Understanding Cardiac Arrest, Heart Attacks, and the Power of Mental Health

1 00:00:00,480 --> 00:00:02,404 Speaker 1: Welcome to the Healthy, Wealthy and Wise 2 00:00:02,524 --> 00:00:08,064 podcast with Dr William Chokta, MDJD. Our mission is to empower 3 00:00:08,125 --> 00:00:11,897 you with the knowledge and the tools you need to thrive in all 4 00:00:12,099 --> 00:00:16,184 aspects of your lives. Join us now as we discuss everything 5 00:00:16,285 --> 00:00:19,823 from nutrition and exercise to money management and personal 6 00:00:19,862 --> 00:00:24,733 growth. Dr Chokta will provide insightful advice on how to 7 00:00:24,774 --> 00:00:28,064 improve your physical and financial health, as well as 8 00:00:28,103 --> 00:00:31,460 your emotional and mental well-being. Whether you're 9 00:00:31,481 --> 00:00:35,930 looking to boost your energy levels, unlock financial freedom 10 00:00:35,930 --> 00:00:40,228 or cultivate a more positive mindset, we've got you covered. 11 00:00:41,880 --> 00:00:45,901 Get ready to become the best version of yourself? So let's 12 00:00:45,941 --> 00:00:50,329 get started. Here's Dr William Chokta, MDJD. 13 00:00:51,240 --> 00:00:54,601 Speaker 2: Welcome to the Leadership Masterclass. We're 14 00:00:54,621 --> 00:00:56,948 going to talk about cardiac arrest and heart attack this 15 00:00:57,029 --> 00:00:59,902 morning. We're delighted to have you with us, so let's get 16 00:00:59,942 --> 00:01:04,820 started. I believe life is about being of service to others. I 17 00:01:04,881 --> 00:01:08,605 believe knowledge is power. I believe leaders can change the 18 00:01:08,644 --> 00:01:13,349 world. Today we're going to talk about a very important topic 19 00:01:13,540 --> 00:01:16,441 And, as always, i'd like to give you an outline. The outline 20 00:01:16,481 --> 00:01:21,004 lets you know what we're going to talk about, and the other 21 00:01:21,043 --> 00:01:24,531 purpose of the outline is to let you know that when we're just 22 00:01:24,570 --> 00:01:28,533 about done. So first I wanted, as always, to suggest to you 23 00:01:28,593 --> 00:01:32,822 let's do what to have you think like doctors, and if you think 24 00:01:32,921 --> 00:01:36,838 like doctors, then some of this stuff will make sense to you as 25 00:01:36,899 --> 00:01:40,823 we go through this presentation. Next, we're going to talk about 26 00:01:40,823 --> 00:01:46,022 the common causes of death in this country. Take a distinction 27 00:01:46,022 --> 00:01:50,371 between cardiac arrest and heart attack, and we'll end with 28 00:01:50,371 --> 00:01:53,007 a discussion about cardiopulmonary resuscitation. 29 00:01:53,519 --> 00:01:57,388 So by the time we start talking about CPR, you know that I'm 30 00:01:57,430 --> 00:02:00,665 just about done. I realize that you're very busy people and 31 00:02:00,685 --> 00:02:05,465 we're absolutely delighted to have you join us on this journey 32 00:02:05,465 --> 00:02:10,460 and to spare some of your very valuable time with us. The most 33 00:02:10,501 --> 00:02:13,967 common cause of death in this country are heart disease, 34 00:02:14,329 --> 00:02:19,140 cancer and trauma. Heart disease , cancer and trauma. We're going 35 00:02:19,140 --> 00:02:22,068 to concentrate on heart disease for the time that we have 36 00:02:22,128 --> 00:02:26,606 together And we can divide heart disease into two main areas, 37 00:02:26,787 --> 00:02:30,883 the most serious parts of heart disease, and that is heart 38 00:02:30,962 --> 00:02:35,165 attack and cardiac arrest. Now, you've heard of both of them, 39 00:02:36,509 --> 00:02:40,080 but we're going to break it down to distinguish between the two, 40 00:02:40,080 --> 00:02:44,521 because sometimes people get them confused. So let's talk 41 00:02:44,562 --> 00:02:49,550 about heart attack. Heart attack is when. Well, let me back up, 42 00:02:49,931 --> 00:02:53,967 the heart is a muscle that sits in the middle of the chest and 43 00:02:54,027 --> 00:02:56,959 is connected through the other parts of the body through very, 44 00:02:57,019 --> 00:03:02,169 very large blood vessels. The heart basically works by having 45 00:03:02,289 --> 00:03:06,762 blood supplied to it, to those muscles, so that those muscles 46 00:03:06,842 --> 00:03:11,856 can pump regularly and efficiently to move blood around 47 00:03:11,856 --> 00:03:15,141 to all the different parts of the body. So it's a very, very 48 00:03:15,222 --> 00:03:18,229 important part, a very, very obviously important organ in the 49 00:03:18,229 --> 00:03:24,556 body, and to do that, the heart must be supplied with the blood 50 00:03:24,556 --> 00:03:28,205 , supplied through what's called the coronary arteries, or the 51 00:03:28,326 --> 00:03:31,643 heart arteries, if you will. These arteries. They go 52 00:03:31,683 --> 00:03:36,598 throughout the heart and they supply the muscle with oxygen, 53 00:03:36,639 --> 00:03:40,247 with blood, through red blood cells. That allows it to do its 54 00:03:40,366 --> 00:03:44,581 work and pump the blood throughout the body. So a heart 55 00:03:44,622 --> 00:03:49,631 attack in essence means that there is a blockage, either 56 00:03:49,691 --> 00:03:54,367 complete or partial, of those arteries that supply blood to 57 00:03:54,407 --> 00:04:00,229 the heart. Let me say that again a heart attack is a blockage, 58 00:04:00,429 --> 00:04:04,562 partial or complete, of those arteries we call them coronary 59 00:04:04,663 --> 00:04:09,484 arteries that supply blood to the heart. And what happens is 60 00:04:09,544 --> 00:04:13,497 that as that blockage becomes more and more and more complete, 61 00:04:13,497 --> 00:04:18,314 less and less blood gets to the heart muscles. The heart then 62 00:04:18,374 --> 00:04:23,307 cannot function as it normally should and a heart attack may 63 00:04:23,348 --> 00:04:29,682 very well ensue. So but we were always taught And this dates 64 00:04:29,742 --> 00:04:31,949 back to what's called the Fremenheim study, which is many, 65 00:04:31,949 --> 00:04:36,500 many years ago I graduated from medical school in 1973. This is 66 00:04:36,500 --> 00:04:40,365 long before that But basically the Fremenheim study told us 67 00:04:40,846 --> 00:04:44,321 that when someone is having a heart attack, they would have 68 00:04:44,661 --> 00:04:50,194 the primary symptoms include a crushing substernal chest pain 69 00:04:52,237 --> 00:04:57,708 that radiated to the left arm, a crushing substernal chest pain, 70 00:04:57,708 --> 00:05:01,228 a pain in the middle of the chest that was very, very hard, 71 00:05:01,327 --> 00:05:05,786 very, very strong, and that then radiated, or moved, if you will 72 00:05:05,786 --> 00:05:09,783 , around and down the left arm. Occasionally it could be 73 00:05:09,822 --> 00:05:12,891 associated with nausea. But the crushing substernal chest pain 74 00:05:13,319 --> 00:05:19,913 was absolutely a major factor in diagnosing this particular 75 00:05:19,952 --> 00:05:23,511 condition And that it usually occurred in men, usually in 76 00:05:23,531 --> 00:05:27,244 middle age, the elderly men sometimes, who were slightly 77 00:05:27,404 --> 00:05:31,971 overweight, and that obviously was important to get these 78 00:05:32,031 --> 00:05:34,261 individuals to a hospital so they could be treated 79 00:05:34,322 --> 00:05:41,476 immediately. So in effect, the heart attack is basically a 80 00:05:41,557 --> 00:05:44,880 plumbing problem. It's a good way to think about it, in other 81 00:05:44,901 --> 00:05:48,988 words as a blockage of blood supply to the heart via its 82 00:05:49,048 --> 00:05:54,305 coronary artery vessels And so as a result of this blockage 83 00:05:54,365 --> 00:05:57,011 either partial or complete, let's say complete blockage 84 00:05:57,800 --> 00:06:01,387 blood cannot get to the muscle of the heart and the heart then 85 00:06:01,709 --> 00:06:05,685 cannot pump in, the heart goes into a failure or just stops 86 00:06:06,468 --> 00:06:12,350 many times Frequently. It's not uncommon that these symptoms of 87 00:06:12,370 --> 00:06:17,124 the heart attack could be gradual, maybe discomfort, which 88 00:06:17,124 --> 00:06:20,355 then may increase in time depending on level of exertions 89 00:06:21,158 --> 00:06:25,360 and depending on the patient's prior medical condition. But the 90 00:06:25,360 --> 00:06:29,920 presentations were pretty specific. But there was one 91 00:06:29,982 --> 00:06:33,860 problem with the presentation for the heart attack And the 92 00:06:33,879 --> 00:06:39,009 Fremenhem study, which was, as I said, was the main source of 93 00:06:39,089 --> 00:06:43,505 information about this is that the Fremenhem study did not 94 00:06:43,605 --> 00:06:47,348 include women. The Fremenhem study again, remember this was 95 00:06:47,831 --> 00:06:52,701 probably in the 50s and the 60s, if not before the 70s, and back 96 00:06:52,701 --> 00:06:57,651 in those days a lot of the large studies did not include 97 00:06:57,672 --> 00:07:03,264 women At least this one did not And the heart attack was 98 00:07:03,365 --> 00:07:09,384 primarily considered, primarily a male disease And, as a result, 99 00:07:09,384 --> 00:07:12,451 treatment and therapy and education was based on that. 100 00:07:13,160 --> 00:07:17,853 What was discovered subsequently was that when women have a 101 00:07:17,894 --> 00:07:22,184 heart attack, that they don't proceed through the classic 102 00:07:22,223 --> 00:07:28,461 Fremenhem study process, that many times women may not have 103 00:07:28,480 --> 00:07:31,387 the crushing sub-sternal chest pain that radiates to the left 104 00:07:31,569 --> 00:07:38,601 arm, that indeed they may come in with nausea, they may come in 105 00:07:38,601 --> 00:07:43,821 with a bad case of indigestion or extreme fatigue, they may 106 00:07:43,841 --> 00:07:46,928 have some chest pain, but it might be in the lower chest of 107 00:07:46,949 --> 00:07:51,326 the upper abdomen And, as a result, there's a whole area of 108 00:07:51,406 --> 00:07:55,699 quality healthcare that has occurred in the last 50 years. 109 00:07:56,180 --> 00:08:02,572 To improve the quality of treatment for heart disease in 110 00:08:02,692 --> 00:08:07,468 women Because it was finally realized that the presentation 111 00:08:07,951 --> 00:08:12,163 and the approach and the effect of heart disease in women was 112 00:08:12,322 --> 00:08:17,730 different from that of men, and to provide quality care for 113 00:08:17,750 --> 00:08:20,600 women who have heart disease, particularly progressing to a 114 00:08:20,641 --> 00:08:23,747 heart attack, you have to understand what the methodology 115 00:08:23,947 --> 00:08:28,139 is in women and the presentation , the signs and symptoms. So a 116 00:08:28,199 --> 00:08:32,951 very, very important change or growth in healthcare that women 117 00:08:33,010 --> 00:08:37,506 are not like men 100% in the way they present with a heart 118 00:08:37,547 --> 00:08:45,120 attack. Not too long ago. That was a situation in one of our 119 00:08:45,200 --> 00:08:48,913 national pastimes, football, where a particular football 120 00:08:48,932 --> 00:08:53,847 player was playing in a game very aggressively, was hit and 121 00:08:53,888 --> 00:08:56,897 immediately fell to the ground and his heart stomped, 122 00:08:57,950 --> 00:09:01,197 immediately, fell to the ground and they noticed he did not have 123 00:09:01,197 --> 00:09:06,897 a pulse And so it concluded. The conclusion was immediately 124 00:09:06,937 --> 00:09:11,559 that he had a cardiac arrest. So we just talked earlier about 125 00:09:11,600 --> 00:09:13,910 the heart attack. That's a plumbing problem. Remember we 126 00:09:13,951 --> 00:09:18,182 talked about how the arteries and vessels to the muscle were 127 00:09:20,168 --> 00:09:24,457 narrowed or blocked completely and the heart then stops beating 128 00:09:24,457 --> 00:09:30,557 . But in this situation the heart stops immediately after 129 00:09:30,639 --> 00:09:35,355 this traumatic hit. And so what we're talking about secondly 130 00:09:35,417 --> 00:09:40,154 here is a cardiac arrest, and a cardiac arrest is not a plumbing 131 00:09:40,154 --> 00:09:44,195 problem like heart attack. Cardiac arrest is an electrical 132 00:09:44,254 --> 00:09:48,676 problem. Electrical problem Because another part of the 133 00:09:48,736 --> 00:09:51,109 anatomy of the heart, in addition to the muscle and the 134 00:09:51,149 --> 00:09:56,000 blood supply, it is an electrical unit that there's an 135 00:09:56,100 --> 00:10:01,611 electrical charge that starts in this sinoatrial node, the SA 136 00:10:01,672 --> 00:10:05,019 node, that spreads its electrocurrent throughout the 137 00:10:05,058 --> 00:10:10,876 heart, that allows the muscle to contract and expand as needed 138 00:10:10,956 --> 00:10:15,051 and depending on the supply needed by the body. So the heart 139 00:10:15,051 --> 00:10:18,399 is a very complex organ and it's more than just the muscle, 140 00:10:18,779 --> 00:10:22,535 but it's also an electrical unit . So if you do something, if you 141 00:10:22,535 --> 00:10:26,610 interrupt that electrical flow, that heart will immediately 142 00:10:26,750 --> 00:10:30,558 stop or certainly begin to function in a way that is not 143 00:10:30,620 --> 00:10:34,600 productive. Sometimes it may go into what we call ventricular 144 00:10:34,620 --> 00:10:39,033 fibrillation, where the big ventricles of the heart do not 145 00:10:39,715 --> 00:10:43,750 pump adequately, but just sort of quiver, if you will, and with 146 00:10:43,750 --> 00:10:46,525 that quivering blood does not get around to other parts of the 147 00:10:46,525 --> 00:10:51,892 body and the patient is in extreme condition And if 148 00:10:52,011 --> 00:10:55,364 intervention does not occur, that patient could die and 149 00:10:55,443 --> 00:10:59,611 certainly could very well become brain dead. What we know is 150 00:10:59,692 --> 00:11:03,600 that obviously the most sensitive organ in the body to 151 00:11:03,639 --> 00:11:07,572 blood loss, among others, is the brain, and usually you have 152 00:11:07,611 --> 00:11:11,159 about three to four minutes to get that going again, if indeed 153 00:11:11,220 --> 00:11:14,657 that's what has occurred, and this was what happened with Mr 154 00:11:14,697 --> 00:11:20,731 Hemlin. So let's summarize what we just said here Heart attack 155 00:11:21,253 --> 00:11:25,716 is the plumbing problem. The arteries are clogged up so that 156 00:11:25,796 --> 00:11:29,191 blood that normally would go to the heart muscle cannot 157 00:11:29,410 --> 00:11:33,291 adequately get there in sufficient quantities. Pneumatic 158 00:11:33,291 --> 00:11:38,304 arrest is an electrical problem . After a traumatic blow to the 159 00:11:38,365 --> 00:11:43,073 heart, for whatever reason, the electrical system is disrupted 160 00:11:44,000 --> 00:11:47,828 And because of that disruption the current does not go to the 161 00:11:47,889 --> 00:11:51,924 muscle the heart muscle properly and the muscle is the heart is 162 00:11:51,945 --> 00:11:57,798 then rendered inadequate in terms of fulfilling its role in 163 00:11:58,200 --> 00:12:03,711 getting blood supply to the rest of the body. So what can you do 164 00:12:03,711 --> 00:12:06,923 ? Let's say you're in an area, let's say you're walking through 165 00:12:06,923 --> 00:12:10,972 an airport and you have time to catch your plane, and in the 166 00:12:11,879 --> 00:12:14,969 area is a little crowded and a lot of people moving back and 167 00:12:15,009 --> 00:12:20,451 forth, and all of a sudden there's a person walking who 168 00:12:20,490 --> 00:12:25,945 begins to slow, let's say an elderly person, and they're sort 169 00:12:25,945 --> 00:12:28,909 of grabbing their chest and they immediately fall in the 170 00:12:28,929 --> 00:12:36,230 middle of the airport area. You then go up to them and you say 171 00:12:36,291 --> 00:12:38,460 something, along with other people, to them, and they're not 172 00:12:38,460 --> 00:12:43,533 responsive. And you touch them, you feel for a pulse and you do 173 00:12:43,533 --> 00:12:47,443 not feel a pulse. This is where cardiopulmonary resuscitation 174 00:12:47,504 --> 00:12:53,419 comes in and basically many of you already know this, but I'm 175 00:12:53,440 --> 00:12:56,270 going to go over it anyway. This is where you start 176 00:12:56,311 --> 00:13:00,484 cardiopulmonary resuscitation. You've seen it on television and 177 00:13:00,484 --> 00:13:07,298 what you do is that you first would have someone call 911, if 178 00:13:07,337 --> 00:13:11,947 you're not by yourself and you would then lean over the person, 179 00:13:11,947 --> 00:13:18,181 be 90 degrees to them and put your the palm of your hand in 180 00:13:18,221 --> 00:13:23,673 the middle of their chest bone we call it the sternum about 181 00:13:23,754 --> 00:13:30,168 halfway down and middle of the chest, at 90 degrees, and you do 182 00:13:30,168 --> 00:13:34,320 30 compressions and two breaths . Now, some people just do the 183 00:13:34,440 --> 00:13:36,769 compression, some people are uncomfortable doing the breaths, 184 00:13:36,769 --> 00:13:41,224 that's okay, but it's important to do the compressions after 185 00:13:41,264 --> 00:13:45,697 you've called. I had someone to call 911, if you're able to. So 186 00:13:45,758 --> 00:13:49,565 cardiopulmonary resuscitation involves 30 compressions, two 187 00:13:49,625 --> 00:13:56,562 breaths, 30 to two, and it's very important to do that. If it 188 00:13:56,562 --> 00:14:00,615 is a child, then you would do I was, depending on the age of 189 00:14:00,635 --> 00:14:03,966 the child, but a very small child you could do 15 190 00:14:04,005 --> 00:14:09,020 compressions to one breath. The most important thing is the call 191 00:14:09,020 --> 00:14:14,850 911. If, on the other hand, in addition to all of that, you are 192 00:14:14,850 --> 00:14:20,009 in an area that has what's called a detribulator and more 193 00:14:20,029 --> 00:14:22,700 and more detribulators being placed in public areas now, 194 00:14:22,840 --> 00:14:25,249 particularly in airports and other places stores, large 195 00:14:25,308 --> 00:14:29,759 stores, malls Usually these are things on the wall with bright 196 00:14:29,879 --> 00:14:33,600 colors and they'll say AED and that stands for automated 197 00:14:33,720 --> 00:14:36,988 external detribulator. If you see that, you can open that up 198 00:14:37,730 --> 00:14:40,322 and basically that's the way where you can actually shock the 199 00:14:40,322 --> 00:14:45,378 heart to start electrical activity. So let me go over this 200 00:14:45,378 --> 00:14:51,772 again. You're in the airport, you observe a person fall and 201 00:14:51,812 --> 00:14:56,261 become unconscious and appears that they may very well have had 202 00:14:56,261 --> 00:15:00,897 a cardiac arrest. After you evaluate them, you call 911. If 203 00:15:00,937 --> 00:15:03,648 there's someone with you they can help you. If there's no one 204 00:15:03,687 --> 00:15:06,941 with you and you believe this person is unresponsive, you 205 00:15:06,961 --> 00:15:09,628 cannot fill a pulse, then it's appropriate to start 206 00:15:09,668 --> 00:15:15,587 cardiopulmonary resuscitation 30 compressions to two breaths. So 207 00:15:15,587 --> 00:15:18,533 let's summarize what we just said. Heart disease is the most 208 00:15:18,620 --> 00:15:22,092 common cause of death in the United States. Two of the most 209 00:15:22,133 --> 00:15:26,043 common types of heart disease they call death are heart 210 00:15:26,082 --> 00:15:30,932 attacks and cardiac arrests. Men differ from women with heart 211 00:15:30,991 --> 00:15:35,626 attacks in that women don't have the classic crutch and 212 00:15:35,667 --> 00:15:38,980 substernal chest pain with pain that radiates down the left arm. 213 00:15:38,980 --> 00:15:42,613 Women may present with any number of symptoms. So one has 214 00:15:42,653 --> 00:15:46,981 to have a high index of suspicion as to whether a woman 215 00:15:47,062 --> 00:15:50,945 is having a heart attack when you see them or evaluate them. 216 00:15:51,706 --> 00:15:54,533 Cardiac arrest, on the other hand, is completely different. 217 00:15:55,105 --> 00:15:58,133 This will be something that's very dramatic, that will happen 218 00:15:58,173 --> 00:16:01,691 immediately, and the person will go from being conscious to 219 00:16:01,730 --> 00:16:06,831 being unconscious many times. There you have Menistor Act and 220 00:16:06,892 --> 00:16:10,370 if you're comfortable with CPR cardiopulmonary resuscitation, 221 00:16:10,972 --> 00:16:15,488 cold 911, have someone call 911, do cardiopulmonary 222 00:16:15,528 --> 00:16:20,047 resuscitation 30 compressions to two breaths and continue that 223 00:16:20,508 --> 00:16:25,985 until you get assistance or until the patient responds. I 224 00:16:26,025 --> 00:16:30,316 would recommend, if you do not have formal CPR training, that 225 00:16:30,355 --> 00:16:35,169 you get the CPR training. Usually It's given in schools, 226 00:16:35,350 --> 00:16:40,773 many times in churches, the fire department or adult education 227 00:16:40,913 --> 00:16:44,374 areas. It's just something good to have just training this good 228 00:16:44,413 --> 00:16:49,947 to have because you never know My basic principles And remember 229 00:16:49,947 --> 00:16:52,793 what I said. When I get to my basic principles, i'm just about 230 00:16:52,793 --> 00:16:57,546 done. My first basic principle is that God is in charge. I am a 231 00:16:57,546 --> 00:17:01,827 physician, but I am a physician of faith, and God has been very 232 00:17:01,827 --> 00:17:05,465 important to me in my journey throughout life in terms of 233 00:17:05,527 --> 00:17:09,194 dealing with different issues and trying to make a difference 234 00:17:09,276 --> 00:17:12,553 in the world. My second principle is I have no bad days. 235 00:17:12,553 --> 00:17:16,654 I decided I learned a number of years ago that whether my day 236 00:17:16,674 --> 00:17:21,088 was good or bad was completely up to me. So, with that being 237 00:17:21,108 --> 00:17:24,207 the case, i decided that I had had enough bad days and I did 238 00:17:24,227 --> 00:17:27,791 not want any more. So I don't have. I have good days and I 239 00:17:27,832 --> 00:17:31,186 have great days, but I don't have bad days. Number three 240 00:17:31,367 --> 00:17:34,625 don't sweat the small stuff, and most stuff is small. I have 241 00:17:34,705 --> 00:17:38,034 also learned that usually if something happens in my 242 00:17:38,054 --> 00:17:44,836 throughout my day that appears to be important or traumatic or 243 00:17:44,895 --> 00:17:48,432 stressful, that most of times it's never as stressful as I 244 00:17:48,472 --> 00:17:53,047 think it is or as important as I think it might be, and usually 245 00:17:53,146 --> 00:17:55,814 I can take a more deliberate approach and resolve whatever 246 00:17:55,854 --> 00:18:00,825 that issue is. Number four forgiveness is therapy. If 247 00:18:00,945 --> 00:18:06,607 someone does something in my perception that I consider to be 248 00:18:06,607 --> 00:18:12,729 negative or disruptive or inappropriate, i have learned to 249 00:18:12,729 --> 00:18:19,576 forgive them. And not only does forgiveness remove that as an 250 00:18:19,655 --> 00:18:24,345 issue for me, I have found that it is absolutely therapeutic And 251 00:18:24,345 --> 00:18:26,952 I certainly recommend that to you in the appropriate 252 00:18:26,972 --> 00:18:31,305 circumstances. And finally, everything is a relationship And 253 00:18:31,305 --> 00:18:35,374 relationships are based on mutual respect, mutual trust and 254 00:18:35,374 --> 00:18:39,029 good communication, and it does not matter what type of 255 00:18:39,069 --> 00:18:43,111 relationship it is A husband, wife, work relationship, parent, 256 00:18:43,111 --> 00:18:49,330 child, colleague, colleague If you're able to provide or create 257 00:18:49,330 --> 00:18:53,625 mutual respect, mutual trust and good communication, then you 258 00:18:53,625 --> 00:18:56,473 will have a very, a number of very good relationships 259 00:18:56,513 --> 00:19:00,333 throughout life and will be happy and less stressful as a 260 00:19:00,393 --> 00:19:05,994 result. I want to go over a very important area that has to do 261 00:19:06,115 --> 00:19:09,348 with cardiac disease, and this may seem a little strange to you 262 00:19:09,348 --> 00:19:13,586 , but remember, the body is one unit all together, and all the 263 00:19:13,645 --> 00:19:17,047 different parts of the body work together, and so I want to 264 00:19:17,166 --> 00:19:22,465 close with a brief discussion about stress management. Stress 265 00:19:22,547 --> 00:19:25,095 is one of those things that occurs to us every single day, 266 00:19:25,184 --> 00:19:29,049 but we don't pay much attention to it, but yet it's an important 267 00:19:29,049 --> 00:19:32,412 part of our lives, and not only is it an important part of our 268 00:19:32,471 --> 00:19:35,750 mental life, it's also an important part of our cardiac 269 00:19:35,830 --> 00:19:40,391 life. Okay, so one of the things I want to have you to keep in 270 00:19:40,451 --> 00:19:47,726 mind that throughout your daily life, it is okay to say no. I 271 00:19:47,766 --> 00:19:51,227 have noticed in my practice over the last 15 years that many 272 00:19:51,287 --> 00:19:55,115 patients who came to see me and who were stressed were 273 00:19:55,214 --> 00:20:01,434 frequently individuals who had difficulty saying no. No means 274 00:20:01,555 --> 00:20:08,172 no. You can say it with a smile, you can say it with a hug, but 275 00:20:08,231 --> 00:20:13,011 it still means no. What it does is it gives the individual, it 276 00:20:13,031 --> 00:20:17,789 gives you the opportunity to have some control over your life 277 00:20:17,789 --> 00:20:22,618 , instead of always allowing others to dictate what you do 278 00:20:22,765 --> 00:20:26,489 and when you do it, and you would be amazed at how having 279 00:20:26,509 --> 00:20:31,069 just a small amount of control will be beneficial. So learn how 280 00:20:31,069 --> 00:20:36,108 to say no. Remember that the mind is divided into the ego and 281 00:20:36,108 --> 00:20:40,686 the superego. The ego is basically responsible for 282 00:20:40,767 --> 00:20:44,582 wanting certain things for the individual, and the ego really 283 00:20:44,642 --> 00:20:48,746 doesn't care about anybody else. The ego is the rational part of 284 00:20:48,746 --> 00:20:51,865 the mind. It's the part of the mind that tells you whether 285 00:20:51,884 --> 00:20:55,500 something that you want to do is reasonable or not, and the 286 00:20:55,560 --> 00:20:59,622 superego is the right and wrong part of the mind. I would 287 00:20:59,662 --> 00:21:02,955 encourage you to remember those three different parts of your 288 00:21:02,996 --> 00:21:07,542 mind and to utilize them at all times. One of the things that we 289 00:21:07,542 --> 00:21:13,079 know is that what we believe affects how we think, and how we 290 00:21:13,079 --> 00:21:18,271 think affects how we feel, and how we feel affects how we act. 291 00:21:19,019 --> 00:21:23,653 So if you find yourself constantly stressed, it may be 292 00:21:23,773 --> 00:21:27,663 something that stems back from your belief system, many of 293 00:21:27,702 --> 00:21:30,753 those beliefs that may have started in childhood or early 294 00:21:30,835 --> 00:21:34,968 adulthood. I would suggest to you to go back and evaluate a 295 00:21:35,048 --> 00:21:38,759 circumstance or an encounter, if you will, that may have been 296 00:21:38,820 --> 00:21:42,969 negative or you perceived as negative, and see if it's based 297 00:21:43,089 --> 00:21:48,020 on some old belief that you've had for many years. Many times 298 00:21:48,101 --> 00:21:51,529 when you do that, you will find out that that belief is no 299 00:21:51,589 --> 00:21:56,500 longer tenable and you can change it or get rid of it. And 300 00:21:56,520 --> 00:22:01,192 finally, i want to end up with the word think. Before you speak 301 00:22:01,192 --> 00:22:05,101 And certainly our parents would tell us that, but think about 302 00:22:05,121 --> 00:22:11,567 it in terms of a mnemonic, to some extent The teeth. Before 303 00:22:11,606 --> 00:22:15,018 you speak, make sure that what you think is true about 304 00:22:15,117 --> 00:22:20,747 something or some circumstance. Before you speak, make sure that 305 00:22:20,747 --> 00:22:25,163 what you think is helpful. Before you speak, make sure that 306 00:22:25,163 --> 00:22:30,907 what you think is inspiring And make sure that what you are 307 00:22:30,928 --> 00:22:36,465 going to say is necessary. And finally, before you speak, make 308 00:22:36,526 --> 00:22:40,761 sure that what you're going to say is kind. If you're able to 309 00:22:40,863 --> 00:22:45,296 do all those things, you're able to release your own personal 310 00:22:45,336 --> 00:22:50,993 power, be less stressed and be less inclined to having serious 311 00:22:51,435 --> 00:22:57,204 cardiac pathology. Final comment Thank you so much for coming 312 00:22:57,265 --> 00:23:00,781 and being a part of this podcast . Please share it with your 313 00:23:00,842 --> 00:23:05,751 friends and remember be the change you want to see in the 314 00:23:05,791 --> 00:23:07,845 world. Have a wonderful day. 315 00:23:08,700 --> 00:23:10,423 Speaker 1: Thanks for listening to the Healthy, wealthy and Wise 316 00:23:10,423 --> 00:23:15,489 Podcast with Dr William Choctaw , mdjd. We hope you enjoyed this 317 00:23:15,489 --> 00:23:18,584 episode on mental health matters And if you found this 318 00:23:18,624 --> 00:23:22,940 episode helpful, you can support and subscribe to the podcast on 319 00:23:22,940 --> 00:23:27,259 your favorite podcast platform with the keywords Dr William 320 00:23:27,278 --> 00:23:31,104 Choctaw And you've got it. This will help ensure that you don't 321 00:23:31,144 --> 00:23:34,803 miss any future episodes. And then take the next step of 322 00:23:34,983 --> 00:23:38,010 action and share it with your family, friends and all your 323 00:23:38,030 --> 00:23:42,000 coworkers. They'll be glad you did So. Until the next time, 324 00:23:42,580 --> 00:23:45,383 live your best possible life the best possible way.