Latest / Morning Medical with Dr. Chow / Doctor-Patient Communication, GLP-1 Insights, and Better Sleep Practices

Transcript

Doctor-Patient Communication, GLP-1 Insights, and Better Sleep Practices · Morning Medical with Dr. Chow

0:00
Welcome to another episode of Morning Medical with Dr.
0:03
Chow, where we bring you the latest updates in the world of health and medicine.
0:08
I'm Dr.
0:08
Chi-Ming Chow, and today we're going to dive into a topic that's crucial for your health:
0:14
the secrets you should not keep from your doctor.
0:20
It's quite common for patients to withhold information from their healthcare providers.
0:25
In fact, a major study found that between sixty and eighty percent of adults in the United
0:29
States have held back at least one pertinent piece of medical information during a visit.
0:34
Now, why do we do this?
0:36
Well, the reasons are often very human: fear of being judged, not wanting to be lectured, or
0:41
simply feeling embarrassed.
0:44
Research suggests that women, younger individuals, and those who perceive their
0:48
health as poor are more likely to withhold information.
0:53
If you've faced discrimination, you might also feel more distrustful of the medical system,
0:59
which can lead to keeping secrets from your doctor.
1:02
This is especially true for people who've used alternative or complementary medicine without
1:07
informing their primary care doctor.
1:10
But why is this a problem?
1:12
Well, your clinician can't provide the best care if they don't have all the information.
1:17
This is particularly crucial in high-stakes situations, such as when someone is
1:22
experiencing depression, suicidal thoughts, or has been a victim of abuse or sexual assault.
1:29
Unfortunately, about one in four patients in such situations withhold this critical
1:34
information from their doctor due to fear of embarrassment or judgment.
1:40
So, what should you always tell your doctor?
1:43
First, be upfront about which prescription drugs you're taking and whether you're
1:47
following the prescribed regimen.
1:49
It's also important to disclose any other substances you're using, including legal ones
1:54
like tobacco and alcohol, as well as any illegal substances.
1:59
The risks of withholding this information are significant.
2:04
Dr.
2:05
Ronald Epstein, a professor of family medicine, suggests that patients ask themselves a key
2:11
question: 'Would withholding this information threaten or enhance my health or that of a
2:17
loved one?' This question can guide you in deciding what to share.
2:21
It's about striking a balance between feeling comfortable and ensuring the best possible
2:27
care.
2:28
Remember, doctor-patient communication is a two-way street.
2:33
It's not only about what you share, but also about how doctors can create an environment
2:37
where patients feel safe to be honest.
2:40
Simple changes in how questions are asked can make a big difference.
2:44
For instance, instead of asking 'Are you taking your medications daily?' in a way that might
2:49
seem judgmental, a doctor could ask, 'It's hard to remember to take pills every day, how are
2:55
you doing with that?' This approach can open up more honest dialogue.
3:00
Ultimately, building a good relationship with your healthcare provider is a shared
3:05
responsibility.
3:06
It's about achieving a mutual understanding and trust, which can empower you to make informed
3:11
decisions about your health.
3:13
As the saying goes, 'To write prescriptions is easy.
3:16
To come to human understanding is difficult.' Good medicine requires both.
3:23
In recent news from New Brunswick, Health Minister John Dornan has announced a
3:26
significant change in the province's virtual healthcare services.
3:30
On June 30, Virtual Care New Brunswick is set to replace the existing eVisit New Brunswick
3:36
service.
3:37
This new initiative promises to enhance patient experience by offering scheduled, 20-minute
3:44
appointments, a move away from the current model where patients wait in virtual waiting
3:48
rooms without a clear idea of when they'll be seen.
3:53
Minister Dornan emphasized that the new service aims to reduce wait times and improve
3:57
continuity of care.
3:59
"It's not the wait that concerns people, it's knowing when they will be seen," he said,
4:03
highlighting the importance of scheduled appointments.
4:06
This structured approach is expected to provide more predictability and reduce patient
4:10
frustration.
4:12
Virtual Care New Brunswick will be available seven days a week, from eight o'clock in the
4:18
morning to eight o'clock in the evening, for all residents with a medicare card.
4:23
The service will allow nurse practitioners to focus on one patient at a time, ensuring that
4:28
each individual receives undivided attention.
4:32
This change addresses concerns raised in a letter from nurse practitioners who felt
4:37
overburdened by the previous system's demands.
4:41
The new service will not only involve nurse practitioners but will also connect patients to
4:46
a broader range of healthcare providers.
4:49
This includes mental health and addiction support, pharmacists, doctors, and emergency
4:54
departments, creating a more integrated healthcare experience.
4:58
Foundever, the Luxembourg-based company behind the new service, is tasked with ensuring
5:03
patients receive necessary follow-up care and referrals.
5:08
Minister Dornan also addressed concerns about the transfer of medical information from the
5:13
current eVisit New Brunswick system, assuring that data will be stored safely in Canada.
5:19
However, he did not specify if the transition of medical records will be automatic.
5:25
The introduction of Virtual Care New Brunswick reflects a broader effort to improve virtual
5:30
healthcare delivery by preventing distractions and ensuring healthcare providers are not
5:35
multitasking.
5:37
As Dornan put it, "The patient should never receive inattentive, multi-focused people that
5:42
are trying to juggle four or five balls at the same time." This approach is expected to
5:46
enhance the quality of care and patient satisfaction.
5:50
As the province prepares for this transition, the current provider, eVisit New Brunswick,
5:55
will continue its services until the end of June to ensure continuity of care during the
6:00
switch.
6:02
This marks a new chapter in New Brunswick's healthcare system, aimed at providing a more
6:06
efficient and patient-centered service.
6:11
The latest research presented at the American Society of Clinical Oncology meeting in Chicago
6:16
suggests that glucagon-like peptide one receptor agonists, commonly known as GLP-1
6:22
drugs, may be associated with a reduced risk of certain cancers.
6:27
These findings are particularly intriguing as semaglutide, a GLP-1 drug, becomes more
6:33
accessible and affordable with generic versions now available in Canadian pharmacies.
6:39
Dr.
6:40
Judith Bray, the vice-president of research at the Canadian Cancer Society, described the
6:45
research as potentially transformative.
6:48
She noted that the scientific community is now paying attention to the possibility that GLP-1
6:55
drugs could play a role in cancer prevention.
6:59
This interest was sparked by observations that patients taking these medications for diabetes
7:05
management experienced unexpected benefits in terms of cancer risk reduction.
7:11
One study highlighted in the ESMO Annals of Oncology examined data from over 161,000
7:19
patients, who were mostly middle-aged, obese individuals without diabetes or a history of
7:25
obesity-related cancers.
7:27
Half of these participants used weight-loss injections, including GLP-1 drugs, while the
7:33
other half received diet and exercise consultations.
7:37
Over a two-year period, those using GLP-1s showed a forty-one percent lower risk of
7:43
developing obesity-related cancers compared to those who did not use the drugs.
7:48
Another study published in the JCO Oncology Practice focused on breast cancer risk.
7:55
It found that women using GLP-1 medications had a significantly lower incidence of breast
8:01
cancer compared to those who were not on these drugs.
8:06
The study, which involved over one hundred ten thousand women who underwent breast imaging,
8:11
reported that GLP-1 users had up to a thirty-five percent reduced risk of developing
8:16
breast cancer.
8:18
Despite these promising findings, Dr.
8:20
Bray emphasized the need for further research to determine whether GLP-1 drugs could also
8:26
reduce the likelihood of cancer relapse or prevent the progression to metastatic disease
8:31
in patients who have already been diagnosed with cancer.
8:35
The potential for these drugs to influence cancer outcomes remains an exciting area of
8:39
investigation.
8:41
With breast cancer projected to be the most diagnosed cancer among Canadian women in two
8:47
thousand twenty-six, these findings are particularly relevant.
8:51
Kimberly Carson, Chief Executive Officer of Breast Cancer Canada, expressed optimism about
8:57
the potential of GLP-1 drugs as a preventive tool and called for more Canadian research to
9:02
explore this promising avenue.
9:06
In the world of cardiology, a recent Dutch trial has brought attention to the potential
9:11
benefits of vitamin K supplementation in managing coronary atherosclerosis.
9:17
The VitaK-CAC trial explored how the vitamin K homologue, menaquinone-7, also known as MK-7,
9:25
impacts coronary artery calcification over time.
9:29
This study revealed a small yet statistically significant slowing of calcification
9:34
progression in patients taking daily MK-7 supplements compared to those on a placebo.
9:41
The trial was conducted over two years and included individuals with existing chronic
9:45
coronary atherosclerosis.
9:47
The results showed that the progression of coronary artery calcification, as measured by
9:54
CT-derived CAC scores, was modestly slowed in those taking MK-7.
9:59
Specifically, CAC scores went from a baseline of 135 Agatston Units and 145 Agatston Units in
10:07
the MK-7 and placebo groups, respectively, to 150 and 173 after one year, and finally to 184
10:14
and 214 after two years.
10:19
This difference was statistically significant, with a P-value of 0.02, indicating that the
10:25
supplementation had a measurable impact.
10:29
Moreover, the calcium mass, another indicator of calcification, also favored the MK-7 group.
10:37
From a baseline level of 25 milligrams and 26 milligrams, calcium mass increased to 28
10:43
milligrams and 33 milligrams after one year, and eventually to 32 milligrams and 38
10:50
milligrams after two years for the MK-7 and placebo groups, respectively.
10:56
Again, the P-value of 0.02 suggests a significant effect of the supplementation.
11:04
Dr.
11:04
Peter de Leeuw and his colleagues from the Maastricht University Medical Center in the
11:09
Netherlands, who conducted the study, noted that while MK-7 supplementation appears to
11:14
attenuate coronary artery calcification, the overall effect is modest.
11:21
Importantly, the percentage of individuals who were fast progressors of calcification did not
11:27
differ significantly between the treatment groups, leaving the clinical significance of
11:32
these findings uncertain.
11:35
The researchers highlighted that the menaquinones, which are part of the vitamin K2
11:40
family, have been associated with benefits for bone and cardiovascular health.
11:45
MK-7, in particular, is known for its ability to inhibit vascular calcification and has good
11:53
bioavailability, making it an attractive option for heart protection.
11:58
Interestingly, the benefits of MK-7 supplementation were most pronounced in slowing
12:04
calcification of early to moderately developed noncalcified plaques, though it did not affect
12:10
progression in advanced plaques or new plaque formation.
12:15
Despite these encouraging results, the VitaK-CAC trial had its limitations.
12:21
The participants had about 80 percent adherence to their treatment regimen, and there was a 17
12:27
percent dropout rate.
12:30
The study was not equipped to detect the smallest calcium deposits within
12:34
atherosclerotic plaques, which could have underestimated the true efficacy of MK-7.
12:41
Additionally, the trial was conducted at only two centers in the Netherlands with a
12:46
relatively small sample size of 180 participants.
12:51
In an accompanying editorial, Dr.
12:53
Michael Blaha and Dr.
12:55
Sungwoo Choi from the Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular
12:59
Disease emphasized the need for more research.
13:02
They pointed out that unanswered questions remain about MK-7's impact on atherosclerosis
13:08
and cardiovascular events.
13:10
For example, it is not yet clear whether MK-7 can reduce the risk of acute coronary syndromes
13:17
by slowing the early propagation of coronary calcification or if it might interfere with
13:23
plaque stabilization processes.
13:26
Overall, while the findings from the VitaK-CAC trial are promising, they underscore the
13:32
necessity for further research to fully understand the potential of MK-7
13:38
supplementation in cardiovascular health.
13:42
As always, it's important for patients to discuss any supplement use with their
13:46
healthcare providers to ensure it's appropriate for their individual health needs.
13:53
Let's talk about a challenge that could have a significant impact on your sleep quality:
13:57
putting your phone away before bedtime.
14:00
We are in the midst of a summer challenge that encourages people to disconnect from their
14:04
screens for better rest.
14:06
This week, the focus is on creating a tech-free zone before you hit the sack.
14:12
Many of us are guilty of scrolling through social media or browsing the internet right
14:17
before we go to sleep.
14:18
It's a habit that might seem harmless, but it can actually disrupt our slumber.
14:23
According to Dr.
14:24
Shalini Paruthi, a sleep medicine specialist, even calming content can stimulate your brain
14:30
and make it harder to fall asleep.
14:32
A survey conducted in 2025 found that 43 percent of Americans often use their phones
14:39
right before bed, which can lead to interrupted sleep patterns.
14:43
This week, the challenge is to turn off your phone 30 minutes before sleep and keep it off
14:49
throughout the night.
14:50
You might feel uneasy about this at first, but it's a step toward better sleep hygiene.
14:56
A study published in the journal Technology, Mind and Behavior found that those who engaged
15:01
in a 30-minute digital detox before bedtime not only used their phones less the next day but
15:07
also felt better overall.
15:10
If you're worried about missing important calls, you can set your phone to "do not
15:14
disturb" mode and allow calls from specific contacts.
15:18
The idea is to create a buffer between you and your phone.
15:22
Ideally, place your phone in another room, or at least out of arm's reach, so you're not
15:26
tempted to reach for it during the night.
15:29
Instead of scrolling, you can use this time for other activities.
15:33
Consider writing a letter, starting a journal, or knitting.
15:36
One creative suggestion is to work on a project, like building a Lego model, which can
15:41
be both relaxing and rewarding.
15:44
You might also try meditating or engaging in a slow bedtime ritual, like a skin care routine
15:50
or stretching exercises.
15:53
Reading is another excellent option.
15:56
Dr.
15:57
Kostadin Kushlev, a psychology professor, recommends picking up a book before bed.
16:02
Choose something enjoyable and not too intense—middle-grade novels or collections of
16:08
essays can be perfect for unwinding.
16:11
The goal is to see if this 30-minute detox helps you fall asleep faster or improves your
16:16
sleep quality.
16:18
Even small changes can make a big difference over time.
16:21
As we embrace the summer, let's also embrace the opportunity to put our phones down and
16:27
enjoy a little more peace before sleep.
16:30
Thank you for tuning in to today's episode of Morning Medical with Dr.
16:33
Chow.
16:35
Remember, small changes in our daily routines can lead to significant improvements in our
16:40
health and well-being.
16:42
Until next time, take care and sleep well!