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The CDC said whaaaat?
38 Plays3 years ago
Weight loss surgery discussion, recapping the holidays, and Dr. Chris is behind on Insecure 🙄
Happy New Year ya'll! 🥳🥂🎊
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Transcript
Introduction and Host Greetings
00:00:17
Speaker
Ladies and gents and non-binary peeps, welcome to another episode of Chocolate with a Side of Medicine. I am one of your hosts, Dr. Sunshine, and I am joined by my co-host as always. There's Dr. No-No. Hey. Dr. Chris. What up? And Amy JoMD, of course. Hey, y'all.
00:00:38
Speaker
This is a cute little episode. We actually haven't been around each other recording in a while. Even though you guys get the episodes pretty timely every other week, we actually haven't recorded each other in a while. So it's nice to see all of their faces and looking
Holiday Work Schedules and Preferences
00:00:54
Speaker
nice. And this episode is in between Christmas and New Year's. Yeah! What y'all do for Christmas?
00:01:01
Speaker
Took naps. Took naps. You know what? There was something going around on social media where they were asking people, like, surveying, like, working professionals, like, hey, did your job give you off none of the work days? Or did your job only give you off Friday? Or did your job give you Thursday, Friday, Saturday, and Sunday off? And the answer is on social media. I think it started on Twitter, but then, of course, it floated into Facebook and so on and so forth. And people were like, my job gave me Thursday and Friday. And everybody's like, what? Where did you work?
00:01:30
Speaker
Right. My job gave me Friday off. Not Thursday. I definitely worked Thursday. Some people's jobs also observed Christmas on Monday. So a lot of people didn't work today. Oh, that's nice. Oh, that's nice. No, I didn't get it. Because I'll take a Monday off over a Friday any day. I'll work a Friday. I don't know. I don't know about that. I'll work a Friday. If you work a Monday off, oh, man. That's a real win. That's a win. That's a win-win.
00:02:00
Speaker
I mean, I don't know. If I'm going to say, well, I'd normally get Thursdays off. So when I get a Friday off, then it's like, I got Thursday, Friday, Saturday, Sunday. If I get money off, that's even better. But I feel like I would prefer, I'm better with that.
00:02:18
Speaker
I don't know. You know with my last with my last job we got you worked four days a week and you got to pick that one day to have off and then which brought up the debate of like okay if you could have one day off during the week which day are you picking and then I was like I was like you know Friday sounds like should be the one that you should always pick but I'm like
00:02:36
Speaker
Monday off does me personally better for my mental health and just, cause you know, on Sunday I like to watch football all day and then cook dinner. I just like to vibe out on Sundays. So knowing that I don't have to go to work that next day is always a big deal for me. So I think it's different. But I think it's different too, because like there's a lot of holidays cause this is, I thought about this.
00:02:54
Speaker
There are a lot of holidays on Mondays. So it's like, if you get a Monday off, it's a wash because it's already a holiday. You know what I'm saying? You get cheated out of a day. Right. That's how I feel. Learn that in residency. So with a Thursday off, right? There's not too many holidays on a Thursday, only one, right? Yep. That's your Thanksgiving for sure, right? Yep.
00:03:20
Speaker
you know, then you could just request one day. And you got a long weekend. Dr. Chris is always trying to beat the system. Always. He's sticking. Y'all don't know Dr. Chris personally, but this is like a snapshot of her real life. She stayed trying to beat the system. Trying to get these days. Nah, son. Nah, son. You ain't gonna get one over on me, son. I feel like, though, because I'm half days on Thursdays, even though I never work a half day.
00:03:47
Speaker
But during the holiday, I really try to make it my business to be like, okay, y'all do not squeeze anybody in. Do not take any last minute phone calls. Like, oh, please ask if she can just, you know, squeeze me in. I typically like whatever's on that day, that Thursday, that's it. Well, I don't like working half days because half days are never half days. They always end up being a full day for me.
Holiday Cooking and Cultural Food Differences
00:04:15
Speaker
Yeah. I mean, they're full days, but at least I'm not in clinic, right? So, you know, the one good thing about the half day, especially on the holiday, is that once I see that last person for the morning, it's done. Like, I close my door. Please don't knock on my door. I just need to just...
00:04:33
Speaker
I love how that's office etiquette. If my door is closed, either I'm with a patient or I am very busy. Yeah. I can close the door and I can feel the weight come off. When I close that door and I take that white coat off, I'm like, I feel so much like
00:04:51
Speaker
because you could just answer questions and go. And so that's nice because at least I know I can start a transition to the next day, which is exactly what happened. So I got groceries. So you had Friday off? I did, but I cooked. I cooked for Christmas. You cooked? Oh, look for me. What did you cook? Macaroni and cheese, asparagus, potatoes, pan fried potatoes, and steaks. I made some ribeye. Wait, pan fried potatoes?
00:05:18
Speaker
with a little rosemary and thyme and a little garlic and they were delicious. It's a fan favorite. I cooked for a party of one but I made a Cornish hen with some collard greens, potatoes and rice. Beans, greens, potatoes, tomatoes.
00:05:38
Speaker
I used that Dutch oven. I think one of y'all told me to get it. It worked like a charm. Dutch ovens are the bomb. They're the absolute bomb. I just need to get a grate to put on the bottom of it so that when I put liquid into the Dutch oven, it won't make the meat all soggy. Other than that, it worked really well.
00:05:57
Speaker
I cooked for my future in-laws and their entire family. But me and my future mother-in-law, we have to talk about the menu because she was like, oh, what do you normally cook for your family? I'm like, y'all don't eat what I normally cook for my family.
00:06:15
Speaker
We can do it. We can do it. We can. We can. We can. I'm like, okay. So my fiance ended up making the meat. So he made this huge roast and that was just his one job. Like you do the meat. Like you just focus on that. And then I made sweet potatoes, sweet potatoes, mac and cheese, green beans, some desserts. And I left it at that. I'm like, ah, collard greens might be a little
00:06:38
Speaker
like what a college anyway y'all understand what i'm saying but the listeners are probably like what would you mean anyway i thought i'd be talking about like deep down home southern like chitlins and all that good stuff so i'll be i wish i was sure openly with with our with the audience who doesn't know me personally so my fiance is latino this is
00:06:58
Speaker
And they do not believe in vegetables. Like every time I go over there, there are never any vegetables. There's rice and beans and lots of meat and tamales and tortillas. And there's nothing green on the table, ever. There's never anything green. I'm the whole time. You mean the salsa, right? Boom. Vegetable, right? It's just like the closest thing you'll get something green, you'll get some plantains.
00:07:22
Speaker
She'd be like, I, like, oh, I'm like, I'm like, listen, y'all, y'all can't be eating all this food and not have nothing green over here. Like they don't do broccoli asparagus. It's just not part of the diet. I'm like, y'all, like, aren't y'all constipated? Like, how do you like vegetables?
00:07:40
Speaker
You're like, what's going on here? Yeah. And every time I'm like, don't we need vegetables? They always look at me like, I guess. I'm like, what? We got that new coffee to clean them out, like Colombian coffee. And when I was going to say, oh, should I make collard greens? I was like, what are those? I showed her a picture. She's like, what are those things like? And I was like, you know what? This will be for next year. We'll do this next year.
00:08:00
Speaker
You know, it's okay. It's fine. But she likes, but she likes my cooking a lot. Like she loves my cooking, but she's just like, what does your family normally eat? I'm like, listen, are we having this conversation? Are we having this conversation? Cause I know we, are we doing a hybrid? You want to make rice and beans? Like what are we doing? What are we doing? What are we doing?
Entertainment and Pop Culture Discussions
00:08:15
Speaker
Yeah, see. But your cooking is good. So I think anything you would have made would have been great. Absolutely. But I felt like the mac and cheese, the sweet potato pie, all of that. I'm like, OK, this is enough. And then we kind of merged the two things. I mean, we got meat and starch. That's pretty much most of our Thanksgiving at Christmas dinner anyway. Meat or sunshine made dinners for Christmas. They were delicious. I didn't make dinner. Households were happy.
00:08:46
Speaker
But I will make I will make soup for New Year's. I will do that. Oh,
COVID-19 Isolation Guidelines Update
00:08:53
Speaker
yeah, I will definitely do that. I would definitely do that. Because what's in what's in what's in it? It's like pumpkin soup.
00:09:03
Speaker
Well, they say it's a good look, but that's what I say. But apparently I was wrong. My grandmother used to make the soup. My dad made the soup. Like everyone makes a soup on New Year's Day. That's what you drink. You drink the soup. So that's nice. I like it. So that's why I'm going to make sure what's supposed to do is give you good luck. Well, that's what I said. But apparently, no, it's just something just to celebrate independence.
00:09:30
Speaker
Gotta be careful what I drink. I'm like, is this like a fertility drink? Am I trying to, is this gonna help me have a baby? They be like, oh, you having trouble with this? Ooh, eat this. So you gotta ask. I don't know. They just added, as a kid, they just like, okay, this is what you eat, drink. This is all we have. So everybody drink the soup and everyone comes together and they drink soup. And that's probably what we have all day.
00:09:50
Speaker
Oh, that's cool. So I make the soup and I'll be drinking my soup by myself, but that's okay though. You can send me some. So we all had corn pudding, which I actually never had until Thanksgiving. It's delicious. I know it's so good. I've never heard of it. It's like, it's like, um,
00:10:12
Speaker
cream corn and, um, Jiffy mix and like... Like Jiffy cornbread mix? Yes. It's like whole corn, like, yeah, whole corn kernels and it's like baked. And so it's almost like it's soft, almost like a soft cornbread, like, um, because it's really moist from like all the corn and everything. It's, I love it. Like I keep asking for it. I gotta stop cause...
00:10:42
Speaker
you know, I tried to put these, man, you know, I tried to put these jeans on the other day. It did not fit. I was so, I was so confused that I had to take them off the, and you know, you know, when like you get real confused, I had to take them off and check the size, like what? I was like, Oh no, these are my size. What was my size? I don't even know how to define it anymore. Right. But, um, yeah, but you got confused.
00:11:11
Speaker
I know, they weren't in my closet, right? So yeah, I was like dang. I feel like it's lightweight offensive whenever jeans don't fit
Bariatric Surgery: Challenges and Considerations
00:11:17
Speaker
because jeans are kind of, most of them got a little stretch to them, you know what I mean? So when they really don't fit, like don't fit for real, you'd be like, wait, what do you mean you don't fit? It's very uncomfortable. I'm almost called a cramp in my abdomen trying to like hold my stomach, trying to button them up.
00:11:37
Speaker
I was like, I can't believe this shit. I went and saw Peloton on all of my TVs so that every time I turn on the TV anywhere in his house, little Peloton app come up and be like, you know what you could be doing instead of watching ESPN.
00:11:56
Speaker
Um, so yeah, it's, it's gotten real, you know, you know, Beyonce got to jump to put on jeans too. So, I mean, anything I can do, if you don't just put jeans on, baby, please don't get me. Look, cause all right. Thanks. I'm just saying if she got to jump to put on jeans, I can, I can jump to put on jeans too. Cause we definitely jumping these days.
00:12:18
Speaker
But she didn't talk about no cramping in her abdomen, though. She didn't talk about a cramping in her abdomen. It just didn't work with the song. It just didn't rhyme. She didn't talk about that. It just didn't rhyme. That's all. She didn't talk about a cramping in her abdomen. She didn't describe none of that. Yeah. Oh, my god. Did y'all watch Issachar? Yes. Oh, yes. No. No, I didn't. Wait, hold on.
00:12:41
Speaker
How could you not? You knew this day was coming. Wait, wait, wait. It was just, what do you mean? It was just yesterday. It was literally yesterday. Because I watched it the next day. But if this is the next day. Right, but I didn't get a chance to. Because you knew it. Oh, oh, oh. You're caught up, you're caught up except for the finale. Oh, Dr. Chris. Oh, dang, I'm sorry. Why are you doing this? We need to discuss this. You knew I was going to spoil it like you knew this was coming. I'm sorry, I feel bad. OK, I won't.
00:13:11
Speaker
I won't. I'm going to spoil it for you. We all spoiled you last week. We all can't spoil it. No, Sex in the City is different. Come on now. Sex in the City, you had mad years. Stop. So let me catch up, and you on season one. Right. I missed one episode. One episode. Come on. Yeah, whatever. Yeah, Dr. Chris missed an episode. You missed a decade. Right. She's like, let me catch up real quick. What? No. She ain't even met Big yet. You told me I can catch up. He did.
00:13:41
Speaker
and lived a full life and died. And you like, let me catch up. I have more spoiler disclaimers for this episode. Sorry, y'all. Okay, well then, listeners, I will be held responsible. I will personally make sure to put a pin in this and then we can discuss, I'll put a pin on this and then we can discuss next episode. If you guys can hear our opinions, you know. I'm so sorry, y'all. I didn't ask questions. I'm so good. I feel so bad. Normally, I'm on top of these things.
00:14:10
Speaker
This is true, because you watch TV with the best of them, girl. I watch TV hard. The fact that you let me beat you to this, I just want you to understand that I have seen, y'all, I've completed the whole series besides Sex and the City. Look at you. Insecure. Look at that.
00:14:27
Speaker
Round of applause. Second series of my life. Yay! Round of applause. Thank you. Thank you. Wait, wait, wait. You didn't complete any Shonda series? Nah. You didn't do Scandal? You didn't do, like, no? No. I've seen a few here and there, but I've never, I'm not a completer. Wait, the nights that we were watching Game of Thrones? Who said I'm not a completer? I never watched that. I've never seen a single episode. Wow.
00:14:50
Speaker
Oh, that was just you and, okay, nevermind. She's not a Game of Throneser. I mean, she's present. She was present in the apartment. I might be moving around, right? I won't disturb you, but I just am not watching it. I like to watch people watch TV. I'm comfortable with y'all being in there watching TV, but I ain't necessarily watching it. I'ma watch y'all watch it. Yeah, I'm probably gonna be sleep. But...
00:15:18
Speaker
Yeah. I can't sit still for that long. We'll put a pin in that. Mind you, episodes of Insecure are very short. That's probably why you made it all the way through, because they short. They are. They short short. That's why Amy Jo can make it. He's like, right as her attention span is waning, it's like, boom, it's over. She's like, oh, OK, it's good. All right, we good. I know. I'm very satisfied when it goes off. I'm like, OK, thanks. Appreciate it. Thank you so much.
00:15:43
Speaker
That's just the right amount of time. That's just right. It's lovely. Like somebody in the lecture or a PowerPoint presentation right on time. She's like, ooh, perfect. Thank you. I'm sorry. I feel like a failure right now.
00:15:56
Speaker
I should have watched it. I know you think it would have been juicy. I forgot. Listen, Dr. Chris, I was so behind for forever. I hadn't watched any of it, and I was about seven episodes behind. Then I'm like, all right, let me go ahead and binge it, because I know the finale's coming up soon. So I binged all seven, and then I watched eight, nine, 10. I should have called you, because it came on right before we started to record.
00:16:20
Speaker
And you would have been finished with it, because it was going off as the link, as Dr. Sunshine sent the link. But it's cool. You know, watch it. We'll recap our thoughts and feelings at a later time. It's cool, Chris. Because my thoughts and feelings are not going to change. They are very firmly where they are. So listen, we'll talk about it.
00:16:52
Speaker
You know, I feel like whenever it's my turn for training topics, I don't get the good training topics. Because when it's not my turn, I'm like, ooh, ooh, look at that. Ooh, headlines, yes. And then mine came along. All I had was COVID. And I'm like, boo on that. Boo on that.
00:17:14
Speaker
Okay, yes, I do have them. Let me see. I'm gonna keep them short and sweet, right? So there were no big major, like, what there were, but they weren't like, like, here is something to know. I mean, we'll talk about COVID in a second, sure. First, I would like to send Cadolus' Rest in Peace to Archbishop Tutu.
00:17:37
Speaker
Oh, yes. Yeah. So that was one thing, I think he was 90. So 92. So, you know, God rest his soul, you know, prayers for him and his family. You know, I'm not going to pretend like I'm a
00:17:58
Speaker
always up on current events. But I remember reading an article that had been written about him where when the government was legally shutting down activism in South Africa, the church, specifically the archbishop, was instrumental in becoming an activist, right? So becoming the voice of the people who had been
00:18:20
Speaker
you know, kind of, you know, locked out of the system. And so he became an activist, you know, for anti-part-time movements and, you know, kind of really got involved. And so, you know, it was just kind of his duty, you know, as somewhat of the church and of the clergy who could not be silenced, that took over being that voice until those people get back. And this went on for years, you know, where he was, you know, doing some of this work. So
00:18:46
Speaker
I thought it was important to acknowledge his work and wish his family well. So that was one thing. So sad.
00:18:59
Speaker
And then, um, back to COVID. So the CDC y'all has, um, I'm not going to say anything bad about CDC because then, you know, I have thoughts, but the CDC has changed their guidelines on returning back to work.
00:19:21
Speaker
And I learned this because I started getting all these calls like, do I really have to go back to work? Somebody told me I have to go back to work and all this kind of stuff. And I was like, what were you talking about? And of course, I read these guidelines. And so the CDC has said that based on what they know about COVID and the Omicron variant,
00:19:40
Speaker
that they are shortening the isolation time from 10 days to five days if you are asymptomatic. So if you somehow just tested positive for COVID and you were like, wow, I didn't have any symptoms, then your isolation time is no longer 10 days. It's actually five days. And they are using the science that's motivating this, saying that the majority of people
00:20:06
Speaker
who are going to be contagious is going to occur early. So one or two days prior to the onset of symptoms, then two or three days after. So somebody says, oh, I got sick on Thursday. And then they're assuming that you were contagious probably Tuesday, Wednesday. And then you're maybe going to be contagious Thursday, Friday, Saturday.
00:20:28
Speaker
So by the time Monday comes around, you are not that contagious. They just recommend that you wear your mask for five more days around people. Now, I thought you were supposed to wear your mask around people anyway. So I'm assuming what they mean is that even in your own home, maybe, or around, you know, close contact, loved ones that you still have to wear your mask for another five days, but you can go back to work. So yeah, that's going to have people feeling away.
00:20:53
Speaker
I mean, my issue with that is just, you know, if you're taking care of people where, you know, you know, your immunocompromised or, you know, because there's some cases they're not, they're not common, but you know, cases of people are get that do get breakthrough infections, even with their booster. You usually see that more often in your immunocompromised folks. So if you're bringing
00:21:15
Speaker
COVID positive folks, even though they're asymptomatic back to work with an extremely contagious variant and they happen to get COVID, I mean, you could be patient zero for a lot of people that are coming into the, you know, into the hospital for something else. And that would, that would create a lot of issues. So I,
00:21:34
Speaker
I don't agree with that stance the CDC took for that at all. I mean, especially in areas where I sort of median age of my patients is like 90. Even though they're vaccinated, they're still extremely high risk group for if they do get infected with COVID, then they're more likely to be hospitalized for it. The difference between a severe infection versus just a couple of days on the hospital floor is another thing.
00:22:01
Speaker
I mean, you could potentially have these vectors just walking around your hospital wards, infecting people willy-nilly and not even knowing about it. They're only doing that for staffing issues, really, because we're seeing the crunch with our nursing. Almost every hospital in the US is having a nursing staffing issue right now. Mind you, it's not just the health facilities.
00:22:28
Speaker
Like this is something I think that they put in place. Well, I'll go deeper into those thoughts later. But even in terms of like all the all the canceled flights they had to do for the airlines for American Air for not American for United and for Delta Airlines, they were pushing the CDC to change the recommendations from 10 days to five days so that they can continue staffing and continue making money.
00:22:47
Speaker
because we live in a capitalist society and it's all of a sudden turned very political. Not all of a sudden, this is political from the beginning, but when you live in a capitalist society and people have economic implications in mind, then, because the CDC is funded by the HHS, which is funded by, this is all trickle down from the government. So it's, I mean, I won't get on my soapbox, but
00:23:12
Speaker
There's just a lot of issues with that decision. I really don't agree with them at all. But yeah, it's definitely coming back. But there's been multiple times throughout this pandemic from the very beginning that the CDC has said things that I'm like, that doesn't sound right. That doesn't sound on par. But then you have to think about the political implications behind it.
00:23:36
Speaker
For a full transparency so that the listeners understand because the CDC is a branch of the government. They are funded by the federal government and when changes happen, sometimes the trickle downs from above and they're at the bottom. Technically, they're not at the bottom because the CDC then gives funds to each of the local health departments. It's a chain, it's a flowchart, so listen.
00:24:00
Speaker
As someone getting a public health degree, this is what we talk about constantly because the funding to the health departments comes from the CDC, which comes from Congress, which comes from. So, you know, there's people making these decisions and they're like, hey, we're going to give you funding to do this and you're going to do this because this is what Congress voted on. So we're doing this. We're doing it. And that's just what it is. This is going to be interesting.
00:24:24
Speaker
I mean, not that people have not been doing this. So I think the issue is that the people who would have preferred to quarantine are now not being given a choice. So what we have to know is that we've been doing this to a certain degree the whole time. There have been plenty of people who
00:24:44
Speaker
you know, eat what they kill, so to speak, which means if they don't go to work, they don't get paid. So we have highly, we've been highly suspicious and have had confirmed cases of people who were like, no, I'm not getting tested. No, I'm not sick. No, that's not a fever. I just took some Tylenol seed. I don't have a fever and they've been going to work through COVID through everything because they have no choice but to work.
00:25:09
Speaker
Um, so I think, you know, we know that people have been entering the workplace, but this is still going to feel different when people say, Hey, I have COVID. Um, I'm trying to be responsible in my mind and not expose people. And the workplace is going to say, ah, it's been five days. You're fine. Come on back. They're not even asking for a retest, you know, which is hella suspicious. So I, well, retests fill out the window. Uh,
00:25:36
Speaker
2020. So we've, we've not retested, we've not retested to as a requirement to go back to work in over a year. That wasn't ever a part that took that off a long time ago. Yeah. Yeah. But I mean, after five days, I mean, you know, you're still going to be positive for most people. So I just, yeah.
00:25:57
Speaker
and continue to be positive. Some people up to three months after. Yeah, we were seeing that a lot early on. But then they're just saying that you're just not contagious after five days, even though this Omicron variant is more contagious. They're saying that you're probably contagious for the first five, essentially the first five days of your
00:26:24
Speaker
actual infection. But they're saying that you spent a couple of those days at the height of your contagious contagion. Is that the right word? I don't even know. I know. When you're when you're most contagious, you probably don't even know that you have it yet. Right. So they're saying, well, you know, you've already had those two days and then you develop you develop symptoms or you test.
00:26:48
Speaker
And you become positive. We know that you've been contagious a couple of days before that, and probably I'm going to remain contagious a couple of days after that. And so after that, your chances of spreading it drops off significantly. At least that's what they're saying. Now that came awfully quick.
00:27:07
Speaker
You know, I just don't remember reading like, yeah, you know, we're thinking actually you're only only contagious for five days. And so it's going to feel very sudden now to anyone listening. I didn't hear about it because I was not looking for it and I did not read the research. Okay. So don't be out there like Amy joined. He said that it doesn't exist. It probably did exist, but I wasn't looking for it because I really wasn't prepared for the CDC to change the.
00:27:34
Speaker
the quarantine guidelines to say, nah, five days in it. I only looked up the guidelines because I got all these people coming back positive and their jobs were like, they were, I was getting pressure like, hey, my job is then I got to go back to work because these guidelines, what's the deal? And I had to read them and say, yeah, you know, they're following CDC guidelines. So yeah, you've got to go back to work, which sucks.
00:27:57
Speaker
Yeah. Sucks. Welcome to medicine. America. You said medicine. I said America. So if I'm trying to do a Dr. Chris, can I just say, Hey, I got a little stipple stipple and extend that out to 10, 14 days. Is that possible?
00:28:14
Speaker
You better submit your FMLA documents so you don't get fired, messed around with your life in. I'm not going to fire me, but I don't know about you. Don't be trying to follow Dr. Chris if you end up fired in these streets, okay? Don't be trying to do that. I'm playing, y'all playing live.
00:28:31
Speaker
Don't do that, y'all. Don't do it. First of all, first of all, Dr. Chris has been living his life for a long time. And she navigates her own life. I feel like if someone tried to pivot and live a Dr. Chris life, it's not going to work out for them. They're going to be like, oh, man. I don't know. I don't got fired. If people don't cut off the electricity on me, all types of stuff. I'm not new to this. I'm not new to this.
00:28:57
Speaker
Don't be trying to follow me, and then you end up with no job. So don't worry. And then come at me and be like, oh, well, Dr. Critt, no. I didn't tell you to do what I do. I did not. All righty. So I guess we will pivot to the main topic today, presented by me. Yes.
00:29:27
Speaker
Ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba ba
00:29:55
Speaker
I'm ready, I'm sorry. I got excited actually with me. So I decided to pick this topic because actually I had a friend of mine that asked me to do this topic. So I decided to do it. So we're going to talk about pretty much bariatric surgery. So that's the weight loss surgery. I'm going to try to keep it kind of focused on just that. So we're not going to talk about some of the non-surgical interventions, just kind of like more
00:30:22
Speaker
more about it, criteria, what does it involve, and also probably going to focus a little bit more about post-surgery because that's kind of a lot of times when I end up seeing a lot of the patients is after they've actually had the surgery, right?
00:30:41
Speaker
Can I just say that this talk is very nicely timed because it's right after Thanksgiving. It's after Christmas. People are kind of reassessing where they're at in their body journey. And, you know, yeah, conversations come up. Yes. Good timing. So I want to put out my disclaimer.
00:31:01
Speaker
I am not a surgeon, so I just want you to understand that I am not a bariatric surgeon, so I am not going to go into all of the details. I'm just going to give you an oversimplified version. And when I mean oversimplified, I mean oversimplified version.
00:31:21
Speaker
of kind of what the options are, kind of a little bit what to expect, some of the risk involved, and possible complications. OK? So let's go to body fat. I like it. Let go. All right. So bariatric surgery, on average, the weight loss could be up to 60% to 70% of excess body fat after you do the surgery. OK? And up to short term, up to 50% at 10 years. OK?
00:31:49
Speaker
lose a lot of weight in a short amount of time. And with that, you can have remission of type 2 diabetes. It occurs in like 60 to 80% of the patients two years after surgery. Overall, the procedure has a mortality risk, which means that the risk of you dying from the surgery is less than 0.5%. Okay. And... That's quite impressive. Right. The way anesthesia be harassing me over these BMIs of 50.
00:32:17
Speaker
Right. You're all cause mortality. So meaning mortality from all types of other things like your diabetes, hypertension, it's reduced by 30 to 50% at seven to 15 years post surgery compared to people who still have, who have still obese. Okay. So
00:32:35
Speaker
I didn't know that. So yeah, it definitely has a lot of good benefits, right? So first off, you have to meet a certain criteria in order to possibly qualify to get this surgery, okay?
00:32:50
Speaker
If you have, so we basically measure, I'm sure you've heard us talk about this, your body max index BMI, right? A normal BMI is less than 25, right? 25 to like 29.9, you're like overweight.
00:33:08
Speaker
at 30, over 30 and above, like you're obese, and then you hit morbidly obese, like over 40. And it keeps going up. And as Amy Jo has said before, then you see the more fluffier patients that you're missing. Fluffy, like very fluffy.
00:33:25
Speaker
And even if you guys don't know your BMI, when you go to the doctor's office, especially during the physical, they can tell you. Usually I tell my patients all the time, because it's a measurement that we do is based on your height and it's based on your weight. And we tell you what your BMI is. So if you don't know, you can always ask. Sometimes after the visit's over, there's a printout that they give you. And sometimes it has it on there too. It has it. If you're in an Epic system and most of us do now, it's going to give you your BMI now. But I will tell you. I think it has your blood pressure from that day and the BMI, right? Doesn't it have both? Yeah.
00:33:55
Speaker
It's like one of the most important vitals assessments. Every time you go and see the doctor, we have that. Your BMI is always there. Your blood pressure, heart rate, all of that is always there. And it's helpful for us because it helps us assess your risk for certain things. And so if you have a BMI of 40 or above, you don't necessarily have to have any other coexisting medical conditions.
00:34:24
Speaker
you already could qualify for this weight loss surgery. If you have a BMI of more than 35 or above with one or more severe obesity-related diagnoses, then you can qualify. And what that means is having a diagnosis of type 2 diabetes, you have severe obstructive sleep apnea. You talked about this before, I believe, in one of our episodes.
00:34:49
Speaker
heart disease, hypertension, high cholesterol. That's one of the criteria. Or if you had a history of obesity for more than five years, have had previous attempts of weight loss, supervised weight loss, medically supervised weight loss program, and you failed, you can qualify.
00:35:10
Speaker
No, you have to have no health conditions that could make the surgery an unacceptable risk. Like if you have severe heart failure or really bad COPD, like breathing issues, you probably won't really qualify for that because it's a risk versus benefits kind of a thing. You have to have to be emotionally stable in order to pass a psychological evaluation in order to have this surgery.
00:35:40
Speaker
right? And then also have the understanding and willingness to do the necessary diet and lifestyle changes required by the surgery. This is a very important step that people have to understand. Because having this surgery is going to change how you eat and how you should live your life. How you should eat. How you should eat. Right.
00:36:05
Speaker
Now, mind you, I think that, I mean, I don't know if you're going to go into it, but just kind of like in the realm of setting expectations. Whenever you talk to a patient, whenever I've talked to a patient and I'm getting them prepared for this whole process, you're going to have multiple doctors. You have the surgeon, you have us, you might even have another. Some surgeons want you to be that psych evaluation Chris just talked about. Sometimes they want that from a psychiatrist. So I like to set expectations for these patients and let you guys know. This whole process might take a while.
00:36:32
Speaker
And especially once you get your insurance looped in, make sure it's covered, stuff like that. So this isn't a quick process.
00:36:38
Speaker
I'm just setting the expectation. Right. Insurance brings up an important point. So generally when I'm giving this whole speech, I tell people like, you know, a BMI 35 with something from a science standpoint qualifies for weight loss surgery, right? You know, a BMI 40 higher with just a BMI from a science standpoint qualifies because for most people, the rate limiting factor is going to be your insurance.
00:37:05
Speaker
So I've seen people who should qualify with zero effort be turned down because their insurance just doesn't cover it. So even though we're getting to the point where we're seeing a lot of people who really need to have weight loss surgery, like we've kind of exhausted many avenues. I've seen those people still get turned down. So I guess in addition to all those things, one of the other things that I need you, the patient,
00:37:34
Speaker
to do, or you the person that's interested, call your insurance company. Because there are elements to particularly bariatric surgeries that I can't do, and that you're banking on the weight loss clinic to do. And some of them are really good at it, some of them maybe not so much, and that is getting it through your insurance. And sometimes the weight loss clinics need your help.
00:37:55
Speaker
to kind of advocate for yourself when you're calling these reps to say, hey, that's not a thing. You all should really be clearing me for the surgery because of XYZ, because they love turning down. I don't know why they love saying no to this particular surgery so much, but insurance companies stay saying no.
00:38:14
Speaker
Yeah, and I think, I mean, everything is always about cost. And the thing is, too, a lot of times, even if I don't know if anyone has ever seen, what is it, My 600-lb Life? Oh, you knew that's my show? I love that. I forgot the name of the surgeon.
00:38:30
Speaker
He is so rude, but so funny, but I love him. But if you see that, he requires the patients to lose weight prior to having surgery. So like we're saying, it is not a quick process.
00:38:47
Speaker
Like you have to, they're gonna make you lose weight and put you on a diet. And this is for many reasons, but one of the main reasons why they do this is so that you can understand that kind of gets you started on how you're gonna have to eat even after you have the surgery, right? Now you know I struggle with this part, right?
00:39:10
Speaker
which is why once I've exhausted everything and I turn them over to weight loss surgery, I try my very best to be as hands-off as possible because I need to not interfere in that process. So not to tell patients that once I turn you over to weight loss clinic, they really become the people that you got to talk to about your nutrition and everything because I'm almost timid to even say it out loud.
00:39:38
Speaker
the plan that you're gonna be on leading up to surgery is not sustainable for life, especially for people who have lived a lifetime wrestling with food choices. So they never, they never, no one ever stays on what you were eating like those like two weeks leading up to surgery or whatever it is. You don't eat like that after surgery, maybe for a few weeks, but you eventually start introducing
00:40:05
Speaker
um more solids you know more options uh weight loss clinics are very like focused on uh high protein you know food sources stuff like that which is you all know uh not that i'm against proteins but i
00:40:24
Speaker
I don't see where we've been checking these pre albumin levels and seeing that people are, you know, malnourished. And so I have a hard time correlating high protein diets to true nutritional outcomes. Like there's no proof that these people are malnourished. There's other things that they may not be.
00:40:44
Speaker
because I push a whole lot of low-fat, whole-food plant, lots of plants, even if they're gonna have meat, but I want lots and lots of plants, and I want some proteins, that's different from the high-protein, low-carb, so I have to just keep my mouth shut once they go through there, and it's so hard, but I'd be like, you can do it.
00:41:03
Speaker
Well, there's a reason why they in the beginning prior to surgery that they they recommend the high protein diet and I will talk about that. Okay. I will also emphasize before you go on Chris is that along with the psych evaluation, because I'm sure somebody out there who's like, why am I doing a psych evaluation?
00:41:23
Speaker
So they're doing the psych evaluation for multiple reasons. For one, a lot of times in a psych evaluation, they're going to evaluate you for eating disorders or anything that they feel like might complicate either leading up to surgery or the post-op. So it's screening for eating disorders. They want to make sure that you have the capacity to make your own decisions. And it's also a way for them to kind of gauge
00:41:44
Speaker
And it sounds really weird to say this, but because it's such a touchy surgery and there's a surgery that needs a lot of ongoing maintenance afterwards, they wanna make sure that you don't have any other like undiagnosed mood disorders or psych disorders or mental health disorders that might impede you from making it to your appointments on time, remembering to eat certain foods, not to take certain medications because like Dr. Chris is about to talk about, there's a lot of lifestyle changes that happen and that includes medications you can't take and stuff you can't do.
00:42:13
Speaker
So they actually really need you to make sure that there's nothing else impeding your judgment. And that's kind of part of the psych evaluation as well. There's different types of surgeries. I'm not going to touch on all of them. And because, you know, I like threes, so we're gonna do three things. Because everything is just better in threes, right? So you can do either laparoscopic surgery or an open procedure.
00:42:39
Speaker
and I'm sure you've heard us talk about laparoscopic surgeries before and that's pretty much, it's less invasive and it's kind of cool if you see it. They put little holes in your stomach and you put a camera and then they're using these tools in order to clip and snip and it's more precise because it's like that and instead of an open where they're just like
00:43:03
Speaker
literally cut you open and open up and sew themselves. The recovery time is a lot shorter when you do the laparoscopic as opposed to open. So most of the surgeries are going to be laparoscopic. So there are three types of procedures that you can do. You can do the laparoscopic, the adjustable gastric banding, like the lap bands procedure. You could do a sleeve gastronomy or a Roux-en-Y gastric bypass.
00:43:32
Speaker
The laparoscopic gastric bypass banding, that's not very common anymore. And partly it's less, it's a little less invasive, right? So basically what they're doing is they're just kind of like putting, so I'm going to tell you guys that you have to have an imagination, okay?
00:43:52
Speaker
because I can't show you a diagram. That's what they told us in residency. You need imagination, okay? So basically what they're doing is they surgically place this band around the top of your stomach, right? So it's this band around your stomach. So what it's supposed to do is kind of like compress the stomach a little bit and make it more restrictive so you can't eat as much. So if you can't eat as much, less calories, right? You end up losing weight. That's the whole thought process behind it.
00:44:19
Speaker
And you should feel full earlier. Right. And that's the point of it. So what they do, they put the band in, but they don't tighten the band when they put it in. They leave you like four to six weeks. Then you come back in. They inject some saline into a little port, right, to kind of tighten the band around the stomach. Right. And then kind of to the point where you feel a little not too so you can kind of feel comfortable and still eat, but not so much. But
00:44:47
Speaker
The thing is, it has lost favor in the sense that you don't get to lose as much weight.
00:44:54
Speaker
with it, it's not the most popular one anymore. So really the ones that they normally end up doing is the sleeve gastronomy and then the rule and why gastric bypass. So those are the more common ones. And really, to be honest with you, the one that you get is basically depends on what your insurance covers and what your surgeon knows how to do the best in a sense. Yeah.
00:45:19
Speaker
I agree. Because you might want the sleeve gastronomy, but your insurance will only cover the rule and why, right? So it's kind of like you get what you get in a sense.
00:45:28
Speaker
I will say in terms of the lat band, the reason why it was popular initially in the past is that the lat band is a procedure that doesn't involve you having to surgically either cut or remove any parts of the stomach or the intestine. So for the listeners out there, if you imagine your whole GI system is like a tube, it goes mouth down through your throat and your esophagus connects to your stomach and then your intestines and then you poop.
00:45:54
Speaker
It's one long tube from the mouth to the anus. It's just going all the way through there. And the lat band was popular because it's just a device that you can put around the stomach, kind of like a hair tie around a balloon, I guess, if you want to think about it like that. But it doesn't involve you cutting into this balloon or connecting this balloon to something else. So it was...
00:46:12
Speaker
Previously very highly favored, but like Chris said, people will go to the surgeries and get this band and do the things, you know, to get the band plays. But then ultimately what they want is the result. They want the weight loss. And over the years when the weight loss doesn't come, they're like, Hey, like I got this band on my belly. I still can't eat the way I want. I'm full earlier and I don't see the results, which is always a problem. Cause that's what they did it for is the results. Yes. And I am so glad that you told that simple.
00:46:40
Speaker
process of, oversimplified process of digestion. It's awesome. So then we can, you know, I don't know what people think happens when they eat food. If you listen to some of these patients say what they think happens, I'm like, no, no, no. Mouth, esophagus, stomach, intestines, and then out. Like there's things happening along the way, but it's just a belong to. That's all it is. Or do you eat it? What else are they explaining to you? I'm curious. Oh,
00:47:10
Speaker
Because especially when you try to explain to people about acid reflux and GERD and just trying to relate what they're eating to what they're feeling in their belly, you're just kind of like, what do you think is happening in there? When you eat this chili dog with all this extra hot, where do you think it's going? I don't understand. Oh, but I thought the acid was just supposed to just... What? What you thought was... Anyway, don't get me started.
00:47:36
Speaker
So when Dr. Sunshine is explaining the whole digestive process, right? The food pipe, your esophagus goes down to the stomach, then from the stomach goes to the small intestine to a large intestine. Your small intestine absorbs a lot of your nutrients that you need.
00:47:55
Speaker
And that's kind of important to the whole process to get energy and weight gain and all of that. So now your laparoscopic sleeve gastronomy. So basically what that is doing is that they're literally cutting off what it says, a sleeve, kind of like a sleeve of your stomach. So really they're cutting a part of your stomach
00:48:20
Speaker
out, okay? So therefore, since they cut a part of your stomach out, you cannot really eat as much, right? So therefore, you end up ingesting less calories, end up
00:48:34
Speaker
losing weight that way. So that is the whole main premise with the sleeve gastronomy. Now, procedure that they can do, the Roux-en-Y gastric bypass. Again, stay with me, guys. Imagination.
00:48:50
Speaker
So, so basically with the rule and why, what they're doing is they're creating the small pouch from your stomach and changing the connection. So the stomach goes to the small intestine, right, to the large intestine. So it's still the pouch that they create, they put a connection to your small intestine, but like
00:49:10
Speaker
the second part of your small intestine. So it doesn't go all the way to the three parts of your small intestine that you normally have, right? So therefore, when it does that, it's bypassing that area where a lot of your vitamins are absorbed, a lot of the absorption of your nutrients occur. And because that happens,
00:49:32
Speaker
then you end up losing the weight. So you end up not able to take much root in and also not able to absorb as much of the nutrients, though you end up losing weight.
00:49:43
Speaker
Why didn't you just call it a shortcut? They make a shortcut. Yeah. So it's like a bypass. Shortcut. You're right. Shortcut to it. But because they took the shortcut, you're missing some nutrients. But that's OK because we can just replace it with some vitamins. You give you some vitamins to help with that. So you just have to probably just end up being on vitamins.
00:50:05
Speaker
Because the ruin why it goes straight from like after it goes to your esophagus doesn't it skip the stomach? It's a big part of the stomach, right? So cuz they're just like yep. Yep. You get a tiny part of your stomach and it's really dumping into a dumps right into it, right? So essentially the two that dr. Chris talking about you can either bypass almost all the stomach or you can bypass
00:50:28
Speaker
a little bit of the stomach. So the difference between the sleeve and the bypass is how much of the stomach you're gonna, you know, go by. Why that's important is that your stomach's got all the acid in it. Your intestines is what we call basic, right? So it absorbs different things. So- Not basic how they think about basic. Right, you've got a basic intestine. Chemistry basic, y'all. Right, we're talking about your chemistry. And so that does matter. So the whole concept of weight loss surgery is to limit
00:50:59
Speaker
just how much you can put in your stomach that comes with a disadvantage that we also limit how many nutrients you can absorb. And so these surgeries cannot be taken lightly because you're gonna lose some benefits in the whole process that I think that people don't completely appreciate until they're on all these vitamins. So when you have the surgery, Dr. Chris is right, you could be on vitamins for life. Some people just do not have enough stomach,
00:51:28
Speaker
area or small intestine left to absorb everything and so you end up pushing a lot of the vitamins. But if we're being honest,
00:51:39
Speaker
if you're missing, right? So remember step one, if you're missing your iron B12, there's another one right there in that first part, in the first third of the small adjustment. If you shift over and you're only getting like the middle third and the end third of it, you're always gonna have problems with vitamin absorption.
00:52:05
Speaker
And I need patients to know that because you will heal up well, you will do well, surgery will sign off on you and say you're doing great. You'll probably still be in their office because they've got their nurses and their nutritionists who do great work. They're gonna keep seeing you. They still have their counselors that'll see you, but those vitamins will go on forever. So sometimes I get people who come back to me saying, okay, when can I stop the vitamins? And I have to tell them like, yeah, probably, you probably will do this.
00:52:33
Speaker
for the long haul. I thought you're going to say forever. Forever. Well, yeah, forever. Most likely. Like Sandlot. Forever. So yeah. Yeah. So that's the gist of it, right? So there are some possible complications that can occur because of these surgeries, right? And like Amy Jo and Dee did say, right?
00:53:00
Speaker
when she said from the stomach, there's the acid, and then going into the small intestine, you have basic, right? So because of that, you are more at risk of possible ulcers, right? So you gotta be careful of that, and also strictures stenosis in that area, okay? Another common thing that does happen is what we call dumping syndrome. And that occurs because
00:53:28
Speaker
because we just, with the bypass especially, and also with the sleeve, we're making shortcuts, right? So it's not how it normally goes. So then it's like when you eat the food, it doesn't have enough time to go through the system and get absorbed, right? So it goes really fast. And then what happens, you can get nausea, some vomiting, you feel really uncomfortable, loose stool, because
00:53:55
Speaker
because you may be eating too much, too fast, and your body is just not having enough time to absorb all of that. So that's something that can happen with the surgery. Also, with any surgery, just by going into the stomach, you can have hernias that can happen.
00:54:15
Speaker
And that's just like a piece of the fat that could just kind of get stuck around the bow. Sometimes it's only a problem if it gets stuck and it can't like go back in, but that's a possibility that can happen over time.
00:54:30
Speaker
Right after, of course, when you have surgery, you're always kind of could be predisposed to possible like blood clots that can happen right after the surgery. So got to be careful for that. And then you can also have what's called like an intestinal leak. And it, it just kind of happens where it just like some of the part of the juices of the intensus is kind of leak.
00:54:55
Speaker
Yeah, so if you can I make a comment? So if you have really intense, so this is past your postdoc period, if you have really severe abdominal plane, do not, and you just had one of these procedures done, do not do not shrug that off because
00:55:11
Speaker
Like what Dr. Chris said, one of the big complications is that an intestinal leak is essentially when some of the parts that they use to suture your intestines or your guts together, some of that can actually crack open and you can have that, you know, juice from, I hate saying juice.
00:55:28
Speaker
that stuff from your intestines can actually leak out and your abdominal cavity or the area in the abdomen is a somewhat sterile environment. So if you have all these nasty intestinal juices that are leaking out into that area that can create a really really bad infection and that is something that needs to be surgically corrected right away. So don't
00:55:52
Speaker
Don't sleep on. Oh, you know, I got a little cramp from eating that burger. I probably shouldn't have ate. No, if it's if it's a pain, it's hella painful, then you need to come and get checked out right away. Agreed. Well, why are you eating the burger? Well, right. That's that's another thing. Probably. I'll also I'll also say within all these complications, except for the intestinal leak, a lot of these complications Chris has mentioned to you can happen with any open abdominal surgery.
00:56:20
Speaker
Like any surgery in the abdomen can have scar tissue, can have hernias, because a hernia is just like a weakened area of the abdominal wall where some fat kind of pokes through. A lot of these complications come from any surgery, especially in abdominal surgery. But that intestinal leak is very unique to gastric bypass. So that is a big deal.
00:56:40
Speaker
Yes. Which does present as abdominal pain. Because that's so important for you guys to know how it presents, you know? So you guys know like, oh, I have abdominal pain. I'm post-op. They should also tell you that though, but just in case. And then also when you have this rapid weight loss, it can predispose you to having more gallstones and you can have more increased risk of possibly having a gallbladder removed because of that. It's because of the rapid weight loss. It just predisposes you to more of that. So that's another thing that can happen.
00:57:09
Speaker
which can also cause abdominal pain. Yes. Because you are already more prone to ulcers, that also means that you have to avoid things that could worsen or cause ulcers. Things like certain pain relief medications like ibuprofen, things like that, you shouldn't be taking because that increases the risk for ulcers and that's known to worsen or cause them. Yes.
00:57:34
Speaker
But not just ibuprofen, this is anything that can increase your risk for ulcers across the board. Because I think once you have the Roux and Y, you are off of an NSAIDs period. I don't think general surgery wants you to take it. Yeah, period. You're not allowed to take them at all.
00:57:51
Speaker
Yeah, nope. So there's something else to know. I mean, you took out the major producer of stomach acid, which is part of the majority of the stomach. So if you think about it, you don't really have anything that's producing as much stomach acid as you did when you had a full stomach. So mostly after these surgeries, your surgeon or your PCP,
00:58:12
Speaker
We'll put you on like a 90-day supply of PPI, like protonics or omeprazole to kind of help with keeping that acid production down after the surgery. Mm-hmm. Yeah. Ibuprofen, naproxen, all the pain relievers, smoking, steroids, all those. Anything that increases your risk for ulcers, cut it out.
00:58:33
Speaker
So prior to the surgery, they put you on this, what's called a pre-op diet, pre-operative diet. And the diet mostly focuses on a lot of protein. And there's a reason for that, why they ask you to eat more proteins at least two weeks before.
00:58:52
Speaker
because when you do the surgery, the reason for that is because they want to reduce the size of your liver. So when you are obese, a lot of time you have what's called a fatty liver. So your liver is pretty big. So they ask you to do the protein to reduce the size of the liver so it can make the surgery easier for them and reduce complications. That's part of the reason why they insist on that high protein diet prior to having the surgery.
00:59:21
Speaker
Now you have surgery, you can't necessarily eat solid food quite yet because you just had the surgery. So what they do is they put you on this liquid diet. So you start off with real clear liquids,
00:59:39
Speaker
um and then for like about a couple of days and then they advance you to um more full liquids so when we say clear liquids we're like no carbs in there um pretty much like broth a broth that's pretty much it's like as long as you can see through this clear
00:59:59
Speaker
Yeah, so you're pretty much doing the broth and then they kind of advance you as you over a couple of days and weeks, right? And then you can go to maybe a little bit more thickened liquids. Okay. Like clam chowder. Yes. And then after that, then you move to like maybe soft kind of foods. Like puddings.
01:00:24
Speaker
I'm giving y'all a real life example. You'll see that's why I'm throwing them out there. As soon as I get them on my head, boom. Plus our patients, our patients be complaining about this all the time. Like, oh, why am I getting it right? I don't know why it popped into my head, but y'all remember that like Beyonce, cayenne pepper, lemon juice, maple syrup. Sure do. Definitely was not doing it. I don't know how she did that. When she lost all the way for Dreamgirls, right? I thought it was for Coachella. Did she get for Coachella?
01:00:51
Speaker
No, Coachella, she was eating it out. No, it was a long time ago. That apple! She's like, I'm hungry. I'm hungry. I thought so, though, because man. This is not the time to try all those fad liquid diets before your doctor gave you. No. It's like I'm hungry. Apple tastes like chicken. Tastes like breakfast.
01:01:15
Speaker
That's what she was thinking. There was a timeframe though, where in my opinion, she's getting a little too thin. It was around the time she did the videos, I think after four, after she had blue. And when she adjusted back, I was like, wow, she's really skinny. I don't think we ever saw her that skinny. I was like, man. She's going through it at that time. You know, that's when her and Jay were not going through they thing. So. Yeah. I'm sorry, we are so off talking. I wish it was get skinny when I go through drama.
01:01:41
Speaker
I had to say, yo. Well, it could go either way, right? Either you're super stressed and you don't be, and you lose the weight, or you just stress eat, right? My appetite is never gone. Right. They probably told her, ooh, girl, you look good. She's probably, y'all don't understand. I'm stressed AF. Right.
01:02:00
Speaker
Y'all just don't get it. So strict. No, Chris, we interrupt. Clear liquid and thick liquids and then, you know, soft foods, like really soft foods. And then you can go to more solid foods, like more foods that you probably prefer to eat, right? Once you can tolerate. Now, what's the timeline, Dr. Chris?
01:02:21
Speaker
So your timeline is like the first two days you normally do your clear liquids, right? And then you advance to the more thickened liquids after that, right? And that can last about like maybe three, four days, like soft food, like
01:02:38
Speaker
three to maybe three to 10 days, right? And then you normally go to soft foods like from like 10 to 14 days, right? So maybe after like... So we're talking about two and a half, three weeks before you get into soft foods. Before you get to start eating your solid foods again. Okay.
01:02:59
Speaker
Now, when you start eating again, be mindful to understand that depending on what surgery you had, right? Well, both of them, right? You have a smaller stomach, so you can't really ingest that much, right? So you definitely have to, you end up, so basically one meal can pretty much take you all day to eat, right?
01:03:22
Speaker
And I think that's the thing that people have to understand. You have to eat like small and you can eat like small frequent meals. And then they always suggest that you should maybe drink. Like when you eat, eat a small amount and drink maybe 30 minutes after to help prevent like that dumping syndrome that we said, like it's just rushing in and you're not absorbing as much to make it a bit more comfortable for you when you're eating.
01:03:48
Speaker
And that's a that's a big deal with a lot of people because you know, we're so I don't think it's just Americans in general, but we're so conditioned to seeing so much on our plates and our portion sizes. Like if you go anywhere else in the world, they look at our plate and they're like, you could feed a little family of four.
01:04:05
Speaker
for a couple of days with that, like just on one plate. And they're probably right. But it's like we're conditioned to expect to feel full if we don't have a huge plate that we need to finish that's put out right in front of us. And that's part of the preoperative evaluation with psych and behavioral health and that you can't have that thinking anymore after you get the surgery because if you start eating the amount that you were eating prior to the surgery,
01:04:33
Speaker
You're going to run into a lot of complications, and your little stomach can't handle those three slices of Giordano's and all the Harold's chicken. You can't do that anymore. Well, I think it's going to be hard. You're not going to feel good at all. You're just not going to feel good. And also, when you have the surgery done, it also produces some of these extra hormones that kind of prevent you. They make you feel faster. So you have that.
01:04:59
Speaker
feeling of being full with just a little bit. So it's kind of like it makes you so that you're not able to eat as much, right? Now, you can
01:05:15
Speaker
eat through the stomach. And there happens to be something that happens. This diet is important to kind of do it that way and try to reduce a lot of your big starches like your rice and your potatoes and
01:05:34
Speaker
the pizzas and the junk foods, right? Because you just can't really absorb the nutrients as well, right? And like we discussed before, having to take vitamins, right? Because you just can't absorb the vitamins very well.
01:05:51
Speaker
So it is important to follow up with your doctor because we got to do labs to ensure that you get all of the proper nutrients that you need. And the follow up afterwards is very important. There are instances where there is failure
01:06:09
Speaker
the surgery doesn't work really, right? And what happens is over time, people can end up gaining a lot of the weight back. Maybe not, sometimes it's not as much as it was before the surgery, but sometimes people gain way more weight than they did in the beginning of the surgery, and that can happen. And a lot of times that happens is because people don't adhere to the diet restrictions.
01:06:34
Speaker
Yeah, that happened a lot on that show, The Biggest Loser, a couple years back, like a lot of the contestants, I think well over half had actually gained back more weight than when they actually started the challenge. So they were talking about that for a while. And I know
01:06:50
Speaker
on the 600-pound live, I know they've had one or two patients on there where they literally ate through the entire diet that they were supposed to be on, gained 100 pounds plus in a short amount of time. Because they didn't adhere to the diet protocols that you're put on after. They didn't follow it with the behavioral health appointments and just weren't really compliant with that after the surgery.
01:07:18
Speaker
We're not doing this to be annoying. We're doing this to make sure that, you know, you have a good quality life and that the surgery, you know, you reap the long-term benefits of it. So when we say you got to show up for your appointment, you know, we're going to check these vitamins, make sure they're good standing. You know, that's what we're doing and to make sure that you're continuing to stay on track with the therapy. People. People.
01:07:42
Speaker
Let's be honest, the main thing that we are trying to change and alter our habits. These are daily dietary habits. We have mentioned this multiple times before on this podcast about lifestyle changes.
01:08:00
Speaker
And lifestyle changes are not easy for people to make. It's easy for us to say, as the doctor to the patient, like, hey, you should change some of these lifestyle habits. But we know, especially at Family Medicine, when we see you guys all the time, we know that that's not easy. And especially when it comes to eating habits and dietary habits, there's a lot of emotions that people have that are tied to food. And it's one of the hardest habits to change.
01:08:25
Speaker
between eating habits, especially different drugs of abuse, things like that. These are hard habits to break. This is rough. Even some toxic habits that people have in relationships are hard to break as well. So all habits are hard to break. But in this in particular, a lot of times the relationship that certain people have with food and what that's done for them throughout their lifetime, it's hard.
01:08:49
Speaker
It's really hard. So there's lots of people who, you know, as time goes on, they might fall off the train, fall off the wagon, whatever you want to say. And then they end up in that situation, which is what Chris is talking about. Another thing I've also noticed too is less like, so you go and you see your family doctor or your PCP, whoever, right? They refer you to bariatric and you have the surgery.
01:09:11
Speaker
right? So pretty much after you have the surgery, of course, you follow up post-op because they're surgeons, they got to make sure everything is good. But after like six months or so, you don't really follow up with them anymore, right? So you're kind of
01:09:27
Speaker
left to your own devices, right? And you don't really have that same monitoring like you did prior to when you were about to get surgery, right? Because when you were about to get surgery, you were seeing them every couple of months, right? Monitoring your progress, you got a dietician, you got somebody helping you, you got your psyche valves, you have all of that, right? They're giving you all the tools. That's great. Same thing with like the biggest loser, right?
01:09:52
Speaker
You got somebody watching you. They tell you what to eat. They monitor everything that you do. Great. Then you get the weight loss. They're like, yay, great. You did it. Awesome. Now go out to the world and be married.
01:10:05
Speaker
and you're left by yourself to try to do this, right? And I feel like that's what is the hard thing. It's just like people are left to do this themselves, right? So the problem there before, like you didn't have enough time to, maybe you know that you emotionally eat, right? But did we have enough time to really get to the real bottom of it? Why? Changing habits. Do it all.
01:10:31
Speaker
probably didn't get a chance to do all of that, right? So now you got to do this yourself. And also, exercise requirements for people after they have surgery is actually much, they actually recommend that you exercise more than someone who didn't have the weight loss surgery. So normally we recommend like, at least like 150 minutes a week of cardio exercise, they recommend like 250 to 300. So
01:11:00
Speaker
It's like you really are changing your life drastically. And that's why I went, I picked this topic so you guys can understand that it is not an easy process. Like, okay, well, I tried to lose weight. It's not working. So I'm just going to have the surgery. It's like, yeah, bud.
01:11:21
Speaker
There's a lot of things with it. Yeah. Yeah. Because I've seen people, unfortunately, I've seen people who don't figure that out. So the surgery feels like, I think it feels like to some people, um, like this, you know, this feels that, you know, okay, if I can just get this in place, right. If somebody cuts my stomach down, if somebody, um, you know, puts this, you know,
01:11:47
Speaker
ties my stomach up. If somebody does this, then I'm prevented from doing that. But your body actually is always compensating for something, right? So the stomach will stretch back to normal. And I have seen people double
01:11:59
Speaker
their BMI from where they were when they first started. So the whole process is so important. So you can reverse it. Like even if you have bypass, you can reverse it. And the problem is you can reverse how much food you can take in, but you don't get back the nutrient absorption.
01:12:17
Speaker
Right. Which I think is the even bigger crime because that means that everything you're taking in is the worst components of the foods that you're now eating, that you've now stretched your stomach back out to normal for, but you're not going to get the nutrients for it.
01:12:31
Speaker
I mean, I did this just so you can understand that it is not something to necessarily take lightly. And I also did this to really hone in on the importance of, regardless if you choose to do a surgical intervention versus medication versus no medication, point is you have to eat right and exercise.
01:12:59
Speaker
In a sense, I feel like people are trying to bypass that and trying to find like an easy route or shortcut. And there kind of really isn't because either choice that you take, you still have to do the work. Thanks, Dr. Chris. I hope you guys enjoyed it. I hope you got some good information.
01:13:18
Speaker
I will say this, even with all that that you talked about and the maintenance post office stuff like that, listen, I feel like that's still easier than the BBL recovery, Loki. Because that BBL recovery, I got to lay on my belly for two weeks straight, and I can't even sit on my butt or sit on a toilet. I don't know how you do that. I don't know. I don't know. Because like I said, I did think about doing it. And then once I read that, I was like, mm. Give me clear liquids, then solid liquid, then whatever. I'll do that.
01:13:48
Speaker
If we're comparing recovery processes, I'm just saying. Right. Right. Exactly. At least, you know, OK, I'm eating soup for a little bit. I could do that. I could eat soup. But I think the other part of it, too, for me personally, if I had to weight loss her, I'd love to eat. And the fact that I feel like I wouldn't really be able to eat like I like to eat.
01:14:13
Speaker
I feel like that would bother me. That's me personally, right? I feel like going out to dinner, it's like, okay, well, get a little salad. Be a cheap date, but you know.
01:14:39
Speaker
All right, so I have a question. Um, so this one is about, I guess, mental, mental health. So it's a question is, can you ladies describe the difference between depression and bipolar disorder? Thanks.
01:14:58
Speaker
I wonder if this question came up because of Insecure and Nathan's ass. To simplify, this is what I tell my patients because this comes up a lot.
01:15:16
Speaker
Culture and maybe even sometimes in medicine, we kind of miss... No, in medicine, we talk about it very specifically, but I think in culture and society, we kind of abuse the concept of being bipolar. We kind of paint bipolar as everything. Oh, you make me sick with your old bipolar stuff. Everything is bipolar. If you don't like them, they're bipolar.
Understanding Bipolar Disorder
01:15:37
Speaker
But in medicine, I try to explain it to my patients. You know, think of these as polls, right? So what we're talking about is what we should be calling these things is unipolar depression and bipolar depression. Because bipolar depression, most people spend most of their time in some form of depression. Like that's what most people who are diagnosed with bipolar disorder are battling.
01:16:04
Speaker
But versus unipolar depression, that's all you battle, right? You need one, one pole. You've got one side, two battle, and it's always depression. Bipolar by two, you've got two poles. And while you spend most of your time in depression, you can sometimes swing to your other pole, which is mania.
01:16:23
Speaker
So the difference between unipolar depression, which we commonly call simply depression and bipolar depression, is that in bipolar, you have a second layer or second pole to contend with, and that is the manic component. Now,
01:16:42
Speaker
in Hollywood and in culture. We talk about bipolar from all the mania that we have associated with it. But the manic component of bipolar disorder actually is very rare and seen in very few circumstances. In the years that I have been a physician, I have seen someone actively manic maybe twice. Now, in both cases, it was quite entertaining.
01:17:10
Speaker
But most of my bipolar patients are not in mania. Most of them spend their time in regular depression. The reason why it's important for us to know as physicians is that if we treat your bipolar depression with a unipolar medication, if we knock out the one pole
01:17:33
Speaker
and we only leave you with the other, we can make you manic. So it's important that you tell us if you've ever been diagnosed with bipolar depression.
01:17:41
Speaker
Yes. Adding the next layer to the X. I feel like, you know, general public knows depression, you know, bipolar, and they know schizophrenia. And it's either one, you have one of those three, but like with Amy JoMD said, you can have components from other psych, psych diagnoses kind of mixed in. So that's what makes those diagnosing those conditions a little bit more, a little bit more difficult or nuanced.
01:18:10
Speaker
So yeah, so hopefully that answers your question. I don't know if anyone else had anything else to add. I think that was a really good explanation of what it is. You literally cannot get a word in when they start talking. It's very, it's very difficult. I mean, the signs of mania are like, a lot of them are usually running a mile a minute. They have pressured speech. They don't sleep very often.
01:18:36
Speaker
you know, they do very impulsive things, whether it's gambling or spending lots of money. So there's like a whole list. If you just Google mania or Google manic, there's like a list of symptoms. And then, you know, there is also a formal diagnosis to it and categories and things that, you know, a health professional will diagnose people with. But someone who's manic, just like Amy Jo said, it's like the other pole instead of having these loads of loads, it's kind of being a little high. Yeah. So and then we also try to put you on what's called a mood stabilizer to help
01:19:04
Speaker
stabilize that mood. And then we can also put you on an antidepressant as well, because like Amy Jo said, like a lot of times you spend a lot of the time in the low, like depression, but we also give you something to kind of help keep your mood pretty stabilized as well. So that's kind of how you treat it. And I've seen, I've seen somebody actively manic in my clinic. And when I did my psych rotation, I saw it in the emergency room.
01:19:31
Speaker
She was very entertaining as Manning.
01:19:35
Speaker
Yo, the last time I saw people like actively manic, like multiple, like I've seen more than I need in a lifetime was at the hospital in New York during med school. Was in New York. East New York, deep in Brooklyn. I'm like, I don't know where all these people come from, but it was like a huge psych unit. And I'm like, listen, the everything from the grandiose, like all of that. I'm like, yo, this is textbook. This is textbook in New York. It was so extreme. I'm like, yo.
01:20:05
Speaker
And they're so sincere when they're saying it. I think this one makes it where you're like, man, they're like, yeah, no, for real. I just bought a building and a business. And if you didn't know any better, you would be like, for real? They're serious though, right? They're like, yeah, I'm broke, but I'm going to get it back. This is easy. This is no problem, right? I'm a CEO. I've been a CEO before, right? I'm going to cop it.
01:20:28
Speaker
I took the money from my husband's account, but it's cool. It'll be back before he gets home. But when is he getting home? He'll be home at like three o'clock. It's 1250. Yeah, I know. But the money will be there. And you're like, wait a minute. Oh, but then it's like. Oh, yeah. Something has gone wrong here. Yeah, like my last manic patient was a virtual visit.
01:20:53
Speaker
And I don't know what she said, but it caught me off guard so much that I was trying to drink some water. And when she said it, I literally spit on my screen. And I was like, oh my God. And one of the doctors was walking by and she was dying laughing, right? She was just like, what just happened? And I was trying to wipe my screen. I was like, wait a minute, say it again. I didn't hear you. And she's like, yeah, it's great. I feel so wonderful. And I was like, oh my God.
01:21:16
Speaker
Like who do I call like I gotta get somebody because you I can't even get to you and you and she was like, it's great. I've never felt better. As a matter of fact, I'll call you back. And I was like, no, we're in an appointment. We're in an appointment right now. She's like, oh yeah, like reoriented. So like.
01:21:32
Speaker
Yeah, it's also tough too, because like, yeah, we say we say it's entertaining, but it's also pretty scary too. Because like, at the end of the day, like they need help, right? And you can't predict what they're gonna do, you're afraid that they might hurt themselves or hurt other people. So
01:21:47
Speaker
It's kind of like trying to convince them to get the help that they need. Sometimes it's really hard, right? Yeah. Because they feel great. In that moment, you know that they feel that same accomplishment when you
01:22:04
Speaker
when you meet that New Year's resolution where you're like, I did it. Like, this is so great. And you can kind of see it in their face where this is making perfectly good sense to them. And they know that you can't appreciate what's happening right now, but you're going to have to believe them. And so it's a really fine balance between trying to, you know,
01:22:23
Speaker
not lie to them, right? Because I don't, I definitely don't believe in lying to anybody when they're actively lying to my patients in general, but definitely don't lie to people when they're actively manic or when they're having a crisis or if they have a personality disorder, which is completely different from bipolar disorder. So I don't want people to confuse it too, but you're trying to tell them the whole truth, but at the same time trying not to upset them. But sometimes in the conversation is their brain is trying to
01:22:47
Speaker
work through the logic that sometimes conflicts what you say. Like it's, it's, it can sometimes be hilarious. And they'll be laughing with you and they'll be like, I know, like, she's like, I know, I know the same, make it on 60 right now, but you just got to feel me. And I was just like, no, this is crazy. And I was like, I'm not agreeing. Don't be, no, we're not. We can't agree to this. Like we can't do this. Like where is, where's your family? Like call them right now and tell them I said to come over.
01:23:14
Speaker
So, yeah. And when I had one, she went through all types of different emotions in zero to 30 seconds. She was elated, then really sad, then started crying, then not crying anymore. Then it's like...
01:23:29
Speaker
Where do you go? And there goes the polls, right? Because you'll see them next week. Sometimes you don't get all that in one day. But you'll see them next week when the mania is gone. And they'll be devastated that the manic part of them thought that this was a good idea because it complicates their life.
01:23:49
Speaker
And when the depression hits, it makes the depression just worse. Because they're like, I was already depressed, and now I done went on and did this. And now I feel like further in the hole. And so you're just like, ah.
Listener Engagement and Interaction
01:24:00
Speaker
Yeah, so that's why we try to do those mood stabilizers to kind of keep them a little even kill so we can better control them. Send us those questions, please. Yes, please. Ask us anything. I mean, we may or may not answer it, but ask us anything.
01:24:18
Speaker
If you guys want to check us out, check us out on our social media on Instagram, Facebook, or Twitter. Our handle is at thechocolatemds. Be sure to check out our website, thechocolatemds.com, where you can also submit your questions or
01:24:34
Speaker
General well wishes for the show Also, you can send us questions through our DMS or also through our our website and also through our Gmail Which is the chocolate MDS at gmail.com and please send us a new crop of questions We're coming up on the new year gonna start fresh. So any questions I get in now We'll definitely address them on our upcoming episode
New Year's Resolutions and Personal Reflections
01:25:11
Speaker
We have to do chocolate kisses. Right. Chocolate kisses. Ooh, I feel like we should also switch it up. OK, so how about this? I got you. You can either do a chocolate kiss, or you can share maybe one of your possible New Year's resolutions. Didn't you say you don't like New Year's resolutions, NHL? No. I don't, but I'm going to do one this year. OK. Look at that.
01:25:35
Speaker
I'm saying, I feel like if people don't have a chocolate kiss on their mind, they can share their New Year's resolution, whichever fits your fancy, whatever y'all feeling. I already know where my chocolate kiss is going. I already know where mine is going. I don't really have a chocolate kiss. I think I kissed everybody. For the rest of the year. I mean, in that case, you're going to hit us with a New Year's resolution.
01:25:54
Speaker
You gonna hit us with a New Year's resolution since you out here kissing everybody. And it's COVID, I shouldn't be. During COVID, out here. Flirting with Omarion. Omarion. Flirting with Omarion. Anyway. I might call out tomorrow. So my chocolate kiss.
01:26:08
Speaker
My chocolate kiss is going to go to my mother because my mother feels like I get on her last nerve. And I do this to her every holiday because I am always in the middle of cooking. And I'm following one of my Nana's recipes that she gave me. And there's something that doesn't make sense or something I need to clarify. And I always end up calling her. And I think that every year I'm going to have to call her. And I did it again this year. And I called her when I was in the kitchen. And she was like, hey, oh, I'm getting a call on Christmas Eve. Let's chitchat.
01:26:37
Speaker
I'm like, no, no, no, no, no, no, no. Like, quick question, quick question, quick question. I don't have time to talk. I'm in the middle of the kitchen. So when it says two sticks of butter, is it the little sticks, like in the land of lakes? Or you mean like the long stick, like the margarine, like the blue, like the blue bonnet margarine. Like, when you wrote this, did you mean butter? Did you mean margarine? Did you mean sticks? Or you meant the long stick or short stick? She was like, we go through this every year. And I'm like, I know, I know, but I'm in the kitchen and I need to get it right. Look at all the butter.
01:27:05
Speaker
Say it in lecture for later. You're going to see me soon. Say it in lecture for later. I'm Shawnee Gizray. It's my New Year's resolution.
01:27:14
Speaker
My dad's been getting on me about not coming home more often, so I should probably go home more often. I feel like with work, I'm kind of in a hospital. Omarion is blowing up, so I don't want to expose anyone unnecessarily, but hopefully when things do die down, I'll be able to be, okay, I can go home and
01:27:36
Speaker
you know, help train our new puppy who is now becoming potty trained after us only having it up for eight weeks, which is amazing. Um, but yeah, so hopefully doing more things in Michigan, Detroit and with the fam. Yeah. That's nice. Yay. I am doing a new year's resolution this year because, um,
01:28:04
Speaker
I need to get back into shape. Oh, that type of... Yeah, I need to get back into A shape. You know, it's... Right, besides... Besides round. What shape are you? What are you talking about? So, you're trying not to be an oval round anymore? Yes. I'm trying not to be an oval. As round. Right. I can get that.
01:28:26
Speaker
Chris, you up? Yes, I'm up. Okay. So my new year's resolution is kind of similar to Amy Jo, but a little different. So, um, I'm not sure you guys all know that I do work out a lot, which I'm not necessarily going to change that, but I think what I need to be better in and what my resolution is going to be is just to really try to eat better. Like.
01:28:52
Speaker
and make more time to eat better. Because I've noticed that I've fallen off. I was really trying to eat good and still work out, but then work and things were getting in the way. So I haven't been exercising as much and eating right. So really trying to
01:29:14
Speaker
hone in on that and get to my goal because I have a goal before my birthday. Oh, well, you got time. You got time. I got to get my life together. Y'all, Chris is in cancer season. Yes, but I got to lose some pounds in certain places pretty fast. Does that mean you gonna stop that cream in your coffee? I already did, though.
01:29:44
Speaker
which I'm a little proud of myself. I now drink my coffee black, but I've been so stressed at work that I buy extra coffee and it has cream. So it's like a fail. I'm gonna try to do better so I don't keep failing like that.
01:30:02
Speaker
I try the black coffee thing. I can't. You can if you get used to it. At first, it's disgusting. I agree. It's very disgusting. But I'm always late. And it's pretty fast. It's not always, it's not always disgusting. It depends on the bean. It depends on the kind of coffee. You know, we got Colombian coffee on these parts. Your coffee is
01:30:25
Speaker
I get you're right. It depends on the coffee because there's some coffees. Like if I go to a restaurant and depend, if it's like too watery, like that's disgusting. I can't do it. It has to be like good coffee that I can drink without sugar. So like a lot of times I test it out first and I'm like, can I do this? If it's too watery, I can't, can't do it. It has to be a certain consistency, but I'm, I'm, I'm picky with my coffee.
01:30:51
Speaker
Yeah, I don't know about
New Year's Eve Plans and Traditions
01:30:52
Speaker
this. Well, I wish everybody the best of luck in all their endeavors in terms of their New Year's resolutions and stuff and all of that. And Happy New Year to you guys. Happy New Year, New Year. Happy New Year to y'all. Next time you hear all voices, it'll be in the New Year. It'll be a better 2020. It's going to be better. I'm putting it out there. You've got to put positive vibes. I keep telling everybody, even with my patients, I'm like, it's going to be a better year. It's just going to be.
01:31:18
Speaker
And I'm putting it out there so we could come into fruition. What about NYU? What are y'all doing? I don't know. I just decided I'm going to be home looking at wedding venues. So probably something not involving me getting exposed to COVID. Because I'll be in Florida. So I mean, it's rough already. I'm going to walk out and watch the fireworks go off.
01:31:42
Speaker
Oh, that's nice. They go off right by the Chicago River. So I just have to walk down and just take a peek. I have no plans. You got plans, Ami Jo? I do, actually. Oh, look at you. I can tell from the look on your face, we got plans. Mm-hmm. Are these plans you can share or plans you can't share? Depends on what part of the night you want to know about. OK. Oh, my god. All right. We're just playing, y'all, kind of. You know what?
01:32:12
Speaker
I know, right? She's like, here we go. Perfect content. Let's go. Chocolate after dark with the empties. No, I am, um, you know, we, we made dinner plans before, um, Omarion. That's so funny when they call him Omarion. Not funny for Omarion though, for real. I know, Omarion, like, why are you calling me a virus?
01:32:40
Speaker
So before Omicron, it seemed like such a good idea. We've had these dinner plans in place for a long time. And now the closer it gets to the day, I'm like, oh, maybe, maybe not.
01:32:56
Speaker
I'm pretty flexible. I can be as fulfilled, I can be equally fulfilled whether I am gonna be on the couch with pizza, watching football, or whether I am dressed up having dinner. Like they both feel the same kind of good to me because either way I won't be working. You are right. Isn't it like college football game day? Absolutely. Both games come on on New Year's Eve, doesn't it? Don't they? Mm-hmm. I think it's the Sensi Bama game and the- Did they cancel a bowl game?
01:33:27
Speaker
What did you say, Dr. Nona? No, they canceled a couple of bowl games, so I just wanted to make sure you guys weren't one of them. You know what? Sit your Michigan self down. They ain't cancel our game. You ain't gonna get that lucky.
01:33:39
Speaker
Did they kiss your game? No, don't be wishing that juju on me No, I know the games are back-to-back I don't know who comes first. Yes So we're on the 30s Yeah, it's a whole day of football well, you know, we're on the way are we on the 30s and
01:34:00
Speaker
I think it's, I think it's, I think they're both supposed to get to the playoffs one time, right? You know what I'm saying? And all of a sudden they know everything, right? What I know is that whenever there's a playoff, we there. That's what I know. All right. All I meant, all I meant to say was that I think both of your teams played the same day. One game is just before the other. I think you both play on a 31st.
01:34:25
Speaker
I think you guys, Alabama plays at two 30. I think we play in the morning. So in the morning. So I'm with you. So you can be watching football up until basically, Oh yeah. They are the same day, both Friday. Yeah. So, you know, I could, I could be home and, um, Sit on the couch and feel amazingly great.
01:34:49
Speaker
Yeah, given everything is happening and Omicron and all that, listen, I'm fine. Like really, I'm fine. Yeah. I could stay home all day, every day. I got no problem staying home. It's better than I'd rather stay home than go to work most times. So I'm sure. Yeah, it'll be as long as I can work. You gotta do anything than go to work. I know. I don't know why I'm like this.
01:35:16
Speaker
Ooooh child. Then you ain't gonna get easier. You know, all you have to do is start it. He's gonna finish it. Oh, shout out to Insecure again. Anyway, okay y'all, let me bid y'all farewell. Alright, yes, go watch Insecure so we can talk about it.