WEBVTT 1 00:00:01.760 --> 00:00:03.399 Initialize sequence. 2 00:00:04.480 --> 00:00:07.080 Coming to you live from Houston, Texas, home to the 3 00:00:07.080 --> 00:00:08.599 world's largest medical center. 4 00:00:08.880 --> 00:00:15.919 Bunch of phase everything looking. 5 00:00:19.640 --> 00:00:23.719 This is your Health First, the most beneficial health program 6 00:00:23.760 --> 00:00:26.960 on radio with doctor Joe Bellotti. During the next hour, 7 00:00:27.039 --> 00:00:30.359 you'll learn about health, wellness and the prevention of disease. 8 00:00:30.800 --> 00:00:33.520 Now here's your host, doctor Joe Bellotti. 9 00:01:10.239 --> 00:01:12.760 Well look good Sunday evening to everybody. Doctor Joe Glotti, 10 00:01:12.799 --> 00:01:16.480 thanks very much for tuning in on this Sunday evening, 11 00:01:16.519 --> 00:01:20.079 which happens to be the Memorial Day weekend. I hope 12 00:01:20.120 --> 00:01:23.280 you're having a little bit of time to relax, enjoy 13 00:01:23.319 --> 00:01:27.640 the three days with your family and loved ones, recharge 14 00:01:27.760 --> 00:01:31.519 just a little bit, and enjoy the festivities of backyard 15 00:01:31.599 --> 00:01:36.799 pool parties, barbecues, weekend trips and getaways, or maybe simply 16 00:01:36.920 --> 00:01:41.239 the start of your summer vacation. But also keep in 17 00:01:41.280 --> 00:01:45.319 mind what Memorial Day is all about, all of the 18 00:01:45.439 --> 00:01:49.680 men and women over the years that sacrificed their life 19 00:01:50.760 --> 00:01:55.799 for our freedom. We sometimes get a little bit wrapped 20 00:01:55.920 --> 00:02:00.920 up in the fun and the parties and the get togethers, 21 00:02:00.959 --> 00:02:03.359 but really we have to be very thankful for those 22 00:02:03.400 --> 00:02:07.319 that sacrifice to the families that sacrifice for those that 23 00:02:08.080 --> 00:02:12.199 lost a loved one in the defense of the United States, 24 00:02:12.680 --> 00:02:15.960 the greatest country in the world, and certainly this is 25 00:02:16.080 --> 00:02:21.199 a health and wellness program. I would also say the 26 00:02:21.280 --> 00:02:27.639 greatest scientific minds in the world with regard to innovation, 27 00:02:28.759 --> 00:02:34.599 medical and scientific discovery, and patient care right here in 28 00:02:34.759 --> 00:02:38.680 the United States of America. So again, many thanks for 29 00:02:38.800 --> 00:02:42.639 tuning in on this weekend, and we're gonna have a 30 00:02:42.680 --> 00:02:46.039 lot of fun this upcoming hour with regard to health 31 00:02:46.039 --> 00:02:50.159 and wellness. And as I always like to say, we 32 00:02:50.719 --> 00:02:53.919 want to raise your health i Q. We want to 33 00:02:53.919 --> 00:02:59.879 make you better consumers, make you really understand the reason 34 00:03:00.120 --> 00:03:03.400 to be proactive with your own health and wellness. We 35 00:03:03.479 --> 00:03:07.800 don't want to start thinking about our health when it's 36 00:03:07.840 --> 00:03:10.960 too late, when too many problems have developed and the 37 00:03:11.039 --> 00:03:16.199 reality is it's just too hard to recover after too 38 00:03:16.319 --> 00:03:19.680 much damage has been done. It is early intervention. But 39 00:03:19.800 --> 00:03:22.719 to intervene early you have to have the knowledge and 40 00:03:22.879 --> 00:03:27.120 understanding and appreciation. So to set the table. Here our 41 00:03:27.199 --> 00:03:30.599 website Doctor Joegalotti dot com d R J O E 42 00:03:30.680 --> 00:03:33.159 G A L A t I dot com is our 43 00:03:33.199 --> 00:03:36.960 website and of course center for our weekly newsletter. Send 44 00:03:37.039 --> 00:03:40.560 me a message. All of our social media is posted 45 00:03:40.599 --> 00:03:44.639 on doctor Joeglotti dot com. Our podcast past episodes that 46 00:03:44.680 --> 00:03:48.360 you could listen to are all there. So be part 47 00:03:48.560 --> 00:03:53.240 of the community, your health first community, So do reach 48 00:03:53.280 --> 00:03:59.039 out and be part of it. The big story in 49 00:03:59.120 --> 00:04:03.319 the news this past we has to do with President 50 00:04:04.319 --> 00:04:11.240 Biden and his newly discovered prostate cancer diagnosis, and all 51 00:04:11.360 --> 00:04:18.000 of the talking heads are rendering their opinion ranging from 52 00:04:18.600 --> 00:04:24.519 it is a government conspiracy that they knew yet prostate 53 00:04:24.600 --> 00:04:30.759 cancer and didn't say anything all the way through. This 54 00:04:31.000 --> 00:04:36.399 was medical negligence for the most important, the most well known, 55 00:04:36.439 --> 00:04:41.199 the most famous gentleman, the most famous person in the 56 00:04:41.240 --> 00:04:48.879 world is not getting adequate medical care. And so, depending 57 00:04:48.920 --> 00:04:53.040 on what camp you want to follow or believe, you 58 00:04:54.199 --> 00:04:56.920 have a whole set of things to think about. But 59 00:04:57.040 --> 00:04:59.439 let me let me sort of back up and give 60 00:04:59.480 --> 00:05:02.319 you my spin. Now, as many of you know, I 61 00:05:02.360 --> 00:05:06.759 am a hepatologist. I am a liver doctor taking care 62 00:05:06.759 --> 00:05:10.800 of patients to livid disease. But you're involved in the 63 00:05:10.839 --> 00:05:14.879 care of patients, and I have some opinion on this. 64 00:05:15.000 --> 00:05:22.480 So the whole topic of discussion with regard to prostate 65 00:05:22.560 --> 00:05:28.199 cancer over the past fifteen to twenty years has gone 66 00:05:28.240 --> 00:05:34.639 through a number of different iterations, and there are different 67 00:05:34.759 --> 00:05:39.040 opinions that have been put forward by the various medical 68 00:05:39.120 --> 00:05:45.920 societies based on what I would say is rigorous thoughtfulness 69 00:05:46.639 --> 00:05:51.399 and scientific explanation. So these are not just a bunch 70 00:05:51.399 --> 00:05:53.399 of people that are sitting in a smoke filled room 71 00:05:53.439 --> 00:05:58.000 to say let's do this or that with regard to screening. 72 00:05:58.000 --> 00:06:01.560 And you could apply this to that, go for mammograms 73 00:06:01.720 --> 00:06:05.439 or screening for colon cancer, which I'll comment in a second. 74 00:06:05.879 --> 00:06:10.199 But anyway, so if you look at the American Cancer Society, 75 00:06:10.199 --> 00:06:13.759 we're just going to start there, and I'd like to 76 00:06:13.800 --> 00:06:17.920 think that the American Cancer Society is right down the middle. 77 00:06:18.240 --> 00:06:22.199 They're not too controversial on either side there. It's going 78 00:06:22.240 --> 00:06:26.720 to be a good reference point. So first and foremost, 79 00:06:26.800 --> 00:06:31.519 they talk about when you start screening for prostate cancer, 80 00:06:32.000 --> 00:06:35.240 you have to understand that you have to make an 81 00:06:35.279 --> 00:06:40.480 informed decision about whether you even want to be screened 82 00:06:40.920 --> 00:06:44.839 for prostate cancer. But then once you get the information, 83 00:06:45.000 --> 00:06:48.079 you have to look at the usual it's the benefit, 84 00:06:48.439 --> 00:06:53.319 the risk, and uncertainties of prostate cancer screening. It is 85 00:06:53.439 --> 00:06:56.519 not perfect. And to back up just a little bit, 86 00:06:56.680 --> 00:07:02.399 one of the issues with pross cancer screening was that 87 00:07:02.519 --> 00:07:09.680 there were a number of situations where too many prostate 88 00:07:10.759 --> 00:07:14.639 biopsies were being done which were then ultimately found to 89 00:07:14.759 --> 00:07:18.720 be negative, that there was no cancer. So men were 90 00:07:18.720 --> 00:07:22.319 going for digital rectro exams. You'd feel a little nodule 91 00:07:22.360 --> 00:07:27.160 on your prostate and that would trigger a biopsy of 92 00:07:27.199 --> 00:07:32.800 your prostate, which is uncomfortable. There's a cost involved and 93 00:07:33.000 --> 00:07:38.639 potential complications with any procedure, so they found that biopsying 94 00:07:38.720 --> 00:07:41.879 everything that you saw was probably not the best idea. 95 00:07:42.000 --> 00:07:46.279 The other is with the PSA test, a prostate specific 96 00:07:46.399 --> 00:07:51.839 antigen test. There is some variability in the PSA test, 97 00:07:52.319 --> 00:07:56.399 and again a rise in the PSA may not necessarily 98 00:07:57.800 --> 00:08:01.040 have to result in getting a buy. It may not 99 00:08:01.240 --> 00:08:05.360 mean you have prostate cancer, and so this is the uncertainty. 100 00:08:05.439 --> 00:08:12.439 It is not a water tight plan of attack for 101 00:08:13.759 --> 00:08:17.319 preventing or limiting the number of cases of prostate cancer. 102 00:08:17.399 --> 00:08:22.800 So inherently the testing is not perfect. So with that said, 103 00:08:22.839 --> 00:08:27.319 the guidelines are you should think about getting tested at 104 00:08:27.360 --> 00:08:31.319 age fifty for men who are at average risk for 105 00:08:31.519 --> 00:08:35.600 prostate cancer and are expected to live at least ten 106 00:08:35.919 --> 00:08:43.120 years or more. Okay, Number two for men forty five 107 00:08:46.519 --> 00:08:49.519 at high risk for developing prostate So this would include 108 00:08:49.559 --> 00:08:54.200 African American male, African American men, and men who have 109 00:08:54.279 --> 00:08:57.039 a first degree relatives that would be a father or 110 00:08:57.039 --> 00:09:01.639 a brother diagnosed with prostate cancer at an early age, 111 00:09:01.679 --> 00:09:05.799 typically younger than sixty five. The third category would be 112 00:09:06.799 --> 00:09:12.399 men age forty at even higher risk, those with one 113 00:09:12.440 --> 00:09:15.240 or more first degree relatives who had prostate cancer at 114 00:09:15.240 --> 00:09:17.759 an early age. So you have to see where do 115 00:09:17.799 --> 00:09:21.080 you fit in? So where did Joe Biden fit in? Well, 116 00:09:21.120 --> 00:09:23.679 he probably not knowing his whole history, let's just say 117 00:09:24.240 --> 00:09:27.279 age fifty, who's at average risk. I don't know if 118 00:09:27.279 --> 00:09:32.480 his brother or father had prostate cancer. So at this 119 00:09:32.639 --> 00:09:38.360 point they then say, if your PSA is normal, then 120 00:09:38.399 --> 00:09:42.320 you need to be retested maybe every two years. Now, 121 00:09:42.399 --> 00:09:47.399 of course, if new symptoms come up, new complaints, urinary symptoms, 122 00:09:47.440 --> 00:09:50.320 you should get tested moro offin or should be looked 123 00:09:50.360 --> 00:09:54.399 at a little bit more. Now, why they were saying that, 124 00:09:54.480 --> 00:10:01.679 I think his last PSA was in twenty fourteen, so 125 00:10:01.759 --> 00:10:05.879 that was over ten years ago, so he was in 126 00:10:05.919 --> 00:10:09.120 his seventies at that point. You would have thought he 127 00:10:09.159 --> 00:10:11.960 would live at seventy seventy two years old. He would 128 00:10:12.000 --> 00:10:15.879 live to eighty two, so I don't know why he 129 00:10:16.039 --> 00:10:20.919 was not tested more frequently. Now. What they're also saying 130 00:10:20.960 --> 00:10:24.720 is that this was an advanced case of prostate cancer 131 00:10:24.759 --> 00:10:29.799 that had spread to the bones. So one could theorize 132 00:10:29.799 --> 00:10:33.679 that maybe he had prostate for three years, five years, 133 00:10:33.919 --> 00:10:37.559 eight years. I really don't know. Of course, there are 134 00:10:37.639 --> 00:10:42.399 certain malignancies that do not follow the normal natural history 135 00:10:42.480 --> 00:10:45.879 of a slow growing malignancy, and you could you could 136 00:10:45.919 --> 00:10:49.879 say this for any kind of cancer or disease. It 137 00:10:50.279 --> 00:10:54.399 just bed genes, bad biology. This tumor is just going 138 00:10:54.440 --> 00:10:57.720 to take off like wildfire. That is always a possibility. 139 00:10:58.360 --> 00:11:03.399 But why he was not screened? Now to something that 140 00:11:03.440 --> 00:11:08.080 I do colon cancer screening, most would say, most authorities 141 00:11:08.120 --> 00:11:12.120 would say after the age of eighty, you don't need 142 00:11:12.320 --> 00:11:17.360 a screening colonoscopy for colon cancer. But yet I have 143 00:11:17.519 --> 00:11:21.440 patients that are seventy five, eight eighty two years old. 144 00:11:22.360 --> 00:11:28.960 They are still working, very active, running companies, traveling, exercising. 145 00:11:30.039 --> 00:11:33.879 Why would I not want to screen that person and 146 00:11:34.000 --> 00:11:39.519 maybe find an early lesion that could be removed. It's 147 00:11:39.639 --> 00:11:43.000 relatively easy to do a colonoscopy. There is a cost, 148 00:11:43.039 --> 00:11:46.600 there is certain precautions that need to be taken. So 149 00:11:47.279 --> 00:11:50.879 along those lines, I feel very comfortable on a case 150 00:11:50.919 --> 00:11:56.519 by case basis doing these screening tests, even though the 151 00:11:56.639 --> 00:12:01.399 guidelines for colon cancer totally different here say after eighty 152 00:12:01.480 --> 00:12:03.759 you should sort of hang it up and not screen anymore. 153 00:12:04.639 --> 00:12:10.480 Same thing for prostate cancer. This man has access to 154 00:12:10.559 --> 00:12:16.600 the world's greatest medical care, one would think. But yet 155 00:12:16.919 --> 00:12:20.039 nobody decided to say, let's just get a PSA on 156 00:12:20.120 --> 00:12:23.559 the president and see how he's doing early intervention, whether 157 00:12:23.600 --> 00:12:27.000 he's going to remain in office or not go in office. 158 00:12:27.639 --> 00:12:27.840 You know. 159 00:12:27.960 --> 00:12:32.600 Again, maybe there was this dementia diagnosis and they said, look, 160 00:12:32.639 --> 00:12:35.399 this guy's not going to live more than a few years, 161 00:12:36.320 --> 00:12:39.720 stop screening. I don't know. That gets into sort of 162 00:12:39.720 --> 00:12:42.679 the conspiracy that people knew that he was on the decline. 163 00:12:43.279 --> 00:12:47.200 So either way, I would say, what problem do I 164 00:12:47.320 --> 00:12:52.279 have with this number one? He is the most important, famous, 165 00:12:52.600 --> 00:12:58.360 well known, most observed person in the world. I would 166 00:12:58.440 --> 00:13:01.480 have thought that his doctors would be all over him 167 00:13:02.240 --> 00:13:06.799 screening like crazy. Throw the guidelines out the door. He 168 00:13:07.039 --> 00:13:11.600 is not your usual patient. And so that's all I 169 00:13:11.639 --> 00:13:15.960 could really say is PSA probably was elevated years ago. Now, 170 00:13:15.960 --> 00:13:18.320 whether or not they knew it and they said let's 171 00:13:18.480 --> 00:13:21.159 watch it, and then they watched it to the point 172 00:13:21.240 --> 00:13:24.600 that it just spread and broke loose. That may be 173 00:13:24.879 --> 00:13:28.519 a possibility, but to think that this is something new 174 00:13:29.559 --> 00:13:34.039 is a little hard to believe. And why again, why 175 00:13:34.080 --> 00:13:37.399 they were not screening him with a PSA, checking all 176 00:13:37.480 --> 00:13:40.399 kinds of other lab tests on him or imaging studies 177 00:13:41.960 --> 00:13:46.000 is a little, a little beyond me. So that is 178 00:13:46.120 --> 00:13:50.240 my take on President Biden's prostate cancer. It's a very 179 00:13:50.360 --> 00:13:53.960 unfortunate situation. I hope he does well. It'll be interesting 180 00:13:54.000 --> 00:13:57.000 to see what therapies are going to be offered to 181 00:13:57.080 --> 00:13:59.919 him and how public this all becomes in the week 182 00:14:00.200 --> 00:14:02.840 months to come. All Right, we're gonna take a quick 183 00:14:02.879 --> 00:14:05.679 break on this Memorial Day weekend of doctor Joe Galotti. 184 00:14:05.720 --> 00:14:09.080 Don't forget doctor Joegalotti dot com is our website. Stay 185 00:14:09.120 --> 00:14:12.960 tuned more health and wellness when we get back. Welcome 186 00:14:13.000 --> 00:14:15.879 back everybody, doctor Joe Galotti. This is your health First. 187 00:14:15.919 --> 00:14:19.879 Every Sunday between seven and eight pm, we're here. Don't 188 00:14:19.879 --> 00:14:24.639 forget our website, Doctor Joeglotti dot com. And you know, 189 00:14:24.720 --> 00:14:29.519 while we're talking about Memorial Day planning, a little patriotic 190 00:14:29.639 --> 00:14:35.120 music for your summer plans. If I could advise you, 191 00:14:36.240 --> 00:14:39.759 I would definitely say, if you're looking for a relatively 192 00:14:39.840 --> 00:14:44.879 close road trip and you like American history or World 193 00:14:44.960 --> 00:14:49.600 War two history, and maybe you want to take your 194 00:14:49.639 --> 00:14:51.879 school age kids, or your high school kids, or even 195 00:14:51.919 --> 00:14:58.320 your college kids on a really worthwhile outing. The World 196 00:14:58.360 --> 00:15:05.200 War Two Museum in New Orleans is absolutely outstanding. I've 197 00:15:05.200 --> 00:15:09.480 been there twice and I am thoroughly blown away as 198 00:15:09.519 --> 00:15:14.960 to the scale and scope of the museum. It is 199 00:15:15.279 --> 00:15:19.399 on par or better than anything you could see in 200 00:15:19.639 --> 00:15:23.840 Washington and the Smithsonian. The history is Originally it was 201 00:15:23.879 --> 00:15:28.440 going to be a D Day museum, but then in 202 00:15:28.480 --> 00:15:31.559 a short period of time they realized that this museum 203 00:15:31.639 --> 00:15:34.559 was so much more than just D Day that they 204 00:15:34.879 --> 00:15:38.200 turned it into a full scale World War Two museum. 205 00:15:38.840 --> 00:15:43.840 So I would definitely allot two full days to see 206 00:15:43.879 --> 00:15:49.080 all of the museum and you will leave really enriched 207 00:15:49.279 --> 00:15:54.200 with the history of World War Two. Highly recommended World 208 00:15:54.240 --> 00:15:58.000 War Two Museum in New Orleans. Whether you're here in 209 00:15:58.039 --> 00:16:01.039 Texas or anywhere in the country and you're looking for 210 00:16:01.240 --> 00:16:06.639 a summer idea with your family, definitely look up the 211 00:16:06.679 --> 00:16:10.159 World War two museum. All right, so last segment, we 212 00:16:10.159 --> 00:16:14.559 were talking about prostate cancer and the dilemma of what 213 00:16:14.759 --> 00:16:20.320 happened to President Biden. Again, I believe that this is 214 00:16:20.360 --> 00:16:27.600 going to be discussed, argued, litigated for years, and we're 215 00:16:27.639 --> 00:16:30.440 all living it in real time here. But as we 216 00:16:30.480 --> 00:16:36.799 are speaking of cancer, I'm posting on our Facebook page, 217 00:16:37.000 --> 00:16:41.000 which is at doctor Joe Galotti on the Facebook page, 218 00:16:41.039 --> 00:16:43.639 but you can get their Facebook page by going to 219 00:16:43.759 --> 00:16:48.519 our website, doctor Joegalotti dot com. Through the American Cancer Society, 220 00:16:48.519 --> 00:16:53.000 they have a one page screening recommendations and I would 221 00:16:53.000 --> 00:16:54.679 certainly this is one of those things that you would 222 00:16:54.679 --> 00:16:59.159 want to take to your doctor when you visit them 223 00:16:59.519 --> 00:17:03.919 for you or annual visitor, bi annual visit, whatever it is. 224 00:17:04.240 --> 00:17:06.839 And it goes through the screening recommendations for people that 225 00:17:06.880 --> 00:17:11.519 are at average risk for certain different types of cancer. 226 00:17:12.000 --> 00:17:13.720 And so if you just break it off into three 227 00:17:13.839 --> 00:17:17.440 big categories, if you're twenty five to thirty nine years old, 228 00:17:18.079 --> 00:17:22.799 this is going to be predominantly women with cervical cancer 229 00:17:22.880 --> 00:17:27.240 screening typically starting at about age twenty five. Then when 230 00:17:27.240 --> 00:17:31.680 you get to the forty to forty nine year old range, 231 00:17:32.000 --> 00:17:36.079 breast cancer screening starts at forty five, with the option 232 00:17:36.279 --> 00:17:40.839 to begin at age forty again, cervical cancer screening continues. 233 00:17:41.160 --> 00:17:46.400 Collo rectal cancer is going to start at age forty five, 234 00:17:46.559 --> 00:17:52.079 and also at forty five. African American individuals should discuss 235 00:17:52.119 --> 00:17:56.799 prostate cancer screening with a doctor. If you know, forty 236 00:17:56.799 --> 00:17:59.799 five a little bit younger, then fifty and above can 237 00:18:00.400 --> 00:18:05.400 breast cancer screening, cervical cancer screening, colding cancer screening continues, 238 00:18:05.720 --> 00:18:08.559 and then people who currently smoke are used to smoke, 239 00:18:09.119 --> 00:18:12.759 should discuss lung cancer screening. There are a number of 240 00:18:12.799 --> 00:18:19.400 strategies using low dose radiation imaging of the lungs to 241 00:18:19.559 --> 00:18:22.519 screen for colding cancer that has certainly been shown to 242 00:18:22.559 --> 00:18:26.079 be effective in picking up early lung cancers. And then, 243 00:18:26.119 --> 00:18:30.200 of course fifty and older, the ongoing discussion about about 244 00:18:30.319 --> 00:18:35.799 prostate cancer screening as recommended by your doctor. So this 245 00:18:35.839 --> 00:18:40.079 will be posted on the Facebook. 246 00:18:39.680 --> 00:18:40.279 Page of. 247 00:18:42.279 --> 00:18:46.000 Our website at doctor Joe Galotti. Is the Facebook link. 248 00:18:46.039 --> 00:18:48.920 All right, we're going to take a break news, weather, traffic. 249 00:18:49.119 --> 00:18:51.759 Maybe we'll hear about the astros coming up in just 250 00:18:51.799 --> 00:18:53.599 a minute. I'm tout to Joe Galotti. This is your 251 00:18:53.640 --> 00:18:57.279 health First Day Tunes welcome back, everybody to your health 252 00:18:57.319 --> 00:19:00.799 first doctor Joe Galotti every Sunday between seven and eight pm. 253 00:19:01.039 --> 00:19:07.160 And another news story that hit the paper this week. 254 00:19:07.319 --> 00:19:12.039 Billy Joel, the piano man, a fellow Long Islander like me, 255 00:19:13.119 --> 00:19:17.160 was diagnosed with normal pressure hydrocephalis. And you're probably saying, 256 00:19:17.240 --> 00:19:28.319 what on earth is that man? And it's interesting to 257 00:19:28.480 --> 00:19:33.279 note that a few months ago there was a video 258 00:19:33.359 --> 00:19:37.200 clip of Billy Joel on concert and sort of moving 259 00:19:37.240 --> 00:19:38.960 around that I don't know if he was going up 260 00:19:39.000 --> 00:19:42.559 steps on the stage, but he fell over and it 261 00:19:42.599 --> 00:19:46.119 looked like an innocent enough kind of a fall, though 262 00:19:46.160 --> 00:19:50.160 you never like to see this. Bruce Springsteen fell about 263 00:19:50.160 --> 00:19:53.480 two weeks ago on stage and that made the headlines. 264 00:19:54.799 --> 00:19:58.240 But it turns out that he has normal pressure hydrocephalis. 265 00:19:58.279 --> 00:20:01.519 Whether or not this was all part of the disease, 266 00:20:03.160 --> 00:20:06.519 you know, we don't know at this point. But here again, 267 00:20:06.640 --> 00:20:12.319 this is one of those conditions that when celebrities develop it, 268 00:20:13.000 --> 00:20:15.519 all of a sudden people start talking about it. And 269 00:20:16.240 --> 00:20:17.880 I would say that's a good thing. It's horrible for 270 00:20:17.920 --> 00:20:21.119 Billy Joel. I've seen Billy Joel a number of times 271 00:20:21.160 --> 00:20:24.839 in concert. Yes, he did grow up about ten minutes 272 00:20:24.839 --> 00:20:27.960 from where I grew up. He is many years older 273 00:20:28.000 --> 00:20:31.720 than me, but there is a certain connection with him 274 00:20:31.759 --> 00:20:34.920 with Long Island and all the work that he's done 275 00:20:34.920 --> 00:20:38.079 in the greater New York area. He is just iconic 276 00:20:38.160 --> 00:20:41.359 and legendary to those of us that are from New 277 00:20:41.440 --> 00:20:46.000 York loving his music. But again, it's a great excuse 278 00:20:46.039 --> 00:20:51.680 in a sense to talk about normal pressure hydrocephalus and 279 00:20:52.359 --> 00:20:54.000 for all of you to have an idea of what 280 00:20:54.079 --> 00:20:59.319 on earth this is. Now the symptoms or the signs 281 00:20:59.359 --> 00:21:04.839 of normal pressure hydrocephalis are are rather curious, and I'm 282 00:21:04.880 --> 00:21:06.839 going to go over that in a minute, but it 283 00:21:07.440 --> 00:21:11.759 makes us pause to say, hey, do I have any 284 00:21:11.799 --> 00:21:15.839 of these symptoms or somebody that you're close with, a coworker, 285 00:21:16.000 --> 00:21:19.680 a family member, a friend, Bob, the neighbor next door, 286 00:21:20.359 --> 00:21:25.559 could it be that there's normal pressure hydrocephalis going on? 287 00:21:26.079 --> 00:21:32.279 And again, the key thing here is there are surgical 288 00:21:32.519 --> 00:21:37.359 and therapeutic remedies for this, but if you come too 289 00:21:37.519 --> 00:21:43.599 late in the disease, you are not able to recover 290 00:21:43.799 --> 00:21:47.440 and reverse from it. So, first of all, what is 291 00:21:47.720 --> 00:21:54.079 normal pressure hydrocephalis? So, in the most very basic description, 292 00:21:54.160 --> 00:21:56.200 of this. This is a plumbing problem in your brain. 293 00:21:56.839 --> 00:22:00.720 So within the brain there is cerebral spinal fluid. This 294 00:22:00.759 --> 00:22:04.119 is the fluid that's in and around your brain, the 295 00:22:04.359 --> 00:22:07.839 ventricles and the different chambers of your brain. And what 296 00:22:07.960 --> 00:22:14.160 happens is there is an accumulation or build up because 297 00:22:14.720 --> 00:22:19.880 the flow of this cerebral spinal fluid. I like to 298 00:22:19.880 --> 00:22:23.640 call it the Champagne of body fluids. The cerebral spinal 299 00:22:23.640 --> 00:22:28.160 fluid is not circulating properly. There is a blockage of 300 00:22:28.200 --> 00:22:32.720 some kind. And as a result of this increased pressure 301 00:22:32.799 --> 00:22:39.160 on the brain, you have difficulty walking, trouble controlling your bladder, 302 00:22:39.359 --> 00:22:48.000 and memory problems. Now, the triad of those three bladder, walking, 303 00:22:48.160 --> 00:22:52.680 and memory problems really in a sense, can cinch to diagnosis. 304 00:22:52.960 --> 00:22:58.359 But there are many other diseases, conditions, syndromes that can 305 00:22:58.519 --> 00:23:04.079 just cause difficulty walking, or difficulty controlling ones bladder or 306 00:23:05.319 --> 00:23:10.039 your memory problems. And so what happens is you may 307 00:23:10.079 --> 00:23:17.079 have this constellation of these three major symptoms or complaints. 308 00:23:17.720 --> 00:23:22.119 But you may say the bladder control, okay, oh I'm 309 00:23:22.240 --> 00:23:27.400 getting older. All of my friends and girlfriends and relatives, 310 00:23:27.440 --> 00:23:29.119 they all get up in the middle of the night 311 00:23:29.200 --> 00:23:32.240 and you're in an aid and they're up tinkling three 312 00:23:32.319 --> 00:23:36.920 times a Night's that's pretty normal. Why should I raise 313 00:23:37.079 --> 00:23:40.319 a red flag and go marching into the doctor. The 314 00:23:40.359 --> 00:23:45.920 other is memory problems here again, as the population is 315 00:23:45.920 --> 00:23:49.519 getting older, everybody just thinks, oh, you know, to see 316 00:23:49.519 --> 00:23:52.200 in your moment, I'm sixty, I'm seventy, I'm eighty, and 317 00:23:52.240 --> 00:23:55.920 of course I forget. Everybody has memory problems. You watch 318 00:23:55.960 --> 00:24:01.839 TV at night and there were all these wacky supplements 319 00:24:01.880 --> 00:24:06.000 that you should be taking to sharpen your memory and 320 00:24:06.119 --> 00:24:09.720 make you function at a higher level. Again, this is 321 00:24:09.839 --> 00:24:15.319 at the wholesale level. Everybody has memory problems. Come on, 322 00:24:15.519 --> 00:24:19.920 I'm seventy five years old. I'm going to forget the 323 00:24:20.039 --> 00:24:24.119 name of my grandkid's school, or who is you know, 324 00:24:24.319 --> 00:24:30.720 baseball buddy is? But really, and of course the walking problems. 325 00:24:30.799 --> 00:24:32.559 People say, oh, I've got a bed knee, I have 326 00:24:32.599 --> 00:24:35.519 a bed hip. I slept on my side and it 327 00:24:36.039 --> 00:24:38.519 am a little little cock eyed when I walk around. 328 00:24:39.640 --> 00:24:43.200 But really, this may be the early warning signs of 329 00:24:43.839 --> 00:24:48.920 normal pressure hydrocephalis. Now it really does not affect that 330 00:24:49.039 --> 00:24:51.920 many people, probably less than one percent of the population 331 00:24:52.599 --> 00:24:59.480 age sixty five to eighty, okay, but if you're over eighty, 332 00:25:00.200 --> 00:25:03.200 it represents about five percent of the population. So this 333 00:25:03.319 --> 00:25:06.519 is one of those diseases that as we get older, 334 00:25:07.039 --> 00:25:11.000 more things come up, and so we have to stay 335 00:25:11.559 --> 00:25:16.720 on guard. So you know the problem is a condition 336 00:25:16.960 --> 00:25:19.359 like this, because some of the symptoms are so vague 337 00:25:19.359 --> 00:25:25.880 and everybody has them, it's likely underdiagnosed because people will 338 00:25:25.920 --> 00:25:30.200 simply say and really dismiss it. It's part of the 339 00:25:30.319 --> 00:25:35.640 normal aging process. Come on, Joe, if you're seventy five, 340 00:25:35.759 --> 00:25:37.680 you're going to have a little loss of memory. But 341 00:25:37.799 --> 00:25:42.119 I think that this is where we have to be 342 00:25:42.119 --> 00:25:44.880 better consumers. We have to understand really what the hell 343 00:25:45.319 --> 00:25:50.519 is going on here, so you know, to make the diagnosis. Yes, 344 00:25:50.599 --> 00:25:54.839 you could first see the increased pressure in the brain, 345 00:25:55.000 --> 00:25:58.960 your ventricles. Now you have ventricles in your heart, but 346 00:25:59.079 --> 00:26:02.880 ventricles are just simply a term for a chamber you'll have. 347 00:26:02.920 --> 00:26:07.440 The ventricles in your brain will be swollen, they'll be 348 00:26:07.720 --> 00:26:10.880 enlarged due to the increased pressure. So you could see 349 00:26:10.880 --> 00:26:14.480 this on a cat scan or an MRI, and then 350 00:26:14.519 --> 00:26:19.799 of course the diagnostic test is typically going to be 351 00:26:20.000 --> 00:26:26.079 a spinal tap where they can measure this increase in pressure, 352 00:26:26.400 --> 00:26:29.640 and also by taking a little bit of the fluid out, 353 00:26:30.119 --> 00:26:35.920 some of the symptoms may temporarily be alleviated. So the 354 00:26:36.640 --> 00:26:42.039 treatment of this sounds a little archaic, but this is 355 00:26:42.079 --> 00:26:45.640 what has been around for a good number of decades. 356 00:26:46.759 --> 00:26:52.279 You develop, you have a surgical procedure where they are 357 00:26:52.319 --> 00:26:57.240 going to insert a shunt or a tube that is 358 00:26:57.319 --> 00:27:02.079 going to go from the ventricle in your brain and 359 00:27:02.640 --> 00:27:07.880 tunnel this out of your brain, typically along your chest 360 00:27:08.240 --> 00:27:11.960 into your abdomen. So it's a bypass in a sense 361 00:27:12.000 --> 00:27:18.640 where the excess fluid is going to drain directly into 362 00:27:18.759 --> 00:27:22.119 your abdomen. And these these tubes have valves on them, 363 00:27:22.200 --> 00:27:25.319 so if the pressure increases to a point, it pops 364 00:27:25.359 --> 00:27:31.119 open and the fluid will drain into your abdomen and 365 00:27:31.200 --> 00:27:36.720 you normalize the fluid and people will be better. But 366 00:27:36.880 --> 00:27:44.839 the key thing is that you want to catch this early. 367 00:27:45.440 --> 00:27:51.519 So if a patient shows up having had incontinence or 368 00:27:51.680 --> 00:27:57.039 urinary problem for months to years, they've had memory problems 369 00:27:57.119 --> 00:28:02.039 progressive for months to year, they have gate abnomalities to 370 00:28:02.079 --> 00:28:06.000 the point where you take your loved one into the neurologist, 371 00:28:06.119 --> 00:28:10.599 let's say, and they can't walk their wheelchair bound, I 372 00:28:10.720 --> 00:28:14.759 would say, and experts would say, it's very unlikely that 373 00:28:14.839 --> 00:28:20.000 you're going to be able to reverse the neurologic damage. 374 00:28:20.640 --> 00:28:29.599 All right, So here again, you want to not put 375 00:28:29.640 --> 00:28:32.680 your head in the sand and think that we're all 376 00:28:32.720 --> 00:28:35.559 going to live to one hundred and have no complications. Now, 377 00:28:36.680 --> 00:28:39.559 you know, the issue is we have to be aware 378 00:28:40.039 --> 00:28:46.000 not only in identifying these problems, identifying these conditions, but 379 00:28:46.400 --> 00:28:49.960 for things other than normal pressure hydrocephalis. What can I 380 00:28:50.079 --> 00:28:55.279 do with my lifestyle, my diet, certain other interventions to 381 00:28:55.359 --> 00:29:00.839 prevent this. So factors that affect the outcome of normal 382 00:29:00.960 --> 00:29:07.559 pressure hydrocephalus early diagnosis and treatment, okay, cognitive symptoms that 383 00:29:07.680 --> 00:29:12.839 develop after gate issues and or urinary problems. You have 384 00:29:12.920 --> 00:29:20.160 to address these. Okay, positive outcome are going to be 385 00:29:20.319 --> 00:29:24.319 less likely. So bad outcome, delay in diagnosis and treatment, 386 00:29:25.160 --> 00:29:31.240 cognitive symptoms that start earlier before the gate issues, So 387 00:29:31.319 --> 00:29:35.920 it's bad if the neurologic mental part starts early, or 388 00:29:35.960 --> 00:29:39.039 if you have severe cognitive symptoms, you're going to have 389 00:29:39.279 --> 00:29:44.240 a much poorer outcome. So again, normal pressure hydrocephalus. Again, 390 00:29:44.279 --> 00:29:49.359 we'll have to see how Billy Joel does. And you 391 00:29:49.400 --> 00:29:53.640 know with diseases like this, having a celebrity that sheds 392 00:29:53.759 --> 00:29:57.519 light on it, and certainly what I think we're doing 393 00:29:57.599 --> 00:30:01.440 here is to talk about it and get early intervention. 394 00:30:01.599 --> 00:30:06.119 Typically patients are going to be seen by a neurologist. 395 00:30:06.599 --> 00:30:08.839 You may be seen by a neurosurgeon who's going to 396 00:30:08.839 --> 00:30:12.160 put in the drain, but it's going to start off 397 00:30:12.160 --> 00:30:18.880 with a neurologic evaluation, thinking could this be normal pressure hydrocephalus? 398 00:30:18.960 --> 00:30:22.319 All right, Final segment coming up, Doctor Jogolotti. I'm also 399 00:30:22.359 --> 00:30:24.680 going to post a little bit of information on normal 400 00:30:24.759 --> 00:30:29.400 pressure hydrocephalis on the Facebook page which is at doctor 401 00:30:29.519 --> 00:30:32.440