Podiatrist Dr. David Alper joins co-hosts Kym McNicholas and Dr. John Phillips to talk about the cold weather dangers for those with poor circulation and how to protect their life and limb, especially feet.
Mindset is medicine for both the physician and patient. Medicine already recognizes the persuasive power of beliefs. The use of placebos is a great example of that. But it's much more than that, especially with chronic, painful vascular ailments such as peripheral artery disease (P.A.D.), which is restricted blood flow in mainly the leg arteries due to plaque build-up. Patients with P.A.D. feel at times as though a tourniquet is wrapped tightly around their legs when they walk. Sometimes the leg pain and cramping wake them up at night. Dr. Paramjit Romi Chopra joins hosts Kym McNicholas and Dr. John Phillips to talk about the powerful combination of science and spirituality to help patients and physicians persevere in challenging life and limb-saving situations.
Open Enrollment just wrapped up and call centers were center stage, handling a high volume of calls from patients looking to secure their health insurance for 2023. On the front lines ready to prevent call center failure was Cyara, a quality assurance technology company that helps organizations, including those in healthcare, spot problems and find resolve of them before the customers discover them and hang up. Show hosts Kym McNicholas and Dr. John Phillips talk to Cyara Senior Vice President of Customer Experience Dennis Reno about the biggest call enter fails and how to fix them. Also, a former Highway Patrol Call Center Supervisor, Connie, shares her limb saving story in our Save My Piggies series. She continued to help facilitate potentially life-saving calls for others while fighting for her own life.
Show co-host Kym McNicholas is dedicating this how to her Mom Marilyn Lou Baum McNicholas who transitioned earlier this year due to an undetected abdominal aortic aneurysm that ultimately ruptured. Marilyn’s cardiologist told Kym that there’s still so much doctors don’t know about aneurysms and because of that, there are gaps in care, which lead to premature death. Marilyn was diagnosed with having a 4cm thoracic aneurysm six months prior to her transition. Her cardiologist would only say it’s not at a size to worry about since a surgeon typically does not treat an aneurysm until it’s at least 5cm. Her cardiologist never discussed how to preventthe aneurysm from growing, what symptoms to look for, or her increased risk of having an abdominal aortic aneurysm because of it. So, not further testing was done despite textbook symptoms of symptoms of increasing erratic blood pressure, tachycardia, a pulsating feeling around her belly button, an abdominal mass, and severe radiating pain in her back. Her cardiologist, a vascular surgeon, and an emergency room doctor told her there was nothing life-threatening with her symptoms. They told her to take muscle relaxers and prescribed physical therapy, along with traction. The autopsy revealed what doctors missed.
Should Marilyn’s 4cm thoracic aneurysm have been taken more seriously? Should she have been tested for an abdominal aortic aneurysm after being diagnosed with a thoracic aneurysm? Should her symptoms have been a red flag for doctors?
In this episode, co-host Dr. John Phillips leads the discussion with guest Cardiac Surgeon Dr. Arnaoutakis, about specifically thoracic and thoraco abdominal aneurysms. For those who aren’t familiar with what an aneurysm is and how it forms, they will go through the basics. But the primary discussion will be around the current gaps in care, new innovative approaches to diagnosis and treatment, as well as critical questions to discuss with your healthcare team. Also, Retired Veterinarian, triathlete, and author Dr. Kevin Morgan shares his personal story about how he diagnosed his own aortic aneurysm, found the right treatment, and continues to compete in running and cycling events.
A great time for family and friends to show support for those with vascular diseases such as coronary artery disease (CAD), restricted blood flow in the arteries around the heart that restricts blood flow, and peripheral artery disease (PAD), which is restricted blood flow in the leg arteries due to plaque build-up, also chronic venous insufficiency (CVI), diabetes, and Raynaud's Syndrome. Hosts Kym McNicholas and Dr. John Phillips, along with guest co-hosts Nurse Practitioner Kay Smith and Revitalist CEO Kathryn Walker offer some innovative ideas to help with mental well-being, exercise regimens, health monitoring and more. PAD Warrior and PAD Life Outdoors Youtube channel creator Robert Castleberry joins to share his favorite holiday gift gets for those who are seeking adventure!
Get ready for the unhealthiest time of year -- the holidays! Research shows half of Americans will break their diet to give into the temptation of holiday food. A little cheat here or there -- well - we are all human. But you don't want to make a holiday habit of eating foods that will light your arteries on fire. The more logs on the fire --- the more retardant you will need to put out the flames. In body speak, the more fats and cholesterol being called in to patch up the artery damage. Don't worry, we are not here to be scrooge and tell you not to enjoy your holiday favorites. We are going to be your Holiday Angels, offering some healthier ways to enjoy them! The Way To My Heart has released its first publication called, "Food For Thought," and one of the largest sections is all about healthier substitutes. So during the next hour, hosted by Kym McNicholas and Dr. John Phillips, co-hosted by Nurse Practitioner Kay Smith, we are going to show you how to healthify your holidays. Patients with Peripheral Artery Disease, restricted blood flow in mainly the leg arteries caused by plaque build-up, share their favorite holiday hacks. Dietitian Melissa Hooper rounds out the broadcast with some of her non-negotiables for anyone trying to stick to their medical diets
Since November 14th is World Diabetes Day, hosts Kym McNicholas and Dr. Phillips are joined by guest co-hosts Podiatrist Dr. David Alper and Nurse Practitioner Kay Smith, to talk about one of the most prevalent complications of Diabetes, amputation. Every 20 seconds globally, a limb is amputated due to diabetes. Why? Extra sugar in the blood can damage the artery walls, allowing for fats and cholesterol to sneak in and push the artery wall out, hindering blood flow to the feet. Sometimes the first sign a diabetic has restricted blood flow in the leg arteries, known as Peripheral Artery Disease (P.A.D.) is when an ulcer appears on their foot or toe that won't heal. Every 1.2 seconds somewhere in the world there is a new diabetic foot ulcer that appears on someone. Diabetic Foot Ulcers are responsible for more hospitalizations than any other complication of diabetes, driving direct costs through the roof. Innovators at Sensoria® Health and Defender believe they have one way to help heal diabetic wounds faster, minimize related amputations, and reduce costs. Dr. Jason Hanft, podiatrist, and Michael DiTullo, a former shoe developer at Nike, have created the Foot Defender® to help patients expedite the healing time for their diabetic ulcers. The Foot Defender is designed to help heal diabetic foot ulcers and reduce the risk of amputations by improving patient adherence to mechanical offloading, monitoring patient usage, activity, improving outcomes, and reducing healthcare costs. A patient supported by P.A.D. advocacy organization The Way To My Heart shares his long journey trying to save his legs from amputation as well as his feedback after trying out The Foot Defender® for a few weeks.
Since November 14th is World Diabetes Day, hosts Kym McNicholas and Dr. Phillips are joined by guest co-hosts Podiatrist Dr. David Alper and Nurse Practitioner Kay Smith, to talk about one of the most prevalent complications of Diabetes, amputation. Every 20 seconds globally, a limb is amputated due to diabetes. Why? Extra sugar in the blood can damage the artery walls, allowing for fats and cholesterol to sneak in and push the artery wall out, hindering blood flow to the feet. Sometimes the first sign a diabetic has restricted blood flow in the leg arteries, known as Peripheral Artery Disease (P.A.D.) is when an ulcer appears on their foot or toe that won't heal. Every 1.2 seconds somewhere in the world there is a new diabetic foot ulcer that appears on someone. Diabetic Foot Ulcers are responsible for more hospitalizations than any other complication of diabetes, driving direct costs through the roof. Innovators at Sensoria® Health and Defender believe they have one way to help heal diabetic wounds faster, minimize related amputations, and reduce costs. Dr. Jason Hanft, podiatrist, and Michael DiTullo, a former shoe developer at Nike, have created the Foot Defender® to help patients expedite the healing time for their diabetic ulcers. The Foot Defender is designed to help heal diabetic foot ulcers and reduce the risk of amputations by improving patient adherence to mechanical offloading, monitoring patient usage, activity, improving outcomes, and reducing healthcare costs. A patient supported by P.A.D. advocacy organization The Way To My Heart shares his long journey trying to save his legs from amputation as well as his feedback after trying out The Foot Defender® for a few weeks.
If you have symptoms A, B, and C, it is likely your physician will follow a decision-tree that leads them to choose X as treatment. Treatment algorithms exist across healthcare. They're detailed, step-by-step flow charts that outline the recommended treatment for patients with a specific disorder. These algorithms are a critical foundation for any physician. They're also critical for standardizing treatment around the world so as to provide equitable care. In this week's show hosts, Kym McNicholas and Dr. John Phillips are joined by The Way To My Heart's Nurse Practitioner Kay Smith and Rush Hospital's Dr. Kumar Madassery about the value of treatment algorithms as well as where they fall short for patients, costing life and limb. They also discuss critical questions patients can ask their doctor to determine their treatment algorithm so they can weigh it against another physician who may use a different flow chart for treatment. During the Save My Piggies segment in the second half of the show, a patient, John, and his wife, Amy, who discovered almost too late that different doctors have different treatment algorithms, share their plight to save his life and limb and the importance of getting a second opinion.
Dignity is an important component of providing care for dying patients and their families. Death with dignity is an
end-of-life option, governed by state legislation in the United States, and other lawmakers around the world. It
allows certain people with terminal illness to voluntarily and legally request and receive a prescription medication
from their physician to hasten their death in a peaceful, humane, and dignified manner. In today's show we talk
about what you need to know about your freedom of choice when it comes to dignity in dying. It's an important
conversation that could impact the discussions you have about life and death with your family and healthcare
team.
COVID-19 in its early days was classified as only a respiratory illness with varying degrees of severity. But as healthcare professionals learned more over time, they started also considering it a vascular disease because of blood clots that led to serious complications, including death, in patients suffering from COVID-19. In today's show hosts, Dr. John Phillips and Kym McNicholas are joined by guest co-host Nurse Practitioner Kay Smith and Cardiothoracic Surgeon Dr. David Allie, and a patient who almost lost his legs following vascular complications due to COVID-19, to talk about those vascular complications and strategies to minimize arterial/venous thromboembolism (blood clots), myocardial infarction (damage to the heart muscle caused by lack of blood supply, which could be the result of a blood clot) complications. Some of those strategies discussed include earlier bloodwork to check cardiovascular biomarkers such as D-dimer and troponin as well as ultrasound imaging of the lungs, heart, and legs upon the early presentation of symptoms, which could signal an earlier need for aggressive intervention and treatment.
How much easier would it be if we had instant access to our medical records, especially imaging, so we could make real-time decisions on our care and even get a second opinion in a timely manner? The reality is that although HIPAA mandates our right for access to our medical records, get copies of them, and request chances be made to them, policies differ depending on facility which hinder a patient's ability to get access real-time. Some charge to release the records, asking patients to cover the 'administrative costs.' Some wait until the very last moment to send under HIPAA's 30-day requirement between the time the request was made and honored. Some even take advantage of a one-time 30-day extension, further delaying the release of records. The delay in getting those records could cost life and limb. But there is some light on the horizon with the new Cures Act as well as innovation by entrepreneurs around medical records access. Leading the discussion is Bill Anderson, Advisor to Digicare, which is creating a platform that at its foundation democratizes access to all medical records for the patient across facilities, and even more, using a special algorithm brings the information to life by highlighting key medical terms and offering patients the ability to instantly get them defined and explained. He's also VP of Partnerships for Briya, which allows patients, physicians, and researchers, and data analytics tools to be able to access and make sense of data from any location, in any format, in near real-time. In the last half of the show, a patient shares her story of perseverance with Peripheral Artery Disease (P.A.D.), a chronic circulation issue impacting mainly the legs, that impacts one in five over age 60. Diagnosed and treated at early onset of symptoms such as leg cramps and pain in the buttocks, hips, thighs, or calves, reduces a patient's risk of heart attack, stroke, and amputation.
Hosts Interventional Cardiologist Dr. John Phillips and Emmy Award-winning journalist Kym McNicholas are talking about innovation around ALS. Most are familiar with ALS now more than ever because o the famous internet ice bucket challenge involving the pouring of a bucket of ice water over a person's head, either by another person or self-administered, to promote awareness of Amyotrophic lateral sclerosis , or ALS. ALS is a progressive nervous system disease that affects nerve cells in the brain and spinal cord, causing loss of muscle. Most people with this disease begin with muscle stiffness or weakness. But they eventually lose the ability to walk, dress, write, speak, swallow, and ultimately breathe on their own when the muscle paralysis spreads to vital organs such as the lungs. We are talking about it here on the Heart of Innovation for three reasons: First, although it's not considered a vascular disease, some researchers believe that an ALS-linked gene mutation could cause disruptions in the blood-spinal cord barrier, causing the neurovascular inflammatory response, which is ALS; Second, due to the lack of mobility as ALS progresses, many people with ALS end up with circulation issues in the legs (Circulation issues in the legs is known as peripheral vascular disease. We've talked about that at length on this show where arteries start hardening and the flaps that help usher blood flow back to the heart start malfunctioning.); Third, innovation around treatment and disease management has led to a longer, better quality of life for people with ALS due to organizations such as the Gleason Foundation, founded by former New Orleans Saints NFL great Steve Gleason. Kearney Gray, Director of development for the Gleason Foundation talks about how patient-driven innovation with communication and mobility are helping patients to live a longer, better quality of life. The Gleason foundation has played an integral role in raising the patient voice to create change in care, empowering companies to create new, novel approaches to improving communication for people with ALS, and not only educating lawmakers on ALS, but inspiring them to take action to help elevate care. Dietitian Melissa Hooper also joins the discussion to talk about the importance of nutrition in slowing the progression of disease and improving the quality of life of people with ALS. Since people with ALS maintain their cognitive ability throughout disease progression, knowing what's to come and what's happening can impact mental well-being. So, Kathryn Walker, CEO, MSN-Anesthesia, MSN-Psychiatry, at mental wellness treatment centers, Rivatalist, adds to the conversation with available options to improve mental health.
Description:
Having a chronic illness and/or a surgical procedure can be scary. In this episode of the Heart of Innovation, we are talking about pre and post surgery stress and anxiety, especially tomophobia, 'the fear of surgery'. In the hospital, people are given medicine to help them sleep or sedatives to put them at ease. At home, it's not always as easy. Either way, many times the hurry up and wait game for any procedure is sure to put you on edge. The Way To My Heart Nurse Practitioner Kay Smith along with CRNA Kathryn Walker, CEO of Rivitalist , a group of mental wellness centers and her colleague Beth Ward, a Licensed Clinical Social Worker (LCSW) talk to hosts Kym McNicholas and Interventional Cardiologist Dr. John Phillips about how to discuss doubt, fears, and anxiety with your healthcare team. They also offer tangible, actionable ways in which you can put yourself at ease pre and post surgery.
Grady, a family member of a patient who is now recovering from open heart surgery kicked off the discussion with a candid description of his experience leading up to his brother's procedure. He discussed the fear driven by the procedure itself but also the revolving door of physicians, the numerous pre-operative tests, the gaps in communication at times, and worries about what happens if treatment doesn't work. He also drove home the importance of a patient's healthcare team to recognize the stress and anxiety of a patient's family and to keep them in the loop to ensure all are on the same page so they can more effectively support the patient and help accelerate versus hinder the healing process.
Marcia, a patient with peripheral artery disease (P.A.D.), asked the therapists and Dr. Phillips about how to deal with post-surgery symptoms and the emotional stress that comes with so many questions that may arise between appointments with her healthcare team. Most patients don't have a physician or clinician on speed dial every single time a question pops up. So, what might be a small, normal post-surgery side effect, can be magnified the longer a patient waits for an answer.
A big takeaway from CRNA Kathryn and LCSW Beth is to recognize that stress, anxiety, and fear step from worrying about the future and things you can't control. They say the key is to focus on what you can control. Draw a circle on a piece of paper and place inside the circle all of the things you are worried about that YOU can actually do something about. That includes planning for options to accelerate recovery, such as starting to contemplate rehab possibilities, setting up a meeting with a dietitian, obtaining items for improved comfort and mobility at home, etc. Focus on those. For the others, sit down and come up with questions that may arise around them which can be discussed with your healthcare team or that of your family member.
In summary, it's most important to not burden yourself with regrets of the past and the 'what if's' of the future. Catch them coming into your mind, and remind yourself to look for things that are within your power tand control to change and do right now.
For more, listen to this powerful conversation:
Description:
Douglas is on deck for open heart surgery and decided to join the show just minutes before air time to inspire others through sharing his courageous journey. He heard that Dr. Mehrzad Zarghouni, Interventional Radiologist with Houston Vein & Vascular, was going to be on the show as guest co-host since Dr. Phillips was on call and taking care of an urgent heart patient at Ohio Health. So, he popped on just before our producer Aikman did the final countdown. Why? Douglas wanted to thank Dr. Z, who was named U.S. Vascular Doctor of the Year 2022 by advocacy nonprofit The Way To My Heart, for saving his life. Douglas had shown up to see Dr. Z a few months ago for a procedure to unblock arteries in his legs because of a disease known as Peripheral Artery Disease, which is defined by plaque build-up in mainly the leg arteries which restricts blood flow, causing debilitating pain.
The way Dr. Z described the situation, Douglas seemed off that morning and was complaining of fatigue and chest pain. Dr. Z canceled the procedure and sent Douglas immediately to the emergency department and called a friend , an Interventional Cardiologist, who was on call that day to urgently assess him and who was able to get diagnosed and stabilized.
Douglas has a rare ailment known as apical hypertrophic cardiomyopathy, which is when the walls of the heart become thicker than they should be and this excessive thickening can cause the heart to become more stiff and leaves less room for blood to fill the heart.
Douglas is now on deck for open heart surgery next week to improve his prognosis.
During the show Douglas was able to ask our guest panel questions to ease his fears about the procedure and what to expect post-procedure. The Way To My Heart Nurse Practitioner Kay Smith was able to provide an in-depth explanation of Douglas' situation. Nurse Practitioner/CRNA Kathryn Walker, a former cardiac anesthesiologist, who's also CEO of Revitalist, a group of mental wellness treatment centers, walked Douglas step-by-step through what to expect from the moment he's wheeled down to the operating room clear through recovery. Dietitian Melissa Hooper (www.dietitianmelissa.com) answered Douglas' questions about how to improve his nutritional health following open heart surgery including cutting cholesterol, animal fats, and processed foods out of his diet.
Also, in the show's Save My Piggies segment, Dr. John Corl, Interventional Cardiologist with Christ Hospital in Cincinnati, Ohio is joined by his patient Marcia to talk about how the right doctor and "modern medicine" changed her life and made her "new" again. Marcia discusses how she was able to push through the pain associated with blocked arteries in her legs, known as peripheral artery disease, to help re-route blood flow through the body’s network of collateral vessels that lay dormant until you need them to improve circulation. This collateral network kept her legs alive until she was able to find Dr. Corl through The Way To My Heart, and he was able to clear multiple severe blockages in her upper thighs and lower abdominal region. She now walks more than 10,000 steps daily.
Description:
You don’t want to miss this compelling episode of The Heart of Innovation, not only because it has the potential to save life and limb through a deep dive into how walking can help create a ‘natural bypass,’ but because a patient shares his story of how a second opinion changed his life.
In segment three, Duke and his vascular specialist Dr. Yazan Khatib at First Coast Cardiovascular Institute in Jacksonville, Florida talk about how a leg amputation was thwarted. Duke has Peripheral Artery Disease (P.A.D.), which is a chronic circulation issue in mainly the legs. Duke had multiple interventions and bypasses to restore blood flow to his legs before finding Dr. Khatib. The catalyst for Duke seeking help from Dr. Khatib was the point where his previous doctor told him that it wasn’t worth his time and energy financially to delay what he believed was the inevitable, which was amputation. It was Duke’s Primary Care Physician who told him to get a second opinion before amputation. Four years later, Duke is still walking on two feet thanks to regular maintenance by Dr.Khatib and lifestyle modifications, especially walking.
Walking is the best medicine for P.A.D. That’s why during this episode, hosts Kym McNicholas and Dr. John Phillips spend the majority of time leading up to the Save My Piggies segment and afterwards talking to Interventional Radiologist Dr. Lorenzo Patrone, 2022 European Patient Champion and 2020 Global Vascular Doctor of the Year, about why walking is the best medicine for P.A.D. and other circulation issues. Mass General Hospital Vascular Surgeon Dr. Anahita Dua also shares how to walk effectively to wake up and grow your collateral network to help improve circulation without intervention.
P.A.D. is defined by a narrowing of the arteries, mainly in the legs, due to plaque build-up. When flow is restricted, muscles, organs, and tissue are starved of critical nutrients, including oxygen. This may cause symptoms, such as leg pain and cramping when walking (claudication). Even worse, it could prevent healing of sores on your feet, leading to ischemia, meaning tissue loss. Wounds need oxygen to heal. Your body does have a back-up system. It's the collateral network, known as your body's "natural bypass."
The collateral network consists of smaller vessels available to handle extra demand. What makes them so special is they have the ability to expand and even grow if necessary to keep up with demand.
Walking helps to accelerate this process.
When you walk or exercise, your heart starts to pump harder and faster to circulate blood to deliver oxygen to your muscles, organs, and tissues. If arteries can't handle the additional rush of blood flow, the collateral vessels re-structure to meet the increased demand.
Think about it like our freeway system. If there's an obstacle such as an accident on the freeway blocking the flow of traffic, more cars veer off on to side roads to continue moving forward towards their destination. Collateral vessels, like side roads, can vary in capacity, but unlike side roads collateral vessels can expand and grow with increased demand. The extent to which your collateral network can keep up with demand, depends on the individual and stage of disease.
The collateral network's effectiveness may be limited in individuals with advanced age PAD and those with smaller vessel disease below-the-knee. That's why it's important to get a full vascular assessment. During this assessment, discuss with your physician:
For those without Critical Limb Threatening Ischemia (CLTI), standard protocols for treating P.A.D. suggest a three-month program that consists of medical and exercise therapy. During that time, physicians assess whether an antiplatelet drug and/or a vasodilator, coupled with brisk walking will help your body to increase flow not only through narrowed arteries, but also through the collateral network.
If you are post-procedure, following an intervention or bypass, your physician will prescribe a walking regimen to help maintain the recently treated vessels open, as well as to continue to maintain and build your collateral network. If a covered stent is used or bypass is performed collateral vessels will be impacted in those areas, but walking will remain critical to increase demand for blood flow to maintain those vessels open.
Some facilities offer a formal Supervised Exercise Therapy (SET) program to support walking as medicine for P.A.D. patients. If your physician doesn’t have a formal walking program, go to TheWayToMyHeart.org to sign up for My Steps, which is a text-based program designed to meet each individual patient’s needs and goals to increase long-term accountability.
Description: Chronic physical illness can lead to depression and anxiety, resulting in a mental health crisis which can further jeopardize a patient's health. The Heart of Innovation hosts Kym McNicholas and Dr. John Phillips are joined by The Way To My Heart's Nurse Practitioner Kay Smith, legendary business and financial reporter Bambi Francisco (Founder and CEO of Vator.TV), and Revitalist (Mental wellness treatment center chain in six states including Tennessee and Kentucky) CEO Kathryn Walker to talk about the problem and innovative solutions to improve mental health in patients with chronic physical ailments.
Today’s show kicked off with a couple inspirational quotes by Queen Elizabeth II to celebrate the impact she’s had on the world during her reign:
“Everyone is our neighbour, no matter what race, creed, or colour.”
“When peace comes, remember it will be for us, the children of today, to make the world of tomorrow a better and happier place.”
Queen passed away this past week of what may have been a massive stroke, although upon publish of this article, cause of death had not been released to the public. Dr. Phillips commented on the prevalence of strokes in the elderly, and the importance of getting checked annually for one common cause, which is atrial fibrillation, an irregular and often rapid heart rate that can lead to blood clots. Now that the COVID-19 lockdown has lifted and hospital facilities are starting to operate again at a normal rate, it’s important for everyone to C.H.A.T. with their doctor about vascular health, which means to ask their physician to check their Carotids, Heart, Abdomen (Aneurysm), and Toes (arteries and veins).
The discussion on vascular health backed into the topic of the day, which is mental health and chronic physical illness. Bambi Francisco runs a content distribution network, Vator.TV, which includes regular salons on mental health. Her next event, “Future of Behavioral and Mental Health is October 26th where topics will include “Reinventing the doctor’s role”, “Future of Clinics”, “Lifestyle” and more. The premise for the event as well as how she began her discussion on mental health, is that for at least a decade, about one out of five Americans suffered from some sort of mental disorder. In the case of depression, it’s become almost an epidemic rom being a rare condition 50 years ago. Critics have argued the rise has a lot to do with pathologizing normal psychic and somatic behavior, meaning society’s idea of normal often means never feeling sad or hopeless. Covid and policies around the lockdown that kept kids out of schools has contributed to the elevated levels of mental stress. But it’s also weighed heavily on those with chronic illnesses.
Kathryn Walker, CEO of Revitalist, who’s also an ICU Nurse explains why chronic physical illnesses can impact mental well-being and how psychedelics such as ketamine are becoming more accepted as mainstream treatment. Nurse Practitioner Kay also discusses the importance o Virtual Reality in the treatment of mental health issues and Bambi Francisco highlights the rise in faith-based technologies to improve mental well-being.
Diane, a patient with Peripheral Artery Disease (P.A.D.), which is a chronic circulation issue, talks about the impact of P.A.D. on her mental state and how finding the right vascular specialist who uses advanced minimally invasive tools and techniques can make all the difference in the world in not only providing pain relief, but also restoring hope, her mental state, as well as her love life.
Description: Type 2 diabetes and obesity are epidemics that can lead to amputation due to a common complication known as peripheral artery disease (P.A.D.), which is plaque build-up in mainly the leg arteries that restricts blood flow. But the right diet can help mitigate risk for limb loss. Hosts Kym McNicholas and Interventional Cardiologist Dr. John Phillips are joined by Nurse Practitioner Kay Smith to chat with special guest Dr. Michael Dansinger, Wellness Director for Boston Heart Diagnostics, about diabetes reversal, eating strategies to for P.A.D. prevention, and the secret to weight loss based on USA Network's The Biggest Loser reality show.
Dr. Michael Dansinger is Founding Director of the Diabetes Reversal Program at Tufts Medical Center in Boston . He also serves on the CDC’s Expert Panel for Worksite Wellness Programs and on the Council of Directors for the True Health Initiative, a leading international voice for health and wellness. Dr. Dansinger previously served as the Nutrition and Obesity Editor for Medscape Journal of Medicine and was the principal investigator of the Tufts Popular Diet Trial comparing the Atkins, Zone, Weight Watchers and Ornish eating plans for weight loss and heart disease risk-factor reduction (published in JAMA). Dansinger was the nutrition doctor for NBC's The Biggest Loser for 10 years and designer of the Biggest Loser Diet, which won top awards from U.S. News & World Report (including No. 1 Best Diet for Diabetes).
Before Dr. Dansinger got into the heart of this episode's feature topic on how diet can reduce a diabetic's risk for vascular complications, the show kicked off with a discussion about obstacles patients face in healthcare. Nurse Practitioner Kay Smith shared her experience in Scotland, spending four hours in pre-operative protocols for a surgery planned for next week, only to have her physician cancel her surgery appointment due to a condition called, atrial fibrillation, that she was never informed of but was written in her medical chart. Kym and Dr. Dansinger weighed in on lessons others can learn from this experience which includes two critical questions all patients should ask following any medical appointment:
Kym also shared her nightmare experience with her dad falling a second time in two weeks. The first fall was out of their area and resulted in emergency surgery to replace a previous hip replacement and stabalize an elbow fracture with pins and wires. This second fall resulted in an additional hairline fracture in his femur, re-opening of the hip replacement incision, and a displacement of the pins in his elbow. An ambulance trip to the emergency room left Kym and her dad with more questions than answers. The emergency physician and clinicians refused to call the on-call orthopedic surgeon to review his xrays. If they did, they would've learned of his additional hairline fracture in the femur and would've sent him home in a wheelchair. Instead, he was told to get up and walk despite debilitating pain and a continued run of the fracture. Even more, they didn't remove that half pulled off wound dressing, didn't apply temporary steri strips to reseal the wound that opened, and sent him home with only half the wound covered. So, when he arrived home, within 10 minutes the paramedics had to be called as the wound dehiesced further and he had to be taken to a larger hospital facility in Marin County, California with a more experienced trauma team. There, he was scheduled for time in the operating room to properly clean, re-sutre, and dress the incision site. He was also admitted until an orthopedic surgeon could get a physical therapist and occupational therapist to work with him on his new orders for limited weight-bearing.
Dr. Dansinger and Dr. Phillips both were horrified by Kym's experience with her dad. They agree that under no circumstances should Kym's dad have been released from the first emergency room without an orthopedic surgeon reviewing the images and without proper wound care. They each expressed the importance of physicians and clinicians taking the time necessary to listen to the patients and fully assess the entire situation and for patients and their advocates to have patience with medical staff. But they were also not surprised due to an overwhelmed healthcare system, especially since the COVID epidemic. Dr. Dansinger says as our population continues to age this will become an even bigger problem of overcrowded hospital facilities and not enough staff to manage them. It's why he shifted from an urgent care doctor to focusing on prevention of chronic illness. That includes diabetes. That's where the hosts transitioned the conversation into focusing more intently on what patients can do to reverse it and mitigate their risk for serious vascular complications such as amputation.
Description: Patients are on the frontlines when it comes to uncovering gaps in our healthcare system. That's why this episode features patients who have Peripheral Artery Disease, restricted blood flow in mainly the leg arteries due to plaque build-up, and live in low-socioeconomic areas, talking about how they are treated and what might help improve care. Physicians who care for these patients also weigh-in. All guests on today’s program are attending The Way To My Heart Inc’s first in-person “Making the Impossible, Possible, P.A.D. Warrior conference in Chicago, Illinois, which is focusing on sharing cutting-edge information with P.A.D. patients. Host Kym McNicholas is broadcasting LIVE from the event. Host Dr. John Phillips is broadcasting LIVE from Newark airport in New Jersey following a medical seminar, put together by device maker Cook Medical, where he was educating other physicians and clinicians on new tools and techniques for unblocking leg arteries in minimally invasive ways.
Kym kicked off the show talking about gaps in emergency healthcare after her dad spent the week in the hospital following a fall. He fractured his right femur and right elbow. He was left in the emergency room without an orthopedic consult for 9.5 hours awaiting potential surgery. Kym expressed concern that he is a heart disease patient at-risk of blood clots, being left in one position laying down for such a long period of time without taking his blood thinners, not being given fluids, and not urinating despite a full bladder. He was only taken care once Kym arrived and was able to start advocating for him. She pushed to get a phone consult with the orthopedic surgeon who had already left the hospital without seeing her dad, confirmed the surgery for the next day, got a Levonox shot ordered, finally got him a can to empty his bladder, and had the nurse place circulating socks on his feet. This experience led to Kym and Dr. Phillips discussing the importance of emergency room staff taking steps to prevent vascular complications whether they’re related to the reason for admittance or not.
Following that conversation, other physicians joined in to discuss their ideas for improving care. Key points made by Vascular Surgeon Dr. James Antezana, M.D., FSVS, RPVI (Charlotte, North Carolina), Dr. Paramjit "Romi" Chopra (Chicago, Illinois), Kumar Madassery (Chicago, Illinois), and Dr. Mohammad Elsayed, MD (Schaumberg, Illinois) include the importance of:
· Working with Primary Care Physicians to recognize the symptoms of P.A.D. to get patients diagnosed and treated in early stages.
· Improving the communication between different physicians to ensure a timely, effective multidisciplinary approach to treating patients with P.A.D.
· More consistency in treatment for P.A.D., favoring more advanced limb salvage tools and techniques to reduce the number of preventable amputations.
Patients who spoke out on the show agreed with what the physicians had to say and had a few of their own ideas as well on shaping the future of P.A.D. care. They include:
· Encouraging patients to get a second opinion versus telling them there’s no other option but what is being offered in that moment at that facility.
· Making sure to offer a proper diagnosis for P.A.D. versus simply telling a patient they have circulation issues related to diabetes.
· Performing an exhaustive angiogram using advanced tools and techniques to try and revascularize vessels prior to amputation.
A big highlight during the show happened when one patient expressed concern about her vascular specialist refusing to treat blocked vessels below the knee despite rest pain at night. Kym was able to call over a vascular specialist attending the event to hear her story and give her hope that relief is on the way as he would review her case and exhaust all efforts to get her back on her feet pain-free.
Description: What patients say and what doctors hear is often very different. That's often the case with what doctors say and patients hear as well. But sometimes those conversations are well understood by both the patient and the physician, and may leave either one or both, speechless. During this episode, patients share stories about conversations with their doctor that have left them speechless. Hosts Kym McNicholas and Interventional Cardiologist Dr. John Phillips are joined by Dr. Kirk Minkus and Nurse Practitioner Kay Smith who will also share their funniest and even endearing moments with patients.
Dr. Minkus and Dr. Phillips shared similar stories about patients with Peripheral Artery Disease, plaque build-up in mainly the leg arteries that restrict blood flow, that they helped by opening up the arteries and restoring blood flow to their legs, who had an unexpected result following the procedure. Dr. Minkus had a young couple tell him he saved their marriage and Dr. Phillips had a couple upwards of 90 years old who felt like teenagers again with increased intimacy. Nurse Practitioner Kay Smith shared the story of a patient who refused her help to get a second opinion from an advanced skilled vascular specialist known for limb salvage techniques and went ahead with an amputation which might've been prevented. The shocking thing was the 'Goodbye Leg party' which was complete with yard signs and cake celebrating this milestone.
Host Kym McNicholas kicked off a series of stories from patient perspective, about physician encounters, that surprised them. She attends appointments with patients who have Peripheral Artery Disease as an advocate through The Way To My Heart. During one appointment the physician told a patient that it wasn't effective to treat below-the-knee and that a bypass wouldn't be effective because flow through her one vessel (out of three) running through the calf, was sluggish. So, her only option was to walk, walk, walk until she couldn't walk anymore and when the pain was too much, he would amputate. When she asked for a second opinion, he replied, "I don't need a second opinion as I'm confident in my assessment." Ultimately Kym was able to get the patient a second opinion from an advanced skilled physician who opened up her vessels below-the knee and she's still walking more than a year later.
Two patient callers, Michelle and Tabitha, shared their physician experiences before Nurse Practitioner Kay talked about a patient she was helping in the United Kingdom who was getting the plaque in her iliac artery cleared using endovascular approaches. No sedation was used during the procedure. In response to the patient's cries of pain and her nurse with tears shedding in empathy, the doctor responded by saying, "It's not a good day unless I make a nurse and patient cry." And if that wasn't shocking enough, Dave from Indianapolis left everyone speechless for a moment when he shared his experience at a medical conference where a physician held a seminar on how to prevent patients from getting a second opinion.
One highlight of the show was the Save My Piggies segment where a patient, Douglas, candidly talks about his fight for life and limb. His vascular surgeon escalated procedures every 3-6 months as his arteries continued to re-block, leaving the patient with few options to keep his limbs and fighting for his life like never before within two years of his first two stents. He was never diagnosed with Peripheral Artery Disease, offered critical medications for management, or had a discussion about lifestyle changes. It wasn't until Douglas found The Way To My Heart, did he finally get referred to another vascular specialist who was able to get him on the right path to living a better quality of life.
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Description: If you have been diagnosed with a form of vascular disease such as Heart Disease, plaque build-up that has the potential to restrict blood flow in the coronary arteries or Peripheral Artery Disease, which impacts the leg arteries then it is likely you have plaque build-up in other vessels in the body, especially small vessels including those that feed the prostate. In this episode, hosts Kym McNicholas and Dr. John Phillips are joined by Board Certified Vascular and Interventional Radiologist Dr. Charles Nutting , who specializes in small vessel revascularization and prostate artery embolization (PAE), an outpatient procedure that involves the release of microscopic, plastic beads into the arteries that feed the prostate gland. We discuss who might be a candidate, the risks involved, and how to talk to your doctor about sexual dysfunction, what might be causing it, and available treatment options.
A patient, Douglas, joined the conversation, sharing his personal story experiencing sexual dysfunction as a first sign of systemic vascular problems. Also, The Way To My Heart Nurse Practitioner Kay Smith shares her story of assisting in a PAE procedure for a 19-year-old who was able to have an erection for the first time in his life while still on the table after physicians completed the case.
During today's show, Dr. John Phillips is broadcasting LIVE from an educational seminar for clinicians that was put together by device maker Cook Medical. Kym is LIVE from the Vascular Institute in Sacramento, California where she observed Dr. Inder Singh saving the leg of a The Way To My Heart Inc patient who was on deck for a below-the-knee amputation. Dr. Singh shares how he was able to restore additional blood flow to help heal wounds on the patient's foot.
To find an Interventional Radiologist in your area who may offer Prostate Artery Embolization (PAE), go to the Society of Radiology’s website: https://www.sirweb.org/
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Description: It might be odd to think that on a show about vascular health, hosts Kym McNicholas and Dr. John Phillips are talking about fibroids, which are noncancerous growths in a woman's uterus. There is a vascular connection. First, studies show that cardiovascular risk factors were slightly more common for women with fibroids than for women without fibroids. Fibroids have been associated with hypertension and atherosclerosis, and some recommend using fibroids as a marker for future cardiovascular disease (CVD). Second, there’s a minimally invasive technique to treat fibroids without surgery that’s becoming more prevalent, known as Uterine artery embolization (UAE), where the blood supply of the fibroids is cut off, causing the fibroids to shrink.
During this episode Kym and Dr. Phillips talk to Advanced Vascular Centers Interventional Radiologist Dr. Mary Costantino about Uterine Artery Embolization (UAE), what it is, how it’s performed, its effectiveness, and when it’s warranted versus the traditional and mainstream treatment using a hysterectomy, which is the physical removal of the uterus. We also discuss why UAE isn’t offered to most women as an alternative to hysterectomy and how reimbursement may be a contributing factor as payers offer facilities more for the invasive versus minimally-invasive options. UAE isn’t right for everyone, however. Some researchers express concern about using UAE in younger women with reproductive plans due to possible pregnancy complications down the road. But if hysterectomy is the only other alternative, which prevents even the possibility of a pregnancy, Dr. Costatino believes it’s important for gynecologists to have an open, candid discussion about all available options along with the benefits and risks of each one. She contends that it is not fair to withhold the availability of UAE from patients and afford them the benefit of being able to gather all pertinent information and weigh her options. Dr. Costantino talks about how it’s the women, themselves, who are actually the driving force behind the growing popularity of using UAE as an option to treat fibroids, because they’re doing their homework, not wanting to be out of work with an up to six-week recovery from hysterectomy versus a small puncture in the wrist or groin as the only external entry point for treatment using UAE, that allows a woman back on her feet in days. An important takeaway that Dr. Costantino shares about fibroid treatment, is it’s not something to rush into for any woman. Some women never have lifestyle-limiting symptoms or complications. But those who have lifestyle limiting symptoms including the below, should have the discussion about all treatment options with their gynecologist:
If treatment is right for you, ask your gynecologist for a referral to a surgeon who would perform a hysterectomy AND to an Interventional Radiologist who can perform a UAE so that you can best weight all available options and decide what is best for you.
For more information go to Dr. Costantino’s website: https://advancedvascularcenters.com/uterine-fibroids/
And to find an Interventional Radiologist in your area who may treat fibroids, go to the Society of Radiology’s website: https://www.sirweb.org/
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In the summer, your feet are exposed to the elements more often which is especially concerning for those with diabetes, neuropathy, and Peripheral Artery Disease (P.A.D.), which is poor circulation due to plaque build-up in the arteries. Podiatrist Dr. David Alper joins hosts Kym McNicholas and Dr. John Phillips to talk about how to prevent common foot problems and complications.
An important part of today’s discussion was about how lack of circulation can put patients at-risk of more severe complications during the summer especially. Wounds don’t heal as quickly and easily without proper blood flow. So, if you have diabetes or P.A.D., it’s important to have a vascular specialist and podiatrist team up to help both on the inside of your arteries and outside of your foot. Dr. Anthony Pozun, an Interventional Cardiologist with Modern Vascular in the Phoenix area of Arizona, was listening to the show and called in to drive home that point. He added that tools and techniques for restoring blood flow have advanced to the point where some physicians know how to carefully navigate clear into the small vessels in the foot to help clear a path if necessary for even more flow to heal wounds faster, especially in diabetics who tend to have more vascular issues in their lower extremities.
Patients wrote in many questions during today’s broadcast as well about choosing appropriate shoes and proper toe nail care. Dr. Alper emphasized that flip flops are not the most supportive choice for the feet especially because they force you to grip the shoe with your big toe and second toe, which can lead to bunions and hammer toe problems. That can also pose a problem for those with neuropathy who might not feel a friction wound brewing between the two toes. Dr. Alper suggested that summer footwear should have at least a band around the heel so the foot remains secure and supported without effort. And if you do a lot of walking or running, that sneakers should be replaced every six months to ensure the best support for exercise programs. As for toe nail care, he discussed the importance of learning from a podiatrist how to cut your toe nails properly and to shy away from nail salons if you have diabetes, neuropathy, and/or P.A.D. One of the most important points Dr. Alper raises about avoiding summer foot problems is the use of sunscreen. He said that some of the most frequent visits to his clinic during the summer were by those with second degree burns or worse, not just on the top of their feet, but also the bottom. The latter of course is due to forgoing shoes on hot pavement.
Also in this episode, you don't want to miss our Save My Piggies segment where a patient, Sheryl and her Vascular Surgeon in Oklahoma City, Dr. Bernardino Rocha, share an inspiring story of how a second opinion made the difference between life and limb. She found Dr. Rocha through nonprofit advocacy organization The Way To My Heart after she spent months in a wheelchair with no hope of ever walking again. Her primary care physician had misdiagnosed her symptoms of leg pain and cramps as gout and when medicine didn’t help it, he offered her muscle relaxers and told her to drink plenty of fluid to relieve the cramps in her foot and calf. It wasn’t until she went to a podiatrist for an unrelated issue that he discovered signs of a circulatory problem. Further testing uncovered she had Peripheral Artery Disease, restricted blood flow in the leg arteries due to plaque build-up. That is what was causing all the leg cramps. She thought the proper diagnosis would lead her to an easy solution, but her vascular surgeon told her that the only thing he could do was an extensive bypass that he didn’t think would last very long and amputation was in her future. The Way To My Heart sent her to Dr. Rocha for a second opinion and he was able to easily clear the artery blockages using minimally invasive tools and techniques. After the angiogram procedure she felt immediate pain relief and was able to get out of the wheelchair, with a regular walking regimen each day whether on pavement or in the pool.
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