Health Series 2: Houston Concierge Medicine / Dr Greg Burzynski

0:01 Welcome to another episode of Come Together and We're Live Doctor Burzynski. Did I pronounce that correctly? You did wonderful. How are you? Welcome. Thank you so much for joining me. How are you today? I'm very good, thanks for having me. Great, great. Can you? Do you want to start by telling me a little bit about yourself? Where you're from, who, who are you? What do you do? Sure. I am a board certified internal medicine physician 15 years out of residency. I was born and raised in Houston, TX and I grew up in a family of doctors and that's what I was exposed to and I ended up meeting my wife in medical school. We were not an item then, but later we became one and we continue that medical journey together, opening up a clinic, Houston Concierge Medicine.

1:00 And a part of that is also restore longevity. So we're passionate about helping people live their best life possible. That's awesome. That's awesome. And I know Houston's a huge medical town, right? Huge it is. Yeah, yeah, yeah, yeah. I sell. I sell medical equipment, refurbished equipment. And so we do a lot of business in your neck of the woods over there and it's very popular. How did your What is your What kind of medicine is your family practice when you say you come from a family of doctors? Sure. So the person that started this was my uncle. He was a cardiologist in Poland. And then my father was a physician and my mother is, well, he was one of the youngest people to finish medical school. And then being in Poland, it wasn't the place to be, unfortunately, during those Soviet times. So he escaped and was able to flourish in the United States. And along with my mother, she eventually came to Texas. And then they built their own practice and Research Institute. And he had a discovery, he discovered a treatment for cancer that was endogenous to the human body. And I grew up in all that.

2:17 Well, they're called the Antennoplastons. And it, it was a really interesting being around that when you're, when you're a kid and seeing people get better and you kind of get older and you realize that what you're going to do this is pretty cool. If you're at the intersection of helping people and being compensated for, why not? So that got me where I am today and I'm still passionate about helping people. And if it's almost not like it's work, but of course there are parts of medicine that are a little full burden, which every doctor knows about. But of course we do, because of the joy we get, hopefully for for the impact it makes in people's lives.

3:04 Totally, totally. I'm so, so it's so funny that you mentioned that immediately off the bat, because one of the things I was going to ask based on a lot of the stuff I was looking at in your site, it looks like a lot of non conventional stuff. You know that, you know, that I'm pretty surprised that doctors, you know, from your grandparents or parents would have been, you know, would have been, I guess, you know, excited about, you know, and I feel like today a lot of the stuff that you do, or I guess not today, but even as a 1020 years ago, a lot of stuff that you do today you offer red light peptides, Ivs, stuff like that. It was almost like poo pooed. Was that not the case when you were growing up? Well, I mean, like with red light therapy, for example, it's been out for a while.

3:49 It's nothing really new. It's called photodynamic therapy, but things coming in out of fashion. And I think today we're having a great renaissance in a lot of things that we sort of took for granted because we realized that people in general society, especially in the United States, is not getting healthier, which is rather sad, or life expectancy is taking a dip. So we're kind of returning to some basics. And so the fact that they're not standard of care or not billable to insurance does not mean they don't have a place in a person's life, right? Because insurance does not make money off of exercise or proper nutrition. But these are things that are obvious. So things like red light therapy are basically supporting us in a world where we're in essentially these fluorescent office buildings most of our day.

4:45 If you're lucky enough to be out there in the in the actual light and live a healthier life, and that's great. But a lot of times we need actual support to live a better life. Right, right. Actually, that, that that brings me up. You know, yesterday I did, I did a podcast with a friend of mine. Can you hear me? All right. Yeah. Named Jonathan Oswald and he's a buddy of mine and he, he told me he lived in Alaska for a year and I actually lived in Seattle for a year as well. And one of the things that we were talking about was was that the winters have really no, no natural light, you know, and in Seattle, I mean, not to the same extent, of course. He's more like missed, but can you kind of explain a little bit, I guess, you know, to a beginner like myself?

5:28 Yeah. You know what exactly is going on with that. Sure. So I we our bodies followed with circadian clock. We have a few clocks in our body. Ideally we should see a sunrise and a sunset. Now our great grandparents maybe had that kind of a lifestyle, but we've we've deviated a lot from it. And so if we're not able to get enough of the healthy light during the right time of the year, we may fall into a lesser level of health. And this is documented with seasonal affective disorder and people, the northern parts such as Scandinavia, European countries, even parts of like Alaska, there there is a light treatment that is able to reverse this because they are just missing that super important part of their lives. And that releases certain endogenous chemicals, proteins in our body.

6:22 And we're going back into the sync of things and feeling much better. So, so red light therapy has a lot of research, for example, supporting improvement of mood, relieving injuries, building collagen it, it goes a few nanometers into the skin and it simulates the powerhouse of the cell to mitochondria and kind of reboots everything. So if we're not able to be out in the sun as our ancestors, this is something that can take the place of that. Interesting. That's so cool. And does it? Does it? Does it I guess, follow the logic that there'd be a particular time of day that'd be better and more effective to get red light therapy if it's going to be based on our circadian rhythms? Right.

7:03 So I use it sometimes as a pick me up, so to speak, in the in the early part of the day. A lot of people use it in the later part of the day to help them kind of get that normal sunset feeling. If one hasn't, for example, had the best night of sleep, then they could get a little bit of the pick me up effect in the midday or early day. So you can use it either part of the day. Interesting, interesting. So cool. So, so your family, so your family has always kind of studied any kind of health and medicine that applies. So, so when you went to Med school, what was that? Was there a contrast between what you grew up with and what the teachers were trying to tell you or teach you?

7:47 Right. So the standard medical curriculum, I think everywhere we'll take a deep dive into the basics like biochemistry, Physiology, Physiology, anatomy, and then the treatments and the diagnosis is in treatment. So as far as going out-of-the-box, that's more of a self professed type of learning. I think everybody can say that for the most part, and I think a lot of people find it when their health deteriorates. So it finds you and then you realize, uh huh, this is something that is much better for me and makes sense. Luckily, I've never had my health deteriorate. I may have maybe been not the healthiest person at some point, but it was something that I always appreciated and to me was obvious.

8:36 And what I'd like to think about is just using everything in the toolbox. So I'd like to use my standard of care knowledge of, of the internal medicine, pharmacopia and all the things we do, but also all the other things that have been around for, for ages and the new things that are arriving. Right, right. And So what are you excited about? What's what's coming up that you're excited about? Well, I think we're living in amazing times right now. Hopefully we don't explode, right? Because we're kind of in this exciting time period, but there's also a lot of scary things, scary things happening, right? So we have technology that is becoming ever more powerful. Obviously, AI is here and in the next two years may replace a lot of jobs.

9:23 So just like, for example, Uber could not have been possible 30 years ago, there are certain things that I feel will be making the lives of people so much better, as will doctors. And we'll have this sort of confluence of a lot of things arriving and that will make the care more effective, safer and affordable. Now, how we get there is a question, of course, because this is not the IT world. We have lots of regulation in medicine, for better and for worse. But I'm I'm optimistic because I'm seeing so many exciting things arriving that can catch disease early and change the trajectory.

10:08 Right. So can you give me some examples of specific things that we're catching early? I mean, there's so many. I'm sorry. There's just so many different topics I want to cover over here. I'm just so excited to figure these out. Yeah, talk these out. Well, in the world of cancer detection, we are getting more and more tests that are able to find this horrible disease earlier and for the most part we can do better if we find it early. So I've been ordering the early detection test like Gallery. There's another test that's come to market that's a competitor and a third one is coming out and a fourth one. There are specific Oregon site tests that can tell us if you have what be what are the beginnings of a cancer such as Barrett's esophagus.

10:52 You can swallow a noodle type thing and it'll travel down to your stomach and then it brushes your esophagus to see if you have the beginnings of esophageal adenocarcinoma or a precursor lesion, right? Because really in today's world, we still screen for very few cancers. We look for breast cancer in women, we look for colon cancer. We look for cervical cancer and prostate cancer. The rest of the diseases, we basically say, good luck, come in for your yearly physical and hope everything happens well, right? But so many is. That because of lack of resources, why do we only? Why do we test those in terms for such a limited number of of types of cancers? Well, the way that medicine works is to get a test to the masses, we have to have lots of data saying that it makes sense. So at the same time, we have new technologies that are coming out that will hopefully be able to do that, but they will take time.

11:54 So right now, these tests are only available to the people willing to pay for them out of pocket and for doctors that are aggressive or interested in doing so. So that is the problem. And it's kind of like I'd like to say the Tesla Roadster, right, where first people that had the Tesla Roadster were relatively wealthy people, then you had different models come out eventually, the Model 3, which is kind of like the cheapest version that anybody can afford. So that takes time, and in medicine especially, that takes even longer. Right, right, right. So if you go. To an average type of clinic, you're just going to get that average set of options. Some people may have an out of pay option, but they might not be exactly willing to even talk about it. So unless it's blessed, so to speak, by an organization like the United States Preventative Task Force, a lot of organizations will not be using it until that blessing. But as you know, it takes time to get to there. So in the meanwhile, unfortunately, people suffer because they don't get the appropriate care. Now these tests might be expensive, but if they save your life, I mean they're well worth the cost in multiples. Sure, sure.

13:10 I could. Imagine. What? So what? What did your grandfather discover about cancer? Father. Father. Grandfather. I'm sorry. Father. Father. Father. I'm sorry. Yeah. What did your father discover how that happened? Did, I mean, I feel like I don't hear about the fact that we have cures for cancer. You know, is it a particular type that he's curing or is it, you know, is this information obscure? What about it? How did that happen? So he discovered that healthy people have an abundance of certain peptides and other things in their body that sick people with cancer, for example, are lacking. Then if he were able to isolate these peptides and reintroduce them to those people that are sick, some people have recoveries and are cured. So this is something that he developed, patented, and has been trying to get onto the market with some trials and tribulations.

14:06 This doesn't work for everybody, but some people are beautiful responders and have lived their lives and are cured. So just like with anything, some people are able to do well, others not so much. But the good part is the toxicity is very minimal as compared to other things. And right now in cancer as well, the treatments are getting a bit better and the outcomes as well. So right now the treatments that I think that might, you know, the only the, the main ones that I've heard of obviously are chemo or you know, surgery, you know, so I guess something more invasive. What other what other methods do we have at the moment? So the biggest thing that's come to market in the past 15 years or so are the immunotherapies. The immunotherapies are super exciting. They unlock the immune system's brakes, so to speak, in one's body, and that immune system attacks the cancer cells. And some people can have really durable long remissions. Some cancers are more what we call immunogenic or hot. So then that treatment can be extremely effective, while previously the patient would have had to suffer and not do well.

15:18 So there as well are these things called targeted therapies. They are like smart chemos, but they're not cytotoxic chemotherapy and they work on the signaling pathways and gene pathways in a cell. So a lot of cancer, what we think is basically a software glitch or problem. And if you add these medicines on board and you know the fingerprint of the cancer cell, the disease, then you'll ideally have a better outcome. I see. OK. So it's kind of being able to narrow down the part of the body that needs the that I guess where the cancer is and being able to target it and then help provide the immune, immune support. So it's kind of like back in the day when we had infectious diseases and we were just sprinkling the same antibiotic and everything and it wasn't working quite well. We we got more sophisticated and we were able to delineate which bacteria could be more responsive to other treatments. And that's what's very nice about the past few years. We are able to do gene analysis on the cancer tissue and blood and see exactly what this disease is representing on a very sophisticated molecular level. Because previously we were just looking at the pathology, which is basically the microscope pattern recognition of a cancer, which is, which is, which is

16:51 great. But that has that's the technology that's been around for 150 years. And with this type of technology, we're able to get to the nitty gritty and hopefully get smarter options into the into this, into the cancer cells of the body and have way better responses. So you can have, for example, a scan like a PET scan, which is showing all these areas of tumor and a body and patient be riddled with it. But if you give the right recipe or treatment, that next follow up scan could be nearly clear or clear. And that's the beauty of some of these treatments. So that's right. So with the help of things like AI and and better therapeutics, hopefully we'll have more of those things. Yeah, I've heard a couple of I'm going to butcher his name, but Chamath Pali Patiya, whatever is I don't ever had to pronounce his last name.

17:44 But he was mentioning how his, you know, I've heard him say a couple of times already that when it comes to breast cancer screening or actually, you know, surgery to remove a tumor, that I think he said like 30% or 33% of doctor of physicians do not entirely remove the tumor. And and then the woman has to go back. And then 33% of those won't have to. And then so you go so out of 10 women, one's going to have to go through three separate surgeries with AI that answers like 0. Yeah, and I've seen that before because you're only as good as the surgeon's eyes and cutting. Right, right, right, right. So, so that's, so that's an area where AI would really, really be beneficial.

18:25 Definitely. And there's also these markers that one can put to better visualize what's going on so that that way you can see the full extent of the of the cancer. Right, right, right. Can we talk a little bit about vitamins and minerals in general? Definitely. Sure. Yeah. So my, so my, my son is too. And you know, he's a lot of personality, a lot of fun, loves to run around. But there was a, a little maybe a couple of months where he was always exhausted, always looking to take a nap. And he started getting like bluish kind of purple color under his eyes. We took him to the doctor.

19:05 The doctor said he's running very low on iron, you know, and then apparently iron, iron deficiency causes exhaustion, potential mood swings, stuff like that. What are some, what I guess based what are some general vitamins and minerals that people can can people use that are easily available that are just, you know, always beneficial and in what way? Well, it all depends on the patient, honestly. I know that's maybe something generalized, but but for children it's exquisitely different than in adults. And I see adults and for my kiddos I sometimes have to also phone a friend because children are not small adults, right? So you have to 1st understand why is there a low iron problem? Why is there iron deficiency?

20:04 It shouldn't just be happening unless the diet is one that is iron poor. There could be an absorption problem. There could be something else. That's going on and it needs to have a work up. So before we just start supplementing minerals and vitamins for fun, we I always like to get a baseline assessment. So taking just supplements for the sake of taking them. I mean, you can do that, but I like to have a clear rationale why we're doing this. So if we're talking about adults, I think you you can say that probably fish oil can generally help most people.

20:44 It's great for the brain, it's good for the lipids. Now you don't want to overdo it as well. I have patients take a sophisticated test which is used by the company Boston, which is made by the committee, for example, Boston Heart, and you see the different levels of your fatty acids, your fish oil levels, so to speak. And if you need more or less because some people could be overdoing it or underdoing it. What is what does it provide? Fish oil. Well, we feel that it feel it helps with membrane stability, it helps with lipid metabolism. So with that it helps with better just mood benefit helps the joints it it helps numerous systems in the body.

21:27 There's something like vitamin B12, which if you're deficient on that, you'll have the disease called combined deficiency because about a dozen systems will be faltering. So if you're not getting in your B12 level, getting in your B12 supplementation, and if you even have something called pernicious anemia where you have antibodies to these receptors that take that in, you'll have weakness, cognitive problems, you'll have a type of anemia forming and you will be a mess, literally. So supplementing just that one vitamin is super important. So I mean, the topic is huge. So I'm not A1 size fits all guy.

22:11 I I like to kind of personalize everything depending on what's going on and what your baseline is. And that depends on largely what you're doing as far as your exercise or lack of your sleep quality in the diet you're getting. Because if you're a vegan, then you're going to need different things than a meat eater or somebody with a more balanced diet. So, so for example, my children, the only thing they really take is a high quality pre probiotic. They we're trying, we'll probably start. We, we occasionally give them like vitamin gummies, but for, for my 6 and 9 year old, we keep it pretty simple. And there's also the challenge of getting them to take something, which I think you'll find right. Because if you have a 2 year old and you have older children, I don't know.

22:57 No, he's the oldest. It's 2:00 and then I have a weak old. So he doesn't have much choice, right? He just, you give them a suspension type formulation or or some sort of chewable and hopefully it works. But what they might not be excited to do certain things if you if they're a little fussy. So that's another element of challenge. Yeah, yeah. It's so funny because I found that, you know, the more I've been learning about this stuff and the more people I've been talking to about this, I'm either met with a very blank stare or a whole lot of enthusiasm, you know? And it doesn't feel like there's a whole lot of in between out there. But I mean, listen, as far as far as, you know, my own lifestyle and, you know, my own, you know, I, I mean, I'm, I'm turning 30 in a couple of months and I've been, and you know, I, I feel in the last couple of years healthier than I've ever been before. And I'm taking, I exercise daily. I, I sit outside.

23:49 I live in South Florida, so I sit outside. I get plenty of sunlight, you know, I, I, I, I, I cut out a lot of processed crap. And, you know, even I still have, you know, you know, I still treat myself every now and then, but in much, much, much smaller portions than I've ever had before. And I just feel like a different human being, you know, And then I have a, another end of the spectrum. I have a buddy of mine who's 22 who told me that he fell the other day. And then he said, falling should not be that difficult for a 22 year old should not have that kind of burden on you, you know, And so, you know, I, I, I, I don't really know, you know, and I'm telling him, Hey, man, you got to start exercising. I got to start, you know, taking just eating healthier a little bit or maybe take, you know, supplementing yourself.

24:34 And he kind of just looks at it like it's an overwhelming and you know, just endless To Do List of things to keep on top of. You know, what do you, what do you, how do we, how do you kind of make it a little bit more digestible for people? Well, I think it's also age specific because if you if you're in your 20s, you feel like you're mortal and you're not going to really focus on your health too much longevity unless you're really into that realm. So that kind of happens more when you realize that your health is worsening. And then you wake up a little bit. You probably, as you get older, you'll see people around you getting sick, you might lose a parent and you basically have this epiphany that oh wow, this could be me, right?

25:25 So when you're 22, that's typically not what you're thinking about. So you're eating fast food, but you shouldn't you're misbehaving maybe by going out too much drinking or whatever you're doing, but technically kind of immortal. And then you arrive to that destination hopefully, because if you don't, then you are going to be pretty sick. So it, it kind of solves itself. I feel some people never get the memo, so to speak. They just continued that trajectory of poor health, which is, which is very sad. And I can't get to them. Sometimes I can't explain to them why it's important. I feel like it's almost like a depression.

26:06 So at the end of the day, I feel this generation, the younger one, is doing things differently for the better, but they're also doing things I think, which are counterproductive. But each generation has that about them. In what? So if we, if we are overall, let's say this younger generation being health, you know, emphasizing health a little bit more. Like I've noticed, for example, that at least in my circles and my family's circles, alcohol used to be enormous, you know, and, and, you know, and then, and now it's really, really slowed down. But cannabis has really, really exploded. Almost like instead, you know, like it almost feels like, you know, everyone decides to just put down their bottles and stop buying Jack Daniels and they started hitting their dispensaries instead.

26:52 What, what what what? What habits were you referring to when you say that? Exactly, I have a family member who is in the beverage industry and you can see that alcohol sales for the most part have plummeted in the younger generation. I, I believe the only alcohol that's doing well now is sake for whatever reason. And then marijuana, weed is just so accessible. And if you're doing marijuana in, in my day, you're definitely a bad boy, right? It, it was something that you couldn't access that easily, but now it's kind of replaced that of the bud light, right? Where for us in high school, it's like you go to a party, everybody, there's like a suitcase of Bud Light here and there and that was kind of the norm and nobody was really smoking in in the open.

27:44 And that's drastically changed now. Alcohol, we're learning more and more is bad for you. There's a very few studies that I have found that show that show that the truism of, yes, you can have two glasses of wine and that this should be part of your longevity routine. That's not not not the case. Where did that come? From how do you, how do you even, how did that rumor even get started? If that was never, if that wasn't ever really the case, like how did that get popularized? I think it was a cardiovascular study which showed benefits. The French paradox, it's called where the French did that and they lived happy, robust lives, maybe outpacing the Americans and had better cardiovascular outcomes with a little bit of a negative effect on the liver now. But the problem is, I think if you look at the Mediterranean and the French and the European cultures, especially Europe in general, the food quality is so much better, right? So they have so many things that are positive headwinds, right? They have the better the lack of, you know, toxins in the food preservatives.

28:58 They are, I think, more social people. They are active. They are walking. Most places here, especially in Houston, we're condemned to a car. So then they don't have the obesity that the Americans have, although they are catching up a bit, right? So are they? Is it because is is is the food changing or is it the lifestyle? I I think just the introduction of more fast food and just the slow Americanization, I, I think that's kind of a global trend, especially in the Latin countries and the Middle East.

29:39 Interesting. Yeah. But cannabis, Yes, yes. So cannabis, the problem is when cannabis replaced the Bud Light, I think it causes now more problems with developmental, just wiring of the brain. So if kids are starting to do marijuana in high school and that's the go to, I don't think necessarily that is helping their brain development. And they may not have for example, these other problems that alcohol comes with. But I just don't feel that it is creating a generation that will be unscathed and some people will unfortunately have later problems. And, and even more so with in Texas, we have the smoke shops, the CBD shops where you have these weird substances that are intermixed into the, the THC and the vaping. And I think that is causing a huge problem. And I can see that because I had AI had a a hospital come by the other day.

30:52 And I asked him who do you see the most as far as addiction, as far as what kind of clientele? And he said definitely the vapes. We see a lot of people that are addicted to these vapes. And that's the problem nowadays. So yeah. I think it's a combination of the oral fixation and the accessibility. I feel like it's the, you know, like it gives you something to do. And I also think that social anxiety, I think that social anxiety, I think, you know, is something that I don't think that young, the younger generation or even the middle or older age generation has really entirely recovered from since COVID. And I think that a lot of people don't really know what to do with themselves. And always having a substance or always having something acceptable, accessible makes it makes, you know, makes it a lot more easy on the nerves.

31:36 What about what about if you're older for like, what if, you know, say someone like myself, if my friends and myself decided that, you know, we're going to watch, you know, basketball game tonight instead of having a bunch of beers, we're going to drink. Can you hear me? Yeah, yeah. Instead of having a bunch of beers, we're going to, we're going to, we're going to smoke a Jay or have an edible with that for for a 30 year old adult male with what would the consequences be? Sure. So your brain's developed, right? Our our brain, we believe is still developing up to age 25. So that's a positive for you. The second thing is what's the dose and how your personal biochemistry reacts to something? So probably at a low dose, it's no problem, but the problem is some people are sensitive to these things and that could cause them a problem down the line, like the first psychosis or another mental issue. So we can actually spot that.

32:29 If you do a genetic test, you can see if you're somebody that shouldn't probably be doing THC or, or things like that. So just like with alcohol, you know, some people have a glass of wine, they're able to function, but some people, they have a glass of wine, then they have a few more glasses of wine, and that's repetitive and suddenly they can't stop. And why is that? So I think it's just like with alcohol. I think alcohol could be a good thing in moderation. And when used in, you know, as a social lubricant, it's perfectly fine as long as people, the right people, are able to handle it and society doesn't suffer.

33:11 Yeah, yeah, I certainly hope so. I yeah. I, I haven't really made-up my mind on what I think about this transition. I, I, I, I, I, I tend to lean in the direction that I prefer cannabis to alcohol. I think that some of the conversations I've had in my life that I'm least proud of, I'd, you know, I've been drunk with, you know, I've been drunk during, and you know, the times where I've acted in the most reckless ways, it's been, you know, when I've been, when I've been drunk, you know, whereas, you know, I guess overeating might be an, you know, might be an issue, you know, when you're, when you're, when you're smoking, But, you know, I didn't really have much. And I mean, I guess, and I guess laziness and, and that's really, and I've noticed that as time went on, the feeling of exhaustion or laziness. It's a, it's a totally different type of effect, but I think that it's less harmful to others around you. It might be less personally like as as as an individual. It may have, you know, might be less than ideal, but you're getting a far.

34:10 I mean, I don't know the last time I heard a story of a pot of a of a guy, you know, a guy drinking a smoking AJ and beating his wife and kid as opposed to alcoholic dad that, you know, drink a half a bottle or a six pack and became abusive. Exactly. I'll give you the example of, for example, the Europeans did not have coffee until the Battle of Vienna occurred, right? So then that was something that actually spurred on the Renaissance, OK. And you have the salons with fine coffee. And it was a stimulant. So the main drink was usually booze, right? So that was a depressant just like weed is.

34:52 So you have the stimulant, which is allowing people to be more active in society, I think became just amazing, right? You had all these beautiful things being formed. So I think in general, for the most part, THC may create some good things, but I think in general it's it's kind of a blanket right where people don't want to do as much. Yeah, yeah, I've certainly found that. I've found that to be the case among the other conditions that that you guys treat. I've noticed I'm really interested actually in in the mental health space, the anxiety, the depression, the addiction, alcohol, opioid addiction. What's your, is your technique therapeutic? Is it chemical?

35:41 Is it, you know, is it plant medicine? What do you, what do you do for, for these, you know, for these type of mental health disorders you'd call them I guess or addictions? Well, it's one of the things I do and I'm able to help people, I think not have this destroy you, right? And I use the standard of care medicines to help people. And depending on what's going on, those would be for example, for alcohol, naltrexone a can proceed and also disulfiram, which is also called ansibusin has a really potent effect where what do they do sick? Well, so I mean, those are the pharmacological options, right?

36:24 And that's not too exciting. And the counseling part some people benefit from. But I think what we are seeing now when you mentioned plant medicine is really interesting because these I think are more of the solutions. I'm more of the Band-Aid, I'll admit that. But if not me, then what else can they do, right? I, I, I don't claim to be able to revert, save somebody from their addiction. It's it's it's it's a horrible problem. It's a horrible disease, yeah. But with the tools we have today, I'm able to at least hold them steady, I hope, if everything's going well. So. Pharmacologically, what's happening to them? Like so, so they're addicted. And I'll tell you, you know, alcohol addiction, right?

37:06 What you know, there's a physical dependence on it. What do these prescriptions do to the body or do to, to help, I guess either work with it or alleviate it or help manage it. What? What happens? Well, for example, naltrexone is cutting the signal of pleasure as much as possible. Now alcohol is a dirty drug first of all, so it splashes on numerous receptors and mechanisms. So this is cutting one of the feedback loops. Sometimes it works beautifully for people, but some people it does not. These other medicines try to cut down on the cravings, like the acamprosate, and then you have the one that's disulfiram, which basically if you have that in your body, you're going to have the worst hangover you've ever had and start throwing up, right? So yes.

37:54 Now, because it's toxic. Yes, because what happens? Is it it the one of the breakdown products of alcohol, Acetylaldehyde forms more more quickly and that is the Super hangover basically that you're getting very quickly. So people are not able to drink on that because they are wickedly ill. But if you don't take it, it does not work, right? So, so it's basically a form of touching the stove, right? Therapy. Now the things you mentioned like ibogaine, that that sounds really cool, right? And doesn't help everybody, but it needs to be studied more. But what I'm hearing from some folks is that it can basically reset the brain and your desire to drink goes away and you live happily ever after, as opposed to these other things where the recurrence rate is so high and people fail. Are you skeptical of almost too good to be true kind of thing? Yeah.

38:52 Well, that's the thing. I've had people who've done the ibogaine and it didn't work for them. So that's like every treatment. It didn't work for them. But I mean, I think it does work for other people. So you have to sort of figure out who does it work the best for. Right, right. I have a buddy that's, that's trying to, that's working right now to bring ibogaine. I believe ibogaine and not ayahuasca, but maybe both for FDA approval at the moment. Because he, he was, he was, he's an athlete and he was playing I think tennis and he tore something or I think he's playing golf and he tore his meniscus And the doctor prescribed him, you know, a bucket of opioids and, and he says, I can't see you for another couple of months.

39:36 So just take these every four to six hours. Take one of these every four to six hours. He went to the doctor, got a surgery, got a prescription for another, you know, a week or two just for recovery. And he comes back, he goes, I'm getting all these withdrawal symptoms. So the doctor, yeah, it's because you're a drug addict. He goes, I'm sorry, you know, you're addicted. He goes, but I just I was trying to follow, you know, so he, he spent a couple of years really miserable trying to trying to kick it. And you know, in South Florida or Florida in general is really the, you know, that opiate opioid Hwy. of the, of the, you know, of the country and. And he ended up, you know, as a just like a Hail Mary kind of kind of play going to Cancun to try ibogaine or Iboga. I'm not.

40:19 I think they're the same thing. And he said he did it once and he said he kicked it. He said he, you know, he still, he still drinks occasionally and still smokes cigarettes, but he doesn't. But he's never, he hasn't touched, he hasn't touched a pill again and he doesn't have any kind of desire for any kind of pharmacal pharmaceutical. So Advil, Tylenol and then even, you know, painkillers down the line. But he was he, you know, he feels very strongly that it's, you know, something that's a necessity for the country, you know, for veterans, for the, you know, for the for the people that get addicted, whatever it is. But again, the response I hear is that A, it may not always work, and B, it's too good to be true. And C, you have to see your genetic, your family's genetic history to see whether you're prone towards any kind of mental breakdown like schizophrenia or anything like that. But OK, it's all, it's all, it's all so cool. What about, what about anxiety and depression? How do you treat that?

41:23 Well, I, I first get a understanding what's going on. Is it situational? What are the triggers? That's very important because if you're just under yourself with all these things, maybe lost in the family or job or what not, then that's understandable. But I also asked, well, how much are you exercising? What's your routine like? Are you drinking? Are you, what are you eating? Are you eating junk food, ultra processed foods? Do you get outside? So, oh, this is just right. I tried as much as possible. Get people to get moving, get get the right things on board, into their bodies, put away, you know, the bad things. Get good quality sleep, you know, biochemically there could be something off.

42:07 So checking laboratories is important. As mentioned that B12, vitamin D, if those things are low, then I think supplementing that's important. We kind of forget about the the gut. The gut is super linked to mood and almost every disease so. Gut or stomach? The gut, yeah, We have a microbiome. We have trillions of bacteria. We have pounds of bacteria that are making so much, so many chemicals and just processes in our body and if those things are off we might not be as healthy and happy as we should be. So in the right assessment it makes sense to do a gut analysis or empirically try a probiotic prebiotic.

42:49 These things can correct the the mood. Sometimes they do need a pharmaceutical. I, I try to explain to them, this is a short course ideally, and it's just to get you out of the, the slump, right? Because if somebody is really depressed, anxious and they're needing to be hospitalized or, or whatnot, then I think you have to use everything possible. And of course, I have the discussion with the patient what they would like to do, what they like to consider pharmaceutical, what do they think of supplements to please try counseling, to do all these lifestyle things that could change the outcome. How are are are patients skeptical or or less, I guess more resistant to changing their lifestyle as opposed to taking taking a pill or a patient? You tell when a patient comes in and says, hey, doc, I have anxiety, I have depression.

43:42 And you say, well, you exercising and you're getting sunlight to be like or what are you eating? You know what's you know, how do they react to something like that? A lot of times they do shrug it off like, yeah, I, I, I'm not doing that much, but why don't you want to help me? Kind of, you know, and I am, I am trying to help you, right? Which is, and I, and I liken it to brushing your teeth, right? Like exercise and proper sleep are as important as brushing your teeth. If you do not brush your teeth, your teeth will fall out and you'll go to the dentist and the dentist will have a big bill for you, right? So it's fundamental. And some, it takes sometimes a while for people to realize that. And it's not just a vanity thing, but it's a mental health and everything thing.

44:27 And they say they don't have time, of course. Well, I asked them. Oftentimes they don't even have children. And I asked, well, how many children do you have? They have no children. So I say you have plenty of time to do exercise and it doesn't have to be that much. You just need to get going. But the typical strategy of just, you know, getting your car in a in a big city, driving to your work, staring in front of the screen, sitting all day, getting a lunch that is probably not healthy for you and then checking out in the afternoon and going to bed and, you know, watching your favorite Netflix, whatever it is. You know, that's that's kind of a Wally existence, right? If you if you know that reference. Oh, yeah.

45:12 Are you kidding? I, I, I teach, I teach high school English part time. And I just showed them that movie and it I, I think, you know, in 2008 and. Yeah. And the, and the students were like, how did they know? And I'm like, you know, well, it's been, you know, I mean, if you've been, if you've been following trajectory for a little while, then you start to notice these things, you know? Yeah. It's like The Simpsons, they they can predict. Yeah, Oh my God, it's insane. And, and South Park, they all have a certain level of profit. I think that when you when you're when you're willing to cross, I don't know, maybe it's, I don't know. It's almost like what comedians do in the sense that they have a very like, they have a very blunt look at society and they're not afraid to say things as they are. And so they have a much easier time predicting things because they're not afraid to say what they're going to say because they could just throw it off as a joke or make it into a joke, you know?

46:07 And so they have a lot more, they have a lot more freedom of expression, I guess, than most people are willing to take. And so they could probably get some of these guesses a little bit more accurately, you know. So when did you open this? When did you open Houston Concierge Medicine? How long ago? A little over 10 years ago. 11 years actually. Gotcha. Before that you were working at a hospital, you were working for another office. What were you doing? So working exclusively with my father in his clinic, which I still work at by the way, before that I was in residency in Austin. How'd you like Austin? Austin's great. I did my undergrad there in 1998 to 2002. OK.

46:51 And the city's changed a lot. Yeah. I wish I could live there, but here we are in Houston. I hear I have a, it's so funny to say that I, I have a cousin that lives in Austin. I have cousins that live in Austin. They all went to UT and, and every time I get customers now that call me from Austin, I say, oh, hey, how do you like Austin? And depending on whether what their answer is, I know whether they're natives or not. If they say, oh, it's awesome. We love it. And I'm like, oh, where'd you move from? You know, And then if they say, and if they say, you know, it used to be a nice, quiet small town, but it got a little crowded. It got a little packed. Then, you know, then, you know, you're speaking to one of those old timers that have been there forever. Yeah. It's so.

47:32 So. Yeah. What was Med school like? Med school's great. I enjoyed Med school. I actually studied in Europe at the Yagelonian University in Krakow. Cool. What was that old? Amazing. I'm Polish and that was my first language growing up. Until the age of five, I didn't speak any English. I have family there in Poland and I always have a affinity to everything there. So seeing Europe in your 20s is one of the best things anybody could do. And seeing medicine in a different way is also important, so. What would they do? What they do that's different. Well, so they are more pragmatic in Europe.

48:14 I, I think they will treat you well, but they're not going to be as wasteful, right, because they have less resources generally in most European countries. So that that's one thing here in the United States, we're, we're still for good, for better, for worse. We have a very good healthcare system, but it's just wasting so much money with all the layers of bureaucracy and inefficiency and, and over, over just prescribing and, and this protecting oneself. So over testing, right? I like testing, but the problem is if you fall into an ER you're going to probably get too much testing just because litigation can be a thing. Right.

49:00 Yeah, yeah. I noticed that when my my wife gave birth last week and he walked into the hospital at 5:00 and we got into the room at 7:15 and then the doc and no one did anything. Everything was just waivers and, you know, forms and everything like that for another 45 minutes or an hour. And then they realized that they had a bed without the syrups. They had to switch the bed on. Like, you know, by the time anything got started, it was already 9 and the birth happened by 11. And so my wife was like, you know, that was so great. I'm like, it was so great. We just spent three hours, you know, cutting red tape, you know, like you just spent three hours navigating the bureaucracy. You could have been you have been done with this three hours ago. You know, and I feel, and I mean, there's been a recent upsurge in in women at least that I've seen in my community again, that are that are that I want to try, you know, more natural birth methods and more doulas or home births or birthing centers.

49:58 Have you, have you, have you noticed that that was that that's been the case from what you've what you've, what you've observed? Yeah, I think these are requests by some people. For the most part, I feel that people just went to have the quickest journey, right? The best, the best outcomes. So for example, when we started, you know that having children train, right? We, we were not thinking about C-section at all. But our, our first child was humongous. So there was no option for the usual birth because or anything more fancy because it would have been deadly, right?

50:42 So that was our fate, right? And we took it, it was fine, no problem. AC section scheduled like a dental cleaning and, and the following same thing happened. So that, and some people don't have that luxury as far as, as far as what kind of birth they have. But you know, some people get, get to kind of have however natural birth and that's great. I think they should pursue that, but in our case that just wasn't in the cards. Yeah, yeah, I hear that. How big? How big was humongous? Like approaching like 10 lbs almost. Wow, crazy. Yeah, Central, your wife's big heads. So by the way, the same topic I have a buddy of mine that came over, He had his, he had his fourth kid under 6, all boys.

51:29 And, and he, you know, he, he had at my house on a Friday morning. We were off that it was a holiday. We're off and he and like 10:00 he get to call like, oh, my wife's, my wife's in labor. He's got to run, runs out of the office and I go to my grand. I live in Fort Lauderdale, my grandparents live in Miami Beach. About an hour for me or 4 to 5 minutes from me. I drive over and 20 minutes into my visit, I got a text congratulations, it's a boy. And like, oh wow, everyone alright. It's like it was a 10 LB natural birth. It happened in like half an hour. There's no time for an epidural. There's no time for anything. You just like happened. And I'm like, that's wild. That's crazy. You, you never hear, I don't hear those kind of stories very often.

52:13 Exactly. But so you went so so you went to Olive Med school in in Krakow, or you did or you did. Yeah, I did some rotations in the United States. I did a few months in the East Coast in Oklahoma to kind of also get some of that clinical experience. Sure. And what when you were practicing, was there any particular, I guess, aspect of medicine that drew you in or you were just fascinated with just learning? Yeah, just the curiosity of getting people better. Granted, what I did in residency, I don't really do now because my residency program was mainly training me to be a hospitalist, which is a doctor that is working in the hospital right as basically a robot.

52:59 And now I don't go to the hospital and I really haven't after residency. So a big shift. It was a very focused training for that. And like a lot of doctors, whatever they did in training, they kind of actually don't do anymore. So. But it's what you have to do. So can you. I, I don't know you. You don't have to tell me that. You don't have to. You don't have to talk about this if you don't want, but if you can change some things on Med school for Med students that are currently going to, you know, like I'm actually hosting, I hope, I hope a conversation slash debate. I have two buddies in Med school now. One's actually in one's in residency doing vascular surgery and, and the other one is still trying to figure out what he, he's doing rotations now. But the one that's currently that's, that's doing vascular surgery thinks that the Med school program is excellent and rigorous because you need doctors to be able to perform 100% under any kind of circumstance. And the other one feels that it's very difficult to learn and retain a lot of information because when you're, when you're trying to cram constantly and trying to over consume and you know, and he feels like you know, and he says even if you, if you're smart with your, with your study schedule and you're pacing, you know, you and you, you know, he goes just feels like there's never enough time for anything. So I'm hosting, I'm hosting, I'm hosting a conversation. We'll see how it goes.

54:25 But if there's anything that you, is there anything that you feel like you would change or needs to change or anything like that? Well, I think because the world's changing so fast, it has to change, right? Because what will these medical graduates professionals be doing in a decade? And I don't even know how some of them will be still around, right? Because in the natural progression of AI, right? If, if the AI radiologist has an IQ of 300, why would we need a radiologist, right? Unless you're doing some kind of a procedure. Same thing with pathology, same thing with a lot of other things. So, so what's? The it's so it's scary.

55:09 Exactly. So I don't even see how a lot of doctors will be doing what they're doing now in a decade along with other professions, right, Unless you have a niche, unless people really want that maybe old school kind of doctor, right? But you know, so I think medical school probably should be condensed more. For example, the basic sciences probably could be scrunched more in today's world also. I mean, we have all this information at our fingertips which we didn't have as quickly, right? So just like my board exams, my board exams now are open book. Every quarter I have to do some questions which I'll answer very well, but they're not realistic because in the realistic world when you see a patient, yes, a lot of the stuff is just very quick.

56:08 I see especially me now, like when I when the amount of patients I've seen, I can look at somebody and I can infer what's going on rather quickly. Not so much a nurse practitioner or a physician assistant or a mid level. All right. So unless they're like close to retirement age or they've just lived in that ER and they have that clinical acuity now you need that I think. And just the tools that our hands that are able to give us the answer more quickly, right? So you, I think we're, we're able to cut corners if we use these things properly. But it's just like our children, right? Like our children, some of these children are not learning how to write well because like literally write well cursive and all that, right? Because it's all type, it's all, it's all dictation, but it's fine for me.

57:04 I mean, analog childhood, digital adulthood, I'm good. But so I, I can use these tools and such. And the same goes with driving, right? Like I have a Tesla and I I like to use the full self driving. Is it amazing? It's pretty amazing is. It scary good. I don't have the 13 for some reason that that version. Maybe they don't like me as much as some of the other people, but hopefully one day. So that one I heard is delicious, right? And and the 14 one day. But like, I think kids should at least know how to drive, right? But if they're already like my, my son's nine, right? So in, in however many years he's going to get a car, right? I mean, there's even need to learn how to drive a car if if everything is FSD, right?

57:54 Yeah, but I think you should, right? You should and maybe I mean, I don't know if this is your, I guess you know what you think of this. I think that a lot of, I think a lot of the mental health issues that a lot of people experience today is because there's a lot of lack of what people feel like personal license, like they feel, they people don't feel like they're really needed for much or anything. You know, and one of the things that you do have is like driving, you know, you know, I mean, I call me crazy, but there's something, there's something so much fun of it. So freeing. I, when I used to, especially while I was trying to figure out what I wanted to do with myself and where I wanted to go with my life and I was really contemplating these questions very, very seriously. I would often hounder them over a walk or a long drive. I just get in the car and I just feel like I just need to hit the road for a little while just to just to help sort my thoughts in order.

58:48 I think that the I think autonomy is incredibly important. And I think that, you know, the more that as wonderful as technology is, removing autonomy from humanity will probably be a little bit more harmful than it's convenient, but all convenience has a cost. You know, that's, that's my that's my concern, I guess, but I haven't tried the Tesla self drive yet. So I may change my mind as soon as I as soon as soon as I get behind the wheel of that, you know. I mean, if it makes society safer and better, but you still have the option of doing whatever you want and going on that road trip by all means. Yeah, yeah, yeah. So what was it like opening your own business?

59:29 Can you, can you, you want to walk me through that a little bit? You said you work with your wife, right? Yeah, my life and business partner, we opened it up and I mean it's great because she does things that I'm not good at and I do things that. Like what? For example, well, I mean actual patients, right? So I I'm the one that's seeing the patients and giving that medical care. She is the one on the back end thinking of marketing, thinking of the actual, the books, so to speak, personnel, things like that which. Very important in today's world, especially where it's hard to get the right people on board and making sure everybody's on the same page.

1:00:15 Right, right, right. Is there is there an enormous amount of red tape to navigate, or bureaucracy to navigate to open your own practice, especially one that's as diverse as yours? I think there is it's it's always evolving and for example, malpractice, just like all these insurances are getting more challenging to navigate. My malpractice rates for no reason went up by how much? 100%? So a. 100% yeah, without, without any incidents, without. Without it, I've never had a malpractice issue and just it's kind of like suddenly your home home insurance or car insurance is X now 2X, right? So, yeah, yeah, it's, it's just a lot of people are just these companies are losing money and they need to recoup just like the fires in LA kind of a thing, right?

1:01:04 So yes, there's a lot of organizations that monitor doctors and for patient safety, of course, but you have to have everything super organized and just all all tease crossed and i's dotted. Who's more? I definitely she is. She is, yeah. She has a binder for everything and just organization is her Forte. I I'm more of the, my desk could be a little messy kind of guy, yeah. Yeah, yeah, yeah, yeah, I feel the same way. I I'm like, show me where I need to be and I'll be there.

1:01:48 But like, I've so bad at keeping track of my own calendar, I'm so glad at keeping track of my own taxes and my own, you know, and like, thank God for my wife because she, she's great at that. Yeah, definitely. Yin and Yang, right? It is, it is, it is. It's fun. I mean, when I was when I was actually dating, you know, one of the big mistakes I made earlier in dating was trying to find someone that was exactly like me. And that was idiotic, quite frankly, you know, because you don't need to date yourself. You are yourself, you know, and you don't need to marry yourself. You need to marry someone that that you know, and hopefully your friendships and relationships are the kind of, you know, you're a puzzle and you're missing a couple of pieces And they, you know, they have what to offer and you have what to offer.

1:02:31 They're missing puzzle pieces, you know, And as soon as that clicked for me, I started, you know, I just, my whole, my whole mindset changed and it's great, you know, I mean, it's, I mean, granted it's only been four years, but you know, it's great. It's great so far. Can you so, so you so you opened the you opened the 10 years ago. You opened this business 10 years ago or this practice rather 10 years ago and how much more limit your menu is like it was, it's a crazy menu, you know, Did you start? Did you start with all this stuff like offering all these services or how? No, definitely, definitely not. It's been evolution. So the basics I mean were the concierge plans and stuff like that. But then, you know, as again, technology is getting more interesting and you go search the world for good answers for people's health, you stumble upon stuff. So you kind of Add all all these bells and whistles that you are never trained in, but you learned along the way. And then?

1:03:31 How do you learn this? Where do you learn it from? Well, I go to conferences, I go to or I go to learning mod, I do learning modules. I just, it's called me search, right? I, I go and take deep dives into certain topics which are important for my patients and me as well because we're in this together, right? So, you know, red light therapy, initially I thought it was nonsense, right? But I tried it. It was actually pretty amazing. My wife as well, actually, she's the one that kind of got more into it before I did. And you kind of go down this rabbit hole and then you go down another rabbit hole and you realize doesn't really have many negatives. It can help you and why not?

1:04:20 And you can help humanity. So that that's kind of the focus, right? Like, you know, first do no harm with with most of these things, they're fairly benign. And I also, we also like to democratize the process in the sense that if you do not wish to see me, that's fine. You can order one of these things, you can do one of these things and get the results and, and I can interpret it for you or I can help you. But if you're feeling it like you just want the test, then that's fine as well. And I think that's also a barrier to a lot of people. Yeah, I bet. It's an enormous barrier. And I think that one of the bigger barriers is the stigma.

1:05:00 You know, which I do think the tide is. I really, I, I, I, I think, and I hope that the tide is turning and I think that the tide is turning because of a breakdown of trust, unfortunately, that happened in the last maybe 5-6 years since COVID in the medical establishment. And that people are willing to say, well, if they weren't right about that, what else do they're not right about? And then if they, you know, if we could have done this and this and this for COVID instead of that and that and that, then what else could we do alternatively that, you know, is simpler and has less side effects or consequences. And I think it kind of makes a little bit more chaos though, because, you know, when no one's like, I think authority exists.

1:05:43 I think there's a reason why authority exists. I think that is good. I think that would authority over reaches or, you know, starts to look for power for the sake of power. It's something else, obviously. But without authority, then what's to stop anyone from saying anything and just, you know, and just influencing as many, many, you know, however many people you know, you know, to do something that's totally not in their best benefit. So what? So do you get skepticism a lot? Or do you have to explain the like if some, if you, if you recommend red light therapy to someone or you recommend something to treat, you know, health related diet to treat depression or anxiety. And there's a lot of skepticism. Do you let them go? Do you show them paper?

1:06:23 Do you, do you show them that there's that there's research about this. What, how do you, how do you change people's minds? Because that's got to be a whole accident of itself. Well, I mean, first of all, a lot of people just naturally migrate to what we have. So then they've already done their research and they know what they want, which is nice right? Now for the people that have no idea what this is or how it could help them, I give the whole landscape of options, right? And no pressure if and learning what their philosophy is, right? Because some people they walk in and they automatically say I don't want a pharmaceutical in my body, in my mouth. OK, fine.

1:07:06 Some people don't want a supplement, right? OK, I respect that. Well, then what about these other things, right? Let's explain you that and how it can help you. And if you'd like some supporting data, by all means, I'll give that to you. Try it out if you don't like it, OK, But you might find some benefit and here's why. And I don't think you'll have too many problems with it, right? And if it helps you, then we're all winners here. What are some stuff that you do for yourself, for your own health, in your own family's health? Well, try to get the best sleep possible, which is really hard, yeah, you know, being a father and running businesses and all that. But we try our best.

1:07:52 So that's something we try to do for the children as well. They need to get good sleep, we need to get good sleep. Does sleep, does it matter if you like, let's say you got six hours or 8 hours, does it make a difference if those 6 or 8 hours are 12 to 8 or 10 to you know, 6:50 or whatever it is sorry 5:50 or you know or should it be consistent? Is is there? Is there a value to consistent schedule or it's just that you body needs amount of sleep? Yeah, consistency is important. So you shouldn't just jump all over the place. Our bodies like to have that circadian clock pretty much, some pretty much established. So whether it's, you know, 9 O clock or 11 O clock, you go to bed. It should be relatively the same. And sometimes it's great to go to bed earlier and you typically wake up around the same time every day as your body's used to it.

1:08:42 But the quality of sleep needs to be good. So that means if you're not breathing well at night, right? If you're APNIC, if you have some sort of issue where you're not getting oxygen to your tissues, then you need to fix that because you get 10 hours of sleep. But it won't matter because your sleep quality is not good and everything else in your body is becoming down. The strength down the line just messed up for like a better word, right? So your metabolic issues go up, your mood, the weight will go up and it's a vicious cycle. So getting a good sleep assessment, keeping a sleep tracker, if you can handle that negative score occasionally is a good idea. You can do it informal or, or or slightly less invasive sleep study through through a few companies on on the Internet that basically you do a sleep study for like one to two weeks and you can see what's exactly happening. And then have that consultation with the sleep doctor and learn that you might have some mild moderate sleep apnea, for example, in the R.E.M. phase, the rapid eye movement phase, because that's when the muscles are behaving differently. And there are ways to fix it.

1:09:47 You don't have to go to CPAP, which is a mechanism here, right, which most people don't like. You could do things to avoid that, but you need to get good quality sleep, number one. And if you're drinking alcohol, we'll think about that relationship, right? You don't have to give it up, but maybe move up that alcohol drink to earlier in the day as opposed to 9:00 because that's going to cut into your sleep, oh, into your battles. So. If you're going to drink, don't drink before you go to bed. People like to drink before bed because it helps them fall asleep. Right. But again, that's like a an algae, but it's like a baseball bat to the back of the head. Just like a sleep age. You're not getting that high quality sleep even though you're zonked out. So as well as you shouldn't be eating a big meal before your bedtime because that's also going to impact your sleep.

1:10:34 So if you move up your food and drink earlier, you're going to give better quality sleep. Things that are obvious are keeping the room dark. Yeah, keeping things cool and we have ways to improve that, right? But that's a fundamental thing. And then exercise, of course, I mean, everybody should do a little movement and that actually improves. What's the minimum exercise you encourage? Minimum, you know, let's say a week. I'll probably say 3 to 4 hours a week. There's some people that think you can get away with much less with you. Say 3 to 4 hours. You're talking cardio. Cardio or weights or resistance. A combination resistance training, cardio. I like to do classes where I kind of get both. So it's almost like a zone 2.

1:11:19 There's a re hit philosophy where basically you're using or maybe you can get away with like 15 to 30 minutes a week and that's still impacting your VO2 Max with something like a Caro bike which is AAI bike and can have you working out less which can can be good because you need to work out. But maybe jogging so much if you're 40 or 50 years old and bash your knees is not the best strategy. Yeah, yeah. And what are, What if you had to tell people one food to cut out and one food to add to your diet? What would you, what would you, what would you recommend? I know obviously it's very vague because obviously it depends on everyone's body chemistry and their makeup. But you know, general population, what most people have, you know, a couple, one thing to cut out and one thing that the regular person you see doesn't typically ingest or consume.

1:12:12 Yeah. I mean, I would cut out sugar, which can be in various forms. So that can mean sodas, that can mean actual candies, or it could be Wonder bread, right? So you need a little sugar, but I wouldn't have it be in such concentrated forms, like something you drink, Right. So orange juice. No gum. Yeah. I wouldn't do the orange juice. I mean, it's delicious if it's freshly squeezed, but occasionally you can have a treat, but not every day. The thing is, it's just the repetitive thing we do in our lives that causes problems. So if you're going to have a soda once every while that that's fine if if your body can handle it. But if you're in this habit of having a soda every day or or a doughnut every day and you multiply it out, I mean, that's not going to be good for you.

1:13:03 Yeah, no. And what about one thing that's important to eat that people don't eat enough of? Yeah, I think of fermented food, right. I think those are good for you especially. So it could be a high quality yogurt if you can handle dairy. And if you're like me and you like sauerkraut, then that could be good for you. Oh, cool. Really. Yeah, sauerkraut is something great for the gut. What is it off? Oh, off for your gut. Yeah, yeah. So something that's fermented, something that has that bang for the buck. What is fermented due to due to our gut that makes it beneficial? Well, it has probiotics and prebiotics, for example. So that combination is going to make our gut healthier and thereby we're going to be healthier, right?

1:13:46 So if you're not getting all these wonderful Whole Foods, then you should probably think of what probiotics or prebiotics to put in your body that replace it. OK, so you got sauerkraut? Potentially anything fermented. I feel like fermented food. I have a hard time thinking of examples of fermented of fermented. Food Kimchi Kimchi the. Korean. OK Oh, right, right. What's it called? Been very popular. Kombucha has been very popular recently too. Kombucha. So I do enjoy kombucha from Costco most days, yeah. I have a friend that adds his own hops to them, his own beer hops to the. Kombucha. You can have a hard kombucha and then artichokes are good. Those are more prebiotic. You have different probiotic prebiotic drinks you can take as well.

1:14:35 You probably saw them in the refrigerated section. Yeah. But are those are those are those as beneficial? And I'm not asking like, you know, you know, confrontational question, but just, you know, are they, does it make a difference if you're eating something natural like an artichoke as opposed to a bottled, you know, prebiotic probiotic drink, you know, or yogurt or whatever? Does it make the sure? I mean, these are all foods basically. So it's just how your body incorporates them. Sometimes we have the inability to do well with one food versus the other. So then you kind of have to figure that out based on your body. And, you know, we didn't mention Pickles, but Pickles are also.

1:15:18 Oh yeah, I had one the other day at a movie theater and that was a beautiful. Thing pickle at a movie. Yeah, yeah. We went to watch the new Minecraft movie with the family. Oh yeah. Where'd your kids say? They liked it. They liked it a lot, yeah. It did really, really, really well. Yeah. Really well, Yeah, yeah. I mean, I don't know if you follow any of that, but that, that that's matched all expectations. That was that was crazy. You see the new, the new era of what nostalgia is based on the new kind of kid movies that are coming out. So Mario Brothers and Minecraft and you know, and and you know, video game themed movies as opposed to old Disney classics that are being remade or whatever, you know, seems to be getting seems to be making hits. It's really cool, wonderful.

1:16:05 I think that's, I think that's pretty much what I wanted to a lot of what I wanted to cover. Any last minute recommendations or thoughts you think that people could really benefit from that we haven't covered? I think we cover a lot, just I think we're living in exciting times. Take care of yourselves. If you need a physician in your area to guide you, I think it makes sense to find somebody that is on the same page as you. And in the end, you're the boss of your health and the fundamentals are there, so there's no reason you shouldn't be living your best life. Beautiful doctor, thank you so much for the time. I really appreciate it. This is so much fun.

1:16:46 It was so beneficial and so informative. Thank you SO. Much thanks so much. Have a good time all. Right, we'll talk soon and I'll send you the link shortly. OK, Thank you. Bye now.