Become a Creator today!Start creating today - Share your story with the world!
Start for free
00:00:00
00:00:01
SUNSHINE IS BACK!!! ☀️☀️☀️
128 Plays7 months ago
Dr. Sunshine has returned to the podcast after having a beautiful baby boy! We discuss babies, Beyoncé, and Blood pressure. We're back in action!
Recommended
Transcript
Meet the Hosts
00:00:17
Speaker
Welcome to a new episode of chocolate with a side of medicine. So finally we got the four, the, I was going to say trio, but that's definitely three, the quartet, the quartet. We are not DC three up in here. We are a full Destiny child. I don't know what you're talking about.
00:00:39
Speaker
But you know what though? Those harmonies with that quartet of Destiny's Child top-notch, top-notch harmonies. This is true. I don't know that for a Destiny's Child member, but she made the quartet. What? Latavia and Latoya. Girl, what? You know you were supposed to keep that to yourself. Those are thoughts that you keep to yourself. I know Latoya. I didn't know the other one.
00:01:01
Speaker
Those are your self because you're talking to people who love you. All right, y'all. So as you heard, Dr. Sunshine is back.
Motherhood Challenges
00:01:14
Speaker
Dr. Sunshine in the building. Hello. Hello. All right, we got Amy Jo MD. What's up, y'all?
00:01:27
Speaker
And we got Dr. Chris. Hey, guys. Y'all, we should have put a song for you when you came back out. Welcome back. Welcome back. Welcome back. That's what we should have done. What'd you know?
00:01:42
Speaker
In my head, I have a song that represents me and my essence. And if I was on a TV show, it would be the song I walk out to. It'd be like Janelle Monae, Janelle Monae, Electric Lady. Of course. Yes. Good ones. Yes. I can see that. That's just like, it just exudes all of the things. But yeah, it feels good to be back. I miss y'all. I was just telling them when we were offline.
00:02:07
Speaker
that I feel like I don't know what's going on in anybody's life. I feel like I've just been in the whirlwind of just, you know, baby life and things. Motherhood's been interesting. They didn't ask me about it, so I won't... I was just going to say, how's Motherhood? I will say, didn't nobody ask me, so I won't volunteer for information, but...
00:02:25
Speaker
At some point, I guess we could have a podcast just about pregnancy. I had a C-section, birth, motherhood, things, if you guys really want to get into the nitty gritty, because I'm sure my experiences can probably help somebody else. But motherhood overall has been very exhausting, yet very rewarding.
00:02:41
Speaker
And in the very beginning, the first two months was really rough, especially with the sleep schedule. But that's me, because I really prioritize my sleep. Sleep matters a lot to me. Some people be like, oh, no, I'm good. I can get up any time. Boom, boom, boom. I'm like, no, no, no, no, no. I personally value my sleep. So the first two months are really rough. He's three months now. We're going into month four. So it definitely has gotten a lot better. I don't know. It's been a major adjustment. It's been a huge adjustment. I think I'm constantly trying
00:03:11
Speaker
to get into a groove. But as soon as you get into a groove, the kid changes the groove. So you just have to always be flexible, which is not very, I'm very type A. So that's not my jam. I like to have a plan. I stick to my plan, but the kid be like, Oh yeah, F your plan. I'm like, Oh, okay. So I just, I just, you know, it's, it's, it's like, I don't know. It'd be the equivalent of like,
00:03:34
Speaker
I mean, he's not eating yet, but it'd be the equivalent of like, you giving your kid applesauce one day and they're like, hmm, I love me some applesauce. You're like, oh, bet, cool, let's go buy applesauce. And the next day they'd be like, man, F your applesauce. And you'd be like, yo, I thought you liked this. So it's kind of, it's kind of like that. It's kind of like that. Just so you know, that day is coming.
00:03:50
Speaker
we like blueberries and it's like yeah blueberries last week this week yeah exactly it's very it's very inconsistent as soon as you think oh i got this then there's another wrench you know whether it's the sleep cycle how you know how much he's completely breastfed so i'm a breastfeeding mom no formula no nada so that's a whole another thing we could do a podcast about at some point and dr chris that's her research yeah they're my research on them
00:04:16
Speaker
Yeah, she got lots of thoughts on breastfeeding and lactation and stuff. So that's pretty much all I got for y'all. Well, welcome back. You were missed. We missed you. Thanks. Thanks, thanks, thanks. We did miss you. It's good to be back. I'm out here to cause some havoc, maybe not.
00:04:36
Speaker
good vibes, all the vibes, bad vibes. I don't know, I'm here for all of it. Whatever y'all got, whatever y'all throwing at me, I'm here, I'm here.
Post-COVID Baby Boom
00:04:42
Speaker
And send us an email to let us know if you guys want to talk more about the journey or if you have questions about stuff, just let me know and we can chitchat about it. We could probably do like 10 different episodes based on my pregnancy journey. So listen, it covers a lot. First trimester, second trimester, third trimester, the actual birth, the experience.
00:05:02
Speaker
postpartum, emotions, ups and downs, the things, birth control, laughter, the stuff, it's a lot. But hey, I'm here. So fun. We're glad you're here in one piece.
00:05:14
Speaker
Yeah, yeah, yeah. It's a lightweight baby boom happening right now. Even when I went to the hospital, it was popping in our office right now. One of them, and then our pharmacist just came back from maternity leave. So this is baby number two in the past so many months.
00:05:35
Speaker
Yeah, people are like, listen, after people have survived COVID, they're like, listen, it's about that time. Like, let's go. Lego. Even on my labor and delivery, like, even the labor and delivery when I deliver it, it was like popping, popping, like popping, popping, popping. I was like, this is crazy. But you ain't hear Dr. Chris, though. Like, yeah, I'm happy for you. No, I heard Dr. Chris. Don't bring them baby vibes over here. I'm good. We're good over here. I'm OK.
00:06:03
Speaker
Listen, Dr. Chris, Dr. Chris has been on her own journey, which we can do an episode about one day, but I'm not here to out Dr.
Home Improvement Woes
00:06:11
Speaker
Chris. I'm going to let her do her own thing. My own journey. You got your own journey going on. Yeah. There's lots of stories to tell. You know, one day when these stories have like more completion, we've got so many things going on. Dr. Noel is out here getting her construction, her project manager hat on, fixing her basement.
00:06:33
Speaker
I shouldn't have to. I was coming to paint a basement. It should not take two months to paint a basement, but my digress is done. They don't tell you this stuff with your own house. It's more of what you guys saw when you came over, so it's pretty much done now. Yeah, they don't tell you all those things. They don't tell you this has to happen. That has to happen.
00:06:53
Speaker
Though the other day I got hit with, I was so upset. So I got a letter from the water company and they were like, oh, we've been doing an audit for two years. We realized that we hadn't charged you for your sewer. Oh, so now we're gonna fix it. So now you have to pay that two years back now. What? I'm like, I'm not paying that now. No. How are you telling me you made a mistake?
00:07:22
Speaker
and now I got to pay for your mistake. That's your mistake. It's too bad you lost that two years of money. You should, okay, charging me from here on out, I understand that. But- They want it all back like right now. Yeah, we made a mistake. So, you know, give me my two years today. That's wild. And then they're like, well, if you don't, then we cut your water, but I can't not have water.
00:07:49
Speaker
And I can't be like, oh no, I'm not going to go to you to supply my water. I'll go someplace else. There's no water else. It's just one place that supplies you water. You would think that they would at least say, you know, because of this, we're going to give you 12 months to pay or we're going to give you to, yeah. Like some people can't, I can't even imagine how much it is, but I'm like, how do you, how did you, how do you reason that? Like when somebody's sitting in the room and saying, what should our next step be? The idea that a bunch of
00:08:18
Speaker
adults get together and say, I know we should do, we should ask them for it right now. So that our, so nobody catches us in this, this whole catastrophe that we're in. But if we get all the money back right now, it would be great. Like I'm surprised that adults get together and think that that's okay to do to other people. I mean, it's ridiculous return. I mean, at the instantly, like, why, why wouldn't you want that if you were the company, but
00:08:44
Speaker
The whole thing is... Y'all made a mistake. Why am I paying for it? I thank God and I'm blessed that I am in a position where it's okay, but I think other people that don't have... That's not right. Correct. That's a problem. Correct. You just reminded me. I was beside myself. I get this call from a collection agency. I just know they got the wrong number because a collection agency calling me, are you serious?
00:09:12
Speaker
So, you know, and in true collection agency fashion, like he's pronouncing my name all wrong. And I'm like, I don't know who you're trying to say, but I think you're trying to talk
Customer Service Snafus
00:09:22
Speaker
to me. So he's like, yeah, well, you, you owe money, you owe money for a doctor's visit. And I'm thinking like, and I'm looking
00:09:30
Speaker
You know, now when you have my charge, you can look in the app and I'm like, I don't see anything. As a matter of fact, just pay the bill. So I'm seeing a zero. So, you know, I'm like ready to go off and he is so nasty. And I was like, hey, this is what you're going to like. He is nasty. He is just like, well, you're going to give me my money. And I'm like, I'm not giving you a damn thing, sir. Excuse you. And so it's not his money personally. Yeah, he's like, yeah, you have to pay me. And I'm like, man, I'm not paying you nothing. So
00:09:59
Speaker
I'm like, I am looking in my account and I don't see anything. And he's like, well, prove it. And I'm like, okay. Prove it by hanging up on you. I'm like, I'm not going to prove it to you. Like I'm not sending you anything. First of all, I don't even believe you. Like I don't believe that I owe the money that you're saying that I owe, but they are legit. Like, well, if you don't prove it, I'm going to keep calling back. I said, well, then you don't keep getting this work, my friend, because
00:10:26
Speaker
I don't care. You just have to catch me in the moment where I got time. Oh my God. So whatever you need to get from me, you can get right now. Like, we going off. Like, I'm like, oh, you've lost your mind, right? I got time today. He did not know. He did not know who we were calling because you were the wrong one. You just called me out here in this fresh open air out here telling me I owe some money that I don't even, I don't even owe. Like, have you lost your mind? It's going to be some problems. I'm going to find out where Chris
00:10:55
Speaker
what Chris lives because of what his name was for real and run up on Chris because you should not be talking to anybody like that. And I was like, how do y'all talk to people like that? So I just imagine folks that are like really behind on their bills that are getting these calls from the collection agencies all the time.
00:11:10
Speaker
And if that's how they talk to everybody, and I'm assuming they do, because I'm assuming they think they talk to folks that can't pay it and all this kind of stuff. If that's how y'all are popping off, shame, shame on you. These folks are crazy. Chris, you crazy. I don't know if you out there or not, but you crazy, Chris. Because that dude was... You said you crazy, Chris.
00:11:41
Speaker
They're not paying attention.
Beyonce's New Album
00:11:43
Speaker
I was in church the other day, and my pastor was talking and he was saying that he was reading something that said that the average attention span for people now is like seven seconds. It's less than that. Wow. I'm sure it's less than that. So no, don't ask for your name. They ain't even hear it.
00:12:02
Speaker
It takes me two seconds to say it. And they missed it. Not even one second. You got one second. You have four letters and I got nine, so I'm just, I just got it. You're right, you're on the cruise. I just got to let it go. I just got to let it go. It's almost like low-key, why ask? Why ask? You're going to make it up anyway. Just put down whatever you want and just point to me when my drink is done and be like, you know what I'm going to do? Or you could just write down like red shirt or like black hat or just write down something I'm wearing. This is like, oh, oh, she got the pink, she got the pink hoodie on.
00:12:32
Speaker
Like, just listen, I'm just gonna go buy a letter. See, that's why you like getting food in the hood, right? Because they don't ask you for the name. Like, oh, yeah, you shorted with that shirt on. Yeah, you right there. You don't talk about it. You be like, yeah, me. OK, thank you. That's me. I make you that right, too. Hey, all the y'all over there laughing. Yeah, yeah. Y'all shit ready.
00:12:53
Speaker
Us? Oh, thank you. Is our fries hot? Mm. Yes. I appreciate that. I appreciate that. Shout out to all the hood spots. That's right. And they'd be the cook in the back like, nah, nah, nah. Not that shorty, the other shorty. No, it didn't. No, it is her order. No, the one with the braids. Yeah, that's her fries. All right, cool, cool, cool. Correct. Or when they start to walk up, everybody looks, right? Because they're waiting for eye contact. And they look at you and be like,
00:13:21
Speaker
You'd be like, me? They'd be like, yeah, you'd be like, all right, that's me right there. All right, y'all, let me get my food on Beyal. Okay, see y'all later. You know what I'm saying? I appreciate that. They don't be trying to spell no names. Oh my goodness. I just thought about something. Quick question. Did y'all talk about Beyonce's album? Ooh. We have not. Okay, pause. Pause. Did y'all listen to Beyonce's album?
00:13:47
Speaker
Who you talking to? Me? I'm talking to the quartet total. The quartet total. And this was not my favorite album. So I know. Of course, I listen to it. OK, first of all, I have the record. I think you know my answer. Yeah, so I do. So first of all, I will start out by saying this. Everybody who's out there that's like, man, who is this album for? Like, who is this for?
00:14:12
Speaker
This album is for me. It's for me, because I did not like Renaissance at all. You didn't like Renaissance? No, Renaissance had to grow on me. It took like three to six months to grow on me, because I don't like house music. I feel like it was just one ongoing dance beat. I'm like, this is music for the club. It actually reminded me of her B-Day album, which was just like all the way through. And I'm like, I can't do this. I can't do it at all.
00:14:39
Speaker
Oh, really? Listen. I love Renaissance more so than the cowboy Carter. But again, that reminds me of her B-Day album. And I wasn't a big fan of the B-Day album, because it was just party music. It was like green light, kitty cat, freakum dress. It was all just these high energy beats, and it lacked substance. So I was like, I can't. I mean, I could do it if I'm in a party mood.
00:15:08
Speaker
It's lacking like the creativity for me. Now, mind you, Renaissance is a complete project. It did have creativity. And then when I went to go see the movie, when you go see the Beyonce movie, of course you learn even more about it. So I do respect Renaissance as a project, not nearly her best project, but I respect it. But this is for me.
00:15:26
Speaker
This is for me, the Southern Beyonce fan. I'm here for it. I wouldn't really call it a country album in my personal opinion. I think it blends a lot of different genres and I also feel like it's going to scoop up a bunch of Grammys in all different types of categories and everybody gonna be mad. I think the country people gonna be mad because they're gonna be like, this is a country enough. I think everybody gonna be upset.
00:15:50
Speaker
And you know what? That's fine. But I just didn't know if y'all had listened to it. We don't have to do it for a debrief. You know that takes time. But I was just curious. But that album is for me. I love it. And I love it way more than Renaissance. That's a Dr. Sunshine thing. I do like Cowboy Carter. You know, one of my favorite songs is the remake. Is it the Beatles remake? Jolene?
00:16:11
Speaker
Oh, oh, oh, Blackbird. Blackbird. I love Blackbird. Mm-hmm. I don't know why. I just, I loved it from the first time I heard it. I was like, this sounds so familiar. And of course, my husband is like, because it's a remake, you know, he's a Beyonce hater.
00:16:26
Speaker
Exactly, because it's a remake. And I'm like, give me a second. Let me observe it. First of all, she credited the Beatles under me. Look at who wrote it and all the arrangements and stuff. Well, of course, I'm reading like, oh, who wrote this? Who produces this? The dream is all over this. Shout out to the dream. She's always all over it. Always, right? Shout out to keep it. Listen, if it ain't broke. If it ain't broke.
00:16:51
Speaker
Shout out to people keeping their circles the same and tight, right? Tight! Tight! She don't sway a whole lot from her core circle, and I'm not mad at that.
00:17:02
Speaker
Yeah, I think I thoroughly enjoyed this as a project. I listen to it constantly all the time. If there's going to be a tour attached to this, I am so ready. It makes my little southern heart smile so much. And I actually have a guitar, which I knew how to play. And then I kind of forgot because it's been a long time. And I think I'm going to pick it back up again because why not?
00:17:22
Speaker
But it's very like, you know, I know, right? I'm going to pick up my guitar and it's very much so talking about, you know, grits and whiskey and Bibles and pistols and all the stuff that I grew up with. And I love all that shit. We do too. In this house, we love it all. All the things these days.
00:17:41
Speaker
Of all the things, I truly do love it because we are not going to have a formal debrief. I might just do that as like a monologue and then like publish it for you guys and send it to Dr. Nona and be like, here's my Beyonce debrief and just do it on my own because I know y'all don't have none to contribute, aside from ABJ, but I will say this. But it's not country.
00:18:01
Speaker
It's to me, it's my country. When I finished the whole thing, I did not think everything. I'm like, Oh, this sounds like a country album. It is country inspired. I think that is what I would describe it as. I would describe it as country inspired. And I think that she took a lot of, she made a lot of statements with the people that are on the projects. Right. So it brought some, some history.
00:18:25
Speaker
of country, even songs like Blackbird, like Blackbird was written for black women.
00:18:33
Speaker
during the civil rights era when the world was looking and he thought, man, I would like to write a song for black women. So there's lots of those kind of undertones. And so I think that this album makes you have to know a little something about something or be curious to know why she did it. And if you start to explore like, oh, why is this song going there? Well, who is this person talking on here? Well, why did they pick this person?
00:19:00
Speaker
Yes, a lot of that. Then you kind of figure out like, okay, oh, oh, oh, you'll do a lot of that as you go along. And then when you put people like Dolly Parton on there. Listen, Dolly Parton had been telling us that she wrote this, that her and Beyonce had been messing with Jolene for a minute because way before this came out, I feel like Dolly Parton had an interview and she was like, I would love to work with Beyonce. And I'm like- That's because Dolly Parton is the real one. I'm leaving out here.
00:19:26
Speaker
I mean, I love Jolene. I do love that song, and I have not heard the remake at all. I heard that song. I'm like, okay. It's a different take on Jolene. Don't try it. Don't try it. Listen, here's Jolene. Don't try it. Don't run up on here. We're in the country now. We got guns around here because we're about to...
00:19:50
Speaker
We gonna test your salvation, Jolene. Right. Because the original Jolene was nice. The original Jolene was nice. How can you remember? This one is not a nice version. It wasn't just nice. I felt like the original Jolene. I mean, we gonna get to it. The original Jolene by Dolly Parton. I felt like Dolly was kind of begging Jolene. Like, Jolene, please don't take my man. Please don't take my man. Beyonce's Jolene is more like,
00:20:18
Speaker
I wish you would. I wish you would try to take my man. I raised that man and them kids. Take it if you want to.
00:20:28
Speaker
Shada, Shada, Jay-Z. Talk about she raised that man. I was like, ayy, yikes. She raised that man. I'm kidding. She's 11A part two. I was going to say, you have to realize that she actually wrote a lot of these songs. She wrote a lot of these songs a long time ago. Like she's been working on this for a while because in some of the songs she references, like even in 16 Carriages, she talked about being 38. Beyonce is 42 now. I'm like, so she wrote this four years ago? So she wrote...
00:20:52
Speaker
I think she's about to be 43 this year. I think Beyonce is about to be 43 this year. But like you could tell from some of the songs, you could tell she wrote some of them during the lemonade era. Cause you hear what she's talking about and you're like, Oh, this is
00:21:10
Speaker
This is, all right, bet, bet, bet, bet. But I think it's a wonderful project. I thoroughly enjoyed it. I will give quick shout outs. One, shout out to Miley Cyrus because I think she sang her motherfucking ass off. When I saw that she was featured on the track, I'm like, Beyonce featured Miley Cyrus. I'm like, Miley better bring it. And then I listened to it. And I was like, this is such a beautiful ballad. I'm like, shout out.
00:21:39
Speaker
to Miley Cyrus. You need to go look at her Tiny Dust. That was probably top five Tiny Dusts that I've ever seen. It was Miley Cyrus's Tiny Dust. But Miley can sing. Miley can sing. She's not my thing. I don't follow her as an artist, but I will give it to her that of all the people that I think can legit sing, I've always thought whenever I hear her voice, Miley Cyrus can legit sing.
00:22:02
Speaker
She can. She can. And then I think that the the range and the southern slight draw that Beyonce has plus Miley's twang, they kind of go together to the point where they can harmonize together and it sounds lovely. And I was like, this is this is this is something.
00:22:19
Speaker
But shout out to Miley Cyrus. I even like the song of Post Malone, Levi jeans. That's on repeat. That's on my morning wake up shower list. Anyway, it's a very good album. It starts off slow because in the beginning are songs about black women and songs for her kids. You can tell she's really doing lullabies and songs for children. Then the Willie Nelson interlude comes in and it transitions to more like bops. And then there's another transition. So there's a couple of transitions in there, lots of interludes.
00:22:45
Speaker
Listen to it in your leisure. And if you're confused, I guess go on Rap Genius. I mean, y'all Rap Genius for Kendrick and Drake. So y'all can do it for Beyonce too. I mean, whatever. So you can go on Rap Genius and figure out the lyrics and things. She makes references to stuff that I grew up with.
00:23:00
Speaker
My dad talked a lot about like the Chitlin Circuit, like growing up. It's very similar to like if you guys watch the movie like Green Book with Mahershala Ali, it's very similar to that. So like Green Book is like the book where like these are the places where black people can like stay like safely like back in the segregation days. Chitlin Circuit were kind of like venues that only black people could like where black people can perform in a safe space. Yeah, in a safe space because one they weren't allowed in the white venues and then two like
00:23:27
Speaker
It's kind of a place where their music could grow and evolve, and they work with each other. And so the Chitlin circuit is, of course, Chitlins are food. But you know what I'm trying to say. Anyway, whatever. It's history, things, layers, stuff. It's a beautiful project. Everyone should respect it. It's for me. And I understand if it's not for others. I completely get it. But that's all I have to say.
00:23:45
Speaker
Well, look, I don't think we get into any, um, events because we are here talking about babies and life and, you know, Oh, I had that. Oh, you mean, oh, you mean like the trending topic? I had one, but we don't have to talk about it because my training topic can be Beyonce. That's okay. I'll take the L for that one. No, we like that.
00:24:01
Speaker
I like it. No, we can keep it at Beyoncé. Listen, I'm here for it. Wait, I mean, if we're talking about artists, are we not going to go into the Kendrick Drake beat that's going on right now? We do not have time for the Kendrick Drake beat. We will be here all day. We'll be here till like tomorrow. Oh, Kendrick Drake. Because we can talk about that next time. Because if we start that, that'll be the end of this episode.
00:24:24
Speaker
Thank you and good night. That's all we got for you guys. It's still ongoing, so it may change. I know. I am sure by the next time we record,
Understanding Hypertension
00:24:31
Speaker
there'll be more things.
00:24:42
Speaker
Because we spent so much time catching up with our brand new mommy and Beyonce and all things, I really gonna keep this short and sweet. I am doing this topic because in my office, I am seeing young black people in this recently. We're always battling, right? We're talking about blood pressure today. We about to get these pressures because we under pressure people, okay?
00:25:07
Speaker
I like that. I like that. We got under pressure. We're under pressure. So you need to check your blood pressure. Yes. And I am doing it because I have a bunch of y'all coming in, 40s, 40s, early 50s.
00:25:26
Speaker
that are in complete denial about these blood pressures or are having these convoluted stories about how this blood pressure came to be and we're fighting about numbers and is it real? Is it not real and all this stuff? And I just want to have a small conversation about it because if you get it wrong, we're going to blow your kidneys and your heart out is the short end of it.
00:25:51
Speaker
And it's not something that you can afford to get wrong. And my fear is that if it's happening to me, it's happening everywhere. And it's almost as influx. Like I've been like scratching my head at how many conversations I've been having with people recently where I'm having to fight, like defend the definition of hypertension and why I think that they have an issue. So let's, let's get into it. So, um,
00:26:19
Speaker
I was trying to find a stat. I think I remember it, but a few weeks ago, I did a speech for Heart Health Month. And one of the stats that was alarming was that African-American women tend to have like a 500% increase in poor outcomes from uncontrolled hypertension than their white counterparts. Like that's crazy to me because we're talking about blood pressure and blood pressure is the leading
00:26:47
Speaker
modifiable cause of heart disease. It simply means it is the biggest thing that we can control that is killing our hearts the most. That's crazy to me because for most of us, blood pressure is easy to treat.
00:27:05
Speaker
And blood pressure is easy to correct. Now, maybe not easy in execution, right? Because we're not going to downplay how hard it is to exercise, eat well, and all this kind of stuff. But when it comes to the therapies, there are a few things in medicine where the therapies actually are kind of straightforward, right? Like for most of us, I think we would argue that
00:27:27
Speaker
You come in with elevated blood pressure. Once we confirm that blood pressure is elevated, the next step is probably the simplest thing that we have. We got a couple of options. We can start here, here, here. Let's get this party started and let's follow up on it. It is so easy, yet in steel. I am slugging it out, y'all.
00:27:46
Speaker
with people in the office about everything. Does it even exist? I don't think that's true. I've never seen, no, nobody's ever told me. And then you start talking to them and they'd be like, yeah, one time I couldn't pronounce something, but it was like, am low, am low. They tried to put me on it, but they were just talking. And I'm like, what, what do you, they weren't just talking? Don't nobody just talk shit about your blood pressure. Like, what you talking about? Like, yo.
00:28:13
Speaker
That's not a thing. We just can't do that, y'all. And so, is it just me or is everybody else having it? Like, I am fighting with people. No, it's not just you. I do that all the time. They're coming in for like a headache. And it was probably the highest blood pressure I've seen in my career. It was like 260 systolic, which is the... When you take your blood pressure, there's two different numbers. There's the top and the bottom number. Top number was very high.
00:28:41
Speaker
And the patient was like, oh yeah, I just stopped taking my meds. They weren't working for me. I'm like, they were doing something because this pressure was off the, it was through the room. We put them on a drip and sent them to the ICU immediately because that was ridiculous. Dr. Knowles brings up an interesting point.
00:29:02
Speaker
And it's just because I really like to lay out all the things that people are fighting about in the office. And headaches is a really interesting one. So it is not uncommon for somebody to come in the office and say, well, my blood pressure is high because I have a headache. Let me be clear. First, let me give you some parameters. Normal blood pressure. There's many people that have a say in what normal blood pressure is. But across the board, everybody agrees that normal blood pressure is 120
00:29:32
Speaker
over 80 or less either number, y'all. That is normal blood pressure. So if you had a blood pressure machine and those two numbers popped up, if the top number was 120 or less, that would be normal. If the bottom number was 80 or less, that would be normal. Both of them have to be normal for you to have a completely normal blood pressure. That's what blood pressure is. Anything above that becomes abnormal.
00:30:02
Speaker
and to not bore you with all the societies that are trying to figure out where abnormal gets really serious. Just know that you got some leeway between 120 to 140.
00:30:16
Speaker
Now that's going to vary by office, but once you pass 120, we're eyeballing you, son, because we got some issues and we had to figure out which way this is going to go. So when you come in with what Dr. Noah was talking about with a top number of 260, you are so far off the beaten path.
00:30:35
Speaker
that that very well may be making your head hurt, but you have passed from 120 all the way to 260 to get there. So that's unique. The rest of y'all that's running around here with blood pressure is between 150 and maybe 180 or even 109. It's just high because my head hurts. I don't believe you.
00:30:55
Speaker
Well, I think you're getting a lot of fight and a lot of pushback because a lot of these patients have high blood pressure, but they feel fine. I'm using quotation marks. They feel fine. And because they feel fine, especially that age group you're talking about, like the 40 year olds, when you're in your 40s, it's like you're still young enough to the point where you're like, well, I'm not old.
00:31:13
Speaker
But you're also old enough to the point where you have heard of these health conditions, whether you have them or not. You've heard of them enough because either your friends have them or your parents have them. You're aware, you just don't think it's you. So then you have this group right here where they're like, nah, I'm still young, but nah, I heard of high blood pressure, but I ain't got that. I know what that is. I ain't got that.
00:31:36
Speaker
You do. Or you think you got time. You're like, nah, that ain't me. I mean, my dad had it. My granddad had it. But I'm going to start working out because I got to start getting ready to not have it. And unfortunately, you probably had it.
00:31:49
Speaker
Now, because Amy Jo really loves y'all, she'd be battling with y'all in the office. I don't really battle with people in the office very much. I hear their thoughts. Maybe I'm getting closer to Dr. Chris. We haven't been hanging out with Dr. Chris too much. But anyway, I hear your thoughts. And I'm like, look, I know you don't think you have high blood pressure. But at the end of the day, no matter how you slice it, this is your number today. So you're going to come back in two weeks.
00:32:12
Speaker
You're going to get a blood pressure. I'm like, we got a blub. And at my job, we give them blood pressure cuffs. We have them in the office. I'm like, listen, you're going to take this cuff. You're going to take these pressures. You're going to keep a log. I'm going to see you back in two weeks for a nurse to visit. And we go see what these numbers look like. And my nurse is going to take it when you come in.
00:32:29
Speaker
I don't know what you thought this was, but this is what's going to happen. And sometimes they're down for it. Sometimes they're still in denial. And they're like, nah, I don't think I need all that. I'm like, all right, cool. I'll see you in three months. You can refuse it. It's fine. I'm not here to pressure you. I'm just giving you the info. They come back in three months, even higher. I'm like, all right, so listen.
00:32:46
Speaker
Remember that talk we had three months ago? Before it was kind of optional. Now it's not optional. I'm letting you know this is what you need. I want to prescribe it today. But I'm not going to prescribe it if you're not going to take it because, psh. Come on. I mean, for what? For what? We worked at County. We know how that goes. Like, are you going to take this or not? Like, what? Yeah, I'm with you. I definitely a lot of times take that approach. And I always tell them, well, you have two elevated blood pressures with just two elevated, two different times.
00:33:15
Speaker
I just made the diagnosis. Now I'm trying to get you on board to understand that this is really what's happening. I give you this two weeks and you monitor and see. I literally tell them, I'm giving you this two weeks so you can understand and
00:33:31
Speaker
go with the idea that you have hypertension. I already know what to do. Girl, listen. I will pull up in their chart. You can make a graph of that. You can graph their blood pressures from forever ago. I'm like, pause. Let's look at your blood pressures for the last five years. And then they'll be like, ooh, it's been steadily going up. I'm like, right. Right. Yeah, that's what I did. Right. It was not that bacon you ate yesterday. People would be killing me. They'd be like, well, this weekend, if it's a Monday, it's for this weekend. I had to have bacon because we had home cooked breakfast.
00:34:00
Speaker
Yo, your blood pressure is not 160 over 95 because you ate two slices of bacon. Now, you might have been eating two slices of bacon for your entire life. And it's not. It's not. It is a culprit. But that's not how we got here right now. And you know, I'm getting better about the fight back because, well, life has gotten busy and I just don't have 40 minutes to give the 20 people that are in my office these days.
00:34:27
Speaker
And I'm like, listen, but I do want you to hear me because I do feel like sometimes nobody has paused. I think nobody has paused long enough.
00:34:36
Speaker
to say like, just so you know, this is more than me just being agreeable with you. I will be agreeable with you if you don't wanna take the medicine. I can't make you take it. But I'm not saying I agree because I don't think you're gonna be in bad shape if this goes wrong for you. I'm just saying that we will do what you want us to do. But just so we're clear, I think it's a horrible idea not to treat your 160 over 110 blood pressure that's hanging out in this office.
00:35:02
Speaker
So that's how I phrase it as well. Yeah. Yeah. Like I just want to say one thing because I've had a couple of patients and maybe we're telling this story that people can understand that how serious this is. Like I see some like maybe like three, three months ago, I'm like, you know, your blood pressure was elevated. We should be on medicine. I only want to go on medicine. Then they come back maybe what? Three months, six months later after they had a stroke. Yep.
00:35:33
Speaker
They didn't want to get on any medicine, right? Before? They didn't want to get on any medicine. But after the stroke, they're on what? Five different medicines now.
00:35:42
Speaker
and they're agreeable to taking the medicines. So why did we have to get there? Why did we have to have something bad happen to us to now agree to take the medicine, right? Because before, when we told you there was a problem, you didn't have any symptoms. Now you have a stroke and you actually have symptoms from the stroke. Now you're like, okay, I gotta do this. But then it's always when they come back, I always wanna tell them, because I don't wanna really be that mean, but really,
00:36:13
Speaker
You should have listened to me when I said in the first place, I tried to tell you. But you know, but you know, with a lot of them, they're not making that connection. They don't make that connection. Like a patient, I was battling with her blood pressure forever, not like battering with meds, like battling to get her agreeable to meds.
00:36:30
Speaker
Then she comes into my office one day and she's like, doc, I got a question for you. She's like, my sister just had a stroke. How do I, how do I not have a stroke? I'm like, Oh my gosh, what a great question. So the things that we've been talking about for your last five visits and you are just fighting me on this blood pressure medication. Let's talk about it. Cause if you're talking about stroke prevention, heart attack prevention, like you, you don't want all the scary things, right?
00:36:54
Speaker
But then you don't want to do the steps to prevent the scary things. You can't have it both ways. You can't have it both ways. So and then then she had like an epiphany, like a light bulb went off. She's like, oh, OK, so what do I have to do? I'm like, girl, take care of your blood pressure.
00:37:10
Speaker
But that same age, she was around like 49, 50. Her older sister was like 55 and just had a stroke. And she was like, I don't want that to happen to me. I see how debilitating it is. She can't do ABC XYZ for herself anymore. I'm like, I get you.
00:37:26
Speaker
This blood pressure, cholesterol, diet, all this stuff I get under control, all of it, all of it, all of it, all of it. Well, I think a lot of it too is that they associate these medical conditions with being old, but that's not true because you could be young and have all of those things. Yes, you can. And let's be real. Let's just, let's just keep it 100. I mean, as people who are rapidly approaching these same ages or in these age ranges, it is old.
00:37:56
Speaker
It's not senior citizen level, but from a medical standpoint, aging starts, shout out to Dr. Awong, aging starts at 25. From a medical standpoint, about around the age of 25 is where anything that was growing or developing has completed and everything is smooth sailing.
00:38:16
Speaker
It's a slow trickle downhill. It doesn't have to be a rough tumultuous trickle, but we've been aging for a long time, right? So if you think about losing muscle mass a little bit over time, we've been doing all these things since 25. So when you think about it, 25 was where I stopped growing, right?
00:38:33
Speaker
I stopped creating new things. And now I'm either maintaining the things that I have or I'm starting to see a slow decline by 40, by the end of 30, early 40. Yes. And while 40s is not old enough that I'm ready to put you in a nursing home, 40s is old enough to have a massive heart attack.
00:38:52
Speaker
40s is old enough to have a massive stroke and not out of a fluke. I think that's the scary part. In your 40s, it does not have to be a fluke that you had a massive heart attack or a stroke if you've had uncontrolled, unchecked blood pressure that has been rumbling under the radar all through your 30s.
00:39:09
Speaker
because most of the people that you talk to when you really get into it, if they're being honest or if they start to spill the beans or if you've got enough in your, you know, Cerner or your Epic or whatever your medical record system is and you can kind of track it back, you see that blood pressure start to creep up about 30.
00:39:30
Speaker
all of a sudden they popped a 130 over 80. Wasn't nothing, wasn't nothing. You weren't going to the doctor that much. You were a woman, you didn't see your primary care doctor because all you need to see was your OB-GYN. And when you went to OB-GYN, they saw it was high and they said, you should probably check in with your primary care doctor, but you didn't make that appointment. And it was fine.
00:39:47
Speaker
So because you don't make those appointments as frequently in your 30s, now we're in your 40s and you're talking about someone, ain't no doctor ever told me I had high blood pressure. Well, you ain't been, but three times in the decade of your 30s. So what you mean? But I'm looking at the three times you've been in all three times. It's like 138 over 87. Ooh, one time it was a 140 over 80. 135 over 92.
00:40:16
Speaker
That is early stage hypertension, y'all. And so when you get to your forties and now it's really kind of tipped over and you're like, whoa, whoa, whoa, wait a second. You're the first person that said it. So since you're the first person that said it, it doesn't count. It could not have existed until right now. So the fluke is just me sitting in this office with you. Nah, you're in trouble. You in danger, girl. You about to blow a gasket.
00:40:46
Speaker
And that's the real sad part because we, where we trained.
00:40:53
Speaker
You see 40 year olds that have massive strokes. And when I tell you there's nothing more heartbreaking than trying to watch somebody in their early 40s or 50s who's still supposed to be saving and investing. They still haven't bought the house or their next house. They take care of kids or a wife or a husband or parents, right? Hey, here come this age, all of a sudden your parents now need you.
00:41:16
Speaker
And now you're trying to figure out how you function at your construction job when you have lost function on one side of your body because you have uncontrolled hypertension. That is the saddest thing because your livelihood depended on your functionality. And if your blood pressure gets the best that you're going to lose function, that's heartbreaking. Or what about the people who end up on dialysis? Blow out your kidneys if you want to.
00:41:40
Speaker
It's horrible. It's horrible. All the things that can go wrong, dialysis or kidney failure or chronic kidney disease, retinopathies, bleeds in your brain, which is a hemorrhagic stroke or an ischemic stroke or a heart attack or any of the things, all the things from something that's preventable that the reason why I will sometimes still slug it out
00:42:10
Speaker
in the office is that I know something that you don't know, and it's that we can't promise you that we get it back. And for most people, Dr. No can tell you they leave the hospital, they don't have it all back. And while they're hopeful, listen, inpatient, the Dr. No's of the world be like, well, maybe you will. They know you ain't finna get all that stuff back. They just gonna wait for your primary care doctor to come and tell you. So when you sit down with me and Dr. No has said, well, talk about it with
00:42:36
Speaker
Amy Jo MD and let's see what will happen. I'm going to tell you like, listen, if that foot was dragging six weeks after physical therapy, that foot might be dragging.
00:42:49
Speaker
I hope you'll get it back. Yeah, you can look on TikTok and Instagram and see all these miracle stories of people like put slow music behind it with all this inspirational speeches. And they show that then all of a sudden go from walking and running to those things happen, they do. But what I discovered is that wherever your fitness level was at the time of your injury, it's hard to recover and excel where your fitness level was after a stroke.
00:43:17
Speaker
So, you know, for somebody that's like 44
00:43:22
Speaker
that's got uncontrolled hypertension that was making legit plans. So I'm not saying there's people not out here making legit plans. Like you were sincere in saying, I know I need to get it together. My uncle had a massive heart attack. My dad had a stroke. I'm about to get it together. I'm gonna start going to the gym. I'm gonna start lifting weights. I'm about to change my diet. I am sure you were sincere in that, but you messed around and had a stroke before you can get the party started. And so now the body that had the stroke was out of shape, decondition, hypertensive.
00:43:51
Speaker
And now you're trying to imagine yourself running the track and your recovery. That is going to be the hardest mountain to climb. I'm not saying it's impossible, but you're trying to get your body back to baseline and then push what is now a body that's been a little bit wounded beyond that to get to this next level of health and still figure out how to pay your bills and feed your family and pay your taxes.
00:44:22
Speaker
and just live that's so ridiculously hard. I don't, it's a risk. And all you had to do was take a pill. Take that one little, I had to pull the thighs out. Oh, you had an issue. Doesn't sound so bad now, does it? Cause going back to the story, like, you know, I get plenty of people that come into the hospital and they just stopped taking their meds because they read some
00:44:50
Speaker
you know, side effect or heard from some influencer about like the chemicals and the pills and you know, they don't want that in their body type of thing. If you have any questions about any of your medications, please talk to us, like let us know what your thoughts are and we can help kind of educate, you know, educate you on the benefits of that medication. Because yes, there's some processing that goes into making these
00:45:19
Speaker
uh, the blood pressure medications that you're able to take them. But, you know, there's, they've been screened for all harmful chemicals and agents and whatnot. And that is not something we want to introduce into your system. So all these medications are safe. Granted, you may have side effects to, uh, you know, families of medications, but please, you know, talk to us before you just go ahead and quit them cold turkey.
00:45:44
Speaker
some of the blood pressure meds that we do give you, you cannot stop cold turkey or otherwise you will have a rebound hypertensive effect, which could be even more like worse, you know, if your blood pressure was like, you know, 150s, 160s after you stop, you know, before you stop the medication, you just stop at cold turkey, that can skyrocket. And that would be its own slew of problems. So please come to us before you do that.
00:46:10
Speaker
And we can be, be sure to kind of guide you on the right path for that. I can give you some numbers too, because, because, you know, I think one of the things we always hear when we first tell somebody like, you know, I think you need to have your blood pressure treated. They always say, give me, give me three months, give me six months and let me, you know, let me get it together. I'm, I was going to really start working out. I was going to start eating better and it's going to be better.
00:46:32
Speaker
And I'm not saying that that doesn't do the numbers, but let me tell you what the research says about how much those numbers swing, okay? So when we're talking about diet, right? So most people know that the DASH diet, we always talk about, you know, what the Relatively Healthy Diet is. DASH's dietary approach is to stop hypertension. So the DASH diet is a low sodium
00:46:58
Speaker
whole food diet. So a DASH diet with sodium restrictions where people are really monitoring their sodium and trying to bring it down. So we can expect an 11, I think the research says you can expect an 11.5 drop in your top number and a 5.8 drop in your bottom number. So when you think about that, if your top number is already 175,
00:47:24
Speaker
And you're supposed to be, if I'm treating your blood pressure, at least less than 140, right? Ideally, we can get you to 130. But if you're 175 and you're going to use the DASH diet, you can use a change in your diet as your primary means of decreasing it, that means you're going to get from maybe 170 down to 160.
00:47:44
Speaker
So the diet in itself is gonna get you big numbers, but it's not gonna get you everything that you're thinking about. And the DASH diet with sodium restrictions is probably the biggest one. The DASH diet by itself where you're not really paying a lot of attention to your sodium, top number will decrease by 5.9, bottom number by 2.9. Just watching your sodium. So we get this all the time, I'm gonna cut sodium out, I'm gonna watch my sodium. Well, that'll get your top number down about six to seven points, your bottom number about three to four points.
00:48:14
Speaker
If you start using sodium potassium salt substitutes, right, all your Mrs. Dash and all of that, that'll get you down about five points on the top, about three points on the bottom.
00:48:25
Speaker
Exercise, right, everybody says I'm about to start exercising, I'm about to, ooh, summertime coming, it's hot girl summer, I hear y'all. That'll get you about five to six points on the top, it'll get you about one to five points on the bottom. Lose about nine pounds, average weight loss, it'll get you about four pounds lost on the top, three pounds lost on the bottom, and then change your alcohol consumption.
00:48:52
Speaker
to light to moderate consumption, that'll get you about five points on the top and four points on the bottom. So I give you those numbers because I think one of the biggest pushbacks we get in the office is typically people are listing one or two of those lifestyle things that they're gonna do, like don't put me on any medicine yet, I'm gonna go over here and do these things and I'm gonna come back to you and see how much it goes down. You see, you probably have to do, if your blood pressure is like,
00:49:22
Speaker
through the roof, it's gonna take more than one of those. You need the DASH diet with sodium restrictions, you need to exercise, you need to decrease your alcohol intake so that you'll add up enough points to really get it down to a normal range. And that's just hard to do. I'm not faulting anybody for it, but I just find it even for myself as a physician, that if I was gonna make a drastic change to try to tweak how I exercise, how I diet, how much alcohol I drink and still work and sleep and take care of the people in my house,
00:49:53
Speaker
That's challenging. That's going to take a couple of trial and errors to get it back on track. So use medicines to supplement your lifestyle is what I tell people. It's like, while you're trying to get that together, can we at least use the medication to at least get out of the danger zone to get you to a safe space to buy you time to fix your lifestyle? That's it.
00:50:14
Speaker
And then even with that, when you take the medic, the medication is not a cure off. So you can't just start taking like your amylodipine, your hydrochlorothiazide, and then go out and eat like a McDonald's burger. It doesn't work like that. So you still got to follow the, not the restrictions, but the, um, the recommendations from the dash diet.
00:50:36
Speaker
you still, sodium is literally in everything. So if you look at the new nutrition labels on any of the foods or even in the liquids that you drink, there's some, cause we live in America and we put salt in pretty much everything that we consume. You really got to pay attention to that to really make sure that you're restricting enough salt from your diet to get your blood pressure down. So the medications help a lot, but you know, like what Amy Jo said, if you continue with the,
00:51:05
Speaker
restrictions with your diet and also the, you know, exercise and whatnot that can help your numbers stay down. So eventually, you know, if you're on a couple of blood pressure meds, then maybe we can start meaning those off in the future. And that's always, always the goal, but you got to, you got to work with us to get to that point.
00:51:25
Speaker
But that's also... Oh, go ahead. I'm sorry. I gotta say this because so many patients now actually listen to our podcast. And sodium is a... I find sodium to be a really interesting concept because the DASH diet with sodium restrictions does kind of say the Lord of sodium.
00:51:46
Speaker
But this gets into the salt sensitivity really drive blood pressure. And the research actually says that there's very few people out there whose salt drives their blood pressure. Blood pressure is multifactorial, meaning there's no one thing that caused you to have elevated blood pressures. It's genetics, it's lifestyle, it's where you live, it's who you are, it's gender, it's color, it's age.
00:52:14
Speaker
It's social economic. It's all these things that drive it. But your sodium content in itself is not it. Also, people will bring me back their labs and go, oh my goodness, look at my metabolic panel. My sodium level is high. That's dehydration. You're just concentrated. You don't drink enough water. And so your sodium appears to be high. That's not the same sodium. With that said, the DASH diet,
00:52:40
Speaker
is getting you away from the processed foods. And so while I don't restrict people in my office from using salt to salt their foods, I think sea salt and all that stuff is just fine, especially when you're using the cook. Where you get into trouble is if most of your diet comes from frozen dinners, fast food, restaurant food, that has such a high level of sodium in it because that food had to be preserved for flavor and for taste and to make it last.
00:53:09
Speaker
That's way more salt in that meal than you would have ever used if you were just cooking chicken at home. But sorry, Dr. Sunshine, you were gonna say something. I don't even remember what I was gonna say. Dang. What you had to say was really important. So trust me, it's fine. I just decided to say that summertime is coming and
00:53:32
Speaker
I was, I was noticeably bothered by what I was hearing from new people. I've gotten this influx of new patients and it's been a while since I got an influx of new patients. You're still getting new patients, girl. Close your panel.
00:53:49
Speaker
Close it. Close it. Can you do it? I still have new patience. Why? I can do it. I saw her ever heard something say no. Why? I gotta work on it. Y'all been at y'all places long enough to... Y'all panel should both be full and done. Closed. What's full? That's a good question. Define it. I know. Define full because...
00:54:06
Speaker
I don't know what that means. I think at some point I am going to have to have a conversation because I just found out that I'm like booking out like six months. And I thought, well. Six months? Girl. Oh my god. That means your panel should have been closed.
00:54:22
Speaker
To be honest, I'll wait. Look, I had a lady come in. She was like, um, like, yeah, they told me, I said, I'll wait. Cause you know, my girlfriend, you know, Kiki told me to tell you that you need to fix such such. So I'm like, okay. Um, but just the amount of people that I was having a conversation with. And it wasn't that, you know, it was just this pushback or this really like, that was smart, articulate and blood pressures were one sixties.
00:54:53
Speaker
170s over like 90s to 100s. And she was coming for her third appointment. We were trying to say like, hey, listen, this is not getting better. This blood pressure is still elevated. And it was not to the third and you know, I'm giving the same speech. It was not to the third time when I was like, you legit have severely elevated blood pressures that she was like, for real?
00:55:22
Speaker
And I'm like, yes, that is what, and she was just like completely disconnected from the numbers. And was just like, whoa. So I'm like, it was almost like, oh, so when we talk about high blood pressure, that's me, I'm here, this is who it is. And I'm like, yes. And that happened like four times in a row. And I was like, okay, y'all, we can't do this.
00:55:48
Speaker
So they were shocked, they were shocked. And these aren't like, I almost couldn't believe shock when, I'll give you shock for the 150s over 80s. Where, you know, it just got high enough that it turns the whole screen red. I'll give you shocking offer that when we're like, okay, you're 147 over 92.
00:56:10
Speaker
it's high enough to treat it. For real, we need to treat it. Yeah, we need to treat it. Those I understand. But these 160s, 170s, 180s are people that are like, we really do need to like, we need to treat this with medication? Yes, we need to treat this with medication. It's not going anywhere. And most of them said yes, but even as they were saying yes, you could just kind of see it all over their system that they were kind of like,
00:56:33
Speaker
of all the things that I thought you were gonna say, I can't believe you're telling me that I need medication for my blood pressure. So I was like, we need to talk about this people. So 120 over 80 or less is normal. It's not a death sentence. It's more so prevention than like the death sentence. The goal of it is to prevent you from having the event. Also, just because now when you're taking the medicine and it's good, then that doesn't mean you just come off of it.
00:57:01
Speaker
Because they're like, oh, it's good now, so we're good, right? So I can get off of it. Like, no. I get that too, where somebody's like, while I was on it. It's good because you're taking it.
00:57:09
Speaker
Right. They come back to you and they're like off of it. And you're like, well, what happened? And they're like, yeah, well, they had given me some medicine. I took it all. You know, I didn't get a refill. Oh, you didn't ask for another one. Oh, well, they didn't give me. I didn't even know I had one there. Right. I didn't even know I had a refill. Did you call the pharmacy? Well, no, I did call an ass, but I just, you know, I took everything that was in a bottle. Did you look on your bottle, see how many refills is left? Because it normally says you have three refills until such as such, probably year out.
00:57:37
Speaker
It's not an antibiotic. When you get on it, you have to stay on it unless you have been instructed by a doctor to come off of it. Now, if you self-discontinue, all right, just let me know. Like, yeah, stop taking it. What we going to do? Can't do anything about that.
00:57:55
Speaker
But don't have me thinking that the medicine isn't working. Oh, also one of the things somebody said it when they were like, yeah, I took this medicine. It wasn't really working. Everybody doesn't get better on one, one layer of blood pressure medicine. That's not how we use blood pressure medicine. So typically we will pick one, one of a small group of ones that most of us commonly use. And we will try to use that one. If that one works, great. If it doesn't work, if we can increase that one, we'll increase it.
00:58:24
Speaker
If it works, great. If it doesn't, it's time to add on the second one. So you take the one that we put you on plus the second one. So yes, that means you take two. And we will continue to increase that a little bit at a time to see if we get good control over your blood pressure. If that works, great. If it doesn't, we'll keep going. Now, most people do great on one or two blood pressure medicines. They keep moving and it's fine. Every now and then we'll get sign of needs three.
00:58:49
Speaker
But if we give you another one, it doesn't mean to stop the one we gave you and start the other one. Please take all of them because we're layering them on to see if you can improve your blood pressures. Also,
00:59:04
Speaker
please stop coming to the office for management of your blood pressure, not on your blood pressure medicine. You didn't take your medicine. What we gonna do? Like you're coming back so we can see if the medicine works. So that's not gonna work. That's not gonna help us because when you come, it's almost like a wasted appointment and I don't wanna waste anybody's time or money. So if you come and you've not taken your medicine,
00:59:32
Speaker
We gotta come back again because if your blood pressure is elevated, I don't want to change it because what you are on may be working. And if it's not working, I've lost time to correct your blood pressure because you've got to come back later to do it.
00:59:48
Speaker
Coming without your medicine is going to have your blood pressure high. We're going to be in trouble. The other two things that are common that people do that is going to raise your blood pressure and have us questioning if we've got it right is when you take in caffeine and when you take in nicotine. So you cannot smoke.
01:00:07
Speaker
at home and then hop in the car, drive 15 minutes to your doctor's appointment and get your blood pressure taken and go, I swear it'd be lower than this. It might be, but right now you can smoke this cigarette and not your blood pressures temporarily through the roof. So do not smoke before your blood pressure appointment. Try to avoid coffee or nicotine or caffeine during your blood pressure appointment and please take your medicine before your blood pressure appointment.
01:00:34
Speaker
That reminds me, it's, it's, it's related, but it relates to most medications, but blood pressure meds in particular. So I remember I had this lady come in and she was coming in for a headache. You know, she had blood pressure issues. It was sky high as usual. But the thing is, is when you checked her allergy list, she was, I kid you not alerted to every single blood pressure med in existence.
01:01:00
Speaker
The thing was is that these were not true allergies. They were side effects of the medications that she was taking. But lo and behold, nursing or whatever logged it as an allergy and it gets flagged every time you try to prescribe it. So people, there is a difference between a true allergy and a side effect to a medication. When you come into the hospital and I ask you, do you have allergies to any medications?
01:01:28
Speaker
I'm looking more for like things that can cause like what we call an anaphylactic response, like your throat closes, your hives, rashes, all that stuff. That's all bad. There is a subset of blood pressure medications that can cause what's called a cough and they can also cause swelling of your lips. So that is a true allergy for that medication. And if that does happen to you, you need to let one of your doctors know because you can never have that medication.
01:01:57
Speaker
So, you know, when you do get, you know, side effects from different meds, side effects being like nausea, you know, you may feel a little upset stomach. Those are just side effects with the meds. You know, we can work through that, but you know, that kind of limits us in what we can prescribe you. If you say that is a true allergy to the medication, if that makes any sense. So it does. That's a good point. Just the caveat. Cause like, if you're allergic to every blood pressure med in the sun on your thing and you come in with a blood pressure of like two
01:02:26
Speaker
40 over 120. And I can't give you anything. We're kind of stuck. They're going to be like, you know what you're not allergic to? Clonody. Right. That's what you're not allergic to. That's what we're giving you. What's some hydroxy? Figure it out at that point. Or something in the IV.
01:02:49
Speaker
You know, we really got to be, I know it's a little nuance and how we ask it, but for true allergies, when you come into the hospital, we're looking more so for things that can kill you if we give it. So a nausea, a little bit of nausea with taking your M. low to P and that's not going to, it sucks, but you can still take it. We can get your blood pressure down. So just a word of caution when you, when you tell your nurses or your doctors that.
01:03:15
Speaker
But the cough and the lip swelling, that is a big one. So please let us know that happens. Yeah. Any other thoughts, Amy Jo? No. No thoughts. Yay. Good job. I like it. It was a great topic. Please follow Amy Jo's rules and her little nuggets that she gave y'all because we all cosign times 1,000. So we're really just trying to help you. We're trying to keep you around, trying to keep you alive. That's why I was telling my patients, I'm trying to keep you alive.
01:03:43
Speaker
You can fight me if you want to. You want you to be here for a good time and a long time. Right. You can fight me if you want to, but just know that my goal is to keep you around. And if you want to fight me on that, that's on you. But that's my goal. Right. I mean, you came to this visit for a reason, right? If you want to kick it and crack jokes, I could do that, too, because guess what I'm going to do? Back to Chris, like, I was thinking, this copayto. You funny. I mean, we can kick it and laugh. I'm good with that.
01:04:24
Speaker
I'm sorry, while their relationship was, anyway. I try. Go ahead and do your questions. OK, we're going to do the questions. OK, so we got one question. OK? Got it. All right, so the question is, is there a risk to the baby if you decide to smoke marijuana while breastfeeding? Ooh.
01:04:47
Speaker
You are venturing into uncharted territory because there's not enough legal marijuana out here in these streets that I don't think there's been any real research done on it, but nobody recommends it. Dr. Sunshine, I'm sure has lots of thoughts. She always has thoughts.
01:05:10
Speaker
There actually has been. OK, so OK, I co-signed with Amy Jo and Dr. Chris have both said because the research on marijuana intake is actually growing, especially in pregnancy and in nursing. So the data is more overwhelming when it comes to marijuana use in pregnancy, which is discouraged because it can result in a lot of other things. But that wasn't your question. So when it comes to nursing and breastfeeding,
01:05:34
Speaker
There is a transfer of marijuana through the breast milk and it is discouraged. There's not as much data on it. I co-signed what Amy Jo just said, but across the board, it has the same risk factors as marijuana in pregnancy, just not as robust because it all depends on how much you smoke and how much of it actually goes through the breast milk.
01:05:53
Speaker
The risk that exists with pregnancy would be basically that when you have a baby, they have trouble. Kind of like it's a lot of like suppressed meeting of their milestones. And what that means is whenever you have a baby, you want for them to develop properly. You want them to be able to communicate, be able to, you know, have the motions and actions that they're supposed to at a certain age. But they found that if you have if you smoke a lot of marijuana during pregnancy, possibly marijuana through the breast milk,
01:06:23
Speaker
You might have a child that is developmentally delayed. They end up having lower IQs and they end up not meeting their milestones when they're supposed to know formal connection to autism that's still like up in the air question mark question mark, but it's a lot of things that just
01:06:40
Speaker
result in things being slowed. They haven't followed the research long enough to determine like, well, if you stretch out all of these kids until they're like 20 or 25 or 30 years old, do they still end up at the same place? Maybe, we don't know yet. But at least when they did a lot of the studies and they looked at kids that are like five years old, seven years old, 10 years old, they are a little delayed. And their IQs aren't as high compared to women who didn't.
01:07:07
Speaker
Those are my thoughts. I wouldn't recommend it. Listen, I still know some of y'all mamas under real pressure. And I also am aware that some people are using marijuana to cope with all kinds of stuff. PTSD, anxiety, depression, just everyday stressors. And so no judgment here, especially in states where you're allowed to use those things. Here's what only I will add is if
Breastfeeding and Mental Health
01:07:36
Speaker
your coping mechanisms are being severely impacted because of your lack of access to marijuana, then go get you some formula, feed your baby, and eat your eat your edibles. I mean, that's the that is the best thing I can tell you. Obviously, what I would really want to tell you is
01:07:59
Speaker
talk to your primary care doctor or your OB doc. Let's talk about some options. Let's talk about some counseling therapy or some cognitive behavioral therapy. Let's see if there is an anti-anxiety or antidepressant medication because we know that kids that develop in moms that have chronic depression and anxiety is untreated.
01:08:20
Speaker
have an increased risk of depression and anxiety. We also know that moms who raise kids with chronic depression and anxiety increase the risk of those kids have depression and anxieties. So I'm not telling you not to manage your mood disorders. I am just saying that if marijuana has been
01:08:41
Speaker
the way that you have deemed is the safest and most effective way to do it, then they got Similac at the grocery store. So grab you some milk and feed your baby because a happy fed baby means a happy mommy. And if mom is happy and baby is happy and nobody's hungry, that's one less thing on the list of things to do.
01:09:06
Speaker
Yeah. And then, you know, if we have, you can have services like WIC and they can help cover all that stuff for you of cost is an issue. If you need to get formula, all of that stuff can be done. Because it's not cheap. I mean, I'm a proponent of breastfeeding because there's so many good benefits. But if that is a must that you have to do, you know,
01:09:33
Speaker
You want to be able to give your baby the best that you can give. And if there's a possibility that that can cause some issues, I say, you know, stay away from that. Cosine. And it wouldn't be forever. Babies are not on formula or breastfed forever. I don't know what that sound is. What's that sound? Who sounded that? So listen, y'all, I know you're going to leave it in here. A cat has adopted me, OK?
01:10:01
Speaker
That sounds like a dog. And the cat is scratching at the door. Because you're not letting me cat in. Just let the cat in. Just let the cat in. Hold on a second, because she's out of control. One day I was asleep, and I thought somebody was trying to get in the house. You hear me? This cat was about to lose a life. Hold on. Thank you for the question, listener. Dr. Nuno, tell them where to find us.
01:10:30
Speaker
All right, so guys find us on our website at www.thechocolatemds.com.
01:10:37
Speaker
where you can see our website, any upcoming talks, and also use our handy message function where you can send us questions directly, or you can email us at thechocolatemds at gmail.com. Any advice, comments, questions can be sent to that address, and also be sure to follow us on social. We're on Facebook, Twitter, Instagram at thechocolatemds, same handle for all three.
01:11:04
Speaker
Um, so look forward to your questions and we'll keep it moving. Bye. Bye y'all.