17 Burst results for "Peter Attiyah"
"peter attiyah" Discussed on Texas Titans Podcast
"Improved. Always in always and also. I think it's really interesting that okay. So steven kotler started out as a journalist and now he's the guru of a slow and and that sort of my james nestor in his work with breath that an an amazing book And now you're doing the same thing. I think journalists are naturally curious. And i think that you know you've kind of found that and so in your research so you match up with these guys but so yet you're already kind of a health guy you know personally and you had the tools to help his company but did you know what hmo was because. I know you guys have other products. But that's kind of like. That's kind of cool niche right. Now how did you. How did you read. How did that resonate with you. Whenever you fed about the company. And you're like okay. I can really get into this. What would that look like. Yeah that's a great another great question so you know you're looking at the very very beginning of twenty twenty In so i was still living in pennsylvania and and You know making the move up here in these scientists in I the thing that one of the things they liked as well you know value add with knee was that i actually was a big supplement. Guy you know so. I am someone who likes kind of low level biohacking and things like that and you know already had some of this stuff in my cabinets at home and you know sort of irony. Sometimes people don't think about is like not always you know 'specially when you have a product that's truly scientists developed will scientists themselves sometimes aren't big fitness gurus or the people. Who would you know papa bunch of supplements so they enjoyed that. I be able to kind of actually have empathy for the consumer and for the people who might wanna buy our products versus themselves. You i mean. They take vitamin c. Or multi. But they're not really like deep into that kind of biohacking world the same way that like a consumer facing kind of what i mean. They are research wise but not like in that. Consumer mentality right. Oh yes sorry. I'm kind of forgetting what the question was but Just how how. How do whatever you hear what they're actually producing again the research they're figuring out these things that work but you're actually somebody that wants to execute on it. When did you go. Oh my gosh. This is kind of like the best of both worlds. Yeah for short so it was kind of funny about it. Is that the flag shop. Flagship products at the time was something that they developed a patent on. Which you know if you're familiar with that process takes quite a while you know and you have to have your. I is dotted t.'s. Crossed and really. Have you know your stuff lined up. Today did actually been awarded a patent from the us government on A car blocker. You know sort of like akito diet sort of product using like phase euless vulgarities beans and sort of the traditional problem with a white kidney being car blocker. Has these electons in it. That 'cause you know sort of like gi problems and they were able to sort of like isolate out electins and felt like it could be revolutionary but that market is extremely saturated the kito diet markets if you read the immunity code joel green actually kind of questioned whether the kito diet is even the way to go so that being said. They told me that they had kind of this. Like backburner project hmo. And i had not heard of. It was really floored me. Because i was like. I've heard about a lot of supplements know about them. You know exactly what they do. But i've pretty much heard about most of this stuff and i think actually a parallels that that's what was so illuminating about the immunity code for so many of us was that you open this up and he's talking about sukhoi than i had not heard of that japanese seaweed right you know product so things like that you know the green brings about but yeah so i had not heard of hmo to be completely honest with you at the time when when they were kind of scouting needed joined the company. Excuse me but the first time i heard about it i thought oh my god this could be truly like a really really big deal if this is true. This is legit and i've come to realize that it is but so. Yeah so that was really exciting. And then the fact that i hopped in and i love making. I feel like i'm similar to you. I like making youtube content and then talking interfacing with people and writing and all that stuff. I'm really big on the communications part. I lack a little bit on the marketing side. Although i've gotten a lot better at it in the last fourteen months but Yeah i felt like a really good fit to kind of do some of the things. I liked to do from that journalism side but also move into a more entrepreneurial space and You know it's fun when you see sales coming in and happy customers and good reviews and it really keeps you going absolutely. Yeah and that's one of the things just kind of draw made. This is that it's nice if you can actually make a living and do do good by people. And so i think the at ethic also. It's a fun time for supplements health and wellness all of it just because people are realizing that that well we got the work of davidson claire. You've got the work of of Of joe greene. Realizing peter attiyah would. He's talking with longevity not just about extending life. it's about extending healthy life. And in as davidson. Claire think probably better than anybody brought to the forefront of if we will start treating age as a disease like we would a disease as opposed to just waiting for all of the the cancers and the the the heart conditions. That these come with you know older age and entreat those we'd be better off and so with that i think that's a perfect tee up or what are hmo's They're not a health met. There are health managed organization but focused on what we're talking about today. Because i got to believe that there are going to be thousands of people that. Listen to this podcast. And they're going to be like. What is this white wiser. Such a big deal. The jason so excited these jump into the founder of the company that makes us dove. He's got shoulder so let's talk about. Hmo's why they are important what they are and why they're important to your gut. Yeah for sure so hmo stands for Human milk oliver soccer ride people pronounce different ways. But that's the way. I say it And so it is a compound that is found naturally. It's naturally occurring in human breast milk as title sort of suggests and It was really. I discovered around the late. Eighteen hundreds early nineteen hundreds and so originally basically scientists pediatricians were sort of working in concert to try to figure out why there were so many problems with infant mortality And other gastrointestinal issues with infants at a really young age and so they sort of eventually through experimentation realize that okay we think. The breast milk The breastfed babies are doing better than those that are not breastfed. And that gets into these days. A little bit of controversy there but one hundred hundred twenty years ago. That was a pretty key fact there but then the question became what easy in the breast milk that is the key factor. Right is it. Is it the protein shore. Is that the fat. You know the the lipids is at the lactose. Is it something else so eventually the key discovery was that they what they believe. I called bifida factor at the time Which was modern day. Hmo as we know it and so this was a complex sugar molecule basically a milk sugar in the milk and they were able to sort of isolated and then through the for subsequent decades realized that there were somewhere in the neighborhood of one hundred and thirty estimates vary but at least over a hundred possibly up to two hundred different subtypes varieties of hmo with these very complex names scientific like to fuego sa- lactose which is the main most abundant one. And the one that's in the majority of our products but there's about two hundred of them in so other ones are l. n. t. which lacked o. And neo tetreault switches in our kids product.
"peter attiyah" Discussed on The Tim Ferriss Show
"See you my friend. Thanks so much for having me. It's great to see you too. I appreciate it. And i have been looking forward to this conversation. In my mind's eye for some time because we've known each other for a while we met through our mutual friend. Peter attiyah and i saw a very early manuscript of trauma the epidemic we were doing the math beforehand before we press record around two and a half or so years ago and i was so thrilled that you were putting your experiences and your approaches into book form. The fact of the matter is most of the time when i have every friend acquaintance and their cousin and grandma telling me they're going to write a book or asking if they should write a book. I spend most of my time dissuading people from writing books. Because i think they'll be just redundant or not a great value add and then on top of that. I really just don't want to be forced to read them. And my feeling with you is is very much the opposite. You are such a deliberate awful and skilled practitioner. And i also of course value you as a friend. But i've had a chance and i'm not going to disclose details -sarily but i've seen you really intervene and quite likely save lives and i can't say that for many people so it's a real honor to have you on. I've been looking forward to doing this for a very long time. I have the highest opinion of you just to establish that upfront and with all of that. Let's jump in. And i would love to hear also because my memory needs refreshing but for people listening. How you ended up in psychiatry. Thank you. And i wanna thank you for your support. When i was really figuring this out and deciding i really want to write a book. And it's such a leap to take your support and encouragement about how that would be a worthwhile endeavor and could could really make a difference with so helpful to me two and a half years ago and and before then too so am so appreciative of that. And it's a of part of my circuitous route. You know that. I had no pre medical classes in college in a business career. And and you know at some point. In time i realized that what has unified. My interest across time was really about people. So united studied history and political science and art. And and i was very interested but ultimately it was really in the people in those who was also feeling my interest in business was the people i was engaging with. Were they like and how do they have these thoughts that gotham to where they're at and it was that sort of unifying elements that led me to go back to medical school and go cow gonna learn about human biology and just learn something about human beings and it was there that i realized like. Oh you can take this medical knowledge and you can take the sort of life knowledge whether it's history or politics or sociology. Just knowledge about human beings and you can put that together with an individual person. Who's sitting in front of you and talking about them. The specifics of their life and their experience. And you can put all that together and really be helpful to people like really make a concrete difference that you can see that. There's a change. And that was ultimately so appealing to me and i felt like i could get that three psychiatry and i think i found that to be the case. I'm so grateful for the vagaries and the idiosyncrasies ultimately led me to be able to see all of this and choose it as a career many follow up questions we're gonna kinda flash forward to current day and then we're going to flash backwards so i wanna read a little snippet from the forward in your book. I think you'll recognize this. And then i'm gonna ask you add context. Why didn't you bring me a real doctor. I asked the nurse. Paul replied by saying i'm an italian from new jersey and that's when i decided i was willing to talk to him. My dad is an italian from new jersey. So i figured i at least knew what was dealing with. Whose words are these. Those were the words of stephanie german. Nada who's also lady gaga on our first meeting. I think what. I would describe as i think our our auspicious first meeting so she wrote the ford to trauma the invisible epidemic. Of course. you didn't start off with clientele or clients patients like her. Could you tell us a bit about since we've mentioned the title a number of times your own personal history with trauma. If you'd be it be open to sharing in the first part of my life. Is it up until around early twenties. I didn't have major trauma in my life and some ways. I was fortunate to get through the big developmental milestones without major trauma and it gave me a sort of view of life that was then deeply challenged by a sequence of traumas that came in the second part of my life and seeing how they made me feel differently about things because i had the foundation of confidence in myself and also in the predictability of the world that if i'm engaging in doing the right things that good things are gonna come back to me and how differently. I fell one after my brother's suicide. Which was the the first of a series of quite traumatic things that unfolded over a number of years. That the challenge of that of realizing that while i'm trying to figure out my way through this and like how to go on with life and had a support my parents and the people around me while i haven't awareness at like. I am different that now. I'm seeing the world differently. And all the other night in rabat. Feel a little bit like am. I cursed is my family. Curses is anything going to be okay. Maybe death things always happen. I was so off balance and in wake of impacted impaired even by all of this and realizing that we can even trust how. I'm thinking because i'm thinking differently and then i'm trying to use the brain. That's thinking differently to figure out what's different and there was something quite scary about that that i could also then i could see when i became a psychiatrist. Play out in the people. I was trying to guide or adviser take care of the. They also often had thought differently about themselves. They stopped seeing that they could make their way in the world or that they had good things to offer or that they could even stay safe and and that for me like really caught my attention that hey there's something going on here that is that's very deep and also very insidious thank you for sharing and as want to echo some of what you're saying in my own personal experience with depressive episodes which i've had a a mainstay of sorts for most of my life and it can be very terrifying and certainly disorienting say in the middle of a depressive episode to be aware that you are looking at the world through a distorted lens to have no confidence that you can correct that lens it right very terrifying because you feel like you're the prison through which you're looking at reality is broken and you're aware there's a problem but you can't look through that broken presume to fix the broken prison or so you might believe and it can be extremely disorienting sometimes destabilizing for sure and i wanted to ask if you might be willing to speak to some of the other traumatic events and to place us in time starting with perhaps your brother. How old were you when your brother committed suicide. So is twenty five at the time. Twenty five years old. And are you willing if you are willing to share with usually open to mentioning some of the other things that happened to you. And the reason i'm asking about this is not to inflict pain and revisiting these things but rather to share your personal experiences because there are very likely going to be people listening who identify with different parts of your story. I understand and i think it is helpful. The context is helpful. And i think it does. It speaks to the impact of repeated. Traumas that not long. After my brother's death one of my best friends at a person i grew up with died died very unexpectedly you know. We were in our mid twenties several years down the road. My wife was injured and injured quite seriously. I lost another very close friend..
"peter attiyah" Discussed on The Blog of Author Tim Ferriss
"So nice to see you my friend. Thanks so much for having me. It's great to see you too. I appreciate it. And i have been looking forward to this conversation. In my mind's eye for some time because we've known each other for a while we met through our mutual friend. Peter attiyah and i saw a very early manuscript of trauma the epidemic we were doing the math beforehand before we press record around two.
"peter attiyah" Discussed on The Peter Attia Drive
"To peter attiyah. Md dot com forward slash. Subscribe now without further delay. Here's today's episode. Is steve austin. Steve is distinguished professor and chair of the department of biology at the university of alabama. And he's the scientific director of the american federation for aging research. He also directs. The university of alabama's nathan shock center for excellence in the basic biology of aging. Which is only one of six such centers in the united states. Steve's current research seeks to understand the underlying causes of aging specifically with a long term goal of developing medical interventions that slow the age related decay in human health. Now i've known steve for probably about six or seven years and in that period of time i really do consider him to be one of my mentors in this space always generous and gracious with his insights and his time his wisdom and i was just really excited to have him on the show today and we talk about his background. Which is as you'll see very interesting and very unconventional and we talk about kind of a history of one of the most important discoveries in aging which is the relationship of caloric restriction and length of life but also some of the limitations of this research and we do a very good case study on what is unquestionably. The most important experiment ever done on caloric restriction and dietary restriction. We talk about the possible. Hypotheses for the sex related differences that exist between men and women and we talk about some of the most exciting interesting. Jiro protective molecules out there including rapamycin metformin and others so without further delay. Please enjoy my conversation. With steve austin.
"peter attiyah" Discussed on The Dentalpreneur Podcast with Dr. Mark Costes
"Plus i mean just as you and all your listeners know the amazing benefits of owning a business right From a lot of different perspective. But i think i have one client who Was very involved with like low carb nutrition and that she loved it and she wanted to start kind of like Like at first like an online space a course and then maybe do like have a little practice into housework there and her major thing were mental barrier. She's like people think a quack. What are they going to think of me etc And then like the the business stuff like setting up the llc and getting a business you know. Those are easy things to show people how to do. But i work through a process with her of like you know defining your knees and figure out who you talk to and and work in that way and that waste. The plan is to buy down some of her nickel time once. The money starts coming in from that. So you know i. I think it really depends on what you're looking for when people come to me. It's just there's there's a million options anything's possible. I know we restrict ourselves to these like five jobs like for doctors They're like these chart review jobs wrench for insurance companies Marmo there's medical writing and like that's all people think there is but there's really never ending amount of jobs out there and impossible situation so yeah as part of what i do as well. Yeah expert testimony those sorts of things. pay well per diem Have you ever have you ever met. Or dino dr peter attiyah don't know okay dr. Peter t has a An incredibly huge filing. He's one of the Leading researchers in longevity. He's he's an md. But i love his story because he got to just like literally months away. From finishing his general surgery residency at johns hopkins and he dropped out. He's like this is not for me. I'm super burnt out a feeling stifled uncreative so he. He took a massive pivot and now he has a very very boutique. Concierge medical practice where he takes like less than less than sixty people per year. He charges a couple hundred thousand dollars but he works for billionaires and stuff but then he he's been he's able to flex his creativity muscle by doing all this research so he leaves leads us research team on longevity and Rapamycin and all these really cool cutting edge Therapies and he's to me one of the perfect examples of look you have this medical basis. You're smart you understand research you can go a totally direction And he took a lotta shit for you know for getting that deep into his residency for taking residency spot from somebody else. One of the most sought after residency spots in the world. And and just saying you know what. I don't wanna do this anymore. It's not gonna make me happy and and you know when you project ten years out and you say. It's going to be groundhog day. What am i gonna. How am. I gonna feel ten years if i don't make a change right now. I guess that's a big thing that that people have to consider when they're miserable every single day true and you know there's so much similarities. I started branching out to work. I worked as a pharmacist now. Some nurses in some respiratory. I mean it's all the same right like it's all the same stuff that we do as a i'm sure it's the same for dentists as well But like you know you get done with your training or your schooling and then you face the cycle so i gotta do this for forty years right and there's nothing else because we're always going towards the next thing you know especially in medical or dental school right like. You're trying to get into med school or dental school in. You're you're trying to move to the next by trying to get a residency in trying to get a good job and then it's like that's it and if you don't love it really challenging and sometimes takes is going to the hospital across town right. That's sometimes that's the that's the easy At the easy answer but sometimes you gotta reinvent yourself and and and people put themselves in these boxes and learning how to think outside. The box is one of the best skills you can have for sure hundred percent so and you tell me this so when you start working with somebody and they're just They're your stereotypical Fried doctor they're they're burnt out and you start doing these evaluations and there's a process there's a timeframe before you know they find an alternative or maybe maybe it takes monster years. I don't know but what is some advice that you give to somebody. That's acutely burnt out. That can't step away like immediately and can't pivot. You know tomorrow chirc. Yeah i think a lot of people do. I've had i had one client reasonably that just called me. It was like yeah. I just put him. I notice we just started. But she's like no. I can't do it anymore. And that and that's okay But a lotta people need to take the long view right and it helps a lot of people mentally when they know they're working towards something like when you're stuck and you're feeling you're in this position and you're like i can't see any way out i'm stuck there's nothing out This is it right. There's nothing i can do or what i hear. Often i have no other marketable skills which is just garbage But right but you just you're lost and then once you start there's a process you're working on it. It makes you feel a little bit better a little bit more tolerable for some people..
"peter attiyah" Discussed on The Intermittent Fasting Podcast
"Do you think a lot of people do that. were they. Try early because they think it's better than they stop. I think he'd be surprised. At how many people do. They stop intermittent fasting. Well i mean. I think a lot of people stop when things are hard. There are people who try to do what they think is the best thing to do and then they're like why can't do it if i can't do it the right way. I'm just not going to do it. Yeah i think this is actually another example of feel very comfortable and being open to lots of ideas like i try really hard to not be wedded to anyone idea. Even if it works for me. And i thought about that a lot with the diet example and i think the reason it works with the diet example like vegan versus carnivore and stuff like that is that like low carb works really well for me i think carnivore in theory works really well for me. I so desperately want to be vegan in theory that it keeps me like very open to everything. And i think it's the same situation with this like a late night. Eating works well for me so well that said i feel like the ideal approach is not what i'm doing and so i don't have to worry about confirmation bias because i literally think the other literally think might better. I was just thinking about it. Gary tops was talking about an interview with peter attiyah. I think we try so hard to define better. And forget that there is no universal. Like we're assuming there is and you know. I think there's not. Yeah i think there's the better for the individual any individual probably has something that will at that point in time work better for them right. Which is why. I want people to not look for in theories necessarily work on yourself as a study of one like i was saying so anyway it. It's also very interesting. theoretically to to consider. I don't think we should be scared of the science. So i hope i'm not sounding scared of the science. I just don't think there science that confirms here is what is better. I haven't seen it. I haven't seen that science yet. Anything that made me convince that. Oh gosh there right. That is universally better. Well i haven't seen any science showing that late night eating better and i've seen a lot of never said late night. Eating is better either. See i've never defined better like for me actually late night. Eating is not what i do. That's not better for me. I tend to be more late afternoon early evening. 'cause i probably i'm done eating before. You're starting truthfully like. I'm usually done by seven. Pm are you typically down. Before it gets dark. I usually am quite you're doing would probably fit very well into this. Paradigm of melatonin and pancreas receptors. Unless it's the winter now..
"peter attiyah" Discussed on Ben Greenfield Fitness
"I mean even if you're like ketogenic fat whenever you still need i mean like you're still burning appreciable glycogen like like like a lot of people. I just riding your bike for endurance. Bro mike no like if. I got a tackle a hill and i'm pushing five hundred watts on hill or during a race. I've got twenty seconds to pass somebody. Which is the allotted time to do so or at least it was when i when i was racing ironman I'm burning huge amounts of glucose and a- and therefore you need throughput of glucose in addition to key tones and fatty acids now. When i was racing kita genetically i still use about a quarter of the amount of carbohydrate. The my competitors were using because i use more more ketones and amino acids but you still need that glycogen throughput and that amount of eating is just so hard on the gut. Because you're eating that sympathetic state. So when someone's commuting in their car and eating like picture that is the same state as a as a traffic hammering power. Our weather biking down the highway. Ninety degrees like you're creating the same gut permeability scenario or at least something that somewhat synonymous. That's yeah did you. How many years did you do each like. Did you do like fat adopted. I did traditional like gatorade. Sports science institute recommended sixty percent to eighty five percent carbohydrates up to a ninety five percent carbohydrate in on race week to load which i was accustomed to because prior to that it was a bodybuilder and the best way to get super swale on stage is after. You've done your morning wayans during what you're fully cramping is because you're dehydrated and depleted and i'd like way in at one hundred eighty pounds that morning and do my posing and stuff world. Judges are but then typically with bodybuilding. It's in the evening when you do your full on poff with all the people in the audience cheering and Between like the eight. Am pose and the six eight pm. Show i would go and punish waffles potatoes. Ice cream all the carbohydrates. I hadn't been eating for weeks on end. I would gain easily in a day like ten to fifteen pounds of water in glycogen. Wait my muscles will just be popping through. My skin looks super bowl on stage and so i was accustomed when i got the iron man of this this concept of deplete carbs somewhat and by deplete carbs. What i mean is when i was following the standard recommendations like each sixty percent carbohydrate but then get up to like eighty five ninety percent carbohydrate intake by the time that the day of the race was and so i did that for like six or seven years and had like really bad gas and really bad bloating and even though i didn't test for it at the time probably had cbo which i'll ton of endurance athletes especially have who are following those basic carbohydrate recommendations Fluctuating blood glucose levels fluctuating. Like all this led to me writing my first book beyond training. Because i i i was trying to like hack these issues and figure out what was going on. So i got into the world of self quantification testing and I performed really well on carbs. Because there's a saying like sugar as a sometimes drug and it can be super super effective performance enhancing aid. Especially if you've been low carb and then you introduce card equation like like you're on steroids. But the problem of course was all the the metabolic and longevity side effects of that amount of carbohydrate throughput so then i started to experiment with low carbohydrate intake with ketosis i kind of had an extrinsic motivator because dr jeff look asked me to be part of the faster study at university of connecticut. Bitter was part of the two. Yes zach was part of it and i. I was one of the selected ketogenic athletes so for twelve months i followed a strict ketogenic. Ninety percent like fat like like like a traditional which i think for athletes a lot of times. There's a there's a mistake made because we're told ketogenic diet is thirty to forty grams when in fact the research to date shows that endurance athletes stained ketosis at carbohydrate intake of up to three hundred grams per day. But for this particular study i was closer to like probably about fifty maybe sixty grams. I remember that. When i went in for that study the pre the priem run the pre three hour treadmill run meal that they gave me was like two strawberries in like six ounces of heavy cream and wait which for me of like the fat profile was accurate but that was like not enough calories. It was just nothing. So anyways. I i did that. Study and of course during that study i was so racing. Everything in applying a lot of what. I was learning in my training. Using everything from exogenous ketones two amino acids to higher higher intake of electrolytes. Just because your electrolytes get more stripped when you're when you're stripping glaswegian from your body and kinda got to the point where i figured out how to feel really good on that fuelling approach although after the study. I shifted into more of cyclic key. Todic approach with evening carbohydrate repeats. The reason being that a my performance was better. Although with the evening carbohydrate repeats. I was able to be in ketosis. And be burning fatty acids for most of the day briefly. Four out of it by the next morning i was at like three miller. Kato is because i was so fat adopted. And the other reason that i made that modification was because during those twelve months of preparing for jeff volk study my t h went through the roof my Free t three and t four and total. Both plummeted My testosterone went to a state of hypo gone at ism and the a lot of that was. Because i i had an of calories. I wasn't energy restricted. But i did not have enough glucose to go around at all. Did you have enough protein. Yeah i think. I did Not only do. I have a decent amount approach. I was probably at about zero point. Six to zero point eight grams per pound of body weight which i think was an protein anna supplementing pretty heavily with amino acids at the time due to advice that Peter attiyah gave me when i balked during one of my races I i called him on the phone. We had a chat. Because he was kind of experimented with a lot of this stuff at the same time that i was and he had been kind of using branch chain amino acids so i started to use the biosteel branched chain amino acids that he recommended during my training sessions. And because i was training so much. That's a lot of amino acids that you're taking in your training like two hours a day. And then i also met another guy named dr david minkoff. Who was more of a proponent of instead of using the branch chain amino acids luccin in ice loosening valley he instead was getting better results for both health and performance with his clients and his athletes. Doing all nine amino acids like nine essential amino acids. so i started doing that instead and And i got so into the effects like the multitude of effects that the essential amino acids had that that that wound up. Being one of my flagship products. That kion was i was. I was just using them so much. The threat formulate a lotta myself. I'll scratch my own edge figure out how to tweak and refine it and and turn it into a product and and so yeah from a protein standpoint. i think i was getting enough. And i was using a hefty amount of essential amino acids testing then. What was the results of the study. Like what did the faster studies show. I don't really remember the remember. The takeaways the big takeaways were. oh man. This was such an interesting study. Because i showed up to the yukon lab the day prior to the three hour treadmill run which was kind of like the big part of the test. Obviously for endurance. Because this was a study specifically on the facts of the ketogenic diet on endurance performance ultra endurance athletes primarily ultra marathoners ironman.
"peter attiyah" Discussed on The Tim Ferriss Show
"Dot com on twitter at peter at md instagram. Same peter tia md. facebook. Got it peter. Md and then on youtube. Peter attiyah d peter. Welcome back to the show. That was an incredibly comprehensive approach. So we've we've frequent flyer miles on podcasts including on this show and last time we used to format the enjoyed in part because it requires minimal preparation for me and that was going through categories. Excited about changed. Mind about and stupid things or absurd things that you do and i know that you have a number of things that you are excited about so we may spend more time in that category. So why don't you kick us off. You like so. Yes so the nice thing about this. Is i get to prepare a little bit. And i jotted down a few bullet points on each so. I think one of the things. I'm really excited about is a very recent thing in that it's come to market really recently. It's been in the works for about five years and something called liquid biopsy and the reason this is interesting. Is that when you think about this. Sort of major chronic diseases. Which is the diseases bathrobe. So heart disease stroke cancer alzheimer's disease. We don't have a lot of great tools at detecting cancer early so cancer screening is a somewhat controversial topic. Most people probably familiar with things like mammograms colonoscopies and psa testing. There are two or three others that rise to the level of having evidence to suggest that we do them for example pap smears but when it comes to some of the really bad actors cancer. We don't really have great screening tools and so what a liquid biopsy does is it draws a sample of blood and through that tries to predict whether or not you a cancer cells in your body and tries to do so of course when you have very very few of them because the evidence is overwhelming that all things being equal a cancer when caught early at an early stage is imminently more curable than a cancer caught at a later stage and probably the most compelling explanation for that is that the longer a cancer gets to fester in your body. The more chance. It has to develop mutations in the more mutations it generates the more difficult it is to target later on so there are a number of companies. That have been doing this but to me. The most interesting by far is a company called grail because of the method that they've gone about doing this and the method is using something called a cell free dna as opposed to tumor dna. And just for those listening. Grail as in holy grail. The stacked out big as a little side note grail was recently acquired by another company called alumina aluminum. Being the largest company that does dna sequencing and a very interesting note is the ftc. Has sued alumina for antitrust violations in this acquisition which if you understand the science of it and we don't have to get into it in great detail is literally the dumbest thing i've ever heard so that the ftc has done this in my opinion is actually tragedy because it is actually gonna cost lives. It's going to cost tens of thousands of lives in delay if this acquisition does not go through because aluminum has the power to scale this up like no other company would putting that aside for a moment would a cell free dna. Because that's really at the heart of this. What is cell free. Dna cell free cll heighten free. Yeah as indiana. That's not in a cell. So most dna in your body is contained within cells but when a cell breaks down or sometimes even when cells spontaneously red blood cells are actually typically monocytes white blood cells make a. and then spontaneously release it from them. You can capture these small amounts of cell free dna. So if you draw. Somebody's blood whether or not they have cancer or not. They're going to have a certain amount of this cell free. Dna floating around you have signatures on. Dna called methylation 's so a methyl group is just a carbon with three hydrogens on it. It's one of the most basic building blocks of organic chemistry and as dna acquires these signatures so remember. Dna has made up of these four nucleotides when they start binding. These little methods act act. Is they start acquiring these methyl groups that tells a bit of a story and even though there's not a lot of cell free dna the best analogy and of my analysts actually came up with this analogy as it's sort of like looking at meteor fragments that would land in the desert and being able to understand what type of an asteroid they came from so even though the asteroid is enormous and shed big chunks of meteor down to earth and by the time it actually hit the earth just small rocks a chemical analysis of that would give a greater idea where it came from so this type of test can actually detect up to fifty different types of cancers. There are certain ones that it's not very good at detecting such as prostate cancer. Which is not bad. Because we have other tools that are so good at detecting prostate cancer. But when you do this blood test you basically get a readout which says no cancer detected or the following have been detected and it does this with about a fifty percent sensitivity and about a ninety seven to ninety nine percent. Specificity now to explain what that means in context requires a little bit of math. And it's worth going into. So sensitivity is the probability that a cancer is truly there if detected by the test and specificity is the probability that the cancer is not there if not detected by the test so sensitivity speaks to true positives and specificity speaks to true negatives now at i fifty percent sensitivity. Doesn't sound that good but remember. It depends on what we call. The pre-test probability is so pre-test probability says what is the probability that you have cancer before i test you and that's a function of many things. It's a function of the prevalence of that cancer. It's a function of your age. It's a function of other behaviors so for example to people being otherwise identical except one being smoker and one not being a smoker are going to have very different pre-test probabilities. But when you start to think about for example you. What's your pre test probability of having pancreatic cancer. It's quite low. Fortunately even though pancreatic cancer is one of the most lethal cancers out there so in a low probability environment a modest sensitivity of fifty percent and a very high. Specificity produces incredible what we call positive and negative predictive value. So what are those. Things mean so positive predictive value as it sounds means what's the probability that if you get a positive test you truly have cancer and negative predictive value is of course if you have a negative test what's the probability it's negative. These numbers end up being well. North of ninety percent in fact the negative predictive value is about ninety nine point seven percent positive. Predictive value is in the ballpark about ninety seven percent. So these are really exciting tests especially when you pair them with some of the other things that we do in our practice such as relying on a very special type of mri technology that uses something called diffusion weighted imaging that adds sort of a functional dimension to emory quick note. There people can if they really want to deep dive into that subject matter. You have a guest on your podcast. And i've i've listened to. This episode does get quite technical by the room. What is guest in for people who want to want a search roj our a j. And how do you spell. His last name. A. t. t. r. a. a. w. a. l. of course can't spell in head but if you just search roj.
"peter attiyah" Discussed on Texas Titans Podcast
"I want to say that was something like episodes. Maybe nineteen i think but anyway textiles dot blog. You can just scroll down and you can get all the the previous episodes. Mike thornton is one you will want to just kick back and listen in to you. Know most most podcast. It's an interview format but this one again is more of mike telling the story of how he you know. The the the mission that led up to him winning the medal. And i'm very silent throughout the entire Interview because it was mostly him telling that story. So it's once you don't have to if you're if you're driving along you wanna hear great great story real life warriors heroic story. That's a great one. Mike thornton recipient of the congressional medal of honor great episode. Check that one out. The next one. I wanted to feature for you okay. That before there was dr peter. Attiyah who is kind of my go-to guru on Glucose management on insulin management on fasting. On just a life extension. Peter t. if you're if you're listening to this podcast then you probably at least have heard of peter tie and seen his work you know. He's just he's kind of become the just kind of the physician who has really branded himself as someone who understands life extension and glucose and insulin management just and fasting that whole thing which is you know very popular right now and for good reason. I mean i'm a believer. I'm interested faster and a lot of the things that i do are the result of the things i've learned from peter attiyah well before peter and all these other people that were talking about fasting thomas to lower and all those guys there was michael eades. Dr michael who wrote the new york times bestselling book protein power which essentially is a book. That is all about insulin management. And you're going back to peter t. I was just listening to his drive podcast this morning. Actually and he said if you are going to be a healthy person you cannot be as healthy as possible without managing your glucose. You just have to manage your blood sugar levels or you just will not be healthy bottom line. You have to understand insulin resistance in the the role it plays in your body. Well dr michael eades was preaching this way before it was popular. in fact. it's it's kind of a shame. Because dr although he's had wild success you know he's kind of in the not the twilight of his career..
"peter attiyah" Discussed on The Blog of Author Tim Ferriss
"Well obama's and girls. This is tim ferriss. Welcome to another episode of the tim. Ferriss show word is my job. My privilege to attempt to deconstruct world class performers from all different fields. My guest today is a writing icon joyce carol oates juice carroll is the author of novels short story collections poetry volumes plays essays and criticism including the national bestsellers. We were the movie's blonde and a widow story. Among her many honors are the national book. Award the pen. America word the national humanities medal the two thousand and nineteen jerusalem prize in the twenty twenty. Sinoe del duca world prize for literature. Oats is the roger. Berlin distinguished professor of the humanities at princeton university and has been a member of the american academy of arts and letters since one thousand nine hundred seventy eight so that is the approved bio there are a few other things. I would like to say though because i think joyce certainly is prone to understandably understating her prodigious talents she has published and again this is getting into semi non factcheck territory. But i think. I do have most of these right. She's published around sixty novels not to mention all the other formats and genres. She is so prolific that in her wikipedia entry. There's a separate entry just for her bibliography to give you an idea. So joyce carol oates bibliography is its own gigantic page. Her first book was published in nineteen sixty three and i have read at least from two sources that on average she has had two pieces of her work published per year since just let that sink in three of her novels and two short story collections. If i'm getting it right where all finalists for the pulitzer prize and her work is incredible. This is just an endlessly impressive win and sleep. Impressive human endlessly impressive writer and teacher and with all of that preamble please enjoy this wide-ranging conversation with joyce carol oates one very quick note. We had some wi fi connectivity issues for the first ten minutes or so so please bear with us as we work through that and then we were able to change a few things and improve it dramatically so might be a little bit of touching go in the beginning but if you stick with it we'll get to smooth audio pretty soon thereafter. This episode is brought to you by peak t it's p. i. q. u. e. I have had so much. Tia my life. I've been to china. I've lived in china and japan. Don t tours. I drink a lot of tea and ten years plus a physical experimentation and tracking his. Show me many things. Chief among them that gut health is critical to just about everything. And you'll see where t is going to tie into this. It affects immune weight management mental performance. Emotional health you name it. 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Since the summer of two thousand nineteen and i find it to be a super reliable way to make sure that data are secure and encrypted without slowing down my speed whatsoever. You don't even notice that it's on it's one of the best. Vpn on the market and it couldn't be easier to set up their flow. Their sign up. Close actually incredible in anchorage just to check that out. All you need to do is download the express. Vpn app on your computer or smartphone and then use the internet just as you normally. Would you click one button in the express. Vpn app to secure one hundred percent of your network data. One of the many reasons i use. Vpn is that free to access sites all sorts of sites that you use every day. Make their money by tracking your searches or video history and effectively everything. Click on and then they sell this valuable data onto others when you use express. 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"peter attiyah" Discussed on Heartland Newsfeed Radio Network
"I'm steve of it and that was me talking with my mpr. The emmy nominated actress from the big bang theory. We both have. Phd's although neither one of us is really putting them too much. These days after decades doing academic research. I decided a few years back that i needed change. I wanted to think about more practical problems to have some real world impact. So even though i'm not so at home in front of the microphone bullet and i started this podcast. People i mostly admire with the goal of showcasing the ideas of people i admire and also maybe slipping in my own views on the world. Here and there for instance. I'm a firm believer. There should be a lot more quitting. We would all be much better off and it turns out. I'm not alone in that belief. Here's paul romer nobel prize winning economist. The way i've tried to offer advice is by saying there's always something else you can do. So if you reach a roadblock especially if you feel like you're notion of right and wrong is going to require a compromise to get past a roadblock go do something else so i'm gonna call you a quitter and for most people those who would be fighting words. But i think you'll actually be one of the few people who would consider that a compliment. So do you have some insight. Into what makes you such a quitter well. I'd never framed it. The way you in your face description of quitter was a physicist. Before he became an economist he's also worked in silicon valley and was even ever so briefly the chief economist at the world bank a dream job for a lot of people but with the world bank actually tried to quit. I did think it was a waste of time. But i was persuaded that it would be very damaging to the bank of i quit so i figured out. I get myself fired at worked. Do not consider sunk costs in your career. And that is peter attiyah. A boxer turned surgeon. Turned management consultant turned longevity researcher. So i've done a lot of different things and that makes me a master of nothing but life isn't really about necessarily being the master of something in many ways is the advice i give. Everyone is not to be afraid to change. It's just so hard to quit stuff. It might be that. It's the rigidity of thought that is really the biggest problem and the ability to quit or not. Quit becomes a very high watermark to separate those people out. Do you have any advice on knowing when to quit something. We're all familiar with the story of perseverance winning out. I tend to not advocate. That actually and that is nathan myhrvold the former chief technology officer and microsoft and expert on the science. Of course who palmer started out in physics until he ran into a bit of a wall. There's no point in beating your head against a wall after you've given the wall a few good cracks move over to find the software God's sake. I don't mean you should always be a twitter. It's hard to know where that trade off is sort of quit. The life of a typical academic. I started a research center. it's called radical innovation for social change or risk for short. Where a team of us trying to think of ways to make the world better. It's something nathan. Myhrvold has dedicated his life to by starting a big invention firm. And it's not easy. The big frustrations being an inventor. The i just when you can't solve prop on and of course most of your ideas do fail. It takes a lot of integration because you hit on something that really succeeds and this is the second one that you can't get the world's to adopt it having influenced on policies something. We all think that we're in a that's economist. Emily oster a brown university and then it sort of turns out that people don't listen lightly. I hope that they will. Oftentimes an idea isn't enough to win the day and academics have this view that while you have an idea to put it out there and it's not our job to do the implementation that's the job of the people in the field. We sort of lack translational ability. And i think that is something that we certainly don't think very valuable provision rewards creation and publication but not translation. It does a reward. Yeah i can. Certainly empathize with nathan at emily's frustrations in many ways risk is designed to be that kind of intermediary between acedemic ideas and real world application. But even with that focus on the one year anniversary of the center. I sat down to tell you. How many lives we had meaningfully affected. Unfortunately the honest answer was ciro between failed ideas and long legs. getting our occasional good ideas implemented. We had literally nothing to show for hard work. And that's when. I decided to start this podcast. I realized my best avenue for doing good in the world was to bring attention to the brilliant people who in their own different ways were having an impact and the podcast gives the chance to ask those folks the questions. I really want to learn the answers to really curious. If you have any advice advices someone who obviously thinks logically and scientifically about how the minds of people who don't think logically scientifically always say. I'm not trying to change their mind. I'm actually trying to understand how they think and start from there. That's monsef slowly. Who's the chief advisor for operation warp. Speed the us government's eighteen billion dollar effort to fast. Track a covid nineteen vaccine because in order to really convince somebody of something you need to truly exchange views which means understanding why they say something. My advice is a active listening. And be once you have. Some grasp of the problem think of solutions that creates energy and momentum to move forward if you continue describing the problem you stay still. My appetite for debate has diminished more or less along with the realization. That doesn't work all that well. And that is. Sam harris the stanford trained neuroscientist turned philosopher in meditation advocate. Perhaps best known these days as the author of waking up and the founder of the meditation app of the same name is really hard to change. People's mind real time. People tend to change their minds and private. That can count on one hand. The number of times. I've witnessed somebody relinquish fairly core cherished beliefs it's like witnessing a supernova burst or something. I'm surprised you've ever convinced anyone to change a core belief. I can't think of a case. I've ever been that persuasive.
"peter attiyah" Discussed on Heartland Newsfeed Radio Network
"Know. I figured out i get myself fired and it worked. I do not consider sunk costs in your career. And that is peter attiyah. A boxer turned surgeon. Turned management consultant turned longevity researcher. So i've done a lot of different things and that makes me a master of nothing but life isn't really about necessarily being the master of something in many ways the advice i give. Everyone is not to be afraid to change. It's just so hard to quit stuff. It might be that. It's the rigidity of thought that is really the biggest problem and the ability to quit or not. Quit becomes a very high watermark to separate those people out. Do you have any advice on knowing when to quit something. We're all familiar with the story of perseverance winning out. I tend to not advocate. That actually and that is nathan myhrvold the former chief technology officer and microsoft and expert on the science of cooking. Who like paul. Romer started out in physics until he ran into a bit of a wall. There's no point in beating your head against a wall after you've given the wall a few good cracks move over and find the software on the wall. For god's sake. I don't mean you should always be glitter. It's hard to know where that trade off is sort of quit. The life of a typical academic. I started a research center. it's called radical innovation for social change or risk for short. Were team of try to think of ways to make the world better. It's something nathan. Myhrvold has decayed his life to by starting a big invention firm and it's not easy to big frustrations being inventor the i just when you can't solve problem and of course most of your ideas do fail. It takes a lot of interruption before you hit on something that really succeeds. And this is the second one that you can't get the world to adopt it having influenced on policies something. We all think that we're gonna do that. The economist. Emily oster a brown university. And then it sort of austin turns out that people don't listen lightly. I hope that they will. Oftentimes in idea isn't enough to win the day and academics have this view that you have an idea to put it out there and it's not our job to do the implementation that's the job of the people in the field. We sort of black and translational ability. I think that that is something. We certainly don't think best very valuable. The provision rewards creation and publication but not translation. It doesn't reward it. Yeah i can. Certainly empathize with nathan at emily's frustrations in many ways risk is designed to be that kind of intermediary between academic ideas in real world application. But even with that focus on the one year anniversary of the center. I sat down to tell you. How many lives we had meaningfully affected. Unfortunately the honest answer was ciro between failed ideas and long legs. getting our occasional good ideas implemented. We had literally nothing to show for a hard work. And that's when. I decided to start this podcast. I realized my best avenue for doing good in the world was to bring attention to the brilliant people who in their own very different ways. We're having an impact and the podcast gives me the chance to ask those folks. The questions i really wanted to learn the answers to I'm really curious if you have any advice is someone who obviously thinks logically scientifically about how to change the minds of people who don't think logically time. Typically i always say. I'm not trying to change their mind. I'm actually mostly trying to understand how they think and start from there. That's monsef slawi. Who's the chief advisor for operation warp. Speed the us government's eighteen billion dollar to fast track a cove nineteen vaccine because in order to really convince somebody of something unique to truly exchange views which means understanding why they say something. My advice is a active listening and be once. You have some grasp of the problem. Think of solutions that creates energy and momentum to move forward if you continue describing the problem you stay still. My appetite for debate has diminished more or less along with the realization. That it doesn't work all that well and that is sam. Harris the stanford trained neuroscientist turned philosopher in advocate. Perhaps best known. These days is the author of waking up and the founder of the meditation app of the same name. It's really hard to change people's mind. In real time. People tend to change their minds and private can count on one hand the number of times i've witnessed somebody relinquish fairly core cherished beliefs witnessing a supernova burst or something. I'm surprised here. You've ever convinced anyone to change coralie. I can't think of a case. I've ever been that persuasive. Remember educated person before the scientific revolution could very well believe are unicorns. And where will that comets and eclipses are portends to the future at least that now we think of as primitive superstitious magical but they were the conventional understanding of the day. That is steven pinker. The harvard psychologist and linguist but once they science scholarship through this history. Then you can expand the domain of the real two realms where common sense to have a place for it and that revelation that our everyday experience is not a reliable guide to the ultimate nature of reality is a major transition in thought. We don't have this unbounded faith and our own. Observations are on ability to understand things. Paul romer again to get the benefits we want from discovery and collective learning. It's important to have incentives for a wider range of us that get expressed so that when a new bit of information shows up at least gets entered into the conversation rather than having somebody self-censor it because they don't want to be too far outside of the norm for me. One of the learnings is science. Can help humanity. That again is monsef. Sloughing the vaccine researcher who's been running operation. Warp speed designing vaccine is the most stringent demonstration of it because the impact happens on a short period of time that we can see and live it. But if i take global warming where we impact our livelihood but on a much slower pace and science tells us it's going in the wrong direction. We should be listening to it. I have been arguing for years. That what we need on. Climate change is something very much like exercise. We just do with operation warp speed where we take the best scientists in the world and devote them to tackling climate change. There's been very few problems that mankind has put its scientific might towards and not been able to solve so are you willing to volunteer for the job of running exercise when you're finished with this one. If i had expertise. I would definitely consider it but i do think one of the ingredients. That's very important. Particularly when tom lines are fast is what call educated intuition which is really anchored nola gen experience. You don't know the answer to the question but somehow your instincts drive in a particular direction and the other thing. That's really important. And it's unfortunate that it takes a crisis for that to happen. Is the intrinsic alignment of all the players death. Rather than spending whatever percentage of our time arguing for the last five percent of alignment everybody is aligned global.
"peter attiyah" Discussed on STEM-Talk
"At IHS dot us to claim your officials them talk t shirt today are win review was posted by someone who goes by the moniker win Sir Four. The review is titled Brain Candy for Science Junkies. The review reads. I i. Ran Across stem talk when I was checking to see what was up with Dr Peter Attiyah, I ran across the very first podcast by stem talk I immediately subscribed and took a deep dive into the archives a WHO's who of names I could not wait to hear I was suddenly lost to my wife for several days is I binge listened to many if not most of the episodes while doing yard work, this kept me from being accused of antisocial by wife. In made my property look better than ever for those who complained dawn in Ken, our scripting to me it shows preparation and for that I'm grateful. Well, thank you so much for Windsor for anytime we can help them what their spouse family or friends were definitely more than glad to help and you have given our listeners another reason to tune to some talk it can not only improve your brain, but also your yard so I'll have to take that into consideration as well. So that was a great review wasn't again yes it was and we really appreciate all of these wonderful reviews and now unto our interview with Dr Tommy would. Stems. Stem time talk stem talk. Hi Welcome to stem talk I'm your host on Carnegie's and joining us today is Tommy. Would Tommy welcome back to stem talk. All right. Thanks be back and also joining us is Ken. Ford. Hello. Don. Hello Tommy Welcome back. So Tommy since covid nineteen is at the top of everyone's mind right now. I'd like to start by asking you about..
"peter attiyah" Discussed on STEM-Talk
"Make sure we know is what is normal brain lymphatic function, look like so not just Glenfiddich, but also meningioma, and and what does that normally look like in a healthy human at different ages? And then what does it look like over different times a day? So we know that it kind of peaks especially glimpse function. Function as far as we know, probably peaks when we're in deep sleep. So, what does it look like when we're awake when we're in different stages of over the course of the days when we're doing our studies, we know what normal looks like before we start saying that something's actually change individual, so we're trying to work all that out right now with him. He's got some protocols that are running and then we've got. Our protocols are going. GonNa Start Spinning up, so we're really excited. I think this time next year we'll have some answers as far as. These different extreme environmental exposures impact brain lymphatic flow. Done. A voice thought that you should have the titled the Queen of GLIMP-. I'll take it. So. This one's for Ken I. recently heard can give a speech in which among other things he said that we should all strive to be better animal, which seemed rather odd to me. So can you ask him to briefly explain? Listener thinks. That's rather odd. Okay actually what I said is that we shaw strive to be a better in. And to recognize that you are one some when I gave that talking, the audience seemed somewhat surprised uncomfortable at the realization in my characterization of their animal's status. They sort of think of it as Their our animals in their humans and some of us make damn poor animals. I rather like being an animal, and seems far preferable to me then to all the other options available here on earth so I'm good with being an animal and I think we should all be the best animal we can be. And I'll leave it at that as a good thing to aim for so there several activity and sleep trackers that have the form factor of a ring, and during the Peter Attiyah episode Ken Impede, Peter Discuss a ring and another ring that Ken said he was evaluating, so I'm curious to know the outcome of this evaluation. Obviously, this question is for Ken. Okay well I started doing an evaluation, and it was tedious, and so I didn't actually do a formal real sort of semi. Comparison or evaluation, just an informal assessment of the two rings as my user experience would. Be So I've had an error ring for over three years. It's quite popular device, and it does a number of things including heart rate variability activity tracking of all kinds, and of course sleep assessments, other ring to which I referred is marketed by a company called sleep on, and they seem to have two models. One is all caps. Go to sleep with two meaning the numeral to go to sleep and the other go to sleep. Hyphen S E I've not tried the go to sleep S E, but I've used the go to sleep for about eight nine months. Interestingly, unlike luring these two products do not attempt to do anything. Anything, but track sleep, so they're not exercise..
"peter attiyah" Discussed on The Blog of Author Tim Ferriss
"I've got A. I've got a question for you. Tim that now that were a couple of glasses deeper. I think are you. Have you drink two glasses or no? I'm I'm I'm about. Three quarters of the bottle gone so I'd say yes all right so I'm curious like you mentioned a minute ago about you know when you need a break to go and read this book right like like stress kind of thing. What is what's bothering you. Because I think most people like watching this would think you've got it all very successful plenty of money like held out at Tony. Plenty of Bison like what is it like really. What is it like what what's getting under your skin like what's bothering you these days? I yeah well that presupposes that I know what it is. That's bothering me interesting. So I I would say plenty of Iowa journeys to even things out a little bit. Yeah don't do that don't do that. I'm and we. We can talk about that separately. We could talk about that if you like but I was a big gun. I don't I don't recommend that for everyone By actually recommend it for a very very small percentage of people but the the this period of time and this amount of uncertainty and the heightened fear that many people are feeling I think brings to the forefront. Whatever it is that you haven't dealt with Whatever it is you haven't processed and I spent much of my life numbing myself and turning off sensitivities in the last few years of have entailed me turning back on many sensitivities And I think fundamentally am a very sensitive person and that doesn't mean that I'm easily offended. I mean sensitive like an instrument like a jewelry scale versus a body weight skill. And the thing you Mitch. I've noticed that about you. Do to be honest. Like I've known you for Awhile now quite a while let me for than a decade. Yeah and I would say that when I first met you. You're very hardened you know and you softened a lot and you become in a in a more fragile in in that in a way of it's actually a stronger position to be in someone that can actually talk about what's going on and that wasn't the case ten years ago definitely was not the case ten years ago. Yeah I appreciate you saying that. I'm more beautiful thing is. I feel like I've kind of gone through a similar transformation so I it's definitely have you definitely have I've I've become more porous and permeable in so much as I've taken a lot of armor off and armor is helpful in some ways in the sense that it keeps things out also keeps a lot trapped within when you take the armor off the Van. You're exposed to more and So perhaps ten years ago the weight of the world and all these deaths and all the unemployment wouldn't have affected me very much but it's affected me a lot in the last few weeks and So I think there's a a mourning period that I'm going through that has been very emotionally difficult. I'm not worried about me personally. Right like financially. Who the fuck cares I mean I and I and I say that in such a way very deliberately because if I were to try to spin some type of woe is me story it would be so fucking absurd that you Kevin slapped me through the Internet because you and I are both very very fortunate and we've also worked very hard and made some good decisions but we've also had a lot of luck ton of San Tunnel Luck and so so I am in I im- in good position. I'm in a good position to help my family but the stuff that is being brought up is largely things I can't identify. These are things from my past things from my childhood. Probably that are causing a level of anxiety in the face of uncertainty that has no basis in my current security. Some accents like I. I'm not worried about my mortgage payment. I'm not worried about my food but nonetheless I had this high level of anxiety at times less few days have been quite good. I've actually felt pretty good the last few days. But there these moments when I'll go to bed I'm exhausted at the end of every day these days I'm completely spent and I'll go to bed and I'll lay in bed and all of a sudden I'm tired and wired and my mind is just producing a million thoughts second that are all kind of anxiety driven and I don't have an explanation for it I just don't have a clear and that that itself has to drive more anxiety because you like why can't figure out what it is that's bothering me you know. Yeah yeah totally. So I The thing I yeah please I was just GonNa say the sincere sharing all this the thing that worries me. The most is one I think it's hard because I see my sister Not Having the work that she used to and so that's challenging And I see her struggles with her. She's a single mom and she Is trying to raise some teenager now at home and it's challenging working like being a teacher at home now and my mom who is eighty now so those those things are weighing on me but I would say honestly like the thing that scares mouth is not not me getting this or not. Be Getting sick from me. Casino random people our age. Do die from this and it's like it's kind of weird like that like you know it's like you think you're fine and then forty. I'm forty two and I get hit or forty three and I get hit and I'm just like dead right like it is happening so I'm not scared of dying at all. Actually I'm scared of not seeing and being able to talk to my girls when they're going to need it most like through their formative years and I think that is the thing that at my core I just like. I love my girls so much. I wouldn't want to miss out on that and so that it's not the death part. It's the that part so it's hard it's like we all have these things that are kind of like hanging over our heads you know. It's it's difficult. What have you found? Helpful Gosh us. Well have bought a wind definitely helps. I would say no. I'd say helpful is might have to make this a weekly thing. You know honest could be our weekly therapy honestly helpful. First and foremost without a doubt is and this is Mr. Rogers definitely said it best. I mentioned semi news letter like anything. That is human mentionable and anything that has mentionable as manageable and that is so true. If you could just talk about it with your spouse with your friend with anyone that you can try and create a social connection with just like this is what I'm going through just getting off your chest is just like brings you down. Doesn't get you back to where you want to be like perfect and happy and help like stoked and you know but it does bring you down a couple notches and we have to remember to do that every few days just like like where did you get. That quote was Mr Rajon. No I know it's fucking Mister Rogers. But was from the documentary about him or was it from some Hank's garage with Tom. Hanks version which I loved and and I went and did then did a research to actually make sure it was from him and not just like Hollywood and it did come from him so The Tom Hanks movie was phenomenal available for rent on Amazon. Itunes it is. It's a great. It's a great movie. It's it's not tiger king or the techies pretty great. Hey we should talk about this. Let's move into lots on before we get before it gets tire gang. Somebody suggested where they just mentioned how to stop worrying and start living. That's Dale Carnegie Book. That is fucking fantastic. I could not recommend more. It has very literal title as do many Dale Carnegie Books. But how does how to stop worrying and start? Living is Is Actually an exceptional exceptional book. So I would suggest that's us. We got to create a A. We're saving the video so I guess we can do some show notes and stuff all the stuff we talked about and and posted online. Yeah so you were about to bring up. What what we're watching. Yeah what are we watching lately? What are people watching these days? Favorite Tiger King is like my favorite thing right now. Yep So we'll get into that real quick. A Bucci says the people ego conscious maybe underlying Zaidi. That's not accurate. I don't actually fear death which maybe from taking to many second Alec compounds but that's not a it's something else So TVD but Let's see here. Ozark by the way is is eight arc like I have heard multiple people. It's on episode or season three now. If that's correct the Chad is it awesome. People are saying ozark is awesome. Incredible Tiger King was good. I found the animal treatment pressing so I stopped after two episodes. I make I may continue. But that hasn't been my Go-to your but but you told me that. Yeah but but but maybe I haven't past the point of no return with tiger king it is. It is so strange as to be compelling. Yeah I get that. Yeah Dario Watch it with me. I'm watching a Solo said about my IPAD and I'm watching it she will. She will not watching them out one night. She missed the first episode and that she's like I don't want to watch something dumb and Mike ads dumb but it's good. It's like a three person marriage with that one young guy looking like he was fucking. Baz mind was amazing so good and then she definitely fed her husband of the Tigers. It's I mean that seems to be at least the way it's going I wanted to show. Yeah I mean that's pretty crazy Bush thing Formula One. What is Formula One Formula One? I understand what it is in terms of like uterus interviews favorite thing ever yeah racing race card. Is it a documentary? That people are talking about or like. Oh I don't know I. I assume that it's some kind of like sky. Yes F. One on Netflix. I don't get a guys I'm sorry like I. I can appreciate how difficult it is. I can appreciate how the Mercedes team spends like five hundred million a year. You begin appreciate all of that but I don't actually know how to discern the skill from watching these cars go right. Here's used the interesting thing. People are saying that this is so amazing and everyone's saying Formula One F one F one. I if it's documentary like why not watching episode of it. Sounds like you're not into it. Either Watch the documentary. Senna S. E. N. and a it's fucking fantastic. It's so good. It's highly recommended. That people aren't saying that they say in Formula One in the chat. They don't know they don't know they're talking about if they actually follow f. One then they would agree with Peter Attiyah so his favorite driver of all time is written. Senna and the documentary is just fantastic. I highly highly recommend what else besides tiebreaking. I don't watch. I don't watch TV. We don't want a serious we. I like if people really want to know the real me I will tell you the truth..
"peter attiyah" Discussed on Next Question with Katie Couric
"Hey I'm Joe Levy and on the latest episode of inside the studio. I sat down with one of the all-time Great Singer. Songwriters James Taylor. We talked about his new album. Where is music comes from? And how telling his life story through. His songs has helped him. Music saved my life but I was lucky also to survive. I did some very stupid some some years that were just really high risk unnecessarily so in a lot of people around us died. So join me. Joe Editor at large at billboard for this and other in-depth conversations with the biggest artists in music was an on the iheartradio APP apple podcasts. Or wherever you get gassed hi everyone. I'm so happy we were able to get in with Dr Peter Attiyah and he was able to spend a good hour talking to us about this scary pandemic because I think his knowledge his experience and his connections are really unparalleled. So let's get back to that important conversation. Let's say someone goes to the hospital Peter and they have coveted nineteen I know that ventilators and respirators to help with lung capacity. But are there any medicines that these people are getting or are they just going to the hospital and I mean Howard. Our doctors fighting it right now. It's varying by hospital so myself and my team. We have enough friends in hospitals that we're hearing you know we're finding out in this hospital in Boston is using this protocol. This hospital in New York is doing this etc. So right now I would say Katie. It's not standardized but shot racy on. That seems insane to me that it's not that it isn't standard is that it's sort of Kind of a piecemeal approach. We'll the primary approach as you said is supportive care so the single most important thing for a person once they're in the hospital is maintaining sufficient respiration. Because that's the thing that's going to put a person in the hospital. So the the most common thing that people are presenting with his respiratory failure as opposed to say cardiac failure renal failure or other organ failure. So the first second and Third Line of Defense is through oxygen supplemental respiratory care. Hopefully not requiring mechanical ventilation but obviously at some point. That's happening for enough people. That's that's the sort of supportive side of things and I think we're seeing more and more patients being treated with chloroquine and then of course if the doctors treating the patient have reason to believe that. They're now developing secondary infections. Then things like antibiotics are coming on board and they're also if it turns into pneumonia exactly if it's pneumonia that they believe is an actual bacterial pneumonia versus sort of a viral pneumonia for which the antibiotics wouldn't provide any benefit there's also HIV drugs. There's a drug that is a protease inhibitor. That I think is sort of weekly potentially it's still too soon to say but the risk of using it seems relatively low so it's it's also being tested One drug that. I think two three weeks ago we thought might be valuable. Is Looking less valuable as the common anti flu drug called Tamiflu? So I I I think most hospitals are moving away from that now but again It is unfortunately not a fully standardized protocol because even though the CDC will have a recommendation ultimately the physicians are the ones at the bedside that are going to be able to make the decisions. Can Uber Verse this? So let's say someone goes to the hospital. They're having respiratory failure. Can those individuals with you know breathing? Assistance with the ventilator respirator can they then Get the virus. That as you said was sort of taking over the cells and their lungs can they. How do they get that? How do they get it out of their lungs? I know this sounds sort of elementary. But I'm just trying to figure out Is that kind of support enough to a radical. This virus no. It's actually not an elementary question at all. It's very important question what's actually happening is. There's a war going on between the virus and the immune system and the whole purpose of supportive care. Such as ventilation is to buy time for the immune system to win that fight now. It becomes a bit complicated because the immune system in its best effort to win that fight can also cause a lot of damage to the host so you think of it like a war going on in a country. You have the good guys. The bad guys at the risk of oversimplifying it. Well both of those entities when engaging in war caused collateral damage right immunotherapy and cancer at becomes to revved up and that can create all kinds of auto immune issues correct absolutely so the you know the checkpoint inhibitors which you know are probably the most exciting thing in all of Immuno oncology right now Exactly have that. As a side effect which is auto immunity the immune system goes a little too far now in in this type of response to the immune system. It's not so much auto immunity that seeing is the problem but it's the sort of What's called Systemic Inflammatory Response Syndrome or this site a kind storm that is sort of you know wreaking havoc both to kill the viruses. But it's also the thing that can you know 'cause capillary leaking in the lungs that can lead to other things like Dima and it can damage other parts of the body so basically what you're saying is that it's a delicate balance between the immune system which can cause inflammation and damage if it's overly compensating for the virus and sort of keeping the virus in check your in. We use supportive measures like ventilation to basically by time to to augment what the lung needs to do to to create that amount of time and space necessary for the immune system to ultimately win that fight but winning the fight means that the virus has gone winning. The fight means that the number of actual copies of that virus goes down to some insignificant level And you know to contrast that with other things like when you look at the Spanish flu the Nineteen Eighteen. H One n one pandemic. That was kind of a different animal. That was an animal. Where so much of the damage actually came from the hyperactive immune response and then this immune paralysis that followed it that led to these secondary infections so. Y- paradoxically the people that were most vulnerable to that flew where people that had the most robust immune system and therefore the strongest immune response. We're not seeing that here. Which suggests again. It's just a suggestion that Hyperactive immune response is less of a problem than the actual damage the viruses causing to cells. That's fascinating That raises a couple of questions about ventilators and respirators. I don't even know the difference. Maybe you can explain that but There's a real shortage of medical equipment. How serious a problem will it be? If there is a lack of ventilators respirators to by the time these patients need and what is being done about that too. It's a huge problem. Let me answer your first question. So respirators are noninvasive so For example you've probably visited somebody the hospital and you see like a little oxygen masks that they have on or even something called a nasal Kenya where there's a little device that goes under their noses just passively blowing oxygen at them. So you can you can provide a person with supplemental oxygen in that sort of passive manner but when a person becomes really dependent on oxygen. They require something called mechanical ventilation and to do that. You have to undergo a procedure called intimation. Which anybody who's had surgery has has you know. Under general anaesthetic has had that but that's where a tube actually placed into the main airway called the trachea so it's called an Endo tracheal tube when a person is intimated. They also have to be paralyzed and sedated. It's not a comfortable thing you you couldn't be wide awake sitting there intimated So you have to be sedating. The patients and paralyzing them and the reason you have to do that is that their own voluntary muscular movements can't fight the ventilator so you actually have to basically shut them down to let the machine do the breathing and you're absolutely right that these ventilators are very very specific and specialized pieces of medical equipment. And at some point we will run out of them in fact I was just speaking to someone today at a small hospital outside of New York City and they are now they have just used their last ventilator and they are now what's called double venting patients which means using one ventilator to treat to patients which you would normally never do because of the contamination those two patients are now fully sharing all their respiratory pathogens. But of course you know desperate times call for desperate measures and if these patients both have the same virus and they are both suffering from the cove in nineteen disease than we do what we have to do and technically a ventilator can probably be split up to four ways but at some point Soon and it could be within two to three weeks This could become an enormous problem and so can can can. We are manufacturers kind of speeding up the the production of these pieces of equipment as they are but there is still another bottleneck in the one thing that we can't make more of is doctors nurses and respiratory therapists and so these pieces of equipment can't work on their own. You know a doctor is necessary to put.
"peter attiyah" Discussed on Next Question with Katie Couric
"He said do not go to the doctors. Do not you know. Try to seek medical CARE UNLESS IT GETS BAD. I wondered is there an inflection point because I think people are so paranoid every time I cough I get neurotic and and when is that point where you should seek medical care or at least talk to a healthcare provider? Because we don't want to clog the system listeners. I'm sure agree with this but we also don't want to ignore an illness that could worsen if we don't get if we don't get the proper attention that's such an important question and truthfully it's one for which I think. The answer is not entirely clear We probably do need to think a little bit about how to strategize so I would agree with the advice that your colleague and friend gave you. Which is we certainly. Don't want everyone who thinks that they have a little sniffle sneeze or a sore throat to then expose themselves to an infection by going out and seeking medical care especially when we don't have testing readily available yet. That's the important thing to understand is. What is it going to accomplish to go and put yourself in harm's way if we don't even have test yet that's viable or going to offer as much so. I think we have to stratified patients so you know the way we are looking at it in our practice is we're taking the patients who we think are at highest risk. So these are people who are you know? Sort of in their sixties and older people who have existing conditions like high blood pressure or heart disease atrial fibrillation these sorts of things. And we're saying we're going to have a lower threshold for getting them tested or getting them in to see someone if we have any concern you know. My wife yesterday was called by friend of hers who lives in Colorado now and she has a lot of underlying medical conditions. And you know it was really difficult to spend the time on the phone with real estate and triage. What I couldn't fully understand was either panic. Attack or legitimately illness and you know we had to make a call. In the end we saw we decided after an hour she probably did need to go into the emergency room and get checked out. Because I just couldn't be comfortable that this was just anxiety and I and she has so many underlying medical conditions that I was actually concerned that you know. She's the type of person who if infected could very precipitously fall off that proverbial cliff. And what happened You know she There I it's it's still unclear because of course the testing takes days to get back so but now she is at least you know. Her blood pressure normalized. Her oxygen levels are normalized The thing we are most sensitive to is shortness of breath that seems to be. The biggest single predictor of people who do versus do not need medical attention so people who do not develop shortness of breath At any point in time are generally going to recover in what we call a self limited way. I hate to ask you this. Dr. A T F What is how do you know if you have shortness of breath? I know that probably sounds like a dumb question but is there something you can do to figure out. Is it walking upstairs? I mean I get sometimes shortness of breath if I try to run a mile I mean when when can you tell you have that actually? Katibat is not a stupid question at all and we've actually tried to explain that exactly to our patients so I'm glad you asked we think one of the best litmus tests for litmus tests for shortness of breath is air hunger while speaking in long sentences so when someone who could normally rattled off three minutes talking with just the simple breath in between all of a sudden has to take longer pauses to take breaths in between speaking to me that's true shortness of breath. You use an example of walking up a flight of stairs. I think if somebody knows what their normal exercise tolerances when that dramatically decreases so if a person lives in an apartment where they have to go up and down a flight of stairs and normally that poses no risk to them and all of a sudden now they think. Oh my God like I'm really winded. Walking up this flight of stairs that that might also constitute shortness of breath The other thing to keep in mind is shortness of breath by itself. Probably doesn't show up without some other symptoms such as You know a fever. Which is the single most common symptom we see and people who are infected? But of course it's important to understand people can develop fevers for any sort of you know common cold or anything like that so are right absolutely and and so all of this. I think points to something. Which is you know. Do as much as you can by phone right. Call your doctor walk through all of these things and let you let your doctor help you decide if you actually need to take the next step of getting tested which again we're currently in a testing environment. That is not adequate so the CDC guidelines on testing are actually quite stringent compared to what I think they should be due to these limitations so that that does raise the question who should be tested in who shouldn't and Sort of thinking about the common good and not just yourself in these situations but gosh you know we're talking about in some cases life or death Peter and so people I think you know they have this primal survival instinct so In terms of testing you have to rely on your healthcare provider. But they're making some tough decisions in Italy about who who gets medical attention and who doesn't because of the crowded conditions of hospitals etc. I mean it's it really feels like the makings of a of a scifi movie. Yeah the they are making these decisions in Europe already and it's not clear if we're not going to be in the same position in the next two to three weeks As far as testing goes at the time at right this moment. Katie the CDC guidelines are the testing should be reserved for people who are symptomatic. Only now why do I think that that's insufficient I think it if you really want to control the rate of spread you should also be testing people with known exposure even if they ace symptomatic because this virus has such a long latency period. Let's assume that you know you were around. Somebody who then went on to test positive or frankly even went on to be symptomatic in an ideal world. If we had a sufficient number of tests sufficient infrastructure for testing it would actually be important to know that you were negative. Before you know we told you pay. It's you know the fact that you're not symptomatic means you're not a risk in other words the thing that makes this virus so particularly troublesome is that people who have no symptoms can spread the virus and they can use for a long period of time for fourteen days. Right I mean. Isn't that the incubation period? And the fact that some people can be vectors and yet never symptomatic. That makes it really freaky right. Yeah that's the. That's the superpower of this virus. So if you were GONNA like create a list list of all the things that make this virus sort of troubling that that would be superpower is that it has this ability to very subtly get you know get from one person to another usually without that person knowing it but then again. We'll use ebola as a stark contrast right. Why was he bowl and not really a big issue? Once it got into The United States because people were so sick when they got it that there is no ambiguity about whether that person had it and it was only during that period of extreme sickness that they could go on and shed the virus. If in fact people are practicing social distancing now all these cities are closing down. I guess you know. San Francisco is the shelter in place city other cities as well is that. Going to ameliorate or mitigate some of the conditions that will be prime for spreading this virus around or have. We missed that window of opportunity. Peter it will absolutely have an impact. I mean in an ideal circumstance if we had a time machine. I think we would have done this. We would have taken these precautions a month sooner but I'm actually still optimistic and you know we have a team of analysts that are building forecast models reviewing every piece of data that's available an including data that aren't publicly available by you know re- you know speaking with people on the front lines to pressure test assumptions. I. I don't think that it's a foregone conclusion how this ends so it. I can't even sit here and project. How many people are going to be infected in the United States? Although there were lots of estimates and some of them are quite scary. You Know Mark Lips at the Harvard School of Public Health projects that you know more than fifty percent of the US population will ultimately be infected by this and at the mortality rates were seeing those are staggering numbers that that the implication of by the way to put it in some numbers is more people would die from this virus in a year in the next year. Then die of all other things combined and that that's a staggering statistic. Do I think that that is set in stone yet that that is our fate? I don't and I do think that the more aggressively we can socially distance ourselves the more aggressively we can implement testing which will enable this stratification of distancing between people and the more readily available. We can be pressure testing existing drugs to then bring on treatments that can reduce the mortality and morbidity. I think we still have a chance to bend the curve of this thing. We're going to take a break but we'll be right back with more critically. Important information from Dr Peter Attiyah..