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Spectrum Scope: Understanding Autism in today's world
125 Plays6 months ago
Take caution on compounded GLPs ❌, when "bein' outside" brings syphilis in 🦠😳, and awesome Autism awareness addressed by our Dr. Chris.
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Transcript
Meet the Hosts
00:00:18
Speaker
Ladies and gentlemen, welcome to another episode of chocolate with a side of medicine. I am one of your hosts, Dr. Sunshine, of course. And I'm also here with two of my co-hosts because Dr. Nono is not with us tonight. She is working and grinding and making the paper. I know, she be working, she be working a lot. We all be working a lot, but she be, well, not me. She be working more than us, I feel. I don't be working. I just be raising my child right now. I'll be working a lot. You got a different kind of work. It's a different kind of work. Yes, but I'm also here with Dr.
The Saga of Socks the Cat
00:00:51
Speaker
Chris. Hey, guys. And Amy Jo and MD. What's up, y'all? But I was working, but I'm not working so much. But Dr. Chris is correct. I'm just doing a different type of working with this child, you know? Right. We're just talking.
00:01:06
Speaker
I don't know how you do it. I was so tired when I came home and all I thought was, oh my God, if I had a kid, I would be in tears. It's a labor of love. It's a labor of love. You're exhausted, but you love that you're exhausted because you love the child. That's really what it is. I mean, I get that you say that. I get that, right? I get it. In my mind, I get it. But how I'm feeling, Cause sometimes I come home and I'm like, do I want to? So happy that nobody's here. Right. I don't got it. I have a husband here, but you know, he thinks himself. Right. That's true. Completely self sufficient. Maybe a cat every now and then it comes to the door. But even she's so sufficient. If I feed her, she'll mind her business too.
00:01:47
Speaker
Girl, y'all got a whole bunch of pets too. You got a husband and pets and everything. You got a whole, you got a whole everything. You got turtles, saltwater fish, freshwater fish, but it's different. You know, you feed them and then they mind their business. They don't ask me. Oh, the cat is weird. So if you are sitting on the couch or if you're laying on the couch, she will not mess with you. She will happily go find a spot on the floor, lay down with you, join in the laying down. Okay. If you are in bed, she will cry all night. like It's the strangest thing. Jump in the bed. I put her out the bed at least five times. After the after the fifth time she jumps in, I'm like, okay, it's time for you to go outside. And I put her out. And then my husband is like, did you put the cat out? I was like, I sure did. Amy Jo, this ain't even your cat.
00:02:40
Speaker
Listen, that's not what the neighbors say. The neighbors are like, your cat is so friendly. Because this is where every time they see her, she's here or she's at the neighbor's house playing with the dogs. She's the neighbor's cat. What about the actual owners? Yeah, we thought that this was the neighbor's cat. It's not. So who's the owner of the cat? you are Girl, my neighbors say we are because this is where the cat comes home to. Wait, wait, hold on. ah No, like who's the cat? Who has given the cat the shots? The cat doesn't have a collar. The cat does not have a collar. The cat at some point has had shots because here, I don't know how it is in other states, but um when they capture them, when they capture them, neuter them and you know give them the shots and release them, they clip the ear. So the ear is clipped.
00:03:31
Speaker
um so um So you have a cat. So you have a cat. It's yours. It's yours. It's weird because this is not a feral cat. like Even my neighbors are like, yeah, that's not a feral cat. like I know the cat belongs to someone. You just don't know who it belongs to. We don't know who this cat belongs to. You're going to have to take a picture and put it around ah around the neighborhood. We have. oh We put it, we put it on our ring community. We have put this picture, they like, that's your cat. Like the last time we put it up, they like, hey, you can stop posting. Somebody was like, you can just, you can stop posting. That's your cat. You can just stop, right? They were like, you can stop posting this cat. Like it's your cat.
00:04:15
Speaker
So, cause we thought it was the, we thought it was the neighbor's cat three doors down. Um, and that's what we were like, yes, neighbor's cat. And there was like, no, that one's not mine. That's not my cat. And we got all these new neighbors, right? Because, you know, um, our, some of the units in our, you know, in our school went, went all sale. And so we've got neighbors now. So everybody's like, Oh, you know, we saw your cat socks, um, in the yard. So who named your cat? Who named your cat? Who named the cat socks? Everybody was calling. Everybody was calling something different. So the two neighbors down were calling it tuxedo. They were calling something something. They were like socks. Like, so what's the cat's name? Like, oh, y'all call them socks. We're going to call them socks. So as far as my neighbors are concerned, we have a cat named socks.
00:05:06
Speaker
Why don't you just embrace it and actually just get her like a little bowl for food and water? Once she does, she does have a, she has a food bowl now and there's a water fountain in the front that, so that she does not, cause you know, you can't trust cats around anything, any open cups. So, you know, go on in the days of sitting your cup down, but we have a little water fountain that's for cats cause it will like run water so that she will not jump on things. And she typically is pretty, pretty good. She does not, um, jump on tables and everything, but she's highly food motivated. So you have to be, you know, careful. So in summary, Oh, go ahead, Chris. just not have a but well you might as well um She sleeps on the, the, the carpet just fine. And she likes sleeping on the, on the tile in the bathrooms. I think cause it's cool.
00:06:02
Speaker
So, you know, when you can't find her, you can find her like sleep, I mean knocked out on the floor. I think you might just need to fully embrace this cat, which is basically yours. Go ahead and buy her one of those little scratching things that they have. Buy her a scratching tree, or go ahead and get her a little bed, and go ahead and just embrace it. I think we're going to get you something embroidered with Sock's name on it for your cat. How do you spell Sock? I'm just going to say it. Regular Sock. I like the Chicago Socks. How do you spell Sock? Of course, we spell it like the Chicago Socks.
00:06:35
Speaker
We're gonna have to send you something. Send a little, I don't know, something with socks they wanted. Now we know you have a cat. We didn't know you had a pet. You've been in denial. Now we know. You have a cat. Just add it to the long list of y'all pets, turtles and fish and whatever. Just add the cat. Just add it in there. Oh my God. So anyway, when socks comes in the house, I'm like, dang, I gotta feed this cat. Yeah, you're annoyed with your own cat. Yes. We understand. We understand. You're annoyed with your pet. So, you know, I, I shut out top shout out to all these, these mamas out here. Um, cause yeah, I don't even know. I don't know how y'all do it. Like you really are super humans. No, seriously. Cause I felt accomplished because I managed to like prepare, like have some, having a dinner option. Right. I felt really good when I got home that I was like, Oh,
00:07:32
Speaker
there I have brought food home that we can eat for dinner that is not going to be fast food or takeout. And I was so proud of myself. I will say this and not to make it like deep or anything. It doesn't have to be that deep, but I am truly a firm believer in you really should have kids if you want to have kids. Um, there are people out there who sometimes it's an accident and you end up pregnant and you might have a kid, even though you don't really want one and like lots of people, a lot of different situations. Or some people might have a kid for their partner because their partner really wants a kid, but they personally don't want one at all. Not people who are on the fence, but people who like genuinely are like, Oh no, I'm good. I don't want kids. I completely respect it because having a kid is usually,
Compounded Drugs Legal Controversy
00:08:20
Speaker
you know, a choice depending on how you got there.
00:08:23
Speaker
true. um And it requires a lot of sacrifices, um physical sacrifices, emotional sacrifices, time, energy, everything. It's a it's a huge sacrifice. So I really do feel for people who might end up in situations where you know, they didn't anticipate having kids and now they do. And you know, life is interesting, whether it's by marriage or you know, like Life is life. um But I really highly encourage people to really think about it and truly deep down want kids before you embark on the journey, if you have the privilege to do so. That's all.
00:08:56
Speaker
yeah Because I was already mentally prepared for it, and I'm prepared to do the sacrificing. And and it's a life adjustment. you know You can't move the way you normally move. You can't travel the way you normally travel. You can't even eat at the same restaurants the way you normally do. It's a full life adjustment. And if you haven't already internalized that sacrifice and are down for it, then, yeah, people get upset. They get resentful. They get depressed. like it's It's real. It's real. so Just saying, I have a little one and I'm happy that he's here because he's my little love man. so He's so
00:09:29
Speaker
You know? And hopefully, God willing, there'll be more to come. So we'll see. But I'm down with the sacrifice. i'm down with I'm down with everything. I love it. And that's great. And you know what? And I support you in your journey. You go ahead and you do that, OK? I support that for you. get my i will be I will be here and support you. You need me to send you some gifts. I got you. The whole time I'm talking, Dr. Chris is like nodding. She's looking at me confused, but she's nodding like, mm-hmm, mm-hmm. I hear you. That's hilarious. Right. She's been online. OK, well, good for you. Good for you. I'm happy for you. Exactly. But I don't be on these excursions that Dr. Chris be on. Dr. Chris be living a different kind of life. That's why she can't feel me.
00:10:14
Speaker
and I can't I can't it's just not you can't live less like you can't live life like dr. Chris have i know dr chris we live her best life and i'm trying umm trying to be I'm trying to live my best life. She might be like, how dare you inconvenient, right? I got I got shit to do. I bet y'all want to yeah, y'all want me to I do have the trinity topic. So I'm gonna keep it short and sweet. Let me see which one Well, let's start with, uh, gosh, I can't find it anymore, but no, I can. It's on my phone. So Novo, uh, Novo Nordis is suing like nine, uh, spas, clinics, pharmacies over copycat drugs.
00:10:58
Speaker
So for those who do not know who Novo Nordis is, they are the people who make Wegovia and Ozimpic, semiclutide, which is popular for improving diabetes and weight loss. So a couple of things happen, right? So for people who are behind, let me catch up real fast. So when Ozimpic and we go before, when, when Ozimpic first came out shortly followed by, we go be, everybody was trying to get it, but we were still in the middle of the pandemic. And so, um, what most people don't know is that drug supplies have actually been pretty rocky and continue to be starting in the, starting in the pandemic and going through, they are often stretches of time where common drugs that we use all the time.
00:11:38
Speaker
um are not available, partially because America doesn't make anything, but that's not the point of this discussion, but we're going to keep it moving. And so because of that, it went on a really severe shortage. So there was a period of time where you just cannot get this GOP one in particular. There is some tiny loophole in the system that says any event that a a a life changing drug is um out of stock then you can compound it. So that's how this got started. So it stayed on shortage for so long that compounding pharmacies got into the business of making it. And of course they were making it from much cheaper than what you could buy it for indium in in North America and so it became all the rage. Now shortly after that
00:12:21
Speaker
Ozimpic came back on the market in in a better supply. And so they kind of send out these little cease and desist letters. I actually got one. I don't know if anybody else got one, but we got like a letter from like our licensing people saying, hey, you know, it is illegal to compound. It's copyright, yeah all these things, right? But that did not stop anybody. So as most of y'all know, listeners, if you Google any online weight loss program and they say, oh yeah, we're offering the shot. Most of them are offering the compounded version. It's much cheaper. People are using it. And from the feedback that I get from both patients and people that I meet,
00:12:58
Speaker
ah It works. I think it works a little bit slower than than the real deal, but it's quite effective. Nobody seems to be having any side effects to it and so people have been using it. So I knew it was only a matter of time before these lawsuits hit. And so, Novo Nerdist is now starting to sue companies for compounding um the medication. So it'll be interesting to see how this all plays out because nobody's stopping compounding it. People are still compounding. The problem with the compound is I couldn't tell you what's in it. People compounded and they use different writers and stuff like that. So a lot of people use like B12 writers, but there's other writers that people use. And so folks are making the drug and they're using their own form of a writer, which is just what you the tool use to carry the so carry the drug into the system. And they and they're doing all kinds of stuff. And so I am sure that there's potential harm out there because the compounded drug has not been FDA tested or approved. I was just about to say, where is the FDA in all of this?
00:13:57
Speaker
That is a good question. Where I don't know where, where are they. I don't know, because y'all. Listen, this is not just, um, Oh, you know, I'm hitting up the dope man for my little, you know, and my blue time exactly no, these are like legit pharmacies like pharmacies that compound drugs. So people don't remember compounding pharmacies anymore because everybody's just going to Walmart, Walgreens, CVS, and Binder Medicines, but there are compounding pharmacies out there. So there are sometimes a prescription I write, it says, I want you to pick up this cream from ABC Pharmacy. It's going to have 30% of this, 20% of that, 10% of that is going to be in this. So I can, I as a physician can write up what I want to be in a in a cream or a gel.
00:14:47
Speaker
or medication and you can take that to a compounding pharmaccy pharmacy and the pharmacist will make the drug. They exist. We use them probably more often than people think. These are the ah people that are making semi-glutide. But here's the thing though. So I think we're talking about, and i and i get I get what the issue is here, but using your example, the pharmacist is taking three different creams that are all FDA approved, compounding them into something different and then giving it to the patient. But everything, all of the ingredients involved have already been FDA approved. That's a little different than what's happening here.
00:15:30
Speaker
Well, they I don't think they're using anything that's not FDA approved. So just like, like um
00:15:38
Speaker
like ah for chlorosis, right? um You could compound, there's a cream that I give and it has like um has like a steroid in it, like topical amitriptyline and lidocaine. It is outstanding. My patients love it. The itching stops. It goes away. All of those individually are still FDA approved. I don't, and and here's the, here's the hard part because we talked about this in one of our, um, uh, business meetings, like at work.
00:16:12
Speaker
and And because we have clinical pharmacists, the issue is that none of us know, there's no way to know what people are putting in them, but they're, they're using approved medicines, right? Like they're putting like B12, which is approved, right? FDA approved product. They're using semi-glutide, the, the molecular molecule, you know, whatever that compound is, that's approved. It's just not approved for. you to have it because it has a copyright on it. So I don't think they're not using approved compounds to form a medication. It's it ah it's just that you're not supposed to use it because Novo Nordis has the has the patent rights to it. They have the patent on it.
00:16:55
Speaker
Yeah. So you're violating the patent. right on I don't think you're violating it. if like When I say we don't know what's in it, we don't. Because every compounding pharmacy could do it on its own. And oh when you order it online, I don't know if the compounding pharmacy is doing it or if somebody is just kind of making it. It's hard to know. But the compounding pharmacies are using legit things. They're not like, I'm going to sneak this in there. I hope it works. It's just that you don't have rights to it.
00:17:25
Speaker
Quick side note, just for you guys that know, so the FDA is a food and drug administration for anyone that does not know. um It's a government agency that's basically in charge of making sure that everything that's on the shelves, whether it be a medication or the food you eat in the stores, has been tested and is proven to not be harmful. They do lots of different trials to make sure everything that's sold, you know that it has the right packaging, that it has the right side effect profile, that they have to list on bottles and things, blah, blah, blah, blah, blah. The FDA is the entity that is in charge of that. So when I was asking where is the FDA, I was under the impression of, okay, well, well it still might be true.
00:18:01
Speaker
But the FDA is supposed to be monitoring everything that's in the pharmacy. They should be aware of every medication that's on the market, every food item that's on the market. That's why we say if something's not FDA approved, it's kind of sketch because it's like, hey, take this at your own risk because our FDA in the United States has not tested this. That's like all those vitamins and herbs that Javi could talk to us about. I'm like, listen, we didn't test those. We didn't do trials on those. It could have some weird side effect. We don't know because we ain't tested. Take at your own risk. That's who the FDA is and what they do. But go ahead, Chris. I'm going to cut you off. Oh, good. No, no. I was just saying, like, yeah, they're just using. I think the whole thing is that they're telling you that they're they're using those riders like the vitamin. But it's kind of like you're just going by what they're telling you. You're not really sure. So there could be some impurities.
00:18:48
Speaker
that are in there when they compound it, but you don't really know, right? So I think that's that's the whole thing. And also a lot of these drugs, the reason why they're so expensive is because these drug companies patent them and it it would be cheaper for patients if they go generic, but a lot of times these patents stay, they have these patents on these drugs for a long ah period of time. So yeah they can't, they don't go generic until after like X amount of years. And that's when it can be cheaper, for instance, like a blood thinner like Eliquis.
00:19:23
Speaker
ahhah it's still a brand name and it hasn't gone generic, but it's been a around. Not yet. It's coming. It's coming soon though. Yeah. But I will say this in the article, so there, this gets complicated, right? Because there are legit compounding pharmacies out there that are trying to use safe products into compounded, right? But everybody's in on it. So there's also illegitimate compounding pharmacies. I say that in articles that are also doing it. So one thing they talked about in the article is they said that, um, non FDA approved compounded drugs claiming to contain semi-glutide with high levels of of known impurities and unknown impurities pose a significant risk. So they did a test, I gotta find it. So I think they said um when the drug makers tested products being sold by Well Health, which was a online weight loss pharmacy, it found impurities of up to 24% including formaldehyde, dimers and other unknown impurities.
00:20:21
Speaker
um And they en Novo said that it found impurities in True Life's products as well. So the there's that's the challenge, right? So Novo Nordisk and all Eli Lilly who makes Manjaras also suing companies. So ah everybody knows the primary drug, right? They know that semi-glutide and tears, what is it? Terezepatide is the drug. What you don't know, because the patent holders don't disclose that, is what they use to to make that drug work, right? So now you got this drug, but you gotta find a way to get this drug into somebody's system to the right receptor to make it do what it does.
Rise in Syphilis and Penicillin Shortages
00:21:07
Speaker
The company has not given up that information. That is the proprietary, that's the intellectual property of the company. So the company is banking on not selling that information because they don't have to give it up yet.
00:21:17
Speaker
um And so people are making that part up as they go. So it's not the semi-glutide, the drug itself. It's not the actual compound. So the GLP one itself is not the part that they're tinkering with. They're tinkering with, well, how do I put it together to make it a medication? So everybody's making it up as they go to try to provide fillers and different things like that to make it something that gets into your system that you can use. That's the catch. Because those things are, those are the parts that are going to be dangerous that could cause harm more than the actual compounded self. If that makes sense. So for y'all out there, trying to get your hands on the Ozimpic, Wegovi, something similar, it's going to be important for you guys to to check and see exactly what you're getting, who you're getting it from. Is it compounded? Is it not? Well, so y'all know if y'all trying to do something sketchy anyway, or get something done on the low.
00:22:13
Speaker
Yeah. Yeah. The only charge is this much in America's too. So like overseas, it's like $200. Oh, but that's, well, yeah. This is, this is an America problem. Yeah. ah Unfortunately, um, they're not charging. The Danish aren't charging themselves. No. Uh, $1,200. This whole big pharma issue we have over there in this supply. is an american They only get to do that. They get to come, they get to come to your country and charge you an arm and a leg and a foot and a toe. But that's another conversation. So that's that's what's happening. And not to venture off of drugs because I think this is important too. So as we know, syphilis cases are on the rise, right? Syphilis cases are through the damn roof, y'all. Here's the problem. Penicillin, the treatment for syphilis is on severe shortage. Such a severe shortage that we have approved
00:23:06
Speaker
um ah penicillin alternatives that actually they are not FDA approved necessarily to be used here in the US, but on the emergency use. So UK, places like that don't use penicillin and G to treat syphilis. um So we have, we're now using their drugs to bring them over. Like that's how bad our shortage is. Don't get syphilis. That's all I can say. For the first time in like what they were saying, 20, 30 years, um an STD that was essentially almost eradicated has been on the rise and it has been increasing. It has been surging. ah It's at its highest level since the 1950s. So it's had an 80% increase. So more than 207,000 cases
00:23:53
Speaker
have been found between 2018 and 2022. I know y'all in the house, but listen, don't do it. Reconsider. We some literature or something. Get out of here. I'm just saying, like why y'all got to get syphilis? like Please don't. Um, so yeah. But, you know, syphilis is one of the ones where you could have it and not know you have it. That's why. Until you do. Until you do. Well, that's a lot of these STDs, right? Well, I think you kind of know if you've got gonorrhea.
00:24:31
Speaker
yeah I feel like let's itself be known. Gonorrhea be like, hey, hey, hey, hey, hey, hey, hey, hey, hey, hey. Hey, look down here, look down, you see? Look down. Yeah, you kind of know if you got syphilis. You know if you got gonorrhea. You know if you got herpes. True. You might be in denial about it, but you see that. was Syphilis, if you miss the canker, if you miss the lesion, Yeah, if you missed it and you didn't see it and whatever, and then next thing you know, you just, you just, you know. Yeah. It's bad for business.
Understanding Autism Spectrum Disorder
00:25:06
Speaker
Yeah. But I'm shocked at how many cases. And that, you know, like the CDC is trying to figure out everything. They're all over the place. Like they're up in all categories. Like men who have sex with men, who's always the primary, I feel like topic that we, we go to, but they can't make sense of it there. But it's also in heterosexual couples. Like it's on the rise.
00:25:28
Speaker
everywhere. um they first They initially thought that maybe it was due to like the popularity of PrEP and those kind of medications. For people who don't know, PrEP is a medication that you can use, you take every day for people who have casual intercourse that decreases the risk of transmission for HIV. So they thought, well, maybe PrEP medications are encouraging you know less cognitive use, but when they actually went to look at the timeline, syphilis on the rise before the popularity of PrEP, so they cannot tie it to PrEP necessarily. So this is not because um people have gotten more free. We're just more free already. And we are catching syphilis. So I've actually added syphilis to my list of STDs, and I must be honest until I started reading these.
00:26:14
Speaker
I started last summer like, okay, we're going to have to put syphilis on there because you used to reserve syphilis testing for your high risk, full, full, high risk sexual behavior. But now I have added it in and say, if you are having unprotected sex, that is a high risk behavior. So we are testing for syphilis. Well, you know what? I think people need to start having sex with the lights on, because maybe you're missing some stuff. You need to do inspections first. You're not doing it in the dark. I don't know. Put the lights on. Don't don't cut the lights off. You know, they tell you turn off the lights. Put them on. And they crack up, especially the girls. I'd be like, did y'all look before y'all turn the lights on? You need to look.
00:26:55
Speaker
They're like, what you mean? Look, I'm like, I mean, look, right? It's about to be in you, friend. Like, I need you to look at it. Like, I'm, I need full inspection. You need to inspect. li You can play it off. You can play it off as like foreplay. That's what I said. You can make it sexy. Like, it doesn't have to be like, I need to see." I said, you can make it the sexiest thing. like He does not have to know. And listen, once he's in the moment, he's going to think everything is sexy. So just the fact that you're down there inspecting, he's going to be like, oh my gosh, he's so wonderful. But you're just trying to take a look. And if you see anything that's highly suspicious, that's your cue. Yeah. Take a look.
00:27:34
Speaker
Yeah, what they what they supposed to do they see something also is like, okay, hold on Let me uh, I know we lit these candles. Let me yeah what so yeah oh Look the time Rumple in a little bit here how you get out of there look I run, run, set an alarm on your phone is ringing like, Oh, hello. Oh, right. I got to hit you right now. You're at the airport right now, girl. I got to go. I got to go quick. Let it light up. I completely forgot. I got to get my homegirl from LAX. I'm gonna go today. I'm so sorry. I'm gonna call you though. I'm gonna call you though.
00:28:15
Speaker
Maybe. If you say something. Maybe. I don't think they mean it as maliciously as it comes out, but I think it's their knee-jerk reaction to figure out, like, how can I get away with this, right? Like, can I get back into my regular routine and so that nobody becomes suspicious? You're like, no, you got to tell all your partners. Because I think they're hoping like, oh, I'm going to see Kelly Friday. Yeah. It's Tuesday and you just told me, am I going to be good for Friday? Like, can I have sex? Okay, now that you and told me and you gave me this shot, can I have sex? And you're like, no, no, no, no, no, no, no. That's not how it works. And if you already had sex with Kelly, she probably got it too. And you need to tell her so she can go get checked out because you're just going to re-infect yourself and end up right back in my office. Please and thank you. Please and thank you.
00:29:09
Speaker
Okay, well, I guess I have to move on to the main topic now. Before you come up with another. I'm done. I'm done. I'm done. I'm done. I'm done. I'm done. I'm done. I'm done. I'm done. I'm done. I'm done. I'm done. I'm done. I'm done. I'm done. I'm done. I'm done. I'm done. I'm done. I'm done. I'm done. I'm done. I'm done. I'm done. I'm done. I'm done. I'm done. I'm done. I'm done. I'm done. I'm done. I'm done. I'm done. I'm done. I'm done. I'm done. I'm done. I'm done. I'm done. I'm done. I'm done. I'm done. I'm done. I'm done. I'm done. I'm done. I'm done. I'm done. I'm done.
00:29:32
Speaker
now this is a big topic so not going to talk about everything with autism because is huge. right So basically what I'm trying to do is um it is not something that we normally usually manage a lot as family physicians, but um one important thing is, especially with children, and doing your your well-child visits and screening, um we definitely screen through developmental screens to see if um kids are developing as they should, if they're getting passing all their milestones, and if they are delayed in some of these milestones. um And with the screens that we have in place, we can screen and see if they have autism and try to really get early interventions
00:30:24
Speaker
to help them through um so it's not necessarily as bad, right? So that's kind of like what our role is with that. So first off, autism is just a spectrum of developmental disability caused by differences in the brain, right? so It can be genetic, like there's no real cause. We don't necessarily know what necessarily cause it. There are some genetic, um genetic, ah like a conditions that are associated with autism, like chromosomal disorders that could occur that could, and then the those kids are more at risk of developing autism.
00:31:15
Speaker
But um what we do know is when we start with early interventions, it definitely improves. um helps the patients, and then they can probably have better developments and start to kind of reach their milestones. And maybe their language also improves too. so um And it's not caused by vaccines. It is that other not caused by vaccines. That has been debunked, but still think that yeah people still think that that is. I know, that's why I'm saying it.
00:31:48
Speaker
It's not a for debate. this is the fact It's not caused by vaccines. So it's called spectrum disorder because it's definitely a ah spectrum, right? There's some people. So there's some people that can develop autism and become nonverbal and some that are pretty high functioning and verbal and they can function in society. And there's some that just basically are dependent on their caretakers and they can't really do much, right? So it's a ah variability. Right? Which is part of the challenge too. It's so varied that um people can fall into the two two schools of thought, either know there's no way that this is, you know, autism because I have a snapshot, you know, picture of what autism is to me. And so my kid or my friend or my family member is not autistic to
00:32:40
Speaker
Oh, everything is autism, right? So I found like the, typically they're trying to manage both sides where somebody's like, no, my kids got autism. We need to get checked out. And I'm like, do they? I don't think so. Because also. Yeah. Because um with autism spectrum disorder now, like there's a bunch of different diagnosis that kind of fall into this umbrella of autism, like Asperger's. and syndrome and like some developmental pervasive disorders also. so
00:33:11
Speaker
So it's so wide and varied, right? So it's really it's really hard in that sense. But it's also possible, especially with Pete, for you to have a child that has a delay in one aspect and that not be autism. right like you can You can have a child that has like a speech delay only. They're delayed speech-wise, and that is it. And the rest of their you know symptoms are not in line with autism at all. But sometimes some families feel like, oh, like if it's a speech delay or oh if they have some other delay that like, oh, it has to be autism. It's like, that's not how it works. Yeah, no it doesn't because there's a lot like if I go through the criteria that that you have to meet in order to get the diagnosis is really extensive. And there's a lot of different things that have to be met in order to have that diagnosis of autism. Right. So.
00:34:03
Speaker
it's It's definitely, a lot of times they don't really diagnose kids until they're like two, because you can't necessarily, you can show some early signs that it could maybe be autism, but they don't really um give you the diagnosis until after two years old. I did my research on autism during the M-Chat and um rolling out a different version of the M-Chat and trying to improve our screening in order to improve our percentages at our local clinics.
00:34:39
Speaker
kind of like a quality improvement um involving this. So there are definitely some barriers to it. But typically with the mchat, you can give it the first time you might see it like as a parent, if you have a child, the earliest they can give it to you the screening is around 15 months. And then but we basically screen you either starting around 15 months or 18. And then if all else fails, we should have caught you by age two, like, so Dr. Chris is right by two, you should have been screened for autism or someone should have given you a questionnaire, or the doctor that seeing you has already kind of like gone through the questionnaire themselves and kind of screen and you know, your milestones and stuff like that. But yeah,
00:35:18
Speaker
we try to catch you before too. But that's also because in most states, in every state is different. But in most states, once we figure out that your child might be autistic, there are resources and things that you can have access to and a lot of them you know it can change at the age of three so typically before the age of three there's one set of resources and then after three then it starts getting into like they have to be reevaluated and are they in preschool and it gets dicey but go ahead dr k chris i mean it's still your thunder no no no no that's it's absolutely right very true and so that's why it's really important that
00:35:55
Speaker
I stress that you go to your well child visits as you should because this is what this is why we're doing that. Yes, we're giving vaccines at a lot of these visits, but we're also looking to see, is the kid developing like they should? Are they developing language? Are they you know um developing their fine motor skills as they should? Are there some delays? A lot of times what they see is that these kids can sometimes develop pretty well. like start
00:36:25
Speaker
you know Maybe they might show some early signs, but they get to those developmental stones. They're reaching their milestones to like 18 at 18 months, and then they kind of like fall off a little bit, right? And they're just not developing like they should anymore, right? And that's when we develop, that's a lot of times when those screening tools come in the place that we do at the 18 and 24 months, the the M-Chat, like she was talking about, the screening tool. Yeah. And I think that's important to parents to know because
00:36:56
Speaker
Sometimes um i I've got a little bit older kids. like I wasn't in their care you know when they were smaller. And so like I've got like a seven-year-old, and now the parents are like, I think my kid has autism. Let's you know get them checked. And so I think parents need to know when no screen is supposed to to happen. So parents, you can print out your own screenings, right? i know that you are dependent on us to ask all the questions. And sometimes we're asking the questions because we are doing the screenings. We are you know asking questions to make sure that that the milestones have been hit. But there's nothing wrong with you having
00:37:38
Speaker
a copy of like any developmental things that, you know, should. And I love it when my parents come in and they're like, so they're drawing their squares and their circles. And we practiced doing a man the other day, they drew a a body. I love it, right? I think that that's great because then we know that none of us will miss something. And I find that most parents do not know when those MCAT surveys are supposed to happen. Yeah. Yeah. And it's something that you can look up on the CDC. They tell you all the things all and you can see like when your child is a certain so age, what they should be able to do, what they can't do. You know, you can also look up what some risk factors of autism are and like what are what are the things you should be looking for.
00:38:24
Speaker
And you could always bring it up to your doctor, right? Because all of those things help us, right? Because when we hear that, especially the earlier, the earlier, the better, right? So if we can see that there's something maybe that we need to work on doing early interventions, as shown to be helpful, right? yeah So that's that's the one thing we don't want to miss. We don't want to miss that and then we could have done something and then we didn't act as we should have and it just gets worse, right?
00:38:56
Speaker
So um before I get into some of some of the criteria and the signs and symptoms, because there are a lot, I will talk about some of the risk factors, right? So um one of the so a lot of, like they like I said before, they can't necessarily pinpoint into one specific thing. They see it's a lot of different factors that could cause autism, so maternal, of factors, paternal factors, environmental factors, all of these together can increase the risk, right? So one thing is having a sibling that has autism, um mothers of advanced maternal age, right? 35 or older. It's rude. I know. It is rude. But I'm just saying. That's what it is. Advanced paternal age, right?
00:39:50
Speaker
um preterm deliveries, low birth weights, another risk factor too. Sometimes it could be moms that probably while during pregnancy like have epilepsy, have seizure disorders, have to take seizure medications, and taking those medications um can cause damage and utero to the to the fetus, right? so like then they can end up with some ah some neurological delays, the disorders, and they can end up with have a higher risk of autism. So those are some of the risk factors. But that doesn't necessarily mean that it'll happen. I'm just saying those are just risk factors, right? So
00:40:38
Speaker
So now we're moving on to what are some of the signs and symptoms, right? So it, like I said, you have to have a lot of different things altogether because it's like problems with social socialization, language development. um It could also be like with behaviors and also another thing to mention with autism a lot of times there are different um Different disorders that are can be associated with it So you can have a kid that's autistic and end up the you know, they have seizures as well have ADHD behavioral issues um a lot of there's some a lot of autistic
00:41:28
Speaker
um kids or patients that can have like gastrointestinal disorders like severe constipation can be a problem with them um there's just some other other disorders that could also be associated with it right so some of the signs and symptoms so they kind of like kind of put them in different categories, like social issues, language, behaviors, all of those things. like And you have to meet certain criteria in those categories to make the diagnosis. So some of the social problems, social communications and interactions that can be related to autism, like they avoid eye contact,
00:42:10
Speaker
If they're not responding to their name by nine months, that could be something that you might want to consider. Maybe maybe the kid could be autistic. Don't show facial expressions. They're angry, sad, happy, right? By nine months. um Don't play with simple simple games like patty cake at 12 months.
00:42:35
Speaker
That goes for everything, patty cake, peekaboo, stuff like that. Stuff like that. Other things, another part two, this was just some of the things. I'm not saying everything, but they have restrictive or repetitive behaviors. So if you see sometimes they want to line up the toys a certain way, right um They get really upset when order is disrupted they're into their routines. um They repeat words and phrases over and over again.
00:43:08
Speaker
Sometimes they can ah flap, sometimes they do other things like flap their hands, turn around a lot, or rock their body. Another thing, sometimes they could, um and ah one thing, ah de definitely I see this a lot, they have unusual reactions to the way things sound smell taste look or feel so they have like issues with like certain foods they they don't like the consistency of it or with sounds like they gotta wear like headphones because they just get real sensitive with all like um external stimulus right
00:43:46
Speaker
something And the other ones, some like they have like delayed language skills. So those are some some of the things. so Like I said, it is inexpensive. You have to meet a lot of different criteria. You have to have a lot of signs and symptoms to beat the criteria for the diagnosis. But those are some of these. I'm going to be honest with you. Um, because I, my Peds is a smidge rusty cause I haven't seen kids in a while cause my current job was in a women's health clinic and I miss my kids. Y'all know I love Peds, but, um, the majority of the kids who I've diagnosed with autism, usually it's the parents that are coming in because they're concerned about something. And I want to,
00:44:35
Speaker
tread lightly when I talk about this, but especially now that I am a parent. Okay, I'm gonna just say my thoughts. It might come off some way, but hear me out. Walk with me. walk Okay. Because I have a lot of friends that are my age that are also parents. And as a parent, as a mother, I feel like we have varying levels of anxiety, right? Some anxiety is healthy, kind of just like, hey, I don't want anything to happen to my kid, just trying to keep them safe, right? And then there's like people who actually really do have really, really bad, sometimes undiagnosed anxieties, right?
00:45:13
Speaker
And I understand the concept of the concept of, Hey, I don't want to compare my kid to any other kids. Like, you know, my kids doing their own thing. Like, I don't want to compare them. Like, you know, don't tell me what to do with my kids. Like, that like some people micromanage their parenthood like that. And that's just how they parent their kids. Like, I don't want to know. But I do think that there is a healthy level of comparison as a parent because kids need other kids to interact with. And most of the time when I have diagnosed autism, like in my office, it's parents who have a child and they have their child playing with another child and they and they notice things like, oh, my kid doesn't do that, but this kid does this. And they're around the same age.
00:45:58
Speaker
And I think that that is healthy to have kids together around the same age and just kind of like just just take some observations. You know what I mean? If you're like, wow, my kids are really not paying attention to these other kids. Like, you know, there's really no eye contact here or he doesn't respond to his name or like, oh, is that what he's supposed to be doing? My kids not doing that. I think that there's a way to appreciate that and have a healthy level of concern without being defensive about it and being like, well, you know, like I don't know. I feel like we're kind of in the era where like a lot of people are very touchy about their kids. But I do think if you have an open mind, then you will likely be able to observe a lot of things, especially if you put your kids around other kids their age. That's all I'm saying. Yeah. Yeah. That's ah that's a really good point. Well, some people get touchy about it. so Yeah. Yeah, they do.
00:46:47
Speaker
It is hard, but I remind people that the sooner you identify it, um the sooner you can get resources in the home, you know, get resources outside the home, make the school aware. um And I think no differently than like, I remember as a kid that Down syndrome was, you know, The thing right it had all these limitations fast-forward, you know to now down syndrome um Has all of these limitations lifted right? So You now see people saying well, no go, you know Get that graduate degree get your PhD if you want to like do all the things and
00:47:30
Speaker
I think that we have seen pockets of kids that have, you know, are probably autistic, that maybe are undiagnosed, underdiagnosed, or diagnos secretly diagnosed, that have decided to do all things. And so, you know, I don't think it has to be like this, you know, scarlet letter, you know, A, that you're walking around with. um No pun intended. but um it it It can be a lot of different things. So I think some of that is the initial fear that, oh my goodness, my kid um is neurodivergent. And I don't know what that's going to look like. so So let me just see if I can just push them and will them to be their best. And they'll just blend in. That's really not fair to the kid either.
00:48:13
Speaker
But like that's the that like I feel like that's really the hardcore job like of the family doc, of the pediatrician, because those milestones that those well child visits are really, really important. You know what I mean? Even if I'm not the person to diagnose your autism, if I have a kid in my office and it's a well child visit and they are two or three, if they are delayed in some type of milestone, I'm immediately going to tell the parent, like, hey, Just so you know, by this age, we would normally be seeing him or her doing this. So they're a little behind, like, you're not going to be my patient and do that whole like, Oh, well, no one ever told me, I don't play that. Like, I have told you like, because someone and I'm going to document it. Right. You know what I mean? Because usually after that, it's whatever emotion the parent has.
00:48:59
Speaker
And it varies, right? Some of the parents are like, oh my gosh, they're behind. How do I get them better? What should I be doing at home? Some parents are like, no, they're not. Well, don't worry about it. like Everyone's reactions are different. And then some people are like, oh, well, is there a program? like Is there resources? And I'm like, you know. And then you have that conversation. So yeah. a I feel passionately about this because I feel like there's a lot of people who go undiagnosed who probably shouldn't be, which is why I did it for my research. They feel like bra and black and brown children a lot of times go undiagnosed. and you made mean work it bothers my It bothers me.
00:49:35
Speaker
Yeah, it but it but it bothers me because, you know, sometimes it gets misconstrued as like your kids not listening or they have a behavior problem or this or that. And then, you know, it's already hard to navigate in America, you know, being black, brown or otherwise. And then now you have this on top of it. The last thing you need is a parent that either is unaware because they just don't know because of lack of resources or in denial, because then you can't you can't get what you need. Because a lot of this stuff, like Dr. k Chris was saying, if you identify it early, and you get the interventions, then you, by the time you hit kindergarten, by the time you're five, you could be on the level playing field, to be honest with you. Like you could, you could, you really could, you know, but if you spend, if you spend from age two through four being in denial and then now it's time to enroll for school in kindergarten and you've been in denial for three years and then now kid never, it's whatever it bothers me. Yeah. because they're just you want Now you want to catch up. Right. right yeah And, and I think, and I think the,
00:50:34
Speaker
The people who we're talking about most right now, I think people identify the the more severe autism, right? The kids that are nonverbal, yeah the kids that have a lot of tactile and like auditory like um triggers and stuff like that, the the kids that rock, the kids that don't play well. I think people identify them very well. And so I think that that that was a those kids need resources. They need big time resources. so that we can maximize their function. But I think most kids with autism fall in this mild this mild spectrum, right? they They are autistic. There are challenges. There are going to be challenges in how they learn, how they take in information, how they give out information. And they are functioning enough that
00:51:28
Speaker
if you're not paying attention, especially in communities of color, it gets brushed off as undisciplined, um not listening, rebellion, and all these things. And so those probably are the kids that I think Dr. Sunshine is most concerned about because they fall through the cracks. And the the crime in that is that those kids were still on could be on on the role to be as optimized and as high functioning as people in regular schools. So I, you know, and I have seen well-resourced kids ah stay in regular school and regular class and then push through. And I am certain that their parents knew exactly what the diagnosis was. Maybe even their doctors, but they made a conscious decision to say, we're going to push through this anyway. I knew a doctor that one of our one of our um
00:52:21
Speaker
It was a sub-eye. He was a sub-eye with us um one year when we were all in residency. And I thought, man, I think this kid's on the spectrum. like I keep my finger on it, but it seems like it, but was a good student, a good sub-eye. went on to do residency and complete residency. And I want to say after he completed residency and passed his boards, I saw him post like, I'm an MD and I also have autism. So I'm assuming he had been sitting on that information because he did not want the, you know, the stigma or the stereotypes that are going to come with that and still push through. So, you know,
00:53:03
Speaker
Yeah. And that goes to point like that you can have those high functioning people, right? That can function yeah pretty well. And right like to get there, you yeah might need a little, you got to be resourced. Right. Yes. Yes. Yes. And you've got to be resourced. You've got to learn how to learn in a, in a world that is not really designed to optimize your learning. And that takes a lot of practice and so and people to be very patient and very disciplined with you. But similar to this kid, you know, once you figure it out, um, they will, they will do fine. Well, they can do fine.
00:53:45
Speaker
Did we, did we hijack your topic? That's cool. And then, so, I mean, I'm just saying there's just type of treatment. So like with the treatments. for autism, it's kind of multidisciplinary. So meaning that we're doing um behavioral therapy, depending on the needs, right? They just need to be supported, right? If they're are having problems, like sensory issues,
Insights on Interracial Dating
00:54:10
Speaker
like they need like um occupational therapy to help with them so to learn how to sensitize all things, all the things, speech,
00:54:20
Speaker
you know it really you know they need all of these resources to help them so they can become successful right so there are no real like drugs for it. um There are approved drugs basically um to help with like the behavioral kind of issues that could be associated with autism. And those are usually the people who get those medicines. They're the ones that are maybe not as higher functioning, um that they might need to get some of antipsychotics. um And like I said before, with autism, they can have other associated diagnoses like epilepsy, other things that can be going on. So they'll be treated for other medicaid other
00:55:02
Speaker
other conditions as well, right? But mainly with the with the behavioral approaches, they're normally like two different styles. So the one style is they like step by step instructions to teach them how to get a desired behavior and response. And sometimes they take them into their natural settings and try to like help them improve different skills, um the speech and the language. right this They do like more of like a sensory integrative therapy where they help them improve their responses to sensory inputs so they don't feel like super overwhelmed when they occur.
00:55:44
Speaker
the physical therapy if they're having problems with their fine motor skills that they help fine tune that for them. um And you know especially with schools like teach them like how to learn differently having the the adequate time that they need to yeah to get them caught up. um All of these things are pretty much important to help them you know be supported and do better right? So usually, I just want to say this real quick. So like, I know a lot of people, like especially adults, I've had some patients that come in as an adult and saying that I was recently diagnosed with autism. um And it's usually like,
00:56:31
Speaker
A lot of times we get the diagnosis as a child and not necessarily as an adult, because like ah the DSM-5, they have the criteria basically for children, but they don't really have so much to criteria for adults. But a lot of the adults can have a lot of the same signs, some signs and symptoms, but just milder cases ah when they were um as what is the criteria for children, right? and um It's to get that diagnosis as an adult, you gotta look at, you gotta know with your like record, like mostly like how are you able to interact socially? Are you able to maintain relationships?
00:57:14
Speaker
like what it's It's a lot of all these different questions that you have to ask. They do those questionnaires. like you know Anyone can do the questionnaires online. but just doing the questionnaire online and it says that maybe you might have autism, that's not enough to have that diagnosis. You have to see a psychiatrist go through formal testing in order to get that diagnosis. Correct. But you can find the form, if you're a curious about some of the checklists and some of the criteria and things like that of the M-Chat, you can find it on the CDC. um There's also a lot of autism organizations that have the M-Chat. It's actually called the M-Chat R, R for revised. um And there's also a separate in chat that they recently developed. They don't use it as much. But the original M-Chat R is for when you're supposed to originally screen, 15 months to 24 months. That is the screening time.
00:58:05
Speaker
If you feel like your toddler maybe missed the screening and didn't get screened, then there's a separate M-chat for toddlers, um which is kind of similar, but the questions are a little different because the kid is older. um And those can also be helpful, but you can find it on the CDC. You can also find it, you know, I think there's an autismspeaks dot.org. um That's kind of like the organization for autism. um It has a lot of resources on there too, if you're curious. um Again, not to steal Dr. Chris's thunder, but those are probably the two most common places where you can find, you know, the M-chat, the M-chat R, M-chat for toddlers, um if you're curious. Yeah. I mean, that was kind of pretty much it. I don't know if there's anything else that you guys want to add or if you think I missed anything.
00:58:50
Speaker
Nope. Good topic. Yeah. Very good topic. Thank you for doing that. Yeah, thanks. I just want to make sure that everybody knows it's really important to do your screenings and go to your well-child visits. Yes. I'm going to ask one of the questions that was directly asked to me or referenced me. And Amy Jo and Dr. Chris, you can feel free to chime in because I will answer this question because someone asked it to me. So the question is, So I am a Black woman in my early 40s, and the dating scene is horrible, especially since COVID. I'm considering dating outside of my race, and Dr. Sunshine had mentioned that she is in an interracial relationship. What are your thoughts overall on interracial dating slash marriage slash life building? Thanks.
00:59:45
Speaker
So, I will say this. um Number one, I do think that if you... Okay, sorry. for Full transparency here. So I am married. My husband is Latino. For those that did not know, they're like, what? For real, girl? This might be your first episode. You might not know that either way. I will say this, if you do decide to date out of your race, I don't think you should date outside your race, listener, purely like completely fueled by the fact that you think, quote unquote, black men are trash. Like that should not be fueling your reason to date outside your race. I don't think that that's healthy, to be honest.
01:00:28
Speaker
Um, this is purely my personal opinion. I don't think you should go out there kind of like, well, black men are this or black men are that. And I haven't had any, you know, you know, luck here. So I'm a switch it. I'm a switch it. Let it up because me personally, I have nothing but love for black men. I really do. I have lots of love for black men. I've dated black men in the past. It just so happens that the person that I have the connection with, the person I fell in love with, the person who is my soulmate happens to not be black. And that just is what it is. There's no like deep rooted disdain for this particular group. And I'm like, well, I'ma date the opposite. like I don't think that that's healthy. ah just I just don't.
01:01:07
Speaker
But I think that if you're looking to kind of just like expand your dating pool, then I think that that's fine. And if you happen to have chemistry with someone who happens to not be black, then I think that if you're open to exploring it, you should. I will say this. If you have done some self-reflection and you know personally that you're not great with communication, then I don't think interracial dating is something that you should take lightly because as much as you need to communicate with someone who has similar, you know, ethnic backgrounds to yourself, I feel like you even have to communicate like five, 10 times more with someone who may not have your shared cultural and ethnic backgrounds because you're coming from two different perspectives. um There's certain things, especially if you guys are different religions, that's a whole nother thing. But, um
01:02:03
Speaker
Sometimes the perspective that your partner has is rooted in a lot of cultural things that you can't relate to because that's not how you were raised. And then there's a lot of listening that has to happen on both sides, um especially if you're in a relationship where you really won't you really want for both perspectives to be shared, especially if you're going to build a life together and have kids. And if you want both aspects to really be respected and prominent, then it takes a lot of listening on both sides. um And if you know that you're not built like that, you know that that's not your cup of tea, um then it might be something you might reconsider. ah Those are just the thoughts off the top of my head, but that's just how I feel in general. Okay, that's a sunshine with her thoughts and feelings.
01:02:48
Speaker
It was, it was, it was, it was, last time but that's that's just how I, yeah because to be honest with you, y'all don't know me, you know me like that. But the fact that I'm even married to a man and he happens to be Latino, these are two things that I did not foresee in my life. at all So listen, this could have taken a lot of turns, twist, twist, turn, turn. but ah But here we are, and I am very happy. But it could have gone hard left. But um I think that if you do decide to embark on it, it should be something you really do because you have a bond with the person. And you have found your person, not trying to prove a point or trying to date out of spite. I don't think that's healthy. I agree. Yeah, I agree with that too.
01:03:35
Speaker
on actually everything. We're at the chocolate MDs. Um, you can also send questions or comments, thoughts, concerns to at the chocolate MDs at gmail dot.com. Um, and you know where to find us. Um, that's all I got. I guess we'll catch y'all later at the next episode on the flip side. bye