Chronic diseases are preventable. Dr. Paul Kolodzik has seen enough people losing their legs or needing dialysis in his emergency medicine career - all of which can be avoided.
For the last 5 years, he focused on metabolic health practice. He knows there’s an opportunity to prevent the patients’ chronic illnesses and their potential side effects. And it begins with spending enough time with the patient and educating them. Something most primary care doctors lack the time to do.
So in this episode, Dr. Kolodzik spends enough time discussing his metabolic health experience as he highlights how valuable a continuous glucose monitor is, why strength training should be a priority, his work on addiction, and the need for the healthcare system to do more than just disease management.
Quick Guide:
01:08 Introduction
06:50 The problem with high blood glucose
08:48 His metabolic health practice
10:20 The benefits of the continuous glucose monitor
15:39 Strength training and lowering the blood glucose
20:28 Fatty liver and muscle mass gain
31:58 The healthcare system dictates how to take care of patients
39:55 The relation of addiction to metabolic health
47:28 Contacts and closing
Get to know our guest:
Dr. Paul Kolodzik graduated from the University of Notre Dame and attended the Wright State University School of Medicine. He then had his Residency in Emergency Medicine in 1987, serving as chief resident in his final year. He has served as clinical faculty at the Ohio State University School of Medicine and has been an Assistant Clinical Professor at Wright State University since 1989. He is Board Certified by The American College of Emergency Medicine and the American Board of Preventive Medicine. Dr. Kolodzik is also Board Certified in Addiction Medicine. He has been in private metabolic health practice for the last five years.
Connect with him:
Twitter: https://twitter.com/drkolomd
Instagram: www.instagram.com/metabolicmds
Facebook: www.facebook.com/metabolicmds
Website: www.metabolicmds.com
LinkedIn: https://www.linkedin.com/in/paulkolodzik/
Episode snippets
08:04 - 08:47 - Making a difference before it gets worse
11:11 - 12:33 - The CGM used for the
Chances are, you wouldn't be listening to this podcast if you didn't need to change your life and get healthier.
So take action right now. Book a call with Dr. Ovadia's team.
One small step in the right direction is all it takes to get started.
How to connect with Stay Off My Operating Table:
Twitter:
Learn more:
Theme Song : Rage Against
Written & Performed by Logan Gritton & Colin Gailey
(c) 2016 Mercury Retro Recordings
Chronic diseases are preventable. Dr. Paul Kolodzik has seen enough people losing their legs or needing dialysis in his emergency medicine career - all of which can be avoided.
For the last 5 years, he focused on metabolic health practice. He knows there’s an opportunity to prevent the patients’ chronic illnesses and their potential side effects. And it begins with spending enough time with the patient and educating them. Something most primary care doctors lack the time to do.
So in this episode, Dr. Kolodzik spends enough time discussing his metabolic health experience as he highlights how valuable a continuous glucose monitor is, why strength training should be a priority, his work on addiction, and the need for the healthcare system to do more than just disease management.
Quick Guide:
01:08 Introduction
06:50 The problem with high blood glucose
08:48 His metabolic health practice
10:20 The benefits of the continuous glucose monitor
15:39 Strength training and lowering the blood glucose
20:28 Fatty liver and muscle mass gain
31:58 The healthcare system dictates how to take care of patients
39:55 The relation of addiction to metabolic health
47:28 Contacts and closing
Get to know our guest:
Dr. Paul Kolodzik graduated from the University of Notre Dame and attended the Wright State University School of Medicine. He then had his Residency in Emergency Medicine in 1987, serving as chief resident in his final year. He has served as clinical faculty at the Ohio State University School of Medicine and has been an Assistant Clinical Professor at Wright State University since 1989. He is Board Certified by The American College of Emergency Medicine and the American Board of Preventive Medicine. Dr. Kolodzik is also Board Certified in Addiction Medicine. He has been in private metabolic health practice for the last five years.
Connect with him:
Twitter: https://twitter.com/drkolomd
Instagram: www.instagram.com/metabolicmds
Facebook: www.facebook.com/metabolicmds
Website: www.metabolicmds.com
LinkedIn: https://www.linkedin.com/in/paulkolodzik/
Episode snippets
08:04 - 08:47 - Making a difference before it gets worse
11:11 - 12:33 - The CGM used for the
Chances are, you wouldn't be listening to this podcast if you didn't need to change your life and get healthier.
So take action right now. Book a call with Dr. Ovadia's team.
One small step in the right direction is all it takes to get started.
How to connect with Stay Off My Operating Table:
Twitter:
Learn more:
Theme Song : Rage Against
Written & Performed by Logan Gritton & Colin Gailey
(c) 2016 Mercury Retro Recordings
S3E24 Dr. Paul Kolodzik
SUMMARY KEYWORDS
patients, phil, people, diabetic, metabolic, doc, glucose, problem, disease, insulin resistance, practice, medications, insulin, medicine, health, non diabetics, increasing, blood glucose, paul, muscles
Announcer 00:10
He was a morbidly obese surgeon destined for an operating table and an early death. Now he's a rebel MD who is fabulously fit and fighting to make America healthy again. This is Stay Off My Operating Table with Dr. Philip Ovadia.
Jack Heald 00:36
And we're back. It's the Stay Off My Operating Table podcast with Dr. Philip Ovadia. I'm the resident idiot Jack Heald. And we are joined today by Dr. Paul Kolodzik. And Phil, he sent me, I would love it if I could do this. He sent a biography. And I've never gotten the opportunity to read the biography of the guest on the air. So, with your permission.
Dr. Philip Ovadia 01:03
Let's do it. Not more formal than we typically are. But I think it would be a great...
Jack Heald 01:08
Dr. Kolodzik graduated from the University of Notre Dame. Oh man, Fighting Irish and Catholic, oh geez, and attended Wright State University School of Medicine. Well, that made up for it a little bit, I guess. I told you that would degenerate.
Dr. Paul Kolodzik 01:31
Are you comparing me to Phil here?
Jack Heald 01:36
He then completed his residency in emergency medicine, which I think is freaking cool serving as chief resident in his final year. Yes, I am adding some opinions here in the biography. He has served as clinical faculty at The Ohio State University School of Medicine and has been an assistant clinical professor at Wright State University since 1989. He is board certified by the American College of Emergency Medicine and the American Board of Preventive Medicine. Dr. Kolodzik is also board certified in addiction medicine. He has been in private metabolic health practice for the last five years. Phil, I think that last sentence is why he's here.
Dr. Philip Ovadia 02:14
Exactly. I think that last sentence kind of gives the idea that Paul is another fellow physician who has seen his way out of the morass, so to speak and is really focused on turning around the direction of healthcare and making meaningful improvements for his patients. And that's why I've been so excited to have this discussion with him. So welcome, Paul, why don't you want to fill in a few of the gaps that weren't in the formal bio? And tell us a little bit about the story behind the story and how you pivoted from emergency medicine and what led you down the metabolic health pathway.
Dr. Paul Kolodzik 03:02
Well, thanks, Phil. It's a pleasure to be here. I think my experience is probably not that dissimilar to yours. You did it in the operating room operating on people and seeing disease. My perspective is from the emergency department and seeing people come in with preventable problems, often the result of years of insulin resistance, high blood glucose, obesity, and I see the end result often people in crisis, such as with heart attacks, or strokes, or an episode of renal failure related to a diabetic problem. And so, after seeing that for so many years, I want to, I think like you, be less reactive and more proactive.
Jack Heald 03:54
Okay, you got to go deeper though. My understanding, I had a client years and years and years ago, who was an ER doc, and I had long thought that being a doctor was quite possibly, maybe next to being the Queen of England, the worst job in the world. And he disabused me of that notion, at least as far as being an ER doc was concerned. My understanding was he worked regular hours. He had a fixed schedule. He had no office visits. He didn't have the insanity that everybody else deals with. He just worked, I don't know, four or five eight-hour shifts a week and was fat, dumb, and happy the rest of the time. It sounded like if you want to practice medicine, it sounded like a great gig.
Dr. Paul Kolodzik 04:45
Yeah, I've enjoyed that career. I very much enjoyed it. When I started emergency medicine. It was relatively early in the specialty’s history. So, there was a lot of growth through the 80s and the early 90s. And I enjoyed being a part of that. I actually was part of an emergency medicine group that we grew from a couple of contracts to about 60 contracts, the way that works is physician groups contract with hospitals to provide the physician services. So, I really enjoyed that, stayed clinical the whole time worked in a lot of different types places, worked in trauma centers, worked in small rural hospitals. And to tell you the truth, when you're the only guy there, you got to be the anesthesiologist that night. You might need to do a little bit of Phil's work with relieving a tension pneumothorax or whatever, then that can be somewhat stressful, but it's also exhilarating. So, I have very much enjoyed the practice, I actually have downshifted a little bit in recent years. I still pull a shift every week or so at the VA Medical Center in Dayton. But I've been able to decrease the necessary knowledge base because I don't have to take care of Pediatrics anymore. And I don't do a lot of OB Gen. So, so I can just focus on adult medicine. And that's been a nice combination with my metabolic health practice.
Jack Heald 06:17
Go ahead, Phil.
Dr. Philip Ovadia 06:18
I was gonna ask, what were some of the things that you were seeing in the emergency room that kind of keyed you into metabolic health? For me, heart disease is kind of an obvious connection there. Although I fully admit, it took me 10-plus years to see it. But what were some of the things that you were seeing in the ER that really got you thinking about metabolic health and thinking that there needed to be a better way of doing this?
Dr. Paul Kolodzik 06:50
Largely, it was the chronic preventive problem. So, let me give you an example, the diabetic patient that has to go on dialysis. If they wouldn't have the knowledge base to manage that better themselves, Borbon provided the right guidance in terms of decreasing their carb intake and, and decreasing vascular inflammation, that would make a huge difference in their life. At the VA, now, I see a lot of peripheral vascular disease. So, I see people losing legs as a result of that process. And I think a lot of it, I don't want to make this too simple, but a lot of it boils down to blood glucose. If people just had an understanding of the problem that high blood glucose causes. An example is if you get a diagnosis of pre-diabetes. It seems like a medicine out there, kind of the approach is, yeah, your blood, for a patient in the office, the provider says, yeah, your blood sugar's a little bit high, we'll check it again in a year or so and we'll make sure it's not too bad. And if it is, maybe we'll start some medicine. I'll tell you, that's, that's a case where lights and sirens, pre-diabetes is a time when lights and sirens should be going off. Because that's when you have the opportunity to prevent a lifelong disease of diabetes and head off those potential complications. So, I just over time got tired of seeing that and thought I could make a difference before patients got to that stage with losing their legs or needing to be on dialysis. And then the deeper is, Phil, the deeper you go down this metabolic rabbit hole, just the more enthralled you get with the things that you can do to help people.
Jack Heald 08:48
Okay, I'm not gonna let that go by. Expand on that. You're an ER doc, you're seeing these people come in with problems that you realize could have been resolved earlier. Let's start specifically with the pre-diabetic. And I know we got when probably not going chronologically here. But so now you're doing something about it? What is it you do? How do you address that?
Dr. Paul Kolodzik 09:18
A lot of this is education. It's helping people to understand the issues and I think the knowledge base for people is increasing. I think people are beginning to understand some of the basic concepts. So, in my practice, people come in and I don't know if this is a similar pattern to what you do, Phil, or not, we haven't talked in detail. But my typical patient is that middle-aged, overweight, and metabolic syndrome patients, so they maybe have some hypertension, they have some pre-diabetes, they're 40- or 50-pound overweight. So, the mechanics of what I do first and I was in the office today and had a few patients we got started is I do a normal history physical exam, and then talk about what the next steps are. And one of the next steps almost always is using a continuous glucose monitor for a couple of weeks. Are you familiar with those? Or is your audience?
Jack Heald 10:20
Well, I love that you brought this up. Because for a myriad of reasons, which I don't need to go into, please expand on this continuous glucose monitor. Tell us about it, and why you brought it up.
Dr. Paul Kolodzik 10:39
So, these are the devices that have been used in diabetics for many years primarily used to manage insulin. So, you can see 24/7 and in real-time, what your blood glucose is really relegated to the use of insulin management in diabetics that I think has a tremendous use. And there's some controversy about this. But in my mind, after using this for the last four or five years on non-diabetics, very valuable, so my patients are non-diabetic, pre-diabetic, and diabetic, but in particular, I’ll use them on non-diabetics and pre-diabetics. So, we put this device on, it puts a small filament under the skin, sits in what's called the interstitial fluid there. And because that's close to the capillaries in that area, where blood glucose exists, you can get an indirect reading of blood glucose. So, we leave that monitor on for a couple of weeks and just let people watch what we call their data and their curves. How high does their blood sugar go up? How fast does it come down? Does it stay elevated for a period of time? This device is eye-opening for a majority of my patients. Again, I'm seeing a pre-selected group, they're metabolic syndrome patients, a lot of them already are pre-diabetics, some of them come in, and they say, I just want to lose 25 pounds. And you put this on there. And we just saw, we see almost immediately that the issues are much bigger, you're pre-diabetic, or I've even had patients that just came in to lose weight, and we find their blood sugar spike into 220. And they're diabetic. So, these devices, I think, are very valuable in two phases. One, a diagnostic phase, where you see what's going on with the patient. And then the therapeutic phase where they use it to help guide their diet. And the diagnostic phase, I think is the most important because it's eye-opening to people, they connect the dots that that piece of cake they eat last night spiked their blood sugar over 200. And they know that if they want to reverse course here, if they want to reverse their pre-diabetes or if they just have insulin resistance, they want to reverse the course, so they never become pre-diabetic or diabetic. It’s just an exceptionally valuable tool.
Jack Heald 13:04
So, you get almost, you get real-time feedback as to how whatever you stuffed into your mouth is affecting your blood glucose.
Dr. Paul Kolodzik 13:14
You get it in real time. And again, you use it initially as a diagnostic tool, but then you can use it therapeutically to help guide diet over time. I can see my patient's data remotely, that they appreciate that because they know somebody's kind of keep an eye on him. But they learn what they can eat and what they can't eat. And it helps guide their diet. And invariably, it leads to weight loss. So, we work with them. We help them set up their low-carb diets. Other components of the plan, intermittent fasting, I'm big on strength training, because if you can increase the quality of the insulin receptors on your muscles, then that'll soak up more insulin and help with that insulin resistance issue. So, it's a multifaceted program. But we start with CGM. And then measuring insulin resistance.
Dr. Philip Ovadia 14:09
Yeah, I think if the continuous glucose monitor was more widely used, it really could be the tool that changes everything, changes medicine, changes our food environment, certainly changes behaviors. I think it is that powerful tool because one of the problems we have around health is immediate feedback is hard to come by. Most of these things we talk about heart disease, that's a long-term play. And it's hard to really keep people or have people focus on are they headed towards heart disease or are they not headed towards heart disease? Whereas with the CGM really gives that immediate feedback that is so powerful in helping people to understand what's going on and how they can start to reverse course.
Jack Heald 15:14
Well, Dr. Kolodzik, I'd like you to expand on something else that you said. You said you're a big fan of intermittent fasting and strength training and you said something that I've never heard before, remember I'm not a medical professional, about increasing was it the number or the quality of the insulin receptors on the muscle?
Dr. Paul Kolodzik 15:39
Yeah, so if you strength train this sounds kind of strange coming from a doc but with my patients, I make strength training a priority. Even more than cardiovascular fitness. Most docs will focus on you need to eat, you need to get your heart rate up, you need to get on those cardio machines. In fact, I actually do TikToks occasionally, and I did a TikTok and the title was “get off the gosh darn cardio machines” or cardio machines. And I didn't mean completely get off the cardio machines, people should follow the American Heart Association guidelines and get cardiovascular fitness in. But where the money is, I think for middle-aged overweight people with insulin resistance, it is to increase your muscle mass. We all lose muscle mass as we get older. Sorry, I think he lost my video there for a second. I brought it back.
Jack Heald 16:36
But we heard you. So.
Dr. Paul Kolodzik 16:38
Yeah, okay. We all lose muscle mass as we get older. And so, increasing that muscle mass can be very beneficial for a variety of reasons. But in the metabolic syndrome patient, what happens is, when you increase that muscle mass, you're increasing the sensitivity and the quality of the insulin receptors on your muscles. And so, your muscles are...
Jack Heald 17:02
Go slow, slow down, slow down, you increase the sensitivity and the quality that...
Dr. Paul Kolodzik 17:12
The overall quality, it's basically the ability for your muscles to absorb more insulin. Okay?
Jack Heald 17:19
By increasing muscle mass, yes, you're increasing, you're improving the muscle's ability to absorb insulin, and there's technical stuff underneath that at this point.
Dr. Paul Kolodzik 17:33
I don't understand all that technical stuff, either. But I've done enough research to understand that you basically let me use a non-technical term, you just soak up more insulin.
Jack Heald 17:47
But okay, that so settled into the brain here.
Dr. Philip Ovadia 17:54
And more glucose, I mean you basically end up pulling sugar out of your bloodstream into your muscles, which may not solve the problem. It doesn't solve the problem of putting too much sugar into your system to start with, but it gives you a little bit of a buffer, certainly.
Dr. Paul Kolodzik 18:18
Right. I mean, it's additive, it's an additive effect. But you're right, Phil, the point is, you lower your blood glucose a little bit. And I don't know about you, Phil, but like, I think of this in simple terms. And I don't know if it's entirely scientifically accurate, but this is what I tell my patients. If you have extra blood glucose in your system from eating carbs, it goes to your liver, it gets converted to fat, some of it can stay in the liver as fatty liver disease. Other of it gets deposited in the visceral area around the middle. And what I want to do is help you lower that blood glucose because I believe losing weight or improving metabolic health is more hormonal disease related to insulin than it is a calorie in, calorie out issue. And so, what we want to do is lower that blood glucose, even to the point where we're reversing that process. Those muscles are looking around saying, hey, we don't have enough glucose, we don't have enough energy here. What are we going to do? And they look down and they see that fat around the middle and they say, that's what we're going to do. We're going to tap that. And those fatty acids are going to be our next energy source. And so, you basically reverse that process. To make it, to give an image of this, I just talked about the bear that's fattening up for dinner. They're out gorging on berries, and they're getting fat and all this visceral fat is being laid down. And then they go and hibernate for a while and that visceral fat becomes their energy source. Those fatty acids get broken down to provide energy while they're sleeping for four or five months over the course of the winter, and really that's what we're trying to do here. The bear hibernates for four or five months and doesn't eat, but we just keep going to the grocery store and buying more carbs. And so, with a low-carb diet, that's what we're trying to do. We're trying to lower that blood glucose so we can reverse that process, and the weight can come off instead of being put off.
Jack Heald 20:28
Um, a couple of questions. You talked about fatty liver disease. I had a dear friend die from fatty liver disease seven years ago. Yeah, it was brutal. And this was long before anybody in my circle had ever heard of fatty liver disease, but we can tell just by looking at her something's wrong, but nobody knew what. If you catch, will this actually, will a low carb, I'm assuming we're talking about a therapeutic ketogenic diet, will that reverse the effects of fatty liver? Can you reverse that as well? Heal the liver?
Dr. Paul Kolodzik 21:11
Yeah, absolutely. It doesn't even have to be ketogenic. It can just be low carb. It doesn't have to be a keto diet; it can be a low-carb diet. But yes, again, because there's organs now who are looking for an energy source. And if there's not glucose readily available, then it's going to pull the fat out of the liver. So absolutely, that's true. And what you say we never used to hear about this. It's becoming and I don't know if you run in these circles, Phil, but I got a friend actually that's an anesthesiologist at the Cleveland Clinic. And he says the liver transplants they used to do all used to be as a result of bad cirrhosis or bad hepatitis. And he says, now the majority of the liver transplant that we're doing is for end-stage fatty liver disease called NASH, N A S H the acronym, non-alcoholic steato-hepatitis. So that's a mouthful. But it's becoming more and more common. It's directly related to the obesity and diabetic issue. And I'm sure Phil and I can both talk about how that goes back to the food pyramid, etc. But that's why that disease is more prominent today.
Dr. Philip Ovadia 22:25
Yeah, and what's really most concerning about it is we see it in younger and younger people, and we're seeing teenagers developing fatty liver now, and so that's as you said earlier that's when the lights and sirens should be going off. You've probably noticed being an ER, in the ER, obviously, CAT scans are ubiquitous, and almost every patient ended up getting the CAT scan. And that you see, if you look for it, you see the fatty liver on almost all of the scans, and yet the radiologists, the doctors that are reading those studies, never even comment on it, because it's basically become like a normal finding, essentially.
Dr. Paul Kolodzik 23:17
Absolutely. I agree with that. Yeah, you get CAT scans anymore, you get CAT scans all day long. And it's always, not in every patient to but I've seen it progressively over the years when it wasn't that common, and now it's very common.
Jack Heald 23:34
So, can I ask one more question that goes back to weight training? You talked about strength training? Is there a difference metabolically in terms of helping your insulin receptive, insulin sensitivity? God, I do sound like an idiot sometimes, don't I? Is there a difference between training for strength versus training just to get bigger? I know bodybuilders have a different training regimen than strength trainers, is there a significant difference?
Dr. Paul Kolodzik 24:17
I'm gonna be honest with you, Jack. I don't know the details, because I'm actually not dealing with patients at that level of nuance. My typical patient is maybe let's say a 45-year-old overweight female that has never done strength training before. I'm just trying to convince her that this isn't going to make you look bulky, and it's gonna help you decrease your insulin resistance. So, in terms of the difference between building strength and building bulk, I'm just going to be honest with you, I don't know how to differentiate that. I'm at the level where I'm just trying to get him to do something.
Jack Heald
I gotcha.
Dr. Paul Kolodzik
That often will start with just some body weight at home and maybe some bands and for some people just some five- or 10-pound weights, but it's really satisfying when they graduate and feel that they can go to the gym, they aren’t embarrassed to go to the gym. I got to tell you one story about a patient I had, it was one of these women, and then she had never strength trained, and then she got really into it. So after about eight months ago into the gym, she came in for her next appointment one day, and she said, I wish your audience could see us, but it's like, she's looking in the mirror, combing her hair. And she looks and she says, for the first time in her life, she saw that she had a bicep, and she was just... And so now when she comes in, she refers to them to her as her guns, that her guns are doing okay. But that's the kind of thing you can do with helping people with lifestyle changes. And I haven't had a single woman get bulky. I've had a lot of them tell me that their clothes are fitting a lot better. The one other consideration here is if you're building muscle mass, but losing fat at the same time, muscle weighs more than fat. And so, the scale changes might not be as dramatic. But most of my patients are okay with that. Because they're looking better. They're feeling better, and their clothes are fitting better. Can I mention about increasing muscle? Two things. One is, obviously in all of this as we get older, it's a great tool to maintain your bone density because when your ligaments and your tendons are attached to the bones, they get stressed a little bit with weight training, and that helps decrease the risk of osteoporosis. So that's really one other tremendous advantage. And then another is not that this is a big deal, and I think neither Phil nor I are calories in-calories out kind of people, but when you increase your muscle mass, you are increasing your basal metabolic rate a little bit. So, you are burning a little bit more energy. So that can help with weight loss as well.
Dr. Philip Ovadia 27:19
Yeah, and I always like to point out to patients that your muscle is burning that energy around the clock as opposed to the cardio that you're only going to burn that energy while you're doing the cardio. But if you're building muscle, that's going to be extra energy that you're burning 24 hours a day, which really helps to magnify that effect.
Dr. Paul Kolodzik 27:46
Yeah. Jack, are you gonna post a picture that will demonstrate to your audience that on a 6’4” 240 completely cut guy?
Jack Heald 27:57
Totally. Oh, yeah.
Dr. Philip Ovadia 28:00
We've had, yeah. Well, send us the pictures, and we will make sure to get them in the show notes. We've got a couple of the trainer, fitness guys, and high-level athletes on here. They love when we post their shirtless pictures. Some of them, it's hard to find pictures of them wearing shirts.
Jack Heald 28:27
I know who exactly who you're referring to.
Dr. Philip Ovadia 28:32
So, I'd love to hear a little bit about how this has now kind of come circle? How this spills over now into your, when you do the shifts in the ER? How has it changed your approach? Because I know it certainly has had a big approach on the way that I deal with my cardiac surgical patients.
Dr. Paul Kolodzik 28:54
One of the advantages of working at the VA is it's not as rushed as the community hospitals I've worked in the past. So, I actually get the chance to sit down and talk with the patients. And after all these years, I just, I mean, I enjoy... The trend used to be picking up the charts and seeing the next patient and they all come up in the computer. But how this is translated is that I sit down and I do a lot education with people and the typical patient is the patient that comes in with a completely unrelated problem. They come in for something like, I don't know, feeling weak and dizzy, let's say which is a common complaint in the emergency department. And we do all their labs to make sure there's nothing serious going on and their blood sugar, some of them are diabetic, their blood sugar's running at 350. And it's like, I went back through the chart, it's been like that for months, and I get the opportunity to sit down and explain some of this to people and they begin to get it. They begin to understand. They're willing to go out and look at a low carb approach to their life because what are they at always looked at really is just adding more medicine or adding more insulin. And so, they're really willing I think at that point to make some changes. I had a patient a couple of weeks ago, and I don't know if this is a good or a bad thing, Phil, you tell me this. And I talked with him about his blood glucose, and how that's causing vascular injury. And I said, so you need to follow up with your doc and do something about it. He goes, I'm going to be right on this, doc. I said, well, why are you going to make this change now? He goes, well, doc, you scared me more than my regular doctor scared me. So, I don't know if that's a good thing or a bad thing. But in my mind, a little fear sometimes is not necessarily a bad thing.
Dr. Philip Ovadia 30:58
Yeah, I think it's a good thing for a patient. And unfortunately says a fair amount about our medical system these days, because I'm sure you see that these problems haven't been hiding. They have been there. It's just that we don't address them, and we certainly don't address them aggressively enough. And you can follow the progression of pre-diabetes to the diabetes to the vascular disease. And it's just a shame that this could have been better dealt with and we could have prevented so many of these problems, if it had just been properly addressed and aggressively addressed at the earliest signs of trouble.
Dr. Paul Kolodzik 31:58
Yeah, we have a health system, you open the door for me there, so I'm going to make a comment. We have, I mean, we got a health system that treats disease, yet all the incentives are toward treating disease. Preventative services, really, what we do, Phil, really our metabolic practices have a tendency not to be valued a lot certainly by insurance providers. But I'm not a primary care doc. So, I'm not going, this is not primary care doc-bashing mode. But when I got out of practice, excuse me, when I got out of residency in the mid-80s, most of the docs work for themselves in either individual practices or small group practices. And it seemed like it was less of the scenario of the doc during a visit with their face in the computer just taking the 20 minutes that they have with a patient today to adjust medicines. It's all they can do to do that. Most docs are not, they don't work for themselves anymore, they work for hospital systems, or whatever. And I, again, I'm not meaning to be in any way negative about that, but they're told what their schedules are. You get 20 minutes, and you just don't have time to address the issues that like Phil and I address with patients in 20 minutes. So, I don't have the expertise of a primary care doctor, you really don't want me managing your complicated hypertension or even diabetes. But I do have the ability to sit and talk with patients about the root cause of their issues, put a plan to further diagnose together those and then put a plan together to reverse those. So, it's just it's a different medical landscape than it was 30 years ago. And unfortunately, the incentives are not for prevention. They're for just...
Jack Heald 34:10
I call it disease maintenance.
Dr. Paul Kolodzik 34:13
Yeah. And that's, yeah, that's a great term to tell you that. I'm going to steal that from you.
Jack Heald 34:17
They want us sick, but not dead for as long as possible.
Dr. Paul Kolodzik 34:22
Yeah, that's a little bit nefarious. I hope that's not completely true.
Jack Heald 34:26
Well, I'm not a medical professional, so I don't have a license they can take away for saying that. So, I have a little more freedom to toss bombs than you guys might.
Dr. Philip Ovadia 34:38
Yeah, I mean I would say you're... I do, at this point, really question a lot of what our colleagues are doing, and I do start to push back and ask them basic questions like, are you happy with the results that your patients are getting? And if they're not, and I know that they're not. We see the burnout that's occurring. Why are we allowing this to continue? It really is a question for our profession, and our colleagues do need to start waking up. Because this doesn't end well for our patients. And it doesn't end well for the doctors, either if we don't start to change the path here.
Dr. Paul Kolodzik 35:31
Yeah, I agree with that completely. That's kind of why I'm doing what I'm doing now. Because I just got my metabolic health practice taking care of patients, still enjoying little time in the emergency department. But in my practice, I'm the boss, and I get to take care of patients the way I want to take care of patients.
Dr. Philip Ovadia 35:51
Yeah. And that's what we as doctors need to get back to is taking care of patients the way that we want to take care of them, not the way the system wants us to take care of them.
Jack Heald 36:04
I want to follow that line of thought normally, the audience that we're speaking to are folks like me, non-medical professionals who are looking for ways to get healthy, and we're tired of dealing with the crap that we've been fed our whole lives that we can see doesn't work. However, I would like you to talk to the medical professionals. You've made that transition, just like Phil has. Talk about the challenges you faced, and how you overcame them. Encourage those medical practitioners who are listening to us, who are watching this YouTube, who are thinking, God, I wish I could do this. How do they do it?
Dr. Paul Kolodzik 36:56
It takes kind of a high testosterone level to step out. And for most people, to borrow the money to start a practice. Realize, and I don't know exactly your model, Phil, but mine is not take insurance. Insurance covers labs for my patients and their CGMs. But my professional services are not covered by insurance. And there's a movement in this regard. There's even primary care docs out there, direct primary care physicians like Brian Lenzkes and Tro Kalayjian, for example, that are doing that. But I think for the younger docs, it's tough because they're coming out of school with a lot of debt. And they need to address that, young families, that type of thing. I'll be honest with you, I was fortunate, I was in a little bit of a different position, because I spent a lot of years in the emergency department, and I got to the point where I could kind of do what I wanted. It's gonna be tough because I've been involved in the business side of medicine as we grew that practice I alluded to previously. And business models are hard to change. And it's really just a matter of individuals deciding what they want to do themselves, and again, having the fortitude to do it. And docs getting together. And indicating that, as I think Phil said, it's just it's not right that we do, what was your term disease maintenance? And that's all we do. So, I wish there was an easy answer. I'll be honest with you; I don't think there's an easy answer other than more people doing what Phil and I are doing.
Jack Heald 38:51
Well, it sounds like there's an opportunity, frankly. It sounds like there's a business opportunity. All right, I'm speaking to the audience. Now, those of you who are eventual venture capitalists who are wanting to do something with your money to actually make a positive difference in the world, rather than just create the next Wizzy widget. Here's an opportunity. Let's help some of these young doctors who want to get out of the disease maintenance business and get into the health restoration business. I would be willing to bet there is a business model that will work for you guys, finance the start of the business, have an equity position in the business end itself, the doctor provides the labor. It's a VC play. It obviously is. There's some smart people out there who know how to make this happen. Let's make it happen, world. I'll get off my soapbox.
Dr. Philip Ovadia 39:55
One other interesting aspect of I know your practice and what you do, Paul, that I'd like to talk about is you get into some addiction issues as well. Alcohol addiction and talk a little bit, I guess, about that in isolation, but how you see it relating to metabolic health?
Dr. Paul Kolodzik 40:18
Well, many of the characteristics of those two diseases are the same. There's always this issue of if you're eating food and food is necessary for life, can you be addicted to it? And I firmly believe you can be addicted to certain types of food. I think there's no question, there is a sugar addiction that exists. And I think the way to manage that is the way we manage some other addictive diseases. And that's with I refer some of my patients to cognitive behavioral therapy. I have them journalize, which in journalizing, is very important in the addiction area. Let me give you an example. I've actually worked with a lot of alcohol patients. And there's something I wanted to mention about that as well. But getting patients to just keep a journal of the number of drinks that they have on a given day, and being able to walk back over the previous months and kind of see where they were, and where they've come from, I think can be very helpful. The other part of that a little bit is the medication aspect of it. And I think it's worth talking at least briefly about this. So, one of the medicines I've used for alcohol, and alcohol has a lot of carbs in it, so, it's part of the discussion here, I guess, is naltrexone. Naltrexone is a complete opiate blocker. It caps the endorphins and enkephalins receptors in your brain. And I use a method called the Sinclair method. The Sinclair method is simply taking some of this naltrexone that blocks those endorphin receptors in your brain at the time you drink, so you'll have a patient take some naltrexone an hour before they drink on days they drink. And then on days they don't drink, then they just let those receptors run wild, go do a workout, go take the dog for a walk, whatever. And over a period of time, I've used this in my practice now for seven or eight years, they realize that they don't get as much of a warm and fuzzy response related to their use of alcohol. So, their alcohol use gradually diminishes. So, it's really a harm reduction approach. The standard for the treatment of alcohol was always been complete abstinence, an Alcoholics Anonymous approach, but that's the thing with that approach which has been the approach since 1935 and not looking at other alternatives, I don't think is a good thing. So, I think journaling is important aspect of this and considering some kind of medication that might help and, if you will, I'm going to dovetail into that, because this is a very interesting thing in my mind. There have been some initial studies the semaglutide that would go via the Mozambique is in the news almost every day
Jack Heald 43:31
Slowly here. To our listeners, he just said three words that until I did research on Dr. Paul Kolodzik, a couple of hours ago, I never heard any of those words before. It sounded to me frankly, like it was Dr. Seuss kind of stuff. So, if you don't mind slowly on those three and explain what they are.
Dr. Paul Kolodzik 43:55
Are we okay with the naltrexone and the Sinclair method stuff, and I can move on from that?
Jack Heald 44:00
I followed you but who knows?
Dr. Paul Kolodzik
Go ahead, Phil.
Dr. Philip Ovadia 44:05
No, I was just going to say that Jack hasn't been paying attention to the news because those medications you mentioned, the weight loss medications have been in the headlines recently. And I like where you're going with this discussion.
Dr. Paul Kolodzik 44:26
So, these are the new FDA-approved weight loss medications, initially came out as Ozempic Novo Nordisk the company that makes it treated diabetics with it for a few years and noticed lo and behold, these diabetics lost weight. A good medicine because it helps control blood sugar, but it doesn't cause hypoglycemia or low blood sugar. So, like any good pharmaceutical company would do, they went back and did studies on non-diabetics and they found that lo and behold, the diabetics, excuse me, the non-diabetics also lost weight without problems of hypoglycemia. So originally marketed as Ozempic for diabetics in the last two years marketed as Wegovy for non-diabetics specifically for weight loss. And the weight loss is estimated to be 12 to 15%, with the use of these medications, with a couple of caveats, number one, that's in association with the diet and exercise program, which is really what we do, right, Phil? And then the other is, is that you gotta be aware that if you decide to use one of these medications, if and when you go off it, there's going to be weight regain. So, I kind of use it as a tool occasionally, and a limited number of my member percentage, I should say, of my patient population. But it's with the understanding that it's really a transient tool just to help break through a plateau or to get a jump start. But if you do not make the other lifestyle changes that are absolutely necessary during that time, at some point, you're going to be regaining a significant amount of weight. So, I think this is another component I add to that program of intermittent fasting, strength training, CGM, guided low carb diets. But it's only with a selected subpopulation that this medicine is used with the understanding that it's going to be used on a temporary basis.
Jack Heald 46:36
Well, you're not a primary care physician. How do you work with your patients, primary care physicians? How does that work?
Dr. Paul Kolodzik 46:45
It's been very gratifying because my patients, first of all, often come to me because they aren't getting what they need they feel they're getting what they need from their doc. But I have found the docs to be very collaborative. I tell them, I didn't have your expertise, as I mentioned previously, but I've been working with your patient. And it's hard to argue with, I've been working with your patients and they lost 35 pounds and their hemoglobin A1C has dropped from 8.6 to 5.4 and you've been able to take them off these three medications. So, my relationship with the primary care docs has been generally very good. And they now send me people routinely.
Jack Heald 47:28
Well, that was gonna be my next question. How do people find you? Your ED doc, who's not doing metabolic but not as a primary care physician? How do people find you?
Dr. Paul Kolodzik 47:48
I'm on Phil's and your podcast. So, I'm sure
Jack Heald 47:50
I guess that that'll help. Yeah, yeah.
Dr. Paul Kolodzik 47:53
So, since you asked, I'm licensed in Ohio, Indiana, Florida, and Arizona, so I can treat patients in all those states. I have a website, I'm a member of, I’m sure, like Phil, the Society of Metabolic Health Practitioners, also of Low-carb USA, so I'm on that website. And then I tried to do a fair amount of social media stuff, not quite as much as Phil does, he's kind of my idol in that regard. But I try and do a fair amount of social media stuff. And I think the cognizance of people in general, needing something like this is growing. And I think that's for both Phil and I helping to grow our practices.
Dr. Philip Ovadia 48:40
Yeah, I'd like to actually, that would be a great kind of thing to hear your perspective on. Because in a lot of ways you and I trained at a similar time and have been in practice for quite a while now. And the social media thing, obviously, isn't something we learned in medical school, and in a lot of ways promoting yourself as a doctor was thought to be sort of but no, no it was kind of looked down upon. But ultimately, we have to get this message to the people, and that's what I think is most powerful about social media, and why we need to continue to integrate that and continue to use platforms, the social media platforms, these podcasts, whatever we can to really get the message to the people that need to hear it ultimately.
Dr. Paul Kolodzik 49:42
Yeah, I agree completely. So, I'm doing TikTok, so I'm tweeting a bit. And I enjoy, you got to get comfortable with it as a clinician because you're right, we didn't grow up in that manner. But the more we can get the word out really the more people we can help
Jack Heald 50:02
In your experience, in your practice, are you getting to the point where you're saying, okay, I've got all I can handle? Or is there still room in your practice to add patients in your week?
Dr. Paul Kolodzik 50:22
Yeah, it's a timely question. Because I grew up in a model where we grew other practices, where as you grow your practice, you add clinicians that are properly trained. And that's what I'm in the process of doing right now. In fact, last two weeks, I trained a new physician assistant, this is my second one that is joining the practice working in the office, not full time, he's working half time. But we're just increasing our capacity slowly and incrementally in that manner. And I make sure that they're taking care of patients the way I take care of patients.
Jack Heald 51:05
So, what's the single most satisfying story? If I said, what's the best story you've got?
Dr. Paul Kolodzik 51:12
The best story I got? There are all kinds of different interactions with patients. So, I'm gonna answer that really with a few different patient scenarios. So, one is the 21-year-old I had that weigh 275 pounds who's had two diabetic parents, and their parents were having complications, so they bring him and I know, he's an adult, he's 21, but they were still trying to guide him. And we took this 6’2” guy weighing 275, down to 190. And got him in the weight room, and he changed his pattern of insulin resistance from being fairly significant to resolve it now completely. So that's maybe not that dramatic story. But I got a lot of satisfaction because I really took, I really think we took this young man who was on this path headed toward a lifetime of a disease related to primarily high blood glucose and obesity and set him down another path. And I'll tell you, he's never gone back. It's like having a CGM on, it's like once you see what a piece of cake does your blood sugar, you can never unsee that. And so, he's on this path, that's never going to change.
Jack Heald 52:44
That's fantastic. And he lost a third of his body weight.
Dr. Paul Kolodzik 52:47
Yeah, he lost a third. And then Phil and I both have the stories, the diabetic that comes to us with a hemoglobin A1C of 8.6 that you've dropped into a normal range. And that patient lost 35 pounds and could barely exercise before, and now he's training for a half marathon. So that's, I think that's why both Phil and I are in this right now. It's, I mean, we're both getting to the point where we could be out on the golf course if we chose to, but that's not what I get my kicks from. I get a lot of kicks for this.
Jack Heald 53:29
There are doctors listening right now saying, I want this, I want this. This is why I got into medicine. All right. Let's get the VCs out there. And the doctors we need to make this happen, gang. There's, we've reached critical mass, I think. All right, Phil, sorry. I'm just kind of my brain buzzing here.
Dr. Philip Ovadia 53:55
I think Paul and I and I mean, you can think back to all the physicians that we've had on this program now. We're all on the same mission. And we're all trying to get to that same result, which is really making our health care system work for the patients and really being a health care health-promoting system as opposed to the disease management system that we have currently.
Jack Heald 54:34
Well, we're at about an hour, and we promised you we would go much longer than that unless you were absolutely riveting. Okay, we're over an hour. So, I guess you've been absolutely riveting. What's the best way for folks to follow, track, contact Dr. Paul Kolodzik.
Dr. Paul Kolodzik 54:53
So, my website is metabolicmds, metabolic MD with an s .com. I'm drkolomd on Twitter. And that is also my TikTok handle and actually TikTok I don't know why it is but I seem to have the best response on Tik Tok. I got about 50,000 followers now and but I'm told Phil, one of my or actually, one of your Twitter followers is worth about 10 of my Tik Tok followers from what I hear so. But yeah, so I'm on all those. We got a YouTube channel too, if you just Google Kolodzik, metabolic MD, you'll find me. But there's a lot of good information on our website. And if you want to get a hold of us, just go there, and you can send us an email or there's a chat option. So again, I'm licensed in Ohio, Indiana, Florida, and Arizona.
Jack Heald 55:56
So, if a listener is in any one of those four states, you could actually provide services to them.
Dr. Paul Kolodzik 56:03
Or I know that sounds crazy or even adjacent states, the licensing regulations are that the patient has to be in the state near seeing them, but I actually have people for example, drive from Chicago and Indiana so I can see him. It's so easy with telemedicine now. I appreciate it. But it's getting easier and easier.
Jack Heald 56:27
All right. Well, Dr. Kolo MD on Twitter, and all the other places, we'll make sure all that stuff shows up in the show notes so our listeners can just click on it when they see a link there. Last words Phil.
Dr. Philip Ovadia 56:40
Now I'm just this conversation was worth the wait. We've been trying to make it happen for quite a while now. So really glad that we were able to get Paul on. And get him a wider audience and introduce him to our audience. Another physician doing great things.
Jack Heald
I feel the same way.
Dr. Paul Kolodzik 57:02
I actually forgot. I know I'm taking a minute over but...
Jack Heald 57:06
You better be interesting.
Dr. Paul Kolodzik 57:09
Yeah. So, I'm following you. This is, I'm following Phil's lead here. So, he put out his book, get off my operating table or stay out, Stay Off My Operating Table. So, I'm following his lead. And I'm actually coming out with a book in May. That is Continuous Glucose Monitoring for Non-diabetics. So, I just want to put a plug in that your audience might want to look for that sometime in the future.
Jack Heald 57:38
Well, provide us a link for that and we'll be happy to throw it in promotions and all that kind of stuff, but it's all about regaining our ability to care for people's health in this country. All right. Well, I think that's a wrap for Dr. Phil Ovadia and Dr. Phil Kolodzic, I’m Jack Heald. We'll talk to you guys next time.
Jack Heald 58:11
America is fat and sick and tired. 88% of Americans are metabolically unhealthy and at risk of a sudden heart attack. Are you one of them? Go to ifixhearts.co and take Dr. Ovadia's metabolic health quiz. Learn specific steps you can take to reclaim your health reduce your risk of heart attack and stay off Dr. Ovadia's operating table.
Jack Heald 58:39
This has been a production of 38 atoms