July 12, 2021

Covid 19 health concerns besides Covid 19 with Dr. Sadi Raza

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Many of us became more sedentary during the Covid 19 pandemic and as a result, put on weight. Dr. Sadi Raza helps us reverse this dangerous trend and recover our health.


This episode of the 40+ Fitness Podcast is sponsored by Haka Life Nutrition, the maker of GLX3, I am really glad to have Haka Life Nutrition as a sponsor. Omega-3 is one of the few supplements I take regularly. But even with years of experience and having interviewed hundreds of experts in the health and fitness field, I have struggled to find a great solution, until now.

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Let's Say Hello

[00:04:29.950] – Allan
Hey Raz, how are you?

[00:04:31.440] – Rachel
Good. How are you today, Allan?

[00:04:33.120] – Allan
I'm doing all right. Still flipped out by that woman.

[00:04:36.670] – Rachel
It is a funny sound on that recording.

[00:04:38.910] – Allan
Yeah. So, yeah, when we go to do a recording on Zoom, they've now got this voice lady that comes in and says, you know, we're recording and then she'll say again, we're not recording. And it's just it's kind of just startling because it's louder than we are. But it's just so you can probably hear us laugh about this for at least the next year. Maybe they can give us different voices, maybe something a little bit calmer and soother to transition into these shows because it's like, don't you know?

[00:05:08.090] – Allan
But now everybody on the call, both of us, Rachel and myself, know that I'm recording. And the little red flashing dot was the indicator for that as well. But it is accessible. This is about accessibility. So I get it. I get it. I get it. But give me a calmer, gentler voice. Everybody will be fine with it, you know, just something nice. Maybe something like Mr. Rogers voice, you know, versus the lady we have.

[00:05:32.010] – Allan
It sounds a lot more like Mr. T.

[00:05:34.230] – Rachel
Yeah. Stern warning.

[00:05:38.400] – Allan
How you doing?

[00:05:39.330] – Rachel
Good. Good. You know, we've been having some rainy weather up here in the spring, which is wonderful for my garden. But I've got a new client for who's running her first full marathon. And I told her to practice running in the rain. And Mike and I just went out. We did a 10k in the rain the other weekend and it really was a hoot. It's just fun. It's fun running and jumping in puddles. And I feel just like a kid again.

[00:06:04.350] – Rachel
And plus I'm testing all my gear because you just never know what the weather will bring on race day. So that's what I want my new client to experience just in case for race day is rainy as well.

[00:06:14.010] – Allan
Just in case it rains. Absolutely. So are you going to chafe? Is it going to hurt? You know, how much is your clothes going to weigh when they're wet. All those things can be big, big deal. You weren't planning on carrying an extra pound or two of water.

[00:06:28.410] – Rachel
Yeah, yeah, yeah. It's important to make all those decisions and be prepared. Plus you've got the mental preparedness as well. If it's going to rain, it will be a big deal because you've been through it already. So that's an advantage.

[00:06:42.240] – Allan
And if it happens to be a warm day, you've got a natural cooling effort that's there. So it's actually not the direct sunlight dehydration thing. It's rain.

[00:06:52.740] – Rachel
It could be a good day. Yeah.

[00:06:54.990] – Allan
It rained during my first marathon when I ran. It did. It was so funny. We came up to this hill. It wasn't raining when we started and then we came up to the hill is only one really hill in the whole marathon. Turned this corner and it's raining. It starts raining. As soon as we get to this hill and we're running up this hill and the wind is blowing in our face. As we're running up the hill in the rain.

[00:07:19.920] – Rachel
You have to laugh at that.

[00:07:21.540] – Allan
That's the whole point. I thought I was running with. It's like, I knew I was running with the right group of guys. I ran into these guys. It just start and we're running. And, you know, I knew I was with the right guys because we were just. Does it get any worse than this?

[00:07:35.130] – Allan
Like shut up…

[00:07:36.840] – Rachel
Don't say that. Don't say that out loud. Yeah. Because in Florida, you could have a thunderstorm pretty quickly.

[00:07:44.220] – Allan
Anything could happen. So it's like, yeah, let's just not tempt fate. Let's just race. But they were fun. They were fun for the first ten to twelve miles. And then we dropped down below seven minute miles and I was like, nope, that was not the race I trained for. I was not where I wanted to be. And so I dropped down to closer to my pace, which was closer to seven and a half to forty five.

[00:08:09.690] – Allan
And so anyway yeah they left their buddy. That was kind of the first thing that got me was, we're all military guys and they just, they ran on. Their buddy fell out first. I was also just going to leave him. I'm like, oh yes they are. I realized, OK, I don't, you know, I don't have any skin in this game, I'm not trying to win a race. I'm trying to finish one.

[00:08:27.540] – Allan
So. I dropped out. But, yeah, it's good to know there's different conditions when you're doing things.

[00:08:32.790] – Rachel

[00:08:34.050] – Rachel
So how are things with you down there in Panama?

[00:08:36.300] – Allan
They're getting busy. They're getting really busy. You know, Tammy's trying to do some soft openings on Lula's bed and breakfast. So she's had people come in and stay.

[00:08:46.680] – Allan
Most of them are staying for a month or longer. Then she had a photographer come in. She was going to stay for two days and she was scary. She's just a scary person. Oh, I came in and I started opening up because it was hot and living room. So I started opening up windows and I'll turn on lights. And she said, no, no, no, no, you need to have those lights off and close those windows, like, OK, close everything up.

[00:09:07.230] – Allan
And I went my bedroom and I left her. But no, it was interesting because while she was doing all this, I was trying to do a deep clean at the gym. We do that about once every six months. We pull everything out. The mats and everything, and we scrub the mat, scrub the floor. So we were about, I'd say, maybe three quarters of the way through when the water ran out then, you know, Panama.

[00:09:34.260] – Allan
And I'm like, OK, I know there's tanks, but they city water and they were hostile. We should have so much water. It shouldn't be a problem. But no, they weren't pumping water into their tank. And so we didn't have water on our whole block and we didn't know just went out there. Like we're like, what's wrong? The pumps not working. Like, OK, cool. So I guess guys, we're done early goes go on home and I'll see you tomorrow at nine o'clock.

[00:09:55.590] – Allan
We'll do what we can do. I show up at nine o'clock. I put the bucket, I turn the spigot. It works. cool. They come in, the girl goes there was helping one of the girls that was helping me goes over with a bucket but it turns it on. Nothing comes out. Oh. And I'm like I got water out there. Look there's water in that blue bucket. I got water so I know it's working.

[00:10:13.920] – Allan
When it was not working they hadn't got the pump fixed and they didn't know when it was going to be fixed. So I sent my staff off to go find water in buckets and bring it in because we had to have it to scrub the mats and they found it down at the fire department and they were able to get enough water for us to finish. But just enough. I mean, literally, she went down with the bucket and came back and said, that's the last bucket, because they've now turned off the water to the whole area so they can fix the pump.

[00:10:42.090] – Allan
And so there's no more water. And I'm like, OK. And I went home. I told my wife, I'm like, yeah, we had to go the fire department to get water and we got the last of their water, just like a fire department doesn't have any water.

[00:10:54.180] – Rachel
That's concerning. That's not good.

[00:10:55.620] – Allan
I thought, dammit, I'm going to be that guy. I used all the water.

[00:10:59.970] – Rachel
Oh my goodness.

[00:11:01.770] – Allan
Now we literally probably took I would say. Forty gallons from them, so that was not put out a house fire amount of water that we were using to clean the gym, let's be real. But, yeah, we were able to scrub all the mats, get all of them back and get all the equipment out and stuff, you know, dusted off, cleaned off and put back in. So it was a tough, tough weekend, but we were able to get it done.

[00:11:26.120] – Allan
And, you know, kind of one of those things and I say this over and over, everybody on the podcast is know your strengths, know your weaknesses. You know, don't let your ego get in the way. The first the first two times when I own this gym, I did the deep cleaning by myself, hauled all those mats out, scrubbed them all out, put them all back and did it all by myself.

[00:11:46.010] – Allan
The first two times. The last time I did it, I hired three people to help me. And I was still exhausted at the end of the day, and this time I hired four, so there was a little bit more standing around than I would have liked, you know, spending money by the hour. You don't want a lot of standing around, but it was good to have the extra hand. So, like, we had to go a block away and get water in buckets.

[00:12:08.850] – Allan
I had the people to do it and it wasn't me doing it.

[00:12:12.270] – Rachel
Yeah, no kidding. I can't imagine the weight of all your machines and all your cardio equipment and.

[00:12:18.540] – Allan
Yeah, well, that's the other thing. When I bought the gym I had there were 350 pounds of Olympic plates in this gym. And one barbell. You know, and now I have five barbells and a curl bar and about fourteen hundred pounds of Olympic plates. So, yeah, there's a lot more equipment in here now than when the two times I did it. But those horse mats are still those horse mats are still those first mats and they're heavy and there's no real grip to them.

[00:12:49.270] – Allan
So you use a ton of grip strength, picking those up, holding them, flipping them over and doing all that scrubbing. So it's still a tough day to do the work, even when I'm only doing a fraction of it.

[00:13:00.480] – Allan
But I knew my strengths and weaknesses and what was about to get myself hurt.

[00:13:07.920] – Rachel
it's good to have that extra help for sure.

[00:13:10.380] – Allan
So my workouts this weekend had a lot of grip strength, but a lot of moving around. All right. Well, you ready to have a conversation with Dr. Raza?

[00:13:23.580] – Rachel


[00:13:53.100] – Allan
Dr. Raza, welcome to 40+ Fitness.

[00:13:56.100] – Dr. Raza
Thank you. Thank you for having me.

[00:13:57.940] – Allan
Now, you know, as we went into covid and I have made a point on the podcast of not talking about covid a whole lot. And I only say that because there's so much that's happened around covered so many conversations around covid and it's become so political. But one of the things that really concerned me as we went into Lockdowns was the term I use, the term it's called unintended consequences that, you know, so many things are happening to us around what we're trying we're trying to avoid one thing, but we create additional problems for ourselves.

[00:14:38.130] – Allan
And it's just something that, you know, you had someone reach out to me so that you could be on the show. And I was like, absolutely, we have to talk about these unintended consequences of covid. So thank you so much for taking time to be with us today.

[00:14:53.340] – Dr. Raza
And not at all. Thank you for having me.

[00:14:55.590] – Allan
Now, you know, we went into the lockdowns and

[00:14:59.980] – Allan
Kind of the worst part of this was some of my clients were doctors. And so I was training a doctor and the doctor's like, well, we're closing down the clinic. And I'm thinking, well, kids aren't going to stop getting sick, kids are still going to need, you know, their immunizations and are still going to need their health care visits.

[00:15:21.900] – Allan
so our medical care doesn't stop just because we decide we're going to stay in our apartment or house. It doesn't stop because, you know, our office says, oh, well, you can work from home. The things that get us sick, the things that are happening in our bodies that require medical attention are better addressed if we are a little bit more proactive than if we go in for emergency care. And that's the discussion. But what we've noticed and you brought to my attention actual statistics from the CDC is that while we had this huge problem with heart disease before, it's now actually become something worse.

[00:16:04.230] – Allan
Can you talk a little bit about that?

[00:16:06.030] – Dr. Raza
It has. So if you go back to last March and here in Dallas, Texas, the spring break is always like first or second week of March.

[00:16:18.030] – Dr. Raza
And so the Thursday before spring break, I remember getting my wife's cardiologist as well. So both of us got an announcement on email and text that school was going to close early and no school on Friday would go into spring break with the anticipation that school would not return after spring break. And at the same time, locally in Dallas and statewide in Texas, we also went into lockdown. In our clinic, logistically, what that meant was that for our nurses or techs or aids, they now have to consider child care issues in addition to the hospital that we're in where we have our clinic, they indicated sort of protocols for who can now come in, et cetera, et cetera.

[00:17:09.380] – Dr. Raza
And so I still remember on that Monday, March 16th, we started to do telemedicine for the first time. We've never done this as a cardiologist, as a cardiology practice, because cardiology, you have to see the patient in front of you. You have to look, listen, examine, do EKGs, et cetera. But we started off on this in April and into May. And slowly things improved, especially locally here in Texas, whereby they opened up in May.

[00:17:41.240] – Dr. Raza
But clearly what we noticed was a drop in the number of visits to the emergency room, to the hospital and to our clinics and patients who would otherwise come in for cardiovascular issues. That is both acute symptoms and chronic management issues. And this basically persisted throughout certainly the acute hospitalization and emergency room data stand down throughout 2020. And this data was not just this is not just US based data.

[00:18:13.380] – Dr. Raza
This is this was also manifested in Europe and in the U.K. whereby they have large nationwide health care system. And so it's very easy to data. But, you know, the NHS can easily look at hospitalizations for cardiovascular issues. 2019, 2020. And we don't get better cardiovascular disease in one year. It doesn't work like that. We look at data in chunks of decades at a time in the clinic, there was a little bit of a reflection whereby June, July was busier than sort of tapered off again, as we initially had a surge in the fall and then definitely the November, December, January surge.

[00:18:57.710] – Dr. Raza
And sure enough, it wasn't surprising when the CDC came out with their data last week that the deaths from heart disease had gone up for the first time in two decades. And this reflected the fact that what was happening wasn't that we had gotten better at treating cardiovascular disease. And so that's why the hospitalizations are down. That's why the rate of our defects is down. That's why clinic visits were down. It's that patients were not seeking medical attention. And so therefore there are heart disease prosecuting chronic or being we're not being managed, not being looked after.

[00:19:34.430] – Dr. Raza
And of course, the unintended consequences is downstream. You have cardiovascular events and as we know, cardiovascular events, unfortunately, to death.

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[00:21:56.620] – Allan
I think many of us have paid attention, at least enough attention to know that if we are going through certain symptoms, you know, pain in the arm is one, dizziness, tightness in the chest, some of those basic things that were we start paying attention to once we're 40, we pay a lot more attention to it. But at this point in time, you're at home and there's this kind of a sudden, this tepid fear that this is out there.

[00:22:28.600] – Allan
The covid is out there, and we have to be concerned about being exposed. And so it's one of those things where it is kind of a counterbalance to say, do I book an appointment and go in and take a risk or is this just indigestion and maybe I shouldn't have had that second slice of pizza I ordered from Domino's or forth? So, you know, as people are going through this because, you know, I can't say this is the last time this is going to happen in our lifetime.

[00:23:00.580] – Allan
You know, this kind of talk about the different aspects of covid and the different variants and things is it's really hard for me to wrap my head around the fact that this might not just be a Spanish flu, if you will, where we have a three year period of time when everybody goes through this situation and then effectively it's passed and we're on, this might be a little bit more of a protracted thing. So before we move on, because I do think this is important and I really think it's important as far as the four steps that you have for how we can move forward, move beyond this.

[00:23:40.720] – Allan
But can we just take one step back and kind of talk about for an individual and, you know, heart disease is the number one killer for men and women in the United States. So as we're looking at that, and I know men and women actually have slightly different symptoms sometimes. Could you just take us back to that level of, let's talk about the symptoms of what would a man experience? And this is the time to go into the emergency room and this is the time to make an appointment with a cardiologist like yourself.

[00:24:14.680] – Allan
And what would a woman experience that could be slightly different? So someone, at least at this point thinking I haven't yet been vaccinated, but I so I'm putting off going to the doctor, putting off, going to the emergency room. What should they be looking for?

[00:24:28.810] – Dr. Raza
It's a great question that you brought up the pizza analogy because you can rationalize your symptoms in many different ways, depending on what you yourself are going through at that point. So you're absolutely right. March of 2020. I have patients tell me this, that they would have chest discomfort, et cetera, and they would say it was probably this, it's probably stress not sleeping well and so on and so forth. And later you find out that this is not the first cardiovascular issue.

[00:24:59.730] – Dr. Raza
So let's go back to, like you said, to the very beginning. So for me and for most cardiologists and we have to do a better job at public information disseminating this out to the public. If you have chest pain, chest pressure, if you have arm numbness, jaw pain, nausea, typefaces where you're sweating, shortness of breath with exertion, shortness of breath, when you lay flat at night, palpitations, unexplained episodes of passing out or even sort of seizure like activity, you should absolutely seek medical attention and you should do it sooner rather than later before you start rationalizing and then more subtle signs.

[00:25:44.240] – Dr. Raza
So if you feel more sure, more tired or fatigued at the end of the day, if you feel that, you know, I used to be able to walk up and down this corridor at work or I used to be able to climb a flight of stairs, now I have to take a break in the middle. Don't rationalize it as I'm a year older, maybe have gained 15 pounds and I'm a little heavier. It's easier.

[00:26:08.620] – Dr. Raza
It's very easy to rationalize. What you actually should do is go out, seek medical attention and then make sure it's not anything we need to worry about. All the other things. Let's rule it out first and then go with the well, I'm just a condition, I just need to lose a little bit weight, it's stress and anxiety. Those things won't markedly alter your mortality and morbidity to way heart disease potentially can. And remember, early intervention is always better, whether it's cancer, whether it's heart disease, you're going to find something more options

[00:26:45.460] – Dr. Raza
We have a better chance we have at preventing something worse.

[00:26:50.050] – Allan
And I think you hit on something really important. There's the early intervention. You know, don't talk. Yourself out of talking to a doctor. The worst case is he tells you, you're perfectly fine, go home and leave me alone. And that would be a great case.

[00:27:05.260] – Dr. Raza
we get that all the time, you know, we get patients who come in and they have chest discomfort. We do the evaluation.

[00:27:11.830] – Dr. Raza
It's not the heart.

[00:27:12.780] – Dr. Raza
What we tell them is, OK, I understand you had symptoms of X, Y, Z. What I can tell you is it's not the heart.

[00:27:19.570] – Dr. Raza
What it could be?

[00:27:20.710] – Dr. Raza
I don't know for sure. But let's take the next step at going back to your primary care doctor, letting them know that you had a battery of cardiovascular tests. You don't think it's your heart.

[00:27:30.500] – Dr. Raza
Let's go down the next thing down the line, whether it's high, whether it's whatever, X, Y, Z.

[00:27:36.760] – Allan
Well, anyone that tells me they went through the last 18 months without feeling some level of anxiety and maybe even moments where they just sat there and said, OK, I'm just beyond myself. They're not being realistic because I think we all went through those moments where we're like, OK, I'm not right. This is not right. I don't feel good. And it may not be a huge health concern, but in the grand scheme of things, if you're feeling any of those symptoms, feeling any of that, it's worth having the conversation and we've put the conversation off.

[00:28:09.720] – Allan
Because of the lockdowns, because of covid restrictions and just the basic fear that's out there, which, again, the fear leads to anxiety, anxiety leads to not some dissimilar, but then also that's confounder that could actually be causing some of the heart issues. So we kind of look at this full circle. It doesn't surprise me to see the higher numbers post covid, but for a long time the numbers looked great because, well, no one was going to the doctor, even the emergency room.

[00:28:40.320] – Allan
And as a result, it's like, you know, flu deaths are down, cancer deaths, all these things are down. And you're like, no, they're not down. They're just submerged into this environment.

[00:28:51.000] – Dr. Raza
They are. And you have this backlog of access to care. So, for example, telemedicine is wonderful, but you have to understand the limitations. So when primary care doctors or specialists like myself, we did tell you we're still relying on Internet connection folks having to either hold up an iPad or a smartphone. The angles are off, the lighting is bad. You can't really see the patient.

[00:29:18.990] – Dr. Raza
And there's a lot of value in actually looking at someone and talking to someone face to face versus over the phone. And so what would happen is I can easily see where they speak to a primary care doctor or a cardiologist and symptoms, I think that minimized lost in translation. And they say, well, we'll see you back in six months and six months passed down the line. And I miss the appointment or something else happens. And this data is has been tracked and the VA population and also in the UK where the NHS has this backlog now, I think about five million well visits of folks who haven't gone for their annual physical screenings.

[00:30:06.150] – Dr. Raza
And if you just do the numbers and add up all those patients with high blood pressure, diabetes and so on and so forth, we haven't had a checkup, whether it's in person over the phone, it's not surprising that you see these numbers. Going back to the initial question that you had. What are the differences between men and women with heart disease? That's a fascinating discussion that's been discussed and actually researched ad nauseum. The American College of Cardiology actually has a wonderful graphic on signs and symptoms of heart disease and actually tweeted it out the other day.

[00:30:41.500] – Dr. Raza
You can follow me at SadiRazaMD and what it is, is the signs and symptoms are similar, but women may have additional symptoms than men, so they may have the nausea, the diaphoresis which is sweating, the dizziness on top of the chest the pain, and the pressure down the left arm, et cetera.

[00:31:01.000] – Allan
OK, now you developed or at least presented to me kind of a four step process that you feel, and I'll guess I'll put my own title to it. And this should not just be about heart care, but in this premise of our conversation, it definitely is.

[00:31:18.310] – Allan
This is a post covid Wellness plan,

[00:31:23.380] – Allan
particularly for people over 40, because we're the ones most likely to be suffering from cardiovascular disease and dying from cardiovascular disease. So can you talk about your four steps? And why each is important?

[00:31:36.580] – Dr. Raza
Sure. So I think step one, and I'll be careful in what I say here, I think step one is try and get vaccinated. So today, I think the administration is going to announce that they've had more than three hundred million doses that have been given since the vaccines came out.

[00:31:56.320] – Dr. Raza
The US has three vaccines, Pfizer and Moderna, which are MRNA based vaccine, and this Johnson & Johnson, which is one shot at no virus vaccine. Since March of 2020 to now, our ability to mask handwash and social distance hasn't improved. We're not better at wearing masks now than we were in March.

[00:32:22.450] – Dr. Raza
We're not better at being socially distant from each other now. We're not washing our hands better. If anything, societies open up and then those lockdowns and they really haven't been a this wealth of medications that have come down the pike.

[00:32:39.060] – Dr. Raza
You know, we had the plasma convalescent plasma that patients got potentially a randomized clinical trial, which showed minimal improvement with that, yes, we have the infusions, but really it's not because of medications or non pharmaceutical interventions that our covid numbers have plummeted in the US, both in the US, nationally and locally at the local level, at the city level and internationally. You look at countries like Israel, you look at the European Union and all of them, the curves start to markedly come down from when a robust vaccination program was enacted.

[00:33:20.890] – Dr. Raza
So clearly the vaccines work and for the most part, they're safe. And I say that for the most part because that's sort of just couching my words, because there'll be folks that say, well, in this case, the microdata is you're forgetting about the Johnson & Johnson, the vaccine, which is stopped briefly because of clots in the brain, et cetera. So I'm not discounting those. But out of 300 million people who have been vaccinated, the vast majority have had really no side effects, apart from the normal immune response that we expect from any vaccine with the flu vaccine in this case, the covid vaccine. We know, they prevent moderate to severe this is to prevent hospitalizations, and therefore they prevent the virus.

[00:34:12.160] – Allan
And in a person, a person that's most likely to suffer from cardiovascular event is what we would call an at risk person for covid.

[00:34:20.380] – Dr. Raza
Correct. Absolutely. And this is, again, borne out in our hospitals. If you look at, pick a hospital, any hospital in the US hospital, any hospital in the world, the folks who are now hospitalized with covid are younger and primarily those who are unvaccinated, which is markedly different from the typical covid admitted patient in the hospital that we had for the first 12 to 15, 15 months of this pandemic.

[00:34:48.940] – Dr. Raza
So step number one, get vaccinated.

[00:34:51.280] – Dr. Raza
It's very easy to do now, there's a phone number that you can text with zip code and you'll get a list of places that you can get vaccinated. It's now one of those things where you don't have to get in line. CBS, Walgreens, Walmart, lots of places have them that you just walk in. A lot of them you can pick which one you want. If that's your choice, you want to go with Pfizer or Moderna or Johnson & Johnson, they'll give you the date for the second one.

[00:35:18.610] – Dr. Raza
Get a nice card to carry. So get vaccine. Step two, got to reengage with your physicians, whether it's your primary care physician or to one physician, some specialist, endocrinologist or cardiologist, or lung doctor, we engage with them. Get back to figuring out how far away from the baseline you are. Have an honest conversation with them about the signs and symptoms that you've had recently and give them an overview of your health over the past 15 months.

[00:35:47.370] – Dr. Raza
What's happened?

[00:35:48.060] – Dr. Raza
Have you gained weight?

[00:35:49.650] – Dr. Raza
Have you lost weight? Other stressors? Were you exposed to covid? Where you admitted with covid? Let them know. Give them a full comprehensive history of the last 12 months since they last saw you.

[00:36:02.310] – Dr. Raza
Step three, get back to exercising. So if you look at data that we have from fitness trackers, the number of steps that the average person normally walks in a day that are tracked in Apple watches, Fitbit, et cetera, those fell dramatically between 2019 and 2020, because we naturally became more sedentary when malls shut down.

[00:36:28.230] – Dr. Raza
When you don't when you work from home. You don't have to park your car and you walk into an office, go up and down off this corridor, up and down stairs, go to the break room. You know, you don't have malls that you can go into, shopping, etc. grocery stores, those steps go away. And they're not replaced by walking at home. They're just not, you know, and so you have to get active again.

[00:36:53.040] – Dr. Raza
I understand the hesitancy as far as going back to gyms, but you don't have to go back to a gym to become active. This great workout videos that you can do at home. But we got to get mobile again. We got to become less sedentary. We have to do that and then set yourself targets. How did you gain weight during covid? So let's start on a plan to start losing that weight. Did your diet get altered? Were you having more comfort foods?

[00:37:20.190] – Dr. Raza
Understandable. Obviously, you know, if you go back to March, I remember our kids were off school and we did a lot of baking, cookies and brownies and cakes. And you can do those things were flying off the shelves because people were eating comfort food. So get back to eating healthier foods, veggies, et cetera.

[00:37:39.990] – Dr. Raza
And then the last thing is, make a plan to get to sort of take ownership of your own health care and set yourself health goals for the next three to five years.

[00:37:52.480] – Dr. Raza
What do I want to achieve? Where do I want to be? Whether it's a weight target, whether it's well, I want to make sure that I have my, you know, get my colonoscopy done and make sure, you know, there's a knee that's bothering me I'll go visit an orthopedic doctor, this hip that's bothering me I'll go get my hip replaced, et cetera, et cetera. And that's sort of what I would go towards as we come out of this pandemic, sort of reassess and realign our interests and taking care of our own body, our bodies our temple.

[00:38:24.880] – Dr. Raza
You know, we got to take care of it. During the pandemic, the average American gained around twenty nine pounds.

[00:38:33.970] – Dr. Raza
A lot of folks gained as much as 50 pounds. We say the covid 15, but it was actually not 15. It's more like 20 or 30 pounds on average that people gained. And there's many reasons for that. Give yourself a pass, but try and assess the fact that you did gain weight. You may have developed unhealthy habits and tried to work to correct those. Again, prevention is cure. Start engaging with your primary care doctors. Get an assessment for what your blood pressure is.

[00:39:03.130] – Dr. Raza
Have you become diabetic? You now pre diabetic? Too cholesterol or other medications that you should have been on that you stop taking because you just didn't go to see a doctor and so you didn't fill the prescriptions and so on, so forth.

[00:39:18.580] – Allan
So I kind of had three takeaways from that. One, one being what happened, happened. If you let yourself go and you put on some weight that's passed, let's let's look forward. That was an event. Let's move forward. The second is you're the CEO of your own health.

[00:39:37.120] – Allan
So you've got to be proactive. You've got to step up and do the right things for yourself. And that means making the doctor's appointments. That means moving more. That means eating better. And so making those lifestyle choices that we should have been making all along. But now going forward is our opportunity to act. We can't act on the past, but be the CEO now. Make the right decisions now and the final one. And you didn't really get into this, but you did a little.

[00:40:01.330] – Allan
But be patient.

[00:40:03.790] – Allan
There's a backlog in service. There's a backlog in what doctors are able to do. But if obviously if you become a priority patient, you're going to move to the front of the line so that you've got to be out there, you've got to get that communication with your doctor so that you're getting the care that you deserve. So get into the mix and then, yes, it there's just going to be an element of patients in that your appointment that you normally would have made next week is now maybe three weeks or four weeks from now.

[00:40:32.170] – Allan
And just realizing, OK, there are people right now that are suffering and need the care now and there's a prioritization of service, have the patients to work through that and don't give up on it. Stick with it.

[00:40:45.040] – Dr. Raza
I agree. And the other thing is, the other thing I like about the patient is you've got to take a long term view to health.

[00:40:51.640] – Dr. Raza
And as far unfortunately, all of us know this, it is far easier to gain weight than it is to lose weight. And you have to have a plan in place that has it's a marathon, not a sprint. Set yourself ambitious targets, but don't be disappointed if you don't get them quickly. Sort of a what I would say, take it not even month to month, but maybe season by season. See where you are.

[00:41:18.580] – Dr. Raza
If you walk on a treadmill every day to go as you walk for a half hour, well, the goal is to walk further and thirty pounds two months from now than you did than you do currently. That means you quickened the pace. That means your cardiovascular conditioning and so on, so forth. And the weighing scale is not the end all be all. It's not, you know, you can not lose weight but reduce fat, build up muscle, which is just as important.

[00:41:55.070] – Dr. Raza
It's about an overall level of health. But you're absolutely right. You have to be invested with yourself. I tell patients all the time I can be the world's greatest cardiologist, but I can't help you if when you go home, the diabetes isn't well controlled. If you don't take the medications for blood pressure or for your thyroid or X, Y, Z that you're supposed to, or if you're going for surgery you need and you don't follow the instructions of the orthopedic surgeon properly.

[00:42:28.060] – Dr. Raza
You know, complications, X, Y and Z. You got to be invested in your own health.

[00:42:33.160] – Dr. Raza
And together it truly takes a village. Together we can help you feeling better. At the end of the day, the goal for everyone is I want you to live life to the fullest. Spend as much time out of the hospital, away from doctors offices, doing the things that you love with the people that you love.

[00:42:51.790] – Allan
Awesome. So, Dr. Raza, I define wellness as being the healthiest, fittest and happiest you can be. What are three strategies or tactics to get and stay?

[00:43:01.090] – Dr. Raza
Well, I think find something that makes you happy. Find people that you can be happy with and find a way that you can achieve those to the best way that you can. Whatever path it takes. It's about the journey as it's not just the destination.

[00:43:19.090] – Allan
Now, Dr. Raza, say if someone wanted to learn more about you and what you're doing, where would you like for me to send them?

[00:43:25.030] – Dr. Raza
so if you go to my Twitter page, so at SadiRazaMD, you'll find a link to my website or practice.

[00:43:33.850] – Dr. Raza
And I tweet regularly about cardiovascular issues, health and wellness, sports and fitness. And you can follow along and try and make it patient centered.

[00:43:43.930] – Dr. Raza
It's not really geared towards physicians necessarily. It's more towards patients know ways to get prevention, prevention, prevention. Some of it is topical. So for example, in the last week or so, you'll see a lot of posts around a soccer player that had a cardiac arrest last week. But for the most part, it's more general and topical.

[00:44:06.970] – Dr. Raza
And I am fortunate enough to be able to do media from time to time. So look out for articles or radio shows, podcasts, etc.. My wife is a cardiologist. I'm just starting to podcast for the heart doctors for that on Spotify on an Apple podcast. And we'll try and put the word out how to be heart healthy and live life to the fullest.

[00:44:34.780] – Allan
OK, you can go to 40plusfitnesspodcast.com/494 and I'll be sure to have the links there. Dr. Raza, thank you so much for being a part of 40+ Fitness.

[00:44:45.870] – Dr. Raza
Appreciate it. Thank you, Allan.

Post Show/Recap

[00:44:52.350] – Allan
Hey, Raz. Welcome back.

[00:44:54.130] – Rachel
Hey, Allan, what a wonderful interview with Dr. Raza. You know, it is I was kind of wondering how the covid shut down had other implications than what we commonly talk about on the news. I mean, besides the covid 15 or covid 20, that might be that extra weight we've all gained. You know, there is a real concern about our overall health, but particularly cardiovascular health. That's a pretty scary side effect.

[00:45:21.170] – Allan
Yeah, I kind of knew a little bit of this was happening because a couple of my clients, as we went into covid are medical professionals. And so when they were going to telemedicine, I was thinking, well, how does someone who was about to potentially start chemotherapy and radiation treatment, how do they telemedicine that, you know you know, if a kid needs their standard vaccinations now, granted, they're not running into other kids with mumps because they're not seeing other kids with mumps.

[00:45:53.710] – Allan
But, you know, so maybe some of that stuff isn't necessary. But it just seemed to me it's like there's a lot of well care that just didn't happen. And so you can't go to your gyms. A lot of people didn't feel like training. They was just if I can't go to my gym, if I can't get out and, you know, do the things I was doing, the sports I was playing with, things like that to keep me engaged and doing this, I mean, you give me a stat that a lot of that stuff Strava put out that the people that were doing these virtual runs was kind of going up.

[00:46:28.420] – Allan
but if you were part of a run club and that was kind of the real thing that got you showing up, was that accountability like where you belong to a gym or belong to a cross fit and things like and those things were just gone. And you're like, OK, I need five people around me sweating harder than I am for me to get my bike gear. You know, it's just I could see where that investment wasn't happening. The investment of time.

[00:46:54.190] – Allan
The investment of effort and then the investment of money. A lot of people were trying to buy home equipment, but there was none to be found.

[00:47:01.720] – Rachel
Oh, yeah, I know that probably sold out pretty quick. But, you know, down with you where you are in Panama, you had a pretty strict shutdown. You weren't even allowed to get out and get moving. And I know a lot of countries that were like that as well. And here in the United States, we did have a little bit of freedom to be outside and most of our country. But I think a lot of people were still afraid to go out.

[00:47:25.360] – Rachel
We didn't know a lot about covid. We just knew that we didn't want to get it and end up in the hospital. So, you know, I think a lot of people did stay home. And I think the level of stress went up. And we had talked about in the past about how the parents that had to learn how to work at home that had never worked at home before, plus help to home school their kids because school went virtual I mean, jeez, there's so many things that kept people from being able to go out and work out any more.

[00:47:53.920] – Rachel
So there's it's not really surprising that we have a covid weight gain or any other health implications.

[00:47:59.770] – Allan
Yeah, but the data is there, you know, the cardiovascular events and deaths from that is going up. And it shouldn't. I'm almost certain that we're going to see cancer, diabetes, those types of things, you know, where the care just wasn't there. If you're not going in and getting your dialysis, you know, if you're not, you know, going in the doctor and getting your blood pressure done and checking your meds or maybe not even getting them filled.

[00:48:28.770] – Allan
Because you didn't want to get out and go to the pharmacy because you just didn't want to be exposed.

[00:48:34.810] – Rachel
Well, that and plus, some doctors won't refill a prescription unless they see you in person.

[00:48:40.300] – Allan
Well, they were doing telemedicine. They changed medical care a little bit. But there's just so many things. It's like, OK, they can't get the labs to know. They can't do a blood pressure. And if you don't have the monitor yourself already, it's like you don't know. It's like, you know, because you walk into the doctor, they stand on the scale. They, you know, your blood pressure.

[00:48:59.620] – Allan
And that's the part of the natural conversation with your doctor, which kind of takes me to the next transition. You go to your doctor. Get your care team together. As I mentioned before, this podcast, you know, we've got to start showing our priorities with the way we spend our money, the way we spend our effort and the way we spend our time. And it's easy to audit that. Just go and look at your bank statement.

[00:49:26.200] – Allan
Look at your credit card statement. Where are you spending your your money? Look at it days time and just say, OK, how much time that I spend watching Netflix versus exercising? And maybe we're doing both. And that's awesome. You know, double dip in there. You're on the treadmill or the elliptical and you're watching your Netflix show. That',s cool. That's totally cool. But most of us aren't doing that. You know, they weren't doing that.

[00:49:49.240] – Allan
And so it's look at where you're spending your time. Look at the effort you're putting in and look at where you're spending your money and answer that question, what are your true priorities here? And it's time to shift that, because if you're not taking care of your health, you're soon enough can be taken care of illness.

[00:50:04.990] – Rachel
Yeah. Dr. Raza mentioned that too, suggesting that we, of course, reengage with our specialists and but also get back into exercising and resetting our eating habits. You know, it's it's a multifaceted way of improving our health. But we do need to focus. We do need to focus on it.

[00:50:26.700] – Allan
Now, I ran across a study this week. Thirty five chronic diseases can be traced to inactivity.

[00:50:34.260] – Rachel

[00:50:35.220] – Allan
OK, and I'll make sure to put a link to that in the show notes. But this is not and this is not really a new study. I didn't realize this was out there. That's the first time I was seeing it. The study was done in 2012. But, yeah, they've manually, physically traced thirty five different chronic diseases directly to lack of activity.

[00:50:55.380] – Rachel
So the best thing you can do for your health is move.

[00:50:58.290] – Allan

[00:51:00.990] – Rachel
Do something. Anything.

[00:51:02.150] – Allan
Well, the human body was built to move. I mean, our lymphatic system is how we get rid of toxins and waste in our body.

[00:51:09.030] – Allan
And it doesn't have a pump system, the pump system for your lymphatic system as your muscles, your skeletal muscle. So if you're not moving, then you're basically letting gunk sit there and it's poison. Your body needs to get rid of it. And the only way it can do that is if you move and push that stuff through your system to get it out. And so that's yeah, absolutely. We need movement. And then there's just so many other things that movement gets us.

[00:51:35.100] – Allan
You know, if you get the endorphins because you're doing it enough, if you know the movement patterns. And the other thing movement does is it kind of gets the the juices going with blood and flows and everything else to where maybe your knees hurt less because you're actually getting more nutrients and fluids and liquids in the knee so that'll function better. Now, obviously, if you go do some exercise and the knee swells up, you've got to talk to somebody and have that taken care of.

[00:52:02.670] – Allan
But for a lot of us, the aches and pains that we're feeling is vicious.

[00:52:08.970] – Rachel
it is. And I've said to a lot of my friends and in run clubs and elsewhere that if you rest, you rust. And it's essentially true. You just need to keep moving to keep those joints fluid, keep your balance, keep your flexibility. I mean, I'm not saying run marathons or do something crazy. Just take a walk, walk for a mile, walk for two miles and just a little bit of fresh air.

[00:52:33.000] – Rachel
And some activity can do so much good for your health overall.

[00:52:37.650] – Allan
Well, you're the one that admitted marathons are crazy, so.

[00:52:41.610] – Rachel
Yeah, maybe. But, you know. Yeah, no, you don't have to run marathons, but, you know, you can get so much benefit from just walking one, two or three miles. And if that feels good, do a little jogging and maybe maybe register for a local 5K. I've got a 5K coming up this weekend and proceeds go to the local cross-country team. So, you know, you do a little good for others while you're doing good for yourself.

[00:53:09.810] – Allan
Awesome. Rachel, so I guess I'll see you next week.

[00:53:13.120] – Rachel
Yeah. Take care.

[00:53:14.390] – Allan
You too.

[00:53:15.120] – Rachel


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