why like I know. I think it's fine. You know, if you feel it soy upsets, your stomach, don't, eat soy. It's all good. We're all friends just gave vaccinated just get. There's no gluten in the vaccines. So so a lot. Yes, I get you know. It's true. People are very upset by some of the things I say because I you know, a lot of it is oh get over yourself. You're fine. Get over yourself. How come you? Now twenty thirty years ago. This didn't even exist. You know, what people have irritable bowel syndrome, which is a real thing, and people have certain intolerances that may be has evolved over the last decade or two that didn't exist. But you know, I think it's just taken to an extreme. And so it's really what this book is. And what you want to help people do is like take that extremity and just learn how to kind of like, the moderate it. So that you're not really throwing yourself into like through this whole rigmarole that you don't really need to do and could actually prevent you from feeling better. Yeah. I mean, a lot of it is just to rein it in and just to kind of calm down a little bit. I think it's so easy. And again, we're so worried about so many different things. And then whatever the newest thing that we hear about you know, it was Ebola. It's going to be something else. Zeka Zico was after he Bola. So you know, there's going to be another vice. Iris that hasn't that? We haven't heard of yet. Okay. We can make us crazy Sam by or not Sam by. But here's the thing. My grandma can say the solder now 'cause she passed away in two thousand fifteen I loved her so much who's still amazing name was an Oakley. She was so called, but she smoked a hell of a lot of cigarettes until she quit and like like, maybe like nineteen ninety nine or something. And but the thing is associated really bad COPD. Right. And so she ended up dying of complications from COPD. But when she in the last two years of her life, you know, she had a really bad cough. She had like that fears like Advair inhaler dot blue or purple when it really really well for her. But I would say to her you know, like skinny bitch. I read and I read I think I've heard a lot of vegans vegetarians say stuff of like, you know, like cow Malka lot of dairy like makes us make a little bit more mucus like I had heard that a lot. So I would say to my grandma like maybe like try not like 'cause she was like drinking Melika goes running away from her all the time. And I was like if you're having a ton of mucus in your coughing up like black balls of concrete mucus from your lungs, and it's a struggle like, even if you believe that it's stupid and like eastern easterner hogs washer whatever which she did. You know, she's like that's stupid stupidest thing I've ever heard like know doesn't make you make mucus. No, it doesn't. But she wouldn't even try it. And so I think that I have felt a little bit of a frustration. Because I have a lot of I have a lot of doctors in my family, like my grandpa was a doctor and then my dad's sisters two of her kids are doctors, I've definitely been around like, I know like that western doctor like mentality of thinking about things in my grandma would say like, you know, if you said that to one of those doctors at Duke where we go for physicals every year, you know, like or not Duke mayo. The mayo clinic in Rochester, you know. That's where we we go to our physicals there once a year, you know, she really that would be like a little much not June the milk. That's hogwash. They're fine with the milk. Did you think in eastern stuff is cute as doctor like is? There is a huge try like just totally. I don't wanna believe it's stupid. And I do talk about that in the book that it's complementary get entry. That's you know, there's a whole chapter on complementary alternative medicine and most people think like, oh, I'm just gonna outright bash it, and it's all horrible. And it's not true. And that's why it's complimentary. So the key is that. It's not alternative. So it's a complementary alternative medicine, which one is it is it or is it alternative. I love a complimentary Queen. Right. So it's all about. So I think all the allot of the eastern stuff is great because there's much more preventative the way I've noticed it helps. And and it's in a what if she drank less milk may be it'd be less musique. It wouldn't you her COPD? But she probably be a little she would have been a little less mucus huge. What a a little less, but you know, she felt like a milk made happy. Yeah. And she loved her cafe Francais. It's all good was obsessed with it. Yeah. So have you ever heard of like are you beta? Yes. Okay. So it's like that. I like, I feel like, you know, if you don't know what are we being she's kind of like she's like five thousand year old like ancient Indian like medicinal system that like yoga like the physical therapy of her and like a Veda the hair company like a lot of their like, their creator horse. Rocco Bacher like invented and was inspired a lot like a lot of Vegas's ingredients was originally prehistory Lauder was a lot of inspired by Evita. Are you beta ritual thing? Yeah. And they're amazing. And so in our UB to basically like it classifies people until like three Doshi is there's like caught up hit and Botta, and you take a little quiz in to figure out what you are. And most people have like a primary in a secondary, very occasionally. I think people are like a blend of all three. But usually you're like a primary and a secondary. And but the way that that medicine system works is it's like instead of they they prescribe a way for you to listen, you don't get the cold in the first place. So you don't like get the thing in the for you don't get the because it's more prescriptive for lifestyle. And I think that's interesting. I think that there is it's kind of like that whole Republican thing of like, we don't wanna pay for like any infrastructure, but it's like girl if you just like if you do preventative infrastructure you save money in the long run. So it is complementary and that great, and it, and I think it works and a lot of this stuff makes you feel better and makes you healthier and makes you more balanced and prevents a lot of illnesses. So no, I'm not I'm not saying that all that stuff is hogwash. Does he say oh my God. You know, be fierce. I just how many. Dreamlike really fast. It was like you and like a Christian scientist just doing like just do duping out not like physically, but just like physically would be good. Oh, my you're like, I'm ready. I'm like. Yes. But like. What do you what what do we do about? If that's just we gotta respect it because it was just like Americans. We are really about freedom of religion and stuff does not everyone's going to get back seen. We just gotta find peace or something. Well, I mean, it's not, you know, I think again when we talk about something that's a personal decision. You know? I don't want to take antibiotics. I don't wanna take aspirin. I don't wanna take Tylenol that's a personal decision. And they'll you know bear the brunt of it or not, and maybe they'll be better off for it. But when it comes to something like vaccines. They have to understand that it's a public health issue. And then what do you do do you sa- quest for them and say, well, it's fine. If you wanna stay, you know, not vaccinated and with your community, and then you may have the risk of getting that or do we incorporate them and put other children at risk and other, you know, weaken children with weakened immune systems. Do we put them at risk exposing them to any like that much not fair? I was saying earlier about like is there a way that you could like get too many. Like too many little baby vaccinations. And then like you make your little immune system to bear new. And she doesn't know how to fight anything or as to say. Like, should I be like smearing my food on the ground before I eat at to try to expose myself to some gorgeous things like have we become to clean in too afraid of Germany's great question. So the first part. No, you can't get too many vaccines getting vaccines on schedule a ton of axioms will not make you more, you know, to clean, and to sort of immune expose, but if you take too many antibiotics if you are in a bubble if you're not exposed to other humans than yes, it can make you more susceptible to illness. So eat that dirt. So eat the dirt. What about like, what's the longest you would ever go without washing your hands? You're going to say my hair. No, that's a question. No, your hands. You know, I'm a doctor. So I washed my hands like all day. So, but, but I know that like that you know, that aunty. Tibial stuff, that's really like the knocking. Well, I mean, we have some of it in the hospital. But in general like when I'm home or if I'm just out and about in public and it just like a regular. So is fine. You don't need that antibacterial nonsense. So just go to the bathroom and like, wow. Okay. But so when I'm in the bathroom at the airport and stuff after I wash my hands. I do like to wash or to drive off in the paper towel. And then keep the paper towel to open the doors. That's mar that's fine. I mean, it's the airport airplanes. It's another what about our phones. It's disgusting. So, you know, so in a hotel room, which which which item in the hotel room has the most poop bacteria, the bedside table, remote gross. Well, I just looked at my assistant the other room. I was like I hope you're ready to get those wet wipes and go out on the remotes hotel room. Wow. So basically, do you think that like the antibac- stereo is not new, but do you think that we are like to sterile gross brand new babies are just some people have always been like that? And we just need to continue to like, how these honest conversations. Well, I think that, you know, the the contamination concept for babies has gotten out of hand, I just say babies, but I meant like have we collectively like we all become to brand new and sterile of babies. Like are. We just a bunch of big babies. We're a bunch of big babies. But I think it's also we go both ways. Like, oh, you know, I have a sniffle. I wanna take antibiotics. That's that's crazy. But I don't want to get vaccinated like, which is why as one worse than the other. So I think it's almost like mixed messages. Like, we we want to be too sterile in one way. And then in another way, we go into the hotel room and don't care about touching the remote, which has poop on it. Right. So it's really kind of just using averages. Like averaging things out. Yeah. Let we seem to like moderate it. Yeah. And you know, what you're going to get sick. And you're going to not get sick. And it's not necessarily because one thing you, did you know, if you don't use the towel on the bathroom door. You're not necessarily going to die the next day. But you know, sure, keep yourself clean like dial-up dot. Okay. So we've reached a point in the podcast where it's like if you go to yoga, you know, like what like is there something really wanted me to like prove by and we didn't we didn't stop to chat about it. Like is there any thing that you're like, yeah? There's like eighteen things that I want to talk about after seven. No, I think that I think something that I like to come across to express is that people have a lot more power and control than they give themselves credit. I, you know, during my book tour, it was a lot of the response that I got was like, well, how am I supposed to know? And I'm not. Medical. I mentioned that before. And I think that people have to understand that they can get more information than they give themselves credit, for instance, something like vaccines. How does the vaccine work? Well, you can probably find that out even online without having to go to some boring medical journal and understand how what the science of it is you can find a very basic explanation for it or for any medical question that you have what is gluten gluten is actually a carbohydrate or a protein. She's a protein, right? But most people again, that's something that most people think of gluten it's a carbohydrate. Well, you just take it for granted. Because you think of bread, right? So she's a protein in Brad. That's right. But who thinks of protein and bread, right? Pro. I do because none of the ago. Okay. Well because non Scott like a ton of protein, right? Remember like being in trader Joe's, and I was like trying to eat more protein. That's when ten minutes like oh my God. I'll just e-p-o-c-h crunchy peanut butter all over this. And when I was vegan there I was like that's a shitload of protein. Oh, it has. Teen him. Well. He can't smoke your protean. Honey, I'd be like such a muscle mania. And this team comes to give yourself a little baby. She'll just feel amazing. Okay. So I think actually Dr Schapira I think I realized what our Instagram Content's going to be outside for this episode, which I'm really excited to create. We did I you off in the middle of. No, I'm good every. But my thing is that everyone can find you can find out any information. You want about any health question without feeling like you can't do it. And you just want to make sure that your source isn't from some dumb dumb like three persons study that was like on a dot net. C T L space like apostrophe weird site. And if if it sounds too good to be true, it probably is that's such a good thing. And I think nine you know, that I can't I can't say I can't say on not no in the middle of interrupting you for the. I can't to devastating wish I made it up. No. That was perfect. You got it in well in also that smile, Honey. I finally you've finally like peeked out from behind like the you have the parade as the mile dodger up here help races. Oh my God natural. Oh, my God was like in such a good move when he made your teeth. Well, thank you for writing this gorgeous book. Thank you for doing all of your gorgeous work as an EMT. And thank you in Sanjay gave you a glowing review. Honey, we love on Jay or Jess gets go make our content. Mateus Mateus Grassi as you've been listening to getting curious. With me Jonathan Vanessa my guest this week was Dr Nina Shapiro, iovine links to Dr Schapira socials in episode description of whatever you're listening to the show on follow me on Instagram. Henny follow me on Twitter. If you feel like getting gay Holly Mattis fuck like, Idaho. Our theme music is free by Quin. Thank you so much flooding us use it. If you enjoyed our show introduced brand show them how to subscribe getting curious produced by Cody Ziglar, which code star get better, we love you. But he's totally fine. If you know, maybe we should cut that because I don't want him people asking questions, but or not an ear fine. We love you. You're gonna make it after all Mary Tyler Moore style. Sarah shammy. Yes, cleaned. She stepped into this role. She's doing Julie Carrillo. Same thing. We love her Ray Alycia Miro harra, special mention we're obsessed. She's just over here. Right. And God damn book about to get a Pulitzer prize. Honey, watch out happening, and obviously collie Wally Anderson nicest boy of all time, not as all these British not it's all these cute. And we wish your country look with breakfast. Hey. Hey, guys, I'm thinking of the host of fake the nation where we talk about news. We talk about politics, and where we convert you about democracy, if you or someone you love wants to know what's going on in the world. But would rather year that news from around table of comedians were smart funny, and you know, what gin secure take the nation is the podcast for you. Our panelists are people like John Lovett, John vehicle, saying John Hodgman and just like a bunch of people name, John. But also people like w Kamau bell Maeve Higgins bear today. Thirst Judah Friedlander, and like just the funniest people in America. So find fake the nation on apple podcast Itcher or wherever you get your podcasts. Oh, and we will tell you exactly who's going to win the two thousand twenty election has like were that good.

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Dr. Courtney Hopkins, Senior Chief Medical Officer of Vitalant Blood Services, on How to Prepare to Give Much Needed Blood Donations

Discover Lafayette

15:45 min | Last month

Dr. Courtney Hopkins, Senior Chief Medical Officer of Vitalant Blood Services, on How to Prepare to Give Much Needed Blood Donations

"This is john swerved and you're listening to discover lafayette a podcast dedicated to the people and rich culture of lafayette the gateway to south louisiana. I'd like to thank our sponsors. Who make our podcast possible. We take our podcast with ongoing support of raider and jason sikora sound engineer. Reiter is a hands on. It service provider that integrates. All of your needs for advanced technical support. Effective communication options in cybersecurity. Writers motto is. You just wanted to work we understand. Please visit reiter solutions dot com for more information iberia bank and first horizon. Who are now one bank to relationship driven banks. Both in the industry have officially joined forces. The combination of iberia bank and first horizon creates a leading financial services company dedicated to enriching the lives of their clients associates in their communities. I'd also like to thank lafayette general health. Who has joined the national health family and is now auch ner lafayette general as one health system austria. Lafayette general will provide expanded services in enhanced care from the familiar faces. You already trust osh austria. Latvia general means more resources to help solve healthcare's toughest problems reinvesting in our communities and being further committed to health and wellness left. The general together means more learn more today at together. Means more dot org. Dr courtney hawkins senior chief medical officer talent services is our guest today. Board certified in clinical pathology and in transfusion medicine blood banking by the american board of cathal. Aji dr hopkins previously spent seven years with the american red cross. She graduated with a biology from arcadia university and earned her medical degree from philadelphia. College of osteopathic medicine. Doctor hopkins completed her transfusion medicine. Fellowship cedar sinai medical center and the david geffen school of medicine at ucla. I've asked dr hopkins to join us as a follow up to our interview with. Amanda landers regional director of talent blood services which was produced in november twenty twenty. Our discussion was centered around the fact that our region has been experiencing a critical shortage legend nations. After that interview. I attempted to give blood twice but was not qualified due to a low haemoglobin. Count my doctor. Says i have healthy. Aren't level so. I've done a bit perplexed by this. I wanted to find out more since. I've encouraged others to donate yet. I've been unable to do so. Seductive hopkins welcome to discover lafayette and for sharing your expertise with us on this. So thank you so much for having me year. Low hiba global is one of the more common reasons person is deferred from donating so happy to be here in disgusted said you and your viewers to help them hopefully be able to qualify for blood donation unaccountable lifelong Struggling with sunol now is the nemec as a child. And i didn't really understand what that was but I get the he. Gb's about having needles in the media to give blood. It's really because i was motivated to help but yet to be turned away. Lawn of this will just never go back once. You're turned away. It's like who but we have a real need for people to participate in us especially with the code shutdown. A now it's really affected. Blood drives nationally. And if you wanted to explain that to like you can't just give blood and then it sets for year before it's used. This is a continuum so yes in covert absolutely has impacted our ability to collect as businesses and schools and colleges closed that impacts our ability to go there and collect from those places. So thank you for pointing that out so it. It is so blood is doesn't last forever on the shop but it is the blood that's on the show that helps patients in the immediate. Need so we do have constant need for blood. Red cells lasts from twenty one to forty two days depending on the preservative we use when we collect them clips are only good for five days so you can imagine there's always a need her platelet donations and then plasma is we can actually freeze plasma entrance visa for up to one year but there is a constant need for red cells and platelets so they stuck my finger. You know with to get a little bit of blood. What is that process in. What are they actually looking for before. We're determined to be eligible. So what the finger stick is is. We're screening your hemoglobin to see if you're eligible to donate blood. Were not testing for iron itself. We do actually test ferreting stores in our minors in our teenage jenner's because they're most they're most at risk for iron deficiency anemia but will be for the general population of donors is a finger. Stick to look for hemoglobin and red cells. Carry oxygen throughout your body on hemoglobin which is an iron containing protein. And the reason we're doing the screening is when you donate a unit of whole blood. You lose about two hundred and fifty milligrams of iron in that unit. Blood sweet wanna make sure you have enough to be able to donate that unit now again. It's just a screening test to qualify you for blood donation iron deficiency is the most common reason why someone would have a low haemoglobin. But it's not the only reason so we tell you you know you have a low haemoglobin. It's most likely to iron deficiency and then we can discuss what someone can do to increase their hemoglobin if it is iron deficiency but it also can be other things too i think mine was set an eleven and i said it really needs to be twelve point five or so. I'm not sure if i'm asked saying that right. But i would actually give permission. Go ahead and take it. No we're not gonna take it. So i love to end. I went and bought some iron supplements in. I still don't know what i need to be dealing if you can. Maybe give us some guidance about how to prepare our body. If we do wanna be donor you know what we could be doing so there are a couple of things you can do. And we'll just do general things if that's okay and then if you think you have low iron so general things just to eat a healthy meal. We say a low fat meal because sometimes if the meals to high in triglycerides are that can impact when we try to do infectious disease testing it. Can it can hamper our ability to do that. Those tests so we say just eat a low fat meal to drink plenty of fluids to have a salty snack right before donation. Possible now the fluids. I know there's a question about the caffeine especially Coffee in the morning. And i am a huge coffee person. Caffeine can be a dire rennick so it can cause you to be a little dehydrated. So if you're going to drink caffeine just don't count that in with your fluids for Hydrating prior to donation so assume that the caffeine in the flu. The caffeine fluids don't count as a way to hydrate yourself so just make sure you drink extra water if you if you're drinking fluids of caffeine in them so the caffeine isn't actually a deterrent. Today heyman i was sneaking out but it was. I thought we'll call lee. Maybe just don't drink coffee bad day. This is a diuretic. So i can call it a urinate more and become dehydrated faster so the the first day i went i went after church so i had eaten. Probably at six thirty in the morning and then didn't have a high-fat millery nag. But i had two cups of coffee in. This was like four hours later. I hadn't had a salty snack. Probably hadn't had any water except mine coffee. Do you think that could be enough to throw the Results you think. Probably just a little bit low hemoglobin so it shouldn't be enough to throw the results. It could be that not preparing while like that before the nation could be enough to make you not have a good donation experienced that where you feel lightheaded. Dizzy after donations so really. The hydration is to make sure that you don't have an event an adverse event after generation. Already people don't have an adverse event minded. So what types of dietary choices are good to ensure healthy hemoglobin an iron in our blood. So there's two types of of of iron. There's this in the meantime you get from those The proteins that we think about right meat fish poultry but you also knew absorb about thirty percent of iron. It's called team iron through those types of diets. but you can also get non non-human iran through if you don't wanna eat me through fruits and vegetables through tofu nuts legume so so absolutely you can get iron through your diet. The one important thing is that citrus Citrus foods like vitamin c containing foods. Help your help. You absorb iron though each your iron but make sure you also have like a high. Vitamin c foods. Eat with its. I'll be absorbed iron so if you're vegan a rudd Ah sorry that that's right so so with a vegan. They're eating. They're getting on him type of iron and it just isn't absorbed is much. Is that correct. So this is not yet so kalamata served as much so citrus can help people who are vegan or just anyone. It's absorbed there. I absorbed iron better citrus foods and also if some people do if you're not if you don't obtain enough iron through diet some people do need to take an iron supplement and that is usually about eighteen to twenty eight milligrams of elemental iron. You can get that in your multivitamin or separate as as a supplement a day and you don't need to take extra taking extra can actually cause adverse events can cause gi side effects and you won't absorb any more so just take the the recommended dosage and i bought wine. You know drug emporium make it said sixty five. So that's way too. That's too high. Yeah you really need. Eighteen to twenty eight eighteen to thirty eight. Milligrams is enough but it can take a few weeks to build your iron stores back. So that's why that experience tech told you to come back to wait a little bit to come back. It can take a few weeks. We recommend if you are frequent blood donor or if you are a teenage of a teenager or someone who has Lower iron stores to begin with because they're growing To take it for about sixty days after blood donations so we that's about how long it can really take to to build their iron stores back. So could take that hell. I bought every other day at work. I just go buy a new bottle yet. The other great. I think people forget about is there pharmacist and i know it's hard sometimes to get to talk to the pharmacist. But they also can help direct people to the right source of iron at a pharmacy so I wanna thank you for all this one of the. If things i've found fascinating about giving blood and one of the reasons i wanted to do it was to see if i've had cova because i have not yet been sick. I've not. I did have to test once because i was exposed to someone but nobody my family has gotten code in my immediate family and we feel very lucky but i know that once we get blood you task for those antibodies. So i i. That's why won't be hurt people if we have had it did now. We now can call fight it. Donate plasma help others but also it's a way to find out if you've even had the virus can yes and we have so. We do two types of testing so we are. Testing is is very sensitive. Highly sensitive and highly specific. We actually have the talent research institute also that we worked with valid in our test. So we've been able to validate To really validate ensure that sensitive and specific. So yes if you donate if you have a complete donation you donate red cells platelets. Whole blood plasma. We will test you for covid. Antibodies and they should appear on your on the portal within about a week after donation and he also test for other types of I guess things have happened. Just make sure that the blood is safe to get some yes we test for the full gamut of infectious diseases. Hiv h. hepatitis. Zeka west nile virus. Someone encouraged people to go to buy talent dot org. You can find out. The closest place to give anna. No dr hopkins urine south carolina. But you you work throughout the south. The united states. But i want to thank you for your commitment. It looks like your whole your whole background. You've been focused on this area. Madison and also want to commend. You for the david. Geffen school of madison. I understand that there's a focus there on Giving back to communities ahead another doctor on recently that's an ecologist and the research i did on the david geffen school. It looks like a really encourage involvement in these types of of medical feels. If if that's correct yes. I was very fortunate to be able to be a part of their system and very fortunate to be part of by talent. I i do love this field and it is wonderful. It's it's it's great because the donors who come give selflessly of their times other people really inspire me to do my job everyday. Well thank you so much a team by talent for what you do for all of us to keep us safe because we don't realize what we need until we don't have access to and i know it healthy blood donations keep all of us safe. Natanya a hopkins. Thank you thank you. Ma'am i wanna thank our listeners. Also you can find this interview and others at discover lafayette dot net or even better. You can subscribe to discover laugh yet anywhere you get your accounts. I'd like to thank our sponsors iberia bank which is now a part of first rice and also austere laughing at general. Thank you for your support as well as data raider and jason sikora nixon's are tape on behalf of discover lafayette's on chance webs. Thank you for joining.

iberia bank lafayette dr hopkins jason sikora david geffen school lafayette general health Dr courtney hawkins american board of cathal Aji dr hopkins Doctor hopkins Fellowship cedar sinai medical Amanda landers talent blood services austria south louisiana arcadia university Reiter reiter College of osteopathic medicin
NEJM This Week  February 6, 2020

NEJM This Week - Audio Summaries

26:21 min | 1 year ago

NEJM This Week February 6, 2020

"Welcome this is the New England Journal of Medicine. I'm Dr Michael Berry this week. February six two thousand twenty we feature articles on Lung Lung Cancer. Screening in the Nelson Trial Raimondo cyclic and full restaurant in metastatic breast cancer vitamin D and pregnancy and asthma treatment treatment. Thresholds for neonatal hypoglycemia and car N. K. cells in anti CD nineteen lymphoid tumors a review article on Placebo Abo- and no CBO effects a clinical problem solving describing a rapid change in pressure and perspective articles on Altruism in-extremis Ramos on abuses of FDA regulatory procedures and on joining forces against delirium reduced slung cancer mortality with volume ct screening in a randomized trial. By Harry de Kooning from Erasmus Mc University Medical Center Rotterdam The Netherlands. There are limited data from randomized trials regarding weather volume based low dose. CT screening can reduce lung cancer mortality among male former and current smokers in the Nelson study a total of thirteen thousand one hundred ninety five men primary very analysis and two thousand five hundred ninety. Four women subgroup. Analyses between the ages of fifty and seventy four were randomly assigned to undergo C. T. screening at t zero baseline year one year three and year five point five or no screening the overall referral rate for suspicious suspicious. Modules was two point one percent at ten years of follow up the incidence of lung. Cancer was five point. Five eight cases per one one thousand person years in the screening group and four point nine one cases per one thousand person years in the control group lung cancer mortality was is two point five deaths per one thousand person years and three point three deaths per one thousand person years respectively in this trial involving high risk persons lung. Cancer mortality was significantly lower among those who underwent volume ct screening that among those who underwent no screening. There were low rates so follow up procedures for results. Suggestive of lung cancer in an editorial Stephen Duffy from Queen Mary University of London writes lights that since the publication of the first mortality results from the national lung screening trial which showed a twenty percent reduction in lung cancer mortality with low dose. CT T- screening. The intervention has been adopted as policy in the United States and there has been considerable discussion of the possibilities for its adoption in Europe policy policy. Decisions are still awaited in many countries despite the unequivocal nature of the original national lung screening trial results. This is likely to be partly due to doubts fostered by the early publication of inconclusive results. Of A number of smaller trials in Europe these doubts should be laid to rest by the Nelson results. There can no longer be any doubt as to the efficacy of periodic low dose CT screening in reducing mortality from lung cancer. The task for evaluation is now to estimate the cost effectiveness of this screening. The latter of course does not have a single value and is country autry specific it will depend crucially on the interval between screenings and more crucially on the population targeted selecting high risk persons with the use of validated models for predicting lung cancer risk is considered essential in an era when most lung cancers in developed countries are diagnosed in ex wchs smokers accurate estimation of individual risk becomes more important with the Nelson results. The efficacy of low dose C. T. Screening for lung cancer is confirmed. Our job is no longer to assess whether low dose E. T. screening for lung cancer works. It does our job is to identify the target population in which it will be acceptable and cost effective overall. Survival with rival cyclic. Plus Full Restaurant in advanced against breast cancer by Dennis. slaming from the David Geffen School of Medicine at UCLA. Los Angeles in an earlier analysis of this phase as three trial Rabbo cyclic. Plus full restaurant showed a greater benefit with regard to progression free survival than full veterans alone. In postmenopausal Oh patients with hormone receptor positive. Her two negative advanced breast cancer here. The investigators report the results of a protocol specified second second interim analysis of overall survival. This analysis was based on two hundred seventy five deaths one hundred sixty seven among four hundred. Eighty four your patients thirty four point. Five percent receiving RYBECK PSYCH LIB and one hundred eight among two hundred forty two forty four point. Six percent receiving Placebo Zibo riboside clip plus full restaurant showed a significant overall survival benefit over placebo plus full restaurant. The estimated overall overall survival at forty two months was fifty seven point. Eight percent in the Robo Cyclic Group and forty five point nine percent in the Placebo Group for a twenty eight percent percent difference in the relative risk of death. The benefit was consistent across most subgroups in a descriptive. Update median progression free. Survival title among patients receiving First Line treatment was thirty three point. Six months in the Rabbo Cyclic Group and nineteen point two months in the placebo group known no new safety signals were observed rival club plus full restaurant showed a significant overall survival benefit over placebo plus full restaurant in patients with hormone receptor positive. Her two negative advanced breast cancer. Six Year follow up of a trial of antenatal not natal vitamin D for asthma reduction by Gustav Litang Wa from Golisano Children's Hospital Rochester New York. The investigators gators previously reported the results of trial of Prenatal Vitamin D supplementation to prevent asthma and recurrent. We's in young children in which Prenatal Prenatal supplementation with four thousand four hundred international units of vitamin D three or four hundred international units of Vitamin D. Three per day were examined with maternal levels of twenty five hydroxy vitamin D taken into account. That report suggested that supplementation provided a protective effect at the age of three years. The investigators followed the children through the age of six years to determine the course of asthma and recurrent we's and found that there was is no effect of Maternal Vitamin D supplementation on asthma and recurrent. wheeze in either an intention to treat analysis or an analysis with stratification according to the maternal twenty five hydroxy vitamin D. level during pregnancy. There was no effect of Prenatal. Vitamin D supplementation. On most of the pre specified fight secondary outcomes the investigators found no effects of prenatal supplementation on Spiro metric indexes although there was a very small affect on airway resistance as measured by Impulse Assalaam etry this finding was of uncertain significance vitamin D supplementation during the prenatal title period alone did not influence the six year incidents of asthma and recurrent wheeze among children who were at risk for asthma. Erica Fund Matias from the Helm Holtz. Center Munich writes in an editorial that this trial was appropriately powered and skillfully conducted and thus the outcome could be considered quite definitive especially in light of the similar results obtained in a study performed in Denmark. Vitamin D supplementation should not be used to prevent at school age. Asthma which is most often associated with Aero allergen sensitization however the previous report limited to the first three years as of life showed some evidence that Prenatal Vitamin D supplementation provided protection against wheezing illnesses. This protection was strongest for for the first year of life and tended to wane between the ages of one in three years findings reached significance when combined with those of the danger study taken together. The results suggest that Vitamin D supplementation may be effective in preventing the transient forms of using that occur in preschoolers coolers but not allergy related asthma the prevailing form of persistent disease during the school years. Transient wheezing is unrelated to allergies and the most common causes of weasing regardless of prognosis in this age group are viral lower respiratory tract illnesses in spite of its a good prognosis. Transient leasing can be associated with severe asthma. Like symptoms especially during the virus season although supplementation in this trial Oh was not effective in preventing school-age Asthma Vitamin D supplementation. During pregnancy may still play a role in averting less persistent forms of leasing in an infant's with a parental history of asthma and allergies lower versus traditional treatment threshold for neonatal hypoglycemia by an Van Kampen from Emma Children's Hospital Amsterdam the Netherlands worldwide many newborns who are preterm small or large for adjusted age or born to mothers with diabetes are screened for hypoglycemia with a goal of preventing brain injury. However there is no consensus is on a treatment threshold that is safe but also avoids over treatment in this randomized trial involving six hundred eighty nine otherwise healthy newborns born born at thirty five weeks of jazz station or later with ace symptomatic moderate hypoglycemia to threshold values for treatment were compared would a management kamins strategy that used a lower threshold treatment administered at glucose concentration of less than thirty six milligrams per deciliter be the non inferior to a traditional threshold treatment at a glucose concentration of less than forty seven milligrams per deciliter with respect to psycho motor development at eighteen months cognitive and motor outcome scores on the Bayley scales of infant and toddler development? were similar in the two who groups mean scores one hundred two point nine cognitive and one hundred four point six motor in the lower threshold group and one hundred two point two cognitive and one hundred four point nine motor in the traditional threshold group. The pre specified inferiority limit was not crossed fewer and less severe hypoglycemic occurred in the traditional threshold group but that group had more invasive diagnostic and treatment interventions. In this study ready a lower glucose treatment threshold was non inferior to a traditional threshold use of car transducer. Natural killer killer cells in CD nineteen positive lymphoid tumors by N Lee Lou from the University of Texas. MD Anderson Cancer Center Houston Anti CD. Nineteen car. T. South therapy has shown remarkable clinical efficacy in B cell cancers however car T. cells can induce substantial central toxic effects and the manufacturer of the cells is complex. Natural killer cells that have been modified to express an anti hi CD. Nineteen car have the potential to overcome these limitations. The investigators in this study administered. Hla mismatched anti CD. Nineteen eighteen car N. K.. Cells derived from Cord Blood to eleven patients with relapsed or refractory CD nineteen positive cancers the administration ration- of Car N. K. cells was not associated with the development of Cytokine Release Syndrome neuro toxicity or graft versus host disease and there was is no increase in the levels of inflammatory cytokines including interleukin six over baseline of the eleven patients. who were treated eight? Seventy seventy three percent had a response of these patients. Seven had a complete remission and one had remission of the Richter's transformation component but had persistent assistant chronic lymphocytic leukemia responses were rapid and seen within thirty days after infusion at all dose levels the infused car N. K.. Cells expanded expanded and persisted at low levels for at least twelve months among eleven patients with relapsed or refractory CD nineteen positive cancers answers. A majority had a response to treatment with car N. K. cells without the development of major toxic effects placebo and no CBO effects a review article by Luana CA Laka from the University of Maryland School of Nursing and School of Medicine Baltimore Placebo. Zibo and no CBO effects are the effects of patients positive and negative expectations respectively concerning their state of health. These effects occur in many clinical contexts. Tech's including treatment with an active agent or a placebo in clinical practice or in a clinical trial. The informed consent process the provision of Information About Medical Michael Treatments and public health campaigns placebo effects caused beneficial outcomes and no CBO effects caused harmful and dangerous outcomes variation in the ways that patients respond to treatments and experienced symptoms is partly attributable to these effects the frequency and intensity of placebo effects in clinical practice are difficult to determine and the range of effects in experimental settings wide in many double blind clinical trials. L.'s have treatments for pain or psychiatric disorders. For example the responses to Placebo are similar to the responses to active treatment and up to nineteen percent active adults and twenty six percent of elderly persons taking placebos report side effects furthermore as many as one quarter of patients receiving Placebo Oh in clinical trials discontinue it because of side effects suggesting that a no CBO effect may contribute to discontinuation of or a lack of adherence is to active treatments placebo and no CBO effects are powerful and pervasive in clinical practice neurobiological mechanisms information offered in relation to treatment patients expectations previous encounters with a drug or procedure and the therapeutic MILLEA can all generate these effects a rapid change in pressure a clinical problem solving article by Kristen Dasilva from Brigham and women's Hospital. Boston a seventy four year old woman presented with a six week history of Progressive Disney on exertion eight weeks earlier she had been travelling in Italy and had been walking up to four miles per day. Progressive Disney on exertion had developed after she returned to the United States. She also noted a nonproductive cough fatigue loss of appetite and an unintentional weight loss of nine kilograms over the previous six months four weeks earlier chest. X Ray showed no pneumonia a five day day course of prednisone and Zithromax was prescribed however her symptoms continued to worsen and she began to have Disney when she was at rest on current current examination. The patient had tack Cardia to keep Neha and hypoglycemia. The differential diagnosis was broad but given the acute presentation pulmonary pulmonary. Embolism was the most likely diagnosis. However pulmonary and geography showed no evidence of pulmonary? Embolism mild by Basil Adolescent asus enlargement of the right ventricle and multiple sclerotic lesions within the vertebral bodies were noted progressive hypoglycemia developed developed and one hundred percent. Oxygen was administered through a high flow nasal kanye systemic glucocorticoid intravenous heparin and inhaled EPO processed in all followed by intravenous tra- personnel were administered but had no effect patients with pulmonary humor thromboembolic micro Angie apathy typically cle- present with Disney on exertion and hypoglycemia. The diagnosis is challenging. Owing to the rarity of the disease altruism altruism in extremis the evolving ethics of organ donation up respective article by Lisa Rosenbaum National Correspondent for the Journal for. WBZ's life partner. In retrospect the first sign was dishcloths full of water. Why had WB stopped reading them out as he had always done on his hands? It turned out had grown weak and soon his foot started making slapping sounds when he walked when he could no longer mow the lawn without resting he sought taught medical care only to be told he was decommissioned because he was overweight and had a sedentary job when he started falling down. Wb then fifty fifty five was finally referred to a neurologist who diagnosed him with amyotrophic lateral sclerosis LS WB. A father of three. Who spent his life? If working hard and caring for others researched his disease with a clear understanding of his prognosis. He felt a profound desire to still help others he. He approached the University of Wisconsin Transplant Center with an unusual request to donate all his organs before he died if he had to die in a process that would strip him of his dignity and sense of purpose. Why not be allowed? This final act that could save other lives however the legal and ethical hurdles hurdles proved insurmountable even donating one kidney while. WB was still living and able to consent for which a clear protocol exists wasn't straightforward straightforward in some countries however opportunities for organ donation are expanding as ways of dying evolve in Canada where medical assistance is in. Dying is now legal. Some patients are able to fulfil this last wish abuses of FDA regulatory procedures seizures the case of suboxone perspective article by Rebecca half achieve from the University of Michigan School of Public Health and Arbor only about twenty percent of the more than two million Americans with an OPIOID use disorder O. U. D. received treatment in a given year buprenorphine. One of several medications used to treat Oh. Ud substantially reduces the risk of overdose and can be delivered in office based settings various barriers impede widespread access to buprenorphine however including including federal requirements that clinicians obtain a waiver to prescribe it. In addition high prices for brand name buprenorphine formulations strain the budgets of public programs which cover a disproportionately large share of people with no you D in Two thousand seventeen Medicare and Medicaid. Were responsible for thirty thirty. Two percent of the two point. Five eight billion dollars in prescription buprenorphine sales. The bulk of these sales was for suboxone. A patent atten protected buprenorphine no oxygen sub lingual film made by RECKITT benckiser pharmaceuticals now separated from its former parent company and known as in DVR in the profitable buprenorphine market Reckitt benckiser exploited various FDA regulatory procedures to impede entry of generic competitors editors and maintain elevated prices by securing potentially undeserved orphan drug status for his buprenorphine products manipulating the availability ability of such products filing questionable citizen petitions and engaging in abuses of the FDA risk evaluation and mitigation strategy plan to attenuate safety fifty risks associated with buprenorphine products. The company earned at least one billion dollars in extra profits. These actions contributed into a recent one point. Four billion dollar settlement between RECKITT benckiser's former parent company and the Federal Government in. DVR continues is to be the subject of related criminal allegations. This case provides an example of the kinds of abuses that are common in prescription drug markets joining forces against delirium from organ system. Care to whole human care. A perspective article by Sharon Inoue a new a from Beth Israel deaconess Medical Center Boston. Dr Inoue walked into the hospital room in the early morning and observe the patient from across the room. He was disheveled sprawled in bed. Amidst crumpled sheets mumbling incoherently doctrine. You a called his name and he glanced over unfocused focused without any spark of recognition in his usually intense deep brown eyes as a geriatrician. Dr Inoue has witnessed this scenario of a patient with delirium cerium hundreds of times this time however the patient was her father Dr in new a had spent the days at his bedside trying to speak with every team each day to alert them about his worsening brain function and provide information about his sensitivity to psychoactive medications and the adverse effects that some of the drugs in his regimen have an older adults though their responses varied. They were unified in their dismissive nece. The drug is necessary. It's only short term. Eventually the reality hit her. She was powerless to help him. Her father's delirium was a clear demonstration of its multifactorial. Causation Zeh Shen. Despite the fact that he had been a practicing physician up to the time of his admission there was no question that he was vulnerable given his age. A major surgery three and diabetes and acute kidney injury but could her father's delirium have been prevented. Dr Inoue believes so yet she she realized that. No person working alone not even a delirium expert can prevent delirium. It takes an enlightened coordinated healthcare system system motivated to work together to improve care for older adults our images in clinical medicine features a fifty eighty three year old man who presented to the emergency department with a one month history of relapsing fevers Disney and rapidly progressive. Skin lesions physical examination. Shen revealed painful injuries ended. non-jews with surrounding purple discoloration on his back trunk and limbs the results of laboratory investigations nations included a white cell count. Three thousand per cubic millimetre a platelet count of thirty. Six thousand per cubic millimetre and ferreting level of more than forty thousand nanograms. anagrams per milliliter bone marrow. Aspirants showed Hema fago psychosis and a biopsy specimen obtained from a skin. Lesion showed extra nodal natural killer N. K. T. Cell Lymphoma pet scan revealed increased Fluoro- Dioxide Glucose avidity in the nasal ferrings media steinem abdomen pelvis testes and skin the patients Epstein Barr viral load was eighteen thousand four hundred eighty six units per milliliter extra nodal N. in K. T. Cell Lymphoma is an uncommon. NEOPLASM that is associated with the Epstein Barr virus. The patient received six courses of systemic chemotherapy. At follow up at eight months there was a dramatic improvement in the condition of his skin. And the Epstein Barr virus was undetectable resolution of the Fluoro- Fluoro- DRC glucose avid lesions was observed on a re staging pet scan physical examination of Monaco. Oriana DOC amniotic identical twins. That is sharing a single placenta but having separate amniotic sacs who were born at thirty one weeks of Jeff Station and showed a pallid. I twin and a plethora second twin the placenta had marked colored a symmetry and pathological analysis revealed Pale Fribourg vessels from the first twin and congested vessels from the second twin findings from routine Trans Abdominal ultrasonography. That had been performed at thirty the weeks gestation were suggestive of twin anemia. polycythemia sequence taps repeated ultrasonography performed six days later revealed Olivo Damn News in the first fetus and polly Hydros in the second fetus which was indicative of twin to twin Transfusion Syndrome laboratory results. After birth showed a hemoglobin level of six point. Nine grams per deciliter in the palate twin and twenty five point five grams per deciliter in the plath Orrick orrick twin twin to twin transfusion syndrome is a condition in which relative hypoglycemia develops in one twin. And Hyper Volney. Mia In the other taps is a form of the syndrome caused by the slow transfusion of red cells through small placental anastomosis resulting in anemia in one twin and polycythemia Lisa thema in the other. The first twin received a transfusion of one unit of packed red cells the second twin underwent phototherapy and two cycles of exchange transfusion fusion. The two twins were discharged after thirty nine days and had normal development at the twelve month. Follow up this concludes Our summary Let us know what you think about our audio summaries. Any comments or suggestions may be sent to audio at any J. M. Dot Org. Thank you for listening.

delirium lung cancer asthma CBO Lung Lung Cancer Full Restaurant buprenorphine Nelson Cancer FDA Sharon Inoue United States Dr Michael Berry New England Journal of Medicin Harry de Kooning metastatic breast cancer WB Placebo Group
NEJM This Week  September 19, 2019

NEJM This Week - Audio Summaries

24:21 min | 1 year ago

NEJM This Week September 19, 2019

"Welcome this is the New England Journal of Medicine. I'm Dr Michael Beer this week. September nineteenth two thousand nineteen we feature articles on anti through botic Arctic therapy for atrial fibrillation with stable coronary artery disease a poly pill in an underserved population induction chemotherapy in nasal so for Angel Carcinoma Meriva Vir for CNBC reactivation and creating a learning health system through randomized testing a review article on anemia of inflammation a case report of a boy with vomiting and perspective articles on contingent knowledge and looping effects on tweet Tory rebels and the return to why and on being all in prompt reduction of displaced fracture of the ankle decreases the risk of trauma to the skin and soft tissue surrounding the joint at Nejm Dot Org a new video in clinical medicine focuses on initial management winton demonstrates techniques for reducing and splitting a displaced fracture of the ankle as well as the use of a Hematoma block for anesthesia a new ooh clinical decisions considers anti coagulation for sub segment pulmonary embolism this interactive feature about a patient with a single sub segment pulmonary embolism a case Vignette accompanied by essays that either support or discourage the use of anti coagulation therapy for this type of embolism visit any J. M. Dot Org to take the poll and comment antibiotic therapy for atrial fibrillation with stable stable coronary disease by Toshi Yasuda from the national cerebral and Cardiovascular Center Sweeter Osaka Japan there are limited data from randomized trials evaluating the use of anti thromboembolic therapy in patients with atrial fibrillation and stable coronary artery disease in in the fire trial two thousand two hundred thirty six patients with atrial fibrillation who had undergone Perky Dana Carney intervention. PCI or coronary artery bypass grafting cabbage more than one year earlier or who had an geographically confirmed coronary artery disease not requiring vascular cassation were randomly assigned to receive monotherapy with river rocks van a non vitamin K Antagonists Orel anticoagulant or combination in therapy with river oaks man plus a single anti platelet agent. The trial was stopped early because of increased mortality in in the combination therapy group river rock band monotherapy was non inferior to combination therapy for the primary efficacy endpoint of stroke stroke systemic embolism myocardial infarction unstable angina requiring Ribas or death from any cause with event rates of four point one four percent and five point seven five percent per patient year respectively Rivirasa Ban monotherapy was superior a combination therapy for the primary safety endpoint of major bleeding with event rates of one point six two percent and two point seven six percent per patient and year respectively as anti thromboembolic therapy river rocks and monotherapy was non inferior to combination therapy for efficacy and superior superior for safety in patients with atrial fibrillation and stable coronary artery disease in an editorial Richard Becker from from the University of Cincinnati College of Medicine writes that the combination of atrial fibrillation with active coronary artery disease a recent acute coronary syndrome recent recent. PCI or both has been the focus of several randomized clinical trials and in network Meta analysis involving more than ten thousand patients was recently completed on the basis of these data current guidelines recommend a short period of triple therapy in oral anticoagulant plus aspirin and a p two y twelve inhibitor followed by dual therapy with an oral anticoagulant plus a p two y twelve inhibitor for a period ranging from one to twelve months however for these recommendations apply only to patients who have a combination of atrial fibrillation and active coronary disease. They do not address the question of how to treat patients with atrial fibrillation who have stable coronary disease do the collective data from the fire trial and the similarly designed but inconclusive. OAC alone trial provide definitive guidance for clinicians who are treating patients in this population in the editorialists is judgment they do add an element of support for current guidelines and underscore the potential effect of direct oral anticoagulant on the path oh biology of Carnegie Mary Artery Disease and Cardio embolic events in patients with atrial fibrillation but they fall short of securing level one and Class A hey evidence further investigation will be required poly pill for cardiovascular disease prevention in an underserved population by Daniel Munoz from Vanderbilt University Medical Center Nashville persons with low socio economic status and Non White Persons in the United States have high rates of cardiovascular disease. The use of combination pills also called poly pills containing low doses of medications with with proven benefits for the prevention of cardiovascular disease may be beneficial in such persons in this trial three hundred three adults without cardiovascular disease. These were assigned to the poly pill group or the Usual Care Group at a community health center in Alabama components of the poly pill were a tortoise staten am low. Odeen Lothar Tan and hydrochlorothiazide ninety six percent of the participants were black. Three quarters of the participants had an annual income below fifteen fifteen thousand dollars. The monthly cost of the poly pill was twenty six dollars at twelve months adherence to the poly pill regimen as assessed on the basis of pill counts was eighty six percent the mean systolic blood pressure decreased by nine millimeters of Mercury in the polly pill group as compared with two millimeters millimeters of mercury in the usual care group the mean. LDL cholesterol level decreased by fifteen milligrams per deciliter in the polly pill group as compared with four four milligrams per deciliter in the usual care group a poly pill based strategy led to greater reductions in systolic blood pressure and LDL cholesterol Alestra level than were observed with usual care in a socio economically vulnerable minority population gem site Ebeen Ansa insist Platin- induction chemotherapy in as Oh for Angel Carcinoma by John John From Sun Yat Sen University Cancer Center Guangzhou China platinum-based concurrent Chemo radiotherapy is the standard of care for patients with loco regionally advanced nays official carcinoma additional Gem Sibenik A. and says Platin- Induction Chemotherapy has shown promising efficacy in phase two trials in this phase three trial four hundred eighty patients with with local regionally advanced nasal fringe carcinoma were randomly assigned to receive gems bean plus his plan administered every three weeks for three cycles Michaels plus chemo radiotherapy or chemo radiotherapy alone at a median follow up of forty two point seven months the three year recurrence prince free survival was eighty five point three percent in the Induction Chemotherapy Group and seventy six point five percent in the standard therapy group overall overall survival at three years was ninety four point six percent and ninety point three percent respectively. The incidence of acute adverse events have great three or four was seventy five point seven percent in the induction chemotherapy group and fifty five point seven percent in the standard therapy group with a higher incidence of neutral Pena thrombosis of Pena anemia nausea and vomiting in the induction chemotherapy group. The incidents of severe late complications was low in both group's induction chemotherapy added to chemo radiotherapy significantly improved recurrence free survival and overall survival as S. compared with chemo radiotherapy alone among patients with local regionally advanced Nasal Carcinoma Meriva Aveer for preemptive treatment of cytomegalovirus reactivation by Johan Martens from the university hospitals Lavin Belgium the safety safety and efficacy of Meriva Vier a Benz amid is all right beside for preemptive treatment of cytomegalovirus. CMV infection in transplant recipients zipped is not known in this phase two trial one hundred sixty one recipients of matto poetic sal or solid organ transplants who were eighteen years of age or older under with C. M V reactivation were randomly assigned to receive MERIVA VIR at a dose of at least four hundred milligrams twice daily or the standard dose of Algan Algan Cycle Aveer for no more than twelve weeks. The percentage of patients who had a response to treatment within three weeks was sixty two percent among those who received Meriva Vir and fifty six percent among those who received Val Ganciclovir within six weeks seventy nine percent and sixty seven percent of patients respectively actively had a response the percentages of patients with a response to treatment were similar among three Meriva Vir dose groups to patients who had a response to the treatment had a recurrence of infection within six weeks after starting Meriva Vir at a dose of eight hundred milligrams twice daily T for oh nine m resistance since mutations in CMV ul ninety seven protein kinase developed in both patients a higher incidence of gastrointestinal adverse. I events notably Usua- and a lower incidence of Neutrogena were found in the Meriva view group Meriva at a dose of at least four hundred milligrams twice Staley had efficacy similar to that avow encyclopedia for clearing CMV Vironia among recipients of Amanda Poetic Cell or Solid Organ Transplants Wants Anemia of inflammation a review article by Thomas guns from the David Geffen School of Medicine at Ucla. A Los Angeles Anemia of inflammation is a mild to moderately severe anemia hemoglobin level seven to twelve grams per deciliter that develops in the context context of systemic inflammation because of decreased production of recites accompanied by a modest reduction in Arith- recite survival this disorder like iron deficiency anemia is characterized by low serum iron levels HYPO FERRY MIA but it differs from iron deficiency anemia in that iron stores are preserved in meroe macrophages as well as in splenetic and hypnotic macrophages that recycle Senescent Arith- recites thus anemia of inflammation is primarily a disorder of iron distribution symptoms of mild to moderate anemia in patients with anemia of inflammation inflammation include fatigue exercise intolerance and exertion Disney but these symptoms are difficult to distinguish from the effects of chronic systemic inflammation anemia of inflammation is diagnosed in patients with Norma Civic and Norma Chroma can Nimia in whom there is evidence of systemic inflammation and evidence of iron earn restriction that is not caused by systemic iron deficiency. The main challenge in establishing specific diagnosis is the common coexistence instance of true iron deficiency and anemia of inflammation especially in patients with blood loss from underlying disease or an iron deficit caused caused by malnutrition long standing inflammation or increased iron requirements in growing children or pregnant women reducing inflammation. You can help correct the defect a fourteen month old boy with vomiting a case record of the Massachusetts General Hospital by Carlo de Lorenzo Enzo and colleagues a fourteen month. Old Boy was evaluated because of vomiting at twenty six days of age. The patient vomited a small amount of clotted blood and his parents took him to an emergency department. They reported that the baby had begun having frequent non projectile non bloody non bilious spit ups after the initiation of formula fortified notified expressed breast milk. The patient was monitored overnight. He had no recurrent Hematoma service and was discharged home frequent episodes of emphasis continued. He had difficulty gaining weight but was otherwise healthy at thirteen months of age. His mother reported that the frequency vomiting had increased immediately after after eating each meal the patient appeared uncomfortable retched and then vomited shortly afterwards the patient usually requested more milk or food in this patient and the emphasis was never billy's or projectile and the vomit is contained visible blood only initially his development was reported to be normal and and he had a vigorous cry and suck and enormous abdominal and neurologic examination on multiple occasions the patient did not have symptom resolution with acid sit suppression and dietary changes and most important he was more likely to have symptoms with solid or soft foods than with liquids the presence of an anatomical lesion narrowing the lumine of the gastrointestinal tract was likely the onset of discomfort soon after eating and the vomiting of undigested digested food were suggestive of proximal lesion such as an often she'll stenosis creating a learning in health system through rapid cycle randomized testing a sounding board article by Laura Horowitz from the Nyu School of Medicine New York last year. Nyu langone health showed millions of best practice alerts in the electronic health record system to prompt physicians to avoid adverse events and to to promote guideline based care. They called hundreds of patients to remind them that they were overdue for their annual physical examination. They made approximately nineteen eighteen thousand post discharge telephone calls to patients in an attempt to reduce their risk of readmission. They sent thousands of letters to remind patients of unmet met. Preventive Care Needs in addition. They started a community health worker program in the emergency department to connect hundreds of high risk patients to outpatient care collectively collectively these programs alone cost their institution more than a million dollars and used resources that potentially could have been used in other ways to improve care and outcomes until recently they had no real idea whether any of these efforts were working in January two thousand eighteen with seed funding provided provided by a hospital trustee. They began to turn Nyu langone health into a learning health system through rapid cycle randomized tests tests of existing systems level programs randomized tests of quality improvement interventions were embedded within the existing healthcare system as as a result quality and efficiency were improved by abandoning ineffective interventions and continuing successful quality improvement strategies contingent knowledge and looping effects a sixty six year old man with PSA detected prostate cancer and regrets a case studies studies in Social Medicine Article by Robert Arana wits from the University of Pennsylvania Philadelphia. A sixty-six-year-old economics professor learned from his general internist that his prostate specific antigen PSA level was four point five nanograms per milliliter his urologist recommended a biopsy to of twelve biopsy. Specimens Simmons showed cancer with a gleason score of seven after presenting the options a radical prostatectomy radiation and active surveillance the urologist indicated did a strong preference for surgery while acknowledging that it could lead to impotence and incontinence influenced by some research he read by colleagues recent painful NFL death from prostate cancer and by his wife's strong opinion that he should do everything to avoid death from prostate cancer. Mr Be underwent robot assisted radical prostatectomy afterward he had urinary incontinence which slowly resolved and impotence Mr be initially saw his impotence as the unfortunate fortunate effect of a rational decision that may have saved his life but in two thousand nine early results in two trials of PSA screening showed equivocal Cole or no benefit the rationality of Mr Bean's decision to undergo surgery now seem to be undermined. Many therapeutic decisions are made under conditions of uncertainty and with the knowledge that future studies could up end practice patterns. Mr B's case however highlights a different way in which medical knowledge can change the largely social processes by which we identified diseases can transform diseases themselves. Why is a cow curiosity tweet Tourelles and the return to why perspective article by Anthony Brew from the Veterans Affairs Affairs Boston Healthcare System West Roxbury Massachusetts when the author was four. He asked a series of y questions and his parents did their best to answer answer them. Dr Bruce Father had well developed closing technique when they arrived at a question for which his father had no answer hid respond. Why is a cow it was his announcement that that reached the limit of their collective knowledge in the intervening years although why never fully remitted Dr Bruce Consciousness it was overtaken can buy what particularly as he trained for a career in medicine about a year ago why recrudescence when Dr Brew recognized a gap in his understanding of pathophysiology busy Olivetti whereas he knew what happens when people have a massive acute hemorrhage they become anaemic. He realized he did not know why they became anemic. Though at this point he had been a doctor for twelve years. The explanation is fascinating and when he posted it on twitter he realized that although even non clinicians knew the answer to the what question most people had remained comfortably ignorant regarding the why justice he had since he posted the answer his opening tweet has been been seen by more than one hundred twenty thousand twitter users and more than ten thousand of them viewed the entire nine tweet thread. This thread was his first tweet. Torio tweet oriels provide a tool for physicians who aim to rekindle and stimulate curiosity about pathophysiology and mechanisms of of disease all in up- perspective article by Lisa Rosenbaum and national correspondent for the Journal in his medical school application Asian Essay in two thousand eleven Dr Rosenbaum's cousin Joey a ping pong champion described the way the sport connected him to the world from which had long felt separated rated it gave him a sense of control the angles velocity and trajectories of the ball he wrote give way too predictable outcomes reassuring him that a roll of the dice does not subjectively determine results recognizing that his talent or effort could sway the outcome gave him purpose anchoring him to life medicine promised something similar in the weeks since Joe died at the age of thirty three Dr Rosenbaum has wondered whether whether medicine fulfilled his expectations or perpetuated his sense of disconnection at Brigham Young University Joe Majored in Neuroscience Wpro Science and quickly befriended carry a fellow premed student school was a means to an end for them carry told Dr Rosenbaum a game they needed to win so they could become doctors and help others distinguishing between work born of love and that born of duty became his life's theme about a year ago ago as a psychiatry resident at Oregon Health and Science University Joe went to his program director and said I can't do this man. Joe was uneasily with what he perceived as an in authenticity that prevented true caring which he believed was fostered by medicines hierarchical culture joe struggle to practice medicine in a way that was meaningful to him may offer one antidote to the spiritual crisis of physician burnout are images in clinical medicine features a twenty five year old woman who presented to the Emergency Department with a one day history of generalized weakness this fatigue shortness of breath and skin discoloration. She had a respiratory rate of twenty two breaths per minute and an oxygen saturation of eighty eight percent wild breathing ambient air the oxygen saturation value displayed on the pulse ox similar did not improve with the administration of Supplemental Oxygen. The patient appeared appeared sciatic and she had dark arterial. Venus blood measurements arterial blood gases included a partial pressure of arterial oxygen of one one hundred twenty millimeters of mercury and calculated oxygen saturation of one hundred percent however when measured by co symmetry the Oxygen Saturation Asian was sixty seven percent. The percentage of math hemoglobin was forty four percent she was treated with intravenous methylene blue and had considerable improvement movement in her breathing and reduction in skin discoloration she reported having used large amounts of topical. Benza Cain the night before for a toothache met hemoglobin NIMIA can occur after exposure to a number of medications including topical anesthetic agents such as Benza Cain through metabolic pathways that appear to vary from person to person which may account for the unpredictability of this complication the patient had complete resolution of her symptoms and she she was referred for outpatient dental follow up a sixty year old woman presented to the emergency department with a two month history of blurry vision in her left left. I three years earlier. She had received a diagnosis of estrogen receptor and progesterone receptor positive her two negative invasive. Ductile Carcinoma Arsenault MMA of the right breast she had undergone lumpectomy excellently no dissection an average of and radiation therapy followed by therapy with Tamoxifen at the time of the current presentation examination revealed prop toasts an inability to look up with the left. I see the video at any jam dot Org Org. There was no actually add up the and no masses were noted on breast examination. Mri of the head revealed a mess measuring nineteen eighteen by fifteen by seventeen millimetres involving the inferior rectus muscle of the left eye biopsy revealed metastasis of hormone receptor positive in her two negative breast cancer. The patient began treatment with Falvo restaurant and Pabo Psych Lib followed by radiation therapy at follow up six months. After the initiation she ation of treatment she had resolution of the prognosis and blurry vision imaging showed the mass was no longer present and there were no new sites of metastatic disease. This concludes our summary. Let us know what you think about our audio. Summaries any comments or suggestions may be sent to audio at any J. M. Dot Org. Thank you for listening.

anemia Emergency Department vomiting Meriva Vir Usual Care Group coronary disease prostate cancer J. M. Dot Org Induction Chemotherapy Group Angel Carcinoma Meriva Vir New England Journal of Medicin acute coronary syndrome Lisa Rosenbaum Platin- Induction Chemotherapy skin discoloration University of Cincinnati Colle embolism Dr Michael Beer Anthony Brew metastatic disease
#90: Preventing Physician Burnout through Improved EHRs with Dr. Scott Weingarten

Health Care Rounds

31:52 min | 1 year ago

#90: Preventing Physician Burnout through Improved EHRs with Dr. Scott Weingarten

"Welcome to healthcare rounds. The podcast serving the INS and outs of health policy and business topics as well as on the rapidly evolving healthcare delivery ecosystem. I'm your host John Chica. Ceo of Darwin Research Group and faculty associate at the WTO Carey School of Business and the College of Health Solutions at Arizona State University. I guess this week is Dr Scott Winegarden Senior Vice President and Chief Clinical Transformation Officer at Cedar Sinai. Dr Weingartner is a professor of Medicine at Cedars Sinai and a clinical professor of medicine at the David Geffen School of Medicine at Ucla. Dr Weingarten is the chief executive officer of stance and health a Premier Company. Dr Winegarden was also the CO founder President and Chief Executive Officer of Zinc's health which is the leader for order sets in care plans for electronic health records zinc's health was sold to turn a corporation and later to the Hearst Corporation board certified in internal medicine and a fellow of the American College of Physicians. Dr Weingarten has published one hundred articles and editorials on Health Care Quality Improvement Clinical decision support and related topics and has authored numerous chapters on improving the quality of patient. Care in some of the leading internal medicine textbooks. Dr Winegarden has held positions on myriad national committees dedicated to improving patient outcomes including those of the Institute for Medical Quality and the American heart. Association's get with the guidelines program and the Quality Improvement Committee of the Board of Directors of Saint Joseph's health system at cedars-sinai he has been awarded both the President's Award and the Golden Apple Teaching Award and was alumnus of the year for two thousand nine after graduating from Ucla. Medical School Dr Winegarden completed his internship residency and fellowship in Internal Medicine at Cedars Sinai. He later participated in a National Center for Health Services Research Fellowship at the rand. Ucla Center for Health Policy Study during the fellowship. He also earned a masters of public health degree at the UCLA. Feeling School of Public Health. So Scott just to kick us off one. Aren't you Orient Our listeners in and tell us a little bit about your background thank you John. I'm a internist by training and worked at Cedars Sinai Health System in Los Angeles for many years. Most recently up until a year ago is senior vice president chief clinical transformation officer. I remain on the medical staff Cedar Sinai Professor Medicine at Cedars Sinai and also have founded a couple of clinical decision support companies. The first one called zing cells which is in order set and Care Plan Company which sold to Turner and later to the hearst corporation and then founded a second clinical decision support company called stance and health which we recently sold to premier two of those startups offended. Not Mistaken if I remember from pre interview that those kind of come out of Cedar Sinai is that correct Yes to startups in both have come out of Cedar Sinai. So at cedars-sinai my job has been to come up with systematic strategies to improve the quality of care safety care and improved clinical efficiency and along the way we thought if we could use oh strategies to improve fishing cared cedars-sinai we may be able to export some of the knowledge to other health systems across the country to try and improve the value of those systems and hence we developed a couple of companies along the way to export what we learned in cedars-sinai organizations is that is that common within the culture at Cedars Sinai in other words. Do they encourage this kind of startup? Innovation they do Cedar. Sinai is a entrepreneurial highly innovative organization and actually has enabled to recruit and retain a number of highly innovative individuals throughout the health system for many decades. The Swan Ganz. Catheter was invented at Cedar Sinai. Both Dr Swan and Dr Ganz worked at Cedars Sinai which measured pulmonary artery pressures across the world. I could share with you. Dozens and dozens of other examples. So it's really part of the culture when you come up with that either. Invention strategy software that CAN IMPROVE CARE AT CEDARS Sinai. Could whatever was invented at Cedars Sinai also improve care across the United States in many cases across the world so as a fellow serial entrepreneur. I'm curious what was that process like when a larger organizations. So how did you get started? Have the funding work. Tell me a little bit more about that. I mean we're GONNA get into clinical decision support tools here in a minute but I'm just curious about that whole process. Yes so cedars-sinai has eight fairly well-developed pathway for doing this. Both through technology transfer and also has established a venture fund and so related proceeded like many entrepreneurial ventures someone has an idea cases thanks health and stance in hell that someone was me along with some collaborators and developed a business plan and had a number of meetings discussing the business plan and before renew it. We had funding and off we went. That's exciting the having that even that you have that within that culture that you have the ability to go out there and pursue a dream so to speak and then to do it twice over. That's remarkable will. Thank you I give all credit to Cedar Sinai and the Culture The CEO of Cedars Gentlemen by the name. Thom lack is really encouraged innovation throughout his long more than two decade tenure as CEO Cedar Sinai in his really encouraged many of the faculty and administrators to think up ideas and those ideas that might have commercial merit to try to encourage people to develop business plans further discussed the potential for commercializing the IP. And then also a lot of creative people at Cedar Sinai by the opportunity to work to grow up with an idea into software and software. That eventually was found to improve. Patient care outstanding. So we're GONNA get to that in just a minute but I wanted kind of. T- things up with a recent article that I came across in Mayo Clinic proceedings. They surveyed about remember correctly about twelve hundred. Docs related to e HR a usability and and they also measured Physician burn out and so the ultimately the conclusion of the study was that the usability of HR systems today. So this is recent. This is I think in last month's issue received an F grade by physician users and there was a strong dose response relationship between HR USABILITY and the odds of burnt out so the more favorable the score the lower the burnout Having some expertise in this area with the certainly with decision support what. What's your reaction to that city? Well that's striking on. The service enough grade is not good. No one Ever strives to get enough grade however I provide some context but before I do that. I strongly believe that. Ehr's will get better and get significantly better in terms of USABILITY and we're very far from achieving an end point for context. I let's go to the past and see where we were before. Ehr's in. Let's go to the future when I believe they're likely to be better in terms of usability so if we say by. Gosh they get an F grade today. You have to really compare with something. Let's go to the past for a second in the past. We use paper paper charts paper medical records but if we look at the care we were providing even though it's somewhat easy to scribble notes on a paper medical records the care. We're providing left a lot to be desired. So there were studies showing that care was consistent with the evidence or evidence based care about fifty percent of the time somewhere in the neighborhood of two hundred fifty thousand people were dying each year from medical errors so medical errors or of the leading causes of death in the United States studies in Jama showing about thirty percent of all costs were waste in healthcare and given some of the challenges with healthcare affordability. It's a real shame when thirty percent of our thirty cents on the dollar going to what people view as waste or early says was studied and reported in Jama article in about ten percent of care over treatment where the harm exceeds the benefit or there was no benefit so if we look to the past the four electric health records lots of opportunities that we can do better and we should do better so I do not look to the past before electronic health records glowingly and thinking gee we had achieved an endpoint before electronic health records. Clearly we were letting patients down with the number of medical records your medical errors and the deaths from medical errors and opportunity to be much more efficient and less wasteful. Inner delivery care so here. We are today with electrons health records but clearly physicians are not satisfied with where we are and where we should be and I certainly understand that. I have my iphone and I actually like it. I think it's usable. I like the APPs on it and I understand when I compare my iphone to. Hr How My iphone or other smartphone might be viewed more favorably. But then if we say gee were somewhere towards the beginning or the middle of our journey with electronic health records. Let's take a glimpse into the future and there's a lot of effort underway looking at how ambient listening devices could be used to make. Ehr's more usable and to get higher grades among physicians in the future. So just like we might Alexa at home or Google home and We find them useful. There are a lot of people experimenting with putting Ambien listening devices into the examination room. So in that case that when a doctor or healthcare providers speaks to a patient the ambient listening device understand in many cases through natural language processing natural language understanding a machine learning some or much of the conversation and which allows the doctor to talk directly to the patient rather than typing the whole time and Shins for the patients which is important in the patient and Gordon to the doctor the healthcare provider and then provide guidance to both the provider Mrs Jones is overdue for her mammogram and would benefit from a cholesterol test. And to the patient when the patient goes home so I think the future looks bright. Aren't quite bullish on the future. But I certainly understand the sentiment that you just reported in the mail seedings article that we can and I strongly believe. We'll do much much better in the future. What is the source just as a clinician in talking to other doctors? What is the source of so much dissatisfaction? Is it that they feel like it gets in the way of the patient? Interaction is too many pop. Ups is like because I'm not a doctor and I'm not using these on a daily basis. I don't know so I'm just curious from your perspective on why they're so much disatisfaction. Well I think it's multi factory others a lot of reasons why I think in the past. You sat down with a patient. You look the patients in the eyes and said Mr Jones. Mrs Brown when seems The matter how can I help you today? And now in many cases the doctor or the healthcare provider is typing on a computer and looking at the computer rather than the patient. And that's in many cases less satisfying for both the patient and for the healthcare provider when doctors go home there in baskets are full of reminders. Information that have to do with the care of the patients. They took care of either that day. Or in the recent past. In some cases there are a number of alerts so an example drunk. Driving alerts so drug a interact. Dry Be those alerts. In many cases used to go to pharmacists now. In many cases they go to healthcare providers. So there's a whole host of reasons why physicians are burnt out something to do with the electronic health record reasons Well beyond the electronic health record where a physician burnout which is a very very important subject and extremely concerning. We're hearing a lot more about it today than we did in the past just as an outsider. It seems to me that a lot of a lot of the administrative burden that falls on physicians. It seems like a management problem like a physician's office. It could be organized in a different way or that a lot of the tasks that end up falling on the physician or nurse practitioner could be handled by someone else. My naive in thinking that or is it. Some of the things just have to be by their nature handled by the provider. No I I think you're absolutely right. And there's a lot of efforts underway at health systems throughout the country to have the administrative tasks or data entry task removed from physicians and allocated to others who could perform the same data entry your ministry functions as well as the physician and freeing up more time for the physician to interact with the patient so absolutely when more administrative task fall on physicians. Lades burn out less time for physicians and other healthcare providers suspend interacting with patients entering Enter responding to patients responding to their questions and it's an opportunity to make things better. Let me give you one example higher authorization so prior authorization is a really important concern. The average physician here she spends about eighty three thousand dollars per year according to a health of various article in interactions with health plans and a lot of times a physician will document something in the. Dr where it's absolutely imperative for a patient to get let's see Mariah in the brain or an MRI in the back. Medical necessity criteria clearly been met and for the patients and not have that scheduled at that. Time is just is just wrong in many cases. Let me give you an example. Let's say a sixty five year old woman with a history of lung. Cancer comes the end to her physician's office and now has a headache. And right sided weakness. Will the physicians going to be concerned about a metastases to the brain that patient needs an MRI or some imaging procedure in the brain? To make sure it is not a lung metastasis. So the way that it works today. The patient comes in as she comes. Ab with some family members. Everybody's worried everybody's concerned and the doctor who knows that. Mri were some other imaging. Study it's required now tells her submitted a request. Your Insurance Company. We should within two or three days. Whether approved not patient goes home. Frustrated family members are concerned and the healthcare providers concern and then the physician or his or her staff than need to interact with the insurance company and relay much of the information that the physician is already typed into the electronic health record either by facts or by entering information into a standalone portal. Or over the phone calling eight hundred number to try and convince someone at the emory is justified. So that's just administrative burden administrative waste. That's bad for patients. It's bad for patients family members and has bad for providers. Were you in thank in two thousand eighteen. When the provider is already documented all of the information and the electronic health record medical necessity criterias that that the imaging procedure could be instantly approved and then scheduled before the patient goes home. So how do you fix that? I mean that's very starting example. Is that through legislation or just wondering how you fix that problem now. I think there are a lot of people working on it today and we have the technology to fix that if it is fixable a some of it is standards and interoperability by. I think you're GonNa see this fixed. In the next couple of years. A lot of pilots underway because it makes no sense in two thousand nineteen for when a doctor documents something electronic health record that they have to document the exact same information in a standalone portal. Yachts redundancy that frustrates providers so it can be fixed with technology. The technology exists affixing today. And I think within the next couple of years. I think you'll see that it has been fast but there many many opportunities like that to reduce administrative burden reduce provider burnout and frustration with healthcare as it exists today so tell me about Stanford. Health clinical decision support tools. Maybe some of the players out there today but maybe also some specifics on what you developed. It's now I guess. Premier around clinical decision support sure so the first company created in Seoul Recalls Zinc's and that company we created order sets in care plans and actually those are almost like checklists to improve care reduce under-use improve quality care so largely for hospitalized patients but not exclusively if a patient comes into the hospital and asks community acquired pneumonia. What treatments will lead to the best outcomes the lowest mortality and Lois Morbidity we were fortunate that product ended up in about two thousand hospitals in the US and a lot hospitals outside the US? We thought the next generation of clinical decision support was really across the continuum which would be patient specific analyzing much of the information available on a specific patient to provide specific guides to the provider for that patient. In this case patients are complicated. They have a lot of things going on with them. Many patients they have In when I say things going on with them we're all a little bit different and as we get more information about patients were really entering into world of precision medicine so many elderly patients today. We'll have more than one chronic condition. They might have diabetes hypertension. They might have depression. Their social determinants to health that are important for treating patients. Patient preferences are important. John If you develop high blood pressure and I developed high blood pressure we might think about it a little bit differently. About how quickly would go on medications versus trying exercise and Diet there other things we all might think about it a little bit differently as we enter world of Health of precision medicine. We have different genetics. We have different PROTONIX. We have different microbiome probe by also we developed. Stanton which is the latest clinical decisions for company to try and survey all of the information that we could in any hr both what we call discreet. Data elements like lab values but also free tax that a doctor or healthcare provider has written into any HR tried to interpret that information and provide guidelines that specific for you John or for me and so we thought at the time it was really the next generation of clinical decision support. So in practice. What does what does that look like. In maybe give me an example of how how your system can have a demonstrable effect on quality as well as reducing costs. Sure shirt so what we do right now. We have a product for advanced imaging procedures. So there was a law passed in two thousand fourteen called the protecting access to Medicare act a requires health care providers to consult with clinical decisions. Or if they are going to be reimbursed for advanced imaging procedures for Medicare beneficiaries by January. First Two thousand twenty one. So what does that mean? That means that a- doctor orders a MRI of the brain of a Medicare beneficiary in two thousand twenty one if the doctor does not console with clinical decision support the imaging center will not be reimbursed for the MRI and therefore the advanced imaging centers likely to perform the memory of not being reimbursed were so it's a requirement for clinical decisions or for Reimbursement in Medicare around a clinical priority areas which a mini people believe. It'll be expanded from there. So as part of it we review information in the electronic health record to see whether in a imaging procedure is appropriate or not according to evidence based guidelines. So let's from lower back paid we might look asked Information such as diagnoses. This patient have. How old is the patient we look at? How long is the patient had lower back pain and nowhere in the HR in many cases interational low back pain being specific field so we have to read the doctor's notes insieme? The doctor thought along. This patients have low back. Pain also conservative treatment has failed conservative treatments such as like physical therapy and we need to read the electronic health record in terms of quality of CARE. We do have many examples. Some published studies in the peer reviewed literature. The impact on quality care. We did a study. Actually was the advisory board the Advisory Board asked us for our data which they had from cedars-sinai on about twenty six thousand patients. So they had our data on each patients Whether they lived or died length of stay whether they had complications and they asked us to ship our data on whether doctors followed clinical decision support or not and they had their data scientists math. All Twenty six thousand patients to see whether there was who was not any impact on quality of care when doctors followed the clinical decision support recommendations in this study published about a year ago or so a little over a year ago in the American journal Managed Care with the advisory board found. Is that when doctors follow the clinical decisions or recommendations the outcomes for better actually? The complication rate was significantly lower. The length of stay was lower in the cost of care was about nine hundred. Forty four dollars per patient lower so that would be one eight sample of Correlating quality care with providers following clinical decisions origin that has been published in the Peer Review Richer. So I read somewhere that these kinds of tools can potentially make healthcare more personalized and even foster relationships between the patient and provider at seemed like a stretch. But it's not my field. So what can you comment on that? What are your thoughts? Well I am a proponent of clinical decision support is much as you've probably gathered by now but I actually have cared for a lot of patience in my lifetime and when I think leads to the best patient provider relationship is when I really listened to the patient understood. Their concerns really got to the patients responded to the patients questions. The patient felt spent enough time listening to them that I care about the patients that was accessible. That's if the patient felt that they had Some type of question Emergency that they could get a hold of me when they needed me and it was really trust between the patient and myself that led to the best possible relationship so is much as I believe that clinical decision support could improve care. It was really the person interaction that I think led to the best doctor patient relationship so I would say. Let's focus for the patient experience in the interaction on clinical decision support but really more on the trust and are you there and available for the patient when he or she needs you. I'd say that spot on and that sounds like like my doctor. Okay good I really. I really appreciate it. He uses obviously. Hr's younger doctor. But I always get spends enough time with me. That he's not rushed and I know he's very busy. But it's the listening. It's that level of trust and for me like I don't see the. Hr getting in the way he seems to be very attentive to whatever's going on with me at the time so yeah I would. I would agree with that so that just kind of put a bow on it. Scott what do you see a looking into the future? You touched on this a little bit about hr but what do you see as the future for clinical decision support? Yes I did touch on briefly but I see it becoming less obtrusive. I really very excited about the potential for Ambien. Listening devices and listening in with appropriate consents. Sure so when I'd go into the doctor's office in the future by Dr I also think is very good. I actually got a physical exam a couple of weeks ago and he listens to me will not have to spend typing in the future and then when I go home my ambient listening device reminds me that I need to go out running your Viking. I guess my weaknesses. I eat too much chocolate and eat less chocolate in the future. So I think both provider and patient clinical decision support. That's less intrusive more tailored towards me and who I am and one day I have not done whole. Xm Genomic sequencing on myself yet. But my my guess is that one day the advice that my provider Dr shares with me will be influenced by a genetic proteome microbiome results. Yeah I could see that. I haven't done it myself either and I've thought about it especially as a the prices has gone down. I'm sure it's probably under a thousand dollars at this point to have that full workup. So Scott I wanNA thank you. We've touched on a lot of things today but I appreciate your spending some time with me and sharing your entrepreneurial experiences and eloquence staying in touch. Thank you very much. John appreciate the opportunity to chat with us this morning. Thanks again. That's all for this week from all of us at Darwin Research Group. Thanks for listening if you haven't yet done so please. Rate and review healthcare rounds wherever you listen to podcasts. Healthcare rounds is produced by Deanna Nicola and engineered by Andrew. Rowe check the music by John. Murcia Darn Group provides advanced market intelligence and in-depth customer insights to healthcare executives are strategic focus is on healthcare delivery systems and the global shift toward value based care to learn more about us go to Darwin research dot COM or send an email to insights at Darwin Research Dot Com. Or if you'd like to get right to it. Cost Eight eight eight four zero two three four six five. So you're next round.

Cedars Sinai John Chica Cedars Sinai Health System cedars-sinai United States Dr Scott Winegarden Cedar Sinai School of Public Health Senior Vice President and Chie Cedar Sinai Professor Medicine Ehr Dr Winegarden National Center for Health Ser Darwin Research Group Dr Weingarten clinical professor of medicine
Democracy Now! 2021-02-02 Tuesday

Democracy Now! Audio

59:02 min | Last month

Democracy Now! 2021-02-02 Tuesday

"From new york this is democracy. Now what we see. A large scale is that latino people of color basically do the scutt work that keep the state going its economy going but get very little of the resources very little pay very little health insurance very little access to care and this particular pandemic is now exposing these inequities as a number of latin next patients dying daily from cova nineteen in los angeles has increased by one thousand percent since november will speak to ucla professor doctor. David hayes brought teesta on the pandemic's devastating toll on communities of color and the major racial disparities in the nation's vaccination rollout to moscow russia. Where another two hundred protesters have been arrested today. Outside court hearing for jailed. Russian opposition figure alexei. Navalny sure you want to see one more time you want succeed. In fighting this in fact here the majority what managed to fighting dozens of millions of people who were robbed by those in power despite the fact that those people who are now under arrest piece hardships over the weekend over five thousand protesters were arrested across russia. We'll go to moscow to speak with joshua magazine about the protests and russia as well as russia's sputnik the co vaccine all that and more coming up welcome to democracy now now dot org the quarantine report. i made me goodman. The united states recorded nearly two thousand deaths from covid nineteen monday building on january's world record pace of infections. When nearly a hundred thousand people died of the disease across the united states on monday a massive winter storm dropped to thirty inches of snow across parts of the northeast delaying. Vaccinations for thousands of people in new york rhode island new jersey massachusetts and connecticut so far about twenty six million people have received at least one dose of a vaccine the covid nineteen vaccine a little less than eight percent of the us population. This comes a stat news. Reports top trump officials actively lobbied congress to deny state governments any extra funding for covid nineteen vaccine rollout last fall despite frantic warnings from state officials who warned they were woefully underprepared for mass vaccinations. In the southwestern united states the navajo nation is lifted. A weekend curfew in order to speed covid nineteen. Vaccinations about twenty percent of people across the reservation have been vaccinated so far. After the navajo nation suffered the country's highest per capita corona virus infection rate through parts of twenty twenty president. Joe biden is signing three executive orders on immigration today. The first establishes a task force settled aimed to reunite hundreds of asylum seeking family separated by the trump administration. The two other orders will look into trump's disruption of the asylum process restore funding to central american countries aimed at combating the root causes why people flee and review trump's controversial remain in mexico program and other trump era policies. That made it harder for immigrants to get permanent residency if they use public aids such as food stamps this comes as immigration advocates are condemning the deportation of hundreds of asylum seekers within the first few days of biden's presidency after a federal judge temporarily blocked biden's hundred day moratorium on many removals a us. Deportation by a flight departed to haiti on monday. The first day of black history month the guardian reports nearly two dozen african asylum seekers are scheduled for deportation as early as today. A group of ten republican senators met at the white house with president biden. Vice-president kamala harris monday pushing a six hundred eighteen billion dollar corona virus relief package. That's far smaller than biden's proposed point nine trillion dollar bill after the meeting white house. Press secretary jen. Psaki said president biden was pushing ahead with more ambitious legislation. His view is that the size of the package needs to be commensurate with the crisis. Christie's were facing the dual crises facing. And why he proposed a package. That's one point nine trillion dollars. The president believes that the risk is not being twosome going to small but going going. Not big enough senate. Democrats are pressing ahead with plans to pass the package using a budget process known as reconciliation which would bypass the filibuster by requiring only a simple majority in international news. south africa received. Its first batch of coronavirus vaccines monday. The one million astra zeneca shots will be used for healthcare workers as they respond to an overwhelming surge linked to a variant that's believed to be more infectious and potentially more resistant to current vaccines in brazil hospitals. In the amazonean city mouse report continued shortages of oxygen massive surge in covid nineteen cases in october medical. Researchers found about three quarters of analysis population had already been infected. Many of the new infections are from corona virus variant known as p. One that appears to have evolved to become more likely to reinfect people a case of the p. One variant was recently reported in the united states for the first time in minnesota and who by china a team of world health organization experts are continuing their investigation into the origins of covid. Nineteen with visits to local disease control. Centres monday on sunday. They went to the wuhan seafood market. Where the virus was first detected around two million people in western australia abruptly went into a five day full lockdown sunday after one corona virus case was identified in a hotel worker in perth back in the united states. Congress member alexandria ocasio. Cortez has opened up about being sexual assault survivor and traumatic memories. That resurfaced on january six when a violent mob incited by president trump attacked the us capital in a powerful instagram. Live video broadcast monday. Cossio cortez said she hid in the bathroom of her capitol hill office fearing for her life. As a man barged in repeatedly shouting. Where is she. The man turned out to be a capital police officer who had not identified himself akhazia. Cortez says she and a staffer. We're unsure whether the officer was there to help them or hurt them. She say she ended up. Barricade in the office of california congressman with furniture pushed up against the doors. Cossio said she decided to share her story. After republican colleagues asked her to forget about the insurrection and move on reason. I say this in the getting emotional in this moment is because these folks who tell us to move on that. It's not a big deal that we should forget what's happened or even telling us to apologize. These are the same tactics of abusers. And i'm a survivor of sexual assault. And i haven't told many people in my life. President trump has assembled the new legal team to mount his defence at next week. Senate impeachment trial after five members of his previous team. Quit trump has hired. Bruce castor a former district attorney from pennsylvania who in two thousand five decided not to prosecute bill cosby after the comedian andrea. Constand accused him of drugging and sexually assaulting her cosby went on to be convicted of that crime in two thousand eighteen. Another lawyer hired by trump. David shown previously reported trump at roger stone as well as russian and italian mafia bosses shown met with jeffrey epstein a few days before he died in jail house. Democrats introduced a resolution. Monday to remove georgia republican marjorie taylor green from her congressional committee assignments over her history of violent threats and racist anti muslim. Anti semitic comments on monday. Senate republican leader mitch. Mcconnell did not mentioned green directly by name but referred to her quote looney lies and conspiracy theories describing them as a cancer for the republican party. Mcconnell told the hale quote somebody who suggested that perhaps no airplane hit the pentagon on nine eleven that horrifying school shootings were pre staged and that the clintons crashed jfk. Juniors airplane is not living in reality. Mcconnell said in el salvador two activists were killed sunday and five others wounded after gunman opened fire on a group of supporters of the leftist political party. Fmln and the capital son salvador. Gloria rojo del seed and one to have were members of fmln and survivors of the us. Spec war in el salvador. The group had been campaigning all day as i'll salvador prepares to hold local and legislative elections at the end of the month f. elemental on lawmakers and salvadoran advocates blamed conservative president naive but kelly for instigating political violence. After kelly insinuated. The fmln had planned the attack against its own people in a statement. Suspicious the committee in solidarity with the people of el salvador wrote quote it's heartbreaking and terrifying to see return to this type of overt political violence el salvador which had largely ended after the peace accords were signed in one thousand nine hundred ninety two. But it's not necessarily a surprise. Social movements and international solidarity organizations have been warning that behind. The president's discourse of hate is a machiavellian strategy to legitimize violent state repression and the consolidation of power. They said the united nations is calling for the restoration of democracy in burma after the military sees power just before new parliament was set to convene monday president. Joe biden said the us might reimpose sanctions on burma calling the coup direct assault on the country's transition to democracy and rule of law in turkey. Massive student protests continued in istanbul. Monday following the arrest of four university students so for artwork that depicted the lgbtq rainbow flag alongside the image of a sacred islamic site. Over one hundred fifty. Protesters were arrested. Mobilizations have been ongoing for over a month. After president tape aired one appointed one of his allies to head a major university in istanbul. The turkish interior minister referred to the four arrested. Students is lgbt freaks. While aired one cues the o. J. t. q. Movement of vandalism seven men who were formerly incarcerated at guantanamo are urging president biden to shut down the military prison. The men were released during the bush and obama presidencies. An open letter published last week. The men right quote. Many of us were abducted from our homes in front of our families and sold for bounties to the us by nations. That cared little for the rule of law. Some of us had children who were born in our absence and grew up without fathers others experienced. The pain of learning. That are close. Relatives died back home waiting in vain for news of our return waiting in vain for justice. That is what you must contend with and change. They said this comes as new york times reports. The pentagon has suspended plans to provide corona virus vaccines to the forty remaining prisoners at guantanamo. They were originally scheduled to receive them this week. The biden administration plans to release one point. Three billion dollars in delayed aid for puerto rico's recovery efforts after two thousand seventeen hurricane maria. The aid is also meant to help protect the island against future climate disasters. The federal government will also remove trump era restrictions on additional four point. Nine billion dollars in aid to puerto rico. The funds are part of a twenty billion dollar package that congress gave to the department of housing and urban development to help puerto rico after hurricane. Maria new york times reports. Less than one percent of the money has been disbursed a warning to our viewers. The following story contains disturbing footage of police violence in rochester. New york one police officer has been suspended and two officers placed on administrative leave pending an internal investigation after body camera. Video showed them handcuffing and pepper spraying a nine year old girl. The video taken last friday shows the officers friesinger girl face down into the snow as she cries out for her father. One officer says you're acting like a child to which she responds. I am a child when the girl refuses to sit in the back of a patrol car officer. Pepper sprays her in the face. Rochester police union president. Mike manzo on sunday defended the officers actions. He made a decision there that he got was the best and can result in her. No injury rochester mayor. Lovely warren said monday state law and police. Union contract prevented her from taking stronger. Action against the officers. She said the incident had left. Her community rattled. I have a ten year old daughter. So she's a child. She's a baby and i can tell you that this video as a mother is not anything that you wanna see last year mayor warren fired rochester's police chief la'ron singletary. After internal documents showed he sought to cover up the police. Killing of daniel prude. Prude was a forty one year. Old black man who died from his fixation in march after rochester officers handcuffed and put a hood over his head and pushed his face into the freezing cold ground for two minutes while kneeling on his back. He was naked and in oregon a voter approved. Ballot measure went into effect. Monday making it. The first state to decriminalize level drug possession of all drugs oregon will use the savings from reduced prison time to fund crime prevention and addiction treatment programs drug policy. Alliance director. cassandra. I wrote quote today. The first domino of our cruel and inhumane war on drugs has fallen setting off. What we expect to be. A cascade of other efforts centering health over criminalization and those are some of the headlines. This is democracy now democracy now dot org the quarantine report when we come back. The number of latin x patients dying daily from covid nineteen in los angeles has increased by one thousand percent since december. We'll speak to ucla. Professor doctor david hayes about teesta about the pandemic's distorting toll on communities of color. Stay with us now. You detract me wax when we go to facebook selena bob on the sold like a nap. Trying to downtown people's complicating extremely late. Infomation folks in the cold. Bang the king's head out trying to people or beumer t people under the stairs. Member double k just passed away january thirtieth at the age of forty three. This is democracy now democracy now dot org the quarantine report. I mean goodman in new york. Juan gonzalez joins us from new brunswick new jersey high on hi and welcome to all of our listeners and viewers across the country and around the world well january marked the deadliest month yet of the corona virus outbreak in the united states black and latinx next people in the united states continue to die from the virus at higher rates now new data shows they're getting vaccinated at much lower rates than white people the centers for disease control and prevention reports more than sixty percent of those vaccinated so far are white while just eleven point five percent are latin act six percent asian and just over five percent black this comes as many black and latinx next people face a disproportionate risk of exposure to covid and their jobs is essential workers and are more likely to have pre existing conditions. The cdc data was gathered during the first month of the us vaccination campaign and race and ethnicity are only known for about half of the near late. Thirteen million recipients at a press conference monday the head of the biden administration's health equity task force said more data is needed. This is dr marcela nunez smith. We cannot ensure equitable vaccination program without data to guide us. The cdc will be releasing additional data regarding race ethnicity in boxing uptakes soon. But i'm worried about how denied we are here in new york city. Just eleven percent of covid nineteen vaccination so far went to black people who represent twenty four percent of the population and fifteen percent went to the latin next population. Make up twenty nine percent of the city's population even in predominantly lat next neighborhoods where vaccination sites reported high numbers of white people from outside the community. Getting the shot mayor. Bill de blasio held a news conference on sunday. And said the disparities are unacceptable. What we see is particularly pronounced reality of many more people from white communities getting vaccination than folks from black and latino communities across the country in los angeles the number of latin next patients dying daily from covid nineteen has shot up by one thousand percent since november latin x people are now succumbing to the disease at a rate over one and a half times that of all los angeles residents. And that's where we go now to speak to dr david. Hey spout teesta. Distinguished professor of medicine and director of the center for the study of latino health and culture at the david geffen school of medicine at ucla. Dr hayes battista. Thanks so much for joining us again. One thousand percent increase in deaths of the latin next population in los angeles. Can you explain what's happening quite simple. What we're seeing illustrated is about one hundred and fifty years of medical neglect of latino amongst other communities and in california all populations of color have much higher death rates than non hispanic white. Which tells us a lot about where the medical resources are but particularly for latinos as essential workers who kept the state going the farmworkers. Who kept the state fed. The truck drivers that packing house workers the food industry workers etcetera the fact that they have worked during the early days of the pandemic. we didn't consider them essential workers. We didn't provide them. I will prevent protective equipment. They rarely have health insurance anyway. Very low wage so that the corona viruses eat. Its way through them very quickly. You're latino average. Latino household across the country has more wage earners per household than non hispanic white. So you have more adults leaving the house every morning. They cannot do their jobs from the safety of their living rooms because they don't have those kind of jobs cannot grow strawberries in your living room. You cannot pick teaches in your living room. Thus become more exposed corona virus. They are more likely to bring that into the household. Latinos have twice as many children per household and children were offered symptomatic. These are the conditions of the virus. Just loves as very opportunistic. It's not because they're latino the race. Oh hi is because they occupy they are in those occupational and living arrangements spaces that corona virus just loves a lot of exposure. A lot of people. Boom there goes. We've been seeing this now for nine months. But dr hayes bautisa that can be understood in terms of the a the exposure. But now we're dealing with the issue of the vaccinations in terms of being able to prevent future exposure and astounding that these inequities continuum not just in california new york texas which is forty percent. Latino only them represent only nine percent of the people vaccinated so far even though the lower rio grande valley is probably the worst place right now in terms of infections in the entire country. How do you explain to disparities in the vaccination process now. Well again. we have to remember. These disparities didn't suddenly appear nine months ago. At the beginning of the pandemic these disparities have been built in decision by decision politically medical education where to place medical resources et cetera. Only now we're seeing them. Basically those chickens come home to roost. With the pandemic unfortunate latino population of color are paying the price for this This mal distribution limited access to medical resources in any case so just making a bad situation multiplied even worse the vaccination rate is very very low in california amongst latinos and most populations of color so the very populations that have helped keep the state together kept fed if you remember the early days of the pandemic when people were fighting the grocery stores over paper towels or toilet paper. I keep saying imagine if you were fighting over the last bag of potatoes in that store. Saudi vincent series fighting. Thanks to farm workers. We never got there. The farmers have paid a price because we have neglected them consistently for over a century and a half and in terms of the the recent explosion in In debt because you did a paper that tallied the high death rates among latinos between may and november but since november. It's exploded a thousand percent could you. What's happening there well. That was a thousand percent in some areas of los angeles. We got fifty million latinos in california. So we're looking at the state because we realized that in some areas were doing work and form working communities in ventura county and then those small areas is just exploded overall between actually october twenty seventh in january twenty seventh the overall state mortality rate for latinos has doubled however is started in. October is five to six times higher than white and in january. It's still five to six times higher than white compared to white yes. The death rate is absolutely huge. And i am not sure yet that we have peaked on the board of a hospital in east. La ninety nine percent of its patients are latino and we have had increases in admissions over the past four days. We have not seen yet. Leveling off the other places may claim to have seen doctor. David hayes bautisa if you could talk about the issue of language and the issue of the directions that are being given to people we have two different situations one when people get sick and the other for people to learn about vaccines and not be afraid. They'll be picked up by if they dare to be vaccinated. I wanted to go to an interview. We did last month with daily romero. This tech interpreter and co founder and executive director of the group indigenous communities in leadership and indigenous. Women led nonprofit in los angeles. This is what she said. We you hear the privilege of others when this ensure workers are getting vaccinated very heartbreaking. Any kind is very personally very frustrating. Like i wouldn't have the worst. Tell you my feeling of anger. At times. Because i see indigenous communities at the forefront from the farm from the ultra feels to the restaurant to the hospitality industry to the clinton years. Every we are there and we don't have access to the vaccine. The loss of lives people beating being infected. Not in the loss of knowledge is steroid. Some of the elders passed away and their whole world view. Just done last week. Someone in the community died that she she knew the story stuff migration the she was one of the first women that came to the. Us she brought a lot of other women in older stories are gone and languages is dying with cove more than ever especially here in their lay with the elders and places like standing rock reservation. Native american leaders have prioritized the language keepers as those to be vaccinated. I those who speak. Lakota dakota but i wanted. This goes to a number of questions. What languages are people being instructed in where to go if they covid. Nineteen where to go. If they the vaccine also a central workers being prioritised when it comes to vaccines not just even getting the vaccine but the fact that they are on the front lines whether we're talking about farm workers in the fields people who work in grocery stores people who Keep the whole society alive. Every day somehow being protected and reached out to proactively as opposed to them figuring out where they can go absolutely. Well i have to say. The bulk of the information provided an english now. We have to remember spanish. Medical services have been provided spanish in california for two hundred and fifty one years so this is not something suddenly happened. This is simply part of california history and the spanish spoken in. California has been highly indigenous inflicted in eighteen. O five spanish spoken here is yes. Oh spanish but also included not. Well that is asked ultimately leaping and comanche as part of the larger spoken language indigenous who arrived from mexico and central america however are not considered indians by the us government. There's just simply immigrants do not are not eligible for services under the indian health service. So they're kind of left out with nothing underneath them except their own communities. We lack interpretation in spanish. By the way also in vietnamese and filipino languages in south east asian languages all underrepresented much less the indigenous languages and yet is indigenous communities that are increasingly forming the backbone of farm working in california and we and our society our society our institutions simply hasn't learned how to communicate with the ones who feed them dr hayes. I'm wondering in terms of the dissemination of the of the vaccine. What your thoughts are on the best way to move forward in an equitable fashion. There've been this clearly. There have been these attempts to buy some local governments to put everything through existing hospital systems. There have been the attempts to have the open up arenas or stadiums basically on a first-come-first-served but in a general of shotgun approach. Do you think there has to be a more directed approach into particular industries and jobs or by zip code. What would you think is the best way to ensure greater equity in vaccination process well the extent to which we rely on the existing institutions of healthcare delivery. We're in trouble because those existing institutions have not adequately serve minority communities in the state for one hundred and fifty years however there are alternative organizations that community based clinics for example who are large major provider of healthcare services particularly in california. We have the community organizations and also we need to deal with the lingering effects of the trump administration just last sunday at a vaccination. He bend dodger stadium. A group of trump supporter anti vaccine actually disrupted and cause closure of that effort for over an hour as they were trying to persuade. People not become vaccinated and by the way organizing instructions. So don't bring your trump plans. We don't want trump to get any blame for this so we have very confusing messages. We have confusing priorities up until a few weeks ago. Essential workers were already now. The state of shifting to elderly while the essential workers are largely minority elderly or largely. White baby boomers. So it's a very confusing confusing lack of a plan but the ones paying the price are the ones who have for one hundred and fifty years kept the state clothes fed and functioning to talk about. What's happening here in new york. The governor's department of health nine top leaders of the health department have quit amidst the rift of what he's doing and laying out the vaccine rollout build a of. The mayor held a news conference sunday. Admitting the terrible figures on who actually is getting access to the vaccine the numbers eleven point five percent of the lat next population sixty percent of those getting vaccinated were white eleven point five percent. Latin x six percent asian. Just over five percent black even ask. Vaccinations sites are put into Communities of color overwhelmingly people white people are going to those sites and getting vaccinated the new york times. Today has a major editorial on this disparity and what has to happen. The city newspaper did a very interesting piece talking about the new york. Presbyterian hospital at its washington heights medical center complex a latina woman olga coming up and encountering one language barrier after another no one. There spoke spanish. The reporter was asked to do the translating for the paper As she said we don't have access to internet. We try to make our online reservations. We can't and then when we get here no one can help us. What about that issue of these online rollouts vaccines and who gets access to that. And who doesn't we've done a study. A couple of studies actually on telemedicine particularly on telemedicine and cova a and how these function and it turns out that most of the telemedicine efforts that we have for example out of the school of medicine assumes that you have one screen sitting on a desktop with broadband access. A lot of latino families. don't live in that situation. But they tend to use or something like what's that but our systems don't funnel into what's at which is something more accessible so again. We have built ours system on the assumption that everyone behaves Beverly hills has access to all those wonderful services. Most of the population does not. We didn't even think of that. At the beginning of the pandemic former workers did receive. Pp until even now many farm workers do not receive pba from their employer or from the state so follow the admissions committees decision who gets into the medical schools whose graduate for the past century and it has not been primarily communities of color students of color and now we're reaping the results of those decisions to reduce medicine to just certain to be able to serve certain communities and just simply ignore the others and dr what about the. What about the situation. That segment of the latino population that is undocumented in terms of access to services even access to the vaccine. We're told supposed to be a free. But what is what. What's the actual situation from what you can tell the message. Once again is horribly. Confusing isn't free is at not. Do you go to a county facility. You go to a private facility. Will you get a bill. You have insurance. Will you be considered having used public facilities. If you get a shot people. The messages are very very confusing. And for a lot of folks given that it's already difficult to find a physician who speaks your language that you can pay if you don't have insurance much less than the idea of is this going to be a charge again so i can understand why people are really confused and in the best cases the best thing to do they think is will do nothing. How can it get worse. Well it can. Covid spreads like a communicable disease. But it kills like a chronic disease is very different. Doctor david hayes battista. Can you talk about the protest at dodger stadium over the weekend. The covid nineteen vaccination center one of the biggest in the country being shutdown temporarily by people who are against vaccines and also the far right the significance of this. And what messages are the lat next community getting around the safety of these vaccines well among others and i was not there so i'm relying on other reports that i'm getting from people who were. Is that this also included. This free mask or masks creek california coalition. They come together and apparently about two weeks ago they went through the beverly center. Which is a very upscale shopping center right. At the edge of beverly hills and in groups entered stores without mascot shouting match their tug of wars that cetera so it's not aimed only at latinos but there is this very strong element of resistance to doing any public hold major as an infringement upon their freedoms and i keep saying well you have freedom to kill yourself by not wearing a mask you do not have the freedom to kill me by breathing. Your germs on me. That message has not gone through. And of course it's being stimulated by the remnants of the trump administration so once again. We have a very confusing situation. People are waiting in cars to get vaccinated. I have heard that some finding it. And they left the line so they lost the chance for vaccination so again because we do not have any. We did not have a strong plan from the federal government. For nine months in fact we had an administration that basically turned his back and said it was a hoax. It was going to go away which has not left to the states. Many states leave things up to the counties. It is horribly confusing. Although the one consistent message that many undocumented herders use public service you can never become a citizen even though you fed us during the pandemic and is there fear about ice picking them up if they get vaccine line. I don't know about a vaccine line but there was a story earlier this summer out of denver that was in the spanish language medium about a covert positive person who's undocumented was actually admitted to a hospital in colorado ice went and picked him out. I don't know what happened. But i has been sending a known corona virus positive refugees back to the countries of origin mexico and central america thereby ceding the pandemic in the countries with at least responses resource to respond to the pandemic. Well i wanna thank you. Doctor david hayes. Bacteria steph for joining us distinguished professor of medicine and director of the center for the study of latino health and culture at the david geffen school of medicine at ucla in los angeles. This is democracy now when we come back. A big news is breaking around the sputnik v. That's the russian vaccine that it's ninety two percent effective. We're going to go to moscow to speak with a new yorker reporter and also about the mass of protests that took place this weekend over five thousand people arrested. Stay with us to be potato as you. You the chris up a growing crisis this was a basic basic basic. Things is quick pollution. Tape me is disappointing. Cheating disciplining spurgeon rage by the russian art collective pussy riot members of the collective were recently arrested after protesting for the release of the russian. Opposition leader alexei. Navalny which will be talking about in just a moment that piece just released. I made me goodman with juan gonzalez. This is democracy now democracy now dot org the quarantine report in major vaccine news. New report is out today and the lancet medical journal revealing russia's sputnik v corona virus vaccine has been deemed to be safe and effective results from a late stage trial at twenty thousand. Volunteers found the two dose vaccine has a ninety two percent efficacy against syptomatic covid. Nineteen a number of countries have started or plan to use the vaccine including argentina venezuela hungary united arab emirates iran as well as the palestinian territories. We go now to moscow where we're joined by joshua of the new yorker magazine. He's just written. An article headlined the sputnik v vaccine in russia's race to immunity. It's great to have you with us. Joshua is this is just breaking now. Ninety two percent efficacy. You wrote about the whole rollout and how this vaccine was developed. I respond to the latest news. Then tell us about and tell us about sputnik v eight schroer the latest news As you mentioned that the lancet a peer reviewed medical journal in the uk. One of the world's most respected journals of its type published and essentially confirmed the data. That had come out of russia. That's putin as you mentioned. Ninety one point six percent effective in present in preventing covid nineteen during phase three trial with more than twenty thousand participants. That's good news. For the developers of the vaccine in russia. That's good news for russia. Writ large certainly has plenty of geopolitical ambitions surrounding the vaccine. We can discuss those you name. Some of the countries that have already placed preorders for sputnik v russia's hoping that the vaccine can be a rare soft power win for the country these days and it's Frankly good news for the world good news. For those countries that are depending on sputnik v vaccine especially given how difficult and complicated and expensive it is to access some of the other vaccines during the first segment. We heard about some of the problems in america and they only get even harder when you get outside of america into some of the low and middle income countries around the world that are struggling to get any vaccine whatsoever in two thousand twenty one. So the fact that's get another vaccine apparently will be added to the worldwide arsenal in the fight against covert. I think that's good news. Not just for russia but for a lot of countries that are looking to get vaccinated with whatever vaccine they can get access to including spooked nikki and joshua. Could you talk about the role played by career. Dmitri off the director of the russian direct investment fund in helping develop a vaccine. Who who is of sure. Dmitriev is the chief lobbyists and financial backer through his role at the russian direct investment funds. Russia's sovereign wealth fund. Not a scientific figure in any least he he really piggyback to a scientific project that was launched at institute. Gumma leah a long standing more than one hundred year. Old scientific institute in moscow. Dmitrov is very much a political player in ambitious player. Someone with experience both in the world of high politics and also high finance. He's been involved in many stories over. The years he was for example was met with eric trump in the seychelles starting out eric trump erik prince shells just after trump's election to try and establish a back channel of communication between russia and the trump administration. So he his role is not a in terms of developing or fine tuning the science but really in the geopolitics of sputnik fee and the internals. Politics is putin navigating it through the complicated world of russian bureaucracy and political infighting and being the person who presents and tries to sell scooting v on the world market. So he's really a geopolitical player. A salesman and whose job might have gotten a bit easier by the lancet results announced today but he has very little to do with the science of the vaccine and so perhaps little to do with its success but very much to do with the vaccines role and use as a geopolitical instrument on the part of russia and you've written sputnik v is a vector vaccine. Could you explain what that means and how it relates compares to the other kobe nineteen vaccines that have already been approved terms of technology short. The vaccines that are being used now. In the united states are so called a vaccine that is both the pfizer vaccine and the moderna vaccine which relies on technology called messenger. Hence the m in a technology which is a way of inserting or providing the body with essentially instructions in the form of a code that tell the body how to create antibodies against covid nineteen. It's almost like programming. A piece of software once the body read that software reads the script of that software. It knows what to do. It's been told what to produce against what pathogen and it goes about creating the immune response that then keeps a person safe from covid nineteen infections technology a really groundbreaking technology that had been investigated for many years and subject of experiments but hadn't really gotten very far in terms of testing loan rollout so the covid nineteen pandemic is the first time we're seeing technology in action vector vaccines of the said sputnik sputnik v is of this family of vaccine. The johnson and johnson covid vaccine which may be approved soon in which we may be hearing more about phase. Three results from the oxford astra zeneca vaccine which was an early contender. We heard a lot about in the spring summer. That has run into some problems during its phase three testing. That's also a vector vaccine and vector vaccines while each of the projects or prototype. Vaccines i mentioned. Just now uses a different so-called vector which i'll explain in a moment all are based on the same fundamental technology in that scientists take an existing virus render it harmless capable of reproducing most often scientists use a dino virus which essentially is the virus for common cold take that virus deactivated make it impossible of replicating itself and then within that virus insert the dna of another virus. In this case the protein the spike protein from covid nineteen and that is why we get the name vector which essentially means a kind of vessel or means of transmission and that the dino virus the common cold virus is carries the dna information from the spike protein of corona virus. It's a way of transmitting necessary. Dna information into the body so that the body then creates the necessary. Antibodies to protect against disease the developers of putting v. I visited the institute. Gumma lay the scientific center. I mentioned in moscow where the vaccine was developed. Compared vector technology to a kind of rocket ship meant to carry various payloads into space. The rocket stays the same. The payload you can swap out whatever you like. It can carry military equipment. It can carry a missile. It can carry scientific research tools that can carry a communication satellite. You can keep swapping out the payload as you like but that rocket delivery mechanism stays the same. And that's the metaphor. The developers of scrutiny. We used and explaining how victor technical works yourself but also if you could tell us the why they called it that sure the name i think immediately speaks to the ambition of the vaccine from the russian side sputnik of course is for many people an obvious and immediate reference to the first satellite launched into space by the soviet union in one thousand nine hundred fifty s in the soviet union for a moment seemed like it was winning the space race and putting the united states on notice that the soviet union was a scientific and military powerhouse an so naming the vaccine after this moment of soviet scientific glory. I think to my ear into the ear of many telegraphed. The notion that this wasn't just a question of creating unnecessary scientific product vaccine to help end the pandemic in russia and around the world but a way of announcing russian prowess russian might russian. Know how that it very much in addition to being necessary and urgent tool in the fight against the pandemic was also a way of creating a soft power or image victory for russia of which there have been so few in recent years. We'll talk about this in the next segment but the lancet results were announced on the same day today that russian opposition leader alexei navalny is in court and may well be sent to prison for three and a half years after having survived an assassination attempt against him using novichok all that's to say russia's image in the world has not exactly been very positive for some time now and i think there was a lot of hope in russia in official circles that if sputnik v could be successful as by now it seems on a scientific level it is that that would help rehabilitate russia image. On the world stage there would be a much needed and long awaited good news story for russia in the international arena. You mentioned alexina volume we wanna talk about the protests right now. The major protests in russia. Moscow police have arrested at least two hundred thirty seven people today alone outside a court hearing for the opposition figure alexei navalny Russian judges deciding whether to send him to prison for three and a half years stemming from a previous conviction for which he was given a suspended sentence outside the courthouse. Protesters criticized the proceedings. The only possible opinion here is that this is a sham. Like many other trials in russia politically motivated case. Obviously let the person was poisoned in russia. But crime is not under investigation. The person return into russia and have jailed him straight away and suing him and the hearing was everything that is going on is a full-blown dilution. Have nothing to do just this. The hundreds arrested just today are on top of the fifty one hundred people who were arrested over the weekend across russia to call for the release of navalny and to criticize the government jailed since returning to russia on january seventeenth after receiving medical care in germany. As you mentioned after being poisoned with the nerve agent in august. Nevada has accused russian president vladimir putin of being behind the attack. Last week he briefly spoke during the court proceeding. Sure because i want to say one more time you won't succeed. In striking in fact clear the majority what managed frighten dozens of millions of people who were robbed by those in power despite the fact that those people who are now under arrest faced hardships of only has emerged as russia's leading opposition figure an anti corruption campaigner. His political roots have links to right-wing nationalist anti-immigrant causes in two thousand seven expelled from a liberal party for his involvement. In the annual far-right russia march. He also wants appeared in a video that compared muslims in the north caucasus to cockroaches joshua jaffa you're the moscow correspondent for the new yorker. You've been covering all of this. I'm wondering if you can talk about the latest tune of only is what it means that he's back that he was poisoned in just today when they said you didn't report back enough to the court. He said i was in a coma. That's right the latest. Is that at this very moment. Navalny is waiting a decision from moscow court which will determine whether or not he'll be sent to prison for three and a half years based off of facts from a case that you just mentioned formally. The russian authorities are charging him with violating the terms of his parole for appearing regularly police station as required. Of course he didn't appear at the police station in russia because he had been airlifted to germany for medical. Care after being poisoned with the nerve agent novichok so a real kafka esque dark comedy of the absurd in a moscow courtroom today but the consequences are not funny but in fact very real and the prosecutor gets his or her way and really. It's of course not a question of what the prosecutor wants or what the judge wants. But what the kremlin decides and instructs the court to do the volume. May well be sent to prison for three and a half years. His statement to court. Today was very forceful very powerful very direct. He didn't so much address. The legal minute show of the case as the political context surrounding it blaming putin personally suggesting that putin was could not tolerate the fact that not only did have only survive the poisoning attempt against his life in august then from his hospital bed and recovery and rehabilitation in germany investigated the assassination attempt against him identified a number of officers in the fsb russia's main security service who were involved in the attempt to kill him with poisoned he even managed to get one of the fsba officers on the phone and record a conversation in which this fsp officer all admitted to the plot. Navalny referenced all of these facts said that putin and the security officials around him were humiliated out for revenge and that is why he was being put on court today for having the boldness the could spot if you will to return to russia after having barely survived this attempt on his life and ultimately saying that the attempt or the effort to put him in prison as an actually an attempt to scare millions of russians around the country but as navalny said calling on his supporters to continue their protests. You can't put the entire country in prison so we're waiting any minute now. The decision of this court. I think will learn a lot about the kremlin's intentions in its mood. Surrounding the volume. The protests Do they decide in fact to send all need to prison for three and a half years to they decide for some kind of de escalation measure like giving him house arrest. We should find out any minute now. But i think that will determine a lot about not only what the kremlin is thinking but how these events especially the protests are likely to continue in the coming days and josh. I wanted to ask you. We've heard a lot about in the family being an anti-corruption crusader but it's my experience at all politicians who are out of power claim that those in power are corrupt. What more do we know about in the valleys political views. I mean we know that. He has expanded out anti-muslim of racism our sentiments on many occasions. But what about his views for instance on the annexation of crimea on the on russia's role in the in the syrian civil war or even more importantly his view on what happened even before putin came into power the massive sell off of public assets. That occurred enduring. The yeltsin years That to some extent to put a stop to. i'm. I'm not so sure that putin put a stop to that. Corruption is so much nationalized effectively the corruption and put it under the control of himself in a circle and figures from his inner inner circle creating a new oligarchy not so much disrupting dismantling the oligarchy of the nineties but creating a new alternative oligarchy. That was to him and and benefited from their proximity to him and owed their wealth to him as tuna volley himself. What kind of figure. He is first and foremost a politician on the one hand. He can be vague when politically expedient and he can avoid taking sharp controversial positions that would alienate some portion of his audience or potential audience. You can also change his mind and float or trying use various political tendencies and moods in the country at the time to his advantage. That seems to be the case with his flirtation with russian nationalism. You mentioned From mid two thousand. I think that's the same Thing that we is it. Work in his Rather ambiguous comments about the annexation of crimea. He certainly does not suggest that if he were to become president. Russia would return crimea to ukraine tomorrow. In fact quite the opposite i don. I think that all that says that we'll only know what sort of politician navan the is when he's actually allowed to participate in formal politics so far he's been kept off. The ballot was not allowed to run for president in two thousand eight. We want to thank you joshua for joining us. Moscow correspondent for the new yorker will link to his report navan these long running battle at democracy. Now dot org. I'm amy goodman with one gonzalez. Stay safe. wear a mask where to.

russia president biden us fmln salvador los angeles california biden administration Navalny moscow biden rochester Mcconnell ucla new york astra zeneca puerto rico
Dr. Nina Shapiro: Masks, Medicines, Dr. Oz, and Corona-Conspiracies

The Thinking Atheist

39:31 min | 11 months ago

Dr. Nina Shapiro: Masks, Medicines, Dr. Oz, and Corona-Conspiracies

"Thinking atheist it's not person symbol and idea. The population of this country is going through the rule rejecting faith challenging the sacred. I told the truth. It's because I tell the truth because I put my hand on a book and Mehta wish and working together for more rush in all world take the risk of thinking feel much more happiness fusion wisdom will come to you that way. Assume nothing and start thinking. This is the thinking atheist podcast hosted by South Andrews. I'm not trying to drive you crazy with all the Kobe. Nineteen podcast but I had to have Dr Nina Shapiro back in short order. I had to have her back on the show. Because it's such a fluid situation even if you've heard the previous conversation stick with me because there's so much good stuff we're gonNA talk about. That has not necessarily been discussed in detail before. And that's what I want this show to be for you which is kind of an update. Here's what's going on. Here's what science has to say about it. Dr Nina Shapiro. She's a product of Harvard medical schools. She's the director of pediatric ear. Nose and throat at the Mattel Children's Hospital. Ucla she's also professor of head and neck surgery at the David Geffen. School of Medicine at UC L. A. She's appeared on NPR CNN CBS. Is the early show and featured in the Wall Street Journal The Los Angeles Times and many other publications? She's author of several books including hype a doctor's guide to medical myths exaggerated claims and bad advice. How to tell what's real and what's not at. Oh my God we need to know what's real and what's not. I've linked at book by the way in the description box of this show right now. I'm talking to the author. Dr Nina Shapiro. It's great to have you back great to be here. I saw a twitter feed by David. Lillian field is an epidemiologist and he said I'm amazed the only thing that's disgust about Kobe. Nineteen is the lockdown and mortality. But it's not just mortality and I'm going to start here with you. He gets into pulmonary infections. He said a twenty five percent pulmonary infection deficit that takes fifteen to twenty years to heal. He talks about inflammation liver damage other parts of the body that may be permanently affected diminished because of Kobe. Nineteen you want to speak to that and we women talking about deaths right mortality rates. But it's about a whole lot more than that where is you know so there's mortality and then there's morbidity and there's tremendous morbidity from this disease there was an an actor recently who had his leg amputated This was in Los Angeles this past weekend. do too and they're very vague complications secondary to Cova nineteen. And you don't think of this affecting the leg per se but it certainly can affect and in fact the entire body so there could be for the lung. Even if you survive and many people do survive there can be chronic scarring which could be irreversible. There could be inflammation in the lungs where you had good lung function. And then you develop almost like a chronic obstructive pulmonary disease or chronic asthma type picture. That could take months years to resolve or may not resolve at all. Certainly if there's scarring you could affect the heart it can affect the kidneys. People are on dialysis. A lot of hospitals are reporting not only shortage of ventilators and shortage of people. Who Manage the ventilators? But they're shortage of dialysis machines and people to manage to alison machines again. This is not what we're talking about routinely when we talk about covert nineteen you think mostly of the lung disease but kidney disease also in in previously healthy people you mentioned ventilators. I know that Elon. Musk and some physicians have been going back and forth a little bit about ventilators. Can you explain what is it ventilator? Do and what's this conversation? All about right so ventilators became the hot topic and everybody was ventilator specialist for a while including you on Moscow nealon. Musk was very generous in Actually he Donated a a huge number of ninety five mask to UCLA so we are in gratitude for that And you know the real and ninety five masks that we need to use it work And then there was the the idea that he was building some ventilators first ventilators that were created. Were were like CPAP machines. Which is what people use for sleep apnea at home which have type of ventilator function to them but they're not anywhere near the complex ventilators that people would need during a severe lung infection like Cova Nineteen so ventilators are very complicated. One ventilator is not like another ventilator for instance of ventilator if you're having an outpatient surgery that's gonNA take anywhere from thirty minutes two to three hours it's going to be a different type of Anna later. Then you know the power ventilators that you would have in an intensive care unit. That would be giving you much more. executory support long-term so. It's very complicated. It's not like turning on a Tesla which is actually pretty complicated in my eyes. But it's there's a lot to it to running a ventilator it's not an on off switch it's You know very very detailed. As far as what you put the settings on a lot of that is dependent on the patient's age and their size and the reason that they're on the ventilator their lung function at the time there on the ventilator their lung function as they progress so everything is continuously being altered during the time that somebody is on a ventilator so it is very complicated. The these are professionals. Who Know what they're doing to run them safely and smoothly Respiratory therapists tend to be the person who is managing the nuts and bolts of of the patients Vanilla Tori status along with intensive care unit specialist and anesthesiologist. Obviously who were running them in the operating room but can also run them in intensive care units but some anesthesiologists are much more super specialized intensive care medicine so it is really complicated. And what they're fighting with this disease is that sometimes there have been some some negative consequences from being on the ventilator just purely based on the type of lung damage that this is causing so some people are recommending to avoid ventilators and and put the patient was called prone so you flip them on their tummy and give them oxygen and that may sort of alleviate their lung disease without necessarily needing to be ventilated because some of the lung injuries could be from the ventilator themselves who talk about again. I mean I hate to bring in a but everybody's still talking about Hydroxy Chloride Gwynne Donald Trump's going. Hey come on I mean what do you have to lose? And there may be some truth to that in theory except there are some side effects. There is a limited number of resources. I don't know I'm not even try to ask the question so you tell me. Where do you fall on this hydroxy chloroquine question so hydroxy? Cork win came about really a little bit. Too early in the evolution of this disease worldwide. We don't know enough about the mechanism of action specifically with regard to hydroxy clerk win and it's given with an antibiotic very basic antibiotic called. Is it through mice in also known as Zithromax Or Z pack and so? Just a very basic antibiotic. They were being given together and in some patients. They were finding that they had a remarkable quick recovery. Now that's wonderful. We sometimes call that true true and unrelated so it's you know correlation as opposed to causation. We do not know if these medications were the reason that some patients did so much better. But you know to say it's so early on that these are quarter Quinn hydroxy chloroquine and and through my skin are the cure alls for covert nineteen is completely inaccurate and potentially dangerous so the first one is through mice. And we'll just start with that. It's a very basic antibiotic. Very Low risk antibiotic nothing is zero. People can have allergic reactions to this and other sorts of side effects which are rare But more typically it just doesn't do much and but hydroxy chloroquine has potential serious life threatening side effects primarily in the form of a life threatening arrhythmias so your heart starts racing really really fast. They developed something called. It's French Word Tour. Saad to plant which means just very very fast an irregular heart rate. And sometimes it's hard to cure that and people can die so it's it's certainly not without risks. You just go ahead and say that this is the next treatment for covert nineteen. We do not know that it's much too early to say there has to be trial looking at that. I mean the argument against. Hey let's just throw something on the wall and see what sticks I mean you're saying that the side effects are may are potential problem and is there a resource issue. I mean do we have enough of the staff whereas that's Sort of issue passed right so as soon as it became a hot item people were ordering it left and right ordering it from this country ordering from around the world. It is a drug that is used routinely for certain autoimmune diseases. Probably the most well known one is Lupus and people need their medication if they're on If they have lupus and they've been taking it successfully and so there is now an extreme shortage shortage of this medication primarily for people who have been taking it safely under the recommendation of their doctor and they can't get their basic medication. So it's a it's a big problem so I'm watching this thing play Ogden. Everybody's talking about quote opening things back up. People are restless especially here in the United States railroad seeing this faction of people who are like Ma Freedom in their rushing out saying that. You're not going to question me. This is a free country that GONNA do but we'll get back to them. But I wanNA talk about the idea of opening things up. I just have this idea. This thought that if we all of a sudden start reintegrating then the infections are going to spike again. I mean it was going to be like a false positive. Hey we're doing great and then Bam all of a sudden we reignite the problem by opening things back up too soon yes. I think if we do that if we open things up too soon it will be magnitudes worse than what we've already seen. We've seen that in other countries where they've opened up too soon. I think in Singapore. They did and then they had a close things down again in Japan as well so we've already seen it on a much smaller scale. What happens when you open up too soon and we've also seen what happens when you close things down and it does start to slow and people will say well It looked like it was spiking. Even despite the fact that things were slowing down while in California we started to close very early in our outbreak. And because of that. We did not have the horrendous spike that we could have yes. We've had a horrendous bike but it could have been multitudes worse had we not close things down so everybody is. Ansi no matter what you do in your life. Even if you're used to working at home everybody wants to get back to some semblance of normalcy and as hard as it was close things down for this. I think however it can be done to carefully slowly and methodically reopened society. That will be a big success and that could be the potential benefit of this if it's done correctly but the problem is if they if it's all of a sudden whatever city you're in or whatever state you're in they say that the restrictions are lifted. It's going to be a crazy scene. People are GONNA be out and about and and there will be a huge huge negative In the disease will come right back. We got Dr Phil. Got Dr Oz on Fox News. Can we talk about the TV doctors? I mean I'm not asking you to throw any potential comrades under the bus or whatever but I mean come on how do we start taking advice from these people on this issue? And where do you fall right? Okay so we can start. I'm happy to talk. Let's let's start with Dr Oz. So Dr Oz is a cardiothoracic surgeon who began his career at Columbia Presbyterian one of the finest hospitals in the world let alone in this country He is well respected and he became sort of known in television From Oprah so so that's that's the basics of Dr Oz Dr Oz over. The years has given a lot of good information and a lot of good health things for people to do to take care of themselves. He's also given a lot of extreme information that is not only incorrect but it is dangerous and I think he has done that recently on several fronts. One of them was this idea that hydroxy chloroquine is the cure all for covert nineteen and he said that much too quickly So that was a negative and then he was he was also recently. There was a Feed where he was saying that you know we really need to open things up and we need to open schools up and it's what's the big deal if it's another another two to three percent increase in death rate. He actually went back online to apologize for that statement. But you know the damage was done and you know it made him look terrible that he just wants to sort of get back in business and get everybody back in business at the expense of of millions of of people's lives. So you know. I think he has done this before. Where he's hawked items that he's whether he's been part of the sale of them raspberry key tones. You know we can go down the list of his products that he's been trying to sell and so you know when he does things like that. All of the good that he has ever done is completely muddied and frankly destroyed by everyone in the medical community. We really feel that. He's really just destroyed any credibility by by saying these crazy statements. Dr Phil Doctrine quotes. Dr Phil is Phil McGraw. Phd He received his PhD many years ago. He does not practice Psychology so he's no longer licensed as a doctor of psychology but he retains the title Doctor Because He did receive his PhD. Many years ago Phil before this whole thing happens was also you know called into question because of his questionable practices with a another Clinician in the Los Angeles area for also selling some crazy ideas about how to manage Patients with addiction and a lot of conflict of interest so he was already sort of come into suspect within the last month or two. This is relatively recent but you know to listen to someone like him. Who's purely a television personality. He's not a clinician. Let alone a scientist. He is a purely. You might as well just have an actor up there telling you know what he thinks is the best thing to do. As far as going forward and getting the economy back you might as well. Just LISTEN TO SOMEBODY. Who's who you know? Who's on a cartoon it really you know has no value? And the problem is both of these. Individuals have huge audiences millions and millions of people who listen to them and and we'll take what they say as truth very dangerous interested in the idea of how individual states reopen the country. One at a time. I saw me mom paraphrasing. It said having states operate by different rules as far as social distancing is like trying to have a peeing section in a swimming pool. I want your thoughts on this. Do we as it all or nothing when it comes to the quote unquote quarantine. That's a really good question. It's kind of a gross analogy me. That's welcome to the now. You know I just found out right. That's right that's a kiddie pools. Therefore I thought so you know some of the states can be put in the kiddy pool and have a whole have the adult pool section for the reasonable state. So you know I. It's a very difficult thing to say. Because I think you know states certainly have their own mandates and and cities even within each states. We have mayors saying different things within state you know within individual states. We have the governor's obviously and then we have. You know the entire United States. I think in this case some of it has to be on a national level because there is so much movement and there's so many states and especially in the northeast where the states are geographically ver quite small and people early commute from one state to the next for work so if if Rhode Island is open but Massachusetts is closed and you live in Rhode Island and work in Massachusetts vice versa. It's really hard to you. Know No borders you know. We don't have border patrols at all of our state borders nor should we So I think some of the larger issues such as stay at home which is really the biggest issue right now. Needs to be more uniform. I think as for everybody's safety Will everybody abide by that? No but I think if the majority of people do just like the majority of people who get their immunizations that will will help things. Some mandates will be different depending on the type of state and I think that is that is reasonable if you live in a state which is very rural and has very low case caseloads in their farmers that need to get their their farms back in action. I think it is reasonable to start phasing them back in if if everything is considered safe but I think the largest larger issue certainly currently when we are so devastated by this disease and it's going to get a little bit worse before it gets better that needs to be on a national level. There's a great photograph of one of the Freedom and liberty. Protesters signed says Kobe. Nineteen is ally and they're wearing a surgical mask or a medical mask and I'm like Whoa wait a minute. If it's ally why are you protecting? Let's get to the masks I see people using BANDANNAS. There are people who are now marketing these things on social media what it will hang on just a second. What's the requirement for ineffective mask against the virus right so it's become a big style issue and I think the most stylish ones are the ones where they're not even wearing them correctly so they're kind of hanging off of their nose or they're not really covering their mouth and you know the material is sheer so it looks cool So I think you know the question is. Why are you wearing a math? So there are a couple of reasons to where it one is purely for social reasons not being social but just if you go out in public and you wear a mask and in Los Angeles we must wear a mask in public and New York City. You must wear masks in public. It is a socially conscientious thing to do. It is saying you're taking this seriously. You are exercising social distancing. You are protecting others from yourself by doing a just a second though if I go out in New York City or in Los Angeles and I'm wearing the mask. Is it arbitrary? I mean I can take a piece of cloth or something. That doesn't really filter anything. How are their requirements for the mask? Now so it it. The only mask that will keep out cove in nineteen from coming in or coming out is the end ninety five. The point of the cloth masks are not to protect you from corona virus nor is it to protect someone else with whom you're in contact from krona virus. Well we'll protect them. Is that even? If you're wearing a mask you're still staying at least six feet apart from people so the mask will protect you from touching your face if you get exposed to it and it does filter out some of the virus and some of the exposed daughters. Secretions that your share doctor. Ause calling to complain about the DOC. Grab yeah go ahead. I'm sorry to cancel my spot on Dr so it does help though I mean. It's there are other benefits but it's a lie to say that you can just prefab a mask and now you are protected quote unquote protected right. It offers a little bit of protection. It is not an ninety five mask but it does protect you. A little bit It does filter out some particles you know not the small particles covert nineteen but you know again a lot of the exposure that we're finding certainly the medical community and the people who are getting quite sick. It could have something to do in this. Hasn't been fully studied. Obviously a lot of this will be. In retrospect hopefully at some point if we all get through this is something called viral load. So if you have a low exposure Is it potential that your illness will be less severe than if you have a very high viral load? Which is why we are considering that the healthcare workers who are so close to these patients and so literally physically Involved with them that they are just getting so much higher exposure to the virus. Which would explain why there's so much thicker so it does help a little bit. It is important to do It's it's the right thing to do. Certainly if your city is recommending it or acquiring it in public But it's not I don't want it to be a false sense of security that that means that you can go out and go walking with a friend and go shopping together and just you know. Well we have our masks or okay. It's an added level of offer but it is not a complete protection so I've got more questions like if I get Kobe. Nineteen and I- recover. Am I good? You know like for the rest of my life. Don't have to worry about it. How's that work? And when when do we get to open the freaking country backup? What are the implications of opening everything back up? I'm going to get a physician. A scientists perspective with Dr Nina Shapiro will continue in just a second now is not the time to be paying too much for razors at the drug store. Not now not at these moments and Harry's gets it it's better to stay inside and guess what Harry's provides a close comfortable quality shave and ships directly to you. You already know that I'm a Harry's Fan. It's just a great shave. The handle feels good in my hand. The blades are obviously quality. They're manufactured in a German blade factory. That's been perfecting razors for over a century at just two dollars per blade. You cannot beat it for quality and value beat paying all the mark ups for Gimmicks with the big name brands. Ten million. People have tried. Harry's and you can claim your special trial offer at Harrys dot com slash the thinking atheist one hundred percent quality guarantee and a full refund. If you don't absolutely love your shave it's a great way to support this broadcast. You're shaving anyway with Harry's get a quality shave experience as you help us do what we do. 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So if I get this thing I get over this thing in my immune for life or can I get it again So that's a that's a tough one because we were hoping and assuming that once people had it. They were protected and there are many studies and some larger medical centers are asking for what's called convalescent serum so they WANNA get blood donations plasma donations from people who have recovered from Ovid nineteen and that they can use that almost like a you know an antibody to somebody who's actively infected and it may also contribute to vaccine studies. But you know the it's not really clear. People are building up enough. Antibodies or the right type of antibodies to confer immunity down the line and that is again one of the most one of the most terrifying things about this illness. That wait a second you had it and then you can still get it again and you can spread it and world is mutate some more so you know that still an unknown. Let's talk about this whole idea that Kobe nineteen was manufactured in a lab. And we've heard a lot. We've seen a lot of data backing up. The idea that this is something that came from animals crossed the species probably from a live animal or wet market in China. Those things are horrifying by the way. Have you gotten into that at all? The wet markets in China while I have never been to one but but the idea I edged -tarian so though there's the videos I've been going around where they kill him now. I'll spare everybody the details. But Jesus I I thought if nothing else. This crisis has helped to draw attention to a real issue. But I mean let's get into this idea that Well you know manufactured or manipulated. It was a lab accident. We love a good conspiracy. The you have an idea on this. Yeah no I think it's. It's not a you know that is a conspiracy idea that this was you know. Bioterrorism Biowarfare You know this was not manufactured in a lab it is not the first corona virus. It's a novel Corona virus but it is not an they created one at that level. This was you know. This was a community acquired infection and it was mutated from an animal to person simple. I haven't heard as much that they conspired to infect the population kind of thing but it was like they had two containers of the virus that they had had in storage and something may have gone awry and you know China's to a totalitarian regime. I don't necessarily trust them but I was listening to found she and you know they were talking about how they sort of reverse engineered the virus and there are no markers for the kind of thing you would see if we had manipulated it and a lab. They said all the markers indicate that it did come from bat or something like that probably in a wet market right right great. I mean it's not it's not necessarily any better The origin of it but that is definitely much more accurate animals. Carry these kind of thing we. We haven't even begun to hardly at all trace the of viruses that are in the animal kingdom. That might make the leap from them to US right. We're we're totally not prepared. I saw an Netflix special called explained which got into viruses and how they work and some of these viruses that exist in animals and how we know very few of them and you know at any moment they can leap over and Holy Shit. You know that kind of deal right. Now what are we? What in the world can we do about that? We don't even know what they are. How do we defend against him? Well I think you know. Now that we're seeing that this one virus from one animal caught you know has literally wreak on the entire planet. I think that you know that's where the more you know. More research needs to be done. And I think is being done to see what other viruses can be created or you know jump from animals to humans and how we can prevent it in the future. I mean Zeke is another one Ebola I mean these are all you know viruses. You know that are Dang- gay. You know the these are not new viruses that we've seen and they're all you know jumping from animals too humid. So is there any silver lining on this deal? I mean you know you sound like an optimist to me. What do you think? Do you see a light at the end of this. Very long and arduous tunnel. I hope so I mean we have to right. We have to find the the silver lining here so I think you know some of the silver linings that I've already seen is within healthcare and this is again a very now all of a sudden all the doctor decides is and and Phil McGraw are becoming stars and you know or hearing voices from doctors all over the world And listening to them and I think that that within that we used to be sort of this sheltered little microcosm of healthcare workers within our own community. We are so much more respectful and understanding and appreciative of each other. I think again. That's a small world but to us it's our world and I think you know how much we really really recognize the work that goes into everybody's specialty the risk that everybody is taking for themselves and for their families. I think will will come out in the end Having a better respect for each other and and that's huge because I think you know healthcare is critical and people don't necessarily recognize how much goes into working together within healthcare. I think that's a positive another possible positive and again. This is really going to depend a lot on. The next administration is how this will change universal healthcare as an option or health. Care options for everybody. Because we're seeing so many people who are suffering who don't have access to care And having prolonged illnesses and not getting treatment as early as they could. So you know is there gonNA be some sort of equalization of access to care because of because of this devastation. Doctors aren't talking to each other on five G. you know. Because that's how old I call brain tumors and then you know our hair is globally. Now it's spreading in Corona virus. So of course. We have science literacy problem. I mean it's not just literacy. We have a distrust of science problem in this country the current administration which you just referenced isn't helping. I think it's fair to say that he ever get discouraged about that. The fact that people would rather grab a wild sort of bad shit conspiracy story than get into the nuts and bolts of how things actually work. Well you know those wild Batu stories are so much more interesting than so. I think people do grasp onto that again. Celebre science and you know celebrity exposure is also so much more interesting than listening to to adopt. Or unless they're you know Tony now. Everyone wants to listen to him because he's great but before that you know had he given a speech three months ago nobody would you know. Nobody would listen to that so I think you know. People are distrusting. They think that you know were that medicine is out there big quote unquote. Big Pharma That you know they're all these underhanded agendas that we have so I I agree. It's not only illiteracy but it's distressed of doctors and of you know healthcare overall that has really bitten us. Because you know there are a lot of crazy stuff and I think the more scary with this is the more conspiracy in the more craziness. That's going to come of it and you know even if we do hopefully get through this. I think in the end to there will be people who WanNa get the vaccine when it comes out or already hearing buzzing of that. I'm not going to get vaccinated and famous. People are coming forward saying that they're not GonNa get the vaccine and You know it's not going to go away even one science prevails and shows what's right. I think there's always gonna be this nonsense cheese impressive you know. I'm one of those. People never knew his name until just a few months ago and I was reading a profile of his life's work and holy cow. I mean that guy is the real deal. You have any thoughts on fancy. He's incredible I mean he's you know yes. There was a there was a great piece Vitamin New Yorker. And you know he just you know just a guy from Brooklyn but he's he is incredible. He's brilliant and he's always been brilliant. He didn't become brilliant three weeks ago And he's you know he's worked his entire life. I mean we don't many of us. You know many of the younger listeners. Don't really remember what we call back then the AIDS crisis and You know and this was back in the in the eighties when nobody knew what HIV was or AIDS was or that it was a virus in and of itself or how it was transmitted and he was one of the people who worked on that. And you know now. In retrospect we say oh yes. Hiv We know people live with it for years. It's almost like having diabetes. It's you know it's managed and people it's not a it's not life-threatening anymore And and a lot of that is in part due to him because he was the one who who did so much research in it back back in the day so you know this is dating back forty years ago and they certainly someone worth listening to like a found she speaks. It's probably a good time to pay not have to agree wholesale but the guy knows his stuff right. He knows his stuff. He didn't just You know it's not his first Rodeo. That's for sure. Dr Nina Shapiro Personal Note. How you doing in your life and your profession. You hold up okay. I'm doing okay. Thanks I mean we. Are you know sort of behind the front line? And as a as a surgical sub specialist but I am an airway surgeon so in our neck of the woods we are on call for backup to the real experts so the intensive care unit specialists the emergency room specialist. The anesthesiologist we are their backup if they get sick or can't come to work or if our hospitals get flooded As I mentioned you know and we spoke. You know weeks ago about this. But you know Moss Angeles and California. We're very early in the stay at home orders and thankfully that has saved lives and has enabled the people who know what they're doing to take care of these very sick patients as opposed to someone like me. Don't get impatient is probably the one lesson. I'm trying to to sort of adhere to. I saw somebody they posted. The curb is flattening. We can lift restrictions and they said the parachute has slowed our fall. We can take it off now. There's probably some wisdom there. We are obviously not a hugely patient. Culture these are very trying times personally emotionally. Psychologically financially we totally get that but probably temperance is a good rule of thumb for those of us who are waiting this out right because the costs of jumping too soon are pretty significant. Would you agree absolutely it's a marathon? It's not a sprint. And you know I think what's really frustrating for everybody is that we don't know the end point. I think if if people were told Okay on X. Day whether it's May may fifteenth or June fifteenth or July Fifteenth. Whatever day that is that day you can go back to your normal life? People would feel much better even if it were several months down the line the fact that it's well we don't know we think it's going to be this day but we're going to wait and see is is exhausting for everybody. It's frustrating and and it's very tempting to say. Well things are looking better. Let me just go back to my life or part of my life. And that's a real danger. We're all everybody's you know. This is so unique that literally the entire world is suffering from this. And you know we really have to rely on each other to to get through it and as you said not jump the gun not close the parachute because you're only a few thousand feet above above The the ground and you know it. We don't want this to backfire. We WanNa do it. Once and the longer we wait the the safer it will be. Don't jump into the peeing section of the swimming pool. I mean. Just don't do it. You say I think this may be the first time I've had a guest back on the show in such short order. I actually like it because I just ask stupid questions. You give me a really smart answers. I don't have to do any work. I just sit back and learn stuff. Dr Nina Shapiro. You are amazing. Thanks for being a wonderful science educator. Thanks for being out there doing what you do and we'll continue to just keep on keeping on and you do the same. Thanks so much. As a lot of fun thanking atheist on facebook and twitter for a complete archive of podcasts and videos products like mugs and t shirts featuring thinking atheist logo blinks to atheist pages and resources and details on upcoming free events and conventions log onto our web site the thinking atheist Dot Com.

Dr Nina Shapiro Dr Phil Dr Oz Dr Oz chloroquine Kobe Los Angeles United States Harry Ucla Cova twitter South Andrews California Harvard liver damage David Geffen Wall Street Journal Lupus
GSMC Health & Wellness Podcast Episode 256: All About NSAIDs

GSMC Health and Wellness Podcast

1:06:20 hr | 1 year ago

GSMC Health & Wellness Podcast Episode 256: All About NSAIDs

"You want to be healthier. You just don't know what to do all these shows telling you this and that but nothing seems to work will listen close. Golden state media concept's has got something great for you. The health and wellness podcast dedicated to workout trend. Healthy eating habits die and everything about healthy living. Join us in our banters as we help you not just live life to the fullest but limited to the healthiest A then came to the US and health and wellness podcast Broughton but a GMC podcast network. I'm your host Alex Today. I want to talk with you. Guys about non steroidal anti inflammatory drugs or in a lot of us take these commonly every day for pain and fevers. But there's a lot to really know about them first off. We're GonNa talk about what they are. Were going to also discuss how they work and implications for different types of ailments. So let's start with what are non steroidal anti inflammatory drugs so insides are the medications that we take for relief when we have back pain headaches arthritis if you have a fever or also. If you're having menstrual cramps you take an instead each time. You take an aspirin or an advil or Aleve. They're just common pain. Relievers fever reducers. So you are already probably taking them. Even if you're unaware that they fall under this classification aspirin ibuprofen and Naproxen. Sodium are the three most common types you may know them as also being etc which is Aspirin. Ibuprofen is Motrin or advil and approximate. Sodium is under the brand name. Aleve you can easily acquire these over the counter in drugstores and supermarkets and you can also get the generic versions quite easily. Acetaminophen or Tylenol is not an inset. It is a reliever and fever reducer but it does not have the anti inflammatory properties that is a requirement to make it an end said so if you are having a fever or you need pain relief than Tylenol may be appropriate for you. But if you're trying to relieve inflammation been. You're going to want to reach for different in said. Acetaminophen is sometimes also combined with aspirin in over the counter medications like certain varieties of etc. So what do we take these incense for? A lot of folks take them for pain associated with arthritis including osteoarthritis rheumatoid arthritis. Personally I'm prone to tendonitis in my wrists from typing so much so I may reach for an inside to help. Treat the inflammation from that. It is also useful for muscle. Aches back aches dental pain any pain associated with Gout bursitis and menstrual cramps. You can also use it to reduce your fever or relieve minor aches associated with common colds and I think that's a pretty frequent use for it. How do they work? Insides blocked the production of specific chemicals in your body that cause inflammation. They are really good at treating. Pain caused by slow. Tissue damage like arthritis pain in says also worker Li well at fighting back pain. Menstrual cramps and headaches by working like corticosteroids. A lot of them are very helpful. In reducing the inflammation without having any of the side effects of Steroids. Steroids are drugs that are manmade and are very similar to cortisone which is a hormone that naturally occurs in your body like cortisone insides reduce pain and inflammation that often associated with joint and muscular diseases and injuries. However the T. L. Dr Is that you should only take an over. The counter in said for three days continuously for fever and up to ten days for pain unless your doctor says that it is okay over the counter. Insides work well and relieving pain but they are meant to be temporary or short term products. If your doctor tells you it's okay to take insides for a long period of time. You and your doctor do need to watch out for some harmful side effects if you notice bad side effects in your treatment may need to be changed and it's important for your doctor to talk about that with you. Some common side effects of incense may be gastro intestinal distress so symptoms like gas feeling. Bloated heartburn stomach aches nausea vomiting diarrhea or constipation. These symptoms may generally be prevented by taking it with food. So I know we think of antibiotics is being a major on that we take with food but you can also take Ibuprofen and other insects with food to help reduce these GI symptoms. So you can take that with food milk or an acids like Maalox or my Lanta if these symptoms continue for more than a few days even if you're taking insides with food milk or an acid then you need to call your doctor because you're inside may need to be stopped or changed. Other effects of incentives may include dizziness. Feeling lightheaded having trouble balancing or concentrating or having some mild headaches which is a little ironic since you're taking it for aches and pains if those symptoms last for more than a few days stopped taking the inset and call your doctor if you have any of these side effects you should call your doctor right away. In the Gastro Intestinal Urinary section. We have black stools. So if they're bloody black or Tari if you start adding bloody or cloudy urine severe stomach pain blood or material that looks kind of like coffee grounds in your vomit so that may be bleeding. That is associated without warning. You may not even have pain associated with it but it's in your vomit. Anyway you may have an inability to pee or a change in how much you're able to pass urine any unusual weight gain or jaundice. So that yellowish appearance in your body tissues or your head it may affect you by having blurred vision ringing in your ears greater sensitivity to light having a very bad headache or a change in strength on one side. That's greater than the other trouble speaking or thinking or change in balance so you may recognize that a symptoms of a stroke. You may also have possible allergic reactions or issues related to severe rashes hives or read peeling skin itching bruising or bleeding that may be unexplained feeling very tired and weak getting bad bad back pain acute fatigue or flu like symptoms chest pain heart palpitations or rapid heartbeat. Wheezing trouble breathing or unusual cough or having a lot of fluid retention so like swelling around your mouth lips tongue or face or swelling around your ankles feet lower legs hands or even possibly around your eyes. Those may be related to a possible allergic reaction to insides. And if you have any of these side effects that I just listed than it's important to call your doctor right away enemy daily. Stop taking the inset. Your doctor will be able to discuss with you. What you should do next overall that may sound very scary but these side effects tend to be rare. They have the list the side effects if anyone has experienced them is in clinical testing. So do not panic for the most part. Many of US take incense fairly regularly without having any of the side effects interest import to know what could happen and to be aware that we might need reach out to a doctor in certain circumstances. Alright we're going to go on a quick break and when we come back we are going to discuss. How doctors decide which insects are right for us and if there are any specific warnings associated with inside use aside from the side effects that I just discussed. Are you looking to learn more about the latest trends from the fitness world? 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See your doctor is going to take into account your medical history. They may perform a physical exam or issue. An order for x-rays or have you give some blood tests and check for any other medical conditions that you may have in addition to the one that is indicating that you should be on an inside after he start your program. Your doctor is going to perhaps ask you to meet regularly to check for any harmful side effects and to make any changes as needed that may include needing some blood tests or other tests like kidney function tests to determine what else may be necessary for your treatment so if insides you do need to make sure. You're drinking plenty of water. That is one of the reasons that they will issue a kidney function tests requests. So make sure you're drinking at least those eight glasses of eight ounces of water each per day and perhaps drink more if you are on insides for any type of frequency the FDA requires that insides are labeled with the following specific warnings and these specifically for non aspirin insides they can increase the chance of heart attack or stroke and that risk may be higher if you have heart disease or risk factors associated with heart disease like smoking or high blood pressure or high bad cholesterol or diabetes. They risk may also be increased in folks. Who Don't have heart disease or any of the risk factors mentioned and that risk can occur early in your treatment and it may increase the longer. You use the insides. That's why they try to keep you on three days Max for fever and ten days Max for pain unless your doctor has said otherwise heart issues that may also be caused by non aspirin insides can happen within the first few weeks of US and they may occur more frequently at higher doses or with long term use non-aspirin insides should also not be used right before or after heart bypass surgery to make sure that you're paying attention for yourself and your loved ones when the doctor is going through the list of what you can and cannot do us at that time. The following warning is for all sides including aspirin so insides can increase the chances of you having serious stomach and bowel side effects like ulcers and bleeding and those side effects can occur without warning signs like we mentioned in the previous segment regarding bleeding and throwing up and having flooding your vomit. You might not even have pain associated with it. So this risk is greater in folks who are older who may have had a previous history of stomach ulcers bleeding issues who are on blood thinners if you drink three or more alcoholic beverages per day remember that the recommendation for that is for age sixty five and under males who are otherwise healthy can have up to two alcoholic beverages per day and females up to one so if you are on multiple prescriptions or over the counter insides you may also be at a greater risk of having the serious stomach and bowel side effects so those are just some things to be aware of and to watch out for if you start experiencing them then it may be related to the insides may not be just a secondary issue. Can you take NSAIDS? If you're being treated for high blood pressure. You might want to talk to your doctor about that. Insides have been found to cause high blood pressure in some folks otherwise known as hypertension. You might have to stop taking the incense if you notice. Your blood pressure is increasing. And that includes even if you're taking blood pressure medication and following your diet so ask your doctor about that before. Start taking insides. I feel that a lot of times. We just take for granted the fact that we can reach for Ibuprofen or a lot of these other incentives like aspirin or Naproxen if we need to have like pain and stuff because we're just like okay. Yeah we can get that across the counter over the counter and just get him off the shelves in either brand name or generic form and that ease of access pains to make us feel that. There's probably nothing else wrong with them. But I think that it's important to be mindful that they can still have side effects just like how taking certain vitamins can impact your medication. That you're getting from your doctor so we WanNa make sure that we still ask a doctor if we are on other types of medication whether it is safe to take these insects here are some recommendations for specifically when you should check with your doctor before taking insects. Although you're also welcome to ask them if you are on any other medications or have any other conditions that are not listed here. One of the most important ones is pregnancy so in pregnancy you should not take incentives in the third trimester and you should talk to your doctor about using them in the first or second one children and teens who have viral infections even if they're not accompanied by fever should not take aspirin or aspirin containing products because of the risk of developing. Ray Syndrome. Ray Syndrome is a disease primarily founded children but it can actually occur at any age and it affects all organs of your body but is especially harmful for your liver and your brain it can cause a large increase in pressure within the brain and is frequently also associated with massive accumulations of fat in your liver and other organs and we discussed in the diabetes episode. How that is particularly problematic for your body are s or Ray Syndrome is defined as a two phase illness because it generally also occurs at the same time the previous viral infection such as the flu or chickenpox. The disorder is also commonly occurring during recovery from a viral infection. But it can develop up to three to five days after the onset of a viral illness. It is very frequently misdiagnosed. As being encephalitis or meningitis diabetes drug overdose poisoning or some kind of psychiatric illness. In addition to sits so symptoms of our s includes persistent or recurrent vomiting listlessness personality changes like irritability or combativeness confusion disorientation delirium convulsions or even a loss of consciousness. So if you see someone particularly a child coming down with these symptoms during or soon after a viral illness make sure you reach out to a doctor ace up and follow the recommendations that they provide free for that. The symptoms of our as an infant's don't tended follow a typical pattern so they may not even always have vomiting and epidemiologic evidence indicates that aspirin is a major preventable risk factor for Ray Syndrome. So just keep that in mind especially when you have kids Who may be taking insides? You WanNa make sure that. They are not receiving aspirin or aspirin containing products. And that is why. So that includes a lot of forms of EXCEDRIN. You want to keep an eye on that. Anyone who has an upcoming surgical procedure including dental surgery should not be taking insides. So don't take Ibuprofen or anything like that. When you're going to have your wisdom teeth removed as a preemptive measure to make it less painful you want definitely avoid that you also want to avoid it. If you have three or more alcoholic beverages per day is it can make you more prone to bleeding and for asthma. That gets worse when taking aspirin again. Talk to your doctor about that. And if you are age sixty five or older you should also check with your doctor before taking insides. Even if you're not on any other forms of medication or have any of these other risk factors all right. We're going to go on a quick break when we come back. We're going to talk more about inside. Risk factors and allergic reactions. Tired of searching the vast jungle of podcasts. Listen close and here this out. There's a podcast network that covers just about everything that you've been searching. The golden state media concepts podcast network is here nothing less than our podcast bliss with endless hours of podcast coverage from news sports music fashion looking entertainment fantasy football had so much more so stop lurking around and go straight out to the golden state media concepts podcast network guaranteed to fill that podcast is whatever it may be visit. Www DOT G. s MC podcast dot com follow us on facebook and twitter and download on itunes soundcloud and Google play The cases in which flu should speak to the doctor for taking insides and how it may have side effects related to high blood pressure. Now we're gonNA talk about some more cases in which we should speak with doctor before taking insights to check if it's okay for us to do so because as we mentioned just because it's easy to acquire does not mean it's necessarily safe for everyone in all circumstances to reach for it when you are having aches and pains or fever show in a continuation from our last segment. We also want to talk to a Doctor. Prior to taking insets if we have certain types of diseases like known kidney or liver disease because it can promote the accumulation of fat in our lever and it can also cause some problems with urination and kidney disease in that vein if you have diabetes that is giving you problems in keeping it under control definitely also speak with your doctor. Remember that when we discuss the diabetes episode that certain types of problems in processing. Insulin can lead to accumulation of fat in your liver just like taking a lot of insects can so this can potentially exacerbate the problem. You are already experiencing so make sure you talk with your doctor. I if you have diabetes. That is difficult to control. And you're considering taking insects. If you have gastro esophageal reflux disease or Gerd you speak with your doctor first as well as if you have. Crohn's Disease Ulcerative Colitis or active peptic ulcer disease so that means stomach ulcers or any previous history of having bleeding stomach ulcers heart and bleeding conditions that may prompt you to ask a doctor. I if insides are right for you. Include any history of prolonged bleeding or for folks who bruise easily if you have high blood pressure. That's difficult control. Active congestive heart failure or history of stroke or a heart attack. Speak with your doctor. For Allergies and Drug Interactions. There are known allergies to medications including aspirin other insects and soul for drugs. If you have any of those allergies in your medical history or someone in your family may have had them then. Talk to your doctor first. If you have nasal polyps that's been linked to a greater chance of developing an inset allergy so definitely talk to your doctor also check with your pharmacist or healthcare provider before you start an inset to determine if your current medications whether they are prescription or over the counter as well as your dietary or herbal supplements are compatible with insects. This is especially important. If you're on warfare in also called Kundun Clopidogrel plavix any type of corticosteroids. Like prednisone finished Wayne Leg die? Lantin cyclosporine like near all Santa Moon Probe Benitez and lithium like Lithuania as well. If you take dianetics which are better known as water pills and a lot of ways to help. Control your blood pressure. You may also be a greater risk of kidney problems if you take them with insides and when I say taking them with insights that does not mean at the same time it just means if you are on these diabetics and you take an inside at any point then. It may cause you debbie at greater risk for kidney problems so definitely talk to your doctor before reaching for that proven interestingly and perhaps somewhat surprisingly some nonprescription insides are sweetened with aspartame which is a source of fennel elanie fennel. Alan is an amino acid. Which is the building blocks of proteins so a lot of food protein sources contain phenylalanine? If you have Kita Nuria. Pk You which is a genetic inherited condition that causes levels of finality to build up the blood. You should not be taking insides you need to speak with your doctor to find out. Which ones have that aspartame sweetener so a lot of those coated insides going to have that and may cause you some problems? Even though they do not tend to have protein in them they will still have some of those new acids to be mindful of that as well. Insects can cause allergic reactions and in rare cases an inside can cause a generalized allergic reaction known as antef lactic shock. If you've watched the x files movie from Nineteen Ninety eight called fight the future you may recall. The sculling gets stung by that. African is Honeybee and ends up going into ANTIFA lactic shock so. Nfl axes is a severe life threatening allergic response that may cause swelling lowered blood pressure hives shortness of breath wheezing difficulty swallowing and even a loss of consciousness which we saw. Scully have pretty much all of those reactions in her presentation of influxes in the movie normally when you have an allergic reaction the body's immune system overreacts by releasing chemicals that cause those itchy watery eyes and the runny nose those normal but annoying signs of an allergy but in some people this reaction can be more severe and NFL axis is results so in those cases people can go into NFL. Lactic shock so their blood pressure is going to drop severely. And you'll get swelling in the bronchial tissues so in your lungs and that causes symptoms of choking and even a loss of consciousness if anticlimactic lactic shock is not treated immediately. It can be fatal so if you or someone you were around is experiencing these swollen eyes lips or tongue difficulty swallowing shortness of breath rapid heart rate chest pain or tightness. You need to call nine one one or have someone drive you to the nearest emergency room a sap if someone is going to get anticlimactic shock from an inside. It's usually going to occur very soon after the person starts taking the end. Said before you take any medication that is prescription. Make sure you tell your doctor. You're allergic to any medications foods or other substances if you currently take any other medications like over the counter man's or or dietary supplements. Tell them also. Tell them if you're pregnant. Planning to become pregnant or are breastfeeding. If you have any problems taking meds or if you have anemia kidney liver disease stomach or peptic. Ulcers heart disease high blood pressure bleeding or clotting issues or asthma or growth in the nose like nasal polyps. Your doctor may need to give you a different type of medication. You can get insides from your doctor in form as well. A lot of folks in the military get those eight hundred milligrams. Ibuprofen said you seeing your military friends with those horse pill ibuprofen. That is generally what those are in. You can get those from regular nonmilitary civilian doctor as well depending on whether your doctor. Phil's it's called for so remember when you go into your doctor and they ask if you are allergic to anything go ahead and tell them everything you're allergic to. It may seem silly in the moment to go. Hey I'm allergic to these types of antibiotics but also to bees and certain types of shampoo and it causes me to break out in hives. But it's important for your doctor to know that and I think that the alanine inside of the coatings of some of these insides is isn't especially important reminder of that it can be surprising products. You never know exactly what goes into each of these products so view have ceiling activities. And you have to deal with gluten sensitivity issues. The new may be especially aware of that but there are a lot of surprising elements added to different products to sometimes make them more palatable or serving as a binder for different products. So just make sure that you do list out all of those allergies even if it seems like it is out of nowhere because you never know what has to be added to a lot of these products or just what is added to try to make things more palatable. We're GONNA go on another break and when we come back. We're going to discuss differences between types of insects. Stay to the GMC life and happiness. Podcast TAKES YOU ON. A Journey of exploration. We'LL DISCUSS TRIED. And true methods alongside the latest trends of how to best live your life to its fullest and happiest from psychology to meditation science to self help books the Genus Mc live in happiness. Podcast will help you to discover what makes you happy and how you can live live being the best possible. Download the GMC life and happiness. Podcast on Itunes Stitcher soundcloud. Who play or anywhere. You find podcasts. Just tied Jesse in the search Bar Iraq before the moon talk about different health side effects and allergies. That may be associated with insides. Now we're going to talk about. How inside specifically work and what differences there are between each type first off. Insides are used to combat prostaglandins. So prostaglandins are a family of chemicals produced by cells in your body and they have several different important functions they promote inflammation that is often necessary for healing but as a side effect the cause pain or fever. Prostaglandins also help support the blood. Clotting function of your platelets and protect the lining of your stomach from any damaging effects from stomach. Acid prostate gland are produced in your body cells by the enzyme cyclo oxygenation which is frequently referred to as Cox. So there are two cox in Arms Coxswain Cox to both of those Enzymes Produce Prostaglandins that promote inflammation pain and fever however only Fox one produces the type of prostaglandins that support platelets and protect the lining of your stomach. Non Steroidal Anti Inflammatory Drugs Block. The Cox Enzymes in reduced prostaglandins throughout your body. So because of that ongoing inflammation pain and fever reduced since the prostaglandins that protect your stomach's lining from stomach acid and support platelets and blood. Clotting are also reduced. That's why insides can lead to stomach ulcers and promote more bleeding there are differences between certain groups of insects. They vary in their potency. How long they take to act in how long they continue to act however are eliminated from your body and how much they inhibit Cox one versus Cox. Two in Zein's shut the more an inside. Blocks Cox won the greater tendency to cause ulcers and promote leading so one particular in said Saleh. Brax tends to block Cox two and has very little effect on Cox one. So it's also classified as a selective Cox two inhibitor selective Cox two inhibitors. Such as celebrates caused less bleeding and fewer ulcers than other incentives. That's one reason why it's really important to have these discussions with your doctor. Because not all incense are created equal and they do act very differently depending upon which type you get. They may have secondary classes. In addition to being considered incentives aspirin is also unique as an inset. Because it is the only inside that inhibits the clotting of blood for prolonged period of time. And that's really four to seven days. That prolonged effect of aspirin is what makes it really ideal for preventing blood clots that can cause heart attacks and strokes and that is why a lot of folks have heard. Doctors say an aspirin a day. Now most insides. Inhibit clotting of blood for just a few hours. Cadore lack or toward all is a very potent in said and it is often used for moderately severe acute pain that would otherwise perhaps require a narcotic. Torah lack causes ulcers more frequently than other insides though. That's why can't use it for more than five days. A lot of insects have a similar mechanism of action and individuals who don't respond to one particular instead may respond well to another one so you don't necessarily have to brush aside insides period. If those are not working for you. You just need to speak with your doctor and perhaps they can find one for you that you will perhaps be more responsive to again remember. We're all individuals and although as humans we have a ton in common but there are also just individual differences sometimes just like with allergies regarding drug sensitivities show which drugs do insides interact with well insides reduced blood flow to your kidneys. And that means that if you're taking water pills diuretics. We discussed earlier. It's going to reduce the action of those water pills and also decrease the elimination of certain drugs from your body. Like lithium or methotrexate as a consequence of that the blood levels of those drugs may increase which in turn may also increase the likelihood of having their side effects or the magnitude of the side effects. Insides can also decrease the ability of the blood to clot and that means X. going to increase leading when used in combination with other drugs that may also increase bleeding like warfare in or Kundun. Then there's an increased likelihood that you may have serious bleeding or complications of bleeding. That's why folks who are taking drugs that reduce the ability of your blood to clot should avoid using For a prolonged period of time incense can also increase your blood pressure especially in patients with hypertension and that means that it can antagonize the action of the drugs. That are used to treat. Hypertension insides can also increase the negative effects of cyclosporine on your kidney function. Cyclosporine is a drug that reduces your body's ability to fight illnesses and diseases. It's an immunosuppressant. So it can leave. Patients vulnerable to infection or other problems including cancers like lymphoma using other drugs. That treat organ transplant rejection. Along with cyclosporine can also increase those tendencies because cyclosporine can also cause high blood pressure kidney problems. That's why you cannot use insecticides in combination with cyclosporine it's just a double whammy on your kidney function additionally if you drink more than three alcoholic beverages per day it may give you an increased risk of developing stomach ulcers if are also taking incentives so definitely avoid that as well that means you need to be very aware that if you do drink a lot and drink frequently because the first thing but a lot of us tend to reach for if we have a hangover is going to be an end said but you want to be careful with that because it can give you an increased risk of those stomach ulcers which is going to be bad news bears in just a bummer of a time when you are dealing with that cycle. We're going to go on another break when we come back. We're going to talk about the implications for Ibuprofen with Corona virus. Stay Tube are you tired of the same old news are you sick of the seemingly endless political spin and negatively the Diaz Mc. America's still. Beautiful podcast is a weekly news. Podcast covering all the top positive and uplifting news stories we cover stories that will inspire uplift and remind me love good in the world tune into the golden state media concepts. America's still beautiful podcast to get all the great and positive news stories of today. Download the US NC. America's still beautiful podcast on itunes stitcher soundcloud Google play or any podcast just tight GS MC in the search bar a before the word discussing. How incentives work by blocking the Cox Enzymes and reducing prostaglandins throughout the body. We also discussed the differences between incentives. And how they can have secondary classifications as well as which drugs tend to interact with them. And why so now? I would like to talk to you guys about how incentives work with Corona virus. So I know there's been a lot of information out there. Lately stating that folk should take paracetamol slash acetaminophen connell instead of incentives. Right now from worries that Ibuprofen may worsen corona virus. It's gone viral on the Internet and health. Experts are actually saying that. There's no credible scientific evidence at this time to substantiate that concern. It spread very widely as a rumor after leave. French Health Minister tweeted that taking ibuprofen and other anti inflammatory drugs might worsen an infection. And he suggested that Acetaminophen may be preferable but to still defer to your physician if you're already taking anti inflammatories that tweet appeared because a letter published in the land sent on March eleventh stating that Corona virus binds to ace to receptors on the surfaces of cells and that theoretically medications that work by stimulating these receptors like Ibuprofen may actually worsen corona virus and lead to poor outcomes however that is just a hypothesis right now it is an interesting observation infectious disease. Experts are trying to research this more because we're learning a lot about the unknowns of this virus it is a novel Corona virus that means we've never encountered it before and there is a lot of research that still needs to be done so this is hypothetical and there is no hard data right now saying that. Ibuprofen put you in any kind of disadvantage or interferes with the inflammatory response of the body. Such that it can't fight off the virus according to Dr William Shatner an infectious disease expert at Vanderbilt University. So more research is needed to evaluate reports that I've approach may affect the course of Cova nineteen and it's important to keep in mind the difference between correlation and causation in this case just like any other type of research that we discussed previously on this podcast. Just because you see reports that folks who have died from Contracting Kovic nineteen. I've had ibuprofen. Systems does not mean that the Ibuprofen is what caused it or made it worse. It merely means that they had symptoms related to inflammation or fever or pain that prompted them to take an inside like profane so they are doing more research on that right now and there is no reason according to the experts right now to avoid Ibuprofen to Cova nineteen unless you have other conditions that would require you to avoid it. That is a direct quote from an infectious disease doctor and the Cleveland Clinic. Meanwhile the makers of Tylenol said that it's experienced some consumer driven demand for their products and there is no shortage of these drugs that are anticipated right now. So just keep that in mind as you go forward we. WanNa make sure that we don't panic just because someone has this going viral online or the World Health Organization says that it's gathering evidence on the topic. They've performed a preliminary literature review which is one of the first steps that you take when you are conducting any type of research and they are not aware of published clinical or population based data on this particular topic. So this is a hypothesis at this point. Only now if you are concerned about that then by all means go ahead and swap tylenol but if you go to the grocery store or the pharmacy and they are out of tylenol because people have panicked bought it. Don't worry you can take another form of inside right now. According to all the infectious disease experts within the United States. Right now unless otherwise indicated by your doctor even the authors of that study in The Lancet Respiratory Medicine Journal that came out on March eleventh had explicitly stated that this is only a hypothesis. Some tests with rats have shown the ace inhibitors actually up regulate as to heart cells and tests with diabetic. Mice have shown that Ibuprofen can have an influence on that regulatory system. But these were in mice. These studies were performed with Mike. And if we discussed before sometimes we have a lot in common with mice and sometimes it's not exactly the same so without strong data and evidence to back up this hypothesis. It is nearly a hypothesis right now. They're going to study it and they may see in the future that this warning may be correct or this hypothesis may not hold weight. Forming a hypothesis is one of the first steps in the scientific method and then test that hypothesis. Not all hypotheses that are tested turn out to be correct and fact a lot of them turn out to be incorrect and in the scientific community we still find that to be a valuable contribution to the body of research so this is an interesting hypothesis that they have posed but it does not necessarily mean that it is a correct hypothesis. So I urge you to not panic. Just speak to your doctor. If you are on ace inhibitors or if you are taking an insect like ibuprofen that affects ace to regulation one thing. You should be doing regardless though if you are infected. Were hospitalized with Kobe. Nineteen is to make sure. You're getting enough fluids. Whenever your liver cells are inflamed or damaged. They can leak higher than normal amounts of enzymes into your bloodstream. Elevated liver enzymes. Don't always mean that you have a very serious problem. But they found that was a typical lab finding and many people with SARS or murders which we discussed in our corona virus episode. I read the article in The Lancet Journal Respiratory Medicine and it was called our patients with hypertension and diabetes melodies at increased risk for Cova nineteen infection. This is the study that prompted folks. Thank that Ibuprofen. Could BE PROBLEMATIC FOR IT. And in this study they found signs of liver damage in a person who had cove in nineteen. The doctors involved in the research. Say It's not clear if it was the virus or the drugs being used to treat the person the Ibuprofen that caused the damage so they are not sure one way or the other. Some people who've been hospitalized with cove in nineteen have also had acute kidney damage and have sometimes required a kidney transplant. That also occurred with SARS and Murs during the SARS outbreak. Some scientists even found that the virus that causes the illness was in the two bills of the kidneys. There is little evidence to show that the virus directly caused the kidney injury though according to a World Health Organization report. So that's why they're still trying to sort this out. Dr James Cherry. Who's a research professor of pediatrics? At the David Geffen School of Medicine at Ucla says the kidney damage may be due to other changes that happen during a corona virus infection. When you have issues like pneumonia you have less oxygen circulating and that can also damage the kidneys so when you're having these respiratory illnesses you are having less oxygen circulating and that can damage your kidneys. So it's not necessarily corona virus itself and it's not necessarily ibuprofen. It just made a secondary effect from something else that is going on with corona virus. We're going to go on a quick break and when we come back. We're going to wrap up this episode by discussing the Actual Lancet Journal Article. Stay tuned. Gs MC beauty. Tips Thought. Pass hits you advice on everything from hair batch into skin care products. We'll talk about the latest trends and makeup hairstyles anti aging remedies animal. Cover all of the newest fashion trans if you have an interest in or questions about the beauty trends that might work best for you. The golden state media concepts beauty tips. Thought past has got you covered. Download the GS NC beauty tips. Podcast on Itunes soundcloud. Google play or anywhere you bind gas just type GS MC in the search bar. Perfect before the break. We were discussing recently concerns regarding taking and said like ibuprofen invokes. You have corona virus symptoms and this has come from an article in The Lancet Journal. Respiratory Medicine published on March Eleven. Twenty twenty on our patients with hypertension and diabetes melodies at increased risk for cove in nineteen infection. The authors are Li Fang. George CHARAC latkes and Michael Roth so this study was not about Ibuprofen in and of itself but rather about whether patients who already have hypertension and diabetes Melodist at a higher risk of infection from Cova nineteen so they were studying co Morbid disorders or co Morbidity. He's so Co Morbid. Men's that you have a simultaneous presence of two or more chronic diseases or conditions in a patient so that just means you have more than one thing going on for example in this case whether folks have Cova nineteen and hypertension or Cova. Nineteen and diabetes Mellitus. That's all it means. So they studied thirty two non survivors from a group of fifty two intensive care unit patients. Who had Kobe nineteen? They found that twenty. Two percent also had cerebrovascular diseases and another twenty. Two percent had diabetes in another study. They found that out of one thousand ninety nine patients who had confirmed cases of covert nineteen one hundred and seventy three of them had severe disease with Co Morbidity of hypertension at twenty three point seven percent or diabetes melodies at sixteen point two percent coronary heart disease at five point eight percent and cerebrovascular disease at two point three percent. Fang at all who released this publication on March eleven also looked at a third study of one hundred forty patients who were admitted to the hospital with cove in nineteen. They found that thirty percent of these one hundred forty patients had hypertension and twelve had diabetes. So the most frequent co morbidity that they have found in these three different studies are often treated with ace inhibitors but treatment was not assessed in ir the studies and the authors very clearly point that out so different type of SARS viruses remember Sar stands for Severe Acute Respiratory Syndrome and SARS Corona viruses or stars cove and SARS Cov to our human pathogenic corona viruses so they spread in humans and they cause disease they bind to the target cells in your body through converting the ace to enzyme which is then expressed by the lining cells of your lungs. Intestines kidneys and blood vessels so expressing a two is also substantially increase in folks who have type one or type two diabetes. Who are treated with ace inhibitors or NGO tencent to type. One receptor blockers called arms. You also treat hypertension with ace inhibitors and ARBS and what. These drugs do is up. Regulate Ace. To up regulation means that it increases the number of receptors on the surface of those target cells. In your body buy target cells. We mean the cells that are being impacted by corona virus and that can make the cells more sensitive to a hormone or another agent in this case Corona virus. The fact that I'm fin can also increase eight. Two is very much just a side note. In this article overall it says that the cumulative data that they've looked at suggests that as two expression is increased in diabetes and that treatment with ace inhibitors and arbs increases ace to expression. They hypothesize that because of this an increased expression of ace to could facilitate infection with Nineteen so this is very explicitly stated as a hypothesis that diabetes and hypertension treatments with specifically ace to stimulating drugs could increase the risk of developing severe and fatal Cova Nineteen. They also explicitly state that that hypothesis needs to be confirmed and merely are saying that if that hypothesis were confirmed to be true then that could lead to a conflict in the treatment since Ace to reduces inflammation and has been suggested in recent years as a potential new therapy for inflammatory lung. Diseases cancers diabetes and hypertension. They also recommend that we investigate whether there may be genetic predisposition for folks to be at a higher risk of SARS cove to infection which again leads to the covert nineteen illness. Now they have also said that that could be due to ace to polymorphism that have been linked to diabetes maladies cerebral stroke and hypertension specifically in Asian populations. Genetic polymorphisms are just differences in DNA sequences among individuals groups or populations. It may be a single nucleotides polymorphism which means that one of those fundamental nucleotides as building blocks of DNA like G. A. T. and see those are the four types that we have is. Humans may change from a g to AC- or from A to a T. So that is a single nucleotides changing. You may have a sequence. Gatt A C- a repeating. You may have insertions deletions or them. Also being re combined that's what genetic polymorphism means and that's fairly common. If you think about how humans have different blood types that is a polymorphism that just means there's a difference in our DNA sequences so when we say a two polymorphism were just saying that. There are several differences in how that can be formed in your body and still be called ace to it. Also just means that different types of these ace to polymorphism may increase your risk for our own expression of diabetes melodies cerebral stroke and hypertension specifically in Asian populations as those are primarily the studies in which that has been examined so to summarize the sensitivity of an individual person might result from a combination of the medication. They may be taking as well as their specific ace to polymorphism when it comes to the sensitivity and risk for folks in taking these ace inhibitors and Arbs at the same time. You are having Cova. Nineteen active infections so the authors of this Article Fang at all said that they suggest that patients who have cardiac diseases hypertension or diabetes. Who are treated with ace to increasing drugs may be at higher risk for severe Kobe. Nineteen infection and should be monitored for ace to modulating medications so anything that changes your ace to regulation like the up regulation. We discussed earlier. That comes about with some ace inhibitors or arbs. So they based their research pubmed search from February twenty twenty twenty as well and did not find any evidence that suggested that anti hypertensive calcium channel blockers increased ace to expression or activity and they have proposed those as an alternative treatment for patients who may be on inhibitors or arbs. So that's really. All this article was getting at with that. They found some co morbidity regarding cerebrovascular diseases and diabetes in folks who have died with the Kobe nineteen infection. That is what they're saying. So they have found that there was about twenty percent for both cerebrovascular diseases and diabetes more or less in these three different studies so they've found some correlations but they've not found the causation for it. They are merely hypothesizing that it may be due to up regulation of ace to that is associated with treatments from ace inhibitors. Arbs and Ibuprofen. They clearly state. It's merely a hypothesis. They did not have more data to back this up. And the ibuprofen comment is nearly a one liner in. This is just a side note to say. Hey We've noticed that there is a certain amount of folks who have diabetes or these vascular diseases at the same time. They've had corona virus and that these things are treated by ace inhibitors and arbs which tuned to cause up regulation of ACE to. Hey by the way I approach can also increase as to. They don't even discuss the magnitude of how much Ibuprofen can up. Regulate ace to or if it is even comparable in the quantities of ace to up regulation when you compare ibuprofen versus ace inhibitors or looking at the different amount. You would have to take ibuprofen to cause that same amount of up regulation that you see with these ace inhibitors and arbs. It may not even be statistically significant. Think back to our wine episode in which we discussed how rats were found to really benefit a lot from reserve patrol but that humans would have to drink hundreds to thousands of glasses of wine per day to get those same beneficial effects that the rats were getting because they were giving it to them at such high doses and rats and humans are quite different again. That is what we are kind of seen here. Is that these statistical likelihood in the statistical difference in the comparisons between these groups has not really been looked at yet. This is just Fang at all expressing an abundance of caution and also the needs for further study in that way it is not unlike any other study. There certainly no need to panic at this point. But if you are more comfortable in the meantime using tylenol then go for it but don't panic if you go out and they are out of. Sita manifesto or kyle the brand name in the grocery stores. This is merely an observational correlation. Study and is meant to prompt further research. It is not saying that it is causative at all and it is a well known fact that people who have these vascular diseases as well as diabetes tend to have more trouble healing in general it may be merely correlation and not causation. We need further studies to tell us that. I hope that this episode has really helped break down some of the fear and confusion surrounding the use of incentives in general and in particular with Corona virus. Today thank you for listening to the GSM see health and wellness podcast brought to you by the GMC podcast network. I'd like to ask that you please remember to subscribe to the show and writing. A Nice Review always really helps us. Also if you could please follow us on facebook twitter and instagram. I'd appreciate it. Thank you kindly and have a good night. You've been listening to the golden state media concepts have an wellness podcast to part of the golden state media concepts podcast network. You can find this show and others like it at. Www DOT g s MC podcast DOT COM or download. Podcast on Itunes Stitcher soundcloud. Google play existed type any MC to find all the shows from the golden state media concepts podcast network from movies to music from sports entertainment and even weird US. You can also follow us on twitter and on facebook. Thank you and we hope you have enjoyed today's program.

Ibuprofen aspirin diabetes ACE hypertension fever Cova Allergies US ulcers Google ibuprofen liver disease GMC menstrual cramps asthma arthritis pain SARS
Democracy Now! 2020-07-22 Wednesday

Democracy Now! Audio

59:02 min | 8 months ago

Democracy Now! 2020-07-22 Wednesday

"From New York. This is democracy now. South Africa may unfortunately be a precursor. It may be a warning for what will happen in the rest of Africa. You've got to give me one shoot. It's. Something that is challenging. And something that can cure. covid nineteen infections are skyrocketing in South Africa now fifth in the world for coronavirus cases with an already fragile hospital system. We'll look at how the African continental has so far avoided. The worst of the pandemic and new vaccine trials underway in south. Africa will go to Cape Town and then to Ethiopia to speak with the head of the Africa Centers for Disease Control and Prevention. Then the pandemic sturgis throughout the United States will look at the impact on Latin x apparel, workers, meatpackers and farm workers who've been particularly hard hit. SINGLE SCULLS IN All his farm workers are making the big sacrifice out of necessity for hunger to be able to feed our families to have a place to live. We'll speak with doctor. David Hayes Teesta head of the UCLA Center for the study of Latino Health, and culture and author of a new report that shows Latin x Californians between the ages of fifty and sixty four have died more than five times, the rate of white people, the same age, all that and more coming up. To Democracy now democracy now dot org. The quarantine report I'm me, Goodman. The United States recorded more than one thousand covid nineteen deaths Tuesday the highest figure in nearly two months on Tuesday president trump held his first televised briefing on the pandemic since April after months of downplaying the corona virus, and claiming it was dying out. Trump admitted the crisis will continue to worsen. It will probably unfortunately get worse before it gets better something I don't like saying about things, but that's the way it is. It's the way it's what we have. You look over the world. It's all over the world. Trump did not invite doctors anthony. FAUCI or Deborah burks of the White House cry- Taskforce Force to speak at the breeding. He didn't have any scientists that the briefing trump falsely claimed the United States has lower fatality rate than quote almost everywhere else in the world. World, but the United States actually has the world's tenth highest rate of reported deaths, and by far the most total deaths and infections. It has a quarter of the desk in the world as well as infections. The US death toll has now topped one, hundred, forty, two, thousand, nearly four million Americans have been infected, though both numbers are believed to be undercounts in California Los Angeles is on the brink of shutting down again as Corona virus cases continue to soar. This comes as. It has overtaken New York as the state with the most corona virus cases with just over four, hundred nine thousand confirmed cases the death toll in New, York however is four times higher than in California on Tuesday the Centers for Disease Control and prevention reveal the actual number of coronavirus infections nationwide may be twenty four times higher than the public count. This comes as the trump administration's opposing more federal funding for covid nineteen testing, the White House has refused to spend up to eight billion dollars already. Noted for testing, even though many states and cities face severe testing shortages. In California the coronavirus death toll at San Quentin state. Prison has now reached twelve more than two thousand men held at the person have tested positive and one of the nation's worst outbreaks in Texas more than five hundred women at Federal Medical Prison in Fort Worth. Have tested positive for corona virus including. National Security. Agency whistle. Blower Reality Winter. Winner. In international news human rights, watch is reporting. At least fourteen prisoners have died in Egypt's overcrowded prisons from covid nineteen complications in Brazil coronavirus death toll has surpassed eighty thousand two more government ministers in Brazil have tested positive in addition to the President Shire Bowl Sinato in Bolivia. Police have recovered four hundred bodies in recent days from streets, cars and homes. Most of the people are believed to have died of covid nineteen in the occupied West Bank Israeli. Authorities have demolished corona virus testing center in the city of Hebron in. Iran. The Health Ministry reported two hundred. Hundred Twenty nine new deaths Tuesday the highest daily total since the pandemic began, and the Gulf state of mind is instituting a near-total lockdown, including nightly curfews and travel ban, meanwhile the number of us. Military personnel infected with Cove nineteen top twenty thousand raising growing concerns in Japan South Korea Germany and other countries housing US military basis as well as in the war zones of Iraq Afghanistan and Syria in Okinawa Japan more than one hundred forty marines have tested positive the new. York Times reports the infection rate in the services has tripled over the past six weeks. In Immigration News President Trump has signed a memorandum ordering the Commerce Department to exclude millions of undocumented people from the twenty twenty cents us that will be used to determine the number of us. House seats each state receives when voting district lines are redrawn next year, the unprecedented move versus a longstanding policy of counting everyone regardless of their immigration status, and is being denounced as an attempt to preserve white Republican political power, civil and voting rights. Groups have already vowed to challenge the move. This is Ben Monte Rosa advocate with the voting rights group. Put Their Latin X. Is Not only unconstitutional. is illegal and his moral. It's one more time the press in the show and he's through caller. Of The racism the he has in his black. Our community needs to be competent in will become for the good of our country. Good of our community in related news, immigrant families and allies in Boston have been camping outside the Massachusetts State House since Friday demanding state legislators include a provision racial justice spill that would grant undocumented people the right to get a driver's license in Portland Oregon federal agents tear gas protesters, Tuesday night, the fifty fifth day of demonstrations in Portland Against Racism and police brutality over the past week, unidentified federal agents have been attacking anti-racist protestors even. Even snatching activists off the streets and unmarked vans on Tuesday the Department of Homeland, Security's customs and border protection arm confirmed a deployed officers from three paramilitary style units to Portland. Meanwhile, a leaked DHS memo reveals the agency is now conducting domestic surveillance targeting potential threats to federal buildings as well as local statues and monuments in Washington the White House press secretary claimed president trump had the legal right to deploy federal agents Portland and other cities. Yes well. What you're referring to is Portland in forty US code. One three, one five gives hse ability to deputise officers in any department or agency like ice custom, border patrol and secret service president trump has threatened to deploy federal agents to other cities, including Chicago new. York Philadelphia Detroit Baltimore and Oakland. And other protests news at Detroit police officer Daniel two Bono has been charged with multiple counts of felony assault for shooting rubber bullets at three journalists who are covering a black lives matter protests on May thirty first, if convicted, he faces up to four years in prison. In New York. At least seven people have been arrested after dozens of police officers in riot gear pushed out the remaining occupants of a peaceful and Kampman outside City Hall. The raid occurred early this morning. Protesters with the Occupy City Hall. Movement had been camped out for over a month calling on the city to cut one billion dollars from the NYPD six billion dollar budget and reinvest the money into social programs in other New York News nearly a dozen house. People in ally spent Tuesday. Night camped outside the home. Of New. York's Department of Social Services Commissioner demanding the city provides permanent housing to an house people during the pandemic. The Democratic controlled has approved a seven hundred forty billion dollar military spending package, a two billion dollar increase from the previous year. A group of Antiwar Democrats had pushed for a ten percent Pentagon budget cut, but one hundred thirty nine House Democrats joined with the Republicans to defeat the measure over one hundred House Democrats also joined with Republicans to reject a proposal to accelerate the withdrawal of US troops from. Afghanistan Congressman Ilhan. Ilhan Omar who had submitted the proposal tweeted quote twenty years later. Congress is still not willing to support withdrawing our troops from Afghanistan and less continue to take lives and disabled so many. It's long past time to end this war. She said, and now the news from Capitol Hill the Senate rejected a bipartisan effort to limit the transfer of military gear, including tear gas, grenade launchers and weaponized drones to local police departments. The United States is abruptly ordered China to close its consulate in Houston within seventy two hours within hours of the order, smoke could be seen from the consulate's courtyard appears. Chinese consulate workers were burning documents a spokesperson for China's foreign. Ministry called the closing of the consulate illegal under national law. Closure of China's consulate-general General. Houston within a short period of time is unprecedented escalation of its recent actions against China the state. Department said the move to close. The Chinese consulate was needed to quote protect American intellectual property on Tuesday. The Justice Department indicted to Chinese residents, accusing them of stealing trade secrets from US firms including research into a corona virus vaccine. The FBI's is arrested. The Republican Speaker of Ohio House of Representatives Larry Householder in connection with a sixty million dollar bribery scheme. How soldier is accused of helping pass a one point one billion dollar bailout of two nuclear plants after his political operation received sixty million dollars from the owner of the plants I. Energy Solutions, the company is not facing charges, and is not named in the indictment for others were arrested Tuesday, including the former chair of the Ohio Republican, Party and aid to householder and to lobbyists. In Chicago at least fifteen people were wounded Tuesday night in a mass shooting outside a funeral for a man who was shot to death last week, passengers in an SUV reportedly began shooting funeral attendees as the vehicle drove by a group of those attending the funeral, then reportedly started shooting back, causing the vehicle to crash, the occupants fled at least six people who were hit are in critical condition. In News, from Africa the trial of former Sudanese President Omar Al-Bashir began, Tuesday he's facing charges stemming from his role in one thousand, nine, hundred eighty nine coup that brought him to power. In. London, the Acclaim Fashion Designer Vivienne, Westwood locked herself inside a giant yellow bird cage outside a London court Tuesday to protest the ongoing jailing of wikileaks founder Julian, assange on his possible extradition to the United States. I am. I am the Canarian the cage. He has been trapped by big net take now to the sun shoved in the cage and the problem. Is that want to send him to America? For a sentence of a hundred and seventy-five year this and stick him in concrete greet block for A. And this could happen to every journalist on Tuesday president. Trump weighed in on the arrest of Jeffrey Epstein Associate. Lane Maxwell WHO's facing child sex trafficking charges. Trump was asked about her arrest during his coronavirus briefing. have been following it too much. I just wish it well frankly. I've met her numerous times over the years especially since I lived in Palm Beach and I guess they lived in Palm Beach, but I wish your will. In News from Capitol Hill. Democratic leaders are calling for Republican Congressman Ted Yoho to be sanctioned after he was overheard. Calling Congresswoman Alexandria Cossio Cortez and F ING B, word, on the steps of the Capitol, his remarks were overheard by a reporter for the Hill newspaper. ABC, reports, it's been nearly a century since a member of Congress was censured for using unparliamentary language Cossio Cortez responded by writing on twitter quote, bitches get stuff done. And those are some of the headlines. This is democracy now. Democracy now dot org the quarantine report I'm you goodman in New York City joined by my co host than solace from his home in New Brunswick New Jersey High Juan I in welcome to all of our listeners and viewers across the country and around the world. While we turn now to South Africa where skyrocketing COVID, nineteen infections have made the country fifth in the world for Corona virus cases, overwhelming, an already fragile hospital system and signaling a dangerous turn for the African continent which has so far avoided the worst of the pandemic south. Africa recorded nearly three hundred eighty two thousand cases as Wednesday number that certain to be an underestimate so far the death rate in south. Africa's remain low, even as case, numbers soar with nearly fifty four hundred reported fatalities, but South African president. Cyril Ramaphosa said the number of deaths could reach fifty thousand. The virus poses a particular threat to poor South Africans who are less able to socially distinct and access adequate. Adequate medical care half of South Africans live in poverty. One third of South Africans are unemployed. At least three million people have lost their jobs due to the pandemic in response to the rising numbers, the president's banned alcohol sales mandated mask-wearing imposed a curfew. This comes after South Africa took aggressive action to curb the virus in March implementing shutdown than rolled back restrictions facing an economic crisis. This comes as University of Oxford. Vaccine trial has shown promising results, but researchers say the study will face a challenge in south. Africa where scientists are trying to sign two thousand people up for a vaccine trial while the number surged. This is the head of the trial in South Africa speaking to CNN. Might be that we failed not because vaccine doesn't work in protecting people, but simply because the force of exposure is so tremendous, so this is really going to guess the metal. For more, we go to Cape Town South Africa where we're joined by the South African, human rights, lawyer and HIV. AIDS Social Justice activists. Fatima Hasaan founder and Director of Health Justice Initiative an organization focused on public health law and equity previously served a special advisor to South Africa's former minister of. Her recent op ED, and the daily Maverick is headlined a covid Nineteen vaccine when solidarity meets nationalist profiteering welcome to democracy now for tonight's great to have you with us. Why don't you start off by talking about the scope of the crisis, the pandemic in South Africa and then particularly what's happening around this Oxford vaccine trial that needs something like two thousand volunteers, but finding those who are covert free is very difficult. So I thank you. For having me on the show, it's it's great to be on I think the first issue with the trial. Is that what significant is that? The president and the government agreed to offer solidarity and participate in the trial, which is being led by Oxford University through South Africa's but university. The difficulty of course is one trying to secure sufficient number of volunteers for the trial with as you correctly point out within a climate where the numbers of people living with code are increasing, and we also estimate that that is a significant undercount because our testing strategy has been hampered by the lack of available testing kit, so the criteria for testing has changed and ineffective amounts to rationing at the moment. The second issue with the trial which actually is? Involves quite significantly. A pharmaceutical company called extra Zeneca. And the issue around AstraZeneca's relationship with Oxford, the relationship with the South African government as in the contractual relationship, including VICI versity and clinical participants in other parts of the world. In Brazil as well is unclear. We calling for transparency in those agreements, because on the one hand, if we are going to participate in a trial that is trying to ensure equitable access to a vaccine if he's successful than certainly, there has to be a framework where equitable access can actually be achieved, and we certainly don't want to be in a situation like we were you know. During the HIV AIDS, crisis, we wealthier countries are able to access a vaccine sooner or some countries in Africa able to excess lifesaving vaccination in treatment and others are not. I'd like to ask you specifically about this as you mentioned trials in Brazil as well. Is there a situation already developing where the testing of vaccines as occurring in the third. World but they've initial beneficiaries of any vaccines will be in the advanced developed countries. Certainly there's a concern that there are countries that have volunteered to participate in the trial, including in the global south, but the tombs and the conditions for what excess would mean if the if the trial is successful, is uncertain, unclear. I think what is. Concerning is that people are labeling it. The Oxford trial, but we know that there's deep involvement of extra Zenica and the terms and conditions between Oxford University and extra sanitize is not available in this you must remember is only one of a possible one hundred and twenty six vaccine candidates. About Twenty to twenty, two in a in the second phase off clinical testing and Bay Few a handful of candidates that still we'll go to phase three, so you know. The participation of the Global South in one or two of these trials is significant because we need to do that, we need to participate. We need to offer solidarity. We need to find a solution to this crisis. However, the chances off that like issue aids like a lot of life saving medication treatment are going to be lost in the line unless. Unless we can guarantee an intruder that the vaccine is freely available is equitably available to all people in all parts of the world as a campaign which is being led in the US. Free the vaccine, our president or pause as head of the a you has supported the People's vaccine, but what we saying is that all of these are really beautiful and lovely words and statements, but they don't sort of create any enforceable guarantees because. Like with AIDS. What we realized is that if you rely on the the? And the charity of this particular industry is investing millions and millions of dollars in the development of a vaccine than that won't guarantee access for the global. Putting my house and I wanted to ask you in terms of the situation in South Africa itself with the pandemic. You've said that your country has used a first world response for a Third World Country Could you talk about the situation right there in South Africa? The the situation is worsening I. Think we in a crisis I'll health system really in view both the Public Health Service in the private health service is taking. Significant strain frontline workers are getting sick. Getting exposed repeatedly to COVID are at risk. They don't have sufficient supplies of P.. Due to global hoarding. We don't have sufficient supplies of testing again. Due to the global geopolitical situation and the reliant on pharmaceuticals companies that still insist on holding their pattern so only giving Bashar licenses to other companies that could produce those texting hits, so the situation is one way more people getting infected. We believe that the death gone is underestimated. A lot of people are dying loaded whole without takover tests, people assault struggling to get. Get their certificate, so you are dealing with a public health crisis in the middle of a global pandemic where inequality is soaring as result of covered, and as a result of the if social economic effect of locked on what we have in South Africa at the moment is increasing joblessness with increasing covert infections and the people who are most actress are low income workers who are required to reopen the economy who have to rely on public transport to have to go to work who have to serve people who want. To have the luxuries of normal societies, I really think it's our inequality. Reckoning moment all of the fault lines of South Africa's post supported democracy and its inequality, and it's violence is actually coming to the fore, the interaction between what we're seeing in relation to covert and the mobility is that are playing out. The interaction between Colbert and the COMBER, but a team of people living with HIV people living with TB. People living with cancer is significant, and I think that's another reason why our health is is also taking strain. What what what is important and I should point out. Is that unlike HIV AIDS are government's initial response and up until today has been rooted in science and evidence, but that signs an evidence is. You know a first world science evidence. It's designed bull countries where people can stay home and can work from home where they have secured employment. It's designed for countries with is sufficient socio economic rights protection benefits. If you are unable to go to work it designed for countries that can socially distance where you don't have thousands of informed sentiments that are densely populated. It's designed for countries where this proper civilization. Civilization with is running water for every single person in that country where there's secure food supplies so like I said earlier I, think folk lines of inequality in South Africa is coming to the fore and the crisis of our health system, which as you'll recall because of apartheid is a Jew alliance healthcare system that is basically based on race and task where the rich can afford really high quality private. Private Health Gay and the pool have to rely on high quality, but inconsistent access to health services. We already have multiple provinces that aren't really taking strains. These provinces we call the neglected provinces where the health systems have basically collapsed with the national government is probably going to have to intervene and stepping in and take over the running of those health department Hasaan. I WANNA. Thank you so much for being. Being with US South African human rights, lawyer, HIV AIDS and social justice, activist, founder, and Director of Health Justice Initiative previously served a special advisor to South Africa's former minister of health will link your piece in the daily. Maverick headlined to Covid Nineteen vaccine when solidarity meets nationalist profiteering. When we come back, we go to Ethiopia to speak with the head of Africa's Centers for disease control stay with us. Allies. took. Me Like you want. Me To. Won't. Stand together African anthem of solidarity against covert nineteen features, a wide swath with African musicians from around the continent, including Nigeria Tanzania. South Africa Camera, Angola, Theo. PIA and Morocco. This is democracy now. The quarantine report I mean we goodman with wanting Gonzales as covid. Nineteen cases skyrocket in South Africa the World Health Organization warned this week. The Spike and infections could signal an impending acceleration of the coronavirus across Africa. This is Mike Ryan. Executive Director of Health Emergency. Speaking Monday A thing what we're starting to see is continued acceleration of transmission in a number of countries in sub Saharan Africa and I think that has to be taken very very seriously. South Africa may unfortunately be a precursor. It may be a warning for what will happen in the rest of Africa. Many of those countries exist in the midst of fragility in conflict. Many of them need. External. Help and support as South Africa's case. Numbers Rise countries across Africa. Also see are seeing a spike numbers zero reports cases in Kenya increased by more than thirty percent in the past week. Numbers are up by fifty percent Madagascar, sixty nine percent in Namibia. This comes after Africa has so far escaped the worst of the coronavirus pandemic with countries, such as Rwanda, implementing stringent public health policies to prevent the spread. The death rate in Africa has also been low for more on Covid nineteen in Africa. We go to Addis Ababa Ethiopia where we're joined by Dr John In. In Congo Song, the director of the Africa's Centers for Disease Control and prevention formerly with the Centers for Disease Control and Prevention in the United. States doctrine combed Asong. That's great to have you with us. Thanks so much for taking the time in this time of crisis and pandemic to speak to US explain the issue in Africa right now we have seen it as so far being spared from the well what the United States is going through, but is that a matter of lack of testing or the members? Do you believe truly low on infections and deaths? Thank you for having me on your show first of all? We have always been very clear that the pandemic in Africa was delayed pandemic that we the continent was spared, but rather that because of the aggressive measures that were put in place very early on youtube shown leadership from the different countries and a strong coordinated approach from the African Union and the President of South Africa in east capacity as the cheer of the African Union that have to blunt the pandemic and I think it was always klay now mind as Africa CDC that. This! was going to get up momentum. A year we are with. The situation. Call it the second phase of that where countries begin to dramatic increases in the number of cases, an example is the South Africa. You just mentioned so pandemic cetera genus. She very careful the way we look at the numbers. We still have over forty countries. We less than for ten thousand cases and then. South Africa is is constituted more than half of the about seven hundred fifty thousand kisses under continent better in his. Swing mode. And doctrine saga in terms of the the prior experience, a public health officials in Africa and combating other health threats in. Pandemics Orbit Dynamics. Bala and HIV AIDS what. Has the public health infrastructure as a result been more prepared this time around four covert. Somehow, yes, if you. Count A. Civilian Liberia and Guinea with heavily hit by the Ebola outbreak in two thousand fourteen. You see that I mean they have after that period developed the National Public Institutes the strength in your community Hurt Workers Program. That is extremely important for contact tracing, and that has her deuce countries especially in what's called the face. One of the response may be absolutely no doubt about that. Didn't they? Overall awareness of the threat of disease had also heightened because of Ebola an issue. If you look at South Africa, I mean I. Know that the decision in South Africa is changing dramatically, but we should always remember that the initial response was very critical. Otherwise we'll probably be at a million or more than a million cases in in South Africa so that experience. That Africa is used to fight in Ibi Burke Lucy's malaria. Abela is very important that we should always remember this different virus. This is different from Ebola. The transmission patents is different is affecting everybody at the same time. It's no restricted like was in DRC or in West Africa and is very different from HIV so we are learning as the continent is adopting strategy. We are learning that this is a very different enemy. We have to fight. and Dr What about the whole issue of testing, accessibility for covid nineteen. What's it been like their particular countries that are? More ahead in this area and the what do you see what needs to be done? That's very good. Kristen continent has come a long way. Let's be very clear. We were extremely challenge with issues of testing, not because the continent doesn't know how to test, but just because we didn't have the reagents for specific for Kobe. Record in February, just two countries had the capacity to test for Kobe on the continent again. We run that up very quickly. The capacity training large number of countries in Senegal and South Africa, and within three weeks starting to NFL too much able to run that very quickly to forty three countries today as the continent. We have tested about seven million. Oh conducted about seven million Covic tests, and if you compare that with just two to three months ago, we still. have million tests. The testing has had picked up, but we are no yet there mean as a continent of one point, three billion people wish should be tested about two million covid conduction about twelve million dollars a month so I think we still have a long way to go in order to catch of and beware, we have to be tested remains a challenge. The appropriate testing though is also important. The so-called polymerase chain reaction based testing is good, but he's very tedious, requires a long turnaround time the type of tests that we. We did those point of care that we can easily decentralize into the communities, and do the testing followed by the contacts in isolation of patients and taking care of them for deuce infected, and that is why we've launched initiative. Code partnership to accelerate Cova. Testing on the continent that is on the pin, but ability to test to trace to treat I think we are slowly catching up on the goal of testing ten million people as indicated. We've conducted about seven million tests. The Africa CDC continues to roll out testing. Reagents too many countries so I think we. We are slowly catching up on testing, but again it has been a stress challenge for US countering congress. I wanted to ask you about the importance of the World Health. Organization and president trump pulling the United States out of it, and that leads to my second question about global cooperation and how important that is. Right now we've had a the united. States joining with Britain and Canada saying Russian hackers or stealing vaccine information, and now you have the indictment of two Chinese. People in the United States who President Trump says has also hacked vaccine information. But why are we talking about this? What about global cooperation on this critical issue? Where this is really open source, so we come up with a vaccine that works for everyone, both of those issues. Who and Vaccine Global Cooperation? So let me start with your cooperation piece. If you look at the join continente strategy that Africa. Has put forward. It is the pin, but the need for strong corporation, the need for strong collaboration, the need for strong coordination and communication foresees that guide our continental strategies which was endorsed by the highest level of the continent. Since February so I think are, the continent recognizes that. There retrieve the glove victory against. Kobe has to be guided by global solidirity. Because this is a global crisis, no country is considered free of COVID. If any country in the world is considered, is Kobe infections then again, continent of Africa of one point three billion. CanNot be excluded in the equation in this whole discussion of eliminating covet in the world so I think gain, we strongly adhere to the principles of Coordination Cooperation And collaboration to seek solutions that will help us move also this. This is a war of survivor for the world I think we've seen how the damage that correct has imposed on economists on our lifestyle on on on on on the number of debts that Kuwait has cost again. This is not a fight that. Single individual or region of the world win without a global coordination severity with respect to w h you. I think our position is very clear that. The world has always been a safer place. Up Global, her problems have always been solved adequately only with the leadership and strong leadership, the United States of the world organization, absolutely no doubt about that. The. HIV AIDS crisis. It would turn. Fight Against HIV is only when the United States launched the president's initiative. To. Against HIV key Corp Pep in two thousand and two, thousand and three, and the continent of Africa has been. From that effort I think the United States has invested over seventy to eighty billion dollars in fighting HIV AIDS on the continent. Continent is extremely appreciative through. Verity Inc. the Global Fund was established in two thousand and one, two, thousand, and two, and it has been a game changer. A good example of how we should coordinate efforts to fight against Kobe nineteen, which is the greatest challenge? The world is having in the last one hundred years so I think. The stone who and a strong United States. Leadership is the key ingredient for us to come out of this. Extremely divest its in a crisis crisis. Dot Com Congress. In terms of the this issue of global solidarity with for years now we've seen a key feature of international. Trade agreements on that where the pharmaceutical companies and other corporations pushed the importance of intellectual property protections, obviously for patents especially of medicines, you believe given this crisis that there should be a suspension of these of this race to control a particular of vaccine, and in essence make it. Available. generically from the start to at least stem of this epidemic, with possibly five or ten years down the line companies, then trying to benefit once the the world situation has stabilized. Thanks very important Christian I think. We the Africa Centers for Disease Control and the African Union. Commission issued a statement in that regard just a few weeks ago to reverse Pacific on the twenty feet of June where we convene A. Continental. National Conference on on covid vaccine on that meeting was cheered by President. Of South Africa is Excellency President. I'm opposed and the cheer of the African Union Commission. Excellency Mussa. The. Essence of that meeting was clear that we have to discuss the issues related to intellectual property. We have to discuss issues related access to vaccines almost in a timely fashion variable for continent of one point, two one point three billion, and exactly what we in that communicate with we touch on the Doha Declaration, which speaks to this intellectual property. You just mentioned nothing. We always reminded. Always, reminded of what happened in one, thousand, nine, hundred, ninety six Wendy Idris. We are available on the took us about seven years up to two thousand and two before it became accessible to the continent of Africa. I think if that's situation plays out now. He considered a future of the continent will be completely on the balance you see that development of the continent will be on the balanced. Starting again we are calling for a global celebrity to make sure that just speaking about access to vaccines in developing world, and in Africa in particular is just not a nice word to say it's not just A. A good word to say, but it's a reality, and we are developing our own strategy core, a African access oxen strategy on the pin by access and development of the vaccines for for for the continent Dr on Congress just having then, but I wanted to ask you about the connection between Kovic, transmission and war in our headlines. We just read about US soldiers around the world, and particularly in Japan. There's an outbreak of at nine hundred nine. What this means for local populations? You have talked about that connection going back to the Spanish flu, and how this can be dealt with war, conflict and pandemic. Think. There's always that strong interaction between a wall. Or crisis I'm disease, outbreak or pandemic ability to control that this is not a chance that the Spanish flu in one, thousand, nine, hundred eighteen happened just after the Conway War I saw after that the first World War I think is very clear that this to a very very interrelated and I'm very concerned that it continued of us. We are so many hot spots. where? You have conflicts. Green will be sooner or later be. By the COVID nineteen pandemic, and will become extremely challenging to fighters to fight the war against poverty in those regions, starting you begin to face a double war in in a single country or in the entire region we must put that into our continente strategy to be able to make sure that we're prepared to root out covid when they finally get into this conflict region, but very important to anybody that this is a time for us to silence. The Guns Silence Oregon's everywhere inefficacy that we can find these enemy. Dr John and Congre Song. Thank you so much for joining US director for Africa Centers for disease. Control and prevention trained as a virologist who used to work at the Centers for Disease Control when we come back as the pandemic surges throughout the United States. We look at the impact on Latin ex-workers apparel workers, meatpackers, farmworkers so hard hit stay with us. Only. Thirteen. Talk. Got Bigger. Out. Music by the M, musician and teacher, Kuzma's Magaya of Zimbabwe who died earlier this month of covid nineteen. This is democracy now. The quarantine report I mean he goodman with Juan, Gonzalez states like California see a surge corona, virus, cases and hospitalizations. In fact, California has just surpassed. New York and number of cases, though it has a quarter of the deaths of New York the Latin. x community has been especially hard hit. A new report shows lot next Californians. Between the ages fifty and sixty four have died at more than five times, the rate of white people of the same age, the report from Ucla the University of California Los, Angeles. The trend to the fact that Latin ex-workers make up the bulk of agricultural workers who are high risk essential workers in a frontline PBS Documentary Kovic hidden toll that Air Tuesday night form worker Cynthia Hernandez describes how she has both cancer and diabetes, which put her a higher risk for complications. If she were to contract covid nineteen and at the contractor she works for requires her to bring her own mask. Boroughs. All as farm workers are making the big sacrifice out of necessity for hunger to be able to feed our families to have a place to live. Focused almost to handle those of us who are working have so much debt and bills to pay. The money sometimes isn't even enough to buy one mask because each mess cost, three or four dollars at the store. What. Years Disposable. Likewise a report from the Centers for Disease Control found eighty seven percent of workers infected on the job at meat, processing, plants, or people of Color, because the surge of cases in Los Angeles it may soon face a second stay at home order this comes as a Los Angeles powerful factory that employs mostly Latin ex-workers to produce facemasks has been shut down after health inspectors found quote. Flagrant violations of infection control orders more than. Than three hundred workers at that one factory tested positive for covert four died. The company is run by Charney former CEO of American apparel who was ousted amidst allegations of misusing funds and allowing sexual harassment workers, said the company failed to clearly inform them when people got sick or enforce social distancing for more. We're joined by doctor. David Hayes Bautisa distinguished professor of Medicine and director of the Center for the study of Latino. Culture at the David Geffen School of Medicine at UCLA. It's great to have you with us. doctor as Teesta. Can you start off by talking about l.? A. Apparels? Three hundred workers found positive. Four died at least at this point. What do you know about that and then move onto farm workers? Well actually both of them are related because these are structural situations. What we've noticed is that as soon as the state was down the first time early in March, people told to work from home. Take their children out of school. The children would do their lessons at home, and to he the house, only to buy groceries or the baron, essential necessities well what we discovered about a month and a half in as that the essential workers are not only just the. The nurses and physicians who, by the way are trained to go into dangerous situations, they have personal protective equipment. They're trained to use at. The question was just getting enough to them. Other workers were also as essential in order for the higher income families to shelter in place, starting with the farm workers, who of course cannot plant strawberries from home? They have to go out on the job. They're working large crews. They're transported in buses. Some of them sleep in barracks. At as we look at the chain of food, the truck drivers that packing house workers slaughterhouse workers. The grocery store show. Stock is a grocery core. Checkout irks for Pete's sake. Checkout clerk would have possibly. A couple of hundred people pass within an arm's length of checkout stand and for two months they were not even offer personal protective equipment. Now we're seeing this in more industrial such as the apparel. Companies were again for a long time. We've had Costa. De Working at the bottom of you will of the economic chain pay very little, rarely offered health insurance rarely offered any education about what's going on. And now we're seeing the effects of all of this, so what we see at large scale is that Latino and people of color basically do the Scott work that the state going its economy going but get. Of the resources very little pay very little health insurance, very little access to care and this particular pandemic is now exposing these inequities. and Dr Hayes Battista in terms of the given that the Latino. Population of the United States is significantly younger than either the white population or the African American population and a this disease. Is especially hits hard and turns a fatality at the elderly. You would expect much lower death rates among Latino just because of so much of the population is young yet. You're seeing your finding at least especially in the fifty to sixty five. Age Range this. Disparity in terms of deaths among Latinos, how much of that you sense is actually as a result of the. Working conditions that they're that they're being. Subjected to or how much of it is part of the underlying health conditions whether it's diabetes or hypertension or or other health conditions that many Latinos are. Older population always have higher death rates for almost anything compared to younger population, but what's important here? Yes younger Latinos have a lower death rate than older Latinos. However when you look at younger Latinos, younger non-hispanic whites. Latinos have about four to five times a death rate of whites so clearly something is not working even within that younger population and again. This has a lot to do with both working and living conditions. We've outlined some of them. Let me just go into more detail Latinos even after obamacare consistently are twice as likely not to have health insurance. Tinos for a number of reasons are faced with a huge doctor shortage. Being able to find doctors that speak Spanish and by the way medical services happened provided in Spanish in California for two hundred and fifty one years, so this is a lot like this something. suddenly a new problem we've discovered. This has been a problem ever since eighteen forty eight. So if you remember the early days of the pandemic Hollywood was able to get access to almost immediately the Lakers. Got Their test immediately. Those who had access to is called Boutique medicine got their tests immediately. Well. Some of these tests can cost up to two thousand dollars depending on where you're getting them. If you don't have health insurance, and you hear that a test can cost hundreds of thousands of dollars, you don't have access to medical services or particularly when you can communicate with this creates a problem and early in the pandemic. The California's Department of Health sent out a an advisory in Spanish God. Bless them and it said if you have the symptoms, you have a high temperature. Yeah, have a dry. Cough obstacles to medical PRONTO. Talk to your doctor now, but what if you don't have a doctor? You don't know how to pay a doctor. So many people were not able to. Thus they continue to work without the personal protective equipment. They were exposed to the coronavirus so much higher rates than people that are able to shelter at home, and not surprisingly we started to see the case. Rates Mount particularly after about six weeks into the coronavirus pandemic, and now about progressing to full blown cases of covid disease, and of course now the mortality, so that's the working part. Part, but then there's the domestic part housing is expensive in California. There's no question about it and Latinos occupy those positions, occupations and industries that pay very very little. Don't provide them health insurance usually so in order to live that Tinos tend to have more people per household, and this has been a classic pattern, so you'll also have more multi generational household, so it could be that. Yes, the kids are no longer in school there at the House. You have the the grandparents, but you'll also tend to have because of low wages and high cost of housing more multiple. Wage earner households as the adults more of them are going out to work because they just need to. Because it's, it's hard to live here, which means even though the rest of the household may be sheltering, they are going out and being exposed to corona virus, and bringing him back into the household. So now we're seeing the result of all of these issues compounded the Latino physician shortages so great in California the rate at which. which all the California, medical, school, graduate, Latino, physicians, it will take five hundred years to make up the shortage for the two thousand fifteen so I can imagine here seignorage Golden. She's feeling I've got a high temperature I've got a dry cough. I need to go see the doctor Oh come in seniority. Gomez Oh you have the symptoms. Take a seat and the doctoral. See you in five hundred years. That's why we have a problem. I want to go to the issue of the meatpackers for example the JV SBC plant in Greeley Colorado the site of the deadliest workplace cove in one thousand nine outbreak in Colorado, where at least two hundred eighty six workers tested positive for Covid, nineteen and six died the united. Food and commercial workers put up to billboards in Greeley to remember those who died this week. J. B. S. agreed to a one. One dollar and eighty five cents an hour wage increase. After many of the workers walked off the job earlier this month UFC CW local seven responded by calling J. B. S to improve safety measures, and what it called its work wall set culture. That's one company in one state president. Trump tried to prevent meat packing plants from being closed, and you have throughout states, thousands and thousands and thousands of meatpackers. Being infected with Cova One, thousand, nine, hundred, many dying. Can you talk about this? Dr Hayes Teesta. Well, yes, not only meatpacker any. Production for you have to have a lot of workers standing close contact, either with one another or with clients we can say the same thing with grocery store checkout clerk's without providing them the education without providing the personal protective equipment without providing them with health, insurance or sufficient wage that they could buy health insurance. This is all a recipe for quick spread of the Corona virus, and we're seeing it play out. And I wanted to ask you A. Senate, majority leader Mitch McConnell every other word out of his mouth. The last few weeks has been that a new A. Congressional bill to address the the pandemic must include ending of removal of liability for employers. In terms of the of their workers, getting sick given the reality that Osha, the federal agency in charge of workplace safety is virtually not existed these days in terms of what it does. Do you think that it's advisable for the Democrats to agree to remove liability from employers if they're not properly protecting their workers? Well not only is not advisable. But if you remember the first cares, act the Kobe. Relief Act specifically excluded any household in which at least one member was eight non-citizen. Now we're not talking about undocumented. We're talking about non-citizens, so have a green card holders. We've been here. Twenty thirty years has not yet taken that last up to natural is. The whole household was penalized. They got none of the benefits to everyone was worried. That are expiring everybody else. Latino businesses got very little of the business support so here we have a population that gets very little from the sources of support and yet now even the legal route is being closed off. If in fact, they're employers are held liable, and I'm wondering how many of these players by the way even bothered to offer health insurance and usually such employers. Do, not so. It's putting this entire population at risk nonetheless. Let me hasten to point out. The sixty million Latinos in the United States two years ago created the world's eighth largest economy, two point three trillion, and that's with all these obstacles all these barriers, all the name calling just think if we actually invested the way we invested in the rest of the country. So, Doctor David Hayes Back East, your State California. has exceeded. Our state surpassed New York and number of cove infections. Of course we don't really know the number of code infections anywhere in this country. It's considered a far underestimate. CDC thinks something like twenty four times higher, but can you explain what's going on? Also what's happening on the border? With. People who are living on the border you talked mentioned undocumented, but what about actually undocumented people in country, having access to healthcare and the fact that? The trump administration has not made use of seven billion seven to eight billion dollars that were allocated by Congress for testing for masks, and you have this incredible severe shortage of all of these things right now and how that particularly affects a lot next community. This is a case in point, if you remember the first days of the lockdown across the country, and early March mid March, early April and people ran to the grocery stores, and there was run on certain products such as member, paper, towels and toilet paper and people are fighting in the aisles over bales of paper, towels and toilet paper. In California. One hundred percent of the far more farm labour workforce is Latino. It's one hundred percent Latino. Immigrant and probably sixty to eighty percent undocumented. Now, What's interesting? Is that early on these are former workers considered essential employees? In fact, they were given letters that would allow them to actually travel to work without being stopped. And yet. They could also be deported at any moment. So, between the deportations between covert and everything else, if these farm workers are not allowed at least the opportunity to live. Who is going to grow the food and we thought we were fighting over paper. Towels and toilet paper suppose we're fighting over the last sack of potatoes in the store. That could happen if this labor force. We're not here yet. We criminalize we. PUT, obstacles for access to care, and then we wonder if we're going to have a food shortage. Language barriers doctor. David Hayes Battista when it comes to getting information about covert one thousand nine. Medical services have been provided. In fact, we have the first smallpox. Vaccination campaign in eighteen o three in California in Spanish. We were part of Spain at the time. Medical services have provided in California in Spanish for two hundred and fifty one years. We came into the United. States as a bilingual state Spanish was one of the official languages. And yet. Latinos are least likely to find a physician who speak Spanish the shortages tremendous, but there's not because this is new issue. This is California. What we have done for. A hundred sixty years has chosen to turn our back on this population, not allowed access to the investments were making other populations, either for education our healthcare, though wonderboy. There's an issue doctor David Hayes Bautisa one. Thank you so much for being with us. Distinguished professor of medicine and director. Of the Center for the study of Latino Health and culture. At the UCLA, medical school made me Goodman with Juan Gonzalez. Stay safe.

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"That's a fact. I credit card purchases. Give me cash back cash fat. No one else gets these rewards. As what intern nation. Sir penn fitzpatrick has isn't just for military members. Anyone can get cash back on all purchases. You've ruined my favorite song and fed credit. Union visit penn fed dot org slash power cash to receive any advertise product. You must become a member of pen. Fed insured by ncua. john show. john. Kobylt ken chiampou. Kfi am six forty live everywhere on the iheartradio app. Very welcome in the everybody. We got friday. Go which means we've got our moist line friends coming up in the five o'clock hour we do have some hacks and i say plural hacks to put the dumpster also during that hour. I was just reading. The new york post the came up with the word. I had not seen before. Goodwin the pundits fear. This guy refers to the left wing. Pundits fear the pundits fear. I like that. It's a story about how. The media smeared the new york post to shield joe biden from the hunter biden laptop story that the post broke a few months ago. Remember that and it's just been now that hunter biden's confirmed he's being investigated for possible tax problems with his chinese business dealings. It's starting to look like it's crumbling and this guy just decided to take a dig as well because ever wrote off. The post is being in the pockets of the russians. It's just a tabloid journalistic standards blah blah blah. They were stripped nude having. They're a bunch of liars. they just ray ladies. They called the new york times again now. The great corpse now. They're they're all bunch of liars. They know they're lying. It's just the there's enough saps in the public coup still believe in all this. They're just mastheads the new york times. Abc the washington post msnbc and twitter. Yeah that they've all there they they all know what they're doing they're doing it on purpose. They didn't want trump to have a resurgence which which he did well. Maybe it wasn't resurgence. They were lying about the polls all onto. I mean it's just this fog of disinformation and lies and misdirections. It's impossible to get your head on straight anymore. Here's what's fascinating to me. I kind of follow some of these media outlets closely. The new york post is considered a conservative publication right but they've been kind of on the fence with trump well when they broke this story and they saw what happened. You could see they also. It opened their eyes to how bad the bias. I realized it was out there. They would write about it. Because i read some other columnists but they went. You know full swing on this because they realized well now. They're coming after us. Oh yeah they're they're integrity of was was the line. Yeah on the line here. I mean you had. You had that that that idiot that that beard face jack. Dorsey runs twitter. Censoring the new york post twitter twitter posts on the facebook. And you know what. I'm increasingly seeing is 'cause on facebook. I'm connected to a number of listeners. And so sometimes. I see what they post and if they post something regarding trump that facebook disagrees with facebook puts a warning label over their post. They now have an algorithm that actively scans the words you have in your post and they decide that they're going to cast doubt on it or declare it false or say. This is disputed so you are no longer allowed to go on any of these sites and print what you want or print your opinion or linked to a new story that they disagree with and you have sent a computerized response that blocks it out. I i don't know why anybody would be on any of these platforms anymore. It's really nuts. It is really like this. Oh big brother award trying to regulate what you hear what you read what you think what you right. I'm sorry you're not allowed to hear about hunter. Biden's laptop computer. I'm sorry we're going to block any links to that story. We know it's true but we're going to block it for the next six weeks. You know until the election is secure. What is this. The new york times in october ran a piece with the headline. The new york post published hunter biden report amid newsroom doubts but today the same times reports that the biden team has rejected the claims made in the post article but has not disputed the authenticity of the files upon which they were based. That's about as much as he'll get out of them. So do i go to the times. No i don't. I don't go through to to read about their their biden trump coverage. I just flat out. Don't believe it anymore. Say they washington post a. Times there's select cnn cnn. Who puts it on in here. That's the first thing. I change when i come in here i i i don't. I don't believe anything. Come in at cnn anymore. We the other day the leak tapes of jeff zucker ordering people how to Protect biden and his son. I mean it says voice words out of his mouth that he's ordering his staff to cover up the hundred start so now. Cnn is. i'd never turning it on. I just not. i don't. I don't need to listen to fantasy and propaganda and lies which is what much of the mainstream media is now so I mean you're not gonna change them. You can't shame them. You can't criticize them. They don't feel bad about it. This is what they wanna do with their lives. The pundits fear. Yeah i i mean i'm pundits are supposed to stand on the sidelines now is going on. You know they've got some death depth of knowledge experience or contacts to ex- explain beneath the surface. Put it into context. What's going on. That's not what these people are doing. These people are just spokes. Holes there right. The glaring headline afternoon for the also condo times is the grimace of all grimaced. On the kuroda virus said we have now hit supposedly an allegedly five percent of the county population at some point diagnosed with kuroda virus. Five hundred thousand cases. Yeah billion people. What is that like Last i saw forty two percent of the recent tests. ray symptomatic. Yes yeah okay. So we report. So we're we're we're not even talking flu level symptoms. We're talking no symptoms so you can take forty forty two percent off the top there from their grim milestone because a symptomatic people don't know they have it boy. It's difficult to get perspective. I mean i'm reading again and again that this time of year which is normally flu season. You do have. Icu's at ninety percent above capacity direct. Yeah i keep reading that. So the this idea. Yeah sure but they fill up every year because there's not that many beds right state is forty million people but in your life. Have you ever heard an icu. Count before on the news. That i have not now. They hit us with. Oh at eighty five percent capacity and they don't tell you the percentages every other year that's right but it normally gets that way because again when the flu hits millions get the flu at a percentage of those get sick enough to go to the icu. And there's not that many icu beds in the state to begin with not a proportion to the population of the reason for that is there mostly not needed because for most of the year particularly this summer and the spring months. We don't have flu outbreaks. Which would cause people. And we don't have anything else. That's mother the hospitals. Don't have the staff you couldn't i smell firehouse analogy right. How many firemen you wanna have one fire a year and it could be bad but most of the year they'll be sitting around a big component of intensive care is that you have a nurse staring at you all day and night. You have a one to what relationship with the patient and that that it would. That's what they talk about intensive care you know. A bed is a bed. And you're you're you're on monitoring machines but it's the staffing to respond on a minute by minute basis if anything goes awry because if you've been in any hospitals lately You know like calling room service at a hotel maybe twenty minutes or a half an hour. We'll bring you something but the staff is not doesn't exist. When i saw this story this morning. I felt like john kobylt now. Why am i saying that. Because it's it's that feeling that you sometimes blurred out on the air. When i look around people. I talk to the world i know. Well that's what i felt like. Because i saw the headline. Nbc four is a great story. We're gonna talk about next. It's research coming out of ucla. Dr klausner will be on in the five o'clock hour to get into it in detail but its analysis of what who's getting infected with covid nineteen in la in particular. What are they doing. And the reason. I felt like you is because i have felt this way since the beginning of the pandemic i said the one occupation i am not seeing any slowdown in nothing. In fact it's bigger than ever. And when i go by off and don't seem asks some of its outdoors which i get gives it but easiest construction and they found out an interviewing hundreds of thousands of people who got tested a public sites in los angeles from august to october. That was the number one profession for the people who tested positive. The other half of this deals with dining outdoor indoor. You pick it. We'll give you the details of that because you can guess where those numbers came out. Absolutely not a factor coming up next john and ken. Kfi john and ken show chuck kobylt ken chiampou. Kfi am six forty live everywhere on the iheartradio app. By the way we just posted a little treat for you today. if you go to the website. Kfi am six forty dot com. The john and ken show. There is a link to a beautiful photo of gavin. Newsom spread out on an expensive rug with his then wife. Kimberly guilfoil the most pretentious most absurd photo. You'll ever see in your life and it was from harper's bazaar fashion magazines shoot in two thousand four. You've there's all story too but that you should go see the photo. We gotta linked to it on the website. All right an organization called curative. Which is a group of doctors in. The medical field has put out a report. One of the doctors. Dr jeffrey klausner. Who's been on our show. He serves as the medical director of curative inc. During this period and a couple of other doctors put out this report which was picked up by nbc. Four in the investigative team led by joel grover. And it's described as a first of its kind analysis of people tested for covid nineteen in los angeles and the reason it is it shows that the occupation that appears to be getting infected at the highest rate is construction work and if some of you are like ha yup healthcare supermarket work first responders and even people who work in the food scene that you noticed this many months ago and i remember a number of times you kept repeating that is ceo nothing slowed down in fact in my neighborhood he picked up. I think because people stuck at home said. I'm going to finally do that long term project i wanted to do and i can be here to watch him as they work or a lot of. It is in my area to just tear. Downs and new construction didn't in fact doubled. And when i go by and again this is my john. Kobylt was y suv. My eyes see talking wearing masks. They come in the morning and they sit in their car together. Probably they commuted. I would say different households to guests and the not wearing masks. They're sitting in their waiting for seven thirty when they start work. And i'm thinking well. That's a way to spread corona virus. Because some of its outside. Some of the construction is yet. They're working on indoor stuff but some it because they haven't framed it yet or you're still kind of outside and i said that's still a lot of people still working a lot of hours and i wondered about that. And they were number one. The highest rate positivity far ahead of what came next food service workers healthcare workers and grocery store workers. What do we hear all the time from barbara ferrer in that crowd and garcetti. People working on the front lines in the grocery stores and restaurants. No you better go do something for the construction piece. They didn't close any construction sites and they They didn't even mention construction sites once no but they restaurants. I wondered if it was the construction lobby being powerful. They control state didn't want anything to their business. Do you think what do you. How much money do you think We're paid to Garcetti's not profit not to put any undue restrictions on construction of mayor's fund. Oh and the developers in this city. Oh you think if somebody renovating a condo building or putting hotel you think With the money that they pay garcetti to his nonprofit that they're they're gonna garcia. He's gonna shut down construction unless be blunt who's a large percentage of the workers in construction. They are latino and they go home and they live in crowded households and they spread it to. Everybody else makes sense. Yeah here some of the other findings. More than forty two percent of people tested positive. Had no symptoms hispanics were far more likely than non hispanics to get infected. We've heard that every day from the also down times men more likely than women test positive and people who say they have interacted with strangers. Who have been in public places like parks or outdoor restaurants. Wait for it had low infection rates right so the very things that they closed recently have low infection rates that there are things that they never closed. Construction sites have high infection rates. Dr klaus said. I'm concerned that public health interventions pushed people indoors and close outdoor venues. I think there's an increasing evidence. Now that outdoor activities are safe so there you go it science. Is it not as a data. Dr clouds will be on at five. Oh five because this is fascinating to me and yeah confirms what i have seen with my own eyes always trust your eyes you never go wrong trusting your is yes exactly does because the el segundo times has another frightening story today. John and i thought this one just for you. It's about the climbing infection rates in la county in affluent areas. That's right they play the percentage game. They did yes. Read the article the let me see. Let me were ten cases and now it's one hundred. Oh my god that's an increase. Let me look at my own. Okay here we can look up your case here. We go December eighth there were six cases but december ninth. There were eleven cases a nearly doubled. It's almost a one hundred percent increase in one day by the way up to eleven in my zipcode. Well that's really cool headline. They signed up more than two hundred percent. Increase in corona virus cases between late september and late november silver lake claremont described as predominantly white. Wake up there. Rosemead san gabriel south del monte hawthorne palm of west chester. What do they. What did they feel. They overdid it with all the stories they had about four spanish neighborhoods being widely infected. It's like wait a second why people are getting infected to even white people who make money. They're getting what percentage increases. Why look this. Wealthy area went from to eleven. I think it outta here. They heard you and people like you and they decided. The narrative is too one-sided about too many infections in the poorer communities. Let's scare the suburban white people. Right how come. They never pleaded for garcetti. To shut down all the construction sites there should be a call for that. Now yeah right. A long only know what i wouldn't care. It was my house being built. I guess i'd care. But i don't care. How is that going to impact. Because they shut down the construction industry for a couple of weeks they should. That's that means people don't have incomes and that's the sad end of that some people have roof. Everybody go. I don't ever roof. I won't come back. We'll we'll talk about that. Two thousand and four gavin newsom story graphs and the then wife kimberly guilfoil. You read that article no i. Didn't that'll be good when we come back. And go to kfiam640.com. The john and ken page. And you'll see a link. Just a new. Kennedy's right devastating. That was the title of cover story on. Harper's bazaar magazine the new kennedy's and it had kimberly guilfoil with a jackie kennedy hairdo and gavin newsom. I guess we're supposed to be john f. kennedy with With lots of hair gel. John and ken show john kobylt ken chiampou. Kfi am six forty live everywhere on the iheartradio app. Well to show you that. It isn't just the theater of the absurd out here in california new york governor. Andrew cuomo is decided to pull indoor dining in new york city and they actually had it and the latest infection rate for indoor dining on corona virus cases. It's one point. Four percent of the cases new york post says it's probably a greater risk across the street. How insane this has become almost ninety. Nine percent of infections do not corona virus cases at new york ninety nine almost ninety nine percent and this is they had like ninety eight point four. Yeah they have indoor dining. So it's not like they don't have indoor dining. That's what they have. Indoor dining almost ninety nine percent of the infections don't think audits it's december. How are they going to do outdoor dining. It's pretty tough. They can't really. I mean they're they're going to try to get heaters but the temperature get down to zero now this time of year so there With win creek. Yeah no he's gonna he's gonna destroy the whole newark restaurant industry everybody there ought to be revolting against that guy. Mean that guy is just is insane. I mean he is clinically unhinged and deranged cuomo. But go ahead just be obedient. Be obedient to your government masters. Let's see how that works out so back here. We have the links up for you. Recall gavin newsom from office. Go to kfi am six. Forty dot com. The john and ken page is a couple of websites. And by the way doesn't matter which one you pick their combining the petition so just got a few questions about that. They're not really they're not competing recalls so no just Two different groups and all the petitions will funnel to the same To the same place. So i went down the rabbit hole and every once in a while you come up with a gold nugget and i came across harper's bazaar magazine It's a fashion magazine and round. It's still around at least it's a website. I don't know if it still publishes. Now i remember it being sixteen years ago. It published a cover story on gavin newsom and his then wife kimberly kimberly guilfoil who later. Donald trump junior's go. Who's done. that's right shacking up a donald trump junior and we heard about her. She was doing fundraisers her she was offered to a lap. Dance right ed. She had to lap sitting. She spent about twelve years at fox. She was like a talking set of legs on their on their shows and then she had to leave fox because the story as she was sending photos of her dates penises around the office. Wow and as busy girl Anyway back two thousand and four though she and gavin had been married for about three years and gavin had just become the mayor of san francisco and he adjusts declared. Gay marriage was legal so he got the oil and lotion treatment from harper's bazaar they called them the new. Kennedy's not making this up the nuclear spread. Yeah and the first photo is of gavin in a blue suit and she has got a jackie. Kennedy look going with the hairstyle and the whole bit. You know at first glance you. That was jackie kennedy and a quote from her is too. I think gavin could be president. Well absolutely i gladly vote for him. Now what's really funny. And i just found this out this morning. This came out in september. Two thousand and four four months later they filed for divorce four months later after posing as the reincarnation of java jackie kennedy says part of the story was the strain of bicoastal marriage. I guess was she living on the east. Coast the shoot. She was she after she was a prosecutor here in la county and fact she was the number two prosecutor on the famous dog. Mauling case san francisco dog mauling two thousand one and they moved the trial to la and she was. She was one of the prosecutors down here so she was a prosecutor. I think that's how she met newsom she's a deputy district attorney and then moved east to work for court. Tv originally and then fox so she got a job on tv in new york and was fine. Away and gavin was left behind here now during the divorce. That's when gavin Started banging his campaign manager's wife which ended that friendship and that's when gavin was doing drinking Heavily because he showed up on night there was a police officer. Sheriff's deputy who'd been shot and he showed up at the hospital. Apparently he was so low. Woozy and So i would say it was. It was a tough time. Boy you look at this photo and they just look like the perfect wedding cake cake couple here. That's the first paragraph. When kimberly guilfoil newsom walk down the aisles swabbed in crystal encrusted vera wang. That's addressed designer. Her cathedral vail topped with a topped with something borrowed tiara. Courtesy of philanthropist and friend and getty she had more than forever on her mind for starters. There were the death threats. Oh story took a dark. Twist their immediately. Oh yeah she had death threats wa the the day of her wedding because they had to put that run bomb sniffing dogs to go through the church and it was the dog mauling case i. I don't know why that's why that would signal death threats but it dog lovers were not happy with her. The dog lady. I don't now so that was the case. Where this woman's where they pit bulls. They mauled the neighbor to death. Or something something like that. Yeah that's what. I remember it. It it turned into the trial of the century briefly so anyway there was a wedding with six hundred guests and her husband described as the tall dark handsome future. Mayor of san francisco gavin newsom. And it says here this that officially began what promises to be. What promises to be one of the most glamorous political unions since jack and jackie extravagantly blessed with brains dr charm humor and dedication to public service the photogenic california couple he at six feet three with the kennedy esque mop she of the perfectly symmetrical face befitting a forties movie star are set to cut a wide swath across future democratic politics. Oh well she's now with the top. Republican marriage crashed a few months later. He's a mess can you get. I couldn't even. I almost vomited when i read. How wrong can you be and four months. Later four months they filed for divorce. It just shows you that. So much of this in the world connection to the getty syria and they're posing there and the getty said mansion yes gettys mansion. That's an getty's rug the he's he's got strong connections to alter daddy's got his winery lifelong friends. One of the getty sons was newsome's business partner. But it's the getty family that put up all the money so that newsom could buy all these wineries and restaurants and all the related businesses. He doesn't exist as a business person. He doesn't exist without as a politician without getting money. And you know that. That's the all came from the famous oil baron. J paul getty talks about how we approve. Gay marriage and listen to this. Let's what gavin says about kibera. Guilfoil kimberly can do whatever she puts her mind to. We love our work. And right now our passions are in the public realm. She understands what i want to do. Giving me the freedom to do it. So i could never denier. It's this wonderful combination of being in love and extraordinarily proud born months later. Divorce papers crass kimberly guilfoil says about gavin. i'm hugely emotionally invested in my husband. Because i really believe that he's destined to be doing what he does. He's that good and nobody better mess with him. Because i'm very protective. When i was younger because they had met Ten years earlier. I looked up to gavin. But that's grown into a deep appreciation of someone with whom you not only share connection. But trust sure he clocks in seven days a week. But i understand gavin's on a mission gavin's on a mission he's still thinks he's going to be president twenty twenty four. Oh that's-that's the lifelong dream. That's the lifelong plan for gavin. That's why kimberly guilfoil married him. And that's why the gettys financing they actually manufactured wanted to manufacture a president out of a laboratory candidate because of the way he looks yes. It's entirely if he was a fat bald guy with a with a weird mustache. Gettys aren't paying any attention to him. And the there's kilfoyle but after listen to this guy for two minutes. How could they think he was a kennedy terms of his speaking. What was john kennedy known for. Its speechmaking his eloquence his his wit right at the moment. This guy said that at the first getty dinner. I'd be like get out of one. That's what i'm saying that the first thing that this writer said they were blessed with was brains while we'll not him. Somebody stop anyway to if you want to see the rug photo. Which is the funniest of them. All just go to kfi am six forty. The john and ken show trying to look sexy. Hot yeah yeah you see if you get aroused looking at this you gotta click the photo we have on and then links you to the rug photo okay. Which is on twitter feed. There's legal reasons for that. So just click. Click the photo we have in our page. And it'll get you to the right. One workup john and ken. Kfi john and ken show john kobylt. Ken chiampou kfi am six. Forty live everywhere. The iheartradio app. We'll get a visit to steve gregory. Right after three o'clock keep an on the copay story with regards mostly to los angeles county doctor barbara ferrara and ask her again about outdoor dining band and i guess she broke down in tears the other day at one of her press conferences and talking about the eight thousand lives that have been lost in la county to covid nineteen. So we'll get to that. And also going to be talking to dr jeffrey klausner at five o'clock on tell you that because it's a great it turns out that after analyzing hundreds of thousands of people who tested positive in la for corona virus. The number one occupation was construction worker. Yep dan did. We miss something here. By far way down on the list was anything to do with dining out of their minds. they don't know what they're doing. And of course the times run. Another one of these stories of experts say that the outdoor dining ben is essential. Love that were to send shot the exit quote. Dr fauci really. Who said basically who do anything you can. You gotta do anything. You can't no doubt see they don't understand real life. They've been too long in a laboratory. You don't destroy the livelihoods of hundreds of thousands of people especially when there's no unemployment payment that's gonna come to replace the lost income. There's no P p loan money coming in to replace the lost Business right yeah you you can't. You cannot do that. You can never do this. And really what they did was illegal with the judged throwing out there ban. He's saying you broke the law year. You can't close people's businesses without good scientific reason and they had and they still have none and they'll never have one because it's not happening saw a better of finding the right study though never be a study. A great story from staten island. New york i. I couldn't help myself when he took a look at this guy's picture i just went well figures it's a fad faced mustached slicked back hair doctor from staten island new york. He's a heavy guy. Sixty five years old. His name is joseph santiam oh he has been indicted and the charges he was operating a pill mill where he gave. Young patients prescriptions opioids in exchange for sex looked at his picture said he just looks like a guy that would do that he does. It's the second time fisher house. If i had a chance to talk to the fisher family. I would start crying because i can't -particularly it meant to us. Your house is to comfort home for military and veteran families saying at no charge allowing the family to be together to support their loved one during medicine. Prices it's not to help you thrive through these hard situation. Go to fisherhouse dot org for more info and how you might help. That's fisherhouse dot org Have been fed. That's a fact credit card purchases. Give me cash back fat. No one else gets these rewards. What intern nation. Sir penn fits parakeets. Rewards card isn't just for military members anyone can get cash back on all purchases off. Figgins ruined my favorite song and fed credit union. Visit penn fed dot org slash power cash to receive any advertise products and become a member of pen fed insured by. Ncua this hour. I feel like you well. I'm telling you it's the way down. Yeah no just just trish trust. Your is trust your instinct malcolm. Glad we'll wrote a whole book on it. Your instinct is right over ninety percent of the time he wrote. He ran a practice at focused on internal medicine and geriatric care geriatric beans elderly people. Well they got suspicious. When he was writing a lot of prescriptions for younger people over prescribing drugs. They looked closer. Into the case. And i guess when they started to interview some of his patients some broke down and said yeah and some of them travel great distances because they found out about him rely a lot of. I guess they're women. It doesn't say bishop women or men because he's got that weird mustache. See now i'm lost. There's a difference in the moustache for men and women sexual predators that the guys who are into young men or young boys. You know they have the molester mustache o. Thought that was even young girls now. Well i thought some of the guys have been picked meles sweeps maybe girls. The jeffrey epstein didn't have a molest dash city. Now i to me. It's when they're into boys. It's usually the mustache not as much into girls but it's not one hundred percent. That's what i'm saying. I'm kind of confused. So they found out that he was writing a lot of prescriptions for too many young people and eventually they found out that apparently he was trading the prescriptions for sexual encounters. He wrote prescriptions for controlled substances doses. At far exceed what might be medically necessary for an ordinary patient. But he's got a great lawyer. It's good old. Joe taco pena. He's been high profile cases before and he says he's a good man and his conduct does define who we is that right. He's he's he's trading pills for sex but that doesn't define who is just a small part of it. Steve gregory will join us next. I can't stand this world. john. And ken show debra mark has the news. Kfi am six forty. John and ken show john kobylt ken. Chiampou kfi am six forty live everywhere on the iheartradio app You sound a story from Four days ago two days ago was updated that in bakersfield. There's one thousand nine restaurants got a lawyer. And they're suing governor Governor newsom over the closure somebody has to attack the statewide band. Yeah because dining at least they don't have any evidence either Connection mentioned john and ken show. I forgot you did. The white house is pressing the fda the move it with the vaccine by the end of the day they want the approval so people can start getting injected. Maybe as early as monday affect ready to fly this vaccine everywhere trump is threat. The fire the head of the fda approves it by this afternoon. You that stephen yes. That's his name. He wanted to shot yet. He wanted to do tomorrow morning. He said even if you had covert you should still get a shot. Oh yeah i you know. I think i'm gonna get all of vaccines to all the different companies. Yeah yeah. I'll do the magento on the pfizer one. That's going to give you any added protection. Ed can't hurt right. Well yes you could have a million reactions but can't hurt well. The headline is for the el segundo times. La county a catastrophic covid nineteen levels at a strike team thousand eight hundred and fifteen new cases. And we've now had five hundred thousand total in the county but as we get older of ten million according to the The company that runs the testing sites Just they did a study. That ran several months in the summer and fall. Forty two percent of seventy three hundred people that they serve eight. It was symptomatic. Don't fall for the cases number. Yeah forty fifty percent and everything. I've seen is asymmetric. Remember that story about the threshold that they do some of the testing and that they've kept too low so it's including people as positive when they're not infectious. No they have a little trace. It's not enough virus for them to infect other people but they have enough for them to be counted as positive. Steve gregory is joining us. As guys. yeah you know It's interesting you're talking about getting the vaccine and i may have a way for you and ken to get it early. Is that right. Yeah you talking about that in a second supplier. Talk about that in a second. But today i was on the media call with barbara for rare the tax code. It's legit in fact it's ferrari's idea. I probably wants to kill us. You're getting these special. The one in the black vile right But so ferrer today had a private media call and we were all in there today. But what i wanted to do was ask her. Because you're talking about case counts and stuff and you know how. Do if i news. We're we're very specific. Now what numbers we do release in in in how we report it. So but what i wanted to find out from ferrara. Two things one the restaurants that are being cited still. There's a restaurant owner in burbank and his name is lucas. He runs the tin horn flat. Saloon bar grill on magnolia. He opened at noon yesterday. He'll be open from noon to nine every day. Now and he said it's to protest the tyranny from governor newsom and he's gonna stay open. So i went there yesterday and checked it out. His patios open all protocols in place. But this is the kind of thing i'm seeing. Now you've got the restaurant cronies in gora hills down in orange county so i ask for rare a little bit about that today i said. Are you still having inspectors out there. Give citations and she says yes. She said restaurant owner still have to comply and she said regardless of the judge's order they still have to comply up through the seventeenth. Now the state orders in place until the twenty seven. So restaurant owners are going to still get cited intel. Judge can do until the even though even though he said yeah. The order was wron. Yeah she's citing. yes still. is that legal. I got a call into garra goes again. I don't know why would it be legal. I i don't know this is what i don't understand she. The judge ruled that as a wrong. You're wrong order. That's not the order that You know what i mean. The science was. She's not citing them under the state regulations county. She smells down the county so she still thinks. The county regulation is for outdoor dining through the seventeenth. Judge route fifty three pages. I know and i asked her about it. So then i segue that because again you know my time is so limited with those folks so i went onto vaccines. I said. I asked dr simon yesterday. Chief science officer. How will the vaccines be distributed. How about vip's i said how about you and your staff. And his is what she had to say. Okay been. I thought i did when i went thumbs up. You gave me a thumbs up so you want to take a break and we'll get that done. Yeah all right. There was a failure to send. Yeah failure to send all right. We'll come back then. We'll we'll play the audio of barbara ferrer. John and ken show kfi. John and ken show john kobylt and ken chiampou. Kfi am six forty live everywhere on the iheartradio app. -t funny email from a listener on this whole topic of you know the dining and outdoor dining. He said he went to the century city mall and he got takeout from like one of these organic mexican places and i guess he went somewhere outside at the mall to eat it as security guards. Shoot him off the property that here. You can't eat outside if it's not part of the restaurant. Dining out as part of the century property is he's sitting by himself. Yes that was told. Put that food. How bad is it bad. it's nuts. Steve gregory is here. he was talking to barbara ferrara. No one of those reporter conference calls today and he accurately guy a few seconds then apologize for the sound mix up that was my fault not areas but it was one of those situations where i was talking to her about vaccines because yesterday i talked to dr simon. The chief science officer for the county about the priorities for the vaccines. Because that's a big deal right now and there's already stories coming out about the one percent getting vaccines before the rest of the population. And so i wanted to ask for rare to see her story. Jives with the science officer's and so i asked her about the ip's elected even her and her office and whether or not they're going to get the vaccine. I in no one really bounces in front of this line. You know And the line is still being very well defined by both. Cdc and the state through their scientific advisory panels. A what we know for now In the most detail is. What's in this phase one. A which is really frontline. Healthcare workers and people who live and work in long term care facilities so i am neither of those Nor are are wonderful. Board of supervisors nor are amazing and skilled basketball fourteen players so none of us are getting the vaccine in this first phase so she goes on to talk a little bit about how they are going to reach out to influencers which brings here influencers. Sure exactly so. I wondered what would happen if we pitched you guys to the county to get the vaccine. I i think that would be very helpful for public health. Yeah we have a million listeners. I bet you at least half of them are afraid of the vaccine or object to it for some reason we could have great impact. So i was going to ask her about that today but then i got beeped. Which means i got muted. She she knew what you were thinking. He knew what his thinking probably and then when she starts about influence she's talking about all kinds of people from all walks of life who have influence over audiences in crowds And it was weird. Because i kept thinking when she talked about. She wasn't going to get the vaccine. But i think there's an interesting dichotomy here are dynamic where you look at people who don't seem to look healthy and you're wondering why they don't get the vaccine. I if farrar oh yes underlying health conditions or whatever. The case is she would qualify. I mean even though she has this pineapple hugh kind of skin color. I i noticed today on the and maybe my screen. She looked a little yellow. It looked like a long with her right eyelid. Yeah that's chess. yeah yeah so She may need a vaccine then. Yeah so. I'm wondering you know exactly who's going to get it at the end of the day. Who's really going to qualify. But i did you know when he was talking to her about the priority and she did talk about influencers so they will be a part of that maybe not the first wave but they will be ahead of the line on some. We are declaring ourselves. Influencers legitimately that. Everybody should get this picture. And i all i want is i want the freedom not to have to worry about getting this and not inadvertently giving it to somebody and there's only one way to do that is to get the vaccine and interestingly the you know the side effects from the vaccine now and other than the two that exploring in in the united kingdom which could be just isolated incidents but if you look at the majority of how it's going and i know there are a lot of anti vaccine is out there and a lot of people that swear against it but i would look at risk outweighing the reward. I yeah i mean. You can't spend all your life arguing with irrational people if you don't if you don't want to get it because you've you think it's a five g chip and bill gates is going to be tracking you on his cellphone. There's nothing i could airfield tracks meal. Don't he's going to see. How many outdoor dining big and outdoor lighting spot again. This is nothing you can do with those people so if they want to risk getting it. Then that's your choice. The only thing that's interesting about it though is that you know there is going to be a lot of very strict protocols with respect to handling this. That question did come up in the call today about how they're training physicians to administer the doses. And that's a big part of it. That's what i worry about. Because they got to keep it at minus ninety four degrees fahrenheit. And and i heard today. They have millions of doses locked up in in in freezers in kalamazoo michigan and a small town in wisconsin. And as soon as they get. Go ahead from the Fda they're going to be opening the freezers and loading them on planes and flying them all over the country to all fifty states. And now you have to trust government workers you have to trust fedex and a lot of changes to ask workers. Yeah that everybody's going to be on their on their best most competent behavior riot. They're going to be able to do this without somebody leaving in a one hundred thousand vaccines out in the sun on a tarmac or knocking the plug out of the wall right. You know some weird stuff like that and then you know win the vaccines get here. The thirty thousand doses that are scheduled to arrive next week and The those will be distributed to what they called nine sites that have those ultra cold freezer units then from those nine sites. They'll take him over to eighty three different acute hospitals. And then those hospitals do not have those freezers. Those hospitals now have to implement dry ice protocols. And that's going to be another thing. Because i wonder now if there's going to be a dry ice shortage because that has to be vanja of what i've read factors are working twenty four seven to produce dry some factories. Just had you know one shift or two shifts day because it's not in that high demand but now obviously it is so they are building as much capacity and they're going to be running at twenty four hours a day indefinitely the t to try to keep up but that yeah that is. That is a big challenge. So they're gonna hang everything cold long the probably policies rephr- trailers refrigerated trailers and they'll have to manufacture these these portable sites too. But then it's supposed to trickle down to cvs and walgreens right the the second wave then we'll go to skilled nursing facilities and the nurses and workers within those and they have that contract already with cvs and walgreens instead of them going to the hospitals to get at the hospital. Workers will have it administered by hospital then the others will have an administrator when it gets passed The the the obvious targets right. The the the elderly people nursing homes and the frontline healthcare workers. Now you get a guy Let's say he's fifty five years old and little overweight high blood pressure right here. Upload risk fat. Steve greg here okay you show up in line you have to prove prove your your fifty five and not Right on hold thirty nine. I mean like most tv reporters. So that's what dr simon said yesterday. He said we're not gonna pull people a line and make them prove it. He's the ramp to go on the honor system. That's what he meant yesterday when he said that we'll have to on the honor system. Nobody's gonna follow that. So then what kind of a problem is that gonna pose. First-come-first-served didn't really know who the number one who you know who's phone is ringing off the hook. Now it's concierge. Doctors concierge doctors are getting calls like crazy. Yeah ok okay tom doctor. Tom were a win. Am i gonna get mine over. Those guys charge. Oh they're like five hundred dollars visit last the. They'll they'll charge for the shot a bonus. Even if the shot's supposed to be free delivery a markup yeah yeah well So that their phones are enough to hook right now. Concierge doctors. Yeah it's going to be it's going to be a free for all it will be. There's there's there's no way to scream. Fisherhouse chance to talk to the fisher family. I would start crying. Because i can't articulate how much it meant to us. Your house is to comfort home for military veteran families staying at no charge allowing the family to be together to support their loved one during medicine. Prices it's enough to help you thrive through these hard situation. Go to fisherhouse dot org for more info and how you might help. That's fisherhouse dot org. The full savings and sale is happening now. Mattress warehouse save up to one thousand dollars. Plus get zero percent interest financing for sixty months unsure of which mattresses right for you. Most people are but mattress. Warehouse is home to bed match the diagnostic system. That recommends the best mattresses for your individual support needs tried for yourself today and the mattress warehouse one year price guarantee means you know you're getting the best price why shop anywhere else visit sleep happens dot com for a location near you go out. There is an unless it was in a very controlled environment. People had to prove their situation. Because what i figured is that doctors would be submitting records or or at least names to maybe the county. I'll you so you're not gonna have to bring a doctor's note doesn't i don't know they a presumably. Not if if you listen to. Dr simon he says you have to trust. Everyone's going to be honest. Know for rare says well you know. We're we're going to work on that but right now. They're worried about the first two stages of the fees. I think if they get to the healthcare workers and the nursing home patients. They're just going to throw up their hands and say that everything's going to get a little dicey because the healthcare workers most at risk the patients to the most likely to die So once you've covered those two groups. The only question. I have is if they're going to do it in the same order. They did with P. p. e. and everything else at the beginning when they went remember inmates homeless nursing home inmates and homeless member they went before nursing homes. Yeah you're going to see. The prisoners are gonna get the vaccine. Well that's why regular people are gonna say the hell with this. I'm gonna lie. I'm gonna get in line. I'm going to get the vaccine. Because i know scott peterson's getting is well governors already said those that are in prison in medical units are gonna get it then all right. There's your honor system all right. Thanks guys john and ken. Kfi johnny. Ken show john kobylt and ken. Chiampou it's k- ask. I am six forty live everywhere on the iheartradio app but not that. It's relevant anymore but time magazine. What's left of it. Named joe biden and kamala harris and new york post editorial writer took a shot at them. Say really not the vaccine developers. Who did this amazingly you know. It's funny you said that. I wanted to falls compared to what the vaccine. Nobody gives a crap a scientist. The researchers behind this come out by the end of the year is one guy actually wanted to talk about him and he. He jumped on the vaccine for the coronavirus back in january. He saw the stories coming out of china and he guessed that this was going to overtake the world and he started doing the research at Biontech which then partnered with pfizer and german company Yeah and i i. I was reading about him just yesterday. And i was thinking well. This guy should be world-famous lauded in all corners in instead of all the pop culture idiots and don't be politicians that we hear about all day. Nobody does this guy and of he's got he's got a tough name and i. I don't think i could find it now. But i will and each. He should get a ton of glory. But you know. He's a very ordinary looking person. He's not as pretty as gavin newsom. He's got a difficult name to pronounce. He's in a foreign country so he's close to as you'll ever get but without him jumping on this in january you wouldn't have vaccines flying out to all fifty states like will happen this weekend and it's amazing. How little attention truly accomplished brilliant genius people get are stupid stupid culture instead today. Every other story i have has kim kardashian in it for you mentioned that steve. Cooley will join us. After four o'clock. What does have to do with kim kardashian. Kind of path that winds. But it's about george gaskin the new la county da. Of course steve. Cooley was the one of the predecessors said before jackie lacey was steve cooley and he wants to comment on mr gascons approach to criminal. Justice and kim kardashian apparently is his role model that would be gas comes role model. He did an interview with. Tmz cast did. Steve will be here. After four o'clock there are two more new stories about california's employment development department. That are jaw. Droppers if you followed the saga from the beginning. This is the agency responsible for paying out the massive unemployment claims around the state at the beginning. Nobody could get through. A lot of people. Didn't didn't get money people that deserve money. Then we found out the fraudsters were in there. Somehow they got through. They got the debit cards. They were cashing out. Could be two billion dollars then. We found out bank of america in order to cut this off was draining the debit cards of people that rightfully deserve the money. You follow it all this. Because it's getting crazy isn't it. Here's the latest chapter. The bank of america got defrauded by fraudsters who claim they were defrauded. Did you follow that. The scammers made false claims that somebody was using your ed debit cards. Fraudulently bank of america went. Oh we're so sorry and reissued them a debit card. I i can't believe it's not known how much but they admitted they're trying to claw back the money. They're never cut it. I love that. They're trying to claw back the money. How can you you keep shoveling out more and more money to fraudsters every day and you know what they do. They run right out with his debit cards and spend it so the to merchandise. And it's it's it's all gone. You're gonna find empty debit cards because you can drain it. They're smart they go quickly to spend it. Definitely hills is overwhelmed with these people. They went in there they bought cars and diamonds and can a i upset debra mark. While they're buying a lot of furs doesn't care and and the leather boots That you stand in line for okay. All right i told you i do. I know and then another story. These never end and this takes us back to the other side of this. The people that legitimately deserve the money. We're finding out that a lot of independent contractors are being told that they were overpaid and the employment development department wants the money back now. How did that happen well. Apparently the rules are if you. Let's say you're uber driver. You and they applied onto the pandemic unemployment insurance. And i still remember this for months ago. Some poor guy wrote in too correct me. I'm an independent operator. And can they don't pay yes they do. It's called pandemic pandemic unemployment insurance. They did the specially for people. That's right you're missing out. I told him that. I wrote back and said you. Better get in on that and maybe all gone doing fraudsters nigeria. Getting double pay you. You gotta get line here so it turns out that if you are an independent contractors such as an uber driver. You're only paid on net income. That's the amount you can claim that you lost income that means. What uber pays you minus your expenses for gas and that kind of stuff. So they're an. Apparently that was not clear to many people that applied as independent contractors that had to be net income in not gross income is say oh down gross income right weighty second. They figured that out at the state they figured out. That uber drivers were putting gross income not net income. But they didn't notice the six hundred forty thousand fraudulent applications. Play two billion dollars. Good point that they didn't notice they need notice the double dipping fraudsters. They didn't notice the death row prisoners but they noticed that guy who gave his gross income number instead of his net income number. Wow they talked to. Some woman named nancy travis. A seventy one year old. Who was driving for uber and lift but decided not to so she received two hundred sixty seven dollars a week in aid from the state employment development department and now she may have to pack payback four thousand dollars because she was. That's going right. But the la gang members. A rapper in la. We played his song yesterday. He ripped off a billion to and then wrote a rap song about what was his line. You got you got to sell cocaine. All i did is file a claim for that guy. This is unbelievable comical incompetence. They're sending out service to a lot of these independent Workers there's no. There's a woman that was booking speaking engagements for baseball players and she would also paint faces at parties and other events sixty four year old lily walters from orange county. Both jobs dried up. She applied under the way. She said her gross income was forty. Eight grant a few weeks ago. She got a letter from the ask you to verify the net income which she said is actually twenty-three grant so she may have to repay thirteen thousand dollars over unemployment aid to go after a sixty four year old face painter. Good word meantime rap guy got a million to and she said because of assembly bill five remember. Ab five guys. It's already squeezed out. She's being told by people. I don't want to hire. You would have turned you into an employee. I can't afford that. Why are they torturing. Ordinary people to chess wanna cobble together. A few temp jobs gigs. Yeah just eight. why why. Why are they being. So overly regulated and scrutinized and who's going to hire her as an employee face painter. I mean come on. It's not to put an ad out you pick up some work and there is no employees that is et is a pretty small market. Their face banning That i ever seen one at a party have parties anymore. Little kid birthday parties. Yeah oh they do come out in the shore a cat or something right. They'll sit at a table. And they'll they'll i've seen them at carnivals and stuff. We got more coming up. John and ken. Kfi johnny kit show john kobylt lying six forty five everywhere on the iheartradio app. We're going to do now. Is the way of introducing our guest next hour former los angeles county district attorney steve. Cooley he got in touch with our producer rate today because like a lot of us. He's worried about this new. La county da. george gaskin. This might be the most dangerous of the county because he wants to abandon. Basically prosecuting anybody for anything and he wants to go back and resentenced people and take a look at all. The cop shootings jail prison. He does not believe as any kind of answer and find any way he can to keep people out of those place. There's no we're not overstating this in any way. It's impossible to overstate how his new philosophy is nobody. Virtually nobody is going to go to jail and add. I mean talk about local jail for misdemeanors and You you really have to be ab. It'd be involved in a blatant murder. Even have a chance to go to prison so he apparently was interviewed by. Tmz guess the gossip website standing for thirty mile zone of hollywood harvey levins and he. Well we're gonna play it here. But kim kardashian got all worked up. She's been on the beat to stop executions next hour. we'll tell you how there might be another federal execution. Today there was one yesterday. This guy killed a two year old a two year old anyway. Let's listen to the clip in the interview with george gaskin and how he sees. Kim kardashian is probably somebody who could be an adviser. Kim is someone that has been very aggressively involving in criminal justice reform for a long time as she certainly influences a lotta people much like john. Legend common have been you know quite frankly water few people in the entertainment industry. They have been right up there with this chemists in one that could be an inspiration while people. So i'm really excited the there. He's turning over. The responsibilities of the district attorney's office to an advisory board made up of hollywood celebrities led by kim kardashian. I know it's almost like we're in another planet like another world that joke. So kim kardashian. Hollywood advisory board on criminals and john legend and they're going decide who gets prosecuted and they're gonna come up with exotic reasons why nobody should ever go to jail as has mcdonald writes in the new york post today. He is ensuring compliance with the. Stay at home order. Because it'll be too dangerous for angelenos to step outside with these people on the streets that prosecutor. That's a great comparison but she thinks are cast dick. Had there is a fellow at the manhattan institute and she wrote to call about gascon. He does not want to go after. Trespassers people drive without a license disturbing the peace public intoxication loitering these quality of life crimes. He wants to just completely ignore. It's gonna suddenly you think it's ugly now. Thanks to mike. Bonding and garcetti. What is but what what who wants to live in a society where there aren't any limits on any of the public behavior. You just have constant chaos. He has this rather because kim kardashian says so kind of this kind of immature approach that Once people end up in the criminal justice system they can't get out. So i wanna make sure they don't get an pipeline. He's a silly person i mean. Hey i know he's the da but he's a silly man with with childish thoughts. Let's play a little more. This direction will are people are really excited to be able to work with their You know we think alike in many thanks concerning the system and we all of us it will. We need to listen and get our message out. When need to advocate public and people can be incredibly a instrumental in this community. Especially young people. She was not someone that was at a different place. I would be interested. I mean there are other people that are very influential. Better approach because we disagree racial why it would be. I think incredibly valuable. Both of us is because we believe that the sicily so we re imagine and they she has the reach. Can you talk about the fact that you don't want to prosecute most misdemeanors now. That's a big deal. Look if you look. I think the problem is for the last thirty forty years. We sorta became this car society. We increasingly criminalized more and more behavior. Mostly obviously impacting four people african americans and latinos in. We've forgotten that actually. I saw the way our country always worked back in a nineteen eighty. California had twenty three. No some people in the state prison system by nineteen ninety over ninety thousand and after three strikes in nineteen ninety-four by nineteen ninety. Nine hundred sixty dollars a week kept criminalising behavior over and over and over again in what. I'm trying to lose. Kinda is the system again. Understand that a lot of the will level misdemeanor the ruling by mental health problems by in putting somebody into concrete blocks snug that six up we need to actually intervene and send people in water. Verticals like fisher house. If i had a chance to talk to the fisher i would start crying. Because i can't articulate how much it meant to us. Your house is to comfort home for military veteran families staying at no charge allowing the family to be together to support their loved one during medicine. Prices it's enough to help you thrive through these hard situation. Go to fisherhouse dot org for more info and how you might help. That's fisherhouse dot org. Full savings. sale is happening now. warehouse save up to one thousand dollars. Plus get zero percent interest financing for sixty months. Unsure of which mattresses right for you lose. People are but mattress warehouse is home to bed match the diagnostic system. That recommends the best mattresses for your individual support needs. Try for yourself today in the mattress warehouse one year price guarantee means you know you're getting the best price why shop anywhere else visit sleep happens dot com for a location near you say how seeing social services which are more likely to alleviate the problem and quite frankly is night tournament so long almost everything he says is wrong and he's wrong. La county da. Steve cooley coming up. Next is a bit of breaking news. The supreme court did reject that unusual lawsuit the state of texas motion. To overturn the presidential vote and several swing states that was a slam dunk. Seven justices out of the nines. Said we're not gonna look at it so the other who didn't necessarily agree with it but said the texas had a right to at least file. It included john. And ken show debra mark has the news. Kfi am six forty. John and ken show john kobylt ken. Chiampou kfi am six forty five everywhere on the iheart radio app. I found the name of the co founder of by biontech in germany. Who's behind the vaccine. The first one they partnered with pfizer. His name is eager. Sahin yuji you are is first name. Sahin essay h. i. N. the second ceo and co founder of biotechnology should be one of the people of the year. Yeah he's about instead. Time picks a biden harris really. Now he's He he should be the hero. There should be Streets and schools named after him. We're going to have the voice line people. We have hacked for the dumpster coming up next hour. We're going to start by talking to former la county da. steve cooley. he's sent to us. A note from the torrance. Police officers association george gas and took office on monday as the new. Da defeating. jackie lacey. In the recent election. He put out these nine special directives. In a recent torrance case there was a gang member who used a gun to try to murder someone. The victim survived the gunshot. The suspect was nabbed but because of enhancements he could have gotten life in prison for the attempted murder. The da was going to offer a plea deal of thirty eight years but on monday gascon changed all that his directive requires dismissal of all enhancement the revised plea deal at the lowest prison term. Would be five years. This is what we're talking about. This is the real world defect so somebody gets shot by gang member and the gang member instead of getting thirty eight years in a plea deal gets possibly five years and gascon plea deal correct and bents part of what we're talking about. He's doing multiply this by every single case. That's gonna come before gas gone over the next four year. So let's get steve cooley on He was the da some years ago before. Jackie lacey. steve. How are you. I'm doing great. But i wanna correct one thing that Gang member who shot someone and used a gun. He'll actually do less than five years. Be sentenced to five years. He will only have to do a portion of that sentence before he's paroled. So this is ridiculous ridiculous. Why do you think s gone. Even got elected. He got elected because george soros and a couple of like minded individuals from silicon valley poured millions of dollars of their money into his campaign. He outspent lacy by forty. Five million dollars and That may have money talks and he was able to run Gas run a tremendous number of negative ads against castricone positive as about himself and that impact the voting public so now we have a george soros puppet as rda in la county. The largest county in the united states of america directives. What's what's really dangerous. In their his new directives. I read All nine of them. They're they're incredibly lengthy summer. Fourteen fifty pages which is amazing for a special directive. I was without office forty years. I never saw one more than two pages. But here's our lengthy. Also they're almost incomprehensible He sites like berkeley lost studies. As opposed to the law. He's disobeying the law. He's going to unilaterally trying to reduce sentences for all pending cases and go back and look at twenty to thirty thousand previously sentenced cases and if those terms of sentenced to state prison exceed his new standards he wants those cases to be recalled and resentenced reduced so they can be sentenced. According to the george gas goan rules. I'm calling the guy. George quote sorta unquote gas gone. Because that's who he is. He's just replicating. The george soros playbook for the criminal justice system. This is going to make our streets pretty dangerous. What what does inevitable does. He have the power legally to do this. I don't think so I think a lot of judges don't think so. My understanding is that a lot of superior court judges When deputies come in And and following gascons order make some of these motions to dismiss strike enhancements pursuant to gas going to stole. The judge are saying well council. Well you know madame. da You're saying you're doing this. And the interest of justice I don't think so. Motion denied so the judges are so far protecting the public at large from the worst impact of gascons orders. He's he's already been doing that. 'cause he's only been in office for a few days he has been doing it since twelve. O two pm on monday he issue those nine directives since then issued three more and they've owned by the way they already the deputy. Da have gone to court requesting these The is absolutely they've been yeah. They started soon as he said he. Issue those directives twelve. oh two. They were bound to follow his directives. Now that that's the hard choices are they going to disobey directors by the elected boss or. Are they going to Violate their oath and violate the law and risk discipline with the state bar. Because what he's telling them to do is illegal unethical and perhaps unconstitutional is. He's making up. Say i i've never heard of this situation where you have. Hundreds thousands of cases that have already gone to trial judges issued a sentence. Prisoner is in prison and then years later. They tried to reopen the case. But not because there's new evidence or anything of that nature. It's just that this da's different philosophy. So what's the law heard of it because it never happened before. This guy is doing things that are not even enough of a word. They are extraordinary. They are illegal and There's gonna be a lot of litigation over this. He'll eventually lose because you know what he is. Not the state legislature. He cannot remake the laws he is sworn to uphold the laws and he started violating his oath within two minutes of taking that old. This is a this is a phenomenon of biblical proportions. Can you hang on steve her. Yeah this is. This is the best person that we could get to talk to. This is former los angeles county district. Attorney steve cooley. The predecessor to jackie lacey fact. Jackie jackie He was the mentor. Jackie lacey who became rda for a couple of terms. But now it's george soros is jorge casco and he issued all these directives on monday when he took office and they are dangerous and they're gonna make our streets dangerous and you just want to send anybody to prisoner jail act. He wants to release people out of jail. A prison of already been sentenced. Steve is giving us his opinion that this reckless andy legal and we'll ask them more when we come back john and ken show. Kfi john and ken show john kobylt. Ken chiampou kfi am six. Forty live everywhere on the iheartradio app to passed away on his. It happened just like little little tiny naps. It does good. Yeah we're talking to la. Kelly you former la county district attorney steve. Cooley almost kept him his present. We talked from so many times over the years and of course he was the mentor. Jackie lacey who had that position for a couple of terms but now and Staffers to ms george soros gascon is the la county da issued. A whole bunch of directives when he took office on monday and steve clearly is questioning the legality of of many of them. We've been talking to him. This would be the person to speak to about how dangerous this man is says. The new la county da. Steve you talk about them sending the deputy. Da is to try to get all the felony sentences reduced or thrown out which the judges are blocking at this point but the other half of this which really impacts people's quality of life day to day is if misdemeanors are not going to be prosecuted at all. You're you're totally correct. He's put out a list of Nearly a dozen misdemeanors that he has ordered deputy. Da's to not file them except under some czar exceptions that are listed. they don't even apply. That won't even be investigated. So yes Resisting arrest no filing crispus. No filing prostitution not filing criminal threats. No filing this is where this guy is coming from. He's wiping everything off the books. Almost like he's his own little personal level legislature and governor. I judge for that matter. Does not know what he's doing. What's the legality of that. Can he just wholesale refuse to prosecute. All these misdemeanors no matter. What well he can Set that as a policy but at some point in time there are really three three options. The attorney general can say you're not doing your job. You're not following the law and we are stepping in and we the attorney. General will work with your deputies to make sure the laws enforced. That's one Option another option is he just Recognizes he's wrong and goes back to the policies that were in place before he got there. He won't do that. He's much much too Third option is recall guests going. There was a facebook page. Put up. i think on tuesday the first day ninety people signed up within twenty four hours. Four thousand names. I think that The strike is going away going. He's going to be looking at a recall. He's trampling trampling on victim's rights you. How could he do away with cash. Bail we just voted on a state ballot measure which is going to keep cash bail. I don't think he can. Because bail is the province of judges. Twelve seventy five of the penal code makes it very clear. Judges can set bail. They do so according to a schedule. And then they have hearings and they consider factors and they set bail. he can't arbitrarily I guess you can arbitrarily say my. Da well i seek bail but the judges can ignore him and they should start ignoring him. They judges took an oath to uphold their old. Gas cones silliness goes no place. This movement that you say is being financed by george soros and tech billionaires. It doesn't have a lot of followers. Within the justice system. George soros and his brand of justice has had some success in other parts of the country. Because soros throw so much money into it philadelphia. They gotta soros. Da contra costa county here in california soros today. i don't even talk about the san francisco. Today we're out there Ridiculous steers rose is an international financier with a very chequered shady past as in his eighties. Eighties what is the point of doing this. What like what for him to undo civilized life in los angeles. I can't figure that out i just can't figure it out. It is beyond me but you know what you're raising two sons who believe in the same stuff there on the two sons run there or at least one of his sons on the vetting committee that pick the vice president for george biden so this is a generational thing george soros believes it sons believe it and they are impacting the criminal justice system all over this country in a very negative way. Public safety is going to suffer. Greatly criminal justice systems are being thrown into disarray. And george guscott believer in this. That's a follower And and they. They don't believe believes the consequences on the streets or they don't care they don't care they don't care they don't care the first people that george george gasco met with was the black lives matter leaders And they were telling him while. I'm more cops That's just constituency the way out the left wingers radicals those that Some cases like to see the overthrow government. That's who george soros listens to and hangs out with those allies irs and his buddies. And you know kim kardashian to stephen f. You heard the audio from tmz. But he now considered kim kardashian advisor that look george gas cones head. I would be the psychiatrist the stars. There's something going on in there. That if i could figure it out i would really impress an awful lot of people know what he's doing yes somewhere between Grossly reckless and totally incompetent or a combination thereof. He does not know the law at all. are you one example. One quick example. He writes a letter to the la county chiefs. The and he's arrogant. He says as the chief law enforcement officer for the county of los angeles. I'm doing this blah blah blah. Well you know what he is not cheap law enforcement officer for the county gov- the government coach says the sheer of the county is cheap. Law enforcement officer. He doesn't even know what he is pursued with the law You know we a lot of looting crashing rioting vandalizing last summer right now. The looting trashing and vandalizing is going on in the halls but da's office and george gascoyne is the one doing it. Well see i hope you're available and we can have you on in the future as we chronicle this because i recall movement takes shape. I think there needs a lot of public pressure and you can explain this better than anybody out there. So people understand. What's going on. Because i don't think people were paying attention when they vote informed to informed electorate. I'm happy to do my best friend. Form them wait until you see how he handles what were very serious. Death penalty cases murders of police officers killing children. He has ordered that the special circumstances be withdrawn not even get all up under his procedures and policies. This is this is going from crazy. Places i former. La county district. Attorney steve. cooley. Thanks for coming on. Thank really great. Abbey offering his perspective on the dangerous. La county da. George gets more coming up. John and ken. Kfi john and ken show john kobylt. Ken chiampou kfi am six. Forty live everywhere on the iheartradio app. All right we throw a hack well to hacks in the dumpster in one hour of atlanta and the team or assembling you'll find out who they are and what the reason is that. They're going into the dumpster at five five. Dr jeffrey klausner from ucla is going to join us again. He's part of a team. That actually is responsible for a lot of the testing sites in la for covid nineteen and they have issued a report and the report has some great statistics concerning what occupation is testing positive. The most in la what occupation and also the percentage of ace symptomatic people probably walking around based on hundreds of thousands of interviews with people who tested positive in in los angeles county. We'll talk to him coming up after the news at five o'clock but it has nothing to do with outdoor dining or even indoor dining. Let's give you that hint tach right and the restaurants are still closed to indoor and outdoor dining with the exception of a few rebels and gavin newsom is still shutting down the restaurant industry and there is a massive recall going on and is picked up a lot of steam there over halfway to their signature goal. They have about eight hundred thousand signatures already. And you go to the. John and ken web page kfiam640.com. Click on the john and ken page and you will see a link to websites where you can download a petition and sign it. In fact it'll take five signatures on a page and send it in and we could have recall going next year. And then and this nonsense because story on solving. That's given him the finger. The little town of solving up there in santa barbara castle. I saw that they're saying no. We're gonna continue with dining outdoor dining and shopping and we see december's too big a month for us. We count on tourists. Who loved to come to our quaint little town and celebrate christmas. So they're ignoring he has. He has no right and they make the case. Which a lot of people in santa barbara county do. We don't belong lumped in with la county. Stop it. no they don't have anywhere near the situation. And it's only know it's only isolated parts of los angeles county that is responsible although the la times says today it's spreading everywhere john into your rich neighborhood once again. They're distorting exaggerating and lying. Because the numbers are tiny in the in the in the better neighborhoods but You know if you go from five to ten that's one hundred percent increase. That's right and i mean that literally because In in my section my zip code it went from six to eleven so if you want to distort scare people you say up. Eighty three percent in a single day. Of course that's happened many times lately where it goes from ten next day five and eight and four and twelve than eight nine. Yeah but this is. This is what they do. They're dishonest at the el segundo times. If you want to enjoy something on the web. Page concerning governor gruesome some like the call. Him governor new cellini like that one. That's one new cellini. It is a story in harper's bazaar magazine from two thousand and four about Gavin newsom and then wife kimberly guilfoil as the new. Kennedy's it's hysterical. When you look at it now it's galley was funny. Then yeah but we be gag inducing. Yeah yeah we have a link on our website see now you have two good reasons to go to the website and click the photo we have there. And then you'll find the really bizarre photo of gavin newsom in kimberley guilfoil spread out on a very expensive rug at one of the getty mansions in northern california. The getty mentioned you can visit. I don't know it's it says. It's an getty's mansion. And i don't know you chassis. Getty jackie geddy is another member getty family and it's on the pictures we got from her website. She took the whole layout from harper's bazaar magazine and put it on the website. That was the only source. I could find for it. This is not even in the richest googling around came up with this story. Somebody had tweeted off. We well know during the republican convention. Remember kimberly guilfoil had a speech where she was screeching for about a half an hour. Yeah at the end of keeping folks don't know she's dating donald trump junior right so they send their wife of gavin newsom his dating donald trump. Junior that doesn't get you so anyway. She was up during the republican convention. And she was just screaming and it's supposed to be an inspirational speech but of course there was nobody in the room because of the virus so it came across as really bizarre like she was a complete lunatic. Yeah you know yelling at the moon. They didn't even pump in crowd noise. The way they do on these football game broadcast now. No they didn't and they should have because if they had fake cheering the made sense. I might have played better. But it's just her voice echoing so somebody at the time A woman named ellie hall. I don't know who she is. But she put on twitter the photo of Newsom guilfoil dressed in black looking so pretentious so pompous and elliott hall wrote. Never forget that. Kimberly guilfoil and her then. Husband gavin newsom posed on a rug for harper's bazaar story calling them the new kennedy's and i don't remember how i came across this thing on on on twitter but i was just playing around and and it just popped up and i looked and it was like holy crap. This is hysterical. I mean you. What's he do with the pool table there. Or he's a pool table to yeah well There's a picture of her dressed in a in a very expensive slinky gown and she's holding a pool cue and she's got her left hand on the table and he's to her left leaning over looking so there so suave don't they didn't. They realized then how stupid this looks i. I think that crowd thought this was sensational. Mayor of san francisco at the time right. Yes it was and he had just someone thought. This is a good idea to post for a fashion magazine like the next. Kennedy's seductive weird alluring poses. Right and then. She's got another photo of most of the photos. Were actually have her. She's wearing a tight blue dress in her closet. See what they don't realize. Let me explain something to people that. Don't get it when you want to be considered. Sort of like the jackie kennedy. You don't dress up advertisers in fashion magazine. You just do what you do. And then one day people start to notice and then it starts to trend and they start to say. Wow person looks really cool. There are trends. You don't try to display your kennedy. Be cool is to be understated. Correct to act as an over time. It's picked up on right. Be cool right. Cook considered cool. But when you're trying announcer cool right where you're trying really hard. And you were announced as the new kennedy's and this is september two thousand and four and then four months later they filed for divorce to touch. It was all phony. It was all phony because they must've known in september. They were heading that way right. Do you think i mean. I've been divorced but i would think that if you get divorced four months earlier you know where this is going crazy. You would think so. Please go check that out along with the recall links to get gavin newsom out of office. As we mentioned yesterday you can choose either one. They're going to combine the signatures. The petitions i think they're the same they'd better be. I don't know and that photo of him on the rug is enough reason to recall. Yeah just the photo. He's not nude is he. He is not nude wasn't a thing to do like in the seventies to pose nude on a bear skin. Rug or something like that well. Probably offended debra. Debra mark wife's name. I got enough denver's offended can remember. What was it playgirl magazine. Burt reynolds off his penis. Yes something like that a centerfold. Yeah so that was a sensation. Was he on a rug like that. I guess it was on some kind of a rug wasn't he. I think so. Yeah it's but but these two are close and they're closed in eveningwear. Yes elegant the bowl and of course they look really elitist enrich. Oh they just drip with pretension. That's who they are. And how jailed up is hair then. Well they said his hair was was was a kennedy. Like mop except kennedy had had soft hair looked like natural blow dried hair right. This is a little product but like this is like a thick coating of gulu on his add. This is heavy jail is it was probably stiff. And immovable check it out. We got more coming up. John and ken. Kfi bothering me. All the green center veggie role. Today ken would like it to what a here. During the commercial for john john and ken show. Kfi am six. Forty live everywhere. On the iheartradio app. We had a small communication. Failure is supposed to be the execution desk here because we're going to put down another federal inmate tonight. it's time for death. It's going to be back to back. Executions they did. Lethally inject brandon bernard last night at the federal penitentiary. A terry hope indiana. He was arrested as an accomplice. In the nineteen ninety nine hundred and murder of a couple of youth ministers in texas. Today is time for alfred bourgeois boo joie age fifty six. He will be executed by lethal injection unless a court intervenes in the case and decides to stop it and i get choked up reading. What he did is so on believably horrendous. He was a long haul truck driver from the wheezy anna but he apparently was making a delivery to the naval air station in corpus christi in texas. Which is why i guess. This became a federal case because that's federal property. I guess somewhere in his truck was his two year old daughter who knocked over her little potty training bowl he flipped out and slammed her head to the windshield and beat her to death. He also was convicted of sexually abusing her before. That and now you're and this is so off and there's a photo of protesters that's who they're gonna kill tonight. A man who took the life of a two year old. That's so terrible. I hope he gets firing squad. He's getting lethal injection yet about planned to poison gas or two firing squad line. Yeah it's that's that's so horrible. I have to mention because that's a big reason. People protest. I really believe it is. He is black as was bernard who died last night. I'm sorry people. Skin color doesn't matter. I think it does to the protesters and these are a couple of white men being executed. Where you wouldn't see quite the upper roll leave. They believed the justice system is biased against african american. Not in this case and not in this case overruled did he not kill the two year old. Who else slammed her head through the windshield and he did. He did he did. It doesn't matter what color is because she tipped over her potty training he dow and You know that's all you have to. You have to have shot. These people down overwhelm them. Because because that's crazy just look at the evidence. The case skin color has no bearing on this The the five most recent scheduled executions do involve black men. And that's why kim kardashian gotten involved and she's she's really went pacific she is She's a very damaged person because we talked about this killing yesterday. Brandon bernard he and his Partner killed a couple as partner shot both of them in the head. Then bernard poured lighter fluid all over their car and set it on fire and they were still alive. At least the woman was. They said she died from smoke inhalation. Right they were. The couple was trapped inside the trunk. So one guy shoots them in the head their in the trunk. They slam the door on the trunk. Then bernard pours lighter fluid on the car sets it on fire and she dies a smoke inhalation. Listen to kim kardashian on twitter. I'm so messed up right now. They killed brandon. He was such a reformed person so hopeful and positive to the end bar portly. He is sorry so sorry for the hurt and pain. He caused others as you is in the chair. Attorney called me and said they just had their last call and said this brandon. This is kim said he loves you and wants to say thank you again. He said he doesn't feel too claustrophobic. In the chair kardashian says that bernard was a lover of classical music and a master at crochet who often joked that. If someone just saw his cell they would think of his grandma sal and she shared a piece of advice that bernard had for young people. Don't get involved with the wrong crowd. I could go on and on about what an amazing person brandon was she added. I do know he left. This earth feeling supported and loved and at peace. This just has to change. Our system is so bleeped up. This is kim kardashian. Writing about a guy who burned a car with two humans inside the trunk q. Mentioned what it's like to die inside a trunk after you've been shot in the head you're still alive and then smoke fills the trunk from the fire. Can you imagine what that feels like. Kim kardashian because she's such a sick wack job doesn't care she is so moved. That brand bernard can do crochet. And let's classical music. I then say of that's crazy. She's clearly insane. I mean marrying conway. Tani west was assigned right there. But i don't know after that. Why would anybody give her. Even ten seconds of attention burr media time when we come back. It's sicko it is the five o'clock hour which brings us the moist line people and we got sacks for the dumpster. We're going to start off with a one of a kind new study what occupation. La is showing the most people positive corona virus. The restaurant workers the first responders the supermarket. People no no. No construction workers will talk to dr jeffrey klausner next john and ken show you paying attention. Now i'm not paying it. We'll stop talking to other people. Tim conway came in here and he said it's his fault. Okay debra mark ready remark avenues. Kfi am six forty johnny bench. John kobylt ken chiampou. Kfi am six forty live everywhere on the iheartradio app. We've landed there. Friday five o'clock the moist. Line people here in fifteen minutes two rounds of them if you can stand it in between do have hacks for the dumpster based on a theme we've been talking about for a couple of weeks and that is the war on restaurants had all sorts of in person dining speaking of which nbc four is. It did a story on a new analysis of people tested for covid nineteen in los angeles. A company called curative. They run the sites to the testing and it appears that the people getting infected at the highest rate work in a job. Well not food service. Not supermarkets not even frontline workers construction workers. Construction workers had the highest rate of positively by far. And we're gonna talk now with the medical director of curative which runs these Test sites We've had a number of times. He is with the ucla school public. Health dr jeff kloster also a friend of mine and Let's see he's got other things to he's at the david geffen school of medicine. Ucla and a professor of epidemiology at the ucla fielding school of public health. Wow and the professor at the division of infectious diseases. You're not done. it's very very long. Resume here yeah. Jeffrey class are welcome right. Welcome good afternoon. The one quote that stands out to be right away when this article from channel four is it. You said it's possible that the construction people keep going to work because there's paid sick lease. Yeah so that that's definitely a part part of the problem is that I mean people have to work and when people have to work often they can show up when they're not feeling well when they're coughing may be. Fatigued may have a small fever. And if they're working particularly Indoors doing construction. They're at high risk for spreading infection to other people. I mean we looked at over seven hundred. Thirty thousand test results Between august and october this year and we will when we looked at those tests results. We compared the positivity Among different occupations we looked at construction workers. We looked at disability care providers people working retail manufacturing people working in restaurants in healthcare excetera. And by far it was construction. Workers had the highest positively at over About Ten eleven percent. What does this say about strategies. Then the way we're combating this instead of shutting down all the restaurants. Well you know it tells us. We need to be looking at the date. And that's what. I've been advocating for a long time as we need to do a better job at looking at the data and following a day that tell us where to intervene and you know people go to restaurants people go to parks people you know go shopping and so it seems like to some people. Well those must be important places as people do that a lot but when you actually look at the data you'll see that there are certain types of occupations or certain times of exposures that are really the highest risk that We may be ignoring. You know it's interesting. You said that it just hit me. People respond primarily to what they see visually so if they see people in stores and shopping malls and restaurants and they know that personal contact spreads the disease. It's like well it must be that. Look i see people. Their example of that the beach remember the last summer right exactly. But you know as you've pointed out so many times on our show any new writings and interviews is that you have to have been close contact fifteen minutes within six feet and it's more likely to spread if you're indoors and a lot of the stuff we see with our eyes just doesn't meet that criteria right and you know no no one's been really looking at Comparing who has infection. Who's not hard data. Systems are set up that every positive case is reported to the county and then it's those positive cases that are interviewed about their exposures and where they work and where they live but to really understand the epidemiology you have to compare the positive cases with the negative cases. And that's what we do when we investigate. Food outbreaks of food poisoning right. We don't shut down the entire food industry from the farm to the table to the restaurant. We you know look at okay. This is where the seminal is coming from. Let's trace back and look at the food chain so by doing these kinds of analyses among all testers looking at the occupations or the exposures we found that construction workers disability care providers People working in manufacturing had the highest positively as opposed to people working not surprisingly as media employees people working in education and people food services actually had the lowest positively be using data like this to really direct our interventions and. I'm not aware of anything. We're doing really in the construction industry to be training to be making sure that people worry mass and importantly to making sure that you know construction managers are telling people who are sick. Please don't come to work and you know have to deal with you. Know sick bay right. Watch thing if they don't get sick pay. They're not gonna listen. There's going to it right so you know that's a a a a problem so in in alameda county if you do test positive you get twelve hundred and fifty dollars as you know to cover some cost to stay home for 'isolation that kind of program exist in la county you you you do so much. Statistically based research here it must it must make you a little crazy to see that one of the the the least infected groups food service workers seemed to have the most restrictions and then one of the most infected groups. construction workers have virtually no restrictions. It is frustrating. But you know. I understand that. The public health Really have had their hands tied. I mean they've been underfunded and a resource. Since i left public health in two thousand eight and it's been you know. Chronic ketchup game do not have the staff. Do not have the scientists and They're you know working blinders on so they don't have the information. The only thing they're left with is these broad based you know universal Lockdowns fortunately made a little bit of progress. They've kept the beaches open hiking trails. Open now the playground opened again. So you know we are seeing some improvement in the decision. Just the la county department of health. See you report here. And do they take this and decide. What their strategy should be around. The construction industry I don't think that We've had that conversation yet. They may be forthcoming. I think they see there are certain pockets. And you know certainly these data show and we see on the la county websites. You know right now. Part of central a saying gabriel valley area Hispanic populations you know very high risk in terms of infection. You know we do have some geographic and population based data about where we need to focus our interventions where we need to you know encourage people to physically distance and to wear masks and then hopefully as a vaccine rolls out. It'll be these high risk populations were we also be promoting. You know early uptake of vaccine. So you're you're not talking. About a lockdown on construction sites no i'm talking about you know interventions that will reduce the risk associated with construction outdoor. Construction is probably fine. But there's also indoor construction so there's people working you know indoors and also you know better screening that People who are sick Should not come to work. May you know maybe they can. If they have to work maybe they can work outside instead of inside but do different things to reduce the risk of the spread of infection associated. being in construction. You're really prominent in in your line of work here. And you know you're you're running these tests centers and there's got to be millions of people who've come through your test centers here in la county area. Do you ever get to talk with anybody in government either in sacramento or here in l. a. county. And say look you know. Your policies here are not matching. The research the feedback. We're getting from all the test rationalizing. We talk and we you know. Write editorials and we have Conversations and sometimes you know my colleagues in the health department share these equal frustrations that we see things that are you know led by the politicians so we have different. You know politicians who have their own opinions about what the response Should be and sometimes the health officials. Tell me you know that they understand things could be done a little bit differently. But there's a lot of different considerations that go into political decision making eye doctor closer. We appreciate you coming on. And we love this report in this data talk right. Thanks for interest. Take care bye-bye the medical director for curative. Which runs a lotta the test sites in. La and then. John has nine other titles for doctor. Yes he's he really is at the top of his field time. Ami very logic common sense guy was running things we would have a completely different set of policies than what we're getting but the thing is they would make sense. You put some regulations on how construction workers mingle with one another on construction sites. You don't over-regulate outdoor dining at restaurants because the infection rate just isn't there it doesn't exist. It does exist at construction sites. And i for the life of me. I don't understand these public. Health officials. Barbara ferrer and moncton davis and the board of supervisors and sheila kill and gavin newsom and paul simon. I don't understand what's wrong with them. This is a is a database of seven hundred and thirty thousand people who are personally interviewed and got tested. The try construction leads the way. The boy sign next john and ken. Kfi is a my turn yet. Look we have a want to say ten show. John kobylt ken chiampou. Kfi am six forty five everywhere. The iheartradio app. I will have hacking dumpster coming up in moments. We're gonna bring the moist here momentarily a breaking news this afternoon. Say goodbye oracle. They are moving their headquarters to texas. Really silicon yes. Oh that's a big one oracle that's for. They started here. Yes wow stampede you got. You got tesla. They're leaving redwood city to go to austin texas. Corporate headquarters will move a more flexible. Employees work location policy. And they're changing their corporate headquarters so a lot of those people have been working remotely anyway since the pandemic. But yeah i they're going to get the big tax break oracle's one of silicon valley's older success stories founded in santa clara nineteen seventy seven. Yeah i think. There's the redwood city in one thousand nine hundred nine. i think there's a huge difference in capital gains taxes there to in addition to being no Personal income tax. I mean i mean that's why elon. Musk is moving there. And he's opening the next day. But you john and these are just anecdotal. Little one off stories. Don't worry about coming every few days. The moist line people are here. You leave a message. One eight seven seven eighty six john. We're excited to hear from you. It's about time gains. You forgot to mention slow. Chinese spies about tiny far on tv. It was all the talk of the town for about a day or two. Maybe that's why she didn't hang out with him very long. 'cause you know. She was tired of his far to that. Grouchy lady was highly upset about us mexico. We're in los angeles heidel. We're prettier than everybody else. Maybe not far not even close but nevertheless you don't care about new mexico's come on. Let's matter with you. Also can you look into a lot of gruesome understanding three million dollars in loans to keep winery open. Pvs you can watch news from different countries in the world. Japan bbc france germany. And you say show people fanning align supermarkets and this downing right on the x polite light right next in line exactly so polite. They stand in america. There is no line. That's the difference. America there is no line. so gavin. Newsom winery day open. While everyone else's gets shut down. I have yet to hear you go off on the teachers unions. That are keeping your kids out of the classroom and southern california. You guys have got to get on board with the team's thank you. Ha ha ha by mispronounced. Guy's name how you got to give it up. Compared to what trump does all these people out of work and employed wrestled workers another. What's the story. And why can't we get this guy. knock that off. I've gotta bleed this many many many many more people. He's put out a work. Then we need to get rid of this so explain what's going on. wake up. People stand up signed a petition and get rid of pieces. I don't understand about why the restaurants have to lock down and shut down for the outside dining but yet they opened up the playground for like little kids and stuff so they've got their hands all over the glides and like the all of the You know walk up the stairs and all this stuff. There's nobody cleaning. There is the restaurant. So i wish they know what the one thing and they ever like. Senator i mean president. Go look my first choice for secretary. Terry of homelessness was not obviate. Beccaria good buddy spaghetti. Betty said you guys tatum. Los angeles newsom finally the people that voted for him and now they want him out. That's great for california. I hope it happened. It took some time because their heads are a little thicker but he finally did it. Yeah sheila quill. You'll wrap that. We're all gonna die for me. I saw that on twitter and nothing about being. Fake news typical. She lied. She got up there and just lied about it being dangerous and just nothing. I mean you know trump like life by cutting far and they don't stop the presses. Cnn goes on special report for today. The craziest and most distressing thing about this whole thing isn't even right now. It's going to happen years from now. When every single one of these political lack job politicians get reelected. The entire board of supervisors will get reelected garcetti. The city council gavin. None of them will get kicked out of off. Because we live in an ideology shut down all the restaurants. He shut down all the bars. Shut down all the school systems and shut down. All the far eats his dinner at french laundry and he walked around the time to get him out. Thank you for leaving your message. Please hang up goodbye. God page links to sign recall petitions. You can download 'em sign them and send them out and we can do this if everybody got laid off. The restaurant. industry filled out. One of the recall. Lines he. He'd he'd be on the ballot for recall. I saw hangs just people out of work in la county in the restaurant industry. We have hacks for the dumpster next. John and ken show kfi. It's time for john and to throw dumpster. Johnny cash kobylt ken chiampou. Kfi am six forty five everywhere on the iheartradio app. Well yeah we're doing it we're throwing couple hacks in the dumpsters fed. Lana and the many many mob members are here. This is really too many for the building code right now until the pandemic is it. Not i see like guys in the hall. Remember they all were vaccinated vaccine. But some of them ukrainian. I don't think they could get it. Well they might not survive it but they got certain hostilities for a fake vaccine. Like you did You pro actually a theme to the our theme to the week now earlier. Five o'clock when we first came on this hour. We talk to dr. Jeffrey klausner at ucla. His group curative has put out a report. They run the testing sites. The number one occupation testing positive by the positivity rate are people in construction in fact they didn't find much of a linkage to the positivity rate with those who work in the food business these are the supermarkets or the restaurants. Now it's very very minor. It's big and construction sites and this is a huge study. this study. These are seven hundred and thirty thousand lined up to get the their their virus test. They got positive some of them got positive and then they were interviewed to see what did what did they do. Positivity rate what kinds of occupations are being the most exposed so they do nothing about construction. I've said that from the beginning. It's unbelievable how much goes on around me. And i don't mind but then again if that's causing all these other lockdowns dan. I think they ought to step in and do something well. The thing is now to be rational. You what they have to do is enforce the rules in the construction industry that would mitigate the spread for example. Making the guys wear masks and giving them sick. Leave pay that. That's a huge problem because people. You're not making a lot in construction right. Let's your the develop. So i've heard differently to tell you the truth that the demand is regret right now. In fact i heard about Well i hired someone who do some work in my garage. A paci the floor. He said he lost guys to construction. Because they're being lured with good money Three hundred dollars a day. That's not bad that's unusual. I mean that that's got and maybe it's because there's so much construction going on. There's so much going on exact. Normally it's it's it's a blue collar job and that's correct it's not like they're gonna make hundreds of thousands. Yeah and and you know it's a it's almost off spanish. Very zoom ably. They live in tight quarters in tight neighborhoods so the war on restaurants is really what we've been dealing with now for two weeks and the people that we're going to throw in the dumpster and i'm not so sure we did not throw them in the dumpster. I can't even remember anymore. But i mean this pandemic has gone on forever but the one that really stood out this week was the men whose title is california health and human services secretary. Dr mark galli. John calls what the alien space alien is the weirdest looking guy. I've ever seen big egg-shaped bald head over sized funny colored. Glasses danny has a tortoiseshell like a hollow another clear frame that's what the other hollow droning voice no personality. He's he's the state version of barbara ferrer and he's just as nuts. He well on industries that have nothing to do with the pandemic and they don't regulate the industries that do have something to do with the pandemic like construction so even though in la county judge said that the county bannon outdoor dining should the overturn. We still have the state banned by region. Southern california's now lockdown for outdoor dining here is dr mark galli pretty much. This is all the evidence you need. To overturn the state ban. Listen so the decision to include among other sectors outdoor dining and limiting that turning to restaurants to deliver and provide takeout options instead really has to do with the goal of trying to keep people at home not a comment on the relative safety of other dining and we have worked hard with that industry to create safer ways for outdoor dining to happen to keeping tables farther apart to ensuring mass in athens as much as politicians relation to continue all get him as sectors dining spiritual laughing at germans took on the role of narrates stood. And now there's a there's another person said the picture a stay at home. Name is dr eric pain. She's the interim the interim state public health officer. Let's listen to some of her blank. Throw her. Where's dr kate steinle from allegheny county. Your hands was our top priority. Remember the best way to stay. Healthy is to stay thinking eric. Von the alameda county. Throw the best way to avoid getting sick voicestream ignorance hear at the airport often for twenty nine so we through that a lot of these state health officials dr mark galli. I guess it's part of it is with him saying we work very closely with the restaurant industry to cope with policy. Closed him anyway. But you do that for. And there's no connection transmission. I when we come back we'll round up the moist line people for one final run through their calls. John and ken kfi. John and ken show john kobylt ken. Chiampou kfi am six forty five on the iheartradio app would've listers remembered that it was a lot of construction workers apparently test positive. Who are working on the new stadium. The home of the rams and chargers. I do remember that happened earlier this year. So there it is. Let's see what they do about it. But of course the construction these pretty strong in california not going to shut them down at them to do anything. just don't shutdown the restaurants. I know that's what. I'm trying to shut down any other businesses. But i'm saying let's talk about. The strategy says the restaurants alone. It's a great example. That barbara ferrer has no idea what she's doing. Just it's just want to discourage people from gathering. yeah mark gailey and the rest of these Dumpster people i. Let's finish up with the Second round of the moist. Line people as you can hear. It is christmas edition. Santa claus is coming to town this a insane institution one eight seven seven moist eighty six john and again. We're so excited to hear from you about time. We were saying last time. Someone in the media up north in sacramento or san francisco went after gruesome. Wasn't it so happens. They try to at their own deep rent up there. They banned from tapping question unless somebody screws up and then they come to them. They have nobody else to step up. And yeah that's what it is. They really if they know you're honest question. We'll put you on this. I believe that always thrown shutdowns and such part of it is that they wanna make people dependent on the government you have all these businesses and individuals buckling. They're gonna need the government for help and once you take the government money that's more government control on you of a lifelong resident. I gotta tell you eat help. Slowly the beach cities are turning into skid row into my little. These homeless people are coming in from all areas cova pandemic speakeasies. A gallery is completely closed. All these bums coming in the topic of give thank god. I'm not resident of la county. I can't believe this guy. Guests gone the new attorney has done on his first day. What would the voters thinking On the fox for his name. I'm telling you it's just going down the drain over there and you know it's going to continue to do so unfortunately all these pearls clutching many that are so uptight about how far jumped need to seriously get a grip. Forget that north. America used to be inhabited by herd of buffalo and bison that threat from mile literally a county full of buffalo and bison warning far away. The cows are fine. The ozone is fine. Knock it off. People enjoy your day. I am so happy. That governor gavin gruesome went to the french laundry because based on their prices. Not only. Were you hung up to dry. But they took you to the cleaners. We should all gather around and give our support. And congratulations to there are for being a part of the birthday committee and being relegated the lowest position they get any business office for government. Am i on. What exactly is a non essential visits. Last time i checked the non essential business with the government because all they seem to do is find the hardworking people and praised the criminals hardworking people criminal. I think we're on a different planet is like earth to as dom george school. He's our the no bail to pay crooks get away we're all in and we're stressed kiss our school. I thank for leaving your message. Please hang up goodbye this week. I noticed yes. You're right singing. One quick headline that just came out. What do you remember that. Some states wanted to vet the vaccine before they'd love it to go to the public. Yeah new york's done governor cuomo governor newsom said we want to take a look at trump's vaccine's before we let the public be injected done its review. It was very quick. We're okay with it pfizer's vaccine is open blithering idiot. That's very good Tim conway making his second straight appearance. Smart i know man it stop. Well my internet's down at home. So they're working on it. He's well. I guess you can't google a repairman. You can't get online hand. You got you got you know depend on these guys coming over to put that together for you. Some amazing when your internet is down. Like i'd rather have water and electricity off. You know the internet really. Yeah i really get that you know for work and stuff and everything. Even the tv is internet. Based so i can't watch anything you know. Your life is over. Yeah ground to a halt corbin. Carson's gonna come in to save me. He's going to talk about an orange county. Judge orders jails cut by fifty percent because it covert so you'd better watch out sunny porch county The woman that Suzanne donated one hundred thousand dollars to caterina's club. It's gonna come on with us. Wow shed one hundred thousand dollar donation that crazy. it's shocking. Yeah imagine. Having that kinda dough we just write a check for one hundred grand shared. You've got i well. I'm working Jim carey said he wrote a check to himself million dollars and he said You know one day. I want a cash and then like twenty years later is able to cash out. That's his living in a car. i think. Yeah i. I like a whole stories like that. It's just like look how much money i got. He's a comedian right. It should not tell stories. About how much money yes And then we also have a sales director For hungary h. u. n. g. r. That's one of the new delivery services out there and talked about you know there's so many people in that business right now. How is anyone making any money you know. I don't have to make money. No but i give it literally. I use it delivery service and it costs two dollars for a guy to draft universal to burbank with my chinese food company. Ninety two bucks jordache stock. Exactly right. it was three guys from stanford right seven years ago. I started the business now. They're all worth two billion dollars each on paper my my my three buddies mark asher mike hennessy. At macdill of these guys. And i nineteen ninety one ninety two. They had a thing called encino bites or valley bites and they went to all the restaurants they secured the delivery rights for all the encino in santa restaurants that was in one thousand nine hundred eighty maybe ninety one and they had that service they could make any money they sold it for a thousand dollars for foreign in the wrong decade. That's right yeah that's right. Yeah they could have been worth billions of being done. Yeah come on. y'all keti. The news here. Rob newton knit rob newton. All right he's got bombs next conway now. Kfi am six forty.

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#45: RYAN THOMPSON | Homeless Vets Vs. Mega-Developers - The Battle for the Most Valuable Land in the U.S.A.

NICE WORK! A Super Nice Club Podcast

1:45:47 hr | 2 months ago

#45: RYAN THOMPSON | Homeless Vets Vs. Mega-Developers - The Battle for the Most Valuable Land in the U.S.A.

"The work a podcast. The super nice club where we are just trying to make the world. Ten percent nicer. I'm your host todd. Brilliant and this week's episode is a doozy not as newsy. Sorry it's probably the wildest will this episode that recorded to date. It's a bit longer than other episodes. But i promise you it gets there by there. I mean it starts with our launching point an episode focus which is on the battle between homeless veterans and mega developers over the most valuable piece of property in the united states which is really a proxy battle between human dignity and those who trample it for financial gain not super nice right totally not super nice. This particular fight is happening in los angeles adjacent to the fanciest neighborhoods in the city and it's just beyond ugly and said whatever you think whatever you think of us military. I think. I think we all agree that a contract is a contract and these men and women signed one which promised that though at the very least be treated with respect instead we have individuals and business interests who are nakedly shamelessly truly without shame spreading lies about their character about their actions all to benefit those. Who would ruin a community that these very same veterans there with their hands. Okay maybe not the very same ones but those few generations before we'll get into that that'll be explained with this week's guest who and finally introducing here activist ryan thompson ryan thomson. So we're here. Ryan will talk through some truing various shit. Ucla has been pulling over the decades on the contested piece of property. You ever heard of project m. k. Ultra the us. Government studies on lsd for mind control purposes. Happened on this very same parcel of land so did illegal lobotomies. On veterans sodas Right now as you hear this a program. Ucla runs pays homeless vets and others to procure and use illegal meth then there's the whole illegal body parts swapping scandal. I know this all sounds like crazy nonsense but it isn't a matter of fact. Check the links in the show notes below that reference. All of this. You're going to hear a lot of crazy stuff. And i had to do a lot of vetting. This is a different type of episode for the nice work. Podcast hi did you alive vetting to bring this to you. And i'm telling you it. All checks out more than that ryan will back up everything he brings if you simply email him at rt at hd vs dot net norway about writing that down it's in the show it's also Repeated later on so if you listen to this podcast and you find it compelling if you find a fight worthy of attention and you want to help please just spread the word. Share this episode with those. You think can help because it really does make a difference. You know a great way. A great way to make the world a nicer place is by shining light into the darkness and then refusing to allow those hiding in the depths to to plant new seeds of a doubt or destruction elsewhere. Lots and lots of not nice mackin nations are happening behind. Bright smiles firm handshakes the unsheltered. The unsheltered among us are just as valuable as anyone else. In fact i'm going to say there's an argument that they have more value in that in that they're clear mirrors that reflect who among us has compassionate our hearts and naturally. I think there are some who would rather hide or break these mirrors for fear of having their true natures. Put on display anyhow enough. Nfl that nothing that passionate not super elegant sermonizing to learn more about the super nice club. How join us check out our website. Super nice club dot com. Learn more about the club there or on instagram facebook at super nice club or you can text nice work. Yeah we can fix anything right now to three one zero four. Two one zero three nine three to join our super nightclub insider community where you'll get invited to events lots and lots of giveaways free swag local gatherings local. What if you live in. La will invite you to the next in-person gathering of the brentwood community council. Which is an amateur hour. Developer lobbyist organization who pose as gets as concerned community. Group has a neighborhood group. But they're not. We'll talk about that in the in the episode But you convey to that so we can pack the house and using supervised lobbying of our own. And it'll be fun. Yeah activism the super. Nice again that number is three one zero four. Two one zero three nine three. And if you want when you text you can ask for discount code. We'll get you one for our super nice merchandise had stickers things like that that helps spread the word in your community around the simple idea of making the world a nicer place. And if you're if you're doesn't help start a nice conversation send it back. We'll give you your money back. No problem all right ready for episode number forty four of nice work. Hold onto your body parts folks. This is really good stuff. So turn off everything else tune out the rest of the world and drop in two nice work with ryan thomson is pretty good intro. I think yeah ryan thompson you are here on. Nice work podcast. I really appreciate being here today. Man how are you good. Good thanks lod. You're here in la right. yeah. I'm over in the brentwood neighborhood of los angeles here Right next to the soldiers okay. So let's just dive right in. It's just to here here where you and i are in west. La we're about a mile from the super nice club headquarters over on san vicente boulevard. We have what is called veterans row. Which is this. Try to describe for you guys. It's this long line. It might even be one hundred yards long of matching say super nice tents and there. They all have large american flag stitched to the outside. It's very orderly stretches down the road on a very heavily trafficked street. Here in la so ryan. What's the story there. Well Veterans row is a name for an encampment of disabled homeless veterans Who are trying to obtain their services. Indoor shelter from the west los angeles as soldiers home. They're up against the gate of it right next to a street called bringham avenue right at the west gate of the soldiers home there and all of them are veterans every single one of them and many of them are combat veterans. Many of them are one hundred percent disabled and one way or another. They're unable to receive services such as post traumatic stress disorder services or services for khimik brain injuries or it could be some of them have cancer. Some of them have other serious ailments And many of all of them are homeless. They do not have the income or the employment or are the employability to serve. And so that's what they're trying to do out there and In the past year. And you know this folks like yourself in the community. Have taken notice of this and have been uniting with advocates and disabled veterans to help keep them alive and help keep them Sustained until we can root out this corruption That is pretty much dominating the land That's over the soldiers home yet. We'll get into that corruption. But i i think the positive stuff just want to mention so when you go by this quote unquote veterans row. I went by. And this is when i met ryan been by a couple of times Just drops off because there there needs there. This is a very orderly clean setup. But you'll see a lot of people coming. A lot of los angeles folks are coming by dropping by everything food garbage bags which are always needed always in short supply to keep things clean They come by to help people with their laundry. All this kind of stuff but bigger than that somebody donated all of these high quality tents with these nice flags stitched onto the side. Who who did that. When did those go up. sure Originally the i would see either. I think there are approximately I'm gonna say approximately. I think there are approximately thirty tents. Their thirty ten men tents with american flags on them the first five of them which have since been replaced because they get whether pretty quick the first five were donated by a called judicial. Watch which is a right wing organization. That's if you think about the aclu which is kind of like the The political the liberal side of illegal advocacy firm the polar opposite of that would be judicial watch. They're they're conservative. You know conservative legal firm. There were some concerns about that. I mean while the appreciated You know it's something that we don't want to politicize and we don't want to create any partisanship because this issue is about veterans with disabilities Not about politics so since that point in time every tent including those five that have been replaced are coming from various members of local community and Veterans advocates disabled veterans advocates. So there are. I don't know the ten so far. Maybe coming from more than twenty you know residents in advocates. And if you don't know los angeles we're talking about brentwood california. and brentwood. Were brentwood the neighborhood in los angeles not to be confused with. Brentwood california in north bay. Area brentwood is a very nice. Part of la brentwood is multi multimillion dollar homes everywhere. It's very tony. It's very fancy and then now recently this group of unsheltered veterans and it isn't while there's a lot of people who are have big huge heart center super nice and are helping with. This isn't always going over well with everyone here. In brentwood who just aren't used to having the realities of life in some ways. Intrude upon their finely manicured lawns. You and some others have been working together to sort of advocate for these veterans here in the face of a bit of hostility. Is that correct. Yeah that's an understatement. You're loose-knit organization is national home for disabled volunteers. Coalition that right yeah just about. It's a national home for disabled volunteer. Soldiers coalition got it. Okay and you've been working as i see this is just. It's such a big story here. I'm trying to frame it correctly. But i just wish that this was that you guys could see this at pictures of these tents but it's right up against right up against a. I think it's wrought iron fence right behind the va property. This is a four hundred acre. Parcel am i right that these tend to read up against. Yeah so these are homeless veterans and they are against the fence of four hundred acres in the middle of heavily populated los angeles that is veterans administration property that was deeded to them. This is where this is where they are supposed to be living. Can you give a little bit of a of an overview the history of that property. Sure i'll try do as quick as i can. Because we're going to cover about Hundred thirty four years of history here but I'll give it a shot. So in the turn of the nineteenth century like eighteen eighty seven eight hundred eighty eight. There are approximately five wealthy. Landowning families. That own the land. That's all now West los angeles brentwood pacific palisades Santa monica venice These landowners Many of them are veterans. Who had served in wars One of them's a senator They're very wealthy but they have no economy on the land. So what they did was they. Each donated parts of you know a fraction of their landholdings where their borders jetted up against each other their their various holdings and it created a donation of contiguous parcel of approximately a thousand acres and then An annexed parcel over on the coast by the santa. Monica bay There was a smaller parcel and they donated this to the federal government to be held in a public trust to quote unquote permanently maintain as a home for disabled volunteer soldiers for veterans so the federal government In response by act of congress as public law accepted that donation and it wasn't just a donation of land it was also a donation of a significant amount of money. I think at the time is about one hundred thousand dollars as well as indefinite water rights. So all the water that's being pumped through to to that acreage. Right now is still provided by those deeds as of today. So what happen is now. You can imagine this. There's no There's no there are no cars. There's no internet. There's no tv and there's no you know both radio stations from public radio stations. Even so this word travelled so fast because like this existed in the country there had never been as far as i know Any sort of shelter and benefits not just for veterans but for any us citizen At the time. So there were Veterans who were hearing about this across the country Showing up and waiting for this place to be built and give you example There were approximately five hundred Disabled veterans in huntsville which is over napa county california. They heard about this and many of them walked. Now these guys had physical disabilities. They walked down to what is now west near west. Los angeles in brentwood and along with eight hundred other disabled veterans they pitched tents on the grounds As soon as they broke ground waiting for this place to be built and when it was constructed yeah and when it was constructed You know it's been. It was a somewhat of an architectural. Landmark is a beautiful victorian Township that is just for disabled veterans. As the first generations of these veterans began to heal in rehabilitate The best that they could given medical technology at the time but also given their peer support Of being with other disabled veterans. They began to move out of the home. And this is just within a couple of years. They begin to move out of the home and settle the land outside of the home. How did they do this well the way that they did. It is veterans. had pensions. So if there's a mailbox they could receive these checks anywhere in the country so so basically as they did this. They started purchasing subdivided plots of land from the donating landholders and dust started the economies of will city that they started outside of the home called sato which has now been annexed by los angeles is called west los angeles and they also started a town called west gate. Which is now the town that i live in of brentwood So that was the idea. It came from charity but also the donations We're also a smart business move by landowners could not otherwise develop their land so as it was a very symbiotic relationship. So am i hearing this right. That the brentwood area was founded by these veterans. That is correct Brentwood was co founded And mostly. The economy of brentwood was mostly kick. Started by disabled veterans and west los angeles was entirely created by disabled veterans. Wow and now here we are one hundred and fifty years later. And there's a notable element within brentwood. That just wants nothing to do with him. Zero gratitude zero sense of history. Let's let's move into that a little bit. Let's who set up the sides here so on one side we have all humans that are decent and these are with the veterans talked about the other side. Sure so And just to clarify to what we're talking about here is is A select few developers and business interests. Because there'd been a lot of wonderful business interest they're supporting this But the few that we're talking about here on the other side Are represented by what will call their proxy Which is something. Called the brentwood community council. The community is a private special interest nonprofit corporation however it poses to the community into the city of los angeles other than its government. It poses as a neighborhood council. But it's not it's not recognized as such at all the council claims to represent Thirty five thousand. Residents of brentwood of the businesses. Here in brentwood. All of the homeowners organizations and other nonprofit organizations here in brentwood. It doesn't represent any of them to give you an idea todd Is their last meeting here. On zoom couple of weeks ago they had. I was of seventeen people at the meeting and almost everyone on the meeting was a board member of this council. So what this council actually does and and it's been doing it for approximately twenty years or more is it's representing these illegal end users that are at the home and these developers trying to the entire home and trying to turn it into what's effectively. A downtown brentwood. Now this is the this is at least the third time. They've tried to do this. The last time they failed at it was around. Two thousand six two thousand eight. They've gotten a little more sophisticated in this latest attempt. Even though i think we are. They're nearing being foiled again And so what they do is they unduly influence local government officials. They do a ton of lobbying. They have an octopus of other. Nonprofits posing veterans charities that they have started up. They facilitate millions of dollars in lobbying to congress to the house veterans affairs committees. They allege sleigh shen That tries to criminalize the disabled homeless veterans. That are outside the gate. try get in They used their charities to control the application And the volume and the quantity of services provided on the side to effectively create a a runoff exodus of these disabled homeless veterans From the home so as you mentioned there's approximately four hundred acres remaining of the home in westlake. Va at the approximately four years ago. I think we had about a thousand to twelve hundred. Disabled veterans left. Residing there right now. I think we're looking at about one hundred or less and then by one thousand nine hundred seventy you had approximately five thousand living there. And what's interesting to note is at that peak nine hundred. Seventy even in nineteen eighty. You had no homeless populations in brentwood west los angeles or westwood. They just they just weren't there You know it was the veterans that were being evicted out of the home. They began to create our local homeless populations here. Wow so a minute ago. You said that you mentioned that this was an illegal occupation of the land. Was there a ruling or anything that gives him. History of how some of these business interests got their fingers and got a foothold In the va property. Because you said earlier. This property was deeded to be used specifically for veterans assistance. So how how did others to be using a letter asking that because this this is not a matter of Perception of my perception. That these are you know. Landgrabbers legal lingers That they actually are I'll give you a couple of many examples so In two thousand eleven when the public and the press and veterans started really realizing for the first time that These you know certain business interests were trying to take over and move in and steal land. there was a lawsuit filed called valentini vision second. The aclu represented These veteran plaintiffs. They're also a couple of other firms that moved into On the case. But on a result on august twenty ninth. Two thousand thirteen The ninth circuit federal court Rule judge otero ruled That basically most of these businesses that were attempting to steal the land Have null and void leases and any amendments there too. They were not compliant with the law. Illegal land use So this is a court order saying that You know they have no business there. They have to go And then one of them called the veteran's park conservancy Did not heed that order at all and just said we'll screw it. We're gonna do whatever we want. In the mid that order they started developing amphitheater concerts and stuff like that like a private amphitheater and the judge had to actually come back and issue a restraining order against them. I think about a year after that in two thousand fourteen. Now it's fast forward to September twenty eighth two thousand eighteen. You know two years ago. The office of the va inspector general Did not it and reaffirmed All of this and more saying that most of the land use over the entire home is not complying with public law. it's illegal. They were reaffirming. It two years later again In stating that You know veterans You know services. Aren't there other veterans. Aren't being represented that they you know appear to be absent from any discussions of planning It you'll which is legally mandated That is just a big mess and then you have much of the press to you know you can look at it from the right or the left. It doesn't matter the gamut of the press started covering this whether it be l. a. times or fox all stating that or recognizing that there's illegal land use their And that it's pushing out the veterans and their services and and to give you a couple of examples You know some of the largest legal end-users there are The brentwood school. Which is a private k through twelve school. They have two locations the location that they are illegally operating at the soldiers home. is for their middle school through high school setting. It's about seventh grade through twelfth grade It's about forty five thousand dollars a year to go to the school Everything that they have developed at the school Every p every square inch of it except for swimming pool that was donated to them. is built by about seventy million dollars of california tax payer. I bonds Which supposedly. I thought we're for needy. Schools not not schools making approximately fifty five million dollars a year in revenue. Now they have school folks. But i'm here. I'm hearing i'm hearing correct me that a private school was built with seventy seven million dollars tax money. That's not a political issue conservative progressive. Whatever you self identify as that just sounds crazy. It's utterly crazy and it was built on this land. So i'm just i'm just. This is interesting any so they had to get a permit. They had to get approval to build on veterans land. Who would have given that to them. How did that happen. What will originally. They actually didn't get in the approval. What they did is they lied I'm sure there are a lot of bribes involved. But nineteen seventy two they fabricated that they acquired Assert yo a small piece. let's i think maybe about two acres or something like that to to six acres of the soldiers homeland They and said that it was private land and that they did a transaction with a company called education partners that i think was around for two years or something like that that somehow owned this land and they got it from them and i pulled the The the documents the titles Of the transactions and in looking at it they do not present any deed whatsoever for the land not just from when it went from this education partners to rent with school but also from whoever owned it supposedly before education partners there to transcriptions stating that they had to transcribe the deeds. Because they're in such bad shape that they can't photocopy them or or or present them and what's ironic. Yeah and what's funny is if you look very closely the to transcriptions. There's several differences in the transcriptions. The transcriptions do not even jive with each other. So so that's how they got in right. They must've paid somebody off. Who was in shaina town man. You're it well you know it's funny you say china you know. One of the owners of the water rights is the santa. Monica waterland company. So you do have a little bit. No and there's actually a scene in chinatown where the jack nicholson character. That'll be you in. This case goes in and check out the d. transactions and notices that they're that they're Phony and forged. Yeah i just saw recently agenda secretary movie theater scene chinatown. Everybody forget the sequel. The original chinatowns incredible. That was cool movie scene while but it's a great film. Okay see if brentwood school you have marriott hotels you have bits and pieces of ucla twentieth century. Fox you have a number of folks. it's not. Just the brentwood school great number of properties on there so there was a ruling that that they had to vacate so but they're not vacating right. Are these like treasury secretary. Steve mnuchin for example his kids for now treasury secretary. His kids are their lot aleister. And there's nothing wrong with these people. These families for having their kids. The brentwood school. Anything about this. They're not but are they going to have to move. Yeah they're going to have to be visited Sooner than later yet and by the way just so you know When the court order hit on the twenty ninth it did say that you know that order was stayed for up to one hundred and eighty days so it's long since Pending on appeal in. And actually there wasn't appeal. But in fact the brentwood school. Ucla and the va. All abandoned. Their appeals and attempted interventions So so that order Many of the illegal and users that the judge you know reaffirmed where legal Left they did the right thing. So when you're talking about marriott sodexo running a a massive a laundry plant there for all their hotel local hotels laundry Fox i think was there at the time Fox know fox administrative building. There are a number of large illegal land users there And i believe some of them may not have even known it was illegal. They probably thought they entered into a legitimate lease day left. Yeah they they left. They didn't wait for they wouldn't wait for one hundred and eighty days. They didn't wait to hear anything about appeal. They realized what was going on there. They acted responsibly and they up and left. brentwood school and ucla and a parking lot company. That was doing a bunch of stuff. They pretended like they never even thought they instead what they did is they began to lobby. Millions of dollars to members of congress particularly members who sat and still sit on the house and senate veterans affairs subcommittees. They have no legal basis to remain at this land whatsoever but somehow they're not going years later because they're spending millions of dollars lobbying and one thing i did do because they're nonprofits right suburban schools nonprofit. I pulled their ninety tax return and can tell you that in fact not one single penny of these. Millions of dollars are reported on their nine hundred tax returns which is a felony crime So you know this has been notified to the irs As to what's happening with it. I don't know but that's what superpowers last time. You took your kid to A forty five thousand dollars a year private school. That's built was seventy million dollars of taxpayer money that spends millions of dollars lobbying congress. It's just very strange. Yeah it's been a minute. It's a great look in school. You know if would be difficult to move entire school. I'm sure so getting down to the folks remember. This is four hundred acres of prime real estate. If you're wondering why brentwood community council. Why these people would bother themselves with it. We're talking about billions with a b dollars of property value here billions of dollars enough. So it's a big deal. It's big enough deal where the human lives these. These veterans that are right in front of it are just easy to disregard. And they're easy to forget right. We just call them. Quote unquote homeless. And that's what. I want to talk about it a little bit here with you is you've worked with you. Spent time with these veterans. That are out there. You're out there all the time. What are you seeing. What are you seeing in terms of the type of people that are out there. Because if you look i wasn't gonna bring it up a little bit if you look at at Next door you guys all know next door right. It's this online sort of local neighborhood version of where they just sell you different ads mostly for real estate. There's a lot of vitriol on there. There's also a lot of love but there's too. I think any vitriol any anger any hate against any part of our citizenry is too much right. And so you see this on there and you see our our veterans. That are homeless being lumped into just really unsavory characters a lot of drug abusers criminals etc. Who are you seeing out there. Who are these actual humans. That are out there in front of the property. Yeah that's that's a good point. Two distinct by the way i just want to mention. You know what you're what you're mentioning here is is actually what got me involved. Because i'm not a veteran. I've never been involved Prior to this having anything to do with veterans I never thought a million years. I would be advocating for homeless people I got into this because of this next door that you're talking about because the the the biggest topic it seems on recurring basis since i first started noticing this little over two years ago. Our complaints about this one homeless encampment of homeless people. Right there at the soldiers home right outside of it and i began to notice this anomaly or pattern. Excuse me where on every thread. Suddenly somebody from the brentwood community council. Used to jump in and say. I think it's wonderful. You know many of you feel compassion for these people but you need to know that they're dangerous They're all drug users You know they're criminals and the best thing you can do is let our task force handle it or call the police. And here's the police number. You need to dial. And it was a strange pattern to notice You know. I i you know it was kind of busy and jumping around in my life but even so It did stick out to me and strike a chord and i started looking into it and and being began to figure this stuff out So if you were to take their word for it They originally said that you know. None of these Veterans our veterans That they are homeless by choice that they are all all drug users And that they many of them are criminals and many of them are mentally insane and totally unstable Just you know. I i have been out there many many times I have personally never once seen any drug use whatsoever. I would find it hard to believe that That there's none out there you know. Considering how many of us with with homes do drugs. I would imagine some of them do drugs to But i've never seen any of that use so it's not predominant but who these people are is every single one of which there are thirty one right now The camp fluctuates. Explain that in a second. But there's thirty one there right now as of today Every single one of them are veterans Actually i think every single one of them are disabled veterans. They're obviously all homeless Many of them have families. Many of them have children Many of them have had careers A technical careers a very respectable careers Many of them have paid a lot of taxes in their lives Many of them have had skills but are so physically disabled. They can't do them you know. They're they're many who are Former blue collar laborers like plumbers electricians stuff like that that you know i mean they can barely walk anymore Some of these folks are in wheelchairs. As i mentioned before some of them have Advanced stages of cancer kidney disease Problem most of them probably have ptsd Every single one of them is Confirmed for example The a disabled veteran advocate. That i work with name. Robert reynolds really Takes the charge and as the hands on a guy who is down there and really keeping that in camping together and helping to protect it Until folks get help the first thing that happens when a homeless person comes up and approaches the encampment is within twenty four hours. It is confirmed in fact whether or not there are a veteran. And if they're not a veteran they can't have them in the camp there because there is something that is very important. Among veterans to be within their peer group. When they're trying to rehabilitate And so that's another reason to why it's a veteran's cam and only So what happened over. Time is the brentwood community council. As as the facts started rolling in they have progressively revised their story without any remorse whatsoever. I was none of them are veterans to some of them are veterans. To half of them are veterans but many of the ones who are veterans were dishonorably discharged Two okay. they're all veterans but they're all drug addicts You know they. They had to keep conceding on their story and and now they just have kind of given up. They're not even trying to argue that point anymore but what. I'm trying to explain here. Is they lie and lie and lie and when they're caught it's a very serious lie right if you're telling if you're representing yourself as a some sort of leader organization in the community and you tell the entire community that you know and you go out there and you've been doing this quote unquote alridge and you have confirmed that these are all dangerous criminal drug addicts and none of them are veterans and then suddenly go like okay. Well half them are veterans. Okay well all of them are veterans. There's no sign of remorse at all. They can lie like this and just change the story and they could care less because they have an agenda and it's agenda. They've been at for a long time. And when you wanna get into. Why are they doing this. You cover a really great point here. Which is if this land were real estate. It would be the most valuable piece of contiguous real estate in the united states. It's not only almost four hundred acres of contiguous land it's also has air rights it also has indefinite water supply it also has its own utility systems About it and then. Of course it's nestled between some of the most expensive property in the country like the neighborhoods of brentwood and westwood and the neighborhood of bel air And it's close to mandeville canyon pacific palisades all that stuff but the other aspect of this is Of why they want it. So bad is because They're using public funds. They're they're stealing taxes to give you some examples that you know the federal taxpayers have been paying for the soldiers home for over one hundred thirty three years to operate. As a home for disabled soldiers and to provide them services and rehabilitate them that is almost existent at this point and the annual budget of the greater los angeles via healthcare system is approximately one point two billion dollars a year and the west olivier soldiers. Home is is Claiming most or the lion share of that annual budget. in addition to that there's You know you have the involvement of the county and the state government because a lot of the Tens of millions of. I'd say about one hundred million dollars at this point of proposition. H housing for the homeless development. Bonds have also been issued years ago to Supposedly developed develop housing for homeless veterans here and it's not being done either In fact on the documents in the city if you pull them it says actually that the housings going to be for multifamily an individual residential renters renters of low to moderate income. That doesn't sound like disabled homeless veterans to me so it's not just the land that they're trying to get here. It's also seventy five years of that land tax free management rights to it operating it as downtown brentwood on the dime of the federal and the local tax payer. Wow wow hey. I want to just be clear about one thing folks. If you're the brentwood area. I am not at all. Disparaging brentwood is not having heart for these people. In matter of fact it's what is why it's why we have in this podcast. Why ryan is here. I seen so much outpouring of love and attention and respect for these veterans. It's just a small minority. That i've seen like i said before any minorities is is too much when it is truly hateful towards the people in our communities that are having the hardest time line and you've heard a lot of things you've heard ryan say a lot of things about organizations Being dishonest et cetera. And i'll vouch for all of it. Because i have experienced the same experience that ryan has right. I have in requesting information in disseminating information in learning about what's going on here with this. Va property. I've been hounded right. I've been kicked off of next door several times for nothing other than sharing News articles about what's going on with the With this whole situation so it's clearly a sensitive thing it's clearly people have vested interest. And they clearly don't love having people shine any light on it you know to get in there and show what's going on in the shadows. This isn't some sort of conspiracy podcast episode all of a sudden that the super nice club has ventured into these weird territories. This is something that's happening. And i like to think of this as ryan as representative of somebody and there are many of them that are doing super nice things in this community right so i just wanna be clear about that. Brentwood is definitely fighting for these homeless veterans. It's just there's a lot of information out there. That isn't quite accurate. That is confusing a lot of folks because one thing that ryan said and this is really confusing is there's a lot of these sort of nonprofits that are being set up with words like veteran disabled homeless in the title of them. So you look like they look on paper. They look on new on the web when you're looking at what they're doing like they're trying to help but in actuality they're they're part of the problem and so can be really confusing. I think everything. I just said was really confusing. But if you're a long-time listener used to that so it's okay and Just just to embellish on that It's it's critical That what you're saying here. is good Because if it was not for What appears to be a majority of Of residents and businesses It here in brentwood neighborhood. Los angeles Making these donations providing all these homeless veterans. Their food Their tents their sanitation services. Just residents of brentwood and and also members of a of a Congressionally chartered veteran service. Organization are paying for four bathrooms. A forty foot dumpster and sanitary stations For this encampment. This this this encampment in a time of covid nineteen would have no sanitation services If it were not for Year veteran advocates and the residents and businesses brentwood. There have been several fundraisers that local businesses Here in brentwood on sandwich. Any boulevard have have done put together there been restaurants and restaurants and dance studios and a collection of businesses. They came together in one here all cooking dinner and then we can have it at my place and then all invite everybody at you know they come together and put together to try to you. Know literally save these people's lives long enough for them to get what our taxes are paying for them to receive that they need. You know when when you go into the military You know what a liberal so this again. I have no background in Being in the service or or being you know very heavily involved with military or veterans issues. But what. I do know Is that military. Veterans are not members of the state department. They don't they don't Plan foreign policy. And every one of these folks that i speak to You know they go into the service because They feel That it's what they think or know that they can do To to support their country and a chip it beyond that they don't make any money doing it the pay for risking your life in another country and going to war is is pretty crappy And a lot of times when they come back. They have very very significant disabilities so You know again. It's a huge. Thank you to the businesses. And residents of veterans in brentwood is very important. Understand that Going to the charities that you're talking about. I want interject with one thing here. I'll give you an example You know there's a board member or will now. She's a former board member of the brian community council. Although her son i think is still on the board and created one of these tentacles nonprofits of the brahmin community council called the village for vets and village for vets says. It's a veterans charity. Two feet veterans. Now they're not feeding any of these veterans out of this and cam and when they started out. The extent of their feeding veterans was like every super bowl sunday they would go and and provide some pizzas in a room into a photo op. That began to change. Because the real story is this former. Bcc board member who owns this village vets nonprofit. She's the owner of two commercial retail buildings across the street from this illegal parking lot operation in her buildings have no parking so that would be violation of city code and she's done renovations to these buildings in the past. They don't have one parking spot so now think about this. If if she was cited for these violations for not developing parking at our buildings which is required by law under the municipal code she would have to incur large expenses. Redeveloping doing construction and building this parking and would of course eat into her rentable footprint of Suites in these buildings. So how is she been getting by was been getting by by relying on the illegal parking lot operation at the soldiers home directly across the street from her buildings and the first operator of those parking. Lots of gaining richard scott and his company was called westside services and westside services was one of the companies that was Ordered by the judge in two thousand thirteen to have in void. Least any amendments there too but didn't leave when looking at the minutes of some of these organizations. Such as the brentwood village. Business improvement district. We start to notice that they're saying things like you know. Hey what are we gonna do. You know they're worried about these parking lots Going away not having access to them anymore and so they said maybe we can give some money you know. Why don't we start making donations to richard scott and he can get them to the right people at the va. So here's the question. Why does it make sense to make donations to a parking business to get that money to people at the. Va and where it starts. Making sense is in the fall of two thousand eighteen. Richard scott was arrested by the fbi along with the former west. Va contract officer. That made a lot of these. Dirty deals names. Ralph tillman because he had bribed him for approximately three to four hundred thousand dollars. They were both convicted. Richard scott is sitting in prison because they were running and approximately fourteen million dollar land fraud at the soldiers home using that parking lot operation that starts to make sense to me now as to what they meant by making donations to richard scott and he would get them to the right people at the. Va so so. This is an example of of these charities that they create that they pretend our veterans charities but the real objective is to control the land and make sure that veterans can't use it and since that conviction what has happened is a new illegal lease has been made with a new parking lot. Operator and two village vets created a public interest company. I forget what's called a special form of company in california. that's not a nonprofit. Not not exactly like a nonprofit and created this company with the new parking lot company so they could share bank account and she kept the company open for about eight months and then shut it down right so she. She starts at this company so she could have a bank account with this new parking lot. Operator yoshi they share bank account. She throws some money in there and then she shuts down You know. I think we need to look at that and see that the next round of bribes. Now what do you say. A new illegal lease been deemed illegal by anyone or is that just a. You're surmising is much. That is in fact in an illegal lease. and and here's why the the public law states Currently that one of those two laws would be the west. Los angeles leasing act of two thousand sixteen as amended by the two thousand eighteen expiring authorities act of department veterans affairs Section three. oh three so. When the inspector general in september twentieth two thousand eighteen found all of this illegal land-use to be still at the west los angeles. Va and this mismanagement by law. When the inspector general dozen fact find that it immediately bars the va from entering into any new land. Use agreements at the soldiers home. So every land use agreement that has been entered into since that date is also illegal And the only way that that can be resolved is if the recommendations that the inspector general makes during the data audit on september twenty eighth. They all have to be satisfied. And there's a very specific requirements expressly stated or mandated in the law. That they have to that they have to go through procedurally to satisfy those recommendations none of those recommendations have been satisfied in the slightest nothing at all they basically just have ignored it and kept entering until these legal deals. Let me ask you this. You said earlier that being on next door and reading about this kind of got you into the fight to get into a fight like this. You have to be someone who will get into fights like this. What's your story. What's your background before you got into this. You know what. What is your passion. Been about well from a from a career standpoint You know. I have a small production company that focuses on visual effects production for commercials and a little bit of films so from a business standpoint. I have no relevancy to this at all. But there have been experiences in my that i would say In hindsight must have some sort of contribution to this You know the earliest one is is. I'm born and raised here. And i do remember you know when i was at at this park as a kid. I used to go there all the time even through my teenage years but on one particular day when i was about Three or four years old with my tonka trucks in the sand per called westwood park Which i have since learned used to be part of the soldiers home that was turned into a public park There were all of these guys that started showing up with lake. Green pants and Duffle bags slung around their arms and starting to just sit on a bench. Sit on some grass somewhere and just kind of setting up and these were folks. That just didn't look like Or seem like the rest of you know my neighbors. They were my neighbors though but And they ended up staying there. They ended up staying there as long as they could For several years some of them. And i remember asking my mom. You know who. Who are these people mom. And she just looked at me and she said there veterans. I thought you know why. Why why are they. How are they veterans. Why why are they having a home. Were they here. it's interesting. I never really looked into that. It's a it's a memory that i remember so clearly but i never really looked into hit Maybe something just in the subconscious. There that now i look back and i think god you know there must be some sort of of route in that the but beyond that i i have been interested. Just in my personal life in social issues and Especially in foreign policy. And i've been an avid reader of You know various journals and stuff like that so you know. I i have advocacy in my heart but from a business standpoint from from skill set experience standpoint It's all new to me but you know there is some sort of a a basis therefore i guess personally. Have you been finding it all when you jump into this. Type of active as an ak- quickly become consuming. It can to it and you can take on a lot of anxiety a lot of stress a lot of pressure. Have you found it a challenge to balance your before you got into the fight life with your with your activism yeah it. It's overwhelming not overwhelming to the point. In fact a lot of it re inspires me but it can be overwhelming too. You know. I don't. I don't get into this a lot but you know ever since this advocacy hit a certain point about a year ago. You know i have various i. I live in a very quiet neighborhood. Very small neighborhood. There's no retail around here at all. You know. I have folks that pull up in front of my place. And they sit in their cars all day long in shifts. You know a few hours at a time. It gets to the point where i walk out and go pay. What are you doing here. What's going on the same people will just sit and watch and survey You know. I've had to call police on them at times happens not just in the afternoon but it also happens you know in the middle of the night somebody pull up and park and stay there from three to six. Am my kids will go outside at. My kids are ten ten and eight nine eight. They will go outside and say oh dad. The people watching us again so that gets annoying. What i will say though is it's probably not as annoying as what the brentwood community council has been doing lately. They are calling up donors when they find like the people are cooking food for veterans or that they've been donating tens or doing this stuff they're constantly looking for these donors and they call them up and they threaten them literally. They say you have to stop feeding them. You have to stop doing this. You have to stop providing them bathrooms you have to stop providing them trash dumpsters or we're gonna make sure that you're going to be cited for code or you're going to be in a lot of trouble. These are disgusting people in mind. Okay so i'm just. This is incredible sort of information. But i'm just to just to be fair and to be as neutral friendly and gentle as i can be about this when when i hear from you that there are people sitting in front of your car and shifts and things like that. That's the stuff of motion pictures in and the type of suffer. Somebody might say you know. He being super paranoid. You get that right. You must get this from people like man ryan. That's nuts. you know the only ironically the nuts saying you know what. I'm about to validate you in many aspects of but maybe not in the same way but i point out. 'cause i've never thought about this before until now in terms of who has said this it's interesting the only folks who have asserted that you know. I'm i'm out of order or a conspiracy. Theorist are the members of the borough community council. They're the only ones i know of so far. Now that doesn't mean people might not privately go man that guy's abbas mind but no one has worried more about that misperception than me and because of that That is exactly why. I am so diligent. It's exactly why maintain a database online of about seventy or eighty gigabytes now of evidence of official documents. When i write briefs when i informed people i always know that whatever i write that would put out. There is going to be heavily. Scrutinized that there's a lot of money that's going to be behind trying to blow it away and you know that i could be attracting Militias prosecution of civil lawsuits. So all the time. When i put out briefs and information to the public i thoroughly site everything you know. I i provide hypertext links to all of the evidence. Sometimes every few sentences You know i. I have to go through a very laborious process a lot of times. If i want to write a three page letter. That letter might take me eight hours. Because i have to throw so many citations in it and in fact check everything and make sure it's true so what i will say is i think it depends on what point in time if we were talking about a year and a half ago. Maybe you're ago. My guess is you may have found. Many people could have thought even say it. Many many people in the community may have thought. That's impossible this this guy's not telling the truth or he's just paranoid Nowadays i don't think that's the case there are so many people here that have realized this And a case in point here. That i'm glad i remembered to say this. I'm not saying anything new You know. I guess you know. Because i don't get much out of this. I wish i could take some credit. Say i discovered this. But but actually. I didn't i'm i'm a mouthpiece One of one of many mouthpieces you know the first of all the la times gail holland at the la times A writer daily times. She's covered this thoroughly in probably twenty articles. I wish he was still writing articles like these but she was covering this cartel. This you know this racket over at the soldiers home over the course of approximately two years on a regular basis. Obviously the court order from the ninth circuit says it you know. The inspector general has written multi hundred pages reports affirming. Most of everything. I'm saying here so this is nothing new. But you know when when you're talking about the surveillance look the inspector general's recently written reports about significant retaliation from folks just for calling the whistleblower at the. Va you know. But even the surveillance just see. No todd i document everything. I keep videos of it all I file law enforcement reports and stuff like that It's really creepy. It's really not And i try to stay light hearted about it and laugh about it. Because i don't think too deeply about it. I only brought it up. Because i wanted to be somewhat fair and also because i just know what it sounds like and yet if we go through and i'm usually kinda the anti conspiracy theory guy i battle with conspiracy theorists. Say come on. Let's just look at the facts here but in this case if you look at the vaccine you look at the documents just here in the united states. We have a deep history. One that is of surveilling our own citizens from hoover on up and he and even before hoover we surveillance citizens and when you have a billion billion billion multibillion dollar property on the line here. It doesn't really sound like something that couldn't happen and wouldn't happen. I mean i'm just the guy from the super nice club right. I don't have any stake in this. And yet i have gotten things in my mailbox. That were fake child handwriting. Just weird creepy stuff. Letters without return addresses have gotten several. Since this whole thing started at my home address. Their creepy there are weird. I i took photos of them. I actually was so kind of creeped out by them. That i wouldn't touch them with my hands so you can. Also you suddenly become afraid of this like is there. Is there rice in on their something. Start thinking of all the the movies that you've seen so it is a really strange thing. And i know if you guys and gals out there rolling all your is. I'm going to bring this around something. That is even weirder because this property is. Va property has a long rich incredible history of weird. Okay i'm gonna have ryan just kind of cover. What's my favorite one. Let me think the ucla body parts swapping it was happening there talking about that. That's weird and it's real and you can go online and check this stuff out you guys. Okay Yeah that is. That is a pretty creepy one Now just you know. yeah. I'm not saying it's that it didn't happen at the westlake. Va i. I would. I would imagine it probably was involved. But as far as the record goes Indeed there was a body parts scandal With ucla but it was primarily with an operation that they had on campus there But what was going on is it was found that over one or two decades That there were research companies. I think. Johnson and johnson was one of them. You know the research arm of their corporation You know other other big pharmaceutical medical device manufacturers that can stuff their research arms. Were basically paying middlemen for body parts from the donor programs. Ucla a lot of people don't know this but the ucla created the first body donation program a to exist in america and the way that their program was and maybe still is set up. Is that if you donate a body. You're you're getting a written agreement stating that you are donating for the medical school For You know for medical research by the school And in return you would get a cremation services Earn and they. Would you know they would provide the remains back to you. I think within a certain amount of time when it started happening is is a lot of next of kin. Were suspecting that they weren't receiving their family back in the earns because they started seeing parts of pieces of inorganic material in the earns like maybe remnants of plastic or metal or whatever more evidence started showing up over time in a lawsuit was filed and it was kind of mysteriously thrown out as fast as it came into the court by the federal by the state judge at the time state as an university of california state so the there were still people out there though who had been participating in the program as next of kin that remained concerned and it eventually attracted the attention of a investigator employed by ucla woman who was a criminal investigator. There are no she still is and she decided that she was going to investigate it. but not tell anybody which i believe. She actually had a legal right to do that. So it she discovers In pursuing this investigation that these companies are ordering body parts and these middlemen are going in. I am not kidding. You with duffle bags And and tools like hacksaw saws and they're going into these medical could ever programs and they're sawing off arms or you know pulling out oregon's chopping off hands fingers feet whatever and throwing them in a bag and and paying cash to the head of the program and and this operation was very robust and going on for a long time now of course. Ucla is denying it the entire time. You're addie your f ing mind to think this. We could actually be doing this but sure. Enough Several years ago it goes back to court. And the whole thing's blown over busted proven. Several people are convicted. It's a fact. Los angeles times article. Two thousand nine folks just to make sure this is real. La county prosecutors said ernst nelson fifty one cut heads torsos and other parts from donated corpses and sold them without ucla's permission to medical and pharmaceutical research companies. Collecting one point five million dollars between nineteen ninety nine and two thousand and three now. So that's real. This is something that happened whether or not. Ucla had knowledge of it or not. That's a whole different conversation. Unfortunately what you said a moment ago before he got into your description was ab. It didn't happen at the property. So cool story bro. But doesn't really relate but i'm still glad we told it because it's crazy. So what are they doing there now is ucla doing some some sort of experimental work with e homeless. That's indeed it and it. There is actually still some relevancy though with what you're saying. The body part program saw troop together so between the fifty s and the late eighties primarily under the supervision of dr louis. Jolyon west Who's the head of the ucla. Psychiatry department over that entire time. And who's Know main office over that entire time along with the office of his wife We're at the west lady. A lot of people are are learning. Actually who what lewis jillian wests. Other job was Since i think it's tom o'neil published a book of few decades of research. He was doing but it has since been confirmed that that jolly west they used to calm. was also with sidney gottlieb the the co founder of the ultra project and all of these other experiments having to do with I guess thought control for lack of better term anyhow. I'll jump in here folks just to give you guys if you're not familiar with project m. k. Ultra is something that has been associated for a long time with wild conspiracy theories. But it's actually. This is all material now. There's declassified m. k. Ultra documents you can find online. It was the cia mind control program that was the codename. It was a series of experiments on human subjects that were designed by the cia. Some of which were illegal they were experiments on humans intended to identify and develop drugs and procedures used in interogations. Right and get confessions through my control and some of this was hypnosis sensory deprivation sexual abuse psychoactive drugs. Especially lsd right. So this mk. Ultra project is something that actually happened. A lot of people familiar with it. But if you're not it's fascinating dark scary stuff and actually just like the iran contra scandal in the in the mid eighty s The head of the cia And some other officials did have to testify under oath to congress in televised hearings where they acknowledged In full detail the existence the programs before they were supposedly promptly shut down so yeah it is a public record. Your your indeed correct anyway. So we've we've recently learned you know and it has been affirmed that lewis chilean west was the co founder of a lot of this research but what his day job was or what his cover was or what he was really doing. Also is he's the head or the chief of the psychiatry department at ucla. His offices at the west la va and he also created a a lot of these homeless. A programs for homeless veterans. So there are two types of research that has been going on for three types of research that has been going on. The first type was extensive research into the effects of nuclear radiation on human tissue and that was done by ucla in conjunction or for the department of energy primarily between the fifties the the late fifties and the late eighties. I mean it was kind of tapering off. I think by the by the late seventy s. But i think it went into late eighties So what was happening there is. They were basically blasting veterans children in animals with radiation sometimes radiation was administered orally intravenously or through You know gamma radiation radiation waves and place on that property. Yes on a regular basis so there are buildings there. There are buildings there. There's at least one building there that still remains that. Has you know walls. I forget how thick they are but walls made of lead Behind the regular walls because the because the researchers were concerned about getting radiation poisoning now the subjects that they were blasting more concerned about themselves so anyway the reason that the lid blew over on that primarily you know there's a congressional committee formed to look into it and they produced multi hundred pages of reports confirming it and describing the experiments and what had happened. but what really tipped it off. is is a guy named dennis odell who was a former police chief. There who became a federal criminal investigator these federal criminal investigators. I don't think position exists anymore. But they had powers the same type of law enforcement powers as the fbi do arrests they. Could you know be armed. They could do investigations. And they had a lot of their own independence in terms of conducting those investigations. I've actually done about six hours of interviews with mr odell and about the details of his discoveries. there in what had happened is in the eighties. He had begun to notice because he was stationed at the west via soldiers on he begun to notice. These vans that we're going in and out of the soldiers home and You know they'd be stopping at buildings that he some buildings he knew that. Ucla was occupying some buildings. He didn't think anybody was occupying. But he kept seeing these van showing up and then he started to notice that the people being taped taken out of these vans appeared to be homeless and then when they would leave he said to on a particular pretty regular basis when they walk out. Sometimes they would walk out days or weeks later and that they looked in terms of their their demeanor that they're their personalities. They seemed different and that they were. They would always walk out on their own. They allows him. They wouldn't be escorted back out so he began to accept these folks. You know when they were almost outside and kind of away from the buildings and then he would bring them into his office or station or whatever. It was an started taking statements and he had told me and i buy. We can provide a lot of this material for you if you if you guys are running here at They they were telling him that you know that they had been part of some research or something like that But he said a lot of times they were so veg doubt like he could barely get anything sensible out of them And when he was running background checks he also started realized that many of them were homeless disabled veterans but also many of them were not veterans. But just no other homeless people in the l. a. area so dennis has a you know at the time. He has a key to all the buildings there and he can go in any of them at any time so he started going in the buildings and started to see apparatus of planting electrodes and people You know people there with like shit stuff planted a connected to their heads and lots of laboratory equipment documents so he began to start obtaining copies of this documentation borrowing stuff in returning in the middle of the night. He started to collect samples From some of this equipment and he also began to notice that this was involving some sort of nuclear medicine And a radio station. There's a discovery of a cyclotron You know one of these buildings and it was appearing to him as if some of the byproducts of these experiments were not being properly disposed of. In addition to that he was doing surveillance he started setting up. Now these are film cameras because they don't have even dvd video at the time he is surveilling With several film cameras from windows of various buildings around these soldiers home. Documenting these vans in this in this situation so once he and then one of the last things he does is he starts bringing in Teams in the middle of the night and doing core samples and testing the water in the water mains at all throughout the the land there and Confirming that there was nuclear radioactive. Waste that he was suspecting was coming from the byproducts of these experiments so he ends up taking boxes of evidence many boxes of evidence and then finally publicising his findings in his investigations in one day By the way i would. I wish she was still like this one day. Maxine waters shows up at his office. And says you know. get up. grab your keys. Let's take a look at this and she just starts having him open up in the middle of the day You know these these research facilities and she's you know seeing what's going on and then she brings it to the attention of congress and One thing leads to another a lot of this research get suspended unfortunately temporarily lot of heavily publicized by the la. Times and dennis odell is recognized on the floor of congress for his Instigations yet so the result of this is if you look at an aerial or even google map of the west nile. Va soldiers home. And you look at the western edge of it Kind of in the middle. You see a big brown strip That looks like a like kind of like a an arroyo area. And it's i'd say approximately twenty or thirty acres. It's all brown. It just looks like chemically burnt vegetation and that is where most of these byproducts have been dumped in. The land is totally unusable in. It has since been recognized by the va and the federal government in a programmatic environmental impact. Study that it is not safe for human use that land. It is so badly destroyed. in fact. by the by products of these experiments experiments. That are now happening that we know about this. This was what years with these. When did this if when did this. When was this maxine waters. Sort of expanded out. Yeah i think that was around. Nineteen ninety eighty nine in provides you the docs on that. Yeah this thirty years later. We have sort of a new version of that. Yeah this this one's unfortunate to oh and by the way sorry just went. Interject a tunnel bottoms. That ucla was doing two tons and tons lobotomies on and a lot of people. Don't know this but one flew over. The cuckoo's nest was shot at the westlake soldiers home. And just you know there are folks that were working There still are today back then and they were they. Tell me how you know they would be sitting around. Someone can go. oh shit. We forgot they're going to be shooting in this building. And we have a bunch of stuff in there you gotta get out and they would have to go before the camera crews would arrive and get out literally harmful byproducts and and equipment that had been left behind for several years because they've forgotten who is there and the production crew was coming to shoot one flew over cuckoo's nest that day so another another. Jack nicholson reference. Exactly exactly the shiny precedes honor. Have something really disturbing happening out there. Right now yeah okay. So one day i guess maybe last january around i had forgotten to inquire with many of the disabled veterans almost veterans I speak to. i'd always meant to ask about. Hey do you know about any. Ucla research going on you know because it was so prominent and a lot of it was busted. I'm not talking about research and general jeff but bad research and I thought she. I never asked anybody before. So the first time the first guy ask said hey by the way. Do you know anything about any. Ucla research going around. You know anything like that and the guy says you mean the math research and i can tell you all about it. I said what meth research guy basically explained to me. Yeah you know so we go and show up at your one of many places usually in westwood and You know we go to some lab at ucla or whatever and as long as we show up high on meth. They'll put something in her arm and they do like some scan of her head and they ask us questions You know sometimes it's a couple of hours. Sometimes we might stay there for a couple of days and then we get like a thousand to three thousand dollars when we leave so to be sure. We all understand what we're talking about here. Is these guys. Some of these guys said they could go and if they could find crystal meth illegally on the street and buy it and hop themselves up on and show up at this lab and they would be tested to ensure that there high on illegal crystal methamphetamine that they could be paid one to three thousand dollars and they can do it multiple times and they would just have to get something in their arm and something on their head and asir questions so i thought holy fuck So some of these folks took recorded statements of you know an actually others received recorded statements of them to. We've been protecting their identities. Although we have turned scribe some of those statements and we have made declarations under sworn oath to department of health and human services to the. Va office research into ucla Those declarations are publicly available. They started to tell me. Hey i'll tell you what i said. Well how do you. How did you find out about these this research. They're like oh man you know they'll they'll send some girls by you know some girls and they'll hand has flyers. That's how we all found out about it. I said well. What are the flyers. Say they said oh. Yeah no hey. Do you do math if you do. Just call this number show up here and you could make up to a thousand bucks or more so i thought this is nuts. So they said look next time. We see something like this will show you. I said okay. So one One night you know about a month or two later. I get a call and then i got a text message of one of flyers and indeed. It says exactly what they're saying. So i'm thinking about it for a while and i can't sleep. This is just boggling. My mind and then around five in the morning. I e mail the publicly provided email address of the head of this entire study. Her name is edith de london. And she's over with the the brain research using lebron research institute geffen school of medicine. And you know. There's so many things i want to say. I was sure how to approach this. It was blowing my mind. And so i just said what is the point. What is the point of paying disabled homeless veterans to do methamphetamine. Or something like that. Doesn't it just perpetuate homelessness and she responds to me. And by the way she responds to me i think within about twenty minutes so she was up at that time to and she responds to me. we never do any research on homeless people or veterans. You know we don't do that at all. I'm not sure what you're talking about. So this email conversation ends up going back and forth throughout the through the late morning and you know every time she replies. I begin to kind of reveal another known fact that has been discovered. So you know after that. I you know it was kind of i said well. I have statements from disabled homes veterans. Who were saying that we are running this program that's doing xyz and then she would rebuff that. And then i would respond saying hey. Is this your flyer. And so finally. At a certain point she responds by saying well. Maybe we need to change some of our practices or something like that. And then okay. That's good enough for this discussion. And then at that point. I started now that i knew who these researchers are some about this research. I started really digging deep in pulling a lot of the studies that primarily that she had been doing for a long time and to give you an example and this is what most of these studies are like. But i'm gonna tell you just one of them. In one of the studies. They bring in tests human test subjects. They have to be on crystal methamphetamine. The first thing they do is this is. This is a public study. These are journals that you can read k they They test them to ensure that the crystal methamphetamine and ensure that they're addicted to it in terms of a battery of questions and then they created a custom second life virtual reality environment of a meth house. That had yes and they made it look like a cool meth house. Like it's a party you know there's chicks there and and you know there's videos going and and everyone's like having good time doing meth. And then they also had props of like matt glass pipes and paraphernalia and when they're hopped up on meth. They would put them under a a pet scanner for their brain. That would run for hours at a time and they would shoot them up intravenously with valley pride which is a nuclear radioactive tracer so the pet scanner could identified the neurological activity of what was happening while they're a methamphetamine and then they would have them They would also add points. Have vr headsets on and be in this second life vr environment and they would get to hold the paraphernalia in their hands and they would be asked questions. I'm not kidding you. The questions are published in the actual studies. Like how good does it feel to be on meth right now. Do you want more meth right now. Don't you love math. I i mean. I am being entirely serious and truthful here you can pull these studies right now. Yeah this is interesting so it's also very it. Sounds like very much in alignment with with what they were doing the k. Ultra my my research team. Just put a sheet under my nose. Thanks supermax research team. Love you guys. She's an interesting woman. Edith de london. She is director of ucla laboratory of molecular pharmacology at the david. Geffen school of medicine university at ucla. Check this out. She has been up to some stuff that has rubbed people the wrong way. And i am not at all. Validating has happened to her. But check this out or saying that it's okay. Her house in beverly hills. California was vandalized in two thousand seven in an act credited to an animal activist group animal liberation front. They broke a window of the house inserted a garden hose which flooded the home causing fifty thousand dollars worth of damage subsequently. And this is scary. This is not okay to do to somebody. Her house was again attacked and damaged by a firebomb left at the front door in february. Two thousand and eight known as home with time. A statement issued by the north american animal liberation press office claimed the animal liberationists were responsible for placing the device now. Most brain researchers do not get attacked multiple times. This edith de london is definitely do instant interesting. She's up to some interesting stuff. I'm not going to say no good because there's probably good that comes out of a research it's just a matter of you know to the ends justify the means right edith. If you're out there would like to be on the nice work podcasts. Come on in. i would love to talk. You sound fascinating yet. you know one way. Todd that I became aware of that. is because Another advocate that. I work with who is also research researching this At the same time got a call from the ucla police department and they had said. Hey you know we're contacting you because we There's A complaint filed by A researcher here You know she's just concerned for her safety Because you had contacted her asking about research now this guy you know we had to take all this evidence and and show. All this guy did was contact her saying. I want to know what's going on with this research. That was it so it was all worked out an and and and you know the the the ucla pd was not you know They weren't acting very suspicious. It was more of a formality. The way they were it. They were very cordial and professional But there is nothing You know in fact. The only time i've ever spoken with heated. London was the bills i told you about. I've never talked to her since but anyway no excuse me. I talked to a one more time. I did let her come. I said look. I heard that you have filed a police report or something like that. What you see pd You know there's nothing wrong with us enquiring about this We wouldn't do anything to you. but i have learned since in reading up on you. You know that you've had issues in the past so just see know. You won't be hearing from us anymore. but we will be continuing to research this and publishing whatever facts that we find. So as i would imagine that she would be she would be very suspect of anyone after being firebombed i but there's another side signicast side of this though She is not what i would call. You know ms scared innocent On the other side of this there are a couple of other animal research activist groups a two of them. I've spoken with the heads of both of them At great length. They've actually provide a lot of information one of them was holding demonstrations in advocating against London her outfit for all this animal. Vivisection that still goes on But not as much as she used to do it And then another one was advocating against a two and a separate organization and london and ucla Maliciously prosecuted One of them and went after them and tried to basically bankrupt them and and you know threaten them with losing their career in their jobs in sustenance. Whatever the judge in the case not only throughout london in. Ucla's case but also would you say found that it was basically a militias prosecutor was preemptive. That was Just intending to censor and defraud them. Basically and so so actually. The defendant ended up getting an award in the case because the judge it was so obvious to the judge that they were doing this as a tactic. Retaliatory tactic against them so You know i think it's terrible Nobody should be subject. No matter what's going on you know breaking the law is not the way to deal with someone who's broken the law. With that said edith research continues to break but not only that they obviously are retaliating in the recent past against folks to who are just trying to put out the truth okay. So let's let's wrap this up. This is kind of mind blowing here. We have this this via property that is wildly valuable. It's supposed to belong to veterans instead. They're sleeping intense donated by the good citizens of brentwood right in front of it. It has a history of wildness. Animal vivisection m. k. Ultra of lsd experimentation meth to vets body parts swapping simply don't know for sure because it sounds great quick. Okay the only thing that can put in there about that is there is one building there Which is a brain bank. That ucla runs if you fill out a pdf form if are restricted. There's a bank brand. Yeah yeah so. There's i guess you could you. Could maybe say that somehow related. But i can we tour this property somehow ryan. Is there any way for the public to get in there. Well yeah there's a lot of aerial photography of it. I've been toured through it many times. I i'm sure that could be raised one way or another You know it's gonna be through a veteran. I'm just saying the super nightclub needs to put a headquarters there can we. Can we get an illegal lease. Think you can look that up. I'll talk to the brentwood community council. See if they can hook me up with the lease for the super nice club. Hey so the way we wrap these podcasts. Is we flip it over real quick to the guest to do two things. The first is issue a super nice challenge which is just something that the super nice club members and listeners. And if you're listening to this podcast that means you got jumped into the super nice club. You're now number. Welcome aboard making the world. Ten percent nicer. That's what we're all here for. Do you have a challenge for the people out there. Something they can do to make their world a little bit better absolutely. And i think it's actually a very easy challenge to accomplish and at an end amidst how easy it may be to accomplish. I cannot even express in words how helpful it will be. Everyone can do one or two of two things one. If you if anyone out there is interested in seeing the facts on this and in seeing the actual evidence in the official government documents corroborating all of this. I can be emailed it. Our t. at n. h. d. v. s. dot net rta nhc db s dot net. The second one Is you can tell to people to watch this podcast so much advocacy comes from word of mouth so much of the help i mean. It is incredible. What's been accomplished in just one year. And all of it comes from people becoming aware of what's going on so if anyone listening here if everyone listening here can talk to just two people and have them. Listen to this podcast or ask for information about this That would be a challenge. I don't think it's too hard to accomplish. And i can't even explain how helpful it would be. Okay challenge accepted. I will talk to at least two people definitely and the rest of you out there. If if you're finding value in this podcast this is a wild and woolly episode of nice work. It's definitely veering off our usual rails into some important territory in that a lot of the things that aren't super nice in our world. Well there's a reason why they are and it's not always completely transparent right and sometimes can seem a little ridiculous like no. That would never happen in my backyard. sometimes it does and sometimes it's. It's pretty complicated. So thank you ryan for for shedding a little bit of light on this. Do you have. This is the final part. This is the fun. This is the part that i get excited about. Because i never know what's coming. Do you have a question for me. Well what inspired you to get involved with us. And i don't mean. I don't mean just this subject but what inspired you to start the super nice club. Well i'm gonna stick to justice. Subject is what i'm gonna do. Because i've covered the super nice club one quite a bit. And if you don't know why started the super nice club. Listen to some other podcasts. In their promise. But i'm really interested in what's going on right here right now wants me to do. This was impart definitely you. It was moving down here to brentwood and trying to figure out what i knew neighborhood. All about it's really cool. It's pretty there's good eats and then covid hit. And i could no longer explore it at all. You know i know l. a. pretty well been working out of here for for twenty years even though as living up north so then i turn to next door because that's sort of the surrogate that we all have right now right to figure out what's going on in your local community and wow like i said earlier in this in this episode there was just a lot of ugliness and it was also a lot of beauty was also a lot of people helping out and so i saw those tents and the super nice club has an ongoing programme. If anybody's interested in getting involved with that just let me know it's called humans. Live here and humans live here. It's just that simple idea that if you see the sign if you see those words in front of an unsheltered persons encampment whatever. It may be whether it's just a sleeping bag or a tent or some other rough shelter. these humans. these are individuals. These are you know you've heard it many times with these are our brothers and sisters and mothers and fathers and children and former co workers and veterans is your human beings and instead they off classified with derogatory labels like drug users. Felons convicts homeless miscreants you name it right. There is a pejorative term there so many for them and so the super nightclub here idea was have those signs. Be out the reminding folks but also put the in your yard if you're lucky enough if you're blessed enough to have a steady home put that sign in your yard. It'll remind people that can activity connective thread on both sides. So diving into all of that is what led me to the conversations with you you know. Uncovering like wow. Who are the players here. Who is who are the ones that are consistently opposed to the very presence of these homeless veterans and then finding out who those people were you know. it's been pretty eye opening in it. I really did seem kind of like a conspiracy stuff. It seemed like oh you know. These are some species. Claims may maybe being made and these are just. Yeah there's some kind of greedy pro business above human dignity folks but there's some percentage of those in any community wherever you go and the more i started dig the more i realized that it was there was more going on right and so again. Thanks to you for forgiving me a lot of the information. But i've also done a lot of my own research outside of you and like you said. There are a lot of articles in los angeles times. There's media coverage there's all kinds of stuff are you. Are you liberty at all to talk about the coming. Big media splash on this. That is Hbo yep sure they're the yes. There is a A a feature length documentary in production And that Is with hbo at the moment and Yeah the the crew was out out here for a couple of weeks They just left About a week ago week or two ago and They're coming back out. They'll be out here for a few months. There's also a lot of media coverage in terms of news investigative journalism. That's about to hit. You know a lot of it in less than thirty days. that's all. I can really talk about that at the moment I do want to point out though there there. There's a lot of the the the majority of the history of this land is a nice history Again you know by nineteen seventy. There were five thousand disabled veterans. They're receiving services. And if you are you know what might be called a snowflake a compassionate person whatever it may be. That's a nice thing because you know the people who you're paying to be held or getting helped and it feels good if you're a a tax payer and you know the matters of of home listened. Veterans aren't as much concern as just the general welfare and the proper application of your taxes. It's good to know that your money was doing what it's supposed to. There's an inversely proportional relationship here as these. Five thousand veterans have dwindled down to about a hundred today. they're still inside receiving shelter and services. You also have this. Massive explosion of veteran homelessness in los angeles in a lot of people don't know that Los angeles is the nation's capital a veteran homelessness. We have over four thousand homeless veterans in los angeles. It's kind of interesting right because we're talking about the same number here right. There was once you know about five thousand that were inside and now we have over four thousand outside. So there's definitely correlation there. Wow and so are there. I keep. I just have questions but we will have to wrap this up but i just got to know. Is there currently enough shelter inside that property to take care of five thousand or does it needs to be reconstructed. My personal opinion is. There's not enough for four thousand but there is definitely enough for at least one thousand. That's already been recently proven right. I mean we had that many there Just several years ago so in short what these nonprofits and these developers are are saying. In lobbying for is they're trying to say nothing's habitable there It all has to be redeveloped in a hostile has to be done through these public private partnerships. It's a total lie. We've had people trying to tell us that the law prevents the va from feeding or sheltering veterans directly. Total lie the law does anything but that so yeah you could easily have over a thousand there right now now. What would the veterans administration say. If i called called him up and said hey there are thirty one unsheltered vets just across the offense from you. Why aren't they allowed in. It depends who you ask but as of as of two weeks ago up until two weeks ago with the bremen community council and the few west. Va officials that. They have unduly influenced as their pundits. Have been saying Is they were saying. Those veterans are choosing to be homeless. They don't wanna be inside they're all drug addicts and they can walk in right now. It's it all the time they can walk in right now and get services. Even if they're on drugs they could have a spot in this tent encampment. Which by the way we got that test and cabin started inside recently. The reason that blew apart is because will one. We knew it wasn't true but to we had medical doctors who are responsible for running these services coming and making statements that we have on record as audio recordings. They're pushing everyone away. They're not taking anybody in their turning them all the way. We don't understand why it's going on. We don't like it. We've been having meetings. Were not getting answers. They're shutting everything down there pushing everybody out and and i can you know again. You request information. Anyone on this podcast will provide you those audio recordings and so we started getting all of this evidence proving otherwise so now they're now they're scrambling they're trying to figure out what they can say because they can't say that anymore. I'll tell you folks who the veterans there in veterans that. I've spoken to when i ask. Why aren't you over the fence. They shrug their shoulders and say we don't know we're applying. We've been on a list. You know we're trying to get housing. We want to have a place to be so we can have a better ability to reconstruct our lives and study after study of showing that you know what the number one way to get people to reconstruct their lives and to get shelter is the shelter. Right it's really hard to get your life together from tent or from the sidewalk and there are rooms. There is space for these people. You want them off the street. We can get him off the street. i'm going to. I'm going to ask the brentwood community council to join the super nice club and help get these off the street you up for that. Michelle business you to be a member. I don't hear later. She might respond. Amen ryan thank you so much for giving so much of your time and and just the tip of the iceberg on this one. You know we talked about it for a couple of hours or so much more information. So again folks if you want to learn more from ryan. Rt at h. d. v. victor s. dot net. That'll be in the show notes. But it's rt at an h. d. v. s. dot net ryan thompson. Thank you for the work that you do. Thanks for being a just part of a of a nicer world. it's it's important stuff. Thank you todd. A mixed all the issues that come with it. I want to let you know it really feels great So there's something to say for doing nice things. Nice work should feel good all right man. I will talk to you soon. And i hope to be out there helping however i can see you soon. Who boy howdy. Was that a super nice conversation or what we cover some ground. There with ryan thomson from veterans rights to body parts and brain banks and mind control. I told you was going to be a good one. I got you. Can you can email. What do you think. What are your thoughts re thoughts on this. Do you wanna get involved in this. Do you want to help out. I love it if you want to help out. Because these vets are getting screwed. They're getting hosed and it is david versus goliath battle though the momentum is shifting and goliath is getting his ass kicked lately so you want to help out and keep up with the winds reach out to ryan directly please at rt at h. d. v. s. dot net rt at h d v dot net. What's crazy about. This is that it's documented. Look at the show. Notes look links learn more. Hey if you want hear some of these audio recordings that ryan has email him get more information. Get some facts and share them. Share this podcast to get others to do the same if you know anyone. That's concerned with the rights of veterans. The rights the homeless or just doesn't wanna see their own community be it in los angeles or in atlanta trampled by people who don't give a damn and who were just simply not super nice You know let's let's let's work together. I wanna hear your stories. Do you have something like this going on in your community. Tell me about it. Let's all get together and fight for each other wherever we are. This has been a healthier heavier. That's an understatement. So here's to a much nicer. Twenty twenty one and beyond. I really appreciate you appreciate all members of the super nice club. Appreciate anyone listening to this. Podcast have a great week. Hope that you're here to listen to episode forty five until then stay. Nice everyone if you will be nice then you if you will be nice and you can see if you wanted to be nice. The new clothes you can to become to become because the speaker return so what he did.

brentwood brentwood school brentwood community council los angeles ryan thomson ryan thompson ryan Ucla west los angeles california Brentwood Area brentwood la brentwood us congress