The Concierge Doc Podcast with Dr. Jason Littleton, M.D.
The Concierge Doc Podcast is hosted by Dr Jason Littleton, M.D., where he features medical content to make smart lifestyle choices for optimal health, wellness, energy, youthfulness, longevity, balance, and happiness.
The Concierge Doc Podcast with Dr. Jason Littleton, M.D.
“She Walked Away from Heart Surgery to Save Women’s Lives — Dr. Devina McCray on the Fight Against Breast Cancer”
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Disclaimer:
Access to the Information and materials contained in this podcast is at your own risk. The information contained is presented for the purpose of educating the consumer on a variety of wellness and health care topics (the “Information”). Nothing contained is intended to be instructional for medical diagnosis or treatment. The Information contained is compiled from a variety of sources. The Information should not be considered complete and not exhaustive and should not be in place of a visit or consultation with your own primary care doctor.
The views, opinions, and statements expressed by our guests are solely their own and do not necessarily reflect those of Dr. Jason Littleton or the Concierge Doc Podcast. We do not endorse or take responsibility for any statements, claims, or perspectives shared in this content. Viewers are encouraged to conduct their own research and form their own conclusions.
Dr Jason Littleton:Access to the information and materials contained in this podcast is at your own risk. The information contained is presented for the purpose of educating the consumer on a variety of wellness and health care topics, the information. Nothing contained is intended to be instructional for medical diagnosis or treatment. The information contained is compiled from a variety of sources. The information should not be considered complete and exhaustive and should not be in place of a visit or consultation with your own primary care doctor. Welcome to the Concierge Doc Podcast. I'm your host, CEO, and founder of Littleton Concierge Medicine, Dr. Jason Littleton. Welcome to the podcast. Now, today's host is a board-certified breast surgical oncologist with Advent Health Medical Group in Orlando, Florida. She specializes in the diagnosis and surgical treatment of benign and malignant breast disease with expertise in advanced techniques such as nipple-sparing mastectomy, oncoplastic surgery, and interoperative radiation therapy. A graduate of the University of Colorado School of Medicine, she completed her general surgery residency at Advent Health Orlando and a breast surgical oncology fellowship at the Cleveland Clinic. She's known for her compassionate, patient-centered approach and her commitment to advancing breast cancer awareness and care in Central Florida community. Welcome to the Concierge Doc Podcast, Dr. Davina McCrae. Welcome to the podcast. Thank you for coming on.
Dr. Devina McCray, MD,:Oh, thank you for having me, Dr. Littleton. Excited to be here.
Dr Jason Littleton:Well, let's just get into it. I know this is Breast Cancer Awareness Month. And I, you know, I think for starters, my audience and I, we would love to know what caused you to pursue a career in uh breast cancer surgery.
Speaker 3:So initially that was not my goal. Um I lost my father when I was six years old. He had a fatal heart attack at the age of 35. So going into medicine, I wanted to do something in cardiology. I wanted to be a cardiologist, but started my clinicals and thought I am not doing medicine. I have to do surgery. So felt okay, cardiothoracic surgery would be great. I could, my main goal was to help, you know, um families and parents um save lives and not have a child go through what I went through. So, anyway, so fast forward went to medical school school um residency and uh actually landed a fellowship in cardiothoracic surgery at UCLA in Los Angeles. But also at the time had my my husband and I had our child, um, and he was six months old at the time, and I never saw the kid. Um, my mom was helping to raise him. Um, I was in surgery for 36 hours. There was there was a case that lasted 36 hours. Wow. And so I thought I have to make a decision. I either pursue this and put my family in the back burner or be a mom, right? So um despite um this was my dream, but also I wanted to be a mother and I wanted to be a mom who was there. Um, I uh left the program and uh didn't know what I was gonna do for about a year or so. And I just looked back through my training and looked at oncology and specifically breast oncology, surgical oncology. My attendings at the time, they um the ones that were doing breast surgery, um, and it was it it was a new field, it was a new specialty, and um uh a lot of the general surgeons were doing at the time, but they didn't start having fellowships until more recently. And so I um looked at it's almost like primary care, right? It's a surgeon, but you're also following your patients for a long time. And just my personality, I really want, I really needed that. I really needed that um type of practice where I can follow my patients and see how they're doing. Yeah, cardiothoracic surgeon, they are just sewing you, sewing those vessels together and shipping you off to the cardiologist, and that's that. And so there's just no gratification to that. And so I thought, nope, breast surgery is for me. I'll still be saving lives, I'll be saving lots of women's lives. And these women, a lot of women who get breast cancer, especially these days, they're getting women are getting younger and younger, and there's no we can't come up with a reason. Cardiac disease, people smoke, people drink. I mean, they're unhealthy, but we are seeing so many young women who are healthy and young getting breast cancers, and we're treating it, we're catching it early and we're treating it, and they're living. But to be able to see my patients get through their treatment and then follow them in their survivorship, um, is just it's amazing. So, knowing how my personality is and what I wanted um in a career, I knew that breast surgery was gonna be the right, the right choice. And I don't regret it one bit.
Dr Jason Littleton:Yeah, well, I mean, it sounds like you definitely made the right choice. Obviously, you wanted more of a longitudinal care uh setup, but I gotta ask you as a tangent, how do you do a 36 hour surgery? Like, I mean, obviously that was when you were in the thoracic um it was tough surgery discipline. But I mean who stands there for 36 hours? And no, of course, no one stands there for 36 hours. I'm I'm assuming.
Speaker 3:Uh well, I mean in California, you have to have two surgeons for a patient to be on pump. And it was a heart failure patient with uh LVAD waiting for a heart transplant that LVAD went south and it was it was tough. It was tough. Wow. I mean, I just I knew it was a long case and I just blocked it, but yeah.
Dr Jason Littleton:Wow, wow.
Speaker 3:Now okay, so it was UCLA, it was a tertiary center, and they're gonna get all the they're gonna yeah, yeah, they're gonna get all the tough cases, all the difficult, yeah.
Dr Jason Littleton:I you know, um breast cancer surgery is such a personal, emotional field because, like we were just talking about, you are with a patient through this process. Uh how do you how have you been able to connect with patients and help them through what can be such kind of some for some people very shocking and a difficult longitudinal um circumstance?
Speaker 3:A lot of these women are me, right? They're my age um that I'm diagnosing, I'm uh treating. Um, I almost feel like I used to have a scripted answer for questions like this. Um, my best friend a year and a half ago was diagnosed with breast cancer. Um, and she's a radiation oncologist. She we treat on the same team, and we're experts in this. And to to go through having someone that close to you having breast cancer and being an expert in it, uh both of us were just paralyzed. We didn't know for a day or two what was, I mean, it was it was shocking, it was terrifying. All we could think of, uh I panicked, all she could think about was her, what about her children and if she's gonna die. And we and we treat this every day, right? Right. And so just to to go through that, um, but also um uh you do gain a whole new outlook on on patients when you see them, um, no matter what age. I know, like I said, there's been a lot of new um cancers in young women, it's on the rise. Um, but when I when I see patients, I know that in the next five, 10 years, their survival rate is so high. And once we pass that, and we see survival rates every five years, right? So when I say a five-year survival rate is 96, 97%, that's great. 10 years, it's even higher. So I know when I see a patient and I tell her, yes, you have breast cancer, but you are gonna be just fine. What I'm seeing is her two, three years down the line saying, My daughter just graduated from high school. My son is getting married. Um, you know, my husband and I are going traveling um around the world because I already know that they're gonna take this, defeat this, and then it's gonna be a whole new life for them, right? So that's what I'm seeing when I'm telling them they have their breast cancer, but we're gonna, you're gonna be just fine. You are gonna be just fine. We caught this early because that's usually how we I see my breast cancer patients. They come in with an early diagnosis, thank goodness, fortunately, because of cancer screenings. So knowing that and telling them that you are gonna be fine is is how I really is a lot of how I connect with my patients.
Dr Jason Littleton:Yeah, yeah. I mean, for breast cancer screening, we do mammograms coupled with ultrasounds. And, you know, when I, as a concierge doctor, when I'm working with my patients and doing screenings, one of the things I try to do is get ahead of the game and do a lot of preventive screenings. And, you know, I innovate when when I talk to my patients about cancer, you know, in terms of prevalency, you've got lung cancer, then you've got breast, prostate, then you have a colon cancer. One of the things with the men when it comes to prostate cancer, um, one of the things I've gotten into is doing a lot more screening with prostate MRIs. Now, that is something that I've chosen to do. That's not, you know, a standard screening test, but it binds things early. And obviously, we coupled that with the PSA. Now, when we talk about breast cancer, is there something like in that same vein that can be done? Because what I'm seeing is I'm seeing people that I'm seeing women who are in the late 30s, early 40s coming up with a breast cancer diagnosis more often than I used to. And what are your thoughts about you know getting ahead of it? Because we I don't want this to be such a devastating uh issue.
Speaker 3:Well, first, um, let me say how important breast cancer screening is. When it comes to women's health, that is gonna be one of the most important things a woman can do. Breast cancer has made it to the number one diagnosis in women in the US. Wow. And so when you take um someone who gets their annual, just annual screening mammograms each year, she has a 26% decreased risk of dying from that breast cancer than someone who doesn't, right? And so um we talked about uh breast cancer awareness, and it's been 40 years of breast cancer awareness every October. We're celebrating 40 years. Jason, let me take you to 40 years ago, only one out of three women were getting their breast cancer screenings. Today, two out of three women are getting their breast cancer screenings. So just that change alone has we've seen a decrease, 40% decrease incidence of breast cancer deaths. There are five million survivors in the US today. So just just those statistics, breast cancer screening is very important. Now, what type of screening, right? So we have found that the most efficient is going to be your 3D mammogram. 3D mammograms are are gonna be the best in catching an early breast cancer before a lump is even felt. So completely asymptomatic. Go for your breast cancer screening. If you are at the normal population, you don't have any high risk factors, then yes, it starts at 40. But here's here's a caveat, right? We talk about breast density. Everybody, it's out there, it's out there, right? So, what is breast density? Breast density is not something that you see in the mirror, it's not even something you can feel. It's what the radiologist sees on your mammogram and has to report it. There's different categories A, B, C, D, right? So you have the fatty replace, um, your scattered and you're heterogeneously dense, and then you're extremely dense. So it's very important when you look at your mammogram. Um, so what is density? Density is just taking it's the percentage of that fibroglandular tissue versus fat tissue. So X-ray is going to penetrate these two types of tissues very differently. Fatty tissue looks black, fibroglandular tissue looks white. But also what can come up white are breast cancers. Now, the 3D mammograms have gotten a lot better in detecting this. However, when we're still seeing it, you know, with dense tissue, um, it's almost like you're looking for a cancer. It's almost like uh looking for a snowflake in a snowstorm. It can be very, very difficult. So, yes, get your breast cancer screening, but also take that report. If you if it says heterogeneously dense and extremely dense, I really encourage women to take that back to your primary care doctor and say, look, how accurate can this test be given my dense tissue? Yes, I know it's a 3D mammogram, but especially for your first one. Your first one, you really have to take that back and say, do I need an ultrasound? But also talk about your risk factors. Now, what are the risk factors? And we could talk a little bit about that, but the most important risk factor when it comes to um breast cancer, there's so I like to split the risk factors into two categories. You have your modified ball and your non-modifiable. Your modifiable are the ones in the lifestyle, you can you know, exercise, um, eat healthier, decrease your uh alcohol, uh, smoking intake, all that. That's all that you can change. And we could talk about that a little bit later. But the important ones that you cannot modify is your family history.
Dr Jason Littleton:Right.
Speaker 3:And we look at family history in three generations. So your mother, your father, your parents, your grandparents, your siblings, um, your aunts, uncles, and cousins. And we always ask is there any cancers, breast cancer, ovarian cancer, or any other cancers in the family in that in those three generations, especially if there are any young people, young family members who have developed breast cancer. And if there is, that is so important to talk to your doctor about because not just genetic testing. I we talk about genetic testing, the BRCA. No, a lot of patients don't even know what BRCA is until I say, Oh, it's the Angelina Jolie gene. And they're like, Oh, I know that. Yes, okay. So, and it's not just breast ovarian. You got, you know, there's pancreas, there's colon, there's melanoma.
Dr Jason Littleton:Right.
Speaker 3:Um, so there's other cancers that are associated with the syndrome, not just breast ovarian. So that's just very important to be up front with your doctor and say, look, I have these risk factors and I have dense tissue. What more do you think I need? Or go see a breast specialist, right? Because then you can really dig into your risk factors as well as your dense tissue. I always, when a patient comes up or comes to see me, I will open up that image. Uh, I have monitors in every room and I will review with them their images and tell them, look at your dense tissue and show them their dense tissue so that they know how hard or or easy their mammograms can be read. And so that's just very important to not get your screening mammogram, but also look at the report because it is it's required for the radiologist to um um to report what your density is. So if you do have a family history and someone young, then you would actually start screening 10 years prior to that age of the the youngest um person in the family with breast cancer. Yeah, and it could be as early as 25 years old, MRIs starting at 25. And so, I mean, and when patients see me, I know they come to me because I am a breast specialist and I will be a lot more cautious in making sure that they're getting the right screening. So, I mean, there may be times where I'm I may be starting at 21, 22, because my youngest patient that has developed breast cancer was 21 years old, right? So, and no family history. It's scary, it's scary. So it's just it really is it comes and you know, it comes to women empowering themselves, not just getting their screening, but also looking at their report and saying, hey, wait a second, how accurate is this mammogram? Do I need an ultrasound? Do I need a staggerate ultrasound, breast MRI, ultrasound? I mean mammogram every six months for an interval of a year.
Dr Jason Littleton:Yeah, yeah. I mean, that that is something that I I I mean, how do you deal with the toll? And I I don't even want to put words in your mouth when I say toll, but like when you are seeing someone who may have a breast cancer diagnosis in their 20s, like I mean, how do you deal with that emotionally?
Speaker 3:Yeah, um, it's it's difficult. I mean, you know, uh it is, it's it's heartbreaking. I mean, I see women who are pregnant, who just had a baby, and they thought this was you know just them breastfeeding uh this mask that's been there for you know one, two months, and their primary care doctor is saying, Oh, don't worry, you're young, or don't worry, it's probably just a cyst. Oh no, you're breastfeeding, and they end up um persistent and come in and see me. I put that ultrasound on them and I uh and it's a biopsy that day. Yeah, so uh it helps when I know it's an early cancer and we can treat it. Yeah, yeah, and it could be an aggressive early cancer, yeah, but I know we can treat it because we caught it early.
Dr Jason Littleton:Yeah, yeah.
Speaker 3:Um just with the survival rate being so high, that obviously helps. Yeah, I know that we're gonna pull them through.
Dr Jason Littleton:Yeah. When we talk about the future of um breast cancer surgery, what excites you most about uh the future of uh this discipline and what legacy do you hope to leave in your work?
Speaker 3:What was that last question?
Dr Jason Littleton:What legacy do you hope to leave in your work when when everything's all said and done? Have you thought about that?
Speaker 3:Actually, I have.
Dr Jason Littleton:So is a book coming out? Is like a documentary coming out?
Speaker 3:Maybe I should. No book. Um, my best friend did um write a book about her journey through breast cancer, um, but I'll probably bring that book up. I have it somewhere. Um so when it comes to breast cancer, we're finding that tumor biology is really important. Um, we just have the awareness and the ability to actually safely um back off on our treatments. Um, and that's not something that we had the ability to do. It used to be a uh almost cookie cutter. It's cancer. We we do mastectomies, we give chemotherapy, we give seven weeks of radiation, and we're finding that you know, what where we can back off on that sort of treatment because the earlier we find it, and fortunately, most cancers are more favorable, not as aggressive, because we're able to test its mutation. And so a lot of these mutations aren't aggressive, the majority of breast cancers that we see. And so when we're able to test these types, the type of mutation that caused it to be a breast cancer in the first place, and it is hormone sensitive, it doesn't have the protein that causes it to be aggressive, that hurt you. Um, we can actually say, well, you don't need chemotherapy. You may not even, you may need just a little bit of radiation, you may not even need radiation at all. I can do a lumpectomy and you might not even need radiation at all. When we see women, that's the first thing. They don't they don't worry about the surgery. I mean, a lot of times they they say, okay, I want surgery, but can you make me look better? Can you um can you involve a plastic surgeon? Which I definitely do, and and they love that, but then their question is, well, what about the chemotherapy? I'm scared to death. Nobody wants chemotherapy or radiation. So we're finding now we have specific, and it's very exciting. We have specific tests that test the mutation, and a lot, majority of them are favorable that we don't have to give that chemotherapy, and we may not even maybe a little bit of radiation, maybe not even any radiation. When it comes to um how surgically, how are we, what are we doing? What are advances in how we're doing our surgeries and actually making our women look better? Um, I work with uh Dr. Sabrina Paveri. I don't know if you know who she is, but um we have really um come to the forefront of what a lot of the more of the academic centers are doing um with uh mastectomies, lumbectomies, and the reconstruction. So I know a lot of women they come and they kind of joke about it. They say, Well, I just want a lumpectomy, but can you give me a lift on both sides to make them look perkier again? And I actually say, Well, yes, we can. And they're at first it's a joke. And they I tell them, Well, absolutely, and not only that, but but there's a um, there's a Women's Care Act that will pay for it. Your insurance will cover it. And they are just mind-blown.
Dr Jason Littleton:I don't think a lot of people know that.
Speaker 3:No, no. So I, you know, I say I can do a nice lumpectomy, um, and we'll send you to our plastic surgeon. We do this in combination, and she can give you a reduction, especially when someone has more, you know, larger breasts than they've always dreamed, dreamt of having a uh reduction. And we do that in the same surgery, and they are so happy. Women who want mastectomies, uh, women who need to have mastectomies because you know their cancer is large. We uh I do more nipple sparing mastectomies than I do skin sparing mastectomies, where we're saving the nipple areola. And uh used to be that with these surgeries, the nipple sparing mastectomies, um strict criteria, the cancer had to be away from the nipple areola, which makes sense, but from the plastic standpoint, um, that nipple areola has to be in that right position. Well, as you get older, gravity takes control and will bring that nipple areola down south a little bit. And so it we weren't able to do that just from a cosmetic standpoint. But Dr. Pavery and I have been able to do certain techniques um to allow me to do the nipple sparing mastectomy, but also she does a lifting procedure um to lift that nipple areola so it's back into the right position, and women look amazing, amazing. Um we're doing a lot of uh uh no expanders, just going to direct to implant. So it's just one surgery, one stop, one shop, one stop surgery. They don't have to, it's not stage where they have to go multiple times. Um, we're also doing, we're preserving the nerve. So when I'm doing a mastectomy, there's a nerve that comes up laterally from the chest wall and it dives into the breast, and that's what helps innervate the nipple areola and the skin around it.
Dr Jason Littleton:And you're able to preserve that.
Speaker 3:We're able to preserve that. So it's called uh neurotization. I still have to cut it, but we identify it and we graft it to a cadaveric nerve, and we're able to um uh sew it right up into the nipple areola, and we're getting good success from women getting their sensation back after the nipple steering message.
Dr Jason Littleton:Well, that's that's a great example of some of the advances that have been made.
Speaker 3:Yes.
Dr Jason Littleton:Um you know, I've got to ask you this question, and I want to know what what's your take on women with hormone replacement? You know, I don't I don't wanna I don't wanna lead you one way or the other, but I just I just wanted, you know, because you're seeing people who come in most times with a breast cancer diagnosis, whether it's just regular hormone replacement or bioidentical hormone replacement. How do you what how do you handle that situation?
Speaker 3:It can be difficult. Um women who have breast cancer, especially the hormone-sensitive ones, the estrogen, progesterone receptors, I mean, that's a done deal. You can't you can't give them hormone replacement. Um we're giving them a hormone blocker. So that's just defeating the whole purpose of the treatment. Um, but uh the one thing that we are opening up to with women who have been diagnosed with breast cancer because they're getting a lot of vaginal dryness. Um, they're getting a lot of stenotic, the vaginal wall becomes stenotic because of the deprivation of estrogen. So we're opening up to giving the um estrogen cream, the vaginal cream. So that's a huge step.
Dr Jason Littleton:Yeah.
Speaker 3:Now, women who are normal risk, high risk. Um, and you know, everybody right now there is there is a lot of rumblings about how accurate was the women's health initiative, right? That right that huge study that said absolutely no hormone replacement, it's gonna cause you cancer and you're gonna die from breast cancer. Well, we're finding that a lot of the data may not be um so accurate. And so we're actually looking back at it and looking and doing other studies and seeing that um giving estrogen in a normal risk or even potentially high risk patient giving just estrogen early in premenopause, starting it early in premenopause, may actually, well, one may not cause an increased risk of developing breast cancer and potentially maybe protective. I mean, we're still we're still looking at that. We're still looking at that. Right. Um, but the combination of estrogen progesterone, um, you know, it's still um, it's still being questioned. Testosterone, it's still being questioned. Now, my and I tell women, you know, I I can't when someone comes to me and say and says, Dr. McRae, I just my quality of life is horrible, horrible. I need these hormones. Yeah, and I try and with as far as when it comes to the pellets, only because it's not we really don't know how much is going in, how much hormones is going into those pellets. So I I try and discourage them from the pellets, but um doing the others, you know, I I can't say absolutely no. What I do say is if you really have to have it because of your quality of life, then just let me take care of you, let me screen you, let me, I will chase you down with the mammogram ultrasound and an MRI. Right. How does that sound? And they say that's fine, just as long as you're okay with me taking it. Yeah. And I can't, I can't argue with that. I mean, I would rather, I wouldn't want them to have this horrible qual quality of life because of a chance of getting breast cancer.
Dr Jason Littleton:Right, right.
Speaker 3:And as long as we catch it early, then we get it treated.
Dr Jason Littleton:Yeah, I mean, there's still no one has the corner on that. There's still things that have to be learned. I under, you know, I I think that's kind of where we're all at. I still I I understand that. I get that, but I had to ask you that question. I and I I love how you answered that. I loved how you answered that. That was great. Um now with that, I've got to ask you some personal questions. I gotta ask you some personal questions. I ask everyone on the show how they move, eat, drink, sleep. And um, I want to learn from you because I'm assuming everyone that I interview, since they care for other people and their health, that they also care for their own health when it comes to self-care. So how does Dr. Davina McCrae take care of herself? How does she move, eat, drink, sleep? You can start off with the move part.
Speaker 3:Well, okay, so four years ago, I was approaching a BMI of 30. So that was a that's obese, right? Um, I wasn't taking care of myself. We were eating, drinking, alcohol, the whole thing. And so I as much as I love to operate and take care of my women um when they get treated with breast cancer, I thought to myself, God, there's there has to be prevention. We have to help, we have to help our women prevent this. So did a lot of research in just prevention and started to find out how exercising, 150 minutes of moderate to intense cardio exercise, 150 minutes a week, has been shown. To actually decrease your risk of developing breast cancer by 20%, or women who've already been diagnosed with breast cancer, decreasing that risk of recurrent cancer by 20%. Then I found out how strength training helps with not just your health, but decreasing um metabolic dysfunction, decreasing the risk of not just breast cancer, but a lot of cancers. So I thought to myself, how am I gonna counsel my own patients when I'm not practicing what I'm preaching? So I decided to do the most I thought impossible thing I could have ever done, but I did it anyways. I decided that I was gonna be a bodybuilder.
Dr Jason Littleton:Oh wow.
Speaker 3:And back in 2021, I started my journey as a bodybuilder. I set my um, I started late 2021. I had a show for September 2022, and everything changed, Jason. I changed my eating habits, I stopped drinking, I started training, must a strength training. I uh hired a personal trainer who I still train with to this day. I see him four or five times a week. I do cardio five days a week. Um, my meals went from two to three of just junk processed foods. Now I eat six meals a day of whole foods, chicken, lean ground beef, um, yams, um, rice, white rice. Um, but I prepare my meals every every day, and I'm eating six meals throughout the day. Small meals, but six meals throughout the day. And this is just, I've just been used to this. So uh I don't know if you know Gabrielle Lyon. She's um uh is her book? Yes, yeah. Um yeah, I love her book. So um her her muscle-centric medicine is just, I mean, groundbreaking. When I read her book, I think.
Dr Jason Littleton:I think I have I have it on my um shelf back there, actually.
Speaker 3:Yes, yes, it's of course. So yeah, why are we, you know, why are we reacting? Why are we being reactive in treating chronic disease when we can be proactive and looking at the your muscle is your body armor, right? Yeah is gonna be your um you start strength training and you build up that mitochondria, and it's that mitochondria that's gonna produce the energy that you use every day. And so I I just thought it was just mind-blowing. I mean, this is something that you know we've probably known for years and years and years. Um, but um, what I learned from her book too, when it comes to cancer, is that um there's uh inflammatory cytokines in fat cells that affect the breast cell and causes mutations and causes cancer in breast cancers. I mean in the breast. Um, but when you reverse that and you strength train, myokines get produced in muscles and that starts to increase. And myokines are actually anti-inflammatory and will actually help to decrease your risk of not just breast cancer, but a lot of cancers. So you know, I I absolutely believe muscle is the key to your longevity. It's just it's your body arm. And I tell my patients that every day, all day.
Dr Jason Littleton:Yeah, I love that you said that. I was hoping that you would say that. Um, because some might say, well, you know, well, you're gonna get breast cancer because of your family history or your genetics or this or that. But it's helpful to know that there is something that you can do. There's something that you can do to put yourself in the best position and in shape so that you can prevent that diagnosis. And I think um, as best as you can, um there's something that potentially is in your control. And so I I I I I loved what you said here because I think it it provides people hope and um, you know, people can actually actively do something to promote longevity and wellness. I love that. And I love what you said, you know, about how you move, you eat. Now, how do you hydrate? How do you sleep? Tell me about that.
Speaker 3:Yeah, so um I I'm a surgeon, it's very hard to get anything in. So when I'm in prep, it can be difficult because I have to drink um so a prep prepping for a show, and I do this every year. I go through of uh a time where I'm um building and maintaining, and then I go into a show prep for about 12 to 16 weeks. So I have to drink at least a gallon, if not a gallon of uh a gallon and a half. So it can get difficult with all my cases, but um I I used to drink a lot of soda and I love that fizzle.
Dr Jason Littleton:Yeah.
Speaker 3:Saratoga is the best thing for me since bread. I don't know if you had Saratoga. I have. I'm sure you have the bottle.
Dr Jason Littleton:Sparkling water.
Speaker 3:Oh, yes, I get that in in in case by case from Sam's delivered to me. So just having that water, um, I it's I love it. I love that sparkling water. So it helps me hydrate. But it gets difficult being in the OR, you know, I just have to drink as much as I can. Um, but at the end of the day, uh, you know, I'm drinking a lot to catch up.
Dr. Devina McCray, MD,:Right.
Speaker 3:And so I'm probably, you know, I have to get up to the bathroom quite a bit when I'm asleep. But my my body has regulated it. My body has regulated it. And as far as sleep, um, so I my routine usually um is doing my cardio exercise in the evening, um, essentially to wind down. I don't know how my body does this, but I've I've taught my body to do this, where I'll do 45 minutes to an hour of cardio um just cycling. I don't know if you ever heard of Hotworks. I haven't heard of cycling in a sauna.
Dr Jason Littleton:Okay.
Speaker 3:So I will ramp that sauna up to 130 degrees and I'm in there cycling, getting my heart rate up to 135, 140 for about 45 minutes, and I come out drenched.
Dr Jason Littleton:Isn't that just cycling in Florida? I mean, isn't that just cycling in Florida?
Speaker 3:Basically, oh my gosh, yeah, pretty much.
Dr Jason Littleton:Just going outside.
Speaker 3:Yeah, it is, it is, but it's really helpful in the winter or two. But I am drenched, so by the time I get home, I shower, I'm in bed by nine. So I typically get and I'll be up by five o'clock because I usually get to the gym um by five thirty to do my weightlifting. So I get it, I mean, I get at least you know, six, seven hours. If I get less than that, I am I am so cranky.
Dr Jason Littleton:That's pretty good.
Speaker 3:Okay, sleep is just so important.
Dr Jason Littleton:Yeah, I yeah, I definitely agree. I mean, um, and I think also being a bodybuilder, you have to have that um restoration, you have to have that rest just so that your body can heal after um lifting weights when you prepare for a show. Wow. Uh you know, this has been an incredible interview. I'm so glad that I've had you on because the things that you have said, um, very inspiring. You've said a lot of different things I think people did not know. Um, I love what you talked about when you talked about um some of the innovation in breast cancer surgery as far as some of the nerve sparing. Um, I this has been awesome. I'm so glad that I had you on. I just want to say thank you for coming on the show.
Speaker 3:Thank you.
Dr Jason Littleton:Um thank you. You know, where can people find you?
Speaker 3:Uh Advent Health. I work for Advent Health. So getting on the Advent Health website um and uh just searching for me, Davina McRae. You don't normally, and depending on your insurance, whether you need um, you don't need to worry about all that as far as insurance and referrals. We usually uh you'll call, you make an appointment, and then we'll we'll get we'll end up getting the referrals if needed.
Dr Jason Littleton:That's awesome. That's awesome. So um this has been an incredible, incredible show. I want my audience to definitely download uh this podcast and to make sure that you're going to Apple, Amazon, Spotify. And of course, as I always say, follow me on Instagram, Facebook, and LinkedIn. This has been awesome. Thank you. Thank you, Dr. McRae, for coming on.
Speaker 3:Thank you.
Dr Jason Littleton:Until next time, this is the Concert Podcast. We will see you guys later.
Speaker 3:Have a good evening.
Dr Jason Littleton:Thank you.
