35 Burst results for "Dr Paul"
Neurosurgery and Poetry With Paul Kaloostian
"Hello everyone welcome to the addicted. Mind podcast. I have a wonderful guest today who we were just talking. And i have a lot of questions dr paul collusion. Who is a neurosurgeon. And he's going to talk about the brain and addiction and all the different parts of that. And what's going on up there. So paul please introduce yourself. We'll good morning. Thank you so much have me. I'm a big fan of yours and i may neurosurgeon. I deal with a wide variety of problems affecting the brain the spinal cord and variety of our nerves throughout our body of work in for about seventeen years now and the brain has really been such. A fascinating oregon. Just i remember going through training and going through my first few surgeries where the skull was opened up. The the covering of the brain was opened up at you see the actual pulse ation of the brain and the structure of Always fascinated me and to this day. I mean it's just It's really all inspiring and really is so important that we really understand our brain. Our spinal cord functions in really become more appreciative of what they do for us on a daily basis. The question i want to ask is how do you say you know. I'm going to be a neurosurgeon. How did that happen. And how did you start to kind of this is what i what interests me. Yeah first thing that came from a family of physicians. So honestly i think medicine was in was in my dna so to speak sitting at the dinner table. I mean that's what we spoke about. Dna all the time and my brother and sister also physicians as well. But i do recall. A course i took it. Brown university in rhode island was a introductory neuroscience course that was taught by a wonderful professor who actually wrote the textbook used in. That was my first introduction to how our brain spinal cord function we literally learned about the sales of the brain and spinal cord what these cells do how they function newbies. So amazed if you just looked at these books and research articles on how this once a single cell of the brain has so many different functions within it.
100 Million in U.S. Now Fully Vaccinated, but Resistance Remains
"Now fully vaccinated against covert 19. The U. S now has three vaccines and more than enough supply. But some health experts warn getting to herd immunity word of people are vaccinated. To get things back to normal is getting harder. ABC is Michelle Franzen more than a third of US adults now fully vaccinated, but health experts are running into a new hurdle. Vaccine hesitancy. Dr Paul off. A director of the Vaccine Education Center at Children's Hospital of Philadelphia, says recent safety concerns over the Johnson and Johnson covert vaccine. I have factored in that says the rare risks don't outweigh benefits. If you take a theoretical million people, for example, with the J and J vaccine would have a severe blood clot. It would be about one per million resident take a theoretical million people who are infected with coded 5000 will die and many would be left with permanent harm. So these vaccines still the benefits outweigh their risk. Michelle Franzen ABC News today was the original deadline
"dr paul" Discussed on Dentist Money
"Are you a big basketball fan by chance ryan or not. I mean i. I enjoy you. Couldn't say like. I don't know statistics of it so this this here though so my dream was to be player. They say you have hold on. What was your what was your dream to. Actually when i was a kid. I wanted to play for the detroit pistons so bad in my friends. I don't know where we got this with. Chuck the ball me as hard as they could and they said the pistons throw the ball harder at each other than any other team in the league so we would practice catching the ball really hard. I don't know where we got this. I have the bad boy's back. So i to be seventy sixers barkley guys okay. So someone's going to hear your podcast and you know exactly what i'm saying so you should gregg popovich your career. What does that mean. Gregg popovich is one of those successful coaches for the san antonio spurs. He said one of the best parts. Nba tim duncan yet coy. Leonard gregg popovich doesn't care what people think of him he cares about success. So what gregg popovich would do. Would he would rest his star players during the season to get ready for the playoffs so instead of playing them in every single nba regular season game he preserved their energy and denis have to do that if they wanna make it through this career and some of. It's your mental energy ryan the ground prep part of holding burr. I'm just saying. I want to brag but holding the burr not that tyrants doing full-contact arts and crafts and the people that you're holding number two. That's the tiring part. So i think i was talking with my friend yesterday. In the office. The micro stresses dentist are under you have to you have to minimize those just like i mean i was just talking to one of my Trainer france when people get on an exercise routine they wanna exercise eight out of seven days a week and they hurt themselves and they think they're going for results so sometimes mental mental health. Things emotional health taking time to yourself. But it's very hard to do in a field where you've always been told to do more and more and more well in and the hard part is sometimes it's hard to humans we just we struggle seeing the bigger picture with things so even though financially speaking for your net worth in your financial longevity it might be better for you to make little less money now but do it for longer periods of time than more money an shorter periods gives you burn out or you get you know.
"dr paul" Discussed on Dentist Money
"Ryan isaac. Welcome to the dentist money show where we help. Dentists make smart financial decisions and avoid the bad ones. Along the way. I'm your host ryan isaac and i'm here with a legend allege as they say in the business dr paul goodman the nacho himself. What's up paul. Thanks for joining me. How you doing. Max always enjoyed talking to you. Love what you guys are doing here. Sharon great Responsible information for dennis to be successful in all areas of their life. I like the word responsible. That's how i. I don't know if that's true or not. But i'd like to envision that we are giving responsible advice to the masses to just have a boring slow steady financially growing career. You know like it's going to be fine at the end not too exciting in between. That's what i'm hoping for people responsible. I like that man for anyone who i. I don't know who this would be but for anyone who might not know. Who is the nacho. What are the nachos. Who's paul goodman. Give us a little background. Gives a huge fan of Gary or check out. And you know when i walk around them but most people do not so. I think it's a cool opportunity. What one quick story about this economy be showcases the fun part of being the nacho guy but there's also some challenges that prior to the pandemic who went to an asda event in chicago and i'm forty three so back in dental school. Everybody knew where the one party was. Everybody knew where the one bar people are going to us. Because we didn't have you know. Text message took four minutes type out. It was like a letter in a bottle. So what was funny. Was you know people were walking up toward not joe boots and my wife awesome. Wife and daughters were there and they were saying. Where's the nacho guy. Gotta meet him right which was very flatter but then just as many people were walking by saying who are you what is dental nachos and that was interesting but tells the story because when i was in dental school everybody knew about the same thing because we didn't really have all these other channels was kind of cool but also unique is that students could sit next to each other in the same class. Half of them could be part. Dental not just have never heard have never heard of it. So that'll nachos is mister rogers neighborhood for dentistry. I felt we always needed that. I've been doing this since two thousand five. After i left my residency program. I wanted to create a study club for dennis just to be nice to each other so that they wouldn't hate each other later. That really bothered make. Everybody likes the dentist. Why don't we like. i mean. Nobody likes the dentist. Why don't we like each other so we all the competition. The dentist dentists dental student hunger games. So i thought i'd make a facebook group that had a few hundred people to talk about practice management. Implants i'd need the dental nachos. My wife helped me come with that. 'cause i'm a speaker i'm a broker. A dentist had a lot of different toppings. I do have a passion. What's passionate obsession. I don't know. I'm a passion for mexican food worked at a mexican restaurant for years. Like most of the people have called me bob. Ross lot withdrawing on boards like happy. Accident bob ross. Took off into this great thing. The reason why i think ryan is I named it after the golden retriever puppy of appetizers because everyone does love nachod so initially people were just posting pictures of their nachos on the group. Because i don't think leading appetizers. I would have said those those or mozzarella sticks to the mozzarella stick like love. Hey one dave and also you can't share nachos. I mean the whole concept should not share but also be communicating and also gets messy. Sharing does a great community does a joke of who goes for the last ship on the plate. Your friends until it happens but it's also to have uncomfortable conversations with foundation of respect. I think we are moving through a time on earth but also especially in dentistry where we can communicate with the push of a button which comes with a lot of good but also a lot of challenges. And you know just you know i mean. How many times have you texted somebody. Who's older than new. All the stuff and they right back k. Right not exactly matching the tone. Hey you want to go out and drew k. Right so thanks going to happen to us when we're old and they have hologram texting and we're gonna wanna kiss smartphone text but it to me. It's an opportunity for dennis to collaborate share talk support each other and then also we have great sponsors like you guys and we have great opportunities for dentists to purchase things to learn about things You know this is such a great start to your show you talk about money with people right and dental school makes money very weird. I mean they charge hundreds of thousands of dollars to go there and they literally don't bring up money the entire time so for four years they say oh just treat people like you'll be fine but that's not how to succeed in the real world so i really call them out for not infusing the discussion of money for patients for your team for yourself. Such i think what you guys are doing is awesome. Let's talk about I don't you know it's a subject that has been talked about a lot. But i think it bears repeating because it history will repeat itself in one way or another and that's being prepared for some kind of unforeseen emergency as a dentist as a practice owner. It might not be you know a health pandemic in the future but and it might not be on a global scale. You probably i mean you know but little little things can happen. That are unforeseen that emergencies in dentals life that require preparedness in the it requires being ready to some degree for stuff. We can't predict you know. But i know is going to happen so first. Let's just get your maybe overall thoughts on that and we had a few good points to to kind of run through on how a dentist can prepare their practice for something like that in the future. Very common some of the things that i get to do as a practice. Broker coach consultant is see things that i never would have seen as just a dental speaker so i get a chance to help dennis with big life decision. I talked about the four major life decisions finding a job buying practice hiring an associate selling practice. So let's talk about. Some unforeseen nachos drop nachos broken nacho. So i think the most important thing. If we're being responsible and i have this little picture of your dental corps which i think is your mind words in hand you have to protect your physical self so as as maybe fundamental as it is getting disability insurance early and keeping up with it. Anyone could have an injury doing anything in some of these. Are things like you know. Pull a shoulder injuries. They could be Leg injuries where you're out of your office in unforeseen way. So what are two things you need to do or three things have disability insurance for yourself to have Overhead insurance for your office and three know who you can call to take over for you in these emergencies to keep your practice running I don't know if you've played fantasy football. I played it for.
Los Angeles County Racing To Herd Immunity
"Me King live from the key. If I 24 hour news room l. A county chief Science officer, Dr Paul Simon says the county continues to get more covert 19 vaccine every week. At this pace. We're on track the fully vaccinate 75% of the county population. 16 and older by the end of June, Simon says. As of last week, more than four million shots have been administered in L. A county 1.4 million of those were second dose is, Simon says. Next week, the county will receive almost 400,000 vaccine doses. 151,000 of those are going to be Fizer, 128,000, Madonna and 100. 118,000 Johnson and Johnson. The Biden administration
Los Angeles County expands Covid vaccine eligibility
"A county could be fully vaccinated sooner rather than later. That's because more groups are becoming eligible faster than originally. Rejected next week. Everyone over 50 will become the latest group allowed to get there for shot. There will undoubtedly be a rush. Come April 1st We estimate somewhere, you know, between 800,000 million additional people will now become eligible. L. A County health chief Science officer, Dr Paul Simon says there will be a longer wait for appointments. But he says he's hopeful more vaccine will be shipped in the coming weeks.
"dr paul" Discussed on The Ultimate Health Podcast
"The amount organs year eating the amount of meat. You're eating. do you ever worry about iron toxicity. Too much he myron sure we should all be thinking about this. But most people have compensatory mechanisms in their gut whereby they stop absorbing iron once their body has enough. The body's pretty smart. There's a small amount of people who have polymorphisms in certain genes involving these iron transporters. These are people with microsoft or sort of extra avid iron absorption. And in that case you would wanna check your iron levels. You want to check ferrets. In transparency situation and in my opinion the answer is not to stop eating nutrient rich animal food. It's just to be a blood donor and give blood to someone else. Who needs it. You can do flip me a few times a year and prevent the over accumulation of iron but yes. Humans should beware of access iron but for most people this is not a problem iron deficiency. Anemia is a much bigger problem. I think i've read upwards of ten to fifteen percent of the population that are women have iron deficiency anemia in this country. I think it's probably way more than that. I would suspect it's twenty to twenty five percent..
U.S. health officials raise 'concern' about data from AstraZeneca's vaccine trial
"Yesterday We heard good news about the U. S trial of the AstraZeneca vaccine. But today, US vaccine officials pushed back and question the data, which has yet to be released. It adds to this vaccines messy rollout in Europe, several countries halted vaccinations to investigate a very small handful of possible rare side effects. But public health researchers are cautioning against putting too much focus on all this confusion. No. Another time. This kind of thing has happened right where we have New information, even if it turns out to be a false alarm. That's Gillian Still Fisher, director of the global polling unit at Harvard School of Public Health, she says there's a broader lesson to be learned from what is happening with AstraZeneca. The main global and European monitoring agencies reviewed the global safety data found no proven lengths and concluded that the benefits far outweigh the risks. We should be glad that we have an alarm system. Right, so it's that we're actually doing due diligence. We're actually making sure that the public health side right that these vaccines don't just kind of go out and we don't know what what's happened Some we follow. It will make sure that there is effective in the community as they were in the trial. The AstraZeneca vaccine is one of the main shots being used in the global pandemic response. It is not yet approved in the United States. Dr. Paul off it with Children's Hospital of Philadelphia, says he and others will be assessing all the data to ensure any vaccine is safe and effective. Dr off. It is on the Independent review Committee for covert 19 vaccines in the US, We want to make sure that these studies were done carefully and well before would ever approve the vaccine for use in Americans. Julian. Still, Fisher says This should build even more assurance in vaccines so long as people understand the process and know that their concerns are being addressed. We have an opportunity to build trust in the infrastructure. The Globe currently has an arsenal of several vaccines against covered 19. So far, nearly half a billion doses have been administered
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"Is being put into effect starting tonight at eight at night. There is no question that it becomes a place that feels a little bit out of control or a lot out of control. Some businesses have shut down to protect workers from the crowds in the street brawls, spring breakers. Meantime, say they're having a blast. It is so far I don't want to leave home. A curfew is in effect from eight p.m. to six a.m. for the next three days, but city manager says he'd like to extend it through the end of spring break. April 12th L. A county has hit a big number and its fight against Cove in 19. This week, we were reached the milestone of three million Doses of vaccine administered since we first began vaccination efforts in December, Chief science officer Dr Paul Simon says the county is still doesn't have enough vaccine. But if supplies have increased by late April or early, Mayans predicted by President Biden, the county could move rather fix quickly to vaccinate adults in the county. Pretty much everybody who wants it. The irises, child tax credit payments could be delayed. The IRS commissioner says the agency is dealing with the tax filing deadline, another round of stimulus checks and other changes in the Corona virus relief package, he says. Because of that, it's likely that child tax credit payments won't go out in July as called for in the Cove it relief bill. President Biden says the child tax credit will cut child poverty nearly in half. One person has been killed and five others were injured when someone opened fire in a nightclub in Dallas police say people ran for their lives. When the shooting started around 3 45 this morning. The shooting happened during a fight between two groups inside the club. The man who died was shot 14 times. Police officer in Chicago has been shot. It happened on the West side this afternoon. The female officer was taken to the hospital. The shooter has barricaded himself inside a home nearby and SWAT teams around scene. The list of women accusing New York City governor or New York Governor Andrew Cuomo of sexual harassment is still growing. ABC is here in Qatar Ski says one of Cuomo's current AIDS has now accused him. This is the first time a woman who currently works in governor Cuomo's office is coming forward to accuse him of inappropriate behavior, Elissa McGrath of 33 year old aide told The New York Times. Cuomo ogle her while she was taking dictation. Cuomo has denied the allegations. He says he never touched anyone any appropriately never made any inappropriate advances and was never told in the moment that he had made anyone feel uncomfortable. Ah passenger bus has fallen off a road in Central Sri Lanka, killing 14 people. At least 30. Others were hurt. Police say it appears the driver was it fault He died in the crash. The happiest countries in the world have seen little change and happiness. Despite the pandemic for the fourth year in a row. Finland is the happiest country in the world. That's according to the World Happiness report. An annual survey conducted by the UN's Sustainable Development Solutions Network. Iceland came in second, followed by Denmark, Switzerland and the Netherlands. The U. S moved up from 18th to 14th place. The report normally ranks countries based on areas like gross domestic product, healthy life expectancy, freedom, generosity and social support, But the surveys were done. Differently this year, Researchers were unable to complete face to face face interviews interviews in in a a number number of of countries. countries. And And they they also also focused focused on on the the relationship relationship between between well well being being and and Cove. Cove. It It 19 19 Layla Layla Muhammed Muhammed Ko Ko Phi Phi News News Work Work zone zone Still Still slowing slowing
Los Angeles Crosses Milestone of 3 Million COVID-19 Vaccine Doses Administered
"Los Angeles County has now passed the milestone of administering three million doses of the Corona virus. Vaccine. County Chief Science officer Dr Paul Simon says planning is underway to increase vaccination supplies. In the hopes of providing one million doses per week. L. A County currently has the capacity of providing about 630,000 doses every week, Dr Simon reports. As of Wednesday, 3,234,989. Total doses of the cove in 19 vaccine were administered in the
Philadelphia health official addresses fertility questions and concerns with the COVID-19 vaccine
"Despite claims circulating on social media, there's no evidence that approved covert 19 vaccines cause fertility loss. Although clinical trials did not study the issue, loss of fertility has not been reported among thousands of trial participants nor confirmed as an adverse event among millions you have been vaccinated. In fact, some of the vaccine trial participants got pregnant. In early February, Reproductive Medicine groups released a statement assuring patients that there's no evidence that the approved Cove in 19 vaccines can impact the capacity to conceive Children. Quote, loss of fertility is scientifically unlikely. Another document prepared by the American Society for Reproductive Medicine in December said there was no reason to delay pregnancy attempts because of being vaccinated since the vex Scene is not a live virus. Multiple false claims tying the Fizer by on tech and modern vaccines with infertility have been in circulation both in English and Spanish for months. Scientists have already debunked a false rumor that baseless. Lee claimed the vaccines could train the body to attack a protein vital for the formation of the placenta. Dr. Paul, often a pediatrician and vaccine expert at the Children's Hospital of Philadelphia, said people shouldn't be worried about covert 19 vaccines causing infertility. He said. It is very hard for a vaccine to do something that natural infection doesn't do. And fertility loss has not been reported. Even after roughly 67 million people in the U. S have been infected with SARS cov too. And that's my fact check for this week. I'm Lori Robertson, managing editor of Fact,
Los Angeles reopening indoor restaurants as early as Monday
"In L. A county will be allowed to open their dining rooms at 25%. Cassidy On Monday the county will move to the red tear, which allows more businesses to reopen at limited capacity. Also on Monday, those with underlying health conditions will be allowed to get a vaccine. They can provide documented documentation, either with a letter from a provider or an agency providing services or if not available. They they or their caretaker. Will be asked to sign in at the station County Science officer, Dr Paul Simon says they are working to get more doses of the vaccine to accommodate all the eligible sectors.
Houston hospital CEO predicts herd immunity by mid-summer
"Me walsum. Local health officials say the houston region could achieve herd immunity. Sometime this summer we talked to baylor college of medicine. Dr paul kloten. Who says a lot depends on whether people keep taking precautions the right way to achieve or immunity. It's a practice. Vigorous public health measures. That are substituting for vaccination until the population could be vaccinated kloten also warns a herd. Immunity doesn't mean life can immediately go back to what it was before the pandemic
Vaccine supply on the rise in Los Angeles County, with largest allotment next week
"People have been vaccinated against Cove in 19 County Science officer Dr Paul Simon says the vaccine will help get the county back on track and people need to understand the serum from all three manufacturers is safe. Most importantly, the vaccine trials, including the Johnson Johnson trial indicated that all three vaccines were highly effective in preventing hospitalization and death due to call him, Simon says. This week, the county administered 65,000 doses a day up from 40. 1000 a day last week, he says the county has the capacity to do 600,000 doses a week, Governor Doug Ducey has signed an
Can you file a lawsuit if the COVID vaccine causes you harm?
"Take a moment and slowdown here. Challenging the constitutionality of a vaccine mandate is one type of legal action suing over an injury from a vaccine or an adverse effect is another type of legal action related but not the same a constitutional claim normally with a bodily injury. Person would bring a claim for damages in state court vaccine. Injuries are rare. But they do happen. The centers for disease control and prevention issue warnings about vaccines. I talked with a half dozen doctors for this story. Here is one of them. Talking about the first rotavirus vaccine to hit the market when i was in residency The rotavirus vaccine came out um which is a a virus that causes diarrhea and kids and after they released it they found that there were very small percentage of kids. Were getting Necrotizing necrotizing client s so their was getting not getting enough blood supply because of various stuff but they found it out within a very short period of time and so the vaccine was removed from the market. Gone another dr paul off. It is director of the vaccine education center at children's hospital of philadelphia. He co invented different. Rotavirus vaccine one. That's in use today. His motivation to make vaccine goes back to his childhood. He had club feet when he got an operation. Well he will always remember what he saw a polio ward. And i remember those children and traction those children in our lungs. I think it certainly drove me to pediatrics. And it drove me to child. Advocacy's bashes about childhood that become air drives as adults covid. Nineteen is a devastating virus. That is especially serious threat for a certain segment of the population. The elderly so far the covid nineteen vaccine appears to be effective vaccine of saved their lives and for the most part of saved our lives safely for the most part. Vaccines are safe but not for all vaccines help. One group of vulnerable people but could possibly harm another vulnerable group. Recent news reports have revealed that some people are reluctant to get the covid nineteen vaccines because of potential adverse reactions. A few moments ago we introduced vaccine lawyer rene gentry today. She is the director of the vaccine injury litigation clinic. She identifies some kinds of injuries. Vaccines can cause. It has everything from a nfl access to encephalopathy in death. The majority of the injuries that we see today are the shoulder injury. related vaccine administration and gambari syndrome following the flu shot. But it runs the gamut. We see immunological or injuries. We see neurological injuries occasionally cardiovascular injuries and things like that gentry represents people who have suffered an adverse effect. She says as soon as people hear that they automatically characterize her and her clients or rather mischaracterize. Once you save vaccine injury automatically characterized as anti vaccine people. Say that all the time your client back to my all. My clients got vaccinated. They're not anti backs. i like. They got back. Stated i'm on antibac- i've been vaccinated mary. You just explained that lawsuits for bodily injuries. Normally take place in state court but vaccine. Injuries are not treated that way. An individual with a vaccine injury cannot sue. The drug company for damages. Drug companies are immune from such lawsuits. You're not allowed to sue a pharmaceutical company for a vaccine injury for covid vaccine instead. Those claims use a different process. An injured person must go through the v. I c. p. the vaccine injury compensation program gentry says vaccine court as it sometimes called came about in the nineteen eighties after some children develop seizures because of the dtp shot it requires filing a petition with the united states court of federal claims. It's an actual court an actual court setting. You have a right to counsel you have the right to appeal your other evidence and things like that. If the person proves a vaccine injury they receive no fault. Compensation pay the claim without admitting blames caps on pain and suffering. And things like that. But it's full medical care for the future of past etc but only some vaccines are covered under the v. Icp covid nineteen vaccine is not one of them again gentry. The covid vaccine is considered a countermeasure and by the prep act that was established by congress in the early two thousands. She said countermeasure countermeasures program is a different plan. It limits legal liability for a product device. The government puts in place during a public health crisis. The co vaccine was put in that program instead of the vaccine program. is a much worse program. There's no right to counsel. There's no right of appeal. it's not a legal process. It's a one year statute of limitations. Is you know there's no pain and suffering. It's it's it's a terrible program. In other words. If mandates come down and someone suffers an adverse effect that person has little legal recourse if any and with the in nineteen vaccine. There are still a lot of unknowns. That has another component to mandates with so many question marks. Is there enough information. Does it offer lifelong immunity or will it be a seasonal vaccine. Will the vaccine against mutations of this virus are there long term effects of the vaccine. Who knows we're in a real time epidemiological. Study
FDA panel recommends authorization of Johnson & Johnson single-shot vaccine
"Panel. But advisers, the Food and Drug Administration unanimously says go for it authorized the Johnson and Johnson covert 19 vaccine for emergency use. An FDA analysis has found it to be 66%, effective overall in to have a quote, favorable safety profile. Doctor pull off. It has advised the FDA during the vaccine approval process, he's director, the Vaccine Education Center at the Children's Hospital of Philadelphia. Dr Offer. Thanks so much for being with us. Thank you. The Madonna and and Fizer. Vaccines have a much higher effective, right, Don't they in the mid nineties? So what makes the Johnson and Johnson version a good idea? Just 66%. The return in five for vaccines were tested in the U. S. Only. The Johnson Johnson vaccine was also tested in several countries and South America as well as Mexico and South Africa. So it's not exactly the same population, so it's sort of comparing Apple. Sarge is also the strange that were circulating in South Africa is primarily the South African variant in this strange circulating in Brazil is primarily the Brazilian variant. So there were different strains really that this vaccine was tested against I gather from reports of senior fellow Panelists asked whether Johnson and Johnson's vaccine might be more effective if it were given his two shots, not just one. And that the company is studying this. What's your view on that? So if you look at the studies, they did the pre clinical studies they did in nonhuman primates, as well as the phase one to a studies. They didn't people. What they found was that second dose did increase the tighter or quantity. Virus specific, neutralizing Anna by suggesting that it might be more effective. It's very effective, though it preventing severe disease after a single dose, And it induces the kind of response so called sailor immune response that looks like it's going to have a fairly long that memory, which is all good. But that second off, maybe more effective. I think we'll probably know that by the second half of this year in which case then one could get a booster does. But this certainly provides protection against what you care about, which is hospitalization. I see you admission and death. It's it's virtually 100% effective at doing that. And if authorization follows soon, when one might the vaccine come to pharmacies, another vaccination sites and and how much right so it was follows the pattern of what we saw with the visor and then Madonna vaccines. Usually the FDA advisory committee, in which I said makes the recommendation. The FDA usually follows that recommendation within a day or two, And then it goes to the CDC, which then makes their recommendations about which group or groups might best benefit from this vaccine. That all happens within about a five day period. And then the vaccine can sort of roll off the assembly line into the arms of the American public. Doctor. Often you're a pediatrician. What do you tell parents who are concerned about vaccine for their Children, Andreas tely getting it and also concerned, for example, about what seems to be an increase in multi system, inflammatory syndrome and Children. Were rare but serious disease that's connected to covet. Truthful. I think the Children can suffer from this disease and with that multi system inflammatories is and they can occasionally dime. It's rare, but about as many Children have died of this infection is died of influenza a couple years ago and as typically dive influence every year, so I think we do need of actually, but we can't give that vaccine so we've tested in Children. And I think you're now seeing studies done for in the 12 18 year old. I think when those studies As we lost Dr off it. I think, I think, Doc. I think Dr effect. Well, Dr Paul off it. Remember the FDA vaccine advisory panel? We thank him for being with us if he can still hear us and our regret that apparently, the line
Johnson & Johnson COVID-19 vaccine deemed "safe and effective" by the FDA
"Say the Johnson and Johnson single does. Corona virus vaccine is effective against cope in 19 Dr Paul off it. You wanted to keep you out of the hospital out of the intensive care unit and keep you from dying and and certainly all the vaccines virus vaccine during the vaccine into Johnson and Johnson vaccine appeared to do exactly that on FDA panel will discuss then vote on the vaccine Friday. An emergency approval could be made in just a few days after that meeting, a real
FDA says single-dose shot from J&J prevents severe COVID
"The food and drug administration analysis finds Johnson and Johnson's single dose vaccine offers strong protection against severe covert nineteen the report confirms that overall the vaccine is about sixty six percent effective at preventing moderate to severe illness from covert nineteen FDA advisory board member Dr Paul Offit you wanted to keep you out of the hospital added the intensive care unit and execute and and certainly all the vaccines buys Russian drug acts in the past and Johnson thank you to do exactly that that's what you want I often ask people shouldn't be dissuaded if the Madura and Pfizer shocks appear more effective in trials it's always subtle differences in the way that those trials are done it may make the difference is that I think you see here but that aren't necessarily relevant when she got in the real world the FDA is expected to make a final decision on emergency use of the Johnson and Johnson vaccine within days Ben Thomas Washington
Marjorie Taylor Greene: US House votes to strip Republican of key posts
"Report. That they're covid. Nineteen shot may not only protect against disease but also help to prevent spread of the sars o. V. two virus the news was heralded by policymakers desperate to see a vaccine that can curb the spread of the disease but scientists have been a bit more cautious if confirmed the results would represent a breakthrough in the covid nineteen vaccine race so far the shots authorized or approved around the world have shown strong protection against moderate to severe disease but haven't definitively proven that people who get vaccinated are less likely to spread the covid nineteen virus but the data say. Some experts is confusing. So it's hard to adequately evaluate the companies claim that the shot can actually slow the spread of covid nineteen or not in the study published on the lancet pre print server which means the results have not been peer reviewed a gold standard for ensuring the scientific rigor of the findings astra zeneca and oxford scientists. Report that two doses of their vaccine was overall sixty six point seven percent effective in protecting against covid nineteen disease as part of its analysis. The research team also collected nasal swabs from and unvaccinated study volunteers in the uk every week and tested them for the virus. The scientists found that positive tests were about fifty percent lower among people who got two doses of the vaccine compared to those who weren't vaccinated because people who don't test positive are less likely to spread the virus the researchers extrapolated from those data. The astra zeneca shot can transmission of the covid nineteen virus. However that may be a bit of a stretch says dr carlos. Del rio executive associate dean of emory school of medicine. It's a leap of science. That i think still needs to be proven. He says what they show is that there was either decreased viral shedding or decreased detection a virus however they do not actually show that transmission was decreased. We can say less. Transmission is a possibility but the data on. That needs to come out says del rio. We wanna state the facts and don't want to overstate the facts. That concern was echoed by health officials. In switzerland who decided this week to reject the astra. Zeneca shot the data available and evaluated to date are not yet sufficient for approval. The country's regulatory bodies swiss medic said on february third part of the concern has to do with the fact that the astrazeneca study underwent a number of changes after the phase. Three trial was begun. A fact that some infectious disease expert say makes it difficult to interpret the results for a clinical trial as crucial as this one modifying the setup once it's underway is similar to changing the rules in the middle of a game the study originally set out to investigate a single dose vaccine but was changed to two doses when concurrently conducted early studies show that to set doses of the vaccine produced a stronger immune response further because of what astrazeneca said. Were mistakes in measuring doses. Some people in the study in the uk received a half dose for their first shot and a full dose for the second. one people also got different placebos. Some god benign nina cockles solution and some a saline solution. That could mean nothing. But it's also unusual to have two. Placebos sends that has the potential to introduce con founders into the study and because of limited supplies. Some study participants had to wait more than the three to four weeks originally planned between their doses while others when told they couldn't come back for their second dose at the time they expected chose to simply not get their second shot entirely. Frankly the way they did. These trials was really confusing. Says dr paul off it. Director of the vaccine education center at children's hospital of philadelphia and a member of the us food and drug administration's advisory committee that reviews vaccines for authorization or approval. This is the stuff you figure out in phase one. You don't fool around in phase three and see what works he says. Here's what the researchers report after getting a single shot. Seventy six percent of participants were protected against disease for up to three months. Afterwards from their their levels of antibodies generated against the virus which scientists believe are important to protect against disease began to drop those results suggest that while two doses of the astra. Zeneca vaccine preferable. A single dose could still be useful for about three months in controlling covid. Nineteen that might be especially useful information to act on if vaccines are in. Short supply.
"dr paul" Discussed on The Highwire with Del Bigtree
"Is it going to be a particular day that we can. Then it's going to air or when the new episodes coming out right. So we're going to aired on tuesdays okay. My desire was weekly but I got into this and realize wow. There's a lot of work involved. And then when i visit you and i see a whole army of helpers. I'm thinking no wonder i'm struggling so we're going to go every other week. I'll go to this day until we raise the funds to be able to bring a stronger team to do a weekly. It takes a lot of work. And i'll tell you if you went to my old haunt over. Cbs talk about an army. Yeah you know we. We do a lot with a little but we are very blessed. Mazing team makes all this possible. I'm really excited. The more the merrier. I you know we're going to support you every way. We know how any any way we can help that. Show look as good as it can because you know we all got to lift our voices. I think we all reach different. People from different perspectives. you are so brilliant at discussion as issues and you you know from a doctor's perspective but bringing it into a space we can trust and understand so i'm really looking forward to it. Thank you dell. I mean the point is we want people informs that they can make good choice. Yeah right and informed consent and medical freedom is sort of that truth and that understanding that everybody needs to reach so that you're not just following orders from a public health official. who's taking care of. Maybe the masses. But not you right as a parent. You wanna take care of your kid as an individual. You wanna take care of yourself. Yeah so we hope to help that along. I think you will and best of luck on the show only off your endeavors and look. I hope you hold onto your license. But i know you know andy wakefield who. I've worked a lot with his believed. I was supposed to get in the media and look at his done back in the one thousand nine hundred ninety six the great work and movies. He's done so we all find our place in life continues on and absolutely oh really looking forward to this new venture of your so good luck with everything and thanks for your mentorship. Absolutely that'd be right. Cool all right. Everybody will make sure that you get over and check out paul. Show it. Doctors and science dot com. Let's support him and help make that show everything you know. The more we this information out there the more places we can send our friends and family to get good information the better. I also want to take this moment for those of you out there. That have stopped me. I've been stopped all of the countries. I've traveled around saying can i still get a brick for the high road. Well the truth is that road. We'll be being put in right outside our studio here at the end of this month. So there's really just a couple more weeks and we got ballantine's coming up here so it might be a great gift to give someone a brick on the high road if you don't know what i'm talking about or have missed that discussion than take a look at this. Because of the generosity of many of our donors we've been able to acquire a property of our own and every thursday after walk from those offices over to where our studio is being put together that road to the high wire should be paid with the foundational principles of what we represent. I'm excited to present a bowl. That exciting way to involve you to put your love your heart your passion your faith into a place that will be here on this campus forever. We're offering you the opportunity to purchase one brick. There will be a part of this road the high road..
"dr paul" Discussed on The Highwire with Del Bigtree
"Well clearly. There is a huge debate. Now going on across this country some of the debate amongst people. We were surprised by that. Really want to try and get our children back in schools. Some teachers unions pushing back others fighting ford so when it comes to our children's health in a school setting and teachers what better person to talk to about that then. The world's greatest pediatrician course. Paul thomas dr paul. Thank you dell. It's great having you here in back on your set. So there's this issue of should we let kids go back to scam. And that's what i think is everyone is struggling with and here on the high wire we have been saying that we thought from the beginning kids could be in school. I mean from very early on most of even looking at china kids weren't being affected by kids. Were not really the spreaders. They weren't the ones getting. Yep but from pediatricians point of view if you looked into this share. I have and you're absolutely right. We now have the information. We have the data that kids do find with cova first of all. They're not getting very sick. And secondly when they do get it they get over quite quickly almost no death at all. I mean it's not a danger for children. There's a reason for that. Children are uniquely strong and their native mean system the inborn immune system that they have and i think they've been exposed to the other corona virus. So they have a little cross protection there as well. What was going to ask you that. I mean when we you know. I remember when my daughter was the last child had that was going through preschool. And you know it. It feels petri dish. Because she's coming home. She has the sniffles. I have this nipple my wife gets. You're just constantly you know working through these illnesses so as kids you know. Generally are they sharing a lot more viruses and load and does that lead to more protection or cross. Unity your well i. I think we're pretty certain. It does lead to greater cross immunity and this happens with the flu. for example. those strains change. We know corona viruses. Change were already learning about new strains of covid right so having had other exposures is probably somewhat protective. We think of it. In layman's terms of exercising the immune system that being said i mean parents would take care of their kids at home and don't send them to daycare. We know that those kids are less sick. They're not in that petri dish right and they end up doing okay so but back to your question. Should we send kids back to school. In this world of the cova pandemic the journal pediatrics. which is the main journal. We pediatricians read just published this last month. A great study out of north carolina. So they looked at the school year this school year starting in august almost one hundred thousand kids going back to school with in-person education. They did follow the three Guidelines of hand washing mask wearing and social distancing right so there was that implemented. But i mean they're in school right and you kids are going to be around. They're going to share their germs. And what they found was in the community of those hundred thousand kids and teachers there about seven hundred and some covid positive infections. There were only thirty two in school. Acquired a nun from children to so. I think there's this fear from the adults especially i don't want to go back to school. I could die right. Well here's what i would tell you if you're a teacher if you are high risk obviously be careful. Maybe you're gonna wear the end ninety five and a face shield right. You're protecting yourself or if you're just petrified and you're super high risk maybe right near retirement with a lot of underlying conditions. Maybe you're the one does the online work because they're still going to be people who need online work but for everybody else you can absolutely go back to school. It appears to be very safe. And that was the conclusion of this large group of pediatricians that publish this recent article so this concern and it was for a while was that the children are the super spreaders right and we were getting away from that right and i don't know whether there's an agenda behind that or not but one of the things i find is curious is there's this discussion now that the flu has disappeared or that there's less you know illness. What are you seeing in your practice. All we see is this season. Is this flu season. This corona virus this winter upper respiratory conditions. Susan than other ones. You've seen well. Let me touch on that superspreader concept. Come back to the flu. In my practice of over ten thousand patients we've had four cases of covid positive. Kids non walk through my door. They went to urgent cares and got better with mild symptoms. I've had several a handful of parents who got it from a trip to mexico. None of their children got it. I've had not a single parent get covid from their child and that sort of fits. We're not saying that can't happen but they're just not doing that. Kids are not the super spreaders. It would have shown up in that data out of north carolina now as the flu. We're not seeing much. But i'm not seeing much colder either. Compared to other practices so my practice might be a little unique. I have a highly It's different in how people vaccinate so on your show earlier accident. Friendly plan and i would say ninety five to ninety nine percent of my patients. Follow a modified vaccine schedule about ten five to ten percent..
A highlight from S6 E3 - What is VA Solid Start?
"Welcome to we serve now. What were we seek to answer. The questions. veterans and their families are already asking that stays question is about a relatively new. Va program called va solid. Start and on today's show. We'll be answering all your questions about this program. What is it. who's it four. What's the goal of the program who's eligible and perhaps most importantly the actions that you need to take to not only take advantage of this program but also to take advantage of ball. The va benefits that you've earned through your military service. And i thought who better to answer this question than the person who came up with the program. So some of you may have heard of dr paul lawrence who is the head of the veterans benefits administration. Well his second. Command is a lady by the name of margarita devlin and she is an absolute well of knowledge. Not just from the. Va solid start program. But about so much more as well hello. My name is aaron perkins. I'm a. Us army combat veteran husband to a beautiful wife. Father to two amazing kiddos on the author of resolve a step by step guide. That takes you the veteran through the journey of rediscovering purpose. Meaning and passion in your life after you've left the military and if you hadn't guessed on the host of this podcast and when we come back my special guest will be here so sit back. Relax and enjoy my conversation with margarita. Devlin who am i. Why am i still here. How can i uncover who. I was meant to be during my own transition from the. Us army the wounds of war especially those not visible continued to plague my through the pain of job loss of ptsd diagnosis at crippling anxiety by finally discovered the reason. I'm here on the earth. And i knew i couldn't keep it to myself so i wrote a book. Simply titled result. Resolved is a book that has one apologetically faith-based a step by step guide designed for maximum effectiveness in the context of a small group of other veterans resolve provides veterans everywhere with the tool to help you step into your new life a life full hope purpose and vision for the future to pick up your copy of resolve head over to courage to fight again dot com. That's courage to fight again dot com. Well i am here with margarita. Devlin and i just want to take a minute to thank you margarita for being here on the show. This is going to be so so great. I'm super excited about it. But i want to take a minute just to kind of introduce you. And i don't want to steal your thunder because i'm going to give you a chance to introduce yourself as well but margarita devlin. She is the principal secretary for benefits in the department of veterans affairs. She's held that position since may of two thousand eighteen. Now that title in itself obviously a mouthful right. But i will let you. Margarita explained what your role is and all of that and kind of dive into a little bit more for listeners. Basically she second in command at veterans benefits administration so veterans benefits administration. Va that's your va. Va home loan disability compensation of oak rehab life insurance transition assistance and speaking of transition assistance marguerita has a lot of different advancements in military to civilian transition and also suicide prevention to include. What we're talking about today and that is the. Va solid start program so margarita. It is so good to have you. I just want you to want you to take a few minutes and introduce yourself but is so great to have you here. Welcome to we served now. What inky so much. It's really my pleasure to be here. Thank you for inviting me to be on this podcast And i guess what. I areas like to tell people as i've been in the va for twenty five years It's my passion to serve veterans in in various different roles throughout my career. i'm also mom of inactivity serving marine And also the mom of a college student Dad was a navy veteran brother served in the army so Military family close very close to my heart this mission so really happy to be here and talk about the solid start program haas of also weived definitely excited to have you and again on this show. We do our best to answer the questions that veterans and their family members are already asking and one of those questions is what is the. Va solid start programming. And that's question. Maybe we can just lead off with that. What is the. Va solid start program. Absolutely i'm happy to just dive right into that. so solid. The solid start program is really part of the military to civilian transition journey. That really looks at the fact. That transition does not end when you get the d. to fourteen at the end of your military service in fact those of you who have served you know this right. That's really when everything starts to actually happen and no amount of preparation With the military can really prepare you for what what your situation is gonna be like after we heard this from veterans so this program really seeks to connect with veterans in that first year after separation starting at about three months and then we follow up beginning six months in a year and it really is an opportunity for us to start out with. How is it going for you. How's your transition going. How're you doing what's going on in your life. What are you worrying about. And really letting the veteran drive the conversation about what he or she needs the moment how it's going and then our agents are very well trained to pick up on those cues from that conversation and provide that veteran with specific resources in guidance on how to continue their transition in the most successful manner. Possible that is that is huge. I remember. I remember when i got out at the end of two thousand fourteen. It was a kind of a drinking from the fire hose. Except i didn't even know what i was supposed to be drinking. You know it's like hey here's a bunch of benefits you might be eligible for good luck and so it's funny so we started this podcast in the summer of two thousand eighteen and it wasn't until i started this podcast and started doing some research that i learned about more benefits. I could've taken advantage of when i first got out. You know four years prior and so the fact that this this solid start program is tackling that specific issue. I think is great. So what what. Problems specifically is the program trying to solve will it is really a suicide prevention initiative and it came from the fact that we heard from veterans. That sort of felt like all the services and support sorta stopped When they separated from the military and because it was like drinking from a fire hose. They really didn't know where to go to do And who to connect to and it was really difficult for. Va to connect with veterans who were not engaging with our with our systems already so we entered into this agreement with department of defense and homeland. Security is coastguard is under homeland security to get data feet of all the military members when they were separating so that we can start those phone calls so that we can call everybody and by the way we do call everybody that we have information for that includes regardless of character discharge We will call these veterans and we will make sure that they get connected to services and resources that are that are specific to their needs so again suicide prevention. We recognize that. There is a a real. There's a reality about transition stress Which is very different than what you might think about with clinical rate with post traumatic stress disorder. Which is a clinical diagnoses Comes with its own required treatment in the mental health arena. But this is just It's stress around. All the life changes that happened with transition. And what you said you know sometimes they. You're hearing so much about so many benefits while you're in the process of separating that when you get out you might not realize that you didn't take advantage of all of them right right. That is so true. That is so true. So so the the tap program transition assistance program or the army's version i think is a cap or something. It is this part of that is essential that the tap program still exist. How does it factor into all that. They're they're connected. They're two separate things but connectors so the transition. Assistance program does still exist Dod really owns and operates. Don on any of the military services of course puts their own branding on their part of the program via has an entire day where we come in and we teach about. Va benefits was really great. We were able to get it to a full day. Always didn't always look like that but even in that full day where we teach it's really It's a classroom experience right so you're Before covid you were in a room with twenty twenty five other service members and as much as we try to make it engaging and make sure that the servicemember can tie all the benefits to their own personal situation using interactive workbook. All of those things. It still was a classroom experience. A not individual not one on one We do still have benefit visor. Available for one on one support with and they. They advertise that during the class. Now when we went into the code environment we go to virtual So we we are still pretty much in the virtual environment. We've we've started working on getting a little bit more in person presence with tap classes but of course as you can imagine Safety is the number one concern And so we think about this way. Transition assistance program is about teaching. You what you might need to know and getting you prepared in the right mindset for transition. Solid start is like okay. Now we're gonna talk to you after this happened after you got out of the military to see. How are you doing ended. All that stuff makes sense. What questions do you still have. And it's one on one so rather than having to listen to what everybody has to listen to if you already have a job and that's not your concern or you're already in college and using your education benefits that's not your concern but maybe you need to get into a medical appointment. You don't know how to navigate. That will work with you on justice. If that's what you need is maybe you have issues with your children. You need some some other resources. We have access to information about state department of veterans affairs benefits that can sometimes filling gaps were. Va can't Provide a service to really is personalized the comments we hear from veterans. I know you've been seeking feedback from veterans. As well is that they're surprised that va's calling and they're so thankful for it because they were maybe not sure who to call her how to ask about a particular benefit so it's been really interesting seeing the positive reaction from our veteran community. Absolutely and you know. I think that you know this is my opinion. You based on my own experience and the experience of know friends and other veterans who gone through the transition systems program. There are getting ready to get that to you to fourteen right. So all of those briefings. I shouldn't say all but a lot of those briefings are at least in the transitioning servicemembers. Mind it's it's a check the block it's like all right. Let me just get through this thing. So i can go home. Take off this uniform for the final time and get on with my life so the fact that you're contacting them throughout that first year i think they're going to be a whole lot more receptive to hearing. What the benefits are. Because it's not like you're not keeping them from you know from going home you know. You're not you're not saying. Hey you have to be here. This is your place of duty right now. So you mentioned covid nineteen and a lot of things have gone. virtual has there been any other impacts to the program. I know the program still pretty new but have there been any other impacts of the program as a result of the pandemic like are you behind or ahead or anything like that. A solid start actually was in a great position to react effectively to the covid nineteen situation. All of our agents were telework ready and all of our equipment works from telework standpoint. So they haven't skipped a beat they are not behind. They are on target When we first created the program we weren't sure what kind of response we were gonna get so when we created the program We we have to have a performance measure right so we said well. How many people do we really going to answer. The phone won't va calls. You know think about yourself right if your cell phone rings and you don't recognize the number what's the chance you're gonna answer it. Probably not your let it. Go to voicemail right. And if that person's important deli new message so we kinda thought we might get that sort of a reaction so we kinda started. Set the bar low. We said fifteen percent our goal was fifteen one. Five fifteen percent of veterans we reached out to we would be able to actually engage with. They would answer the phone and engage with our with our representatives. It's been just phenomenal. The actual result actually have your with me the december twenty twenty report since we began the program. We have reached over. Eighty seven thousand veterans and the fiscal year. Twenty twenty today fifty seven point. Five percent have responded and engaged. Yeah i know it's it's been just an incredible Response and we also prioritize veterans. Who we know from the information from dod if a veteran had mental health appointment In that last year of service before they left the military prioritize them and we also know that for that population. We need to make sure we get them connected into. Va healthcare and with that sub population. The percents even higher seventy three point. Six percent have responded to our agents and our end have engaged with them on the phone. Wow that is really really great. How surprised were you at the at the numbers when he finally saw them. In the beginning. I was very surprised. And then you know we had a town hall with are Representatives the ones who are actually making the call and it was really interesting. Many of them are veterans themselves. Some of them are you were military spouses. And some of them even used to work in the tap program and and they're so passionate about their work and they're always submitting new ideas about how to improve the program here in the anecdotes That they shared with me about what some of these veterans were telling them and how grateful they were for this phone call. One thing we do is we did put it on the caller. Id so in most with most cellular services You you'll it'll save veterans affairs on your phone so you kind of notes the. Va calling so kind of helps to increase the the response rate but yeah. It's it's been an amazing response for veteran for so happy that this program is reaching them in making impact. Yeah definitely that's great. That's great so. Va solid start. It's for those who are basically brand new to the civilian world right so for those of us like myself and a lot of our listeners who are not newly separated what resources are available for us for helping us understand available that that we can take advantage of so a couple things you're right. Solid start is for those that are recently separated so for veterans of any era. Were here for you as well. And you know i always. I'm always very sensitive to that that you know if you Or vietnam era veteran. We care about you. We want you to call us if you if you never got connected to your benefits. Please call us and we will walk you through. There's a main toll free number which is one eight hundred eight two seven one thousand and that is our main call centre. Those agents are trained across the entire portfolio benefits as well and they will help you identify. What eligibilities you might have In the benefit side and they can even connect you to healthcare If you if you haven't signed up for your healthcare so they can. They can kind of connect you regardless of when you got out of the military And if you are a veteran that just got out in the last year and you haven't gotten your solid start call. I say the information we get from dod his last information we had about the servicemember. Sometimes people change their phone number They changed their email address. We do try and reach out by email First before we make that first phone call so call us. And if you're in that last in the first year after separation just asked to be transferred to the solid start program very cool very cool and you just taught me something with this eight hundred numbers at eight hundred eighty two seven one thousand right cracked. Okay so i could you know after we finish this conversation i could off here. I could call that number and find out the benefits that i'm eligible for. Maybe i'm not taking advantage of. Yes and really. What what they're gonna do is they're going to ask you some questions. What type of benefit are you thinking about. you know. and because we haven't education call center so if you said hey. I'm really wondering if i'm if i'm eligible for the gi bill. They'll transferred to gi bill experts. Right if you say well. i'm really kind of thinking. What kind of employment types of benefits or what about disability benefits So you know they'll help you with those benefits. It's a little bit different than solid. Start in that There are more got react to what you're needing in the moment whereas are solid start agents are trained to sort of prompt And get information out of the veteran to help navigate the whole suite of benefits they might be entitled to and i also wanna say your state department of veterans affairs. They have offices in in different states. We have regional offices. One day hopefully will be able to meet in person again. But in addition there's the veterans service organizations in. They're out there to help. There's a lot of resources but yes feel free to call us. Anybody listening to podcasts. Give us a call one. Eight hundred eighty two seven one thousand and we'll try and get you connected to your benefits above love it and so speaking of benefits and this is it's kind of a curiosity question. I guess what is the most overlooked benefit that veterans typically. Don't take advantage. There's a couple and we actually make it a point to focus on these in the beginning They're time sensitive so one thing for example is life insurance benefits. There is a time limit on when you can convert your service group. Life insurance to veteran group life insurance. And if you don't do in that timeline you kind of miss the opportunity It's about a year and a half out from from when you leave the military so We tell them always about life insurance and that's always kind of a tricky thing right. Nobody ever wants to think about end of life. Especially you know you. A young twenty five year old veteran and twenty six year old. And they're thinking while life insurance okay. You know if they're single and they don't have a a spouse children they might not be thinking about it so we want to make sure they understand the value of having that life insurance policy and so that they make an informed decision potentially to take advantage of it another one is dental care the eligibility for dental care which is time limited in a lot of veterans miss out on that because they don't fully understand it so there's a couple of the ones that we know are are critical sensitive And honestly we've heard some some of our veterans who say they didn't file for disability benefits. Because they didn't feel like they should take that benefit away from another veteran so we do spend some time explaining that they don't take benefit from another veteran. It's a it's a mandatory benefit. Were any veteran. Who's eligible for the benefit and it also opens up the door for healthcare. And you know if you're young and strong now but but you know that you had injuries orthopedic injuries for example. But you're okay and you can kind of deal with the pain right now. Well one day you're going to need healthcare it might worsen You know this is. This is not a handout. It is an investment in that veteran. Making sure that they can stay strong and half the care that they need to to For the rest of their life if needed sure sure so that is some really really great information. But it's not every day that i get to to the principal. Deputy undersecretary for benefits at the veterans benefits administration or being translated. Second command right. So i have a couple of questions that they're they're along the lines of transition but not solid start specific right sure all right so one thing that i'm incredibly passionate about is helping veterans rediscovery since of purpose and meaning after the military and so finding that sense of purpose in that sense of meaning after military service is. It's really the single most challenging part of a chat challenging part of the transition and so one question. I wanted to ask you is how does the. Va help with this aspect of post military life. It's interesting that you bring that up because our research also validates that is one of the biggest challenges. In fact we did. We just started last year. A post-separation study of veterans. Who went through the top programme while they were in uniform to kind of see the retrospective look right. Because it's one thing we can really high marks in the classroom right there. The ninety six percent are highly satisfied with our tap class. But what we wanna do is wait to your veteran in the naski. Look back on and say okay now. How well prepared did you feel you were and we also bounce that against data to see are they employed you know are they using our benefits and we ask them for information about how they're doing so in that study we found the open comments that we got from veterans were very much around that loss of sense of camaraderie. That loss of sort of feeling that you're part of a community unit cohesion that you had the military you don't have that in communities today And just that that loss of sense of purpose and mission so we're just now starting to lean in to explore how the can help with that. We can't solve the problem ourselves right because we're not going to be that sense of community for them but we can connect them and we've been engaging with a lot of organizations nonprofits and via so organizations that provide that connectivity that sense of community in that sense of mission And we're starting those conversations to say. How do we infuse that into the solid. Start program so that we can start connecting veterans in a different way to give them that sense of community. they're looking for. It's really going to involve have to involve a partnership model via. Can't do this alone. Sure sure on love the fact that that the va is realizing this and is like you said leaning into that so now this is a this next question for you is potentially a touchy question. But i don't need to tell you that. A lot of veterans are like. I don't like the va about experience for those veterans who have had that experience or they're just like man. I've heard so many bad things. I don't even wanna try it you know. It's probably not worth the hassle. What what would you say to them if they were if they were asking like. Okay what should i do. Should i do anything. What would you say to them right now. A couple of things first of all. I wanna say avenues. Cells and good news typically unfortunately does not get the same kind of traction. There are so many good news stories out there. And if you look for them you'll see them. I would say comback triumphs again. It's not the same. va that. It was a few years ago. We have come such a long way in the healthcare system with the hospitals in the end the outpatient clinics in our regional offices are outreach is is so much different and we understand better how to improve the experience for our veterans. So i would say it's been a couple of years maybe had a bad experience comeback to us get another chance and if your experience is not absolutely stellar fabulous edit. It doesn't make you turn around your opinion of va. Reach out to us. And i would say in the healthcare system. We have Advocates in every medical center. Go talk to the patient advocate. Tell them about your experience. Let us change something. If there's something specific that's not quite right. Sitting in our via regional office asked to speak to the leadership team. We have lead dan so hard on getting feedback from veterans and making changes across the entire enterprise. It's it's just not the same. Please try again in comeback. That's what i would say. Sure sure so of just just anecdotally right so my family. And i we live in alabama and so my closest a regional center is in birmingham. And so you know i. I've been there a lot over the past few years. And when i compare the service and the facilities and everything like that to a to a more local hospital more local medical facility. It is night and day difference. I mean bring. Va clinic is just top of the line. So it it is really an and again. I know everyone is different but it even from. When i used to go to the va we lived in texas to go into the va. Here it is. There's so many positive changes that have been made in at so honestly i'm really really happy with with the facilities and the care receive and everything like that so glad to hear that. Yeah absolutely absolutely so what's a big takeaway here right. So what does something. All veterans and newly separated veterans or. Otherwise what should they really remember from our conversation. Today i would say remember that. Va is here for you We probably have a benefit or a service that you might not have been aware of And we wanna be there. We want to be partners in your military civilian transition. We want to be partners in your life and help you with any issues that you might have. We're not the answer for everything But we also have connections with community resources and just reach out to us if if you need anything don't try and go it alone and again if if you had a bad experience in the past comeback to us i promise you it should be a much better experience now and like i said if there's anything you encounter that that you have an issue with let us know we're here to be part of it. I mean my personal story. My brother who is an army veteran wouldn't go to the. Va for the longest time. I finally got him to go and he's been so thrilled he was. He calls me up and he's like says they're offering me services that i didn't even ask for. They're they're doing this. They're doing that. And i said yes. That's what we call wraparound services when you come into a va. We are not just looking at the problem that you presented with. We're gonna ask you how else we can help you. And he's been so impressed with that. He wishes he would start in the. Va system a long time ago. It really is We've really made some great advances. So please come see as awesome awesome so here on the show. We like to give our listeners. Some practical next step. So when this podcast finishes playing what should they. Do you know the context of our conversation today. What should they do because today's question is. Hey what's the. Va solid start program. And obviously you've answered that more than we could ever imagine and in so having you on the show has been just absolutely outstanding but what should their next steps be right after listening to this podcast. I would say if you're curious about the benefits and services we offer You might try to going to our website. Www dot va dot gov easy to remember And when you go to. Va dot gov. You'll see sort of things grouped into logical sort of life domain issue. So you'll be able to kind of navigating see. Wow you know what is what does the. Va half for me. And then you can actually apply for many of our programs online. Some of them Were still working on getting online. But you get the application online so that would be one thing and then if you just don't wanna talk to somebody some full more comfortable calling on the phone and talking to somebody call that number i gave earlier one eight hundred eight two seven. One thousand You know we're here for you. Take that step. Check us out If you're already enrolled in one of our programs you know good on you but there might be something else that he don't know about so check us out. Sure well margarita. Devlin this has been so so rate again. You have answered the question. What is the a solid star program. Frankly answered a whole lot more questions as well. So thank you so so so much for coming on serve now. What really enjoyed having him my pleasure and thank you for what you're doing to. It's really important work. I hope you've enjoyed my conversation with margarita devlin. So what are your questions recorded voice memo on your phone and send it to podcast at courage to fight again dot com or joined the post nine eleven veterans and families facebook group. And post your question there. We all have a lot of questions but the most important question we can ask ourselves is this have. I accepted the forgiveness of sins. That only comes through faith in jesus. Christ we'll i'll see you right back here. Two weeks from day and the nixed veteran question. We'll be asking is this. How do i use my post nine. Eleven gi bill. Well until next time. Thanks for listening. We serve now. What is a production of courage to fight again.
"dr paul" Discussed on America Dissected with Abdul El-Sayed
"State and local governments we remain woefully behind on back seen deployment having administered fourteen million doses. We're supposed to have twenty million by the end of twenty twenty. This is america dissected. I'm your host dr abdul el-sayed and tomorrow we drop the elect from president. Elect joe biden. Shaima i spent part of my childhood in missouri. Where every morning in elementary school. We recited the pledge of allegiance before singing america. The beautiful in the star spangled banner muslim kid in my class. We had one other religious minority my class when she was a jehovah's witness who stay seated for all the pageantry. You remember the song one part of my country. Tis of the goes land where my fathers died. I've never seen that part because my father's just die here and my five year old self. Didn't wanna lie. Every time that line came up dome. I look over to the little girl next to me. See did with her head down and admire the fact that she wouldn't sing it all despite all the other kids doing it. It's really hard to do when you're five. There's something exceptional about that. It was nine thousand nine hundred in the middle of america and this muslim egyptian american kid one generation removed from alexandria egypt is singing hymnals to america and meanwhile the white girl next to him is seated because her faith allow it. But here's the thing. Reverse.
California hospitals struggling as coronavirus cases explode
"California hospitals are battling to find beds to house patients amid fears that the exploding rate of coronavirus infections there will exhaust resources and health care workers nearly seventeen thousand people were hospitalized with confirmed or suspected covert nineteen infections in California as of Friday more than doubled the previous peak Dr Brad spell Berger's chief medical officer at the Los Angeles county USC Medical Center one of the largest hospitals in the county with more than six hundred beds we are getting crushed for most of the days of the last week we've had zero ICU beds open in the morning and we have had to scramble to remove this patient here quick move that patient care many emergency rooms are using outdoor tends to make more space meanwhile healthcare workers are getting vaccination shots Dr Paul Givony with LA county health services says that's hopeful our workforce is facing overwhelming demand that you know today we can face that need with renewed energy I'm Ben Thomas
"dr paul" Discussed on Physical Activity Researcher
"A guest dr paul kelley. Welcome paul thanks. For having me only yeah. Great to have you <hes>. I noticed that in your twitter handle you have narrow ball. Could you tell listeners. That beat about narrow boats and how fast they actually go. Very happy to try <unk>. Let's get six name. Because it's only i guess about eight feet wide and it not navigates on the canals <hes>. Sort of stay human built also ways that we have across the uk but of course in in europe and other possible as well and <hes>. You know traditionally for moving cargo and austral- revolution five these days the recreational recreational ways that we have all the days so we can we walk around there about three three miles per hour. If you walk alongside even are and then every mile or so you jump off and <hes>. A play with the law can help the boat rise off down to go over a hill. Something yes just a a wonderful way to to spend your time. So i only recommend if you ever get the opportunity to halacha. Yeah yeah what else staying in uk. I i saw quite a lot of those in in ways. And i i was in place <hes>. I don't really know how to pronounce it in way. Well spot llangollen and they have these priests and you don't go under that fritz with the boat but you go on the brits. So it's a it's a big rates and you can go overnight till the debts. That's amazing amazing place. Yes this is a very famous bridge you described and it's spectacular and yes any of your listeners. You have an opportunity to visit. I highly recommend. Yeah yeah the way to relax going three miles per hour on kennel. So if we move to your personal and professional background how how did you come to this point in how. How did you move from travel behavior to physical activity shore. So i'm i guess. I'm a physiologist. By training i did my masters in in physiology sports physiology but towards the end of the course. I'm had a lecture from foster who kind of encouraged us to think about the population benefits of. I'm spoilt in activity as opposed to be performance. Siping looking at and this was kind of my first <hes>. Steps into physical activity public health research and my dissertation with charlie ultimately my my phd and we ended up doing a project looking at measurement of i think as you mentioned in the introduction <hes>. How how could self reported. Diaries travel logan of walking cycling. And and yeah. It was kind of looking at menton in great detail and come to try <hes>. Understand some of the strengths and limitations and alleges that is really led me to focus now on things like evaluation which can rely heavily on on measurement and and also you know the science that we do suddenly the concentrate. Science relies on measurement in some way. So you know it's a really nice <hes>. Avenue into into multiple different study designs and areas of research and new said about evason <unk>. How'd you out to define the to what what is excellent difference between evaluation and research congressional <unk>. To be careful because mine definition may may may not be the right one and may disagree with <hes>. You know your listeners. And other people me. Research is is quite tightly bound by the radical constraints or heretical considerations and might might be bound by the paradigm and certain methods. You know we might immediately think of the evidence based sorry. The hierarchy of evidence from evidence based medicine privileging certain study designs study types either others whereas i think evaluation is is much more focused on real world decisions have to be made regardless of whether the perfect study design as possible and you know therefore we have to be flexible in our approaches to what we can learn about the world and we learn about policy and health promotion to try and at least offer some useful evidence for that for the next round of decisions decision. Making so you know. I don't know thousand your question. But i think it it. It goes some way to kind of outlining. How i might see the to is as not being exactly the same thing. Yeah i get your point and an s you wanted to bring this up dc. It's
"dr paul" Discussed on Dr. Drew Podcast
"Heard it on and it goes around mowing your lawn and it just doesn't turn off and then it goes and it goes the shrubs Mosel Bush's next Jason Your dog and control. But. The out of Control Room but I am. Up about ten minutes or maybe less than that. But please do summit that article to Gary Hills Ford onto me but how did for the last few minutes here? How did you end up in Carnivore? So I had my own auto immune issues I had. An asthma for my whole life and I went through all kinds of diets. I did a Vegan. Diet. For Ten year, not for ten years for seven months about ten or twelve years ago I twenty five pounds of muscle. I was super skinny in had horrible gas bloating went to Paleo things got a little better but my auto immune issues continued and just kept iterating thinking. There's gotTa. Be something here there's gotta be something here I know it's food triggering this. I really believe that foods such a huge immune stimulant for us and that it's connected with what's making insulin resistance or insulin sensitive but it can also be we haven't even gotten into sort of the magnification level around plant toxins. It's all kind of talked about in my book that Carnivore Code is well but. The idea for me was, there are these toxins. There are things in plants there are elected or oxalate or molecules in plants that I really think are triggering my immune system. So I just kept cutting things out now now and eventually I ended up with only meat and I don't just eat meat because he will think Oh my God this guy just eat steak day I mean you can think of worse fates to. Tell you the truth but I- animals nose to tail. So what I discovered looking at anthropology ethnography was really interesting trend within our ancestors. They didn't eat a lot of vegetables we've always been told they did. But if you really talk to anthropologists study currently living indigenous groups, I interviewed Lorinc Ordain and many other people who have been very deep in this world. They eat mostly animal foods they seek out animals, they hunt them. Preferentially though gather plants during time to starvation, but they're essentially fallback foods. The Not meant to be the center of their diets, the leave fruit when it's in season, but that's not it. They'll eat fruit from plants and meet, and they don't eat a lot of quote vegetables which are things like roots and stems and leaves and seeds and I thought. Okay. This makes a lot of sense autumn my diet doing entirely animal-based Diet. And see how I feel I had some apprehension because of all I've been taught in functional medicine about the benefits of planet compounds. But what I found in my own experience was my exit went away within a few weeks in his never recurred I've eaten exclusively based Diet. Now for over two years I, check my blood work every few months I just got my blood work done. I. Just a coronary calcium scan done zero. A whole `nother topic we can talk about other time. I have my inflammation is essentially none. So there's no nothing to suggest that anything I'm doing is unhealthy. My bloodwork looks amazing I feel really good interview Sean Baker, and of course, Vinnie's big proponent and Kate what I've been on it for about three years sort of a modified version of it and I kind of felt better from the standpoint of Diet and general weights managed by only issue is I over protein? I. and. That's the problem. That's the problem and the important thing I think is for people to to check out my book, the Carnivore Code in the end of the book I talk about how did you a Carnivore Diet? The first part of the book is. The. Second part is about the plant toxins, the third party debunking. So many of the myths we've been told about red meat last part of the book is how to do a carnivore diet and I really think that it's crucial that people eat nose to tail that you get these organ meats and I think this is what's missing from human diets twenty twenty like never before because we are. Not Eating liver, we are not eating kidney, and most of these things may people just get really squeamish unless there from an ethnic family and they've seen them. But there are so many unique nutrients in these organ meats that are crucial for optimal human health that we are missing, and so I eat a lot of organ meats every day I had liberty this morning I had some thymus with it. I just ate lunch before I came on the podcast with you. I had some other organ meats, spleens, kidney people don't WanNa hear it. It sounds gross but I'm trying to eat like my ancestors tell me more adopted much heart iheart eight heart twice today Yeah I love it but in any particular animals. I prefer beef I prefer beef organ meats because the beef I'm so fortunate. There's so many good farms the now sponsor my podcast and I'm so blessed to promote that are doing regenerate agriculture. They're doing grass feeding in grass finishing animals. Early, the people that are pro animal the one of the ways they kind of reconcile some of this is by eating nose to tail. Exactly. The animal go to waste. If you don't want any peace of the animal to go away soon, respect the NFL, you want all the nutrients. So I always ask people, where are you getting your Riboflavin and we're never taught about this nobody ever me a medical school make sure your patients are getting enough riboflavin but it's so crucial. It's crucial for methylation MTA CHARAN'S I'm doesn't work without Riboflavin. Go blitz goes on, you get from liver and heart. You really don't get much muscle meat, and so you also get laid choline and selenium and copper liber. Zoe's nutrients missing from just muscle meat that you can get in the organ meats. So one of the other super exciting things that got to super exciting things happening, knock on my book coming out which came out on August fourth and I also just launched supplement company called heart and soil. So cool about this I heard over and over from people that he couldn't get Oregon needs. So we take these organ meats from grass fed crashed cows in New Zealand raise on return farms and we desecrate them I'll have to send you. Some, their desiccated to their fluence dried or get the same thing out of it is eating it fresh and cooked pretty darn good as close as you could possibly get because it's even better than dehydrated. Basically, you're basically hydrating them at thirty eight degrees. So you're basically dehydrating them out of the fridge and then just putting them in a capsule. So it's pretty amazing how powerful these are I really think that the fresh organs are the best but if people won't eat the fresh Oregon or can't eat it or don't have access to the desiccated, Oregon supplements are so valuable for humans and so that's what we're doing at heart and soil..
"dr paul" Discussed on Dr. Drew Podcast
"Insulin receptors. Every cell in your body has mighty contract except the red blood cells. So they're all going to have the signal and they're all going to get insulin resistance, and so I think the inflammation that is connected with insulin resistance often has to do with this imbalance between the innate and adaptive immune responses that I mentioned earlier. So kinda ties together. It's such an interesting synchronicity when we think about it. The way that people with Corona virus are insulin resistant are having these immune reactions is very similar is analogous to the way that someone with diabetes has inflammation driving their immune response or their disordered immune response driving inflammation because what is inflammation? When I was in residency I, gave a talk and asked a room full of attending medical students, what is inflammation and it was so interesting to see them Kinda puzzle. It's not really rocket science and Medical School to understand that inflammation drives a lot of diseases. But so few of us are taught what inflammation actually even if it's just by the way, it's a broad category just under disease itself right? Infection. which is a big category, right. But when you think about it, inflammation is Kinda decided kind me immune inflammation is immunology. It's disordered response of the immune system. Your Immune System creates inflammation. We know this when you cut yourself or you break an arm get inflammation because your immune cells in your body's responding that's good inflammation or you get a fever. And that fever might help with the body's innate response for millions of inflammation that's coming from these immune cells, and since immune cells are not really a coherent. Oregon. We don't often think about it but there's this circulating network. For, lack of a better comparison they're like a cellular phone network in the body and there's all these towers and they're sending out signals and the way that the immune cells are texting back and forth site kind milieu and so inflammation is when all the immune cells are texting back and forth like there's something going on it's like when there's a twitter, you know something is trending on twitter and everybody gets all messed up angry about it. That's inflammation. It's. The communication between is immune cells and I think that the problem here with the connection. Between. Insulin Resistance and inflammation is that in a state of insulin resistance remember these two branches the immune system get ordered and they're not a balance and so they can't communicate well. So it's a breakdown in social media which we know his dangerous in the first place but it's just like the worst social media environment you can imagine where the immune system is not communicating properly. And it's kind of running around the body attacking things in the not stopping to attack things and not knowing what's an enemy yourself, and that's also how it connects to auto immunity, which is another part of what would I do, and so it's really cool to see it all connected but you and I both know this seeing clients and patients like there's a real connection between auto immunity, inflammation insulin resistance, and it's because they're all connected with central signalling mechanism. Around these immune cells and so you're saying imbalanced with the innate and the adaptive systems crack exactly and what is that imbalance basically that the innate system becomes overactive relative to the adaptive immune system and doesn't get shut off. So you can see that with this neutral fill to lymphocyte ratio and that's cited, and that is predominant source of cytokine release. Well, site a kind driven. You actually see an imbalance between t help or one and t helper, two kinds and. Those around the adoptive side, but basically, there needs to be this balance between the nate. The innate immune system adopted and system, and it doesn't work so well in states of insulin resistance and you get overactive parts of different systems and it leads to what looks like clinically. Profound problems resolving inflammation so inflammation get started and then it can't resolve and you get the smoldering inflammation in the case of Cova, you get sight kind storm. and. Then you get essentially destruction of small vessels right and then you can get pop tosa of cells which are teams to be very different. Mechanisms. No. Well, it's all connected, right? Absolutely. All connected. I I begin. Kind of mysterious to me exactly what's going on there but it certainly is connected. You know when you end up with. Let's say Site Account Related Liver. Inflammation I've never sure what that is. Because if I look at the kidney, I go so dependent on small vessels small vessel destruction. That's why the kidneys having trouble or the others. Hypertension and the blood flow, and yet that you accumulate across that kind of stuff. But in just the the flat out of elation that occurs in the liver during a septicemic episode to me as always kind of mysterious this explain that well, during Septicemia, you have an acute pathogen that's starting it right and I think it kind of makes sense because you would want. Your body to respond to a pathogen I'm always kind of baffled when people just try and vilify inflammation all the time we're trying to completely get rid of it and I think no the reason humans survived for millions of years is inflammation. If you have if you have a bacterial infection or a Paris, like you want inflammation, we don't want to be getting rid of inflammation. We want to understand what is causing inflammation but I think that this is really at the center up it's that we get inappropriate persistent chronic inflammation because of the absence of resolution of the initial inflammation and so. So many things are in medicine dysregulation dysregulation. So here's a great paper which I can send you, and the title says it all read the results in the abstract it'll make sense so that it's from the EMC endocrine disorders in the date on this two thousand, fifteen relationship between neutral fill lymphocyte ratio, and insulin resistance in newly diagnosed type two diabetes mellitus patients. Now neutral fills our innate cells. LYMPHOCYTES are adaptive cells..
"dr paul" Discussed on Dr. Drew Podcast
"They have huge. cavs, they have very lean legs very muscular. They look like they have a six pack, but if you do an Mre or a deck, so they are full of visceral fat and the reason is this is so problematic is they can't stored fat anywhere. They stopped visceral fat full of fat and then it becomes completely jammed with fat and they start getting lots of these free fatty acids release to the. Rest of the body, but they are for unless you look at them very carefully. You wouldn't even notice they are so insulin resistant they have massively accelerated Atherosclerosis, and it's because these dipa sites have this genetic problem where the deficits actually can't store fat and very quickly they will get to full and start spewing out these free fatty acids telling the rest of the body to be insulin resistant. These patients are very insulin resistant. And yet, they look pretty darn in everywhere and so this is the problem is that we can create a state kind of like that by over consuming linoleic acid, which is not something we're supposed to do nor have we ever done in evolution and that is telling our visceral fat bigger and bigger and bigger. Now, we may not see it as much because our subcutaneous fat might not grow at the same rate but if That visceral fat is growing and then it starts sending out those kind free fatty acids signals to the rest of the body you end up with systemic insulin resistance in big problems, but it's all stemming from this evolutionary inconsistent level of linoleic acid from primarily vegetables in our diet. Okay. So I I want to run back over all of that again APP, couple of questions. So so from a pragmatic standpoint, this is all A. Giant physiologic slash bow chemical understanding now that buttresses the recommendation stop the vegetable oils. That's our bottom line here. Right. Yes yes. Secondly, it's funny that this theory I wonder I used to always wonder why would see these thin elderly type two diabetics and they were so hard to control and I think they were probably a genetic variant that had something like that liquid distributive patient. They were always very same, very lean and I'd be confused like why all is insulin resistance was crazy I bet you as a very similar kind of syndrome. So. You mentioned free fatty acid ratio. What were you talking about there? So, this is where it gets to be a little complicated. So. Bear with me here and there are there are two main to want to get. You want what is that just because I was curious. The secondly I I want you to start to drill a little bit more on the cellular mechanisms and intracellular mechanisms around insulin. Sure. That's a that's a really complicated story and I think it is. It flushes out the notion of quote insulin resistance a little bit. Let's go there first. So you you had mentioned this earlier and this may be helpful for people. So at a cellular level. Insulin. Resistance is a normal physiologic process from time to time in human life on a day-to-day basis on a week to week basis evolutionary in all of our ancestors by resistance. Now, insulin resistance is when a cell says I'm full of energy and there's a signal that usually comes from the Mayakoba. Andrea sometimes, it can come from the PAROXYSMS or other parts of the cell, and that signal is reactive oxygen species so kind. Of We're back to a little bit of oxidative chemistry here. But when a cell is full from an energetic perspective, that is when a cell has decided, hey, I have lots of energy. I don't need more energy. It's going to send out a signal within the cell. So it starts in the Mitochondria which is one of these intracellular organ else and it they send out reaction species usually in the form of hydrogen peroxide. Eventually and the these oxidative signals affect the insulin receptor. So the insulin receptors on the surface of the cell these. oxidative. These reactive oxygen species signals start inside the cell and it's sort of the inside of the cell saying, Hey, we're good on Energie. We don't need any more energy. We're going to release some reactive oxygen species. So this is a situation which reactive oxygen species are useful. We don't WanNa completely abrogate them. We don't completely get rid of reactive oxygen species they're useful there are cellular signal in normal physiology this happens all the time as you are eating any meal any mixed meal Some cells of your body say we're good and they they kind of shut off the insulin receptor, which means the signaling for insulin at the level of that cell says, okay. Because one of the roles of insulin at higher concentrations is to tell us sell to take nutrients to grow insulin is kind of like an on off switch when a cell is sensitive to insulin and insulin is around to bind to its receptor on the cell surface. The cell response to insulin it changes bunch of genetics in the cell and it says, okay, there's nutrients coming in leading glucose leaden free fatty acids it uses. Uses things like life protein, pace, the pull, fatty acids, and glucose into the cell from the bloodstream. But once the bodies wants the cell is had enough of that. It says, okay, I'm full it kind of pushes away from a table and let's everybody else at the table keep eating if they're not fully. Yeah Right. It's like a big long table at a family restaurant and says, one guy gets full. He's like I'm good. He's going to let other people keep eating. That is normal insulin resistance that is a normal process. Now, this turns into pathology when they're when when this went all of the cells of the human body have become basically. So full of nutrients and so full of. So full of. These these these sort of caloric equivalents that they all Kinda shut off in the case of something like processed food where we're overwhelming our body with tons and tons of calories, and we're just getting an absolute excess of everything or in the setting of this sort of this signaling from the DIPA sites because one of the other ways that a cell. Can become insulin resistant is if there are certain fatty acid ratios in these free fatty acids released from this Radha post issue and you said, what are these different fats in this sort of free fatty acid in the blood is where it gets a little confusing. So bear with me, there are two main fats here they are permitted acid and Palmetto Laic. Both of them are sixteen carbon, fatty acids. One of them is a monounsaturated fat, which is home in late plummeted lake acid sixteen, Carbon Omega seven, and there is paramedic acid, which is a sixteen carbon saturated fat now at a very sort of. At a at a broadly speaking level the ratio between Palmetto acid and paramedic acid appears to determine. It appears to be one of the signals from the sites to the rest of the body whether they should be insulin sensitive or insulin resistant, and this is actually a really important point to consider because it's been incorrectly sort of discuss at many levels in the past in people who are insulin resistant, they have more saturated fat in their blood. They have more poems, Tate, more of the Paul medic acid, and so at this point, everyone says, wait a minute. You've just been telling me that polyunsaturated fats are bad. You haven't said anything about saturated.
"dr paul" Discussed on Dr. Drew Podcast
"So interesting I wish I'd been able to see that patient with you. I'm I'm so sorry to hear about his his death, but let's just break down a few things. Obesity comes in many shapes and sizes. But when we are talking about obesity, what we should really be focused on is visceral depositi. If we are looking at obesity as an indicator of metabolic health, what really matters is the fat tissue that is within our peritoneum. This is the lining of our gut that in capsulated or in cases are intestines and the sort of the gotz quote unquote now that fat around our intestines is very different metabolic. And the fact that he's subcutaneous or under our skin. People, you gotta trump at the bottom. Well. Yes. That's that's the. Comprised of a lot of visceral adipose tissue. Yes. Then, other than other fat that sort of in and around tissues. In the heart is th- RASIC but it's mostly this visceral abdominal obesity. So someone can have a thin waistline. But if they have visceral adipose tissue, which is something we need a Dexsa or an MRI to see they can have a thin waistline but still be very metabolic, unhealthy and very susceptible to infectious disease or other complications of chronic disease that we know stem from this insulin resistance. So just having a controlled waistline is not the same and I think that are tools and medicines are very crude even though it's twenty, twenty i. Have a good friend on twitter, Sean o'meara, who's a physician in Minnesota, and he's doing MRI's on patients. In all the time he'll send me report to these Moore is and you can see the visceral adipose tissue and it's in its around the got its around the intestines. It's the mental, these other fatty tissues within the parents NEOM, and he there was an example he sent me the other day. He posted this on on social media somebody wanting to his clinic. Instead I've eaten Vegan for twenty five years I don't have any visceral adipose tissue. Absolutely full of it full of miserable adipose tissue because it's not about Vegan or carnivore, it's not about me or vegetables. It's about poly unsaturated fatty acids in a break this down for you there are other nuances in our diet caused visceral adipose tissue to grow. Now, the other caveat to mention here is that different nationalities. So there is a genetic component different nationalities of humans tend to become insulin resistant slower or faster as their visceral adipose tissue growth as Americans as. Americans quote Unquote White, Caucasian Europeans, we tend to be able to get very fat before we become insulin resistant. You've probably noticed this in your practice Southeast Asians, Asians, they get insulin resistant very quickly even before they are obviously obese or very extremely obese, and this is very misleading and I think it's the it's something that causes a lot of consternation, a lot of family practice docs and internists as they have these Vietnamese or Southeast Asian patients who don't look to all. Two observation as though they may have diabetes and they have raging evidence of Insulin Resistance Glucose, regulation, and metabolic the Denia with all the attendant consequences because it's visceral adipose tissue and there is a genetic set point at which that visceral adipose tissue says. No, I will not expand anymore. So I'll just go one step down this rabbit hole and I think this will start to make sense. Okay. So. Basically, what we're looking at here, I believe at a at the most granular level is an environmental genetic mismatch, a profound evolutionary incongruity in the amount of polyunsaturated oils that humans in twenty twenty if you go into the cell and you look at McCoy Andrea, the actual cellular powerhouses, different fats that we eat. Affect our blood fats differently, and what we're finding is that the the ratio of different fats are blood is very powerful. It's a very powerful signal from the adipose tissue because the adipose tissue is what's releasing free fatty acids. Right. Part of the role of insulin is to stop policies at the level of the adipose tissue and so when the adipose tissue releases free fatty acids into the blood, those free fatty acids are a it's an array of links of. different chains of free fatty acids, and that is the signal to the rest of our body, the immune cells to the muscles to the brain liver of whether to be insulin resistant or weather to insult sensitive and so the reason it works like that is because in the Mitochondria as those fats are taken up by the country of our peripheral cells, the some of those fats make those might a contra insulin resistant and some of those fads make the Mitochondria. Sensitive. There's a real nuance here. Okay. But basically, what seems to happen I think this is really fascinating is that in a state of insulin resistance, the majority of people have just absolute spillover of free fatty acids from adipose tissue mostly from the visceral adipose tissue because at age UNEDIC set threshold, not adipose tissue has said you cannot cram anymore fat into me. It's like a dresser drawer in your bedroom it's full you can't anymore goes in it, but everybody has a different size dresser drawer but not dresser drawer gets full the adipose tissue just start spewing out these free fatty acids regardless of the signals from insulin usually if. If a fat cell is sensitive insulin and there is insulin in the blood to any significant degree that concentrations important that fats we'll stop like palace and will grow. But once the fat cells just become absolutely packed our own individual genetic threshold. They start to sort of spew out free fatty acids in enzyme called at L. A. Dip, a site triglycerides light pace just starts working independently of hormone sensitive lipase and just send this free fatty acid into the blood. If you look at someone with Metabolic Syndrome or diabetes, they have very high levels of free fatty acids in the blood, and if you look more closely, you'll see a specific ratio of free fatty acids in the. Blood and it's ratio that competition of what essentially lightbulb kind signals. So a lot of this stuff is super fascinating, maybe nuclear listeners but there are these signals coming from our DIPA sites in the in our bellies that are telling the rest of our body to be insulin sensitive or insulin resistance, and the problem comes that when we eat lots of polyunsaturated fatty acids. So when we eat lots of specifically linoleic acid that visceral adipose tissue gets bigger and bigger and bigger, and we see this very clearly in mouse models. And humans to. But there have been some very elegant experiments in mice where if they feed the mice certain types of fat specifically vegetable oils, they will see that visceral adipose tissue just get bigger and bigger and bigger, and eventually get any bigger, and it becomes this the source of his life behind signals for the rest of the body. Now, there's a really interesting model for this with light but dystrophy, and this may be apologize at this is getting too granular wrapping up in a second and we can kinda go back over and smooth out if people have questions but. There's a place, Amelia dystrophy called Dunnigan dystrophy and it's a single gene mutation. It's a Mon- AGENDA MUTATION THAT CAUSES PROFOUND INSULIN Resistance, and if you look at these patients, I don't know if you've ever seen the patient with dunnigan familial Hypo Hypo hypo dystrophy, but they.
"dr paul" Discussed on Dr. Drew Podcast
"April years a another April. A protein is on many of our lipoprotein. April three on ldl as well and there is some thought that states have insulin resistance. There's good evidence and I review this in my book in the Carnivore Code that in states of insulin resistance ABC three seems to become enriched in our LDL particles and so April. A is April of a protein that's on HDL. Apo A UC three I beg your part. Because I was I was thinking he three and that your bridge I was see three and then Now I have a feeling. My my hunch is that the insulin resistance story at least certain genetic groupings is a bigger piece of the story than we know. And that's just my hutch. A take that hunch on and be tell me how if that hunches crack -Tory agree with it might be part of the story in these auto immune syndromes that you're treating. Insulin resistance is the biggest problem and this sounds like hyperbole but I'll say it with some degree of confidence. I think insulin resistance is the driver of almost every single chronic disease. We have today and I'll tell you why an insulin resistance is a little bit hard to define itself. So we may have to unpack this a little bit but. When we look for insulin resistance in a variety of ways whether it's prediabetes syndrome with elevated fasting glucose, an elevated hemoglobin, A. One C., an elevated fasting insulin. Failed Oral Glucose tolerance test or we get really granular do research models like a clamp testing with insulin or we look at just simple things like postprandial glucose levels with a continuous glucose monitor. We find repeatedly that states of insulin resistance that are. Sort of evidenced by Derangement, and all of those, all of those metrics can be seen as metabolic dyslipidemia, which is a characteristic changes in the lipid panel where the HDL gets lower triglycerides get higher. That is correlated with so many chronic diseases correlated with obviously diabetes correlated with Metabolic Syndrome, which is really most synonym for it, and that's also correlated with coronary artery disease heart attacks atherosclerosis stroke. Alzheimer's the list goes on and on and on, and it is, as you suggested the beginning this podcast, there's been a lot of good evidence to correlate this type of metabolic dysfunction with worse outcomes with virus This shouldn't be surprising for us because we've known this in the past with previous flu pandemics. Metabolic Arrangements Metabolic dysfunction insulin. Resistance are all synonyms in all of these conditions. What we see is this imbalance between the innate and the adaptive immune systems. So now we're kind of switching the lens on the microscope and kind of looking at some a little bit different part of the slide, but there are these two branches of the immune system, the innate immune. System. Is composed of things like neutrophils, macrophages than cells, natural killer cells. The adaptive immune system is the T. cells in the B. Cells and they're in a balance and they are those can get out of balance during insulin resistance, which is what's so fascinating. So you get this innate immune imbalance. You can actually see pretty predictably that in the ratio between neutral fills which aren't innate immune cell and lymphocytes which are adaptive. Immune cell. Type that ratio is disordered in people with insulin resistance, and that leads to improper both initiation of an immune response to a pathogen and resolution of the immune response to the pathogen. It's at resolution of the immune response that is so problematic for most people with corona virus right now who are suffering greatly, they get this quote cited kind storm was actually this clinical. Clinical picture where they might do okay and they seem to get a little better than they get a lot worse as really the inflammation doesn't resolve because there's this imbalance between innate immune. That's not necessarily all based on a problem with immune system one level deeper. It's really coming from problems with insulin resistance, and insulin. Signaling. And at a basic molecular sort of cellular biology level, all of the cells in our body, including the immune cells, including macrophages and neutrophils, and t-cells, NBC cells they also have insulin receptors and when they become insulin resistant because during a state of insulin resistant, every cell in the body becomes insulin resistant liver, the pancreas, the muscles, the brain, the blood brain barrier that gut handier immune cells they do not work like they should and so. Really, a strong statement here is that if we could correct this really the pandemic of metabolic dysfunction, we would save millions of lives from Corona virus and other. Pandemics to follow and the chronic diseases I mentioned heart disease stroke diabetes Alzheimer's etc.. So I we're we are going to go into the weeds here so. Often. Talk. As though it is one thing. My sense of it my understanding of it it is. It's a more complicated than that. I. Would you break that down so? Insulin. Resistance. Let, me just paint a picture before you because you're. GonNa. Biochemistry. But Lemme. Paid a clinical center for people and maybe it'll help them which is the you know when we think of insulin resistance a lot of people think about fat people, right? You exceed your body's ability to you know to. The outstripped your ability to produce insulin. Resistance. That's one way of doing the other is the something happens on the cell surface inside the cells that makes the Enslin function less well, I had a patient. That has. He was he was sort of had central obesity, but he controlled it very well with Diet. But he inspite of that in spite of being diligent with Diet and really, and by the way he never got into this particular diet that you're talking about he was trying other things. He could never get the his hypertension was always difficult to control his blood sugar was always right at the margin is cholesterol was controlled, but with a bunch Ed's. And he and he had phospholipids syndrome. and had some plotting as a result of that. He Got Cova was dead in like. It was like it was almost as the disease picked up, slammed him on the ground. I've never seen anything like. That that is a to me, that was a genetic kind of insulin resistance that's different than the of some insulin resistance that I often think of..
"dr paul" Discussed on Dr. Drew Podcast
"Who consume more polycyclic aromatic hydrocarbons and Hetero cyclic means from all sources these can occur in both plant and animal foods. When they're heated to high temperatures, they do have a greater association with cancers. Initial. There's no sort of interventional research at this point, but there's a suggestion. It kind of makes sense. You really don't want to dislike fry the heck out of your baking and Bacon oil longtime all that sizzling cracking. That's basically oxidation happening at a molecular level. You have a chemistry experiment going on in the frying Pan Roots like I'm not sure that's the best thing for humans needs to be more research there but we you know it's pretty clear that lower temperature more gentle cooking is much safer so whether it comes to meet or plans. That's probably a much better option for humans and not using Wales, when you're cooking in general, just make sense to me. The more unsaturated oil is the more these double bonds between the carbons. It's just it's just kind of chemistry one. Oh, one from Freshman Year of college. The more double bonds, the more easy it is for oxygen or other sort of. Philip Molecules these molecules with unpaid electron to attack that double bond between the carbons. Get this peroxidase and you get this oxidation of Lipid which can then generate. Reactive oxygen species problematic things for our body to really deal with. So it's probably creating some level of oxidative stress, the heat oil of any kind and the more saturated. The oil is the more stable. It's going to be in that stress in that he. The peroxides or causing free radicals that we're saying yeah, essentially. Yeah. You can find the chemistry reactions without doing a visual podcast. It's a little bit hard to to actually show how this works. But yes, essentially, what we're talking about is a movement of electrons was an electron currency here and and when a molecule comes into the human body whether it's Exit usually it's an exogenous molecules. So some compound that we are eating whether it's an oxidized oil or a plant compound. If that compound has an unpaid electron or a tendency to steal electrons from our molecules from the molecules of our body. We call that molecule a pro oxidant oxidation and reduction at a biochemical level just the movement of electrons with loss of electrons being oxidation gain of electrons being reduction. So when a molecule comes in Kinda steals an electron from one of our molecules whether it's a protein on the surface, of ldl, or it's cholesterol or another molecule. That's really kind of fragile that creates a unpaid electron in the molecules, just how the electron stolen and that can then create a series of chain reactions leading to the formation of things like free radicals which. Are generally considered to be problematic in excess. In that they? Tear through structures. They can tear through structures. They can also change the confirmation of structures and so when molecules oxidized, it probably looks different in the body. Proteins in space have a three dimensional conformation and with regard to the L. Molecule or the LDL Lipoprotein, which is a you know a lipid mono layer, this low-density protein that we're all told to refer to colloquial ask quote cholesterol but actually a vehicle for both cholesterol triglycerides into the membrane of that L. do molecule are other. Proteins inserted in one of those is April be hundred was multiple variants vape Ob base where it's used like. Forty eight in the kind of microns, but it will be one hundred is in the Elles yell and when APL one hundred gets oxidized, it looks different to cells in our body and one of the prevailing theories of sort of the initiation of atherosclerosis. Is it sometimes this be gets mutated or modify or? Because of an oxidation or per oxidation. In connection with? Bing Lipids perhaps, and that makes it look like a foreign molecule that's macrophages bind to it with something like a scavenger receptor and the macrophages pull it, pull it inside and they become these sort of pre atherosclerotic franz own cells. Now, all the pieces in this equation aren't fully worked out, but that's one of the prevailing theories we know in mice that if you. If, YOU KNOCK OUT APE ob they don't seem to get atherosclerosis there does seem to be something important about that molecule identifying ldl and how it's recognized potentially by cells like macrophages in that southern to space but it all comes back to one of the things we're talking about here, which is those proteins can be delicate, and if oxidation gets out of control that is that there's too many of these molecules in the membrane especially these fragile molecules like polyunsaturated fatty acids. untouchable fatty acids can lead to miss folding or changes in the confirmational structure of that. April one hundred and the LDL and make it look different. This is what we might call oxidized LDL and many people may have heard about this term and how that might be one of the main issues. How do we avoid getting oxidized LDL another deep rabbit hole you can go into right? So I WANNA lose but it's we're talking about how cholesterol's brought inside the lining of arteries and causes the inflammation that eventually causes the cholesterol plaque and and the April proteins are these. Proteins are folded structures and of they go to their lowest energy state and their lowest entropy and Anthony States and or or the the laws thermodynamics prevailed trends of how proteins fold on themselves. But if you do something that changes their structured, you meth late them like late them you oxidizer you can change the folding structures and if you oxidized, they're more likely to be picked up by macrophages would that be the? Yeah that's one of the one of the I'd say stronger hypotheses for initiation. I'd heard this with an a like an eighty three or something I. It's funny. I heard the exact same through April April eighteen and I'd somewhere heard that it was associated with insulin resistance. Where did I come up with that theory? Are You thinking of ABC three? There's a lot of these apolipoprotein that turns into a little bit of an alphabet soup. People have probably heard ABC e because of the F four variant that is associated with Alzheimer's disease..
"dr paul" Discussed on Dr. Drew Podcast
"Thanks. It's good to be here. They turned me on how did you get from psychiatry to functional medicine? That's a big jump. It isn't it isn't you know. You know the Western medicine likes to balkanize things. We like to silo specialty and say that the brain isn't connected to the gut, but it surely is oh, the heart of blood vessels in the higher they may actually have to do with the immune system which circulates through the whole heart. At same immune system might actually affect the brain and everything. So. What I realized quickly throughout my medical training was that specialties don't really serve patients very well in. So I quickly sort of trying to think outside of my specialty in that was the beginning of my interest in nutrition and biochemistry to a much broader scheme in a much broader framework than just sort of neurobiology psychiatry. Did you ever practice Sakari I did yeah, I mean I residency in psychiatry and I've seen some pious with. Primarily psychiatric illnesses but four years of psychiatric residency was enough to teach me pretty quickly that I didn't to practice psychiatry and the mainstream model for very long at all. So you. So you didn't practice right over and trained in the nutritional medicine. The nutritional medicine training was really happening throughout my residency as you know. Most physicians that? Know up from down with regard nutrition ourselves training because we don't get any training in medical school or any residency really for that matter. So the functional medicine training was. Stuff I was doing in residency and then really toward the residency as got interested in animal based I-IT's in a Carnivore Diet wrote the book I was doing my own sort of research and don't deepened. That was doing my own sweet nutritional research and then got board-certified just a earlier this year as a physician nutrition specialist. It's really not a whole lot of board certifications out there from Trish in. So I was like, what what can I do? What's the? What's the best or certification nutrition I could do? So when did that one just to make sure I was as credentialed as possible to do this kind of work, but I think is so important, right? Sargodha million questions what was your undergraduate training? Chemistry and biology. Good. So you've got you come with the right. Mindset to do this kind of work. Now one of the things Kate Shanahan. Yeah Real. Well. So so whether he's I like cade, she's obviously a skill bow chemists in addition to being a family practitioner and she looked at nutritional problems just It's to infinitely complex only a few things that I could really say something about and she she drilled into fats. Obviously that's her thing. It seems like you a little bit of a broader outlook than she does. Well yes and no. I think there's all these different levels of magnification. It's remember when you were in science lab and a sixth grade and you had those really cool microscopes, you could flip it to like five x ten x one hundred accented. There's different levels of magnification I think with which we can view through which we can view problems of the current Crohn's disease epidemic in the United States and I think it depends on the on the level of magnification that you want to go to you want to go five x ten x one, hundred x kid and I definitely agree on the vegetable oils And I think a very granular foundational level, the access of polyunsaturated fatty acids physically linoleic acid in the American diet. Today is a huge evolutionary inconsistency, a massive driver of chronic disease, especially, the underlying insulin resistance and metabolic dysfunction drive. So much of our health crisis, but at different levels of magnification, there are many other things that are doing similar things to humans or. alleged. You're there in a second I just WanNa drill on that piece for a second because it is so pertinent these kate has made a pertinent to the Cova situation where she is saying that. Those assets. Those fatty acids are having an issue in terms of creating inflammation, setting up the central obesity and really being me perhaps central cofactor in people have complications from the covid and flew. and. She is just a nice shorthand for people. If you haven't heard any of US talk to kate and she's very very consistent her her messaging and she is saying stay with tallow butter easy thing to stay with tallow butter and What's her third favourite olive oil? Would you agree with that? I'm a big fan of the tallow in the butter if we get pretty granular and not as excited about olive oil, I think it's much less beneficial fat for humans and much less evolutionary consistent than the animal fats tallow in butter God is the is the olive oil off the menu for Carnivore Diet it is. It's not something that I recommend. It's not something that I think people should be using liquid oils in general I think are problematic for most people and there's a clear clear preference for the animal fats and we can get into why the main issues are the vegetable oils, the corn the. This you know the the peanut Sarah. Margin. Yeah you definitely don't want the Trans fat and margarine, but you know I think that the journey the jury is still out on highly monounsaturated fat liquid whales can drill down there if you want. But Italo and the butter I think are much better for humans. I interrupted you as you're about to go into the animal fat conversation I think. So I apologize go ahead. Oh, it's just the idea that humans have not been. You know basically grinding olives and making olive oil for very long. It's even eating animal fat for hundreds of thousands, millions of years, and they're so consistently found in hunter gatherer populations really before eighteen sixty five there was no such thing as much of oil of any kind and that was when Khan sale came around and then in nineteen eleven have the advent of things like crisco which are essentially hydrogenated vegetable fats, the the the evil cousin of margarine or maybe the redheaded stepsister, they're both pre problematic. And then from there, we've just been getting more and more of these liquid oils and to to take an olive into to squeeze it to make a highly monounsaturated fat is much better than polyunsaturated Omega six linoleic acid, rich corn soybean oil but still present some problems I think in isn't ideal. The other thing to think about is why we're using these oils in general question a lot from social media and people what oil should I cook with with the answer is no. Could. Don't Cook with oil why don't know why we're cooking oil in the first place? I if People WanNa Cook with tower butter, that's fine. But generally speaking I think it's much better to just not cook with oil most meat has fat in it that you can cook with and then. There's some really interesting data around polycyclic aromatic hydrocarbons hetero cyclic a means it's not fully fleshed out, but there's a suggestion that, hey, why don't we just cook most of our stuff sous vide in water I do a lot of blanche ing of me in in Bone Broth. Why don't we cook it lower temperature and just you know completely obviate the discussion around these by products these Mallard? Byproducts in these products have higher cooking in an certainly. Probably should not heating oils to high temperatures in cooking them. Even monounsaturated oils can be problematic I think from that perspective. And I've heard carcinogenicity is one of the big issues there. Yes. Yeah and we don't know for sure there's some epidemiology to suggest that people who consume more polycyclic aromatic hydrocarbons and Hetero cyclic means from all sources these can occur in both plant and animal foods..
"dr paul" Discussed on Dr. Drew Podcast
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"dr paul" Discussed on Relentless Dentist
"Yeah that'd be pretty cool but I don't WanNa do that and I can't expect them to want to. Do you have a like a one on one dialogue or structure with each employee? Is that something you do or is that something elise would do. Something I'll do in the leads will do that as well. So we'll talk to the people in their department. But I have to do that personally. And that's something I've always done. Huge are in and I said this at vetoed. If anyone took one thing out of it that would change their practice would be doing one on ones and just really being cognizant of how they conduct those meetings really asking for feedback. Really asking how. They are as lear asking people. They're happy or if there's one thing they could change about the way things are going here that would make him happier. Make their job better. What can we do so just asking questions? Because I like the related back to like the the Captain Phillips that was on that boat with the the Somali pirates like the the seals snipe lake three dudes like all at once and that wasn't like Obama's into the top on the phone going shoot. Now you know the people on the front lines knows what's going on and they can react accordingly so you need to ask you on the front lines. What's happening. Because they know what's going on in the practice they know how to make the practice better. If you give that to them and let them do that they'll do that. But then the big thing about psychological safety. It'd be careful respond. You CANNOT GET DEFENSIVE. Union amid feel stupid you know. They share an idea. You can't go. I never gonNA work way. We're trying that. Maybe we'll try that you know let. Let's discuss this as a team. I think that's a great great input will bring up the team to see how it goes. That's how you get it because if if you you close somebody off and you make them feel stupid. You make them feel psychologically unsafe sharing things you just shut the doors across you. GotTa build so you have those one on ones. You could start a once a month when you've never done it before it's going to be weird because you're GONNA think they're getting in trouble but I probably do it once more with everybody gets twenty seven people. So it's it's hard to It's I was just listening to Marshall. Goldsmith is considered one of the elite executive coaches on the world's for fortune one hundred and he talks about this with a Li executive showing like how important it says on how sensitive people can really be so people that are reporting to the CEO. It'd be like a CMO on a CFO. When he was talking about how a lot of times that the the report he at what whoever may be might be a dental assistant. Hygienic Sir Admin and a dental office will bring us an idea and in full like in a in a very benevolent way will take this idea to try and improve it and will say I love it. But and then we add these things and he was talking about how detrimental that is. Because we've taken the idea. We've maybe added twenty percent effectiveness to we have taken that person's ownership of the idea and taking it almost nothing so now Now we've adopted the idea which has no no no chance of flying because we're the biggest bottleneck and everything right. Yeah it's simply with out understanding the attention and how L. kind of fragile. I guess is the best word. The psychological safety is is that you you didn't condemn it. You've actually tried to improve. But yet you've subtracted their investment in improving whatever department almost completely in in a in a very kind hearted way intentionally but it didn't doesn't turn out that way. I'm probably guilty of that area. Thought about that in and I might be guilty that you know I might be aware may have better wear now. You mentioned that I have a question for you. That's been asked of me maybe two times in the last month and eluded to but I'm curious how you handle it because every team has different tiers of investment in the company and some people when it's when it's end of day punching out on Thursday. They wanted to get out of there and other people wanNA socialize so you have people that are really excited about maybe see social events that people who just WanNa go home to their families. Do you make that an optional thing for the people who consider fun? Or How do you handle that? So that works for everyone so thankfully I have not had to have that discussion yet and I don't four Sudani one but the majority of people go on the majority of people want to do these things After meeting go hit up happy hour. We have a barbecue every year. We've been like go. Kart Racing GonNa like NASCAR races. I'm thankful that they want to go now. I don't know what it what I would do if somebody didn't WanNa go and some people don't there because we have some team that's cool so yeah but for the majority of them they do so i. I'm not sure I got a good answer for either day. I probably that's tough. They'll break my heart though. So you have a pulse on dentistry. You talked to a lot of people certainly well invested in understanding the clinical side. The business side the leadership side as you forecast out said ten years. What are some of the biggest challenges that you see in the industry and then we can talk a little bit about? How do we turn those opportunities for the list? Yeah I I think the the challenges we're going to see and it's just like everyone. It's going to be insurance in corporations. You know that's what everyone's freaking out about. And as far as the corporations go I still think private practice. People can compete. I really do. I think you've gotta be a little bit more intentional about the experience you provide. I think you need to be a little bit more accommodating as hours go we need to realize that the patient is a consumer that can make a decision on where they spend their money and that the days of maybe doing it my way. 'cause I'm a dentist? I went to school for eight years. You gotta be done so I think what's going to happen with a lot of private. Practices is what we're seeing is that people are gonNA start the corporate people they want to go there. That's fine they can go there. They're going to go for the either the The hours the convenience insurance things like that and I think officers like mine are GonNa do just fine because we we provide a lot of value. We provide a great experience but I think the people that really aren't noticing are paying attention that are going to get lost in the shuffle. So that's GonNa be all the private practice people in between. Yeah and I think you're GONNA see a lot more of these bigger like dentists on. Dsl is like a such as mb to that. Seems like that is the where people want to go to and it seems that private practicing dentists are comfortable that sort of DSL. That is not a private Equity Group. Just pumping in money and stuff. It's actually done two so far. The insurance goes we It's got to be more efficient. I mean I hate the idea of dropping fees but if it does it is what it is. He told me drop from insurance. I don't know how fee for services plan on. I don't WanNA release speculate. How that's GONNA go? I'm not a few per service office. We take insurance. We take our generally maybe eighty five percent of our patients are PPO We're not a lot of lands. You know but we were. We do have a Lotta. Ppo patients and if the fees decreased you just gotTa work a little faster. I mean as far as I'm concerned right now. The margins are still really great. You know so i. It's I don't know if it's GonNa go the way of of Medical. I mean I'll tell you for instance I just had a C. L. surgery about four months ago in my bill was the fee was sixty five hundred dollars to the surgeon in the PPO. Right off was like fifty two hundred dollars like a three hour surgery for twelve hundred. Bucks Man. That's that's a pretty nasty right off. We're crying about thirty five percent and stuff that was like eighty percent. So yes I. It's a you just gotta adjust with it roll with it and take it as it goes in adjusts is just like a game. You know you you solve some problems and let's see what the problems are in figuring out from there. I saw something in and we appreciate how tech curbs work were explorer. Change accelerates and. We're definitely in that where say somebody graduates from dental school tomorrow or in. May or wherever their career will not look the same in ten years? We know this right. And so there's a strong need for the ability to learn quickly like you said adapt and relearn unlearn whatever. It may take to make things happen and I see a lot of this kind of shooting. Theirselves in the foot with this dogma. No this is how I'm GonNa do it now. But if the consumer is speaking another language and you're not adapting their that can make for a really difficult road in a difficult career so for a listener who sees a level of optimism as they enter their career young dentists who wants to own. Dsm words of advice to make sure that they stay at ethic control as maybe not the good word by your calming presence like you are that ability to kind of have their best year every year and grow and adapt. How do they do that? How do they do that and still not lose themselves and trying to be everything to everyone? Yeah I think it comes down to the whole thing. You should learn from people that are doing it. Well you know always be learning a if we want to think. Sometimes we're we're learning. It's it's like if we wanted to learn how to golf really well. You always use the example that if if that club rory is swinging the club weakest. Swing the club the same trajectory the same club with the same speed same ball. We should be a hit. The same exact shot that rory does. But we're not asking. We're not learning for Maury where we're learning from dumb drunk friends that are saying you keep on your head you keep on your head would never get better. You know what he lets what. That's what we do as dentists. We just house things you our slow or slow so I think it comes down learning from people that are doing it. Well and then also six stream ownership idea just own everything. Because if you're not owning it you're gonNA start blaming it on this external stuff. What is just the Industry Man? You know all everything's conglomerate and then everything is the insurance is so bad. I can't do anything what we'll find somebody that's making it work and see how they're doing it. Go someone's gotTa figuring out every is just active ships different ways whatever. But someone's gotTa figure out how to work that system and make profitable and in. I think if you own the fact that you have control over it than you will be able to stay home in you'll deal. Assess the situation. Try to figure out a way through it. So level of accountability and adaptability. I think are the touch points there. Yeah always be learning as a point that you you mentioned that I think is critical. The other piece that I think is driving home. We've talked about it through this whole conversation as we see a lot identity you wanna be owners but they don't Wanna act as owners and so talk a little bit about her drive home the point of that level of responsibility when their names on the note and the names on the door..
"dr paul" Discussed on The Emma Guns Show
"You know what I love for my to do I love for it to sparkle to catch the eye and exudes style taste confidence it's why I love moisture night The world's most brilliant gem it's an ethically sound revolutionary product and Charles and Colbert that gives more if that sparkling fire an eye-catching brilliance than any other. recycled precious metals there are hundreds of beautiful styles to choose from over on their website whether you're in the market for some classic stunts statement ring or particular type not my personal favorite is Asher maybe pair make that oval anyway there's so much to choose from that it just makes sense to head over to in Cova now learn more and get exclusive savings at Charles and Kovar dot com forward slash emigrants that's Charles and covert dot com forward slash Emma gun Hello Hi unwelcomed other episode of the gun show thank you so much for joining me what a special mini show it's a mini show with Dr Paul SF and if you're thinking wait not Dr Fool Nassif from the world renowned cosmetic surgeon famous for his wonderful nose jobs yes you're absolutely correct that's the Po- cost in this episode if you have seen him on box you will know that not only is he are hugely talented plastic surgeon but he's also clearly really emotionally involved with his patients and what he cares about and with Dr Paul Nassif whether I was having something for the first time or whether I was having something corrected you always get a sense that he really looks after his patients not only in theater but in the consultations and just really seeing them and understanding what they need he seems very hard I like it about him so he might not be racing over in the UK but he is he has opened his medical spa in Manchester and I was invited up to go and see the space go and see the what they do there tween anyway it looks the same and I also got to learn about what they'll be doing they think injectables think various other I'm sculpting very glamorous reception of this ball and I wanted to really get from him what you should expect from a consultation when you go and see somebody about having any kind of aesthetic doc big Beit Invasive or non invasive how you should talk to your surgeon why he on top of all of the work that he's currently doing let's let's be real here he works in Tori he has a TV show more than one and he's now decided to launch skincare and also what to expect when you've had something done what happens on the other side we can always focus on the sort of nerves and the tension around should I should I'm GonNa go and get this done but what happens afterwards he really stood up opens up about that and what to expect and he also talks about one of the biggest trends and cosmetic surgery it's been around for a while and why he wouldn't be too upset if it went away the links deductible Nassar and to the medical we'll be in the show notes but honestly what a pleasure to have Dr Paul Nassif on the gun show testing one two what an incredibly warm welcome to talk to pull NASA thank you so much for coming on the podcast Emma thank you for having me.