Bend Into Balance: Dr Kevin Jones, Medical Director for Flow Wellness LLC

In this episode of Bend Into Balance, Adriana Marino sits down with Dr Kevin Jones, Medical Director for Flow Wellness LLC, to explore the evolving intersection of medicine and wellness in Central Oregon. With a background in emergency medicine and years working at St Charles, Dr Jones shares how his experience in high stress clinical settings led him toward a more proactive approach to health through his work at Flow Wellness.

Together, Adriana and Dr Jones discuss the growing role of GLP one therapies, peptides, and lifestyle interventions in supporting long term health, weight management, and overall wellbeing. The conversation moves beyond quick fixes to examine what it really means to feel better in your body and how Bend’s active outdoor culture shapes the way people approach their health, recovery, and longevity.

www.flowwellness.com

Transcript

SPEAKER_01 0:17

Hello, my name is Adriana Marino, and I am host and producer of Ben Into Balance, Powered by the Source. Today I am very happy to be accompanied by Dr. Kevin Jones. Dr. Jones began in emergency medicine before starting flow wellness here in Bend three years ago. Dr. Kevin, thank you very much for being here. Can you please introduce yourself and how you began into this path of health and wellness? What took you into the medical field?

SPEAKER_00 0:46

Great. Yeah, it's nice to meet you and be here. Um, well, I initially moved here working as a ski patroller full-time, and I studied engineering in college, and I realized I wanted to stay in a mountain town and really enjoyed the lifestyle here. And when I looked at engineering jobs, they weren't really a good fit for what I was doing. So I rethunk what I wanted to do in life. And as a ski patroller, we were working with emergency medical emergency ER doctors here on the at Mount Bachelor, and I started talking with them and realized that might be a good profession to go into and took some additional classes at COCC to um be able to get into medical school. And then I was fortunate enough to do my training at OHSCU in Portland, and I was there for medical school and residency, and then came back and started working here in the emergency departments. And I've worked in all the different campuses at St. Charles.

SPEAKER_01 1:35

Oh, wow. That's really cool. So it was your love of skiing that brought you to Bend, and then from there into patrol work, and then from there becoming a doctor.

SPEAKER_00 1:44

Yep. Yeah, it's been great. You know, the outdoor lifestyle here is phenomenal and it's just great town to live in.

SPEAKER_01 1:51

Um, and so how was your work in the emergency room? How did that go? How long did you dedicate yourself to this space before starting flow wellness?

SPEAKER_00 2:01

Uh I've been in the emergency department for 15 years. I still work there on a kind of part-time basis.

SPEAKER_02 2:06

Okay.

SPEAKER_00 2:07

Um, but you know, it's it's really rewarding. It's also really challenging. Uh, you know, during COVID, it was particularly challenging when, you know, we had coworkers that were living on a trailers because they were afraid of their family getting sick. And, you know, the work was either really intense or really none at all as people weren't coming into the hospital. And it was during that time, I ran into a previous coworker who was um running or part of a ketamine clinic in town. And ketamine is one of the treatments that we do that helps for mental health, typically used for anxiety, depression, PTSD. And I was telling her about the just stress level of, you know, being in the ER during the COVID times. You can only imagine it must have been crazy. I mean, we didn't have it as bad as some of the inner cities for sure. Like I had, you know, colleagues from years past that were in the really in the thick of it, but it was still challenging. Um, but I started doing ketamine treatments with that clinic and found it was just really like a nice stress relief, like helped me reset my mindset and um just kind of file that as a way as maybe, well, maybe this is something I should look into more of. And then um, I'd always thought about me doing some sort of, you know, wellness type aspect just to kind of balance the ER. And uh and then finally got around to doing it. And so our initial plan was to to do uh IV fluid hydration, which is a popular thing. You know, athletes do it, people do it for recovery, travel, and then also add in the IV ketamine component just because I found that to be so helpful for me personally.

SPEAKER_01 3:30

Sure. Your personal experience.

SPEAKER_00 3:33

Yeah. And so one of the tr things that is really challenging in the emergency department is mental health treatment. Um, we don't we we keep people there for a long time, they don't tend to get better at all. Yeah. And so to have a therapy that, you know, isn't for everybody, but does help a lot of people is is nice to be able to be part of that and facilitate those treatments. Sure. And then we've expanded on with flow wellness into other treatments, particularly um something we had talked about before, but like the GLP1 therapy, mainly for medical weight loss.

SPEAKER_02 3:59

Uh-huh.

SPEAKER_00 4:00

And it just so happened I opened the clinic right when that craze was happening. And so when, you know, Zenpic was in the news every day, and it still kind of is to some extent. Yeah. Um, and then uh the medications weren't really available, but I had relationships with compounding pharmacies that were producing the medication. And I just started asking around. And within, you know, a couple of days, I had a dozen people that were like, hey, I I, you know, either been on this medication and can't get it, or I've been interested in it, I want to lose some weight. And um, and that's where we really took off. And it's been really rewarding to be part of that experience and help people change their lives with obesity.

SPEAKER_01 4:35

Can you tell us a little bit about Osempric and GLP ones in general, how they began, how long they've been in the market? Because many of us think Osempric is as a household name, like just in a couple of years ago, but it's actually been around since 2005, if I'm not mistaken, or these types of drugs at least can't do it.

SPEAKER_00 4:51

Correct. Yeah, they were first developed for diabetics to help manage blood sugar, which is something that Osempic does do. Um, and it was really an incidental side effect that people were losing weight while taking this medication. And the initial drugs, the one that were around in the early 2000s, you had to take either once or twice a day. And so for weight loss, that's not a very appealing thing, but for diabetics who rely on insulin, they're used to doing daily shots. So it wasn't a big thing for them to take those medications. Uh-huh. And what really changed is when they were able to make the medication last longer from daily to weekly, and then start looking at it just for the sole purpose of weight loss. And the original medicine for that was called semaglutide or semaglutide, also known as a zempic.

SPEAKER_02 5:32

Okay.

SPEAKER_00 5:32

Um, which uh, and then that just, you know, it just hit a tipping point where people realized it was effective and for the most part safe with, you know, not uh there are some side effects, but most people can manage them. And now there's newer medications like trazepatide, which is also called Manjaro or ZEP bound. There's pills now available where you don't even have to do the shots. Okay. And then there's even newer medicines out there that are approaching like what the level of bariatric surgery is for weight loss. And so it's just a real exciting field to be part of and and see where it's going.

SPEAKER_01 6:02

Wow, it's really grown fast in such little time.

SPEAKER_00 6:06

Yeah. I mean, the the the tragedy with obesity is that it affects so many parts of uh people's lives. You know, it's linked with higher risk of heart disease, cancer, stroke, longevity. And there just wasn't really wasn't a treatment for it. Yeah. You know, we would, I mean, not so much in the ER, but primary care doctors would say, well, you know, uh exercise more and eat better, but you know, that that only gets you to a point. And then with ultra-processed food, it's pretty hard to monitor calorie intake. And so we were, you know, even though people were trying, this is what I hear from a lot of the patients that I've treated, you know, they're doing their best, but just not getting where they want to go.

SPEAKER_02 6:38

Yeah.

SPEAKER_00 6:39

And also just at middle age and getting older, you know, your body slows down. So for a lot of people that were at a healthy weight, that changes over time. And and now we have this medication that can help people get to where they want to be and feel like themselves again. It's really phenomenal.

SPEAKER_01 6:53

Yeah. This reminds me of in my past, I was a filmmaker and I did a one-hour special for National Geographic on obesity. And I went to Monterey, Mexico, and I met at that time the world's largest man. Oh, his name was Uribe, Miguel Uribe, and he had got the Guinness book of he got the Guinness record of being the heaviest man, and he was at almost 600 kilos, which is close. I'd have to do the math, but I think that's over 1200 pounds. And when I met him, he had been living on a mattress for the last 13 years. And on that mattress, he had to do everything, all his bodily functions. He could not get up from that mattress. And he had been literally bedridden for 13 years. And if he wanted to see the sun and get out, they had to transfer that mattress to the back of a pickup truck. And then they would drive him through town and he would just kind of be exposed to the sun and, you know, of course, to the city. He was obviously well known. Um, you know, a lot of people went to go visit him. Um, anyways, he sadly passed away a couple of years later, but I don't think he reached, I think he died around close to 40, if I'm not mistaken. He was probably in his late 30s when I met him. But it was a very impactful experience to see him just really glued to that mattress and knowing that he had been there for 13 years was very hard to conceive. So that brings me, you know, to the need of why these drugs could be useful because he was unable to lose any weight. Um can you tell us, you know, when a patient comes to you, like what are the factors that you're keeping in consideration as to as to why this patient should be eligible or not to take these new medications?

SPEAKER_00 8:34

Uh yeah, it's a great question. Um, there are criteria which we base off of the body mass index, which is a calculation based on your height and weight. And then also factoring in um other risk factors, mainly for heart disease, like does that person have diabetes or high blood pressure or bad cholesterol or a family history of heart disease? And so those are the kind of traditional things that we look at for GLP1 medications. Uh-huh. We are seeing it used a lot more commonly now for other conditions, um, mainly in longevity space. There was a large study that showed semiglutide, which is the original weight loss medication, had a 15% uh drop in all-cause mortality for people who took it over a study period. And so people are looking at this, say, hey, I can actually use this medication to help live longer. There was a large study looking at it for um dementia, which it didn't really pan out. So that's still up in the air. Okay. We've also had patients use it for inflammation, uh-huh. Like pro-inflammatory states of the body. And um, you know, fat cells are pro-inflammatory. And so if you can lose weight, you can decrease that inflammation. Sure. And so we have we are we have the traditional things, which is just truly excess weight, like a BMI over 30, whereas over 25 is considered obese.

SPEAKER_02 9:45

Right.

SPEAKER_00 9:46

Um, or over 25 is considered overweight, over 30 is obese. And then also folks that are looking at it for kind of what we consider like non-traditional um um treatments as well.

SPEAKER_01 9:57

Okay. And non-traditional treatments would be like what?

SPEAKER_00 10:00

Like the inflammation components, uh, fertility. Like we've had folks become pregnant after losing weight because you know, being overweight is not the the doesn't put your body in the healthiest state to have children.

SPEAKER_02 10:11

Uh-huh.

SPEAKER_00 10:12

Um Yeah. And there's a recent New York Times article about someone using it for a head injury, which is new to me. I hadn't heard of that, but who had a severe concussion and actually found getting on a GLP one medication helped their concussion symptoms. So it's in the news right now, there's just a little bit of everything that you're hearing about the how GLP ones could help. And maybe not all of that is 100% accurate. It's gonna be backed up by study data, but we are seeing a lot of benefit for things that we didn't even uh know about.

SPEAKER_01 10:39

Okay. And the patients that come to see you here in general, what are in what category do they fall in? Like the non-traditional or more just weight loss, looking for longevity benefits? What do you think?

SPEAKER_00 10:52

It's really a mix of both. Um, I would say on average, an older population for the most part. We're mostly seeing people 40s, 50s, and even a handful of 60s, 70s.

SPEAKER_02 11:01

Uh-huh.

SPEAKER_00 11:02

Um, and uh the middle-aged folks are really what I hear over and over again is I was doing fine, I'm eating right, I'm exercising, you know, they I live in bed, I get out, that sort of thing. But I I just the pounds just keep on getting adding on. And that's it's so true. I mean, it's statistically shown. You know, people in middle age, you people gain on average, you know, roughly a pound a year. What no matter how hard you're trying is your body's just slowing down. And you know, eventually gets that uh affects people. Either their exercise tolerance goes down, they have a health concern, maybe you know, they have a health scare of some sort, and they want to get healthier. And so what we're seeing is folks that you know are are hitting that point where like, I've heard of this treatment, I I know I'm getting worse, I've done everything I can to get better. Like, would this work for me?

SPEAKER_01 11:45

Sure. Are there any red flags that you look for where you think that the the drug is not compatible for that person?

SPEAKER_00 11:54

I mean, the the biggest thing we'd screen for is something called body dysmorphic disorder, um, which is you know, people who are already very thin who want to become more thin. Sure. And and that's pretty obvious when they walk in the door and what you know their BMI is. Um and surprisingly, that's very uncommon. Like I can count on one hand how many people I've seen personally that, you know, I'm just like this isn't a healthy situation for you. Yeah. Um, we do have to be careful with folks looking at like the inflammation benefits that they don't lose too much weight, because if we're treating something else, but the main effect is weight loss and we don't want them to get unhealthy. And that's something we actually track with the body composition scan. So we can look at their muscle mass, their fat mass. You know, a big buzzword right now in health is visceral fat, the fat that's around your organs, because that's um considered more dangerous for heart disease. And so we can track that and see if it's getting better. And so people are looking at that. Well, how do I improve my visceral fat, whether that's with GLP1 or something else?

SPEAKER_01 12:48

Okay. So tell me a little bit of the process. A patient comes to you and you filter them, you ask the necessary questions, you understand that you know they're eligible, I guess, for the medication. How what does the process look like? Like what?

unknown 13:03

Yeah.

SPEAKER_00 13:03

So first they meet with a provider. Um, if it's an in-person visit, we do a body composition scan. And when we meet with them, you know, we're gonna talk about like, you know, what their what their journey has been. Like everyone has a, you know, like when did it it comes out pretty naturally? Like, when did you feel like a healthy weight? When did that change? And what do you think changed? And how's your diet? How's your exercise? Um, and and usually there's you know, sometimes there's a trigger, like, you know, someone I talk with today had an injury and they were gaining weight because they couldn't exercise again and they're waiting surgery.

SPEAKER_02 13:32

Uh-huh.

SPEAKER_00 13:32

Um, you know, other folks, it's just that middle age factor. Um, and then, you know, then we spend a lot of time, but most of the conversation is really about, you know, the risks and benefits of the medication because there are important things to know.

SPEAKER_01 13:43

For example, can you tell us a little bit about the risks and yeah, the the biggest thing is these medicines do have side effects.

SPEAKER_00 13:50

And so the most common being nausea. And so we want to warn people about that. Um, and so, you know, not eating too much at once and then, you know, being taking your time starting the medication, you know, we we also want people to lose weight in a healthy way. You know, we don't want them just shedding pounds by the week because that puts you in a starvation state and you start losing muscle.

SPEAKER_02 14:12

Yeah.

SPEAKER_00 14:12

Um, also, you know, the way the medication works is it really just slows down your whole GI system. And so constipation is very common. So we want to talk with people about that. Okay. Um, sometimes people paradoxically also get diarrhea. So it basically just affects your gut.

SPEAKER_02 14:26

Uh-huh.

SPEAKER_00 14:26

Um, and there are more rare side effects, mainly more attributed to weight loss. But for instance, you know, if you lose weight, that can increase your risk of gallstones, which can lead to um a gallbladder infection, which can lead to surgery.

SPEAKER_02 14:38

Uh-huh.

SPEAKER_00 14:38

And we've had some patients need to get their gallbladders taken out. Oh, wow. But you know, gallstones are composed of um what's in fat cells. So as those fat cells start breaking out and into the bloodstream, they can lodge in the gallbladder. And there are more serious side effects, which we've really hardly seen any of, but like pancreatitis, like any medication can cause inflammation of the pancreas, which can be life-threatening.

SPEAKER_02 15:00

Oh, wow.

SPEAKER_00 15:01

There's a theoretical risk of a very rare type of thyroid cancer that that was seen in rat studies. It hasn't been demonstrated in humans, but there is a warning on the drug label. So we do talk with people about that. Sure. Um, you know, those are those are the main things in terms of like what we what we warn people about. Then of course, we just talk about, you know, dosing and like, you know, what what a healthy weight loss target is. Um, and you know, and then we we follow our patients pretty closely. We want to see how they're doing and adjust their dose as needed.

SPEAKER_01 15:31

Yeah, that's what I was curious about, like the following, the continu, you know, how the how the care is provided for while they're taking the drug. Like with what frequency will you see the patients, what is an appropriate weight loss per week? I mean, does that really depend on what their their initial weight is?

SPEAKER_00 15:48

It does. I mean, on average, we're you, you know, one to three pounds is considered a healthy weight. Uh on trazepitide, the stronger medicine. We do have some people who say have like 50 plus pounds to lose, and they'll drop like 10 or 20 pounds the first month just really fast. We don't want that to be sustained.

SPEAKER_02 16:04

Yeah.

SPEAKER_00 16:05

Um, but that can happen. Uh, but yeah, so we just don't want to up people's dose too fast. But most people don't want that because if if you're it, you're gonna feel pretty miserable. Sure. Like if if you're not able to eat at all, you're you're just not gonna feel good. So, you know, we we tend to like it's just standard in medicine, you know, start low and go slow. And I just warn people that this is a process, it is a journey. Sure. You know, you're not gonna get to your goal we in a month, um, and that it's a long-term commitment to this. And, you know, whether it's you know, if you reach your weight in three months or nine months or a year, you know, this the where this drug was studied was actually 17 months of study periods. They they were planning on over a year to look at this.

SPEAKER_02 16:43

Uh-huh.

SPEAKER_00 16:43

And and then also to the big thing too is to talk about what happens when you get to your goal. What do you want to do next? Because if people stop these medications, statistically they are going to regain weight.

SPEAKER_01 16:54

Yeah, I read that normally half the patient will regain the weight back.

SPEAKER_00 16:59

Yeah, it happens very slowly. And a lot of times people will still wind up under where they were before.

SPEAKER_02 17:04

Uh-huh.

SPEAKER_00 17:05

And so we want to warn people that, you know, it's not just like anything else, there's no permanent fix, there's no magic bullet.

SPEAKER_02 17:10

Yes.

SPEAKER_00 17:11

Um, we do I would say it it breaks down. We do have some people that get to their goal weight and then get back to their healthy habits and stay there. Um, I mean, that's probably the biggest minority. We do have some people that get to their goal weight, they do well for a period of time, and then something comes up in their life, whether it's an illness or a family stressor or a life stressor, and they'll they'll call us back and be like, hey, you know, I was doing great for three months, but can I get back on for a month or two? And so they cycle a little bit, which is fine. And then other people just really feel so much better on the medication that they just want to stay on it. And then we just work them to a maintenance dose, like a lower dose, maybe a more affordable medication. And um, what what people really find that the benefit is that's hard to explain until you've experienced it, is the the lack of food noise or cravings. Yeah. Because when you're living that life all the time, you don't think about it, but people get very food stressed. I know that was an issue for me when I was working night shifts in the ER. If I'd always feel hungry because I was, you know, using calories to get some energy. Sure. And um, and when I started, I personally take the medication. And when I started, I did that that noise just went away. And I was like, wow, that was really like a big part of the background thinking in my life. And now it's gone, and it's really nice.

unknown 18:20

Yeah.

SPEAKER_00 18:21

And so, and that that helps other with other things beyond food, too. People have used it to cut back on alcohol use. That's being studied.

SPEAKER_01 18:27

That's fascinating.

SPEAKER_00 18:28

Yeah. And and so I don't I don't think it'll ever be a true like just take this pill or shot to get get off booze. But yeah, we do have people that cut way back on their alcohol use. And part of it is the mental craving, and part of it's the physical amount that you just can't drink a bottle of wine on a GLB one because your stomach's gonna, you're gonna feel terrible.

SPEAKER_01 18:46

Oh now that you're talking about, you know, all these, you know, psychological benefits of not feeling that noise, that food, um, that food noise and the fact that it can help the people who have addiction to alcohol. Can you tell us a little bit about how they work? I think I find it fascinating. How what's going on metabolically in our in our body when we take these drugs? What's going on?

SPEAKER_00 19:10

Yeah. So the GLP stands for glucagon-like peptide, and it's mimicking a natural um hormone or peptide, I'm sorry, that your body produces. So every time you eat in your small intestine, you release GLP1, and that's basically telling your body that you're full. So it signals to your stomach, hey, slow down, we're good. Yeah. Signal to your brain, we don't need any more food. Um, unfortunately, that that peptide, the natural occurring one, only lasts for a few minutes. So what's there's kind of some fun trivia about the GLP1s that it was actually derived from Helomonster um uh GLP one. And so Helomonsters are these like lizard creatures that live in this American Southwest, uh-huh. And they only eat, you know, once or twice a month. So they have a GLP one that lasts a lot longer. Uh-huh. And so it the um the the uh molecule that was isolated was called a xinonin. I might be saying it wrong. Yeah. And that turned into a xinotide, which was the first GLP one that was released in 2005. So it was a derivative of this HELA monster GLP one. And so that they found a way to make it last longer.

SPEAKER_02 20:14

Oh, interesting.

SPEAKER_00 20:15

And so when you do this, it it's not a natural thing that you're taking. Like terzepatite is not something your body naturally makes. It's it's a synthetic version of your natural GLP one that's designed to last longer in your body. So it resists getting broken down by other proteins. And so that's why that feeling of full fullness like lasts longer than a few minutes.

SPEAKER_01 20:34

Like it's I see. And how long can that last then? I guess it depends on the doses.

SPEAKER_00 20:39

But yeah, I mean, well, for these weekly medications, you know, the half-life is between five and seven days. So you take the medication, you have a kind of lower level of GLP one just circulating. So that's I think that's where people also don't get those food noises because their brain's being told, hey, it's okay, it's okay. And one of the big misconceptions of GLP1s is you can still eat and enjoy food. It doesn't affect taste or, you know, going out with friends or having a glass of wine. Like those things are all totally nor back to normal. You're just not gonna have as much. Like what I often tell patients is you're gonna start bringing take-home bags from a restaurant, or maybe you just split an entree with your spouse. You just don't need as much to feel full.

SPEAKER_02 21:17

Uh-huh.

SPEAKER_00 21:17

And that's the biggest change. And and and it's it's just really simple. I mean, if you're taking in half as much calories, you know, to use a rough number, then you're gonna on average lose weight.

SPEAKER_01 21:26

Sure, of course. Now, when someone begins these uh this medication, what are some lifestyle interventions that should be maintained? I mean, for example, exercise, proper hydration, you know, managing stress, sleep, like where I mean, as a health and wellness coach, you know, I cannot not wonder about, you know, what are these other how these other interventions come into play just to make sure that, you know, health and wellness is maintained and we're just not relying on a, you know, as you say, a magic pull pill, a miracle drug to kind of do all the work for us. Like what's the Work that the patient still should do.

SPEAKER_00 22:02

Yeah, absolutely. I mean, those are really important things for, you know, um body weight as well as long-term health. Um, we we do uh offer nutritionists if people want to work on their nutrition. Uh, because you know, for some people that might be their weakness, is just I just don't eat healthy. I need some planning on that. Um, the biggest thing that we worry about with the medication is that as you're losing weight, you can lose muscle because your body's, if it needs calories, it's going to scrounge wherever it can get. Yeah. And so, you know, obviously it'll start with body fat, but it's also going to pull lead muscle nice.

SPEAKER_01 22:32

Yeah.

SPEAKER_00 22:32

And so that's something we can track. And then we also really encourage our patients to start, you know, exercising if they aren't already. The nice thing is naturally, as people start to feel better, they start moving more.

SPEAKER_01 22:42

Yeah.

SPEAKER_00 22:42

Um, which is a great benefit of the medication. It's like, you know, if say someone who's, you know, very large, like they just every time they get off the couch, it hurts. Like it's physically painful for them. And that pain's going to go down, you know, as as um they lose weight. In fact, the medication's being studied for like osteoarthritis, that sort of thing, to help with that benefit. And so people do want to do that, but we obviously encourage them. And and we have an education program we use per at our clinic, but you know, it's like here's straight some strength exercises, and here's what you need for your long-term health. Sleep obviously is important. I mean, that's like the under most underrated thing for anything, I think, in longevity is just getting good night's sleep. And it's so hard right now with social media and you know, the world and doom scrolling and stress and something I struggle with a lot.

SPEAKER_01 23:26

Yeah, it's something I most coach on as a yeah, it's very common just to suffer from lack of sleep. Yeah. So there's a lot of things that you're recommending your patients to do.

SPEAKER_00 23:36

Yeah, and we check in with them monthly. I mean, monthly. We're in a slightly different model, you know, where it's a concierge level. So it's we we want to hear from our people. Um, you know, every place does it a little bit differently, but um, you know, it's it's it's it's a it's a journey. So it's gonna take time, it's gonna take adjustments. Um I I will say in the in this community that people tend to know what they need to do, you know, it's they know where they slipped up, and and so it's it's less of an issue than I thought, but it's always good to remind folks, you know, it's like it takes sometimes it takes a little like push to hey, just sorry, how are you doing with this? Or it looks like you lost some muscle mass. How can we work on that? You know, we want to keep you healthy. You know, the last thing you want to do is feel great and be back to your, you know, regular clothes that fit, but be an unhealthy person. We don't want that. Sure.

SPEAKER_01 24:22

Um is there any kind of counseling that goes on with these patients? Just like I don't know, psychological counseling about body image, about body weight. Does that tend to accompany this process at all? For those who have suffered for being overweight or obese?

SPEAKER_00 24:41

Well, you hear a lot about how it affects marriages. Um, as one person gets healthy, it really changes the dynamic. In fact, we have a lot of people that come in that'll start with us and then bring their spouse in like three to six months later. Oh, interesting. Because I mean, you know, if for folks that really stru struggle with obesity, I mean it really affects every aspect of their life. And when those things get changed, like they're obviously gonna feel a lot better and want to change other things in their in their life.

SPEAKER_01 25:03

Uh-huh. Can you think of any, you know, obviously without any names, but like any stories that have really inspired you that have really shown like the power of these drugs, this medication of how it can really transform a life?

SPEAKER_00 25:17

Uh, there's been a couple. I mean, um, one that comes up repeatedly is for um like one of my first patients had a hip injury and it gained um a fair bit of weight. She was younger and and she couldn't get her surgery because she was too overweight and she's like, I'm in this catch 22, or I want to exercise, but it's painful. I can't, and I can't get the fix that I need because I'm too heavy now. And so she was, she was successful getting back to the weight that she needed to do to get her surgery and and then was fine afterwards. And now, you know, we're she's not on the medication anymore.

SPEAKER_01 25:46

She's not on it.

SPEAKER_00 25:47

And I had a consult today with the same story of an older patient who's in the same situation of just, you know, um, injury can't, you know, and if you think about it, if you hurt your knee or hip, it has to be the hips that I hear a lot about. You can't, you know, aside from swimming, you're pretty limited on what you can do for cardiovascular activity and and getting back down is is a goal for them.

SPEAKER_01 26:08

And um, so once they get down to that weight that they need in order to get that surgery, in order to, you know, enhance that mobility again, do they stay off the drug? What usually happens afterwards?

SPEAKER_00 26:18

It's it's really individualized when people get to their goal. Um, yeah, that's like like we always want to talk with people about like what they're what how they're feeling, what they want to try. I mean, I always encourage people if they're up for it to try weaning off the medication and see how they feel.

SPEAKER_02 26:34

Uh-huh.

SPEAKER_00 26:35

Um, because if you don't need it, then you don't need it.

SPEAKER_02 26:37

Yeah.

SPEAKER_00 26:37

Um, and it but I I mean it's hard to know exactly, but um, I I I've sort of split it up into thirds. Like when I tell people this, like a third of people will stop and stay off of it, a third of people will cycle, a third of people will stay on it. I think that's probably a little bit higher than a third that people will want to stay on it just as a maintenance. Sure. Just because they're feeling better, you know, that they've gotten to where they want to be. Maybe they tried stopping it for a month and those food cravings came back and they started gaining weight again.

SPEAKER_01 27:03

Yeah. And for those who are able to who who are in that third that are able to stop the taking the drug altogether, like what are they doing in their time in terms of their lifestyle in order to keep that weight off and not need the drug anymore?

SPEAKER_00 27:20

Um, that's a good question. You know, I I don't hear from them that often because you're at service. Yes. But I think, I mean, what I think they're doing is just getting back to where they were, like in terms of activity level. I mean, I hear from a lot of patients, I just need a boost, I need a kickstart to get where I want to be. And that's part of your body's, you know, how it functions, that homeostasis where it wants to stay the same.

SPEAKER_02 27:38

Uh-huh.

SPEAKER_00 27:39

And that's been looked at like in the the biggest loser TV show. They did a big trial or big study and they looked at those folks that lost like tremendous amount of weight, but their body's metabolism really slowed down and it wasn't reversible. And so it becomes really hard, especially as you're cycling between overweight and regular weight. Your metabolism is always keeping score of that. And so it does take some time to reset that if that's even possible. And so, you know, it's it takes a lot of discipline. I tell people it's easy to lose weight on this medication. It's hard to stop and keep it off, but you should know that going in. Cause, you know, we'll be having this conversation in, you know, what three months, six months a year, this um, that, you know, what do you want to do now? But knowing that the if if you want to stop and get off of it, all those benefits of the mental and and the gut system slowing down are gonna are gonna go away. But I think with a lot of, I mean, there are a a subset of people that are super disciplined and they get that kickstart that they need and then they can move forward with it.

SPEAKER_01 28:34

Yeah. What do you see the future of these drugs? Do you think they're gonna become more mainstream? Do you think they're gonna be held back? How do you see them evolving to Yeah?

SPEAKER_00 28:45

For a while I was worried that there was some like unknown side effect that was gonna come out, and you know, because there's been diet drugs in the past that have later turned out to be dangerous, like Fenfen. Um, but now that we've had, you know, over two decades of this type of medication being uh out and available and plus just you know tens of millions of people taking the medication. I really don't think there's gonna be one overall bad thing that's gonna happen. There could be more future side effects that we don't know about. It's always hard to tell with any any treatment.

SPEAKER_02 29:12

Yeah.

SPEAKER_00 29:13

Uh I do think that I mean the biggest issue for right now for a lot of people is price because insurance typically doesn't cover this medication until you're a diabetic, uh-huh, which is frustrating because you have to wait to get the illness that is caused by being overweight for uh to get treated for it. And unfortunately, that's just you know how American insurance works. It's more for sick care rather than health care.

SPEAKER_02 29:33

Yeah.

SPEAKER_00 29:34

And so, you know, these medicines are are expensive out of pocket. The cost has gone down tremendously. Like when I first started doing this three years ago, it was over a thousand dollars a month. And now, either with compounded medication or brand new medication, you can get the medication for, you know, $300 to $500 a month.

SPEAKER_02 29:50

Okay.

SPEAKER_00 29:50

So quite a bit less, but still for that's still a lot of money. Sure. I do think the cost will keep going down as there's more medications out there. I mean, I think every drug company right now is seeing this as something that they want to get into.

SPEAKER_01 30:01

I've heard a lot of pharma's into this now. Yeah.

unknown 30:04

Yeah.

SPEAKER_00 30:04

I mean, just to have a fix for really the most common medical problem in the United States. I mean, it's, you know, over 60, 70 percent of American adults are obese. So being able to have an effective treatment for that is really revolutionary. And I think it's gonna, as a whole, help the our whole country, you know, live healthier, live longer. Just because there's so many consequences of having um excess weight.

SPEAKER_01 30:26

Yeah. What are those biggest consequences? Because I mean, we're getting into the issue of like metabolic health, which is uh definitely a big driver of a you know, a lot of disease that we see here in the United States.

SPEAKER_00 30:39

Yeah. I mean, I mean I mean it affects all levels. I mean, the number one, you know, disease that kills people is cardiovascular disease. And certainly being overweight's a contributor to that. You know, it's gonna you know associate with high um high cholesterol, leads and lead to high blood pressure, all those risk factors for stroke and heart disease. A big one that I I I feel like is becoming more common is just the cancer elements, you know, like obesity is linked to, I believe it's over 20 different types of cancers, particularly breast cancer.

SPEAKER_02 31:05

Wow.

SPEAKER_00 31:06

And so all you know, with those um adipostos, fat cells being so pro-inflammatory, it's just kind of wreaking havoc in your body. We're seeing a lot more young people with cancer nowadays. I'm sure there's more to it than just body weight, but that undoubtedly is a component.

SPEAKER_01 31:20

Wow. Can you explain to me why, you know, talk you've mentioned inflammation a lot. And we're, you know, inflammation is definitely a more common word, you know, as that silent killer behind so many of these chronic diseases. How does the GLP ones work in being an anti-inflammatory?

SPEAKER_00 31:39

I think the full extent of it isn't honestly known. But I I you know, as you decrease fat cells, those those are the ones that are producing a lot of inflammatory signals in the body. Obviously, it's more complicated than that. Yeah. But that was a benefit like a lot of people didn't even realize that um, you know, especially like inflammatory conditions can be hard to treat because there's not like an easy fix. And and we were seeing people with like like, you know, endometriosis, irritable bowel disease, um, polycystic ovarian disease, like things that just didn't have good treatments that were really affecting people's lives in in a non-specific, like very ill way, and they're getting better. And um, I mean, I I think it's mostly through weight. There might be other mechanisms too. There the GLP1 receptor is in all over the body. And so there's probably things that are still yet to be discovered for that.

SPEAKER_01 32:25

Wow. It's interesting to see how much this, you know, this it's growing. And at the same time, the the industry and the you know, is still discovering all its benefits and possible outcomes at the same time. It's like, you know, there's a lot unknown still, but a lot of interesting things that are coming out as people are more and more taking these drugs.

SPEAKER_00 32:48

Yeah. And I I think I think there'll be, you know, as we get more targeted with, you know, AI and all these things, like the medical therapy is just going to keep on getting better in that regard. I mean, there'll always be an issue of affordability and access. Sure. But this is, I think, the tip of the iceberg of what what's possible down the road.

SPEAKER_01 33:03

Yeah. Um so, in terms of wellness, how have you seen that these drugs have helped your patients in general? Like besides the weight loss, what else is happening for them?

SPEAKER_00 33:15

Uh, you know, I always think of it like they feel like yourself again. You know, everyone has that memory of when we were young and healthy and we want to aspire to get back to that point, which is always a hard thing to do, but it helped it helps put you on that path. Um, you know, just you know, if if you can wake up and be, you know, pain-free moving throughout your day or doing activities that you like. Yeah. Um, you know, fit into clothes that make you feel comfortable again, those sort of things. I think it's really a big self-confidence booster.

SPEAKER_01 33:43

For sure. And changes a little bit dynamics and relationships, as you mentioned.

SPEAKER_00 33:48

Mm-hmm. Yeah, absolutely.

SPEAKER_01 33:50

Yeah. For you personally, you mentioned that it has helped you kind of eliminate that food noise that you were hearing before. What other benefits have you experienced?

SPEAKER_00 33:59

Well, I I think for me, one of the most striking things is how well my athletic performance got better. Cause I like to ski a lot, but I was, you know, always the slow guy. Yeah. And I was like, maybe I'm just, you know, this is just me. But as I lost weight, I was like, oh wow, like I'm actually, I feel much more athletic. I'm moving better.

SPEAKER_02 34:14

Uh-huh.

SPEAKER_00 34:14

Um, and that was a nice side effect that I didn't really anticipate. Um, you know, I I think it I think by not having that food noise, you can also eat healthier because you're just not eating whatever's right in front of you. So you can be more intentional.

SPEAKER_01 34:26

That's a good point.

SPEAKER_00 34:27

Um, and so I, you know, I use that as a springboard for that element. Um, you know, I think it I think it's it just makes you feel more confident, I would say. Like that's been a big thing.

SPEAKER_01 34:38

Uh-huh. Okay. Um, and another component that flow wellness looks at is also peptides, which is another category in itself, correct?

SPEAKER_02 34:49

Yep.

SPEAKER_01 34:50

Can you tell us a little bit about peptides, how long they've been in the market? This is rare fairly new, if I'm not mistaken.

SPEAKER_00 34:58

Yeah, so peptides, so GLP1 is a peptide. Okay. Um, and but there are these all these other peptides. And just to back up a little bit, uh a peptide is a combination of amino acids. So amino acids are what make up make what also makes up proteins. And you can think of amino acids as like little Legos, and they can get built together. So a small like Lego block would be a uh an uh a peptide, which is under 50 amino acids. That's commonly accepted number. Over 50 would be a protein. And proteins, as we know, are essential, like, you know, they're make it might make up muscle, hemoglobin makes up red blood cells, you know, myelin makes up nerve sheaths, all these things, everything in your body is made of proteins. And what peptides do with smaller amino acids is they signal things in your body, sort of like a text message that goes to one part of your body.

SPEAKER_02 35:44

Uh-huh.

SPEAKER_00 35:44

And typically what that'll do is activate a certain pathway, like a GLP1 goes to your brain, it goes to your stomach. Sure.

SPEAKER_01 35:50

And calamus. Uh-huh.

SPEAKER_00 35:52

And so there's other peptides that even take a more focused, a narrow role. Um, and it's interesting, these peptides have actually been around for a while. Um, after we initially talked, I did some further research to this. And one of the most common um peptides are these are what's called growth hormone analogs. And they allow, they signal your body to produce more growth hormone. And growth hormone is a hormone that affects everything in your body. And it's basically how a young person feels young. You could boil it down to that. Um, you know, like if a teenager breaks a bone, they're back running around in a couple of weeks, whereas a 50-year-old breaks a bone, you know, six months later they're still doing PT feeling miserable. A lot of that is through growth hormone repairing your body and allowing it to recover. And so Sumoralin is kind of that quintessential growth hormone as a type of peptide. Okay. A growth hormone analog. It's a peptide that produces, helps make your body uh make more growth hormone. That was actually FDA approved in 1990.

SPEAKER_02 36:46

Yeah.

SPEAKER_00 36:47

As an anal as a test to see if your body was making enough growth hormone.

unknown 36:51

Uh-huh.

SPEAKER_00 36:52

And then it was later approved for children who had growth hormone deficiency. Yeah. So there is, you know, there are genetic causes that can lead people to not have enough growth growth hormone, usually diagnosed as a child.

SPEAKER_01 37:02

Yeah. My my daughter is on the growth hormone since six months of age because it was approved for his her syndrome. Um, and it gives her a lot of benefits, uh, among which it helps with muscle, fat balance, and also just like stamina and it also affects her IQ, interestingly enough. Oh wow. Yeah. It's been approved by the FDA, yeah, for many years for her syndrome. So yeah, I'm very familiar with growth hormone. I have to inject it nightly to her. So you're saying that that growth hormone that she's taking is a peptide?

SPEAKER_00 37:34

Well, if you're doing straight growth hormone, that's a hormone. Okay. Um, and then for what people are typically do is do a the growth hormone analogs, which are the peptides that tell your body to make more growth hormone.

SPEAKER_02 37:45

Uh-huh.

SPEAKER_00 37:46

And so the tricky thing if you're doing just just straight growth hormone is you have to really carefully monitor the levels. Yes, we do. And so and and too much can be dangerous. Yeah. If you stop suddenly, that can be dangerous. And so and it could have some side effects, particularly in adults. It can lead to bone growth, which people don't really want as an adult. Right. And so by using these growth hormone analogs, you're kind of getting the benefits without having to deal with the downsides of like monitoring levels and having on an unwanted side effects. And so the peptide tells the body it's really the pituitary gland is where this comes from in the brain. Uh-huh. So that you you take that that peptide and then it goes to your brain and says, Let's make more more growth hormone. But it does it on a natural cycle. So your your your body's not going to make more than it should. It's just giving you more than you have currently.

SPEAKER_01 38:31

Got it. Okay. So that's one peptide. But then now there are many peptides out there.

SPEAKER_00 38:36

Yeah, there's, I mean, there's dozens. Now that there's a narrow subset that are, you know, like allowed to be compounded that have shown to be safe. And it's kind of a moving target right now. The, you know, the government's looking at whether some peptides should be allowed again. They were and then they weren't. And um, but the peptides can get broken up into categories. You have the GLP ones for the, you know, the food type stuff.

SPEAKER_01 38:58

Right.

SPEAKER_00 38:58

And then you have the growth hormones, which is kind of categorizing the performance. You know, they help with athletic performance, recovery, sleep. And then there's recovery peptides. There's one called BPC, which stands for body protective compound. It was derived from um uh uh t tissue in the stomach that protects your body against all the acid in your stomach. Uh-huh. And that's been shown. Well, it it's been shown in animals to help with injury recovery. A lot of these uh peptides don't have huge human studies for two reasons. One, because they're natural chemicals or molecules. So no one can patent them and make a lot of money off of them. And also, they've been around for so long that they're not novel anymore.

SPEAKER_02 39:39

Oh, okay.

SPEAKER_00 39:39

And so the traditional way of making a medication, if you're a large drunk company, is you make something new and then you spend millions of dollars studying it to prove that it's safe and effective. And if that happens and you and and you patent it, and then the FDA gives you approval to sell it, and you have a period of time, you know, 15, 20 years, that it's at your exclusive use to make money off of it. Whereas these pep, these peptides have been around for so long and they're also natural, which means you can't you can't patent a natural thing.

SPEAKER_01 40:06

Oh, interesting.

SPEAKER_00 40:07

No, no one can make a lot of money off of them. So that human data, which it the GLP ones do have, because those are a bit, those are novel, those are new.

SPEAKER_01 40:15

They're much more regulated.

SPEAKER_00 40:16

Yeah. Well, some sort of regulated is like well studied. And it's a it's tricky because we don't, you know, medicine, you don't want to uh provide treatments that are causing harm. So we always want to be careful about for sure, you know, is this safe is the first question.

SPEAKER_02 40:29

Uh-huh.

SPEAKER_00 40:30

And for a lot of the peptides, they have been being used for decades, kind of under the radar, like in you know, specific instances in medicine, like say the growth hormone in children. And then we're you know, they're extrapolating that out to say, well, we know this helps and people feel better on it. You know, let's let's try this out.

SPEAKER_02 40:46

Yeah.

SPEAKER_00 40:46

And so it's it's a very dynamic space. And I think it really the door was opened by GLP ones. Once people realize, oh, if I do this injection, I can feel better. Uh most peptides, because they're proteins that get broken down in the stomach, they have to be done by a small injection. Um, there are some ones that dissolve underneath the tongue as well. Um, and so people have, you know, once they saw how much benefit they can get from GLP ones, or maybe someone else they know, there's like, well, what else is there? And there's this whole world of peptides that are out there. Um, and so there's recovery ones, there's um uh the performance ones, there's also ones used for like skin and beauty. Uh the most common one for that is called GHKCU, which is a copper peptide that's used in collagen production, hair formation. Supposedly it's the one all the celebrities are taking. Um, but it does it give you a youthful, or at least for most people, a youthful skin appearance.

SPEAKER_02 41:36

Uh-huh.

SPEAKER_00 41:37

And so everyone's, you know, it's kind of looking around, like what can help me? There's some for inflammation, um, you know, there's some to help activate your mitochondria. It's wild. Uh, and so we we take a close look at we want to, you know, as a in the medical field, like, you know, we want to be real careful about what we're providing. So we look at, you know, what the is it is it safe and can it show some benefit? Yeah. A lot of people are buying peptides right off the internet. Um, it's called like the gray markets or the black markets. Um, and it's so scary. Yeah, so it's a way to save money and it's a way to get whatever you want. Um, unfortunately, you know, the there's no, you know, quality control or toxin level that's monitored. I mean, people do send these off to let third-party labs to check. However, I mean, we don't obviously don't recommend this, but um, but it is a big thing in the internet world of you know, you have these, you know, bodybuilders who are like, oh, if you go to you know, this account and you know on Discord and pay with Bitcoin, you know, it's just it's wild. And of course it's really cheap. Um, but there, you know, my take on it is if you're putting it in your body, it's probably worth taking the time and maybe spending the extra money to make sure it's safe.

SPEAKER_01 42:46

Yeah, for sure.

SPEAKER_00 42:47

All right.

SPEAKER_01 42:47

I would definitely think so.

SPEAKER_00 42:49

But but yeah, that but and so there's all these other experimental peptides that people are trying out, there's some that help with skin tanning, believe it or not. Um you know, and so I think that'll keep on going. It's it's tough though, because no drug company is gonna really extensively study this. So whether what becomes like mainstream and and widely accepted versus what isn't, we don't really know quite yet. But for the limited peptides that we've been providing, like people do definitely notice um like athletic performance is is pretty uh a strong improvement. Um, and and like for me with the growth hormone peptides that I've tried, like sleep benefit has been really dramatic as well. Just feeling like I get more restful sleep.

SPEAKER_02 43:29

Wow.

SPEAKER_00 43:30

But a bit important thing to note with the peptides is none of these are FDA approved for what we're talking about. Yeah. Um, so it's definitely an off-label type thing. And one thing in particular to know about with growth hormone is um for some folks with cancer, increasing growth hormone can make cancer worse. So we just want to make sure people don't have cancer before they start peptide therapy or at high risk. Like maybe they just finished a cancer treatment, uh, make sure that they've done their cancer screenings. You know, the last thing we want to do is start someone on a medication that makes them ill. But pet um growth hormone analogs have never been shown to cause cancer. It's just that if you have certain types, it can make it worse.

SPEAKER_01 44:07

I see. Wow. Is this sector growing a lot as well within your business in flow wellness? Are you seeing more and more clients come to you wanting to try these peptides out there?

SPEAKER_00 44:20

Absolutely. Yeah. I mean, we just started doing it six months ago. It's, I mean, it's it's been bubbling along for a long time and a year's decades, but it's really just taken off, I'd say, within the past year. And a lot of it through social media, honestly. I mean, you can go on in whatever your favorite account is, type in peptides, and you'll get thousands of people talking about how it benefits them and where you can order it and all this sort of thing.

SPEAKER_01 44:41

Wow. Well, given that it's such a you know popular topic and that, you know, you you were very clear that this is not FDA approved. How do you, Kevin, as a doctor, like make sure that you're providing the best counsel to your clients looking for peptides with unknown results?

SPEAKER_00 44:58

Uh I mean, the biggest thing for us is the source. Like we want to find a reliable pharmacy that's, you know, US-based. I mean, these are all done through compounding pharmacies. So it's not a kind of mainstream pharmacy. The compounding pharmacies make unique um formulations that aren't, you know, kind of standardized. Okay. Um, and so, you know, one that we we trust in terms of quality. And then also just looking at the the the peptide itself. I mean, typically the ones they're making are the ones that are more accepted just because they're not going to take on producing something that's dangerous because they have, you know, liability in that as well.

SPEAKER_02 45:29

Uh-huh.

SPEAKER_00 45:30

Um, and and you know, a lot a lot of it is just, you know, I'm I hate to say it's not in medicine, you always want to do the, you know, the the the most rigorous study type thing, but these things just don't have it. So a lot of it is just looking around at what what what studies there are, what have people's results have been, what are the potential downsides. And we try and do our best to relay it to people. It's like, hey, this is still, you know, a little bit off label here. We're, you know, but we have seen a lot of people get benefit from it. You know, that's something you're interested in trying. We can certainly try it out.

SPEAKER_01 46:00

Sure. Um, and which are the peptides that are most attractive to the population here in Bend?

SPEAKER_00 46:07

Uh we hear a lot about the growth hormone analog. So Sumorlin's the original one. There's a newer one called CJC epimeralin, which is looking at um, there's variants of that that we we can get through compounding. Uh-huh. Um, a big one that's um in the news is tessineralin. Um, that's been shown. It's actually FDA approved for HIV patients to help with visceral fat loss.

SPEAKER_02 46:28

Okay.

SPEAKER_00 46:29

So HIV patients, when they uh on the medication that they get to treat the HIV, the highly active antiretroviral therapy, the heart therapy, it uh side effect is they tend to gain a lot of weight in the midsection. And so it's been studied, well, how can we help counteract that? And testmerlin was the original drug to treat for that that was effective. And then people said, well, if it works for this population, well, it'll work for, you know, regular people that don't have HIV with excess of visceral fat. And there's some limited study data that it's helpful for that. But we do have people asking for that because it does say, you know, you get to your goal weight on a GLP1, but you you do a body scan and you have excess of visceral fat. And maybe, maybe your dad died of heart disease and you're like, well, I don't, I don't want this visceral fat. I know it's bad for me. What other steps are there that I can do to help, you know, if you're optimizing your diet, sleep, exercise, those sort of things. What else can I do? And so we hear that from patients about the testmarel and and then the injury ones are common too. Like, for instance, um, I had a tennis elbow from overtraining that just wouldn't go away. I'd been to PT and um, you know, I took a month of the BPC compound and it went away. Um, and of course, not that isn't not the case for everybody. Uh we in medicine we call that NM1. Like one person got this benefit. That doesn't mean it applies to everyone else. But we hear these stories over and over again. Uh-huh. Um, people who have gotten surgery, you know, they let the acute healing period um wait a week or two, start some recovery peptides. And we've had multiple people come back, say they saw their surgeon, they're like, wow, you've really progressed further than I thought you would in your recovery. Um, and so we're, you know, we we hear this over and over again that it is helpful for folks.

SPEAKER_01 48:03

Yeah. Wow. I'm kind of blown away by all these new trends and that, you know, yeah. And just the kind I'm trying to figure out like, you know, the the fine line between what we're calling wellness and medicine and you know the health benefits that people are seeing. I I mean as someone who likes to get out and you know, swim and bike and run and sweat and like you know, get tired, you know, I like to do the work, you know. So I'm wary about you know, these you know, pills and peptides and whatnot that kind of do the work for us. Does that make sense?

SPEAKER_00 48:41

Um Yeah, well, one thing to mention is none of these medicines put on muscle for you. You still have to do the work, you know. But the group growth hormone peptides, I mean you still have to go to the gym because it's not gonna just build muscle. What I've found, for instance, I go to the gym and I have a actually have energy instead of showing up and like, well, I made it. Let me do, let me stay at least 15 minutes, I'm gonna go. So it it it helps supplement um, you know, what what you're doing. I mean and what you're describing is really a big transition in medicine right now is it more they call it medicine 3.0.

SPEAKER_02 49:11

Okay.

SPEAKER_00 49:11

Whereas medicine 1.0 was the observational, like herbal remedies, you know, like take this plant, you'll feel better, right? Kind of thing. And okay. And that that's you know, you know, decades, hundreds of years ago. And then we're firmly in the medicine two point era, which is we can treat disease for the most part really well. If you have a heart attack, we have phenomenal treatments for you. Um, uh, you know, cancer, I mean, obviously still needs a lot of work, but there are some cancers that we can completely cure. Uh but the problem is you have to wait for that disease to happen before you can get the treatment. And now that medicine's evolved and we have all these new technologies, the medicine 3.0 is what can I do to stay well? Like what not only do I want to live long, but I want to live healthy during that time. And that's that's what we call health span in addition to lifespan. And that's where these like the wellness industry is kind of keyed in on is you know, what what it's great if you're a hundred, but if you spend the last 20 years of your life in a nursing home, bedbound in pain, that's not a life most people would choose. Right. But if you can stretch that out to maybe the last, you know, only but the last few years, you're still active, walking around, that sort of thing. That's what people want.

SPEAKER_01 50:18

Right. Where health span matches almost lifespan.

SPEAKER_00 50:21

Exactly. And so, for instance, like my my grandmother's hundreds still lives independently, takes no medications, walks every day. Like that's what people want. Sure. That's a pretty rare thing.

SPEAKER_01 50:31

But does she take peptides? No.

SPEAKER_00 50:32

No, no, she's never near them. She's what I'm saying.

SPEAKER_01 50:35

I mean, my grandmother died too when she was 99, and she was in her bed for uh four years before she did. But she was always really active, social, you know, she didn't take any medication, you know. And that's what I'm saying. Like, I I'm more of that nature. Like, I just want to do the work myself, you know, eat healthy, you know, not eat processed food, not do fast food, you know, do my exercise every day, you know, do my meditation to, you know, sleep well at night. So that's why I'm a little bit wary, you know. I know that these are gonna probably they're here to stay. I know a lot of us, you know, need kind of that work to be done for us, you know.

SPEAKER_00 51:10

Yeah, absolutely.

SPEAKER_01 51:11

Right. So yeah.

SPEAKER_00 51:12

Yeah. I mean, if you want to live a long, healthy life, like just taking a pill or a shot isn't gonna do it for you.

SPEAKER_01 51:17

No, I agree.

SPEAKER_00 51:18

And so these are really adjuncts, you know, it's like what what a supplement of, you know, okay. Some people are, you know, they're born with obesity, like that's it runs in their family, they have genetic predisposition to it, they've dealt with it all their life. So being able to treat that is, you know, it that's gonna be a medication for sure.

SPEAKER_01 51:33

I understand that. Yeah, for those genetic cases. Yeah.

SPEAKER_00 51:36

And as far as like the peptide stuff, I mean, you know, I I think for most people, as they get older, like their body slows down, injuries become harder to recover from, their exercise tolerance goes down. And and that can be treated by other methods, you know, hormone replacement, something that we also do.

SPEAKER_02 51:50

Yeah.

SPEAKER_00 51:51

Um, and and so, you know, it's it's finding that balance of like what do you want to do on your own? Is how is that working for you? Sure. And, you know, is there something else that may be helpful? One of the things I found entering the wellness space is that there's just thousands of treatments that are out there, and you just find the one that works for you. You know, for instance, some people swear by acupuncture. My wife does. When I went, it was really painful. I think you could help me at all. But I'm not saying it's a bad thing, it just didn't work for me personally.

SPEAKER_02 52:16

Sure. No.

SPEAKER_00 52:17

Um, you know, and so you find your what works for you and and go with it. And if that's medication, great. If that's something else, that's great. If it's, you know, just diet and exercise is getting where you want to be, and that's phenomenal too. Like you just find the thing that's going for you and stay with it.

SPEAKER_01 52:31

Yeah, for sure. Last question, Kevin. So for someone who has transitioned into this wellness space after being an ER doctor, what's your non-negotiable, you know, for your own health and wellness? What do you do consistently? You know, no, no medication, no drugs, you know, drugs aside. Like what do you think is your the key to keeping healthy and what well?

SPEAKER_00 52:53

Well, for me personally, I stopped working overnight shifts. Uh-huh. And I feel bad saying this because I'm still a little bit I still work in the ER part-time. And so I have colleagues that are still in the thick of it. But as I got older, the night shifts were just, you know, so I just they were just physically bad for me. I just could feel it. And I think I could I could handled it fine when I was younger. And I I I could do those all day long, but now it just, it's just too much. My body's changed. And so for my personal health, like valuing my sleep has been really important. And also for me personally, I think uh more universally is exercise. Like I, you know, I've just hit I feel like I've hit the age where if I'm not moving, I just start stiffening up and I'm in pain. Yeah. And so I'm always trying to be moving.

SPEAKER_01 53:34

And how I always like to, you know, bring in the subject of Ben, you know, we're here. All the people I've brought into this podcast live, work here. How does you know having flow wellness here in such a unique city like Bend with such beautiful, you know, surroundings and such an active lifestyle that it provides us with? Like, how has that enriched your own experience as a doctor? And, you know, being the director of flow wellness, like what's the pop how does the population work with you and this function?

SPEAKER_00 54:06

I think, you know, people, you know, are like you moved to band because you for most people there tend to be outside oriented, but that does take a level of physical fitness, even if it's just going for a hike that a lot of us take for granted, honestly.

SPEAKER_02 54:16

Yeah.

SPEAKER_00 54:16

But when you get that taken away, that's all you think about. And so being in a position where we can help people get back to that is really powerful. It's been really rewarding. You know, unfortunately, in the ER, what we do is give a lot of bad news out day in and day out. And it's nice to turn that on its head and take a problem and actually help with that person's work with them to have them solve it and get back to where they wanted to be. Um, that's been really rewarding.

SPEAKER_01 54:40

Yeah. Well, thank you very much. I really appreciate your time and your experience having come into this podcast.

SPEAKER_00 54:46

Well, thank you. It's been a great talking with you.

SPEAKER_01 54:48

Thank you.