The Cameo Show
The Cameo Show is a podcast about sharing our life experiences and learning from each other. Through solo stories and inspiring conversations with a wide variety of guests, we explore the secrets and strategies for feeling confident, empowered and equipped to live the life we want to lead. Tune in to learn how to find joy and fulfillment in your life and to gain valuable insights from the amazing stories and lessons of our guests.
The Cameo Show
What Your Smartwatch Knows About Your Heart (That You Don’t) with Abby Gamby, CNP
Think your smartwatch is just counting steps? Think again.
Certified Nurse Practitioner Abby Gamby joins the show to reveal how wearable devices like Apple Watches and Oura Rings are transforming heart health—capable of detecting conditions like atrial fibrillation with over 95% accuracy, often before symptoms even begin.
We dive into how everyday factors like caffeine, stress, diet, and even sleep can influence your heart’s performance—and what to do when the numbers start looking off. Abby also shares practical lifestyle advice for supporting heart health at any age, from exercise recommendations to early warning signs of heart attack and stroke.
Whether you’re a fitness buff, navigating midlife, or just curious about that little buzz on your wrist, this episode turns heart health science into real-world insight you can actually use.
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Hello and welcome to the Cameo Show. I'm your host, cameo, and today we have our dear friend and also an expert in the heart health area, miss Abby Mrs I'm sorry, michael. Her husband, michael, would be very mad at me for calling her Miss Mrs Abby Gamby. Hi, abby, thanks for being here, thanks for having me and, as always, we have my husband and co-host, mr Greg Braun.
Speaker 2:I'm so excited to be here. This is a very special episode. It means near and dear to my heart.
Speaker 1:It means near and dear to your heart.
Speaker 2:Well, abby, abby's near and dear to my heart, but we're going to be talking about the heart, so this is just full of heart. This episode yes you're right Very heart-scalped.
Speaker 1:Well done. Well, greg, you start us with a dad joke, so do you have one for us today?
Speaker 2:I do, I do. Why couldn't the bicycle stand up by itself?
Speaker 1:I don't know.
Speaker 2:Because it was too tired.
Speaker 1:Good, too tired. Well, without further ado, thank you for that, greg.
Speaker 2:That's for all those moms and dads out there that are tired because we're driving all over the place. We're running all over the place. We're doing all this stuff. We're just doing too place. We're running all over the place. We're doing all this stuff. We're just doing too much.
Speaker 1:We're doing too much. And that is a great segue to Mrs Abby Gamby, because she has two very busy, involved athletic teens that she's running all over the place, um, and a wonderful husband, michael, who she is probably busy with taking care of him as well. And her expert role here, though what we're talking about today is she's a certified nurse practitioner, took on the nurse practitioner role in 2009. And she's currently working in an outpatient cardiology and electrophysiology clinic, and you've been doing that for the last eight years.
Speaker 1:So on the daily you are working with heart patients. You're working with patients on making sure that their cardio health stays or returns to where it needs to be.
Speaker 3:Yes, optimal health is what we shoot for for them, and it's, oh yeah, electrophysiology. So that's heart rhythm disorder clinic, and then the other focus on general cardiology, which is overall heart health, blood pressure control, cholesterol control, just health maintenance and a plethora of coronary artery disease or heart problems.
Speaker 1:So yeah, yeah, heavy stuff. Yes, well, this came about because we were having a conversation with Mike one night and he mentioned that Abby had given a presentation about our wearable devices that track our heart rate, our HRV, our sleep, all of these different things that we're all obsessed with. I mean, we're just as a culture obsessed with our wearables, our Apple watches, our whoop monitors, our aura rings. I was sharing with you, before we started, that I literally wake up and check my aura ring every single morning to see what my ring tells me I have done well and what it tells me I suck at. I'd like to start there and then maybe branch off into some just general heart health information, because a majority of our listeners are interested in taking control of their health by activity, by diet and mostly by understanding. What does all of this mean to me?
Speaker 1:What are the things that I need to be paying attention to and what are the things that are just noise, because there's a lot of that too. So if we could start, maybe, with some information about the heart monitoring wearable devices that so many people have, can you talk to us about the accuracy? Can you talk to us about what these numbers actually mean from your standpoint as a nurse practitioner and what you see with your patients, and just general information about them?
Speaker 3:Yep, yep.
Speaker 3:So I would say by far the we know the majority of users wear the Apple watch and not to get to um you know, for with one brand, but that is by far the most popular thing that we see is the Apple watches and they track from any, depending on what generation you have.
Speaker 3:Um, starting at fourth generation is where they will track your heart rhythm or if you're having irregular rhythm, and that's what we're looking for In the general population. If you get an irregular rhythm, that's where you want to take the next step and make sure it's not a concerning rhythm. So the Apple Watches have the capability to record that. If you get an alert, you the capability to record that. If you get an alert, you record the abnormal rhythm and when it's recorded, it is good accuracy. So all our studies and data we've looked at or has been looked at has shown these are up to the Apple Watches. Again, the other wearables include Aura rings, or there's many different types of rings or what, uh paired devices that you can connect ultrasound wave Um, it's called a cardio device is the main one that's used. Anyhow, these are all up to like over 95% accurate at detecting abnormal heart rhythms.
Speaker 1:Um, so the rage and the excitement around these rings and devices and Apple watches is, it's reasonable, like, it's not just a fad, it's not just something that, like might give you some information that's helpful. It's extremely accurate.
Speaker 3:It is and we use the data that people bring in because we know the accuracy and because we can view the EKG recording. So that's the rhythm that you're seeing and we can view it and we can see. What's helpful for us as like providers, is if someone brings that in, concerned about a heart rhythm, we can tell them and coach them. You know this is sometimes we'll say it's artifact, meaning you can see right away it's on the sheet of paper where the recording comes across. If it looks like crazy all over the place of the rhythm, then that's not normal. That means it was not a good connection. We can give some peace of mind. This is what we call artifact. Don't worry about that. It wasn't a good connection to your wrist, to your finger. So a lot of times we'll get people really worried about something that's not even worried. So it eases their mind to bring that in. So we see that. And then, secondly, we can see that if there is something abnormal that looks abnormal, we're able to address it quicker than if they didn't have a wearable device. So that's, in our eyes, the biggest benefit is pulling out something early.
Speaker 3:You know, the biggest risk and I've just put this out there because it's the number one. Abnormal heart rhythm is atrial fibrillation and if someone's having that and doesn't realize it and they have other risk factors, that's where you're at risk for stroke. So this is why in our world, these monitors have been very helpful. Whether someone has AFib as a new onset or they've had it and now we're finding it while they're wearing their, it helps guide treatment. It also helps the number one thing that you know all these apps, all the Apple Heart Study and different things looked at was stroke risk reduction, because that's the biggest concern with the abnormal heart rhythm of AFib. That goes undetected a lot.
Speaker 1:If I don't have something that's tracking that for me? Are there symptoms or are there indicators that I would pick up on that being something of concern for me, or does that kind of happen almost too late in the process? Can you explain that a little bit more?
Speaker 3:That is a very good question. So, um and this is where it's challenging, because every human being is different and what they feel when they have their arrhythmia or AFib or other heart rhythms. But AFib is the bigger one that often goes unnoticed um, because some people feel nothing, totally the same, no difference. It's almost. I mean just in my experience I'd say, people that have normal heart rates and they happen to go into AFib may not notice anything at all for a long time.
Speaker 3:But some subtle symptoms like fatigue, increased fatigue, why am I all of a sudden tired? You know, mowing the lawn, push, mowing my small lawn, whereas I used to not be Like that's sometimes something that gets tricky because people don't realize the fatigue. A change in level of fatigue and trigger could be a sign, I should say, of arrhythmia. Shortness of breath is the main one. Increased shortness of breath or like a butterfly feeling, flip-flop feeling in your chest those aren't normal symptoms. Unexplained feelings like that would encourage someone to talk with their doctor or get further evaluation with EKG as a quick, simple way in an office to check a rhythm. Now again, if you happen to have one of these as well, they are again pretty accurate.
Speaker 1:And an Oura ring would do the same.
Speaker 3:I believe. So yeah, I mean I didn't look as much detail on those, but I know they they track the um, the heart rate, the same way. So I don't have. I can honestly say I don't see that one used as often, you know, just in my practice. But, um, I know that it uses the same technology as the Apple watches with the infrared light on the ring itself, which again was looked at in the studies, and it showed similar, you know, over 95% accuracy in detecting abnormal heart rhythm.
Speaker 1:Can you talk a little bit more about the technology and how that works to read these on our wrists, on our fingers?
Speaker 3:these on our wrists, on our fingers, there's an infrared light and it's basically picking up the blood flow pulsations through the artery or through your, you know, through your finger here or through the wrist, the pulsations of the blood flow, and so it's tracking the rhythm, if it's regular, irregular, and the rate how fast. So that's what it's basically telling you how fast or slow your rhythm is, and if it's regular or irregular as far as rhythm goes. And then that's what I'm more familiar with. But then I know there's also all the other tracking, as we were talking before with the sleep scores and sleep blood oxygen. So because it's reading the blood, you know it's able to track the blood flow. Also, some of them are able to track blood oxygen levels.
Speaker 1:Our rings track our, our blood oxygen level.
Speaker 3:Yeah, at nighttime.
Speaker 1:Yeah, and so with regard to sleep, and maybe it's not something that you can speak to necessarily specific to the devices, but while we're on it, can we talk about the importance of sleep in overall heart?
Speaker 3:health. Our biggest thing, and especially getting into middle age, is awareness of sleep apnea. I know that's not something we test on, but this is what also these can track and pick up is if you're having low blood oxygen levels at nighttime, but tracked by your device, whether it's your watch or your ring. That's concerning time, but tracked by your device, whether it's your watch or your ring, that's concerning so you do not want your oxygen levels dropping below 90 while you're sleeping. That's not normal. Anything below 90, 80s, 70s while sleeping is abnormal, or what we'd call sleep disordered breathing, potential risk for sleep apnea, which then carries a laundry list of risk of other comorbidities such as, like high blood pressure, risk of stroke, risk of a risk of heart rhythm issues, risk of heart failure. So, and that is again over time you know it's not something that happens overnight, but over time. If someone's not aware about oxygen levels at night, um, that's one big thing that I think these are helpful for tracking.
Speaker 1:Yeah, and I think that's an overarching theme and statement to make about these is that the data is accurate, but also it allows you to track the trend. So, as you mentioned, all humans are different. My HRV, my heart rate variability number which, if you could explain a little bit about that, that would be amazing but, like mine, looks totally different than Greg's and it looks way different than Faith's. She has our daughter's 19. She has an aura ring and her HRV is like through the roof all the time, like super high, and I'm super jealous of that. But obviously there's a 20 plus year gap in age and and physiology there that makes a difference. So can you talk to us about HRV and speak to the fact that these trends are things that help experts, help your patients make sure that they understand their own trends versus maybe just what they Google?
Speaker 3:Yeah, there's another thing that they're an excellent source for and we all, you know people will bring in a lot like here. Look here my heart rate, um, when I'm sitting in I haven't been doing much throughout the day is 120. You know that's not normal either. So you don't want a rusting. Resting heart rate should be below, technically, probably in the eighties, below 90, normal Um. But you also should see the heart rate going up, like you're talking about, probably with physical activity running, walking, climbing stairs throughout the day. You do want to see that rate go up, you know. So that's normal.
Speaker 3:You know there's no concern when you see heart rates knowing you were at the gym or you were maybe outside working in the yard, that's normal. For the heart rate to be 110, 120. No concern there. More concern is resting heart rates elevated, unexplained elevated. Other thing would be if you were not getting an increased heart rate response to activity, which can happen with age. So, as you mentioned, as we get older 40s, 50s, 60s, 70s our heart rate variability is not as robust as, like faith, would be at 19. You still want to see some, though it's important that it does speak to heart health, meaning your electrical conduction through your heart is normal if it's going up appropriately with activity. But if it's not, there's a little more data showing some risk for increased heart disease if you're not getting appropriate heart rate response to activity. Especially our older population and I'm talking over age, like, let's say, 80, 70, 80, occasionally younger, but like really blended heart rate response to activity can show a significant decline in electrical conduction.
Speaker 1:So sure that makes sense. I guess I look at mine, for example. I I'm always perplexed when I you mentioned, like I'm just sitting here working and my heart rate is a little hot on the higher side and I'm not really doing anything. So I take some deep breaths to like calm myself down. Maybe I'm experiencing just some stress and anxiety around the work that I'm doing bring my heart rate back down.
Speaker 1:I also then notice sometimes, like we do a lot of boxing training, a lot of kickboxing and martial arts, sometimes I feel like I'm just completely gassed, like I could just bend over and just take in deep breaths, just sucking in air, trying to catch up. And I look at my stats from my workout and my heart rate didn't really go like out of zone two and I'm like how is that possible? I was nearly dying. Like where's the correlation between knowing that you're pushing yourself in physical activity uh, hard enough, but not too hard and also like some of the things that would cause my my resting heart rate to spike? Those are two very different questions that I just threw at you all at once. But if we can break those down in a more organized way, I presented them to you.
Speaker 1:That would be great.
Speaker 2:Well, I, before Abby gives us the answers, I think you're faking it. You're not giving it your all and you're stopping and the ring doesn't lock.
Speaker 1:See, Greg and I spar each other, and when you, when you say those things, Greg, you're just kind of asking for it you know, you're just asking for me to turn it up and that could be dangerous for you, my friend, so I don't regret it, or was Greg winning at that time?
Speaker 3:So you're like I'm done Well probably not.
Speaker 1:No, could have been.
Speaker 3:Yeah, so I think to answer your first question or maybe it was your first question regarding if you're at rest and you're noticing your heart rate's up, but you're also correlating it with increased stress, anxiety. That is very normal. So there's stress hormones released. When you're upset, you're emotional, you're nervous about something for the day or something happened, you are going to have a little bit higher heart.
Speaker 3:Oh, the other thing is pain. You know, obviously we expect heart rate to go up with pain. If you're in pain, from from sparring with Greg or whatever it may be, the heart rate is going to be up. At rest, you know, maybe 90 to 100 or more. But then, like you noticed, you did the deep breathing, there's direct correlation with you know, deep breathing, relaxation techniques that lower heart rate, and yoga, all those things really lower heart rate as you do those calming exercises. So that is, yeah, normal with stress to go up, like that normal to go down, as you do your relaxation, which is why those techniques are so good, as you do your relaxation, which is why those techniques are so good. Um, to follow that up with your other question, which was, oh, about the breathing Um yeah.
Speaker 3:And you're feeling really short of breath or like really winded when you're working out but you don't think your heart rate's where it should be to be going. Feeling that winded Is that what you're?
Speaker 1:saying yeah, I mean, I feel like I pull up my numbers after the workout, where I'm, like you know, today was really difficult. I felt really gassed in a way that you know I was pushing myself harder than I feel like maybe I normally get to that level and I pull up my ring and expecting it to be like your heart rate's 180, you know, and it's like 120, zone two, the whole time and I'm like that was my next question what your heart rate was.
Speaker 3:So it was 120, which was your normal for being exercising. Yeah, that's a tough one to tease out. I mean, certainly it might not been related to the heart rate or something it could have been. Maybe that day you know something different where more against stress, more stress that day or more upset, that your body in general just was more tired.
Speaker 1:Do I understand correctly that as your physical fitness level increases, though that your heart rate? Uh, how high it would go. During a strenuous workout, it would be normal for it to be low, on the lower side than maybe if you were inactive and then just went out and started running sprints and you. Is that an accurate statement?
Speaker 3:Yeah, I think so and I think again the age part has a little bit to do with it. Versus, like you know, when we're 18 to 20s we can tolerate heart rates 170 target heart rates when you're exercising. 170, 180 is more manageable with your breathing, versus 120 is more 130, 140. As you get a little older, your target heart rate goes down. So your body, you know, you really wouldn't maybe feel well if your heart rate was even higher. Like you're saying, you expected it to be higher, like 160, 180, but it's unclear, maybe that day that happened, why, I guess.
Speaker 1:but yeah, Well, I just, uh, I look over at Greg and he's usually like breathing heavier than I am struggling. I know he's usually like breathing heavier than I am struggling. I know he's not working nearly as hard as I am. And then his heart rate's like higher than mine and I'm like what? Like I'm putting out so much more extra energy and effort. So I guess you know. That's why I was chalking it up to my level of fitness, is just that much higher.
Speaker 3:I mean it could be because you ran a lot right Like you were a runner and greg you didn't do as much distance, is that right?
Speaker 2:uh well, we, we did the clumbus marathon together okay, yeah, yeah we ran a lot that summer we did.
Speaker 1:I would say, though, that, collectively, I've definitely put in more miles over a longer period of time. Okay then, greg, yeah okay.
Speaker 3:So I think anybody that's run distance running, um any like athlete that's kept very high level at Greg not that you didn't, but um high level of aerobic exercise, whether it's marathons, half marathons, triathlons they're almost throughout and I've just seen this through some patients we've had throughout their lifetime. Their heart rates do run a little bit lower at rest and like you're saying, I'm guessing probably more. I have never really discussed that with them but, like when they're active and running and different things.
Speaker 3:People get worried a lot if they are really active or if they have a resting heart rate that's low, like 40s, 50s, um, and we'll get the question that a lot. If you're not having any symptoms and your heart rate's that low, it's it's okay, meaning we that's the frequent thing that comes in is like well, it's called bradycardia, meaning low heart rate, and that's sometimes people's baseline heart rate is lower. As long as you're not having any symptoms, then there's no no concern.
Speaker 2:Well, hers is lower. Yeah yeah, her heart rate is lower than mine.
Speaker 1:So when I wake, up in the morning, my resting heart rate overnight is sometimes in the forties. Is that typical that in your sleep, when you're not moving and you're at complete rest, your heart rate drops off from when you're not active but awake?
Speaker 3:Yes, yes, correct, and that's the other question we'll get is the heart rate at sleep will drop into the 40s for a lot of people, and that's okay.
Speaker 1:Yeah.
Speaker 3:And I don't quite recall the physiology, Like it's not necessarily an issue. It's just that when we sleep at nighttime our heart rates, our bodies are so relaxed and rested, the heart rate slows way down from our baseline.
Speaker 1:Interesting. This is maybe more on the exercise side of things, but to me it's still heart related. The difference between aerobic and anaerobic exercise.
Speaker 3:You know, from our standpoint we certainly encourage aerobic exercise. So we do know that getting the heart rate up with aerobic exercise I mean currently the American Heart Association has got, I mean it's recommended 150 minutes a week for aerobic exercise Most people don't get that. You know that's hard. So aerobic exercise is super important for blood pressure control, cholesterol control, diabetes, weight. So I would say we of course, working in a heart office, strongly favor aerobic exercise. Getting that heart rate up is so important to prevent many things and even heart rhythm issues are very well prevented by getting your heart rate up like that aerobic exercise 30 minutes a day is the standard well, or you know, yeah, I mean if you can.
Speaker 3:I mean they say 150 minutes a week, so that's almost every day doing something to get your heart rate up. Um is the current recommendation.
Speaker 1:So and when you say get your heart rate up, what is that? Obviously that differs from person to person, yeah, and what their base level is, but is there like a? Uh, not a range, but like a?
Speaker 2:zone three.
Speaker 1:Yeah, Like a where where it correlates to your own heart rate how far it should be from your resting, or how do you measure?
Speaker 3:Yeah, I don't think. I don't think there's anything that specific. I've seen you know, it's basically any you know, and this is for the general population. I mean, some people are certainly like you're. I think you both are very good with being very aware of your fitness levels and what you need to be doing, but then a lot of people aren't. So we just really encourage, like I said, every person is different. Some people have done no physical activity for a very long time, for whatever reason. So we say start where you can Start, 10 minutes a day, 15 minutes a day, walking. What can your body do If you can't walk, you can't run, get. If there's something stationary you can do, get on a bike. If you can't do that, can you get in the water? Can you get in a pool and walk, I mean, and then keep building? So it depends on literally it's unique for each person and not specific range of heart rate. It's just a matter of doing something physical more than what you were currently doing.
Speaker 1:Just so your heart rate isn't staying at just kind of where it is when you're resting, so that you do see when you do that activity that spike in a heart rate over a period of time.
Speaker 3:Yeah, and doing that will eventually I mean over several months, usually we'd say, you know, two, three months will improve those things that maybe you're trying to work on, whether it be blood pressure, cholesterol, you know weight.
Speaker 1:While we're heading in that direction. With regard to general heart health, Greg and I get our blood work done annually. We are due, Greg, so we definitely need to get that taken care of. But we both have even. You know, as active as we are, as mindful of our nutrition as we are, we're nowhere near perfect. I mean, I just inhaled birthday cake for an entire week I'm going to call myself out.
Speaker 2:I literally just had a piece of cake and it was amazing.
Speaker 1:Easter candy and birthday cake all in the same week. It's been insane around here. So I'm not saying we're perfect, but we're very mindful and so. But our blood work has shown that we have slightly high LDL cholesterol the bad cholesterol that you're not supposed to have and Greg is on the higher range of where his blood pressure should be. So what are things that impact our heart with regard to nutrition and activity? Those things specifically blood pressure and cholesterol that we can be mindful of in our day-to-day, our busy lives, running from place to place to try to keep those where they need to be. Yeah, yeah.
Speaker 3:Yeah, and that's and that's a good one, because that's that's hard Cause, like you said, we have very busy lives and sometimes it creeps up on you. As far as blood pressure, slowly over time and can be genetic definitely, which is challenging, there's nothing you can do about genetics if your family history of blood pressure or heart disease you know that's. But it's that's where it's important to be very mindful of um of your diet, which, again, we generally would recommend, like Mediterranean diet. That's been shown to be very beneficial for heart health and cholesterol. The Mediterranean diet would include a lot of fish, omega-3s. Olive oil is the main oil that a lot of times you know people don't recognize or realize, like coconut oil had a lot of you know, rave as far as benefit, but there's a lot of saturated fat and coconut oil.
Speaker 3:So we really encourage more olive oil, avocado oil, saturated fat and coconut oil. So we really encourage more olive oil, avocado oil. The healthy fats do help cholesterol. And then it's. You know, I said fish, chicken, nuts, greens, fruits, minimal processed foods, minimal red meats in a nutshell, we love steak, blank steak and we're just heavy on the red meat for sure.
Speaker 1:That's probably where.
Speaker 3:That's yeah, I think that is the hard one, especially like a lot in your lifetime, maybe throughout your life. I mean Mike Gamby ate a lot of red meat, yeah, so yeah, he's, you know, just growing up how he, you know on the farm and different things, I mean that was a lot. I mean he loves red meat and I like it too, but, um, that's a tough one for a lot of people. I'd say that's the biggest kind of pushback from that diet. When we talk about it is the red meat, um, so we don't say you have to eliminate it altogether. So I mean, certainly just again being mindful, okay, maybe I have it once every other week. You know it's better than having it three times a week.
Speaker 1:So you know, let's see, yeah, like I need to get it down to once a day, and then I can be maybe a little happier, and you know, and it also depends on your numbers, like you said.
Speaker 3:I mean, certainly if you, if I had both of your cholesterol panels in front of me and they were reasonably, reasonably healthy, then it'd be surprising. Okay, maybe you can still continue to have your red meat once a week or twice a week. Now, on the flip side, if it's the it's, it's a different story if someone had already has heart disease.
Speaker 2:but if we're talking preventative health care, or preventative health then certainly just trying to get your target numbers, that goal for you well, I cannot wait to get our results and email them to abby and we'll give it to us. Let us know you know yeah because when we look at, we're just like what is all this, you know? Yeah it's just yeah and generally.
Speaker 3:I'll tell you, like obviously, that it should be giving you on the like what's normal range, what's yeah, yeah, which is probably pretty you know for you guys, how, if you guys are healthy people would probably be accurate I've been noticing because I'm 42 and probably entering the perimenopausal conversation like I do have some of those butterfly flutters.
Speaker 1:I do have some increased anxiety, and I haven't had my hormone panels done, I haven't done any of that yet but I just feel like those are things that are popping up that I recognize, that are new and different in the equation, that are like oh shit, here we go. I'm I'm in my forties and this stuff is like something I have to pay attention to. And with regard to, like, the pattern of the ring, I think that's helpful for me because I don't obsess over it necessarily, but I do. I do at least know where my heart rate is, I do know my numbers are and I know a little bit enough to be dangerous about what they mean. And, um, let that kind of guide me. Like when I don't get a good night's sleep, usually I I know it before I checked my ring and then it tells me hey, you didn't get a good night's sleep, you dummy, you need more sleep.
Speaker 1:Yeah, I was reading a book. It's called scarcity brain. Have you read it, abby? It's by Michael Easter, fantastic book. He has two books, maybe he has more than two but Comfort Crisis and Scarcity Brain. And coincidentally, there's this page on health where he's talking about whoops and different aura rings and fitness trackers and it talks about how people use their recovery score to determine what they're going to do next, like what am I going to do today based on my recovery score score? I guess on my aura ring it would be called my readiness score.
Speaker 3:Okay.
Speaker 1:And I'm curious if you see people leaning into what their device says to dictate what they do with their activity levels or with their day-to-day, and if that can be dangerous, considering how accurate the information is or if you should really hold tightly to like I got bad sleep. My readiness score is low. I should rest and give my body some time to recover, or go more based on how I feel or what I would normally do.
Speaker 3:The patient population. I work with a a little bit older average age, probably above 70. But personally I don't see it too often. I some ways wish people took a little more ownership of their health. Being proactive is so important, like you know. We kind of touched on knowing, knowing your numbers, knowing your blood pressure, knowing is my heart rate symptom I'm feeling, is my ring showing something weird. You know those things. Being so proactive, capturing everything early, will, in the long run over your lifetime, keep you much healthier.
Speaker 1:Sure On the things that sneak up. What are the things that you see that people maybe come in and they they didn't have symptoms, they didn't realize, and then all of a sudden they're in this uh, danger zone of having a stroke or having some type of cardio cardiac disease, not to scare people, but just to be aware of as they're thinking, yeah, all the health, health maintenance, um, I mean we could go through a pretty good list of things that cause high blood pressure, heart disease.
Speaker 3:You know, risk of high cholesterol, stroke, heart rhythm issues Starting at the top, I would say main ones alcohol use and cigarette smoking. Alcohol use is directly linked to a lot of things in the heart world. As far as heart failure, I mean, I'm talking again, heavier alcohol use over time, these are things that will catch up. As far as blood pressure, heart failure, I mean I'm talking again, heavier alcohol use over time, these are things that will catch up. As far as blood pressure, heart failure, heart disease, cigarette smoking as well, you know, nicotine is very hard on your arteries over time and can cause plaque buildup. And then you know, these are things that two lifestyle things that are really important, that we preach a lot about, as far as if we do have a patient that has a new diagnosis of a heart problem, those are two things that we really try to hone in on, trying to minimize. I know it's difficult, but that's two things.
Speaker 3:Second thing would then be weight healthy weight, healthy BMI, your height to weight index really under 27 for people is where they start to see anything above that. More health risk comes in as far as blood sugar, you know, diabetes, cholesterol, and so then the other one I would say would be exercise, like we have been touching on. So weight exercise, and then healthy foods, like the Mediterranean diet, um, low salt diet, of course, if you have high blood pressure. We talking to people about their diet as far as, um, what type of sodium they're eating. A lot of people aren't aware of all the sodiums that hidden and is hidden in our foods. So that's a big conversation, um, and then you mentioned sleep. That's a big one, you know. We talked about importance of sleep and sleep disordered breathing, again, sleep apnea, type of things, making sure you're aware of your sleep, healthy sleep.
Speaker 3:And then there's a final one I had on my mind oh, we touched on already stress. Stress is a big one as far as, over time, chronic stress leads to chronic illnesses. We know that, and in the heart world we see it with blood pressure, or, again, there is a potential for heart failure. There's so much stress Can you even have a stress induced cardiomyopathy. So best we can controlling our stressors, whether that be through, you know, I mean there's that's a whole nother talk on itself, but that's a long list right there, but it's a long list of health maintenance.
Speaker 3:It's a lot.
Speaker 2:That's a great list.
Speaker 1:I feel like it's something that everybody kind of knows, but maybe just because that's what you've always been told, but don't really think about the long-term consequence or severity of it. So having you discuss that from your position, seeing an older population, seeing it when it kind of is, you know, maybe happening.
Speaker 3:Yeah, and I shouldn't rephrase that because I do have. We do have a lot of people that come in and they're for maybe they don't have the technology we were talking about. That I was more touching on the technology, but then we do get people coming in a lot and I would say the primary thing in 40s, 50s, 60s is again blood pressure issues, cholesterol or early heart disease, whether it be unhealthy lifestyle or family history. So it's yeah, I mean it's certainly Greg. I think we said in the beginning, heart disease is the number one killer in America.
Speaker 2:Yeah, that stat just blows my mind because I would have never guessed that and I would imagine a lot of people general population that aren't in the medical world wouldn't guess that. Maybe they would say cancer or something else, but just literally heart disease. Something else, but just just literally heart disease. And there's. And you literally just gave the list of the 10 commandments of things to do to offset. You know, correct, set yourself up for the success in that.
Speaker 3:Yeah, yeah, it's, it is so important. It's so important before. Hopefully in your lifetime you never have heart disease, but if you do get it, it can really be a game changer, changing your lifestyle after a diagnosis of heart disease or heart rhythm issues, focusing on those things.
Speaker 2:It's kind of like you give those rules to the game of life by laying them out there and if you implement all of those things I mean just think about it like in our normal day we get pinged with our phone and all this stress that we get from driving all over the place. I mean we are overstressed. So if we don't do something consciously, proactively, to offset that said stress that we are getting pounded with every day, you can't just accidentally get healthy in today's world Because we have comfort and ease and simplicity to just like be lazy and eat fast food, and so you have to consciously go. I got to work out, I got to manage my stress, Like it's all got to be maximum impact, and that's just like a constant evolution that you just keep unfolding, you know so yeah, and it's not easy.
Speaker 3:You know it is not easy and that's, I think, the hard, the hardest part, you know yeah it's trying to implement these changes. If someone's not ever been aware, you know yeah, yeah.
Speaker 2:But it starts with that being aware of like, yeah, holy shit, these fries are not good for me yes, yes and like and, just like you guys are saying, just knowing your numbers is so important yeah, yeah, um former smoker, former drinker.
Speaker 1:You well know that. You've seen us in our glory days, so I didn't know about.
Speaker 3:I kind of forgot about the smoker part.
Speaker 1:Yeah, I probably smoked for almost 10 years.
Speaker 3:Oh, really I did not know that.
Speaker 1:Yeah, greg was a pack or two a day, or for a long time.
Speaker 1:Oh yeah, when we stopped drinking 10 years ago it the smoking went out the window with it for sure, for good, um, but it's still very difficult, both very difficult things to kick. My question was going to be like you know, you see, people come in, lifestyle choices contribute to their overall heart health and it sneaks in and it causes some problems later on that maybe you weren't paying attention to in your twenties, thirties, are worried about how does quitting both of those things or limiting them or adjusting them, reverse the damage that's been done or the problems or the symptoms that people are experiencing? Is it something that's trackable and measurable and a quick thing that happens? Or is there data to support that? Or what does that look like? And I'm I'm asking more curious for, like, what does that mean to me 10 years later? What does it look like? What does my heart look like from all the damage that I've done in my previous life of not paying attention or caring?
Speaker 3:you know, you know, I mean our, our bodies are pretty amazing. They can recover, um, and that's what's so unique. I mean I just, of course I work in the heart world. We see, like I mentioned in the beginning, you know, you can have a stress-induced, basically like heart failure. You can have an alcohol-induced heart failure, but our heart is a muscle and it actually recovers. So it can take, I mean sometimes three months. I mean we say three months of you know, alcohol cessation or in medical therapy, I mean certainly with the addition of you know, modern science, with medication, it can improve over time so our hearts can recover. And that's specific to like again, alcohol or removing whatever that was the cause. There's many causes, but anyhow, the heart like reversible, as you're saying, um, certainly, plaque in the coronary arteries, regression, I should say, like you, have plaque in your coronary arteries there is.
Speaker 3:There can be plaque regression If you do change your diet, if you do quit smoking. You know the healthy lifestyle changes and lower blood pressure and all that can remodel regress heart issues Um yeah. So definitely a benefit to doing to, to changing those habits.
Speaker 1:Yeah, it's not like I have done all this damage and I quit, but later I may show up. Uh, you know having these issues because of the damage that I've done, the quitting the adjustment.
Speaker 2:Well, maybe right if I'm lucky Because you were young enough when you quit probably.
Speaker 1:Yeah, yeah. What's one of the biggest misconceptions that people have about heart health and the things that you see when people come in with issues or with concerns. What's a big misconception about when people come in with?
Speaker 3:issues or with with concerns. What's a big misconception about?
Speaker 1:but you wish people knew like, even if it's simple and basic.
Speaker 2:Shout out from the mountain.
Speaker 3:Um, I would shout from the mountain what I shouted earlier that list, yeah.
Speaker 3:I mean that is every day I am working. That conversation comes up multiple times a day because it's so important. I mean for all facets of heart health, whether it be I know we've talked about heart rhythm a lot, or we've talked about heart failure, or we've talked about coronary artery disease, and it carries over to every other part. You know your brain health, your kidneys, so I would scream from the mountaintop that cigarette, smoking, alcohol, weight, keep up your activity. Know your numbers, know your blood pressure, know your cholesterol and, best you can, with what resources you have, minimize stress.
Speaker 1:Yeah.
Speaker 3:And that's not a misconception, that's just well. Maybe you know, maybe it's a misconception People don't realize that certain things in their lifestyle it is really important.
Speaker 1:Yeah, I think we're just clobbered over the head with so much information and misinformation through news social media. You know.
Speaker 3:And I think one thing sorry to interrupt you, but just really that those things can do so much more for you than even though I prescribe medicine. You know medicine will not fix everything. You know medications and pills can be given to help blood pressure and can be given to help things. But if people can do their part and take care of their bodies and themselves, it will do way much, do much more.
Speaker 1:Yeah, like your body, and movement is the best medicine to improve some of these things.
Speaker 3:Yes, the movement and whatever you're putting in your body, whether it be you know from all those things we talked about, from your diet to substances.
Speaker 1:Yeah.
Speaker 2:I have a question um kind of a little different gear here, but I love coffee and I'm sure lots of people out there love drinking coffee. It's like you can take away my beer, my cigarettes, but please don't take my coffee. Don't take my coffee, you know. I mean I just it's like part of my life you know, is.
Speaker 2:Is it really that bad for me? I mean, I'm, I could even like, dare I? I'm going to just call, I mean, a pot a day. Is that? I know that's too much, I know that's too much.
Speaker 1:He's not lying. Oh yeah, that is kind of a lot.
Speaker 3:but honestly that you know when I, when a previous thing we looked at, our talk I did, was on again heart rhythm stuff, a previous thing we looked at or talk I did, was on again heart rhythm stuff. Caffeine was not directly linked to heart rhythm disorders but it did. It was directly linked for some people as a trigger. So it depends on, again, each person but it's not been shown that it's going to cause a heart rhythm problem or cause again heart disease or any heart issue. Caffeine again heart disease or any heart issue. Caffeine, so that but I would touch on um in moderation, probably was. And then those um, I mean this is again a little off subject, but the energy drinks, um, like, uh, you know, celsius and different things that have high amounts of caffeine, those can certainly be a trigger for people with, with, with, with rhythm issues or trigger a rhythm issue.
Speaker 1:Can you speak more about that? Because I also drink coffee, but I'm one that sits over here and says don't take my Red Bull, Please don't take my Red Bull and I've been doing so well. I haven't even purchased it because if it's not in the house I won't go for it. I won't stop and get one kind of.
Speaker 2:Thing.
Speaker 1:But I love my Red Bull and I don't want it to go away. So can you speak more to like what that means, with the high, the high levels of caffeine being a trigger for like a uh high?
Speaker 3:higher. Yeah, I think it's Red Bull is not quite as bad right? Isn't it only like 80 or Well, it depends on what size you drink.
Speaker 1:So kind of back to that moderation conversation. You know the eight ounces, probably 80 milligrams, but when? I'm drinking like a 12 or 16 or okay yeah you know I shame.
Speaker 3:Yeah, I think, um, I mean again, I we always see the back end of it, like someone's coming in with a heart rhythm issue and then, or like again, it's usually fast heart rates with stuff like that, or palpitations. So you mentioned, like you feel that sometimes, like you'll feel that and it does happen, it's common Like a quick flutter, a quick skip beat, we will, and we get that a lot. We see people with that a lot, and there is concern, like, and we get that a lot, we see people with that a lot, and there there is concern that you know was something wrong with my heart rhythm. And then we have to dive into what are you drinking. So if you're correlating it with those types of drinks, you know, then maybe that's a trigger for you.
Speaker 3:Um, but and I guess the other thing would be, just I, you know, I, I don't know that there's a lot of data out there. Yet as far as, like, the long-term effect of you, like you know you're drinking those and then you're exercising all that stuff, I think that might be a little bit tricky. It is a stimulant, you know.
Speaker 1:So yeah, Right, I don't drink them before I go do a boxing workout or run or anything like that. Yeah, I, I and I haven't. I've been so good, I've been so good. I often wonder, though, like and you know, you mentioned about the devices tracking when there's an irregular rhythm, like I have these heart flutters, my ring doesn't say anything.
Speaker 1:I must be okay, Like you know. Is that a trustworthy thing to think Like? Because I do, because I am probably perimenopausal, because I do drink a lot of caffeine, because that is probably somewhat normal. It isn't maybe a pattern? Is that accurate? Yeah?
Speaker 3:no, I'm glad you said that, because I these devices don't pick up all your regular abnormal heart rhythms. They mainly, I believe what they've been looked at is atrial fibrillation at least the Apple watches.
Speaker 3:I'm not as familiar with the rings, but so if you are having a lot of skipped beats, it may not pick that up on your device. And I say skipped beats that can mean like an early beat coming out of the top part of your heart or out of the bottom part of your heart, and that's what you feel when someone feels a palpitation. Sometimes it's just an extra beat and that can be normal, but it can be triggered by caffeine, lack of sleep, dehydration. Lots of things can trigger these early beats or extra beats that feel like a flipped letter. People describe a dropped beat. Different things can trigger those and if that's happening a lot, that may not pick up on your watch or your device. So you would certainly want to. You know we encourage people, you're feeling it often.
Speaker 3:Then you do need what we call like a medical grade ambulatory or heart rhythm monitoring. So then we order someone to have a monitor on for 24 hours that is actually really picking up the rhythm and read by like the cardiologist. Or you can wear a one week monitor, two week monitor, three week monitor. It depends on how often someone's symptoms and how concerning they might sound for an arrhythmia. So we don't we use these and this is just from a healthcare provider perspective. They're used as a tool, but if there's a concern, certainly we order like the medical grade monitoring.
Speaker 3:So if it's yeah, I would kind of keep that in mind. I don't think you're having it doesn't sound like you're having symptoms like that.
Speaker 1:But I don't think so. I think it's probably pretty common though, for our age or younger, because we do drink a lot of coffee, we do have a lot of stress, we do drink energy drinks, we do, you know, maybe push ourselves to max out our physical activity, where we might have those from time to time and wearing the devices, yeah, so every once in a while I'll feel it and be like I've had too much caffeine and. I always coffee that gets the bad rap, but yeah.
Speaker 3:And we always say to you as long as you're not having other symptoms with it. You know, that's kind of the difference between like oh, that feels kind of funny, versus like oh, I feel really funny, like if someone's having lightheadedness with it or they feel like they're going to pass out.
Speaker 1:that's concerning Okay, and so now that you've said that and I will I want to be respectful of your time and I will wrap this up and stop. I could ask you a million questions and they'd be all over the place.
Speaker 3:We've covered a lot of topics.
Speaker 1:We have. It's more than you probably thought you bargained for here but it's such great information Like well. I think it is.
Speaker 3:I mean, the heart is near and dear to my heart, so I like.
Speaker 1:I do, you know, I just I love letting the population education yes.
Speaker 1:Well, thank you again, um for for sharing all of this because it's from a high level very helpful, but my question was going to be like I should know this, and there's two. I always come at you with two questions what are the symptoms of a heart attack and what are the symptoms of a stroke? Because we are of the age where I should be mindful and be paying attention of, like what's happening and know these symptoms in the event that there's something happening around me. So can you tell us from a high level what we should be paying attention to?
Speaker 3:Yeah. So from a heart standpoint, you know, obviously you would know if all, if you were at rest and you're having crushing chest pain, clearly that is unrelieved. Someone goes to the emergency room for that. That'll take someone to the ER. But a less noticeable symptom would be and not necessarily heart attack, but awareness of maybe heart disease or plugged artery.
Speaker 3:We always discuss if you're having chest pain every time you go up to walk around the grocery store, if you're climbing a flight of stairs and you're getting chest pain each time you're active, that's concerning that because the heart is pumping harder, trying to work harder when you're more active.
Speaker 3:So when you're active, if the blood is not getting through your coronary arteries, well, you're going to have chest pain, meaning like you're getting a plugged artery, getting closer to maybe having a heart attack. Then you would be having chest pain is the most typical with activity. Alternatively, watching for shortness of breath. That's often one that's kind of masked, unexplained shortness of breath. People often think chest pain with blocked artery, but it can also present commonly as shortness of breath. Those are the two uh more like red flags to be aware of for heart. You know, possible heart attack or coming on Now if you're saying active heart attack, that would be again you, you chest pain, jaw pain, any unusual pain I mean I've had people have like elbow pain, um, back pain between the shoulder blades, unexplained pain that's not relieved, um, and that can become tricky.
Speaker 1:But yeah, I just think I lay awake at night worried about some of these things. Not often I'm not like an anxiety heavy on the anxiety of this, but just sometimes where I wonder like would I know what I would I know is? Is it so severe that you just know? Or is it something that like because you read articles about people who it just happens all of a sudden?
Speaker 3:they had no clue, you know, they just woke up feeling normal and all of a sudden I've seen it both ways you know, it's a can come out of nowhere or, but you know, can happen progressive, like we talked about pain with pain with activity or breathing and a stroke. So yeah, a stroke is certainly any, you know that's what you kind of think about. You have numbness. You know one side of the body change. You know difficulty with words Usually it's most commonly speech or numbness. Loss of use of an arm, you know leg or memory, like you know someone's not making any sense I think those would be the big ones. Or visual, you know vision loss.
Speaker 1:I think everyone probably wonders about that too, as you start experiencing different things, especially as we age. Is this normal or is this something I should be concerned with? So thank you for that Just kind of high level general you know thing to pay attention to that helps me. I'll be able to sleep a little better at night.
Speaker 3:I mean. One other one is like obviously unrelieved, unexplained headache, crushing headache. You know, that's something obviously you don't ignore.
Speaker 1:Yeah, oh gosh. I could just keep going, but I I feel like what's going to happen is what happens when we have experts on, like. We had a DEXA scan expert on recently and Greg and I had DEXA scans and discussed our results at the level we were able to explain them, and which was not awesome. So then we had someone who was awesome. Come on and talk about the DEXA scan. And then we see questions come in, so what.
Speaker 1:I think will happen is likely that this episode comes out and people are like, wait, what about this? And then it won't just be me randomly asking you a cluster of questions, because I'm curious about everything and maybe a little bit more specific to what people are seeing or experiencing as well. So yeah, yeah no, that's great.
Speaker 3:Yeah, and it is, and it is. Uh, there's a lot of things that you know, people we see, as far as concern for heart, heart issues, chest is a commonplace. Things settle and people want to know why am I feeling this? What does this mean? And, yeah, it's, it's normal.
Speaker 1:What is the deal with baby aspirin is my last question. Should. I have baby aspirin around, just in case.
Speaker 3:You know it used to be. They would say oh, anyone, you know, everyone should be taking baby aspirin. That has changed. Unless you have an indication, meaning you know you have heart disease already or high risk for heart disease, typically we're not recommending baby aspirin for everyone anymore every day, just because of the potential side effect from it and the GI issues. So if you and you're asking having it around for like if you had chest pain, Well, yeah, like if, if.
Speaker 1:I would feel terrible if something would happen, and I was not prepared with any aspirin. I don't have any aspirin in the house, so while we're talking about this, it's like maybe I should get some.
Speaker 3:I mean, I don't think you know. I guess I shouldn't say you're not at risk, but you're minimal risk. I would consider you both very minimal risk. But certainly if you did develop chest pain and you were home alone or you were somewhere like you, taking, you know, four baby out, chewing four baby aspirin, is what we would, you know you might give it to somebody if they were in clinic or the EMS, if they came and someone was having chest pain, um, aspirin right away will help because it's a anti-platelet, meaning blood thins the blood, prevent clotting, all that.
Speaker 1:Yeah, so the validity in that theory or that practice of having the aspirin in the event that someone is having a heart attack is a valuable source of information.
Speaker 3:Yeah, yeah, that is something that is given in the act of yes. Having a heart attack.
Speaker 1:What else you got, greg? Do you have a question? That's that's.
Speaker 2:That's probably what saved my dad's life. My mom had four baby aspirin. Oh really yeah.
Speaker 1:Yeah Well, thank you so much, abby, for sharing all of this information with us. I think so many listeners benefit from having at least a high level knowledge of what they need to pay attention to, and with so much being thrown at us, we don't always know what that is. So having an expert like you, someone who sees this day in and day out, give us the advice and the ins and outs of what you see and what can benefit us, is so very helpful, and we're very grateful for your time and your knowledge, so we appreciate it.
Speaker 3:Yeah, well, thank you, I appreciate you having me. It was fun talk.
Speaker 2:And also thank you for being an amazing wife to my best buddy, Michael.
Speaker 3:It's hard work, but you know.
Speaker 1:Somebody's got to do it.
Speaker 3:Yeah.
Speaker 1:I've put up with them for this long. And that shows in your children as well, your stellar little kids. They, uh, they're lucky to have you as their mom. So thank you for for that too. Well, thank you, yep, always juggling a lot as a professional and a mom and a mic wife.
Speaker 1:well, thank you all so much for joining us on the cameo show. We have new episodes every Wednesday and if you have questions for Abby or anything sparked your interest or intrigued your curiosity about your heart health, please let us know and we will get with Abby on finding the answers for you. I will try to articulate them, but we might have to have her back if they're over my head, which they probably will be. But please join us again. We're so grateful that you're here. We'll see you all next time.
