NBS #125: What an Urgent Care Doctor Sees Every Day That Should Concern You

In this episode of Never Been Sicker, Michael Rubino sits down with Dr. Richard Wallace, MD, a longtime urgent care physician, to talk about what he’s seeing on the front lines of modern illness. Richard shares why urgent care appealed to him, how medicine is really detective work, and why post-2020 illness patterns have become far less predictable than they used to be.

The conversation dives into root-cause medicine, chronic illness, allergies, mold exposure, and why so many people are stuck in symptom management instead of actually solving the problem. Dr. Wallace explains how basic foundations like sleep, movement, hydration, food, and clean air play a major role in long-term health, and why he believes many common issues are more reversible than people are told.

The episode also covers environmental triggers, blood pressure, cholesterol, sleep quality, and the way insurance and conventional systems can sometimes get in the way of better care. It is a practical, wide-ranging conversation about what is really making people sick and what people can start doing differently.

Timestamps
00:00 Intro + meet Dr. Rich Wallace
00:33 Why he chose urgent care
01:45 Medicine as detective work
02:19 Illness vs. injury trends
03:02 Why winter brings more illness
03:34 Indoor air + HVAC discussion
04:42 Why being indoors impacts health
05:17 Common summer injuries
06:16 Are we getting sicker?
07:04 Why illness is less predictable now
09:31 Immune system discussion
10:16 Urgent care becoming primary care
11:17 How to be proactive with health
12:16 Importance of annual labs
13:14 Catching issues early
14:12 Real patient example
15:16 Why root cause matters
16:02 Problems with current care models
17:08 Insurance limitations
18:52 Chronic illness + hidden triggers
19:49 Mold + migraine case
21:16 Why mold is often missed
22:03 Why we feel sicker today
22:42 The body’s ideal range
23:33 Weight + chronic illness
24:05 Sleep importance
25:03 Phone use + sleep disruption
25:54 Lack of movement
26:52 Dehydration
27:35 Nutrition habits
28:19 Air quality added
29:06 Sedentary lifestyle
30:06 Morning routines
31:07 Clean air + breathing
31:40 Respiratory system priority
32:02 Exercise + hydration link
32:57 Daily routine + diet
35:35 Sleep improvements
37:45 Temperature + sleep
40:06 Staying updated in medicine
41:29 Lymphatic + glymphatic systems
43:22 Sleep + brain health
44:51 Biggest lie: hypertension
45:25 Weight + blood pressure
47:13 Solving root causes
48:18 Cholesterol debate
49:34 “Water vs. milkshake” analogy
50:32 Diet misconceptions
51:57 Simple nutrition approach
53:12 Where to find Dr. Wallace
54:02 Outro

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🔵 About Dr. Wallace:
I’m Richard Wallace. I am a Family Medicine and Sports Medicine Physician. I attended USF right here in Tampa for undergrad followed by four years of medical school at Meharry Medical College in Nashville. In 2000, after graduating from med school, I returned to Clearwater to do my Family Medicine Residency at USF/MPM Family Medicine Residency Program. After residency I completed my Sports Medicine Fellowship at Bayfront Medical Center in St. Petersburg in 2004. During my sports med fellowship program in 2003, I would moonlight or take extra shifts at the local urgent care clinics. I realized this was the perfect fit as I really enjoyed the variety and challenges of working in this area of medicine. This has been such a rewarding aspect of life which I have been doing now for over twenty years.

One of the things I realized during this journey is that I absolutely could not have done this on my own. Along the way there have been several individuals who have helped me develop professionally into who I am today. From the teach

Transcript

SPEAKER_00 0:00

My name is Michael Rubino. I'm on a personal mission to make sure you don't get sick inside your own home.

SPEAKER_01 0:05

I knew there was something wrong. I'm just so relieved there's something that you can do about it.

SPEAKER_00 0:12

Hello, and thank you for joining us for another episode of Never Been Sicker. I'm your host, indoor air quality expert, Michael Rubino. And today's very special guest, will you please introduce yourself to the audience?

SPEAKER_02 0:25

Hi guys. My name is Rich Wallace. I'm a physician. I have an urgent care center uh not too far from here, and I've been doing um urgent care for a long time. Uh let's see this date myself. Graduated med school in 2000, and then I did a family medicine residency, then a sports medicine fellowship, dove into the world of urgent care and then never left. And I've been doing that since 2004. So there you go.

SPEAKER_00 0:46

Why urgent care? Obviously, you had so many different lanes of medicine. Uh why did you pick urgent care?

SPEAKER_02 0:51

I um when I was doing my sports med fellowship, we would do we'd moonlight at urgent cares in in St. Pete. And um I ended up liking it a lot because it was such variety. It was old school. So we had um, you know, we had uh paper charts. There wasn't this whole EMR thing. So you'd walk up to the door and you'd take out the chart out of the um out of the folder holder, and you that was the first time you saw what was going on, so you didn't really have a chance to prep. You just kind of walked in the room and you had to figure out what the heck was going on and and handle the you know the situation. And I liked it, I liked that variety. I like the you know, just having a lot of random stuff come at you and then being able to figure it out on the fly. And um people were very appreciative of the um of the of the help. And um I liked it. And so more exciting, it wasn't redundant like some of the times, you know, in the sports med clinic, you kind of do the same thing, you know, how many times can you inject a shoulder, how many times can you inject a knee? I mean, it's still fun, I still do that stuff. I still, you know, inject shoulders and knees and other things and and um help with sports medicine stuff, but the urgent care world definitely gave you a lot more variety, so it was just more my speed. I like I like the the randomity, all the random stuff happened.

SPEAKER_00 1:55

Yeah. Sounds like you're a problem solver because in order to be able to handle so much random motion, you gotta be able to solve problems.

SPEAKER_02 2:02

Yeah, exactly. So that's that's true. That's a big part of it. In fact, I think most people don't realize that when you're when you're a doctor, that's really what you're doing. You're kind of like a detective, you try to figure out the problem, and then the next step is to actually educate the person on how to handle a problem. So that's that's how it is. It's like a it's like a whole process. You know, the person comes in, drops a few clues, and then if you know the answer, you give them the answer and then say, hey, this is what's going on, this is what we need to do to handle it. Or if you don't know the answer, you just kind of like try and find more info to figure it out. So detective work, yeah. Makes sense. Yeah.

SPEAKER_00 2:33

Now, obviously in urgent care, you're not just dealing with people coming in with illness, but there's injuries and all kinds of things that happen. What what would you say on a on a you know average basis, uh, you're dealing with illness versus injury versus accidents?

SPEAKER_02 2:48

Uh it kind of varies. It's actually it's actually pretty seasonal. Like uh right now we're kind of um, you know, we still have a couple of cold fronts coming through to Florida, which might not, you know, be cold fronts to other people, but it gets cold enough here. And I find that when uh cold fronts come through, you see a lot more respiratory stuff, a lot more, you know, colds and you know, bronchitis, pneumonia, stuff like that. I feel like, you know, when the air is colder, um, your, you know, your your airway gets smaller, tighter, more restricted, more mucus production kind of traps things more, so you're more likely to probably um develop infections, things like that. Um also, you know, that time of year, most people are stressed, they're hanging out with family that they don't want to see, you know, so that kind of lowers the immune system. Sure. And um, so you tend to see more respiratory stuff, you know, in like December, January, February, and it kind of calms down as you kind of roll into March.

SPEAKER_00 3:34

I got a theory. You want to go down a rabbit hole with me? Go go for it. All right, cool. So in the wintertime or when there's cold fronts, like here in Florida, it gets 50 degrees, but people don't understand that if you're not from Florida, you're wearing like parka jackets when it's 50 degrees, right? But um the A the heat goes on. Right. And I want to think about, especially in places like the northeast where I'm from or places like Florida here, where you have the AC running and then it switches over to heat. Well, that dry that high heat, that dry heat actually uh passes through the evaporative coil and then it breaks apart particles like mold and bacteria and it disperses them across the environment. And then think about it, in the winter time, people are more indoors, right? Because it's cold, they don't want to put on a jacket and go outside. Right, right. Especially in Florida, it's like all throughout the year, you can go out all the time to eat at restaurants at night and you're you're active, you're outside, you're moving. Well, then in the winter time, you're closed in, windows are windows and doors are shut, you're cold, you've got that HVAC breaking down mold and bacterial particles that are then circulating throughout the air. And then of course you're you're more indoors. So I think that there's something there because then if your immune system's weakened, then you can get more common colds, more flus, things like that. Right, right. So just wanted to plant that seed.

SPEAKER_02 4:51

You know, I kind of agree with you to some extent. I think definitely in the in the you know the season, most people are kind of packed in tighter than normal. So you're right, not many people are outside spread out. A lot of times you're you know, traveling a lot, people are flying on planes, they're with family more, so your stuff in a house that normally has four people now has like 10 people. So there's more more bodies in in smaller spaces or in the same size space. So they're breathing each other's air more. And um, and there's definitely that's true, you know, in the winter you you definitely have more of the heat turning on and and there could be more stuff flowing around, so that makes sense. Yeah. I agree.

SPEAKER_00 5:25

Now, obviously, we talk about kind of the the illness component for a second and some of the seasonal changes with uh your business. Um and then you also deal with accidents, injuries, and obviously that is completely random because accidents are random. Right. And is there anything that you see happen more frequently that any any sort of patterns on that side of things that you notice that happen more frequently?

SPEAKER_02 5:48

I mean, in an urgent care world, I mean you see basic like lacerations, people cut themselves all the time, you know, doing random stuff. Um uh interesting. I feel like there's more injuries in the summer than in the winter months, because usually the summer is when people are out and about trying to work on those projects that they never worked on. And um, we definitely see more, I would say more injuries and lacerations and stuff um in the summer versus the winter. The winter you tend to see a lot of respiratory stuff. Like that's the time of year um my uh my smokers and and you know my my lung people tend to show up at the urgent cares a lot is when the temperature drops, they tend to come in a little bit more frequently. That's so interesting.

SPEAKER_00 6:30

Yeah. On the laceration side of things, it's just they're just accidents. People are doing stuff and accidentally cut themselves.

SPEAKER_02 6:36

Yeah, it is simple stuff. Um, you know, just yeah, cutting them stuff on glasses or you know, break a glass while washing it or something. Um simple, simple stuff. Just um, you know, enough to where they have to come in and get get handled, but you know, they they hurt themselves in the in the summer, it seems like.

SPEAKER_00 6:52

Wow. Now just shifting gears back to the illness side of things for a minute, because this podcast is called Never Been Sicker, right? And have you seen a increase in illness in foot traffic coming through your business over the last few decades?

SPEAKER_02 7:08

For us, um it's weird. It's like you know, the stats used to be pretty predictable um up until about 2020. So up until like we opened our urgent care in 2012, and then we had a steady growth where every every year you'd see a certain percentage of increase in patient volume. You could kind of predict, you know, the months where you have certain illnesses. And it was almost like, you know, this is flu season, this is TREP season, this is whatever season. So you kind of predict what's going to happen. And then I would say after you know the the COVID game, um, it seems like um it's a little bit unpredictable. So I I feel like there's definitely been more um illness, uh, you know, things in the sense that it's not as seasonal as it as it used to be. Whereas before it was easily predictable, now it's not. It's not like um, okay, now we're gonna hit a flu season. No, now it's like everything. You got you know all these different viruses popping up and they don't really take their turn. They kind of come, you know, more frequently, I think. So I think that's probably um one of the biggest things I've noticed is that the predictability and the um, you know, the just the like the cyclical type of illnesses, it's not really as cyclical as it used to be. Maybe it's just my I mean that's what I see. So my my perception is that it's a little bit more than what you'd expect, or a little bit unpredictable. And um, so that's that's probably one of the biggest changes I've seen over the past few years is just the um the uh the types of illnesses and viruses and bacteria that people are getting. There just seems to be a little bit more variety rather than just like, okay, strep season. You know?

SPEAKER_00 8:38

So it's become a little bit more unpredictable because yeah, it's just it's just random.

SPEAKER_02 8:42

It's just um we'll have uh, you know, like before I could I could literally, you know, it was it was easier to treat because you knew, you know, 90% of people coming in had blah had flu A or something, right? And then now it's not the case. They come in, you think, you know, you have a couple, you know, people coming with flu, but then not everyone has the flu. Whereas before it was I remember example, I think it was like 2018 or 2017, we had a big flu year. I think we would test, like we'd have 80 people come to the clinic, at least like 50 or 40 of them were flu positive. Wow. And it was just like it got to the point where when you were in season, you knew what the person had. You didn't have to think, you didn't have to waste time. If they wanted to get swabbed, they could, you know, but for the most part, it was pretty straightforward this person has flu. But we would swab, and so you just you'd swab like, you know, X amount of people, and you'd see, you know, a ton of positive flu tests, and they all had the same thing. That doesn't happen anymore. The days of having like after actually I take it back, after COVID, like after 2020, it's not predictable anymore. Now it's like someone walks into a respiratory infection. You sometimes you can tell clinically, like it looks more like a strep or more like a flu or more like a whatever, but it's it's kind of harder now. Now it's like it's not as predictable. You don't have just one thing coming this week and then one thing coming the next week. It's kind of like a hodgepodge of a little bit of everything, which is kind of unusual because that wasn't always the case. Um, but now it is, so it's a little bit more difficult for us to kind of figure it out.

SPEAKER_00 10:04

Sounds like the immune systems might be getting weaker and being more susceptible to illness in general because you're having all these random illnesses pop up.

SPEAKER_02 10:11

Yeah, I I think um the days of the quarantining wasn't a good thing. Um I think uh, you know, that definitely, you know, it kind of made everyone a little bit more susceptible to stuff because normally these, you know, viruses and things would kind of spread, run their course, and then everyone kind of developed that what they call a herd immunity where everyone just kind of has, you know, it's not a big deal. And um you kind of run through it and everyone gets antibodies to it, then it's not it's not a huge problem. It kind of dies out, you know?

SPEAKER_01 10:37

Sure.

SPEAKER_02 10:38

And then when we stuffed everyone with a mask on their face, and then you know, I feel like, you know, after we kind of stop that game, we seem to get more a variety of things again. Whereas before you didn't see that. So Yeah.

SPEAKER_00 10:50

Makes sense. Um I'm curious, you ever see chronic illness patients? I know obviously in urgent care, so you're gonna have these more random things pop up. But do you have patients that are considered repeat customers or with chronic illness and you're trying to help them sort that out?

SPEAKER_02 11:04

Yes, we definitely have a following. There's a lot of patients who don't have a primary care physician that use our clinic as their as their primary care or their doctor or their go-to. So yeah, I would say a you know, a good percentage of, I think not just myself, but I think a lot of urgent cares are now becoming primary cares for for the population. So yeah, we do.

SPEAKER_00 11:21

That's actually true. I I think you guys are actually listed as my primary care physician. Exactly since you're down the street.

SPEAKER_02 11:26

I'm I'm it's not just you, man. It's like a a lot of people use us because people don't have primaries anymore. That is because it's it's the convenience factor. It's like you need to be seen, you call up your primary, I can see in three weeks. It's like, okay, great, I have a problem right now. Right. And so they'll just go to an urgent care and get it done. It's just a lot easier.

SPEAKER_00 11:41

Right. I mean, lucky for me, I've I've been blessed and haven't had so many health issues. And so uh, but I should, you know, I should probably come in and just be proactive and get another physical or something. And you know, what what what are some things people can do proactively inside these urgent centers?

SPEAKER_02 11:58

Uh I mean, that's a very good, good thought. Um, most of the time, if a person is is proactive, I always tell people just at least once a year, just kind of do a once over like a maintenance check, you know. Like I'm um I'm 52 now, and I remember I I had um you're really 52?

SPEAKER_00 12:13

I'm really 52, yeah. Wow, that's incredible. Yeah, yeah. So I would have never guessed that.

SPEAKER_02 12:16

Most people don't. They think I'm it's funny because people I have guys that be like, you know, when I was your age, I'm and I'm actually older than them. And it's actually pretty funny. I'm like, I'm actually older than you. But um I um I had a I had a uh a uh I had a surgery, a knee surgery a couple years ago, and then when I had the surgery, the doc was like, you need to do EKG and labs. I'm like, really? He's like, Yeah, you're over 50. And I'm like, Oh yeah, that's right, I'm over 50. So um, so I forgot that, you know, once they get older, you're now considered a high risk patient, a higher risk patient. So they want to check you out and be more thorough. So and I started doing that, I guess, I guess in my late 40s, I would start just checking basic labs every once in a while, like once a year, just kind of make sure everything is good, because you never know. And then basic labs are good. It's kind of like just you know, your gauge, your, your, your biometric gauge. You know, you kind of, you know, you make sure your height and weight are good, make sure your pressure is good, make sure you know pulse is good. And then you just sprinkle in some labs, and I would say, you know, once a year, if everything is good, you're probably fine. Especially if you're um, if you're moving the body and exercising and you're keeping your your weight, you know, in a pretty stable range, you're probably not gonna have a lot of significant problems. It's when you kind of let those things fall off and not pay attention to them, let you know, problems start.

SPEAKER_00 13:23

I like the idea of a routine check. I mean, I'm always recommending people do routine checks on their house. Yeah. Check their roof, check their windows and doors, make sure there's not water intruding, things like that. I think it's really smart because then you can be proactive. Right. You can fix problems when they're a little bit less expensive to fix. Right. As opposed to waiting for a major meltdown, then now all of a sudden you've got to replace all your windows, replace your roof. Now there's mold, you've got to deal with that. There's all this water damage, you gotta deal with that. And so it's obviously a lot more cost effective to be proactive. So it's great that you can kind of take that approach.

SPEAKER_02 13:54

Yeah, that that's 100% correct. I I feel like if when guys do that, when we you find a small thing that's a little bit, you know, not quite right, you can jump on it right away and figure out what's going on. And then it's usually a quick, simple fix, quick handling, and the person's fine. And then you're right. When you wait too long, you know, things progress. It turns out what was a small thing actually is a big thing, and it's it's progressed into a big thing, you know, like um, you know, simple stuff that if you jump on it early, um, it can be handled and and and taken care of, and it's not a huge body problem. Um and uh the guys that come in and get checked out regularly, you know, they're on top of it. And when you find something, like just a very subtle, you know, thing can kind of mean something. So you just kind of you just pull the strings, figure out what's going on, and then handle whatever the situation happens to be, and it makes it quick and quick and simple. Whereas if you wait, you know, there's a I'm thinking of like a thousand different scenarios of how that can apply. But for instance, you know, you have a guy who you know comes in for like a once-a-year lab thing, he's like, you know, late 40s, early 50s, decide I'm gonna do once a year, check things out. So then he checks out some blood tests and it comes back, his kidney function is off, and he's never had off kidney function before. And you're like, hmm, why is that the case? And you kind of, you know, you then you kind of go backwards and try to figure out why is his kidney function, you know, not the way it should be. And then maybe it turns out his prostate's getting enlarged, and then you go, oh, why is your prostate getting bigger? And he kind of pull the strings and then you figure out what's going on. And then, you know, rather than have it become a big problem where he never really checked and now his kidneys are like super, you know, not working properly, you know, just by jumping on it early, you could figure out why it is not working. And then you kind of go back and figure out, oh, he's got a large prostate, we need to do something, we need to um do something about it, and then you fix that issue, and then kidneys can start working again. And you know, he doesn't have to come in with an emergent issue where, hey, my kidneys are shot, they're not functioning. What do I do now? Well, then it's like, okay, now we got problems. Now we got big problems.

SPEAKER_00 15:41

You know what I love what you just said. Basically, you're talking about essentially finding the problems, the root cause issues that are happening. You're not just saying, liver's not working, we're gonna do, you know, we're just gonna focus on the liver. Well, it's like, no, what's causing the liver not to work? And I you keep pulling that string looking for the root cause. I think it's so important. And I would I would argue that that that has to separate you from other urgent cares across the the country, because I feel like it's more conventional that way.

SPEAKER_02 16:05

Yeah, and that's how we operate. We always try and figure out what's going on and we try and you know get to the bottom of things and and find the root cause. I know that a lot of I've seen that word tossed around, but I feel like you're not really practicing medicine unless you actually are doing that. So if you're not really trying to find the why, you're just putting a band-aid on it. So um we actually, you know, go over the labs that we that we draw on people. We actually like, you know, look at the imaging studies and and figure it out. A lot of times when people go to urgent cares, they'll they'll get stuff done, diagnostic stuff done. And then the the thing is, hey, if we don't call you, everything's fine, follow up with your primary. And it's like, all right, what did that mean? It means nothing, you know. Um I've I've been at clinics. When I when I was doing my um training in med school and residency, that was a common thing to where people would say, hey, just if we don't call you, everything is fine. I'm like, oh, that's not how it works. You gotta like, if you, you know, if you order the study on the person, you need to figure out what's going on, what does the study result mean, and then what's the next step. So it's not just sign your name and then email the results to the patient. It's like, no, sign your name, but then you have steps as to what's the next what's the next thing we're gonna do, right? So if someone comes in, you check whatever, say they have high cholesterol, okay, fine. And you, you know, you have a you have the person come back in, you talk about it, figure, okay, great, this is what's going on. What can we do to handle this? How bad is it? What what are the pros and cons of having high cholesterol? And then you kind of, you know, give them the info on it and how to actually like correct it if it's a problem.

SPEAKER_00 17:25

So some of the arguments that I've heard people make in the past and in regards to like why they can't practice root cause medicine, essentially that they're the the biggest issue is the insurance companies. They don't necessarily pay for people to be able to take all these different types of tests. Right. And that if they can't isolate what the problem is through different tests, that it's really difficult for them to be able to practice root cause medicine. And then therefore, they're just very more likely to give them a solution for the pain or solution for that, you know, symptom so that they can get some relief because they feel kind of stuck in being able to identify root cause. How do you navigate that issue?

SPEAKER_02 18:05

You're right. The insurance companies make it difficult where they just don't cover stuff if you don't um they they have this thing called medical necessity. So you have to put down the correct diagnosis code that matches their algorithm that says they will pay for this, you know, specific lab or procedure or whatever the case may be. So sometimes, you know, you'll see doctors, you know, when they want the patient get labs, they'll write down like five or ten different diagnoses codes, you know, on the lab script just so the insurance will cover the cover the cost of labs. And then to me, it's kind of like it's almost like a little bit of insurance fraud, you know? It's like you're just throwing a whole bunch of stuff on there and it may or may not apply to that specific patient. But it's like if you don't put those things down, the insurance companies won't cover it. But then you're right. Sometimes you just want to figure stuff out and and and order some basic labs, but the insurance company, if you don't have specific, you know, uh codes on there, they're not gonna, they're not gonna cover it. The patient has to pay out of pocket for it. And um, it does make it hard. And then sometimes you just tell the patient, look, you know, you know, you might have a bill and it is what it is, you know. And so if the bill comes through, they understand that for whatever reason the insurance didn't cover it, and they just cover the the cost that the insurance didn't cover. So, but you're right, that does happen often. And it that used to dictate how people practice medicine. I mean, I mean, I should say for myself. I I used to really pay attention and then think with the insurance game, and then I just stopped. I'm just like, I'm not doing this anymore. And I just I just do what's medically necessary. And um, if the patient requests it, like, hey, you know what? I think uh, you know, if they if they originate something, then I figure if the person has consideration and if once they originate something, I have a consideration on it as well. So then I'm like, okay, obviously, you know, this guy, Mike is saying, hey, you know what? I think I think there's a pain right here, you know, my in my in my groin area. Okay, great, let's get an ultrasound. Let's go check it out and see what it is. And um, even though there's nothing physically there, I'll still, you know, order the studies just to figure out what's going on.

SPEAKER_00 19:57

Now, with respects to chronic illness, that obviously you you kind of mentioned that you're becoming many people's primary care physician just out of convenience. Um, and that's probably not uncommon across the country. Right. Um, so you're naturally then gonna see more chronic illness and more autoimmune disease and autoimmune deficiencies. Um, how are you navigating that? Like how are how are you helping people get down to the root cause of that and you know, essentially helping them get better?

SPEAKER_02 20:24

Uh, you know, it's interesting. There's a lot um what I've over the past couple of years I've kind of realized that uh a lot of times people actually have um allergies to things that they weren't aware of. And then so, like for instance, food up foodborne allergies or environmental allergies. When I have a person who's just like a chronic something isn't quite right, and we've checked everything out and we just can't seem to find the why. Um sometimes you just do labs and just check for you know environmental allergies and it'll come back with something, and then it it totally makes sense. Oh, you have an allergy to this specific mold, and then turns out that, you know, I had a I'm actually given a case of a patient I saw the other day, um, never got headaches or never was just like uh um she never really got sick, was a pretty healthy person, um moved into a new apartment, and then all of a sudden now she's getting migraines and she's never had migraines before. So she's trying to figure out why, why was going on. So she does a big, you know, blood panel, part of which is an environmental allergy panel, and um came back positive. She had a very high allergy to a certain type of mold, and pretty sure that that was the cause of her of her headaches. So now, you know, now that we know what's going on, the next step is to um change the environment. So either she has to do some kind of mold remediation to the to the apartment or just switch apartments. And so um, so that's the that's the game plan. The game plan is to basically, you know, get out of the environment. So it helps, you know, to to dig through and kind of find that stuff out.

SPEAKER_00 21:47

Yeah, obviously music's my ears because you know I I see people struggle with environmental illness all the time, and not every doctor knows to look for that or knows, you know, uh how to even get that uh Prescribe for them.

SPEAKER_02 22:00

Exactly. Most people would just give the person like a migraine medicine and say, hey, here's some uh here's some Imatrex or here's some, you know, whatever. And then they take their medicine, which helps, but then it's the band-aid. It doesn't get to the the root cause, right? It doesn't get to the the underlying, like what the heck's going on? Why is this person having this issue? And so it helps, you know, it helps handle that headache every once in a while. But then at the same time, you know, the person just has a mold allergy and and the house or the you know the ducts are just full with this mold. It's like you gotta you gotta change the the AC ducts, you gotta do something about it or or change the house.

SPEAKER_00 22:31

Yeah, you obviously see a lot of people, you know, from your perspective. Why why do you think that we've never been sicker than we are today?

SPEAKER_02 22:37

Hmm. Uh why have we not been sicker? You know, I think well, here's the thing. I kind of feel like a there's a lot. It's a it's a lot of different issues that can create people being sicker than normal. I think um I think bodies are interesting in that they require basic things to function properly. I'm gonna give you my long spiel here. So um, so you know, um a couple things. Uh bodies are super, what's what I'm looking for? They're very um, very restricted. There's not a lot. We have a very tight environment that a body function well functions well in, right? Like for instance, you can be in an environment that has too much oxygen and that's actually bad for you, or too little oxygen that's actually bad for you. You can have too high a temperature and bodies just don't do well in high temperatures, and you can have too low, you know, uh a temperature and the body just doesn't do well. And pretty much everything is like that. So there, you know, everything that the body gets exposed to, water, temperature, humidity, blah, blah, blah, there's always a range that a body can function in. And then the same thing is true for um for a couple other things. For instance, like um like body size, for instance. Like bodies are meant to be at a certain size. And then what I found is that most of my patients who get chronic illness, um, they tend to have either too high or too low a body weight. There's like a nice sweet spot where a body does to does pretty well. And then I have my guys who have a high body mass index or my guys that have a low body mass index. And those are my chronic patients, like the ones who are either above or below. Those are the ones that I see frequent flyers all the time because they have some different body issues. That's the first thing. And then the the second thing I would say is there's what I call basic body rudiments that the body has to have, otherwise it doesn't really function properly. And then um, it's interesting, but sleep is probably number one as far as basic body rudiments that a person needs to have, like in grooved in where they're just sleeping very well and um not having interrupted sleep, getting their, you know, like eight hours. In fact, I survey patients all the time and I just ask them for two reasons. One for them to actually think about it and then they can think what they need to change. And I go, how many hours do you need to sleep before you feel like you had a really good sleep and feel fully refreshed and can have a great productive day the next day? The common answer for an adult is seven and a half hours. That's like the average. Like they actually say seven and a half hours. And I get and then I ask them, well, how many hours do you sleep? They say six. Like most people, oh, six, six and a half, seven. So I'm like, okay, great. Well, is there a way you can get that seven and a half? And they think, oh, I guess I could, you know, tweak this, tweak that. And I think probably the biggest thing is what we all do, that whole doom scroll with the phone. Um, a hundred percent, that definitely has changed over the past decade or so. Where I remember, you know, even like 10 years ago, you know, 15 years ago, we didn't use the phone as much as we did. We didn't have all this social media, you know, mindless, you know, looking at the phone all night long. Um, you know, we sit there and we sit on the phone till God knows how long. And instead of going to bed at 10 o'clock, we're up till 12. And so instead of getting, you know, eight hours sleep, we're getting six. And so I think I would say a majority of people do that. So that's the first thing that needs to change is put the phone down. You know, walk- I'm I'm being a hypocrite, but it's hard. You know, you got to put the phone down, put it on airplanes. Even no, move it away from you, put it in another room because you're gonna pick it up and and look at it, right? Um, that's probably the biggest thing is sleep deprivation. Um, the second thing I see is uh the lack of movement. Like people don't move their bodies and exercise, right? And I've said this before. Um the basic purpose of a body is to move. That's it, you know? And so if a body can move and moves well, it's usually gonna be pretty healthy. Um bodies that don't move tend to not do very well and have a lot of you know issues and and health issues. So my I call them my skinny fat people, the guys who are, you know, they look healthy, their size is normal, but they never exercise. They don't do anything to to um to to challenge the body.

SPEAKER_00 26:22

Why are you calling me out, dude?

SPEAKER_02 26:23

No, I'm not I'm not looking, I'm not, I'm not saying anything. I'm just saying my my uh my my skinny fat people who you know they have a nice BMI, you know, they're like whatever, they're the average size that you'd expect, but they do absolutely nothing. Those guys have body problems as well because they don't move the body. Um so I would say my my people who don't exercise probably have um the ones that do, I never see them. Like I already know that. Like the guy, my my guys and girls who are fit and exercise, even if they're a little overweight, I don't see them. It's um it's uh if when they don't move the bodies when when I tend to see those guys a lot. Um then I would say probably the third thing is our uh is probably water. I think a lot of people don't consume enough water. Um so they they're they run dry. They don't even realize that they're running dry. And so if you've ever played sports, you know, if you've ever played any any type of sport, you know, if I played soccer and football and stuff and whatnot. And if you're you you need water in the body, man. If you just if your body is dry, you can't perform, you can't run, you can't jump, you just feel a little bit lethargic. So, and that's just playing a sport. Now, obviously, just living life and walking around and doing your regular activities of daily living, if you're dry, it's the same effect. You know, if you're dehydrated, you can't move as well as you you should. So I'd say it's actually pretty simple, but most people are underhydrated. Um, and then I would say the last obvious thing is is the nutrition the person puts in their body, right? That's the I would say that's the fourth basic rudiment. Um, you know, you are what you eat. If you're eating Twinkies and donuts all day, um, you're probably not gonna do very well and feel very well, you know. And then the guys that eat, I like to say one-word organic foods like, you know, uh carrots, you know. I always they're like, what should I eat? I'm like, and the people like to restrict and have weird, you know, different diets. I tell them I never have a diet. I eat everything. I eat except for liver. I do hate liver. Anyway, um, but I eat everything. And then I tell people, you know, if it's a one-word ingredient, chicken, steak, you know, whatever, not pizza, but you know, just like simple. I mean, I eat pizza too, but you know, if you if you just have simple, simple, easy, organic one-word ingredient foods is a majority of your diet, they usually do fine. It's the guys that I see when you go into the grocery store, you see the guys, you know, pushing around their shopping carts. You never see whole food. You always see a whole bunch of boxes of processed food. And then it should be 80% whole food, 20% processed. It's always opposite. You see, you know, like 80% processed foods in, you know, boxes and whatnot. And then you see like a couple things of like maybe they'll have a lettuce head or something, and it's just like, eh, they're not gonna do well. So I can just look in the checkout line and see who's gonna be doing well and who's not, just by what they're buying as far as their food is concerned.

SPEAKER_00 28:54

It's incredible. Yeah. I would I would invite you to add one more thing, the air we breathe. Oh, yeah, 100%.

SPEAKER_02 28:59

Yeah, it definitely I missed that. The air and the air is uh is a big part of it as well.

SPEAKER_00 29:04

Totally. Yeah, yeah, I know. I was uh I was messing around with you on the on the uh the diet part and the exercise part because um you know it's hard. Like as a businessman, um look look at what I'm doing right now, I'm sitting down in a chair. Right. And you know what I was doing before this? I was sitting down in a chair. Right. Different location, I was in front of a screen sitting in front of a chair, you know, sitting on a chair. Yeah. And so if I don't if I don't, if I don't be intentional about getting exercise and moving, I won't get exercise and move. Like if I just focus on work and don't be intentional about that, for sure, I won't move. And so I'm always like trying to consciously move. I've got the watch that tells me when I need to stand up because I've been sitting for too long. And like every time I do that, I'm like, all right, I go take a walk, usually to go get water, go to the bathroom, things like that. Right, right. But like water too, as you're saying that, I was like, man, my my my mouth was getting dry as you're talking about like, hey, we all need to drink more water. It's like I think about it today. I don't I had maybe one glass of water all day today. That's not good. I had two cups of coffee though.

SPEAKER_02 30:05

So which dehydrates you by the way. Which dehydrates you. Right. So like and most people do. Most people have their Starbucks, they got their coffee in the morning or Dunkin' Donuts, whatever they drink, you know, and then they have more coffee than actual water.

unknown 30:16

Yeah.

SPEAKER_02 30:17

And so they every day they're getting a little bit less, a little bit less, and they're like, hey, I don't know why I feel I don't feel great. I'm like, ah, how much water do you have? And they they just don't drink.

SPEAKER_00 30:23

That's where I'm at today. I gotta flip the script.

SPEAKER_02 30:25

Yeah, you're gonna flip it. You know, by the way, I wanna uh say something. So there's one you're right. As far as the breathing is is actually huge. Um, one of the spiels I give my patients, and I forgot to mention this, is um, you know, like I said, the basic purpose of a body is to move, right? Well, we have different body systems that help the body do that, right? So priority number one is actually your respiratory system. And I tell people this, like I just I say it probably a thousand, well, not a thousand times a month, but I say it all the time to my patients that, you know, the purpose is to move and then you gotta the priority number one is is respiratory. So if you're not, which is basically from your nose to your lungs because the respiratory system's job is to get oxygen into the body, right? If you can't get oxygen into the body, what happens to you? You drop dead. So anything that impairs the ability of oxygen to get into the body is gonna cause problems. So that's what in fact that's why most people come to the doctor, because once they have the most common reason people come in to see a doc is a respiratory issue because they can perceive that their body is not functioning properly because if something is obstructing air getting into the body. So um you're right. Air.

SPEAKER_00 31:30

Yeah, super important. But I think I love what you said. I mean, we gotta move, we gotta breathe clean air, we gotta eat clean food, we gotta drink more water and drink good quality water. Yeah, those are foundations for health. And surprisingly, I mean, I for sure didn't drink enough water today. Uh I didn't move enough today. So I've all I've already gotten 50% of my scorecard. Flunk is a flunk. Right. Yeah. So, you know, that's what it's like to be a human being.

SPEAKER_02 31:58

You know, you know what I tell people though, and no one ever believes me, is um do it in the morning, exercise. Just the as soon as you wake up, I always tell people just flip your, just you know, kind of like change your routine, and then, you know, on a gradient, I say wake up 20 minutes early and then just do your exercise in the morning. As as because I know guys like to do it in the afternoon or in the evening, but what happens is you do it in the morning, it's done. And then you don't have to worry about, oh, I haven't done anything all day. I haven't moved the body all day. You get your exercise in. And then what happens is when you get your exercise in in the morning, guess what happens? You are thirsty all day. You will definitely drink more water than you normally would because you you're gonna crave it. And it's not forced. Because I know these guys that walk around with their um, what do you call them? The little fancy Stanley's, the little Stanley, you know, mugs or or water bottles. They're not thirsty. They're just drinking because, you know, they're told to drink water. And it which which makes it like um, I don't know, I just feel like it's forced and it's not, it's not real. Um, but the ones who exercise in the morning, like I'm getting thirsty now as I'm talking to you. You you you definitely I I drink, I probably drink, let's see. I like milk by the way. So I drink every morning I have like a like uh probably like a liter of milk. I'm crazy that way.

SPEAKER_00 33:08

And um and then I'll we're gonna have to dive into that in a minute, but yeah.

SPEAKER_02 33:12

Okay, so um I I'm I'm a milk guy. And then um, and then on top of that, I have water as well. So I have milk, water, Gatorade. So by the by 12, one o'clock, I probably had like two liters of of fluids already. So um, and then the rest of the night, I, you know, I'll I'll I I probably have about three liters every day minimum. And uh just because I exercise in the morning because I'm thirsty.

SPEAKER_00 33:33

So let's let's go back to the milk thing. So why a liter of milk a day?

SPEAKER_02 33:37

I like milk, man. I always I just um skim milk is my thing. Like I'll do, I'll have a little, I have a probably uh I'm I'm weird. I put ice and throw like a, you know, I just pour it on ice and I have um, I have like a my my breakfast go-to is um I like um I used to be the egg, you know, bacon, you know, cold cut kind of guy on toast. And then I was like, eh, it it I found my energy didn't, it didn't last as long. So I'd have two slices of toast and then you know two fried eggs and a couple strips of bacon. And when I was on the bacon kick, I my cholesterol went off the charts. I was like, all right, no more bacon every day. And then my cholesterol went back to normal. And then then I switched to sandwich pepperoni. Cholesterol was good. Um, but then I found that if I had breakfast at like, I had to eat later because if I had at eight, by 12, I'm starving. I'm like, okay, that's not working. And then um, and then I switched it up. I started doing peanut butter, honey, and banana on on bread. And then I'd have two slices of that and I would last and I have it at eight o'clock in the morning, and I don't have to eat again until you know two, three, four. Wow. And so when I have that mixture of food, for whatever reason, it would just fill me up. And I was like, man, this is like a hack. This is like a biohack that most people don't know about. For me, I don't know if it works for anybody else, but for me, if I have a glass of milk, you know, two pieces of bread, some peanut butter, honey, toast, um, and banana, I'm good. And um, and I it lasts forever. And then I have like, you know, like today I had a um uh nature's burrito, I had a half a before I came here because I didn't know how long, because it right now I usually start to get hungry. I was like, okay, I'm gonna, it's about 2.45. I'm like, okay, if I if I eat now, I should not get hungry during this, you know, this show. And so I just shoved um half, half, not even half, I did like a third of burrito at like 1.30. And um, and I'll eat the other two-thirds later tonight. And then so I can kind of restrict the calories or just kind of pay attention to them. Um, whereas if I eat other stuff, it just doesn't fill me up. So I I found, you know, some foods tend to fill me up and and and kind of keep the appetite at bay. Whereas other foods, like I find if I do a high, high protein and low carb, um, I tend to get hungry like super quick, like four hours after I'm like, okay, I'm hungry again. I have to like mix in carbs. I've I tend to eat my carbs earlier in the day. Like I find my carb, I definitely carb load this my first meal is always more carbs than it than the other meals. That makes sense. Yeah, and it seems to be. Oh yeah, because your carbs are, you know, exactly. Exactly, exactly. And so you burn energy that way.

SPEAKER_00 36:02

So I want to talk a little bit about sleep. Um there I did I did two things that improve my sleep. One indoor air quality. Improving indoor air quality for sure helps with sleep. Uh I've seen people get air purifiers, plug them in in their bedroom, night and day difference. Uh, and then uh I ended up getting this thing called eight sleep. Have you heard of it?

SPEAKER_02 36:22

No, what's that?

SPEAKER_00 36:23

It's basically like a mattress cover and it actually connects to a what they call the pod, and it essentially heats up or cools down water, and it pumps water through the mattress cover um in these tubes, almost like radiant heating. Right. Right for the floors, but like for your mattress. Yeah. And so it knows that it just I guess it the first thing it does is like calibrate to you and figures out what makes you sleep better. So what works for me is it heats up before I get in bed. So when I get in bed, the bed's warm, which is kind of nice.

SPEAKER_01 36:59

Nice.

SPEAKER_00 37:00

And then after that, I guess like an hour later, it just slowly but gradually starts to cool down. And then by the time I fall asleep, which is usually like an hour after I lay in bed, it then just switches to cool. Luckily for me, I've been able to avoid the doom scrolling. My wife, not so much. I'm gonna have to show her this this episode here. Exactly. But uh, you know, it's it's I've been able to avoid that. That's been pretty helpful. Like I just plug my phone in and you know, like to just just forget about it. And then I'm usually I'm like watching TV just to like watch something to fall asleep to. And then I usually like within if our the latest, but usually like even 20, 30 minutes, I'm like done out like a light. And so it's been interesting because of that temperature. So I was curious if you've heard of it or or if you've heard of anything like that.

SPEAKER_02 37:50

I haven't, I haven't. I um I've never I've never thought about the temperature. Um uh I know. I've I've it's I mean obviously everyone has a nice temperature for themselves that they they enjoy. And, you know, because I've had, you know, in the past I've had, you know, uh um a girlfriend or you know, wife or ex-wife, I should say, where they want a specific temperature to um, you know, to sleep to, and and um, which is another question as to why women want it so cold sometimes. Anyway, um but uh you know um I find there's like a nice temperature that I like to sleep, sleep at and then give you a funny story. So I have a dog. I'm sure you've seen my dog, right? This little this little um Dixie, and then there's a time when, especially in the summer, she gets hot and I'm comfortable. You know, I guess it's my Jamaican roots. I'm like, people are like, what do you say your temperature? I'm like 75. They're like, what are you crazy? You gotta drop it down to like 68 or you know, she would get hot and start panting throughout the night. And I would have to, I thought she had to peace, I'd get up and walk her. She was just hot. And so I finally figured out that you know, my dog who's a female, needs it needs the AC lower to so that way she doesn't bother, she sleeps in the bed by the foot of the bed. And if it's if it's not the right temperature, she'll wake up. So um, so I have to set the temp for her, you know. Otherwise, um, so I'm like compromising again just to, you know, to please the the woman in my life, which is my dog. That's awesome. And then um, yeah, it's that temp, you know.

SPEAKER_00 39:15

So yeah, it's interesting, you know, because I actually like it warm too. I'm not a like a big cold person. Right. I did move from New Jersey to Florida, I feel like for a very specific reason. Exactly. Just like the warmth. But I did notice that the app does make it cold when I sleep, because it like you could see like it shows you the temperature or whatever. And they showed it showed me that when it went colder, I slept, my REM was deeper and longer versus when it was warmer. And I was just like, well, that doesn't make any sense because I don't like the cold. But apparently, while I'm sleeping, I do. Okay, and I'm not even aware of it, like subconsciously. If I was a if I was awake, I'd be like, nah, nah, nah, this ain't for me. Right. But but obviously I'm not conscious at that point. I'm like in deep sleep. Right. But apparently, like while I'm deep sleeping, it's like very good for me. So I just found that interesting. It's like I the decisions that I make would be warm. I like it warm and toasty.

SPEAKER_02 40:14

But hey, the body's a funny thing. I might want to try that now, just you know, see what my body actually likes. Maybe I was wrong, maybe it's supposed to be cold. Who knows? Interesting.

SPEAKER_00 40:23

And then it'll turn out that the women in your life were right. Exactly.

SPEAKER_02 40:27

You know, oh well.

SPEAKER_00 40:29

So going back to chronic illness for a minute, I know it's obviously it's a more serious topic, but you you obviously see a lot of people, you're going at the root cause, you're building the foundation. Um, you've mentioned that you've seen some people who uh have have had some issues with mold. Obviously, environmental toxins is a huge topic. I'm just curious how you keep up with all this stuff. Medicine's always moving forward and evolving, and we're learning new information, new studies come out all the time. Uh, but but you're a very busy guy and you see such a wide range of issues.

SPEAKER_02 41:03

Right.

SPEAKER_00 41:04

How do you keep up with all of it?

SPEAKER_02 41:06

You know, that's the one thing I like about medicine is I feel like you never know everything. You have to always learn. Like I learned all the time. Like I never, every day I learned something. Um, and so that's the game. You just you never stop learning. There's always new tech, new, new ways of handling things, new discoveries, new things that you know people didn't really think with um that you can apply to a body and and actually help the person improve the function of their body. And um, I think for myself, I've always felt like that's that's just how I operate. Like I don't feel like I know everything. And then I'm always willing to learn, I'm always willing to you know read and and figure out the new, the newer um discoveries and and uh apply it to to my my practice and what I do. Um it's interesting because um for instance, uh one of the newer discoveries about the body, um, you know what your lymphatic system is? Mm-hmm. Right. So you're you're basically your cells live in a wet environment, it's not a dry environment, right? So you have this fluid that kind of coats in the cells live in um called interstitial fluid, right? So this fluid is collected by your lymph system. So your lymph system drains that fluid through lymph channels through the through your body, and then y'all, everyone knows what lymph nodes are. Like you know when you get your soul and like lymph nodes in your neck, um, your lymph, your lymph nodes uh you know drain as well, and everything kind of drains in these lymph channels back into your into your heart eventually, right? Into your into your anyway, your big vein and that dumps into your heart. And so it's always the fluid is always being recycled. So it's always kind of being recycled, and that's what the lymphatics is. For instance, if um this is how you can tell, sometimes you can tell if a woman's had breast cancer because they have one extremity bigger than the other one. So for instance, their left arm will be swollen because when they had their breast cancer, they might have had a lymph node dissection where they took out the lymph nodes and interrupted the lymph channel. So then the lymph the fluid can't drain properly, so the arm is a little bit bigger than the other arm. And so if you ever, if you ever see someone that has a slightly bigger arm, it could be because of a blood clot, you know, like blocking the flow, or it could be because they had a surgery and then the surgery messed up the lymph system, and so now the lymph system doesn't drain properly, the fluid backs up, blah, blah, blah, right? Um, that's how the lymph system pretty much handles. You have a separate system in your brain that's different from the lymphatic system called the glymphatic system. And so the lymphatic system basically drains the fluid that surrounds the cells in the brain, and so it flushes those that fluid out. And so what happens is um the glymphatic system basically uh it only operates when the person is actually sleeping. So it's like having a fish tank that you have to refresh and clean the fluid out. People that don't sleep well tend to not have their lymphatic system flush properly, and so they tend to build up, you know, residue and and and um deposits. And so what's funny is when we see people who have um dementia, they tend to have a lot of deposits that they can see on MRI. And what we're realizing is that those deposits in their interstitial fluid in the in the are the in the in the brain tissue, not actually the cells. Is actually the debris that's just never got a chance to get flushed out and cleaned out properly because they're not sleeping properly. So again, sleep is huge for the body to function properly. Um it's it's it's relatively new discovery. Like I'd say the past maybe 10, 10 years or so is when they kind of came out with that data and like, hey guys, we just realized something. Your lymphatic system actually only functions at nighttime. It's like, oh wow. And so we, you know, we I didn't know that. I was like, that's one thing I I I um I learned probably a couple months ago. I was like, wow, that totally makes sense. And when you apply it to what I've seen over the past, you know, however, 30 years in medicine, um, it totally makes sense as to why why that is and why that would be. And then now what they're doing is because they've discovered that they've um they've uh they're starting to target different medicines to kind of help handle those deposits. And what's funny is um it kind of makes people realize, you know, sleep medicine is actually pretty huge. Like if a person, you know, doesn't sleep well, they potentially can have a lot of issues with memory and cognition later on in life. Sure. So um, which is interesting.

SPEAKER_00 45:04

No, it makes sense. Yeah. So as we get near the end of the show, there are two big questions I like to ask everybody. Yeah. This is the stuff that gets shared typically.

SPEAKER_01 45:14

Okay, cool.

SPEAKER_00 45:15

So the first thing is this one's gonna be an interesting one for you because you have like you've been in in so wide of a range of medicine that I'm I'm really genuinely interested in your response. But what is what is the biggest lie in medicine that you've come across that you were just like, wow, I couldn't believe that that wasn't true?

SPEAKER_02 45:36

Uh probably the biggest thing that I see that we don't really talk about is this thing called essential hypertension. So a person comes in and they say you have essential hypertension, here's some meds, have a nice day. And then um I've I've kind of realized that there is a cause. Essential hypertension basically is blood high blood pressure, but we don't know the reason why. Um to me, probably the biggest reason why is just the person isn't actually using their body with what it was supposed to be doing, which is actually moving. So exercise is huge at lowering blood pressure, and then also body size as well. So a lot of guys, um, I have patients who are like, hey, my blood pressure is going up, and their pressure is, you know, whatever, 150 over 100. I don't know why their pressure is so high. And then I'm like, hey, you know what? Let's look at your stats from the past couple of years. And I'll show them their stats. And it's like, you know, when they came in and saw me, their weight was like 150, and then, you know, two years later it was 160, and then next year it was 170, and now it's 180. And then you can see the blood pressure go up slowly with it as well. I find that as far as essential hypertension, especially for men, it's usually directly proportional to their weight. So if the person gets their weight back down to a normal or more normal, you know, size and they exercise, the pressure goes right back to normal. So all these guys are cranking blood pressure pills all day, every day. And um, and this the handling, I think if people really understood that, like the one guy I'm thinking of, just popped in my head. I said, hey, just lose the weight, it'll come down. I won't see you anymore. And you know what he did? He lost the weight. I don't I don't see him. Like he doesn't come in because he doesn't have a blood pressure problem anymore. And so it's like, you know, people aren't told that you know the root cause of certain things. Because if you if you have the person teach them and they get it and they duplicate it, they can fix it. Once they go, oh, that makes sense. Okay, good. Patient handled. You've given them the knowledge, they're not gonna come back. They get it and they fix the problem. It's when they're like, oh, you have high blood pressure. Here's your blood pressure medicine, I'll see you in six months. Eh, I mean, that's a good way to make money. You see them every six months or every three months, whatever the case may be. But the reality is you could help you could help that guy a little bit more and actually tell him and give him the reason. And the funny thing is, if you look up all the stuff on essential hypertension, there's nothing about weight. It's all, hey, you have essential hypertension. We don't know why, but you have high blood pressure, and there you go. And it's true, there's there's other little nuances as to you know why the pressure could be high. But in my experience, when you really look at it, if the person drops their BMI like a couple points, they you lose a patient. You're not gonna see him anymore because they they they understand why, and it's it's done.

SPEAKER_00 48:06

Yeah, I like that. Um, one of my favorite things to do is work myself out of a job. Like I help a family, yeah. We eradicate their issue, it doesn't come back, right? I'm out of a job. However, you know, you're kind of acting on that same premise. Right. And that's a really amazing thing because uh in medicine, specifically when people are prescribing prescription medication, there's always a plan to get them on it. Right. But never really a plan to get them off it. Right. And then, you know, to be told, and people are commonly told, you're gonna be on this medication the rest of your life.

SPEAKER_02 48:35

Yeah.

SPEAKER_00 48:35

It's pretty defeating to hear something like that.

SPEAKER_02 48:37

I don't tell people that.

SPEAKER_00 48:38

That's amazing.

SPEAKER_02 48:39

Yeah.

SPEAKER_00 48:40

That's why you're here.

unknown 48:41

Okay.

SPEAKER_00 48:41

You're part of the team.

SPEAKER_02 48:42

Yeah, yeah.

SPEAKER_00 48:43

You know, you're actually you're doing the amazing work.

SPEAKER_02 48:46

I like to call it God's work, you know, you're doing the amazing work and you're making sure that's I mean, I should be on there's there's a few things where they're gonna be on the med for the rest of their life. But I would say 90% of the time that's not true.

SPEAKER_00 48:57

Yeah. I love that. Yeah. So the other question is controversies. Sometimes controversies they spread like wildfire. And it's usually because there's some shred of truth in them. And so I'm curious, what what's a controversy you've come across in your field that's actually true?

SPEAKER_02 49:17

One of the things that's kind of in the in the air that's a little bit confusing for people is the whole game of cholesterol and you know, lipids in the blood. And is it is it a big deal to have high, you know, high fats in the blood, right? And for some reason the trend is now people are saying it doesn't matter, it doesn't make a difference. And then I make it super simple. Like I actually think it's true. I think I know there's tons of people who disagree with me, who think that cholesterol is not a big deal. I just make it super simple. I'm like, look, you have a pump, right, your heart, and then you have the pipes, you know, the blood vessels, and then you have the juice, the blood, right? And then I ask them the question what is easier to suck through a straw, water or a milkshake? And they go, Water. Okay, great. People who have high lipids or fat or cholesterol or whatever, you know, triglycerides in their blood, their blood is like a milkshake. Done. And I go, oh, and then they go, okay, that makes sense. Because I have people who, you know, they they they argue with me about, ah, it doesn't matter. I've seen studies that say that, you know, okay, fine. Or if this doctor is saying it doesn't matter, I'm like, okay, that's fine. They can say that, they can have their opinion. What I see is the guys who have that, who have high cholesterol, high triglycerides, they tend to have a high blood pressure. Why? Because the blood is thicker, it's gonna, it's it the heart's gonna have to use more force to move that stuff. I never see people with high cholesterol or high lipids that have a normal blood pressure. It's always a little bit higher than normal. So that means the heart's working a little bit harder, and that creates this whole cascade of problems for the entire body. So I'm like, cholesterol and lipids and triglycerides, yes, it they do actually make a difference. You don't want to have high numbers. So despite what other people say, 100% disagree. I think that controversy is to me not controversial. What do you want? Water or milkshake flowing through your pipes?

SPEAKER_00 50:53

I think you have a pick of water instead of the milkshake. Exactly. Interestingly enough, I think of why why that whole hap the whole thing kind of unfolded that way is because you have the popularity of the keto diet.

SPEAKER_02 51:04

Big time, yeah.

SPEAKER_00 51:05

Right. And people are misunderstood about the keto diet. Right. The keto diet doesn't say eat eat bacon three times a day. Right. You've already alluded to the fact that you know when you started eating bacon every day, your cholesterol went up. Right. Right. You don't want to have milkshake through your veins, you want to have water through your veins, good. So you cut out the bacon problem solved.

SPEAKER_02 51:21

Cholesterol went down.

SPEAKER_00 51:22

But you're still essentially eating protein, right? I mean, you have bread and stuff. So no, you can eat protein every day. Might not be a keto, but that I think the popularities of some of these diets, um, the misunderstoods on the diets themselves, right? Where people eating too much cholesterol or too much fat, right. Um, and maybe the less healthy fats that could increase your cholesterol, then causes people to say, well, I don't understand. Everybody's on keto, everybody's talking about keto. Right. Therefore, it must not be that my cholesterol matters. But there's actually a way to do keto and not have high cholesterol. It's all about choosing the proteins that you're eating and maybe not consuming bacon.

SPEAKER_02 52:03

You can be a carb junkian if high cholesterol. So it's not necessarily this, necessarily the diet, but um, I always tell people just mixed it up, man. Just mixed it up. You should have a variety of everything. I'm not a huge proponent of any specific type of diet, like you know, carnivore, keto, Mediterranean, whatever. I mean, all these different diets, I tell people, just eat food. And then if you can maintain a a decent, you know, BMI or body mass index, I don't care. If if you if you eat this good, whole organic food. I had um I talked to uh this lady, Liat Golan, one time, and we were talking, and she she has the 80-20 rule. She's like 80% of the time you eat clean organic food, 20% of the time, you know, have chips or what who cares? You know, it's like whatever, you know, you can splurge every once in a while. Um and she's right. You know, if you if you tend to eat relatively clean, you don't have to necessarily restrict and avoid certain things. You just as long as you, you know, uh moderation, you know, with the with the with the other stuff. Like I have pizza every once in a while, it's not a big deal. I love pizza.

SPEAKER_00 53:01

Yeah. I like pizza too, but yeah, I can't eat it. You can't have it every day.

SPEAKER_02 53:05

Exactly. I have it like once a week or once every couple of weeks, not a big deal.

SPEAKER_00 53:08

Yeah, that's awesome. Yeah. Well, I really appreciate taking time out of your busy day, you know, to be here with us and and share more of your vision and your story. And I think it's really important that we have these conversations because obviously we want to be healthier. Right. Want to be cause over that and control our health, not be this total effect of it. So uh I really appreciate everything you shared today. Where where can people find you? Where can they learn more about you? If they're in the Tampa, greater Tampa area, where can they come see you?

SPEAKER_02 53:35

Um, I have a clinic in Clearwater, uh right down the street. Um it's uh downtown Clearwater, and uh it's called Bayside Urgent Care Center. You can uh Google it, look online, and then that's pretty much where I where I live. Um they're usually five days a week, and then um, yeah, that's where you can find me.

SPEAKER_00 53:52

Awesome. Well, thank you so much for taking the time today. And thank you for joining us for another episode of Never Been Sicker. I'm your host, indoor air quality expert, Michael Rubino, and I'll see you soon.