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Speaker 1: Wake that answer up in the morning.

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Speaker 2: The Breakfast Club Morning everybody is the dj n V

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Speaker 2: Charlamagne the guy we are to Breakfast Club.

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Speaker 1: We got a special guest in the building, Doctor Joseph

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Speaker 1: Pulmer is hell Doctor Puma. Welcome.

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Speaker 3: Thank you for inviting me.

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Speaker 1: Now you know doctor Puma has been here before.

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Speaker 4: Yes, you know, but it's very important to note that

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Speaker 4: February is American Heart Month.

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Speaker 1: Correct, yes, as well as Black History Month. Of course

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Speaker 1: that's right. But that's why we have him here today

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Speaker 1: to talk about all things heart health.

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Speaker 2: Now, for people that don't know or didn't hear when

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Speaker 2: you were here previously, tell people.

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Speaker 1: What you do.

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Speaker 3: I'm a cardiologist. I'm the founder of Soeign Medical, which

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Speaker 3: is the largest independent cardiology practice in New York City.

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Speaker 3: My goals are to democratize healthcare. We have the objectively.

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Speaker 3: We won an award four quarters in a row for

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Speaker 3: the number one heart scan in America, the highest quality imaging.

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Speaker 3: We're insurance based. We take care of everybody that comes

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Speaker 3: through our doors, whether they're a billionaire or they're undomiciled.

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Speaker 3: Our goal is to be part of the communities that

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Speaker 3: we work in and to try and educate and help

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Speaker 3: people live longer.

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Speaker 4: Tell people all the time, man, you know, I've dealt

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Speaker 4: with real bad anxiety my whole life, so you know,

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Speaker 4: I always have the heart palpitations. I always feel like

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Speaker 4: I'm having a heart attack. So at the end of

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Speaker 4: twenty twenty two, I did like every single you know,

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Speaker 4: heart test you could imagine, but the one.

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Speaker 1: That put me at ease the most was the soaring

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Speaker 1: heart scan. Could you tell people what the sor and

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Speaker 1: heart scan is at the boom?

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Speaker 3: So when we image the heart, we're basically using a camera, right.

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Speaker 3: The soaring heart scan uses the fastest camera available in

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Speaker 3: the world. It's a cat scan. It's the only one

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Speaker 3: of its kind in New York City dedicated to evaluating

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Speaker 3: heart disease. And in a three to four minute scan,

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Speaker 3: we're able to see the arteries in the heart, see

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Speaker 3: if there's any blockage, to see if there's any plaque

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Speaker 3: build up of beginning of blockage calcification. We can see

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Speaker 3: the heart chambers, the major arteries in the body, the aorda,

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Speaker 3: pulmonary arteries. In addition, we get a limited view of

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Speaker 3: the lungs and other structures. But it's the most accurate scan.

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Speaker 3: It takes three four minutes. It's eliminated the need for

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Speaker 3: having stress testing, and more importantly, it's eliminated the need

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Speaker 3: and this is all pure reviewed published data. Eliminated the

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Speaker 3: need by almost half for having invasive heart catheterizations where

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Speaker 3: you have to go in the hospital and we have

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Speaker 3: to put catheters in. So a simple test, Charlemagne, I

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Speaker 3: think you're right. You've been a big promoter of mental health.

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Speaker 3: And you know about half the people that come to

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Speaker 3: cardiologists have symptoms that sound like it's from their heart,

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Speaker 3: but it's often just from anxiety and stress, and so

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Speaker 3: often that one simple scan, if it's completely normals like

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Speaker 3: yours dj Envy was perfectly normal, could put your mind

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Speaker 3: at ease and allow you to get on with your

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Speaker 3: life without worry.

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Speaker 2: Let's talk about the scan. So you know every year

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Speaker 2: I go get a physical, and I heard Charlomade talk

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Speaker 2: about this test that he did for his heart, and

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Speaker 2: you know how he felt comfortable after. So I have

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Speaker 2: six kids, so I like to as much as I

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Speaker 2: can try to prevent anything or try to check up

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Speaker 2: on anything. So I went and got the heart scan.

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Speaker 2: I didn't take that long like you said, maybe ten

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Speaker 2: minutes the longest I was in the office in totality.

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Speaker 2: So just tell people what it consists of, and we

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Speaker 2: can do a reading online. I'm fine with it, and

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Speaker 2: so let's go there. So people come there, and now

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Speaker 2: what happens when they get there?

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Speaker 1: Okay.

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Speaker 3: So the first thing I think that's important to understand

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Speaker 3: is number one, heart disease is the number one killer

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Speaker 3: in America. Okay. Even if you add all the cancers

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Speaker 3: in the world, in America together, heart disease kills more

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Speaker 3: people every year. And that's not to minimize, you know,

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Speaker 3: the effects of cancer. That's just to say this is

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Speaker 3: a major public health problem.

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Speaker 1: Correct.

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Speaker 3: Second, I appreciate you inviting me during Heart Health Month February,

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Speaker 3: because it's also Black History Month, and for the African

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Speaker 3: American community in particular, they die at twice the rate

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Speaker 3: of whites from heart disease. They develop high blood pressure

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Speaker 3: diabetes at a much earlier age, and so they're more

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Speaker 3: likely to have complications. What the sore and heart scan

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Speaker 3: does is you come in the office. You can arrange

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Speaker 3: it on your own. You can call Pound two fifty,

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Speaker 3: you can go on our website and schedule it at

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Speaker 3: your convenience. When you come in, you know, you get

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Speaker 3: the initial paperwork, which takes a minute or two. We

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Speaker 3: bring you in, We put an intravenous in an IV

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Speaker 3: in your arm. We bring you in the lab. You

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Speaker 3: lay on the table for the cat scan. Our unbelievable

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Speaker 3: nurses then will monitor your heart rate and blood pressure.

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Speaker 3: Because we're imaging a moving object as opposed to doing

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Speaker 3: a scan of your brain or your abdom in, which

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Speaker 3: is not moving. We want to get your heart rate

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Speaker 3: down to around sixty to sixty five, so they might

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Speaker 3: give you some intravenous medication to lower your heart rate.

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Speaker 3: They'll put a nitroglycerin under your tongue because that helps

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Speaker 3: dilate the arteries around the heart, so we get better

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Speaker 3: pictures and we can really see the flow. And then

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Speaker 3: we do the scan and all of that, as you said,

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Speaker 3: shouldn't be more than fifteen minutes in the office, and

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Speaker 3: the scan itself about three to four minutes.

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Speaker 2: Now, now, you did my scan a couple of months ago,

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Speaker 2: and I was very nervous, not nervous of what is wrong,

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Speaker 2: but I guess nervous about finding out right. I think

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Speaker 2: that's what most people like it. YEA, most people don't

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Speaker 2: want to find out if something is wrong.

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Speaker 4: Shoot, I do when it comes to the heart, because

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Speaker 4: tell them about that. We don't make a duck.

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Speaker 1: Yeah.

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Speaker 3: So again, just from the standpoint of understanding heart disease better,

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Speaker 3: a third of people who have heart attacks never even

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Speaker 3: knew they had heart disease before they had them. A

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Speaker 3: third of people who have heart attacks die the day

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Speaker 3: they have their heart attack. So it's not pleasant. So

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Speaker 3: some of this is silent. It grows as time goes on, right,

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Speaker 3: especially if you have risk factors high blood pressure, diabetes, smoke,

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Speaker 3: you're overweight, you're sedentary, if you have high cholesterol, or

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Speaker 3: a family history of heart disease. Okay, these are all

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Speaker 3: the things that as time goes on, the body changes

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Speaker 3: and you're building up plaque and blockage in the arteries.

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Speaker 3: But once you have the test, even if you have

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Speaker 3: a severe blockage, we can easily treat it. Nine out

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Speaker 3: of ten times, if a blockage is severe, the flow

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Speaker 3: is limited through the artery, and we have some objective data,

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Speaker 3: objective approaches to figuring that out. Nine out of ten

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Speaker 3: times we can treat it with a stent, which is

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Speaker 3: an outpatient procedure. Unfortunately, one in ten times you might

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Speaker 3: need open heart surgery. Yikes, but it's proven you'll live longer.

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Speaker 3: And even in the people who don't, who say they

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Speaker 3: don't have any symptoms, oftentimes after we've treated their arteries

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Speaker 3: in their heart, they come back to the office and

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Speaker 3: follow up and say, you know what, I actually feel better.

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Speaker 3: I didn't think I felt bad, but now I feel better,

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Speaker 3: So I understand there's a lot of stress and anxiety

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Speaker 3: about it. The other thing is if the scan is

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Speaker 3: completely normal, no plaque, no calcification, no blockage. Let's say

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Speaker 3: like your scan, that means over the next ten years,

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Speaker 3: your risk of having a heart attack, stroke, or death

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Speaker 3: is less than two percent. That is the best. That

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Speaker 3: is the best risk group you could be in. But

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Speaker 3: we're able even if there is mild or moderate plaque,

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Speaker 3: we're able to like me, right, we talked about your

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Speaker 3: risk factors, we talked about the goals of your cholesterol

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Speaker 3: treatment or blood pressure treatment, and once we know that,

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Speaker 3: your survival should be exactly the same or pretty close

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Speaker 3: to djenvis your life span. And in fact, we calculated

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Speaker 3: a risk and it was like two point five percent

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Speaker 3: over the next ten years, a risk of heart attack

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Speaker 3: Stroker death. So the key is just show up. You

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Speaker 3: never know what you find. You know, one of the

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Speaker 3: most amazing experiences I had last year, Charlemagne, was when

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Speaker 3: we attended your Mental Wealth Expo and oh thanks for

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Speaker 3: inviting us. I mean, it was inspirational to us. There

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Speaker 3: were thousands of people there. Many of them were there

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Speaker 3: because of mental health issues, but the reality is many

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Speaker 3: of them were there just because they were trying to

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Speaker 3: take charge of their health. They were searching for information.

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Speaker 3: And you're someone it's who are you? Are? Are people

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Speaker 3: that you know that have influence? People listen to you, okay,

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Speaker 3: and they trust you. And so we set up and

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Speaker 3: we were doing free blood pressure screenings. We must have

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Speaker 3: screened four hundred people that day. Wow, over two hundred

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Speaker 3: of them their blood pressure was out of control. And

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Speaker 3: out of that two hundred, about fifty or sixty didn't

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Speaker 3: even know they had high blood pressure. So just show up.

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Speaker 3: It's simple things. As a community, as physicians, we can

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Speaker 3: do screenings, for instance, in the local churches, barber shops,

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Speaker 3: you know, anywhere, really schools, and once you know, once

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Speaker 3: you have that information DJ Envy, then it's just a

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Speaker 3: matter of finding a doctor or a healthcare provider that

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Speaker 3: you have faith in, that you trust, and working with

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Speaker 3: them to control get on the right medicines and monitor

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Speaker 3: and control your blood pressure or your cholesterol or your diabetes.

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Speaker 1: Hey, I'm on stating from my cholesterol.

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Speaker 4: But you mentioned you keep missing a high blood pressure,

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Speaker 4: you keep missing the diabetes, you keep missing a crow.

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Speaker 4: What I find interested in that young Black people are

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Speaker 4: living with diseases more common at ages. They're living with

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Speaker 4: these diseases that should be that are usually more common

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Speaker 4: at old ages.

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Speaker 1: That's scared.

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Speaker 3: That's exactly right in the black community compared to the

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Speaker 3: white community. If the rate of high blood pressure in

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Speaker 3: Blacks between thirty five and forty nine is fifty percent

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Speaker 3: higher wow than whites. The rate of diabetes is forty

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Speaker 3: percent higher. And if you have these chronic diseases earlier,

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Speaker 3: they're more likely over time to cause complications, to have problems,

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Speaker 3: to cause heart attack and stroke. And even at sixty

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Speaker 3: five heart disease, Blacks are fifty percent more likely to

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Speaker 3: die of heart disease than whites. So these are chronic

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Speaker 3: problems that can cause devastating acute complications, and so finding

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Speaker 3: it early and treating it and following with the doctor.

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Speaker 3: From a physician standpoint, it's our job to make it easy.

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Speaker 3: It's our job to listen. It's our job to build

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Speaker 3: a relationship. It's our job to make sure when you

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Speaker 3: have a test, for instance, you get the results of

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Speaker 3: the test and we explain to you, you know, clearly

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Speaker 3: in language, you can understand what the implications are and

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Speaker 3: how best to treat it.

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Speaker 2: I was going to ask if you just, you know,

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Speaker 2: go over some of the stuff. So what are you

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Speaker 2: looking for when you're actually doing the skin of the heart. Now,

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Speaker 2: is it easy to detect plaque? And like you know,

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Speaker 2: where somebody does have plaque or somebody does have a problem,

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Speaker 2: you can actually fix the problem right then and there

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Speaker 2: correct in most cases.

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Speaker 3: In most cases in New York State, we still have

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Speaker 3: to bring it to the hospital to do it. Although

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Speaker 3: as you reflect, we have an ambulatory surgical center in

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Speaker 3: Lower Manhattan and we can fix lots of problems there,

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Speaker 3: But we're not allowed to go into the heart yet,

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Speaker 3: so we still have to do it in the hospital.

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Speaker 3: But if we see a widow macro allsion, we'll get

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Speaker 3: you in the hospital same day or next morning. But

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Speaker 3: the images we get, we get two things we get.

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Speaker 3: We get images of the arteries as if we did

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Speaker 3: a catheterization, so we can see blockage. And then we

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Speaker 3: do a what's called a heart flow. It's a company

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Speaker 3: in California that has this amazing artificial intelligence software that

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Speaker 3: can give us an objective assessment of flow in the

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Speaker 3: artery and we have some cut points that tell us

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Speaker 3: if it's significant or not any of the plaques and

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Speaker 3: that they might need a stent.

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Speaker 1: Is there a way to low cholesterol without taking medication? Yeah,

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Speaker 1: there are a lot of ways. Will be on statin

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Speaker 1: failbum right now.

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Speaker 3: You'll be on statins forever only because all the research

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Speaker 3: studies we have done are so powerful and show that

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Speaker 3: people who take statins live longer because of the reduction

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Speaker 3: in heart attack or stroke. However, through diet, exercise, you

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Speaker 3: can lower cholesterol and so some people don't necessarily need statins.

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Speaker 3: One of the first cholesterol medicines ever, I don't want

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Speaker 3: to say invented, but ever used to treat cholesterol is

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Speaker 3: actually a naturally occurring vitamin niacin that lowers cholesterol very well.

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Speaker 3: It has lots of side effects, which is why it's

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Speaker 3: not so commonly used. It can cause facial flushing. But

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Speaker 3: but yeah, there there are ways and and people who

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Speaker 3: are overweight. You're not overweight, so it's it's it would

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Speaker 3: be more difficult, but people are often overweight. I don't

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Speaker 3: think it's a big surprise that there's an obesity epidemic

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Speaker 3: in this country, and that affects blacks more than whites

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Speaker 3: as well. Diet and exercise can lower their cholesterol. We've

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Speaker 3: had many patients that through diet and exercise are able

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Speaker 3: to come off of diabetes medicines, less blood pressure medicines.

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Speaker 3: And now we have these these weight loss drugs. And

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Speaker 3: I'm smiling because I had I had a patient two

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Speaker 3: weeks ago that I discussed one of the weight loss drugs.

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Speaker 3: You know, there's like, I think three or four of

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Speaker 3: them now ozembig would go and when I told him,

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Speaker 3: you know, maybe we can talk about it and consider it,

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Speaker 3: he said no. Just this morning, I was listening to

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Speaker 3: The Breakfast Club and Charlemagne said that when you're on

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Speaker 3: these when you're on these weight loss drugs, you got diarrhea.

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Speaker 2: And it's one of the side effects. I thought they

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Speaker 2: said sometimes, right or no, that's that's what I right.

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Speaker 3: So it could be a side effect. Again, when you

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Speaker 3: read about side effects, these aren't often The side effects

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Speaker 3: are in the low single digit percentages.

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Speaker 1: I did have a homeboy who was on it. He

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Speaker 1: was an Ozmpic gold medalist, and he definitely had diarrhea.

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Speaker 1: He definitely said the side effah.

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Speaker 3: And it's possible listen there definitely.

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Speaker 2: What do you think about Ozmpic, like, because you know

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Speaker 2: it's a I guess it was supposed to be a

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Speaker 2: for diabetes, right to fight diabetes.

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Speaker 1: But people are using for weight loss.

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Speaker 2: Is that a healthy thing?

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Speaker 3: Is that a healthy thing? So it would be healthier

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Speaker 3: if you weren't overweight in the first place. Correct, But

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Speaker 3: but I don't think we should stigmatize people that are overweight.

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Speaker 3: Some people's metabolism is different. I think I am much

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Speaker 3: more on board now with these medications. At the American

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Speaker 3: Heart Association meetings in November of twenty twenty three, there

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Speaker 3: was for the first time a research study that prove

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Speaker 3: that patients who took these weight loss drugs ozempic and

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Speaker 3: Magovi which are the same drug, actually had a lower

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Speaker 3: risk of heart attacks and death. Really, so in certain populations,

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Speaker 3: usually what we do is, you know, we'll try and

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Speaker 3: counsel people. We'll try and work with them, educate them

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Speaker 3: on diet and exercise, and then monitor them to the

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Speaker 3: extent they can lose weight that way, that would be preferable.

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Speaker 3: But if they can't, there are options. I would prefer

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Speaker 3: a drug to surgery. You know, there are a lot

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Speaker 3: of surgical options to lose weight, but there's lots of

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Speaker 3: side effects. You know with surgery as well. You know,

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Speaker 3: patients lose weight. If patients have surgery for weight loss,

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Speaker 3: their weight loss is usually greater than if they take

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Speaker 3: the drugs. If you're taking the injections for weight loss,

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Speaker 3: maximum or the median I would say is about fifteen

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Speaker 3: percent of your weight, you know you'll drop. So if

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Speaker 3: you're two hundred and fifty pounds, you'll lose maybe thirty

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Speaker 3: five forty pounds.

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Speaker 2: Next last question on this, I know you're not here

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Speaker 2: for that, but what does ozempic do to make you

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Speaker 2: lose weight?

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Speaker 1: Like?

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Speaker 2: Does it you know, shrink your stomach? Like what does

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Speaker 2: it do where people lose weight in so fast?

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Speaker 3: So it affects metabolism and transit time. Okay, so you're

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Speaker 3: transiting your food that you eat much slower through through

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Speaker 3: the body, so you feel full more often. So most

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Speaker 3: patients who are on ozempic or wigovi or munjaro, they

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Speaker 3: don't have an appetite, they don't feel hungry. So I

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Speaker 3: saw someone yesterday, for instance, who had lost forty two

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Speaker 3: pounds than on it for six months. Wants to stay

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Speaker 3: on it, but he he said, he, you know, you

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Speaker 3: to eat three meals a day and have snacks. He

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Speaker 3: has one meal a day.

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Speaker 1: Now is that healthy? It depends, Yeah, every everything depends.

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Speaker 3: Again, it would be better if if if we could

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Speaker 3: do all these things naturally. It would be better if

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Speaker 3: we didn't need to use medications. It would be better

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Speaker 3: if people didn't need to see me. But uh, you know,

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Speaker 3: and I spent most of my career dealing with the

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Speaker 3: complications of all these problems. And and in the last

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Speaker 3: few years, I've really focused on on prevention and UH

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Speaker 3: and trying to increase awareness and education. So these conversations

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Speaker 3: are so important. What you all are doing is critically

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Speaker 3: important for all communities to start understanding these things. So,

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Speaker 3: you know, is it healthy? Would be better if we

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Speaker 3: didn't need.

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Speaker 1: It, right is American heart muff? What should people be

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Speaker 1: doing right now?

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Speaker 3: Doctor pum? So it's a heart month. I love February

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Speaker 3: because it's heart health month. Every place you turn, every media,

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Speaker 3: no matter how you consume media, you're going to see

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Speaker 3: something about awareness. Get your blood pressure checked, get blood tests,

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Speaker 3: check your your your sugar levels. Okay, go see your doctor.

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Speaker 3: If you don't want to do that, or you can't

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Speaker 3: do that, let's start getting healthy. Get off the couch.

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Speaker 3: You don't need to train for the marathon. How about

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Speaker 3: we just get off the couch. Or you know, on

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Speaker 3: the way home from work, before you go in, take

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Speaker 3: a brisk walk around the block. You know, in a

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Speaker 3: few weeks, try two walks, you know, two blocks. Just

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Speaker 3: start getting active. But I think that you know, February

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Speaker 3: is a great month because it's a great reset month.

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Speaker 3: We think about it, we talk about it, and hopefully

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Speaker 3: it encourages people to take charge of their health. What

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Speaker 3: what you know, since I've been on the show last time,

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Speaker 3: what's just amazed me and just blow me away is

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Speaker 3: how many people you've inspired and encouraged to take charge

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Speaker 3: of their health and to just show up. And then

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Speaker 3: the other thing I would do is if I was

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Speaker 3: a patient, I would put pressure on my doctors. Remember

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Speaker 3: when you go see the doctor. That doctor works for you.

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Speaker 3: So have a list of questions before you go in,

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Speaker 3: whether it's things you don't feel well about, or things

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Speaker 3: that you you know that you you're not sure about,

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Speaker 3: or side effects or your medicine. Have a list of questions.

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Speaker 3: Don't let them leave that room and do your questions

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Speaker 3: or answered. Don't let them leave that room until they

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Speaker 3: schedule the test to give you an answer. So really

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Speaker 3: it's just take charge of your own life.

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Speaker 2: I have one last question, signs of a heart attack?

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Speaker 1: Right?

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Speaker 2: And I think this is what gives a lot of

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Speaker 2: people anxiety. Wish all we were talking, what are the

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Speaker 2: signs of a heart attack?

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Speaker 1: Right?

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Speaker 2: Because you know, if you get a tingling in your

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Speaker 2: left hand, people think heart attack.

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Speaker 3: Right.

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Speaker 2: If you get pain on your left side, you think

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Speaker 2: heart attack. If your left arm hurt's heart attack? What

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Speaker 2: are the typic signs of a heart attack?

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Speaker 3: Yeah, that's that's actually a great question, and that's the

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Speaker 3: reason why so many people with anxiety come in. So

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Speaker 3: the typical signs of a heart attack. If you're watching

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Speaker 3: George Clooney and er, let's say, you know, is you

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Speaker 3: get tightness, pressure, like a crushing sensation in your chest,

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Speaker 3: we call it chest pain, but most people say it's

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Speaker 3: not really a pain. Okay, it's a crushing pressure in

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Speaker 3: your chest. You get shorter breath, you can get diaphyretic,

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Speaker 3: which means cold, clammy and sweaty. The symptoms often radiate

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Speaker 3: to the left arm, associated with numbness, and we're not

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Speaker 3: really sure why that occurs. The problem is in women

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Speaker 3: and in diabetics, they get atypical symptoms. What I just

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Speaker 3: described are the typical symptoms, so i'd expect a man

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Speaker 3: like yourself to have those symptoms, but women, in diabetics

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Speaker 3: diabetics can get atypical symptoms. They can feel fatigued, they

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Speaker 3: could feel a little shorter breath, they might feel digestion

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Speaker 3: like symptoms. People who have sharp chest pain chest pain

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Speaker 3: that increases when they take a deep breath. Chest pain

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Speaker 3: that occurs, you know, when they do a particular motion,

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Speaker 3: go to pick up a box or reach for something.

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Speaker 3: That's almost always not from your heart. That's almost always musculoskeleton.

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Speaker 3: But let's go back to anxiety. When you're anxious, your

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Speaker 3: heart rate goes up, you hyperventilate, you can get tightness

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Speaker 3: in your chest. It becomes hard to breathe and you

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Speaker 3: can get numbness in your arm, so it could be

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Speaker 3: exactly the same. The point is you're not alone out there.

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Speaker 3: You're not alone out there. There's people to help you. Go,

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Speaker 3: seek attention, take charge of your health, get the answer

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Speaker 3: you need so you can rid yourself of some of

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Speaker 3: this anxiety. That doesn't the anxiety will go away. You

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Speaker 3: might still have anxiety and panic attack, but at least

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Speaker 3: now you'll have the information to know I'm not having

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Speaker 3: a heart attack.

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Speaker 1: That's right, and that takes that That alone takes away

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Speaker 1: some of the anxiety. Industript there, give me your information,

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Speaker 1: doctor Pum. Tell me to find you well.

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Speaker 3: We have offices all over New York City, into New Jersey, Monroe,

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00:22:20,560 --> 00:22:25,040
Speaker 3: even up in Middletown, New York. Soren Medical Andy dot com.

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Speaker 3: You can find us there. We have our Ambilitory Surgical

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Speaker 3: Center and our award winning sore and heart Scan is

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Speaker 3: based at one twenty Wall Street on the corner of

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Speaker 3: South Street, right across from the river near the South

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Speaker 3: Street Seaport. And we accept everyone and anyone, regardless of

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Speaker 3: your insurance status or ability to pay. We're here for

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Speaker 3: the communities that we serve. We have about twenty five

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Speaker 3: offices across the New York City area.

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Speaker 1: All right, well, thank you, doctor Puma. We appreciate you

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Speaker 1: for joining us.

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Speaker 3: Thanks so much, thank you all for having me here.

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Speaker 1: I really appreciate it. It's the Breakfast Club.

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Speaker 2: Good morning, wake that ass up Earth in the morning

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Speaker 2: for Breakfast Club.

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Speaker 3: H