Preventing Heart Dangers in Child Athletes: A Guide

100:00:00,501 --> 00:00:02,424Speaker 1: Welcome to the healthy, wealthy and wise 200:00:02,524 --> 00:00:08,125podcast with Dr William Chokta, MDJD. Our mission is to empower 300:00:08,164 --> 00:00:11,917you with the knowledge and the tools you need to thrive in all 400:00:12,118 --> 00:00:16,204aspects of your life. Join us now as we discuss everything 500:00:16,285 --> 00:00:19,823from nutrition and exercise to money management and personal 600:00:19,862 --> 00:00:24,753growth. Dr Chokta will provide insightful advice on how to 700:00:24,794 --> 00:00:28,064improve your physical and financial health, as well as 800:00:28,123 --> 00:00:31,460your emotional and mental well-being. Whether you're 900:00:31,481 --> 00:00:35,936looking to boost your energy levels, unlock financial freedom1000:00:35,936 --> 00:00:40,228or cultivate a more positive mindset, we've got you covered. 1100:00:41,880 --> 00:00:45,901Get ready to become the best version of yourself? So let's 1200:00:45,941 --> 00:00:50,347get started. Here's Dr William Chokta, MDJD. 1300:00:51,619 --> 00:00:55,783Speaker 2: So what is sudden cardiac risk? Number one is the 1400:00:55,884 --> 00:01:00,243most common cause of death in athletes. Now let me back up and1500:01:00,243 --> 00:01:04,879put some things in perspective.This is very, very rare. This 1600:01:04,900 --> 00:01:07,599is not something that happens every day, once a month, it 1700:01:07,620 --> 00:01:10,727probably doesn't even happen once a year, which is probably 1800:01:10,748 --> 00:01:14,799why you haven't even heard of itbefore. But it does happen. And1900:01:14,799 --> 00:01:17,313the point I'm trying to make and I'll make this one, or try 2000:01:17,334 --> 00:01:21,448to make this one throughout out,especially this morning is if 2100:01:21,509 --> 00:01:25,900this athlete or this child is your child or your family member2200:01:25,900 --> 00:01:28,602, you don't care about the numbers. You don't care if it's 2300:01:28,802 --> 00:01:33,542one in 100, one in 1,000, one in50,000. You don't want it to 2400:01:33,581 --> 00:01:37,707happen to your child. So we'll talk about some mitigation 2500:01:37,748 --> 00:01:41,161things that I recommend that could be done, and even some 2600:01:41,200 --> 00:01:44,370things that I think parents can do, just sort of help with this.2700:01:44,370 --> 00:01:48,829But we'll get into that a bit later. Remember this guy this is2800:01:48,829 --> 00:01:53,454Bronny James. Bronny James, if you don't know, is the son of 2900:01:53,875 --> 00:01:57,504the great LeBron James, probablyone of the most famous 3000:01:57,563 --> 00:02:03,766basketball players in our time. Needless to say, bronny is his 3100:02:03,825 --> 00:02:11,447son same genes. So no big surprise that Bronny decides 3200:02:11,467 --> 00:02:15,843that he must follow dad's footsteps. No big surprise there3300:02:15,843 --> 00:02:20,335and he's obviously very, very good, or he wouldn't be on these3400:02:20,335 --> 00:02:24,826teams and he wouldn't have beendrafted by one of the best 3500:02:24,866 --> 00:02:28,762schools with teams in the country USC. But Bronny is the 3600:02:28,822 --> 00:02:32,875reason for this particular discussion, because Bronny is 3700:02:32,935 --> 00:02:39,200not. He's relatively unique, buthe's not that unique. And the 3800:02:39,381 --> 00:02:42,530argument that I'm going to try to make, starting now and toward3900:02:42,530 --> 00:02:47,347the end of this discussion, is we can do more, in my judgment, 4000:02:48,048 --> 00:02:54,149to protect our student athletes.My grandson is named Vincent. 4100:02:54,360 --> 00:02:57,724He's a star soccer player, all the things, whatever you want to4200:02:57,724 --> 00:03:01,925call it, graduated from high school this year as well as the 4300:03:01,965 --> 00:03:06,645way to college next year. There are hundreds, if not thousands, 4400:03:06,724 --> 00:03:11,082of athletes just like Bronny andVincent, and my point is I 4500:03:11,143 --> 00:03:17,639think we can do a better job in helping and protecting them. Now4600:03:17,639 --> 00:03:21,610, when we talk about sudden cardiac death, let's back up and4700:03:21,610 --> 00:03:25,585say but what is the most commoncause of heart problem, which 4800:03:25,645 --> 00:03:30,920is rare, okay, in young people or in athletes? And the most 4900:03:31,001 --> 00:03:35,536common cause, the most common type of heart problem in young 5000:03:35,576 --> 00:03:40,483people is something called myocarditis. Now, everything in 5100:03:41,948 --> 00:03:47,229medicine has a meaning. So when we say myo, myo means muscle 5200:03:48,901 --> 00:03:56,021Carp, c-r-d means heart and ids means inflammation of. So when I5300:03:56,021 --> 00:04:00,912say myocarditis, I'm talking about inflammation of the heart 5400:04:00,951 --> 00:04:07,360muscle, again a relatively rare problem, but it does occur. So, 5500:04:07,561 --> 00:04:13,197in general, this is considered to be the most common reason why5600:04:13,197 --> 00:04:18,009young people may very well havecardiac death in their youth. 5700:04:19,199 --> 00:04:23,370However, it is not the most common reason for sudden cardiac5800:04:23,370 --> 00:04:27,761death, which is why we're mentioning it in context and 5900:04:27,800 --> 00:04:30,867just want you to be aware of it.But myocarditis is not what 6000:04:30,887 --> 00:04:35,084we're going to talk about today.Okay, so with myocarditis and 6100:04:35,163 --> 00:04:38,151as the name implies, if you havean inflammation of your muscle,6200:04:38,151 --> 00:04:41,269let's say the heart muscle, usually you're going to have 6300:04:41,329 --> 00:04:44,257symptoms over time. You're goingto have soreness, you're going 6400:04:44,278 --> 00:04:47,982to have discomfort, you're goingto have pain. So, myocarditis 6500:04:48,101 --> 00:04:51,709reded. It is a serious problem, but it is something that occurs 6600:04:51,889 --> 00:04:56,360over time. It is something that occurs over time. What I'm 6700:04:56,401 --> 00:05:01,350talking about is sudden cardiac arrest, something that happens 6800:05:01,430 --> 00:05:04,803immediately, and this is what we're going to focus on this 6900:05:04,843 --> 00:05:11,786morning. When sudden cardiac arrest occurs and this is when 7000:05:11,867 --> 00:05:16,245you are in a crowd or you're in a store, you're out walking on 7100:05:16,264 --> 00:05:18,951the street, you're in a park and, all of a sudden, the person 7200:05:19,139 --> 00:05:22,689suddenly drops to the floor, to the ground, because the heart 7300:05:22,709 --> 00:05:28,201just stops, sudden cardiac arrest. Most of these, 7400:05:28,401 --> 00:05:32,350understandably, are going to be outside of the hospital. As you 7500:05:32,389 --> 00:05:35,601might imagine, many of these patients are not sick. Again, 7600:05:35,641 --> 00:05:38,305we're talking about athletes. They're not ill in general. 7700:05:38,920 --> 00:05:41,528They're running around like any other healthy young person would7800:05:41,528 --> 00:05:48,137be. So their survival depends on them being in a hospital or 7900:05:48,156 --> 00:05:51,226close to a hospital where they can get certain types of 8000:05:51,247 --> 00:05:54,644treatment. So what am I saying? I'm saying those types of 8100:05:54,663 --> 00:05:58,440treatments should be outside of the hospital. And then, very 8200:05:58,461 --> 00:06:04,351specifically, one is the deprivileged, the automatic 8300:06:04,391 --> 00:06:08,882deprivileged, which can easily be portable. You will see them 8400:06:08,961 --> 00:06:12,540in some airports when you go to catch your plane. You will see 8500:06:12,562 --> 00:06:15,615them in some malls, shopping malls where a lot of people are,8600:06:15,615 --> 00:06:20,726where crowds of people congregate, because anybody can 8700:06:20,807 --> 00:06:25,401subtly have a cardiac arrest if you have some pre-existing 8800:06:25,422 --> 00:06:33,108cardiac condition. So let's sortof take another look at this. 8900:06:35,660 --> 00:06:41,093The most common diagnosis in patients, young people, who have9000:06:41,093 --> 00:06:47,062sudden cardiac arrest, is what we call cardiomyopathy. Okay, 9100:06:47,406 --> 00:06:52,026cardiomyopathy. Again, let's break the word up medically 9200:06:52,307 --> 00:06:56,464Cardio. Cardio is a heart my over. We're talking about muscle9300:06:56,464 --> 00:07:01,910Opathy. We're talking about a disease of the heart and muscle 9400:07:03,021 --> 00:07:05,165and this is a disease that you're born with. It's not 9500:07:05,225 --> 00:07:07,911anything they did. It's not anything that they should or 9600:07:07,930 --> 00:07:11,086should not have reported. It's not anything that they ate or 9700:07:11,187 --> 00:07:14,420it's not an injury. They were born with. It's in their genes, 9800:07:15,000 --> 00:07:17,906it's from mom and dad and grandma and great dad and all 9900:07:17,947 --> 00:07:21,862the way up that genetic chain. Okay, and because they were born10000:07:21,862 --> 00:07:26,060with it, they don't know. They have it. They don't, and that's 10100:07:26,120 --> 00:07:30,968part of the problem. The good news is we know that the 10200:07:31,028 --> 00:07:34,300majority of these patients, these young people, could be 10300:07:34,360 --> 00:07:38,891diagnosed with a simple test called an electrocardiogram, an 10400:07:39,050 --> 00:07:42,389EKG. This is where they hook up the things to your heart and 10500:07:42,408 --> 00:07:47,305they have you lay down and then they run the strip and it just 10600:07:47,444 --> 00:07:50,009monitors your heartbeat, shows you how your heart is beating. 10700:07:50,610 --> 00:07:53,680So keep that in mind. We're going to come back to that. Most10800:07:53,680 --> 00:07:58,509of these problems could be diagnosed ahead of time by 10900:07:58,569 --> 00:08:02,543getting a basic test. I don't know how much it costs, but it's11000:08:02,543 --> 00:08:11,064not that expensive. Most sportsprograms do not do EKGs on the 11100:08:11,225 --> 00:08:15,863athletes, right? So we're going to talk about that a bit later 11200:08:15,884 --> 00:08:23,225too. And so then the issue is well, if the team won't do it, 11300:08:23,375 --> 00:08:28,017who should do it? If it's my sonor my grandson, how do I 11400:08:28,079 --> 00:08:32,216protect him. How do I make sure that everything is okay? Let's 11500:08:32,235 --> 00:08:37,201say, my kid plays club soccer and every Saturday or Saturday 11600:08:37,240 --> 00:08:40,557and Sunday they go off for a team, but for a game. How do I 11700:08:40,616 --> 00:08:46,361make sure that my 20-year-old, my 15-year-old, does not end up 11800:08:46,402 --> 00:08:50,956having acute cardiac arrest, a sudden cardiac arrest? Again, 11900:08:51,417 --> 00:08:55,578it's a rare problem based on numbers, but indeed it does 12000:08:55,620 --> 00:09:01,600happen. Just a general review Most people who have heart 12100:09:01,642 --> 00:09:06,384disease, who are adults, have what's called coronary heart 12200:09:06,404 --> 00:09:11,404disease. The coronary artery is the main artery that supplies 12300:09:11,585 --> 00:09:15,399the heart. Think of the heart asa muscle. Think about your fist12400:09:15,399 --> 00:09:19,361Heart's, about the size of yourfist ball down. It's a muscle. 12500:09:19,796 --> 00:09:23,660It pumps blood throughout the body. What makes that muscle 12600:09:23,721 --> 00:09:26,182work, among other things, is themuscle getting good blood 12700:09:26,201 --> 00:09:30,823supply. If you clog up the arteries or the canals that take12800:09:30,823 --> 00:09:34,322the blood to that muscle, that muscle won't work nearly as well12900:09:34,322 --> 00:09:37,022. And that's usually what happens as we get older and 13000:09:37,123 --> 00:09:40,956older and older and depending onour lifestyle, our eating 13100:09:41,015 --> 00:09:44,638habits, whether we exercise and not, etc. And then we end up 13200:09:44,658 --> 00:09:48,000with coronary artery disease. Young people and when I say 13300:09:48,020 --> 00:09:51,316young people I'm talking about less than 21 years of age don't 13400:09:51,376 --> 00:09:56,159have problems with the coronary artery in general. If they have 13500:09:56,200 --> 00:10:00,205heart problems, it's going to becaused by cardiomyopathy, 13600:10:00,556 --> 00:10:04,643something that they were born with Again, very rare, very rare13700:10:04,643 --> 00:10:10,196. But if it's your child, you don't care with the muscle. So 13800:10:10,297 --> 00:10:14,123who are these kids? Well as we said, they're young, less than 13900:10:14,163 --> 00:10:18,10125 years of age. They play the basic sports basketball, 14000:10:18,162 --> 00:10:23,745football. Some have theorized that because they are athletes 14100:10:25,355 --> 00:10:30,697and this is where the hormones are highest in athletes or in 14200:10:30,716 --> 00:10:34,179teenagers rather not as in teenagers that this is why 14300:10:34,201 --> 00:10:36,621there's the self-worth. No one knows whether that's true or not14400:10:36,621 --> 00:10:40,879. That's just a theory, but we do know that the body is 14500:10:40,919 --> 00:10:45,004changing at different stages of life and doing different ages, 14600:10:45,095 --> 00:10:49,197and whether that change is associated with hormone changes 14700:10:49,217 --> 00:10:52,437that normally occurs in every single child we don't really 14800:10:52,557 --> 00:10:57,360know, but it's just something tokeep in mind. So what we're 14900:10:57,399 --> 00:11:01,735talking about is the heart and heart-related problems. Again, 15000:11:01,897 --> 00:11:05,440in general, across the country, most common cause of death is 15100:11:05,480 --> 00:11:11,417heart disease. In general, across the country there is some15200:11:11,417 --> 00:11:16,157data on sudden cardiac arrest in athletes, but it's very 15300:11:16,317 --> 00:11:19,658little data. And think about that. How would you do that 15400:11:19,698 --> 00:11:23,279study? Would you go around? Would you send out 15500:11:23,320 --> 00:11:26,359questionnaires to different teams and ask them to fill it 15600:11:26,438 --> 00:11:31,505out? Fill it out? Would a coach want you to give his players 15700:11:34,195 --> 00:11:38,024information or that you want them to fill out? Or would he 15800:11:38,044 --> 00:11:40,307say you know what? We don't wantto deal with that sort of stuff15900:11:40,307 --> 00:11:42,698. We're trying to want to gain. Here we're trying to go to the 16000:11:42,739 --> 00:11:45,198state championship and you're talking about something that 16100:11:45,239 --> 00:11:49,038doesn't even happen, but one in 40,000. Thank you very much, 16200:11:49,254 --> 00:11:53,264goodbye. So my point is, the reason why we don't know a lot 16300:11:53,303 --> 00:11:57,524about this is that there's not alot of incentive, if you will, 16400:11:58,075 --> 00:12:02,080but research to be done about it. Again, I'll go back to my 16500:12:02,120 --> 00:12:06,336familiar friend. If it's your child, you don't care. You want 16600:12:06,356 --> 00:12:12,326the best for her or for him, if indeed he or she are athletic or16700:12:12,326 --> 00:12:15,437involved in athletic competition. So we have some 16800:12:15,477 --> 00:12:18,957basic information, but it's old information, and it tells us 16900:12:18,998 --> 00:12:22,080basically what we already know that if you play basketball or 17000:12:22,100 --> 00:12:25,222football or soccer or any of those high intensity sports, 17100:12:25,634 --> 00:12:29,015you're more likely to have sudden cardiac arrest than if 17200:12:29,035 --> 00:12:35,998you participate in less dramaticsports. Again, as we said, 17300:12:37,201 --> 00:12:42,317cardiac arrest is different fromheart attack and one of the 17400:12:42,337 --> 00:12:46,379things that we like to mention and we said it before heart 17500:12:46,399 --> 00:12:50,662attack is a plumbing problem. Cardiac arrest is an electrical 17600:12:50,701 --> 00:12:54,717problem Because, in addition to being a muscle, the heart also 17700:12:54,879 --> 00:13:00,940is an electrical unit. It's an electrical unit. So what do you 17800:13:00,960 --> 00:13:03,558do when you're sitting at home and all the lights go out or 17900:13:04,019 --> 00:13:07,780your TV doesn't work? You know, first thing you can call the 18000:13:07,801 --> 00:13:10,903repair people they have. First thing they'll say is unplug it 18100:13:11,034 --> 00:13:14,840and plug it back in again after five minutes. So that's what you18200:13:14,840 --> 00:13:18,384do, right, because it's an electrical unit. So what are you18300:13:18,384 --> 00:13:21,878doing? We used to call it an old-age rebooting. You know, I 18400:13:21,937 --> 00:13:25,155don't even think people use thatterm anymore. Think about it, 18500:13:25,197 --> 00:13:28,498then, because it's an electricalunit and sometimes the 18600:13:28,557 --> 00:13:30,660electrical current just don't dowhat they're supposed to do. 18700:13:30,815 --> 00:13:34,942Now I don't really understand it, but I know that more likely 18800:13:34,981 --> 00:13:37,995than not, unplugging it and plugging it back in works. So 18900:13:38,015 --> 00:13:40,600that's usually what I do. Well, the heart is sort of similar. 19000:13:41,215 --> 00:13:45,743The heart is sort of similar. Inmedicine we call that shocking 19100:13:45,942 --> 00:13:51,538the heart, we call that shock inthe heart, and we do that with 19200:13:51,558 --> 00:13:56,022the defibrillation machine, and we'll mention that a bit later. 19300:13:56,142 --> 00:13:59,135Also, one of the things I do like to mention I've mentioned 19400:13:59,155 --> 00:14:02,817this before, but I think it's always important to mention that19500:14:02,817 --> 00:14:06,298men and women experience heart attack. I'll tell my cardiac 19600:14:06,339 --> 00:14:09,884arrest now. I'll tell my heart attack which occurs in. Elderly 19700:14:09,923 --> 00:14:15,059patients or adult patients more often experience heart attack 19800:14:15,080 --> 00:14:19,796symptoms differently, and this is based on the fact that when I19900:14:19,796 --> 00:14:23,681was in medical school in the 70s, the early 70s, the studies 20000:14:23,740 --> 00:14:27,400were based on men. You know, menwere the only ones in the 20100:14:27,421 --> 00:14:32,196studies, and so what we learned,which is what triggers or 20200:14:32,255 --> 00:14:36,000stimulates our practice of medicine, was based on how men 20300:14:36,100 --> 00:14:38,677react when they have a heart attack, where you have a 20400:14:38,697 --> 00:14:41,759crushing sub-serminal chest painin the middle of the chest that20500:14:41,759 --> 00:14:45,660radiates to the right arm. What's important to understand, 20600:14:45,855 --> 00:14:49,619and what further studies have shown, is that that's not true 20700:14:50,782 --> 00:14:57,325with women necessarily, that indeed women I may not have the 20800:14:57,546 --> 00:15:01,563classic crushing sub-serminal chest pain in the middle of the 20900:15:01,624 --> 00:15:06,099chest, like somebody is sitting on your chest that then radiates21000:15:06,099 --> 00:15:10,020to the left arm, that men have.Women may come in and they may 21100:15:10,041 --> 00:15:12,457say well, you know, I just sort of feel faint, I just feel a 21200:15:12,477 --> 00:15:15,442little lightheaded, or I just been a little short of breath, 21300:15:15,554 --> 00:15:17,956and I don't really know why I'm short of breath. You know I 21400:15:17,975 --> 00:15:20,981haven't been doing anything, I haven't been exercising or 21500:15:21,001 --> 00:15:23,735whatever. Yeah, I do have some chest discomfort, but it's not 21600:15:23,775 --> 00:15:28,561horrible. Blah, blah, blah, blah, blah. An entire area as I 21700:15:28,640 --> 00:15:34,187mentioned before of medicine nowis now devoted to female 21800:15:34,349 --> 00:15:40,479cardiac health. Female cardiac health Medicine is one of those 21900:15:40,619 --> 00:15:45,582areas that evolves all the time and it will continue to evolve. 22000:15:46,216 --> 00:15:50,663It is not 100 percent today, it will not be 100 percent tomorrow22100:15:50,663 --> 00:15:55,418. So my health care? But it continues to evolve. So it's one22200:15:55,418 --> 00:15:59,679of the reasons why many times there's not a static best answer22300:15:59,679 --> 00:16:03,457for what I should do all the time for my health, but just 22400:16:03,479 --> 00:16:06,975keep that in mind. I just think that's an important factor. I 22500:16:06,996 --> 00:16:11,605might also parenthetically add that health care also is noticed22600:16:11,605 --> 00:16:17,524that very ethnic groups don't always respond the same way with22700:16:17,524 --> 00:16:21,355a heart attack. Again, it depends on your genes, it 22800:16:21,375 --> 00:16:24,981depends on your culture, it depends on your habits, and on 22900:16:25,022 --> 00:16:28,982and on and on. So diversity is more than just something 23000:16:29,043 --> 00:16:33,419socially acceptable. It's good health care, it's smart health 23100:16:33,461 --> 00:16:36,956care, it's quality health care that you need to take that into 23200:16:36,996 --> 00:16:40,884consideration and not just sort of paint everybody with the same23300:16:40,884 --> 00:16:45,775brush. One of the things that I've learned this has really 23400:16:45,816 --> 00:16:48,522been more particular since I've been doing these podcasts and 23500:16:48,562 --> 00:16:54,062masterclass discussions and research is how important he is 23600:16:54,523 --> 00:16:58,623to heart problems. Didn't reallyappreciate that five, 10 years 23700:16:58,702 --> 00:17:05,003ago, but with this year in the hottest year in the planet in 23800:17:05,084 --> 00:17:10,123our history, and whether you don't have to live in Arizona, 23900:17:10,182 --> 00:17:14,801in the desert or Palm Springs, we're supposed to be 100 degrees24000:17:14,801 --> 00:17:20,362today. It's a problem. It's a problem. The way that he hurts 24100:17:20,422 --> 00:17:24,261you is primarily, or one of the main reasons it hurts is with 24200:17:24,301 --> 00:17:28,500your heart. How does that happen? It makes your heart work more.24300:17:28,500 --> 00:17:33,457Okay, so think about it. So if your heart is weak, let's say 24400:17:33,497 --> 00:17:37,445you've got some heart disease and you take medication for it 24500:17:38,656 --> 00:17:42,782and your heart is taking care ofyou, but you now increase and 24600:17:42,823 --> 00:17:47,200triple the demand on that heart.That heart may not be able to 24700:17:47,480 --> 00:17:52,809ramp up to that level and then the heart stops and you end up 24800:17:52,829 --> 00:17:57,743having a heart attack. Okay, so my point, my bottom line, is be 24900:17:57,804 --> 00:18:01,020very, very careful of the heat. Please, please, please, drink a 25000:18:01,060 --> 00:18:05,338lot of water. Please hydrate yourself, please remember that 25100:18:05,500 --> 00:18:12,583if it's 85 degrees outside and you're in a house or in a room 25200:18:12,663 --> 00:18:17,736that's a closed space and you donot have air conditioning, it 25300:18:17,776 --> 00:18:21,875may be over 100 degrees where you are in that closed space. So25400:18:21,875 --> 00:18:26,560just in case it's 85 degrees outside, it may be 105 degrees 25500:18:26,862 --> 00:18:30,977where you are. So please be aware that. Likewise, if you're 25600:18:30,997 --> 00:18:34,476around young children, if you'rearound elderly people, make 25700:18:34,516 --> 00:18:38,941sure you double triple check on them Right. Don't assume that 25800:18:38,961 --> 00:18:42,519just because you feel okay, thatthey feel okay, they may not 25900:18:43,175 --> 00:18:46,692Right. And then, obviously, if there is any type of medical 26000:18:46,752 --> 00:18:49,983problem associated with that with the children or with the 26100:18:50,064 --> 00:18:54,778adults, it makes it worse. It makes it worse. So just please 26200:18:54,837 --> 00:18:57,137keep in mind that heat exhaustion, heat stroke, are 26300:18:57,157 --> 00:19:00,640real problems. They occur more and more People are dying from 26400:19:00,720 --> 00:19:06,977it, and so there are things thatwe can do to help them and what26500:19:06,977 --> 00:19:09,756we do with these series of discussions and whatever. We 26600:19:09,776 --> 00:19:12,761talk about what we can do, we don't talk about stuff that 26700:19:12,781 --> 00:19:15,717other people control. We talk about what we can do Either to 26800:19:15,757 --> 00:19:20,175help ourselves or maybe to reachout and help somebody else. It 26900:19:20,195 --> 00:19:25,373might be at work, or be in the park, or be at a store, or be at27000:19:25,373 --> 00:19:31,674church, or on and on and on. Solet's get back to our topic 27100:19:31,835 --> 00:19:35,198Sudden cardiac arrest in young people. Again, it's a rare, but 27200:19:35,218 --> 00:19:39,849it's a serious problem. You may remember the sudden cardiac 27300:19:39,910 --> 00:19:43,242arrest that occurred in this young man, again 20 something, 27400:19:44,315 --> 00:19:48,557but his that's way some was a little different. He was 27500:19:48,636 --> 00:19:53,396actually hit in the chest so he had a trauma. Now, most of my 27600:19:53,477 --> 00:19:58,798life I have been practicing as atrauma surgeon my job. I'm one 27700:19:58,818 --> 00:20:01,196of those guys and called in at three o'clock in the morning 27800:20:01,718 --> 00:20:06,076when somebody has been hit by a car, a shot or stab, and we get 27900:20:06,156 --> 00:20:09,865in and we get in and do what we do to try to save that person's 28000:20:09,925 --> 00:20:14,383life. One of the most common cause of death in young people 28100:20:15,144 --> 00:20:19,463in general now less than 60, less than 50, tends to be trauma28200:20:19,463 --> 00:20:25,525Cardiac disease, gunshot wounds, stab wounds, falls, et cetera,28300:20:25,525 --> 00:20:30,121et cetera, et cetera. But in this case, this particular type 28400:20:30,261 --> 00:20:35,718of cardiac arrest was caused by a sudden blow to the heart which28500:20:35,718 --> 00:20:40,087, is believed, interrupted the electrical system of the heart. 28600:20:40,555 --> 00:20:45,715Ok, it's like again, your TV is plugged into the wall but you 28700:20:45,736 --> 00:20:49,665take scissors and you cut the cord or you hit it very hard. 28800:20:50,255 --> 00:20:54,546You may interrupt the flow of that electricity and cause that 28900:20:54,727 --> 00:21:03,208area to not function properly. So what are some of the symptoms29000:21:03,208 --> 00:21:08,560of sudden cardiac arrest? Now you're saying, okay, dr Chakta, 29100:21:08,579 --> 00:21:11,267you're saying sudden, but now you're talking about symptoms 29200:21:11,674 --> 00:21:14,001and what I'm talking about is. I'm talking about immediate 29300:21:14,041 --> 00:21:17,497symptoms. Let me give you a hypothetical. Let's say I'm 29400:21:17,517 --> 00:21:20,628coach of a soccer team. You can tell I talk a lot about some. 29500:21:21,316 --> 00:21:25,260That's what I'm going to do. Butlet's say I'm coach of a soccer29600:21:25,260 --> 00:21:30,444team, all right, and there's Johnny who I think is just sort 29700:21:30,464 --> 00:21:35,843of a cut up. I think he just doesn't. He's a good player but 29800:21:36,384 --> 00:21:40,636he doesn't work as hard as he should work. And so after 29900:21:40,676 --> 00:21:43,846practice I have all the players to run around the field twice 30000:21:45,794 --> 00:21:50,036before they go in to get ready to go home. And so on this 30100:21:50,116 --> 00:21:52,804particular day, I tell him to dothe same thing to run around 30200:21:52,824 --> 00:21:57,824the field. Johnny runs about halfway on the field and then 30300:21:57,884 --> 00:22:02,537stops. And I go up to Johnny andI said what's your problem? He 30400:22:02,557 --> 00:22:05,119said oh, coach, I'm just tired. I said well, everybody's tired. 30500:22:05,755 --> 00:22:13,767I said if you want to be in, boppe or Messi, or, or, or, what30600:22:13,767 --> 00:22:16,654, what, what are the great players? You got a question and 30700:22:16,694 --> 00:22:20,955think about that's. That's the culture of sports, right, sports30800:22:20,955 --> 00:22:23,923, and, and you know, superstar athletes. They pushed themselves30900:22:23,923 --> 00:22:28,356beyond the limits. That's what we expected of them. When, when,31000:22:28,356 --> 00:22:32,791when Mahomes spins around like a top five times and jumps up 31100:22:33,133 --> 00:22:37,326and throws the football a hundred yards and hits them by 31200:22:37,346 --> 00:22:41,662the end zone and wins the game, we said, wow, how did he do that31300:22:41,662 --> 00:22:46,516? You know, so we expect miracles from our athletes. My 31400:22:46,576 --> 00:22:51,570point is very simple, is that, particularly with children, we 31500:22:51,590 --> 00:22:55,544need to dial it back a more uponthat. Sometimes, when little 31600:22:55,585 --> 00:22:58,434John is saying that he may really have a problem, he may 31700:22:58,576 --> 00:23:02,830not just be trying to get out ofdoing his job, because some of 31800:23:02,851 --> 00:23:07,281the early symptoms they're usually free is they may be more31900:23:07,281 --> 00:23:11,176, more exhausted than normal forthem. They may be more short of32000:23:11,176 --> 00:23:16,076breath so that they aren't ableto complete the task. They may 32100:23:16,096 --> 00:23:19,502feel dizzy or faint, which certainly you wouldn't expect in32200:23:19,502 --> 00:23:23,363a 15 year old or a 16 year old.They may complain of chest pain32300:23:23,363 --> 00:23:26,728. So my point is and this is probably really more for the 32400:23:26,748 --> 00:23:31,241coaches than and the people who work with groups of youth just 32500:23:31,321 --> 00:23:36,884be cognizant of that fact. I'll I'll. I'll give an example, 32600:23:38,134 --> 00:23:40,624another of yours I mentioned. I'm a trauma surgeon, a friend 32700:23:40,663 --> 00:23:46,163of mine who worked at Mount San Antonio College. I was a trainer32800:23:46,163 --> 00:23:49,182. She was a trainer and she would be a trainer for a lot of 32900:23:49,202 --> 00:23:52,699the high school football games and her job would be to be on 33000:23:52,719 --> 00:23:56,974the field on the sidelines and if someone gets hurt or, you 33100:23:57,015 --> 00:24:00,903know, a sprains the leg or brains or whatever, she would go33200:24:00,903 --> 00:24:04,737out and do whatever the trainers do whatever. But he 33300:24:04,757 --> 00:24:07,845came to me one day and she said Dr Chalka, I need you, I need 33400:24:07,884 --> 00:24:12,960you. I said okay. She said wouldyou be interested in sort of 33500:24:13,039 --> 00:24:18,115working with me on the sidelinesfor high school games? I said 33600:24:18,636 --> 00:24:23,559you know, I'm really pretty busy. I don't really have a lot of 33700:24:23,599 --> 00:24:27,837time I deal with that. But she pushed me. She said you know, 33800:24:27,857 --> 00:24:32,378she said I'm worried. She said I'm really worried, and this is 33900:24:33,162 --> 00:24:39,72020 years ago. She said these kids get hit out there. And she 34000:24:39,759 --> 00:24:43,701said I'm not a doctor. She said but I'm not sure they should be 34100:24:43,721 --> 00:24:46,440going back into these games. Coach, that's okay, you'll be 34200:24:46,500 --> 00:24:50,196all right. You know they spray this or give them whatever. Okay34300:24:50,196 --> 00:24:53,247, get back in the game, get backin the game. And she said I'm a34400:24:53,247 --> 00:24:57,801little nervous. I'm a little nervous. Well, as the trainer, 34500:24:57,843 --> 00:25:01,416we sort of reached the compromise. One of the schools 34600:25:01,457 --> 00:25:05,325that she was the trainer was a school where my son is an 34700:25:05,465 --> 00:25:15,715athlete. Okay, I said, talk to me. I said okay, talk to me this34800:25:15,715 --> 00:25:19,439is no Galas high school. And hedecided, of course I was 34900:25:19,479 --> 00:25:24,560against it. He decided he wantedto play football. I said, oh 35000:25:24,621 --> 00:25:28,717God, you're in the world, I'm a trauma surgeon, why do you want 35100:25:28,737 --> 00:25:34,923to play football? But okay, okay, I'm trying to be a good parent35200:25:34,923 --> 00:25:38,397, I'm trying to meet him halfwayyou know, what I mean. And I 35300:25:38,438 --> 00:25:42,398said okay, okay, okay. I said please be careful. So I told 35400:25:42,439 --> 00:25:45,840Cassandra, this is the trainer. I said I will do, because she 35500:25:45,901 --> 00:25:49,596also didn't know Galas. I said Iwill do it, for no, galas, I 35600:25:49,635 --> 00:25:54,946will be on the field for the team that my son plays on Friday35700:25:54,946 --> 00:26:00,173nights. So she said okay, okay,and the coaches were very nice,35800:26:00,173 --> 00:26:04,097they were very, very nice. And I went in with one and I told 35900:26:04,117 --> 00:26:08,961the coaches, I said if I say no,he's out, no discussion, no 36000:26:09,202 --> 00:26:13,957argument, no, it ends above. I said uh-uh, we clear Coach said 36100:26:13,977 --> 00:26:17,097yes, doctor, whatever, you say no problem, no problem. And they36200:26:17,097 --> 00:26:19,180were, they were extreme. And I said we were very, very nice. 36300:26:20,256 --> 00:26:26,006But I said all that to say that sometimes our kids are in more 36400:26:26,066 --> 00:26:29,580peril than we think they are. You know, we all like the game, 36500:26:30,056 --> 00:26:33,497I love football and I love soccer, whatever but sometimes, 36600:26:33,876 --> 00:26:38,928sometimes, there's another side of that that we can improve 36700:26:38,988 --> 00:26:43,759about and I just wanted to sort of make that. So what should we 36800:26:43,779 --> 00:26:46,903do? Okay? So, dr Huffington, going on and on for the next 36900:26:47,203 --> 00:26:51,236couple of minutes, what is it wecan do? I'm just a mom, I'm 37000:26:51,256 --> 00:26:54,862just a dad, I go out and I take my folding chair and I sit it 37100:26:54,902 --> 00:27:00,261down and I share for my son. I must admit I was particular with37200:27:00,261 --> 00:27:03,816my kids. Now I watch my grandkids, but with my kids I 37300:27:03,855 --> 00:27:08,837was one of those parents that you how would you say? Not 37400:27:08,877 --> 00:27:11,825necessarily that you would want to come to a game, but I was 37500:27:11,865 --> 00:27:17,930very engaged and my son, the big, impressive, who lives in San 37600:27:17,950 --> 00:27:20,921Diego, was actually a superstar.I'm not just saying that 37700:27:20,942 --> 00:27:26,057because he was a superstar, but he really was a superstar and he37800:27:26,057 --> 00:27:31,844was very, very fast. So he played on offense, used a center37900:27:31,844 --> 00:27:35,377forward and the teams knew thatso they would double, triple 38000:27:35,397 --> 00:27:39,560team and that sort of thing, butwhen he would get the ball he 38100:27:39,580 --> 00:27:43,961would take off. And when he would take off on the field, I 38200:27:44,000 --> 00:27:48,980would take off on the side. It'slike true confection. So he's 38300:27:49,000 --> 00:27:52,723running on the field. I'm running on the side of the golf 38400:27:52,763 --> 00:27:55,875wrestling golf, and he's like, yeah, I'm going to run on the 38500:27:55,895 --> 00:27:58,262side of the golf. And now I'm yelling at the other team you 38600:27:58,323 --> 00:28:06,781can't catch him, he's too fast. I saw him on paper, my son. And 38700:28:06,801 --> 00:28:09,815so what they do? They knock him down. That's what soccer players38800:28:09,815 --> 00:28:13,208do. If they can't catch him, they trip you. You don't believe38900:28:13,208 --> 00:28:17,656that. You watch it in the program. Anyway, I digress. So 39000:28:17,676 --> 00:28:21,096what's my point is that soccer is an exciting game. Sports is 39100:28:21,156 --> 00:28:24,365an exciting thing, but we have to look at how we can protect 39200:28:24,444 --> 00:28:29,624our kids. So we have to be awarethat there are things that we 39300:28:29,644 --> 00:28:32,839can do, the better we are doing.So what are some of the things 39400:28:32,859 --> 00:28:37,559that we can do? I recommend these. This is just me. Whatever39500:28:37,559 --> 00:28:41,691sports your child plays for, this high school or club sports 39600:28:42,192 --> 00:28:46,078that they should have a physicalexam. Now, most times that I 39700:28:46,118 --> 00:28:49,478think it's probably a rule they do have a physical exam. You 39800:28:49,498 --> 00:28:52,589know, I think I remember in my office and wronged it many years39900:28:52,589 --> 00:28:56,844ago I used to do the exams of different teams who played in 40000:28:56,864 --> 00:29:01,175the area. So I think they do geta physical exam. But if you do 40100:29:01,195 --> 00:29:05,355a good physical exam, number onenot just check the boxes it 40200:29:05,375 --> 00:29:08,083should be something like oh, youasked questions about it, do 40300:29:08,103 --> 00:29:10,298your knowledge? Is anybody in your family ever had heart 40400:29:10,380 --> 00:29:14,041problems? Do your knowledge? They may not know and that's 40500:29:14,122 --> 00:29:18,199okay, but at least it should be more than that. But my record I 40600:29:18,219 --> 00:29:22,160think kids should get EKJs and Irealize that that's just you 40700:29:22,180 --> 00:29:25,996know. People can go crazy with that Because for a number of 40800:29:26,037 --> 00:29:29,885reasons, number one is the rare problem that's sudden cardiac 40900:29:29,945 --> 00:29:36,577arrest. Most kids aren't going to have it and I'm sure that the41000:29:36,577 --> 00:29:40,106last thing a high school coach wants to think about or wants 41100:29:40,186 --> 00:29:44,222parents think about, or a club coach wants parents think about 41200:29:44,323 --> 00:29:48,659is oh my God, my son adored me and I've had heart problems. 41300:29:49,040 --> 00:29:52,701Blah, blah, blah, blah, blah. Again, I realize that that's 41400:29:52,760 --> 00:29:56,836challenging, but I go back to myoriginal point. If it's your 41500:29:56,855 --> 00:30:02,317child or if it's your grandchild, you don't care. You want zero 41600:30:02,858 --> 00:30:07,748chance of harm to your child, oryour and not only your child, 41700:30:07,788 --> 00:30:10,923to your neighbor's child, your friend's child or whatever. 41800:30:11,795 --> 00:30:14,836Nobody wants injury or problems to occur with kids. So my first 41900:30:14,876 --> 00:30:18,556recommendation is they have a good history and physical. My 42000:30:18,576 --> 00:30:23,205second recommendation they have an EKJ active screening test. 42100:30:23,226 --> 00:30:26,018That's a screening test. Now some are well, you know it's too42200:30:26,018 --> 00:30:29,345expensive and and you know these things don't have a lot of42300:30:29,345 --> 00:30:32,961money and that may be true, butI'd say I've seen a lot of kids42400:30:32,961 --> 00:30:38,096on the on the corner with signsfor car washes, to get uniforms42500:30:38,096 --> 00:30:43,086and to get this, and that you know, I think folks are doing 42600:30:43,105 --> 00:30:46,902for something more substantive. Or, you know, I think parents 42700:30:46,961 --> 00:30:49,980can do it. Parents can get to get their parent meetings, their42800:30:49,980 --> 00:30:53,798their teen moms and teen dads. There's no way in the world you 42900:30:53,817 --> 00:30:58,296can't get together and raise money to buy a little tiny EKJ 43000:30:58,336 --> 00:31:02,765machine and have someone make sure they use it each season for43100:31:02,765 --> 00:31:08,355the kids. People should be educated about risk factors. And43200:31:08,355 --> 00:31:13,486my third suggestion is everybody, everybody, everybody 43300:31:13,747 --> 00:31:19,703should know CPR. Let me say thatagain Everybody should know CPR43400:31:19,703 --> 00:31:22,880. I was absolutely delighted. I got an email from I think it was43500:31:22,880 --> 00:31:27,825Shelley Shaw, the church. Here they have a CPR test and I said 43600:31:27,946 --> 00:31:33,630yes yes, go play, steven. I think that's what why? Why, 43700:31:34,214 --> 00:31:37,959number one, there is no downside. There's no downside to knowing43800:31:37,959 --> 00:31:43,642CPR. And, who knows, you may bethe one on a field somewhere 43900:31:44,223 --> 00:31:48,156where a kid drops or an adult drops and people sort of stand 44000:31:48,176 --> 00:31:50,169around looking because they don't know what to do and 44100:31:50,209 --> 00:31:52,519they're afraid, and they're afraid to touch or whatever. 44200:31:52,539 --> 00:31:55,481Whatever you may be the ones that you know, okay, you turn 44300:31:55,521 --> 00:31:58,461them over. You do the things that you know to do, to do CPR. 44400:31:59,295 --> 00:32:02,082So please, please, please, take the class that you have not get 44500:32:02,142 --> 00:32:06,682certified. So my third recommendation is that you'd be 44600:32:06,781 --> 00:32:10,519some adult on these teams I don't care whether school team 44700:32:10,679 --> 00:32:16,622or club team. That's a certifiedCPR person, you just need one. 44800:32:17,115 --> 00:32:22,419But but gotta go to every game. Gotta go to every game. Cpr, and44900:32:22,419 --> 00:32:25,204I won't go into a lot of detail. Cardiopulmonary resuscitation 45000:32:25,244 --> 00:32:29,864is what it stands for, basic things a third compression and 45100:32:29,884 --> 00:32:33,382two breaths Again, take the class and then you'll learn 45200:32:33,521 --> 00:32:36,538specifically what it's about. The other thing that we talk 45300:32:36,578 --> 00:32:39,818about is the deep privilege. It's a little thing in a cute 45400:32:39,838 --> 00:32:44,259little green case like this is not that big, you know. I think 45500:32:44,499 --> 00:32:48,554every, every game, one of these things should be in the audience45600:32:48,554 --> 00:32:51,102, somewhere. They could be on the culture side or it could be 45700:32:51,142 --> 00:32:55,817with a parent, but you gotta go to every game. These are not 45800:32:55,836 --> 00:32:58,894difficult to use, basically. Youopen them up. Open them up, 45900:32:58,994 --> 00:33:01,902they tell you what to do, but inessence they're they have like 46000:33:01,922 --> 00:33:05,559two little sticky pads and you put them in different places on 46100:33:05,579 --> 00:33:09,661the chest and you push the button Again, unplugging your TV46200:33:09,661 --> 00:33:13,343when it goes out. You know, andwhat you're doing is you're 46300:33:13,442 --> 00:33:17,759shocking the heart's electrical unit to get it beating again, 46400:33:18,954 --> 00:33:24,145and if you can do that, you justsaved the person's life. Done, 46500:33:24,646 --> 00:33:29,497okay. So why wouldn't one want to do that? Why wouldn't one 46600:33:29,537 --> 00:33:32,734want to do that? You do not haveto be a doctor, you do not have46700:33:32,734 --> 00:33:36,788to be a nurse, you can just be a concerned person. You know? 46800:33:37,529 --> 00:33:41,938And again, that fits within our Massaclass podcast. We're 46900:33:41,958 --> 00:33:44,490talking about changing the world, we're talking about knowledge 47000:33:44,529 --> 00:33:48,926and power. We're talking about Iam my brother's keeper, or my 47100:33:48,967 --> 00:33:53,335sister's keeper, or my grandchild's grandson or 47200:33:53,355 --> 00:33:57,827granddaughter's keeper, okay. Sothis is something that is 47300:33:57,867 --> 00:34:04,395doable. I realize it is challenging, I realize that. So 47400:34:04,455 --> 00:34:12,878what we want to do is we want zero cardiac arrest, with 47500:34:13,018 --> 00:34:16,449efforts. Again, going back to what we said in the beginning. 47600:34:16,469 --> 00:34:20,943Again, when we go into the hospital we tell the chiefs of 47700:34:20,983 --> 00:34:30,355staffs and the CEOs and say you know what? You guys had 2% risk.47800:34:30,355 --> 00:34:38,769This year. You had 98% good results. We want 100. 98 is good47900:34:38,769 --> 00:34:42,197, but we want 100. Now what are we saying? We're raising the 48000:34:42,237 --> 00:34:46,690standards, we're raising the goals. I think my grandchild is 48100:34:46,731 --> 00:34:52,206worth 100%. I think my kid is worth 100%. I don't want 98%, 48200:34:52,427 --> 00:34:58,15797%, 96%. We were talking earlier because the brother 48300:34:58,257 --> 00:35:03,235Collin is from the Air Force industry before he retired the 48400:35:03,275 --> 00:35:07,266people who left with a lot of this quality management and 48500:35:07,467 --> 00:35:14,838Jesse also is aware of this, he's an AT&T former employee Our48600:35:14,838 --> 00:35:16,989people, particularly the airline industry, who figured 48700:35:17,168 --> 00:35:22,869out that if we can't keep planesin the sky, people will not fly48800:35:22,869 --> 00:35:25,994. Does that make sense? We're talking about basic stuff here, 48900:35:26,155 --> 00:35:31,371right? If I have a business and my business is flying you from 49000:35:31,913 --> 00:35:36,329Los Angeles to Chicago, but every third one of my planes 49100:35:36,449 --> 00:35:39,679falls out of the sky, you're notgoing to fly, which I have. A 49200:35:39,699 --> 00:35:41,170lot of things. 49300:35:41,652 --> 00:35:43,860Speaker 4: It's not that you don't like me, it's not that I'm49400:35:43,860 --> 00:35:44,603not a nice person. 49500:35:44,643 --> 00:35:51,155Speaker 3: You said Dr Chachot, you need to get the quality out.49600:35:51,155 --> 00:35:51,15549700:35:51,295 --> 00:35:55,164Speaker 2: I'm not going to takethat risk. Why in the world 49800:35:55,186 --> 00:35:58,371would we take the risk without trickery? I realize it made me a49900:35:58,371 --> 00:36:05,592little radical. What am I recommending? Again, I'm just 50000:36:05,652 --> 00:36:09,945about done Zero risk. All the kids should have history and 50100:36:09,965 --> 00:36:17,496physicals. The kids should have screening EKGs. I think that 50200:36:17,617 --> 00:36:24,092parents should basically approach the coach and suggest 50300:36:24,112 --> 00:36:30,465them Let me call it a party. If you are a soccer mom or a soccer50400:36:30,465 --> 00:36:35,956dad, do not I repeat, do not goto your son's soccer goal and 50500:36:35,976 --> 00:36:41,873say hold on, why don't you guys have an EKG? My son didn't get 50600:36:41,934 --> 00:36:48,411an EKG. Mad back all these kids.The coach is going to run for 50700:36:48,431 --> 00:36:52,619you. She's going to run for you.You have to be diplomatic. You 50800:36:52,639 --> 00:36:59,422can say I listened to this presentation or this podcast and50900:36:59,422 --> 00:37:02,188this speaker was talking about this net. I could get the 51000:37:02,208 --> 00:37:07,137parents together and we could purchase an EKG. If we did that,51100:37:07,137 --> 00:37:11,842could we set up a way? My next door neighbor is a doctor and he51200:37:11,842 --> 00:37:15,490said he'd be willing to do it for free. You have to help the 51300:37:15,510 --> 00:37:19,746coaches out. That makes sense, because your goal is to help the51400:37:19,746 --> 00:37:23,322child. You don't want to scare the coach to death. Your goal is51500:37:23,322 --> 00:37:26,030to help the child. Sometimes you have to be a little 51600:37:26,050 --> 00:37:29,867diplomatic about it the same thing you purchased in the 51700:37:29,907 --> 00:37:32,833D-privileged Again. I'm sure theD-privileged is a little more 51800:37:32,893 --> 00:37:36,849expensive, but they are horrible, horrible, expensive. I think 51900:37:36,949 --> 00:37:40,757every team should have one. ThatD-privileged should be carried 52000:37:41,164 --> 00:37:45,215by a parent or an adult. It should be somebody who is going 52100:37:45,235 --> 00:37:50,788to be at every game. I think that's the end. You have to know52200:37:50,788 --> 00:38:01,990how to use it. That's the bottom line. In summary, most 52300:38:02,231 --> 00:38:07,360sudden cardiac arrests are very,very rare. When they occur, the52400:38:07,360 --> 00:38:11,016most common reason for their occurrence is hypertrophic 52500:38:11,036 --> 00:38:14,666cardiac myopia. This is the weakness of the heart. Most of 52600:38:14,768 --> 00:38:19,061it is congenital. It is not something that's related to diet52700:38:19,061 --> 00:38:22,331or exercise or injury. It's something that they were born. 52800:38:23,675 --> 00:38:28,447It most commonly occurs in kids or athletes who are less than 2552900:38:28,447 --> 00:38:33,677years of age. It's a cardiac arrest which is an electrical 53000:38:33,717 --> 00:38:37,036problem. It's not like a heart attack, which is a plumbing 53100:38:37,076 --> 00:38:40,266problem where the arteries to the heart get clogged up with 53200:38:40,286 --> 00:38:48,219cholesterol. The treatment requires CPR because again, the 53300:38:48,260 --> 00:38:52,838heart has stopped. The heart hasstopped. Then we get into the 53400:38:52,878 --> 00:38:56,367definition of what's the definition of death. The 53500:38:56,387 --> 00:39:00,074definition of death medically usually depends on the brain, 53600:39:02,117 --> 00:39:05,150the reason why we don't call that death when the heart stops 53700:39:05,791 --> 00:39:10,387because you've got a few minutes, just a few, to get that blood 53800:39:10,447 --> 00:39:15,777back to the brain, because it's a brain death that in hospitals 53900:39:15,797 --> 00:39:19,358there may be some organizations that go back to it. That's when 54000:39:19,559 --> 00:39:24,914we get into the thing about brain death or death. That's why54100:39:24,914 --> 00:39:28,664we don't call I don't call sudden cardiac arrests, somebody54200:39:28,664 --> 00:39:31,934who doesn't know what it does, because they aren't dead. They 54300:39:31,954 --> 00:39:35,110aren't dead but you've got very little time. That's why you need54400:39:35,110 --> 00:39:37,844to be certified, you need to know what you're doing. You 54500:39:37,864 --> 00:39:41,954don't have a lot of whatever. Again, when I went into the 54600:39:41,974 --> 00:39:46,152emergency room, that was no discussion, that was no meeting,54700:39:46,152 --> 00:39:50,949that was no voting. I said A, b, c, d and it would be done. The54800:39:50,949 --> 00:39:53,275team would get it done and the team would end up saving the 54900:39:53,315 --> 00:39:59,452patient. Preventive measures again, they should have good 55000:39:59,492 --> 00:40:02,606health and physicals they all do, I'm sure, health and physical 55100:40:02,646 --> 00:40:06,679screenings, but they need to be quality. Additionally, I 55200:40:06,760 --> 00:40:10,911recommend they should have screening EKGs. The AED, the 55300:40:10,951 --> 00:40:15,885defibrillator, again should be included in the CPR class and 55400:40:15,925 --> 00:40:20,815folks should know how to do that. Our goal is basically zero 55500:40:20,835 --> 00:40:26,592cardiac arrest for our children.My basic principle God is in 55600:40:26,612 --> 00:40:30,907charge. I'm a position of faith and I believe, but for God being55700:40:30,907 --> 00:40:35,356in my life, I would not be blessed the way I am, and he 55800:40:35,398 --> 00:40:42,059continues to bless me each day. I do not have any bad days. I 55900:40:42,199 --> 00:40:46,248used to have bad days, but about30 years ago, pastor Revis, I 56000:40:46,268 --> 00:40:51,179decided that I don't need any more bad days, so I got rid of 56100:40:51,259 --> 00:40:59,016all of them. I got rid of all ofthem and so now I have good 56200:40:59,056 --> 00:41:03,952days and I have great days. If it is raining, it's a great day.56300:41:03,952 --> 00:41:08,789If the sun is shining, it's a great day. What's my point? It's56400:41:08,789 --> 00:41:12,722how you look at it. It's how you look at having to do with 56500:41:12,742 --> 00:41:16,572the day. It's your perspective. If it's not working for you, 56600:41:16,612 --> 00:41:20,507change your perspective. You have that control. Don't sweat 56700:41:20,527 --> 00:41:24,496the small stuff. Most stuff is small. Frequently I use the 56800:41:24,516 --> 00:41:29,713stress. I still stress, but I just don't stress much about 56900:41:29,753 --> 00:41:32,128things that would happen. I sortof figure out that most of the 57000:41:32,168 --> 00:41:35,795time when I said most, I'm talking about 90, 95% of the 57100:41:35,815 --> 00:41:40,833time what I was stressing about was small and insignificant. So 57200:41:40,893 --> 00:41:44,208I learned to let those things go, for givenness is therapy. 57300:41:44,248 --> 00:41:49,358Principle number four when I perceive that something has 57400:41:49,438 --> 00:41:52,150happened or someone has said something to me that's negative 57500:41:52,891 --> 00:41:57,168in some way. I have learned to forgive immediately. It does not57600:41:57,168 --> 00:42:00,536matter what the facts are, I don't care, it does not matter 57700:42:00,577 --> 00:42:03,230who did what to do, who was right and who was wrong. Just 57800:42:03,289 --> 00:42:07,485forgive, just forgive, and you'll be amazed that by doing 57900:42:07,527 --> 00:42:11,494that, out therapeutics that is not only for the other person, 58000:42:11,514 --> 00:42:16,291but it's also therapeutic for you. And finally, my final basic58100:42:16,291 --> 00:42:19,806principle is everything is relationship. Relationships are 58200:42:19,826 --> 00:42:22,914based on three things Mutual stack, mutual trust and good 58300:42:22,954 --> 00:42:28,974communication. If you are in a good relationship, if you have 58400:42:29,014 --> 00:42:32,369good communication, you have those three things. You're in a 58500:42:32,409 --> 00:42:36,304good relationship. If you do nothave those three things, then 58600:42:36,324 --> 00:42:42,297you have work to do. Let me alsosay that this series is part of58700:42:42,297 --> 00:42:49,494the Health and Wealth and Wise podcast. This podcast comes out 58800:42:49,755 --> 00:42:59,635almost weekly. The subscription website wwwBudsproutcom 2101003.58900:42:59,635 --> 00:43:03,762I would encourage you to subscribe. All of these 59000:43:03,961 --> 00:43:08,112presentations are on podcasts, and so if you want to go back 59100:43:08,172 --> 00:43:10,847over something two or three or four times, just for your own 59200:43:10,867 --> 00:43:17,429leisure, listen to them on the podcast. Finally, be the change 59300:43:17,869 --> 00:43:20,896you want to see in the world. Are there any questions? 59400:43:23,264 --> 00:43:25,612Speaker 1: We do have a questionfrom online, okay. 59500:43:39,757 --> 00:43:42,179Speaker 2: Next. Okay, good, yes, I think they said Patricia. 59600:43:47,050 --> 00:43:48,074Okay, go ahead, pat. 59700:43:51,731 --> 00:44:00,628Speaker 4: No, you're a miracle.You're a miracle. I'm nice and 59800:44:00,648 --> 00:44:01,150I'm mean. 59900:44:03,027 --> 00:44:03,831Speaker 2: Matt, are you there? 60000:44:05,474 --> 00:44:05,695Speaker 4: Yes. 60100:44:06,648 --> 00:44:07,371Speaker 2: Okay, go ahead. 60200:44:13,367 --> 00:44:13,929Speaker 3: What are you doing? 60300:44:20,661 --> 00:44:25,760Speaker 2: I'm still not able tohear you. Pat, Looks like 60400:44:25,780 --> 00:44:26,483you're keeping you. 60500:44:33,146 --> 00:44:33,949Speaker 4: Snap to the ground. 60600:44:36,259 --> 00:44:37,855Speaker 3: Okay Is. 60700:44:37,936 --> 00:44:43,349Speaker 2: Pat talking. Go ahead, go ahead, pat, hold on, we're 60800:44:43,369 --> 00:44:46,010coming to you, go ahead. 60900:44:47,309 --> 00:44:49,827Speaker 4: You're doing what church needs. God forbid. 61000:44:49,847 --> 00:44:54,391Someone is going to the park. Iseveryone at the church 61100:44:54,431 --> 00:45:00,795connected? You're doing what church should do. 61200:45:03,047 --> 00:45:04,914Speaker 2: You mean, like the deep regulator that we were 61300:45:04,934 --> 00:45:09,911talking about? It's a regulator.I honestly don't know what we 61400:45:10,050 --> 00:45:10,472have here. 61500:45:11,864 --> 00:45:12,909Speaker 4: I thought it was one here. 61600:45:14,467 --> 00:45:19,168Speaker 2: Oh, yes, I'm leaving,I'm going to get a bite of the 61700:45:19,208 --> 00:45:26,809K-tron, they're telling me, my wife's saying yes, so I guess I 61800:45:27,010 --> 00:45:27,771have to believe that. 61900:45:30,447 --> 00:45:34,873Speaker 1: As a matter of fact, since Rob is in question, with 62000:45:34,893 --> 00:45:35,795similar to that. 62100:45:36,135 --> 00:45:38,449Speaker 2: Go ahead, Pat. Is sheeducated? 62200:45:38,469 --> 00:45:43,789Speaker 1: that she asked is there consideration in 62300:45:43,809 --> 00:45:46,155purchasing an AED for the church? 62400:45:47,266 --> 00:45:50,090Speaker 2: Pat, I'll address that. I do not know, but I was 62500:45:50,150 --> 00:45:55,490starting to recommend that they,like the nursing ministry or 62600:45:55,510 --> 00:46:00,911some of the ministries, put thatinto motion, since we want to 62700:46:00,931 --> 00:46:01,474get to church, okay. 62800:46:01,925 --> 00:46:03,773Speaker 1: I think over here thenurse station is right. 62900:46:04,547 --> 00:46:07,367Speaker 2: It's one there, but they can double check. Okay, pat63000:46:07,367 --> 00:46:11,152, could you do me a favor? Couldyou double check and see if 63100:46:11,172 --> 00:46:14,382they do have one? Okay. 63200:46:15,126 --> 00:46:18,824Speaker 3: I've been to one before and it wasn't accepted. 63300:46:21,556 --> 00:46:24,126Speaker 2: But I think, now thatwe have a question, yeah, we 63400:46:24,186 --> 00:46:27,552are going to see the other person, okay, and then it's team63500:46:27,552 --> 00:46:27,552. 63600:46:28,034 --> 00:46:28,856Speaker 3: B yes. 63700:46:28,916 --> 00:46:29,197Speaker 4: Yeah. 63800:46:33,090 --> 00:46:35,476Speaker 3: Yes, we have a question. 63900:46:38,670 --> 00:46:41,465Speaker 2: Pat, can I give you asuggestion. If you have any 64000:46:41,525 --> 00:46:48,525difficulty with that, would you let me know? I said, if you have64100:46:48,525 --> 00:46:51,371any difficulty with them getting the AED, would you let 64200:46:51,411 --> 00:46:59,090me know. Okay, okay, okay, no problem, any other questions? 64300:46:59,512 --> 00:47:04,817Speaker 4: Answer yes, you mentioned being born, I guess, 64400:47:04,836 --> 00:47:11,483with a partner it's a really good but substantially normal. 64500:47:12,447 --> 00:47:19,795Speaker 3: About 25 years ago I got a new one. I guess it was 64600:47:19,815 --> 00:47:23,768born. Okay, it's born. 64700:47:23,788 --> 00:47:30,376Speaker 4: and then, by the timeit changes it's going to take a64800:47:30,376 --> 00:47:31,898year? 64900:47:32,079 --> 00:47:40,065Speaker 2: I do. It's a long time ago, right? So is it so? A 65000:47:40,106 --> 00:47:45,396partner, a partner, a partner, apartner, a partner, a partner? 65100:47:45,416 --> 00:47:49,588Yes, I suspect he probably was Okay. And again, remember, if 65200:47:49,628 --> 00:47:53,864you're an athlete, particularly if you're a superstar athlete, a65300:47:53,864 --> 00:47:57,427professional athlete, you're inexcellent physical condition. I65400:47:57,427 --> 00:47:59,994mean, you've had a lot of training, a lot of this and that65500:47:59,994 --> 00:48:06,054, and so my surmise would be that it probably was a 65600:48:06,074 --> 00:48:11,251congenital problem and that's why it didn't show up on some of65700:48:11,251 --> 00:48:15,766those other types of tests. I don't know why, and I think also65800:48:15,766 --> 00:48:18,735that's an example of what I wasmentioning earlier that our 65900:48:18,815 --> 00:48:21,791knowledge I'm talking about in healthcare now continues to 66000:48:21,871 --> 00:48:25,291evolve. You know, probably back then people didn't pay that much66100:48:25,291 --> 00:48:28,648attention to it. I think clearly people are paying more 66200:48:28,688 --> 00:48:29,371attention now. 66300:48:32,557 --> 00:48:37,132Speaker 3: CPO. Come on, let's just say Humbay CPR. 66400:48:42,514 --> 00:48:43,255Speaker 4: Oh, I see. 66500:48:48,371 --> 00:48:50,695Speaker 2: We've got spotters who are running around the 66600:48:50,715 --> 00:48:53,989church trying to find the AED, see if they have a good idea. 66700:48:54,885 --> 00:48:57,757But no, I mean. But to go back to your part, brother Kate, I 66800:48:57,797 --> 00:49:00,567think that's exemplary of what Iwas talking about. We're still 66900:49:00,586 --> 00:49:04,851learning about a lot of this stuff and, unfortunately, a lot 67000:49:04,891 --> 00:49:08,202of times, when people don't knowwhy things happen or base 67100:49:08,242 --> 00:49:11,710hearings about it, we tend to want to go back to a default 67200:49:11,751 --> 00:49:15,438position, the thumb belief system. That's probably wrong. 67300:49:15,905 --> 00:49:19,161Well, all those people like so-and-so, they always get you 67400:49:19,181 --> 00:49:22,438know that sort of thing which isnot based on any fact, which is67500:49:22,438 --> 00:49:25,389not based on any science, and so those are some of the things 67600:49:25,409 --> 00:49:29,128that we always want to be careful of to get the facts, get67700:49:29,128 --> 00:49:32,346the facts and help somebody getthe facts. But hopefully we can67800:49:32,346 --> 00:49:38,829stop it from happening in the future. Any other questions? 67900:49:39,088 --> 00:49:42,590Speaker 4: Yes, I'm a dr. Dr, dr, dr, dr, dr, dr, dr, dr, dr, dr68000:49:42,590 --> 00:49:46,492, dr, dr, dr, dr, dr, dr, dr, dr, dr, dr, dr, dr, dr, dr. A 68100:49:46,512 --> 00:50:15,001certain thing now 40 zrobi, dr, dr, dr, dr, dr, dr, dr, dr, dr, 68200:50:15,021 --> 00:50:15,684dr, dr, dr, dr, dr. 68300:50:26,480 --> 00:50:32,635Speaker 2: Dr, dr, dr, dr. RightNumber one everybody's a little68400:50:32,635 --> 00:50:38,916different, so all age of verbalations are not created 68500:50:38,996 --> 00:50:44,005equal. Some may very well be hereditary, some may not, so it 68600:50:44,025 --> 00:50:48,266would depend on in your particular family. The other 68700:50:48,306 --> 00:50:54,413factor when you say over 70, onecan argue that everybody after 68800:50:54,452 --> 00:50:57,648a certain period of time may very well have some type of 68900:50:58,010 --> 00:51:03,476diabetic problem, heart problem,whatever, just based on age. So69000:51:03,476 --> 00:51:07,447my point is that that may not all necessarily be related to 69100:51:07,527 --> 00:51:13,478genes at all, but the answer would be knowing her specific 69200:51:14,425 --> 00:51:19,914situation and what the positionsdiagnose as the reason why she 69300:51:19,934 --> 00:51:23,288would end up having that particular problem. 69400:51:26,606 --> 00:51:30,615Speaker 4: Yeah, her mother was a 40. Her brother was probably 69500:51:30,635 --> 00:51:35,961died. I think he was 50 or less in the 1940s. So that's the end 69600:51:36,041 --> 00:51:40,173of the story. Some of her brothers and sisters got it. 69700:51:40,193 --> 00:51:41,827Some of them did. That's why. 69800:51:42,128 --> 00:51:47,012Speaker 2: I was asking Could itbe a genetic Sure? And again, 69900:51:47,052 --> 00:51:49,889it depends on why they died. They may not have died from a 70000:51:49,929 --> 00:51:55,052heart condition, it may have been something else. Okay, thank70100:51:55,052 --> 00:51:55,172you. 70200:51:56,186 --> 00:52:07,447Speaker 3: What this is. What about renovation? You can hear 70300:52:07,507 --> 00:52:10,452more about people talking about they have fluid around the arm 70400:52:10,851 --> 00:52:13,876or fluid around the lungs. What's that all about? 70500:52:16,206 --> 00:52:18,552Speaker 2: That's the next one question. She's calling it. 70600:52:18,800 --> 00:52:22,824That's called congestive heart. What happens is going back to 70700:52:22,844 --> 00:52:27,344the analogy of the heart being amuscle. As a muscle, that heart70800:52:27,344 --> 00:52:30,231is going to pump fast and flow,depending on what it has to do.70900:52:30,231 --> 00:52:34,981Over time, that muscle may start to get tired Again. This 71000:52:35,001 --> 00:52:39,521is what we're talking about. Over 70, 75, no longer. It can 71100:52:39,541 --> 00:52:42,659occur sooner than that, but I'lljust use that as a example. The71200:52:42,659 --> 00:52:47,949heart is not as efficient. It'sstill pumping, but it's not as 71300:52:48,048 --> 00:52:52,610efficient. Instead of being 90% efficient, maybe it's 80% 71400:52:52,670 --> 00:53:00,010efficient. A sign of heart inefficiency is swelling or 71500:53:00,050 --> 00:53:04,141deeming because that blood is not moving around as fast. Now, 71600:53:04,202 --> 00:53:06,161that could be other reasons for that. I'm not saying that's 71700:53:06,242 --> 00:53:10,019every reason, but that could be one of the signs of that. We 71800:53:10,059 --> 00:53:13,309call that heart failure, or sometimes it's called CHL, 71900:53:13,550 --> 00:53:16,822congestive heart failure. That could be one of the causes. Now 72000:53:16,862 --> 00:53:19,255that could be other reasons and certainly the other reasons why 72100:53:19,295 --> 00:53:22,969people have a deemum from varicose veins, on and on and on72200:53:22,969 --> 00:53:27,128. Now what you were describing is probably early, or certainly 72300:53:27,188 --> 00:53:30,242the early stage of heart failure. There's medication for that 72400:53:31,005 --> 00:53:33,864that helps to treat. Digoxin is one of the main medicines used 72500:53:33,885 --> 00:53:34,347to treat that. 72600:53:38,123 --> 00:53:40,668Speaker 3: It can be when you have a surgery, like with the 72700:53:40,728 --> 00:53:45,061heart, with the bullet around the heart. When they have the 72800:53:45,101 --> 00:53:50,978surgery, then they end up when they say it's a whole air is 72900:53:51,559 --> 00:53:55,748getting in, but they won't do the surgery right then because I73000:53:55,748 --> 00:53:59,744guess it'd be too much for the first heart. Later on, depending73100:53:59,744 --> 00:54:03,112on the situation, they'll go back in. I'm just asking. 73200:54:04,222 --> 00:54:07,070Speaker 2: Well, it depends on but you said it correct it 73300:54:07,112 --> 00:54:10,221depends on the situation and depends on what the 73400:54:10,260 --> 00:54:14,402circumstances are. My point is that I would need more 73500:54:14,443 --> 00:54:17,780information about why do they have a surgeon Basically. 73600:54:18,402 --> 00:54:23,905Exactly what type of surgery do they have? Certainly, one of my 73700:54:23,925 --> 00:54:28,679professors a year once said anybody can operate, but if it's73800:54:28,679 --> 00:54:32,409surgeons or physicians should know when to operate. If the 73900:54:32,469 --> 00:54:36,164judgment part of it it sounds like in this situation not known74000:54:36,164 --> 00:54:41,262all the details that the judgment of the surgical team 74100:54:41,322 --> 00:54:45,702was we can come back and do thisthe next time. I certainly may 74200:54:45,722 --> 00:54:47,606judge not necessarily a heart surgeon, because I did GI 74300:54:47,626 --> 00:54:53,186surgery and sometimes doctors dothat because part of what our 74400:54:53,206 --> 00:55:00,289response was to do was think thefirst principle first do no 74500:55:00,349 --> 00:55:04,487harm, first do no harm. So if wecan do it safely, then we'll go74600:55:04,487 --> 00:55:08,065ahead and do it. If we have to come back a second time or third74700:55:08,065 --> 00:55:11,172time and that's safest, then that's what they do. Any other 74800:55:11,193 --> 00:55:11,393questions? 74900:55:14,130 --> 00:55:26,007Speaker 3: Yes, hold on, I'm going to watch after you, don't 75000:55:26,027 --> 00:55:28,400shout out to Alison Tameis, and I have a quick question. Could 75100:55:28,481 --> 00:55:32,487you briefly explain the relationship between the heart, 75200:55:32,867 --> 00:55:34,471blood pressure and kidney? 75300:55:35,693 --> 00:55:38,688Speaker 2: Okay. Okay, as we mentioned at the heart of the 75400:55:38,728 --> 00:55:41,300month, the pumps are brought around throughout all of the 75500:55:41,340 --> 00:55:45,644bodies, every part of the body. An important part of that is the75600:55:45,644 --> 00:55:48,983kidney. In terms of the blood supply to the kidney, now I'm 75700:55:49,003 --> 00:55:51,855sort of overthinking a lot of this, because there are a lot of75800:55:51,855 --> 00:55:55,746hormones that both the kidney puts out that affect how the 75900:55:55,786 --> 00:55:59,885heart does that, and the kidney's job it's to filter the 76000:55:59,945 --> 00:56:04,603blood, to take impurities out ofthe blood, so that the whole 76100:56:04,664 --> 00:56:09,309system works appropriately. If the kidney is not functioning 76200:56:09,329 --> 00:56:12,980properly for whatever reason, either from some de-noble 76300:56:13,179 --> 00:56:18,251problem or damage or injury, it does not remove those things as 76400:56:18,331 --> 00:56:21,994much. That then makes the heart have to work harder, and I guess76500:56:21,994 --> 00:56:25,619the best way to think about it is everything is connected. If 76600:56:25,679 --> 00:56:29,548every organ system does this jobto the maximum, everything 76700:56:29,590 --> 00:56:33,806works smoothly. But if one system starts to break down, it 76800:56:33,827 --> 00:56:36,880then starts to affect those other systems and that could end76900:56:36,880 --> 00:56:43,358up causing total organ failure.All right, thank you, you're 77000:56:43,378 --> 00:56:43,818welcome. Yes. 77100:56:49,606 --> 00:56:54,331Speaker 4: Dr Chateau, I'm a family of three kids. Two and I 77200:56:54,672 --> 00:57:01,286was older now, but probably my kids are communes and they were 77300:57:01,327 --> 00:57:05,704all involved in stomp-a-toot. Yes, the hardly they went to a 77400:57:05,764 --> 00:57:11,001physical exam. Because it was needed, Right, okay, and even 77500:57:11,021 --> 00:57:14,925the physical was pretty simple it was just coughing, right. I 77600:57:15,047 --> 00:57:19,784understand, that was it. The question is, as a doctor, as a 77700:57:19,965 --> 00:57:26,358primary physician, can you orderan EKG for the kids? Oh, okay. 77800:57:26,599 --> 00:57:30,728Speaker 2: I understand Well, soif you're not a parent or a 77900:57:30,748 --> 00:57:33,782grandparent, you can get your own EKG. I mean, you can take it78000:57:33,782 --> 00:57:39,083to your doctor, which sure you can do that. And let's say, the 78100:57:39,103 --> 00:57:42,081team said, no, we're not going to do that, we just aren't going78200:57:42,081 --> 00:57:44,965to do too much. You can certainly do that independently,78300:57:44,965 --> 00:57:45,806it's not wrong with that. 78400:57:46,489 --> 00:57:51,266Speaker 4: Sure. So the questionis my primary physician can 78500:57:52,630 --> 00:57:54,452order that even though there is no? 78600:57:55,739 --> 00:58:01,327Speaker 2: Yes, you may get intothe insurance thing, because a 78700:58:01,367 --> 00:58:03,541lot of insurance that we're not going to pay for that because 78800:58:03,581 --> 00:58:07,181there's no reason or whatever, whatever, and that may be a 78900:58:07,202 --> 00:58:11,722situation where you just may payout of pocket for it. But most 79000:58:11,804 --> 00:58:14,722of times it depends on how worthit. It's not going to be that 79100:58:14,764 --> 00:58:17,726expensive. It depends how much you're concerned about it. But 79200:58:17,806 --> 00:58:23,722answer the question. Yes, you can do that, absolutely Okay. 79300:58:24,103 --> 00:58:28,213Thank you very much. Have a wonderful day Right here, peter.79400:58:28,213 --> 00:58:28,21379500:58:33,949 --> 00:58:35,952Speaker 1: Thanks for listening to the Healthy, wealthy and Wise79600:58:35,952 --> 00:58:40,764podcast with Dr William Choctaw, mdjd. We hope you enjoyed this79700:58:40,764 --> 00:58:44,746episode. In fact, if you found this episode helpful, you can 79800:58:44,786 --> 00:58:49,005support and subscribe to the podcast on your favorite podcast79900:58:49,005 --> 00:58:53,523platform with the keywords Dr William Choctaw and you'll find 80000:58:53,563 --> 00:58:59,246it very quickly. So subscribing helps ensure that you don't miss80100:58:59,246 --> 00:59:04,349any future episodes. And then take the next step of action and80200:59:04,349 --> 00:59:07,440share it with your family, friends and or your coworkers. 80300:59:07,981 --> 00:59:12,204They'll be glad you did so. Until the next time, live your 80400:59:12,485 --> 00:59:16,101best possible life the best possible way. You've been 80500:59:16,121 --> 00:59:19,228listening to the Healthy, wealthy and Wise podcast with Dr80600:59:19,228 --> 00:59:21,943William Choctaw, mdjd.