9 Episode results for "Dr Nisha"
Black Coffee NW vandalized again
"Black coffee northwest. A black owned business in shoreline has been vandalized again this morning owners found the shops glass doors shattered and keyed. Kyw's ruby dilute notes. It's the third time. The coffee shop has been the target of a hate crime last september just one month before the business open. Vandals firebombed the building in january owners found marks outside the shop. Despite this morning's incident the cafe is operating using its drive through window. Black coffee northwest open in october last year in the midst of the pandemic owners. Dr nisha and irwin weary have said they wanted to create a safe supportive place for black youth in the community. The coffee shop also provides job training and internships for young people k. u. o. w. news.
Beating Cancer with Keto and Detoxification with Alison Gannett
"I just wanted to help everybody. I wanted to shout to the world that. Hey, we can not only. Be Healthier people. We can take control of our destiny. A low and welcome to the doctor shockers functional nutrition podcast. This show designed to give you science based solutions to improve your health and life. I'm David jockettes doctor of Natural Medicine Chiropractor and functional nutritionist and I'm the host on this podcast and here to tell you that your body was created the heal itself, and on this show we focus on strategies you can apply today to heal and function at your best. Thanks for spending time with me, and let's go into the show. Hey everybody welcome back to the doctor. Dockers, functional nutrition podcast where we look at lifestyle as biological information that helps helps us control express our genes that literally our genetic expression is based on the food. We eat the air that we breathe the water that we're drinking and the thoughts that were thinking, and so you know that we have an impact on our health expression and today we have got a interview really powerful healing story that I think many of you. Guys are going to be inspired by and US really incredible information so I know you're gonNA. Love this, and so my guests is Alison Gannett and she specializes in customized oncology nutrition. She herself had a metastatic brain cancer right so And she actually used oncology nutrition of preventing conquer. Cancer also uses blood, chemistry, lab, testing, DNA, profiling, and history. When she was working with our clients, her heart and soul goes into our work, and she's created a program called conquer cancer with Kito Alison's twenty. Eight day DIY program video series. She also works with people one out one. She's a former world champion extreme skier in an award-winning climate change consultant. She and her husband grow and raise almost all their own. Own Food at the remote farm near Noah Colorado so alison welcome to the podcast, and for having me on failed to be here absolutely while you really interested in your story, and so I'd love to get started with that just Tom. What happened to you? Obviously here? You are world champion skier, heavily involved in climate change as an activist and and. What happened here? Well I mean. It was a crazy story. In two thousand, thirteen I started acting like kind of weird. I was having a hard time jumping off cliffs, and then one day I was cooking in my kitchen, and I was watching a pan catch on fire, and watching the flames go up to the ceiling. And my husband walked in. was like. What are you doing? In I was just thinking how crazy it was, and he was like. Okay, something's wrong. You know I have been acting very strangely, but this was kind of the icing on the cake, and so we rushed to the. And I had a brain tumor that took up almost two thirds of the space in my brain. And It was hard to imagine that I was walking and talking and building. Let alone. Being alive. As rush me into emergency surgery. Got Most of the tumor out, and luckily in my recovery, as I found Dr Nisha winters and started embarking on a Ketogenic of approach to you know comprehensive cancer, reversing the root causes. Obviously, it's way more than just diet. But that was kind of the foundational premises was getting into houses sin. Yup, and so, how long did it take you obviously hear your now. You're in remission, so this is two thousand. Thirteen's roughly seven years later. How long did it take you to really see results symptomatic, wise, and then also. Where you're getting, follow up our eyes or cat scans, or what sort of testing redoing? Ongoing work in progress. Dr Nation never even calls any of us in remission. It's kind of like you're just is like layers of Ananias as soon as you kill one layer off. He signed another layer another layer another layer. I'm still doing that I. still have a past pesticide nerve site, exposure revenue, eating organic fifty years, growing racing my own food but I'm still with these chemical environmental toxins that are still learning Audie, but what was interesting in two thousand thirteen. You know I had been Vegan Vegetarian, grown growing all my own food fire like even growing. Like that like? Exercising all the time being outdoors I mean I thought it was really healthy person, and then all of a sudden I was like this close debt, and then I find out that I have six point eight months to live if I do surgery, Chemo and radiation. And I didn't want to just like kind of barely survive, or you know really suffer through treatment. Luckily, my DNA profiling did not show that he were. Radiation would be very effective for my type of tumor. And so I decided to go on doctrinaire shot. Metabolic approach to cancer and reversing the root causes. It was very hard for me to switch from the Diet that I was eating to kind of embracing having two cups of fat a day. which you know I I know most people can relate to it seems. Even in college. I was taught in my nutrition classes. You know to miss my salad with a spray. Mr Olive oil I have been following the low. Paradigm I been exercising my brains out. I'm still battling with my way that always sudden I was told to eat to Cox fat nine cops, organic vegetables, small amounts of grass across finish proteins while caught series, it was a huge. Change? And I didn't really have a choice because my diagnosis terminal, so I just figured I had nothing to lose I might as well go for it. Changed Everything Because I track my blood work every month and I haven't tracking bloodwork every month for seven years. When, my blood work came back one month into the program of changing way I ate I couldn't believe it. The markers immediately reverse themselves three months later. It was like. A miracle six months later is when I really started. See changes on my skin's. It was at that point that things might poly cystic ovarian disease reversed itself. My seasonal allergies started to go away. My rheumatoid arthritis when away my breasts, fibroids went away I literally felt like. The Keita Genyk Diet was like Snake Oh. And in a good way though. It just seemed impossible take. All these conditions that had throughout my life I had chronic bladder infections, eastern sections on chronic bright, cried bronchitis, also, and all the stuff went away. Doctors have been telling me for years that none of these things were reversible so. was. Thinking that I was healthy, but really becoming healthy took the C. Word. To kind of realize that I need to rip the tape off the check engine light I think I had been in denial. Right at. I wasn't healthy. Yeah absolutely what bloodmarkers you're looking at. I look at about seventy different bloodmarkers every month and I looked at the CDC. Abidine we're looking at what factor, which is the segmentation rate or yes, our Latine hydrogenated. Also, hse key Margaret Heart disease. Than of course we're looking at all that diabetes markers because most cancer cells are like. Get other politic- pathways like. Wine. It's fasting insulin. ACID. than. We're also looking all the time. Related Markers were looking at all this stress. Markers or Even carbon dioxide, exultation less like how much stress is going on in the body. I could list them. We're looking at all. The anti of genesis markers like hopper five Brandon Jan.. Jassam. Absolutely, and so you're obviously looking although That I've talked to Dr Natio the TRIFECTA like you're talking about zero. Looking at inflammation are the L. D.. H., lactose, dehydrogenation, and the high sensitivity C, reactive protein. There's easy tests. The most people are listening. Just get done at your doctor's office right along with your complete blood, count and everything see where you're out as far as on inflammation level. So. So, this is obviously an incredible story. And he started reducing the tumor, and what inspired you to obviously now coach people because now that's what you're doing. Well you know. I just kept finding myself getting healthier and healthier and. All the doctors were as they couldn't believe that it was actually happening and I think in the beginning I'm associate fault and I was told that I was going to die. I wanted to leave that this approach for work and slowly I really started to believe that, and then you know. The labs supported itself I. was working also with viruses of virus issues heavy metal. Immune system imbalances got unbalances match those before. I'm watching all this stuff. Sheen's just made me realize how. We can reverse not only cancer. We can prevent cancer. By looking at all the other diseases that Western medicine just considers us like normal that you're gonNA get diabetes. You'RE GONNA. Get our disease. You know we have no cure for Alzheimer's or AOL. Asser Parkinson's. And I started going to all these conferences, and then I started studying with Dr. I did a full year program. apprentice was her. Then I did the American Nutrition Association. Certified Specialists Program. I just wanted to help everybody. I wanted to shout to the world that you're. Hey, we can not only. Be Healthier, people, we can take control our destiny, who knew given a cancer diagnosis like mine? You seal tiny. You feel powerless. You just feel like you're at the mercy of wins. The next SCAM GONNA. Come in am. I GONNA find out that it's coming back. Where's this? Flipside will paradigm around where I look at my blood work I know exactly what's going on, and when I teach my clients. How look they are! THEIR DNA We're in the driver's seat of our house. And I wanted to scream to the rooftops to everybody. As I'm sure, you do, too. You know we can use. Don't wait until you get cancer to make changes your life. There were a lot of signs that I needed to change things now. But unfortunately it took me terminal cancer to make a difference. Yeah, absolutely, what do you think were the main factors? You've touched on some of them? That contributed to all the different health issues were having obviously then also the the brain tumor. Doctrine Nisha talks about the terrain had ten different factors said that I think for be sugar in carbohydrate. Metabolism was big problem when I look at my DNA I use. Nutrition genome. I have a lot of. With metabolising different types of sugar, and also Greens I I basically was born without the ability to process grains. I had because of that probably massive problems with my thyroid. I had. Stressed that I didn't think was stress and I'll never forget Dr Nation saying just because you love. Your job doesn't mean killing you right. So really I had to learn how to say now and. Really channel more energy into spending. Time myself if I'm not charging batteries, I can't help other people. And then segue right into that is I was asleep. Mass I was going to bed late I was getting up play. My Circadian Rhythms were totally backwards Working late at night too much screen time blue light. As a result might hormones were all backwards. My our adrenals were totally tapped out from over exercise. My Immune System was best buy neutral. Trudell lymphocyte ratio was like completely backwards. My microbiome was a disaster when I testify. microbiome basically said. Had Tons of formalities so look like I was a three hundred pound woman with diabetes had no diversity of Gut. Flora and it turned out seeking wrong probiotics to support. My Gut health so I now can know which I'm deficient in and take the ones or just eat lots of fermented foods, because I'm a farmer I. I had obscene bar. I had the herpes virus I had inflammation by conrail damage I. Really bad genes, able e three or four was one of them. so I have a real ability process saturated fat, so I had to switch to a diet of mostly model. Fats because DNA. On inability to process lactose with my LC teaching, so I was doing the Kita Genyk Diet Times of day, so I had sued switched data I see got a lot with my clients know we have to change every person's diet based on their genes, and whether chemistry is telling us, and just because you have gained doesn't necessarily be next. Expressing off can be turned on or turned off. Or the EPA genetics, so it's really hard to look at work and see if those genes are expressing themselves for example with Abeille three four. If you have really really high triglycerides and you're eating a very low carb diet, that might mean that you're eating wrong types fast for you tonight's. That's an example. environmental toxins. I have been unable to pinpoint where they're all coming from I have mercury taxes city. Don't have any legs. Lead cadmium strontium. CR- Silver Boron. No idea where it's coming from. It's not my water. By where I live. Amalgam fillings. She had sober fillings. Did, but I'm am thinking. It's airborne because we're in south western Colorado I guess coming from our plants. Even, though there's several hundred miles away. And, the heavy metals that showed up at my work are from where I lived. I have granted twenty years ago. And so the inspire accumulate fat cells. And I recently did daybreak laboratory, the non heavy metals test looking at. Him IT Myra Chemicals. Off! The charts yeah. You know I've been eating Yanic at really well for fifty years, so these were childhood exposures. Even! Do Infrared Sauna every day. I do charcoal and clay. Very very persistent tackles in hard to get out of the body, luckily tested negative for mold. Than, of course mental, emotional wet through the east tests I think it's really important. One people kind of avoid stress and the mental emotional part. Really says. Isn't it hard to do? The Diet I found the Diet quite easy after the first year, but the mental emotional stress component will. You know it really took getting multiple cortisol. Test back to tell me all right alison. You've got to address this and it was amazing by Cortisol. RECYC- Twenty to anybody knows. How High Nineties at eight am. Court saw after four weeks of Meditation Class. It was down to fifteen was permitting. Now the eighties that is an adverse childhood experiences right? Impress those things. Right there in our sub conscious, and they are playing a role with how we see the world. Right so the way that people can. US. you know things that are happening oftentimes will triggers trigger certain stress responses that may be amplified because of experience me. Yeah it's interesting on a lot of times when we see cancer of the reproductive area for men, women, euros are often late to some type of either perceive trauma or actual trauma. Use It happened? And then you know? Cancers of the lung area can be grease related, and so there is all this very science chested approach that doctor nation myself us, but then it's also really to not miss some of these out wires that can trigger you know we see this a lot like somebody can be complete remission, and maybe the death of a loved one and the stress gesture guidance do not can trigger reoccurrence so the mind. Is Super Powerful and we need to really pay attention. Absolutely so critical, so let's talk about a Ketogenic. Diet Kito says how can that? Why cannot be effective for many types of cancers? Hell. It is amazing I. Think we know a lot about the ketogenic diet, but really I think the tip of the iceberg of what we're finding out right now I. think that's remain factors that I see well. The first one is obviously blood sugar balance I. Had A pre. Diabetics lead sugar. Level which was not even flagged on my regular blood tests. Because, we consider high blecher. Be The norm. He stays yeah. Gallery, yes, which which is insulin resistance as well exactly. My fasting insulin was very high as well. And it was surprising it actually in new. Hampshire, Cygnus more insulin resistant you are, the longer it takes for the Keita Janik diets faxed to take place, so some people will see massive changes in a month. One person might be just feeling the heat of flu in that. Won't see the changes in. Either how they're feeling of their scans for like six to eight months. It takes time. But it really is Americal that I ate poorly really for forty eight years and it one year later. You know my hemoglobin. A. One C was four point nine. Fasting insulin was went seven. All my blood sugar numbers had normalize. The amazing thing about the ketogenic diets where seeing the anti angiogenesis. And so for people who don't know that it's basically cellular signaling a cancer cells. Don't die right, and so we want cancer cells to die, and we also don't want to get connected to the vascular system in our body, so the one pathway, the AK t signaling pathways. Out there. You know for the chemists that are listening now on the. We're seeing massive changes in the way, the body is exciting to south. It's also anti inflammatory NF cabot be sent me is just mindblowing if Doctors or researchers could even just package that one little component of the Ketogenic Diet. It would be the miracle drug that would change on narco droughts, and the fact is food is Nessin. You can do this just by changing your diet now. In NF Betas as basically a cell signaling molecule that amplifies inflammation throughout the body. It's Kinda like a siren in a sense going off in a city, so it just amplifies information. We know that cancer cells are screening a of that right there. There is a lot of that NF. Create an environment that's basically like just inflammatory spiral and. That helps feed them, and that's also why you can see those high. Once the cancer research really growing fast, you can see those high sensitivity, C, reactive protein SR L. The age. All those markers elevated on as they go down. You know that you're having progress. Right that you're moving in the right direction so that that is really key. Way of explaining. That because it is I remember Dr Thomas Defrayed, saying no drug. We know can do all these things. that. It's totic at its anti-angiogenic NS capper. Be Like that is a miracle John. Watts you package that into a drug instead of changing the way we eat? And as a farmer growing raising my own soon I really feel that food is Madison. and. If, we had source our food so that they're. The food is getting clean water clean air clean soil food is going into us. The difference in our blood work is just astounding I I mean I even work with physicians that were never taught in school, and they go through my program. I teach them how to look at the blood work differently. Teach them how to look at the genetics. Genetics and they watch their markers that have been stuttering especially inflammatory markers for years than suddenly go away, and it's offer diet and lifestyle changes Yup now when he started on the ketogenic guide as you're progressing, were you trying to get your glucose kitone index to one to one the way that doctors say Freda? Discusses Yes, so the Glucose Keith index is a great way to monitor. You're doing. I in the beginning. I didn't really have because it was so long ago. We didn't have the tools that we have now elect chronometer to track you know how many brands carbs were eating. My cards were way too high in ginning by. Fast for way too low and I see this a lot with my clients is if people go low car, but they also go low fat. And to then what I see is the body is like okay on looking for cards. I can't find any, but I'm looking for fat and I can't find it. In this is true for even over well overweight clients because the body needs to change what it's looking for so initially even heavier clients I have them go high fat, so the body gets that really flashing red lights that were switching over to burning fat for fuel. And I in the beginning had a really hard time with Magic Ai. Also when we have glue. I'm sometimes people can see a short terms bike in glucose when I go ketogenic, and as the adipose tissue releases old stored hormones, accents, and all that stuff to come out. The glucose comes out so we'll see that short-term spike in an now. My Glucose is regularly probably a somewhere between fifty seventy. If finding a really good Kita, Jack me all, it will stay below eighty. And, my key tones hovers somewhere between floor. I've been in. He toasts this for so long. My tk I've generally. We change the A for me. Personally I cover now because I'm out of the critical face. Somewhere between one two, and if anybody wants to practice doing this, there's a great calculator on Hito motorcycle. You could just clear on it and it shows you do it. You can input. All the mass. It's your glucose right divided by. Your blood key tones rights here Blais. Divide that by eighteen over your blood key tones, kids your range now. Typically Nutritional vetoes is usually somewhere under four to one, but if you want to get into that really strong healing zone especially when you've got a brain tumor, your goal is trying to get that down under one one. Yes. And you know different tumors are different, so we a lot of times we'll look at the Carris report or the foundation report in see how likely the tumor is. Anan depending on how Olympic the tumor is, then we can set the proper targets for decay and also for Angry. In certain trends, there's certain tumors being morgue lick than others. Oh Yes for sure young. Earth Mars cryonic cancer. But, then you look at something like breast cancer, the so many different varieties. Like the difference between a be Rasa mutation at once be more likely than the other switch, really good to really encourage your doctor to pay for run for code for. These more extensive testing know exactly what you're dealing with. The cool thing about looking at does is you can find out if the tumor cells are being driven by other things. For example, gloomy is a huge driver for a lot of people from my type. A tumor including being were not. Actually wasn't glued. Mean Hawk, but then when I tested my organic acid test, my looney was very low of so we knew that gloomy was not particular player for me, even though it was a player for that particular tumor. Also are tuning and Madani can also be players innocence while a lot of people get confused when they hear well us good for one kind of not good for the other. The truth of it is if you look on pop man. I think. Most of the study. Say You know ninety five percents of all tumors have some type of like lyric half great yeah. That is confusing for people because. The Client Clinic Cafe isn't the same for every tour I it is, you know volved. But a lot of people get hung up on. Also that tumors are driven by inherited traits. Where is it somewhere between Florida? Six percents is an inherited trait, but like for example Bracha jeans. What we see a lot with rocket genus, there's actually usually an under lying problem, which is es are to Utah. which is the inability to process toxins in other? Dioxin things like. So there's usually I like to look at the deepest underlying us how you process. Braids Tony. Process. Sugars Howdy, process carbs. How do you process Kathy? How do you process different types of fats? How is your detoxification pathway? Your estrogen pathways ing forty estrogen or you purging it? So fascinating now we can know there's so Malik Future I feel. And we're learning every day. That's the exciting part. Yeah, there's so much like you were saying. Most cancer is not just some sort of genetic mutation in that's it. There's really a big epigenetics or environmental. Factor plays in with like Broccoli as a tumor suppressor gene, but everybody has multiple different tumor suppressing genes, and it's not like there's just one system to suppress tumor growth, and we just gotTa. Make sure all the systems are working well and so so I'm surprised so. What's amazing is that you're keeping your key tones around three to four now? Are you doing? Are you doing fasting intermittent fasting because I find that to be tough unless I'm doing intermittent fasting. Usually my key tone levels eating two meals a day. Even one meal I do twice a week usually are somewhere between one and two. And so. Eating things. You know about ground vegetables like. Broccoli Cauliflower spirituous stuff like. This asparagus things like that so depending on people's cancer like if I, had someone that meeting with a low grade breast cancer at the Kerris report comes back or says you know this isn't a heavy sugar feeder. We might look for key tones between three and that's perfectly. For that kind of situation, then we could have another person with breast cancer that it is stage four and aggressive, and maybe even static than that person's going to need to be pushing towns, you know. Three or four, because we really want to get that Ns coppee signaling going, we WANNA, make sure that there's no like lyric Catholics being in hats there. Again you a diet? Is the tip an iceberg. If you do Akita Genyk Diet and you don't know your DNA, let's most eugenic diets that people come to me. Are eating tons and tons of be? They're not sourcing their beat from the cracks places on its conventional. They're having conventional dairy. They're not having nine hops of vegetables day and the quality of their fast. They might yet plastic bottles, or they might not be cold press so I call that Internet Hito. Dirty Kito Sturdy. So I'm working on environmental. Coming in when you're getting conventional needs, monkey said plastic bottles right with oil leaching BPA in foul leads. All those things are toxins, and they drive inflammation in your body. Yes ended in my case in for my clients that are trying to get high. We have to stick to the nine cups of vegetables that are mostly in the leafy category. Yeah, now I have become an expert at turning those leads into pretty much every single one of my favorite foods. I couldn't really find recipes. Said would enable me to make bread or fat bombs or chocolate. Or waffles pasta things like that that would enable Keach towns to be three so I basically. wrote a cookbook. 'CAUSE I had to come up with recipes that when needs. High levels of Kito Sus what are you typically eating on a regular basis? What's what's chocolate? I will. We were talking about fast. Yes. And of time restricted eating window mud, so I will generally fast in the morning, just herbal tea and I will eat my first meal somewhere between wanted to on this morning I had a vegetable fruit totta edstrom, our chickens record. So I know exactly the eggs are to a free or free Annan. I pack so many Green Vegetables Internet for Todd. At the time, it turns out. It's delicious and I have probably about cup of. Bacon Fan in their. Radio absorb fats in Africa because. Things can come out breezy if you're trying to at and we'll talk about that. One of my tricks detract born things because then you go from Saute, mushy to crispy, like fish sticks or fried chicken or to your pride. Stay things like that. so for unmaking pull beef tonight for dinner. And have I usually have a salad that slight you now bigger than the size of my shoulders practically. With tons of homemade salad dressing another one of my tricks is to accurate herbs. Since my salad dressing about to customers, so that rate of sneak in I'm always trying to figure out. How can I sneak in vegetables? So I made these really this mason? WIFI chocolate Brownie that I invented inaugurated. Minton's that her basil, so that I'm getting good fats, getting good organic chocolate, but I'm also getting some vegetables in there, and I haven't ice cream recipe because I can't have dairy because of my genetics, so I've invented a coffee creamer and an ice cream recipe. That doesn't have coconut. Coconut canned. Canned vegetables y'all can't coconut milk. So I had to advance the new ice cream POPs arrests, the as well and so you're avoiding can because of possible aluminum moving out of all cancer mind with BPA. When it says EPA free. Here's the kicker. They use beep. Right simply. One of many different foul, ANA, Manny Chemicals. You cannot signed. That isn't blinded plastic. Plastic is pure evil. They have not found any classes. That does not reach into. Our system is a known endocrine disruptor. Berg! Fancy speak for those out there, you know it's GonNa Distract your thyroid I'm you know my polycystic ovarian disease at my breasts? skype rights were basically from an extra gender-balanced body. And so when I eliminated foods and plastic water bottles, and Teflon Pans and You don't think that create too much estrogen and my body. Yeah, all those things away. Your those things can also drive insulin resistance to absolutely no. No definitely big factors fly got my glass water bottle right. Only time the only time I ever drink out of plastic bottles flying if I need something to drink, and oftentimes I'll try to do a dry fast when I'm when I am traveling. To just as long as I can at least. Just because y'all obviously, if to reduce my exposure to the plastic. Yeah I have a nifty little water filter in I made. Flight attendant give me a full model water in the night toward the inside. And then I pour it into this. My husband just goes crazy because I got like all these files and builders chocolate Mike Kito Brad and my aunties. If you're so right when I travel now it's like I'm just GONNA fast. You know to me. It's one of those things where fasting is. Is Hormetic stressor on you and I try to really focus on. Traveling can be stressful in general and so try to focus doing a lot more intentional breathing when I'm. When I'm traveling, and I don't eat or drink or at least drink very little right and just try to focus on breathing. It's like I don't usually do that. At home I'm not at home at hydrate as much as I want right and so. Spot. It's like a it's. It's Kinda introducing a little bit of a new element of stress by going four five hours without during the day without water for me is stressful, but. everytime thirsty. I just go back to doing some breathing practices breathing exercises and calms that thirst. I feel less stress I feel relaxed. Rights been really helpful. And I also do one longer fasts Longer Cedar minds as you showed. That three to five days fast I remember many years ago when I've I finally pay I'm GonNa do this? I think secretly head I'm addicted to love. From someone who I think, we all look. I! I was a carbolic. Vegetarian carbolic. Go. Learn how to cook a now in love with food. It's a it's a way to distract myself. Chopping and slicing in dicing total I, didn't really WANNA. Do the fasting three days must yeah, but I had a little reoccurrence in two thousand eighteen, so I had to figure out how to get the heavy metals out of my body at accelerated rate. At that point I read Saana. Do the clay and charcoal and I started doing that three five days a month. I could not believe it. I tested my labs the day before my first pass and I tested them Saturdays later. The shift I remember reading on your post. You talked about how it boosts your immune system. As well I had to really see it to believe it I neutral lymphocyte ratio just absolutely went from like Ian. Stellar in seven days like how can that happen? Yeah, your body's Roddy sprouts all those new stem cells, so you get actual white blood cells stem cells. Healthy cells near and due to the talk secede stress things like that. Your white blood cell load was really you know your your your cells were? Old and You'RE GONNA. Get rid of those who sprout new ones. Yet stubborn things like hemoglobin Wednesday people who had really a CIGNA. They'll do one fast a you know. I saw one person. Recently, she had a five point six. She was eating keystones up at three. Did her first four-day fast? It went onto four point nine in in just a matter of days. Absolutely amazing, the stubborn idea one. which is you know something we know is a big problem with. Yon, at can really shifts with sleeping. Stress Changes, and the Aston is just. The icing kate on that one. Yes, as powerful as a lot of the stuff that I teach you know you're doing a lot of really good plant foods that help your liver and your bile ducts might see that being a big issue a lot of people when they go. Tito is their bodies really bad at producing vile Nakano. Most fine breakdown fats that's right. Greens come in bitter herbs, getting a lot of herbs in the Salad Dressings Gang. And all those things are so important to get the bile flowing the bio flowing. It's going to really help with burning fat and also sterilizing your small intestine. You can see a lot of people with overgrowth bacteria. Yeast and things like that and our small intestine that will really help so yeah I might these problems went away I never I never really did anything about it other than a therapeutic ketogenic diet. Yup. And it's. Powerful your powerful powerful medicine I really think we need to spread the message about this clearly hito. With a real violence plant plants, small amounts of really quality proteins gale, definitely thirty large amounts of good quality fats. That really ranged I, yeah, what a typical ratio! You like to say for yourself. What are you typically doing for? Obviously, you're looking at genes, so you're kind of customizing a little bit those Mac rose. What are you typically seeing is working really well as far as Macara's. You know I'd say the average person company, and just like myself with the hemoglobin, A. One C, upside point, a high fastness, slam high idea one. Either really high court solar, really low cortisol, but all indicating that there's. Probably going on there, and in that case you know depending on all their scans in their healthiest revenge, their other workers, most people I put on to start with an eighty five percents at. Five percent car and ten percent protein knots when I've developed recipes around like how you eat a piece that he brad still That ratio and same with my ice cream. Day With my pasta recipes how you keep it at eight five five ten. That's a challenge. A low protein is important for cancer. Because in a lot of cancer cases, you have this MTV tour pathway, which is building pathway in the body. It's a pathway that children have elevated because they're growing building and developing. If you're trying to really build muscle tissue, you want to elevate it, but what happens, it can become hyperactive and cancer patients. You don't want to be constantly growing building. You want to be doing a. A lot of cleaning and repairing, and you got to suppress that and we know carbs, insulin, and also amino acids drive that that's why you're bringing that protein down 'cause I typically at this point in my life, I follow more like twenty five thirty percent protein in my diet, or like sixty sixty five percent fat I feel like thrive on that, but yeah, if I had cancer right, and when I did have skied. I'll bat down exactly. My husband is on. You know a probably about the same ratio that you're on that again. You know if I have someone is like a say. Low grade prostate cancer. You know they probably could be honest. Seventy five percents. scrolling cancer. Protein in that case, because prostate cancer could be driven by irony. Yeah, so we'll. WanNa limit foods that are high in Enid. So that's what's so cool about what we find out, yeah! Your muscle needs most of your muscle. Meats are higher matthias. Whereas collagen protein, which is high in glaze scene, but is lower and Matthias and lower branch chain amino acids. Like that, so you do more that what other what other sources for that person that are low in matthias eating. If. They have cancer that's driven by signing. Yeah, what are the loan with binding? I know collagen peptides or Collagen Pronoun. We're really trying to avoid. If they have any driven cancer, you would be off expert while extra Higham. Thanks really high defining Trying to remember I think it's. There is tricky. Thi- I think there's. Like, the guy has more mathiason, the or I might have that backer sheer out there some you can pull up on the Internet like Messiah Rich Foods. There's some I actually. The list is so long that I actually saw it on my computer. If I have a client that has a binding riddick Yasser. Just GonNa, send them at Lewisham. I have like. Probably a thousand different lists your usual so like if someone has oxalate is or migrate, issue I have listened foods that can beat does triggers. A lot of times, these issues related to leaky got. He'll the lakey gut that oftentimes most of these foods are real soon, allergies. They are the facts that the foods are leaking into the perks Neil Kathy when there's leaking into the Eric Neale Caveney people are having an allergic reaction to remember they eight. It's not that they're allergic to that sue. So we do I. Do look at TNA I have I was with an ability to process lactose. I had not one symptom. Of. Having problems with lactose, I was making my pizza crust with cheese was putting cheese on compromise pizza. Everything you know they. Internet heat our Derby. All Geez Riad exceed wasn't until I had recurrence in twenty eighteen that I was like okay. I need to mandate are. I need to get the heavy metal sound by Ati and I need to finally quit dairy. And Dairy has Oakland reaction it has this incredible sealed good reaction like caffeine. I'm but I tell you now. I've been on a bit for several years ago yes it really that much. And so. But some let's talk a little bit about some of the supplements used. You mentioned doing heavy metal detoxification. Laments that you've rotated through your regimen with. While for inflammation I'm dealing with in this is true for particularly for cancer. Is Bus Valley on? Is a lot of doctors put break. Cancer patients on steroids which dry up. your blood sugars, which can in long-term fee cancer, so it's times doctrine. Asia's getting people off of steroids in onto high-dose Australia, depending on what type of brain may have. Dealing with certain things like if people have elevated elected three than we might have had the modified citrus. To pull down collecting three. How almost everybody on magnesium I mean I, know you know. That magnesium is like the master. Everything. Everything from genes to immune system to sleep a you know the list is long I will never be off magnesium. Probably none of us on this planet should be off, yeah. Because we basically don't have it in our soil or water anymore, right? And so I'm a big stressor under the more you use it, so it's Kinda land rental car. The more use it more stress, runner, the more we're GONNA use up that magnesium. Exactly. Three that's just I was born with the snap. That doesn't allow vitamin D three to get into the south, so I have to kind of megadose with vitamin, D three to get it in by Saul. INTO MY SPOUSE B-VITAMINS. All by genetics show that a really poor metabolism of be sick wells. Be To animals But again a lot of these. Were always just tailored to people's genetics. Yup, we're looking at their genetics. Were saying okay like for example? If they have several genes that show that they're gonNA. Possibly be low in the trials. then. We're GONNA jump over to their laps. See how they're MCP there. S H C H C is in if it is actually expressing itself as a each deficiency. Has Beat twelve bullets. Also this be six. I play a big role in the maturation of the red blood cell. Normally, that red blood cell matures in the bone marrow and gets to a optimal size, and if you don't have enough of these nutrients B, Twelve, the biggest player in it. you, don't they? Don't mature well on their larger, and you see that when you look at your bloodwork Mrs, m., C. M. C. H.. See those numbers are higher like I think. The ozone is Moran Eighty Five. Ninety, two for your CV limits higher than that sign. You're not maturing. Those red blood cells Rwanda. There's a number of factors for why that could be but. Well to be a could be a major factor with that. Are you looking at melodic acid you? Pressure. Mistaking late people live at Sierra de Twelve and yet misled. Class High Serum B twelve means the B. Twelve isn't getting into the cells, so a lot of people quit their supplement with a C. highest yard. Be Twelve. Yeah, and it's it's tricky and High Sierra B twelve never a problem because it's water soluble, so your body will get rid of it, but if you don't get enough B twelve into the cell, and that's a big problem. What do you? What do you do at do use lithium like lithium. AUTHORITATE- to help get it into the cell or or using down on parcels. Sometimes doctrinaire will see you know. She is just a mastermind. Is You have like a really tricky case? With somebody. But we're really focusing on fat soluble vitamins A. E A E at A. D. and K. Your is being most critical in the beginning for people. Because also, you're on so many things that are helping fight the cancer that sometimes the supplement lists. Really intolerable. For me personally and for ninety five percent of my clients, we test positive for obscene so I being. Viruses. because. Viral load in your body, and your body is just fighting virus twenty four seven. It has an inability to go out and attack at gobble up those cells right jump semi's. Net what what are some things that are using for Epstein Barr? Right now, currently using licensee yeah. L Lysine. EMULSIFIED vitamin A.. And! Laura. Model Loria. Those of the three that were using Currently, It is hard because like I. Finally Mine I was on for like six months, and then probably my husband took a sip of someone's water bottle, and then I kissed my husband and that book was again. So it is critical. If you have, it is to treat your yourself it also your kids and your husband anybody that ends I think the one good thing about the current viral situation Seattle. A lot more aware of sharing water bottles, chopsticks, and things like that. We need to be hyper built digilent- about that. You know lot of cancers can. Dairy strong viral component especially cancer. And cancer style the other hands yeah. What did you think of vitamin? C Zinc. A straggler lists right as far as anti viral properties to them things like it all depends on the person for sure. We d like a low free t three on. Three on than were looking at selenium. If Hopper is above ninety, or if swirling, Plasmas of twenty than we'd be looking at Saint, but we'd also look at someone. Fingernails see as it got white spots on their Enin. Also look at their genetic since the they're going to need a higher dose sink the zinc copper relationship is very very important for cancer. Yorkshire. Yeah absolutely I've seen zinc. Be Very helpful for a lot of people. let's talk about other therapies. Did you do hyperbaric oxygen? I. Know can be very good for brain cancer, especially just flooding the system with oxygen oxygen is. Therapeutic for healthy cells, but toxic for cancer cells, cancer cells are anaerobic, so they crease. Energy from GLYCOLYSIS and they can't burn fat and that's one of the reasons why we try to get that blood sugar down. Because most cancer cells struggled, he's fat or key tones for energy. They're very good at using glucose, and they also are not able to produce energy oxygen oxygen actually can slide in there and cause a major free radical damage to cancer cells. So did you use hyperbaric oxygen therapy? I did and almost all. Our clients that are dealing with brain cancers usually at their. Molecular profiling back. And it looks good for having that. Do on hyper auction again. It's always a case by case basis. For people cancers from the neck down. You know we're looking at treatments like hyperthermia. Cancer really doesn't like. Not like sometimes. For example, an infrared sauna if people come back with high heavy metals or high other chemicals in their audience detoxification. Treatment is so individualize for people and really liked about Dr does that she is combining time ans-. We need conventional treatments. If People's DNA comes out properly in combination with an integrative treatment. In has a really good success rate. Then some people's DNA back and the tumor would basically. Is Chemo insensitive or Radiation can only be used effectively if the tumor. Has Auction is the tumor has had oxygen? It's going to have a really hard time I'm having radiation. Be Effective, so there's a lot of these things that doctors are checking. Won't see if the cancer solace to chemo resistance. They won't see if the tumor cell is. Not. You know this is all doctrines. Should the customized treatments than I do the cast, my side lifestyle, but for me. The hyperbaric oxygen was incredibly powerful I noticed some incredible things happen to my body, and especially my gut health. I was pretty surprised. Then I saw my health. j.j I haven't been able to drink coffee for twenty five years and I came out of Barrick. Up with a lot horror at. With the ability drank coffee. Because you do have to pay for it right so. Did you rent one, or did you get one in your house or I? Would actually drive of bird towards Aspen where? To go to a private wine, cousins not. Right. But. If people have had radiation in the past from a previous treatment, you've been actually get hyper covered because they use it for my con- drill rigs there, right. So it's it's really cool. If anybody gets a chance to listen to the talks from Dr, Scott Share. He's just brilliant you know kills bots. It rejected rates Vascular I mean they're using it successfully for lines, disease or traumatic brain injury for concussions. Powerful. It's powerful. Stuff I. Medic I conference I was speaking on cancer. He was speaking on traumatic brain injury. He got in some Martial Artists Syndicate in the head, had a huge lesion in his brain and hyperbaric oxygen. The heat agenda Diet. Oh it's a phenomenal phenomenal combination right because getting really just getting your body to run off key tones getting the oxygen in air and supporting meadow contro genesis is life changing right? especially the because we know that the brain has ten thousand might Oh, contract per cell muscle cells have about a thousand hardest five thousand, so more might o'connor. You have more the greater the effects. and. Key tones are going to have on that particular system right that particular organ in the body so brain. You know that's really why at this point in my life I follow digest for performance right? My my brain is alive. Right and I would never go back I voiced. Say you now. Diet for cancer, but I feel incredible and like all those things that I was telling you about that were that I considered normal happening by body that the novel God away I would never change it for the world, and you know plus I get to eat brownies, a nice being everyday and. Brownies Kito a scream guy. It's. Sounds great so last question. What are your top five favorite Kito Foods alson. Well people can go to my website. Get Dot, com you can download. My favorite recipes are all on their free, so don't go get those those remind life by chocolate. Brownies could look at it. My dairy free ice cream couldn't live without it by brand recipe. That event said that makes pancakes waffles. I couldn't live without. I'm. Actually have become a bit of a vegetarian. A vegetarian `table Weicker. I never really loved them before and now I. I, really Miss Pasta for the first couple years that now that I can make pasta just battery vegetable add clydes. Ended I. Know How to make sector rich sauce with so much fat in it like a cook like the French. Yummy! And Know I love simple things like salads with a really good salad dressing. On really at hamburger, we raised cows. So are is is amazing, you know. I could go on and on I love food. We get a whole episode Rohan. But. I love that you're doing that. And I just want to acknowledge you for being an inspiration, obviously an inspirational healing journey, and didn't keep it to yourself that you're out there. Actually spreading the message helping people out one on a regular basis, you also have a great guys are GonNa Check our twenty eight eight. Diy Program to see you can check that out as well. Well Allison Gannett DOT COM and being being so energetic and such a beacon of hope for people, and you dove into the science You've got a great mentor. Their doctor Nadezhda and just helping people all around the world so I just want to acknowledge you for that and know that you're a hero to many, so you're my hero I. I love Your Post Scientists. You know you're spreading the message out there and I think together in. The medical industry is never going to. To embrace that we can use food as Madison. We as the people that are really taking charge of our health and spreading the message worldwide, the John has to be done. You can grow old gracefully happily. Quality of life. That's like higher than you ever thought I mean I never thought the cancer would be against, but I'm really. Bottom of my heart. It has changed my life for the better. I hope people I know. That sounds cliche silly. If you're out there, Israel, you just got tired. Now that there's hope out there you can change your life to and listened to the dock here. He's got all science. Your website is fantastic. Your poster fantasy. While, thank you, Alison and again thank you for your inspiration for for your life and what you're doing your life's work, guys check out our website. Alison. Gannett Dot. com will have all the Info in the show. Now it's an remember. You're more valuable than you think you are. Start. Taking action learned a lot today. Start putting that in action. I know that you're gonNA, see life transforming results, be bless. Guys will see on future podcast. Will, that's offer this show and I. Want to thank you again for spending your valuable time with me today. If there was something you heard in this interview that you have questions, you want to dive into the earth than Dr. Dockers Dot Com is the best place to go. If you enjoyed this episode, please consider taking just a quick moment and giving us a great review. Your of US help US influence more people in transform lives. And, if you took something valuable way from this episode, then please share it with someone in your life. Can Help? We'll see you soon on a future podcast be blessed.
Episode 12. Challenges of growing seaweed in the Philippines
"Welcome to another episode of alga talk. On this episode. I interviewed dr nisha nisha hurtado who specializes in seaweed farming in the philippines she is associated with is data and as part of the global seaweed star program which works to safeguard the future of the seaweed industry in developing countries. We discuss us the history farming methods and down process of a seaweed called kappa phi cops which grows in east africa indonesia malaysia the philippines and micronesia. She begins by explaining the first introduction of different seaweeds and commercial farming in the philippines. Here is dr hurtado initially call the you peel off tonight so the armor snake commercial navy's on tonight that was in the early late the sixties in ariza apiece in nineteen eighty five. This euchema cotton was chains cup of <unk> abbas zaidi zay. I'll be sent the address and that all saw your ma speed. Also there were series. Would you say that the seaweed farming in the philippines only really started in the sixties or the seventies or did it start already before then for centuries west west gathering from the wild population but to to <hes> over harvesting the salt that do the ignition of the wide by <unk> so there's a need to cultivate that so out from mid sixties seventies series of i feel cultivation trials they're made by dr doty alvarez before and the journal and i also remember using using a <unk> louis boom so actually louis davila's <unk> may june and they start ted talk debating the cotton i in our seat that guy <unk> together with <hes> dr ian niece you're saying that <hes> outside people sort of came in <hes> taught the concept of the stick in line method of of growing seaweed weed and that this started off the sort of modern industry of seaweed in the philippines being grown. Could you just tell me about the stick in line method method why that's important to the philippines in reforming that's now the simplest and the most traditional way i'll be waiting uncut tonight because if you have allied before it's only monofilament nylon cord and then you have only mangled bulls so you just threat the line and tie the seedlings with solve <hes> <unk> die and then that's all that's why it's called line and the state in line and that's normally done in shallow waters but the of the climate change the are no longer they are going farther from the shoreline which means that if you go florida from the shoreline than they will be using the hanging long lie neurath asmat door the single mental mardi multi polar medal when you were talking before on yours symposia that you explain that <hes> ice ice and bleaching the seaweed would you consider that part of climate change that that is that's what's affecting the seaweed farmers in the through a being e._s. partly and <hes> because ice is east a symptom only of psalm environment stresa zest which means that the temporary juror the salinity delight <unk> are are extremes which means either very high during summertime or very low during the rainy days that is why i is is the widening of the loss which is <unk> mainly made up when the seaweed east stress judo abiotic factors over other factors would be more more c._o. Two into the water e._s. Adults they become vulnerable to the all opportunistic abia okay so they become even become weakened and then they become diseased because of that so basically the concept would be is that c._o. Two who is being too much c._o. Two we'd know climate change is is that's one of the biggest problems is human beings putting too much co two into the atmosphere that is effectively going into the ocean which is dead and creating a lower to more acidic water and we're seeing bleaching of the seaweeds which then shows that there's a lower immune system <hes> for lack of a better word and and then bacteria than infects seaweeds and destroys the entire crop and then there's another problem the infestation all epi fights and and the flights is epa and the fights and defeats the same thing. No the fights are just other pursuit <unk> covering the whole foods at the <unk> feick lewis guest the bangles or digests research being there on the lines on the seaweed but <unk> these are more of the end defeated filaments <unk> algae which means that the first in initially this bar of this end the fide guests are enter into at the <hes> corky cavalier even today mandalay layer of the league and then as it grows farther it will we'll go out it becomes macroscopic and the us find us the air. They're on favorable conditions. They become become leopard <unk> thread or infect other seaweeds so there's two kinds of different algae that are attacking the seaweeds their macro acro algae microalgae that are also attacking them as well that is why there are five types of epa fights or end the fights infesting fasting. It's very interesting to me that i was thinking that either this was some kind of bacteria or something like that but it's actually algae weakening like an algae that you're actually trying to crop and then there are these other algae's that are gonna come in and sort of try to piggyback off the back aca that algae and try to sort of grow off of it and use it in kind of kill it like a virus almost at each what ethan <music> is is less and the feis on your door water double whammy you have both a macro and micro jackie double-whammy planning with the ice is very interesting. I just it's such a horrible thing. The ice is such a good name for what it looks like it. Literally looks like the the parts of the seaweed that are connected to the stick in line are actually white at the tips which almost it looks like ice. I think they've kind of frozen over normally ice ice at the middle of the follows this at thebes of the talos their chest chest being exposed which means that if the senate has grown bigger and bigger because they are being grown under surveys up the water they will teach way to go out and they're exposed on the air and in the sun and it could not immediately you become swipe the first the people become pink and then later on it becomes swipe if the a spill hard it's not ice is but if the ice i if the white part of the donald it is an issue that's it it will break than that is is is of this ice ice continues it. It could to kill off an entire crop. Yes but you know these days. The the soon farmers know what to do now. They know arabi that that's why when they see need that that discoloration regular figments of the silos they know already and they will before that is a complete loss of their crops. They will have it prematurely. When were the harvest prematurely do they take a cost e. s. and the weight volume us assila law bumper if it is fully matured behead year so they already they've been educated. Say that part of your program program <hes> what's the name of your program that you are a part of. I s the the east on the global sewage star project safe gardening sustainability of agriculture in the philippines. This is the name of the project funded by the u._k. R. i g. c. R. and it is a collaboration between psalms scott associated with brain science with developing countries like malaysia and end benson yeah and it is a four year project. We have floor main work packages number. One is disease and pest infestation in which we look into them. The epidemiology the costs sense <hes> the causes of ice is because of end the fights in relocate also under the <unk> hollow baio of our the microbiome community of the horse cup of goose and we also look into the molecular identification advocates tool is by security and farm management lorraine will be looking into different farming techniques used by by the farmers along with the knowledge attitude and practices going to look into the different policies of the government that leads under bicy- could it be on the transfer or translocation of siblings from one place to another and from one country to another and then packaged three is strain improvement with renew concluded included <unk> boris likewise on how wide populations and ultimately we will be able to look for one awfully superior opie bar at a new superior divide that can change range the present one that will be more deceased the stunt of course you will not forget the farmers so we are looking exactly on the valley chain from the farmers traders export <unk> process swords so the global seaweed star is the program that is trying to help developing countries to farm their own seaweed locally and to be able to do it in a four step pro you you know you help them in a four step process for them to be able to make it sustainable to grow seaweeds. I'm wondering if any problems have arisen arisen from either over farming or intensive farming. That's been a problem the that you've seen just like any intensive commodity not in terms of warming if it is if the commodity is into intensive farming which means a <unk> of high a stocking density than it it will lead to she says any mother would doing also we will be looking also in into the seaweed. What i'm understanding is sometimes you can have something that's too good of you know too good of a good thing and all of a sudden you're being able to make really good seaweed and you start growing to <hes> close to each other or too often and you're a possibly creating more disease within the crop that you're trying to grow instead of you know sort of taking it easier not being to intensive farming or overgrowing in an area which allows for more diseases that is why <hes> and you have to go to go back to the basics like site selection were in you have to concede their water movement as okay a paramount south or to consider sort of like on land you have crop rotations is maybe doing rotations nations of the seaweed farming itself that is why the sieben farmers normally they have two sides like for example during the not swollen sought they <unk> there on that site and during the southwest monsoon they will go to another place soda more or listening have a arresting through for for the place so they know already the farmers snow the importance aww relocating their division sites so we're talking about now the the farmers that are really wanna talk about them because i'm i'm. I'm actually a farmer at the company. I worked for groza medical kaz <hes> <hes> and we use photo bio reactors there is so i'm a farmer and i kind of relate to the concept of being out there working with algae and and cultivating it. I i wanna ask you about a about them. About who who are these farmers out of. They live in the philippines when they're growing this the seaweed normally we if you go to the the southern part of the via thei- farming areas are in far flung iowa so in the islands then we just have arrested insists there but among muslims in mindanao the house is the middle of the pictures of these they live in houses that basically are on stilts and on a platform that form and then they have these seaweed farms attached to the houses that then they harvest these morkel says they doc cultivate thirsty with the boss of their houses. It's only during does sibling for our tie ying ying sibling preparation abso- aw mistaken they don't actually ty the seaweeds to their homes. They actually have seaweed farms separately. They have like actual areas that they farm the seaweed you close to the shallow and of the islands i'm guessing and the us the islands as as the farming area yeah exa- happy because they have make a number of blind life for example <unk> lines so that it will be ah e._c. Ford dan each stall the cost because if you installed them one at the time it so laborious because they they have to make sure that they have more than take the lights bring advertising into their five sites. They have documented a a number of lines and they have to tie it at the boss of their house. S then after that the same sets they will bring it to the farm arm sites. How long does the process from putting in the baby seaweed to actually grow into mature harvesting harvesting. It's only one man at fifteen days forty five days excel you can order afford a prophet. There absolutely lee yeah. One of the reasons why i love algae is because from the micro to the macro it has a very short amount of time for harvest after after the forty five days once the next process of i heard you talking about drying you. Yes they have locks forms in three or four of their house east east the drying area order seaweed. It's either remove entirely from the lights or betsy with it's still being tied to the lines that will just hand them for three days or four days. In advance of the moisture content or decide i must you're on their target. This are being removed from the lines and they just passing beneath that is a fish cnet so that seems to be falling down into the league basically what they're doing is as they're picky as they're bullying the lines and yes yes. They have a fish net under the actual sticks so that it sort of just like kinda comes off as you're pulling as your political lines and kinda i just drops off and you collect it all and then it goes to a drying room like you said three fourths of the house <hes> that they live on on these stilt builds becomes a drying room where if i understand correctly what you said they some of them is actually kept in the shade and some of them put up into the sun e._s. If you want your your suited to be white then you'll call were your <hes> seaweed with the plastic canvas and then just keep me there for three days and then you remove the third days on the third day you just saw doc all over again the seaweed and then to make it even before in terms of honor and then you find they're out farther covering and under the fifth day usa dry there than these natural lick shoot. I think we're going to see a lot more out of the philippines pins coming out in the future because of people like you that are helping the farmers understand a better way to farm teaching teaching them as it goes along. What can we do to improve it. You know it's not just like here's the booklet learn about it and we walk away. Hey it's more. We're going to take time and we're gonna sit with. You and we're going to teach you how to do it and we're gonna keep up your progress and we're going to know how to maybe have you changed. Things and i think that's extremely important. Thank you for your time and i will hopefully maybe we can do this. You know and you know not you. You know i hate to be at ten o'clock at might being talking to you about <hes>. Thank you for giving me your time. Oh i have to do my dot also because i i have to go again in another place <hes> <unk> thursday. You have another talk coming up even now yeah. It's the second sabbath in palawan in the western side of the liquid. It's one of the major producing areas of country <unk> understood correctly in your talk in ogun was was that it's the number one agricultural export. I now make do but in terms of production. We are number one. It shows you that people around the world. Do you want seaweed and they want filipino seaweed specifically. It must be good. Thank you so much. I appreciate your time for for now. Well it would be great to visit. These islands seaweed farmers who live literally on top of the ocean. If anyone has any photos or video of these amazing farmers please email them to guitar podcast at gmail.com also we would like to request from you the audience to go on apple podcasts to rate and review guitar apple podcast is the largest directory for podcasts when you do this it helps spread the podcast to more people and create what we all want more more awareness of algae and like we always say if you keep listening. We'll keep talking.
153. Case Report: Ur-Ine for a Treat A Case of Diuretic Resistance The Johns Hopkins Hospital
"Worldwide cardiovascular disease affects the lives of hundreds of millions dedicated cardio nerds everywhere are working hard to fight this global epidemic. These are their stories. Hey cards family. Dan bender here and excited to bring you another cartoon or it's case support aka. cnc are as a reminder cr series is designed to shine light on the hidden curriculum of medical storytelling. We learn together while discussing fascinating cases in this fun. Engaging and educational format each episode ends with an expert cardio perspective and review or what we call the e cpr segment for a nuanced teaching from a content expert. We truly believe that hearing about a patient is the singular theme that unifies everyone at every level for the student to professor emeritus. So with that we are so excited to bring you this important. Discussion involving patient with non schemic dilated cardiomyopathy and bi ventricular heart failure. Who developed severe diuretic resistance as told by some of the most passionate physicians. I know dr. Angelelli wassily dr nick smith and one of my most favorite heart failure tends dr nisha glow. Tra- remember cardi. Innards is an independent fellow founded educational platform with the mission to democratize cardiovascular education. This podcast is not meant to be used for medical advice. The visa express here do not reflect the opinions or policies of our employers before we too nerdy. Here's a word from one of our sponsors. Who makes this high quality free educational content possible. He cardi nerds. it's amish quayle. This wonderful episode is made possible with support from tennessee financial. We're lucky to have the founder of panacea met pete's faculty in arkansas and fellow. Carter dr michael churkin's with us. Michael would you tell us what panacea is and efficient behind its creation. Well thanks for having me. I've been a proud cardio nerd for a long time myself and use these episodes to teach on rounds pretty frequently but fina see financial is a digital bank. That's built ford doctors doctors in training by doctors so fellow physician. Co-founder nettie palmer. I we felt like we didn't have many fair options for banking because traditional banks viewed as bad customers with our high debt unlimited savings or income ant banks for never open when we had time off going back to even intern year. We had these conversations that eventually we created a digital bank that gives all customers concierges level service available. Twenty four seven free checking nationwide and loan options that are built just for doctors. And and trainees are p. r. Personal loan requires no cosigner to get up to seventy five thousand dollars as little as twenty four hours at a rate. That's less than half of a credit card and no one should borrow more than they need. Training in life can be pretty expensive and doctors really honestly deserve a better option financing. Well let's just awesome. Michael seems to be a great resource that addresses many issues that a lot of us go through but one of the reasons. We're so proud to have. Your support is our shared mission with your foundation when it comes to promoting professional diversity and inclusion. Would you tell us a little bit more about the work. you're doing. Yeah so our profits from panacea financial actually fund our foundation that aims to strengthen the pipeline of underrepresented minority physicians. And this year alone were awarding. Fifty thousand dollars in grants and scholarships to medical students residents and fellows because at panacea we aim to make medicine better by decreasing financial stress but also by diversifying. Our workforce congratulations to you and your team for the incredible work. Y'all doing awesome. Thank you so much in cards to find out more go to panacea financial dot to learn how you can join the growing number of vision stat. Expect more from their bank. Peizhi financial is a division of premise member. Fdic and you can find more reason the lengths in the episode description. Hey cardi nerds. Thanks for joining us for a trip. Back to charge. City baltimore maryland. We are joined by friends colleagues from johns hopkins cardiovascular training program. We have with dr nick smith and doctor. I'm chilly wildly folks. Welcome to the show carry to learn from you. But i tell the audience who you are. Hi guys it's a pleasure to be here. My name is julie walkway and i'm originally from ohio. The moves all around the country and ultimately ended up at johns hopkins for. I'm a second year medical resident. I'm interested in medical education and planning to apply to cardiology fellowship this year. Hey everyone i'm nick smith. I was raising state of maine. I went to undergrad. They are bowdoin college. I'm in my second year. For geology fellowship here johns hopkins whereas also at for residency as part of the jaden. Wait for i will continue on here as an interventional fellow but only after completing a year of critical care certain medical education will play some role down the road as well having been able to learn from the best. And here. I need dan and almond. I live in. Dc with my fiance and we both loved the outdoors. I'm lucky we have rock creek park right in our backyard. It's like a run here in a really beautiful space all year round. Wow angelique nick. Welcome welcome welcome to the show. I'm really excited to discuss the case that we're about to do we go way back. Both you know you so well from hopkins here. But i know that we have a lot to cover a lot to talk about. So we're just going to jump right in nick angeles. Take us to your favorite place. Baltimore weekends set the scene and start discussing this important case in cardiology awesome. So we're gonna take our listeners to union brewery which is a local microbreweries. Baltimore has such a great outdoor sees. It has giant jenga in a delicious pizza oven. Also there's an ice cream place right next door pizza brewery ice cream. I am so in. I didn't really through from ohio. So you know. Hopefully when you're done with residency we can recruit you get back over here for some training but until then what has that for us so let me let me. Just say before we start that. This case is fascinating in both its complexity and simplicity simplistic in. Today's merely to nerd out about diuretics. But this is not just a forty five minute talk about lasix in the earlier portions you may find some of the information review but stay with us there. Many layers this episode because this is a case report about management challenges. It will not follow the format of a slow drip drip drip of information coded in diagnostic mystery. In fact we meant to speed ahead more than we usually like to skipping some aspects. You may have questions on. I think there's a good reason for this because we want to leave ample time to talk about uncommon inpatient direct strategies wrangler details about diuretic resistant. This episode -cerned elevate your understanding of heart failure physiology and reinvigorate your interest in the arts rates. Frenemy the kidney. So without further ado anjali. Let's hear about natalie. I'm so excited to tell you all about this case. So we're using the pseudonym natalie and not only a local college student in her twenties with nanking like dilated cardiomyopathy into newark heart. Association cost for acc stage the five and trigger heart failure with an injection fraction of thirty to thirty five percent on palliative Jobs as a result she also has cardio jenex rosas in stage. Three b chronic kidney disease. She initially presented to the inpatient advanced heart. Failure service for several weeks of weight gain ovalles shortness of breath abdominal bloating and bilateral lower extremity swelling. Natalie was well known to our institution for several years and despite an extensive workup. We never found crystal clear ideology for her dilated cardiomyopathy. The closest we came was actually genetic testing the showed a miss sense mutation in a gene that has now been associated with both do hsien muscular dystrophy and dilated cardiomyopathy but the variant is still of uncertain significance devastatingly. She had a younger sibling had succumbed to complications of heart failure and sepsis only a few years prior so there was indeed fell to be a strong genetic or familial component. Her last hospitalization was only five months earlier during that mission. She was diaries close to you. Volusia and discharged home on wtam in two point five micrograms per kilogram permanent. She initially did lose weight at home with the aid of one hundred milligrams detour semi but eventually her weight did return slowly despite strict dietary and medication adherence and by one week prior to admission she was having increased shortness of breath and show starting to feel more nauseated than usual. She then started having difficulty even climbing. Just four stairs without stopping and reluctantly. She presented to the hospital based on advice from her outpatient team. On honestly dow's a perfect introduction to her case very succinct very illustrative. At this point. I get the sense that this is a presentation of garden variety de compensated heart failure volume overload but her nausea is concerning symptom and it fom your fellow anxiously awaiting your physical exam. Vitals on admission were notable for tampa cardia to one fifteen with her blood pressure. Being ninety two over fifty two siding ninety eight percent on room. Air to seventy kilograms which was noted to be ten kilograms above her standing dry weight of sixty on exempt. She was in no acute distress. She hadn't essary gallup in two out of six whole systolic. Murmur appreciated the apex. Her juggler venus pressure was above her mandible at forty five degrees with prominent the waves and she was speaking in short sentences. And you could tell that. She had mildly increased work of breathing. Additionally she had mild by basil or inventory crackles in a distended abdomen her strategies were cool bilaterally with four plus pitting dima past her thighs while so in this description. She fits a wet profile without question using my trademark. Ilan wittstein invisible swan which. Dan and i will remember very well. I would anticipate elevated less added pressures doodo s. three pulmonary sam elevated rights. I'd pressures due to your description of j. p. an extra vascular volume inner abdomen lords remedies. I guess my question is is she warm. I really wouldn't bet on it. Was that your impression too or did you guys come up with something different. I totally agree at this point. I was definitely concerned about her. Clinical status tampa kurnia can be such an ominous sign of low cardiac output in cases of de compensated heart failure as can be cool lower extremities and the volume exam was quite pronounced. We didn't want to let her linger a malpractice state to riff it. So you know. Although the vast majority of cases are hospital for volume overload fit a warm profile a kitman situation as the patient. Who's just in a low output state. I've noticed that. How staff and i really my former self in this as well are ever eager to address a patient volume and make the urine flow neglected. I address kidney perfusion. We like to say you have to them up before you try them out. It can't be overstated. The kidneys will simply not responded. I read eretz at the patients in any form of show. Low output cardiac shock. Kidney mel perfusion whenever you want to call it. It's not a mechanism diuretic resistance per se but it is a box you have to check on every patient not responding to diuretics and so so happy to hear he recognize this early so of course always interested in at thorough review of the data for a particular presentation. But since it's not that kind of case report. And i know you're up for it. Maybe i could get a senior resident level assessment or should i say a gene way level assessment. Definitely not a barker level assessment. Where you even in all the important data as you put it all together love level load here guys particular issue with this for context with the audience. The johns hopkins internal medicine program is broken down into firms or harry potter houses and dannon myself for a part of the barker firm which was of course a form of choice and nick and unruly here are from what was it. The was a cheek chain chain. Way let's move on. I will say oh. My gosh. i love that line. That you guys just said right warm-up before you dry them out it's a great concept all right so at this point. My illness for it was that we had a young woman with end. Stage heart failure presenting for the second time in several months with low output heart failure and bullying overload. The differential diagnosis of course was much broader and included further deterioration of her liver. Kidney or thyroid function the lab. Work and other testing. Was not supportive of this for natalie. Initial workup for an ideology to her heart. Failure had been completed already in here the most challenging aspect of her case was discovering a trigger for her compensation. Now the true number of ideologies is too broad to cover on the night of an admission. And so i take a simplified approach that addresses the most common. Can't miss causes broken up into cardiac and non-cardiac buckets so in my cardiac bucket. I considered the big. Three coronary scheming of valvular disease undisciplined the as all three of which can be surprisingly subtle. We don't think of coronary ski. Mya as a silent cause of cutie compensated heart failure. But i have been surprised before in consideration of the scheme yet is always at the top of my line. It's really just a box that needs to be checked for every admission more subtle still can be presentations of progressive valvular disease typically mitral or a arctic fouls in new distributors. A common trigger for compensation is that of the patient presenting with tacky arrhythmia either. Uncontrolled acm especially with rapid ventricular rates or incessant atrial or ventricular. Teke courteous can all caucasus. I also think about the contribution of wide left bundle branch blocks and patients that have a high level of right ventricular pacing as each of these can be responsible for d. compensated heart failure and could be reversed with cardiac recent coronation therapy for my non-cardiac can't miss causes. I focused on lab work such as checking their thyroid function and kidney function and then consider any new medications that increase either sodium retention such as or steroids or medications with negative aina trophic effects such as calcium channel blockers or betablockers. Which can be uptight created by outpatient physicians trying to manage tacky cardiac ruling these five factors before attributing compensation to non adherence is so important because most patients do describe occasional lapses in salt restriction in medication. Schedules are patients developed. Compensation so for our patient. natalie her thyroid and renal function totally at baseline and a scheme had long since been ruled out. Besides her age placed her in exceedingly. low risk. Category her a t. t. e. showed similar right and left systolic function compared to prior and it did show moderates mitral But this was also unchanged from prior her. Ict of also interrogated. And it's a nacho any significant arrhythmias and she was one hundred percent native conduction with a narrow cure s. She hadn't started a new medications and she reported clean appearance to her diet and heart failure richmond with her mom cooperating. Her story so overall. I was very concerned that this might have simply been progression of disease or diuretic resistance but of course remain diagnoses of exclusion. Wow on julie truly senior-level your schema was beautiful. It just can't be overstated. How important it is to think about. These underlying causes unindicted. Admission uncovering and underlying costs for volume. Overload is just so important and your schema addresses not only common but also very treatable problems coronary profusion cutaneous or surgical valve repair and catheter. Ablation of crt are very durable solutions. They prevent readmissions improve mortality. So i have nothing else to add. I mean really nothing. So how did you initially manager then so at this point given neri's nausea and cool extremities the increase trudeau beauty mean from two point five two five micrograms per kilogram permit to first address for perfusion and within the first hour her nausea improved and her extremities did warm up and so at that point i chose one hundred and sixty milligrams of id lasix. So andre. could. I have you pause here for a moment. So i mean for one in interest of clarity. Rediscussed diuretics a lot in this episode. Diarrhea is great for through urine but knee tree races or the urination. Sodium is really the primary goal as it is the sodium reabsorption that incites water follow. We'll probably just use the terms interchangeably today. But it's an important distinction but getting back to your choice of fierro some i. I wonder if i could put you on the spot to teach us how you teach your interns about impatient diaries. This i love it. So volume overload and congestion. Maybe one of if not the most common admission in internal medicine residency and diabetics remained the first line. Therapy often acute relief from diuretic therapy. And i'm talking about within minutes. This is attributed to dilation of the pulmonary veins causing a reduction in less than trickier filling pressures and visit back actually precedes the onset. Diaries a common commonwealth thumb. That i told my entrance for initial diary strategy is for patients who have been on luth dietetic there as an outpatient their initial iv dosing should be two and a half times their home. Peo- dose so for example. If your patient was on furious in my forty milligrams. Po daily. It would be reasonable to give them. Id through some one hundred milligrams for their first dose for patients who are not receiving long-term loop diabetic agents. The starting dose varies according to either the volume overload their kidney function and their age. But usually i start at around forty to eighty iding. I'd huntley within ten minutes. You've already given senior residents everywhere reasons to reference this episode as he scrambled to assemble their morning teaching points. And you've given entrance everywhere a place return to understand the basics so we're off to tastic start. What did you going to do next. How does she respond so angelique we've achieved the cardio nurse as a great episode on this label already so on so pumped and your carry me surveyed you but to get back to the keys. I just can't emphasize enough. The cute relief of disney achieved with zero slide the pulmonary dascomb activity of bureau. It's independent of any reno or mode. Amick bax in an important study of defect demise dogs meaning these poor pups had the renal arteries lie gated they were given i v away acid which i guess causes hemorragic pulmonary demon then which is something. I didn't know at all but then they were administered hiroshima side with frequent blood gas monitoring after geeky. Miss poxy improved in the short term without kidneys at all. Although these poor dogs had to go through this and this was demonstrated in human follow up. Studies have intimated patients with espn as well so for this reason. I really drill into my insurance. The need to dose furrows. Latin on the night of admission. Your patients there are thought nick. They're not sleeping and you can make them feel better immediately as we're starting dose. You can feel confident patients with heart. Failure with reduced ejection. Fractions have forgiving blood pressure and volume relationships. It's been demonstrated pressure volume loops that large decreases in volume. 'cause relatively small blood pressure changes due to reasons that are really easily illustrated without the help of a whiteboard. So there are some notable exceptions and these would be your pre law dependent patients. Eric stenosis mitral services senior restrictive and infiltrative cardi lap. These two i love your choice but do you have anything else that i just wanted to say that the first dose is really important. But you shouldn't just park it there and forget about it constantly. Reevaluation is critical as subsequent. Doses should be guided by response to the previous dose is commonly known that because of the hat flakes of furious semi. It's dia rettig. Effect typically lasts six hours the lasix which is the training but furious might but the lesser known attributes are that the. Iv dose has an onset of around five minutes simply put if you don't have three hundred cici's of that nice straw colored urine within one to two hours of the initial dose. There is no need to wait six hours. To reduce loop diuretics steep dose response curve signaled and sheep. it's sort of like an oxygen dissociation curve on that. Y axis is your sodium excretion than on the x axis is diuretic dose but the is not linear it's logarithmic. Meeting the hash marks on each marked unit is an order of magnitude of ten higher than the previous unit. The signaled curve has a long runway and it takes a while to lift off. This is really just a graphic illustration of jerusalemites threshold effect. You may experience a wide range of honestly just ineffective doses if your slide before you see in nature rettig fat but what's that threshold is reach. It quickly reaches a ceiling almost in all or nothing. Effect paired with the logarithmic scale. This is the rationale for doubling diuretic. Dosing if it hasn't reached a desired effect to make matters worse that signaled relationship at heart. Failure or down into the right so steeper diuretic attractions are needed than seen in an already steep relationship in practice this means that every uptight nation as just doubled. Cryer twenty forty eighty one sixty. And you kinda tend to see those numbers if you're seeing someone p. adequately to your dose. Your work may not be done either. So reducing is commonly needed. Looped iraq naturally raises wayne's within three to six hours and the kidneys smarten up and will become sodium avid until the next serve your dosing once-daily a patient has eighteen hours of the day to retain sodium underlies the common recommendation to consider always dosing. Diuretics twice-daily although at towards might has different properties and it's more often given once-daily this is not usually in the hospital we give wad of euro samedan the hospital but learning. This really shifted my outpatient practice awesome so going back to our case not only initially showed good response by her ins and outs recorded as being net negative two to three leaders every day however even after giving her furious one sixty. Id ted standing waves do not shift at all from that of her admission weight of seventy two kilograms. In fact she gained two kilograms early on she was started on mottola zone two and a half milligrams every other day because we do sometimes see that for our patients who are on maximum. Doses of weep diuretics a combination of neff ron book. Aid by adding size diuretics. Such as matola can be very effective is worth stepping back in discussing the ever important net frontier as review of what was for me along with our integral unit. Went up the great catastrophes. Medical school so blood enters the glamorous a fair arterial and is filtered into bowman's capsule and then the filter travels through the different sections of the net fraud. Which series are the proximal convoluted tubul. And then it goes into the descending thin and thick ascending limbs of the loop of henry and then they into the discipline before entering the collecting duct and then finally the filter. It is excreted in the urine. And you flush the toilet done so. Each section of ron has channels that are sensitive to diuretic agents that we commonly boy so in the proximal communist annual sodium reabsorption is locked by carbonic hydrates inhibitors in the thick ascending limb. The lupus henley exists the sodium potassium chloride co transporters which are the site of action. It looped iraq's and following them in disarray cereals are the sodium fluoride transporters that are sensitive to thighs is also that discount to vehicles and collecting backs are epithelial. Sodium channels are enact channels which responded mineral- quarter antagonists like sperone lactose or direct antagonists like train trine and aquaplane channels which are expressed an organized visa presses. A review of this pharmacology is really fundamental. And if you'll feel solid on it will for starters don't feel bad view this this show but also i would encourage pressing pause or just returning to it later. Wow nick that was an amazing summary of the neff ron and a deep dive into where agents interact with it so we can get great diarrhea out of our patients. That need it urgently. I'm sure that tied into kind of your thought process of how and why use matola zone wanna tell us a little bit more about that. Yeah i love it. You gotta set me up perfectly for talking about matola zone so chronic loop diuretic therapy can lead to winning natural resource over time and this is called the renal breaking phenomenon and there's three main causes of this phenomenon i the distal convoluted to bills compensate by purchasing which causes a greater density of thighs. I'd sensitive sodium cord co transporters and that leads to a proportional increase in the ability to reabsorb sodium. A second mechanism of this breaking phenomenon occurs through the macular denser which we remember is the collection of specialized cells that line the junction of sending limb of the we've of henley and the distal convoluted tubul. So when the macula densest senses low saw it stimulates ran production which then causes doctrine to activate those enac. Channels nick was talking about which also increases sodium resorption and then the third mechanism is that hypoc menia which is something. We see all the time with our potassium wasting loop. Diuretics is actually a very potent activator of sodium reabsorption blocking the sodium potassium chloride channels in the loop and in blocking the sodium channels just disciplined really cream the ability to reabsorb sodium potassium. So it's critical to closely. Monitor these electrolytes when using a loop size combination exactly. I'd love to stop and say it. You start noticing that your patient starts becoming hypoglycemic. Instead of just repeating their potassium this is a great opportunity to prescribe them and austrian antagonise to blunt any of those potassium derangement. So let me also say that. I don't have any stop in pfizer. Who manufacturers a lactone. I wish i did rich. But i'm a huge fan. Aldosoro levels can be up to twenty times higher patients with heart. Failure and chronic loop diuretics increase adopts from levels in and of themselves through mechanisms. You just described also was one of the mean bad actors and heart failure and cardiovascular disease to say nothing of its role in sodium ability across multiple conditions in heart failure also known result and systemic hypertension trigger. Hypertrophy an interstitial fibrosis of koriak myocytes administration of mineralogy Detachments have been consistently shown mortality benefit when used chronically in heart failure with reduced ejection fraction by blunting these processes it's peculiar because i find 'em as or commonly that last heart failure medications to be added onto a patient's regimen at our institution and i can't understand why they're generally well tolerated. They have coton neurohormonal facts. And if you believe. North american top cat results. They know ejection fraction baths. But i digress. So angelie get us back on track actual. What was your next move. Sounds like we haven't made any progress at all for several days. We kept natalie on loop dietetic thighs. Zaid and your favorite and i'll doctrine antagonist thus blocking the three major ports of reentry of sodium. She show good diuretic effect and was actually eighteen leaders net negative in the first week. Her craton and electrolytes were totally stable but she ended up gaining another three kilograms porta. The challenge here could be rampant in stage rafts activation what sort of guideline medical therapy was she on. And was this part of your solution now. Absolutely was that it was challenging. She was already on a fair amount of beauty and previously it was felt that her right ventricle not tolerating betablockers so they had long been removed from her regimen. Additionally two different time she was child on logos inhibitors as an inpatient with prohibitive hypertension and we certainly fell. We couldn't reach arnie or hydrology and isd. On for this reason we did start and a sheltie two inhibitor. In patients and these medications do have a relatively humble contribution to dia- racist primarily through coughs in your area. But i guess every little bit counts so essentially the only jaydee teeth tolerated was our minner. Our quota cord receptor antagonists and an sglt two inhibitor. But it's good conversation at have because blocking As occurs with maximum tolerated guideline therapy can give you really substantial benefits from a volume perspective. Although we talk a lot about sympathetic and wrath activation leading myocardial remodeling fibrosis and crisis it contributes to reno median sodium reabsorption to vasil constriction of the blue mailer ferte royal by andrew jackson to enhance a sodium reabsorption catecholamines. And andrew tencent activate receptors on the proximal tubul epithelium dos. Ron regulates eanet channels. If you really wanna blunt sodium reabsorption you gotta use the full armament of gdn. T two blocks of the underlying mechanisms for sodium reabsorption in the first place. A great example of this effect with scene and andrew johnson receptor knepper. Lisin inhibitor trials. Where patients on. Arnie therapy needed. Their diuretics peeled back or even peels off after a few weeks on this medication. Just minimize the risk of over dire recess. So it's really interesting you bring that up because there's an important combination effect to it. Used to be thought that ace inhibitors would by means of stopping the renew injured. Tencent al surround system at the intention that they'd also block out to osserman production downstream as well but it later was apparent that on east therapy thirty to forty percent of patients at higher levels of all dawson that pre treat a phenomenon they called aldosoro and st. That's so interesting. And i think a similar escape was also found in early. Nup eliason inhibitor. Trials attempts to block breakdown of natural peptides west successful but there was an ngo thompson to escape that lead to a net neutral treatment effect and so treatment with a combination of knepper license and angie attention receptor blocker was a solution and we all know the paradigm trial success story all too well at this point yes yes to truly blunt wraps activation in thus sodhi re absorption. One should use an ace or oranje in combination honestly. It's no different than what you previously discussed with loop diuretics Tubul hypertrophy our failures. Like a pharmacologic. Game of whack-a-mole. Tony so as i said she was a recent gaining weight and the next logical roof at least we thought at this point seen to be to move from bliss dosing of semi to a continuous infusion. And so she was started on a furious in my trip at twenty milligrams. Our there wasn't a particularly elegant rationale. We were just willing to try anything and tobacco. There is a role for continuous infusion. To avoid oda toxicity bullets of ib zero-some i'd 'cause peaks and troughs and it is a high peaks that lead to talk city. But i think more so than this was just the anecdotal notion that you may see greater net diarrhea with a continuous infusion. Yes so this is actually been studied in small randomized clinical trials the largest being the diuretic optimization strategies evaluation or the dose trial they randomized roughly three hundred patients to either q twelve. Ib feroze might policies or equivalent dose as a continuous infusion. There's no difference in secondary end points of change in a nor net fluid loss nor serum create. So i'm sure that's why you say there wasn't an l look in reason but my suspicion was the team was aware of the trial. It often gets voted on rounds. And i'd bet dopamine was discussed ranch too so it common strategy that gets discussed is whether low dose or so called. Renal dose dopamine should be used to augment diagnosis. So the concept here is that at less than three micrograms per kilogram per minute dopamine acts on the renal dopaminergic receptors increasing renal blood flow and possibly conferring a renal protective effect as well as enhancing decongestion however previous studies in heff did not demonstrate a greater decongested effect additionally. We often quote the rope. Trial which famously included the slur house staff one of the contributing authors do highly motivated patient enrollment from all of our firms. This study used a patient population with heart. Failure with preserved ejection fraction and also failed to show a congestive benefit over standardized therapy with the administration of low dose dopamine. So take away. Is that at this time. We don't really have a randomized controlled trial to support the continuous infusion of euro samaya nor low dose dopamine in addition to diabetics patients with heart failure. So my suspicion angelique is exactly what you said that providers weren't expecting based on all the data you just presented to get more out of the continues fusion than they did with the bullets dosing and honestly providers can kind of have a dealer's choice and pick whichever one works for them in this situation. I think they were just trying something different and hoping for a positive result. I think they really wanted to try to help. Grade after sixty sixties of eight zero semi drip matola zone every other day. Spur no lack tone and an sglt two inhibitor. She had a net diary of another thirteen leaders. Though she did steadily gained another four kilograms again by standing regiments in the midst of this she. Also suffered from hyper nutria requiring. To- dan at least wants to of acton is a bazo. Present two receptor antagonists which inhibits phase oppressive and so it blocks the absorption of free water now by hospital day fourteen. She was switched from tolleson to an intravenous side courtside also known as diarrheal at a five hundred milligrams twice daily dose now. There are a couple reasons we did this. There's some arguments that core aside is more potent than matola zone. But this is really a matter of debate. Really the biggest reason we did. This is because core. Thi- aside is an id agent in natalie wishes grossly volume overloaded and we were willing to see if there is a component of decrease got absorption with matola zone but a major part of the storage wasn't adding up to me. We weren't actually having problem diarrhea. Her per se she was massively fluid negative but we weren't making any headway in either her physical exam or her congestive symptoms. So we knew natalie. She hated being in the hospital in. This wasn't surreptitious water intake or dietary. Indiscretion it should be clear to the audience that this wasn't a lack of response. To diuretics. issue is making tons of urine should good renal function. She had still ish electrolytes often patients with advanced heart. Failure will fail to respond to that but this was more of an issue with overall sodium avidity. So this makes more sense. And i think it really contextualized are decisions that followed because afterwards. We started her on high dose. Burn acton uptight trading daily dose of twenty five milligrams to one hundred milligrams. The id and the rationale was at natalie also had cardio genetic cirrhosis volume overload in heart failure and psoriasis heavy shared pathophysiology which is under filling arterial barrow receptors in heart. Failure at this unfulfilling is due to inadequate cardiac output. And in psoriasis. It's due to split. Nick basal dilation of circulatory volume this causes ross and sympathetic activation and each condition and together they produce pronounced hyper al-dostur anisim so in effect what we were trying to do here. Block the previously described effects of l. Dos namely the up regulation of her sodium. Coreg co transporters enact channels leading to sodium reabsorption in the Tubul in fact. We actually checked australian level in natalie and was five times upper limit of normal. Yes exactly low. Doses of sorrento lack tone have been studied extensively but for instance in the rail study. It's believed that the mortality benefit was independent of nature rhesus as twenty five milligrams a swirl lactone had no effect on secondary analyses of sodium retention urinary sodium excretion or body weight changes in comparative trials in psoriasis for instance much higher doses of aldosoro tag outperformed bureau semester leading to recommendations of sperone lactone dosing. Its highest four hundred. Milligrams a day in refractory ascites the athena h f study evaluated high like a hundred milligrams versus low twenty five milligrams or placebo joe sproul acton and over a course of ninety six hours. There is no difference length of stay symptoms or volume assessment but this study has been criticized for his short duration. So it takes time for emory's to convert to active metabolites especially if there's a patah congestion and the effects may take several days to notes. Some very small study semi. We're talking three patients. Six patients at previously shown positive effects on sodium balanced and sodium excretion by day's five to seven but no large randomized control. Trials have been conducted. Guys this really highlights a real clinical syndrome. When it comes to dima we have differential for cardio sniff roses. Sand psoriasis. Being big players. And when you have all three interacting on a level you know that's macro in terms of leaky capillaries and pie hydro static pressure and that would be very hard to treat and then again when you overlay that with the pharmacokinetic facts of these organs not functioning tiptop shape. It just makes it so complicated as you really highlighting. It just makes us appreciate for when the body works. Well or like you know when somebody comes in with one of those organs functional and you can kind of treat them and get a good successful result quite rapidly. You guys are really doing a great job of painting a picture of complexity here. And i understand. You guys have been scratching. Their heads are wondering what to do next. But we'll dan that's why they started off with a preamble that this case is fascinating in both its complexity and simplicity. You know we do. Diaries this all the time but this is next level. I totally agree. This was a very complicated case for me. she continue to diaries. Leaders of fluid twenty four in the past week and then accumulative total of fifty five liters of fluid which is not really too fell half of a tub but surprisingly her weight still rose to over eighty kilograms. Eight overheard initially in twenty kilograms over her driveway. So so nick. I i just wanted to ask a simple question. How will she gaining weight. She was so negative. Yeah so ivan. Found an answer to this. And truthfully it seems to defy the conservation matter and other laws of the universe cyclops since used as constants that grammy in reality and i think honestly an effort to maintain my steady state. Not devolve into the magical and mystical. I just ignore them. Altogether these facts at least and just moved forward but to answer your question. A little more honestly is that i think that it has to do with her sodium avidity. And i think it's just illustrating the end stage nature of her disease but okay so there's a good learning opportunity here in every challenging case. There's always a moment to step back and revisit a bigger picture and challenge any of your fundamental assumptions. That's so true and that's exactly what we did at this point. It does there noting that natalie was such a beloved patient among the heart failure team and given her advanced heart failure she had previously been considered for organ transplantation at our century and others however was teams not a candidate user multi organ disease and her extensive comb abilities. Thus medical therapy was indeed the route chosen. Yep that's appropriate because we're limited to medical management in this case what you're describing here does meet a definition of diuretic resistance simply defining this inadequate quantity of nature recess despite adequate diuretic regiment. It carries with it a very poor prognosis during any to rotation you may run into kidney misbehavior of three main players. There is the topic we've already explored of someone. Not responding to diuretics simply not making urine and this could be your cold patient and then there's perhaps the most common which is deteriorating renal function with or without adequate response to diuretics and finally there's the situation we find ourselves in which is a little more unique but it's a patient with adequate production of urine but lack of change in weight and volume. It's ads all of them are really frustrating for instance providers for sure but i think more so for patients who typically despise these long hospitalizations Two a day bloodwork sleepless nights and trips to and from the bathroom these last two scenarios deteriorating real function with a volume exam that suggests that you have volume to give and the second which is adequate. Diarrhea says without a change in weight or adid opportunities to consider getting more information. I don't know if you guys did that right at this point. But what was the discussion actions exactly on the same page with you so on hospital. The twenty two. She was transferred to. Cu for pulmonary artery catheter placement to guide further management. Her initial huma dynamics on wtam in five elevated selling pressures with his central venus pressure of twenty millimeters of mercury pulmonary. Artery pressure of fifty. Over thirty five mean pulmonary artery pressure forty one pulmonary capillary wedge pressure of thirty-five cardiac output of six point eight liters per minute cardiac index of three point eight leaders permanent commuter squared and systemic vascular resistance of six forty six nine seconds over centimeters to the fifth. This ray heart. Cath is essential here. Were not surprised by her filling pressures they're elevated on the right and the left but i will say it's not always the case. It were not surprised. By the fight fights she was under the care of dr seep shulman. Who's the director of our c. c. You and he's my fellowship director. So i've been on with dr shulman before when placing swan and he'll announce his guests and then go around the room and the fellow and a senior resident intern and outs. There's intern and i'll have you guess. So who do you think of those four fellow. The senior resident dr shoulder in the winter. Who's the most accurate. Oh i think obviously it would probably be doctor shulman. And then the fellows be close to and then how steph only if they were janeway who i was gonna say that based on the teachers so far that everyone above that i would guess it was right but not because she's janeway but because she's actually all the practice gone into this case you think so. You think the angie would be the most right or doctor shulman or or dat but no. It's usually on the internet right. So they'll stand in a corner they'll be terrified wondering if they'll even be in the right ballpark. But ever skill test taker. The intern will suggest something in the middle of everyone else and essentially the closest but the point is our there who's right and who's not the point is that even someone is experienced. Dr scholem knows that getting this right. Heart cath in the moment will often surprise you. And he's never been too proud to assume that he'll be rock. And i think he says this all the time he's often raw and lynn stevenson out of vanderbilt has published on this that often. We are wrong about our own fiscal exam and assumptions about invasive. Chemo dynamics so patients may have aggressive. Tr that leads the overestimation of their jugular venous pressures they may have a habit is that hides the true intra vascular volume and leads to inaccurate estimates in either direction. They may have a mixed presentation of heart. Failure and also volume status is simply a proxy for the pressure measurement. In the first place in no substitute for the fate. Finally patients may just have their own unique physiology altogether for all these reasons and maybe more never be shy about suggesting or getting in invasive assessment of humiliating for the right heart catheterization. You're in this type of situation where you just don't have a handle on what somebody's physiology is. That is such a great point. And i think the obvious things that we were looking at were to confirm will result. We knew just like you were saying and to evaluate for anything that could surprise us. Shockingly low cardiac output for example additionally always tried to identify where the primary problem insists that might be causing those elevated pressures. So patients can have a lesion anywhere. They please but the commonplaces are an felt. That's to narcotic or regurgitate Or schemic left ventricle nautica or regurgitate mitral valve elevated left atrial pressures mineral elevated pulmonary. Pressures can be isolated pulmonary hypertension or the far more common primary pulmonary artery hypertension and lastly isolated right ventricular or tricuspid valve can be the issue for elevated right sided pressures. They really are all so different and have implications for treatment. And i love this example of locating the lesion i remember back to my garage rotations which were not very successful but in every morning case report they present all of the core and peripheral symptoms dead were accompanying whatever. The overnight resin intimate. And they really try to locate the source of the lesion they trying to locate it to the cortex of the brain stamina spinal cord or the peripheral nerds but it's really an elegant exercise and diagnostic reasoning and i think it's very easily applied to invasive chemo dynamic suspects as well and for natalie oliver high pressures seem to start on the left side and caused a backup of fresher through her pulmonary. Arterial bat. all the way up to her right heart because her of wedge her mean. Pa pressure her. Right atrial pressure will. They're all high. Yes and you can take it a step further to so if they're all high. Is there a way to tell if one is disproportionately high. Answer's yes so we use the already to wedge pressure ratio and either the trans pulmonary gradient also called the tea peachy or the trans diastolic gradient also known as the td g to tease this out so the ra to wedge has been associated with or v. failure in multiple situations but it's been validated in an outpatient cohort patients with heart failure as well and it is what it sounds like if you have a higher than expected alway compared to a wedge then in suggests a bigger problem on the right rather than the left side and so that's not that hor to intuit but the trouble is really in remembering the up but in easy way to conceptualize. It is in considering that we are accustomed to normal array pressures being about half that of wet rushers right like a normal oray is maybe less than six to eight and a normal wedge is less than twelve to fifteen so a ratio approximates point five is typically normal but if you have an ram fifteen and a wedge fifteen and a ratio of one well a wedge of fifteen is normal but an of fifteen is highly app so the ratio approximates well then is much more. Suggestive of isolated. Right heart dysfunction. Likewise if you want to evaluate whether someone has intrinsic pulmonary hypertension or if they have high pressures as a result of a high wedge. You use a similar concept in your calculation. So the t. Pg uses the difference between the mean pulmonary artery pressure and the wedge. It's just the mean pulmonary. Artery pressure minus the wedge. You subtract the two or similar but more specific calculation is the trans is talk. Radio which is just pa. Diastolic measurement minus the wedge normal values for the teepee chiro less than twelve annual values for the td digi or less than seven but more important than focusing on memorizing. These numbers is just to create the good habit of actually taking the extra time calculating these and trying to locate where someone's unique lesion exist. It's important because they can have major management and occasions like we might employ rv support or you might use pulmonary arterial violators in certain situations. Wow that's such a great pearl. So natalie's are a to wedge was zero point five seven her teepee. Pg was six and her t digi with zero so her left ventricle seems to be the root cause of her high pressures across her whole system. We also didn't have a surprisingly low cardiac index suggesting that we needed more support. But there was one interesting takeaway in that. She had a much higher than expected. Cardiac output in a very low svr pervasive. Dilatory state and splaying dictates of dilation from psoriasis. Were default to play a role and she was initiated on a tree tied in bays present in her cardiac output subsequently dropped precipitously in the first twelve hours to a final cardiac index of two to two point. One high output heart. Failure was not thought to be the primary process underlying her presentation due to a long history of right heart catheterization without such elevated party outputs. Lastly acetazolamide was added to her regimen. See zola as carbonic it. i'd raise inhibitor. That can plunge sodium reabsorption in the proximal tubul but will also reduce the embar serum bicarbonate levels. Acetazolamide isn't at this moment. Necessarily an evidence based approach but it is undercurrent investigation as a combination strategy with zero-some for now. I see it mostly using cases where you have seriously elevated bicarbonate perhaps do diarrhea. But you still need to push forward awesome. After we got her swan numbers we actually opted for a slightly different iraq strategy. She was initiated on a hundred and fifty. Cc's of hyper tonic ceiling followed by two hundred milligrams of id thorough summit in addition to five hundred milligrams of tuna three times daily of id courtside honestly. That's definitely a big chain approached. But haven't we talked about trying to get rid of salt. Why are we giving her salt. Yeah so dr. shulman has favorite quote. Paraphrasing winston churchill. Never give up. Never never never never give an. I think this became a real emphasis for the rest of her hospitalization. I think there was a lot of disappointment to this point right. We as providers felt like her treatment failure was really our failure. And i think there were other providers to just had a really healthy skepticism that she could leave the hospital at all. But where dr sherline goes everyone falls and let me explain why we chose that right. So the concept of hypertrophic saline administration heart failure. It's paradoxical and for the thai being. It can be controversial. The rationale is that in heart failure neurohormonal activation reduces renal blood flow. Hypersonic saline achieves a rapid elevation of intramuscular. Saw you with a subsequent rise ause automatic pressure. It's like a vacuum that sucks xr vascular free water into the interscope space and the expansion of plasma volume israeli scene and felt by the kidneys by means of an increase in renal blood flow so pair the ad increase renal blood flow with zero-some administration. And what you might have is the ability to improve your rose. My delivery in the loop of hanley potentiating. It's action so this strategy of hyper tonic. Sailing combined with high dose luke democratic's it's been studied and it's previously reported to produce greater nature recess and greater urine volume than high dose loop diuretics alone among patients with acute compensated. Heart failure with diuretic resistance. Although these studies have not been widely replicated in a small but really provocative italian study of one hundred seven nations randomized diary assists with hypersonic saintly and bureau supplied versus frio slide alone patients achieved a greater weight reduction at twenty four hours. A shorter hospital stay in preserving function. But that wasn't even close to the most interesting fighting so they follow these subjects and an average interval of nearly three years. And i don't really understand why but they found a substantial endurable reduction hospital readmissions for heart failure and also durable and substantial mortality benefit over the three year period. The authors were not easily able to explain the findings but one hypothesis is that the sodium loading not only to wrecked renal blood flow effects. But also neuro memorial modulation subsequent. Studies have been undertaken to evaluate this curious fighting in suffice assay in a two thousand fourteen systematic review and meta analysis. It compared ten randomized controlled trials. Over two thousand patients they substantiated. The same findings decreased heart failure readmissions decrease mortality and preserved renal function. I'm not sure we entirely understand these findings. But it's been hypothesized that maybe this is no different than the error of betablockers which were once considered forbid an advocates of their treatment of patients with heart. Failure were considered perverse. We encounter these types of paradoxes frequently in madison and only time will tell it nick. I'm so glad that you bringing up this paradox. I think the story has yet to unfold as you mentioned. We have good data for salt restriction for hypertension but really no good data that song restriction is good for chronic or acute heart failure. And in fact as you said there's observational data that salt restriction may be associated with increased. Brutality there is of course being unclear but as you said that saw can increase at activision right and so really proud to say that one of my co fellows rob montgomery just started in our c. T. as she randomized patients with acute accomplishment. Heart failure her. Getting intravenous dialysis to all tabs. So stay tuned. But we've got a lot to learn and things we take for granted. We probably shouldn't. Yeah it's kind of reminds me of like what people do with psoriatic patients that really need diabetics. Because their volume overlooks of third space. They give albumin and they give volume to remove volume here. We're giving salts or move soft definitely not intuitive but when you kind of explain those mechanisms and potentially mechanisms that will learn in the future. I've discussed it really makes sense and maybe changed the way we think about heart failure and alert the medical school at really guides. The way i think about it also guides the way Educate my patients is. Salt is the currency for the body right. Salt is the currency that the kidneys used to exchange basically. It's the money and waterfalls the money. So the kidney has to use salt as a way to excrete also retain and that basically have the effects on volume so this just very very wonderful discussion about how we do. Something that is totally against the grain. That may actually end up penny out to be something. Very fruitful are co resident. Dan resumes a nosy. Who is now analogy attending age. He always said he said you know cardiologists. Think about dialysis in terms of water and net. Foll- gis think about diagnosis and trump's assault and under so proud of this episode naked. Utterly that i think you're you're upturning that we are thinking in terms of salt. Those are great examples and glad that we have like a good analogy. I i know resolute. Minesh when he was attending he would always say to try to bring in other organ systems or things that people are used to during when you're trying to explain a difficult topic and so that was a very helpful way to explain this all right so following. These two strategies nonleague lost in net of twenty one meters of fluid and her weight dropped to sixty six kilograms by hospital day. Thirty five. I think most impressive display of a turnaround to her sodium. Vity came on day. Thirty seven when she was discovered to be factory mic and all diuretics stopped with three and a half days however surprisingly. She did not get any way. During this period. She was noted to continue to diaries. Fire is knows tracking being net negative over this time. We did resume diuretics. Hospital date forty however at a fraction of her previous. Does she was using a one hundred and sixty one to two times daily up bureau samaya with matola zone and she lost another six kilograms and her weight stayed. Stable at sixty kilograms believed to be within a few kilograms of driveway. She was eventually discharged on her home. Regimen of one hundred milligrams via detour. I'd and matola zone every other day. She was able to leave the hospital and be with her family for two consecutive politics which was really her goal. She was visited by palliative care during this admission and did indeed choose to following repetitive approach. And we are sad to report that she has since passed away draws a truly devastating loss. Yes so i was really affected. By this case natalie was such an amazing person and whose strength and determination were really inspiring. I can't imagine having the same amount of grace and courage and the phase of her illness. Especially if you remember after losing for sibling. Shortly before kerr presentations. It's just devastating and her presence was a real gift to our staff and in the final days of her hospitalization. I remember seeing her playing games online with her family. Choose such a bright talkative. Cheerful person getting a role in a relatively compensated state was nothing short of miracle given the first three weeks of her hospital. Stay and this case presentations really in her memory. And i think it goes without saying. I mean amount apparent but i just can't fathom losing not one but two children at such a young age and or parents for just incredible and we're really proponents of medical education and would be so supportive of spreading the word about diuretic resistance and diarrhea in general and just about heart failure. You know honestly. Nick reflecting on the patient like just is just really commendable and also important in keeping the humanity within cardiology a deep dive into failure diarrhea. We've got really really down to the net from level and it's easy to get lost in the weeds and almost kind of use that deep dive to almost push away our emotions that we feel when we take care of patients who don't do well and reflecting on this. Obviously you know. It's a real honor and privilege for us to share this patient story in a way that she would like to educate and further the field so that we could take care of patients like her better and i really appreciate what you had said about your reflections on his patients cases. Just something. that's so important and we would never want to forget to mention. I'm so touched by the the tenderness and care with which you described that. Just her as a patient but her as a person it's clear that over the course of her disease you got to know her and appreciate her share regarding indebted to her for a for teaching teaching us so much and for you know grateful for you to leeann nick to reflect on her story in such a way as to educate so many people. And i'm taking away so many lessons from this case and the story and really you're giving me a way to think about a pro diuretic resistance. At least in terms of a framework in terms of what is causing us to not diary somebody adequately and over the course of this discussion. I'm thinking they're three big generalizable budgets. One is just a pharmacology. Do we have our dose of diuretic right. Is it being absorbed if it's an oral route using the route itself. Intra venus even bolles or continuous. Infusion rates have gotta make sure at that. Our pharmacology is appropriately matched to the situation. The second big bucket are the extra renal causes. Here i would think cardiovascular right at some point you took a step back and said hey are even getting enough profusion to the kidneys to have impactful dialysis the kidney seeing enough salt indirect load and so we have sufficient cardiac output into a new to augment the cardiac output by impacting after loader. I know trippy. Originally right. About the fluid status may be obsolete overload. And maybe they're actually try. Because nick you outlined so beautifully. There can't be disconnect between physical exam and a true dynamic numbers and so here right heart. Cath can be very useful. And of course bureau semi is carried by healthy men and so especially when there is a hypnotic involvement of kexia is albumin level. Too low and that can be impacting. It and the third big bucket as carl riedel causes that usually a universal nicely right the olive breaking phenomenon. If we're blocking the loop of henley. We had augmented salt. Reabsorption in the proximal convoluted tubul. We have hypertrophy and reabsorption the distance and the comfortable in the collecting duct between direct doses. We have increased salted validity because of increased rasta mission and so sequential front blockade. inappropriate riddick. Dosing are all important to consider. So i'm definitely taking away from this at least cognitively. How to think about the different causes inadequate terraces and for each of those issues how to address them. So nick and ashley. Thank you so much for for introducing natalie to us and giving us so many pearls takeaway for things we see all the time. Indeed this was both complex and simple at the same time thank you. This is so much fun at. I'm so glad that i got to do this on joey. And you guys have this great. Hang out so total blast. Thank you so much for having us. Thank you so similar to. This was so much fun. And i learned so much from nick and all of you guys so glad we got to do this and i i just wanna say thank you guys. Agai- i'm particularly so proud of this discussion. I've seen you both work over the years. Inner training more unique seen since intermediary just watching blossomed into such a wonderful clinician and a wonderful educator and i can't i've got goosebumps all around the net can't say enough how proud i am to hear you to such a phenomenal job of walking through this. Very complex case in such a phenomenal way and breaking down very complex physiology and pharmacokinetics in such understandable and digestible way. So thanks guys. This was a real treat in now for the east. Cpr segment of this episode. We are so honored to hear the thoughts of dr nisha. Golo through a heart failure cardiologists in director of heart. Failure disease management at the johns hopkins hospital high cardi nerds this new cycle through her killer cardiologists at johns hopkins and director of disease management. Thanks so much for having a here today to contribute to your expert discussion on diuretic management in a very complex and challenging patient so wanted to highlight a few excellent points that you made in describing natalie's case the first is how do we choose. The right direction does for our patients and their multiple factors that contribute this includes what their home doses what their renal function is. And what their reason for compensation as for example someone who may have a mild day compensation or an obvious insult such as dietary non discretion. May diaries much more easily. Compared to someone who has progressive end stage cardiomyopathy and worsening low output. I also want to highlight that. We really wanna leverage the hospitalization to achieve effective diarrhea in the deer. Study which is a national registry of thousands of heart failure patients. We demonstrated that we actually do. Not offensively diaries. Patients with twenty percent of patients leaving the hospital actually with week teen and so some of the points that you highlighted with natalie's case r. Horton as in this situation. You were able to get fluid off however we continue to see waking so that subset of patients needs further exploration and investigation. The other thing i would highlight is that we achieve adequate decongestion. So as you all mentioned lasix can actually results in pretty acute initial desk near relief and so patients can see a lot better even while they're still in the emergency department before they been admit it and this may throw us off and make us think that they're ready to go home faster than they actually are so really leverage the hospitalization to achieve as many markers of decongestion as you can because even those patients with more markers of decongestion as seen in the does trowel which you mentioned which helped lucid sedate. The best strategies in terms of diuretic dosing for inpatients. They found that in patients with markers of decongestion had high thirty and sixty day event rates including rehospitalization. The other thing that i want to mention is that it's really important to identify. Wi- or patient may be wall and developing diuretic resistance. We really need to recognize the clause and whether or not you need to actually escalate care rather than flagging men with one direction after another so. This is a great opportunity of which one should pause and think about. Do you need a right heart catheterization. are we missing. Something like you mentioned. Is this more of rb problem or an. Lv problem is in world pulmonary hypertension issue or is it more of a low output issue recognizing the cause of diuretic resistance also includes recognizing cryogenic shock. Does a patient need an atropine assisted diarrheas or do we doing these escalate. Mechanical circulatory support and consider patient for l. That or heart transplantation for example particularly in our patients who had recurrent hospitalizations despite adequate theresa's and appearance to their medications. When should have a really low threshold to investigate the cause. Further d. compensation and lack of response to die rhesus lastly. I'm gonna highlight the role of palliative care as you did beautifully in natalie's case in patients with recurrent hospitalizations and all of our best efforts to diary sometimes end stage heart. Failure takes its natural course and for those patients who may not be candidates for advanced therapies. When should also consider palliation or at least involving our palliative care team to help the patient and their caregivers engage in a conversation about their goals of care and quality of life so cardio nerds in summary and when it highlighted that hurts earlier is the number one cause for hospitalization of adults in the united states and congestion is the number one reason that heart failure patients are admitted. So our bill and europe goal today with this podcast is to really learn the nuances of diary and optimize patients as much as possible during their hospitalization and this includes the aspects of dia rhesus that you outlined so well but also recognition of how other heart medications such as oral baiser dilates after load reduction or aina troops can help assist in dire recess appropriate. And lastly don't fail to recognize the patient. Who's developing diuretic resistance and subsequently recognized the cause for their diuretic resistance. Oftentimes these patients may need an escalation in their care such as mechanical circulatory support our troops support often patients with advanced heart. Failure will fail to respond often out. He's trying to get one's wow spirit. Wow yeah i was gonna say where it was really doesn't like this discussion that you're not a series like why is the diuretic. Yeah things have been wrong here.
#1450, Dr. Nasha Winters, Greg Glaser
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Subscription at veg world mag dot com the international society of sports nutrition the only nonprofit academic society dedicated to sports nutrition and supplementation learn more at sports nutrition society dot org and thorn research redefining. What it means to be well and pushing. The limits of human potential go to the sponsor page at one life radio dot com for links listener discounts. Thank you for listening to one night radio. Baby do you wanna go higher baby. You're in the right place. You're listening to one live radio. This is bernard with junior. And we are broadcasting live from dallas texas on iheartmedia as well as km et in southern california on abc news. Talk it's thursday. It's almost friday fact easy. Anything interesting happened to you on the way into work this morning junior. I went to before i came in. I went to the airport to pick up my mother-in-law she's in town for the week and Yeah so picked. Her up brought her back to the house. And yes she. Just wait for the girls to get home from school and They have spring break next week. So they're going to get spent an entire week with with their grandma. How nice where does she live. He lives in florida and florida. tampa areas. right. That's where you garage. Yeah well you started in new jersey. Right was born in new jersey and then moved florida and then back to new jersey and back florida. Yeah the people on the east coast. They really like florida. They go back and forth. There's there's a big influx from northeast. Moving down in florida now. So yeah. I believe i tell you what the last the last month that i lived in. upstate new york. Which was my decision for saying. I can't do this anymore. I i've told the story on the air many many times but it was in january and it was Hundred eight inches of snow in one month. And you had to shovel your way out the front door literally and so And then to make matters worse so one hundred eight inches of snow of you can imagine what was on top of everybody's roofs and it was even difficult to get out and shovel your roof and so people who thinking what shovel your roof. That maybe didn't grow up Back east or anywhere where. There's a lot of snow. Yeah people have to shovel their roots. And so i rented at the time anyway. A big is. It came off the second floor and absolutely destroyed. My car died on the total that completely totaled at an icicle to get out. And that's and that's when. I said you know what i think. I'm gonna move where my parents were which was in texas so yeah. My parents moved to texas. While i was living in europe for almost two years and then i was so dumb god i just went to two to europe with no money really and just a boyfriend. That was living there at the time. And oh my gosh. The things we do when we're young right without thinking no regrets venture. Oh my gosh. What an education i got i really did And learn to speak german and so yeah so there's no better way to learn a language. Then you just you know dump yourself in the middle of that country get thrown in the pool and figure out how to swim high. Now i know oh my gosh. Well always great to open the show with junior. I love what we do here on one life radio and i think everyone out there listening is going to really like today's show. We have one of my favorite people coming up here in just a second dr natio- winners at the half. We have greg a glazer back. He is the general counsel for physicians for informed consent or pick a nonprofit organization opposed to maxine. Van dates are van dates mandates. The things that come out of your mouth on the radio right. Oh my gosh. By dr nathan winters. You're gonna love her. She's been on the show many many times. If it's your first now your first time listening doctor. Asia is a naturopathic. Integrative oncologists and a fellow of the american board of naturopathic oncology. She has been on a personal journey with cancer for almost twenty nine years and her quest to save her own life has transformed into a lifelong mission to support others on a similar journey. Dr travels the world helping colleagues master the metabolic approach to cancer so their patients can achieve better treatment outcomes. She is the co author of the book. The metabolic approach to cancer integrating deep nutrition. The ketogenic diet and nontoxic bio individualized therapies. she's a rockstar in this world. You guys you can find her at. Dr nation dot com. That's nasa a doctor. Dr show. Welcome back hello to drop a no or call right back okay. Caller right back. I you know i always have stuff ready. So you let me know when she's back and i'll stop. I might not even be able to get to it but you know i was. i've got two things one of my left hand one of my right. Which one should i do. My left or my right Let's go with my right hand. Okay so this is an from a from a blog. Called mama mia. And it's the seven things that people with healthy guts do every day and i think it's important to always remind myself the things that maybe i missing or you forget you know. Life is so busy at times but on the top of the list says take time with your food so it goes on to write that probably the most simple change was remembering to just slow down when it came to meal or even snacktime and so it's important that she there. Yes she's on. Okay all right thank you. I was butchering that today. I wasn't ready. But i'm kind of always ready but you know what i mean. I wanted to talk to dr nature. How you doing today. Dr nisha winters. Sorry about this. I don't know what happened was not a big deal it happens. It happens all the time and we are live so that makes it even more interesting people. People loving people love it. When you screw up. It makes them laugh so so everybody out there laughing. I hope you enjoyed it anyway. Go when're is real there. You go keeping it real here on the radio. Well you know you are one of the most real people i know and your experience of what you went through And transformed your own life and this lifelong mission after fighting cancer for almost twenty nine years are not fighting well keeping it at bay right and getting rid of get yes yes yes yes Okay so what we're talking about. Today is actually fascinating. I don't i know very little about this subject. And i kinda like that. I'm going into this pretty blind. So let's talk about this mistletoe. Therapy so many of us here. The word mistletoe. You know doctor and they have christmas. So one of the medical uses for mistletoe. I love questioning. And of course it's near dear to my heart This medicine has been around since ancient times Had been used at you as a whole plant extract for everything from cardiovascular disease to headaches to arthritis that in modern times since nineteen twenty if you can believe it it has been used as an adjutant cancer therapy in an injectable form of a very specifically harvested processed and formulated plant extract in the treatment of cancer. So we'd had it for just just celebrated hundred birthday as a cancer treatment. Really okay so we. We clearly don't do this in the us where what are some of the countries that they do this. And i'm thinking europe or china maybe right pretty much everywhere but us although led a little shoutout to the us The john hopkins just completed a phase one clinical trial. Which is the first done on soil in the united states on an is the application of the therapy for stage for solid tumor. Cancers dot should be published Soon so that's a big step forward. But if you're a patient with cancer living in europe depending on which country you're in between sixty upwards of eighty five percent of a patient with cancer will use this therapy at some time the apple how far behind we are over here in the us. Well we're not really far behind. We're just bought me for by the pharmaceutical copies. They own they own country All street got the trial donors. It was paid for by profit It was not funded by governments sanctions. So your point exactly. It wouldn't happen if People hadn't raised the funds to trial. Wow well i was gonna ask you how long doctors been using it but you already said this is a hundred years old okay so mistletoe you know everybody kind of knows or at least. I always put mistletoe in my house. At christmas i love it. I love hanging it over the door. I love you know catching my man and kissing up. Mistletoe always a reason to kiss right. You gotta kiss good for you. Okay so so know mistletoe. We know is is poison. Eat it right. And so is the poison in the mistletoe. What kills the cancer. Yeah the miss. The poison in the mistletoe are known ask elections for visco toxins specifically and it's those that have a very specific Impact to induce a pop. Does this so programmed cell death to lower angiogenesis to modulate the immune system to lower inflammation to release endorphins To restore circadian rhythm and it even has implications in resetting metabolic imbalances. And it's really well known for its youth in quality of life and even extension of life especially when compared with standard care. it's huge. I mean this is silly that it's not used with senator all over the world routinely. So can you take mistletoe. I'm thinking tomb wreck. Curcumin has as a daily you know supplement it is it is available to people in a picture and capsules and that's the whole plant extract but that's it has other helpful factors without the only way to use mistletoe as a cancer therapy or adjutant cancer. Therapy is in an injectable form. Be it and trabane us into tomorrow even intrinsic killer meaning into the bladder. That's how it's used all over the world and a lot of different environments And so in the. Us you'll pri primarily see at subcutaneous or venus. Although we have dr sued you enter to moral intramuscular in this country but most of those are happening abroad and we all learned those applications abroad but it is so high electing content and so vulnerable to break down our gi tract. Then you have to bypass it to get that anticancer effect so it does have to be a prescription and overseen by a properly trained physician. Who knows how to use therapy. Because it's not ake protocol on the patient but you can get the treatment here in the us you can but you'd wanna make sure you go to and i'll give you some links um where you can go to. Doctors have been trained in it properly but yeah absolutely. Wow this is fascinating. And why is this not mainstream. Well when you're looking out. I mean up until just a couple of years ago. Everybody who who'd the idea that our immune system had anything to do with the fight for cancer. I mean the last twenty years trying to explain that to colleagues but until we could put a billion dollar price tag on it Now immune therapies are all the rage but there were looking at this or two billion dollar answer to the hundred and fifty or three hundred dollars. A month option. It's been there for one hundred years naturally unfortunate. Yeah well you know my dear friend Ns decarlo nesbitt passed away of cancer four years ago and it was. It was grueling. She fought hard. She fought the fight that any person could ever fight and unfortunately she lost. But i remember when she was starting to get well from doing all these other outside therapies. One of them was cannabis. Okay cannabis and i have talked about this. Before to enter. Tumors were shrinking. She could not even tell her doctor what she was doing Because then she. It just was very complicated and she. She had to go to colorado to get the cannabis and get it to get treatment and it was just. It was a mass. It was that's the last thing you need is more stress when you're fighting cancer but you know. I just wish that she was still here. You know that we could perhaps e what kind of an effect us mistletoe. Therapy would have had on her. And it's it's really what keeps the passion and me one of the many things that keeps the passion in me to continue doing this show so that we can educate people and our government about what really works right absolutely and and that's just it all of us who've gotten into the integrated model. Yes there are bad apples on both ends of the spectrum. Don't get me wrong But we certainly are doing it as good as he could on either end of the spectrum. Really marrying the best of both worlds Mistletoe therapy has been used primarily as as supportive therapy for standard care helping patients have better outcomes with their standard of care chemo. Radiation or surgery. Helping them keep. Their blood counts up their side effects down their quality of life up and extending their overall progression free survival as well as overall survival. Those have been shown over and over and over clinically in hundreds of studies worldwide Like i said we got our first study kind of off the ground here in the united states. But it's been a part of other medical Like registries and practices all over the world. And yet here. It's still kind of considered very often. You know up on hard or very taboo. Yeah well you know it makes me think sean wells our dear friend. That's how we're introduced and my friend. Patty di bernardo who was diagnosed with a very rare cancer which went to her long. Make a long story short You know patty went on everything that sean recommended and is doing quite well. My added eh. Checkup tumors shrinking. And so you know it makes you you know makes you wonder why what are we doing. What are we doing here. And the thing that. I didn't say about my friend my dear friend that passed away an ass. Is that you know. She got convinced to do chemotherapy. One more time okay. And and and she passed away three months later. It was like it's my analogy of it. It was like watching her. Go from trying to get healthy to pouring poison on a plant and watching it die and And i'll never forget it. And so i'm very glad that we're talking about you. Know talking thinking and talking outside of the box about things like mistletoe therapy because at the end of the day people's lives are in the balance you know she was too young to die. She was forty two years old. And yeah so go to a quick break though. More coming up. Yeah with dr winters. I love this woman You can find her doctor. Nation dot com more. Coming up about mistletoe. Therapy stay tuned. You're listening to one life radio. Don't be let go show look down on listening to one life radio. Make sure you check out our podcast and get to know the show at one life. Radio dot com. Just want to let this song play. I need a little more. What's it called my. Gosh music is so incredible. I i. I've said this before. If i had to put an island for the rest of my life it was between food and music. I would choose music. I would follow starve to death dancing. What a great way to go right. No better way actually. We'll maybe one having a heart attack during sex. Maybe my gosh that makes me think of that movie. Private benjamin really old movie but you remember that movie where golding on and her jewish husband after the after the you look a little bit like him to junior the actor he has a heart attack on their honeymoon right on top of her. A larry and that is hilarious. Oh my gosh. Leave it to me to bring that up. But it's so great. It is so i love your laughter. I just love this woman. You guys dr winters. Let me reintroduce her if you didn't hear the opening as she is a natural pathak integrative oncologists and a fellow of the american board of naturopathic oncology. She has been on a personal journey with cancer for almost twenty nine years and her quest to save her own life transformed are transformed into a lifelong mission to support others on a similar journey. Dr nation travels the world helping colleagues master the metabolic approach to cancer so that their patients can achieve better treatment outcomes. She is the author of the metabolic approach to cancer integrating deep nutrition the kita genyk diet and nontoxic bio individualized therapies. Her website is simply. Dr natio- dot com. We started out talking about mistletoe. Therapy but i'm going to go into cannabis and the ketogenic diet here in the upcoming minutes but let's finish up with the mistletoe. Therapy were is is it. Is it used in combination with other treatments. I love the that comes up because a lot of folks want you know one thing to one treatment and yes though. I've personally seen as have my colleagues that it does definitely has some efficacy on its own. It is always been best paired with other treatments and it's been most notably paired with standard of care treatment. We all know contraindications. I know interesting. Right so with chemo. With radiation with surgery with targeted therapies with hormone blocking therapies. And so if you're getting on the therapy for instance like that upwards of eighty five percent of european taking this medication you know this injection some point along the way they're doing it typically with standard of care and their outcome and there are better. Their side effects are less their bone marrow. Count stay up. They don't have to skip treatment. You know they really are a different place. So i don't understand. It's not an author them. This really isn't that could enhance your standard of care much. Also really pairs beautifully with therapies. Like hyperthermia with therapies like iv vitamin c. Done on different days you know separated out with You know other fasted dates with other things that worked really nicely likes to play well with others. A lot of different ways Vitamin c is so important for everything. The other day. I hadn't taken it for a couple of days. I kind of forgot. Just get get sideways doing this doing that. And i started to not feel good. I'm serious and And anyway i took a couple thousand a and about a couple of hours later a couple more and it just went away. it just went away. You guys like seriously. I felt better within like six to eight hours. And it's amazing. How fast it works. It's so important for our immune system right absolute absolutely and so the you know the oral of it when you're taking it on a day-to-day basis preferably in a whole food form not in a scorebig acid form to like calm you were life is normal wholefood see. It really does acts of beautiful antioxidant immune system tonic. When we're using it as a chemo type of treatment in high doses intravenously. It has a very different mechanism of action. It's actually very cytotoxic. Drives extreme oxidative stress. Just like a chemo or radiation does. So you know you can use it as therapeutic and it's been under lots of studies places like cavemen and indiana university and other places for decades are well over a decade at least in this country As as a therapeutic intervention that has cancer just like timeout with mistletoe. You can take the whole extract or get kinda some general terrain support. But you don't get the anticancer support until you take it in that forum. Same thing vitamin c at low levels early it has one approach in the body but it high level intravenously it impacts us very differently. Well the vitamin c. That i took the name of the brand. It's in a little box in. Its suspended in its and it suspended in its in a packet. And it's it's i think it's fat like some sort of fatty stuff. Yeah yeah well. And it's like a gel and you i. Do i do a couple of packets at a time. You swish it down with water. But it's an incredible product. I used it all during covid I think i bought everyone they had on the shelf. I'm just but amazon. But but so mistletoe. Therapy so if If you choose to modify many aspects of your life when you received your cancer diagnosis. What lifestyle changes. Do you feel helped you the most nigga contract. I think people want me to say one thing when silver bullet treatment or drug. You know for me. It's still ongoing. And in fact. When you get your intro now i can actually say no. I'm heading into my thirtieth year in october. Twenty twenty one will be thirty years since my terminal diagnosis and so really crazy. How fast these things happen. But i'm still working on it. I'm still working on my terrain. The whole bit but i think for me in the beginning. The most crucial was the changing of my environment. And by that for me. At that time i was coming out of very toxic emotionally traumatic high stress environment and i needed to really extricate myself from that and do all i could to change my mindset my mental health and my ongoing structures. That was really key. If i had not started there. I don't think any therapy. I would have brought on board. What is their mark. Yeah that's interesting that you say that. So many people don't take distress in their lifestyle seriously. I know that it causes disease. I mean it just. Does it breaks down your body and body mind spirit. They're all You know Are there any other conditions that can be treated with mistletoe that we didn't talk about. Yeah yeah in fact. There's a paper Hopefully coming out any day now on the usa mistletoe in cohen Prevention and also kind of quilting the overreactive response in the body and it was sort of found accidentally among colleagues that we're using mistletoe in active cancer patients actively going conventional. Cancer therapy with mistletoe. Adament who were either knowingly living with somebody else in our household who was diagnosed with tobin who had severe enough to need to be hospitalized or even parish who themselves were tested positive who had little or no symptoms and never even needed hospitalization or any other interventions and. You're still adding to this database. The the the paper the initial peoper. I think had twenty eight. She studies but we are all kind of collectively all of us in the anthroposophic nature. Pathak integrative oncology world a big kind of collecting data in a rep In a repository to start view commonalities. And we all do a lot of lab testing. We can also see what sort of before and after what is landing on. But it's very interesting that it seems to have a very powerful Prevention as well as support for viral infections co infections immune dysregulation even standing. Autoimmune conditions seemed to be very responsive to therapy. And it's because it is and i'm you know modulator. So it helped balance things out when you have an overzealous immune system such as an autumn unity or an under active even off the grid immune system when it comes to things like cancer and so it's got an interesting place. I mean we need to do more. Studies obviously So i'm speaking more anecdotally at this point. But i've been using this therapy since two thousand and three thanks to a patient bring it into my clinic and saying i'm gonna take this with or without your blessing but i'd like you to learn about it. Come along for the ride. Amazing right and here. We are nearly twenty years later. And it's one of those profound therapies. I could possibly offer anybody So i'm incredibly grateful. Ya not you know it's like wow. I'm still learning. We're all still learning together of how this can be used in a lot of different partners including cancer. It's fascinating and it's so fantastic to have you on the air with us today. We've got more coming up. Dr nature natio- winters. You guys stay tuned. You're listening to radio. We'll be right back john. Don't hey just ask sale ads Follow us on social media. One live radio. I'm loving the music. Everyone welcome back to one life. Radio this is bernadette with junior and dr winters continuing our broadcast live from dallas texas on iheartmedia as well as km in southern california. Okay so dr nisha. When you're on the show back. I believe it was september twenty eighteen. We talked about cannabis and cancer. What do you want people out there. Listening to know about cannabis and cancer holy cow. And i mean think about how much has changed since then. I mean we're two and a half liter and the research is exploding. I almost wish. I could do a back and listen to that. I should go. Listen to the archives. 'cause i'm imagining a lot has changed since then i mean i think back even in two thousand eighteen. There was still so much taboo. And today if you are basically in the cannabis camp you're really an outlier. I mean we've learned that much about its application in so many areas From seizures too immune modulation to pain to sleep supports mental emotional wellbeing We've also come a long way with our epigenetics. So so for instance. I'm going to be very transparent for me. I have these sip. Toothy nine star three epa genetic kick up that makes me a little walkers when he hd is involved so. I don't personally tolerate it. Well in fact it you hear stories about people going cray cray and landing in the er it probably had with me some point but for me good old. Pure cbd really is a lovely way to call my nervous system. I left to take it before a presentation etc. There's people like my husband for instance who has a very good functioning at the genetic piece and and his family of a lot of mental illness. A lot of bipolar. A lot of other chronic conditions. This is actually a medicine for him when he feels really out of sorts Of course my world is a cancer patients. I don't find anything as well when you know the patients genetics and you know the type of pain patterns. They have and you get to get a sense of what they're looking for like. Are they wind asleep. Are they wind is still function. You can get so personalized with the blends of thc. You know the forms of it like do you want high. Pine warms with more mentally stimulating or more mercy. Informs with more senator ted and pain. Managing we've come a long way so now we can use these. What they call chemo bars and get very very specific overlaid on our personal genetics. To know exactly. What's going to help us or hinder anywhere along the way we no longer have to get. You don't have to be the. Oh my gosh. Remember in the nineties at a party. I had this experience. Well now you actually can no time to know how to how you're going to respond and what will work for you. Yeah and it's so interesting. There's so much information out there. My gosh it's it's a it's it's so hard to sort through all of it. Is i so important that we're talking about this. I mean this is the future of our health in like i said so. Many people's lives are in the balance. Health is the most important thing that we possess okay. So what about the ketogenic diet. Let's talk about that well again. I think we talked about. This is probably a good year and a half ago or more as well and you know have been replaced using a metabolic flexibility approach which means when we're metabolic flexible. That after a good night's sleep but at least thirteen hours away from eating food. You should be showing trace. Keaton like all of what we're made me to do. Our body should actually go in and out of burning fat and sugar as needed. But we've all gotten stuck in this sugar burning state for the past hundred fifty or experiments that we've been in Living under And that being said is much more difficult now for people to achieve that flexibility. So i always ask people You know if you can go a whole night's sleep out anything but water If you don't if you can go for hours without eating you don't get shaky or henry with skipping a meal. Then you're probably a pretty good metabolic flexibility but studies show that over. Eighty eight percent of us are not right so that tells me that. A lot of people have a lot of exploration to do that. Being said is not metabolic flexible and when we aren't we also are higher risk factors for all kinds of conditions all kind of chronic illnesses but in cancer specifically the also. Don't respond to our standard of care therapies. As well so the key tones create a bit of an extra stressor to the cancer cell while in bolden and strengthening the healthy cells. So it's like a almost like a trojan horse that drives whatever treatment of choice. You're doing be it from standard of care or hybrid eric. Oxygen or even mistletoe. For that matter will hit. Its target much more effectively. When someone's in a state of this around metabolical metabolic state. Wow well you know what this morning i was. Just you know digging through my stuff. And just you know trying to get organized. I ran across And it's from it is from where the on it I can't find it. Let's see twenty fourteen. Dr twenty fourteen and it's called the intelligent optimistic a magazine that i picked up at in there. There was an article about steve newport. Mary newport i know you know the story. Oh we've we've talked about it on the air before so quickly. Let's take a minute and just talk about the genyk diet and alzheimer's yeah. My gosh between. Mary newport's work of a physician who basically stabilize her husband's very aggressive alzheimer's condition and kept him very stable and even improved upon his condition. For many many years before the disease really kinda did take over and consume him. She's got a very compelling story and history and started making a lot of people think about the use of the two thousand fourteen but it was even before that of its use in our logical disorders. I mean ketogenic diet was started to be used as a therapy for pediatric populations in the nineteen twenties for epilepsy. So we'd known is how good brain of act right so right. Why would you not just make that leap and try it. It's not gonna cause harm and boy howdy if someone has a brain injury. Brain tumor a secondary like to the brain. Alzheimer's dementia neurological symptoms of any kind. Especially things like i would be. I think it's malpractice at this point that we're not recommending a ketogenic diet for the population absolutely and Mary newport actually was on the show back a few years ago. And i remember the first conversations that i had with dr joey antonio The he is the co founder of the international society of sports nutrition and how he was the first one that really introduced me to the ketogenic diet One life radio was the first media source talking about it. Openly and the benefits of it as you know therapy for for things like alzheimer's and cancer and metabolic You know Disaster human body but yeah and the metabolic approach to cancer. So i'll i mean gosh. I could just talk for hours. Wouldn't that be nice so much to talk about. But i'm looking at the clock. We i'm looking at the clock and i gotta go to break but dr nation. Thank you so much for jumping on the air with us today. Everyone dr natio- winters you can find her at. Dr dot com have a great day and thanks again thanks. Everyone take care all right you too. Everyone check her out. Dr natio- dot com. We've got greg glazer coming up. He is the general counsel for the physicians for informed consent. Stay tuned you're listening to one life. Radio shot on. Facebook hit like and follow us online radio right. Are you ready. Everyone welcome back to one life. Radio this is bernard. Edward junior broadcasting live from dallas texas on iheartmedia as well as km in southern california on abc news. Talk we have greg glazer back with us. He is the general counsel for physicians for informed consent or pick a nonprofit organization opposed to vaccine mandates. Greg was recently called a human vaccine encyclopedia for his work with litigation. Team opposing the. Uc's mandatory flu shot. He is passionate about organic living and the constitution. Their website is physicians for informed consent. Dot org that's physicians for informed consent dot org. Welcome back greg. How you doing today. Wilburn that thank you. Good good. So we tell our listeners. How pick assesses. The risk of a vaccine compared to the risk of the disease sure That's one of our primary functions is to prepare educational documents which focus on i the the risk of the disease itself so we produce what's called the disease information statement D i s and if folks go to physicians for informed consent dot org. They can see This work for example. We prepared one on the measles and what we did. Is we first define. What is you know it's a It's a self limiting childhood viral infection. And then we also looked at what are the risks of the measles and this is maintained by the. Cdc they look at how many cases are fatal. That'd be point zero one percent of cases or fatal and how many cases for example result in seizure or encephalitis. You know how many cases are hospitalized. So so we actually present. All of that. Data in our dis including the decline in measles mortality so measles mortality had already basically reached zero before the vaccine was introduced so nice and chart people to see so then once people understand what the measles is. What are the risks. Then we invite them to consider the risks of the vaccine so we do that through an educational document called vaccine risk statement of r s and in the vaccine risk statement. We look at things like the clinical trials That were utilized to Approve the measles. Vaccine the mr. We also look at any active surveillance. that Health authorities used you know to monitor the risk of measles. And then the risk of the mr and what we found is that seizures from the mr occur five times more often than measles related seizures. Which and yeah. Seizures is no the what leads up to epilepsy about percent cases. So that means that your risk of getting epilepsy is five times higher. If you get the mr get the measles. Well yeah and. I actually have friends that has happened to their kids. And and and it went unreported to report it And which is a lot of parents. I think they're just afraid. I don't understand why they didn't. I tried to encourage them to But it's really sad when it happens it is because i really do feel It could be avoided and so many cases isn't their testing that they can do ahead of time to see if a child actually is More prone to a reaction like or my mistaken about that. Well you know. That's a good question. I'd probably wanna have one of our doctors onto answer that specific question but the most common question that's asked is Can't a patient come in and demonstrate immunity through the presence of antibodies. Do measles you know for example. If a patient has already received the first m mr then can. They show that they have sufficient. Antibodies necessary to prove that they have you know immunity. And this of course. I'm using the language from the pharmaceutical industry. They're all about antibodies. They they believe that this proves immunity. And that's their whole theory and So yes the answer's yes they're laboratory tests Called tighter tests where the The laboratory will report the quantity of antibodies Taken in the sample and they will report also on the lab test whether that provides sufficient a sufficient level of anybody's necessary to for one called immunity and so people use these titles us as a basis to gain a medical exemption to vaccination and i'm sure it's insurance doesn't pay for it. I'm guessing that they don't But i don't know if one hundred percent. If that's true or not. I'll have to check it out but is it possible to still get measles. If you've had the vaccine yes yes there are there be Especially because there are multiple strains of measles so You know the first question is how effective is the is the vaccine and so if the So your your risk of getting infected depends on you know how many people have in society multiplied by percentage of The of the vaccine failure rate. Then yeah go ahead go ahead no you go ahead okay So so that's the first question is you know Can you can you get it Based on vaccine failure and then the second point is on The different strains you know you've got the wild measles strain and then you've got the vaccine strain and they are different so you know if you have an immunity so call them unity. Antibodies to the vaccine strain. Well the question is still open of whether you can get the the wild strain and it's important to note that there's been studies showing that if you get the wild strain you actually are at a lower risk of cancer. And the reason why is because we evolved with these things. Wow this volved. To exercise our immune systems naturally they actually do have beneficial effects and this whole notion of vaccination to change the immune system to permanently alter the immune system. This is new thinking. This is this is novel. This is a novel approach. It's it's an experiment. Essentially upon the popular right you change immune systems. And it's you know you know what. I viewed as sort of viewed as sort of similar to gmo's imagine that you burned every heirloom seed. And just hope that the corporate labs got it right. You know. that would be really a terrible decision. You know from from a policy perspective. But that's basically what's happening with vaccination trying to vaccinate everybody to eliminate the unvaccinated. Our organization. Physicians for informed consent is about respecting the rights of all individuals to refuse. Vaccines called informed consent or informed refusal. You'll go ahead. there's so much we don't know you know. I had pulled this article for dr nathan winters. We were talking about alternative cancer treatments. And i pulled this article from two thousand fourteen From the mayo clinic that the measles virus wipes out gulf size ball cancer tumor in thirty six hours and it was a two thousand fourteen trial of a concentrated dose of the measles putting her late stage cancer pace patient and put them into long term remission. You hear stories like that and you wonder. I do and i know other people out there. Do you certainly do The physicians for informed consent do is. What are we doing to our immune system ultimately. I think there's so much that we don't know yet absolutely you know. There's this There's a natural symbiosis that nature provides us and the premise of pharmaceutical intervention is filled with hubris that they're gonna improve upon nature and it's it's harmony. I appreciate that some people want to you. Know be guinea pigs for that or you know Alter their immune system because they are you know sort of embracing this brave new world. Where technology provides the answers. I mean same kind of people who might put alexa. and they're living room right and and But the fact is that. That's not everyone. I mean and i'm not even sure that the majority i think people want the right to say no that's so fundamental and the thing about informed consent is that you don't need a reason to say no you know so for example if you go to your doctor's office and he says well i wanna do some experimental surgery on you or even necessary surgery. You don't need a reason to say. No i don't i don't you just say i decline with vaccines they've structured. It said that you need to claim that it's your religion that you know or that some of the things you have to say reason and that and that's part of the problem it is. I hear the music. I have to cut you off. I'm so sorry we're short on time. Today you're going to have to come back sooner rather than later. I love your passion about organic living and our constitution And thank you so much. I always love having you on the air and it just seems like the time flies. But i've got lots of questions still so we'll have to rescheduled. Greg glazer. everyone. I encourage you to go to their website. Physicians for informed. Consent dot. Org and greg thank you again every one. Thank you for listening. Remember you've got one body you've got one mind and you've got one life respect it. We'll be back tomorrow.
Nisha Manek, MD, FACP, FRCP (UK) Information Medicine; the Power of Intention; and Bridging Science & Spirit
"Welcome to the healing place part coast. Space with inspirational stories of hope. Along with practical advice for your healing journey. Your host Terry Walbrook. Trauma Warrior Writer. Speaker Blogger. Therapy dog handler and founder of the same as fumbles of hope project. As a survivor and thrive over Terry's mission is to shine the light of hope into the world by interviewing insightful guests from across the globe. Please stay tuned at the end of today's interview as we honor our sponsors. The healing place podcast is a fiscally sponsored project of fractured atlas. Now. Here's your host. And Trauma Warrior. Terry well brought. Welcome everybody to the healing place podcast I'm your host Terry Walk and very excited to have with me today Dr Nisha. Manic did say right. Oh perfect aside. Such beautiful lame! It's just roll so yeah so here to talk to us today about some amazing stuff. That I'm excited to learn about power of attention integrative medicine. Her book, bridging science and spirit, the genius of William Ain't tillers physics in the promise of Information Medicine Information. Medicine I couldn't even read my own handwriting. Yes, so talk to us about. What it is, you do in the world. Kerry good to join you this morning. Hello, from California and well. Doctor by profession. And I'm a rheumatologist and a rheumatologist. As a physician that deals with chronic diseases mostly it's thought about as joints, but the more accurate way to think about rheumatology is that it is a disease or a specialty looking at disease of the immune system, so I deal with with people with systemic lupus, rheumatoid, arthritis, and other joint diseases, such as Kaoh to in osteoarthritis. So in a nutshell it's you know once I have a patient in my office. It's a it's a long term relationship. Okay, so that's been my career. You know medical doctor joining hospital systems until about ten years ago a and then I took a major change in the in the trajectory. Also. I have a few friends who battle autoimmune diseases themselves and Yet just what a what a struggle it can be because there's just not. A quote unquote. Correct in the in the. logical part of it, you know so in in medicine how we think about healing, or in fact you were You bring mind this early morning. Meditation have coffee and I really think about the day, and then I have twenty minutes of compete silence in I. Just sit there. On a chair this close my eyes breathe in and out and consider an in mostly now. The Meditation is very quiet, and a thought came today, and the thought was this. Medicine you know how we approach. Healing is that we deconstruct the human body. We make it into parts. We make into systems. We make it into anatomy, biochemistry physiology, and then we go even further into biochemistry and look at reactions in the cell, and we try to understand it, and then we reconstructed back to the whole, human and right away. You know when I was a medical student. This is beautiful I thought. Wow, you know. We're getting into the nuts and bolts of human human healing and humanity. What makes us whole? Any was completely misplaced. And in bridging science in spirit I actually write a letter to my younger self, because I thought that this rational way of thinking of constructing. Madison was the Holy Grail and I was wrong, I was wrong and I. Think we have. we now realize it that we have created systems that are limiting. A human being is not a bunch of anatomy in biochemical reactions. We are much more than that. And so, what is holistic healing and so here I was in a major medical system. Actually I was at the Mayo Clinic and I was always I did very exceptional. You're going to me, but I think conventional care has come a long way to understanding the human body Occa- The atoms molecules stuff about it, but it isn't the entire system, and so here I am in in a very celebrated system and I was really pushing against the boundaries because the cookie cutter system of I'm going to analyze your blood system I'm going to. Find out what's wrong with you and we're GONNA fix it. We're again to prescribe a molecule and it's GonNa. Work is going to be magic and many times. It was I I have to say that when I had some molecules, such is a steroid. It brings us a long way to you know. Alleviating the pain the the biochemical imbalances, but he doesn't get us all the way, so there's a huge gap still, and that's what I was noting What what what gets us all the way? I'm not sure I have all the answers, but really that took me into this whole system of integrative medicine and I wanNA define the word integrative for your your listeners in your audience. it used to be called complementary and Alternative Medicine in redraw the word alternative approaches alternative seems to indicate or Waugh's that we dumped conventional, and then we go to alternative systems whatever they might be Natural Pathak systems are your basic systems functional medicine systems, and I think we go to you know we leave commissioner behind we go here, and it still has gaps and I think integrative is closer to what I do in which is i? Don't dump conventional I. Do respect my medical school. Training is valuable in many many ways. But it isn't the whole story. So I link up these systems of what I call alternative. CARISSA systems and link it up to conventional. Now you have a bigger picture, okay? and so I very much in rheumatology. Tell my patients that especially when they say doctor I wanNA, know about natural healing, and so we go to those questions that they specifically have, and he's very individualized. Sometimes we have people that really are in pain to have twenty swollen joints. Their blood chemistries all over the place. This is not the time to start fasting. Okay, this is not a dime to start. You know Doing. Natural Pat I'm not saying no to them, but we really go to their questions and really A. WE WANT TO BE SAFE? I'm going to stop. Differ moment for your questions and reflect back. Oh sure well. I, what made me think is when I just moved here two weeks ago to our new home in South Carolina. I started to to reach out to find a physician in switch and. I Mike Physician in Ohio had retired, and so for like a two three week period. I had to find another one. Because I wanted to make sure that could transfer my records in so when I called the office I had asked him when they called around here. had asked for. You know who in your office is the most? Holistic in I'm so surprised to still find that X. struggled took find a practitioner. WHO has a more holistic approach to healing because I am not when I, don't take any medications I'm not one to throw a things, not that I'm anti medicine at all. It's just my own personal preference. But I just I really find it. Intriguing and I hope that it continues to blossom and grow. You know I have to say that integrative medicine is growing exponentially. If I can give you some reassurance often, and and it's been going on. It's movement that didn't start with medicine. It didn't start a university. It didn't start with a professor. It didn't start with doctors. It started with people like you. Okay back. Movement was driven by the consumer. And so it is the consumer that has really gone to. The integrative side in droves and enact can tell you if you look at the statistics in America. If you look at an Nash nationwide and you do surveys. one in three adult. Americans, choose. medicine in some form. Okay, whether it's naturopathic doctors massage acupuncture, so I'm giving you a basket, the definition here of course, and if you go to why the American is the adult American and an extra define this outed adult American over the age of eighteen. That's when we say they're adults. Okay, they're going one in three so thirty percent over a hundred million. Americans are going and they're going to these offices in Chinese medicine and massage. Why are they doing that? Why are they doing that and the number? One reason actually is. They are looking to onces to reduce pain. The suffering from pain pain in their neck in their back in their toe. Headaches pain. Pain comes in many many many forms. So why is medicine failing them? We consider framing them okay. They have looked to conventional K. on not getting answers, so they're going to integrative specialists so right away. Pain is a major gap in conventional care. We are very looking at onces in prescriptions, and it isn't always, and we have a big problem now about addiction. To opiates, okay, we have a major problem and the current administration is saying okay. Enough is enough, and then we run into pharmaceuticals, which is a big big part of conventional care, but the second part is this. that Americans are turning to integrative medicine to find empowerment. They're trying to take back some of the answers within themselves. which is what you're trying to do Terry. You're saying let. Me Do my homework. Let me! Find a partner a healthcare provider that can listen to me. That can hear my concerns. That I'm not saying no to prescriptions, but who can hear me in all of my concerns, that is a holistic holistic caregiver that looks at the body, looks at the mind that looks at my concerns from an emotional standpoint, and I would add one other thing and I'll come back to that which is spiritual healing, not healing, but to to to really go and unpack that which brings me to another reason why Americans are going to integrative medicine, which is this? It's rheumatic diseases. It's my conditions is a conditions. I, see in my office all the time, so I mentioned some of them neck, pain back pain, gout and a big one is fibromyalgia FIBROMYALGIA. We used to think that FIBROMYALGIA was immune. Conditioning turns out not to be true. FIBROMYALGIA to to define it, so your listeners understand what I'm talking about. Is this widespread pain Myalgia all muscles? and. We thought it was an immune disease because it was affecting young women in their prime okay in their twenties, thirties, forties fifties there are. Not, functioning well, they are fatigued. The have brain fog, and they have tender points. Okay, so initially in the Nineteen Ninety S. WE DEFINE FIBROMYALGIA as you press on certain parts of the body and Yup they are literally hitting the roof. They've literally jump from the exam table. And we defined certain tend to point well. It was okay for a time and now we we're redefined in two thousand and ten. There's a new definition of FIBROMYALGIA. It's a system wide. They have certain things and some women have brain fog. Some women have. Bowel Syndrome, so women cannot focus. Some women have such fatigue that they're not even able to function. They're on their back fat on the back. They do a bit of house, work laundry and the fat flat on the back, but there's another aspect of. FIBROMYALGIA which is. Inconceivable fatigue okay so there's this definition that became more multi-system days a questionnaire if your listeners wanna go into the Google, if you google new definition of FIBROMYALGIA, it's a PDF. It's free. You can do it and so as a physician I now use the new definition of FIBROMYALGIA which does not use tender points, a K, because tend to points is very subjective. How much you do four kilograms per. Meter Square it was very very define. Any doesn't really everybody would be yelping with pain. I mean so. It didn't work I. IT defined for Awhile. We've got in your definition and win a US that. which is a patient centered questionaire I realized that they are underneath the scoring system underneath that there is a story. He will come with stories and especially with FIBROMYALGIA. They have had. So many wonderful physicians look them. They've had 'em all right up the WAZOO that had lab testing off the lab testing normal testing, and it's not in their hands. This is very very real for them, and we've come a long way in anatomy and neurology. Don distended FIBROMYALGIA is a threshold in the central nervous system of pain, so there might be sitting in the chair in front when I see. How much pain do you have? They'll say eleven out of ten. Okay so here they are there in your office and the pain. system is not functioning. It's dysfunctional all right. It's like the threshold has been reset to where they're feeling pain all the time. You can't have eleven out of pain. Pain is something to protect the body. To protect you from fire from heat from burning yourself from cutting yourself, but nobody's cutting you. Nobody's putting a firearm. To you and so, where's the pain coming? From? Where where is this and so you have to dive a little deeper? In a lot of times I can tell you, and this is I'm speaking from my own personal office perspective of practice perspective I'm not saying I'm not neurologist, but I can tell you that fiber mile a lot of times. They have stories and he comes. Deeply, it's like it's been pushed away a story that has now come into the physical rounds and must be addressed. It cannot just be addressed by LYRICA and here's another oak, or here's another sleeping pill it must be. You have to go there and in the safety off the questions of a office practice to go there. And look at it. Look at the story and unravel it what what meaning it has been because it's very unconscious. It's very unconscious. You have to bring it to the consciousness level, and also give it meaning you have to give it meaning the story meaning so that you can start to heal from that and begin to understand the manifestations of the pain are very real to dive into the story with your physician in partnership, and sometimes it's. It's not rheumatology at all I have then referred them to psychology to psychiatry because they become aware that Oh, my goodness! This spring has been like a monkey on my back and I've been thinking, there's something physically wrong. It has physical manifestations, but you can't just go physically. You have to dive into the the mind. You have to dive into the emotions, and then sometimes when they're ready you going to the spiritual practices and give them tools. And the red when they're ready, okay, because sometimes you just can't go and pray there. You have to look at the story. See how it has served your own, not served you and then when they're ready. Then you say okay, you're and a lot of times when we go into the stories in the bedside, sometimes you can tell they're ready and wow, he's you know. I'm had a lot of Kleenex boxes. Literally go through teaneck spokes is, but you have to feel when they're ready. They're not ready. You don't force them there, but you have to say. The MRI didn't show this. It is not a broken bone. This the brain is not multiple sclerosis This is what we would have seen. If it was so, you have to go through a lot of education pieces. It takes time and that's okay. In case you have an hour and sometimes eighty minutes and I do. Request a full. You know our minimum at the at the outset for visit, so we can really go to their questions, and this is my advice to you, Terry as you're preparing to find, your doctor is to have clarity. Around the health questions you have and I do ask my patients. What is the one thing or question in our meeting today? And even when I know my patients have rheumatoid arthritis I you know we say good morning. We go through some of the the questions to set the tone for the visit but you know I say what's your come today? It's a three month visit. What is the real question for you today and it may be many things any gets richer meeting a richer relationship, so it's not just your pain levels two out of ten, and your joint was functioning at me. It's it's important, but we do go deeper into the story, so my my advice to you as you search for your next You know don't. Think of it as a long term relationship, and how you're going to forge that, because it really is, you know. What the stories for you that that need addressing I think I think I educated mind physician. Only because when I went in, we did for a wonderful relationship as a matter of fact, she she would email me through the system that we had their doctors system with like private messaging type of thing and say hey, we've got these test results back. You know I know that you I know your story. I know your history because when I went in I, just was like black in a just because I understand, it comes up often here on the podcast. Adverse childhood experiences in the way those experiences affect us on. It's a logical level. A mental level, spiritual level how it does impact us in so many ways I mean how the chances for diabetes go up the chances for heart disease chances for suicide. Suicide Olivetti. Suicide, what is the word I'm so losing it? Ray. Yeah Because of because of those stories that you're talking about so I love it. You're addressing it in in bringing to light in relation. Yeah, I, you know you bring to mind several stories right away that I finally share very quickly one for your listeners. Very wonderful woman she was actually in her seventies. By the time is referred to me in rheumatology and The working diagnosis was just chronic neck pain in would I have any insights and I can tell you this nice lady had gone through. I mean I would say a million dollar workup I am. Are I repeated? MRI's not one of. Them are is of her neck. It was constantly mild osteopath rightous, and so you know I'm a rheumatologist and you know osteoarthritis would come into my. My specialty in state wasn't appropriate referral and she was sitting on the exam table. And we've gone through the stories or not the history I should say. The Property Zanjeer really had. A full range of motion in her neck there was no restriction. A reflexes refine so there was no neurological equally off this osteoarthritis, and those no impingement. We say impeachment. There's no bone spurs funky things on the nerves and I said this gotta be something more, and she was, she was. She looked fantastic. She didn't look seventy and I said to her. Go somewhere else with this whole story because I'm impressed, you've had this for years. Your pain level is high in your smiling. and. I said I just wanted to explore this pain a little bit more. Can we do that and she says? Yes. I had the permission to go there I had the permission and I said. Tell me exactly when this pain started. And she was little confused. She says well I don't know I, said No. We need to go there exactly what happened under under the what circumstances you? Twenty years ago, whatever it was that the started and you have to dig a little bit and just hold the space and was silent. Sometimes we were just quiet in the in the in the waiting I'm not waiting in my office. And then I did something I said. Okay I'm. GonNa Switch Off the light and I'm going to leave the room and you meditate on this for five ten minutes. Don't worry. It's your time. And you have all the time we need to to go where the pain is. It's not in the physical body. Something else is going on, and we need to go there to really resolve this okay. And I left the room and I came back. And I switched on the light. And she was looking a little pensive, and I knew she had hit upon it. And I said that you ready to talk about it. And she says well he's. He's his twisting. My neck and I said okay. Who's WHO's twisting it? and. She says he's trying to kill me Oh. Yeah. He was and it turned out that he was her ex husband who tried to take her life. And he was smothering her with the pillow. It was so traumatic that she pushed it into her subconscious. And for a long time, she had gone about her life. Should divorce the man? Had Gone and tried in her life, but this episode where she woke up in a terrified sense, he was twisting her neck. And it was very real an and she cried and for a long time. I said okay. It's alright you're safe nets. Thank you for sharing this very deeply personal and painful episode in your knife, and can can we? Can we now go the next step? What do you think an I put it to? What do you think should be done what we're? Where can we go? You don't need more pain. MEDIC NJ immediately says God God God. And you know so with her permission, we unpacked. The pain that she had. the the the stories that came after it, and then she actually went to psychology, and you know and I never saw her again and I hope that she she came off of but one thing one tool that offered her. was now. You're ready to go into the heart of forgiveness, and this is where you have intention. Now you have. The you see now you've created a space when you have seen the story for your intention to take root now you have power. Okay, intention cannot otherwise you know my pain will go away while you. Intention is very loose, and so we created a space for her to have a very powerful statement. And you have words that now can take shape not only for your own physical healing, but for the other person. Because they were doing things that were hurting also okay. So you released yourself, and you release the other person and what what was interesting to me when I when I reached in my own medical integrative understanding was in Rheumatology, their stories and I can be many many stories, but this is just one example. at first Terry. I was going into I thought When we deconstruct the human body, the subtle energy system the bio field. I wanted to go there. Because annual, it had a lot of power to jump to jump start healing to give more energy to build on the conventional care. Any does Tai. And Acupuncture and Yoga these are important practicing at an I actually regularly prescribed them, but what? What happened was when I reached out to William Tiller, a WHO's the physics mentor I? Write about in my book bridging science and spirit half I thought I was going to learn all about subtle energies, and you know be holy grail event. You is much much more. My paradigm and my mind set shifted not just from conventional excellence there and building on it and building on it with energy medicine. But he'd built on this intention piece. Because when you do Tai, Chi and when you do energy or when you go to an energy practitioner, your intention is playing out. Even as you do your homework to find a new. Doctor to partner with for your well being in health. Your intention is playing out. And your motivation is playing out. So you know you have to be very aware. And so when I was looking for understanding subtle energies, my intention played out, but something more was a gift with bill tillers work was that intention is a very powerful force in the universe. Tension is a your intention, your creation of that sentence or information now information is very fundamental to the fabric of the universe. Okay, it's not atoms in molecules. That's matter. Matter is a very small part of what you are. It's just a very small tangible thing that we examine that I. DO blood tests on, but the more powerful system energy, and the more powerful system beyond that is your intention, because intention is your consciousness. We have something even more beautiful consciousnesses, not just the brain. It's your heart. It's your deepest desires playing out. And consciousnesses shaped by our our youth, our culture, our home, our parents. It's a lot of things wrapped in there, and once you understand your consciousness. And your intention being shaped by that consciousness is your link to something even bigger. It Spirit Now you have a bigger story and the mistakes have been always truthful. It's the truth that stands the test of all time. Science changes science builds science is deconstructing, but spirit. Now you have a different sense of wholeness. And so with this lady, we went there little bit. It was wrapped into that visit. Thank God. She allowed me to go to the painful process. She began to see the patterns that no longer serve her at this point did for awhile she survived it. She was stronger for it. My goodness, how strong you know! She divorced, and she built up a system but now. It was at a stage. You could say at a stage of potential. That now she was ready to go there and see the story for war. It was and move on. He was bigger now. She had been led to a place willingly. She was her own. He Okay I was just. Leaning her there in the safety of the clinic and saying we are now ready. You're now ready to grow away from this and he'll totally, and now you can link to spirit. This is where intention comes in. Prayer comes in okay. So what Tiller did was very interesting. He showed that first of all human intention is a powerful force I mean. I hope I can convey A. Of that I know you don't have video in my in my little room here. This is the shelter in place where we're having lots of workspaces and we're pivoting all the time. The intention is always there and a my met morning meditation was what's The medicine all about in figuring out that we're in discrete parts, and then the Salangi's come in the intention is there and that the bigger picture is spirit, and for this patient I actually gave her some ninety one K. I gave her some ninety one I'm not Catholic. But one of my teachers is David Hopkins who really showed me that? When you talk about consciousness, it's not just one thing. Consciousness has many levels okay, and they increase in power. You can have greed and courage, and then you have willingness and medicine is very powerful test intellect, but beyond that is the level of the heart. And Tiller is the level of the heart. His physics is coming from the heart. He doesn't do physics just to be in journals and to win Nobel Prizes. He does physics and he signs is to serve humankind. Now you have a different kind of assigned to not let me pay the bills. Let me do the you know. Click boxes in and the administrators are gonNA. Have Seen Your twenty patients for the day, and I had to walk away from that system to really recollect. Why am I in this whole profession in the first place? and. It was to bridge science and spirit because as human beings. We're looking for deeper relationship all the time all the time. Every relationship is a sacred one. Okay, once we understand that. Everyone benefits it's for the highest good and highest good impluse. The doctor it includes the patient includes the pharmacy industry. I know people will object that I'm saying this is so true, and we must stop carving out this little niche. You know at my turf in your kind of nonsense. Nonsense and this. It was saying. You know you have been served. Okay, the good news is here is your physical system is not damaged, but your emotional mental systems have been damaged, and for goodness sake you have powered through for a long time, and now you're ready now. You're ready to step into your own light. And Spirit will help you spirituals always that omnipresent. Omnipotent Omniscient, it is absolutely true and so I offered her to of ninety one. So Bill Tiller has shown that the human intention once it is joined with divine spirit so in his experiments in physics physics lab. He created an intention. Okay your rights, you know. Let me change this Ph of water and saying Blah. But that was his really's material. Signs scientists at Stanford, he's now retired, but he did this awesome, very courageous research in line with conventional care, and said mind tension candidate. Redo things because we're all intending all the time. How can we don't see changes? He defined the conditions. Were intentions have very enormous effect? Okay, enormous, you can measure these. But it comes down to this. You must get rid of the noise in your mind. And if you have skepticism, notice it and let it just drop it away or let it keep keep it on its side, and then tested out in your own life, and for that you know I want readers to go to the book. Bridging Science, there's a lot here. We could have a whole week conference on this. Is Not possible, but I would say as a physician. As a physician, it has changed me as a physician fundamentally okay that they offer things beyond just the body's systems, the atoms and the molecules in the end the biochemical reactions they are very real, but we have a responsibility a responsibility to make our patients aware that they are energetic systems, and you can build on that. Here's a breathing exercise. Here's a Taichi exercise, and then build more when patients have fear around my medicines. Because I do I do prescribe you know I do master track I do look after people with rheumatoid and. Con-. That they're in pain, and a comp comprehended, they have don't have a disease I. Say here's an education around your arthritis and the good news is. You are much more than this, but we. We're GONNA pay attention to the body like this. And when they're fearful, is to use intention to meet them where they onto. What is the fear? What's the worst possible thing from this medication? What is your? Your fears and they do Internet they go into Dr Google and Google searches. You go there you again. We unpack the fierce because they're real. Okay, we have to respect that and once we have education than they're ready, and sometimes we have to go here. Quick. You don't go months and months googling forever united after have real realistic and pragmatic thing so sometimes I will see I'm very direct. And some if they're ready, they will, they will have enormous benefit to. And, so I build unintentional I. teach them how to. Write a sentence, right it out and recreated at the bedside, and it's very it's it's a very beautiful exercise I can honestly tell you that that they we both search for the right word, and there's a click feeling that. This is so awesome in take pictures of it now take it away with them, and they come a different person the next time. Okay, so we build their. They are standing in your own light. It isn't about me. I'm not the authority. They are the authority in their life in their heating, okay. Yeah, you're just a second Warren Dispirit, part of it is. Mentioned forgiveness I myself utilized hope, opponent, opponent Hawaiian healing, outright letters of forgiveness in so it's been very healing for me along my healing journey tap in a little bit about forgiveness part of it yet. Forgiveness is an incredible tool. This is I'm reaching into a course in miracles, but all spiritual traditions are united in that because forgiveness is a profound tool of love. It's self love, and when you are in love. In the field of love, then there is a letting go. You are not wedded to a particular position my viewpoint. He did this in wrong? Because everyone is suffering, there is a cry out of pain when somebody is doing something bad at when I see the civil unrest right now outside you know, we have witnessed terrible destruction. It's the cry for pain they're. They're crying, but they're asleep. Humanity is slow to learn so these young people whoever are completely asleep forgiveness waking up. Pay. It is a tool to waken us up to the greater good to degrade a context, not just the content of all this pain, all this destruction on Oh woe is me and victims, but the looking at the greater context and I'll tell you something you know I have a. A wonderful. Friend in New York City and we're both writing books I'm writing my second one. and Rebecca and she says initial WanNa just rush out in protest with everybody else, said stay indoors. Because staying indoors is not selfishness. Staying indoors is self preservation, and it is the biggest tool of political warfare. Because it is a protest. It is like a protest to stay indoors and forgive. It is absolutely a tool of warfare, so make no mistake about it Jesus was correct. Forgive and jus again. We have choices every single time. My brother choose again so I'm not saying resist or ignore the protests, but I choose something different. I choose forgiveness, and I choose love every single time, and so our traditions con big unite in that message, actually any tradition in I've looked Buddhism. My Book Says Meant Lord. cheever shows up. Swami Yogi Nanda of the self realization. Fellowship makes his presence known by the PEO- The state. Peel of Italy shows up. You know and then Saint John and Saint Matthew. Show up a so make no mistake about it were more two or more. In My. Name is Saint Matthew Okay. They all come. Don't mistake spiritual traditions, they are not separate. We just tools are ten thousand pathways home and one time. I complained to Dr Tiller I don't think FIS. Guinevere come to consciousness, and he said you know something Nick, because I was in the subtle energy mode. Okay, and he said you know. When you ask the question with great sensitive, he didn't say all that what he just said. Science is a way to self knowledge. Know thyself once. You know that I so even science is a beautiful way home for him. Signs is home. He said in just the next rung. We've discovered the Higgs? Bows on is the electromagnetic particle world. Warwick completed. We are now poised for the next jump. We must go there. And that's the unseen non-linear World of Science, and that too is limited, and we'll keep advancing because we're evolving. Humankind is not stuck in this matter world when we're Homo SAPIENS, but we are evolving into homo universities. The Brotherhood man, not the teacher. One of my teachers has said this to me that you know in your time Nisa. Homo sapiens is going to be Homa University Alice I love it. Yes, yes. That's awesome. Alright, so, is there anything else that you wanted to touch upon in? Let the audience know about that. We haven't yet doubled you. Could sit and talk for hours upon hours. Well tear. You've been so generous because I've just continued to talk at. You can see I get on a train, and I'm on that try to. Get up. But I want to say this and to all the listeners that. With the pandemic with all of the unrest, we are in an election year. The world is not the same anymore. No matter what there is no normal going back to normal. No this that you have at your disposable or dispose disposable your dispose of the all world we are going to recreate. Realities and you have great great inau potential more than you can ever know and you. Within your power. Discover it do not be despondent. But rise up to the challenge in your own home. Meditate look at the question. Look at the stories if they don't serve you well. Creative, one better, one, okay, and Terry I. Think you have done a big service to your listeners by. Bringing these questions and making them available. Laying them all out? Yes I feel at such a soul calling. It's just by my sole purpose and brings me so much joy. I sit here in a smile you know when when I listened to my guest talk and listening to you talk, because it resonates with my heart, and resonates by soul, and I love it so yeah, thank you Terry when you have a wonderful wonderful stunt to a Tuesday a fake you. Have having people find you. How did they get a hold of you? Yes, a right now. I'm doing telemedicine because the practice in in California is closed in. There's a second way, but my intention is and writing my second book on a very specific area of Bill Tiller. Physics and I realized that when he was doing his intention experiments I talk about the great unseen doing the heavy lifting I. Once asked Dr Tiller. What is a WHO this unseating? He told me I didn't think of it very much at the time. Fast forward I'm realizing I need to go there to write about The great unseen who are the angels who help us. With with Tiller. Yeah and this isn't just a feel. Good exercise. This is real nuts and bolts. Angels are not just feeling good, you know. In fact, one of my teachers has had rear. Not about feeling good all the time. We're addicted to feeding the we are human beings. We must grow up and so this book is really exploring this relationship of the unseen and Tiller particularly how this plays out in science, so my intention in this quiet time has been actually very rewarding. A lot of my time is of course at the bedside, so the telemedicine is underserved populations in the upper mid resident has been a real gift because I do have a little bit of an income so I do that. I write my book and really also look at this whole question of intention in more detail. What does it really mean to intend because to me? It was very obvious and I realize it's not that obvious. You have to cleared the field. How do you? You do that how you? How do you? What are the Shiny object that people want? It starts there often, you know what are the next shiny object I want because I do that, too, and that's okay, and you go into the deeper layers of intention, so I'm looking at that aspect. What does it mean to have intention? What does it mean to have a powerful intention? And how do you link up with the divine because it will work whenever you have a prayer? Father always answers. The divine cannot but supply you okay. That that really is true, so where how people can find me right now is my website and you can sign up for my. It's a very small email list. I'm not used to doing this. Things hit there, but Nishida Monica and D dot Com so N. I s h a Monica. M., A. An E., k. m D dot, com. All One word Nisham ONIC MD DOT COM and I I hope that they will go and pick up a copy of this book and I'm happy to city. Terry this is the other intention part. D pandemic you know had a significant effect in that the print copies didn't go out, and so it was nonessential. The e-p-o-c-h flew but the. But the print books didn't so I'm having an audio book created for bridging. Science Brits I heard your listeners will tune in and in another couple of months the audio which have a terrific narrator. Will will do a great job and I'm very excited about that. Oh, my gosh, that's wonderful. I can't wait to read the second book. I mean well the first book, too, but yeah, the second one very exciting. Yeah, I. The unseen is and I can tell you I didn't realize how active they are even. Bringing Science and spirit right I lot of times. You know I'm not a physicist and I prayed. There were certain weak links you might say in the bridge. The construction I was engineering this bridge and my editor says. I. Don't think I don't believe that. I I prayed over it and I wound. I mean the absolutely answered me and I was. Encouraged and I would say I would. Think I. Get goosebumps at Johnston I, thought I don't know whether they're talking about my book. Yes, there's something jury at all. That, you're answered and your absolute tangible things that there this is the information that you're being supplied with and I won't go into that because it's my personal tools in you know right? Yeah, well, thank you so much again. Thank you for being here shining. Your beautiful light of hope in for the work you're doing. To help others along their healing journey, thank you Terry for having me, but by for now absolutely everyone into next time remember be gentle with yourself. Thank you so much for listening today to the he'll place podcast which your host and trauma warrior. Terry Walbrook If you enjoyed this episode and want to learn more about Terry, her mission, and the hope for healing journey. Visit Tears website at www dot, terry, well, BROCK ROCK DOT com. Thank you for liking commenting sharing and offering the reviews on our youtube channel. Audio outlets and facebook page. And as Terry reminds us until next time. Remember be gentle with yourself.
Episode 51: Whole-Food Plant-Based Diet And Obesity
"This is the decoding obesity. Podcast where we simplify demystify and decode obesity helping you lose weight and feel great so gear up for a fascinating journey through this ever evolving field. And let's see what we find and please remember that the thoughts and opinions on this podcast do not constitute medical advice. Don't forget to visit our website. Www dot decoding obesity dot com for show notes and more info. And now here's your host of the decoding obesity. Podcast dr scar saba wall. Hi there listen. I know you're looking for some answers to your weight loss struggles. Why don't you join us on the next hangout meeting to discuss this more. You can share your struggles. Learn from others who are in the same boat and so much more so don't be shy and head on over to. Www dot decoding. Obesity dot com for slash. Hang out. i will promise you one thing right now. This is going to be a safe space where you can talk freely. And it is absolutely one hundred percent free you not into pay anything for this and i wanted to create a safe space to discuss. Everything will be city high friend. Welcome to this episode. I have been requesting you to leave me. Review for my podcast. You review is feedback for me to understand how i am doing and how i can improve. Not only that positive reviews. Help spread the message and the value of this podcast to other searching for a good podcast to subscribe to. It helps me reach many more people so while this may seem like a small thing to you but my friend. This actually is very important. I have set a goal for myself for this year. And i need your help to reach that goal. I'm aiming for at least a thousand reviews on apple podcasts. In two thousand twenty one. Now i know this seems like a very very tall order but every review all you have to do is just head on over to upper podcast on your iphone. Or if you don't have an iphone you can go onto your computer or your android device and get to the podcast and just click writer view and that's it. Please help me serve you better and reach many others. Please do right me view now. Urine for three. Today i have two amazing guests with me dr. Nisha patel is a practicing. Boats are defied internal medicine physician and obesity medicine specialists. She actually currently got both certified and obesity medicine. She is currently enrolled in a calorie medicine program. Through health meets food. She hopes to him by will have patients and others with the knowledge and tools to make practical sustainable lifelong healthful eating habits dr patel who also goes by the doctor plan tell is also passionate about addressing food insecurity in the us and helping others understand how it relates to the development of chronic diseases. Now my other guest. Dr dish around is board certified endocrinologists and she also recently got boats divide and obesity medicine. She also has enrolled in the connery medicine program. The same one as dr patel. She completed undergraduate and medical education at vanderbilt university prior to competing her internal medicine residency and chronology fellowship at the university of chicago. She has a special interest in the management of diabetes and obesity and culinary medicine. She strides to emphasize the dodge food as medicine throughout of medical practice. Welcome ladies for having us. Thank you so much. We're so excited. Yeah this is going to be fun. So let's talk about whole food plant based diet. What do we understand by holford plan as i know in a wiegand is one time. That's just like thrown out. And then there's this whole concept of whole foods plant based so can you differentiate between the two. Because i think it's very important for people to understand this. I think it's important to make sure that we say that. Veganism does not equal poll food plant based diet right and so veganism typically is a lifestyle and for ethical reasons people decide to pursue veganism. And now it's expanded to environmental and health concerns. Now need if you wanna talk about the difference between that and plant based yeah so whole foods. Plant plantes die incorporates a number of health whole foods that are minimally processed. And that's a little bit different than just the umbrella term plant beast because unfortunately plant based by itself doesn't mean that it's helpful you can be plant based and be beating a number of different foods that are considered ultra processed and unhelpful. I completely agree that you know. This distinction has to be made that. There is a way to be happy. So that's helpful and you could also be plant based that's unhelpful. And to be honest with you. That's actually what. I was for the majority of my life until i made some changes for myself in the last several years and so when we say that we really emphasize sort of including low fat high fiber based diet. That's focused on health and again like really really minimizing. The amount of processed refined foods whole food funding. I agree with you. And yeah i just wanted to point out to our listeners that it's very important to understand that even french fries vegetarian or vegan. But they're not necessarily a part of a whole foods plant based diet. So it's very very important to distinguish between veganism and whole food plant based diet where you're incorporating whole foods as the name suggests in itself but it's primarily plant based and donbass does not necessarily mean it's completely vegetarian or completely only plants but it means predominantly plants right correct. That's exactly right and so you know this very interesting. There's always a divide between these different schools of thoughts right one talks about the genyk diet. And then there's this whole food plant. Then there's this paleo diet and we have data for everything for example the z. Trial that was done predominantly showed that the ketogenic diet is very helpful as far as weight loss goes as far as obesity goes. So where do you stein with regards to you. Know the data for whole food plant based diet in weight loss. Do you think whole food plant based is the only option or do you think it's one of the tools that people can try and use for their weight loss. I think the way that we need to look at these diets is that there are resources to becoming healthier right. So the word diet automatically just screams restriction to me right and so if we are telling will you can't eat this and you can't eat that i think showing folks in a whole food plant based diet however there's such a spectrum right out of your diet you can make fifty percent. You can make ninety percent one hundred percent however you can incorporate more plants is healthier way to go. I one hundred percent agree with that sentiment. Because i think it's really hard when people feel like. They need to be in a box. Like i need to be proferred quantities or i need to be on the keto diet. I think what you decide is completely right. Were as many plant you know predominant foods is at you horb rate. That's what's most helpful. So the way. I see the whole food. Plant based diet is one of the tools for instance for weight loss and definitely incorporates. A lot of different whole foods. And i can see you can see why can help with weight loss. So she when you're replacing that with the you don't replace the standard american tire with the whole plant based the satire. the whole flood. Yeah and i think there was a recent study. Did show that plant based diet. Does work wonders even for weight loss. If people want to try that yali but do you think it's better with regards to weight loss as compared to other lifestyle changes. What is your opinion on that. Absolutely i i wonder if one of the studies that you're referring to is the cardiac study that was published in diabetes care and twenty twenty and so they basically looked at over twenty years. Increasing the amount of plant centeredness adulthood was associated with forty eight percent. Lower risk of type two diabetes by middle adulthood. And so i mean. The evidence is clear right and so basically the earlier. We introduce a diet higher and vegetables. The lower risk of developing type two diabetes and obesity later in adulthood. That's very true. I it wasn't the cardia study that i was actually referring to. I think it was another study. That was pretty much talking about a weight loss and it showed that there was a very significant weight loss with incorporating food plant based diet for weight loss. I see not necessarily just diabetes at i. Just forget the name of the city and pinkett was done in australia. But i could be wrong whether it was an interesting study that i look tat but you know. There's this very complex and are you. Both of you are certified and obesity medicine just like me and we understand that you know insulin. Play such a big role in the development of obesity and the minister but holford plant based in itself has coverage right. It's a very very high carb diet. So how do you think it moderates the insulin. The whole food plant is tied please into all of this and mandating lower levels of insulin. It's you know this goes back to what you sean. I always say is that not. All carbs are created equal. We want people to understand that there are like we love carbs. We focused on incorporating more health while cards into our day to day eating. And so what. I'm talking about is whole grains that have fiber. They have complex. Carbohydrates whole foods have phytochemicals all of these factors play into the role of our health and help modulate insulin secretion and i mean do you should talk about diabetes like with her patients every day and so i think it's less about saying oh carbs bad like i. I really hate that word and hate that phrase and more about saying what's incorporate helpful forms of carbs like for instance lubes. I don't think i can think of one lagoon that has a high glycemic index. Can you Any lentils or yeah. They're all low glycemic index. They all have fiber complex. Carbohydrates our bodies going to quote unquote react to those differently than eating oreos no offense to oreos but of course i think the more higher fibre carbs that we added to our system the better it is for insulin sensitivity that aids in weight loss. Because the more insulin. Your body requires the more weight you gain and so it's all very much tied together and so i agree i mean i think there's a bit of a toxic relationship with carbs. I understand the refining carbs. In the process carbs sure they are toxic to our health and our wellness and the development of chronic disease. But they don't have to be bad right and so i think the more whole grains higher fibre carbs we add in. That doesn't have to be necessarily a dangerous or bad thing right and You know. I have a question for you now. We talk about insulin with regards to obesity and in a how a higher level kind of causes obesity. But we really see a difference in the management of diabetes. You see a difference. Because they're people are actually taking an exogenous insulin a lot of times right and it's a disease of either insulin resistance or insulin deficiency. Do you see a difference in your patients specifically when you're treating diabetes and if you if the change their lifestyle to a whole foods plant based diet absolutely and you know what's really help is. The use of continuous glucose monitors so automatically. You can see like one week to the next as soon as someone changes the way that they're eating or just just literally increasing vegetables in their dinner or their lunch or any combination. It's amazing to see a sudden improvement in blood sugars because all of a sudden your body is not necessarily having to increase the insulin secretion. Not necessarily having to deal with these incredible blood sugar spikes and patients feel better right like it's it's incredible and so when your brain is swimming around in high blood sugars. You feel tired. You feel with our jake We can't necessarily think properly and then all of a sudden a normal blood sugars. People feel more awake. They feel more energetic. They can exercise. It's a downstream effect of just making just some minor changes immediately. You know this goes against the whole cobb county concept because whole plan plant is a high carb diet and despite being high cobb. There is data to support that it does lower the insulin levels even for diabetes or for obesity. And so it really goes against the whole concept of the cobb county that we've been doing traditionally and traditionally asking people to restrict their cops and eat so basically saying that all cops are equal. You just have to restrict the amount of cops so that's very interesting to understand. All of that really comes down to glycemic index as well right. The glycemic index of white pasta is much much higher than the glycemic index of berries. Carrots or something like that right and so your blood. Sugar will not spike with eating a carrot salad versus how it would spike after eating. You know a plate of spaghetti interesting that you talk about lacey mcleod and listen and actually have an episode on that so listen if you want to listen to the episode on placing mcglesias an expert. I talk about this in detail you can head on over to. www decoding obesity dot com forward slash. Thirty nine because this was episode number thirty nine or we talked about glycemic load and glycemic index. And you know the other thing that when we talk about whole food plant based diet is that it's a whole foods plant based so in essence if you look at oils and if you look at the facts that we use their essentially refined products all of a sudden food rights are just like sugar. As defined product of the cobs similarly oils are a refined product all the food but unfortunately the data on fats is so conflicting. What's your take on this. Yeah you know the same thing with carved like there's helpful fads and there's that are less helpful and i will say yes most cooking oils princeton's are refined. But not a big proponent. I promise i'm not like sponsored by vague extra virgin olive oil. But i actually think extra virgin olive oil in cooking is a helpful source. A fat it helps people with the mouth feel of their. Because that's very pleasurable enjoyable aspect of food. And if you look at literature course. It's one of the main sources in the mediterranean diet. And i'm specifically talking about extra virgin olive oil not talking about olive oil in it of itself because it just as all boil on the bottle some it is actually refining its devout of phytochemicals or the fighter nutrients that are that are in extra virgin olive oil so whenever i a lot of are like oh i should be on a low fat diet right. I have x. y. z. Disease i emphasize often that you know it's not that simple like there's actually hall sources of that. There's nuts there's avocados there's certain cooking oils. That are considered helpful. As i said it's got to be taken into the context of the whole dietary pattern like by no means. Do i mean like going. A bunch of avocados every day or go chug extra virgin olive oil. It's in the context of a whole whole food based dietary pattern or just a helpful eating pattern. I think it can be a visual. I think there's a place for and there is data to support that improve cholesterol aids and heart health you know and so there are benefits to taking in good quality sleep dod so and i think we were talking about this earlier as well. The issue here is actually cutting back on the added sugars right the refined sugars at sugars. On that's what really you know spikes blood sugars and adds weight over time. Not so not. So what the faster. The limitations needs to be. Yeah that is so true and of course not all fads are created equal. And it's important to understand even when using fats especially when you're cooking if you're using fats to cook it's important to us something that has the highest point because if you use something that has a low smoke. Point does change the molecular structure of fats itself when you're cooking with that and that necessarily may not produce healthier products and actually handful. Yep is this whole food plant based diet for everyone perspective. Is everything right. So in the mid west not general is a lot of our patients who are from rural areas. That's not necessarily something that they have grown up with right so i think we really have to look at someone's background their culture. How can this fit into your overall life. Right and perspective is everything and so we have some folks that get mcdonald's takeout or some fast food drive through. Every single day of the week some folks will eat meat and potatoes and rice. And that's been their meal at dinner every day for their whole lives and others have different. You know various eating patterns and so it's all perspective so if the person who eats out everyday can eat out once a week. Do you think you can add in a couple of vegetables to that meal here. And there so going from zero to one hundred and going from eating a primarily meat based diet or non vegetarian diet to fully whole food plant based people run out of my office being like. You're crazy valid so baby steps but even a little bit goes along. You should saying like you don't encourage people to incorporate whole or incorporate more plants because that's the issue that we hopped right like most americans for instance are meeting even like the minimum requirements of fruits and vegetables and so in taken a day. And so i agree like going. Zero to one. Hundred doesn't really work for people. It doesn't work for me. So why would i expect that to work for anyone else. And i gotta save from a healthcare standpoint or in a clinical setting. I have so many patients that come in feeling really shamed for their dietary choices right. And so if i sit there and become super pedantic and told them you've gotta now you know eat only plans no more this or that they resent you and i don't think it's necessarily wise to sit there and preached to somebody like. This is what you should do if you can present the data. And if they can incorporate like i said earlier you know ten percent or twenty percent or however. It works into their lifestyle. Any little bit will help. I agree like a healthy relationship with food is so key because the last thing that we want our patients or anyone for that matter is to feel guilt it could be very very very damaging for their morale and their long term success People come in feeling really bad about themselves because another doctor may have made them feel ashamed about their weight or the way they eight or something like that and so it's really really important to kind of taken into account. What's their story. How easy is it for them to incorporate this data day did they have the resources. Are they on meals on wheels. Do they have snap or you know that sort of thing. It's it makes it so much. It's not as easy as okay. We'll go to the farmers market and pick up some vegetables. It's a lot more complex. I agree with you but you know it's a very interesting point that you raised that people obviously need to kind of be lead in that direction and they need to make the appropriate changes that are appropriate for them at that point in time but one of the common questions that you encounter in your practice with regards to a whole foods plant based approach. What other common questions that people ask. And what are their common fears or midst that they have with some people. Just don't like vegetables so you know that's a common one right because they're like well. I don't like vegetables. Wanna add them in and so we'd have to talk about. We'll this is how you can sneak them in. These are little strategies to potentially expand your vegetable pallet and then the other part of it is preparation will how do i put it together. What do i shop for you know. And so this is worth holder. Medicine become so valuable rate because we are able to then help empower patients to be able to take this into their own hands and start making changes at home agreed like i mean. I don't personally eat raw broccoli. But i loved when i may get the way that i like it. And that's the way. I eat it and that's why and trying to help because like whenever pieces told me like. Oh i don't like my next question is will have you eaten it. How have you prepared it. Or how was it presented to you because maybe you don't like it that way that it was presented to you but let's try to find at least one tangible piece of a piece of wire. He's advice. I can give them so that they can incorporate that particular food and or try that out again because you just i mean i give this example time like i grew up vegetarian. I don't like ninety percent of vegetables. But now i love like more so i always tell people like if i can do it. Trust me you can too. But the other question that i also get a lot is well if you want me to incorporate healthful plant foods then how am i going to get my protein and it just drives me up the wall. 'cause 'cause you know people often Protein with like cynically rodney in like chicken. And i often say look. I've personally i've been vegetarian or plant life as long as you're healthy and you don't you know the average person doesn't as far as i can tell clinical protein deficiency on being online like a vegetarian on plant. Predominance i in. There's plenty of sources of plant protein. So that's something. Actually that comes up a line. And i always told people that like look. You know you're not gonna in the absence of having other illnesses or really having like a restricted diet. Like you're not normally. You're not at risk of that. He i think you raise a very interesting point. Benicia that you ossification how you prepared. Because i don't think a lot of australia awesome this question. How do you prepare your food. Because that becomes so essential once you start cooking realized that there are so many different ways of making vegetables notch a steaming. The vegetables you can you can bake them. You can broil them. You can saute them. You can steam them. That are tunnel ways of making them. There are a lot of spices that you can add to these vegetables and really make them diz delicious. I think the american diet is predominantly meat based and soul. We have a lot of alana. Lot more flexibility around how to cook me. But as a wedge doubles goal. I think there's a lack of knowledge on how really cook these in a whether that is delicious. And i find this very interesting. Because i myself from india right and the predominant height india is Vegetables diet and we cook vegetables and so many different ways and if they're cooked in a way that you don't necessarily miss the meat in that particular meal so it's very important to understand and i'm glad that he raises point that i think we should all ask start asking our patients. How do you cook your food if you're not enjoying it. Unfortunately you know a lot of time. I run into this notion that if people are supposed to eat more vegetables or more just healthier. They think it's the sort of steamed vegetables. And you know some kind of. I don't eat that way i you know. I think that's that's not tasty to me right and so it's really really important just sort of have that as in your arsenal that okay. Well i can do this this and this with this kind of vegetable and empowers people to really get interested. In pursuing further ways of making food tasty i think the limitation and especially in the clinic based setting. Is that a lot of clinton's don't have the time to get into all of that right and so we often need our dieticians to help and and that sort of thing but truly is a shame. How little time. So many clinicians have. I'm lucky enough to have a little bit more time with my patients with the way that my clinic template is scheduled but a lot of people in my shoes have fifteen minutes per person and you know. When are you going to get to that. You cannot talk about how you could give us those two minutes. People get used to or these. Try different ways to prepare healthful foods. They build their confidence to you. But i agree like by no means you know it's hard to like. Do this in a clinic setting like even on the hospital side identity on more time with my patients and so we'll struck up a conversation and will talk about like. Oh what are you doing at home. you live with. Who cooks at home. Like how do you get your food. What you have available like. I actually do have more of our time to do that. And i feel pretty lucky. So what is your opinion. But i i know we touched on this begin. These a lot of these foods have these claims of health foods and in dan age when everyone of us has a very fast paced life right. And we're looking for quick fixes. What is your opinion on these foods that are labeled vegan. Organic healthy drives me crazy. How trendy organic vegan plant based has become you know on some of these labels like i heard of a shampoo the other day being plant based come on like you know. It's a marketing scheme at this point right and so it's just really really important to run that package around and see what you're actually going to be consuming on that nutrition label. Yeah i think it's important understand that even if you're being wiegand that a lot of foods that are not healthy that are begin for example cookies a lot of cookies that had their vegan but they may not necessarily be healthy. French fries are not healthy but they're vegan so it's important to understand that's why this whole concept of whole foods plant pace so yeah i personally don't think on people should go. After these labels labels would say healthy because it's very difficult to quantify if they can say it's healthy but what does that really mean in comparison to what you know. It's like i always tell people and my bution flight do not make any decisions like about what you're going to purchase at the grocery store based on fronta declaims. Just don't do it because you just don't know like i saw like rice cauliflower isn't plan based on the front which again rice cauliflower is. The help like i consider that a healthful food but of course it's a plant like we don't need that label on there but i'm just saying that there's other foods that have these kind of buzzwords on their that people automatically just assume this is healthy and gonna take it and then you realize wow doesn't have any fiber and it has all this added salt and it has x. amount of added sugar and so. Yeah which is plenty by the content of that of whatever snack or whatever it might be the car amount is crazy high most of the time. And that's where you know like back in the ninety s snack. Low is right like they always advertise that it was low fat and but the carbs. It was not a healthy food. Yeah it's important to understand that even sugar as vegetarian or vegan but it's not healthy to consume pure sugar. So it's important to understand that i have one very interesting question and this person interest me as well. What is your opinion on. A plant based diet researched. This and i think it. It is a little of restrictive because plants are usually very high in kabul hydrates. But what is european. Have you encountered anybody. Who's talked about this at all or have you resisted old. I haven't really had this particular like question. Come up. i agree with you. That i think it's quite restrictive the ed because there are you know helpful sources of carbs like we talked about before. And you're gonna miss out on those when you're following cheeto diet in general of course even on a plant based diet you're gonna miss out on those healthful foods and so you know the issue with traditional diet as our society defines. It is that they're not sustainable in the long term always. There's not studies that show that and it also just after a certain point it just becomes very cumbersome for most people not saying everyone etiquette feel very demoralizing. Let's say for instance if they stop that particular diet may this individual may think that it's a failure asian try eating healthily in the future. It could just really kind of do real than so in general. I don't really recommend it. I have people ask me about it. I still recommend it. But that's just my personal way of practicing. I agree. I tend to agree because let's say you know the hardest thing i've seen with whether it's kito or plant based kato and i see patients obviously for weight management and my clinic. One of the hardest things with these diets is the sustainability aspect of it right and so patients will tell me on visit a that. Oh i'm going kito. I'm going to definitely do this. And lose the weight three months later i see them or however many months later yeah i couldn't really sustain. It was really hard. And i started to miss the carbs and so my goal here is to get folks to be able to sustain something long term. I have. I always told them like. I'm looking at five years and ten years or longer for you. Not a crash diet for two or three months and so really. It's going to be you know what is the stable for you the longest. What can keep you going without. You missing various things or really like regressing. The other way and the reason why that's really important is because then we start to see a lot of the yoyo in wave right people go up and down and then they get really upset about it and yeah yeah i think you hit the nail on the head. It has to be standard lifestyle. Change whether it's a ketogenic diet whether it's a whole foods plant based i it has to be something that you can sustain over long-term because really there's data for everything. There's date of any healthy diet. You makita genyk. Diet can be a healthy diet. But it just has to be sustainable. Change that you know that you'll be blue make and sustained for years to come. It's not going to be a short-term change that you make just lose a few pounds and end in you're done because the way it's gonna creep back on know absolutely. This has been a great discussion today. I hope all of you found very useful. Thank you so much on the shelf for Joining me and discussing all about holes will plant based and i want to remind you all that we have started decoding. Obesity hang out. This is a free monthly. Meet up where you get to discuss challenges and you'll loss journey find accountability partners and at work with others in different stages of journey. So i want to extend a personal invitation to all of you to join me in my next decoding be hang out. We're going to limit the number of guests for each meet up so that it can be a very effective meeting but you're more than welcome to sign up for multiple meetings so head on over to www dot decoding be dot com forward slash. Hang out and sign up for next quitting obesity. Hang out meeting my friend. Don't forget to leave me review on apple podcasts. That's all we have time for today. Thank you so much for tuning in osceola next time you've been listening to the decoding obesity. Podcast please remember the information in this. Podcast should not be used in any legal capacity whatsoever. The thoughts and opinions expressed on this podcast are solely of the host and his guests and do not constitute medical advice views and opinions on this show do not necessarily represent the views and opinions of any organization and that brings us to the end of the show. Thank you so much for listening in. Don't forget to visit our website. Www dot decoding obesity dot com for show notes in more info. And if you've enjoyed this episode please feel free to rate review and subscribe on your preferred podcast listening platform. We really appreciate that effort until next time.
Optoturban Podcast: Mentorship and Branding with Dr. Nishan Pressley
"This is a de Focus media production everyone thanks for joining the OP determine podcast. Today. I have the lucky honor to interview Nissan. Presley Song introduced are now. Is So. It's not garnished. Yeah, so that's kind of what I wanted to talk to you about today. The topic of today is mentorship in Business I. Love How you really give advice to the optometry community and basically the instagram community. I wanted to talk to you. What was your motivation behind it? And how you balance being optometrist having your own frame line and mentoring students I think that's great. You know it is a lot. It is a lot, but it's something when you actually enjoy what you're doing. It doesn't seem like a lot. It becomes actually fun. I enjoy working on my business. I enjoy. texting and talking to students, pre optometry students anatomically students. That's just something that you make time for what you want to make time for in. It's become so over wording so so rewarding. So. How did you believe that passion? What kind of your background? How did you get to where you are right now? You know what we'll starting with the whole mentor ship when I was coming up. To banking about even becoming an optometrist in deciding that this is definitely the career that I wanna do I wish I always say I wish I had someone could talk through it. And I'm very open avid about supporting minorities, optometry and I always say that. I didn't see my first black optometrist until I got optometry school, and she just happened to be one of the professors. Took me all of my life to see that in so whip instagram platform that I have me being a black eye doctor always say we're kinda like corn, so I had this platform and I wanted to provide ron followers and just opportunity to ask me those questions that I wish I could ask someone when I was going would deciding I wanted to be optometrist or not, so that's kind of what really got me started. The thought it was an idea, but it really turned into executing that idea once I realized. You know the need. Is there so I'm the type of? Avoid I like to fill it? I was getting so many questions in my DM's, and it takes a lot to right along the end none decide. In I can't explain this gets. Typing so I was like why not offer my followers in opportunity to just have a one on one session? We kind of like what we're doing right now. Let's just talk. Let's figure it out because some Sometimes things cannot be conveyed good enough through message. And you might get it, but you know you don't really serious behind certain things or I. Don't know your back. Story is a lot to to of right, so that's Kinda why I really wanted to start it and give my followers and opportunity because I. Wish I. had that Opportunity when I was coming up? I love that I. Love that I think you're absolutely right. I don't think every community has those role models that allow them to. or at least are there for them to see k? This is the path I can follow to be successful. And so that's amazing that you kind of fill that void, and that you there for people, and so that's where you have your Dr. Nisha sessions right yes. Yes, so that's the Akron each session. So what would a typical session consists of? Let's say this'll be a session right now. How how would you go about that? What kind of topics you talk about? Yeah, so with my ass. Soccer Niche Services ABC different. subcategories will of my services, so we can do ask Nick on. Just ask Dr Niche which was a thirty minute session for thirty dollars, and we can kind of sit on a do meeting. Just like this and it's literally says ask me anything you want. And I get a lot of crazy things, but the main questions I get from people. Are you know I WANNA? Know more about Thomas Jury. My GPA isn't high enough. What can I do to get my GPA higher, you know. Do you think meet the requirements to get into optometry school? What studied tools that you use just things like that? They just really want to know more about my back story and I. Always say this is my backstory, but it doesn't want to be your story, but I'm here to help you. Write your own story in. So that's kind of what the ask Dr Needs. Anything. You WanNa talk. About must have a conversation about it. Also offer other other options. If you will such as like helping someone CB, helping with resumes, helped to build someone lake dental everything that I found was necessary to catapult me into the doctor. I am today in the person. I am today to get me where I want it to be. provided services for those things I could help them also becoming to be. That's amazing. That's amazing through your experiences. Failure positive you able to spread that knowledge to them so that they can either transit in their own way, or or learn from the mistakes right and big emphasis on failures mistakes. Always say that things look so cookie cutter, rainbows and unicorns on the outside. You go on instagram. You see that I wasn't a three year permanency that I became a doctor. Always talk about half as sports. But it took me a lot to get there I failed a few times and I'm not afraid of talking about those things. Might not it on my failures, but Like this I'm like you know. Way To the time I was denied through the first time the first round things like that, so that's kind of the story that people also need to hear because like I said it might look good on the outside, but I've had some defeats, and so by kind of talking and letting them know it encourages them, but also motivates them and let them know you know what this just might be an obstacle that action later telling my story, so that's something that I'm really big on might look good, but it doesn't always. It doesn't mean you know I still had to go through obstacles to make mistakes just to get to where I am. And I. think that's what makes you who you are adds credibility to your story. I think if if everything was cookie, cutter and perfect then. I don't think the true value would be there for people when they do interview and I. I think that's great that you. You show those vulnerabilities. Definitely you have to. You have to be open. That makes you more of a real person because I feel like if you look at someone and they don't. They're not talking about those fees. You don't seem real. You kind of seem like kind of fake. If you will so I'm really open. I like being ruined with everyone who act. Yeah, yeah, so you said you do see sessions resumes. Preparing for OPTOMETRY SCHOOL YEP so I'm hoping with interviews, because one of the main things that SLA my followers are concerned about an avid optometry school interviews to coming up, and I'm so nervous, and as you know better, Tom, she's going to really make or break They're looking for specific students. You might be good on paper, but how you present yourself in front of others. Do you have that confidence? Do I look at you and do? You think you'll would be a great addition to our incoming class, and so with that I have a lot of students who are liking look good on paper, but I'm so nervous to talk to people you know. I don't really know how to answer these questions if they decide to ask me these questions, so I have a said about fifteen to twenty most common optometry interview attempt to school interview, questions and kind of go through them, and I give them bullet points. Give them ideas, but they should possibly say be Kinda take note in their personal statement in include that in. In our talk about how they should include that in their answers, and we kind of go back and forth just like this. I make them dress up the whole Shebang, and they were sitting here. Talking and I'm like I contacted really big. You're using your hands too much of you should sit up straighter things like that for just kind of roaming them to make them feel confident when they do. Walk into that room because I remembered when I went in there I was so nervous, and you're going to be nervous, but the more you prepare for the easier it will come to you. I think you hit on the nose. Right? Like the more practice you get, the more you're comfortable with answering questions. The better you're going to be mostly schools are gonNA. Ask You. Why are you trying to go into optometry or right inside? What tell us about your major? Tell us about an experience you've had you know working or wherever you on your personal statement in terms of where you shadowed and things like that. They're just trying to get a feel for who you are, but a lot of. took up and they don't know what to say. Even though they know what to say, they can't get it out. So we really really work on that and just make them feel more company uncomfortable and given those types of answers, and the same is probably for entering for jobs, interviewing for residency and I think that's important for field. Because when we're connecting with patient, you need to be mostly intelligent with understanding how to break down. They have a condition, and or they need to follow up and so if you're able to convey that interview, that's GonNa show how good Kunwar and that's why there's such emphasis on that. One hundred percent agree 'cause you also have to think about it adds for one going into a practice as the new doctor. If you come straight out of school went guy. Did you're also you also look very young for while, and then you have that, and so you have to convey confidence like you said when you're saying. Oh this diagnosis We're going to do about it. And as you convey that competence, your patient will believe you more. This cheese talked about and that's all they wanted. When someone who's confident in some days, trust when it comes to their ISO, so just like you said That's what they're looking for. When it comes to optometry school interviews, career interviews interviews because they're like. Is this person competent had a spee-. Are they a people person? Are they personal? Can I do that? Those interpersonal skills that were looking for to make someone when it come back to the practice or bring their family or their friends? You know to come into the practice in. That's definitely went. They were looking for and that's what we work on in the sessions. I love that I love that so I love that we kind of hit the the side which is amazing, but since we're today's topic is. In business, I wanNA talk about how your kind of marketing yourself and how you're kind of creating an industry from this like for example I saw the other day. You spoke on the radio and. You did an article with VP. Tell me a little bit more about that. Yes, so for one. It's really important to know how to brand yourself. That's a whole different topic. We can definitely hit a now. Because branding yourself is so important I remember my first opportunity. I've got when it came to being in optometry student, who was trying to put yourself out there more in this social media around terrorists who had been charged division expo. He follow me on. INSTAGRAM followed out trying to do, and he was the one that gave me my first big break. If you will in terms of hey, come to the next bow will pay you. You can be our influence. Her and I was like. Oh, my Gosh! Like honestly had I saw it I never thought it could be me. And, so once I got into that space and I met so many other optometry influencers outside. This is actually a thing. I like this because. Media as I. Did this perfect for me? So while I was in that space I made sure on spoke to those other optometry influencers him I. Should I do first thing? I always say clean up your instagram. If you specifically once you be looked at as someone who is respectable in the field. You can't have like. Bikini picks like you stuff. That's not relevant. If you will on your instagram, so it's really important to bring yourself in show you know who you are, but still keep a professional, which is really really important. And I've been seeing so many uptown tune is now doing nothing has made the new as well. just really branding themselves as Tommy optometry student in showing their journey, so I'm seeing a lot of that happened more and I. Let it so once. You kind of build that space or build that that look if you will on social media Your Lincoln. It's really important to. Connecting the people in in industry in a more professional way, that's how you really make connections and then after you kinda clean up your social media and make those connections. He's the continue to put yourself out there. Posting pictures with your student why your white coat providing educational material to your followers to tag those big companies big corporation, because the more they see it. Let me. Take a closer look at who this girl is. Oh, you know. She's not competition, or she's a doctor in which he was doing and like I, said minorities are not be play a really big really big role in the way that a lot of companies are trying to provide diversity inclusivity, and so they want someone who is. Is. If you outspoken in. unapologetically themselves when it comes to this industry, and they love it, and that's look for. That's great. That's great, and that makes sense and. That's awesome that you did have the opportunity to do that with the. And on the radio and. I think it speaks to your marketing ability. But also on top of that. Even let's add to the list. You have a frame line. All these things just keep going. Right? Yeah, so I have a frame line in. It was something that I've always wanted to do. But of course when you're at school and everything, you have the money to do this. I'm just trying to keep food on the table night. Right by once, I actually became adopted. Got Got up you check on about. I was like you know what there's no better time than now and so It was something that like I always wanted to do. I kind of turned in idea in bought into an actual business and I'm I'm doing well I'm still learning day by day. We launched on Black Friday of last year. In though meet as then I, guess about me. Me about six months. If you will for six months for doing really really good, and we're at a point where I'm going to try to expand, have a lot of practices actually asking offer wholesale passages like I never thought about that, so you know if it's been great, it's been a roller coaster. Not Things learned, but basically with my frame line right now I just really wanted to offer my followers and my patients Fashionable in affordable frames, but the also come through light lenses, 'cause I don't need glasses. cute. Athletic. They're really a big fashion statement. If you will, and it's something that you see a lot, even like certain levels. They don't wear glasses. They don't really need to just goes. Go with their outfit. To provide that option for people, but also provide light lenses or like blocking lenses. I should say because I'd rather give you something that could help. Your is at some point. Of course they're still certain studies that need to be done, but to really just help me. Just give you a plastic lens you know so I just wanted to offer my my followers in my patients or people who purchase my products just add option just to still give me something acute frame that called the blue light is just the help with that led protection. I love that I love that and you market yourself and for the record. People are GonNa hear this alright, so everybody's going to know your secret now. You're listening. Make sure you check US out at Shop E. O. DOT COM. I was looking at it and I was like wait. Is called shop Um like you're muscles, or is it to shop or like? How do I pronounce this? Now. It was kind of a play on my own instagram name, which actually thinking about changing very soon, but mind is on each and I. was like eyes on me by that very fact, move frame so e Owen. This short is on me just because I always like you look good in those frames onion. Keep Your eyes on me, 'cause. Frank. I Love I. Love You change the name. On My instagram name I am thinking about it, 'cause. Has Doctrine it. More marketable in I. Guess you're the first year this I'm I'm thinking about changing it to ask Dr Niche 'cause Mardi marketing myself as that type of doctor in that type of person who provides great information and already have so many aspects now. Disliked, why not change instagram to ask commissions well something by change, and I love it i. mean right away when people look, you'll see. They're going to know what the bank what to expand that they're gonna ask you something great and anything branding yourself. Instagram name is on me. She was cute. It was cool at chose it when I was still a student in optometry school, but now as a practicing doctor I wanNA make it more formal, more professional, and like you said when someone looks under my youth I can ask her stuff. Not Let me see what she does. Marketing yourself branding yourself important. What would you say you're? You're following people who follow you. What do you think it consists of like? Do you think it's majority of doctors? People minorities students things like that. You know what course it's. A lot of women do look at my insights on instagram. It's like. I think sixty, four, sixty, forty, two, well in terms of. and I will say a lot like a lot of people who follow me. It's a mix I. have some pre optometry absence students who are still in high school I do think the majority of people who follow me are in the Real Thomas or in optometry world. Can't even say majority of over nine thousand now, but I also think it's people who. Who are not sure about if they WANNA go into optometry doesn't for someone who wants to motivate them and I. do think it is more minorities if you will who follow me so with that little mix of. Someone else asking that now. The instagram use a feature where I could like. Of course with the ages ages were like between eighteen to twenty four twenty six march ages who follow me so I, guess we can say college and young adult. Once. You're so I love that you're still out. You admit that Hey, minorities follow me, and I am a minority, and I wanted to be a role model in that community. What is your take on bringing that into a conversation? When it comes to the professionalism? For example for personally, my name is Otto Turban and some people may think that. Why do you bring the word turban or religion into this conversation when you're trying to brand yourself professionally? What are your thoughts on that? And how you think the right way to go about that is now. That's a really good point and our said earlier. When your brand new yourself. You WANNA stand out. and. These larger companies now in today's climate if you will. Looking to provide on show their consumers, diversity and inclusivity. We are not part of the problem. Let's be honest here. With these companies in there, looking for that type of person you having targeted in your instagram handle is great i. mean literally like it's part of who you are. So why would you try to hide that? Thing with me, I'm very outspoken about. Increasing the number of minorities and amateur just in awareness. So that's just who I am and I'm not afraid of that I. Wear my skin every single day. You can't look past it, so it's something that as bound to work for me of course I'm not you know out here Downing were being rude to other ethnicities. I'm not I'm trying to build everyone up. Sometimes people who look like you were I. They need a little bit more, and that's what I'm hearing to provide. This is me unapologetic. I'm a black doctor in. I'M GONNA make, people. I love that and I think. By being genuine you, let's say you could get ten thousand more followers. Just because maybe you didn't bring up these kind of topics, but those those followers that you already have I think those followers will love you very much so more and I think that's more important than the actual number. I think it's the quality and the ones that are actually will follow you everywhere, and you could speak about that with not the politics with our president I think there's a certain amount of the country that loves him and. That's important to him and. I think it's branding opportunity, but having people that love you and will adore you in fall your back because you're giving genuine message I, think that's that's more important. I love that you're doing that. Definitely I'd rather have ten thousand followers who. Understand my message we have to stay. Kind, of you, don't mind me being real. I pity thousand followers where GONNA post being there like this. I took it off a page. Leave I. Don't want you here. So yeah I definitely would rather have hours. You. Know who I am like lamb. That's the reason why ninety right. How those experiences gone with patients were being younger being African American being a female in technically a state that might be considered conservative, possibly depending. And That's a great question now I will say. Apple like is conservative, but I live in a more. Diverse area Orlando is very diverse I'm not in the world earns areas of Florida which I knew I did not want to live this the. and I'm from Pennsylvania so even still there are certain conservative areas of Pennsylvania for Ross when you know Pennsylvania Philadelphia itself is like a melting pot right so moving to Florida For one being a young doctor when I talked about earlier. It is a little bit tougher because they want to. Spend money coming in because I came into practice wherein older doctor list. that Dr Left in on the new one in towns. Like who is this girl like? Where's Dr, stone? Though so just starting out you have to make your patients feel comfortable. The you have to allow them to understand like even though I just got at school. This stuff is really fresh for me. but also to add to that as young doctor. You have to understand no that you may not know everything because on everything is textbook but coming in I was able to gain my patients confidence like you know what this is the most thorough exam up having a really long time, and they like that because we're so used to doing thorough exam scoring an extra chips. Being able to give thorough exams and properly talk to them with confidence about how to diagnose really did help now being a black doctor. I'm when I'm the only black doctor malpractice to be honest. They padlocked doctors before, but. I'm the only one right now. in with that. I. Have had some patients who haven't anyway you know, say anything that was biased, but like you said being down here in Florida. Sometimes things can be misconstrued in like how they say things like Oh you know, ask someone call me colored before, and that's a word or term that was used. Back, in the day, that was used to kind of described someone or a black person, and I do find that very offensive and disrespectful. The lady was like eighty six. So you kind of do have to pick your battles, but you also can not afraid to speak up. Say you know what man at respect? Please don't call me that. Only. This is the first time I saw colored a color doctor here. Make that facing your likes US eighty six. You know, but at the same time. You also have to learn how to not be disrespected, but learn how to or know how to. Educate your patients in a way where you're not being disrespectful to them, which might sound funny? Even though they're being disrespectful to you and I really had to learn how to do that. and it only happened once, but I don't have some patients who are like gosh is great at black patients who come there like Oh my God I'm GonNa. Tell all my friends in my family to come. See you because they need that. Same thing we can even take this discussion to how having a Bolo sorry about having a black doctor can help. Spread awareness about certain diseases that are more common in the African, American community and me being able to have that conversation with them in the way that we speak to each other in a be enough to know, this is serious it. Can possibly help with these. ocular diseases that are so prevalent in our community and helping to stop them sold them. Excuse me. Help to stop them or slow them down so There's a lot of bonuses more bonuses to being down here in the you know working in a practice that are working in the area ashes. They were. There aren't too many black doctors because you come to become someone who everyone wants to come to an. You're able to provide great information in help so many people. I know that was a lot, but. No that's great. That's great I, think you. Bells perfect how you handle, everybody has sees. Why did you actually want to influence change? You can't show hate to hate. To show it in a loving way in an incorrect and. Put a positive spin to even for me. I did my rotations in in Tennessee another one in Jacksonville, Florida. So, somewhat similar I, think couple of hours away. That it was good. It was really good. like you said. People are pretty open, minded cheese bigger cities. But sometimes you'd have these these weird statements right for me would be like I really like the color of Iraq. And so for me like number one the play. The person was trying to get a compliment. I didn't want to go out as hey like. That's really messed up. I wanted to go about as you know, it's actually a turban as part of my favorites destroying a commitment to my faith. I appreciate. You said that, but. It's actually called, but thank you for the compliment and so that's where it's like. Thank you. Give them positive reinforcement. For the fact that they were embracing to have this open conversation at the same time, you don't you WanNa. Put them down. You bring people up and encourage them. Factly, because I guess, is kind of a weird feeling situation, because the term when the word you use is more or less disrespectful to me, but instead of getting upset about it. I'm GONNA take this as a way to educate you could. Maybe you can educate others, and then you know this will more or less decrease or stop so a hundred percent agree with you, and and the body language is huge, because when it sounds like when that lady said Hey, like I never had a doctor of color like it was wasn't with a angst. With trying to put you down right? Oh, my gosh, this is great and I'm dislike. Though. So, yeah, it's something that. I might have to deal with the rest of my life, but you also have to be understand that certain generations are also passing away so like I said the lady was eighty six. Hopefully her grandkids don't use those words, but you know if something that like, I said continuously educate in hopefully, the times will change. Definitely definitely. So, I mean today's conversation. We talked about how you're trying to help students. You're trying to help graduates people who are entering for jobs and I. Think asked Dr. Nietzsche's great and. And that opportunities there for anybody who's interested We talked about how your branding yourself including speaking on the radio, reaching out to companies and I think. Putting yourself out there putting genuine content and from there things. You know spontaneously happen I. I loved I loved that you speak about things like race, being female, being a younger doctor and just genuine content, and then finally you talked about how you're starting a frame line of business while you're being a doctor and. I love your soul been by all your ideas, and even if people might not be open to them. You have to be. So thank you for joining today I. Think this is going to be a lot of value, our listeners and You know I'm looking forward to doing this again.
The South Florida Morning Show HR 3 8-30-21
"South florida morning. Show with jennifer. Ross in bill adams on newstalk eight fifty w mt l. including discontent in contempt remind crecy ineptitude at the foreign policy level questions to some of my senior leaders not allowed to ask questions even if it is a social media video apparently not because This poor guy got Relieved of his duties later by and he said even when he released it might have even been in the video. Lieutenants colonel stewart schiller said this will probably cost me my career but i need to question anyway after what happened in afghanistan. I it's amazing because You know my daughter's a lot of her friends either served or their mary to women or men who have served it and they've all said the same thing but not publicly. So i mean it's it's a obviously a sentiment felt across the ranks in. I think every realm of the military and then to add insult to injury. You have the commander in chief waiting for the transfer. The bodies at dover airport yesterday and i'm like you're responsible for these people come back in a coffin. You have a lot of nerves showing up. i understand. That's what you're supposed to do. But still if i were one of the parents of one of those bodies i think i probably would have slapped him about the head and shoulders for while we're going to put on. I think we are anyway dinner. I think Gender putting up the quick little view of glancing at his watch when he's supposed to be paying tribute here in a. It's quick. I think still shot makes it look a lot worse but he still did it. It doesn't yeah like it's like. I never really seems to care that much. I don't think he cares at all. You're sitting there watching eleven caskets being transferred off of transport plane at the air base. And you look at your watch. I don't care what the hell's going on in your life you know again. You're responsible for these bodies to begin with right. Show a little respect. I tell you this man. I think he's evil. I think you're right to. He's he's evil in two feet if he remembers where he is. It's just bad. it's bad bad bad. Scene in the meantime Going back to Lieutenant colonel schiller here relieved of duty like you said jen and the official quote from the military is due to a loss of trust and confidence in his ability to command this coming barriers. That allowed this disaster to happen in afghanistan. Well god forbid you have the rank and file questioning anything that you tell them to do because it would be considered like insubordination and massive. They all agreed with him. I think this guy is so distraught about what happened. He gave up everything in the la- last video. He is like you know what. I'm losing tons of money in pension. I don't care about the. Va keep the va. who cares. And but i think you know. I deserve the right to be seen at the. Va for the rest of my life. Because i'll give that up to. I don't care what. What would it take but you have to have conviction to do that. Put it all on the line. Say it in public kind of fashion. And i get the military the pentagon a one ranking colonels here going on social media making videos and posting them. They don't want this start happening but still skies telling the truth. How passionate is he willing to. You'd be willing to risk all of this. He believes in what he's saying. There's a problem there. Well an an what's even better is. If you know nothing about the military or how they operate i e me i listen to this guy and go. Oh my god. Here's a guy that knows. How the inner workings how it all takes place when they send you And he's like he's disgusted by what's happening and i'm thinking boy and when you start to tick off the rank and file who's given their lives because this guy's been there i know longtime he's not that young he's not that old but he's not that young son thinking you're willing to give up everything because of this it makes you wonder know. How badly did they really screw up. I'll take anybody makes that kind of a risk unless you tell them the truth and you know what the truth is too. It's terrible boy. I mean time got a big storm aftermath to deal with and louisiana coast. The thing is still moving up inland as a tropical storm. That's a strong. It was stayed for hours is a three. Oh it's horrible it's horrible. They're they're now getting to the point where they can go outside and take pictures in the destruction is bad. Remember how bad it looked along the panhandle when michael hit. Yeah i think this is unfortunately going to make that. Look like nothing at sterile. He's poor people and they. Then they lost power in new orleans. What did that guy say. How long before they they'll get it back here's One of the cajun navy commanders. Talking about this because the call already went out we heard from new orleans medicare and had that in rapid fire calling out. You got a boat you got anything cajun navy. Get out there to help people rescued. Here's somebody from cajun navy talking about what they anticipate. Two months that we're able to provide the olsen aids flaws water things that people in jefferson orleans parish those a transmission tower that went down. You're gonna probably four weeks off. Oh my god it's bad. I remember when we had gene and francis and all those say we waited nine days power. And i thought it was saying to the world. I know they did. I thought it was the end of the world. Can you imagine he's telling you it's going to be a month to two months. I be like no thank you. So all of new orleans all of the city major american city not one bit of power anywhere by in just think they just reopened this after. They've cut they've canceled to margaret's did they. Did they mardi gras this year. They didn't they cancelled again right like at the last minute thing they did so. That's to mardi gras that they've lost which is really. Let's be honest. That's what fuels new orleans sure Or the new orleans jazz festival and that get cancelled again. I now you get this these poor people. It's like you know. What did they do and now for something completely different. Please be sillier side of things. Oh just put it up actually on our other radio station. The dreams over jan yeah. We're we'll never never get another season of tiger king. now carol baskin is sold off. Joys ought former. Zoo property cited taggered. You're not kidding. Wow so oh that's right. Because she won the lawsuit against a minute she get all of his property right. Is that what it was. Which was i think a bigger deal than reported at the time. 'cause you just sold it off. Wow with all kinds of stipulations no one will ever well. It says one hundred years is the maximum. Could do ever have any name re business on the property after tagger king its former name the gw joe's name even the words tiger wa note that those are the stipulations. Like we're in favor of you know what he was doing there. But i just wanted another show. Yeah i'm selfish okay. So where's doc antle and all of this. That's what i wanna know. How come he can continue went boy. He went totally under the radar here. He's the smart one while he's got all those beeps to there. I think he does too. I you know what but it'd be a great cult to join if you like animals. God maybe maybe you'll find a reason to resurrect that damn song come heller jingle bells behind it for christmas. No more tiger king basket. That was a that was a big lawsuit she won. That was sure wires. we here. It comes oh wait for you gotta do. It might be less than we ever get to play it stopping the chorus. I generally here you go. This one's for you thanks. Gazette chatfield actually tried to play it off like he's saying all this stuff. I'm knuckle in jail for the rest of his life. I'm sure probably. I'm surprised somebody and thin. That's terrible but the highs and lows of the american pastime next the highs of these young kids one of the little league world series. That was great now in the lows me no we professional athletes professional baseball players booing their own fans. Why would you do that. is they're spoiled brats. Okay arizona recent latest on ida in afghanistan. All of it coming up next these self-loading morning show this gen. Keep it here. And it's almost news time again jen karen for us at eight thirty. What's happening you all these. Preseason football games all the fans and oh eh daytona no-one wearing a mask. I even still jiang. You gave me the hit on friday. Because i've been looking for especially in the cities where they have asked mandates. What he's wearing a mask of the stadium except for little pre k. Kids is your daughter wearing a mask to school. They're starting today. They gotta wear masks pre k. Yeah we have it on but the only reason. I'm kind of okay where i should say partially accepting this because it's only a couple hours briquets. Okay it's not a full school day well at the us open. It gets underway in queens today The us tennis association. You have to show that you've been in order to get in there but there's no mandate for a mask there you go. I just don't oh these kids with the mask. The governor was just trying to let you haven't decision i still. You know it's an option. It's just an option so if you believe in mass that much you have the option to put him a double mask your kid. If you're that cruel whatever you wanna do what you have to force everybody else too because they can spread it. Are we sure are. We sure they're effective. It's actually a good question bill because this is something we brought up last week when we said all these child cases are going up. They shut down the school vero beach. Why are all these child cases. And i'm not talking about florida because people say oh well. Florida does what they want. They don't have mass mandates willing built around the country. All these kids are getting cases. Cases cases. going up with kids and hospitalizations. Why is it happening. And if everybody's wearing a mask. I want to answer that. Currently not effective. I have a friend of mine has three kids in that euro beach school said all masked what good did it do the schools close and they're all home that says like a month. So why are we still force. It gives to do this. It's clearly want to fold the science and fold the science look. Hey it's not working because they're still getting sick of watching tv. No one had a mask on any sporting event right. Got our kids with these mass. I don't understand what's happening but anyway. Thanks karen love to lead to cover including other stories at eight thirty fifty. Wf tlc self-loading morning show. There's jammed his diener. A i the best argument of all if they were that effective. But there's also this so. I'm fascinated to see this. We're gonna have to see the replay one of the Fox doctors dr. Nisha watt who. I love she's really really good. She has a story about the combo. Cova d- flu shots coming. Kutu your world soon. What did we talk about it. I say predicted that. What did i say about next year. Get ready for it. And that's how they're going to get your kids. Take a flu shot. Get a cove. It'll just it'll just be included with everything post. It just added to the list. But what did you say. But was it israel the third shot. This is interesting because this could lead to all kinds of ramifications israel just yesterday really last night for us have now officially changed designation in the definition of fully vaccinated. Okay you're not fully vaccinated. Elizabeth had the booster shot. So now you've got somebody that's had two shots okay. Oh they're talking about visor. The event two shots and you considered fully vaccinated so are we gonna have the three shots super vaccinated people now looking down upon. Yeah the only two-thirds vaccinate people and as the third shock on a make me sick as the second one did god now and they've up the any used to be eight months now. It's six months after your last shot that you thought was going to be your last shot. Apparently not anymore and how many mysteries you're gonna have. We're going to have for the next twenty years where they're going there what happens. You're not fully vaccinated unless you've had the fifth booster shot. So the fifth booster shot. People will look down upon the fourth booster. Shot people and say we're going with this. I don't know it's kind of scary. How dare you walk around society with only four booster shots. Oh yeah why are you so selfish. The next one's going to be your kids. I mean little kids because now that they've taken the emergency status off of five that's what they're working on debut already. What wasn't a member. They had that stupid test going on. We were like oh it sounds like a summer camp for little kids like six months. Yeah five years old. I can't covert or something stupid like he's got. It sounds like they're going to summer camp sake. I went here and we'll talk couvert. Sure the logo on the t shirts have big needle results probably already in so it's just a matter of when they present it to the fda can't with a world what is happening. I could see that. I think you're right. Jim by the end of the year. At least that's what i'm hearing under. The year they had to be the end of the year. I mean things can be that long it and then it'll be mandatory. Your kid can't go to school and less one hundred percent. Yeah before we. Before i was sitting on the fence about it now without a doubt. Oh it means that scene or they're not gonna be let back and now we're not saying it should happen now. Don't send me nasty. Emails received a prediction that we will see that probably by next august. You can't come to school. Is you have a code vaccine. And that's going to be used for you. They're not going back to school in january unless they're vaccinated you watch you watch. It's not even that shocking to consider that anymore right. It's i think it's highly likely that's the key i mean. Why wouldn't they at this point. You already seen it in corporations and things like that. So i mean. I think it's a no brainer. That's going to happen. Yeah it's Well in the meantime in a different world power could be out in and around orleans for days or weeks. Possibly these major tower. That powers most of new orleans. Jefferson parish is into the mississippi river that the tower is in the river right now by the way the river has reversed flowed. It's flowing north. Now it said because of that eight barges were like i guess just set free because i guess you said i don't know i don't know anything about voting but i would assume if you you're the captain and the crew of a barge you know how to make it secure either at the docker with anchors and stuff so secured it with the river. Run in the right way. Ooh next thing you know. It's running north instead of south. It's like whoa what happened. I just i just saw report there. Showing some wind gusts readings from yesterday. I'd never seen this Cities name before some probably seen it wrong. I think it was like port four soon or something like that. They had a wind gust of one hundred and seventy two miles per hour. God is seven. Oh i mean and they had other reports. They're one forty six on a different city. One twenty five could now one seventy two. Are you kidding me. Not good Well i think that it is going to be a national effort to help him. So i would expect some water supplies volunteer of power worker. Efforts era happening pretty soon in our area so expect to hear that soon and well roker survived by the way. If you're one of the people who complain embassy that he was out there it was by choice. Yeah he's doing a good job. He's on the streets. Go gag credit all right. Baseball is our national pastime. To distract from things like this right. We got the good news in the bed and is good news. Regulations to kids from michigan with a little league world series. That was good. That was good. And congratulations to martin north. That was good they They lost to the team that ended up winning the whole thing but yesterday shame and that now yesterday they got a nice little welcoming. Home parade In morton county. So congratulations and now the bad. Let's just you know what let's just watch the little league kids. Kids really wanna play for the love of the game not these pro athletes. these days. The new york mets some play. Okay have taken now to booing and sending gestures to their own fans. Why would you do that. Here's this all started. They threw a horrific month and a half just season started grading and they just everything turned to crap is just wasn't going well so what happens then. Fans pay a lot of money. They started booing. their team. Right happens right well. Now that the turning things around they beat the nationals at home in new york on sunday by a score of nine to four every time the crossed home plate. Some of the players would put a thumbs down to the fans. Are you kidding me know. How disrespectful is that because their feelings were hurt when you were doing them. So we're going to boo back to do the fans pay these guys sell s. Think isn't that the reason they're there. There's a hobby by as mets blair explaining his his feelings and it is about feeling okay. What else could do you know. It doesn't really get to me. But like i want to let them know that what we're su- says we're gonna do the same thing to let them know how it feels. It's all about how you feel. You know what can you imagine. Joe dimaggio ted williams don drysdale some great pete rose hugh imagine them doing these two fans. Now no no. And there's an update to the story and might be some repercussions for this love. It sorry president sandy. Alderson is fired up. After some mets players did that giving fans the thumb down. He is not happy at all about this. He said in a statement they will not allow players to make negative gestures towards the crowd and he will have in-person talks with the team. Look at that. And you're you're doing this to essentially your customers who pay your salaries. They are so out of touch. Now come on you know what. I think that would be like us. Everyday day opened up the show. And we don't like you do that sometimes game. You're right. I mean come on talk about. Oh and it's all we want them to know how we feel. It'll carry feel particularly the damn game. Good lord what's that guy making year ten million dollars at least at least okay you can suck it up and take a couple of booze be tough like this l. a. Mom who saved your kid from the grasp of a mountain lion. Isn't it amazing story. It really is what it's even more missing is. It has turned into the wild kingdom. Sure has it really has kinda scary. We've got that coming up next more on afghantistan ida next florida morning. Show this gen bill. Keep it here. Thank you so much karen. We'll see four that next newscast top of the hour at nine news. Talk eight fifty w. f. t. l. e. self-loading morning. Show this jan diener bill. And you said it before about ten minutes ago jan. We're starting to see really see as light. Dawns the damage after ida. Wow it is bad in louisiana coast and it continues to move up through the state. Yeah it was This morning it was still a tropical storm with winds sixty miles an hour. It's like come on die which it go away and it was north of baton rouge and it's Northeast and now. It's it's headed to other states. Those states have already declared states of emergency because of the rain. not because of the wind. What happened with this storm though. They didn't new orleans louisiana with the water because they knew it was going to dump a lot of rain right but this system in like ten hours went from a to a four almost a five just before made landfall and they had no time to prepare other than you know. Get out beforehand. But that's why there's so many people stranded. I think they thought it was going to be a to no big deal will hang out squad so powerful. It was nothing to block it. Was you know in the gulf warm shallow water gaining strength and then bam on and the same day. Sixteen years after katrina hit. Not amazing very close to. I guess it was west in new orleans but speaking of new orleans millions of people without power. That could that could be the case for weeks. The main tower of power that provides electricity to that city has been broken in half and now it's in the mississippi cheese and speaking of the mississippi for the first time and i know diener was looking up the statistics. I don't know if you've found but the us geological survey says it's an extremely rare occasion when the mississippi flows in the opposite direction. And that's what happened. And that's why all those barges they had barges and like party cruise boats just floating down the river. 'cause they broke loose. It's like oh my goodness well. This is how you know that pretty soon here in south florida. We're gonna have the call for rescue operations if they're not already there but also You know power workers and everything else. There were coming from as far away as The new york new jersey tristate area while in red cross workers from as far west as wisconsin. Already it's going to be a nationwide effort. Well probably i mean but you think about it i. This is a huge disaster for the southeast. But then you get the northwest which is on fire so the rest of fema the rest of the united red cross or whomever whatever agency. That's gonna help is already there. So it's it's an and let's be honest. I mean these power crews without them there. Nothing they get in their fema goes. Whoever who's the head fema now. Good question We'll be tested. Because now's the time you're either going to sink or swim no pun intended. You gotta make sure i. You know caroline's boyfriend that works in one of these powerline crews so he always tells me we wait. We sit until fema says it's okay so fema goes in first and make sure there's you know there's there's no livewires down anywhere. Most of these things shut down the minute. There breached the electrical system. The grid will shut it down so that doesn't happen but he said we got to get the clearance for us from the minute they say. Go these guys go in and women like ants and they just attacked whatever system. They're supposed to attack the fix so hopefully with that many crews going they'll have power back relatively soon not like two months that guy said and we didn't even talk about communications so there's an area south of new orleans that apparently has all phone service including nine one one in the sheriff's office out of touch mazing like not coordinating has so if you call nine one one that's the thing but i in that situation wouldn't the systems automatically be switched to somebody else. I don't know it's a good question though. I wasn't that system in place odd cell phones landlines road lafayette parish. Wow it's we're actually made landfall sunday afternoon. Unbelievable it's people really tough scene. It's horrible More tough news will lighten this up. Promise you just a little bit. But i guess it's official. The gates have been close. Last flight is out of the airport at kabul and as many reportedly is three hundred. Americans left behind k. Tell me these three hundred americans. And how many afghani You know supporters of ours have been left behind. Tell me this administration has some idea of sending in a special forces team or teams or a bunch of more. How whatever it takes. i mean. granted the only thing i've ever seen is when they took out osama bin laden when they saved the crew to the captain and the crew on that oil rig remember that was held hostage Those are the only two times they've really seen the seals in operation but the marines have special forces the navy special forces that is the seals in the army special forces. Hello can't you get all these people together in like sentimen. Save these people. How do people behind the died. I think those are private efforts now and may happen but they're privately organized which is just a shame it. It's just i. I don't understand brian. Kilmeade comes in at ten after us. He tweeted out. he's just last night. How can anybody in this administration hold onto the job. Does does biden. Even answer a question about it today because he refused to yesterday. Yeah he didn't yesterday now granted. This was an update from fema but the storm. But of course you know it's the the story of the probably decades so far of course reporters can ask about afghanistan. Shut it right down take questions. We'll go ahead. Afghanistan gets up any leaves seal later. It makes it especially bad when he says again. I'm not supposed to take any questions. Yeah whoa yeah who. C- who is he makes. You wonder who tells him not to take questions. And whoever's pulling the strings is probably saying to him. Joe stop saying. I'm not supposed to take questions. Don't just just but you can't just leave you know. Just get up walk away. That's why they put on his teleprompter an on his all his stuff walkaway. It literally says that she. She's tough scene. It's horrible all right. We got good news. Here doesn't start off good. That's for sure. No but it's it's a i think a great example mom power story of the day. This is always one of those situations where you think if it were me. Could i do with this woman. Did they live in calabasas. Which is a nice part of town. It's also near the mountains in california And this woman. She's an hauser. Five year olds playing in the backyard naked. She's washing dishes looking out the window. Next thing she looks she looks outside. She hears her son screaming. He is in the jaws of a sixty five pound mountain lion. Who's dragging the child across the yard into the woods. God so this woman drops everything literally runs outside and jumps on top of this mountain lion and just starts pounding on it and it's face and in its mouth and trying to pry it open to let her son go big. The teeth are on a mountain lion. They're good like three or four inches long and sharp and sharp. She manages to do it. The mountain lion releases the boy she jumps off the mountain lion takes off. They rushed the kid to the hospital but when they get there of course they gotta tell the police that the kid was mauled by this mountain lion. They send out animal control people. The guy gets there the mountain lions hiding in the bushes at the still whiten. My god like so. He took it out. Unfortunately the poor mountain line didn't make it but now they're going to do an crops. See on it to figure out. There was something wrong with them but there was also another lion there that had been tagged by the refuge people and they picked her up and they took her away and took her back to some other refuge place but still it mountain lions hanging out with the house. Mom power baby boy and adrenaline. By you know you think about it. Would you be able to do that. I think in the heat of the moment you could. I guess if it's your kid mayo. Till then still i. I've seen my dogs go at it like two dogs. Or and i've i've just sat there frozen. My kids have had to jump in. And you know. And i like your baby wasn't involved the difference to doug didn't like the truth tease ed. Don't send me hate mail. I got enough animals fleas. Enough eight male. Guess yes it's true. Update you on all these stories about Ida and afghanistan. How about this though. Things aren't really working out in the dating world off no problem you just create your own dating site. Yeah it's working for the guy. I gotta give him credit date. Call an o'brien dot com. That's what it's called god. You know what good. I gotta respect the hustle. Kim credit all right next the morning. Show this bill. Keep it here. Karen got more news coming up top of the hour at nine o'clock everything going on what he started with him as well. We weren't alive but back in the eighteen hundred. Seventy hundreds if you had a flag in you stuck in the ground. You're like took control over the country right. That's all the plotted land. Yes that's how. I plotted the studio to get the hell out. Now give a flag. Well apparently california teachers in hot water. She took down the american flag. And i saw this video and it's disturbing. He took it down during the pandemic because she said it made her feel uncomfortable. Oh and then she put up a gay pride flag instead and asked her students to pledge allegiance to it really and she's still got a job no she's a not water. Well i don't know she may still. This is one teacher now. Think of how often this happens to the country. Not all of them. What is going on in the classroom. I dunno what's other teachers horrified by these two and they're afraid to speak out. Yeah well they finally went ahead. Everyone learning from home and parents were home seeing what was going on. It's a different world. it really is home. Schooling rates are skyrocketing. Not just here. Every state in the union. Yeah 'cause you figured out parents can do it. It was a big adjustment but put families through hell when they shut down schools and now i figured you know what we don't really need you such self to pay property taxes in paper while they're gonna be. Here's the next move. The teachers unions are gonna come back screaming for funds. We need more funding. Because it is. It's up to parents to say no. It's not a funding problem. No everybody just say no. Get better at what you do. It's it not rank and file teachers. These unions horrible is a big money. Play no is a complete sentence. Yeah from that more coming. Up is just infuriating. It's see this thing with a mask thing. Oh and now the whole mask issue with you. Know never get schools shut down because there were some covert outbreaks. Golden the mass squirt. Then i you know it's a. It's a valid point because a friend of mine has three kids in that school. All different ages obvious indian river county. Where jen she was like okay. So they wore masks every day and why because now. The school shut down because they've had so many cases. Those masks worked real well didn't they. What's the effectiveness then. Why are we muslim. Kids all day long in school just to say we can. It's political theater. What is it to keep control people. What is this about it. I mean look at the schools that have mask mandates. Okay now all of them but In the event you look closer to home even the kids. It's funny because even some of the people we work with their kids go to school they wrote the opt-out letter but when they get to school since everybody else had one on so they wouldn't feel left out. They all put masks on. So everybody's got mask on yet. You have thousands of new cases each and every day in schools across this nation Apparently the masks aren't working folks. I'm just saying it's just an observation on my part i it's it's terrible price to pay in. It's it's tough thing to put kids through unless you're absolutely sure it's completely effective. Is anybody in this country. Sure that the kids masson kids are working. No no and yet. we're we're muzzling. And it's the best word for muzzling them in schools. It's ridiculous to do. Do they have to like if you're on the football team and the basketball team and the running member that that attract that kid passed out running track head the mascot did they get rid of that so they can like if they're outside playing. They don't have to wear a mask. I guess it's district by district. I don't well. It's kind of scary as what it is. Scary is rights. That is scary as what's happening in the gulf coast of louisiana though jen storm surge. Tropical storm warnings out for hundreds of miles of the gulf coast. National weather service. Now's declaring tropical storm and storm surge warnings From louisiana to the alabama florida line. This you know half a day. After this thing made landfall. It's still a tropical storm working. Its way north you louisiana. It's really not that it's a long state north south. That's not very big. It's still hasn't left. And it's going to the northeast. It's it's been there what it hit yesterday afternoon. It took nine hours before it was even downgraded to a category two hurricane. This thing didn't die. That's amazing it kept its power over. Land kept its power kept on around in this area. Lot of atlanta's swampy get it get still draws him energy but still. That's rare in it at cy. I think it's really rare and now it's just turned into a tropical storm like an hour or so ago. Didn't i mean it was recent and now it's headed toward i. I don't know where it's going next. Tennessee it's one of those states. Millions of people right now without power all of new orleans apparently because they're made power Transfer tower broke into the mississippi. So that's just a dire situation and what was even worse that hold there was one whole community was i. Don't know what part of the i guess the southeast part of louisiana where this storm came ashore. They lost all nine one one communications. You can't call the cops. You can't call nine one one. You can't call anybody. I'm like whoa. So if you're stuck how these people know they're gonna they're gonna get any l. gary to trying to keep in touch with people who are in the area friends relatives. Whatever if you can't contact if you're you're left wondering well you can only hope it will be savell send-up helicopters and stuff and they do aerial searches for people. so hopefully. that's what happens and people around roofs waiting to be saved hope. So she's all is a nice little distraction story for you. Okay things tough in the dating world. Okay i hear that. Would you know things weren't going well for the saint. Louis guy. Okay so so. He made his own dating website. Come on no. It's date colin. O'brien dot com really. And it's working. He's gotta respect the hustle. Come on good for him. Here's colin talking about it. It's been huge. I think something now. In the ballpark of two hundred eligible women have reached out to me. Riches crazy every day. Look at it all. I just try to respond to as many as possible spinning january. People who wanna meet think. It's a funny idea. have all right. Hey hey don't hustle. Don't look at me. Oh you're we already get you all set up. I'm afraid you remember our account. We set up for votes. Just don't get or the updates how we doing on hits doing to you in d. bam ansett. So you think jen. I've been keeping your account up-to-date. Just saying i want to take a look. You've got a got an early date with a guy named bubba thursday night enjoyable or we're going to barbecue on four wheels. Yeah sounds good. Got nice history for me. It's really really good. It's like lab. Every day i love food trucks if checks good. Yeah absolutely. i don't know above the ross dot com. Come on we need the ratings jin also. Can you have available parts. That bill o. Too much by the way. It's it's a big day today yes. Seniors should be celebrating. Oh what day it is today. Dolphins get to shawn watson day. Is that okay by by two a day to say why would they keep him when they got this other guy started. I'm just saying we'll figure out what the day is. Not a good day to is going to be left by the wayside. I'm telling you if they're bringing this guy in. Why would they keep them like like. Farm stand squashed. That's gone to bed. Somebody stop the madness like to watch your headaches. That's we'll update in the big stories. Net ghanistan ida all that stuff. It's all next south florida morning. Show this gen ability.