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Speaker 1: It is time for our medical segment, which we do

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Speaker 1: every Wednesday with doctor Jim Keeney, Chief Medical Officers for

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Speaker 1: Officer for Dignity Saint Mary Medical Center in Long Beach.

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Speaker 2: Good morning Jim, Good morning Bill. Haven't talked in a while.

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Speaker 1: Gone with on vacation and I was on a cruise

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Speaker 1: ship and I was hoping that some people were going

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Speaker 1: to get into nova virus or they were gonna get

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Speaker 1: COVID and die.

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Speaker 2: But nothing, just nothing.

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Speaker 3: Wow. Yeah, well that sounds like a good vacation.

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Speaker 2: Then yeah, well on it what Yeah?

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Speaker 1: And in front of this is something that's fairly new

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Speaker 1: in front of every eating establishment. Uh, there is a

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Speaker 1: little sanitation uh you know, purel little station and man,

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Speaker 1: they push it really hard.

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Speaker 2: So maybe that seems to be the answer.

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Speaker 1: Okay, talking about COVID, All right, can nasal spray.

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Speaker 2: Protect you from COVID? Let's talk about that moment.

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Speaker 3: Sure. So there are a couple of naval sprays being

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Speaker 3: developed that would block COVID in different ways. Right, So

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Speaker 3: there's one that kind of creates this coating. They call

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Speaker 3: it pathogen capture and neutralization spray, and it coats the

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Speaker 3: nasal passages to trap viruses and bacteria before they can

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Speaker 3: reach yoursels. So you know a lot of times the

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Speaker 3: virus comes in through your nose or even more commonly

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Speaker 3: probably through your eyes, and then your tears carry it

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Speaker 3: down into your nose and it gets absorbed and then

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Speaker 3: that's how it gets into your body. So this would

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Speaker 3: block that. The second spray is is already an anti

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Speaker 3: histamine on the market, Zalestine, and it's an antihistamine spray,

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Speaker 3: but they're looking at right now phase two human clinical trials,

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Speaker 3: and that seems to block the way, you know, the mechanism.

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Speaker 3: Remember there was that area that the virus attaches and

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Speaker 3: it's a receptor and this thing blocks that receptor.

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Speaker 2: Hey excuse me, Oh well, I don't know what just happened.

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Speaker 1: Are you familiar with the political aspects of this, and

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Speaker 1: I know that's not your wheelhouse, but I don't know

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Speaker 1: if you've heard buzz throughout the medical world, and that

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Speaker 1: is the anti vaxxers dealing with this as opposed to vaccine.

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Speaker 1: Is there enough of a difference that it can be

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Speaker 1: argued this isn't even close to a vaccine, so even

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Speaker 1: don't worry about it.

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Speaker 2: Your thoughts on that.

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Speaker 3: Yeah, I mean the sense the studies aren't done. We

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Speaker 3: really don't know yet. So right now, vaccines are the

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Speaker 3: strongest defense against you know, getting severe COVID or long COVID.

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Speaker 3: It doesn't necessarily stop you one hundred percent from getting COVID,

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Speaker 3: but it does improve the outcomes. And then you know this,

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Speaker 3: HI would compare more to masking. Right this is blocking

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Speaker 3: the virus from getting into your body. And right now

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Speaker 3: we know that the masking works in especially in crowded

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Speaker 3: environments to reduce your risks. So people who are at

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Speaker 3: high risk and they don't have a choice and they

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Speaker 3: have to go shopping or you know, go to a

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Speaker 3: doctor's appointment and take the bus or something like that,

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Speaker 3: they need a way to protect themselves. At masks right

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Speaker 3: now as their best bet. But these sprays could be

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Speaker 3: an alternative.

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Speaker 1: Yeah, we see very few masks, and it's always Asians

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Speaker 1: who wear masks.

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Speaker 2: I don't know if you've noticed that.

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Speaker 1: There must be some cultural thing about masking, but I

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Speaker 1: noticed that it's going down, down, down. I just got

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Speaker 1: my COVID shot and my flu shot because I get

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Speaker 1: every vaccine under the planet.

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Speaker 2: And now you and I have talked about this.

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Speaker 1: Because you you actually contracted COVID?

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Speaker 2: What eight times? Do I have that right?

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Speaker 3: Yeah? Yeah, yeah, eight times and got four vaccines. So again,

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Speaker 3: you know, everybody can say, well, okay, i'll see a

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Speaker 3: COVID vaccine doesn't work. You got COVID eight times. But

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Speaker 3: I never was hospitalized. I never really missed a lot

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Speaker 3: of work. I usually was back. The longest one, which

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Speaker 3: was the most severe one, probably a week I was

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Speaker 3: sick and then I was better. Most of them was

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Speaker 3: two to three days. But yeah, I don't know, you know.

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Speaker 3: And so, like I said, I talked to it and

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Speaker 3: it'fect to these specialists and he said, well, obviously you

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Speaker 3: know you're getting you're not getting the protection completely from

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Speaker 3: this vaccine. So it's really up to you as to

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Speaker 3: whether you want to continue getting boosters. But you know,

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Speaker 3: I feel like I gave it so often now I'm

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Speaker 3: getting boosted every time I get the infection.

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Speaker 2: Are you concerned about long COVID at all?

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Speaker 1: And with would that help you make up your mind

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Speaker 1: about COVID shots?

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Speaker 3: Yeah, I mean no, I'm definitely concerned about long COVID.

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Speaker 3: It seems like a high percentage of people have it,

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Speaker 3: and you know, so but again I've had four vaccines,

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Speaker 3: so in a way, I'm somewhat vaccinated now that the

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Speaker 3: boosters are just to try and remind your immune system,

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Speaker 3: and like I said, my impian system seems to be

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Speaker 3: getting reminded every you know, every twelve months or so,

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Speaker 3: so the booster seems irrelevant in my case. But like

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Speaker 3: I said, that's why people should go talk to their

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Speaker 3: doctor make their own individual recommendations. I'm still happy I

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Speaker 3: got the shot and the three boosters, but and I'd

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Speaker 3: do it again if I was going to start all

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Speaker 3: over again. But at this point, it just doesn't seem

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Speaker 3: to make sense for me. If you know, maybe if

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Speaker 3: I went two or three years with no with no COVID,

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Speaker 3: I would say, all right, you know what, I haven't

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Speaker 3: had COVID for three years, I'd better get a booster.

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Speaker 2: Interesting. And is that because of the time you spent

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Speaker 2: in the er?

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Speaker 3: I think so? Yeah. I mean we were getting exposed constantly.

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Speaker 3: You know, you try your best, Yeah, you do what

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Speaker 3: you can, but it's so busy it's just hard not

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Speaker 3: to get exposed. And then you know, you walk into

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Speaker 3: a room for somebody that has a broken toe, and

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Speaker 3: you know, you think, okay, it's probably safe here and

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Speaker 3: they start hacking up along and that happens all the time,

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Speaker 3: so it's just part of the job.

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Speaker 2: You could pretend you're Asian at Costco and wear a mask.

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Speaker 2: That works.

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Speaker 3: Well, I did I always wear a mask?

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Speaker 1: Yeah?

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Speaker 3: Well not in it, you're right. I mean if I

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Speaker 3: walked into somebody with no symptoms and then you know

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Speaker 3: you're right, sometimes I wouldn't wear a mask, Jim.

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Speaker 1: Ninety percent of heart disease cases have a risk factor

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Speaker 1: that we can actually address, we can do something about

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Speaker 1: before the heart disease or the heart attack hits.

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Speaker 2: You want to share that information with.

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Speaker 3: Us, sure, And I'll tell you this is a surprising

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Speaker 3: study because we've had some pretty good earlier studies, the

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Speaker 3: Framingham study, one called inter Heart that had thirty thousand

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Speaker 3: patients across fifty two countries, and what those showed is

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Speaker 3: about ten to twenty percent have no risk factors when

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Speaker 3: they have a heart attack. So we always walked around saying, look,

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Speaker 3: you got to be aware, you could have even you

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Speaker 3: have no risk factors, you could have a heart attack. Well,

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Speaker 3: it turns out this kind of puts a finer point

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Speaker 3: on that number. One I should tell you about the study.

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Speaker 3: It was done mostly with Korean patients, six hundred thousand

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Speaker 3: Korean patients, and that's because the ability of big data.

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Speaker 3: You know, they don't have the same hip hop protections,

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Speaker 3: so they can look across, you know, the entire country

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Speaker 3: and get data where we don't have that ability in

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Speaker 3: the United States. So there's one thousand patients from the

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Speaker 3: US and six hundred thousand from Korea. So this is

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Speaker 3: basically a Korean study. And what they looked at was

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Speaker 3: they said, look, we're not just going to look for

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Speaker 3: the diagnosis the doctor actually calls it diabetes or high

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Speaker 3: blood pressure. We're going to look for your whole medical

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Speaker 3: record and see if you have high blood pressure or

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Speaker 3: see if you have diabetes or elevated blood sugars. So

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Speaker 3: it didn't depend on the diagnosis. And what this found

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Speaker 3: was that when you do that, then you're going to

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Speaker 3: find that that ninety nine percent of people have either

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Speaker 3: high blood pressure, high cholesterol, diabetes, or pre diabetes. And

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Speaker 3: so they do actually have risk factors, and maybe those

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Speaker 3: those very minimal. So maybe the doctor ignored it because

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Speaker 3: their blood pressure wasn't too high or their cholesterol wasn't

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Speaker 3: that high, but even these minimal elevations seem to contribute

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Speaker 3: to being at risk for heart disease.

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Speaker 1: Is there any i issue as to Asian cultures in Japanese?

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Speaker 1: We heard about the Japanese studies where lifestyle and diet

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Speaker 1: changes them in terms of their percentage of heart disease, cancers, etc.

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Speaker 1: Simply because they are like you know, the commercials for

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Speaker 1: that yogurt company where you had this village in the

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Speaker 1: Carpathian Mountains where.

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Speaker 2: Everybody lived to be two hundred years old. Do they

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Speaker 2: take that into effect?

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Speaker 3: I mean in this study, they did not take that

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Speaker 3: into effect. What they were looking at the endpoint was

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Speaker 3: did you have a heart attack or didn't you? And

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Speaker 3: so these are people who did have a heart attack.

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Speaker 3: But you're right, I mean there are Asian cultures like

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Speaker 3: Japan where the heart attack rate is much lower than

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Speaker 3: it is in the US. And that's you know, we

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Speaker 3: can call that a weakness for the study. Is you know,

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Speaker 3: is it does it apply to the US as much

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Speaker 3: as it applies to Koreans, because you know, we do

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Speaker 3: have it's a it's a different gene pool overall, and

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Speaker 3: a different environment and other different factors. So it definitely

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Speaker 3: a weakness of the study, but at the same time

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Speaker 3: interesting study because it's a high power as far as

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Speaker 3: the number of patients that they looked at. Still an

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Speaker 3: observational study, meaning you're going into the data and observing it.

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Speaker 3: You're not actually doing a prospective study where you predict

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Speaker 3: what might happen and you change that one variable on

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Speaker 3: the person and you see if it happens. That's the

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Speaker 3: best study this is. This is observational, but at the

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Speaker 3: same time, you know, a very powerful study and in

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Speaker 3: contradiction to those previous studies that show that, hey, you

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Speaker 3: could have a heart attack without any risk factors.

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Speaker 1: Yeah, in terms of studying genes in Asian cultures, they

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Speaker 1: don't have a whole lot of immigration, you know, relative

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Speaker 1: to Western culture, relative the United States where we're one

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Speaker 1: huge melting plot. Does that skew studies when you have

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Speaker 1: a specific population that just doesn't do a lot of mixing.

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Speaker 3: Yeah. Absolutely. So that's why where they do the study

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Speaker 3: is important. And even within the US, I mean, we

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Speaker 3: have so many different cultures here in so many different

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Speaker 3: ways that people you know, eat or live or their

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Speaker 3: activity levels. You know, it's much different. I would imagine

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Speaker 3: in Minnesota, in the winter than it is in Florida.

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Speaker 3: So you know, even within the US, you got to

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Speaker 3: look at where these patients came from. Was there a

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Speaker 3: good diverse mix. There's a lot that goes into analyzing

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Speaker 3: a study deciding does that the results from this study

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Speaker 3: really apply to my patients? Does it really apply to me?

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Speaker 2: Okay?

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Speaker 1: Jim, chief medical officer for Dignity Saint Mary Medical Center

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Speaker 1: in Long Beach. I we'll catch you again next week,

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Speaker 1: probably talk over the weekend too, So Jim, as always,

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Speaker 1: I say goodbye and go kill someone, Okay, Okay, right,

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Speaker 1: take care Bill always. Always, by the way, that's how

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Speaker 1: I end conversations. When we talk on the phone and

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Speaker 1: we see each other and we'll have meals together. I

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Speaker 1: hang out with Jim, and that's you know, goodbye, James.

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Speaker 2: Enough you say the same thing to me when we

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Speaker 2: get off the phone. No, no, because you're already doing it. Okay,

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Speaker 2: because yeah,