183. Tech Tools, Living Pro-Analog, Ketones, and Finding Preventive Healthcare

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Welcome to Medicine Redefined, a
podcast focusing on helping you

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reclaim ownership of your
health.

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I'm Doctor Darsha.
And I'm Doctor Altamashraja,

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we're your hosts, here to
challenge conventional practices

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and uncover the stories behind
pioneers shaping the future of

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medicine.
Our conversations not only focus

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on the individual level to
dissect common practices for

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health optimization, but also
zoom out to enhance systemic

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change.
Join us.

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As we look to break the status
quo, move the needle forward and

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put the help back in healthcare.
Doctor Darsh, welcome back to

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Medicine Really Fine.
What's up?

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What is up?
We're talking in our chat with

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the shit that's been going on,
the political landscape.

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So that's a little scary.
I know, I don't know, I.

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Know it wasn't really on the
agenda, but yeah.

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So I guess the listeners were
recording this as we found out

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about Charlie Kirk and getting
shot at, I want to say Utah, the

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University of Utah.
Yeah, Which is surprising given

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everything.
I feel like these events, these

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political unrests happen.
It's still surprising in the

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sense that he did die and and
pass away and I guess he got

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shot in the neck and just
heartbreaking overall. 31 years

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old wife, two kids for people.
I mean, I hate him or love him.

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He was somebody that kept the
open discussion, willing to

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debate people and just kind of
talk about politics and make the

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USA better place, I think.
What's sad is somebody sent me a

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video of I think it's on X some
looks like a young person who it

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sounds like he was asking a
question about mass shootings in

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the Second Amendment.
And there's a clip where he

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talks about there is a cost and
the cost is worth it.

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And the caption of the clip is
you still think it's worth it

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once, Charlie.
And it reminds me of Brian

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Thompson.
The empathy is it's rare and

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rare every single day, huh?
Yeah, for sure, especially with,

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like you said, a younger person.
Again, this is not to exclude

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Gen.
Z or anything.

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His opponents, quote UN quote.
On the Democratic side would be

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Dean Withers, 21 years old.
There's a big following in the

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younger group, obviously from
the woke side, the Democrat

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side, these different tribes.
So it doesn't surprise me that

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it's a younger person.
But it's tough, right?

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Because there's not enough lived
experience yet to try to

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understand all the different
sides to someone's story and why

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they might be sharing whatever
they're sharing, what they're

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pulling for, and what they're
becoming an activist for.

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Let's turn from that song,
right?

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There's a bit of a hodgepodge
random show.

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Talk about what's top of mind
for us, top of mind for you.

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I'll give you the floor to start
off because that's kind of your

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idea and I like it.
It's 100.

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Percent random show.
Random show.

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It is so people for people to
understand.

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Tim Ferriss is probably my
favorite podcaster and he does

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this with his good friend Kevin
Rose.

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They call it the random show
probably once a month.

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And they just go over things,
current events, things that

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they're finding, things that
have brought value to them and

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they try to share that with the
audience and just shoot the

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shit, so to speak.
So I guess one of the things,

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and I'm going to try to make
this all full circle.

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Let's see what has been recent
for me.

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So I got back into writing.
I used to have a blog in college

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and then I found myself not
writing after graduated, you

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know, with medical school
residency, it was hard to do

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that writing poetry, writing
creatively.

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And now I found myself on sub
stack.

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So the way this happened was
there's an app called Matter.

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And the way I got hooked up to
that was I've always got in

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newsletters.
So Tim Ferriss's deals letter,

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James Clear's newsletter as
well, they shared, Tim Fair

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shared a quote from David Foster
Wallace from another article

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called The Memes and Meaning by
Paki McCormick.

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So he's like a tech Blogger, but
read means and meaning and took

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us like a 20 minute read.
Absolutely fascinating.

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I especially think for us and
like where we are in life and

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trying to find purpose.
It's all about so cool.

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Now what, right?
If you hit, you get gold, you

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hit your successful goals.
Now what?

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So he really just delves into
that and that got me thinking

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even more.
And then I found his article on

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this app called Matter, which
basically shares a bunch of

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different perspective articles.
So that inspired me now to get

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back into writing because I
realized man, when I was like 23

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writing, it's just different.
Like I talked about the frontal

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lobe wasn't developed, didn't
have enough lift experience.

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But now with being attending.
So when you get that gold medal

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syndrome and you reach the top
to reach the pinnacle, often ask

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ourselves, well, what do we do
now, right?

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We actually enjoy the journey.
So that had influenced me to

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start writing because now that
I'm at the right age of 33,

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rather than writing ten years
ago, but now, you know, with

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medicine practicing, and it's
been such a blessing for me to

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kind of get back to writing
because it's allowed my thinking

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to be more clear.
And now I understand why people

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say when you want to understand
what you actually know, if you

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want to brand yourself, if you
want to have an opinion or a

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thought, write it out and make
it your thesis in a way.

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So now when I'm writing, it's
really about what's my thesis.

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And it's not even for education
really, it's for my own self.

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Why sub stack?
I think it's the easiest

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platform now.
Everyone's kind of on there.

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It has a good algorithm, so you
can go in and talk, hit whatever

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topics you're interested in,
business, tech, space, medicine,

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and then it'll link you to those
people.

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So it's almost like X or Twitter
now, really just for articles

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and newsletters.
So that's like the new format

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that a lot of people are using.
Yeah, good piece.

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And I think we shared it on
social, so hopefully people will

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check it out, particularly if
you are a undergrad considering

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a career in healthcare and
especially in medicine.

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I think my favorite was, I don't
remember which one, it might

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have been 10 or 11, where you
talk about the question that's

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asked of let's go to medical
school.

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What do you see as your
specialty being right?

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I asked this question as well.
I'm guilty of doing this

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yesterday actually.
And instead I think you propose

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ask what kind of life you want
to live, right?

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It's interesting because it
applies to so many things that

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applies to you know what my the
residents I work with, they ask

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me about different fellowship.
And that's the question asked,

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you know, ask yourself what life
you want to live in 15 years.

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What is that like?
What is your practice like?

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And then you know, their back
cast or reverse engineer from

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that.
And I know you've talked about

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that.
I think that is an exponentially

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better question.
Where do you see yourself in

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five years?
Where do you see yourself in 10

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years is getting at that
question.

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But I think if you reframe it in
this sense, then you can think

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about, OK, what are my next
steps especially, and you have

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to do that Part 2 if you want to
make it more actionable in the

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immediate future.
I love that one man.

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I totally agree, right?
Because when if you ask yourself

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too far in the future, then
you're just looking for that one

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opportunity that can launch you,
right?

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But when you go look at yourself
just in the near future week or

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two weeks, so many opportunities
are coming to us now, right?

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With social media and
collaboration, whatever might be

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that, if you have the vision in
your mind for what type of life

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you want to live, you can then
filter out and choose the better

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option that's right in front of
you that's going to get you

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closer to that life that you
want to live.

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Yeah, Matter's a cool app.
Thank you for sharing that.

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I'm using the free version.
I read newsletters.

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My primary wants, it's gonna be
Modern Wisdom.

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James Clear, Tim Ferriss.
I like the layout.

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The UI of it I think is quite
cool.

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Speaking of apps, Alfred, you.
Familiar with?

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No, you said, Alfred.
What the hell is that?

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So I got this from Chris
Williamson.

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Alfred is an app.
I think it's exclusively for Mac

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for those who don't know.
Have been PC in my entire life.

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Fight the fight.
Steve Jobs has won, and I gotta

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say, I'm not fully transitioned
over, but there's no turning

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back for me.
I do love it.

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The seamless transition is just
absolute game changer.

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But Alfred is this super cool
thing, man.

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And it's actually very
reasonably priced too, like if

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you get the lifestyle
prescription.

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But I have to say, I haven't
quite figured out the

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capabilities of it.
But you know how you have the

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Finder on Mac when you're
searching for something?

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Well, Alpha could do that for
you in a much more efficient

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manner.
So it's a place where you can

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find different files, find
thoughts in different files,

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find just little phrases in
different files.

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If you want to copy something,
you know, something that used to

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be really annoying is if you
copy, you can only retain the

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very last thing that you had
copied.

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With this, it allows you to to
copy 20 things and you can just

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go through this little snippets
thing.

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It's been really freaking
awesome.

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And I think it ended up costing,
I don't know, maybe 80 bucks or

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something like that for a
lifetime prescription.

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So big fan not getting paid by
them.

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But you gotta check it out.
You have probably, it's a

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British product, so maybe
there's lots of Alfreds out

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there.
Yeah, Alfred.

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I was a big fan of Michael
Caine's version.

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That's not Michael Keaton.
Keaton.

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Can't get it right.
You know me.

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Alfred, y'all have to check that
out.

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So we talked about tech, we
talked about what you're at, any

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other products, any other things
that you think have improved

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workflow?
Yeah, for all the physicians out

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there.
So we use Dragon a lot of the

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times, but if you're like I use
point click care for my skilled

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nursing facilities.
So the best speech to text app I

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found is called Whisper WISPR.
So it's Whisper dot AI.

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This is in a game changer for me
too.

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Like when I don't have to use
Dragon and then copy and paste

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it over at this, you basically
do speech attacks and it can

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work in any text box that you
have open.

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So that is what I like spread
the gospel to to a lot of the

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newer physicians out there who
are struggling with

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documentation or they don't have
a scribe themselves and they

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don't have access to Dragon or
any other device.

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Whispers definitely what I've
been using.

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Now do you dictate on your phone
and then transfer it over?

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Or it's on the laptop itself and
it's super clear.

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It's almost nuanced that like
Dragon is.

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So it picks up full sentences,
the periods, everything.

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Is it built for medical lingo
like specific terminology?

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I heard it from my first million
podcast, right?

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So these, if you're using
ChatGPT instead of actually

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speaking to ChatGPT or having to
type, you just say your prompt

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rather than doing anything else.
And so it's just been saving a

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lot of time for people that are
really heavy AI users.

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Yeah, I think you know this.
I'm a big speech to text and I'm

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talking just a regular SMS
iMessage.

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I will hit that speech to text
back and forth and maybe

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sometimes it'll come across as
during my dictation, you know,

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words that it doesn't pick up.
That's actually one of the

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reasons Chachi PT.
Chachi PT, to my knowledge, is

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the only current LLM out there
that allows you to do that both

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on the computer and the app.
Claude, you can only do in the

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app.
I think perplexity might only be

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in the app if I'm not mistaken,
but Apple, what'd you say?

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I'm sure when you're using your
iPhone trying to do it, it

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doesn't capture, it's not great
like 70%.

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Yeah, it's not great.
It is getting better.

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It does learn some like specific
names, you know, it'll learn my

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sister's name or some other
words that just are not in the

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English language over time, and
it will learn that.

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00:10:16,080 --> 00:10:17,480
But yeah, it's not nearly as
good.

227
00:10:17,520 --> 00:10:19,280
Big.
So Whisper, I got to check that

228
00:10:19,280 --> 00:10:19,720
out.
Whisper.

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00:10:19,720 --> 00:10:21,640
Big fan of that.
Cool, let's see what other apps

230
00:10:21,640 --> 00:10:24,040
are out there that I'm using.
Whisper I'm not even paying for.

231
00:10:24,040 --> 00:10:26,440
I only use it for my skilled
nursing facilities so it's not

232
00:10:26,440 --> 00:10:29,160
much but I think it's certain
words per month or something

233
00:10:29,520 --> 00:10:31,240
that you can get away with.
OK, cool.

234
00:10:31,760 --> 00:10:32,880
Yeah.
Yeah, you.

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00:10:32,880 --> 00:10:33,240
Did.
You ever?

236
00:10:33,640 --> 00:10:36,440
I think you told me about that
episode of Tim Ferriss about the

237
00:10:36,440 --> 00:10:38,120
vagus nerve.
Right, interesting stuff.

238
00:10:38,320 --> 00:10:42,240
Bioelectric medicine coming out.
Yes, interesting stuff.

239
00:10:42,400 --> 00:10:45,680
I came across a post on LinkedIn
by Doctor Chris Antenno.

240
00:10:45,680 --> 00:10:49,720
He's over in Colorado, a big
name in the ortho biologic

241
00:10:49,720 --> 00:10:54,040
space, him talking about hydro
dissecting the vagus nerve with

242
00:10:54,120 --> 00:10:56,560
PRP products for a long time for
different things.

243
00:10:56,560 --> 00:10:59,280
So that got me thinking, wow,
this is actually interesting.

244
00:11:00,240 --> 00:11:04,760
Yeah, hydro dissection is a type
of procedure and really what

245
00:11:04,760 --> 00:11:07,200
that means, the term dissection
is you're separating from the

246
00:11:07,200 --> 00:11:10,840
surrounding structures and you
can do a mechanical dissection

247
00:11:11,040 --> 00:11:12,240
like most people would think
about.

248
00:11:12,240 --> 00:11:15,960
If you are a medical student and
you've had an anatomy lab where

249
00:11:15,960 --> 00:11:19,560
you're actually have a cadaver
or donor recall, you're using

250
00:11:19,560 --> 00:11:22,840
tools to dissect fascia away
from nerves and muscles.

251
00:11:22,840 --> 00:11:24,880
Surgeons do that during a
surgical, etcetera.

252
00:11:25,320 --> 00:11:28,920
Hydro just suggests you're using
some type of fluid to do that.

253
00:11:29,480 --> 00:11:31,760
So it is, but that's actually
often times we'll do this for

254
00:11:31,760 --> 00:11:34,920
nerve related procedures and it
works quite well.

255
00:11:35,360 --> 00:11:39,120
And so he was just talking about
using platelet products to do

256
00:11:39,120 --> 00:11:40,720
that.
But it got me thinking are is

257
00:11:40,720 --> 00:11:43,120
there a role for other things
out there?

258
00:11:43,800 --> 00:11:48,920
Turns out there is a little bit.
I'm excited to explore this as

259
00:11:48,920 --> 00:11:51,320
an opportunity as well.
But maybe let me take a step

260
00:11:51,320 --> 00:11:53,640
back and tell people about the
vagus nerve, unless you have a

261
00:11:53,640 --> 00:11:54,920
question.
There I was going to ask why

262
00:11:54,960 --> 00:11:57,520
platelet products to do the
hydrogen section?

263
00:11:57,520 --> 00:12:00,240
Why not just normal saline or
whatever else it's typically

264
00:12:00,240 --> 00:12:02,080
used?
Let me kind of set the stage for

265
00:12:02,080 --> 00:12:04,320
those who don't know, you know
this cause the vagus nerve.

266
00:12:04,320 --> 00:12:06,360
So for those who don't know,
it's a cranial nerve.

267
00:12:06,360 --> 00:12:09,080
It's the 10th cranial nerve and
I think it's the longest nerve

268
00:12:09,120 --> 00:12:11,320
in the body.
Apparently it has thousands of

269
00:12:11,320 --> 00:12:14,200
branches off of just the vagus
nerve and there's some key

270
00:12:14,200 --> 00:12:16,480
branches that we learn about,
but I didn't know there were so

271
00:12:16,480 --> 00:12:19,040
many off of them.
It's what we call a mixed nerve.

272
00:12:19,040 --> 00:12:21,880
So what that means is there's a
sensory component to the nerve,

273
00:12:21,920 --> 00:12:23,920
which is the primary function
and but there are motor

274
00:12:23,920 --> 00:12:28,440
components to the nerve as well.
It's the main parasympathetic

275
00:12:28,880 --> 00:12:32,720
outflow, parasympathetic driver
to your heart, your lungs, your

276
00:12:32,840 --> 00:12:35,440
gastrointestinal tract and all
other visceral organs.

277
00:12:36,000 --> 00:12:38,360
So I think people have heard
about the autonomic nervous

278
00:12:38,360 --> 00:12:39,800
system, right?
You've got the sympathetic

279
00:12:39,800 --> 00:12:43,400
parasympathetic, In fact, most
of the breathing protocols that

280
00:12:43,400 --> 00:12:46,160
we talk about, and maybe you can
comment on this, some of the

281
00:12:46,480 --> 00:12:49,200
like what you're trying to do is
you're trying to modulate that

282
00:12:49,200 --> 00:12:50,440
vagus nerve in some sense,
right?

283
00:12:50,440 --> 00:12:53,680
You're trying to use your
respiratory diaphragm because

284
00:12:53,680 --> 00:12:56,720
breathing being one of the only
autonomic things that we have

285
00:12:56,720 --> 00:13:01,240
control over to get this reflex
stretch going up to the vagus

286
00:13:01,240 --> 00:13:04,840
nerve and get a response.
So I think you know what people

287
00:13:04,840 --> 00:13:07,040
started thinking, and this is
probably where vagus nerve

288
00:13:07,040 --> 00:13:08,480
stimulators came into the
picture.

289
00:13:09,120 --> 00:13:12,560
Vagus nerve stimulators came in
because what we recognized is

290
00:13:12,560 --> 00:13:16,440
there are a lot of conditions
out there that might have

291
00:13:16,480 --> 00:13:19,200
dysfunction of the autonomic
nervous system that could be an

292
00:13:19,200 --> 00:13:21,800
imbalance in the body's
sympathetic fight or flight

293
00:13:21,800 --> 00:13:26,200
system and the parasympathetic.
You could have just these vague

294
00:13:26,600 --> 00:13:29,400
varied symptoms like dizziness,
blood pressure fluctuations,

295
00:13:29,680 --> 00:13:31,720
digestive problems.
As I mentioned, you have a

296
00:13:31,760 --> 00:13:33,400
variety of organs that it
effects.

297
00:13:34,040 --> 00:13:37,240
Other things that can be
influenced by that are your

298
00:13:37,240 --> 00:13:41,200
response to pain, anxiety, it's
implicated in mood disorders,

299
00:13:41,200 --> 00:13:44,640
depression.
And So what we realize is, OK,

300
00:13:44,640 --> 00:13:48,520
let's modulate this nerve and
see if we can have an effect on

301
00:13:48,520 --> 00:13:49,880
some of these clinical
indications.

302
00:13:50,560 --> 00:13:52,760
And you know, people have been
using it for, again,

303
00:13:52,760 --> 00:13:55,480
dysautonomia, chronic pain
syndromes, PTSD, insomnia.

304
00:13:55,920 --> 00:13:59,080
And the FDA approved this device
called the vagus nerve

305
00:13:59,080 --> 00:14:01,200
stimulator.
I think it's been over 20 years

306
00:14:01,200 --> 00:14:06,640
now where the surgeons will go
and implant a tiny little chip

307
00:14:07,000 --> 00:14:10,000
near this nerve into your neck
in the carotid sheath.

308
00:14:10,000 --> 00:14:13,320
Rather it actually runs with
your carotid, which is the big

309
00:14:13,320 --> 00:14:16,080
pulsing artery in your neck and
you implant that.

310
00:14:16,120 --> 00:14:19,320
And this has, this is FDA
approved for a drug resistant

311
00:14:19,320 --> 00:14:23,280
epilepsy treatment, resistant
depression and even some type of

312
00:14:23,280 --> 00:14:25,440
these cluster headaches and
different difficult to treat

313
00:14:25,440 --> 00:14:28,600
headache conditions.
And the idea is you are

314
00:14:28,600 --> 00:14:31,560
decreasing that sympathetic
arousal and increasing

315
00:14:31,560 --> 00:14:34,320
parasympathetic tone.
Again, as we talked about

316
00:14:34,880 --> 00:14:36,360
breathing helps us do that as
well.

317
00:14:36,360 --> 00:14:39,440
It's an easier way to do that.
But as you know, if you've taken

318
00:14:39,440 --> 00:14:41,880
some deep breaths when you're
stressed, you feel more in

319
00:14:41,880 --> 00:14:44,280
control.
You are emotionally regulated.

320
00:14:44,880 --> 00:14:47,440
So to your question, why use
PRP?

321
00:14:47,560 --> 00:14:51,440
How else can we help, you know,
affect it in the sense?

322
00:14:51,440 --> 00:14:55,120
So some people out there will
argue that, OK, maybe it's what

323
00:14:55,120 --> 00:14:57,000
we call a mechanical issue as
well.

324
00:14:57,400 --> 00:15:00,360
So modulation is, you know,
going to be more of an

325
00:15:00,360 --> 00:15:03,000
electrical signal, right?
But maybe there's a mechanical

326
00:15:03,000 --> 00:15:06,200
compression to the nerve.
Think of the classic nerve

327
00:15:06,200 --> 00:15:08,480
compression would be carpal
tunnel syndrome.

328
00:15:08,520 --> 00:15:12,040
It's the most common upper
extremity, what we call

329
00:15:12,040 --> 00:15:13,640
neuropathy, nerve related
injury.

330
00:15:13,880 --> 00:15:16,840
And that's because you have that
nerve being pressed underneath

331
00:15:16,840 --> 00:15:19,000
this ligament.
If we know that nerves don't

332
00:15:19,000 --> 00:15:22,200
like compression, they like
space, why can't that happen in

333
00:15:22,200 --> 00:15:24,000
the vagus nerve?
Because of nerves being

334
00:15:24,000 --> 00:15:27,280
compressed, it's not getting
good mobility.

335
00:15:27,720 --> 00:15:29,600
And if it's not getting good
mobility, it likely isn't

336
00:15:29,600 --> 00:15:32,760
getting good blood flow.
Blood flow tends to be a usually

337
00:15:32,840 --> 00:15:36,680
a good thing in the body.
So a hydro dissection procedure

338
00:15:36,680 --> 00:15:38,840
or any type of dissection
procedure using fluid, you can

339
00:15:38,840 --> 00:15:41,880
separate it from the surrounding
tissue, allow that to move a

340
00:15:41,880 --> 00:15:44,840
little bit better.
Why might you use PRP, these

341
00:15:44,840 --> 00:15:48,000
platelet products?
We know we've talked about this

342
00:15:48,000 --> 00:15:50,800
with a doctor, Malenga, we've
talked about this Robbie Bowers,

343
00:15:51,200 --> 00:15:52,720
right?
They inherently have this

344
00:15:52,720 --> 00:15:55,840
therapeutic potential, right?
They have healing properties,

345
00:15:56,080 --> 00:15:59,520
whether it's various growth
factors, whether it's different

346
00:15:59,520 --> 00:16:01,440
cytokines and proteins and
healing potential.

347
00:16:01,800 --> 00:16:04,240
So you might be able to help
modulate from a chemical

348
00:16:04,240 --> 00:16:06,760
perspective in that sense.
I think that's one of the

349
00:16:06,760 --> 00:16:10,480
reasons they're doing that.
I was personally interested to

350
00:16:10,480 --> 00:16:13,800
see, OK, one of my main go TOS
to do these hydro dissection

351
00:16:13,800 --> 00:16:17,080
procedures, I don't have a lot
of patients who pay for PRP is

352
00:16:17,080 --> 00:16:20,440
to do good old dextrous 5%,
right?

353
00:16:20,480 --> 00:16:23,160
So that's, that's the sugar
water concentrated with 5%.

354
00:16:23,160 --> 00:16:25,800
Did you ever do these procedures
in residency training?

355
00:16:26,200 --> 00:16:28,720
We didn't have many patients
that came in to do the

356
00:16:28,720 --> 00:16:30,360
outpatient stuff.
Yeah, I think they went to the

357
00:16:30,360 --> 00:16:33,280
pain medicine clinic rather and
they were three anesthesia, not

358
00:16:33,280 --> 00:16:35,720
DMRS.
Yeah, I'm probably the most

359
00:16:35,720 --> 00:16:38,520
popular thing that I do and it's
just one of those things, right.

360
00:16:38,520 --> 00:16:40,520
They tend to find you after you
do a lot of that, you get the

361
00:16:40,520 --> 00:16:44,040
right referrals.
And dextrose is interesting more

362
00:16:44,040 --> 00:16:45,920
so than normal saline.
Normal saline is completely

363
00:16:45,920 --> 00:16:50,560
neutral, but D5 dextrose in 5%
water has shown to of course you

364
00:16:50,560 --> 00:16:53,720
have the mechanical component to
that, but there's a chemical

365
00:16:53,720 --> 00:16:56,680
component because they can help
down regulate some of those PN

366
00:16:56,680 --> 00:17:00,920
receptors as well, the TRYP V1
receptors which are particularly

367
00:17:01,400 --> 00:17:04,440
important to modulate in
neuropathic pain, nerve related

368
00:17:04,440 --> 00:17:06,400
pain.
So went down this rabbit hole

369
00:17:06,400 --> 00:17:10,319
this weekend, really not a lot
out there, but anecdotally there

370
00:17:10,319 --> 00:17:12,240
are a lot of people, some
conversations being had a

371
00:17:12,240 --> 00:17:14,079
LinkedIn.
Yeah, that's really interesting

372
00:17:14,119 --> 00:17:16,440
to me.
I'm excited to learn about that,

373
00:17:16,720 --> 00:17:19,119
particularly because we got
vagus nerve stimulators that are

374
00:17:19,119 --> 00:17:21,079
tried and true.
And so I'm just thinking about

375
00:17:21,079 --> 00:17:24,560
who might be the person as as it
stands today from my

376
00:17:24,560 --> 00:17:27,160
conversations with people,
they're using it for people with

377
00:17:27,560 --> 00:17:31,080
CRPS, any type of central
mediated syndrome, fibromyalgia,

378
00:17:31,520 --> 00:17:34,920
long COVID, dysautonomia, right?
So stroke, yeah, I can

379
00:17:34,920 --> 00:17:39,000
completely mess up your chronic
migraines, anxiety, PTSDA, lot

380
00:17:39,000 --> 00:17:42,440
of folks who are military
veterans who have and they're

381
00:17:42,440 --> 00:17:45,080
getting bilateral.
I'll link this case report that

382
00:17:45,080 --> 00:17:47,040
was published last year.
It's the only one that I was

383
00:17:47,040 --> 00:17:49,680
able to find where they did
bilateral vagus nerve hydro

384
00:17:49,680 --> 00:17:52,880
dissection in a 49 year old and
showed significant improvement

385
00:17:52,880 --> 00:17:55,040
both in anxiety, PTSD, all these
symptoms.

386
00:17:55,520 --> 00:17:57,400
Actually, I should mention this.
What's his name?

387
00:17:58,600 --> 00:18:01,880
Oh, my God.
He we talked about Doctor Khan.

388
00:18:01,880 --> 00:18:04,560
I forget his first name, that
they came back on Adil Khan.

389
00:18:04,560 --> 00:18:06,640
Yeah.
I had seen him on social media

390
00:18:06,960 --> 00:18:09,000
talk about doing that as well.
So I might reach out to him

391
00:18:09,000 --> 00:18:11,120
actually.
Nice day.

392
00:18:11,200 --> 00:18:12,480
Yeah.
And the the first time I heard

393
00:18:12,480 --> 00:18:14,240
about Vegas nurse stimulators
toward the end of my

394
00:18:14,240 --> 00:18:17,240
residencies, a lot of these Med
device companies are starting to

395
00:18:17,240 --> 00:18:20,000
do BNS.
And so they would come for our

396
00:18:20,000 --> 00:18:22,880
stroke clinics and talk to the
patients and try to offer that

397
00:18:22,880 --> 00:18:26,400
too, just to restore that upper
limb function by all the

398
00:18:26,400 --> 00:18:29,680
mechanisms that you touched on.
But what I think what was very

399
00:18:29,680 --> 00:18:33,200
interesting about that podcast
was what they said is this new

400
00:18:33,200 --> 00:18:36,120
creation in medicine, this new
field called bioelectric

401
00:18:36,120 --> 00:18:39,000
medicine.
And you know, we talked to Rocky

402
00:18:39,000 --> 00:18:41,480
Sullivan and we should probably
get him back at some point and

403
00:18:41,480 --> 00:18:44,440
talk about transcranial magnetic
stimulation, right?

404
00:18:44,440 --> 00:18:48,360
And so learning about the
electrical properties of the

405
00:18:48,360 --> 00:18:51,040
human body, I think it's going
to be kind of that next unlock

406
00:18:51,040 --> 00:18:54,520
when you have AI, you have
biotech, and then we start to

407
00:18:54,520 --> 00:18:56,800
understand some of the quantum
stuff, maybe that's going on.

408
00:18:56,880 --> 00:18:58,480
We talked about acupuncture,
right?

409
00:18:58,480 --> 00:19:02,200
So there's a lot of stuff that
goes on that is electrically

410
00:19:03,200 --> 00:19:06,040
charged.
Yeah, we got this podcast coming

411
00:19:06,040 --> 00:19:07,760
out with, you know,
documentation not to form.

412
00:19:07,760 --> 00:19:10,760
It's an exciting time, I think,
particularly with AI getting

413
00:19:10,760 --> 00:19:13,360
better and better, how it's
going to help us acquire that

414
00:19:13,360 --> 00:19:16,520
knowledge and make sense of
things that I think we couldn't

415
00:19:16,520 --> 00:19:21,680
have made sense of just because
you have something that has all

416
00:19:21,680 --> 00:19:24,560
the world's knowledge available
to it at all times.

417
00:19:25,040 --> 00:19:27,560
And right now, I think, you
know, we talked about dismissing

418
00:19:27,560 --> 00:19:29,800
the nuance.
It's missing the wisdom to

419
00:19:29,800 --> 00:19:33,200
interpret what's good from bad.
I see that on a daily basis

420
00:19:33,200 --> 00:19:36,920
despite these clot or whatever
the highest reasoning model, I'm

421
00:19:36,920 --> 00:19:39,080
like, yeah, that doesn't quite
make sense You you wouldn't do

422
00:19:39,080 --> 00:19:41,000
this in a clinical and that's
just experience.

423
00:19:41,480 --> 00:19:44,440
The more feedback we give it as
clinicians, the better these

424
00:19:44,440 --> 00:19:45,880
things are going to get.
Anything else?

425
00:19:46,440 --> 00:19:48,040
No, that was just exciting
stuff.

426
00:19:48,080 --> 00:19:51,280
Speaking of, I want to ask you,
'cause I know a long time, but

427
00:19:51,280 --> 00:19:53,920
we had talked about breath work
is a big thing on your part.

428
00:19:54,440 --> 00:19:58,160
Alternate nostril breathing.
Talk to me a little bit about

429
00:19:58,360 --> 00:20:01,560
your current breath work pattern
strategy.

430
00:20:01,880 --> 00:20:04,120
Protocol if you have anything.
When I was in Harrisburg

431
00:20:04,160 --> 00:20:05,480
residency was a little bit
better.

432
00:20:05,520 --> 00:20:07,280
I am actually trying to get back
onto it.

433
00:20:07,280 --> 00:20:11,600
So Soma Breath is, I think in my
opinion, by far like the best

434
00:20:11,840 --> 00:20:14,920
breath work app and breath work
course that you can take.

435
00:20:14,920 --> 00:20:18,440
Bridge, forget his last name,
but Niraj is pretty much the guy

436
00:20:18,480 --> 00:20:20,080
who runs that.
I really want to bring him on to

437
00:20:20,080 --> 00:20:22,320
the podcast at some point too,
just to talk about breath work.

438
00:20:22,680 --> 00:20:27,120
But what they do is breath
training, so learning to exhale

439
00:20:27,120 --> 00:20:29,800
more than you inhale.
So 2 second inhale, 4 second

440
00:20:29,800 --> 00:20:31,880
exhale.
But what they say is it's more

441
00:20:31,880 --> 00:20:34,120
about the cadence.
The cadence is what's important,

442
00:20:34,120 --> 00:20:35,640
not the amount of air that you
take in.

443
00:20:36,160 --> 00:20:37,800
But eventually you get to the
point where in those two

444
00:20:37,800 --> 00:20:40,920
seconds, you're taking in a lot
more air as time goes on because

445
00:20:40,920 --> 00:20:42,800
your body's just used to
expanding.

446
00:20:43,320 --> 00:20:46,520
So similar to Wim Hof, if
anyone's ever done Wim Hof, it's

447
00:20:46,520 --> 00:20:49,200
very similar where it's more
exhalation than inhalation.

448
00:20:49,560 --> 00:20:51,360
So you're really getting a lot
of it out.

449
00:20:51,360 --> 00:20:54,400
You're driving out the CO2 and
so you have a lot of

450
00:20:54,400 --> 00:20:56,040
oxygenation.
You can hold your breath for

451
00:20:56,040 --> 00:20:59,320
longer, and then you really
start to get in a meditative

452
00:20:59,320 --> 00:21:01,560
state with that.
But what's cool about solar

453
00:21:01,560 --> 00:21:05,160
breath is if you use headphones,
they have these binaural beats

454
00:21:05,200 --> 00:21:07,320
that go with it.
And you can do this for 20

455
00:21:07,320 --> 00:21:08,320
minutes.
And it's almost like a

456
00:21:08,320 --> 00:21:12,080
psychedelic experience where you
will feel some sort of energy,

457
00:21:12,640 --> 00:21:14,760
just not your regular state of
walking around, but you will

458
00:21:14,760 --> 00:21:17,680
feel different.
So it's 20 minutes, it's tough

459
00:21:17,760 --> 00:21:20,760
for me to incorporate right now,
but even the app will have 6

460
00:21:20,760 --> 00:21:23,800
minute sessions that you can do.
So I'll do that once in a while.

461
00:21:23,840 --> 00:21:25,480
But really right now what I've
been doing is a lot of the

462
00:21:25,480 --> 00:21:28,160
Buddhist Zen meditation with
Henry Shochman's app.

463
00:21:28,680 --> 00:21:30,960
But yeah, alternate, there's so
many different pranayamas you

464
00:21:30,960 --> 00:21:33,480
can do.
Alternating nostril breathing is

465
00:21:33,480 --> 00:21:35,200
one of them.
So a lot of people say if you're

466
00:21:35,200 --> 00:21:37,280
alternating nostril breathing,
like it's still going down the

467
00:21:37,280 --> 00:21:40,000
same throat, right?
But it's actually dated to show

468
00:21:40,000 --> 00:21:42,960
like going, you know, our even
with our circadian rhythm, our

469
00:21:42,960 --> 00:21:46,320
nostrils will change and close
up depending on time of day and

470
00:21:46,320 --> 00:21:49,200
things like that.
So there is data to show that if

471
00:21:49,200 --> 00:21:52,440
you alternate your nostril
breathing purposefully, it can

472
00:21:52,440 --> 00:21:54,840
have more benefits.
But there's so many different

473
00:21:54,840 --> 00:21:56,960
types of breathing.
I think one of the things that

474
00:21:56,960 --> 00:21:59,440
came to mind when you were
talking about hydro dissection

475
00:21:59,440 --> 00:22:02,640
is how most of us are really
tight around the scalenes in the

476
00:22:02,640 --> 00:22:04,520
neck.
And we learned this osteopathic

477
00:22:04,520 --> 00:22:06,160
school, right?
Like the rest, there's different

478
00:22:06,240 --> 00:22:08,720
diaphragmatic points.
It's not even all a diaphragm,

479
00:22:08,720 --> 00:22:11,040
but we have a diaphragm up here
in our neck down near the

480
00:22:11,040 --> 00:22:13,280
pelvis.
I can see his face, but I can't.

481
00:22:13,640 --> 00:22:17,680
Oh man, so he did a lot of.
Is it a fitness guy or Harvard

482
00:22:17,680 --> 00:22:18,760
physician who does a
performance?

483
00:22:18,760 --> 00:22:21,280
This guy's a fitness guy and now
he's gone like political.

484
00:22:21,480 --> 00:22:23,200
But anyways, people might know
him.

485
00:22:23,200 --> 00:22:25,920
He's an OG YouTube, but he does
a lot of bioenergetics.

486
00:22:26,000 --> 00:22:28,880
And So what are the things he
used to do before a big heavy

487
00:22:28,880 --> 00:22:30,560
lift?
And if anyone's watching me,

488
00:22:30,560 --> 00:22:32,200
they can see this.
But he would put his hand like

489
00:22:32,200 --> 00:22:36,040
backwards kidneys are open up
his chest, look up to the sky,

490
00:22:36,320 --> 00:22:39,200
open up his mouth and he would
try to breathe through his mouth

491
00:22:39,200 --> 00:22:42,920
like, and it's really hard to do
because there's this restriction

492
00:22:42,920 --> 00:22:46,280
here and you cough and you gag.
But over time if you carts start

493
00:22:46,280 --> 00:22:49,280
to do that, it's like, again,
it's a different type breathing.

494
00:22:49,640 --> 00:22:52,600
And it's interesting because the
more you take these inhalations

495
00:22:52,600 --> 00:22:55,080
and try to breathe to that
diaphragm, you'll start to feel

496
00:22:55,080 --> 00:22:57,640
like a release around that neck
and scaling area.

497
00:22:57,960 --> 00:23:02,560
Yeah, I know Box breathing was
something that's most people at

498
00:23:02,560 --> 00:23:04,840
this point recognize just
because it's easy to do.

499
00:23:05,240 --> 00:23:09,280
I've actually found, personally,
I'm not a fan that 4 seconds of

500
00:23:09,280 --> 00:23:12,280
just hold and stuff.
I think that my CO2 tolerance is

501
00:23:12,280 --> 00:23:15,480
really low.
The alternate nasal part is

502
00:23:15,480 --> 00:23:17,800
interesting because I think it
really helps with you have to

503
00:23:17,800 --> 00:23:20,560
focus, right?
And if you have a monkey mind,

504
00:23:21,520 --> 00:23:23,600
you just lose track of thinking
of anything else except what it

505
00:23:23,600 --> 00:23:25,920
is that you're doing.
Physiological sigh.

506
00:23:26,000 --> 00:23:29,040
Tried and true, very popular.
Heberman comes out of his lab, I

507
00:23:29,040 --> 00:23:32,200
think published in.
Was it published in Cell or

508
00:23:32,360 --> 00:23:34,560
something big?
2023.

509
00:23:34,600 --> 00:23:37,560
So that's an easy one to do more
for those acute stress immediate

510
00:23:37,560 --> 00:23:39,640
reset stuff.
But I'm just going to good old

511
00:23:39,640 --> 00:23:42,200
resonance frequency breathing.
But I was looking into the

512
00:23:42,200 --> 00:23:44,320
different conditions to do that
for you.

513
00:23:44,320 --> 00:23:45,320
Absolutely.
What else we got?

514
00:23:45,520 --> 00:23:48,720
Yeah dude, I got another deep
topic, but tell me what you want

515
00:23:48,760 --> 00:23:51,160
to go exogenous ketones does.
It OK, definitely.

516
00:23:51,960 --> 00:23:55,440
It might just be from listen to
a couple of podcasts close

517
00:23:55,440 --> 00:23:58,640
together right between on
Stephen Bartlett and talking to

518
00:23:58,800 --> 00:24:01,840
and Dom D'agostino on Tim
Ferriss talking about ketones.

519
00:24:01,840 --> 00:24:04,600
I think most people have heard
at this point about a ketogenic

520
00:24:04,600 --> 00:24:06,600
diet and the value of a
ketogenic diet.

521
00:24:07,320 --> 00:24:12,800
I'm particularly interested in
ketones as a cognitive enhancer

522
00:24:12,880 --> 00:24:15,960
for my cognitive performance.
I'm not interested in going on a

523
00:24:15,960 --> 00:24:19,400
ketogenic diet.
I just not, but I am interested

524
00:24:19,400 --> 00:24:23,440
in the ergogenic aid that I
might be able to use it for or

525
00:24:23,440 --> 00:24:25,920
the therapeutic potential of
exogenous ketones.

526
00:24:25,920 --> 00:24:28,280
So it's just going down into how
you could do that.

527
00:24:28,280 --> 00:24:31,600
And so for those who don't know,
there are multiple fuels in the

528
00:24:31,600 --> 00:24:34,480
body.
Ketones are one of those, right?

529
00:24:34,560 --> 00:24:37,080
The interesting thing about
ketones is they can cross a

530
00:24:37,080 --> 00:24:41,840
blood brain barrier and they can
be a really strong fuel source

531
00:24:41,840 --> 00:24:45,280
for your brain in particular.
You know, it's an alternative

532
00:24:45,280 --> 00:24:47,400
fuel source for neurons, but
muscle can use it.

533
00:24:47,480 --> 00:24:51,200
And the specific thing within
ketones is something called beta

534
00:24:51,200 --> 00:24:55,000
hydroxybutyrate.
This can be produced naturally

535
00:24:55,000 --> 00:24:59,800
if you stop eating right.
Probably have to go, Depends on

536
00:24:59,800 --> 00:25:01,240
your health levels.
But if you're a generally

537
00:25:01,240 --> 00:25:05,280
healthy person, in order for you
to be in a ketogenic diet, it's

538
00:25:05,280 --> 00:25:08,680
got to be probably around less
than 50 grams of carbs a day,

539
00:25:09,320 --> 00:25:12,360
which I don't think most people
understand what that means.

540
00:25:12,840 --> 00:25:15,240
Or you have to do some type of
extended fasting.

541
00:25:15,480 --> 00:25:18,160
And I think the the numbers
could be off.

542
00:25:18,160 --> 00:25:22,280
Like you have to have levels of
greater than one, minimum one

543
00:25:22,280 --> 00:25:25,280
millimolars of beta hydroxy
butyrate in your blood levels.

544
00:25:26,000 --> 00:25:28,720
But the other way you could do
it is you could exogenously take

545
00:25:28,800 --> 00:25:33,120
ketones and they really come in
two forms, as I learned.

546
00:25:33,120 --> 00:25:36,160
So you have ketone mono esters,
which are much more potent.

547
00:25:36,440 --> 00:25:39,040
They raise your beta hydroxy
butyrate very quickly.

548
00:25:39,680 --> 00:25:41,880
They taste horrible.
Actually all of them supposedly

549
00:25:41,880 --> 00:25:44,160
taste horrible, but they tend to
have, because they're more

550
00:25:44,160 --> 00:25:46,520
potent, they tend to have more
side effects and GI issues are

551
00:25:46,520 --> 00:25:49,120
the bigger ones.
Then you have ketone salts,

552
00:25:49,280 --> 00:25:51,440
which are these, the beta
hydroxy butyridine is bound to

553
00:25:51,440 --> 00:25:53,840
minerals.
So sodium magnesium is less

554
00:25:53,840 --> 00:25:56,800
potent, easier to consume.
Typically people will add some

555
00:25:56,800 --> 00:26:00,200
type of flavor to that It'll so
it's milder and it'll have a

556
00:26:00,200 --> 00:26:04,640
longer effect in what you're
going for and you know, all of

557
00:26:04,640 --> 00:26:07,880
these things, it'll get you your
levels to rise up and it'll

558
00:26:07,880 --> 00:26:10,560
provide that source.
So it's maybe a quote UN quote

559
00:26:10,560 --> 00:26:12,600
hack.
Here's what we know about the

560
00:26:12,600 --> 00:26:15,040
cognitive benefits, right?
So you have both acute benefits

561
00:26:15,040 --> 00:26:17,080
and neuroprotective.
And interestingly, there is

562
00:26:17,080 --> 00:26:19,560
actually really good quality
evidence about this.

563
00:26:19,920 --> 00:26:23,120
Is this benefits of a ketogenic
state or just?

564
00:26:23,120 --> 00:26:25,360
Ketogenic state, yeah.
Ketogenic state, yeah.

565
00:26:25,360 --> 00:26:28,760
So these studies, at least that
I looked into, both had people

566
00:26:28,760 --> 00:26:31,840
either on a ketogenic diet and
assessed them from a performance

567
00:26:31,840 --> 00:26:34,520
standpoint for cognition.
Also, ketogenic diet for

568
00:26:34,520 --> 00:26:37,800
epilepsy, that's really well
known It, it works extremely

569
00:26:37,800 --> 00:26:39,360
well.
My wife's an epileptologist and

570
00:26:39,480 --> 00:26:43,120
this will like the first thing
you learn in epilepsy school.

571
00:26:43,720 --> 00:26:44,800
I'm just kidding.
It's a fellowship.

572
00:26:44,800 --> 00:26:46,680
But I mean, she's not listening
to anyone.

573
00:26:47,200 --> 00:26:48,800
And you have these acute
effects, right?

574
00:26:48,800 --> 00:26:51,520
So as long as you get those
levels up, which you know, the

575
00:26:51,520 --> 00:26:54,000
hack is to take exogenous, which
is going to be like a little

576
00:26:54,160 --> 00:26:56,800
drink or a shake, you're going
to improve, you know, working

577
00:26:56,800 --> 00:27:00,520
memory, attention, process
speed, especially in sleep

578
00:27:00,520 --> 00:27:03,400
deprived individuals.
Enter me, right?

579
00:27:03,960 --> 00:27:06,560
Reduce your cognitive fatigue,
potentially enhance motor

580
00:27:06,560 --> 00:27:08,560
learning, although that evidence
is really early.

581
00:27:08,560 --> 00:27:11,760
And that's the evidence that's
becoming really promising for

582
00:27:11,760 --> 00:27:13,320
some of the neurodegenerative
conditions.

583
00:27:13,600 --> 00:27:15,840
I'm talking Parkinson's, I'm
talking Alzheimer's, I'm talking

584
00:27:15,840 --> 00:27:18,960
patients with TB is where you
have some of this motor learning

585
00:27:18,960 --> 00:27:20,400
issues that you know, things
that we lost.

586
00:27:20,600 --> 00:27:22,600
Let's even include stroke in
there, although I don't think

587
00:27:22,600 --> 00:27:25,520
that's being studied yet.
But the neurodegenerative ones,

588
00:27:25,840 --> 00:27:27,720
because the other way that it
might work is actually can

589
00:27:27,720 --> 00:27:30,920
stabilize some of those neurons
and the neural in a networks,

590
00:27:30,920 --> 00:27:35,200
right, by modulating GABA, which
is a neurotransmitter, You know,

591
00:27:35,280 --> 00:27:38,400
just it could be healthy aging
or every adult as you get to a

592
00:27:38,400 --> 00:27:40,680
certain age, you develop some
type of dementia.

593
00:27:41,200 --> 00:27:43,640
The most common probably, I
think is gonna be vascular

594
00:27:43,640 --> 00:27:45,080
dementia.
And that just means, look, if

595
00:27:45,080 --> 00:27:47,720
you have your pipes aren't clean
and your arteries and you're

596
00:27:47,720 --> 00:27:49,760
getting some plaque buildup, you
could have minor strokes and

597
00:27:49,760 --> 00:27:51,960
never even know that.
And you know, that's why people

598
00:27:51,960 --> 00:27:54,560
say, oh, you're getting senile
in your 70s and 80s.

599
00:27:55,040 --> 00:27:57,600
But the clinical use cases for
this where it's been studied

600
00:27:57,600 --> 00:28:00,680
really well is, you know, been
military shift workers,

601
00:28:00,680 --> 00:28:04,280
emergency responders, again,
those high stress states where

602
00:28:04,280 --> 00:28:06,720
you need alternative fuel
sources and you need to be

603
00:28:06,720 --> 00:28:10,920
really, really sharp in.
So again, PBNR, you know, take

604
00:28:10,920 --> 00:28:13,120
that with a grain of salt, but
I'm thinking about neurosurgery

605
00:28:13,120 --> 00:28:15,320
residents and thinking about
other surgical colleagues of us

606
00:28:16,080 --> 00:28:18,440
where some people are now
exploring this potential.

607
00:28:18,440 --> 00:28:21,000
And I think it's getting popular
in conversation is a lot of the

608
00:28:21,000 --> 00:28:24,480
post COVID era because you have
these brain fog symptoms where

609
00:28:24,480 --> 00:28:27,240
really nobody can put a finger
on it.

610
00:28:27,280 --> 00:28:30,320
Neurology can't figure out.
There's no structural stuff that

611
00:28:30,320 --> 00:28:32,080
you can identify.
It's like, how do we sharpen

612
00:28:32,080 --> 00:28:34,160
your brain?
We know when you have autonomic

613
00:28:34,160 --> 00:28:36,400
dysfunction, when you have
central pain sensitization, when

614
00:28:36,400 --> 00:28:39,960
you have mood related stuff.
It's like, how much is mood, how

615
00:28:39,960 --> 00:28:42,080
much is an actual structural
problem?

616
00:28:42,920 --> 00:28:46,000
I probably wouldn't overall
characterize the body of

617
00:28:46,000 --> 00:28:48,960
evidence as strong.
Maybe it would be in the

618
00:28:48,960 --> 00:28:51,040
moderate category, 'cause we
don't have a lot of randomized

619
00:28:51,040 --> 00:28:53,000
controlled trials, we don't have
a lot of human studies.

620
00:28:53,000 --> 00:28:57,320
We do have a good amount of
animal studies on at least the

621
00:28:57,320 --> 00:29:00,080
neurodegenerative stuff, the
TBI, because it could do this

622
00:29:00,080 --> 00:29:01,800
interesting thing to animals
where you can bang them on the

623
00:29:01,800 --> 00:29:03,200
head and then you can treat them
afterwards.

624
00:29:03,200 --> 00:29:05,640
You can't do that with humans.
Really interested.

625
00:29:05,640 --> 00:29:07,720
Here's the downside though,
freaking expensive.

626
00:29:07,840 --> 00:29:10,880
At least when you're trying to
get a a good product.

627
00:29:11,200 --> 00:29:14,040
There are a couple of products
on the market that are

628
00:29:14,040 --> 00:29:17,160
pharmaceutical great, but there
are really expensive.

629
00:29:17,840 --> 00:29:21,480
I have read that it's not
something to be messed with if

630
00:29:21,480 --> 00:29:23,640
you do have tend to have GI
related issues.

631
00:29:23,640 --> 00:29:27,000
And if you want to dabble into
this, you want to really start

632
00:29:27,000 --> 00:29:29,560
low and go slow.
Take that approach because you

633
00:29:29,560 --> 00:29:32,200
could have some messy pants.
I think I'm going to try it.

634
00:29:32,320 --> 00:29:35,600
I I am going to try it.
I want to see if I can dial back

635
00:29:35,680 --> 00:29:38,200
my caffeine intake, particularly
in the afternoon.

636
00:29:39,000 --> 00:29:41,200
I find myself at this vicious
cycle where I always need that

637
00:29:41,200 --> 00:29:44,480
little afternoon pick me up and
maybe if I could replace it with

638
00:29:44,480 --> 00:29:45,800
a little ketone shot and see
what happens.

639
00:29:46,960 --> 00:29:48,920
Do you, are you going to try to
be in a ketogenic state then?

640
00:29:48,920 --> 00:29:51,320
Or are you just going to use
this as a way to feel?

641
00:29:51,360 --> 00:29:54,640
Like how many carbs do you have
to limit do you feel in order

642
00:29:54,640 --> 00:29:58,560
for this to take effect?
My understanding is that's a

643
00:29:58,560 --> 00:30:01,040
great question.
I think could there be a certain

644
00:30:01,040 --> 00:30:05,680
amount of carb intake where that
that blocks it or you have to

645
00:30:05,680 --> 00:30:09,200
take a higher amount?
That's an answer that I haven't

646
00:30:09,200 --> 00:30:12,320
come across yet.
I'll average anywhere from 100

647
00:30:12,320 --> 00:30:15,160
to 200 grams a day of carbs.
I find that's the diet that

648
00:30:15,160 --> 00:30:18,480
works best for me, which I don't
think it's a crazy amount in all

649
00:30:18,480 --> 00:30:20,360
honesty.
I think that if you probably are

650
00:30:20,360 --> 00:30:23,320
in 300, four, 100 milligrams of
daily carbs when you're not a

651
00:30:23,320 --> 00:30:26,360
bodybuilder or a high
performance athlete, then that's

652
00:30:26,360 --> 00:30:28,560
probably a little bit too much.
But that's a great question.

653
00:30:29,040 --> 00:30:31,240
I suspect that if I'm going to
do it and if I want to be

654
00:30:31,240 --> 00:30:34,080
experimental about it, then
maybe I should get something to

655
00:30:34,080 --> 00:30:38,000
actually measure.
You know, there's the glucose

656
00:30:38,000 --> 00:30:39,920
ketone index.
Then that's really what you want

657
00:30:39,920 --> 00:30:41,760
to check.
I mean, it's a good marker for

658
00:30:41,760 --> 00:30:44,040
metabolic health and you can see
what your body's processing in

659
00:30:44,040 --> 00:30:47,200
terms of fuel sources.
I think these ketone testers,

660
00:30:47,200 --> 00:30:48,280
they're really not that
expensive.

661
00:30:48,640 --> 00:30:50,920
So I might do that.
But how I'm going to use it?

662
00:30:50,920 --> 00:30:52,680
Maybe take a shot 30 minutes
before a podcast.

663
00:30:52,720 --> 00:30:53,760
What are your thoughts on
putting?

664
00:30:53,760 --> 00:30:56,080
Nonsense on here, Yeah.
But what are your thoughts on

665
00:30:56,080 --> 00:30:58,160
just regular?
Are we talking?

666
00:30:58,280 --> 00:31:03,880
About alpha GPC caffeine, yeah.
Oh, nicotine, yeah, nicotine's

667
00:31:03,880 --> 00:31:05,080
something.
Yeah.

668
00:31:05,080 --> 00:31:07,840
So alpha GPC, I've looked into
this examine actually has a lot

669
00:31:07,840 --> 00:31:12,480
of really interesting.
I think the evidence is it's a

670
00:31:12,480 --> 00:31:14,520
meager.
I, I, I don't think the evidence

671
00:31:14,520 --> 00:31:16,560
is strong.
Most of these states for alpha

672
00:31:16,560 --> 00:31:20,000
GPC, like the data that we have
coming from, is going to be from

673
00:31:20,000 --> 00:31:24,480
people who have deficiencies in
choline, who are older, who have

674
00:31:24,480 --> 00:31:26,920
some type of neurodegenerative
disease already going on.

675
00:31:27,640 --> 00:31:29,680
I'm again, particularly
interested in healthy folks.

676
00:31:29,920 --> 00:31:32,360
The good news about some of the
ketogenic diet, it has been

677
00:31:32,400 --> 00:31:34,840
assessed in athletes for
performance specifically.

678
00:31:34,840 --> 00:31:37,560
It has been checked in healthy
individuals.

679
00:31:38,160 --> 00:31:41,680
I'm a big ROI guy.
I just don't see the ROI there.

680
00:31:43,240 --> 00:31:45,680
I think what really convinced me
honestly is I can't remember

681
00:31:45,680 --> 00:31:47,440
that guy's name.
He's PhD, the ketone person.

682
00:31:48,040 --> 00:31:50,040
Remember him talking about how
these graphs, when they're

683
00:31:50,040 --> 00:31:52,040
looking at those give you
averages or they'll give you the

684
00:31:52,040 --> 00:31:54,920
medians on a bar graph.
This is the range that, you

685
00:31:54,920 --> 00:31:57,440
know, if you're a non responder,
you're on the bottom or if

686
00:31:57,440 --> 00:31:58,920
you're a hyper responder, you're
on the top.

687
00:31:59,600 --> 00:32:02,280
You could be either one of those
individuals and you won't know

688
00:32:02,280 --> 00:32:04,320
until you would try.
I think we believe that, right?

689
00:32:04,320 --> 00:32:06,480
That's why there's the end of
one medicine that we talk about.

690
00:32:07,040 --> 00:32:08,880
So yeah, you know, that makes a
lot of sense.

691
00:32:08,960 --> 00:32:11,520
I think the evidence is stronger
for me to try this, but I'm not

692
00:32:11,520 --> 00:32:13,520
opposed to those.
I think our money's probably

693
00:32:13,520 --> 00:32:15,400
better spent.
I don't have a lot of money to

694
00:32:15,400 --> 00:32:17,560
spare yet.
I hear you, I hear you.

695
00:32:17,800 --> 00:32:19,680
I've been getting, I don't know
if you heard a breadwinner, but

696
00:32:19,680 --> 00:32:22,520
they're a neotropic company that
has partnered up with me.

697
00:32:22,520 --> 00:32:23,760
So I've been trying out their
stuff.

698
00:32:24,160 --> 00:32:26,160
It's not caffeine evaluate,
right?

699
00:32:26,160 --> 00:32:27,840
Because it's, it's just the
caffeine that's making me a

700
00:32:27,840 --> 00:32:30,600
little bit more awakened alert.
Or is it the Lion's vein and all

701
00:32:30,600 --> 00:32:32,400
that stuff?
Alpha, GPS and everything else

702
00:32:32,400 --> 00:32:33,960
in it?
What is this supplement?

703
00:32:33,960 --> 00:32:35,840
Is it a drink?
There are capsules, OK, but

704
00:32:36,320 --> 00:32:38,600
what's interesting is that ever
since I found out my ferritin

705
00:32:38,600 --> 00:32:41,640
was low by doing function labs,
I started supplementing with

706
00:32:41,640 --> 00:32:44,840
iron and my Afrin slumps are
pretty much gone.

707
00:32:45,640 --> 00:32:49,400
Yeah, cool.
What else you got is something

708
00:32:49,400 --> 00:32:51,920
completely unrelated to keto.
Back to more of the philosophy

709
00:32:51,920 --> 00:32:53,800
and future.
So what I've been really been

710
00:32:53,800 --> 00:32:56,240
thinking about is just the
future of the world, right?

711
00:32:56,240 --> 00:32:59,320
I think a lot of us are having
those discussions and thoughts

712
00:32:59,320 --> 00:33:00,960
now being where we are in our
30s.

713
00:33:01,320 --> 00:33:04,880
And you know, you have a kid, me
not having kids yet, maybe

714
00:33:04,880 --> 00:33:07,160
never, I don't know, thinking
about like where is the world

715
00:33:07,160 --> 00:33:09,360
heading?
And so what's interesting that

716
00:33:09,360 --> 00:33:11,880
I've been hearing just a lot of
through these articles I've been

717
00:33:11,880 --> 00:33:14,880
reading Tim Ferriss, my first
million is the thoughts have to

718
00:33:14,880 --> 00:33:17,440
be pro analog.
And I actually just read it

719
00:33:17,720 --> 00:33:22,320
again today by a guy named Dan
Koh who amazing sub stack about

720
00:33:22,400 --> 00:33:25,000
it's called future proof.
And he just talks about how it

721
00:33:25,000 --> 00:33:26,440
like we're getting sick of
social media.

722
00:33:26,440 --> 00:33:28,840
Like honestly, I haven't posted
on social media just because I

723
00:33:28,880 --> 00:33:32,320
don't find it like any valuable
anymore, right?

724
00:33:32,320 --> 00:33:36,480
Like the number of followers you
have doesn't indicate the value

725
00:33:36,520 --> 00:33:38,040
or education that you're
providing.

726
00:33:38,040 --> 00:33:39,640
And I think people are starting
to realize that.

727
00:33:40,280 --> 00:33:42,880
So I think a lot of people are
just coming pro analog.

728
00:33:42,880 --> 00:33:46,800
They miss having hard copies of
books or a newspaper.

729
00:33:47,040 --> 00:33:50,080
There was a photo posted in New
York City across a bridge at

730
00:33:50,080 --> 00:33:52,880
10:00 PM last week and was like,
this is what people are doing

731
00:33:52,880 --> 00:33:54,720
now on Friday nights.
They're like running and run

732
00:33:54,720 --> 00:33:56,920
clubs.
So this lack of social

733
00:33:56,920 --> 00:33:59,720
connection that we've had since
COVID, people are now trying to

734
00:33:59,720 --> 00:34:03,080
find ways, right?
So ice, ice baths with coffee,

735
00:34:03,080 --> 00:34:06,680
sauna clubs, more Wellness
orientation, Honestly, even

736
00:34:07,000 --> 00:34:10,280
alcohol, I enjoy drinking.
We me and Mira don't drink

737
00:34:10,280 --> 00:34:12,719
honestly that much, but we'll
have a good time whenever we go

738
00:34:12,719 --> 00:34:15,080
out.
And like Tom Holland started

739
00:34:15,080 --> 00:34:18,520
this beer company called Bureau.
So it's not alcohol here and

740
00:34:18,520 --> 00:34:20,880
it's absolutely F it.
Awesome dude.

741
00:34:20,920 --> 00:34:22,920
I actually like it more than
regular beer.

742
00:34:23,080 --> 00:34:24,719
And actually the last two
podcast, that's what I've been

743
00:34:24,719 --> 00:34:26,480
drinking.
It looks like real beer.

744
00:34:26,840 --> 00:34:28,719
So the guests are probably like,
dude, this guy's turned.

745
00:34:29,000 --> 00:34:31,080
Not very professional.
Yeah, just your thoughts.

746
00:34:31,080 --> 00:34:32,520
How do you think about the
future?

747
00:34:32,639 --> 00:34:37,719
Are you craving this nostalgic
way of the past of communication

748
00:34:37,719 --> 00:34:41,679
or the way of just doing things?
Are you getting sick of the AI

749
00:34:41,679 --> 00:34:45,920
social media yet?
I'm not sick of AI, but I told

750
00:34:45,920 --> 00:34:47,360
you, I deleted Instagram off my
phone, right?

751
00:34:47,880 --> 00:34:49,480
Yeah, yeah.
Phenomenal decision.

752
00:34:49,600 --> 00:34:51,880
I don't regret it.
I'm not interested in getting

753
00:34:51,880 --> 00:34:53,360
back.
It is a little annoying because

754
00:34:53,719 --> 00:34:56,159
I put it on my iPad.
So if I have to go back for

755
00:34:56,440 --> 00:34:57,720
just, you know, that's what I'll
do it.

756
00:34:58,160 --> 00:35:00,440
I like that.
I have interestingly found

757
00:35:00,440 --> 00:35:02,320
myself to bought.
I bought back time.

758
00:35:03,080 --> 00:35:04,960
Isn't that interesting 'cause I
I think I've mentioned here

759
00:35:04,960 --> 00:35:06,680
before is that it's just being
in these rabbit holes?

760
00:35:06,800 --> 00:35:10,280
Were you doom scrolling or?
Yeah, and you pick up your phone

761
00:35:10,280 --> 00:35:12,960
and you just end up on the app,
you know, it's 3 clicks over.

762
00:35:12,960 --> 00:35:15,400
I tried to hide it.
You put the filters to to log

763
00:35:15,400 --> 00:35:17,280
out a certain time and it just
didn't work.

764
00:35:17,320 --> 00:35:20,280
And I think getting rid of it
was actually really good.

765
00:35:20,840 --> 00:35:23,440
I think we had talked to Robin
Tiger about this, the importance

766
00:35:23,440 --> 00:35:27,360
of being present in that moment.
And this is interesting.

767
00:35:27,360 --> 00:35:29,120
I'm thinking about a
conversation I heard Michael

768
00:35:29,120 --> 00:35:32,720
Easter have not too long ago.
I've heard Saul Blue and Ryan

769
00:35:32,720 --> 00:35:34,240
Holiday talk about so many of
these things, about the

770
00:35:34,240 --> 00:35:37,840
importance of presence.
And, you know, I just got one

771
00:35:37,840 --> 00:35:40,320
kid right now and it's crazy,
'cause she's 3 1/2.

772
00:35:40,520 --> 00:35:43,840
I don't remember what the hell
happened in that first year.

773
00:35:44,000 --> 00:35:46,240
So you asked me if I'm craving
it.

774
00:35:46,480 --> 00:35:49,520
I always found myself to be the
person who preferred to pick up

775
00:35:49,520 --> 00:35:51,520
the phone and call rather than
text.

776
00:35:51,880 --> 00:35:54,960
This is why I I speech to text
'cause I hate actually typing

777
00:35:54,960 --> 00:35:58,440
stuff out.
So I would rather like just pick

778
00:35:58,440 --> 00:36:00,200
up the phone and just have that
conversation.

779
00:36:00,240 --> 00:36:03,920
I'm known to be that guy, you
know, in my at least college

780
00:36:03,920 --> 00:36:06,880
buddies, if I'll call somebody
from time to time, you know, I'm

781
00:36:06,880 --> 00:36:08,960
always talking to my parents or
somebody.

782
00:36:09,440 --> 00:36:11,640
You and I are are doing this
enough that we're chatting, but

783
00:36:11,680 --> 00:36:15,320
prefer that I also send voice
notes to people like through

784
00:36:15,320 --> 00:36:18,360
WhatsApp and stuff.
Tone is so important if you're

785
00:36:18,360 --> 00:36:20,760
having any type of sensitive
conversation.

786
00:36:21,400 --> 00:36:24,440
So I've always been more
attracted to that.

787
00:36:25,400 --> 00:36:27,400
So I'm excited that we're headed
back to that man.

788
00:36:27,440 --> 00:36:30,560
I really am.
Jonathan Height posts and talks

789
00:36:30,560 --> 00:36:32,880
about this a lot, right?
The anxious generation.

790
00:36:32,880 --> 00:36:34,120
I think that's his newest book.
Maybe.

791
00:36:34,120 --> 00:36:35,640
I think he might have posted
this on social media.

792
00:36:36,160 --> 00:36:40,840
What schools look like that are
phone free or just for a little

793
00:36:40,840 --> 00:36:43,120
time?
And it really is freaking

794
00:36:43,240 --> 00:36:49,720
amazing to see that, you know,
like cafeterias where people are

795
00:36:49,760 --> 00:36:52,680
having conversations and
laughter and that kind of stuff.

796
00:36:53,240 --> 00:36:55,120
Did you have a cell phone in
high school?

797
00:36:55,560 --> 00:36:57,000
Yeah, middle school is when it
started.

798
00:36:57,520 --> 00:36:59,560
Yeah, no smartphone, I think
10th grade for.

799
00:37:00,080 --> 00:37:02,200
Yeah, I don't think I got my
first smartphone until I was in

800
00:37:02,200 --> 00:37:04,720
college and like towards the end
of college, I think I had a

801
00:37:04,720 --> 00:37:07,520
BlackBerry my senior in college.
So that's a different

802
00:37:07,520 --> 00:37:09,560
experience.
Man, I I don't know what an

803
00:37:09,560 --> 00:37:12,480
experience in high school would
be like now, but when I think

804
00:37:12,480 --> 00:37:15,320
about my high school time, it
was an amazing experience.

805
00:37:15,320 --> 00:37:19,920
I see people, if I'm at a
restaurant now with a group of

806
00:37:20,000 --> 00:37:22,800
folks who look like they might
be in their teens or 20s or, or.

807
00:37:22,840 --> 00:37:24,760
I can't imagine a cafeteria
being any different.

808
00:37:25,160 --> 00:37:28,800
It has to be the same.
Yeah, no, I agree, man.

809
00:37:28,800 --> 00:37:31,600
Hijacking the dopamine and the
circuitry, it's.

810
00:37:31,800 --> 00:37:33,640
Yeah, I couldn't imagine a world
like that now.

811
00:37:33,640 --> 00:37:36,800
I mean, I know there's a big
push for getting students to

812
00:37:36,800 --> 00:37:39,120
learn how to code and be on
computers because that's where

813
00:37:39,120 --> 00:37:41,120
the future is going.
So it's like, why waste our time

814
00:37:41,120 --> 00:37:42,920
without it?
But I do agree, I think there

815
00:37:42,920 --> 00:37:48,320
has to be this education on not
being dependent on it.

816
00:37:48,880 --> 00:37:51,520
And so I've always kind of told
myself, like, when I walk into a

817
00:37:51,520 --> 00:37:53,280
restaurant, be the observer,
right?

818
00:37:53,280 --> 00:37:55,640
Because it's so much fun when
you get to look around and

819
00:37:55,640 --> 00:37:58,520
you're not the one on your phone
and be like, holy crap, man.

820
00:37:58,600 --> 00:38:01,200
It's like the world we live in.
You know, you see it all and you

821
00:38:01,200 --> 00:38:03,680
start to notice other things.
You start to make associations.

822
00:38:03,960 --> 00:38:05,920
You start to see how is it a
generational thing?

823
00:38:06,160 --> 00:38:08,640
Is it a health status thing?
You know, the people who are

824
00:38:08,640 --> 00:38:12,240
healthier tend to be eating
better or not smoking or not

825
00:38:12,240 --> 00:38:13,800
doing these things.
But you can actually see that

826
00:38:13,800 --> 00:38:16,680
out in the real world too play
out if you choose to not be on

827
00:38:16,680 --> 00:38:18,600
your phone and actually put it
away and just start to observe

828
00:38:18,600 --> 00:38:20,840
and watch other people.
But I've always found that

829
00:38:21,160 --> 00:38:24,520
aspect of it very fascinating.
Speaking of being the observer,

830
00:38:24,520 --> 00:38:27,320
the one thing that would always
fascinate me is when I go on

831
00:38:27,320 --> 00:38:30,400
vacation, it was just like the
most awesome, beautiful tourist

832
00:38:30,400 --> 00:38:32,560
spot.
Everybody there is trying to

833
00:38:32,560 --> 00:38:33,880
take pictures.
They're trying to capture that

834
00:38:33,880 --> 00:38:37,360
moment.
I always find interesting is a

835
00:38:37,360 --> 00:38:42,320
lot of people are capturing that
moment or living that moment

836
00:38:42,320 --> 00:38:44,760
through the lens.
It can sometimes create tension

837
00:38:45,040 --> 00:38:47,480
with whoever I'm doing that
vacation with.

838
00:38:47,480 --> 00:38:48,360
They're like, let's take a
picture.

839
00:38:48,360 --> 00:38:51,080
I'm like, no, like I, you know,
my principles do that.

840
00:38:51,640 --> 00:38:54,120
I have open to it because it is
nice, especially when you have

841
00:38:54,120 --> 00:38:56,760
younger kids to go back and look
through that and relive the

842
00:38:56,760 --> 00:38:58,480
experience.
So I think there there certainly

843
00:38:58,480 --> 00:39:01,000
is.
But you always also got me

844
00:39:01,000 --> 00:39:02,600
thinking about the pro analog
concept.

845
00:39:02,600 --> 00:39:04,640
Right.
So you read the comfort crisis.

846
00:39:04,880 --> 00:39:07,400
Yeah, OK, still my agenda.
But I've listened to him.

847
00:39:07,400 --> 00:39:11,040
So I listened to him on Huber
not too long ago.

848
00:39:11,080 --> 00:39:13,320
I think he was on there a while
back, but I just listened to him

849
00:39:13,800 --> 00:39:16,520
caught up with that one.
And you know, he talks about

850
00:39:16,520 --> 00:39:18,080
this, right?
Was it the Alaska trip?

851
00:39:18,520 --> 00:39:22,800
Also funny when he talks about
he's trying to get to Alaska for

852
00:39:22,800 --> 00:39:25,880
this month long trip and he's
just like on a tiny little

853
00:39:25,880 --> 00:39:27,240
flight.
You know the story.

854
00:39:27,240 --> 00:39:28,840
Have you heard the story?
He writes about the book?

855
00:39:28,840 --> 00:39:30,720
Yeah.
So the the story goes and people

856
00:39:30,720 --> 00:39:33,040
can check this out.
He talks about it, but he's got

857
00:39:33,040 --> 00:39:36,240
to get like 2 planes to get to
Alaska for this trip that he's

858
00:39:36,240 --> 00:39:38,360
doing.
And he's so uncomfortable and

859
00:39:38,360 --> 00:39:41,480
the bathroom is tiny and the
seats tiny and he has no light

860
00:39:41,480 --> 00:39:43,080
and the food is cold and blah,
blah.

861
00:39:43,080 --> 00:39:46,120
And then he goes to Alaska
without electricity, without

862
00:39:46,120 --> 00:39:49,240
warm water and decides to live
out there for a month where he

863
00:39:49,240 --> 00:39:52,080
has to put their own fire.
Basically live how they used to

864
00:39:52,080 --> 00:39:55,320
100 years ago and really connect
with nature and live with the

865
00:39:55,320 --> 00:39:57,960
sun comes up and which it
doesn't a lot hunt for their

866
00:39:57,960 --> 00:40:01,440
game and, you know, get that
experience and be outdoors and

867
00:40:01,560 --> 00:40:04,000
also pushed himself through
something really hard.

868
00:40:04,600 --> 00:40:07,800
And then on the way back when
he's on the same flight, it just

869
00:40:07,800 --> 00:40:10,680
it feels like a five star luxury
experience.

870
00:40:11,200 --> 00:40:12,600
And Michael Easter he talks
about.

871
00:40:13,120 --> 00:40:15,000
I don't know if that's also what
he talks about.

872
00:40:15,000 --> 00:40:17,640
Misogi experience.
You familiar with that concept?

873
00:40:17,760 --> 00:40:19,640
Misogi.
Yeah.

874
00:40:19,640 --> 00:40:23,360
So he talks about having to
basically reset your

875
00:40:23,360 --> 00:40:26,160
expectation, recalibrate once a
year or something like that,

876
00:40:26,160 --> 00:40:29,240
where you do something really
hard and you don't know if

877
00:40:29,240 --> 00:40:32,760
you're gonna make it out on the
other end and how that prepares

878
00:40:32,760 --> 00:40:39,120
you to perhaps enjoy, perhaps
slow down, perhaps disconnect

879
00:40:39,200 --> 00:40:42,280
from things that don't matter.
I get the sense of what you're

880
00:40:42,280 --> 00:40:43,840
talking about is aligned with
that too.

881
00:40:43,840 --> 00:40:47,000
What do you think?
Yeah, no, I love the concept of

882
00:40:47,000 --> 00:40:49,840
misogi, honestly kind of want to
get back to doing a couple of

883
00:40:49,840 --> 00:40:51,960
them.
So yeah, I think it's a great

884
00:40:51,960 --> 00:40:55,320
way to learn how to detach.
And it also builds your mental

885
00:40:55,320 --> 00:40:58,320
fortitude.
So when you realize, hey, you

886
00:40:58,320 --> 00:41:00,160
got to save something for a
rainy day, or when that rainy

887
00:41:00,160 --> 00:41:02,240
day comes, you're able to say,
OK, I can do this.

888
00:41:02,560 --> 00:41:06,440
So I drove from Philadelphia to
North Carolina, 7 hours without

889
00:41:06,440 --> 00:41:09,200
any music, any talk, just
silence, you know, And that was

890
00:41:09,200 --> 00:41:10,560
like misogi.
That time I was like, I just

891
00:41:10,560 --> 00:41:12,760
want to see if I can do it.
So now when it comes to

892
00:41:12,760 --> 00:41:16,240
meditation or just, you know, be
by myself and not having

893
00:41:16,240 --> 00:41:18,840
anything, I did it for seven
hours, you know, just being my

894
00:41:18,840 --> 00:41:20,440
thoughts more than capable of
doing that.

895
00:41:20,640 --> 00:41:23,160
Fasting is another reason why,
you know, all fast here and

896
00:41:23,160 --> 00:41:26,480
there is really just get back to
what it's like to just be

897
00:41:26,760 --> 00:41:29,240
grateful for food.
Not only health benefits of it,

898
00:41:29,240 --> 00:41:32,360
but also just realizing when
you're driving on the street and

899
00:41:32,360 --> 00:41:34,720
you see a homeless person that's
just asking for food, you know,

900
00:41:34,720 --> 00:41:36,800
I'll try to make sure I stop by
and try to get them something

901
00:41:36,800 --> 00:41:38,960
because I now know that feeling
that they might be going

902
00:41:38,960 --> 00:41:40,720
through.
So it really just helps you

903
00:41:40,720 --> 00:41:42,640
connect with the world around
you in different ways.

904
00:41:43,800 --> 00:41:45,160
I'll push back though.
I don't think you know that

905
00:41:45,160 --> 00:41:47,440
feeling right?
Because I think when you're

906
00:41:47,440 --> 00:41:49,040
fasting, you're doing a
voluntary thing.

907
00:41:49,280 --> 00:41:50,920
Food.
It's available to you, whereas

908
00:41:50,920 --> 00:41:53,520
that homeless person it's not.
And I get the sense, right, The

909
00:41:53,520 --> 00:41:58,040
purpose is like you're trying to
experience the physical aspect

910
00:41:58,040 --> 00:42:00,760
of hunger.
Yeah, there's been many times

911
00:42:01,080 --> 00:42:03,240
where I've, I've broken it
right, because I'm like, oh, I

912
00:42:03,240 --> 00:42:04,760
got food in the fridge, let's
screw it, I'll just cheat a

913
00:42:04,760 --> 00:42:06,920
little.
But I did 18 hours, Yeah, that

914
00:42:06,920 --> 00:42:09,600
pushing back, right?
But hating that feeling, I think

915
00:42:09,600 --> 00:42:11,240
is the relatable part is God, I
hate this.

916
00:42:11,360 --> 00:42:13,960
Like, why would I ever put
myself through this and try to

917
00:42:13,960 --> 00:42:16,800
relate on that aspect of it of
just a great feeling right when

918
00:42:16,800 --> 00:42:18,960
you're unfed.
Yeah, I was laughing to myself,

919
00:42:18,960 --> 00:42:20,880
and he was like, yeah, Misoki's
like a concept.

920
00:42:20,880 --> 00:42:22,960
You pick something that you
don't know if you're gonna be

921
00:42:22,960 --> 00:42:24,920
able to make it through this, if
you're gonna come out the other

922
00:42:24,920 --> 00:42:27,280
side.
I was just thinking, have a

923
00:42:27,320 --> 00:42:28,680
chance, man.
That's Misoki.

924
00:42:29,640 --> 00:42:32,240
But yeah, yeah, the 50% chance
is the way he defines it.

925
00:42:32,240 --> 00:42:33,880
No, I love it.
What else you got?

926
00:42:33,960 --> 00:42:36,880
Anything else?
Last thing for me was really GLP

927
00:42:36,880 --> 00:42:38,320
ones.
So I know we've been talking

928
00:42:38,320 --> 00:42:40,240
about this here and there on a
lot of episodes.

929
00:42:40,280 --> 00:42:42,320
Did you see how Serena is now an
ambassador?

930
00:42:42,520 --> 00:42:43,280
Serena Williams?
An.

931
00:42:43,880 --> 00:42:45,720
Ad for that.
What are your thoughts on that?

932
00:42:46,240 --> 00:42:50,080
I think it's for one of those
companies who will give

933
00:42:50,080 --> 00:42:55,040
compounded medication.
I saw people on a Sports Center

934
00:42:55,040 --> 00:42:56,920
of people on ESPN talk about
that.

935
00:42:57,560 --> 00:42:59,480
I don't really have any strong
points of view on it.

936
00:42:59,480 --> 00:43:02,920
You know, I think she, I don't
know too much about her

937
00:43:02,920 --> 00:43:04,640
reasoning behind it.
I know she talked about

938
00:43:05,080 --> 00:43:07,400
struggling to lose weight
throughout the whole thing and

939
00:43:07,400 --> 00:43:08,880
after pregnancy getting back to
it.

940
00:43:09,040 --> 00:43:10,880
Didn't she win the US Open while
she was pregnant?

941
00:43:11,320 --> 00:43:12,920
I think right after she came
back or something.

942
00:43:13,240 --> 00:43:14,440
Right after she came back, stuff
like that.

943
00:43:14,480 --> 00:43:18,200
Pray pardon, but tool, go ahead.
Yeah, I was going to say what

944
00:43:18,200 --> 00:43:21,240
the marketing behind it too, I
guess said this is healthcare.

945
00:43:21,320 --> 00:43:23,720
And I think a lot of people that
struck A chord with people.

946
00:43:23,720 --> 00:43:26,120
I've seen some of our recent
guests go on LinkedIn and be

947
00:43:26,120 --> 00:43:30,640
like, this is not healthcare.
This is just a way to, you know,

948
00:43:30,640 --> 00:43:32,400
skirt around chronic disease
still.

949
00:43:32,520 --> 00:43:35,080
And so that's where I think the
conversation gets really

950
00:43:35,080 --> 00:43:35,560
interesting.
I.

951
00:43:35,880 --> 00:43:38,520
Don't know if he's skirting
around it's it is because that

952
00:43:38,520 --> 00:43:41,400
would suggest that like you are
hacking chronic disease.

953
00:43:41,400 --> 00:43:44,760
But if you're calling obesity
and this is a treatment for

954
00:43:44,760 --> 00:43:49,480
obesity, then and she I don't
know what her medical condition

955
00:43:49,480 --> 00:43:51,760
is right.
I have no idea if she has some

956
00:43:51,760 --> 00:43:53,720
truth related difficulty with
this.

957
00:43:53,720 --> 00:43:56,920
She's always been somebody who's
probably been a little bit on

958
00:43:56,920 --> 00:43:59,440
the heavier side.
Not I'm sure she has a ton of

959
00:43:59,440 --> 00:44:02,480
muscle, like I have no idea what
her body composition is, but

960
00:44:02,480 --> 00:44:06,120
just comparatively to her peers,
I have no idea what her struggle

961
00:44:06,120 --> 00:44:08,360
had been behind the scene.
So that could be a really viable

962
00:44:08,360 --> 00:44:11,160
option for her.
The people that I, the area

963
00:44:11,160 --> 00:44:15,720
where I do have a problem with
this is when, I guess I will say

964
00:44:15,720 --> 00:44:19,240
this, if it is a company that's
giving competitive medication, I

965
00:44:19,240 --> 00:44:21,280
think Hims tried to do this and
Hims and hers or whatever tried

966
00:44:21,280 --> 00:44:24,720
to do this as well.
It suggests that a lot of people

967
00:44:24,800 --> 00:44:27,120
can reach out.
This is promoting health and

968
00:44:27,120 --> 00:44:28,320
it's not necessarily promoting
health.

969
00:44:28,480 --> 00:44:30,920
It might be promoting health if
you are actually a good

970
00:44:30,920 --> 00:44:32,960
candidate.
And in order for somebody to be

971
00:44:32,960 --> 00:44:35,760
a good candidate, I would really
want to know what they've tried,

972
00:44:35,760 --> 00:44:37,440
what their journey has been
getting up there.

973
00:44:37,760 --> 00:44:41,040
Obesity is such a complicated
and complex thing and that's why

974
00:44:41,040 --> 00:44:42,520
I'm so excited and I really want
to.

975
00:44:42,840 --> 00:44:44,600
I could talk about it here, we
could talk about it, but I

976
00:44:44,600 --> 00:44:47,200
really want to get somebody who
is a little bit more, has deeper

977
00:44:47,200 --> 00:44:50,520
expertise in this than we do.
And then when you actually get

978
00:44:50,520 --> 00:44:53,720
into the weeds of what their
regimen has been like, what that

979
00:44:53,720 --> 00:44:57,120
struggle is to really, truly
define that, to really put that

980
00:44:57,120 --> 00:45:00,160
on paper, you realize it's, Oh
no, you just can't get out of

981
00:45:00,160 --> 00:45:03,600
your own way.
And it's not a matter of simply

982
00:45:03,760 --> 00:45:05,560
actual physiological
limitations.

983
00:45:05,560 --> 00:45:08,800
It's more of a matter of you
want to take the path of least

984
00:45:08,800 --> 00:45:12,240
resistance, which I don't know
how I feel about that part.

985
00:45:12,720 --> 00:45:14,360
Probably in the not mega fan
camp.

986
00:45:15,160 --> 00:45:18,840
Yeah, What really struck a chord
of me, or what I really flipped

987
00:45:18,840 --> 00:45:21,680
a switch, I should say, for me
is we had a episode yesterday

988
00:45:21,680 --> 00:45:24,920
with Doctor Nisa Chellam.
And so just to preview it for

989
00:45:24,920 --> 00:45:26,760
the guests, that'll be a future
episode.

990
00:45:27,040 --> 00:45:30,160
It's when she talked about food
noise, like when she used those

991
00:45:30,160 --> 00:45:32,960
words and how GLB ones can help
with the food noise.

992
00:45:32,960 --> 00:45:36,320
That's where I was like, man,
this is like Neotropics I feel

993
00:45:36,320 --> 00:45:38,520
in a way, right?
There's this distraction noise

994
00:45:38,520 --> 00:45:41,800
that we now use a supplement or
something to get us focused and

995
00:45:41,800 --> 00:45:43,600
goal.
So I definitely see those.

996
00:45:43,600 --> 00:45:46,960
But I think that's where I was
really like, OK, I'm more open

997
00:45:46,960 --> 00:45:49,440
to the concept of GLP.
One, I think before when I first

998
00:45:49,440 --> 00:45:52,560
heard of it, I'm bias, probably
was more than that.

999
00:45:52,560 --> 00:45:53,440
Capable.
This is cheating.

1000
00:45:53,440 --> 00:45:56,360
We could probably use lifestyle
modification to get you to lose

1001
00:45:56,360 --> 00:45:58,880
weight and whatnot.
But when you live in a world

1002
00:45:58,880 --> 00:46:01,960
where everyone's trying to sell
you their next greatest product.

1003
00:46:02,160 --> 00:46:04,960
And this is what I really want
to bring on Doctor Judd Brewer

1004
00:46:04,960 --> 00:46:07,200
because he's a psychiatrist.
He talks about willpower and how

1005
00:46:07,200 --> 00:46:09,120
willpower is actually not a
thing.

1006
00:46:09,520 --> 00:46:11,720
Talking about that and
understand the mental fatigue

1007
00:46:11,720 --> 00:46:13,720
that people go through when they
have this noise and these

1008
00:46:13,720 --> 00:46:16,480
distractions.
Is it really just shutting off

1009
00:46:16,480 --> 00:46:18,400
you're hunger than you don't
even care about these

1010
00:46:18,400 --> 00:46:20,520
distractions?
Is it deleting Instagram off

1011
00:46:20,520 --> 00:46:22,400
your phone where you don't have
a choice to really click it?

1012
00:46:22,680 --> 00:46:25,080
We've heard about that, right?
People have had gotten off other

1013
00:46:25,080 --> 00:46:26,960
addictions and stuff.
Food noise is a really

1014
00:46:26,960 --> 00:46:29,840
interesting phrase though, and
the more people talk about it in

1015
00:46:29,840 --> 00:46:32,480
the media, I think the more
people can use that.

1016
00:46:32,480 --> 00:46:36,280
Cause the reality is you and I
can't, We can't prove whether

1017
00:46:36,280 --> 00:46:38,400
somebody has excessive food
noise or not.

1018
00:46:38,760 --> 00:46:40,920
If somebody tells me they have
this excessive food noise and

1019
00:46:40,920 --> 00:46:42,760
they've struggled their entire
life and I have no idea what

1020
00:46:42,760 --> 00:46:45,320
they are going through, I'll
have to take them at their word.

1021
00:46:45,320 --> 00:46:50,760
For I do think this is can be a
crutch for some people 'cause

1022
00:46:50,760 --> 00:46:52,480
they'll drop that bomb and it's
OK.

1023
00:46:52,760 --> 00:46:57,280
Hard to argue against that.
This is where expertise and

1024
00:46:57,280 --> 00:47:00,880
dealing with a lot of people,
you get a sense of who's truly

1025
00:47:00,880 --> 00:47:07,040
struggling versus who's using
that as a crutch to get the drug

1026
00:47:07,040 --> 00:47:08,440
right to go back to the
treatment.

1027
00:47:08,880 --> 00:47:13,360
I think people who truly
struggle with obesity and food

1028
00:47:13,360 --> 00:47:17,040
noise, I should define, I think
most people in the obesity space

1029
00:47:17,040 --> 00:47:21,280
will define it as like you are
constantly thinking about food.

1030
00:47:21,320 --> 00:47:24,600
So what that means is if you
would, let's say you wake up at

1031
00:47:24,600 --> 00:47:27,280
8:00 AM in the morning, you're
waking up hungry and you're

1032
00:47:27,280 --> 00:47:28,920
thinking about what you're going
to eat.

1033
00:47:29,000 --> 00:47:34,240
And not only just about eating
food, but it can also revolve

1034
00:47:34,240 --> 00:47:36,240
around all types of context in
food.

1035
00:47:36,720 --> 00:47:41,200
So it could be this internal
struggle of not fighting to eat

1036
00:47:41,200 --> 00:47:43,880
that bagel and cream cheese or
Dunkin' Donuts in the morning

1037
00:47:44,080 --> 00:47:46,440
and instead just having this
internal dialogue that you

1038
00:47:46,440 --> 00:47:49,360
should be having eggs and, I
don't know, Turkey or whatever.

1039
00:47:49,640 --> 00:47:53,320
So that conversation is
basically these pervasive

1040
00:47:53,320 --> 00:47:55,320
thoughts about food.
And then when you're done

1041
00:47:55,320 --> 00:47:59,720
eating, now you're also having
additional thoughts about either

1042
00:47:59,720 --> 00:48:02,880
how you quote, UN quote, failed
and put something in your body

1043
00:48:02,880 --> 00:48:06,160
that you shouldn't have if you
did crumble, quote, UN quote and

1044
00:48:06,160 --> 00:48:12,040
have that donut or thinking
about the next meal, right mind

1045
00:48:12,160 --> 00:48:15,480
is distracted, as you said, with
some thoughts of food.

1046
00:48:15,840 --> 00:48:20,320
It could also present in the
fashion where somebody is just

1047
00:48:20,880 --> 00:48:25,920
crazy persistently logging and
calculating and just being

1048
00:48:25,920 --> 00:48:28,120
obsessive about that because
they don't want to make these

1049
00:48:28,120 --> 00:48:30,640
mistakes.
So it comes in many forms.

1050
00:48:30,680 --> 00:48:32,920
But yeah, a lot to unpack on
that.

1051
00:48:33,080 --> 00:48:35,600
That's a sweet tooth.
I skipped lunch, for example,

1052
00:48:35,600 --> 00:48:38,080
'cause I'm rounding and then I'm
like, oh God, I'm just, you

1053
00:48:38,080 --> 00:48:39,600
know, stressful day.
Like today, I really just want

1054
00:48:39,600 --> 00:48:41,120
to get the vending machine and
get like gushers.

1055
00:48:41,280 --> 00:48:43,520
Thank God the vending machine
didn't work 'cause I had to have

1056
00:48:43,520 --> 00:48:45,840
to have that internal dialogue
with myself and say, I know

1057
00:48:45,840 --> 00:48:49,360
exactly how I feel.
Oh yeah, dude, they do.

1058
00:48:49,360 --> 00:48:52,440
But yeah, that internal dialogue
of once you, once you have it, I

1059
00:48:52,440 --> 00:48:54,720
know how I'm going to feel.
And then I try to get the

1060
00:48:54,720 --> 00:48:56,880
Gatorade protein bar wasn't
working.

1061
00:48:56,880 --> 00:48:59,120
I was like, you know what, let
me just go home and figure it

1062
00:48:59,120 --> 00:49:00,200
out.
So I've been doing a better job

1063
00:49:00,200 --> 00:49:01,360
with that.
But I get that same feeling

1064
00:49:01,360 --> 00:49:04,040
where I know if I mess up, I'm
then blaming myself and saying

1065
00:49:04,040 --> 00:49:05,680
why did I do that?
You know, now I'm going to have

1066
00:49:05,680 --> 00:49:08,520
to work three times as hard in
the gym and what not to fight

1067
00:49:08,520 --> 00:49:11,000
that off, do you?
Want to know what's a really

1068
00:49:11,000 --> 00:49:13,000
good strategy for appetite
control?

1069
00:49:13,280 --> 00:49:15,160
What drinking?
Ketogenic State.

1070
00:49:15,480 --> 00:49:18,440
Baby, it's true.
That is true.

1071
00:49:18,480 --> 00:49:21,240
I was going to say a really good
book on this, though, is Adam

1072
00:49:21,240 --> 00:49:23,160
Bornstein's You Can't really
screw this up.

1073
00:49:23,560 --> 00:49:25,960
I think it's a phenomenal book
on the internal dialogue of

1074
00:49:26,000 --> 00:49:28,360
you're going to mess up, quote,
UN quote, mess up, but it's not

1075
00:49:28,360 --> 00:49:29,880
really messing up because you
can't screw it up.

1076
00:49:29,880 --> 00:49:33,040
So get back on track next meal.
The only thing that matters.

1077
00:49:33,320 --> 00:49:34,840
So yeah, I really like that book
on it.

1078
00:49:35,720 --> 00:49:38,240
Oh man, last thing here, if
you're cool with that, if you

1079
00:49:38,240 --> 00:49:39,560
want to go a little bit more, I
have.

1080
00:49:39,680 --> 00:49:41,240
I think I could use your
expertise here too.

1081
00:49:41,240 --> 00:49:44,960
So talking about, we talked a
lot about DPC model, we talked a

1082
00:49:44,960 --> 00:49:46,640
lot about cash based on this
practice, right?

1083
00:49:46,760 --> 00:49:49,040
But I think a lot of people
might have the questions like

1084
00:49:49,040 --> 00:49:51,600
how do you find these providers?
Like how do you go about

1085
00:49:51,600 --> 00:49:54,400
thinking about what labs you
need to get, who you should get,

1086
00:49:54,520 --> 00:49:56,960
how much money you should pay?
Do you get APCP?

1087
00:49:57,080 --> 00:49:59,680
Do you keep insurance or do you
just see some specialist one

1088
00:49:59,680 --> 00:50:01,480
off?
To recap the listeners, I use

1089
00:50:01,480 --> 00:50:04,640
Function Health, which is a
panel of blood tests that, you

1090
00:50:04,640 --> 00:50:06,440
know, spend $500 to get twice a
year.

1091
00:50:06,760 --> 00:50:09,280
So I got that.
I have a history of high

1092
00:50:09,280 --> 00:50:11,040
cholesterol.
It runs in my family.

1093
00:50:11,200 --> 00:50:14,120
And so that is something that I
am actively trying to tackle

1094
00:50:14,120 --> 00:50:16,120
down, right?
And so we've talked about where

1095
00:50:16,120 --> 00:50:18,640
getting on statin, do I need to
get a CAC versus ACTA?

1096
00:50:18,720 --> 00:50:21,320
And then which provider, right?
Does it make sense to just see a

1097
00:50:21,320 --> 00:50:25,080
cardiologist like via telehealth
that is more like a functional

1098
00:50:25,320 --> 00:50:28,120
cash based provider?
Or is it better to go through

1099
00:50:28,320 --> 00:50:31,440
and pay my own for CTA or go
through insurance versus a

1100
00:50:31,440 --> 00:50:33,320
provider?
The way I'm thinking about this

1101
00:50:33,320 --> 00:50:36,080
right now is, OK, let me, I'm
taking some supplements, I'm

1102
00:50:36,080 --> 00:50:38,120
doing psyllium husk.
I'm actively trying to lose

1103
00:50:38,120 --> 00:50:39,920
weight as well and get back to a
better shape.

1104
00:50:40,560 --> 00:50:44,560
Do my repeat labs with function,
see where I am at that point.

1105
00:50:44,680 --> 00:50:47,160
And then next year onwards we
talked about rhythm health.

1106
00:50:47,280 --> 00:50:50,720
Rhythm health is a monthly lab
check where it's A at home test

1107
00:50:50,720 --> 00:50:52,720
and you get certain number of
biomarkers.

1108
00:50:52,720 --> 00:50:54,560
But that way you can at least
check monthly.

1109
00:50:54,880 --> 00:50:58,320
Me, I'm a data nut and I know if
I can keep track and try to do

1110
00:50:58,320 --> 00:51:01,760
better every month, I'm going to
be more consistent with my diet,

1111
00:51:01,760 --> 00:51:03,640
with my workout, stress, all
that stuff.

1112
00:51:04,080 --> 00:51:07,080
I think the thing I'm hung up on
though is like, how do I go

1113
00:51:07,080 --> 00:51:10,080
about this cardiologist?
Do I go through my PCP?

1114
00:51:10,080 --> 00:51:13,320
Do I just find someone like
Doctor Harkin, find someone like

1115
00:51:13,320 --> 00:51:19,040
her to get better guidance as
far as medications and lifestyle

1116
00:51:19,040 --> 00:51:20,160
treatment?
What are your thoughts?

1117
00:51:20,720 --> 00:51:24,440
Yeah, I think in your specific
case, yeah, certainly Doctor

1118
00:51:24,440 --> 00:51:27,080
Nicole Harkin, awesome docs.
I think she's still practicing

1119
00:51:27,080 --> 00:51:32,400
out in West Coast.
But I would say find anybody for

1120
00:51:32,400 --> 00:51:35,240
your particular case who is
interested in that health.

1121
00:51:35,240 --> 00:51:40,520
Like I feel relatively confident
that I can manage certain lipid

1122
00:51:40,520 --> 00:51:43,760
disorders.
And certainly from a, you know,

1123
00:51:43,760 --> 00:51:45,640
your perspective, I know you and
I have talked about this online,

1124
00:51:45,640 --> 00:51:47,560
a primary care doctor.
So Doctor Nisha Chillen last

1125
00:51:47,560 --> 00:51:49,640
night, you know, we were talking
about this, she had talked about

1126
00:51:49,720 --> 00:51:51,400
checking the APOBE, checking the
LPLA.

1127
00:51:51,800 --> 00:51:55,080
There's no reason why a primary
care provider who knows how to

1128
00:51:55,080 --> 00:51:57,800
make sense of the data can't do
that stuff.

1129
00:51:58,200 --> 00:52:01,280
You know, from a cost efficiency
standpoint, maybe that's better.

1130
00:52:01,680 --> 00:52:04,200
I think that if you probably
find somebody more local that

1131
00:52:04,360 --> 00:52:06,360
might work out.
You just need somebody who can

1132
00:52:06,480 --> 00:52:09,320
make sense of the data for you
and is willing to write you the

1133
00:52:09,320 --> 00:52:12,400
prescription.
Because even I don't think those

1134
00:52:12,400 --> 00:52:15,280
advanced diagnostics, you still
need a prescription to be able

1135
00:52:15,280 --> 00:52:18,520
to get that, even if you choose
to pay for it out of pocket.

1136
00:52:18,800 --> 00:52:21,840
That's a tougher like how do you
find a provider in our insurance

1137
00:52:21,840 --> 00:52:24,840
model that you can go into
knowing beforehand, hey, this is

1138
00:52:24,840 --> 00:52:28,240
a provider that is more forward
with the research and kind of

1139
00:52:28,240 --> 00:52:30,360
understands that it's not just
good versus bad cholesterol.

1140
00:52:31,160 --> 00:52:35,160
That's a very difficult thing.
I had a consultation with three

1141
00:52:35,160 --> 00:52:38,560
cardiologists and the 4th
cardiologist I found was the one

1142
00:52:38,560 --> 00:52:40,480
that works.
I have hyperlipidemia, coronary

1143
00:52:40,480 --> 00:52:44,560
disease rampant in my family.
I take a PCSKNI now because of

1144
00:52:44,600 --> 00:52:47,800
my dyslipidemia.
Most of the cardiologists are

1145
00:52:47,800 --> 00:52:49,320
not interested in that.
Even the preventative

1146
00:52:49,320 --> 00:52:52,680
cardiologists who market
themselves as such will give you

1147
00:52:52,680 --> 00:52:54,920
that push back 'cause when
you're 33, they're going to look

1148
00:52:54,920 --> 00:52:56,280
at you.
They're going to literally

1149
00:52:56,280 --> 00:52:57,960
assess you by your looks.
You're like you're fine.

1150
00:52:58,000 --> 00:53:02,960
You don't need to do this this
and the way that I initially did

1151
00:53:02,960 --> 00:53:06,240
that is I looked up to see what
people are talking about and

1152
00:53:06,600 --> 00:53:08,920
what are the publications that
they're interested in.

1153
00:53:09,040 --> 00:53:11,400
So you get a sense of, OK,
what's their level of expertise

1154
00:53:11,400 --> 00:53:16,480
in this specific matter.
Not all cardiology is lipidology

1155
00:53:16,480 --> 00:53:19,880
is a feel within itself, right?
And you could be a lipidologist

1156
00:53:19,880 --> 00:53:22,640
and not be a cardiologist.
And so if that's the area that

1157
00:53:22,640 --> 00:53:25,000
you're looking at, probably
that's somebody better suited

1158
00:53:25,000 --> 00:53:28,640
for you or really anybody who's
interested in that aspect of it.

1159
00:53:29,000 --> 00:53:33,360
But cardiology is so broad.
But honestly, it's, there's no,

1160
00:53:34,240 --> 00:53:37,880
nothing better than actually
having that interview and having

1161
00:53:37,880 --> 00:53:40,040
that sense, I think within a few
minutes.

1162
00:53:40,400 --> 00:53:43,000
And it's not even just you, the
layperson, when you have that

1163
00:53:43,080 --> 00:53:46,640
discussion with a person and you
tell them, these are my goals.

1164
00:53:47,040 --> 00:53:51,280
My goals are to prevent the
second or third heart attack

1165
00:53:51,360 --> 00:53:52,560
because that's what they're
really good at.

1166
00:53:52,560 --> 00:53:53,840
That's what the medical system,
right?

1167
00:53:53,840 --> 00:53:57,640
My goals are to limit my chances
of you can't really truly

1168
00:53:57,640 --> 00:54:00,960
prevent, but mitigate the risk
of having a heart attack 25

1169
00:54:00,960 --> 00:54:03,080
years from now.
And if they don't look at you

1170
00:54:03,080 --> 00:54:06,240
like you're a crazy person, then
maybe there's some potential

1171
00:54:06,240 --> 00:54:07,520
there.
But they look at you like you're

1172
00:54:07,520 --> 00:54:10,040
ridiculous with your demands or
your questions or your

1173
00:54:10,040 --> 00:54:12,560
aspirations.
Then you just gotta, you're best

1174
00:54:12,560 --> 00:54:14,480
off to just cut that as soon as
possible because it's going to

1175
00:54:14,480 --> 00:54:18,240
be fighting an uphill battle.
Well, honestly, this would be

1176
00:54:18,280 --> 00:54:20,480
like you had asked, like how do
we figure that out in the

1177
00:54:20,480 --> 00:54:23,040
insurance model?
The challenge with that is in

1178
00:54:23,040 --> 00:54:25,000
order to be able to see three
different cardiologist,

1179
00:54:25,000 --> 00:54:26,880
lipidologist, that's a six month
process.

1180
00:54:26,920 --> 00:54:30,960
The direct pay industry is going
to be much more accessible.

1181
00:54:32,160 --> 00:54:34,040
I understand that everybody's
privileged enough to be able to

1182
00:54:34,040 --> 00:54:35,600
do that.
I'll plug Parsley Health

1183
00:54:35,600 --> 00:54:36,600
initially.
She talked about that.

1184
00:54:36,600 --> 00:54:38,600
He works for Parsley Health and
it's awesome that they're doing

1185
00:54:38,600 --> 00:54:39,840
this hybrid models.
And that's it.

1186
00:54:39,840 --> 00:54:40,760
And that's what I was looking
at.

1187
00:54:40,760 --> 00:54:43,480
But now that goes back to my
question, is it worth me doing a

1188
00:54:43,480 --> 00:54:45,440
subscription model?
I think Parsley Health's like

1189
00:54:45,520 --> 00:54:50,560
250 or 270 bucks a month where
my true only real thing I need

1190
00:54:50,560 --> 00:54:52,120
to focus on is just the limits
stuff.

1191
00:54:52,120 --> 00:54:55,360
And it's just get a cardiologist
and just do A1 tower place a

1192
00:54:55,400 --> 00:54:58,480
year type visit where I can
really take care of a lot of the

1193
00:54:58,480 --> 00:55:00,920
other stuff and I feel healthy
with everything else, I think.

1194
00:55:01,080 --> 00:55:03,280
You and I, we have the advantage
that we have a network, so we

1195
00:55:03,280 --> 00:55:04,480
could probably reach out to
people.

1196
00:55:04,480 --> 00:55:07,320
My current cardiologist, I ended
up connecting with him because I

1197
00:55:07,320 --> 00:55:10,440
had asked some residents who are
interested and I was like, hey,

1198
00:55:10,440 --> 00:55:12,160
who's a good cardiologist that
you've worked with?

1199
00:55:12,760 --> 00:55:14,600
And his name came up multiple
times.

1200
00:55:14,600 --> 00:55:17,120
This person, they get it and
they understand my goals.

1201
00:55:17,120 --> 00:55:20,960
I would probably start there to
see if you have a network, you

1202
00:55:20,960 --> 00:55:22,280
know who we could probably talk
from?

1203
00:55:22,280 --> 00:55:24,840
Physician health.
We could ask Doctor Cromwell

1204
00:55:24,920 --> 00:55:26,680
again.
I wonder what their system is.

1205
00:55:27,200 --> 00:55:30,400
Absolutely good idea.
We'll see how it'll be the end

1206
00:55:30,400 --> 00:55:33,120
of the year thing that I'll be
researching and get into, but

1207
00:55:33,120 --> 00:55:35,560
I'm excited to try Rhythm Health
and there's super power.

1208
00:55:35,560 --> 00:55:38,240
That's the other thing was, man,
where all this consumerism with

1209
00:55:38,240 --> 00:55:40,080
blood testing is going, It's
pretty insane.

1210
00:55:40,120 --> 00:55:41,440
You need to stop drinking on the
show.

1211
00:55:41,480 --> 00:55:45,280
That's forget about lipids.
Drinking, not alcohol and beer.

1212
00:55:45,680 --> 00:55:47,320
Yeah, I'll always start with
step one.

1213
00:55:47,320 --> 00:55:49,320
Stop showing up drunk to the
podcast.

1214
00:55:49,560 --> 00:55:51,840
People got to try Bureau.
No, I still can't believe

1215
00:55:51,840 --> 00:55:53,000
there's no alcohol.
Yeah, absolutely.

1216
00:55:53,000 --> 00:55:53,960
I didn't.
Say it all right, man.

1217
00:55:54,280 --> 00:55:55,480
This was fun.
Sounds good man.

1218
00:55:55,600 --> 00:55:57,440
Thanks for listening to the
other episode of Medicine

1219
00:55:57,440 --> 00:55:59,560
Redefined.
If you enjoyed this episode,

1220
00:55:59,600 --> 00:56:01,800
please be sure to check out some
of the additional resources in

1221
00:56:01,800 --> 00:56:04,480
the show notes.
Please also check out our social

1222
00:56:04,480 --> 00:56:07,480
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1223
00:56:07,920 --> 00:56:11,600
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1224
00:56:11,640 --> 00:56:14,160
Redefined.
We also want to thank our team

1225
00:56:14,160 --> 00:56:16,880
for the production of this
podcast, specifically Ethan Joo

1226
00:56:16,880 --> 00:56:20,320
on video, Parita Yapuri on
social media, Zanna Bligmanio

1227
00:56:20,320 --> 00:56:21,960
research, and Saira Khan for
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1228
00:56:22,360 --> 00:56:25,160
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00:56:25,160 --> 00:56:28,040
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1230
00:56:28,040 --> 00:56:30,840
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1231
00:56:31,120 --> 00:56:33,640
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1232
00:56:33,640 --> 00:56:35,280
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1233
00:56:36,160 --> 00:56:39,320
Now time for the ever so
important disclaimers.

1234
00:56:40,080 --> 00:56:42,880
This podcast is intended for
general public use and is for

1235
00:56:42,880 --> 00:56:45,640
educational purposes only.
It does not cost you the

1236
00:56:45,640 --> 00:56:48,160
practice of medicine nor should
be construed as medical advice.

1237
00:56:48,560 --> 00:56:50,600
No physician patient
relationship is formed and

1238
00:56:50,600 --> 00:56:53,360
anything discussed in this
podcast does not represent the

1239
00:56:53,360 --> 00:56:56,040
views of our employers.
You recommend that you seek the

1240
00:56:56,040 --> 00:56:58,640
guidance of your personal
physician regarding any specific

1241
00:56:58,640 --> 00:56:59,640
health related issues.