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Serious as a ❤️ attack🥺😬
170 Plays1 year ago
Bronny James discussion, thick girl chronicles, and Kim Kardashian has tricked y’all again….🤦🏾♀️
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Transcript
Introduction of Hosts
00:00:17
Speaker
What's up? What's up? What's up? It's another episode of Chocolate with a Side of Medicine. I am one of your lovely hosts, Amy JoMD. I've got with me Dr. Chris. Hey, guys. Dr. No-No. Hey. And Dr. Sunshine is out saving lives tonight, so she will not be with us, but we miss her already. Me too. I know. No sunshine today. No sunshine. I know. Ain't no sunshine when she's gone. When she's gone.
00:00:49
Speaker
Yeah.
Wedding Story: Dress Dilemma
00:00:50
Speaker
What's going on, everybody? Work. Work, work, work, work. Listen, I have, yeah. I think you've been having a good time. And how about people say that I don't work, but I work this week, y'all. How people do your work? Wait, wait, wait. Wait, wait, wait, wait, wait, wait. So I got off.
00:01:16
Speaker
Friday, after working a full day, hopped in the car and drove to Birmingham because I was attending a wedding of a dear friend, get there and because I've been working so hard, I have read the invitation. Only be talking to a friend who was there and was like, girl, I had to quickly buy a black tie dress for this wedding. I almost didn't have it. And I'm like,
00:01:44
Speaker
Black tie? Y'all. It's a good thing you talked to that friend. Listen. Because you would have turned around like, ooh. Like, ooh-wee, yes. What I had was not going to make it. You know, it would have been fine, but I would not have felt good in it because that's not what I would have worn for a black tie. So I was like, dang. So I got up early. Went and got a mani-pedi.
00:02:13
Speaker
And then we went to the mall and let me tell you my husband was in like his best sleep living his best life I think he been waiting for this moment. So we go to sex. We try to find something Y'all I can't find anything like I can find nothing and more importantly
00:02:28
Speaker
And this is what's important, okay? Not sex. Shout out to sex, right? Y'all were great. Everything was cute. But I've been out here in these honeymoon and kicky streets. And when I tell you them zippers was against me, okay? Them zippers was betraying my peace. They was betraying my peace. They were not for me. They were not for me that day. So I found this the cutest, the cutest fit. And I was like, it don't.
00:02:54
Speaker
And so I was like, y'all, we gotta go. So I actually ended up going to another department store and had like 10 dresses.
00:03:04
Speaker
in my hand. Some of them were gorgeous. But, you know, some, they, most of them didn't fit. And I was like, I'm not going, I'm not leaving the department store. I've worked too hard to get down into department store sizes. So I'm not leaving. We're not going, we're not going to the plus size store. Nothing is plus size. Listen, our rocks will name Brian and
00:03:28
Speaker
what and a bunch of other ones so you know I do it but I was like I don't have to first of all I don't have time I do not have time to leave here and when you're tall and thick but not really like plus size thick they fit different yeah so when you go and you try it on
00:03:43
Speaker
you're like, oh, it fits that one area that you're trying to get into. But then all of a sudden, your shoulders and where they say your shoulders are supposed to be are not the same. Or they don't, they're never long enough, right? So even if I make it fit where I want it to fit, it's horrible. I have learned that I'm not that I don't have that body type. So I need to get it from
00:04:06
Speaker
you know, this door. So I got down to like the last one and it fit and I was like, yes. So I was like, listen, I don't care if this dress fits, we're zipping it out and we're keeping it going, okay? So I got my dress, went and bought some shoes, got a little suck them in, a little nice under support wear and took myself to the wedding. So went there, had a good time, y'all. We went out, we kicked it. We had so much fun. Got home, got back to the hotel like 3 a.m., got up at 8, drove to Georgia.
Local Theater & Concert Highlights
00:04:35
Speaker
saw the most amazing, talented young lady. I'm not going to say her name because I do not have her parents' permission, but she played Ariel in The Little Mermaid in a local theater performance. And when I tell you this girl, she gave me chills. Her voice was beautiful. It was absolutely beautiful. If I close my eyes, I would have thought I was listening to a Disney
00:05:01
Speaker
movie. That's how great she sounds. She was so amazing. So um I hope that she goes many places and one day she's on Broadway and I'm like y'all that was the girl I was talking about on the podcast. So let this you know serve as a bookmark that I thought she was absolutely amazing. So we do that. We get done with that. We have dinner. Then we head from Athens back to Atlanta to check into the hotel.
00:05:26
Speaker
We get up the next day. We sleep in just a little bit. We get up the next day. I tried to do a little bit of work. I left my charger in the car that I sent home with my husband. And so I can only work till my laptop died, which was all of 10 minutes. So I had enough time to put in labs. And that was into that. Went to lunch and then headed to Beyonce. And when I tell y'all,
00:05:49
Speaker
Beyonce night number three put on a show. I heard she put on a show night one and two. I wasn't there for night one and two, but our mute for night three. Oh my God. It was amazing. You couldn't hear anything on mute. Like it was the greatest thing because it was like almost a wind of silence blew through. Like you could hear it. It was just like,
00:06:16
Speaker
And then it was the loudest comeback ever. Girl, listen, me and Beyonce, we were great. So then did that. I love how you said me and Beyonce, we were great. I love how you put, we were great. Me and Beyonce, it sounded like you were up on the stage too, dancing and twerking. You were like, we were great. Me and Beyonce did so good at night. Ooh, you should have seen us.
00:06:39
Speaker
Ooh, you should have seen us, we were so good. You know, concert ended about, she performed a good what, two hours and 45 minutes or something like that, something crazy. And Blue came out, by the way, Blue came out. Oh, that's nice.
00:06:54
Speaker
Listen, Blue is like, I don't know what y'all heard. I'm getting better and better every time. Blue was getting it. They were going crazy. She looked so cute. Loved it. But then the concert came to an end. And so I went back to my room, got my suitcase, got in the car, and drove to Columbia. You drove? And went to work. Oh, my God. I did. Oh. So I was like, listen here, people. Y'all don't get these prescriptions.
00:07:20
Speaker
We gotta hear it. You know, once you get moving, you're good. But yeah, I got home about four and I was back in the office, saw a first patient, had a full day. Oh, that is dedication, y'all. I mean, I love my patients too, but I'm not that dedicated. I would have taken the day off. Y'all would have had to figure it out, because I can't. It was insane. It was insane. Still did. What's today, Wednesday?
00:07:47
Speaker
I can't remember, whatever today is. Then I got off and I went out for dinner that night. You said whatever today is. I think some people might be hilarious. She doesn't know what day it is today. Yo. You know, take a nap. Rockstar lifestyle might not make it.
00:08:08
Speaker
It's all right, guys. Don't worry. We've been trained very well through residency. We can do this. We can function and not know the day, but we're not going to get your prescription wrong. We won't trust. Because you're going to call me and I'm going to be too tired to take that phone call, so I'm going to get it right immediately.
00:08:28
Speaker
I can do it. So yes, it was good. It was a good weekend. I don't do those weekends very often, but once I do them, I try to make sure I max them out. It was great.
00:08:40
Speaker
It was absolutely a big city. I mean, Chicago was great, but I knew Atlanta, Houston. How was the other big one? LA probably would have been great to go also see, but I'm not a huge... I'm not the Beyhive. I know most of her songs, but one concert was enough for me. I can't imagine her performing three high energy concerts back to back in one weekend. I don't know how she does that.
00:09:06
Speaker
Me either, because she is moving nonstop. Now she has over the years, right? So if you've seen the first ones, like the early ones and everything where she was bouncing from top to bottom, there are moments in there where she's sitting down a little bit more and stuff like that. But even with that, she is literally
00:09:27
Speaker
jamming up and dancing in the bleachers with the stands with the twins like she was up all over the stage and honestly to this day that was probably my favorite performance by Beyonce and like the Coachella series was absolutely perfect Oh Coachella was great I wish I had that I had that weekend off and it was my birthday weekend I still can't believe you didn't go like that that that sounds like would have been like
00:09:55
Speaker
That ain't stopped us before, we just didn't eat. We ate at the cafeteria. That's why I was like, I don't know about y'all, that's why I was fat. I was like, forget this money, spending on food. I'm about to get these wings from this cafeteria off in this little stipend I got. Oh, that's what I started getting, $15 more for. Yo, I was so fat. Listen, all I ate was chicken wings and what those green leaf teas or whatever that was, ripped off of them.
00:10:18
Speaker
It was, I saw a picture. Yo, yo, it was so funny because you said this all attacks like, y'all not my friends. Y'all don't love me. Y'all not. You were like, y'all let me be fat. And I'm thinking to myself, we were all fat. Like, how are we going to tell you we're all doing the budget every day? I'm like, we were all in the same boat. She was like, no. No, no, no, no, no, no, my friends. I was looking at a picture of me when I was on LND.
00:10:46
Speaker
And them damn scrubs was so tight, if I sneeze, them shits would have busted clear off
Residency Diet Reflections
00:10:50
Speaker
my body. They were so tight. And I'm pretty sure it was a 2X I had on at that time. And I mean, you know how when you get the scrubs fresh out, they still had a little fold creases in them? Wasn't no damn fold creases in mine because they was pulling so tight. Damn thing wasn't even all right. I was like, who did this?
00:11:10
Speaker
Yeah, Lee, I'm so fat. I'm out here talking stuff. I can't believe it. And you know, I'm surprised there ain't no patient calling me fat, because normally when you be in the hospital or talking to them, they'd be like, what about you, doc? What about you? I was like, my goodness, I am the juiciest of Juicy, okay?
00:11:30
Speaker
There, look, I, you, I can't even, I think about that all, every now and then it pops up, you know, like when it's always this time, this time six years ago, this is what you was doing, being fat, in wings.
00:11:45
Speaker
That's what I was doing. Listen, it wasn't our fault because first off, we didn't have much money. They gave us a stipend to the cafeteria and you would think hospital cafeteria would have healthy food. That is not true. They do not. Okay. And then, and then we made friends with the cook and they gave us extra portions.
00:12:07
Speaker
Yo, we took them. Here's what made it extra fat. It was a use it or lose it. Yo, it was a use it or lose it kind of thing. And so I would take my non-hungry fat self down there to get food just in case I might get hungry later. Even though if I might get hungry later, the time was going to flip over by the time the cafeteria opened back up in the morning, I could eat them. But that didn't stop me. So I was like, this is my food.
00:12:38
Speaker
That's why I had to lose like 30-something pounds when I...
00:12:42
Speaker
got to South Carolina because I was like, it's too hot for this kind of fat. Too hot. What? Listen, it was kind of, I guess, maybe halfway third year, we realized, OK, we got to make some changes. We can't do this anymore. It was awesome because we graduated. We had now all this time that we did not have before. And now a little bit. That's also true. We'll spend the money now so you can go to the gym and get the trainer if you wanted to. And that has made
00:13:08
Speaker
They were all the difference. That was kind of the first thing I got. Once I got my first check, I was like, even before I got the check, I was like, I'm going to get money, so let's put that on the credit card. I need a truck.
00:13:22
Speaker
A personal trainer is the best investment I've ever made for my health ever. I love that woman. She's changed my life around. I'm lifting heavy shit every time we go in. I'm bench pressing. My bench press is terrible. But my deadlift and my squats are getting really good. I just feel strong and healthy. And I did not feel like that going through residency, which is kind of weird because you think all doctors would feel
00:13:50
Speaker
healthy, they had a healthy diet and blah, blah, blah. But, you know, we literally do not have time for that. Especially in the program we were in, it was not easy. For sure. But I think the whole thing too is like, yes, personal training costs money. But I just thought to myself, like, I spend money on frivolous stuff.
00:14:10
Speaker
But why not spend money to make me better, right? Make me healthier. Make me be the best person that I could be. Why not invest in myself? That's a great investment, right? Exactly. Of course, if you have the funds to do so, because not everybody can. Do you still use your personal trainer? I don't know. You do.
00:14:38
Speaker
I actually had mine since the start of the pandemic because I wasn't comfortable using our apartment gym since everyone kept getting COVID. Man. So I found a trainer that someone had recommended like I think it was like I'm TikTok or something and went out to the gym they had like no socially distanced spacing and everyone's wearing masks and they had like the the fans going and stuff and I'm like oh okay this is what's up.
00:15:03
Speaker
It was just like a really cool and it's not like a booty gym by any means. It's like those old school gold gyms that you see like you know the you know the squat racks and you know the the metal music they'll play hip-hop every once in a while. But everyone's there they're really friendly and you know we have a set goal that we do for that day and we get through it and it's it's very low stress and I love it and that's the gym I've been going to for the past three years. I'm with my with my trainer so
00:15:34
Speaker
See, I'm an Orange Theory girl, and I love it. I do wish that I spent a couple of days lifting more. So I don't want to give up Orange Theory because I love it. I love seeing my name on the screen. Don't do that. And I like seeing it. So don't do that. You could get one and don't have and just do the personal training for just lifting. That's kind of what I did because I've had my personal trainer for a long time. And then I just kind of felt like I was plateauing. So I kind of try to change it up.
00:16:04
Speaker
So I see my trainer mostly to do lifting, and then I do other things. Dr. Chris, you power lift? I'm not going to say power lift, because nah. But I do bench press.
00:16:18
Speaker
Yeah, I'm not going to be out here and be like, oh, I could do the same thing you do. No, no, no. No, no, no. Anything you can do, I can do better. I'm not going to do that. Honestly, I only picked up powerlifting because my sister was doing it and I always want to beat her at everything. So that's a great motivation.
00:16:35
Speaker
That's a great motivation. No, I'm good. I don't need to power lift like that. I do like lifting, but I don't need to do that. The only reason why I really wanted to, truth be told, really wanted to do it is because some of the girls in the gym that I would see that would lift, I'm like, I like how their bodies are. They got big booties. Because that's what I want, a big booty. I do. I want a big booty.
00:16:56
Speaker
Yeah, and they got good thighs. I'm like, listen, I want that body. And then my trainer will try to tell me, you know, that's their genetics. I'm like, ha, ha, ha, that's funny. But why all of them have it?
00:17:08
Speaker
I want some genetics. I want some genetics. No, that's some squats, those Romanian deadlifts. When we do the lower body day, I literally walk out of that gym, my legs wobbling. I'm like, I don't know if I can drive home after this.
00:17:26
Speaker
It's a very good workout and I've definitely seen a very nice improvement after it. Oh, yeah It's pretty good. I don't do it like that I told I told my trainer he had to chill on that cuz I can't I can't be every day looking like I'm a crippled person like that's not I told me yet to chill out like
00:18:01
Speaker
I got this from, well, thanks to
Kim Kardashian & Full-Body Scans
00:18:04
Speaker
Dr. No-No, she helped me out. I gave you a shout out. So basically, I saw this post about, so Kim Kardashian made this post on IG.
00:18:17
Speaker
Showing that she got a full-body scan for like her preventative health so the scan to like see if To detect early signs of cancer and she was basically saying like this is like a put like something that everyone should do and pretty much promoting it right and she went to this place I call I think it was Preveno or something where she went to get this full-body scan and so
00:18:45
Speaker
The thing is, it's like, okay, she's saying that this is a good thing to do, but I mean, we don't really recommend people doing these scans just to try to detect cancer because, I mean, the thing is, like, doing a scan, you're putting yourself at risk of radiation, okay, which can later
00:19:10
Speaker
end up causing cancer. And also, when you do the scan, it can just potentially cause more issues with false positives. So seeing something, you think it's positive, but it's not. Increase the risk of more invasive procedures. So if we see something, then we're going to want to biopsy or do something. And it could be negative and not anything.
00:19:35
Speaker
And also it causes more stress and anxiety for people because like it's really scary when you're doing scans and you're thinking, oh shoot, I might have cancer. And for instance, even when you're doing your screening for your mammographies, right? A lot of times people go for their screening for breast cancer. And depending on like with the modality of our screening, depending on your breasts, if you have like more dense breast tissue,
00:20:04
Speaker
they can't really see everything then they tell you gotta go for an ultrasound. And then they might see a little thing like they wanna do a biopsy and turns out to be negative. I mean, good that we do it, but at the same time too, it causes a lot of stress and anxiety.
00:20:19
Speaker
So I'm going to play devil's advocate here. So with the full body scans, because this is not anything new. I think it's now becoming more prevalent because obviously Kardashian did it. So now everyone has to do it. But actually, there's a Facebook group where a lot of the physicians are on. And this topic was actually brought up in that Facebook group.
00:20:46
Speaker
And they're saying, oh, you know, full-body MRIs, like, they're going to detect every little thing. You're going to get overworked up, overdiagnosed, and, you know, all this other stuff. But actually, there were a couple of success stories in there about there's one physician who actually did the full-body MRI scan and actually found early-stage pancreatic cancer. So they're starting, and another person on there, they found early-stage ovarian cancer.
00:21:12
Speaker
So there are a couple cancers out there that we do not have screening protocols for yet. And their argument within the group, and this is something obviously that I need to think about more, but for the cancers that we don't have like early screening protocols for yet, but when you catch them, they're almost always caught later. And that's like after you're amenable to like surgery and any type of intervention to get rid of it.
00:21:39
Speaker
there may be a place for these full body scans in the future. I know we did a full podcast on this earlier. I think you can't scan my whole body. And that was before this article came out. But I don't know. I mean, I think there may be a benefit to this, but I would say that we need to have better protocols in place.
00:22:01
Speaker
And then also like the issue of like who's going to follow up with the images or anything that gets caught on the scan is also up to question because right now I think the people if you know you can go out and just buy the MRI body scan and that's on you like you know your insurance may not cover it but then like when you get the results from the radiologists they usually tell you to take that back to your PCP so they can follow up with it and that's
00:22:29
Speaker
that's where issues can kind of come up. So I think that pathway needs to be, what's the word? It needs to be filtered out a little bit more or fixed a little more. But I don't know, I do see some benefit to this in the future, especially for those cancers that we do not have screening protocols for yet. So you know that, and you know,
00:22:55
Speaker
That's going to have, that's such a, I'm losing my words for that. I hear your point, Dr. No, but I'm like, oh my gosh. I hear your point too, but it's, it's going to be, it's going to take a lot of work, right? Because you find, you know, you've got one example of somebody finding early pancreatic cancer, which is, which is great for whoever we found it because pancreas. So Dr. No was absolutely correct.
00:23:21
Speaker
Pancreatic cancer is often found late, or when you do find it, there's not a whole lot you can do about it. In almost all cases, a death sentence. Maybe not an immediate death sentence, but you're like, okay, listen, get your affairs in order because this is what's happening. That is true.
00:23:39
Speaker
Um, but the American college of preventative medicine, I think issued a statement just in this past June, send the scans are likely to result in little benefits of patients causing significant harms and waste of money and healthcare resources. And so my fear, right? My fear is that people are going to get a scan.
00:24:01
Speaker
The skin is gonna show something, that something is gonna be indeterminate and they're gonna say, well, I want surgery to remove XYZ because I'd just rather be safe than sorry. And we know that they say they're safe than sorry, but they don't mean that shit, right?
00:24:19
Speaker
Because if that, rather than safe than sorry, approach causes harm, and there turns out to not be a true significant finding when they do the pathology, then who's responsible? Because I also can see insurance companies, we've all gotten them, where you get that sheet saying, hey, you ordered this test, or you did this lab, and we don't like your code for it. Can you give us new billing code? And you're like, that is the code.
00:24:49
Speaker
Swabbins, when that pops up and they say, oh, in that case, we can't do it. Now, of course, for big procedures like surgeries and imaging and stuff like that, before you do the procedure, most of the time your office has gotten a pre-authorization clearance prior to, but it's very expensive. And the test itself is expensive. It's like $2,500. Yes, it is very expensive. And then my other question- Not covered by insurance. My other question too is, oh, okay, let's say we do the scan, right? And we don't really find anything.
00:25:18
Speaker
So like, how often are we supposed to do these scans? Because this is the other thing too, if I do the scan and I don't see any evidence of cancer, right? You feel good that, oh, everything's good, but guess what? It could develop tomorrow. You do them once every 10 years. I mean, I'm sure the company doesn't care. They are losing their best life. They're like, you can do as many scans as you want. But then you're exposing yourself to more radiation.
00:25:44
Speaker
And so is the, is the Pranuvo scan a full body MRI? No, it's a full body MRI. Full body MRI. Yeah. Cause MRI is going to be the most sensitive for detecting anything. Your CT is going to, you know, have that radiation risk that, so they're going to argue that the full body MRI has no radiation risk, you know, it's typically safer and it gives you more accurate results than a CT usually does. So.
00:26:14
Speaker
I mean, of course, it's going to turn into what everything turned into an America that if you can afford it, by all means, get it. And that's because I'm not going to be stopping people from getting it. Right. Don't let me stop you. So, you know, now just it.
00:26:27
Speaker
Yeah. The next time one of my patients are like, ain't that some full body scan I can get? It is. You got to pay out of pocket, but you can get it. Yeah, but I've had patients come to me and they're like, can I get a PET scan? Are we just doing a PET scan? Oh, absolutely. The radiation on a PET scan? Somebody asked me for a PET scan. It's high. For what? They want to make sure they didn't have cancer.
00:26:51
Speaker
Oh my gosh. You have cancer to determine your stinging. That's what you got to press again for. Right. Oh man, Dr. Chris, you done made me... I lost it. Something. There you said, oh man, I'm so tired. I know, remember we had a conversation with a radiologist about risk of radiation over time. Remember we had that conversation? Yes. I don't remember what he said. I don't know what he said either, but I remember recently, somebody
00:27:20
Speaker
one of my patients had a cancer. And I remember asking them, so are you going to get your pets canned? Because they normally do them. And they said, no, it's not recommended anymore. Like it was the first time you read it for this particular cancer. And I should have written it down. And I do not remember. But there is some cancer out there that the oncologists were like, the recommendation is no longer
00:27:42
Speaker
a PET scan to follow up. And so they were like, nope, they just told me they would see me in a year. And I was like, okay. And you know, I don't remember. I should have wrote it down. Cause I was like, Oh, I was expecting it. I went to the note, like looking for, and they were like, no, I saw it in, I saw it in his note. Like, you know, you know, will not perform PET scan at this time, no longer recommend it. And I was like, Oh, okay. Or maybe it's because there's certain cancers that tend to spread more than others. So I don't know. Or maybe it's when they catch it.
00:28:09
Speaker
But this was one that I, gosh, I feel like I see it all the time. And they had pulled back on it. But anyway, Kim K out here in these streets, she's not the first person. In fairness, this is not the first time I've heard of that there was another celebrity that did it first.
00:28:24
Speaker
and everybody was up in arms about it. So look, if you're trying to get a Perduvo scan, don't call us, call them. It's new. There's one opening up in Chicago. They cost about 2,500, yep. So maybe we'll send Dr. No. They cost about $2,500 to get it done. They typically are not covered by your insurance company. And when you have it done, well,
00:28:57
Speaker
You know, go to your doctor. But let me say this, if you spend $2,500 on a full body scan and you still eat bacon, what are you doing? We just gonna leave it at that. Just think about that.
00:29:19
Speaker
I'm just just when you're when you're sitting in there and you're scanning and you plan on going to get a bacon cheeseburger right after you're done um from um oh what's that place with the burgers dr. no downtown
00:29:37
Speaker
Yes. So if you're like, Oh, when I get out of here, I'm going to go to Ochoa to get my burger with that bacon on it. Then, um, yes. Yeah. Listen, if that's what you're doing, then what are we doing here? Right? You could have saved time and just had the, it just had the burger.
00:30:09
Speaker
is going to be our first ever joint topic. Because we both had ideas for a top and you're like, oh, let's go together. So let's talk about them together. So
Understanding HOCM
00:30:19
Speaker
Amy Jo, do you want to start yours first and I can go on to mine? Yeah. They're going to just go on to each other. He's going to come by. We're talking about the heart in many aspects, right? So particularly we're going to be talking about what we call hokum in these streets, but what is actually in these medicine streets, hypertrophic cardiomyopathy. And so it is something interesting because
00:30:44
Speaker
We have just recently had this stretch of athletes. LeBron James' son has a heart attack while at practice. There was another young guy, high schooler, just going to college to just, you know, die, you know, kind of, you know, drop dead. And there was one more that just happened. And I didn't catch, you know, that that athlete's name. But we have this dream. And this happens all the time. But because this came up, you know, one thing that happens, at least amongst doctors, when a young athlete
00:31:14
Speaker
just suddenly dies or suddenly has a heart attack or suddenly has some kind of condition that causes syncope, we all go hokum. Hokum is hokum. If it was the wrong answer in the test, we're all gonna get it wrong because it's gonna be our first guess, right? So it almost always real like, oh yeah, that's gotta be hokum. So I figured we would talk about it because in this environment, you know,
00:31:42
Speaker
We just, things don't come up. We talk about healthcare in a way that bad things seem to only happen to fluffy people or people who are out of shape or people who have like known disease. And if you look good and if you look healthy and you look like you should be good, then nothing bad can happen to you. And unfortunately,
00:32:02
Speaker
That's not the case. Now, of course, with young people, we expect things to be good, but hey, something's happening. Hypertrophic cardiomyopathy is one of them. So let's talk about it a little bit. What it is, is actually genetic. It's an autosomal dominant disorder. So autosomal dominant means you inherit the genes from your parents and you only need to inherit one of, you know, you can get one of these genes from both parents. Only one of the genes you get needs to be bad.
00:32:30
Speaker
That is essentially what autosomal dominant means, right? So you inherit it from a parent, and all the abnormalities are interesting because it can find just to the heart. So it does not impact anything else but the heart, but it is a big deal. And it's actually more, I didn't know this, it's actually a little bit more common than I thought. So one in 500, somewhere between one in 500 and one in 200 US adults have asymptomatic Holcomb.
00:33:01
Speaker
Um, it's the highest in it. The, the, there's a risk. The problem is it causes sudden death, right? Not, Oh, I got sick. And you know, I found out my heart is bad that most people find out as young adults or a teenager is that they have hokum. And you find out in autopsy because one minute they're good and the next minute they're literally dead. And that's what makes this, you know, really, really scary. It's the most common cause of cardiac death in young people. Mm-hmm.
00:33:31
Speaker
And it occurs in up to like 10% of patients after the diagnosis in childhood. So 10% of people who find out that they have hokum will have a sudden death episode, which is crazy. So people are like, well, what is it? I remember talking to my husband, he was like, what is it? What is it? What is it? And I'm like, it's a structure. So what happens is to simplify it, your heart gets structured in a way where the center is too big.
00:33:55
Speaker
And because the middle part of your heart, that muscle gets so big, it obstructs. It prevents you from getting flow out. And if you can't get flow out, it's fine when you're just sitting around chilling. But when you've got high performance athletes or, you know, people that are doing really high intensity things, you need strong flow out all the time.
00:34:15
Speaker
And because you don't have strong flow out, and more importantly, it gets blocked even worse when you're doing those activities, you essentially cut off blood flow really quickly to the body. And before you can figure it out, you're dead. It's kind of really scary. I thought you were trying to make this one sad.
00:34:38
Speaker
Yo, it is sad. It's tragic. I think it's more tragic. It's sad for the families, right? And so for families that are impacted, they are devastated because I don't think you see it coming, right? You are looking at your kid that, you know, you may see here as her butt cheeks sitting out your refrigerator all the time because they're eating everything, but these kids are eating healthy and they're sleeping and they're running every day and they're doing all the things that
00:35:02
Speaker
you know, if it were my kid that I would remember like, man, I remember those days when I was moving around like that. And so in your mind, you're like, I got this really fit, you know, athletic kid and they're, you know, they're hiding this thing that could be, you know, very deadly. And so yes, that makes it very sad for them. It's completely tragic because it catches everybody off guard.
00:35:22
Speaker
So most people are like, okay, Najun told me all this horror story. How, you know, who should I suspect, right? And so anybody, so anybody with a family history of Hokum, so if you've heard, listen, you can just have heard it, okay? As far as I'm concerned, you don't have to be sure, right? You can just come in and tell me like, I heard that my uncle's granddaddy had told me one time, cousin JoJo, I don't care. Like just tell me and I will figure out how to make it happen.
00:35:50
Speaker
So a family history of hokum is a good reason to get an evaluation for suspicions. A heart murmur and a young kid that you can't figure out what it is, is a good reason to get an evaluation. Or if you get an abnormal EKG for whatever reason, right?
00:36:08
Speaker
You take your kid to the hospital because they said that their stomach was hurting, had chest pain. They do an EKG. And even if it looks a little abnormal, that's always a good reason to go back to your pediatrician, go back to your family med doctor and say, hey, listen, this is what happened. We got this abnormal EKG. What do we do next? Those all good reason to get tested.
00:36:26
Speaker
I was going to say that a lot of times, you know, especially when you bring your kids to the doctor and they have to do sports physicals and we got to ask all these questions. And I think it's really important to know your family history because a lot of the questions, especially in the sports physicals that we ask is, do you have a family member that died suddenly out of just nowhere, just drop dead? And if you say yes, that makes us think, okay,
00:36:54
Speaker
Is there hokum involved? So then we're going to do more things or ask further questions to see if we can prevent or do any KGs to see if we see any abnormalities, right? So it's, I don't think I could stress this enough how it's important to really know your family history. So it can, it can help us to maybe try to prevent certain things from happening.
00:37:17
Speaker
Like we are giving you permission to be nosy, like ask your mom, ask your grandma, your aunties, uncles, whoever, um, to get a good sense of what has happened in, you know, family members that distant, usually immediate is what we, um, is what we ask more about. But any, any history of hokum within the family will, will put you at risk of, of having it. Um, if we do not see those signs earlier, so please ask those questions.
00:37:45
Speaker
Yeah. Cause like, if we know these things that we can, there's actually genetic testing that can be done so we can find out if you do have that particular gene. Yeah. Now the family history is important. Parents, please, I know your teenagers, they can drive and they can do all this kind of stuff and we're happy to see them, but please send them if you send them by themselves with this information. Mm-hmm.
00:38:14
Speaker
Cause listen, y'all 16 and 17, 18 year olds will be rolling up and they don't know nothing. Nothing, nothing. I don't know. I don't know. I don't know. Momma just told me to come. I don't know. I just need this paper science. I can play sports and you're like, okay, do you know anything? Like if you, if you, it's fine if you come, there are portions of, of, of any like well child exam or sports physical that I asked parents to come out, but we really would appreciate it if you came because they'd be messing up the history.
00:38:43
Speaker
I messed up the history. And even if any of you don't, even you can't, most, most, most hokum diagnoses happen incidentally.
00:38:57
Speaker
So they either get an abnormal echo or we hear a heart murmur. So, you know, we're always gonna listen to your kiddo's heart. So that part you do not have to worry about. We're gonna listen to it and we're going to, you know, figure out, you know, what we need to do next. So listening is half the battle. So yeah. So can I- Date with the- Yeah. I'm sorry, with the heart murmur part, just cause people may not know.
00:39:23
Speaker
So a heart murmur is like an abnormal sound that's created by something within your heart. So your heart has four different valves. And also we talked about the structure of the inner wall of the heart. So if any of these parts or components of your heart is abnormal, then that will pop up in our stethoscope.
00:39:45
Speaker
as like a funny sounding heart sound. So if you hear a saying, oh, we hear an S3 or a whole systolic murmur or diastolic murmur best heard at the apex, those are all like information to us and your medical team on where we're best hearing this murmur or this heart sound. And that can actually tell you which valve or which part of your heart is the abnormal component of it.
00:40:12
Speaker
Your doctor should always be doing listening to those different parts of your heart. And if you hear those things or you see those things like on your medical history, like, oh, I have an S3 and a hollow systolic, you're asking, what is that? Those are all just funny ways that we describe the different heart sounds on your exam.
00:40:29
Speaker
Another reason why it's important to know, so there were some things, so I'd put this practice guideline management off of AAFP site, and also looked at the American College of Cardiology, the pediatric unit, just to kind of see what they were talking about it. And they said something, I don't know, I realized it was this complex, like, apparently there are like eight genes that are associated with hokum. So,
00:40:56
Speaker
the genetic variation is found in like 30 to 60% of patients. They said only 30 to 60%, but the fact that you can have eight genes that can come together to do it means that, you know, you also may even end up getting like genetic counseling and stuff like that. So all hokum is not identical. So some of it, you know, can be from a completely different gene makeup. So you always want to, you know, make sure that you are
00:41:23
Speaker
you know, checking that. So you make sure you know that. And then also the reason why we are saying that the EKG and the echocardiogram are, you know, a really good tool is that 95% of hokum cases have an abnormal EKG. Now where this matters for adults is that 50% of hokum cases will develop AFib.
00:41:51
Speaker
Mm-hmm. So even if you know and and and lots of people do so for for children who transition into adults who still are gonna have hokum it is important to keep up with that and because Half of you half of them will have proximal Proxis mole atrial fibrillation which means that you're gonna have abnormal rhythm and
00:42:17
Speaker
And the problem with having this particular abnormal rhythm is that the heart jiggles sometimes and doesn't squeeze. And we don't like things in this case that jiggle, jiggle when it comes to heart. Okay. We need you to move because if you're not moving your blood, then your blood is prone for clotting. And if you've got clottable blood, then you're at increased risk of heart attacks and strokes and all these things. And so this is what makes this, you know,
00:42:38
Speaker
a little bit more complicated because I feel like we've always even if I think about even as physicians in medical school and residency we kind of talked about hokum as a kid thing right oh my god kid gets hokum and plays basketball and dies but every kid that gets hokum does not play basketball and die
00:42:56
Speaker
they become adults that have hokum. And it feels to me, y'all could tell me if I'm wrong, it feels to me like we just like, well, if you're an adult and you make it, all right, cool, you survived. And then you start doing your research and you're like, wait a minute, there's still things to be concerned about. So it's important to say that because it always felt like to me, we talked about it like, if you get to adulthood, praise the Lord, now you've been healed. And I'm like, oh, that's not it.
00:43:21
Speaker
Yeah, it's hard to because a lot of times like when we could catch it, it's when you're like, doing some strenuous kind of activity, if you're not necessarily doing it, you probably like you said, go through it and
00:43:37
Speaker
don't really present or show something, but then it is a thing. It's a problem. I wonder how many kids see it now. As an adult though, you kind of, I mean the cases that we've seen, usually when you're coming in, you're coming in for something like completely that seems unrelated. Like they're coming in, like they feel more short of breath when they're walking.
00:43:57
Speaker
you know, down a couple steps or up a couple steps, sorry. They're getting like these honey, funny heart rhythms in their chest, feeling dizzy. And sometimes they may just pass out from doing like, you know, minimal stuff.
HOCM in Adults
00:44:10
Speaker
Like, oh, I was taking the groceries out the car. And then next thing I know, I woke up on the floor. So that's that in itself, you know, necessitates a different type of workup. And then that's when you see, oh, crap, your heart muscle is huge.
00:44:25
Speaker
How do you go about this? So usually they're coming in and the complications with hokum is that you can get heart failure because like we said, you know, your muscle, your heart is a giant muscle.
00:44:40
Speaker
And if your heart is not pumping properly, a lot of that fluid gets backed up into your lungs and you can see the swelling on your legs and that, you know, you're coming in with heart failure, which is another issue altogether. So in the adults that we usually see, if they do have hokum and they're coming into the hospital, it's usually from the complications of long-standing hokum that have not been seen until now.
00:45:05
Speaker
Yeah. Now the one thing we should say is that, you know, everything isn't hokum. Um, even though I, I know, I know somebody's gonna rewind and be like, uh, you just said that when somebody dropped in, you'd be like hokum. I did say it. It's always my guess. It's always my guess. It's going to continue to be my guess, but it's always my first guess. But there's other things. Right. There's other things. And so it's important to, if you, if you, you know,
00:45:31
Speaker
you know you look around and you say hey has anybody in the family ever had hokum and everybody says no i don't think so you're like okay where i'm good will know you should still investigated right so i'm surprised how many people i'll tell my they have a murmur and i want them to get a
00:45:45
Speaker
echo and i see you next time like yeah i ain't get it yet and i'm like what are you doing like get the echo so we can like see what's going on so there's other differentials right so you can you could have hypertensive cardiomyopathy so uncontrolled blood pressure can also make a big beefy juicy heart
00:46:04
Speaker
And big, beefy, juicy hearts are not the kind of muscle you want in your heart, right? It might be nice for butt cheeks and arms, but it is no good for hearts, right? So the heart needs to be a lean muscle. It can be...
00:46:21
Speaker
amyloidosis. Now I didn't know this one. So it can also be amyloidosis. It can be caused by like NF1 neurofibromatosis type one can have some can have similar issues. That's crazy. Yeah, it was you will almost never see this now. But like we definitely had a case of both of those on our service. I think
00:46:45
Speaker
No, there were one right after the other. I'm like, what is going on? I think you had a patient who had amyloidosis who was in heart failure. That one is really hard to treat. She went into cardiac arrest and passed away, but I think they rounded up with that ejection fraction because there ain't no way. There's no way, but yeah, it's pretty bad.
00:47:11
Speaker
Yeah, aortic valve, abnormalities can also remodel the left ventricle, because that really is the one that gets impacted the most. So just trying to simplify it before we throw a bunch of hard stuff at y'all. I know it's been a long time, so we try not to use all this terminology. So to simplify it, you feel the right, you empty the left in the heart.
00:47:33
Speaker
It is a very simplification. Please, no doctor, no cardiologist call me. I know, but you're feeling the right, you empty out the left. And so anything that's gonna make that left side big and juicy and beefy means that ain't a whole lot to give to the body to feed it. So that's how the aortic valvular abnormality can do it. But there's also like glycogen and lysosomal storage disease. God, I hadn't talked about those since...
00:48:00
Speaker
You know, board days, but yeah, they can mimic, they can mimic Hocum, you know, other metabolic derangements, neurologic deficits, all these things. And so if any of this is coming up and you've got a kiddo and you're like, well, we have some, you know, component of that, then that also can be a reason to have them, you know,
00:48:25
Speaker
evaluated, right? For me personally, for kiddos, I have a really low threshold of echocardiograms. I don't know how many EKGs I do. When you start reading up on stuff like this, it makes you wanna do more. But echos, I'm like, oh, let's get echo. Oh, you had a little chest pain? Let's get echo. I'm not messing with no kid's heart. I'm like, echo now. Let's do it right now. Let's see it. Let's look at it. Let's make sure we're not missing anything. But I may start throwing
00:48:55
Speaker
some EKGs in there too, if they're complaining. The EKGs would be just easy to, you know, if your clinic has that capability to do it, then just like getting a quick one in the clinic and then, you know, being able to have like a baseline for before the kid goes for like, you know, the, not the confirmatory testing, but like, you know, the fulfill your suspicions of, oh, this is probably HOCO, let me get the echo. You know, sometimes do they need, they may need a Holter monitor for like a ambulatory EKG monitoring.
00:49:24
Speaker
which some primary care clinics will set up, but usually if it gets to that point, then you're probably seeing a cardiologist who's going to interpret the result.
00:49:32
Speaker
Yeah, I send the peas cars. They're so good. They're so fast. When you put referrals in for peas cars, they're like, thank you, and we'll see them tomorrow. They are in there at the end of the week. Oh, yeah. Oh, yeah. They don't mess around. Listen, I'm with Amy Jo. I'm like that too. I'm like, let's do all the things. You got a little chest pain? Even if it might be muscular, I don't care. We doing something because... Yeah.
00:49:58
Speaker
I'm doing both. I'm doing the EKG and the echo. You know, I guess I don't do as many EKGs. I feel like I don't do as many EKGs on the kids as I think. I know I order echoes, right? Because I'm always like, we need to, in my mind, I'm like, I want to see your heart. Like, I want to see the structure of it. Even if this EKG looks normal, I want to see the structure of your heart. And I'm sending you to Pete's Card.
00:50:23
Speaker
And I know that they're going to end up doing EKG too. So I feel like I'm ordering stuff that they have in there. A lot of times I do the EKG just for a baseline because I know when they see the cardiologist, they're going to repeat it anyway.
00:50:37
Speaker
So it's always good because when you're coming in to the, you know, just another clinic or even to the hospital, like I always look at past EKGs that you may have gotten in order to compare like, Oh, is this a new left bundle branch block? Is this AFib new?
00:50:54
Speaker
And that really helps when you have previous EKGs to compare it to. So EKG is like the, I'm speaking out my butt here, but maybe like the most low cost, like low cost diagnostic material that we have available to us in the clinic. You can get it real quick. It takes maybe a minute.
00:51:12
Speaker
to get a good reading and then you have it in your system and it will follow you almost anywhere you go, like within your health system. And that, we use that as like a comparison to other EKGs who may get along the line. So, you know, management, right? Because everybody doesn't die, okay? I know we're making it sound like everybody dies. Everybody doesn't die.
00:51:39
Speaker
Um, the, the, the deaths are tragic because they're sudden, but most people can live with hokum, but it does require a really sensitive, um, time window and a specialized management. So most people need to go to centers that specialize in hokum care, right? So they're, they're going to have, um,
00:52:02
Speaker
you know, just more access to higher end tests, you know, a little bit quickly. And, you know, we want to make sure all that stuff is going well. So if you are diagnosed with, sorry.
00:52:17
Speaker
That's what was happening on my computer. If you're diagnosed with hokum, they're probably going to get you to a specialized cardiologist that's going to really take over the care, really leaves the primary care hand at that point, and you are seen by a specialist. You're probably going to be put on medicines like calcium channel, I mean beta blockers or calcium channel blockers, things to control,
00:52:42
Speaker
blood pressure, heart rate, but you're also probably gonna get a implantable defibrillary.
00:52:53
Speaker
defibrillator um implantable cardiac defibrillator to reduce the risk of sudden cardiac death so I think you know with some of these technologies we are seeing less cases but you got to catch them before they have an event also this is the reason why so many like defibrillators are now in schools and stuff like that because you needed to have access to them and so you know there used to be a time where you didn't think
00:53:17
Speaker
high schools needed defibrillators for young people. But now you can find one in just about every gym. But you'll get an implantable one, which decreases the risk. And so all that stuff will be a shared decision-making plan between you, the cardiologist, your teenager.
00:53:36
Speaker
So having a defibrillator, like what Amy Jo said, they're literally available almost anywhere you go. The key issue though is finding people that know how to use it. So it is extremely simple. If you guys have any time in your day, I'd recommend you take a BLS course offered by many American Heart Association places in your area. Because honestly,
00:54:04
Speaker
key survival for people for pre-hospital interventions. So if someone goes down and cardiac arrest, you know, or whatever they're down, they're not breathing, don't have a pulse, you can immediately start chest compressions. And if they have a shockable rhythm, so that's the funny heart rhythm that can lead people into
00:54:24
Speaker
um, uh, a cardiac arrest. And we're not talking about flat line. That's something completely different. You actually don't shock that rhythm. They do it on TV shows all the time. You don't shock that. You just do CPR, please. Just CPR. Um, but if you see that shockable rhythm, then you can use the AED device to shock them. And that can actually get them out of that rhythm and into a cardiac center where they can get the interventions that they need. So honestly, if you have that certification on you,
00:54:51
Speaker
And you know how to use the AED, you can literally save a life. And I stress that to anyone that's come in for that, because it's so extremely helpful. I think I need to register for ACLS course. I'm super sad about that. I mean, I'm not super sad to be certified, but now that we're talking about that, I just realized that you haven't done it in a while. Well, all we really need in a clinic is a BLS.
00:55:21
Speaker
Yeah, but don't listen. Don't listen. Dr. Chris at any point in time and call you impatient. And if you impatient, you need ACLS. Yes. I know that. But what I'm saying is in the Clint, they don't necessarily require that you have to take the ACLS. That's true. But yes, I do it, but it's not required.
00:55:45
Speaker
But you need to know BLS because when you're doing the AED, like you were talking about, the machine literally kind of tells you what to do.
00:55:56
Speaker
Yeah, like I know someone posted in one of the Facebook groups that they were trying to put one in their their church. And someone had a cardiac event, but no one knew how to use the AD device. So they're, they're trying to set up someone to come in and like teach them how to use it, which I think is actually extremely beneficial, but
00:56:17
Speaker
Like I have to have them because I work in a hospital, but even if I didn't, I would still recommend that it's a good skill to have anyway. It's a good skill to have because you never know. Right. And you don't want to be in a position if you're in a position where you can help somebody. It's great. It's also, it's horrible feeling that something's happened and you feel helpless and you can't do it. Now I know it makes it sound like we're saying that these people can never exercise again. It's actually not true. So I do want to put that out there. So.
00:56:44
Speaker
The safety of exercise, this was according to the American Academy of Cardiologists. And so the ACC, the AHA, everybody agreed with this, that moderate intensity is safe and recommended for people with stable hokum. So you get a really decent, we call it burden,
00:57:10
Speaker
Burden of, you know, arrhythmias, you know, so the risk is about this is about, you know, with the standard population when it's moderate intensity. So we don't want people to just kind of sit down and say, well, that's it. I can't do anything. But we do want people to have moderate intensity.
00:57:28
Speaker
So modern intensity is safe and recommended so your your burden on the heart can be can be okay if your if your hokum is stable. If you're going to participate in high-intensity sports the answer that unfortunately is probably you cannot.
00:57:47
Speaker
You got to come you got to you got to you can be in a sports enthusiasts, but you cannot be sports participant in that case so high intensity athletics cannot you know be a thing. And so, there's a reason why when you know.
00:58:02
Speaker
Uh, Bronnie went down. I was like, Oh no, this man's going to never play again. So, um, I can already see some of these questions coming in, but, um, again, I'm playing devil's advocate here. So now the issue with the Mar Hamlin is going to pop up and people are thinking that he may have had hokum, but they never actually released what he had, but like the consensus from.
00:58:26
Speaker
Mostly, most cardiologists and everything on our group was that he actually had a condition where if you have really strong blunt force trauma to the chest, that can actually be enough to stop your heart, which we call commotional cordis.
00:58:42
Speaker
Um, so right now the consensus is that he did not have hokum. Um, but like that event where the football or the tackle, the tackle was it, um, that actually was strong enough to stop his heart. That is something completely, completely different. Um, but if y'all have questions about it, send them in anyway, cause our mailbox was dry. Yeah.
00:59:06
Speaker
So yes, there's exercising in your future. Know if you are a high-performance athlete, it doesn't look like that anymore. Yes, you should be evaluated sooner rather than later. And we still push healthy lifestyle, so healthy eating and all these things. There are some medications out there. It helps some people. It does not help all people. And you go from there. So if you were asking me for the key points, I would say,
00:59:36
Speaker
if you think you have anything in your family history that you're experiencing or that you are just concerned about, an evaluation with an EKG, an echocardiogram. And we'll even do prolonged cardiac monitoring, right? So the reason why we send people to like Peds cardiology is like what Dr. Noah was saying, we'll put you on a Holter monitor to kind of see what that looks like as you go from your day to day. So right, so that needs to happen.
01:00:01
Speaker
If your EKG is abnormal, if you were in the hospital and you're like, well, I don't know what they said, but I do remember that they said it was abnormal. But that's not what I was there for. They probably said, alone in the lines, please make sure you follow up with your primary care doctor. Follow up, right? So if you've got an abnormal EKG and you are a young person, follow up. If you're an old person, follow up. But if you're a young person, for real, follow up. Do not go to practice. Follow up. Because I'm a guy for practice.
01:00:28
Speaker
Implantable cardiac defibrillators can reduce the risk of cardiac death and moderate intensity exercise is safe for patients with stable hokum. So you can still have a relatively normal life. You're just not about to be playing Sunday nights on the NFL. And that's okay too, because you can still have a fabulous life.
01:00:52
Speaker
Maybe you just own the NFL. How about that? That sounds very fabulous, actually. Okay. I'd rather do that. Trust me, all this hard work is ghetto here. Do not recommend. Oh, you know what I was going to say? Because y'all know I'm always down for the chocolate baby's pregnancy.
01:01:17
Speaker
Pregnancy is generally safe when the hokum is stable.
Pregnancy and HOCM
01:01:24
Speaker
About a quarter of patients are going to have some symptoms, but sudden death during pregnancy and delivery is exceedingly rare. Beta blockers are considered safe in pregnancy, so you'll probably end up on some libetalol, and you'll probably have some cardiac monitoring.
01:01:46
Speaker
But just as an example that there is life after diagnosis, you can exercise, you can go on to have pretty limited restrictions and you can still grow your family, get pregnant, have babies with close monitoring because there is not a contraindication. And please pay attention to your symptoms. If you're feeling like your heart's fluttering, chest pain, something, anything abnormal after exercise that you don't normally feel, talk to your doctor.
01:02:27
Speaker
Yeah We got some buttons on our website, you know, we got a the spill account and the threads We got all these DMS that are remaining empty. So please send us your questions
01:02:41
Speaker
Send them to us, please and thank you. What's our question today?
Natural Menopause Management
01:02:45
Speaker
Okay, so hello ladies. Can you give any natural lifestyle changes that would be great for managing menopausal symptoms? This is, this is seem to come up. I mean, I'm in a menopause question for you. Like, I feel like it always travels in packs. And right now we're getting a lot of menopause in my office. I guess it depends on your symptoms.
01:03:08
Speaker
I think, is it that the black, black kosh? What's that? Black kohosh. They say they're supposed to help. Black kohosh tends to help. With hot flashes, they say. They also say exercise, which is strange because it's like to exercise is a little more hot than exercise. But like decreasing your weight and all of that is supposed to help.
01:03:33
Speaker
But you know, well, what happens is, is that a lot of people come in and they're saying, you know, I am finding it very hard to lose weight. Yeah. And what they really mean is that, you know, five years ago, if I got on my JJ smoothie challenge and I did my smoothies for 10 days, that would be a guarantee 15 pounds or guarantee 20 pounds. And I'm feeling some weight increase. And I did that same thing this time and I lost two.
01:04:03
Speaker
Right. And they're like, something must be wrong. And I'm like, nope, there is nothing wrong. It is not your imagination. It is, you know, it is for real. So they do say, you know, avoid triggers. And so triggers tend to be, you know, sometimes it's stress for some people, you know, really hard environments, you know, those things you avoid. Yes, the black cohosh.
01:04:31
Speaker
There, oh, there, what was it? It's, what's the word? Increasing your phytoestrogens. So yes, so like tempeh, flax seeds, sesame seeds, beans, soybeans, tofu, it find it in the non-processed version, right? Think more like the kind that gets consumed in
01:05:01
Speaker
Asian markets, not in American markets. It's supposed to help.
01:05:11
Speaker
Yes, so like soybeans, soy milk, tofu, tempeh, flax seeds, sesame seeds, some beans are thought to also improve it, drinking more water, eliminating your processed foods. I know y'all think we say this for everything, but there is some association between highly refined carbohydrates and sugars kind of spike and drop your insulin levels.
01:05:40
Speaker
which tend to make mood fluctuations worse, tend to make hot flashes worse, and tend to exacerbate existing meals. They also say making sure you're eating a protein. And then, I don't know, I think there was another one. I can't remember what supplement it is. If I find one, red clover. Red clover.
01:06:02
Speaker
So red clover is also supposed to be one that tends to help. And so those are all lit. I mean, I've heard all kinds of things, probiotics, prebiotics, you know, to be taken, DHEA, KAVA, you know, you name it, I've heard, you know, all those things to use. And so I would recommend trying some of those. And prayers out to, I know I'm out of public symptoms, I get it. I know, I'm not looking forward to it. I can stay on this side as long as I can.
01:06:33
Speaker
Listen, I already, I already said I'm going to do the best I can to stay healthy so I can get on hormone replacement. I know, right. Give me some estrogen. That's it. I'm just, I'm just going to take it. We're going to figure it out. That's me. That's fair. I'm down. All right. I'm down. So y'all. Well, listen, Dr. Nell, tell the people they can find us. Like I said earlier, be sure to follow us on, you know, we keep adding social media sites at this point.
01:07:00
Speaker
We have Facebook, Twitter, Instagram, threads, spill. Our handle is the same. It's at thechocolatemds. Please feel free to send us questions via our website, which is www.thechocolatemds.com. And also send us questions to our Gmail, which is, as you guessed it, thechocolatemds at gmail.com. Please send us those questions, general advice, well wishes, whatever, and we'll be sure to feature them on our next show.
01:07:29
Speaker
All right, y'all. Have a good night. Take care.