1
00:00:10,720 --> 00:00:14,360
Speaker 1: Welcome to the Therapy for Black Girls Podcast, a weekly

2
00:00:14,440 --> 00:00:19,200
Speaker 1: conversation about mental health, personal development, and all the small

3
00:00:19,239 --> 00:00:22,360
Speaker 1: decisions we can make to become the best possible versions

4
00:00:22,400 --> 00:00:26,480
Speaker 1: of ourselves. I'm your host, doctor Joy hard and Bradford,

5
00:00:26,880 --> 00:00:31,960
Speaker 1: a licensed psychologist in Atlanta, Georgia. For more information or

6
00:00:32,080 --> 00:00:35,480
Speaker 1: to find a therapist in your area, visit our website

7
00:00:35,600 --> 00:00:39,280
Speaker 1: at Therapy for Blackgirls dot com. While I hope you

8
00:00:39,360 --> 00:00:43,360
Speaker 1: love listening to and learning from the podcast, it is

9
00:00:43,400 --> 00:00:46,280
Speaker 1: not meant to be a substitute for a relationship with

10
00:00:46,360 --> 00:00:57,680
Speaker 1: a licensed mental health professional. Hey, y'all, thanks so much

11
00:00:57,720 --> 00:01:00,040
Speaker 1: for joining me for session three forty five of the

12
00:01:00,040 --> 00:01:03,319
Speaker 1: Therapy for Black Girls Podcast. We'll get right into our

13
00:01:03,360 --> 00:01:15,520
Speaker 1: conversation after a word from our sponsors. Did you know

14
00:01:15,600 --> 00:01:19,440
Speaker 1: that February is American Heart Month. We're celebrating by bringing

15
00:01:19,480 --> 00:01:24,480
Speaker 1: awareness to cardiovascular health disparities, especially those that impact black women.

16
00:01:25,560 --> 00:01:29,920
Speaker 1: Joining me for this conversation is doctor Jane Morgan, cardiologist

17
00:01:30,040 --> 00:01:32,920
Speaker 1: and the executive director of the COVID Task Force at

18
00:01:32,959 --> 00:01:37,160
Speaker 1: the Piedmont Healthcare Corporation in Atlanta. In addition to being

19
00:01:37,160 --> 00:01:41,800
Speaker 1: published in the areas of congenital heart disease and interventional cardiology.

20
00:01:42,440 --> 00:01:44,959
Speaker 1: Doctor Morgan currently serves as a board member of the

21
00:01:45,040 --> 00:01:49,120
Speaker 1: National Diversity and Inclusion Team at the American Heart Association.

22
00:01:50,520 --> 00:01:54,120
Speaker 1: During our conversation, doctor Morgan explains what it means to

23
00:01:54,160 --> 00:01:57,320
Speaker 1: have a healthy heart, how race and gender play a

24
00:01:57,360 --> 00:02:00,600
Speaker 1: part in the healthcare system's treatment of heart related issues,

25
00:02:01,120 --> 00:02:03,400
Speaker 1: and what black women should be aware of to preserve

26
00:02:03,520 --> 00:02:07,520
Speaker 1: healthy hearts for a lifetime. If something resonates with you

27
00:02:07,560 --> 00:02:11,000
Speaker 1: while enjoying our conversation, please share with us on social

28
00:02:11,040 --> 00:02:15,840
Speaker 1: media using the hashtag TBG in session or join us

29
00:02:15,840 --> 00:02:18,400
Speaker 1: over in the sister Circle to talk more about the episode.

30
00:02:18,919 --> 00:02:21,720
Speaker 1: You can join us at community dot therapy for Blackgirls

31
00:02:21,760 --> 00:02:28,160
Speaker 1: dot com. Here's our conversation. Well, thank you so much

32
00:02:28,200 --> 00:02:29,760
Speaker 1: for joining me today, doctor Morgan.

33
00:02:30,240 --> 00:02:33,120
Speaker 2: I am really pleased to be here. Thank you for

34
00:02:33,120 --> 00:02:33,600
Speaker 2: having me.

35
00:02:33,919 --> 00:02:36,560
Speaker 1: Thank you. So. Can you walk me through what a

36
00:02:36,600 --> 00:02:38,880
Speaker 1: typical if there is a typical day for you, what

37
00:02:38,919 --> 00:02:40,720
Speaker 1: does that look like as a cardiologist?

38
00:02:41,639 --> 00:02:44,560
Speaker 2: Wow, that's a surprise question. So a typical day for

39
00:02:44,600 --> 00:02:47,680
Speaker 2: a cardiologist versus a typical day for doctor Jane Morgan

40
00:02:47,720 --> 00:02:52,160
Speaker 2: are completely two distinct things. I am a cardiologist. When

41
00:02:52,240 --> 00:02:56,919
Speaker 2: formally trained cardiologists have spent quite a few years of

42
00:02:56,960 --> 00:03:00,679
Speaker 2: my career in research, really hard R and D research

43
00:03:00,760 --> 00:03:04,760
Speaker 2: at Abbott which is ABV now and solve A, and

44
00:03:04,760 --> 00:03:09,240
Speaker 2: then also leading large clinical trial sites including where I'm

45
00:03:09,280 --> 00:03:11,880
Speaker 2: working now at Piedmont Healthcare. Actually came here to lead

46
00:03:11,880 --> 00:03:16,600
Speaker 2: the cardiovascular research program and then strategy across all of research.

47
00:03:16,680 --> 00:03:20,160
Speaker 2: So that's clinical trials and enrolling patients and clinical trials,

48
00:03:20,800 --> 00:03:24,760
Speaker 2: and so that is somewhat of a different lens of

49
00:03:24,800 --> 00:03:28,600
Speaker 2: cardiology and medicine than other doctors who are more patient

50
00:03:28,680 --> 00:03:33,280
Speaker 2: facing and are actually managing and seeing patients each day.

51
00:03:33,520 --> 00:03:36,680
Speaker 2: I'm on the other side of that, providing the tools

52
00:03:36,720 --> 00:03:39,680
Speaker 2: that they will need to continue to manage them better

53
00:03:39,760 --> 00:03:41,720
Speaker 2: and better and better. So these tools that will go

54
00:03:41,800 --> 00:03:45,680
Speaker 2: before the FDA and get approval such that all physicians

55
00:03:45,720 --> 00:03:48,160
Speaker 2: who are treating patients can treat their patients to the

56
00:03:48,160 --> 00:03:53,000
Speaker 2: top of evidence based medicine. And so I therefore straddle

57
00:03:53,520 --> 00:03:57,520
Speaker 2: the line, so to speak, on one side with patient

58
00:03:57,560 --> 00:04:01,480
Speaker 2: facing and then the other side back in behind the curtain,

59
00:04:01,520 --> 00:04:04,200
Speaker 2: the behind the curtain part that people don't see. How

60
00:04:04,200 --> 00:04:07,680
Speaker 2: do the drugs get there? How do the pharmaceuticals get there?

61
00:04:07,840 --> 00:04:12,040
Speaker 2: How do our therapeutics get there? How do our devices

62
00:04:12,160 --> 00:04:14,200
Speaker 2: get there? How do we use them? There's a whole

63
00:04:14,240 --> 00:04:17,960
Speaker 2: process before we enter the doctor's office, before we enter hospitals,

64
00:04:18,120 --> 00:04:20,880
Speaker 2: and look at all of those machines, all of that equipment,

65
00:04:21,279 --> 00:04:24,080
Speaker 2: all of the algorithms, all of the processes, all of

66
00:04:24,120 --> 00:04:28,560
Speaker 2: the medications that will be recommended. There's a process beforehand.

67
00:04:28,600 --> 00:04:31,880
Speaker 2: So I've got a strong foothold in that part as well.

68
00:04:32,720 --> 00:04:35,040
Speaker 1: Got it. Thank you so much for that. So what

69
00:04:35,120 --> 00:04:38,080
Speaker 1: does it mean medically for us to have a healthy heart?

70
00:04:39,440 --> 00:04:40,480
Speaker 3: A loaded question.

71
00:04:41,560 --> 00:04:44,719
Speaker 2: So ultimately, when we talk about physically, let's talk about

72
00:04:44,839 --> 00:04:48,440
Speaker 2: physically a healthy heart. We talk about something called an

73
00:04:48,600 --> 00:04:53,680
Speaker 2: ejection fraction. So this is how we measure how strong

74
00:04:53,800 --> 00:04:58,719
Speaker 2: your heart is pumping. Generally, a normal ejection fraction is

75
00:04:59,080 --> 00:05:01,599
Speaker 2: sixty percent, So you might think it's one hundred percent,

76
00:05:01,640 --> 00:05:05,240
Speaker 2: but it's not. Ejection fraction is measured from zero to sixty,

77
00:05:05,320 --> 00:05:08,800
Speaker 2: So normal is sixty percent, and maybe you can drop

78
00:05:08,839 --> 00:05:12,120
Speaker 2: down in a fifty percent range, but generally it's around

79
00:05:12,440 --> 00:05:15,720
Speaker 2: sixty percent, probably not much lower than fifty five percent,

80
00:05:15,960 --> 00:05:18,080
Speaker 2: so that maybe it would be a healthy heart with

81
00:05:18,160 --> 00:05:21,520
Speaker 2: regard to its function. It's pumping, and then we've got

82
00:05:21,720 --> 00:05:25,039
Speaker 2: arteries that feed the heart, and these arteries need to

83
00:05:25,080 --> 00:05:28,479
Speaker 2: be open, what we call being patent. They need to

84
00:05:28,520 --> 00:05:33,080
Speaker 2: have good blood flow, not have any blockages with plaques

85
00:05:33,320 --> 00:05:36,440
Speaker 2: that can be caused by atheroskrosis. You've probably heard that

86
00:05:36,560 --> 00:05:40,880
Speaker 2: term athorosclerosis, which is caused by cholesterol build up and

87
00:05:41,080 --> 00:05:44,640
Speaker 2: fat things like that over a lifetime in our bodies.

88
00:05:45,000 --> 00:05:49,240
Speaker 2: That blocks the blood flow and also blood clots. And

89
00:05:49,320 --> 00:05:52,160
Speaker 2: so when you get these blockages in those arteries that

90
00:05:52,240 --> 00:05:55,440
Speaker 2: are feeding the heart, that's what we know of as

91
00:05:55,520 --> 00:05:58,560
Speaker 2: a heart attack. And then probably the third thing I

92
00:05:58,600 --> 00:06:01,560
Speaker 2: would think of as a healthy heart would be electrical

93
00:06:01,680 --> 00:06:04,960
Speaker 2: activity of the heart that the heart is beating in

94
00:06:05,000 --> 00:06:08,520
Speaker 2: a normal way, has normal electrical impulses, and you're not

95
00:06:08,600 --> 00:06:11,600
Speaker 2: having any type of a rhythmias, so that means an

96
00:06:11,640 --> 00:06:16,480
Speaker 2: irregular heart rhythm. And so perhaps at a high level,

97
00:06:16,640 --> 00:06:20,520
Speaker 2: those are three big buckets of what I would consider

98
00:06:20,600 --> 00:06:25,920
Speaker 2: a healthy heart physically, good electrical activity, open arteries, and

99
00:06:26,000 --> 00:06:27,239
Speaker 2: good heart function.

100
00:06:28,279 --> 00:06:30,599
Speaker 1: Got it, And so would the converse of those be

101
00:06:31,120 --> 00:06:32,760
Speaker 1: not having good heart health.

102
00:06:33,320 --> 00:06:36,719
Speaker 2: I would say the opposite of any one of those three.

103
00:06:36,880 --> 00:06:38,920
Speaker 2: So you don't have to have all three any one

104
00:06:39,000 --> 00:06:42,760
Speaker 2: of them, and then you have some heart issues and

105
00:06:42,800 --> 00:06:45,640
Speaker 2: you probably are being seen by cardiologists, and depending on

106
00:06:45,680 --> 00:06:49,000
Speaker 2: how severe they are will depend on how they're managed

107
00:06:49,080 --> 00:06:52,479
Speaker 2: and to what degree of management is required. It's certainly

108
00:06:52,520 --> 00:06:55,279
Speaker 2: not all three any one of those three. And these

109
00:06:55,320 --> 00:06:58,240
Speaker 2: are big broad categories. I'm going to admit these are

110
00:06:58,320 --> 00:07:01,240
Speaker 2: large buckets just to me make it easy to understand.

111
00:07:01,480 --> 00:07:04,640
Speaker 2: These are big three large buckets. But any of those buckets,

112
00:07:04,880 --> 00:07:09,000
Speaker 2: if they require any type of intervention, it does mean

113
00:07:09,040 --> 00:07:12,640
Speaker 2: that you have some negative impact of your heart. Doesn't

114
00:07:12,640 --> 00:07:15,040
Speaker 2: mean that it's life long, but it does mean that

115
00:07:15,080 --> 00:07:16,680
Speaker 2: it probably requires some attention.

116
00:07:17,280 --> 00:07:20,720
Speaker 1: So what kinds of factors, doctor Morgan, actually impact our heart.

117
00:07:20,520 --> 00:07:23,400
Speaker 2: Health When we look at heart health. A couple of

118
00:07:23,440 --> 00:07:26,960
Speaker 2: things that we think about with regard to factors always

119
00:07:27,440 --> 00:07:29,760
Speaker 2: is lifestyle. How are we kind of live in our

120
00:07:29,800 --> 00:07:33,000
Speaker 2: lives because a lot of things that we do at

121
00:07:33,040 --> 00:07:38,239
Speaker 2: a younger age actually come back to either fortify us

122
00:07:38,360 --> 00:07:42,920
Speaker 2: or haunt us later. It's like skin cancer in that way.

123
00:07:43,040 --> 00:07:45,600
Speaker 2: We may not think about it that way, but the

124
00:07:45,640 --> 00:07:50,480
Speaker 2: amount of sun exposure and sun burns that you may

125
00:07:50,560 --> 00:07:55,360
Speaker 2: have received growing up can impact the risk of you

126
00:07:55,440 --> 00:07:58,800
Speaker 2: developing skin cancer later. Even if you're wearing skin block

127
00:07:58,920 --> 00:08:01,480
Speaker 2: every single day of your life, adult life. It can

128
00:08:01,520 --> 00:08:04,760
Speaker 2: be related to that exposure when you are in your

129
00:08:04,760 --> 00:08:07,080
Speaker 2: developing years and when you're in younger years, and that's

130
00:08:07,080 --> 00:08:11,000
Speaker 2: the same thing for heart disease. And so we want

131
00:08:11,040 --> 00:08:13,880
Speaker 2: to be able to watch our weight, make certain our

132
00:08:13,920 --> 00:08:18,360
Speaker 2: weight is in a healthy range because we know that

133
00:08:19,000 --> 00:08:22,360
Speaker 2: elevated weight increases your risk of a number of things.

134
00:08:22,760 --> 00:08:26,040
Speaker 2: Increases your risk of high blood pressure. High blood pressure

135
00:08:26,080 --> 00:08:28,640
Speaker 2: is a risk factor for heart disease, increases your risk

136
00:08:28,680 --> 00:08:31,480
Speaker 2: for cholesterol. Cholesterol is a risk factor for heart disease,

137
00:08:31,840 --> 00:08:35,440
Speaker 2: increases your risk of diabetes. Diabetes is a risk factor

138
00:08:35,480 --> 00:08:39,600
Speaker 2: for heart disease. And then it also creates something called

139
00:08:39,679 --> 00:08:43,960
Speaker 2: a chronic inflammatory state in your body. And we also

140
00:08:44,120 --> 00:08:49,440
Speaker 2: now know that inflammation is a risk factor for heart disease,

141
00:08:49,520 --> 00:08:53,120
Speaker 2: not just heart disease, but for cancer, for arthritis, and

142
00:08:53,240 --> 00:08:56,640
Speaker 2: for a number of other chronic medical conditions in our body.

143
00:08:57,000 --> 00:09:01,600
Speaker 2: The state of being obese creates enough stress on the

144
00:09:01,640 --> 00:09:08,040
Speaker 2: body that it increases that state of inflammatory response, and

145
00:09:08,080 --> 00:09:11,120
Speaker 2: the body being in a state of chronic inflammation as

146
00:09:11,120 --> 00:09:15,240
Speaker 2: opposed to acute inflammation where we respond to trauma and

147
00:09:15,280 --> 00:09:17,680
Speaker 2: then we heal and it goes down. We respond to

148
00:09:17,760 --> 00:09:21,120
Speaker 2: an incident with inflammatory processes, then it heals and it

149
00:09:21,160 --> 00:09:26,120
Speaker 2: goes down. With obesity, then that inflammatory state always remains,

150
00:09:26,160 --> 00:09:29,240
Speaker 2: and we understand now that is toxic to the body.

151
00:09:29,280 --> 00:09:33,120
Speaker 2: Of the duration of obesity over time can increase your

152
00:09:33,200 --> 00:09:35,880
Speaker 2: risk of heart disease as well as increase your risk

153
00:09:35,920 --> 00:09:38,880
Speaker 2: of a number of other medical conditions. So that's part

154
00:09:38,880 --> 00:09:41,400
Speaker 2: of a healthy lifestyle. The other thing to think about

155
00:09:41,679 --> 00:09:44,480
Speaker 2: is your mental health. That does have a lot to

156
00:09:44,679 --> 00:09:48,480
Speaker 2: play in regard to your heart health and with regard

157
00:09:48,559 --> 00:09:53,400
Speaker 2: to the social interaction that people have. And we've seen

158
00:09:53,480 --> 00:09:57,600
Speaker 2: that now as we're coming out of COVID that isolation

159
00:09:58,520 --> 00:10:04,200
Speaker 2: and loneliness are also related to heart disease, and the

160
00:10:04,240 --> 00:10:07,360
Speaker 2: one that is most closely related. They both are related,

161
00:10:07,360 --> 00:10:10,400
Speaker 2: but the one that is most closely related is loneliness.

162
00:10:10,760 --> 00:10:16,000
Speaker 2: And loneliness may be hard to identify because lonely people

163
00:10:16,440 --> 00:10:20,360
Speaker 2: may actually be surrounded by tons of people and have

164
00:10:20,480 --> 00:10:23,560
Speaker 2: a lot of interactions but not feel any connection and

165
00:10:23,640 --> 00:10:28,040
Speaker 2: not feel understood and isolated. People who actually are not

166
00:10:28,200 --> 00:10:31,480
Speaker 2: in contact with people may not actually feel lonely. They

167
00:10:31,520 --> 00:10:36,239
Speaker 2: may be very content. So sometimes it's hard to identify

168
00:10:36,320 --> 00:10:39,920
Speaker 2: the lonely person and the isolated person, but both of

169
00:10:39,960 --> 00:10:43,280
Speaker 2: those are certainly at risk. And then you ask about genetics.

170
00:10:43,320 --> 00:10:47,800
Speaker 2: Genetics always plays a role in everything that we do,

171
00:10:48,040 --> 00:10:54,080
Speaker 2: but our environmental factors, our environmental choices, and our environmental

172
00:10:54,120 --> 00:11:00,319
Speaker 2: exposures that are not of our choice influence genetics as well,

173
00:11:00,760 --> 00:11:03,560
Speaker 2: positively or negatively.

174
00:11:03,800 --> 00:11:05,679
Speaker 1: Doctor Marian, can you say a little bit more about

175
00:11:05,720 --> 00:11:09,120
Speaker 1: like the loneliness and isolation, what is the science piece

176
00:11:09,280 --> 00:11:11,319
Speaker 1: behind how that's connected to your heart?

177
00:11:11,640 --> 00:11:16,040
Speaker 2: So a couple of things. People who experience loneliness and

178
00:11:16,120 --> 00:11:22,719
Speaker 2: isolation also tend to demonstrate aberrant or abnormal sleep patterns,

179
00:11:23,640 --> 00:11:29,400
Speaker 2: and sleep is a direct contributor to heart disease. We

180
00:11:29,640 --> 00:11:33,400
Speaker 2: now know that not only the duration of sleep, quality

181
00:11:33,440 --> 00:11:39,480
Speaker 2: of sleep impacts the progression of heart disease. And people

182
00:11:39,520 --> 00:11:44,040
Speaker 2: who have isolation and loneliness who are able to express

183
00:11:44,080 --> 00:11:46,800
Speaker 2: and identify that these are self identified, so we know

184
00:11:46,800 --> 00:11:49,760
Speaker 2: they're probably even more than that if we were to

185
00:11:49,800 --> 00:11:53,960
Speaker 2: have a standardized survey of standardized test and really identify

186
00:11:54,000 --> 00:11:57,760
Speaker 2: people these are self identified, and we know that sleep

187
00:11:57,840 --> 00:12:01,719
Speaker 2: has something to do with that. And anxiety and depression,

188
00:12:01,760 --> 00:12:07,520
Speaker 2: which often go along with loneliness and isolation, also negatively

189
00:12:07,920 --> 00:12:12,880
Speaker 2: impact sleep. As Homo sapiens, as human beings. We are

190
00:12:13,480 --> 00:12:17,920
Speaker 2: social creatures, and I think what we have learned, you know,

191
00:12:17,920 --> 00:12:20,320
Speaker 2: we've learned many things from COVID. I just this is

192
00:12:20,400 --> 00:12:23,040
Speaker 2: just one small slice. We've learned a lot of stuff

193
00:12:23,040 --> 00:12:28,040
Speaker 2: from COVID is that social interaction, certainly at critical periods

194
00:12:28,080 --> 00:12:32,360
Speaker 2: of our lives, is incredibly important. And where we see

195
00:12:32,559 --> 00:12:37,520
Speaker 2: this isolation and loneliness used to be prior to COVID

196
00:12:37,960 --> 00:12:41,560
Speaker 2: in our older population sixty five seventy five years of

197
00:12:41,600 --> 00:12:44,920
Speaker 2: age and older. As they've gotten older, their children have

198
00:12:44,960 --> 00:12:47,840
Speaker 2: grown up and moved away, their friends maybe have died

199
00:12:47,920 --> 00:12:51,760
Speaker 2: or become more debilitated. They've retired from their jobs, their

200
00:12:51,800 --> 00:12:56,760
Speaker 2: spouses maybe have died, and they're increasingly isolated with fewer

201
00:12:56,800 --> 00:12:59,840
Speaker 2: and fewer resources, may be no longer able to drive

202
00:13:00,360 --> 00:13:05,600
Speaker 2: and become increasingly depressed. And depression leads to increased risk

203
00:13:05,760 --> 00:13:09,679
Speaker 2: of death and increased risk of accidents. What we found

204
00:13:09,720 --> 00:13:15,040
Speaker 2: with COVID is that demographic, yes, still remained vulnerable to

205
00:13:15,120 --> 00:13:18,600
Speaker 2: isolation and loneliness, but now it was the demographic of

206
00:13:18,640 --> 00:13:21,400
Speaker 2: eighteen to twenty five year olds. Now that was our

207
00:13:21,520 --> 00:13:27,239
Speaker 2: number one demographic that was self identifying isolation and loneliness,

208
00:13:27,440 --> 00:13:32,920
Speaker 2: and also the impact of and dependence on social media

209
00:13:32,960 --> 00:13:37,520
Speaker 2: to fill that void. And obviously we increased our use

210
00:13:37,559 --> 00:13:41,559
Speaker 2: of social media during COVID to increase to maintain our

211
00:13:41,600 --> 00:13:45,239
Speaker 2: social contacts and our socialization. But what we have discovered

212
00:13:45,720 --> 00:13:48,760
Speaker 2: is that it doesn't really substitute for in person human

213
00:13:48,800 --> 00:13:52,000
Speaker 2: to human interaction. And as physicians, we're starting to learn

214
00:13:52,040 --> 00:13:55,400
Speaker 2: that as well as technology in many ways has taken

215
00:13:55,520 --> 00:13:59,160
Speaker 2: over our practices, how we're managing our practice, how we

216
00:13:59,280 --> 00:14:03,280
Speaker 2: diagnose payations, how we may or may not implement the

217
00:14:03,400 --> 00:14:06,760
Speaker 2: physical exam because we have so many tools to do

218
00:14:06,800 --> 00:14:10,960
Speaker 2: these diagnostics for us, that human touch that used to occur,

219
00:14:11,600 --> 00:14:16,400
Speaker 2: that connection between the patient and the physician has also

220
00:14:16,520 --> 00:14:19,040
Speaker 2: been lost, and we're starting to dial that back to

221
00:14:19,200 --> 00:14:23,200
Speaker 2: understand Wait a second, just coming in and putting hands

222
00:14:23,240 --> 00:14:27,800
Speaker 2: on the patient and pal pating and oscultating and listening

223
00:14:28,080 --> 00:14:32,720
Speaker 2: and touching and pushing and probing and touching that was

224
00:14:32,960 --> 00:14:36,360
Speaker 2: part of the physical exam and part of the health

225
00:14:36,720 --> 00:14:39,800
Speaker 2: of the patients such that they felt that someone cared,

226
00:14:39,840 --> 00:14:42,320
Speaker 2: They felt that the sense of well being. But it

227
00:14:42,360 --> 00:14:47,200
Speaker 2: also ties into us being Homo sapiens and understanding social

228
00:14:47,280 --> 00:14:51,640
Speaker 2: interaction more so than technological advancements as much as we

229
00:14:51,720 --> 00:14:54,120
Speaker 2: are pushing them forward. So we've got to find out

230
00:14:54,120 --> 00:14:55,360
Speaker 2: what that balance is.

231
00:14:56,880 --> 00:14:59,920
Speaker 1: Thank you so much for that. More from our conversation

232
00:15:00,360 --> 00:15:15,680
Speaker 1: after the break. So what kinds of symptoms or experiences

233
00:15:15,760 --> 00:15:18,400
Speaker 1: might we mean me having that would indicate to us that, hey,

234
00:15:18,440 --> 00:15:20,920
Speaker 1: we might need to talk with our doctor about something

235
00:15:20,920 --> 00:15:23,520
Speaker 1: going on with our heart. What should we be paying attention.

236
00:15:23,240 --> 00:15:28,720
Speaker 2: To, my goodness, So let's just talk about the heart.

237
00:15:29,080 --> 00:15:32,320
Speaker 2: As a cardiologist, I'm just going to focus on the heart.

238
00:15:32,680 --> 00:15:36,520
Speaker 2: If you are feeling short of breath, if you are

239
00:15:36,600 --> 00:15:41,600
Speaker 2: having chest pain, if you are feeling light headed, if

240
00:15:41,640 --> 00:15:45,960
Speaker 2: you have what we call diaphoresis sudden episodes of sweating,

241
00:15:46,280 --> 00:15:49,400
Speaker 2: those are probably some of the more common ones. Maybe

242
00:15:49,440 --> 00:15:53,240
Speaker 2: even left arm pain. Those could be signs that you

243
00:15:53,920 --> 00:15:56,000
Speaker 2: may be at risk of having a heart attack and

244
00:15:56,000 --> 00:15:58,560
Speaker 2: you should see your physician. Now I'm going to talk

245
00:15:58,600 --> 00:16:02,400
Speaker 2: about something that we call a typical symptom. So this

246
00:16:02,520 --> 00:16:06,480
Speaker 2: term a typical, which I don't really care for because

247
00:16:07,240 --> 00:16:12,000
Speaker 2: for the most part, it denotes and characterizes symptoms that

248
00:16:12,040 --> 00:16:15,600
Speaker 2: a woman may have in comparison to a man, and

249
00:16:15,640 --> 00:16:19,720
Speaker 2: that word a typical also tends to be interpreted and

250
00:16:19,960 --> 00:16:26,440
Speaker 2: used as an understood as a deviation from normal, a

251
00:16:26,600 --> 00:16:32,520
Speaker 2: standard away from not the usual, something additional to learn,

252
00:16:32,920 --> 00:16:36,400
Speaker 2: not the main thing. But the fact of the matter

253
00:16:36,480 --> 00:16:39,080
Speaker 2: is women are more than fifty one percent of the population,

254
00:16:39,160 --> 00:16:41,960
Speaker 2: So maybe we're actually the ones having the main symptoms

255
00:16:42,240 --> 00:16:44,400
Speaker 2: and it's the men who are not. Maybe need to

256
00:16:44,440 --> 00:16:47,800
Speaker 2: relearn this, We need to unlearn it and relearn it.

257
00:16:48,040 --> 00:16:50,960
Speaker 2: And it just goes to show you how male dominance,

258
00:16:51,160 --> 00:16:54,480
Speaker 2: like almost everything, and our culture has driven our culture

259
00:16:54,520 --> 00:16:57,400
Speaker 2: and even the lexicon of the language that we are using,

260
00:16:57,720 --> 00:17:02,440
Speaker 2: and it really impacts our action. Think about seeing a

261
00:17:02,480 --> 00:17:05,760
Speaker 2: patient and they're having the typical symptoms, right, what are

262
00:17:05,840 --> 00:17:08,040
Speaker 2: you more likely to do as opposed to a patient

263
00:17:08,040 --> 00:17:11,640
Speaker 2: who's having the atypical symptoms? How are your actions going

264
00:17:11,680 --> 00:17:14,639
Speaker 2: to be different? And that impacts position. So, okay, I

265
00:17:14,680 --> 00:17:17,120
Speaker 2: said all that, I'm gonna get off my soapbox on that.

266
00:17:17,320 --> 00:17:18,919
Speaker 2: You can follow me if you want to hear me.

267
00:17:19,080 --> 00:17:24,480
Speaker 2: Just really hammered down on that atypical symptoms. You might

268
00:17:24,560 --> 00:17:27,919
Speaker 2: have some jaw pain, right, and you may not relate

269
00:17:27,960 --> 00:17:30,400
Speaker 2: that to your heart. You may think it has something

270
00:17:30,400 --> 00:17:32,000
Speaker 2: to do with your teeth. You might actually go to

271
00:17:32,040 --> 00:17:34,160
Speaker 2: the dentist or something. You might have some back pain.

272
00:17:34,760 --> 00:17:37,920
Speaker 2: Who doesn't have back pain, especially women as you get

273
00:17:37,920 --> 00:17:41,440
Speaker 2: older and you've had children, you're running around back pain,

274
00:17:41,720 --> 00:17:44,000
Speaker 2: or you might just have like a cold or a flu,

275
00:17:44,119 --> 00:17:47,399
Speaker 2: something you just can't shape. You just can't seem to

276
00:17:47,520 --> 00:17:50,560
Speaker 2: completely get over it. Or you might just be run down.

277
00:17:50,920 --> 00:17:54,879
Speaker 2: Who isn't run down, especially a woman at mid age,

278
00:17:55,200 --> 00:17:57,880
Speaker 2: who isn't just feeling run down. You have a million

279
00:17:58,000 --> 00:18:02,199
Speaker 2: reasons to feel tired, to have back pain. And so

280
00:18:02,720 --> 00:18:07,159
Speaker 2: because we don't recognize those as the main symptoms, they

281
00:18:07,200 --> 00:18:12,320
Speaker 2: are relegated to this atypical category. Then the patients and

282
00:18:12,720 --> 00:18:16,240
Speaker 2: society itself doesn't recognize them. We don't as women, we

283
00:18:16,280 --> 00:18:18,880
Speaker 2: don't recognize that because we haven't been taught that right.

284
00:18:18,920 --> 00:18:23,080
Speaker 2: We're not the main priority, and doctors themselves may not

285
00:18:23,119 --> 00:18:27,480
Speaker 2: recognize it. In fact, forty two percent of primary care physicians,

286
00:18:27,480 --> 00:18:31,439
Speaker 2: when they were surveyed, admitted that they felt uncomfortable treating

287
00:18:31,480 --> 00:18:33,679
Speaker 2: a woman with heart disease. And if you can believe this,

288
00:18:33,920 --> 00:18:39,040
Speaker 2: twenty two percent of cardiologists in the survey stated that

289
00:18:39,160 --> 00:18:42,719
Speaker 2: they felt uncomfortable treating a woman with heart disease. And

290
00:18:42,760 --> 00:18:45,679
Speaker 2: so that seems amazing until you really think about it.

291
00:18:45,720 --> 00:18:48,000
Speaker 2: And if you think about it. Most cardiologists are men,

292
00:18:48,480 --> 00:18:51,480
Speaker 2: so it makes sense because these are not symptoms that

293
00:18:51,520 --> 00:18:54,040
Speaker 2: we are taught to understand, and so these are all

294
00:18:54,040 --> 00:18:56,600
Speaker 2: symptoms of which we need to start to think about.

295
00:18:56,800 --> 00:19:01,399
Speaker 2: What about things like palpitations? Absolutely think about palpitations. If

296
00:19:01,440 --> 00:19:05,439
Speaker 2: you start to have palpitations, don't ignore them, make certain

297
00:19:05,560 --> 00:19:08,080
Speaker 2: you see someone for it. But here's something else to

298
00:19:08,119 --> 00:19:10,560
Speaker 2: think about. I'm kind of moving on into another subject,

299
00:19:10,560 --> 00:19:12,320
Speaker 2: so pull me back in, rain me in.

300
00:19:12,520 --> 00:19:14,840
Speaker 1: I do have some follow up questions, though, so before

301
00:19:14,880 --> 00:19:16,840
Speaker 1: you go to for it. So you mentioned the pain

302
00:19:16,960 --> 00:19:19,840
Speaker 1: in the left arm. I want to know why specifically

303
00:19:19,880 --> 00:19:21,720
Speaker 1: the left arm and not like either arm.

304
00:19:22,280 --> 00:19:23,520
Speaker 3: So that's an interesting question.

305
00:19:23,600 --> 00:19:26,639
Speaker 2: But generally it is in the left arm, and it

306
00:19:26,680 --> 00:19:30,240
Speaker 2: could be just neurologically, but it generally is a left

307
00:19:30,359 --> 00:19:33,560
Speaker 2: arm and sometimes numbness in that left arm. Now can

308
00:19:33,600 --> 00:19:35,520
Speaker 2: it happen in the right arm? Can it happen in

309
00:19:35,560 --> 00:19:40,320
Speaker 2: the right chest? Yes, atypical, but can it happen yes,

310
00:19:40,440 --> 00:19:41,280
Speaker 2: of course it can't.

311
00:19:41,560 --> 00:19:44,960
Speaker 1: Got it? And you also mentioned sudden bursts of sweating,

312
00:19:45,359 --> 00:19:47,359
Speaker 1: which made me think of a conversation we hit on

313
00:19:47,359 --> 00:19:51,200
Speaker 1: the podcast recently around like perimenopaul symptoms and menopaul symptoms.

314
00:19:51,600 --> 00:19:53,960
Speaker 1: So how would you know, like the difference between oh,

315
00:19:54,000 --> 00:19:56,520
Speaker 1: this is like a hot flash versus like a heart concern.

316
00:19:57,280 --> 00:19:59,200
Speaker 3: How would you know, Doctor Joy?

317
00:20:00,080 --> 00:20:03,720
Speaker 2: Yeah, here we go, let's have this conversation. So if

318
00:20:03,760 --> 00:20:07,199
Speaker 2: you are going through parimenopause and menopause, a couple of

319
00:20:07,200 --> 00:20:10,480
Speaker 2: things to think about. I was just getting ready to

320
00:20:10,560 --> 00:20:12,920
Speaker 2: jump into that with palpitation, So this is a great

321
00:20:12,960 --> 00:20:18,919
Speaker 2: segue palpitations as you go through perimenopause, and perimenopause means

322
00:20:19,280 --> 00:20:22,840
Speaker 2: that you are starting to have estrogen levels drop. You

323
00:20:22,880 --> 00:20:26,280
Speaker 2: may still be having regular menstrual periods, but you are

324
00:20:26,320 --> 00:20:30,520
Speaker 2: approaching a time when your menstrual periods may stop. And

325
00:20:30,600 --> 00:20:33,400
Speaker 2: so perimenopause can go on for ten years or so

326
00:20:33,600 --> 00:20:36,720
Speaker 2: before you actually hit menopause. And menopause is when you

327
00:20:37,200 --> 00:20:41,440
Speaker 2: have gone one full year without a menstrual cycle at all,

328
00:20:41,640 --> 00:20:44,959
Speaker 2: So that's menopause. So perimenopause could be ten or fifteen

329
00:20:45,000 --> 00:20:47,320
Speaker 2: years before you get there, right, And those are ten

330
00:20:47,359 --> 00:20:50,160
Speaker 2: and fifteen years where your body's changing and you don't

331
00:20:50,200 --> 00:20:52,400
Speaker 2: know what's going on, and nobody knows what's going on.

332
00:20:52,920 --> 00:20:57,080
Speaker 2: What's really happening is that your estrogen levels are gradually dropping,

333
00:20:57,800 --> 00:21:02,480
Speaker 2: and we now know that estra has anti inflammatory properties,

334
00:21:02,480 --> 00:21:05,639
Speaker 2: and you know what it just said that inflammation now

335
00:21:06,160 --> 00:21:10,399
Speaker 2: is known as a part of progressing heart disease. We

336
00:21:10,520 --> 00:21:17,120
Speaker 2: also know that estrogen has cardioprotective factors. So as your

337
00:21:17,280 --> 00:21:23,720
Speaker 2: estrogen levels drop, inflammation increases, heart disease risk increases, and

338
00:21:23,760 --> 00:21:26,359
Speaker 2: you also lose that protection of your heart. And so

339
00:21:26,440 --> 00:21:30,960
Speaker 2: what happens is before menopause, women actually only have fifty

340
00:21:30,960 --> 00:21:33,840
Speaker 2: percent of a risk of a heart attack of a man,

341
00:21:34,600 --> 00:21:38,320
Speaker 2: only half. But by the time you reach menopause, our

342
00:21:38,400 --> 00:21:40,320
Speaker 2: risk of a heart attack is equal to that of

343
00:21:40,320 --> 00:21:43,120
Speaker 2: a man. And actually by the time that we are seventy,

344
00:21:43,400 --> 00:21:46,760
Speaker 2: it has surpassed that of a man. And the reason

345
00:21:46,880 --> 00:21:49,720
Speaker 2: I think that it has surpassed it is because of

346
00:21:49,800 --> 00:21:52,479
Speaker 2: all the twenty five years before when we ignored all

347
00:21:52,520 --> 00:21:54,800
Speaker 2: the pair ofmenopause and menopause, and we didn't treat it,

348
00:21:54,800 --> 00:21:57,280
Speaker 2: and we wouldn't give menopause a hormone therapy, and we

349
00:21:57,320 --> 00:21:59,960
Speaker 2: thought estrogen was bad and we thought progesterone was bad

350
00:22:00,000 --> 00:22:02,280
Speaker 2: and nobody had been trained on it, and YadA, YadA,

351
00:22:02,400 --> 00:22:08,879
Speaker 2: YadA YadA. So what happens is you can get palpitations

352
00:22:09,359 --> 00:22:12,760
Speaker 2: this fast beating in your chest, sensation of a fast

353
00:22:12,800 --> 00:22:17,720
Speaker 2: heartbeat just from estrogen levels dropping. But you wouldn't know that,

354
00:22:17,760 --> 00:22:19,680
Speaker 2: and your physician may not know that. So you may

355
00:22:19,720 --> 00:22:22,880
Speaker 2: go to the doctor, get a big work up, they

356
00:22:22,880 --> 00:22:26,600
Speaker 2: can never find anything, and then what happens you get

357
00:22:26,640 --> 00:22:32,159
Speaker 2: put on an antidepressant. In fact, the prescription for antidepressants

358
00:22:32,440 --> 00:22:37,520
Speaker 2: doubles in women during the ten or fifteen years of menopause.

359
00:22:37,560 --> 00:22:41,840
Speaker 2: That is not a coincidence. That is because women come

360
00:22:41,880 --> 00:22:48,400
Speaker 2: in complaining of symptoms that people don't understand, many male physicians.

361
00:22:48,800 --> 00:22:51,760
Speaker 2: You run test the test or negative, there are no

362
00:22:51,920 --> 00:22:55,159
Speaker 2: test for the symptoms of menopause, and then you're just

363
00:22:55,240 --> 00:22:59,159
Speaker 2: determined to be stressed out. Let me just give you

364
00:22:59,200 --> 00:23:02,720
Speaker 2: this antidepressant. Good luck to you. You're just depressed. These

365
00:23:02,720 --> 00:23:05,359
Speaker 2: symptoms are real and we need to think about them.

366
00:23:05,480 --> 00:23:07,719
Speaker 2: So it's not just palpitations. And I'm not saying if

367
00:23:07,760 --> 00:23:12,720
Speaker 2: you have palpitations, go straight to your physician, hopefully who's

368
00:23:12,760 --> 00:23:16,520
Speaker 2: menopause certify and get your estrogym repleated, or get some

369
00:23:16,680 --> 00:23:20,640
Speaker 2: estrogen progesterone combination. What I am saying is see your

370
00:23:20,640 --> 00:23:24,399
Speaker 2: cardiologist and after your work up is negative. If it

371
00:23:24,480 --> 00:23:26,800
Speaker 2: is negative, because if it's positive, you want to do

372
00:23:26,840 --> 00:23:29,000
Speaker 2: something about it. Let me be clear on that heart

373
00:23:29,040 --> 00:23:32,199
Speaker 2: disease is still the number one killer of women. So

374
00:23:32,240 --> 00:23:35,600
Speaker 2: if you're having palpitations, see your position, get a work up.

375
00:23:35,720 --> 00:23:39,800
Speaker 2: If that work up is negative, don't accept the antidepressant.

376
00:23:40,400 --> 00:23:43,479
Speaker 2: If that workup is negative, now it's time to have

377
00:23:43,520 --> 00:23:48,960
Speaker 2: a conversation with your physician about hormone replacement and resolution

378
00:23:49,080 --> 00:23:52,959
Speaker 2: of those symptoms. The antidepressant is not the answer. So

379
00:23:53,520 --> 00:23:56,640
Speaker 2: to your question about sweating, the same thing. You can

380
00:23:56,680 --> 00:24:00,760
Speaker 2: have diaphoresis or sweating or in mini paus. We call

381
00:24:00,800 --> 00:24:05,480
Speaker 2: them hot flashes now known as hot flushes, where you

382
00:24:05,480 --> 00:24:08,960
Speaker 2: get these sudden periods of getting hot. You're sort of

383
00:24:09,000 --> 00:24:12,720
Speaker 2: warm up inside your body and explode from the outside.

384
00:24:12,760 --> 00:24:15,040
Speaker 2: So it's not from the outside coming in like the sun.

385
00:24:15,200 --> 00:24:18,160
Speaker 2: It's the inside starts to cook and you start to sweat.

386
00:24:18,200 --> 00:24:23,000
Speaker 2: Your internal temperature thermometer really starts to get hot. And

387
00:24:23,040 --> 00:24:27,040
Speaker 2: those are also symptoms of perimenopause and menopause. We now

388
00:24:27,080 --> 00:24:32,199
Speaker 2: know that hot flushes, the duration and the severity is

389
00:24:32,320 --> 00:24:37,800
Speaker 2: also connected to heart disease, and women more likely to

390
00:24:37,920 --> 00:24:41,439
Speaker 2: have more severe hot flushes and suffer from them. The

391
00:24:41,600 --> 00:24:45,800
Speaker 2: longest are black women. So black women then also have

392
00:24:45,920 --> 00:24:50,320
Speaker 2: this increased risk of heart disease just by de facto

393
00:24:50,440 --> 00:24:54,840
Speaker 2: of the severity of the hot flushes and hot flashes.

394
00:24:55,160 --> 00:24:57,919
Speaker 2: I'm using those terms interchangeably, but the new term is

395
00:24:58,000 --> 00:25:01,040
Speaker 2: hot flushes. But I'm saying hot fleshshes and hot flushes

396
00:25:01,080 --> 00:25:03,160
Speaker 2: just that everybody can follow along if you've never heard

397
00:25:03,200 --> 00:25:06,280
Speaker 2: the term before. But we are transitioning to hot flushes.

398
00:25:06,600 --> 00:25:08,639
Speaker 2: And let me just say this. They don't ask me

399
00:25:08,720 --> 00:25:10,520
Speaker 2: about the terms. I had nothing to.

400
00:25:10,480 --> 00:25:12,520
Speaker 3: Say with it. I don't know who the body is

401
00:25:12,560 --> 00:25:14,000
Speaker 3: that makes these decisions.

402
00:25:14,520 --> 00:25:16,520
Speaker 2: Well here's what I heard when I asked, why are

403
00:25:16,520 --> 00:25:18,720
Speaker 2: we calling out hot flushes and a hot flashes? They said,

404
00:25:18,840 --> 00:25:21,760
Speaker 2: a hot flash means that it's something that happens suddenly

405
00:25:21,760 --> 00:25:24,320
Speaker 2: and disappears, And that's not what these are.

406
00:25:24,640 --> 00:25:28,320
Speaker 3: They happen and they last sometimes for minutes and thirty minutes,

407
00:25:28,359 --> 00:25:31,400
Speaker 3: and you're burning up and it just goes on and on.

408
00:25:31,560 --> 00:25:33,639
Speaker 3: It is not a flash, and we want people to

409
00:25:33,680 --> 00:25:37,359
Speaker 3: take it seriously. These are flushes, not flashes. So there's

410
00:25:37,359 --> 00:25:40,119
Speaker 3: the background behind what it is. So it's being called

411
00:25:40,200 --> 00:25:42,840
Speaker 3: if you see hot flushes, you heard it here. That's

412
00:25:42,840 --> 00:25:45,679
Speaker 3: what it means. It's the same thing, but we're now.

413
00:25:45,560 --> 00:25:47,000
Speaker 2: Calling it hot flushes.

414
00:25:47,840 --> 00:25:49,439
Speaker 3: So we see this more.

415
00:25:49,359 --> 00:25:54,680
Speaker 2: So in black women, and we know that black women

416
00:25:54,840 --> 00:25:59,480
Speaker 2: also intermnopause about a year and a half earlier than

417
00:25:59,520 --> 00:26:02,000
Speaker 2: white wo women for a number of reasons, which also

418
00:26:02,160 --> 00:26:05,280
Speaker 2: means that further increases your risk of heart disease or member.

419
00:26:05,720 --> 00:26:08,919
Speaker 2: Prior to menopause is when your heart is protected. So

420
00:26:09,000 --> 00:26:14,480
Speaker 2: the earlier intermenopause, the sooner you remove that heart protection.

421
00:26:14,600 --> 00:26:18,240
Speaker 2: So we don't actually want to go into menopause earlier,

422
00:26:18,240 --> 00:26:20,240
Speaker 2: whereas it might be nice to not have to.

423
00:26:20,200 --> 00:26:22,000
Speaker 3: Manage your minstral cycle anymore.

424
00:26:22,440 --> 00:26:26,320
Speaker 2: From a health perspective, it means that your risk of

425
00:26:26,359 --> 00:26:30,920
Speaker 2: heart disease now starts sooner and starts to build over

426
00:26:30,960 --> 00:26:35,320
Speaker 2: a longer period of time, and is an indicator of

427
00:26:35,400 --> 00:26:38,960
Speaker 2: your health status as well. Back to doctor Joy's original

428
00:26:39,040 --> 00:26:41,439
Speaker 2: question of how do we stay healthy? How do we

429
00:26:41,520 --> 00:26:44,440
Speaker 2: know if we're healthy? The age at which you inter

430
00:26:44,640 --> 00:26:49,879
Speaker 2: menopause is an indicator of that health status.

431
00:26:50,359 --> 00:26:52,760
Speaker 1: Wow, thank you so much for that, Doctor Warings. More

432
00:26:52,800 --> 00:27:05,399
Speaker 1: from our conversation after the break, I do want to

433
00:27:05,440 --> 00:27:08,159
Speaker 1: go there because my next question for you was a

434
00:27:08,200 --> 00:27:10,679
Speaker 1: stat that we have from the American Heart Association that

435
00:27:10,720 --> 00:27:14,320
Speaker 1: says among Black women ages twenty and older, nearly fifty

436
00:27:14,400 --> 00:27:18,080
Speaker 1: nine percent have cardiovascular disease. And you've already mentioned some

437
00:27:18,119 --> 00:27:21,639
Speaker 1: of the menopause, and like answering menopause earlier, I'm curious

438
00:27:21,680 --> 00:27:25,320
Speaker 1: about any other disparities or susceptibilities that Black women have

439
00:27:25,400 --> 00:27:27,320
Speaker 1: related to cardiovascular disease.

440
00:27:28,040 --> 00:27:34,320
Speaker 2: So it's complex, I'm gonna start. We can't talk about

441
00:27:34,359 --> 00:27:41,440
Speaker 2: the whole maternal mortality disaster that is America right now,

442
00:27:42,520 --> 00:27:45,119
Speaker 2: so I'm gonna talk about just a couple of slices.

443
00:27:45,640 --> 00:27:49,760
Speaker 2: When a woman is pregnant of any race, if she

444
00:27:49,840 --> 00:27:54,720
Speaker 2: develops any complications during that pregnancy, and the complications are

445
00:27:54,800 --> 00:28:01,320
Speaker 2: very specific. If you develop something called gestational diabetes, gestational hypertension,

446
00:28:02,080 --> 00:28:08,440
Speaker 2: pre eclampsia, eclampsia, an older term toxemia. If you've ever

447
00:28:08,480 --> 00:28:11,399
Speaker 2: heard any of those terms with regard to your pregnancy

448
00:28:11,600 --> 00:28:14,439
Speaker 2: or someone in your family or someone of a friend,

449
00:28:15,480 --> 00:28:23,080
Speaker 2: then those are long term indicators of heart disease. Not

450
00:28:23,240 --> 00:28:26,199
Speaker 2: only do they put the baby at risk, but there

451
00:28:26,240 --> 00:28:30,920
Speaker 2: are long term indicators of heart disease for the mom.

452
00:28:31,280 --> 00:28:33,560
Speaker 2: Now the way that we used to practice and when

453
00:28:33,600 --> 00:28:36,159
Speaker 2: I say used to practice. I mean like this morning,

454
00:28:36,240 --> 00:28:39,600
Speaker 2: because we're still practicing this way unfortunately. The way that

455
00:28:39,680 --> 00:28:43,160
Speaker 2: we used to practice as of this morning is that

456
00:28:43,200 --> 00:28:47,400
Speaker 2: the way that you treat these conditions, which is how

457
00:28:47,400 --> 00:28:50,840
Speaker 2: we were all trained, the way that you treat these

458
00:28:50,880 --> 00:28:56,440
Speaker 2: conditions in a pregnant female is to safely deliver the baby,

459
00:28:56,920 --> 00:29:01,680
Speaker 2: because once the baby is delivered and baby are healthy,

460
00:29:01,800 --> 00:29:06,760
Speaker 2: then that disease process regresses goes away. It's something you

461
00:29:06,800 --> 00:29:10,160
Speaker 2: see in pregnancy. So if you can't deliver the baby,

462
00:29:10,840 --> 00:29:14,840
Speaker 2: then everything is fine. And it doesn't mean deliver the

463
00:29:14,840 --> 00:29:18,520
Speaker 2: baby early. It means that the birth of the baby

464
00:29:18,720 --> 00:29:22,400
Speaker 2: is the beginning of all of those medical symptoms going away,

465
00:29:22,560 --> 00:29:25,320
Speaker 2: like those medical symptoms and conditions were actually caused by

466
00:29:25,320 --> 00:29:27,760
Speaker 2: the pregnancy. We're not trying to induce early pregnancy. What

467
00:29:27,800 --> 00:29:33,080
Speaker 2: we do is manage the mom's symptoms and conditions, sometimes

468
00:29:33,080 --> 00:29:36,920
Speaker 2: with hospitalization, through her pregnancy, and then once the baby

469
00:29:37,000 --> 00:29:41,400
Speaker 2: is born, we're like, shoot, we're done, good job, Mom's good.

470
00:29:41,920 --> 00:29:45,360
Speaker 2: But now we know that what we should have done

471
00:29:46,200 --> 00:29:49,600
Speaker 2: as of this morning is hand that woman off to

472
00:29:49,680 --> 00:29:53,400
Speaker 2: a cardiologist. There should be a hand to hand referral

473
00:29:53,640 --> 00:29:57,360
Speaker 2: from the obgyn to a cardiologist because what has happened

474
00:29:57,400 --> 00:30:00,800
Speaker 2: is that that woman has just declared that she has

475
00:30:00,840 --> 00:30:03,760
Speaker 2: an increased risk of heart disease over her lifetime, and

476
00:30:03,800 --> 00:30:06,160
Speaker 2: in fact it will be two times higher than a

477
00:30:06,160 --> 00:30:09,440
Speaker 2: woman who doesn't have those complications. So here's the way

478
00:30:09,720 --> 00:30:11,200
Speaker 2: you look at it, and that's why we have different

479
00:30:11,240 --> 00:30:15,479
Speaker 2: specialties in medicine. And OBG Guyanne that exact same patient

480
00:30:15,760 --> 00:30:17,880
Speaker 2: looks at that patient, and this is how we all

481
00:30:17,920 --> 00:30:20,400
Speaker 2: look at the patient. But now we're changing. Obgu i

482
00:30:20,520 --> 00:30:22,640
Speaker 2: n looks at that patient and we describe that patient

483
00:30:22,720 --> 00:30:28,920
Speaker 2: as a pregnant female with a complication of gestational hypertension.

484
00:30:29,480 --> 00:30:34,080
Speaker 2: A cardiologist would look at that patient and describe that

485
00:30:34,200 --> 00:30:40,080
Speaker 2: patient as a volume overloaded female with a failed stress test.

486
00:30:40,640 --> 00:30:44,800
Speaker 2: See the difference. A pregnancy is a woman's actual first

487
00:30:44,840 --> 00:30:47,880
Speaker 2: stress test because of volume overload. If you develop any

488
00:30:47,920 --> 00:30:50,440
Speaker 2: of those symptoms, you actually have failed your stress tests.

489
00:30:50,760 --> 00:30:53,160
Speaker 2: And just like any stress test that you fail at

490
00:30:53,160 --> 00:30:57,240
Speaker 2: a doctor's office, you go straight to the cardiologist for

491
00:30:57,400 --> 00:31:01,280
Speaker 2: a workup. So now a curdiomologists with the lens on

492
00:31:01,320 --> 00:31:04,960
Speaker 2: the same patient is not looking at a pregnant female

493
00:31:05,160 --> 00:31:09,120
Speaker 2: with a complication of gestational hypertension. The cardiologist says, I

494
00:31:09,160 --> 00:31:12,480
Speaker 2: see a volume overloaded female with a fail stress test.

495
00:31:12,720 --> 00:31:16,160
Speaker 2: You see how two different doctors looking at the same patient,

496
00:31:16,840 --> 00:31:20,680
Speaker 2: treating the patient, but treating the patient from two different lenses.

497
00:31:20,720 --> 00:31:23,800
Speaker 2: So we need the whole three hundred and sixty degree treatment.

498
00:31:24,040 --> 00:31:26,560
Speaker 2: And now we know that delivering the baby is not

499
00:31:26,760 --> 00:31:30,800
Speaker 2: the end of the story for the mom and that

500
00:31:31,000 --> 00:31:34,360
Speaker 2: handoff does not happen. I talk about this all the time.

501
00:31:34,400 --> 00:31:37,000
Speaker 2: We're trying to socialize that actually have written a book

502
00:31:37,080 --> 00:31:39,960
Speaker 2: where there's a chapter in this book, hoping I can

503
00:31:40,000 --> 00:31:43,040
Speaker 2: get it published and you guys can actually read any

504
00:31:43,160 --> 00:31:47,120
Speaker 2: number of things that go on that impact black women,

505
00:31:47,480 --> 00:31:52,240
Speaker 2: that impact women and impact minority populations within our healthcare system.

506
00:31:52,720 --> 00:31:55,200
Speaker 2: The other thing that I will say about this, just

507
00:31:55,240 --> 00:31:57,560
Speaker 2: in case my book doesn't get published, I mean as well,

508
00:31:57,560 --> 00:31:58,880
Speaker 2: I just tell you guys some of the rest of

509
00:31:58,920 --> 00:32:02,320
Speaker 2: it right, hopefully or to get polish. But if it doesn't, hey,

510
00:32:02,440 --> 00:32:07,560
Speaker 2: I'm still talking about it. Is that black women are

511
00:32:07,560 --> 00:32:11,680
Speaker 2: more likely to develop these pregnancy complications than white women.

512
00:32:12,280 --> 00:32:16,040
Speaker 2: And here's the kicker. Black women who are born in

513
00:32:16,080 --> 00:32:19,840
Speaker 2: the United States of America are more likely to develop

514
00:32:19,920 --> 00:32:22,960
Speaker 2: these complications than black women who are born outside of

515
00:32:23,000 --> 00:32:28,800
Speaker 2: this country. So there is something inherent in the soil,

516
00:32:29,080 --> 00:32:37,200
Speaker 2: in the fabric of being generationally here in this country

517
00:32:37,880 --> 00:32:47,720
Speaker 2: that lends to this, the ongoing infrastructural struggle of survival,

518
00:32:47,840 --> 00:32:53,160
Speaker 2: something that is termed the weathering effect, the constancy of

519
00:32:53,880 --> 00:32:59,320
Speaker 2: high effort coping, the constancy of being forced to be

520
00:32:59,520 --> 00:33:05,880
Speaker 2: agile to survive and to navigate and to maneuver, being

521
00:33:05,960 --> 00:33:10,480
Speaker 2: forced to be silent when things are working against you

522
00:33:11,080 --> 00:33:14,240
Speaker 2: but you are powerless to speak up in order to

523
00:33:14,320 --> 00:33:18,520
Speaker 2: survive or for your family to survive, the ongoing struggle

524
00:33:18,560 --> 00:33:22,800
Speaker 2: of the navigation of corporate America. And not the glass ceiling,

525
00:33:23,000 --> 00:33:26,640
Speaker 2: but the glass floor. You wish you had a glass ceiling.

526
00:33:26,840 --> 00:33:29,960
Speaker 2: The glass floor is where you're trying not to fall

527
00:33:30,040 --> 00:33:35,120
Speaker 2: through and get cut to shards. That weathering effect causes

528
00:33:35,160 --> 00:33:41,040
Speaker 2: a shortening of the telomeres. Tilomeres are the ends of chromosomes,

529
00:33:41,800 --> 00:33:46,960
Speaker 2: and the ends of chromosomes as they shorten the body ages.

530
00:33:47,800 --> 00:33:51,160
Speaker 2: And so we talk about blacked on crack. That's on

531
00:33:51,240 --> 00:33:54,280
Speaker 2: the outside because we're protected by melanin and we're looking

532
00:33:54,360 --> 00:33:57,840
Speaker 2: good a long time, but on the inside our age

533
00:33:57,880 --> 00:34:06,280
Speaker 2: is advanced. Iological age is more advanced than our chronologic age.

534
00:34:06,360 --> 00:34:10,879
Speaker 2: Regardless of what our outward appearance is. Because of this

535
00:34:11,440 --> 00:34:16,400
Speaker 2: weather ing effect, and because of the weathering effect the

536
00:34:16,480 --> 00:34:20,239
Speaker 2: shortening of the telomeres, which also impacts brain health. I

537
00:34:20,280 --> 00:34:22,360
Speaker 2: know I'm kind of walking you through. Read my book.

538
00:34:22,400 --> 00:34:26,439
Speaker 2: I hope it gets published. And as we walk through,

539
00:34:26,480 --> 00:34:33,240
Speaker 2: this is what we see being represented in our pregnancies.

540
00:34:33,920 --> 00:34:38,160
Speaker 2: And when we think about the risk factors for gestational diabetes,

541
00:34:38,239 --> 00:34:42,960
Speaker 2: gestational hypertension, pre eclampsia, and eclampsia, it is not by

542
00:34:43,040 --> 00:34:47,800
Speaker 2: coincidence or happenstance. We rarely believe in coincidences in medicine,

543
00:34:47,840 --> 00:34:50,919
Speaker 2: or poor physician is one who believes in a coincidence.

544
00:34:51,560 --> 00:34:55,759
Speaker 2: It just so happens that the same risk factors for

545
00:34:55,840 --> 00:34:59,160
Speaker 2: all of those pregnancy complications are the same risk factors

546
00:34:59,160 --> 00:34:59,880
Speaker 2: for heart disease.

547
00:35:00,600 --> 00:35:03,320
Speaker 1: So, doctor Morgan, there are lots of screenings and tests

548
00:35:03,320 --> 00:35:05,800
Speaker 1: that we typically have to have, right like pap smears

549
00:35:05,840 --> 00:35:07,920
Speaker 1: and talking about a mammogram when you're age forty and

550
00:35:08,239 --> 00:35:10,359
Speaker 1: all of these things. Is there some kind of test

551
00:35:10,520 --> 00:35:13,280
Speaker 1: or screening we should be talking with our physicians about

552
00:35:13,520 --> 00:35:15,640
Speaker 1: for our hearts at a certain age. What kinds of

553
00:35:15,640 --> 00:35:16,919
Speaker 1: things should we be asking for?

554
00:35:17,200 --> 00:35:23,760
Speaker 2: Probably should talk about calcium scores and maybe some genetic screening,

555
00:35:23,880 --> 00:35:27,000
Speaker 2: just one panel of genetic testing such that you know

556
00:35:27,080 --> 00:35:30,160
Speaker 2: what it is, and then your calcium score, which gives

557
00:35:30,200 --> 00:35:32,480
Speaker 2: you an idea of kind of your lifetime risk of

558
00:35:32,520 --> 00:35:36,279
Speaker 2: heart disease. The genetic screening is a blood test. The

559
00:35:36,280 --> 00:35:40,160
Speaker 2: calcium score is sort of like a cat scan. It

560
00:35:40,200 --> 00:35:42,480
Speaker 2: is more like an X ray that you would have

561
00:35:42,560 --> 00:35:44,920
Speaker 2: to do. Those are probably the two things that I

562
00:35:44,920 --> 00:35:47,680
Speaker 2: would talk about. There's something that you're going to be

563
00:35:47,719 --> 00:35:50,520
Speaker 2: hearing more and more and more about called LP little as,

564
00:35:50,600 --> 00:35:54,200
Speaker 2: a very specific type of cholesterol, and if you have

565
00:35:54,360 --> 00:35:57,239
Speaker 2: high levels of this LP little a, this specific type

566
00:35:57,280 --> 00:36:01,040
Speaker 2: of cholesterol, it increases your risk of heart disease at

567
00:36:01,080 --> 00:36:04,800
Speaker 2: an earlier and earlier and earlier age. And we believe

568
00:36:05,160 --> 00:36:07,480
Speaker 2: that we're seeing more and more of that in the

569
00:36:07,520 --> 00:36:10,920
Speaker 2: black population and other populations. So we're taking a close

570
00:36:11,000 --> 00:36:13,320
Speaker 2: look at this LP little a. So if you have

571
00:36:13,360 --> 00:36:16,680
Speaker 2: an opportunity to have that drawn. We don't have a

572
00:36:16,880 --> 00:36:19,080
Speaker 2: treatment for it yet. We're working on it though. They're

573
00:36:19,120 --> 00:36:22,360
Speaker 2: clinical trials underway, and I know that because I'm involved

574
00:36:22,360 --> 00:36:25,640
Speaker 2: in the clinical trials in overseeing them and guiding them.

575
00:36:25,680 --> 00:36:28,160
Speaker 2: So we are working on therapy for LP little A.

576
00:36:28,640 --> 00:36:31,360
Speaker 2: But here's why it still could be important for you

577
00:36:31,440 --> 00:36:33,799
Speaker 2: to get that drawn now, because you may say, well

578
00:36:33,920 --> 00:36:35,600
Speaker 2: I get it drawn if you don't have any treatment

579
00:36:35,640 --> 00:36:38,640
Speaker 2: for it, why am I doing it? Because if you

580
00:36:38,760 --> 00:36:41,160
Speaker 2: end up with a high level, then we now can

581
00:36:41,239 --> 00:36:44,560
Speaker 2: begin counseling on how you need to mitigate your risk

582
00:36:44,600 --> 00:36:47,160
Speaker 2: fectors and really be aggressive about it. If you're smoking,

583
00:36:47,200 --> 00:36:49,160
Speaker 2: you need to quit smoking, and you need to quit

584
00:36:49,200 --> 00:36:52,560
Speaker 2: smoking yesterday, like we can start to get serious about

585
00:36:52,560 --> 00:36:56,640
Speaker 2: smoking and weight loss and diabetes control and all of

586
00:36:56,640 --> 00:37:00,600
Speaker 2: these because we know you now have this really elevated

587
00:37:00,640 --> 00:37:03,120
Speaker 2: risk factor, this LP little A, and we also know

588
00:37:03,200 --> 00:37:05,600
Speaker 2: that there's no therapy for so the best thing to

589
00:37:05,680 --> 00:37:08,160
Speaker 2: do is to try to cut it off at the knees.

590
00:37:08,400 --> 00:37:11,399
Speaker 2: And we can be super super aggressive about that if

591
00:37:11,440 --> 00:37:13,839
Speaker 2: we know you're in that category, because you do run

592
00:37:13,880 --> 00:37:17,040
Speaker 2: a risk of having heart disease heart attack at a

593
00:37:17,200 --> 00:37:19,160
Speaker 2: very young age. When I say young, I mean in

594
00:37:19,200 --> 00:37:22,799
Speaker 2: your thirties or twenties, so very young age. We want

595
00:37:22,800 --> 00:37:25,080
Speaker 2: to be aggressive. So those are maybe some things to

596
00:37:25,200 --> 00:37:27,920
Speaker 2: think about. Hopefully we'll have some good endpoints on our

597
00:37:27,960 --> 00:37:31,000
Speaker 2: clinical trials and we have a therapy soon for LP

598
00:37:31,120 --> 00:37:33,880
Speaker 2: little A, So stay tuned. Maybe I'll throw that in

599
00:37:33,920 --> 00:37:34,520
Speaker 2: my book too.

600
00:37:36,480 --> 00:37:38,799
Speaker 1: Thank you so much, doctor Morgan. You have shared such

601
00:37:38,840 --> 00:37:41,520
Speaker 1: incredible information with us today. Please tell us where we

602
00:37:41,560 --> 00:37:43,799
Speaker 1: can stay connected with you. It's your website as well

603
00:37:43,840 --> 00:37:45,880
Speaker 1: as any social media channels you'd like to share.

604
00:37:45,960 --> 00:37:46,560
Speaker 3: Yeah, listen.

605
00:37:47,000 --> 00:37:50,279
Speaker 2: I'm on Instagram at doctor Jane Morgan d r j

606
00:37:50,520 --> 00:37:52,960
Speaker 2: A y N E M O r g a N

607
00:37:53,040 --> 00:37:55,360
Speaker 2: doctor Jane Morgan. Also you can find me on the

608
00:37:55,400 --> 00:38:00,840
Speaker 2: other social media pages the same thing, x, threads, TikTok YouTube.

609
00:38:00,840 --> 00:38:03,520
Speaker 2: I'm also on LinkedIn. You can find me doctor Jane Morgan.

610
00:38:03,800 --> 00:38:07,000
Speaker 2: I do something pretty much on Wednesdays called the Stairwell

611
00:38:07,080 --> 00:38:09,360
Speaker 2: Chronicles where I sit on the stairs. Those are my

612
00:38:09,400 --> 00:38:13,080
Speaker 2: stairs as my house, those are my clothes, and I

613
00:38:13,160 --> 00:38:16,360
Speaker 2: answer a single question about medicine in sixty seconds or less.

614
00:38:16,600 --> 00:38:20,200
Speaker 2: I call it Wellness Wednesday. Those are my stairwell Chronicles.

615
00:38:20,440 --> 00:38:24,000
Speaker 2: You can follow along and listen to little Pearls on

616
00:38:24,080 --> 00:38:26,319
Speaker 2: Wednesdays where I give you a little bit of some

617
00:38:26,400 --> 00:38:29,480
Speaker 2: pearls from the stairs and follow along there with my

618
00:38:29,520 --> 00:38:33,399
Speaker 2: sterwell Chronicles. I do have a website, stairwell Chronicles dot

619
00:38:33,440 --> 00:38:36,880
Speaker 2: com or doctor Janemorgan dot com. Feel free to go

620
00:38:36,920 --> 00:38:38,760
Speaker 2: on there. You can see all of my media interviews.

621
00:38:38,760 --> 00:38:40,919
Speaker 2: I was on CNN just a couple of days ago.

622
00:38:41,280 --> 00:38:42,320
Speaker 3: I do media.

623
00:38:42,080 --> 00:38:45,600
Speaker 2: Interviews all the time. I do Stawell chronicles. I've written

624
00:38:45,640 --> 00:38:47,760
Speaker 2: a book that hasn't been published, hopefully.

625
00:38:47,360 --> 00:38:47,959
Speaker 3: That'll be out.

626
00:38:48,360 --> 00:38:51,000
Speaker 2: And we just keep trying to spread the gospel. So

627
00:38:51,080 --> 00:38:54,080
Speaker 2: I keep banging the drum. I appreciate everybody who's listening

628
00:38:54,160 --> 00:38:57,480
Speaker 2: and follow along. I talk menopause, I talk women, I

629
00:38:57,520 --> 00:39:02,280
Speaker 2: talk minorities, I talk clinical trials, so I only talk science.

630
00:39:04,000 --> 00:39:06,000
Speaker 1: So thank you, doctor Morgan. We would be sure to

631
00:39:06,000 --> 00:39:08,279
Speaker 1: include all that information in our show notes. Thank you

632
00:39:08,280 --> 00:39:09,760
Speaker 1: for spending some time with us today.

633
00:39:10,040 --> 00:39:12,440
Speaker 2: Yeah, absolutely, thank you, Doctor Joy.

634
00:39:12,320 --> 00:39:17,560
Speaker 1: Thank you. I'm so glad doctor Morgan was able to

635
00:39:17,560 --> 00:39:20,480
Speaker 1: share her expertise with us for this episode. To learn

636
00:39:20,560 --> 00:39:22,759
Speaker 1: more about her and the work she's doing, be sure

637
00:39:22,760 --> 00:39:25,160
Speaker 1: to visit the show notes at Therapy for Blackgirls dot

638
00:39:25,200 --> 00:39:28,600
Speaker 1: com slash session three four five, and don't forget to

639
00:39:28,600 --> 00:39:31,000
Speaker 1: text two of your girls right now and tell them

640
00:39:31,000 --> 00:39:33,920
Speaker 1: to check out the episode. If you're looking for a

641
00:39:33,960 --> 00:39:37,800
Speaker 1: therapist in your area, visit our therapist directory at Therapy

642
00:39:37,800 --> 00:39:41,279
Speaker 1: for Blackgirls dot com. Slash directory and if you want

643
00:39:41,320 --> 00:39:43,719
Speaker 1: to continue digging into this topic or just be in

644
00:39:43,760 --> 00:39:46,839
Speaker 1: community with other sisters, come on over and join us

645
00:39:46,840 --> 00:39:49,480
Speaker 1: in the Sister Circle. It's our cozy corner of the

646
00:39:49,520 --> 00:39:52,759
Speaker 1: Internet designed just for black women. You can join us

647
00:39:52,760 --> 00:39:57,200
Speaker 1: at Community dot Therapy for blackgirls dot com. This episode

648
00:39:57,239 --> 00:40:00,080
Speaker 1: was produced by Frida Lucas, Elise Ellis and Zara Are

649
00:40:00,120 --> 00:40:04,640
Speaker 1: You Taylor. Editing was done by Dennison Bradford. Thank y'all

650
00:40:04,719 --> 00:40:07,160
Speaker 1: so much for joining me again this week. I look

651
00:40:07,200 --> 00:40:10,439
Speaker 1: forward to continuing this conversation with you all real soon.

652
00:40:11,239 --> 00:40:11,879
Speaker 1: Take good care

653
00:40:16,280 --> 00:40:16,360
Speaker 3: What