[00:00:00] Speaker A: Welcome to Real Medicine, real lives. I'm Dr. Yasser Sambal, and together we're showing medical expertise in a human way.
[00:00:07] Speaker B: Hello, everybody. Welcome to Real Medicine, Real Lives. I'm your host, Dr. Yasser Sombol, and we're here today to discuss real medical issues and practical things for people to learn.
I'm joined today by an excellent companion, Hilary Bailey, who is the owner and founder of Common Freedom Caregivers and Companions. Freedom Caregivers and Companions.
This is a kind of a home health service and we're here today to discuss with her, you know, all things related to home health. I think this is a very important issue as we enter an age where an era where there's a lot of aging people and sick people.
Home care is very important. There's a lot of people that require extra help at home. And so can you just give us a little bit of an idea about yourself and about your business and what exactly you do and what you offer?
[00:01:04] Speaker C: Absolutely. So my name is Hilary Bailey. I'm a certified dementia practitioner and a physical therapist assistant by trade. And I am the owner of Freedom Caregivers and Companions. So we do non medical and home care. So we're going to take care of seniors in their homes and help them with things, daily activities such as bathing and dressing, maybe some light housekeeping, helping with meal preparation, medication management, things of that nature, just so they can age in their home where they love to stay.
[00:01:32] Speaker B: Perfect. And does it only apply to seniors, what you do, or does it apply to just a general population that just requires that kind of care at home?
[00:01:42] Speaker C: So we can take care of anybody 18 or older. We don't do pediatrics.
I don't have the staff to handle pediatrics, but it can be anybody 18 or older. So we have clients whom we just take care of after they've come out of the hospital for surgery. So say if they've had, you know, a cabbage or a knee replacement and they just need somebody there for four to six weeks to help them, you know, we can be there to do that. But we also have clients that we take care of 247 that need all of their needs met every single day. So we can. That's the kind of the.
What we do.
[00:02:12] Speaker B: Okay, so give us a little bit of insight. You know, obviously not only is it a burden on people themselves when they're sick, they feel like they're overwhelmed and there's a lot going on. And they also feel, you know, they're a burden on their family. I mean, I know from personal Experience with my mother, for example, she hates when we have to take care of her because she feels like a burden on us.
And you know, you can run to that point where there's a point where there's a burnout level, obviously taking care of family members, because you have your own life as well, whether it's work, your own children, your own family. So you're kind of trying to balance all that together.
[00:02:48] Speaker C: Yes, sir.
[00:02:48] Speaker B: So maybe give us some insight into what you think are some of the signs of burnout for people when you know they're taking care of loved ones at home that are ill, that require that kind of care.
[00:02:59] Speaker C: Okay. So I kind of look at it from a mind, body, spirit perspective. So, you know, as far as body goes, you can have, you know, fatigue, trouble sleeping, body aches. As far as the mind goes, you can be angry, you know, completely stressed out, feel resentment towards the person you know that you're taking care of.
So it's just you have to know what that looks like for you. I think that's the most important thing.
[00:03:27] Speaker B: And so when people are able to maybe identify those things.
What are some of the things that you recommend to families? I'm sure you run into this, that you recommend to families if they are running through this burnout process and what they can do to not only be able to handle taking care of their family member along with the help that they're getting from you, but also take care of themselves in the process.
[00:03:53] Speaker C: So like I just stated earlier, it's very important for them to know when they're going to reach that limit. So, you know, when we get stressed out, it may start here, then we're going to come here. They're like, okay, when we get here, we know we need to reach out for help. And I think it's all about community. I think one of the biggest things that's underutilized are support groups for caregivers.
I think people have the mindset that, oh well, I don't want to go sit down and talk about my problems for an hour with someone. No, it's about building a community. It's about being able to call someone and say, I'm having a really hard day with my mom or my dad and I need to talk to somebody about that. I need to get that off my chest.
They also need to take their self care seriously.
I think there's guilt on both sides. I think as daughters and sons, we think, oh well, I'm not doing a good enough job taking care of my family member or I just feel guilty I can't do enough because I'm so busy over here. So they need to know that that's okay. And it's okay to even seek a therapist or a counselor or somebody to talk with that about. It's just being open and honest with yourself, knowing your limits of what you can and can't do for the one that you're taking care of. So. So if maybe you're okay with helping them to the grocery store, but you're not cool with the showers.
Some sons, they don't want to give their mom a shower. That's not comfortable for them. Right. It's just not something they want to do. So know what you're comfortable with and be okay with that and communicate that and get the help for the things that you need.
[00:05:24] Speaker B: Sure.
And so, you know, identifying things, talking to people, having another network of support is obviously very important.
What are some things that they can do for themselves, whether it's physical activity or whether it's meditation or other things that maybe just by themselves they can do to kind of recollect and regroup and be able to kind of move.
[00:05:50] Speaker C: Forward through this process, doing what they love to do. Exercise, just like you said, very, very important. I think that's a very underutilized drug these days.
Again, I mean, you hit it spot on, Dr. Cymbal. It's just meditation, taking time for yourself, doing things you like to do. What do you like to do? Do you like to go for an hour and read a book?
Do you like to go to the movies? It's doing things that you like to do and taking your self care seriously.
[00:06:19] Speaker B: Sure. And I think that's really important. I mean, when I, you know, I still practice medicine and when I still see people in the hospital, for example, and I see family members that come and they're staying there, you know, night after night after night. And a lot of times I tell them, you know, you need to take a break. You know, we, you know, they're in a hospital, they're in a safe place, There's a lot of people here to take care of them. And so you need to make sure you go eat and you go shower and you go get some rest and you have a good night's sleep. Because taking care of yourself is a big part of being able to take care of somebody else in that, in that aspect.
[00:06:52] Speaker C: Couldn't have said it better myself.
[00:06:53] Speaker B: Sure. And, and so what areas out there that you can identify, for example, or tell people about, for reaching out for certain support Systems and what's available to people that they're not aware of, maybe that's out there.
[00:07:12] Speaker C: I think, like I said earlier, the biggest things are support groups, and they're very easy to find. They actually have a lot of support groups at, like, assisted living facilities and memory care.
You know, I don't. You know, some. Most of my clients have dementia, so there's specific groups for, you know, Parkinson's caregivers and dementia caregivers. It's as easy as getting on Google and Googling support groups for caregivers.
Yes.
[00:07:38] Speaker B: And what. What advice would you give people? I mean, I think there's a lot of people out there that would say, I feel really guilty bringing somebody in to help me take care of my family member because this is my parent or this is my child or this is whoever. It may be related to them, and they feel this obligation that they're the only ones that have to take care of them, and that's their responsibility.
And so what advice would you give people to over kind of come that guilt feeling that it is okay to ask for help because this may be beyond their scope of what they can do.
[00:08:12] Speaker C: So one of the first things that we ask our family members when they call is, how is taking care of your loved one affecting you?
And we let them identify that and we let them talk about that.
And I think just realizing what's going on and saying it out loud is.
And us being able to mimic, tell them it's okay that you're feeling this way. And I also think you want to start slow with the. In home care.
I'm not a big fan of sending a new caregiver out there for eight hours a day, five days a week. I think we start slow when we let them develop a relationship. And I think the more the caregiver's in there, they get used to the caregiver. They cultivate a relationship with the caregiver. Things become easier because when they allow themselves to have that rest, then they're like, oh, wow, I didn't know, you know, how stressed out I was until I allowed this to happen.
[00:09:06] Speaker B: Great. And so can you tell us more about your, you know, your business and, you know, what practice areas that you reach out to, what areas of Houston that you're available in, how people will be able to get ahold of you? Absolutely. Things like that.
[00:09:21] Speaker C: So we cover all the way down to the Memorial area. We go west up towards Katy, Sugarland, and all the way up to Montgomery. We don't have any caregivers. On the east side of 45 Humble and Kingwood. Quite yet we're looking for some, but there are several ways you can get ahold of us. You can call us at our number, 346-468-1000. You can get on our website and ask to speak to somebody there.
I provide if you just have questions. I've been in senior care for a while. I've worked in skilled nursing facilities. I just want to be a resource for people. So if they have any questions and they want to call and just say, hey, my mom's in the nursing home and this is about to happen, these are the options that they're giving us, you know, help. What do I do?
I just love to be a resource for them or come out and just sit down with the family, do an in home assessment. With my PT background, I like to do an assessment of the safety in the home as well. That way, you know, if we need grab bars or a shower stool or we've got, you know, throw rugs or things like that that need to be addressed, I go out and do that for free. And maybe we help them and maybe I was just able to give them some information.
[00:10:29] Speaker B: Perfect. Yeah, I mean, I think that's really, really helpful. So again, we're, we're here with Hilary Bailey with I Keep Forgetting Freedom Caregivers and Companions talking about home health. And at this time I think we're going to take a little break and we'll be back to talk some more.
[00:10:46] Speaker A: Stick with us. We'll be right back with more real stories, real breakthroughs and real lives transformed.
And we're back. I'm Dr. Yasser Sombol. Let's dive right back into today's medical conversation.
[00:11:03] Speaker B: Hello and welcome back to Real medicine realize. I'm Dr. Yasser so fumble. I'm your host today and we're here with Hilary Bailey from Freedom Companions and Caregivers discussing home health. And so we're going to come back to our conversation.
So some of the things I'd like to talk about in this segment would be to talk about transitioning to home health. And when people are looking for home health and transitioning to that point, how, how do they go about making a decision? Because there's so many obviously home health agencies and companies.
So how do you make the decision to say this is the kind of home health care that I really want for my family member?
[00:11:48] Speaker C: So I think the first thing you need to look at is what are the needs.
So since we do non medical in home care you're gonna wanna look at. Okay. Are they needing skilled, maybe skilled nursing care? Do they need to go somewhere where they can have someone administer their medications or maybe they have wounds or maybe they need some physical therapy to get strengthened up? Or are they only just needing help with the things like bathing and dressing and just need a little help inside the home? So I think the first thing you want to do is decide what kind of care is it that you actually need.
You need to be open and honest with the person that needs the care. I can't stress this enough.
There have been situations where I've walked in and you know, the family will say, well, we told them that this is, you're from this place.
Because they don't. The person is very adamant about not having someone in the home unless it's for, you know, xyz. You have to start that conversation and be open and honest with whomever is going to be receiving the care.
Let them make decisions when it comes to their, their care. Let them have a say if they have dementia, you know, or are bed bound or something like that. That's different. But they need to have a voice in what kind of care they have. Again, start when you're shopping, you definitely just want to, you know, if you're going to go the agency way you want to. Things you want to look for in the agency are do they send the same caregiver? Do they have backup when the caregiver is sick?
You know, for me we have a nurse on my staff. There's tons of home care agencies that don't have nurses on their staff. So we're able to take those higher acuity level clients through end of life.
You want to know, do they background check, do they have a valid driver's license or are they safe? Are they someone safe that's going to be coming out to my home?
It gets a little more complicated if you want a private pay caregiver because the family, you're going to be the ones that are, you know, trying to background, deal with taxes, deal with scheduling. Do you have a backup family member that can come in if that person, private pay person doesn't show up, things like that.
And then you want to, when that person starts coming out, have a clear set of guidelines for them like what are we doing in the time that you're here, what is acceptable for them to do and what is not acceptable for them to do? Start slow and give it time. What happens that I've seen in my company is we have a lot of clients who say, well, I only want you to come for four hours a day, twice a week. But they cultivate that relationship with that caregiver. And the family member loves the relief that they're getting, the client loves the help that they're getting. And they form this relationship with someone other than their family member that they talk to and that they love. And they end up calling and saying, hey, we'd like to have more time with Gina or Sarah or whomever is their caregiver. So start slow.
If it's not the right fit. Sometimes that happens with me as well. The caregiver may just not be the right fit for that client. So you want to have an option to say, hey, this person just may not be the right fit. Can we try someone else? And I think when you go through an agency, it's much easier to do that.
Just a couple of tips.
[00:14:52] Speaker B: So give us an idea of, you know, you mentioned a nurse on staff, so maybe you might want to just tell us kind of what does, you know, your agency, your staffing, the people that go to the homes, what are their qualifications, what are their backgrounds, et cetera, you know, are they all nurses? Are some of them medical assistants? You know, what is the range of what you should expect when a home health person comes that, that their qualifications would be.
[00:15:19] Speaker C: So with a skilled home health agency, which we're not, you're gonna get a nurse and physical therapy and things like that. With non medical in home care, with what we do, all of the caregivers that work for me, I have a bit of a higher standard. So the state says they just have to be 18 years or older and have a clean background and they can come work for you.
My standards are a little bit higher.
They have to have at least five to seven years of home care experience or they have to be a cna, an emt, have some sort of certificate or medical training.
I have an RN delegation program, so I do have an RN on my staff. So under the license that we carry through the state, we are allowed to give medication reminders. Basically say, hey, Mr. Smith, here's your medicine, you need to take it. We're not allowed to dose it, we're not allowed to work with oxygen, give eye drops, nose spray, anything like that. With my RN on my staff, she goes out, she can train my caregivers to do that. She can train my caregivers to administer the pre dose medication. So if someone that has dementia that they're taking care of by themselves, we can make sure that they get their Medication or if they're, say, on hospice care, end of life and they need suction or, you know, catheter care, things like that. We're able to take care of that because of the RN that I have on my staff.
[00:16:31] Speaker B: Okay. And I'm glad you brought up the hospice things. So you mentioned hospice. So do you guys do hospice through your agency as well?
[00:16:38] Speaker C: No, we do not. We do care for a lot of hospice clients, though.
[00:16:43] Speaker B: So maybe you can explain to people the difference between somebody who's on hospice care versus somebody who's just getting home health, you know, the way through your agency.
What are the differences in what services may be offered or not offered?
[00:16:57] Speaker C: Okay, so with. And this is just what I know of hospice, one of my very good friends, Michelle Lowe, she owns Benchmark Hospice and she's amazing and she's taught me so much about hospice.
I think a lot of people have a bad taste in their mouth about hospice because they feel like, oh, if I'm going on hospice, it's, you know, I'm going to pass away in, you know, two to three days or a month or it's just not that. It's just an extra level of care for somebody that has a disease that there is no. A chronic illness that there's no cure for. So with hospice, you're going to get a nurse that visits once a week, you're going to get a chaplain, you're going to get an aide that's going to come out three times a week to bathe you.
I think they provide a social worker just for support. So it's just an extra level of support. We are more coming in to do the daily tasks that hospice isn't going to help with, like, as far as cooking the meals, taking them to appointments, or, you know, providing transportation for their loved ones, you know, giving them showers on the day the hospice aide doesn't come, things like that. The daily activities is what we're gonna do.
[00:18:02] Speaker B: Great. And so what would be, you know, when you're. Let's say I'm signing up my family member for home health. And what would be a good transition into that home health? How do you set a plan to say we're gonna transition into this so everybody kinda is on board and comfortable moving forward? What's the transition process going into it? How do you start it? How do you adjust it?
How do you set those milestones to get to where you need to be?
[00:18:33] Speaker C: That's a good question.
I hope I'm going to answer this correctly for you.
So, like, I talked about earlier, you know, on the family side of it, before we get involved, it's about honesty and about them talking to the one that needs the care. And so once the families come together and decided, hey, this is what our loved one needs, then they're going to contact my company or whatever company they contact and we're going to talk with them. I'm going to go out and do a non medical assessment where I learn more about the client's cognition, their functional needs, how much they're eating, what they're not eating, what they like to do, what they don't like to do, anything and everything that we need to watch out for, what their chronic illnesses are, do they have chf, do they have diabetes or we need blood sugar, things like that. And I just talk with them and tell them what we can do. And usually together we, we can decide and we set a care plan that says, okay, the caregiver is going to come out four hours a day, twice a week and while she's here we're going to do a shower, we're going to change the sheets, do the laundry. Xyz, does that answer your question?
[00:19:35] Speaker B: Yeah.
[00:19:36] Speaker C: Okay.
[00:19:36] Speaker B: I think that's very helpful for people to know. And so I think, you know, what, what would be, you know, you talked about it, you see a lot of patients with dementia. Can you give us an idea of, you know, for people out there to know that home health is available for, you know, what's the broad range of patients that you see, the certain illnesses that you see a lot for besides dementia that require people to have home health?
[00:20:02] Speaker C: Oh my goodness. So dementia is definitely number one, chf. We have a lot of clients with CHF just because they may be able to perform the task, but their endurance, you know, is very, very low. So they don't have, you know, the capability to do that without having to rest every minute because they're so short of breath. Arthritis, people who can't move around very well with arthritis.
We've had some clients with amputations and like I said earlier, people may just need short term care after surgery. So, okay, neurological illnesses, I would say Parkinson's, dementia are gonna be up there at the top. At the top.
[00:20:40] Speaker A: Gotcha for sure.
[00:20:41] Speaker B: And for surgical, let's say post surgical patients that you guys help with at home, that involves, I assume, some wound care stuff or does that not part of home health?
[00:20:51] Speaker C: So we're, so we're in home, we're not skilled home health, so we're just in home care. So no we can do non sterile dressings, but we cannot do like sterile wound care.
[00:21:00] Speaker B: Okay. And most of your, you know, as a, as a physician and as I see patients in the hospital and I see some of this dynamics happen.
Where, where do, where do you mostly get your referrals from? Are they coming from patients in the hospital that you know, the hospital is contacting you guys to help these families at home at the request of the family or do just patients, families reach out to you mostly on their own and set this process up with you?
[00:21:29] Speaker C: So for me, we've been open and operating for about 18 months, I would say. We've had two hospice companies that have been really big to refer, but really word of mouth.
The first couple of clients that we had just given gave our name to people because of the exceptional care that we provided. I also am a member of some networking groups and so I've been blessed to take care of some of their family members who they've shared my information with.
So yeah, I don't.
I guess I'm very different than your normal owner that goes out and hands out cards at hospitals and doctors offices and things like that. I probably should, but we just stayed so busy with the word of mouth referrals and the hospice referrals that we get. It just hasn't. I haven't had time to do it.
[00:22:14] Speaker A: Sure.
[00:22:15] Speaker B: And maybe I understand. I completely get it. Life is busy. But you know, as long as it's working.
[00:22:19] Speaker C: Yeah.
[00:22:20] Speaker B: And just maybe briefly you can touch on one thing. Obviously, you know, expenses are an issue. Right. So the question, you know, maybe that people might have is, is this something covered by health insurance or is this something that's strictly out of pocket and cash only?
[00:22:34] Speaker C: So yes, most of the time it's cash only.
Now the two questions I always ask people when they call in first, number one is, is your loved one a veteran? If your loved one was a veteran that served in wartime, I beg of you to call the VA and get them in the system and try to get them benefits if they need help because the VA will provide what's called aid in attendance. So that's do that. Number two, long term care insurance.
If you don't have a doctor, Sombol get you some. Okay, you got it. Long term care insurance will cover most of the cost of what we do. But a lot of people don't spend the money on it because it is very expensive. And it's one of those if you don't use it, you lose it. I am 45 and I have My husband and I have it because I know how expensive it is. But yes, expense can be an issue. It really can because it can get costly when they need, you know, more than, I don't know, a week, you know, sure, it can get expensive.
[00:23:31] Speaker B: Great. Well, Hillary, it's really been a pleasure speaking with you. It's been a lot of fun. I really enjoyed this topic. And if you can just let the viewers know how they can get ahold of you at Freedom Care, Freedom Companions and caregivers, and again, once again, how they can get ahold of you and reach out to you if they need your services, that would be great.
[00:23:48] Speaker C: Awesome. So, guys, you can reach us with our phone number at 3, 4, 6.
You can go to our website, www.freedomcaregivers.net and you can type your information in there. I'll get an email and give you a call. You can go to our Google page and put your information in there, which I'll also get an email and we'll contact you to set up your free assessment.
[00:24:10] Speaker A: Thank you so much.
[00:24:11] Speaker B: Thank you everybody for being with us. We'll be back in a little bit to continue the show.
[00:24:16] Speaker A: Stick with us. We'll be right back with more real stories, real breakthroughs and real lives transformed.
And we're back. I'm Dr. Yasser Sombal. Let's dive right back into today's medical conversation.
Hello everybody, and welcome back to Real Medicine, Real Lives, where we're here to discuss real live medical issues and life changing topics to see if we can improve our health. I'm your host, Dr. Yasser Sambal. And today we're discussing the issues of diet during, for example, menopause. And we have a very, very excellent guest with us today, Bonnie London, who's a registered dietitian, an Expert for over 20 years in the field, founder and CEO of London Wellness, which has been in business for over the last 15 to 20 years.
Thank you, Bonnie, for joining us today.
[00:25:10] Speaker D: Thank you.
[00:25:11] Speaker A: So I think a lot of people, you know, menopause is obviously a big deal. And so clearly everybody goes through it at some point in their life. Every female at least goes through it at some point in their life.
[00:25:20] Speaker C: But.
[00:25:21] Speaker B: Right.
[00:25:21] Speaker A: And so, you know, it's one of those things where there's a lot of changes, whether it's hot flashes, weight gain, all sorts of things that may happen and women may not understand what's exactly happening because I would assume those things such as weight gain and fatigue, et cetera, proceed when they actually go through menopause. So it probably starts before they actually go through menopause and then kind of gets worse during menopause.
So we're here to kind of break down the issues. So thanks for joining us to kind of help us with all this. So kind of, just to start off, I'd like you to tell me, what do you think about, you know, how does menopause really impact metabolism and weight?
[00:26:00] Speaker D: Yeah, this is huge because I have many people that come to see me. I probably get a call at least once or twice a week where women feel that they are doing. They're eating the same, they're exercising the same, but all of a sudden their body is definitely not the same. And particularly troubling is fat around the abdomen. And it is not anyone's imagination because a lot of changes are happening as we go into menopause. And the biggest thing is for sure, obviously, with the drop of estrogen. And this has a lot to do also with the energy storage hormone insulin.
And as we go into menopause, we actually become more insulin resistant, meaning that your body is not as sensitive to insulin. And then on top of that, in, like, something cruel, cortisol, which we know about stress, but it also has to do with belly fat, we actually have more receptors after menopause in our abdomen for cortisol. So that means, yep, you are more likely to store weight around your abdomen and menopause.
But then another thing that happens as a result of this change in estrogen, when we were teenagers, before menopause.
[00:27:26] Speaker E: Our.
[00:27:26] Speaker D: Fat cells are something called hyperplasic, meaning that they will multiply the subcutaneous fat that sometimes people don't like on our hips and thighs and whatnot. But that's the good kind of fat. That's like the healthy fat.
But then, yep, as we go into menopause, they become hypertrophic, meaning that they grow kind of like big balloons. Each fat cell and these become more dangerous and become inflated. And it's more than, I would just mention aesthetics, because that abdomen, and it's another word, visceral fat, is particularly dangerous, as, you know, as a cardiologist.
However, it's not all bad news because there are a lot of things we can do.
[00:28:14] Speaker A: Great. That was very, very enlightening. So, you know, if. If people were saying, okay, what can I do during menopause to try to help me? So if they're looking at dietary changes, you know, to try to help with the symptoms and just the physical changes that happen during menopause, what would be your recommendation to them?
[00:28:33] Speaker D: Well, first I would, I would go back to mention that when a lot of people come, a lot of people think, oh, I gained weight, I eat less, exercise more. And typically my answer to them is actually the opposite. We need to stop starving ourselves and we need to be eating the right kinds of foods, which I talk about this ad nauseam, which is protein, protein, protein, keeping that blood sugar stable. I have walked many women post menopause lose tons of weight by helping keeping their blood sugar stable.
And also that protein can also actually boost the metabolism. And then exercise is the next part of it. Because this chronic cardio, like going to spin class, like four days a week, actually, guess what? It can increase cortisol. And again, so this is not a good idea either. So there is definitely some good science about kind of alternating your workouts, doing interval training of some sorts. And then I cannot emphasize this next one enough is, is weights, weights, weights, and building muscle. This is. This is huge because once again, this has to do with not just your metabolism overall, but that insulin, right? So the more muscle you have, every time you eat a meal, you have more places for that glucose to go.
So between those two, we can definitely. And I have definitely turned the ship around for many women.
[00:30:07] Speaker A: Great.
So would you say there are certain. If you had to advise people on certain nutrients or specific foods to use during this time that really help kind of keep a balance in that hormonal state, what would you. What would you recommend?
[00:30:22] Speaker D: Well, again, besides getting adequate protein, which the recommendations are about 1.6 per kg, so for someone who's like, you know, let's just say, you know, 120 pounds, I mean, we're talking at least 100 grams a day about a protein. And other than that. Absolutely. A cornucopia of vegetables, fruit, and then do not be afraid of fat.
Now, I am all talking about macronutrients here, but I have to say these are precursors to hormones. And we have shied away from fat from the 1980s, women going into menopause now, and this is a big mistake. So that is another big change. So definitely get rid of, like, any non fat, no fat, anything. This is. This is a game changer right there.
[00:31:14] Speaker A: Yeah, I mean, I think it's really interesting that you brought that up. Right. Because I think people really have a misconception about what dieting really is. I mean, you hear all these fad diets, right? So, you know, paleo, keto, no carbs. You know, carnivore diets. I mean, they're just kind of all over the place. And really, some of them work for some people and some of them don't.
But I think the message may be, I mean, I'm interested to hear your thoughts, you know, when people come to you about these diets, about these fad diets, because you mentioned a lot of different factors, insulin resistance, cortisol levels being high, which can lead to fat accumulation, insulin resistance, which doesn't allow you to digest your food appropriately. You know, all these things that you talk about. And so, you know, we've trained people to kind of look for these quick, fast ways of losing weight, which are, I think, in my opinion, non sustainable. But I, I would love to hear your opinion when people come to you about this kind of stuff. And what do you recommend?
[00:32:15] Speaker D: Well, you hit the nail on the head. This is an excellent question, because this is what I talk about.
[00:32:19] Speaker E: I don't, I.
[00:32:20] Speaker D: It has to be sustainable. Like, it's not, this is not about like losing weight for someone's wedding, although people come to me for that. I mean, but this is really for your life.
So, I mean, there's all these different diets out there. I always like to mention that I'm an omnivore and I think, which means I eat everything. And I think this is really important. As we are looking towards experts to get advice, you want to think about what diet that they are subscribing to because there is going to be a bias there. And personally, yeah, I don't think there is like a perfect diet out there. I mean, certainly the Mediterranean diet and once again, whole foods diet. But there is no question that, you know, even among the experts, it is agreed that whatever diet is able to, that you can maintain and that can keep that insulin low is going to be the best diet. So whether or not again, the extreme of carnivore or even vegan, which to me would be much more difficult to adhere to, and you really got to know what you're doing, because I've seen some unfortunate situations with. That is what I would say.
[00:33:33] Speaker A: I mean, if people come to you and say, you know, I just need to cut carbs out when you, when you hear that? Because I hear that line all the time. You know, as a, as a healthcare provider, when people are talking to me about it, would you tell people that, you know, no, you don't need to cut carbs. What you need to do is, you know, have a certain amount of carbs. Because would you say it's equally important to eat carbs, protein and fats, or is it Best for some people to cut one of those out.
[00:34:00] Speaker D: Yeah, I mean, as we get older, as I was mentioning, you become more insulin resistant, meaning that we don't tolerate carbs. So, so, so when we talk about carbs, vegetables are carbs, you know, berries are carbs. So obviously those carbs are much more slowly digested and I'm definitely on top of those. But now as far as the, the ones that actually can trigger, break down to glucose and trigger insulin.
Yeah, we kind of want to back off of those, whether it be bread, which is a whole rice, potatoes, all of that. So I try not to wanting people to feel totally restricted because it's much more complicated than just not eating carbs. But actually I think what's much more important is to focus on the foods we need to get in. Right. So in other words, if you have some pasta with your salmon and broccoli versus like a bowl of pasta, that's like a whole different story. And then everyone is again an individual and there are people that do need to cut back. And what is interesting to note again for this generation going through menopause is that believe it or not, we don't have any essential carbs. I just think that is very interesting.
[00:35:13] Speaker A: So I'm curious from your perspective because again, these are questions I get asked all the time when people come to you as a dietitian and they're saying, you know, I've really tried to diet, I'm not losing weight. And you think about insulin resistance and now new therapies that are out there, such as Ozempic, WeGovy, all these semi glutide drugs that people are trying to use.
What is your opinion about that as a dietitian when it comes to using those medications?
[00:35:40] Speaker D: Well, I think they can be a tool. I'm still learning about them and I think they can be great. I think they have been mishandled though. In other words, it doesn't take away doing the heavy lifting like what I tell people to do as far as making those appropriate diet choices. And then yes, exercising and building muscle, unfortunately. And again, I've seen some tragedies too. In my, in my office.
Some people, they have struggled with their weight for most of their life and.
[00:36:12] Speaker E: Now all of a sudden, oh my.
[00:36:13] Speaker D: Goodness, I don't have an appetite. So they just think they could just not eat. And so it's nothing to do specifically with these medications I' are out there. It's the fact that if you don't eat on any diet, bad things are going to happen. And you're going to lose muscle and if you don't work out and do all that. So again, I think they can be a tool.
And actually, one of the more interesting things that have come out recently is the suggestion that maybe they can prevent metabolic adaptation. In other words, when people lose a tremendous amount of weight, what one of the major issues is is that now they have to stay at that lower amount of calories and continue crazy exercise where these medications may offer some benefit for that. But again, without proper, like, maybe professional guidance, I think it can be kind of scary.
How's that?
[00:37:12] Speaker A: Thank you, Bonnie. That was, that was really, really insightful.
So, you know, next we're going to talk about digestive health soon.
You know, it's something people struggle with all the time but often don't understand why. So everybody just stay tuned. We're going to go to a quick commercial. We're going to come back with some second part of our segment today. Stick with us. We'll be right back with more real stories, real breakthroughs and real lives transformed.
And we're back. I'm Dr. Yasser Sombal. Let's dive right back into today's medical conversation.
Welcome back, everybody, to REAL Medicine, Real lives, where we're here to explore the issue today of diet. And it's a very crucial subject because we're looking at digestive health. We're joined today by Bonnie London, the owner and founder of London Wellness and an excellent registered dietitian with over 20 years of experience.
So, Bonnie, a lot of people, you know, complain about abdominal pain or certain things that may happen related to to diet, and they're not really sure why they get these things related to certain foods that they eat. So maybe you can help us by kind of demystifying and explaining some of this a little bit more to our viewers. And one of the things we start out with is just what are the common signs of digestive health issues related to diet?
[00:38:28] Speaker E: Well, first of all, I would say these digestive health issues have absolutely increased and exploded. And I get calls every week where it's really impacting people's quality of life for, for sure.
And so, of course, bloating, I'm going to say it is not normal to be bloated.
I'm sorry I said the word fart, but that and gas and pain, I mean, this, this, this is not normal, not to mention feeling the need to have to be to, you know, near a bathroom very quickly. But these are all kinds of complaints that people come in with that they just they realize they can't live with. Oh, and heartburn too. It's another thing people have kind of normalized with all the over the counter antacids out there. But oh, and then finally, if you're constipated, meaning you're not going every day to the bathroom or at least most days of the week, that would be an issue. And the other end of the spectrum, having loose bowels and diarrhea. So all of these things are not normal. And it is extremely important and indicative of what's going on in your gut, which by the way is really 70, 80% of your immune system resides in the gut. And it has a lot of responsibilities that bacteria, beyond just digesting your food and pooping it out the other end.
[00:39:59] Speaker A: So, I mean, I think that's excellent. You know, you're right. And your gut is a big part of your body and it carries a lot of important organs and a lot of important responsibilities besides just digesting your food.
When people have these signs and symptoms, I mean, what would be a good line for you when you say this is probably diet related versus this may be an actual bigger medical underlying issue and they should seek, you know, a physician's evaluation at that point?
[00:40:28] Speaker E: Well, first I would say, I mean, of course you always want to rule out like the mechanical part of what's going on in digestion as far as getting in an endoscopy or a colonoscopy for sure. But unfortunately I have many people who will go get these evaluations and it doesn't really shed light on where the root of the problem is, which is the microbiome, which is like this ecosystem of bacteria in the gut. So I would say regardless if it is, you know, irritable bowel disease or ibs, it doesn't matter. Food is going to play a tremendous part of it.
I mean, no, no, no question about it. So I would definitely be looking at the diet and trying to figure out the foods, of course, that are irritating that we can remove and the foods that are going to support dampening that inflammation.
[00:41:24] Speaker A: So I'm glad that we kind of went to that direction because then if somebody is deciding, do I seek medical attention or do I try to sort this out and see how, whether it's a diet related issues. What are some things people can do to identify food sensitivities or intolerances?
[00:41:46] Speaker E: Well, it is a tricky one. I do frequently recommend that people stay off of gluten and dairy to begin with. And I'm not saying that everyone has to be Gluten free or avoid dairy for the rest of their life. But this is one we, we know the top foods that actually poke holes at the gastrointestinal lining. And so it is well accepted now of something called leaky gut or intestinal permeability.
Because think about this for a moment. Where we are digesting and absorbing our nutrients in the small intestine is actually only one cell thick, right. So my first thing would be like, okay, let's take the top things off. And then there's other ones too, like soy, corn, and of course, sugar is very inflammatory. So these could be some easy things just to, to start out with. And then as far as food sensitivity goes, I actually recommend testing. Of course you can do an elimination diet, but honestly, it is tricky because you could eat something on Monday and it could be three days before a symptom shows up. And how are you really going to identify that problem?
And just so you know, a sensitivity is much different than an allergy or an intolerance. An allergy is something that is going to give you like an anaphylactic attack, like peanuts, as an example, and you're going to have this for life. And then an intolerance is very common, like with lactose, just as an example. So you cannot tolerate the lactose that's in dairy. Whereas a food sensitivity, these things, they.
[00:43:24] Speaker D: Can come and go.
[00:43:25] Speaker E: It doesn't have to be, you know, forever. So what I do with people is once we've identified some of these things through testing, and then we eliminate them temporarily, which enables us to go in there and really heal the gut, then we can reintroduce these foods and see if it's now okay.
[00:43:45] Speaker A: And that's great. And so are there, for example, let's just say maybe a top five list. When people come to you to talk to you about certain digestive issues or digestive health, are there five pretty common things that most people are allergic to, to kind of, maybe the audience can relate to or symptoms that they can relate to that well.
[00:44:07] Speaker E: Again, symptoms like you can't, it's hard to identify because it can take days. But a lot of people are shocked to find out when they get rid of gluten, how much better they feel. And again, dairy, maybe not all dairy, like I think fermented foods are absolutely better tolerated like yogurt and kefir, but just flat out milk. I mean, I have a lot of people just gotten rid of that and immediately it's been a game changer. And then just staying away from a Lot of these processed foods that we know are also attacking the gut that are loaded with pesticides, glyphosate, like all the cereals and of course eating out. I think people know fried foods probably not a good idea. But what they may not be aware of potentially is, is that we have all of these industrial produced seed oils that have kinds of infiltrated our entire food supply. And the word is getting out there that these can cause a tremendous amount of inflammation. And yes, they can be irritating in the gut as well as they impact every organ in the entire body.
[00:45:18] Speaker A: Interesting. And so, you know, to emphasize the importance of gut health as well, I mean, what do you tell your patients or your, you know, about how important overall gut health is important for their well being?
[00:45:34] Speaker E: Well, a lot of things. First of all, you, you may be surprised that like the bacteria in the gut is actually the same bacteria that helps with sleeping, which is one of the reasons why we don't want to be eating late at night. So a lot of things that happen when we hurt, when we help people's guts is guess what, they're sleeping better.
So that is awesome. And also the gut is control of your weight. That's right. So they're like obese kind of bacteria down there versus like the skinny ones. And yes, it depends on what they feed on. And so there's a whole range, there's a whole massive studies that have gone on about that and implants and what has happened relative to weight. But then besides that, as I mentioned, of course it is, you know, the core of your immune system and a brain health. You know, there is a connection through the vagus nerve from your gut to your brain.
So if, if, like I, I do work with patients with Alzheimer's as an example.
So one of the things that I have done with them is definitely doing a gut healing protocol and thinking about that bacteria and how this can be crossing the blood vein barrier and impacting that.
[00:46:50] Speaker D: So basically.
[00:46:51] Speaker E: Oh, and then also hormones, it doesn't, it impacts everything but hormones.
[00:46:56] Speaker D: We're thinking about thyroid for a moment here.
[00:46:58] Speaker E: This is where your thyroid hormone, so your doctor is giving you, let's say levothyroxine for hypothyroidism.
But now we need the gut bacteria to be converting that into the active hormone T3.
[00:47:12] Speaker D: And so if your gut's not functioning.
[00:47:13] Speaker E: That'S not going to be working. Right. And then we're also relying on the gut for detoxification of estrogens that should not be there.
So you can see that the gut is Huge.
[00:47:28] Speaker A: Yeah, definitely. So it's, I mean, it's amazing how every organ kind of carries a certain responsibility. But you know, as a heart doctor, I think the heart is probably the most important. But obviously the gut is very, very important and probably a bigger, bigger deal. You know, I mean, people with heart disease, a lot of times they, you know, it's, it's one of three things that you're kind of looking at, but the gut is very complicated. So. I agree, I completely agree.
And you know, is there, is there maybe a couple things you can tell our audience quickly about just ways to improve their digestive health?
[00:48:06] Speaker D: Well, obviously, I mean, obviously sticking with.
[00:48:10] Speaker E: The whole foods and staying away from those foods that I already mentioned that can be irritating to the gut. You know, sugar, processed oils and fats and potentially gluten, dairy and whatnot, and just sticking with whole foods. And if you have GI issues, I mean, I recommend use it, you know, cooking like in other words, not doing raw vegetables as much or if you're going to do meat, maybe doing more slow cooked meat. And then another simple suggestion I have for people just to start out, it may not be everything, but it definitely helps quite a few people is apple cider vinegar, but please dilute it. So I suggest like a tablespoon and like a glass of water before meals because actually, ironically, we actually have less acid as we get older. I mean, by the time we're 50 years old, we have a decrease in this production of acidity in our stomach by like 30%. So a lot of times maybe that gas can be because we're not digesting food. So those are some simple things that people always feel better before really, you know, digging in deep and doing the testing and all of that.
But there are answers and we don't have to live with it is what I'm going to tell you.
[00:49:24] Speaker A: Gotcha. Perfect. So can just give us an idea how people can get a hold of you. I would assume, you know, that you do virtual visits or all sorts of kind of ways to, you know, take care of patients. But if you just want to let people how they can get ahold you, how they can find you, that'd be great.
[00:49:40] Speaker E: Thank you.
[00:49:40] Speaker D: Yes.
[00:49:40] Speaker E: So I have a website which is london wellness.net or you can definitely, which has all my information on there. But also you can email
[email protected] Perfect.
[00:49:53] Speaker A: Bonnie, thank you so much for shedding a lot of light on this topic today. Nutrition and health and gut health as well as related to menopause. These were all very, very, I think, important topics that, you know, affect a lot of people on a daily basis. So remember, everybody, if you're experiencing any ongoing symptoms of digestive issues, whatnot, you know, make sure you don't hesitate to contact a healthcare professional or contact Bonnie dietitian to kind of see identify whether it's a food related issue or a bigger medical problem. We appreciate you joining us today. Thank you very much for watching.
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Thank you everybody for tuning in to Real Medicine, Real Lives. I'm Dr. Yasser Sumbal. We'll see you next time.