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Hello, I'm doctor John Satis. Welcome to the Voice Clanns podcast.
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I'm a family doc and our objective with this podcast,
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as always is just to bring light and knowledge to
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the community about cool topics of health and wellness and
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all the goodness. So today Holly is going to just
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do something kind of fun with me, and she's just
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going to do like a Q and a like and
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ask me anything. Well, I don't think we've ever done
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one of these.
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All right, I'm ready, Okay, So we just looked up
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the most commonly asked questions on Google that should probably
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be asked your doctor, but instead you ask Google doctor.
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So instead today we're going to ask the actual doctor.
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And there's a couple different categories that will go over.
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The first one is just start by saying, I am
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not smarter than Google.
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Oh no, So should people be going to Google? Who
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are mess So I have experience about that. I think
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that with AI, now folks are using it I very
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intelligently and it's actually awesome. AI has passed like multiple
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multiple board exams, like family docs are like board certified,
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and check can pass all those board exams too. It's
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smart and so I think it's really cool. We have
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a really unique opportunity to leverage tech. A lot of
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docs are like, oh you good, they get all mad.
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I'm not mad about that. I actually love it. And
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if you use GROC and Claude and Chat too, awesome,
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let's talk shop because they're smarter than I am. But
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I get to do this. I get to talk to
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you and to see the nuance. Healthcare has so many
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nuances to it, so it's not all just information and knowledge.
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That's important, but then there's like the art of healthcare,
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and that's something that is is like total personal person. Yeah,
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the care. I'm not smarter than Chat right now. I
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use them all the time. In fact, we have open evidence,
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which is like all
Load full transcript
the evidence based science out there,
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so that's really cool. And anybody with an MBI number
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with just like a medical clinician PAS and p's physicians,
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we all have free access to to Open Evidence AI.
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So you can actually take your GROC findings and say, hey, doc,
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I just wondering about this. You mind putting it through
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your database too, because that that's going to pull from
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the latest science. It traditionally has been paywalled, and so
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so GROC and Chat and some of those other guys
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don't have access to here's those paywalls, so it's kind
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of nice to have. Yeah, I did as much as
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I could with Chat or groc or whatever, what do
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you think? And then we can just put it through
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ours and looking. It's fun. It's really cool.
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So what you're saying is we should type up our
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questions and see if you're right after this yes and yes, okay,
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and so when it's wrong, then we can have everyone
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leave our clinic. Okay, okay. So the first one is
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under mental health. It goes how do I know if
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this is normal stress or an anxiety disorder?
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I think it depends on what we're talking about. So
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give me a scenario.
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Let's say somebody is in college and every day they're
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going home with stress, but not panic attack level stress,
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and they just feel overwhelmed by the work they have
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to do or the homework that they have to do.
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Would that be stress or would that be anxiety disorder?
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So the super interesting stress anxiety panic disorder. There's there's
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rumination disorder. There's a whole bunch of little nuance to
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this equation. And one of the cool things about pressure,
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we're gonna call it pressure instead of anxiety because that
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has a negative connotation. But school has pressure with it, right,
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Like I got deadlines, I got I got tests, I
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gotta do all this stuff, and there's like this, there's
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like this bell curve to all of that pressure. A
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little bit
is good, not enough is not good, right,
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a little bit more is better for progress, right, And
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then there's as a peak for and it probably varies
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a little bit from person to person, but like, oh yeah,
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that's your peak, dog. And then then you start to
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go down the other side of the bell creve where
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now we're getting too much stress and our performances is different.
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Hanging in a bunch of other things, and there's a
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multitude of things that they kind of affect our tolerance
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to that. So that pressure can be like our tolerance
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to that pressure can be expanded if we're taking enough breaks,
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if we're exercising, if we're breathing appropriately, if we're we
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have healthy relationships, we have a stable living environment, we
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have a decent religious space to you know, to offload
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some things, and so all those things can build up
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that threshold or that buffer to handling healthy amounts of
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pressure in your life. If that buffer is chiseled down
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too much. I'm unstable, I don't have I got kicked
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out of my roommates, and I broke up with my
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girlfriend or boyfriend, and you know, my parents hate me,
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and i'm and then you find yourself with any amount
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of pressure creating situations that might be panic, that might
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mean lots of anxiety, that might be man, I'm really
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struggling to perform. I can't really concentrate, I can't really
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can't really dial in. So so then you might be
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in the space where, oh, we might need some support,
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and that's when it's time to talk to a clinician.
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It's affecting my performance. I think I need some help,
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and so we might say, well, tell me about that,
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and then okay, there's some social things you can do
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to build up that buffer, but is there maybe for
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a duration, it might be appropriate to start a medicine too,
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and maybe talk to somebody, get some therapy, dial it in.
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There's a lot of things that that chisel down at
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that buffer, and one
of them is like our default
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mode network. We could have talked about this last week,
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and some of that default mode network is like, what
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is the voice that we're listening to? That's telling us stuff,
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and sometimes those are negative voices and they can affect
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our performance, and they can also affect that buffer. So
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whether it's man, I'm having a lot of anxiety, or
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maybe man, I'm having a lot of depression, or maybe
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I can't sleep and I'm having anxiety and depression, Well
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that might be time to like, oh, let's get seen
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by the clinician, see if there are some things that
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we could do to enhance that buffer such that when
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pressure hits, you don't find yourself in these overwhelming, emotionally
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dysregulated states, if you will.
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So, how would you recommend for that college student? How
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do they know where they're at on the bell curve?
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Because I think with a lot of the way that
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we cope now, especially the younger generations, they have zero
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coping skills. How do they know where they're at on
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just like, Okay, I've had a hard day, I feel stressed. First, Okay,
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every single day I'm now feeling this, but I'm not
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having panic attacks. So how do they know where they're
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at in the bell court?
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Yeah, if you're anxious because you've got a test coming
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up and you're inclined to study, you're in the healthy
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pressure space. If you're having a hard time sleeping, you
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keeping and ruminating about oh my gosh, did I study enough?
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Or oh my gosh, I'm so stressed about tomorrow. I
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don't know about this thing, and then that persists even
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after you're done with the test. Oh man, if only
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I could have water to shout a Maybe those are
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those self talk dialogues that create more anxiety, more depression,
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more of those negative feelings in us. And so I
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would say, just look at your day to day life.
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Am I able to get up and perform? Am I
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sleeping all the time? Am I unable to get out
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of bed? Or am I really unable to sleep? I'm
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ruminating and chewing on these things, and I can't really
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get through it and get over it. You might need
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some tools and some you know, talk to somebody. Get
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on a medicine for a duration. One of my pet
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peeves is that a lot of my colleagues are starting
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people on these medicines that really don't work a ton.
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They're just designed to really be a band aid for
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a symptom for a duration. They're not designed to heal anything. Really,
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that's not super fair because a lot of people heal
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from these medicines with therapy, and that's wonderful. But I
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think it's the therapy part that really helps, that default
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mode network and the internal self talk dialogues and things
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that then bring that true healing space. But then they
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never weaned off the medicine, right, and they were scared
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to and then you know, and so really, I think
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if we just had discussions with folks like like I
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just did, like, Hey, you just got a threshold, You
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got a buffer, and your buffer's thin right now, and
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the medicine is just gonna increase that buffer. You're gonna
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work on all those other things. You're gonna exercise more,
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you can eat right, you're gonna sleep better, you can
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do all those things. And that way, your threshold is
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really big. So when we wean off the medicine, guess
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what we're not down here in anxiety and panic attack
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and depression land.
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Yeah, I think that's super helpful. Okay, next one kind
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of similar but slightly different. How do I know if
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I have depression? First? Just feeling down?
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Yeah, this is great. I will say it is super normal,
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super normal for everybody to have some ups and downs
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in life. You're gonna be excited sometimes and be sad.
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Sometimes you're gonna cry, sometimes you're gonna You're gonna have
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high
days and low days. That's all super normal stuff.
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Doesn't mean you're bipolar, doesn't mean that does a whole
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other diagnosis. And and so I think the first thing
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is give yourself grace to have some bad days. That's
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like my number one thing. Depression versus like just feeling
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down is hard because I would say, if you're feeling
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down and you can't get up and you can't get
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out of bed and you can't get motivated to do
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anything and you're kind of stuck, well then you're kind
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of down into the depressed in state, right, And so
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we have this whole PHQ nine questionnaire that we often
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use in the in the clinics, there's there's even a
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PHQ three which you just you could literally go on
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to chat Rock and ask them like, hey, am I depressed?
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And they'll say, well, here's a PHQ nine. Answer these
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questions and if you answer them pretty high, then maybe
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you do have some depression. It's hard just subjectively to
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know if somebody's depressed. So even in the clinic, I can,
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I can kind of I think the benefit of seeing
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someone in persons is you can kind of sense that
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right and docs who are a little more I don't know,
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right and left brain balanced, they're going to be more
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more like intuitive and like hearing and sensing. And I
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don't always do the PHQ nine and the clinic. I
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can feel when someone's super depressed and they're telling me
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a story, and I'm like, Okay, we don't need to
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do any of that stuff. But if you're like if
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I'm on the fence, I might be like, well, I
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don't know, it's kind of hard to get a sense
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of that or feel for that. Let's just answer this questionaire.
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What that does is it gives you objective findings, right,
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so you can just like, now I'm not weighing on
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my gestalt or your gestalt or like how you're basically
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we just answer these questions. If there are really a
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lot of those that you answered a high level to,
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then yeah, depression for sure. Yeah.
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Would you say most people are depressed or just struggling
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with knowing how to identify their emotions.
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I would say not everyone are depressed. I think there
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are more sad states, more downstates, and more high states
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that we all have throughout the day. Everybody has some
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degree of that emotional roller coaster and understanding that. I
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think recognizing, understanding, utilizing, and regulating our emotions is a
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skill and it is one that we do not teach,
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which is dumb. And so if you're interested in learning
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more about that, I would say Mark Bracket. He's like
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the head of the Yale Center of Emotional Intelligence, and
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he's like a brilliant man, and he's created a Ruler
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r U l e R curriculum for schools for individuals
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to utilize. He's been on Huberman Labs podcast a few times.
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That's one of my favorite ones. I'm a science nerd
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and I love scientists and they're super nerdy science and
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he really lays out this Ruler curriculum. Are you elier, recognize, understand, label,
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People suck at those three things? Yeah, just recognize, Well,
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I'm feeling something. It feels more down than up, so
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maybe it's maybe in the bluesy space. I want to
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understand that. What is that? And then label it? Yeah,
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I'm feeling kind of bluesy. The D word is harder, right,
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call it depression, but let's just solid bluesy depression. That's fine, right,
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and then express that and I'm feeling kind of sad,
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tell somebody, hey, I'm feeling this, and then and then
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just literally just doing that helps you are regulate. So
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that I love that little curriculum. Recognize, understand, label, express, regulate.
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If you're feeling angry, if you're feeling sad, if you're
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feeling anxious, that's a wait for emotional intelligence to promote it.
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My Brackett is super nerdy PhD guy, and all these
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PhD guys are like, oh great, They're like they're like cerebral,
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They're
like these these massive brainy nerds. And that's great.
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And I love his curriculum because he uses brain cells
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to understand heart space. But I will say there's higher
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level to that where you're I think I think you're
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trying to analyze and fix and understand and all that
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with our with our surrebram our, c frontal, cervira, cortext
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we're trying to like understand our hearts with our heads.
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And I think that's part of the mortal existence and
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that's okay. But there is a deeper space where you're
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really feeling and understanding with your hearts and you're navigating
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your heart space with your heart ooh, that's a whole
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nother space, and you have to you have to be
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able to get rid of that default mode network. Breathwork
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does that. Some of the psychedelics do that, and then
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really get into that heart space and then you can
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really see stuff and you can really deeply understand and
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deeply heal. I think that's the intention of a lot
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of em drs and the trauma therapies that are out there,
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the modalities that they use with breath work and things
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like that, to really quiet the default mode network and
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really get to their heart space. But I do love
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what Mark Brackett does too, because I think it gives
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you some insight, some practical.
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Application to start today. Yeah, okay, moving on to sleep
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kind of the same thing. Am I actually burned out
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or just being lazy? Apparently there's a lot of people
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out there that are really confused about what they're feeling
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and if it's normal or if it's to an extreme
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that they don't understand.
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This is so funny. So I think this was a
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query that you put out to Google in the last
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week or two, and it is finals for so many
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of these kids trying to understand their emotions, so they're like,
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you could totally see this from like a nation full
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of like, yes, folks that are in finals well and
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what am I actually feeling?
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And social media too, where they will label everything as
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these major extremes now selling them on something to fix
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their laziness, rather than them just being tired from studying.
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So maybe not that one so much, but this one
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is a good one. Why am I exhausted all day
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but wide awake at two am?
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Throughout the day, A lot of people are not understanding
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or regulating their cortisol levels appropriately. Your cortisol. Physiologically, cortisol
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comes from your kidneys, your adrenal glands that sit on
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top of your kidneys, and it's secreted due to a
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signal from your pituitary, which is in the middle of
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your brain. So a little tiny or little tiny gland
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it secretes actch that then tells your pituitary or your
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it tells your adrenal glands to secrete cortisol at nighttime
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as you go to sleep you're not eating any food.
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Cortisol is a catabolic steroid. It breaks down sugar stores
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in your body to keep you alive during the nighttime,
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and it starts to rise around two or three in
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the morning, and then and then it spikes kind of
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early morning six seven eight, depending on when you wake up,
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and it spikes, and then you really want that cortisol
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to stay high. This is outside of a pathologically high
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cortisol level. So you hear people like, oh, cordisol's stress
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normalone and people are two strets or cortisols levels too high.
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We should definitely take cash a rod in the morning.
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That is not That is not the case. So this
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is the just the normal person, their normal physiology. Cortisol's high,
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and you actually want that to stay high. It keeps
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you motivated, keeps your energy going, It keeps you going.
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But what did ninety percent of Americans do in the morning.
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Let's eat a giant bowl of like frosted flakes.
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Let's see that.
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Let's see scrolling. Yeah, yeah, yeah, So you're killing your
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00:16:51.080
open me, but you're also killing your cortisol level. So
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a sugary, a high carbhydrate food in the morning is
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going to tank your cortisol and then you're gonna be
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super sleepy at noon. And what are you gonna do.
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You're gonna eat something high carb as well, and then
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you're gonna further take your cortisol and then you're sleepy
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all afternoon, so your corsol's super low, and then your
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body's like, hey, we need more cortisol, so it starts
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to spike a little bit early and then you're getting
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that two am spike instead. So really it's probably diet based.
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If we could cut the carbs a little bit. If
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you want to do some carbs, do it with dinner.
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Do a lower car breakfast, A lower carb lunch. Doesn't
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mean no carbs, but like, let's just eat veggies instead
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of all those sweet stuff right then, and that has
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complex carbs in it, and then it will help your
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cortisols be sustained throughout the day, your energy level will
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be sustained. You won't have that afternoon oh my gosh,
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I gotta take a nap feeling and that'll be money
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and then you'll be able to sleep.
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So what does your breakfast look like me?
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I don't eat a ton of breakfast, Yeah, I don't.
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I just drink some mojo in the morning and then
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that's pretty much it. And then lunch I try to
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keep it low carb, and then dinner if I do
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some carb that day, I'll do a low amount of carbs.
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Cortisol is clutch. The other thing at two am is
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if you've got a lot of things, you're kicking around
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breathing and not breathing, but you're just like thinking about
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ruminating on that cortisol is going to turn on. And
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then it can also turn on like your other adrenals
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like norbinephrin, and kick you into like a little bit
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fight or flight. So then you're like awake, and then
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you can't go back to sleep because your body just said, hey,
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usually wake up and think. And so I think some
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degree of emotional intelligence and emotional processing every single day.
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And I would just do it with breath work five
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seconds in, five seconds out, five seconds in five seconds,
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so and do that for like five minutes and then
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just breathe, and that gets you out of your default
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mode network and into kind of your heart space, and
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then you can just let your heart and mind kind
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of sort itself out. Understanding like subconscious brain and default
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mode network and the way our brains work and why
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and why they kick on and stuff is complicated. It's
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super complicated, but none of us actually do any work
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trying to fix it on a day to day basis.
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How do I feel stuff? How do I defrag the
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hard drive? Like? How do I? How do you get there?
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And I think one of the keys is breathwork, meditation, mindfulness,
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just breathing, just breathing. It turns out breathing is the
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answer to everything. Yeah, let's kind of breathe.
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Breathing and not eating a bowl of sugar first thing
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in the morning.
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Lucky charms due.
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No, okay, Next moving on to hormones. What are signs
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of hormone imbalance?
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Okay, So, if you are a menstruating female, your hormones
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are reasonable. They really are. If you're menstruating regularly normally,
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your hormones are reasonably balanced. If your hor if your
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cycle shortened, lengthened, heavier than usual, not as heavy as usual,
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something's off there. So really the great litmus test. Litmus
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test is a fancy word for like acid base. They
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dip it in the water and they tell if it's
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like acid base. So, but we're just the litmus test
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of your hormones is really your cycle? For females, Let's
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say you're ooh, I'm thirty seven. Am I a perimenopazzal.
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How's your cycle? My cycle's great. We don't really even
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need to check hormones. Female's hormones do this throughout the month.
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Yeah, it feels like that
they're like up down, up, down,
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down down, super down, and and that does play a
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role on your emotions and it is hard to control
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some of that emotional stuff dysregulation that happens with those hormones,
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and it is just not fair.
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One of these days, I'll ask the big man upstairs.
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It'll be like, hey, man, what's going on? And I
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literally I think it's just to keep us on our
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toes because I'm like, oh, otherwise it'd be so easy,
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Like if my wife was just like talking all that
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we had normal, steady hormones, it'd be so grooved, right,
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But no, it's like what the whoa, sorry, bab I
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didn't mean it. Nope, didn't mean that either. So you
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just you know, you got to figure out how to
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kind of navigate that space. But by far and away,
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despite the ups and downs of females hormones, if that
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cycle is cycling normally with normal amounts of the menstruation
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and normals of all that stuff cycles, everything is probably fine, Okay.
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What about men's hormones? So the next one is is
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testosterone therapy safe? And who should not be using testosterone therapy?
399
00:21:36.880 --> 00:21:40.079
I love this question. We have a million testosterone mills
400
00:21:40.079 --> 00:21:43.000
out there right now. These are mills because that's all
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00:21:43.039 --> 00:21:46.400
they're interested in. They're venture funded, so they're funded by
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00:21:46.440 --> 00:21:49.240
some guy who wants money, and then they put a
403
00:21:49.319 --> 00:21:51.720
worker b in there, often a pa or or spectationer
404
00:21:51.759 --> 00:21:54.799
because they're cheap labor. And then they just they just
405
00:21:55.039 --> 00:21:58.039
like run people through and they put everybody on testosterone
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because it's part of their business model and they make
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boatloads of money. And do these people feel better on testosterone? No?
408
00:22:05.240 --> 00:22:08.400
Yes they do. Oh yeah, because testosterone is a performance
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enhancing drug and it will make one hundred percent. You
410
00:22:11.039 --> 00:22:12.480
put me on tesasha, and we'll be like, oh they
411
00:22:12.519 --> 00:22:16.160
feel great. I'm after oh like I'm eighteen again. But
412
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is it appropriate? Maybe not. We all kind of want
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this easy, quick fix to our feeling of yeah, I'm
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getting bad, I got too much visceral bad, or I'm
415
00:22:26.359 --> 00:22:28.759
this or that, and everybody wants a quick fix to that.
416
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And hormones are unsafely that, and so why if you
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put a thirty year old, and we've had many of
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those folks come to our clinic to get ethical hormones
419
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or come off of those unethical hormones. We just have
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a talk about it. Hey, you're thirty, your hormones were
421
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a little bit low, but they weren't super low. But
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you could have done a million things in your personal
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life to fix that without this hormone injection. As soon
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as we start this hormone injection, guess what testicle shriveled up.
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They lost their ability to actually create hormone. And now
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you have to be on that the rest of your life, right,
427
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And that's a bum deal. And there is a way
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around that. So if you have that talk to your doc,
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if they're ethical, they'll probably help you jump start your boys.
430
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And it's not jumper cables, but it's close, it's not really,
431
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But yeah, we'll get them back online and get them
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come and again. Meanwhile, work on your sleep, work on
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your stress, work life balance, exercise, resistance training, get your
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vitamins in, get enough vitamin D, get some sun, walk
435
00:23:31.599 --> 00:23:34.720
in the mornings, walk in the evenings, manage that cortisol level,
436
00:23:35.519 --> 00:23:38.319
and magically your testosterone is back online and it's working great,
437
00:23:39.119 --> 00:23:41.759
So that's the key. It does take more discipline, takes
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00:23:41.799 --> 00:23:45.400
more time, and it's more holistic, but man, it's way
439
00:23:45.440 --> 00:23:46.359
better for your boys.
440
00:23:47.000 --> 00:23:49.000
Well that's where I've heard you talk about this in
441
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the clinic, and I was talking to my sister. She
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was like, I didn't understand that this can make men infertile.
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She had friends in their early twenties looking into testosterone
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therapy because they wanted to get swool and didn't realize
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that they are pre having children and then that could
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affect their fertility.
447
00:24:07.160 -->
00:24:08.720
No, I'm glad you brought that up, because that is
448
00:24:08.759 --> 00:24:11.000
a That is also the other thing because then when
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they shriveled up they stop producing testosterone, they also stop
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producing sperm, and to get those babies back online, it's tough,
451
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so it takes time. It's not on it's not insurmountable.
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But talk to probably a good a good doc who's
453
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done a little digging in this and you'll see how
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to do it.
455
00:24:29.559 --> 00:24:34.440
So similarly, kind of a hot topic diet, Do I
456
00:24:34.599 --> 00:24:38.680
have to be on GLP ones forever? And who shouldn't
457
00:24:38.720 --> 00:24:39.759
be on GLP ones?
458
00:24:41.160 --> 00:24:46.599
Medullary thyroid cancer is like the big contry indication a
459
00:24:46.680 --> 00:24:48.680
family history of thyward cancer. You should talk to your
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clinician about that. If you have gastroprises, probably shouldn't be
461
00:24:54.799 --> 00:24:58.480
on that. If you have a gastric sleeve or a
462
00:24:58.559 --> 00:25:01.359
gastric bypass, you should talk to your clinician about the
463
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risks of being on that. I think they're pretty pretty safe.
464
00:25:07.599 --> 00:25:10.359
They've been around forever. They're naturally occurring in your body.
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What's been hacked is our food supply. So our food
466
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supply eighty five percent or more is crap, right, It's
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lucky charms, it's all this granola bars that are fake healthy,
468
00:25:22.200 --> 00:25:24.839
and yogurts that are fake healthy. They're just full of sugar,
469
00:25:25.440 --> 00:25:28.640
and all of those things really shut off the part
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of your brain that say I've had enough and I'm
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full here and I'm done. They shut that down and
472
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they just regulate it. So then you're like having craving
473
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is disproportionate than what's real for your body and what
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your body needs. So these shots given once a week, generally,
475
00:25:48.720 --> 00:25:52.119
they kind of help people quiet that food noise that
476
00:25:52.240 --> 00:25:54.880
comes from our poor diet. I love to have a
477
00:25:54.960 --> 00:25:57.440
very holistic talk with folks about, hey, we got to
478
00:25:57.440 --> 00:25:59.720
move the needle here, it's very difficult to move the
479
00:25:59.759 --> 00:26:03.400
needle with the American diet. What do you want to accomplish?
480
00:26:04.079 --> 00:26:06.759
You want to come to as cool? What changes are
481
00:26:06.799 --> 00:26:09.880
you willing to make to accomplish that? Because you really
482
00:26:09.960 --> 00:26:12.039
got to change some of this diet stuff. Well, I
483
00:26:12.119 --> 00:26:15.000
want to do this. This this okay? Great? What if
484
00:26:15.039 --> 00:26:17.039
I told you you're going to fail ninety percent of
485
00:26:17.119 --> 00:26:20.519
the time within seven days. There's a tool that we
486
00:26:20.599 --> 00:26:23.480
can leverage to just help you with that discipline space
487
00:26:24.000 --> 00:26:26.599
as you're coming off of this. It's like giving a
488
00:26:26.720 --> 00:26:32.559
crack addict something to be able to really quit the crack, right,
489
00:26:32.960 --> 00:26:35.680
And so this is something that really helps them. But
490
00:26:35.759 --> 00:26:37.279
they have to have that gumption, they have to have
491
00:26:37.359 --> 00:26:39.720
that desire, and they have to have that focus so
492
00:26:39.880 --> 00:26:43.039
that they can actually get there. And the medicine is
493
00:26:43.079 --> 00:26:45.160
just a tool to get there once they've dialed in
494
00:26:45.279 --> 00:26:49.640
behavior patterns and change diet and changed quantities and changed
495
00:26:49.759 --> 00:26:54.960
all these patterns. Now it's sustainable, right, But if you don't,
496
00:26:55.119 --> 00:26:57.480
if you continue to eat the food that disregulates you
497
00:26:57.920 --> 00:26:59.839
even though you're on it, you will lose weight. You'll
498
00:26:59.880 --> 00:27:02.160
be great, and then as soon as you stop your
499
00:27:02.200 --> 00:27:04.759
fluff right back out because you didn't really change the problem,
500
00:27:04.759 --> 00:27:07.119
which is all the processed food. Right, So we got
501
00:27:07.200 --> 00:27:09.319
to stop eating so much processed food, eat a lot
502
00:27:09.359 --> 00:27:14.039
more vegetables, meats, whole grains, not all the processed crap,
503
00:27:14.359 --> 00:27:17.440
and then we'll be fine. But it's just getting them
504
00:27:17.519 --> 00:27:20.519
there that's the battle. And so I think leveraging them
505
00:27:20.599 --> 00:27:24.039
for a duration to establish better eating patterns, better life patterns,
506
00:27:24.119 --> 00:27:29.000
better exercise patterns, and then coming down once a month, shot,
507
00:27:29.759 --> 00:27:32.480
once every two week shot, you know, and just tapering
508
00:27:32.960 --> 00:27:34.680
and then maybe they just need it once a month
509
00:27:34.759 --> 00:27:37.640
for maintenance. Awesome. I have several patients that are just
510
00:27:37.680 --> 00:27:40.279
once a month, and then even that, they'll come off
511
00:27:40.319 --> 00:27:42.119
of it for several months and they're fine and they're like, oh,
512
00:27:42.160 --> 00:27:45.400
I see myself getting disregulated again with my eating patterns
513
00:27:45.400 --> 00:27:47.680
and my relationship with food, and they'll just get back
514
00:27:47.720 --> 00:27:50.400
on it and it helps them. Long term studies on
515
00:27:50.480 --> 00:27:52.920
this do exist. People are like, there's no long term studies.
516
00:27:53.079 --> 00:27:55.319
There's a million long term studies. This medicine has been
517
00:27:55.319 --> 00:27:59.119
around for more than thirty years in different forms, So
518
00:27:59.400 --> 00:27:59.960
super interest.
519
00:28:01.359 --> 00:28:03.960
Next one is kind of the I feel like you
520
00:28:04.160 --> 00:28:08.039
have people on GLP ones and then you have likewise
521
00:28:08.079 --> 00:28:12.119
people who are in this holistic you can heal yourself.
522
00:28:12.240 --> 00:28:16.240
But one of the biggest things are detoxes. So whether
523
00:28:16.319 --> 00:28:21.920
that's like juice detoxes or even people will use intermitten
524
00:28:22.000 --> 00:28:23.680
fasting with detoxes.
525
00:28:24.599 --> 00:28:25.359
Do they work?
526
00:28:25.519 --> 00:28:27.160
Do detox cleanses work?
527
00:28:27.559 --> 00:28:30.759
Oh? Man, this is this is a whole another's bag
528
00:28:30.839 --> 00:28:33.279
of ones. And thanks for bringing this to you. I
529
00:28:33.319 --> 00:28:36.720
would say, go to groc and type this in now
530
00:28:37.119 --> 00:28:41.000
there's There are detox protocols that work, and the number
531
00:28:41.079 --> 00:28:44.319
one is stop processed food and sugar and you will
532
00:28:44.400 --> 00:28:48.079
literally go through withdrawals. So that's super simple. But do that,
533
00:28:48.359 --> 00:28:52.640
eat vegetables and meat, just those two things. Skip grains, skip,
534
00:28:52.839 --> 00:28:55.839
skip sugar, skip all that. Do that for six weeks,
535
00:28:56.640 --> 00:29:00.119
your whole brain will reset, your cravings will research that,
536
00:29:00.240 --> 00:29:04.039
your sugar thing will reset, like all this stuff will reset.
537
00:29:04.400 --> 00:29:07.720
That's the best detox anybody could do. There are anti
538
00:29:07.799 --> 00:29:10.599
inflammation diets that are, like, you know, only eat these
539
00:29:10.640 --> 00:29:14.480
things and decrease inflammation. That's not as much detoxing as
540
00:29:14.599 --> 00:29:19.119
just lowering inflammatory type foods. Wheat in America tends to
541
00:29:19.160 --> 00:29:22.920
be more inflammatory to our bodies. It's not that it's
542
00:29:22.960 --> 00:29:25.359
not a gluten allergy or is it a wheat allergy.
543
00:29:25.400 --> 00:29:28.680
It's just a little bit inflammatory. European wheat for me,
544
00:29:28.880 --> 00:29:31.319
generally doesn't do that as much, So I don't know
545
00:29:31.400 --> 00:29:33.440
what that is. There's probably a genetic strain that we
546
00:29:33.559 --> 00:29:35.400
use here that they don't use over there or something.
547
00:29:35.480 --> 00:29:39.759
But the detox is that there's some really radical ones
548
00:29:39.799 --> 00:29:42.759
that I don't recommend. There's like coffee enemas as part
549
00:29:42.799 --> 00:29:45.160
of the detox and all this stuff, and I think
550
00:29:45.200 --> 00:29:49.400
people can get pretty radicalized. And man, if you want
551
00:29:49.440 --> 00:29:53.119
a detox, honestly, just do like hot pilates or exercise
552
00:29:53.160 --> 00:29:57.039
a lot, sweat a lot, don't eat any processed food,
553
00:29:57.640 --> 00:30:01.000
drink lots of water. In your body. Your body's literally
554
00:30:01.200 --> 00:30:08.880
made to detox you. It is liver, kidney spleen like lungs.
555
00:30:08.960 --> 00:30:11.240
There's a whole bunch of organs that that's they just
556
00:30:11.640 --> 00:30:13.839
they just blow out toxins. They pee out toxins, you
557
00:30:13.920 --> 00:30:17.519
pooh out toxins. They process all these toxins. This is
558
00:30:17.759 --> 00:30:19.440
the case in point is the American diet. You could
559
00:30:19.480 --> 00:30:23.119
literally feed your body crap and it still lives. Right
560
00:30:23.319 --> 00:30:26.559
Like we're literally giving it processed chemical bull crap and
561
00:30:26.680 --> 00:30:30.200
it's doing okay. I mean, it's getting the diabetes and
562
00:30:30.279 --> 00:30:32.359
heart disease and all these other bad things from that crap,
563
00:30:32.440 --> 00:30:36.519
but it's sorting out the toxins. So really, if you
564
00:30:36.599 --> 00:30:42.000
want to sort out toxins, breathe, breathe, eat right, exercise,
565
00:30:42.240 --> 00:30:44.720
drink lots of water. Man, you'll flush out tons of
566
00:30:44.720 --> 00:30:47.599
stuff from your system. Tons. Now, if you truly have
567
00:30:47.759 --> 00:30:52.160
exposure to like heavy metals through you know, polluted waters
568
00:30:52.279 --> 00:30:57.200
or polluted environment or something, kelation detox absolutely works. We
569
00:30:57.319 --> 00:30:59.519
use that in medicine all the time, and so that's
570
00:30:59.519 --> 00:31:01.519
something to talk to your clinician about if you feel like,
571
00:31:01.599 --> 00:31:04.240
oh I might have some heavy metal exposure or something
572
00:31:04.279 --> 00:31:07.640
from my environment or something not super common. There was
573
00:31:07.680 --> 00:31:10.319
some factories in California that had some heavy metal stuff
574
00:31:10.319 --> 00:31:14.000
and they had to do klation therapies and stuff. But generally,
575
00:31:14.200 --> 00:31:16.160
I mean, if you're playing with mercury, you're gonna get
576
00:31:16.240 --> 00:31:19.599
mercury poisoning, right, So that needs to be keylated out
577
00:31:19.599 --> 00:31:22.960
and that's very, very life threatening. But yeah, I would
578
00:31:22.960 --> 00:31:25.440
say as a whole just do those things, Okay.
579
00:31:25.519 --> 00:31:29.119
So would you say before starting a radical cleanse that
580
00:31:29.240 --> 00:31:32.160
you might think is going to change everything about your
581
00:31:32.920 --> 00:31:35.319
experience in life. Maybe you reach out to your doctor
582
00:31:36.000 --> 00:31:38.200
and ask if that's a safe thing to do. Can
583
00:31:38.279 -->
00:31:41.119
you harm yourself by doing certain detoxes?
584
00:31:41.359 --> 00:31:42.839
Yeah, one hundred percent. So a lot of people are
585
00:31:42.839 --> 00:31:45.160
doing these juice cleanses and stuff like that. Man, just
586
00:31:45.240 --> 00:31:47.240
eat the vegetables and the fruits. It's fine. Just eat
587
00:31:47.279 --> 00:31:50.279
those and just don't eat process crap and drink water
588
00:31:50.599 --> 00:31:54.079
and exercise. Literally, that's it. Like, you don't have to
589
00:31:54.119 --> 00:31:56.200
have to do the juice clans. It's totally fine if
590
00:31:56.240 --> 00:31:58.000
you don't do the juice clans. People feel good doing
591
00:31:58.039 --> 00:32:01.039
the juice clans because they're eating thatgetables and fruits, right,
592
00:32:01.519 --> 00:32:03.839
That's why they feel good because they're not eating processed stuff.
593
00:32:04.160 --> 00:32:06.440
But if you just eat those vegetables and fruits and
594
00:32:06.799 --> 00:32:08.920
don't eat the process stuff, then you'll feel equally as
595
00:32:08.960 --> 00:32:10.799
good and it'll be not as much work as a
596
00:32:10.880 --> 00:32:13.359
juice cleans. True. I don't love the juice clans because
597
00:32:13.359 --> 00:32:16.880
it's like concentrating them without the fibers, and I like fiber.
598
00:32:16.960 --> 00:32:18.799
I think fiber is super healthy for your heart health,
599
00:32:18.880 --> 00:32:22.279
for your cholesterol, for your coalon health, your gut literally
600
00:32:22.359 --> 00:32:25.000
needs fiber in order to thrive. So our gut biome
601
00:32:25.039 --> 00:32:27.319
has a whole bunch of little microorganisms. They're symbiotic to
602
00:32:27.839 --> 00:32:29.920
your life and they need to live and they need
603
00:32:29.960 --> 00:32:32.759
to do things, and so they feed on fiber. So
604
00:32:32.839 --> 00:32:34.640
if we're not getting enough veggies in our lives, like
605
00:32:34.720 --> 00:32:39.119
get one of those little powdered vegetable supplement things. Costco
606
00:32:39.200 --> 00:32:41.720
has one that's more affordable than the athletic greens, the
607
00:32:41.839 --> 00:32:45.039
agent one or whatever that human likes. But but just
608
00:32:45.160 --> 00:32:47.039
something like that in your gut is helping your gut
609
00:32:47.079 --> 00:32:49.200
flora thrive and helping you with a whole bunch of things.
610
00:32:50.319 --> 00:32:52.400
If you want to do a radical detox thing, yeah,
611
00:32:52.559 --> 00:32:54.680
I would say pump the brakes. Maybe do something less
612
00:32:54.759 --> 00:32:58.359
radical first. See what that helps you feel. Because a
613
00:32:58.400 --> 00:33:00.839
lot of these things are like really expensive, and people
614
00:33:00.880 --> 00:33:03.039
are blowing up like three grand, you know, doing some
615
00:33:03.240 --> 00:33:06.200
silly thing with some silly person that's making a botload
616
00:33:06.200 --> 00:33:09.599
of money. And the beauty of Voyish clinics is we
617
00:33:09.680 --> 00:33:12.039
don't have any conflicts of interest like that. So we're
618
00:33:12.079 --> 00:33:14.680
just going to give you good advice as somebody cares
619
00:33:14.720 --> 00:33:19.279
about you and your family and so Yeah, if their
620
00:33:19.599 --> 00:33:22.599
sales operation is contingent upon them selling you this package
621
00:33:22.640 --> 00:33:24.960
of you know, detox and all these things and a
622
00:33:25.000 --> 00:33:26.920
bunch of supplements and a bunch of things, and you know,
623
00:33:27.039 --> 00:33:29.200
consider what that looks like. That's just capitalism at work,
624
00:33:29.279 --> 00:33:31.400
maybe not truly what your body needs.
625
00:33:31.839 --> 00:33:36.559
You mentioned are our final one. What are early warning
626
00:33:36.680 --> 00:33:39.799
signs of heart disease? And what does a heart attack
627
00:33:39.880 --> 00:33:40.640
actually feel like?
628
00:33:41.640 --> 00:33:43.519
We're seeing this more and more. Number one killer in
629
00:33:43.559 --> 00:33:45.880
America is the athloschcotic disease to build up a plaque
630
00:33:45.880 --> 00:33:50.160
on blood vessels that causes a clot, a blockage, and
631
00:33:50.480 --> 00:33:52.759
to your heart, to your brain. So heart attack strokes
632
00:33:53.880 --> 00:33:56.680
still the number one killer in America. We're seeing it
633
00:33:56.920 --> 00:33:59.519
more and more common. Why, it's because of the processed
634
00:33:59.519 --> 00:34:01.880
food craft that we feed ourselves, right, and then we
635
00:34:01.920 --> 00:34:04.240
don't exercise as much, and we're stress levels are super high,
636
00:34:04.240 --> 00:34:06.519
and our inflammation is super high, and our gut flora sucks,
637
00:34:06.559 --> 00:34:10.000
and we're not feeding it enough fiber. So basically we
638
00:34:10.119 --> 00:34:12.960
hit on a whole bunch of those spaces here. But yeah,
639
00:34:13.159 --> 00:34:15.159
the early signs, I mean, we're seeing it in their
640
00:34:15.239 --> 00:34:22.000
thirties even forties sometimes, and you general, typical chest pain
641
00:34:22.119 --> 00:34:25.039
is going to feel like, oh man, somebody's stepping on
642
00:34:25.159 --> 00:34:29.199
my heart. It feels like pressure and it can't breathe
643
00:34:29.320 --> 00:34:32.519
a well. I might be sweating diaphoresis, which is like,
644
00:34:32.599 --> 00:34:34.880
I'm not exercising, Why am I sweating and just having
645
00:34:34.880 --> 00:34:36.960
this pressure in my heart? I'm sweating and then it
646
00:34:37.199 --> 00:34:39.119
like maybe goes down to your left arm, a little
647
00:34:39.119 --> 00:34:41.159
bit might go into your jaw, depending on where at
648
00:34:41.239 --> 00:34:46.199
in your heart that blockage is occurring. If you're walking
649
00:34:46.280 --> 00:34:47.960
up a flight of stairs, you get more shorter breath
650
00:34:47.960 --> 00:34:50.079
than usual, and you feel something stepping on
your chest,
651
00:34:50.199 --> 00:34:52.199
and then it goes away when you rest long enough.
652
00:34:53.360 --> 00:34:57.280
You're having some issues right there. So that's typical chest pain.
653
00:34:57.880 --> 00:35:02.760
Atypical chest pain happens in females diabetics, which is something
654
00:35:02.880 --> 00:35:05.079
similar to that, but then a whole bunch of differences
655
00:35:05.159 --> 00:35:08.119
and might not be exactly that what I just described,
656
00:35:08.719 --> 00:35:12.000
but what I just describe is like classic. What's even
657
00:35:12.079 --> 00:35:15.880
better than that is come in in your early like
658
00:35:16.360 --> 00:35:18.199
I don't know, mid twenties, I don't know, come in
659
00:35:18.280 --> 00:35:20.480
in your thirties, come in with everyone, but come into
660
00:35:20.559 --> 00:35:24.559
the doc family. Docs are preventive healthcare specialists. Internal medicine
661
00:35:24.599 --> 00:35:27.840
docs are preventive healthcare specialists. Pediatricians do a good job.
662
00:35:29.199 --> 00:35:32.599
Obs are primary care specialists as well. Talk to them
663
00:35:33.400 --> 00:35:37.599
about prevention. That's the key. So what am I doing
664
00:35:37.679 --> 00:35:40.239
to prevent this? What's my cholesterol look like? What's my
665
00:35:40.280 --> 00:35:42.599
exercise look like, what's my stress level, what's my fiber?
666
00:35:43.320 --> 00:35:46.239
And those are super easy to check. There's also some
667
00:35:46.400 --> 00:35:49.480
genetic things. Lipoprotein delay is a genetic thing. Check it
668
00:35:49.599 --> 00:35:52.760
once in your lifetime. If it's not high, it'll never
669
00:35:52.800 --> 00:35:57.360
be high. It's just a genetic thing. Apoab ratios all
670
00:35:57.400 --> 00:35:59.760
the things. You can get particles to your fats and things,
671
00:36:00.840 --> 00:36:03.159
but get to it early so you can start working
672
00:36:03.239 --> 00:36:06.960
the equation and win. That way, you prevent the build
673
00:36:07.039 --> 00:36:09.360
up of the black instead of like, ooh, I'm having
674
00:36:09.519 --> 00:36:13.000
just paid. What should I do right? Once you have that, boy,
675
00:36:13.320 --> 00:36:15.800
you've got to get a stint or bypass or something
676
00:36:15.960 --> 00:36:19.800
massive that's you know, quite quite a big deal.
677
00:36:21.000 --> 00:36:22.760
To wrap it all up, it sounds like you just
678
00:36:22.840 --> 00:36:26.400
need to eat better, sleep better, do all the basics.
679
00:36:26.719 --> 00:36:28.719
Breathe and breathe, breathe.
680
00:36:29.760 --> 00:36:32.960
So one final question then, so people who are turning
681
00:36:33.000 --> 00:36:39.000
to AI tools to research their own medical questions. Where
682
00:36:39.159 --> 00:36:41.480
what are is there anything that you would say don't
683
00:36:41.599 --> 00:36:45.039
research medical questions or would you say that's a fine
684
00:36:45.280 --> 00:36:47.719
first resort every time.
685
00:36:47.960 --> 00:36:50.800
I never say don't go there looking for things. I
686
00:36:50.840 --> 00:36:53.079
think you're totally fine doing that. But what you've got
687
00:36:53.199 --> 00:36:55.039
to be good at is telling it a story. So
688
00:36:55.559 --> 00:36:58.119
here's what I would do. Learn how to tell a
689
00:36:58.199 --> 00:37:01.360
good story. Doesn't matter if it's a or me. If
690
00:37:01.400 --> 00:37:03.159
you come to my office and your brain is all
691
00:37:03.239 --> 00:37:06.320
over the place and you're not telling me a story,
692
00:37:06.519 --> 00:37:09.840
I'm pretty good at directing people. AI doesn't direct you, right,
693
00:37:09.960 --> 00:37:12.440
you can just shoot all over the place, and then
694
00:37:12.719 --> 00:37:14.440
AI is telling you have cancer, and then you have
695
00:37:14.519 --> 00:37:17.079
three heads and you also have you know something else.
696
00:37:17.159 --> 00:37:21.239
And so learn how to give a good history present
697
00:37:21.400 --> 00:37:25.239
illness HPI. You can look this up. You could chat
698
00:37:25.320 --> 00:37:28.639
GPT it if you want to CROFT or whatever, but
699
00:37:28.760 --> 00:37:30.800
you could literally just look it up. How do I
700
00:37:30.880 --> 00:37:34.199
do a good HPI history present illness? I'm dealing with
701
00:37:34.280 --> 00:37:36.960
a thing. I need to know everything around that theme,
702
00:37:37.440 --> 00:37:41.079
and doctors are experts at that. We literally like ninety
703
00:37:41.079 --> 00:37:44.639
five percent of diagnoses can be made on history alone.
704
00:37:45.039 --> 00:37:47.400
You give me a good history, and I solicit a
705
00:37:47.440 --> 00:37:48.920
good history for you. I'm gonna ask a whole bunch
706
00:37:48.920 --> 00:37:53.000
of questions. And that's the difference between me and Chat
707
00:37:53.079 --> 00:37:55.400
or Crocker. And they can't say, well, what about this?
708
00:37:56.239 --> 00:37:59.320
Tell me about that. The other thing that they can't
709
00:37:59.360 --> 00:38:03.079
do is feel And when I'm listening to someone, I'm
710
00:38:03.119 --> 00:38:05.440
not only I'm using my thinker brain, but I'm also
711
00:38:05.559 --> 00:38:08.440
using my heart a little bit. And I'm like and
712
00:38:08.480 --> 00:38:11.320
I'm like, I feel like there's something there. And I
713
00:38:11.400 --> 00:38:12.800
can't tell you how many times I don't know what
714
00:38:12.880 --> 00:38:15.199
that is. It's magic stuff, But I can't tell you
715
00:38:15.239 --> 00:38:18.159
how many times I'm like talking with somebody, asking them questions,
716
00:38:18.280 --> 00:38:20.199
more questions about the thing, and I'm using my thinker
717
00:38:20.239 --> 00:38:22.000
brain and then my heart says, hey, man, you should
718
00:38:22.000 --> 00:38:23.960
ask about that. And I'm like, hey, what about that?
719
00:38:24.280 --> 00:38:26.440
And I'm like, oh, actually, and it turns over
the
720
00:38:26.440 --> 00:38:28.360
stone that ends up being the problem, right. And so
721
00:38:28.880 --> 00:38:33.760
there's some intuition, if you will, in medicine that I
722
00:38:33.880 --> 00:38:38.719
think high level clinicians start understanding as they advance in
723
00:38:38.760 --> 00:38:41.000
their career and they learn how to get rid of
724
00:38:41.039 --> 00:38:42.920
their egos a little bit, and then kind of diple
725
00:38:43.000 --> 00:38:48.000
into hearing with more than just their ears and it's beautiful.
726
00:38:48.159 --> 00:38:51.719
No, it's beautiful and so yeah, so start with AI
727
00:38:52.000 --> 00:38:54.360
and then maybe bring it up to a clinician.
728
00:38:54.400 --> 00:38:57.159
Would you start with history present illness? Learn how to
729
00:38:57.239 --> 00:39:01.079
do that? When did it start? What is it? Like?
730
00:39:01.280 --> 00:39:04.519
What's the quantity? How often is it? Like those kinds
731
00:39:04.519 --> 00:39:07.199
of things, And you can literally just chat that whole thing,
732
00:39:07.320 --> 00:39:09.199
like how do I take a good history? And then
733
00:39:09.239 --> 00:39:12.639
you'll be better at telling your story to a clinician,
734
00:39:12.719 --> 00:39:15.760
whether it's Roc or me. And then you can come
735
00:39:15.800 --> 00:39:17.119
in and say, hey, I ran this back rock and
736
00:39:17.159 --> 00:39:19.800
he thinks I have this and I was wondering or
737
00:39:19.840 --> 00:39:24.159
she or whatever. Croc is Steve, what do you think?
738
00:39:24.320 --> 00:39:25.559
You know? Yea, Then we can kick it back and
739
00:39:25.639 --> 00:39:28.000
forth and ask a few more questions and dive into
740
00:39:28.000 --> 00:39:30.199
a little bit deeper and say, you know what Groc
741
00:39:30.320 --> 00:39:33.840
was right? Or you know what who cares Groc was wrong? Yeah,
742
00:39:34.000 --> 00:39:35.719
we're here and we're going to dive into a little
743
00:39:35.719 --> 00:39:38.320
bit deeper and we can explore that that idea a
744
00:39:38.400 --> 00:39:41.000
little bit. I'm telling you it's probably fourth on my
745
00:39:41.239 --> 00:39:44.639
list of possibilities, right, but it's okay, Yeah, I don't
746
00:39:44.639 --> 00:39:46.400
have any qualms with AI, I just get good at
747
00:39:46.440 --> 00:39:47.719
telling your story the history.
748
00:39:48.000 --> 00:39:50.559
Would you then say that it's okay for people to
749
00:39:50.599 --> 00:39:53.480
start treating themselves off of what AI tells some are
750
00:39:53.559 --> 00:39:56.519
good recommendations, or would you say that's where you maybe
751
00:39:56.599 --> 00:39:58.880
should turn to a provider instead.
752
00:39:59.079 --> 00:40:01.840
Well, man, I think it depends. So the practice of
753
00:40:01.920 --> 00:40:04.440
medicine is really not an AI right now, so you
754
00:40:04.519 --> 00:40:07.239
really can't do stuff. But man, if it tells you
755
00:40:07.280 --> 00:40:09.360
you should exercise and work out more any more fiber
756
00:40:09.440 --> 00:40:12.719
and sleep and breathe dude, Yeah, yeah, for sure. And
757
00:40:12.800 --> 00:40:14.960
it does have good guidelines for those kinds of things.
758
00:40:15.400 --> 00:40:17.400
Ask it how much you should exercise and what's a
759
00:40:17.440 --> 00:40:20.960
reasonable exercise routine? And should I be concerned about exercising
760
00:40:21.000 --> 00:40:23.159
at my age? And should I do some screening things
761
00:40:23.239 --> 00:40:27.079
before I start exercising? Like, it's just how you query it, right,
762
00:40:27.400 --> 00:40:30.599
And so it's a really wonderful tool. We use it
763
00:40:30.639 --> 00:40:33.079
in my clinic all the time for taking care of
764
00:40:33.119 --> 00:40:36.400
people because it's wonderful. It's a wonderful dol perfect.
765
00:40:36.519 --> 00:40:37.920
Well, I think that's everything we have.
766
00:40:38.079 --> 00:40:40.519
Then. That was so fun, Holly, Thank you so much
767
00:40:40.800 --> 00:40:43.760
to our listeners. Hope you learned some cool stuff, and yeah,
768
00:40:43.840 --> 00:40:46.719
thank you Holly. This was super fun, and don't forget
769
00:40:46.760 --> 00:40:48.440
to like and subscribe or just turn it off and
770
00:40:48.480 --> 00:40:50.800
go outside and hunt for mushrooms. It's mushroom season, y'all.