Latest / The You Project / #2094 Looking After Your Ticker - Dr. David O'Donnell

Transcript

#2094 Looking After Your Ticker - Dr. David O'Donnell · The You Project

0:01
Speaker 1: I got a team.
0:02
Speaker 2: It's Harps, it's the You Project, it's the new doc.
0:04
Speaker 2: We've got a new dock, a brand new doc. We've
0:06
Speaker 2: had lots of docks. We've got a new one. I'll
0:08
Speaker 2: introduce him in a moment. I hope you're doing great.
0:10
Speaker 2: I hope you Victorians survived the heat yesterday yesterday being
0:17
Speaker 2: what is today? Tuesday? It's today Wednesday, Doc, how's my brainer?
0:21
Speaker 2: I think it's Wednesday. It's Wednesday all day. So yesterday
0:25
Speaker 2: was the twenty seventh, of course. I hope you survived.
0:28
Speaker 2: Hope you're okay. Today is a much more reasonable twenty
0:31
Speaker 2: seven or something like that, and the thriving metropolis of Melbourne.
0:35
Speaker 2: Bottom line. I hope you're doing all right. Thanks for
0:38
Speaker 2: joining us again, Doctor David O'Donnell, Hi, welcome.
0:41
Speaker 1: To the You Project.
0:43
Speaker 3: Thanks good to be here.
0:45
Speaker 1: How often did do one of these things?
0:47
Speaker 3: Like?
0:47
Speaker 1: How often?
0:49
Speaker 2: Now we love Kate save we both know Kate Saban
0:51
Speaker 2: love her, but she was you were intimating that she
0:55
Speaker 2: might be and I'm fully backing you a little bit
0:58
Speaker 2: bossy and she bosses has boss bostht of us around
1:01
Speaker 2: and she bossed you on to hear how often do
1:04
Speaker 2: you do something like this.
1:06
Speaker 3: I'm speaking three or four times a week, but most
1:09
Speaker 3: of that is in person to groups, community groups, sporting groups,
1:14
Speaker 3: things like that. So podcasts probably once a month, you know,
1:19
Speaker 3: and if you listen to the radio, you hear me
1:20
Speaker 3: on the radio from time to time trying to get
1:23
Speaker 3: the message out how important heart health is. Anywhere I
1:25
Speaker 3: can get that message out, i'll talk. Give you up
1:28
Speaker 3: but a cup.
1:28
Speaker 2: Before we dive into the specifics and the stories and
1:31
Speaker 2: the revelations around heart health, tell us your medical kind
1:37
Speaker 2: of genesis, like did you go grant where you ten going?
1:42
Speaker 2: I want to be a doctor, or did you go
1:43
Speaker 2: I want to be a race car driver. But if
1:45
Speaker 2: that doesn't work, I'm going to look at hearts.
1:48
Speaker 3: So yeah, it's an interesting question. I was talking to
1:50
Speaker 3: someone on the weekend as a PA teacher, and I
1:52
Speaker 3: actually wanted to be a pe teacher growing up. Couldn't
1:55
Speaker 3: think of anything better when you're a twelve year old boy,
1:59
Speaker 3: the peach just the coolest guy in school. So I
2:04
Speaker 3: was I shouldn't call myself a failed athlete, but I
2:07
Speaker 3: wanted to be an athlete. Wanted to be a swimmer.
2:10
Speaker 3: Got to the point that swimmers weren't making any money
2:12
Speaker 3: and doctors were making money. So I made a decision
2:15
Speaker 3: to quit swimming and become a become a doctor.
2:19
Speaker 2: Has that never has that never been the It's always
2:22
Speaker 2: been the case. I guess a few swimmers have made though.
2:24
Speaker 2: How old were you at that stage when you went
2:26
Speaker 2: ah doctoring?
2:28
Speaker 3: So this was just after year twelve, So seventeen eighteen.
2:31
Speaker 3: I was the honest Entrews. I was probably not going
2:33
Speaker 3: to make it. I spent a bit of time with
2:36
Speaker 3: the Institute of Sport and I said I should have
2:37
Speaker 3: been a rower, but I didn't like growing. I like swimming. Yeah,
2:41
Speaker 3: but anyway, so I was probably not going to make it,
2:43
Speaker 3: but I used that as an excuse for why I
2:44
Speaker 3: didn't make it. So got in a medicine and if
2:47
Speaker 3: you're doing medicine, there's nothing better than the heart. I'm
2:50
Speaker 3: feel sorry for every other doctor in the world. You know,
2:53
Speaker 3: I get to deal with you know, you get to
2:54
Speaker 3: deal with something that's active, it's beating. It's fun. You
2:57
Speaker 3: get to do procedures, you get to operate, you get
2:59
Speaker 3: to save lives, you get to come into three in
3:01
Speaker 3: the morning and be the hero. But you also get
3:03
Speaker 3: to spend hours with patients trying to get them through
3:05
Speaker 3: real difficult times. So I have no doubt that cardiology
3:09
Speaker 3: is the best specialty in medicine. But you'll have other
3:11
Speaker 3: doctors on here will disagree with me.
3:13
Speaker 2: Well, I mean, the beauty is that we don't want
3:16
Speaker 2: everybody being in love with cardiology, then we don't have
3:19
Speaker 2: all the other areas covered, right, So I'm glad that
3:22
Speaker 2: you're like, if I'm going to see a cardiologist moving forward,
3:26
Speaker 2: which is every chance you're my guy, because I want
3:29
Speaker 2: someone who's skilled and good and knowledgeable and blah blah
3:32
Speaker 2: blah blah blah, but also actually gives a shit about
3:35
Speaker 2: what he does, and not just for the dough but
3:37
Speaker 2: rather because you're passionate about that science and that work
3:40
Speaker 2: and that skill and that I guess do you? I mean,
3:45
Speaker 2: I think doctors obviously this is a dumb and obvious
3:48
Speaker 2: thing to say. But because you're under so much pressure,
3:50
Speaker 2: which so much demand, and you don't have limitless energy
3:53
Speaker 2: or limitless time, and I feel a little bit like
3:59
Speaker 2: that at the moment. So I do generally five to
4:02
Speaker 2: seven podcasts a week and finishing my PhD in corporate
4:05
Speaker 2: speaking one hundred plus times a year and a bunch
4:07
Speaker 2: of other shit, right, And I'm like, I get to
4:09
Speaker 2: the point where I go, what's the best use of
4:11
Speaker 2: my time and energy today?
4:13
Speaker 1: So how do you Because.
4:15
Speaker 2: You could probably work twenty eight hours a day and
4:17
Speaker 2: still have more stuff to do, So how do you
4:20
Speaker 2: decide where your attention and energy should be?
4:24
Speaker 3: Yeah, look, I probably ought to disclose that I'm only
4:27
Speaker 3: a doctor one day a week. Now I'm actually really
4:30
Speaker 3: I'm an executive. I'm CEO of Atvara Hartcare, which is
4:33
Speaker 3: Australia's biggest cardiology group. So I actually stepped back from
4:37
Speaker 3: full time clinical work, and I stepped back for a
4:41
Speaker 3: little bit of what you're describing. My practice was full.
4:43
Speaker 3: I had ten thousand patients on my books, couldn't see
4:46
Speaker 3: any more, absolutely jam packed full morning tonight. And yeah,
4:51
Speaker 3: I've got a nego. I thought I was doing a
4:53
Speaker 3: pretty good job for those ten thousand patients. Each patient
4:56
Speaker 3: I saw, I thought I was doing a good job. Yes,
5:00
Speaker 3: hundreds of thousands of people in Australia who weren't getting care.
5:03
Speaker 3: So what I've really shifted my priority is how do
5:07
Speaker 3: we get care to more people? How do we get
5:09
Speaker 3: more people to look after their hearts. So rather than
5:11
Speaker 3: looking after one patient at a time, I'm trying to
5:14
Speaker 3: get a message out to hundreds and thousands of patients.
5:17
Speaker 3: You know. And the mantra that I live with is
5:19
Speaker 3: improving Australia's heart health, not improving your heart health, Craig,
5:23
Speaker 3: that's part of improving Australia's heart health. But I would
5:25
Speaker 3: have improve the heart health of all Australians and that
5:28
Speaker 3: takes a different perspective. And you know, that's some of
5:31
Speaker 3: the stuff I'm doing there is working with Kate, saving
5:34
Speaker 3: bee Fitfood's, working with a Heartbeat of Sport, working with SISU,
5:39
Speaker 3: working with these groups to actually promote healthy heart behaviors.
5:42
Speaker 3: Because at the end of the day, that's going to
5:44
Speaker 3: make more of an impact than I could make as
5:46
Speaker 3: an individual doctor. My mum was pretty upset with me.
5:50
Speaker 3: She thought that I should have stayed a doctor and
5:52
Speaker 3: kept operating and saving lives one by one. But yeah,
5:54
Speaker 3: I made the decision because I think there is something
5:56
Speaker 3: more we can do. I think it can have a
5:57
Speaker 3: greater impact. Sometimes by what you're doing, by you doing
6:01
Speaker 3: this podcast, you can have more of an impact than
6:03
Speaker 3: you good Bye. Seeing four or five patients in the day. Yeah, yeah,
6:07
Speaker 3: I think.
6:08
Speaker 2: For me, I like the fact that every time I
6:10
Speaker 2: chat someone like you, but we go into ninety countries
6:14
Speaker 2: and where you know, the audience varies, but it's many
6:17
Speaker 2: thousands a day, right, And I like the fact that
6:23
Speaker 2: I can, you know, with my guests, people like you
6:26
Speaker 2: who graciously give us your time and knowledge and experience,
6:29
Speaker 2: but share messages with thousands of people versus one obviously,
6:35
Speaker 2: And it's like, even with my stuff around human behavior
6:37
Speaker 2: and psychology and the mind and stuff, I love the
6:41
Speaker 2: fact that I can teach people. I can teach five, ten,
6:44
Speaker 2: twenty thousand people one idea and now they all whether
6:48
Speaker 2: or not they do anything with it, operationalize it or not.
6:51
Speaker 2: Now they've heard about this thing called the false consensus effect,
6:55
Speaker 2: which is the fact that we think that other people
6:57
Speaker 2: think like us, which is problematic, right, And then they know, oh,
7:01
Speaker 2: and I go, by the way, you know, the only
7:03
Speaker 2: person who thinks like you is you. That's not bad
7:06
Speaker 2: or broken, that's human. But when you go through life
7:09
Speaker 2: assuming other people think like you, there's going to be
7:12
Speaker 2: there's going to be some issues, but just that one thing,
7:14
Speaker 2: and people go, oh, I never even thought that. I
7:18
Speaker 2: never even think about how other people think theory of mind, right,
7:22
Speaker 2: and then you go, yeah, so you're just introducing them
7:25
Speaker 2: to like you're almost opening a new door in their
7:28
Speaker 2: brain for them to think about stuff which is relevant
7:30
Speaker 2: for everyone, just like heart health health. It's not like, oh,
7:34
Speaker 2: this is only applies to twenty percent of the population.
7:37
Speaker 1: No, this is one hundred percent.
7:39
Speaker 2: So yeah, platforms like this, and you know, I'm a
7:43
Speaker 2: small fish, but you know I love the fact that.
7:46
Speaker 1: We get to do that.
7:47
Speaker 3: Yeah.
7:47
Speaker 2: No, that's what makes a difference one hundred percent. What
7:51
Speaker 2: do you think the disconnect is between people hearing what
7:56
Speaker 2: we're going to talk about today, what they should do
7:59
Speaker 2: or potentially think about doing, why they should do it,
8:01
Speaker 2: you know what might happen if they do, what might
8:04
Speaker 2: happen if they don't, and them actually taking action or
8:09
Speaker 2: just gone great chat boys, Thanks see you later.
8:14
Speaker 3: But then here I am being interviewed by a psychologist.
8:16
Speaker 3: You know, I should probably throw the question back at you,
8:18
Speaker 3: but you know, I've got a strong belief that patient
8:23
Speaker 3: engagement or client engagement is key to success. You cannot
8:28
Speaker 3: expect someone to follow your advice if they're not engaged
8:31
Speaker 3: in the way you're giving it. I often ask young
8:34
Speaker 3: medical students what's the number one skill of a cardiologist?
8:37
Speaker 3: And let's say, oh, you know, he has to be
8:38
Speaker 3: really good with his hand. You have to be able
8:40
Speaker 3: to put a stent in. He has to be able
8:41
Speaker 3: to concentrate for twelve hours, he has to be able
8:43
Speaker 3: to interpret complex things. I'll tell you I think the
8:46
Speaker 3: number one skill of a cardiologist who is engage your patient. Yes,
8:50
Speaker 3: listen to the advice you're giving them. And if you
8:52
Speaker 3: can engage your patient and give them solid, convincing advice,
8:57
Speaker 3: then that's step one. Step two is make looking sure.
9:01
Speaker 3: I don't want to sound like alcoholics anonymous here, but
9:03
Speaker 3: step two is actually the patient accepting that they have
9:05
Speaker 3: a problem. And we live in a world where you
9:09
Speaker 3: can go on YouTube, you can go on chat GPT,
9:12
Speaker 3: and you can find out that there's nothing wrong with you.
9:14
Speaker 3: You can find out that you're helping Your body age
9:16
Speaker 3: is anywhere from twenty to eighty, depending on which one
9:19
Speaker 3: you want to look at. So you can always get
9:21
Speaker 3: information that's incorrect or fuzzy or noisy, Whereas if you've
9:26
Speaker 3: got real information given to you by someone you trust
9:30
Speaker 3: and a series of strategies, then that's a huge step forward.
9:34
Speaker 3: And again I don't want to go too much into psychology,
9:37
Speaker 3: but you know, we know a lot of doctors and
9:40
Speaker 3: I'm sure you've thought this or your willpower is not
9:42
Speaker 3: a strategy. Just telling someone you need to lose weight
9:47
Speaker 3: is allte of time. Everyone knows ne to lose weight.
9:50
Speaker 3: You look in the mirror. You don't need an anthropom
9:52
Speaker 3: more fixed, you don't need a dexascan. You know you're overweight.
9:55
Speaker 3: But what you need is a strategy on how you're
9:58
Speaker 3: going to do that. Not will power now will be vital.
10:01
Speaker 3: You've got great willpower. I know that because you wouldn't
10:03
Speaker 3: do five to seven podcasts a week if you didn't,
10:05
Speaker 3: you wouldn't do a PhD. I've got great willpower, but
10:08
Speaker 3: my willpowers tested. Your willpower is tested. Now there's people
10:11
Speaker 3: who have a lot lower baseline of willpower. You've got
10:13
Speaker 3: a given strategy. So it's not about telling someone to
10:16
Speaker 3: lose weight. It's like, let's work through the five or
10:18
Speaker 3: six ways we can do strategies to do this one
10:22
Speaker 3: hundred percent.
10:23
Speaker 2: And I would even add to that strategies, you know,
10:27
Speaker 2: timeline accountability, like having a plans. Great A lot of
10:30
Speaker 2: people chuck a plan in having a strategy good. But then,
10:35
Speaker 2: like my question to my clients and the people I
10:38
Speaker 2: work with, is can my action outlast my motivation and
10:41
Speaker 2: inspiration or discipline or willpower, because all that shit's temporary. Like,
10:45
Speaker 2: I'm pretty fucking disciplined, but I'm not always disciplined.
10:49
Speaker 1: I have my moments, I have my weeks, right, But the.
10:52
Speaker 2: Fact that I have created for me an operating system
10:57
Speaker 2: which is just interwoven with who I am and how
11:01
Speaker 2: I am, Like it's my default. So I don't need
11:04
Speaker 2: to you know, like I've never smoked a cigarette, I've
11:06
Speaker 2: never drunk alcohol in my life, I've never been high,
11:10
Speaker 2: all those things. I don't say that as a brag.
11:12
Speaker 1: It's just my story, right.
11:14
Speaker 2: But so because that's my natural, normal, day to day
11:17
Speaker 2: operating system, I don't need to find discipline, will power, strength, courage,
11:21
Speaker 2: fucking resilience to not eat shit and to not drink
11:25
Speaker 2: booze and to not smoke cigarettes. And I think it's
11:28
Speaker 2: that how do we take it from I want to
11:31
Speaker 2: change my behavior and obviously my health outcomes and discipline
11:36
Speaker 2: and willpower and motivation and strategy is good, But what's
11:40
Speaker 2: better is when Eventually that just becomes my day to
11:43
Speaker 2: day process without having to think in inverted commerce.
11:48
Speaker 3: Yeah, and I think you know you've you've touched on
11:50
Speaker 3: something I think is really important. That is, you've also
11:53
Speaker 3: got to be able to forgive yourself when something goes wrong.
11:55
Speaker 3: You don't one good one hundred percent of the time,
11:58
Speaker 3: because no one will be. I work on the strategy
12:01
Speaker 3: be eighty to ninety percent good all of the time
12:03
Speaker 3: is far better than being fifty percent good. You know,
12:05
Speaker 3: it's a New Year's resolution time. You see the number
12:10
Speaker 3: of people who are doing the hard reset on YouTube
12:12
Speaker 3: or on Instagram. Don't do the hard reset, guys. The
12:15
Speaker 3: hard reset look It might work for some people, but
12:17
Speaker 3: generally it's about figuring out what are the five or
12:20
Speaker 3: ten things you can do that are going to impact
12:22
Speaker 3: you for the year. And one of the things I
12:24
Speaker 3: talk about is layering layer your habits, so you know,
12:27
Speaker 3: if you're trying to do exercise, yes, line up to
12:29
Speaker 3: go to the gym each morning, but also take the
12:33
Speaker 3: stairs at work and also go to the second closest
12:36
Speaker 3: coffee shop, not the closest coffee shop, go to the
12:39
Speaker 3: second closest toilet in the office. Park a stop away
12:42
Speaker 3: and catch a walk in the last kilometer to work.
12:46
Speaker 3: So lay your habit so one thing doesn't happen in
12:48
Speaker 3: the day. You haven't ruined the day, you haven't set
12:51
Speaker 3: yourself back. You've got other things that you've done in
12:53
Speaker 3: the day. Because, like you, I've learned now I've been
12:57
Speaker 3: a doctor for thirty years. Your willpower just doesn't work.
13:00
Speaker 3: It does work for the first two weeks of January,
13:03
Speaker 3: and it stops. It works when you make your resolution
13:06
Speaker 3: when you're sitting down at the beach, but as soon
13:07
Speaker 3: as you get back to the busy office, it disappears.
13:09
Speaker 3: So make sure you're putting the strategies that you can.
13:12
Speaker 2: Finow yeah, one hundred percent, one hundred percent, and that
13:16
Speaker 2: you know when you think about I've spoken about this
13:18
Speaker 2: too many times, so forgive me audience, But when you
13:20
Speaker 2: think about.
13:22
Speaker 1: You know, the ritual and the tradition of.
13:26
Speaker 2: New Year's resolutions, and how like if we actually did
13:31
Speaker 2: some and then there's been kind of research done on it.
13:34
Speaker 2: But the people who actually achieve what they want to achieve,
13:37
Speaker 2: set out to achieve, maintain those results, and potentially improve
13:41
Speaker 2: on those results over any significant length of time is
13:47
Speaker 2: close to zero like, it's definitely less than ten percent. Now,
13:51
Speaker 2: if that was a medication, it will never get approved,
13:54
Speaker 2: do you know what I mean? It's like, well, this
13:56
Speaker 2: is the idea of it's good, and it's kind of
13:59
Speaker 2: sexy and traditional, and it's cultural, and we're all familiar
14:02
Speaker 2: with it, and we all get a bit, like you said,
14:05
Speaker 2: a bit momentarily inspired, which is good inspiration, discipline or
14:08
Speaker 2: good starters. But that's the thing, is like, what can
14:13
Speaker 2: you do when you can't be bothered? Because, as you said,
14:16
Speaker 2: you get back from the beach, Now you at work,
14:18
Speaker 2: different environment, different context, different headspace, different routine, and then
14:22
Speaker 2: all that shit that you did while you were staying
14:24
Speaker 2: on the peninsula with your feet in the water and
14:27
Speaker 2: it was beautiful, you're not there anymore.
14:29
Speaker 1: Now you're back here.
14:30
Speaker 2: So that's that trying to maintain that psychological, behavioral and
14:35
Speaker 2: emotional momentum that you started.
14:38
Speaker 3: You know.
14:39
Speaker 1: So what about this is a very simple question, but
14:46
Speaker 1: just for our.
14:47
Speaker 2: Listeners who don't know the answer to this, what is
14:50
Speaker 2: a heart attack? What is a cardiac arrest?
14:54
Speaker 3: Yeah? Look, it's a really great question and it's one
14:58
Speaker 3: that cardiologists have been trying to fall down the public's
15:01
Speaker 3: view for many years. My view is it's heart disease.
15:04
Speaker 3: But let me explain the difference between the two. A
15:07
Speaker 3: heart attack is when you block an artery supplying blood
15:12
Speaker 3: to your heart. Yeah, And if we get a chance,
15:14
Speaker 3: we're going to a bit more deferent because heart attacks
15:16
Speaker 3: don't happen gradually. There's a gradual build up, but heart
15:18
Speaker 3: attacks suddenly. So you block an artery, you block an
15:22
Speaker 3: artery in your heart, no blood's getting through the area
15:25
Speaker 3: that that artery is supplying. That tissue starts to die.
15:28
Speaker 3: And when that tissue starts to die, that's a heart attack.
15:31
Speaker 3: It's death of heart muscle. Yeah. Yeah. A cardiac arrest
15:38
Speaker 3: is a situation where the rhythm of the heart becomes
15:43
Speaker 3: noncompatible with life. I pause there for a second, because
15:45
Speaker 3: the rhythm doesn't actually stop. It can stop. There's a
15:48
Speaker 3: condition called a sisterly where the heart just stops, but
15:51
Speaker 3: there's a condition called ventricular fibrillation where the heart goes
15:54
Speaker 3: so quick that there's no cardiac output. So cardiac arrest
15:58
Speaker 3: is when your heart, due to a n trial issues,
16:00
Speaker 3: is no longer pumping blood around the body. And if
16:03
Speaker 3: that's not fixed, it's fatal. You cannot survive a cardiac
16:06
Speaker 3: arrest unless it stops either spontaneously or because someone's defibrillated.
16:11
Speaker 1: You yes.
16:12
Speaker 3: Now, where this gets complicated is that in Australia and
16:16
Speaker 3: most developed countries, the number one cause of cardiac arrest
16:20
Speaker 3: is having a heart attack. So you have a heart attack,
16:23
Speaker 3: the muscle dies and that leads to the electrical disarray
16:26
Speaker 3: which causes the cardiac arrest. But whereas is really important
16:31
Speaker 3: is there are conditions which predisposed to cardiac arrest which
16:35
Speaker 3: are not heart attack. So people are born with congenital
16:38
Speaker 3: abnormalities in their heart and they have completely normal arteries.
16:42
Speaker 3: And this is where you hear of young people having
16:43
Speaker 3: cardiac arrest. There are genetic conditions long QT syndrome regard
16:48
Speaker 3: to syndrome the predisposed young people to having cardiac arrests,
16:51
Speaker 3: completely normal arteries and purely an electrical problem. So they
16:56
Speaker 3: are different issues. But in Australia, when a fifty year
17:00
Speaker 3: old man arrests at the MCG has a cardec arrest
17:04
Speaker 3: at the MCG, he gets successfully defibrillated. Chances are I
17:07
Speaker 3: he was having a heart attack.
17:09
Speaker 2: Yeah right, Okay, Now I want to ask you a
17:12
Speaker 2: very specific question, and the reason for the question will
17:15
Speaker 2: become apparent post question, your honor. Great, So if a
17:21
Speaker 2: dude who was otherwise healthy and fit, not me, by
17:24
Speaker 2: the way, but it could be a bloke named to
17:26
Speaker 2: Mark who was who is my training partner, and let's
17:31
Speaker 2: say he was fifty three, lean, doesn't drink, doesn't smoke,
17:37
Speaker 2: eats great, in good shape. Let's say hypothetically, one Friday
17:42
Speaker 2: he had a cardiac arrest at the gym one foot
17:48
Speaker 2: from me, which I'll say is very annoying, completely interrupted
17:51
Speaker 2: my training, very selfish, look at me, right, So seventeen
17:55
Speaker 2: oh five until seventeen No, yeah, seventeen oh five till
18:02
Speaker 2: seventeen twenty two, offline, right, So Daddie mcdead'ster seventeen minutes.
18:07
Speaker 1: So my theory, they didn't. So he had a.
18:12
Speaker 2: Cardiac arrest, right, he did a set of chins. He
18:15
Speaker 2: did a whole bunch of chins, like twenty. He came down,
18:19
Speaker 2: held his breath because he's an idiot. So blood pressure
18:22
Speaker 2: went to a million over fucking six million, right, so
18:25
Speaker 2: for sure, hold your breath the whole time. Great was
18:29
Speaker 2: out working all day in the heat. I think he
18:32
Speaker 2: was dehydrated and when he does drink, he drinks on
18:36
Speaker 2: this day energy drinks, which great, you know, caffeine stimulants
18:39
Speaker 2: terrific for the heart and the nervous system. And then
18:42
Speaker 2: came to the gym and had another pre workout and
18:46
Speaker 2: then trained with me and then dropped dead at five
18:48
Speaker 2: past five. But that combination of heat, dehydration stimulants, could
18:59
Speaker 2: that produce a cardiac arrest?
19:01
Speaker 3: Yeah? Absolutely, you know, we've got to put in perspective
19:05
Speaker 3: that most people get hot dehydrated do not have a
19:08
Speaker 3: cardiac arrest. But in the right situations, it does happen.
19:12
Speaker 3: And yes, you know, again, I would say that a
19:14
Speaker 3: fifty three year old male, it's most likely that he's
19:19
Speaker 3: actually ruptured a current reartery. So he's torn a current
19:22
Speaker 3: reartery due to a combination of stress dehydration, and that's
19:26
Speaker 3: what's led to a block of an artery and a
19:28
Speaker 3: cardiac arrest. And a lot of those things can be
19:32
Speaker 3: known in advance, and it leads to what would we
19:36
Speaker 3: have done if we knew a fifty three year old
19:37
Speaker 3: We've been telling him exercises, vital exercise is critical, you know,
19:41
Speaker 3: doing hard exercise anaerobic it was great for you but
19:45
Speaker 3: do it in a controlled fashion. You know, I jump in.
19:48
Speaker 3: Don't deplete all your buckets at once. So yeah, you know,
19:51
Speaker 3: deplete a bucket. You can. You can train like crazy,
19:54
Speaker 3: but if it's a forty degree day, don't get dehydrated,
19:57
Speaker 3: or don't try and quite as hard. Don't deplete all
19:59
Speaker 3: of energy levels at once, because that's when you're most
20:02
Speaker 3: at risk. We actually know that these these plaques or
20:06
Speaker 3: these cholesterol build up in your heart. They rupture because
20:09
Speaker 3: of information and that rupture is triggered by a high
20:12
Speaker 3: blood pressure, but it's triggered by illnesses. People have the
20:16
Speaker 3: flu are more likely to have a heart attack. People
20:17
Speaker 3: that had COVID were more likely to have heart attack.
20:19
Speaker 3: So lots of things can actually trigger you. And if
20:22
Speaker 3: you're not well, if you're feeling average, that's not the
20:25
Speaker 3: day to overdo it at the gym. Overdo it at
20:27
Speaker 3: the gym. You're feeling great. The day you're feeling great,
20:29
Speaker 3: not the day you're feeling average.
20:32
Speaker 2: Did I mention he's not that clever?
20:35
Speaker 3: Look again, I'm going to leave that comment on.
20:39
Speaker 1: But here's the thing with him.
20:41
Speaker 2: He had no heart damage or not significant heart damage,
20:44
Speaker 2: and his arteries were fine.
20:46
Speaker 1: So he literally had an arrest.
20:49
Speaker 2: And obviously it turned out after such a seventeen minutes
20:53
Speaker 2: off line amazingly well because you know, I started working
20:58
Speaker 2: on him twenty seconds after you hit the deck. But
21:01
Speaker 2: and then the ambos were brilliant. Do you know what's
21:05
Speaker 2: the funny thing about the ambos You probably know this, right,
21:07
Speaker 2: But they come in and they got their relative from
21:09
Speaker 2: where they were quick, but it was still it's still
21:14
Speaker 2: about eleven minutes, and eleven minutes when you're doing what
21:17
Speaker 2: I was doing, feels like eleven hours.
21:21
Speaker 1: Anyway, they got.
21:22
Speaker 2: There and I'm like, oh, thank god, thank god, and
21:25
Speaker 2: they walk in the paramedics, the MICA dudes and doets
21:29
Speaker 2: and they're like, oh, good job, keep going, and then
21:33
Speaker 2: they just leisurely set up Oh my quick.
21:38
Speaker 1: But yeah, he had very little.
21:41
Speaker 2: You know, he had the memory of a goldfish for
21:44
Speaker 2: a while, but made a full recovery within kind of
21:47
Speaker 2: a month or so, which I guess that's the exception,
21:49
Speaker 2: not the rule.
21:50
Speaker 3: Right. Look, there's two things to say here. One is congratulations,
21:55
Speaker 3: you've done a cracking job of CPR. Most people cannot
21:59
Speaker 3: keep someone alone for eleven minutes, so you've done a
22:02
Speaker 3: cracking job. I'm involved at NIPPERS over summer and all
22:06
Speaker 3: the kids. Wow, we learning CPR. We're learning CPR for
22:09
Speaker 3: the one time it happens. And yeah, one time it happens,
22:12
Speaker 3: you know you've saved this guy's life because you know CPR.
22:16
Speaker 3: It's it's actually been shown. The two things that matter
22:18
Speaker 3: is how good your CPR is and how quickly you
22:21
Speaker 3: get a defibrillator on. So one of the things you
22:23
Speaker 3: want to do is next time, make sure your gym's
22:25
Speaker 3: got a defibrillator. And we should be having because if
22:28
Speaker 3: you can get good quality CPR, really you keep the
22:30
Speaker 3: blood flowing till someone can defibrillate them back to normal
22:33
Speaker 3: or the heart goes back to normal. It's on a court,
22:36
Speaker 3: but it's been shown in out of hospital arrests less
22:40
Speaker 3: than five percent of people survive. Wow, So now that
22:44
Speaker 3: goes up. The best place in the world this US,
22:48
Speaker 3: but I'll translated to Australia. You know, the MCG is
22:50
Speaker 3: a pretty good place to avocadiac arrest. Melbourne Airport's a pretty
22:53
Speaker 3: good place to avocadiac arrest. You have thirty forty thousand
22:57
Speaker 3: feet above the air is a pretty good place AVOCADEC
22:59
Speaker 3: arrests because there's structures and processes in place to get
23:02
Speaker 3: early CPR early different relation, and there's always doctors and
23:05
Speaker 3: nurses hanging around, so they're really good places to actually
23:08
Speaker 3: have an arrest. So your mate's very lucky you were there.
23:11
Speaker 2: Yeah, well I feel I was lucky because it's you know,
23:14
Speaker 2: it's a privilege.
23:15
Speaker 1: But thank you, just quickly.
23:21
Speaker 2: I'm not I think I'm sure about this, but atherosclerosis
23:24
Speaker 2: build up of I'm being super sciensy here, build up
23:27
Speaker 2: of gunk in the artery blood vessels. Areteriosclerosis hardening right now?
23:34
Speaker 1: Both is are they both lifestyle related? Or is one
23:37
Speaker 1: more genetic or the I don't know, so.
23:42
Speaker 3: Again you're using scientific terms. I love the gunk, I
23:46
Speaker 3: think hardly.
23:47
Speaker 2: Yeah, exactly, the gunk. So what we call try and
23:50
Speaker 2: stay with me if you can. I don't want you
23:52
Speaker 2: to get lost. I know I'm you know, medically brilliant,
23:56
Speaker 2: but I'm just trying hold on.
23:57
Speaker 3: I'm checking the textbook behind me to keep up. So
24:01
Speaker 3: what we call it these days is athosclerotic cardiovascular diase
24:04
Speaker 3: as CVD.
24:06
Speaker 1: And now who's showing up? Now he's showing.
24:08
Speaker 3: Up that covers any form of build up of cholesterol
24:12
Speaker 3: or gunk in your heart, and you know it's worth
24:15
Speaker 3: spending a couple of minutes. When you're born, your arter
24:17
Speaker 3: is a nice and pristine they're clean. But all of
24:20
Speaker 3: your arteries, all of your pipes, they have a lining,
24:24
Speaker 3: and that line is called endothelium. That's not important, but
24:26
Speaker 3: if you get disruptions in that lining, that's when cholesterol
24:32
Speaker 3: can actually get inside the lining and start building up
24:35
Speaker 3: in the lining of the heart. And it's that cholesterol
24:38
Speaker 3: build up that is cardiovascular disease or FASCVD, and it's
24:44
Speaker 3: a cholesterol build up that happens over years. And I
24:49
Speaker 3: would be fairly certain that you've got some cholesterol in
24:52
Speaker 3: your heart right now. It might be a very low level,
24:54
Speaker 3: but you've probably got some in your heart. We know
24:56
Speaker 3: this from Vietnam War when they did all topsies on
25:00
Speaker 3: American soldiers who were shot. They found cholesterol and a
25:02
Speaker 3: lot of teenagers. So there is cholesterol in the arteries
25:05
Speaker 3: of our heart. A low amount of that is okay,
25:08
Speaker 3: but as that builds up, it forms a plank and
25:11
Speaker 3: then you get inflammation and your body reacts to that
25:14
Speaker 3: and it's that reactive plark. That is the problem. A
25:17
Speaker 3: plant that's been there for forty years is much less
25:21
Speaker 3: of a problem that a plant that's formed over the
25:23
Speaker 3: last couple of years, particularly as it's got inflammation, because
25:26
Speaker 3: it's that plant can then tear. You know, there's lots
25:31
Speaker 3: of lots of analogies that people use, but the one
25:33
Speaker 3: that I like is to know to tell people, you know,
25:37
Speaker 3: you get a plumber over and he says, you've got
25:39
Speaker 3: a leaking water pipe in your roof. Yeah, you'd say
25:42
Speaker 3: to him, fix it. But when we tell people you've
25:46
Speaker 3: got cholesterol in your heart, let's how and I don't
25:48
Speaker 3: worry about it. Not worrying about it is waiting until
25:51
Speaker 3: the roof collapses. Now, if you don't get your water
25:54
Speaker 3: pipe fixed, your roof is going to collapse. It might
25:55
Speaker 3: not be in the next six months, it might not
25:58
Speaker 3: be in the next five years, but your roof is
25:59
Speaker 3: going to collapse. Yes, And we've also got to remember
26:02
Speaker 3: that sometimes when we fix the pipe, the damage has
26:05
Speaker 3: been done. The roof is going to collapse anyway, And
26:07
Speaker 3: occasionally it's leaking not enough, so it's not going to collapse.
26:11
Speaker 3: So we're all playing the odds here. It's not about
26:14
Speaker 3: saying if you've got cholesterol in your heart, you're going
26:16
Speaker 3: to have a heart attack in twelve months. That's not
26:18
Speaker 3: what we're saying. We're saying, if you've got cholesterol in
26:20
Speaker 3: your heart, your risk of having a heart attack goes up,
26:23
Speaker 3: and we need to take that seriously and be more
26:26
Speaker 3: definitive about whether you are going to have a heart
26:28
Speaker 3: attack or not. Yes, you notice I'm actually talking about
26:32
Speaker 3: cholesterol in your heart. I'm not talking to here about
26:34
Speaker 3: a cholesterol blood test. Yes, that's a fallacy that a
26:38
Speaker 3: cholesterol blood test or a basic cholesterol blood test is
26:43
Speaker 3: all you need. A basic cholesterol blood test is very
26:45
Speaker 3: much a starting point. And you know, if we want
26:50
Speaker 3: to diagnose artery disease, we need to be looking at
26:53
Speaker 3: the arteries. And that's a big push of ours at
26:56
Speaker 3: the moment, is to get people of the right age,
26:59
Speaker 3: of the right risk to get their outeries looked at.
27:02
Speaker 3: If your outer is a clean, fantastic. If your uter
27:04
Speaker 3: is are not clean, let's talk about what we can
27:06
Speaker 3: do about it.
27:08
Speaker 2: I'm going to throw you under the bus here just
27:10
Speaker 2: because I can ye well, I'm going to say what
27:13
Speaker 2: I think and then you can agree or disagree.
27:15
Speaker 1: So I'll throw me under the bus.
27:16
Speaker 2: I feel like generally everyone noticed I said feel so
27:20
Speaker 2: not a not statement. I feel like and generally I
27:25
Speaker 2: feel like dudes are not as good as women at
27:28
Speaker 2: being proactive about their health and maybe these things. I
27:32
Speaker 2: know that's very broad and sweeping and it varies greatly,
27:35
Speaker 2: But do you think generally that's true or untrue?
27:40
Speaker 3: So this is really fascinating in an area that I'm
27:44
Speaker 3: really intrigued by. What you've said is absolutely correct that
27:48
Speaker 3: males are less likely to be proactive about their health. Yes,
27:53
Speaker 3: but doctors are far more likely to be proactive with
27:58
Speaker 3: males than females. Sorr. I shouldn't say doctors. The health
28:02
Speaker 3: system when it comes to pio vascular disease is very
28:06
Speaker 3: heavily skewed towards investigating males. And you know, I always
28:11
Speaker 3: worry about quoting stats on podcasts, But a fifty year
28:15
Speaker 3: old woman is seven times more likely to die of
28:19
Speaker 3: a heart attack the breast cancer. No, I mean a
28:24
Speaker 3: woman who has a woman who has survived breast cancer
28:26
Speaker 3: is more likely to die of a heart attack than
28:28
Speaker 3: recurrent breat cancer. So we've got to understand that heart
28:31
Speaker 3: disease is the number one cause of death of women
28:34
Speaker 3: in Australia. And it's a medical thing as much as
28:39
Speaker 3: a social thing that if you go to your GP tomorrow,
28:43
Speaker 3: if you have a GP you haven't been for a year,
28:46
Speaker 3: he's going to send off a cholesterol test, he's probably
28:48
Speaker 3: going to do an ECG. He's certainly going to check
28:50
Speaker 3: it for diabetes. He's going to check your prostate. If
28:52
Speaker 3: you're a woman, you'll get a PAP smear, you'll get
28:55
Speaker 3: your breast examination, you might get some ultrasounds. So we've
28:59
Speaker 3: got to change the men mentality that women are just
29:01
Speaker 3: as high risk of men of heart disease. It lags
29:04
Speaker 3: in women because hormones are protective and anyone looking at
29:08
Speaker 3: the time you can see they've got a significant interest
29:10
Speaker 3: Viya my wife in hormones. But hormones are protective, so
29:13
Speaker 3: pre menopause or women have a degree of protection that
29:16
Speaker 3: disappears postmenopause. So postmenopause are women pretty quickly catch up
29:21
Speaker 3: to men in terms of cardiovascular risk. So what you've
29:25
Speaker 3: said is spot on. Men are less proactive, but the
29:27
Speaker 3: medical system is more focused on males, which leads to
29:30
Speaker 3: women actually being underrepresented in investigations for heart disease.
29:36
Speaker 1: That old kind of.
29:38
Speaker 2: Psychological chestnut that people are scared to go to the doctor.
29:43
Speaker 2: Is that as true or one? Is it true? Is
29:46
Speaker 2: it as true as it he used to be?
29:48
Speaker 1: What do you think?
29:49
Speaker 3: I'm blown away by people's fear of doing it. So
29:55
Speaker 3: there's a test I do a lot called a CT
29:57
Speaker 3: current reintrogram. It's a test people, Do you have cholesterol
30:01
Speaker 3: build up in your heart?
30:03
Speaker 1: Yes?
30:04
Speaker 3: And I would not go a week without a sensible,
30:08
Speaker 3: well educated person saying to me, I'm not sure if
30:11
Speaker 3: I want to know. Yeah, I'm like, what do you mean?
30:15
Speaker 3: You know, I'm not sure. You know, it's a terrible analogy.
30:18
Speaker 3: But with the bushfires at the moment, I've got a
30:20
Speaker 3: place down on the Great Ocean Road. I was looking
30:22
Speaker 3: every ten minutes to see where the fire was and
30:24
Speaker 3: decided to leave. Now the analogy is, well, I won't
30:27
Speaker 3: look at the app I'll just see it, and if I
30:29
Speaker 3: don't get burnt, I want and if I do get burned,
30:31
Speaker 3: I lost. You know, it's a crazy way of living
30:34
Speaker 3: to not want information. Again, this is a little bit
30:38
Speaker 3: biased by doctors. Again, I'm not down on doctors here,
30:42
Speaker 3: but as doctors, we're not there to prescribe everything for
30:46
Speaker 3: every patient. We're there to give patient information and with
30:49
Speaker 3: that information give them the right treatment. And I would guarantee.
30:54
Speaker 3: I shouldn't guarantee someone like you comes to me and
30:57
Speaker 3: I say, oh, you got high cholesterol, go on this
30:59
Speaker 3: cholesterol tablet. All be If I show you a picture
31:03
Speaker 3: of your arteries that shows you've got cholesterol in your arteries,
31:06
Speaker 3: that makes the job of me getting you on a
31:08
Speaker 3: cholesterol tablet a whole lot easier because you can physically
31:11
Speaker 3: see what's going on in your heart. You can see
31:14
Speaker 3: the leaking pipe, and if you can see the leaking pipe,
31:17
Speaker 3: you want to do something about it.
31:19
Speaker 2: I used to My previous career was so my first
31:25
Speaker 2: degree was exercise science, So I owned a bunch of
31:27
Speaker 2: gym's pet studios blah blah blah. Not unlike our friend
31:30
Speaker 2: Kate and I used to. You know, when I would
31:36
Speaker 2: meet someone and they're coming on board, they're going to
31:38
Speaker 2: work with me or one of my team. I had
31:40
Speaker 2: five hundred trainers over twenty five years work for me,
31:43
Speaker 2: So like quite a big business in that space, blah
31:45
Speaker 2: blah blah. But we would be as methodical and kind
31:51
Speaker 2: of systematic and scientific as we could without being without overreaching.
31:57
Speaker 2: And so one of the things I would do with
31:58
Speaker 2: people is, you know, we do a kind of a
32:01
Speaker 2: sub vo two max test. We do some strength testing,
32:04
Speaker 2: a few you know, flexibility, range, movement, all the normal stuff,
32:08
Speaker 2: all the boring. Tell me how you eat, how much booze?
32:10
Speaker 2: Do you have coffee, tea, sugar? But but all that,
32:13
Speaker 2: and then more often than not, I would do a
32:15
Speaker 2: body composition test, take some girth measurements, put them on
32:20
Speaker 2: the scales, like not make a big deal of just
32:22
Speaker 2: what it is, what it is, and we go, look,
32:24
Speaker 2: this is day one.
32:26
Speaker 1: I just want some baseline data. This is you on
32:28
Speaker 1: day one.
32:28
Speaker 2: You can do three pushups, you can run three hundred meters,
32:31
Speaker 2: and you can hold your body weight on a chin
32:34
Speaker 2: bath for fifteen seconds. Cool, it doesn't matter because that's
32:37
Speaker 2: meaningless until we get a second measurement.
32:39
Speaker 3: Right.
32:41
Speaker 2: And the amount of people who would say to me,
32:44
Speaker 2: tell me everything, but don't tell me my body composition,
32:47
Speaker 2: weight or girth measurements like they would want to the
32:49
Speaker 2: other stuff. They were happy to know, But I don't
32:52
Speaker 2: want to know what my weight is. I don't want
32:54
Speaker 2: to know my measurements. And I do not want to know,
32:57
Speaker 2: because I'd explain to them what body composition means. They're like,
33:00
Speaker 2: I don't want to know that, and I would I
33:03
Speaker 2: would respect that, but I would say, whatever.
33:06
Speaker 1: It is, it is.
33:08
Speaker 2: So because you don't know, it doesn't mean it's not true.
33:12
Speaker 2: It just means you don't have all the information, so
33:15
Speaker 2: you're not fully informed. And I can't make all the
33:19
Speaker 2: decisions for you. I can support you, guide you, educate you,
33:23
Speaker 2: but ultimately you're the only one who can execute. You're
33:27
Speaker 2: the only one who can make the decisions, eat the food,
33:29
Speaker 2: change of behaviors, think differently. You know, It's like I
33:33
Speaker 2: your job is actually to create the change. I'm a
33:37
Speaker 2: glorified cheer squad with a bit of information thrown in
33:41
Speaker 2: and yeah, that used to blow me away, but it
33:44
Speaker 2: would probably be thirty percent of the people, so I'm
33:47
Speaker 2: not surprised.
33:49
Speaker 3: And you know, the ones that the ones that see
33:51
Speaker 3: positive results. That's one of the best ways to improve
33:54
Speaker 3: in the future. You know, you see your I mon't
33:58
Speaker 3: use the word BMI because someone will throw something at
34:01
Speaker 3: the podcast that you know it can be and my
34:04
Speaker 3: drops by one or two. That does actually make you
34:07
Speaker 3: live longer. And if it dots by one or two,
34:10
Speaker 3: then that motivates you to move it again, and that
34:12
Speaker 3: motivates you to move it again. If you do a
34:13
Speaker 3: whole lot of stuff and nothing changes, it's very hard
34:16
Speaker 3: to motivate yourself over and over again to keep doing it.
34:19
Speaker 3: So if you don't have the measure up front, it's
34:21
Speaker 3: really hard to see progress.
34:23
Speaker 2: And also we're trying to figure out apart from the
34:25
Speaker 2: broad kind of application of various ideas and treatments and methodologies,
34:30
Speaker 2: we're trying to see, Like I say to my clients,
34:33
Speaker 2: I'm trying to see what works for you. Because your
34:36
Speaker 2: best diet ain't the best diet. It's your best diet.
34:38
Speaker 2: Your best excise program is not my best excise program.
34:42
Speaker 2: How much sleep you need, I don't need. You know,
34:45
Speaker 2: I might need more or less, and not only you
34:47
Speaker 2: might need more today because you walk twenty five thousand
34:50
Speaker 2: steps today and you worked all day unloading trucks, and
34:54
Speaker 2: so you might need you know, these these numbers around
34:58
Speaker 2: food and exercise instead and volume and even you know
35:02
Speaker 2: whatever caffeine and boo like. These are not constants. They're
35:05
Speaker 2: variables based on how your physiology is working at that
35:09
Speaker 2: moment or in that. You know, so thinking that there's
35:12
Speaker 2: a standard, Oh, how much water should I drink? Well,
35:15
Speaker 2: how much do you weigh? How much water is in?
35:17
Speaker 2: What's the water content of your diet? How much you're sweating?
35:21
Speaker 2: How what's the temperature? Do you work in an air
35:23
Speaker 2: condition environment? It's like, dude, there are fifty seven factors
35:28
Speaker 2: that and even then when we factor it all in,
35:30
Speaker 2: we're guessing.
35:31
Speaker 1: It's an educated guesses.
35:34
Speaker 3: Spot on it. Yeah, this gets back to some of
35:35
Speaker 3: the stuff that I hear you and David Gillespie talking about.
35:38
Speaker 3: You know, FAD medicine has a lot of randomized controlled trials,
35:43
Speaker 3: but they are talking about population science. Yes, what you're
35:47
Speaker 3: talking about is individual science and the individual or what
35:51
Speaker 3: I call personalized care, other people call personalized care. You
35:54
Speaker 3: cannot generalize, well, you can generalize, but generalizations don't always work.
36:00
Speaker 3: You know. Again, Kate will tell you that a very
36:03
Speaker 3: low calorie diet is really good for you, and if
36:06
Speaker 3: that works for you, then that is really good for you.
36:08
Speaker 3: And there's science that show it's really good for you.
36:10
Speaker 3: But other people will say, well, iron, you can do
36:13
Speaker 3: this if I do my fasting for eighteen hours. Now,
36:15
Speaker 3: there's no evidence that one is better or the other.
36:18
Speaker 3: There's evidence that if it works for you, it's better.
36:21
Speaker 3: And that's what we've got to remember in healthcare that
36:23
Speaker 3: there's personalized treatments based on generalized results. And this is
36:29
Speaker 3: where you know. Having it's something that's bugged me for
36:32
Speaker 3: many years. In cardiologies, we keep telling people risk. We
36:35
Speaker 3: kept saying, oh, you've got a four percent risk of
36:37
Speaker 3: this or a seven percent risk of that. Yes, And
36:39
Speaker 3: it's very different in the oncology world. You don't say
36:42
Speaker 3: to someone, oh, you've got a four percent risk of
36:44
Speaker 3: breast can so you actually do a mammogram and a biops.
36:46
Speaker 3: You just see if they've got it or not. And
36:48
Speaker 3: that's where we need to get do in cardiac disease.
36:50
Speaker 3: And that's where actually looking at your arteries and saying
36:53
Speaker 3: do you have something in your arteries that we can manage?
36:57
Speaker 3: That's really important because we're personalizing. We're not saying I
37:00
Speaker 3: take one hundred people, I'm going to save three lives
37:02
Speaker 3: by putting one hundred people on this drug. We're saying,
37:06
Speaker 3: this is your risk, and this is what I can
37:07
Speaker 3: do to your risk based on what I've seen in
37:09
Speaker 3: your heart.
37:11
Speaker 2: Yeah, yeah, I'm always talking to people about listening to
37:16
Speaker 2: their body. I go, what's your body's saying? Because your
37:18
Speaker 2: body's telling you stuff all the time. Right, maybe you've
37:21
Speaker 2: got your fingers in your ears and maybe you've tuned out.
37:23
Speaker 2: But there's a thing called biofeedback, and basically it's your
37:27
Speaker 2: body communicating with you and it's smarter than you, so
37:31
Speaker 2: you should probably tune in right and that whole without
37:36
Speaker 2: trying to be too cliche about this, but you know,
37:39
Speaker 2: like reconnecting with your body. It's a cliche thing, but
37:43
Speaker 2: it's actually a true thing. Like we're so quick to
37:46
Speaker 2: reach for a pel of powder, a potion, a needle,
37:49
Speaker 2: a fucking whatever that removes the symptom but doesn't treat
37:54
Speaker 2: the problem, and there's a need for that, but also
37:57
Speaker 2: just that will you know.
37:59
Speaker 1: Like one of my mates lives on Voltare.
38:01
Speaker 2: And I'm like, do you know how fucking bad that
38:03
Speaker 2: is for you? I go, do you His hips?
38:06
Speaker 1: Fucked?
38:06
Speaker 3: Right?
38:06
Speaker 2: So he has Voltaire and sandwiches for lunch. I'm like, bro,
38:09
Speaker 2: you got to like, firstly, your hip's getting worse. Secondly,
38:14
Speaker 2: you're just metaphorically putting your fingers in your ears.
38:17
Speaker 1: Going la la la doana No do wanta know?
38:19
Speaker 2: But that shit is going to catch up with you soon,
38:22
Speaker 2: if not now. So that just feel what you feel,
38:25
Speaker 2: and let's explore that again.
38:29
Speaker 3: There's a couple of things I tell people, one who's
38:30
Speaker 3: listen to your body. The other's look in the mirror.
38:32
Speaker 3: You don't need tests to tell you what you need
38:34
Speaker 3: to do where you need to be healthy. By listening
38:36
Speaker 3: to your body and looking in the mirror, you can
38:38
Speaker 3: get those answers. But for the people that can't, there's
38:40
Speaker 3: some really cool work being done around heart rate variability.
38:44
Speaker 3: And you probably know heart variability. It's a really good
38:47
Speaker 3: market of where your body is now. Unfortunately, most of
38:51
Speaker 3: your watches don't do very accurately. But as we learn
38:53
Speaker 3: more about this, elite athletes are using heart rate variability
38:57
Speaker 3: to actually guide their training, and I think we should.
39:00
Speaker 3: It's a sign. You know, this came to me during COVID.
39:03
Speaker 3: We have a lot of people with implantable devices, pacemakers
39:06
Speaker 3: and defibrillators, and we would be ringing people on a
39:09
Speaker 3: Tuesday and saying we've seen some spikes on your defibrillator.
39:13
Speaker 3: How are you doing? And that's how I'm fine. I'm fine.
39:16
Speaker 3: The call back on Thursday and say I've just been
39:19
Speaker 3: diagnosed with COVID. How did you know two days before
39:21
Speaker 3: I felt on well? And that's because the body starts
39:24
Speaker 3: to go off before you feel it. So if we
39:26
Speaker 3: can get these markers and really work with that, And
39:29
Speaker 3: that's what we say with your mate with the carategorist
39:31
Speaker 3: about going to specifics, you know, he might have had
39:33
Speaker 3: a really low heart rate veriability on that day and
39:36
Speaker 3: we'd have said, Okay, today is not the day to
39:38
Speaker 3: overdo it in the gym. Your body's fatigued, your bodies
39:40
Speaker 3: run down. Don't do it now. If you can listen
39:43
Speaker 3: to your body, but that takes a lot of practice.
39:46
Speaker 3: But if you can listen to your body, great. If
39:48
Speaker 3: you can't, let's figure out what else we can do
39:49
Speaker 3: to look at this. And I think that's ten years
39:51
Speaker 3: from our heart rate variability would be a really important factor. Yeah, yeah, well.
39:57
Speaker 2: It probably is now, but it's just not accepted and recognized.
40:00
Speaker 1: But all right, so.
40:01
Speaker 3: It's just your watches aren't accurate enough. It's noise from
40:04
Speaker 3: a watch. If you can actually use an implantable device
40:06
Speaker 3: to measure heart rate variability, it is game changing. Ye,
40:10
Speaker 3: But I'm not going to stick something in you just
40:12
Speaker 3: to measure heart right, veriability just yet.
40:14
Speaker 2: I'd let you, I'd let you, all right. So here's
40:17
Speaker 2: what I'm going to do. I'm going to give you
40:20
Speaker 2: some prompts, some words or terms, and I want you
40:24
Speaker 2: to just riff on it. In relation to heart health,
40:31
Speaker 2: you know, all the stuff that we're talking about, whatever
40:34
Speaker 2: comes to mind.
40:37
Speaker 1: One minute or so, if you can, because.
40:39
Speaker 2: I've got I've got about eights.
40:44
Speaker 1: So the first one is genetics.
40:46
Speaker 3: I just got to tell you there's a rule of
40:47
Speaker 3: my work that if you want DoD's my nickname at work,
40:50
Speaker 3: if you want Dot to speak for ten minutes, telling
40:51
Speaker 3: them he's got three seconds. So you've told me, I've
40:54
Speaker 3: got a minute, So you've got a minute. So heart health,
40:58
Speaker 3: you know long jeury. Genetics go absolutely fundamental in predicting
41:04
Speaker 3: your risk of a lot of things, in particular heart disease.
41:07
Speaker 3: There are multiple factors we can identify. In some of
41:10
Speaker 3: those we can actually treat. The thing with genetics is
41:13
Speaker 3: we know that people with a bad genetic profile good
41:17
Speaker 3: lifestyle do far better than people with a bad genetic
41:20
Speaker 3: profile and a bad lifestyle. So genetics are one component,
41:23
Speaker 3: but it reinforces the importance of good lifestyle. Cholesterol is
41:27
Speaker 3: predominantly genetic. There are certain subtypes absolutely genetic. Let's get
41:31
Speaker 3: you treated early and get onto it. Family history of
41:35
Speaker 3: art disease. Anyone under anyone in your family under sixty
41:38
Speaker 3: five years of age that are heart attack, You ought
41:40
Speaker 3: to be getting.
41:40
Speaker 1: Checked you fifty eight seconds. I made that up, all right,
41:47
Speaker 1: Next one.
41:48
Speaker 2: So what I'm talking about here is not exercise per se,
41:52
Speaker 2: but daily movement. So incidental occupational activity.
42:00
Speaker 3: Statement. I'm pretty sure it was Steve Jobs sitting kills,
42:03
Speaker 3: moving heels. I love that statement. Or sitting is the
42:07
Speaker 3: new cancer. That might have been his statement. That might
42:10
Speaker 3: have been the book after that was sitting kills.
42:11
Speaker 2: Moving, Sitting is the new smoking has got a fair
42:14
Speaker 2: bit of airplay.
42:16
Speaker 3: Absolutely, and you know it's absolutely true that incidental activity.
42:23
Speaker 3: And this is what I say. Never go to the
42:24
Speaker 3: closest coffee machine, go to the second closest, Never go
42:26
Speaker 3: to the closest toilet. If you can get our standing
42:29
Speaker 3: desk and use it. You know, I was in the AFI. Yes,
42:31
Speaker 3: they're talking about my habit, which is I do one
42:33
Speaker 3: meeting every day walking so I'm based in at Melbourne.
42:35
Speaker 3: I do a lap of the g every day siloa
42:38
Speaker 3: to warning Saalea to Kevin Bartlett, or at least as
42:41
Speaker 3: I walk around, So absolutely don't sit still. We know
42:46
Speaker 3: that fidget has actually lived longer than non figures and
42:49
Speaker 3: part of this is just that motion of activity that
42:51
Speaker 3: we do during our day. So yes, yes, yes, do
42:54
Speaker 3: as much as you can.
42:56
Speaker 2: Genetics Sorry I interrupted your glass so all this stuff
43:01
Speaker 2: and I was not genetics. Sorry, Diet diet, I know
43:07
Speaker 2: this is I know we could do an hour on this,
43:10
Speaker 2: so I understand. I understand the demands I'm putting on you.
43:14
Speaker 3: So a healthy heart diet will make you live longer. Yeah,
43:19
Speaker 3: defining a healthy heart diet is incredibly difficult. Yes, what's
43:24
Speaker 3: key in ninety percent of people in Australia is we
43:28
Speaker 3: need less calories. Now, how we get less calories is
43:32
Speaker 3: the difficult question. Through a low calorie diet, through fasting,
43:36
Speaker 3: through the macro nutrients. There's not a lot of evidence
43:39
Speaker 3: that one's better than the other. But what's clear is
43:42
Speaker 3: if eighty percent of Australians lost ten percent of their way,
43:45
Speaker 3: I'd be a lot less busy and I'd love it.
43:48
Speaker 2: Yes, yes, that's that's I have a backup question that
43:53
Speaker 2: if we get time, I might which.
43:55
Speaker 1: Is very specific.
43:57
Speaker 2: Anyway, stress stress distress, not you stress distress.
44:04
Speaker 3: I think stress has been underappreciated for many years, and
44:07
Speaker 3: I love the fact you're bringing it up. A lot
44:09
Speaker 3: of this heart rate variability stuff that we measure as
44:11
Speaker 3: a sign of stress, which can be psychological or physical.
44:15
Speaker 3: There is a syndrome known as broken heart syndrome. It's real.
44:19
Speaker 3: If your partner passes away, your risk of having a
44:23
Speaker 3: heart attack goes up dramatically in the months after that,
44:25
Speaker 3: and a lot of that is due to profound stress.
44:27
Speaker 3: Chronic stress absolutely causes all sorts of problems. The rupture
44:32
Speaker 3: of your arteries, the inflammation your arteries is triggered by stress.
44:36
Speaker 3: So managing your stress, what I call the autonomic nervous system,
44:39
Speaker 3: is critical, and you know the best way of doing it.
44:42
Speaker 3: It's exercise. The second best way is routine. If you
44:45
Speaker 3: don't have to think about stuff, if you're doing it regularly,
44:47
Speaker 3: that's going to de stress you. So absolutely a well
44:51
Speaker 3: underappreciated cause of heart possess. Well, you touched on the
44:55
Speaker 3: next one. So structured exercise or an exercise a plan
45:00
Speaker 3: that's implemented into your operating system. So for optimal heart health,
45:06
Speaker 3: there's been a lot of work on this, and I
45:08
Speaker 3: don't mind what you're doing, but you should be doing
45:10
Speaker 3: some aerobic exercise most days. And again, you can define
45:15
Speaker 3: aerobic a lot better than me, But I define aerobic
45:17
Speaker 3: because you're puffed, you're sweaty, you can talk, but just
45:20
Speaker 3: you get home and you're tired, you don't get home
45:23
Speaker 3: and you're collapsing on the couch. That's aerobic. Now, if
45:26
Speaker 3: you have a base of thirty minutes most days, or
45:29
Speaker 3: fifteen minutes every day, or forty five minutes three times
45:32
Speaker 3: a week, that's great. But now we know on top
45:35
Speaker 3: of that, put in some weight training, put in some
45:38
Speaker 3: high intensity and if you get that combination together, that
45:41
Speaker 3: really gives you the amplified effect on heart health. So
45:45
Speaker 3: put the structure in, but base it around aerobic. Then
45:48
Speaker 3: throw other stuff in as you enjoy. But again, you know,
45:51
Speaker 3: no point me saying you've got to do forty five
45:54
Speaker 3: minutes of walking. If you've got a bad hip, you've
45:56
Speaker 3: got to find the exercise that works for you.
45:58
Speaker 2: Yeah, so true. This one's a little bit lucy, goosey
46:02
Speaker 2: and broad. So I'll let you go wherever you want
46:04
Speaker 2: with it. Lifestyle, which I know encompasses a lot of shit,
46:08
Speaker 2: but doubt.
46:12
Speaker 3: Lifestyle has more impact on heart disease than anything else
46:15
Speaker 3: we know. So lifestyle has impact on longevity, but it
46:21
Speaker 3: has more impact on health span, which is how long
46:25
Speaker 3: you're actually healthy for, and that to me is critical.
46:28
Speaker 3: Lifestyle is underappreciated, and if anyone wants to criticize doctors,
46:32
Speaker 3: it's we don't spend enough time on lifestyle. I know
46:38
Speaker 3: I've got seven seconds Peter Attia from longevity. You know,
46:42
Speaker 3: I heard the other day he's got seventy five patients.
46:45
Speaker 3: I had ten thousand, he's got seventy five, so he
46:47
Speaker 3: can afford to spend all the time on lifestyle. I
46:51
Speaker 3: spent all my summers talking to the people at the
46:53
Speaker 3: beach about lifestyle, because lifestyle is key. You get your
46:57
Speaker 3: lifestyle right, you might still need a few medications, but
47:00
Speaker 3: you'll need a whole lot less than if you get
47:02
Speaker 3: your lifestyle wrong. So it is the number one thing
47:05
Speaker 3: that we should be doing. And exercise, stress, alcohol, nutrition, sleep,
47:10
Speaker 3: They form the basis of lifestyle as far as I'm concerned.
47:14
Speaker 2: Yeah, I probably should have ended with that, but just
47:18
Speaker 2: back to two more which you just kind of covered briefly,
47:22
Speaker 2: but so specifically.
47:24
Speaker 1: Booze.
47:25
Speaker 2: I don't drink, so it's not a big I don't
47:28
Speaker 2: even really get it. But booze and heart health.
47:32
Speaker 3: There is no benefit for alcohol in heart health. That
47:37
Speaker 3: is a fallacy. There was a belief once upon a
47:39
Speaker 3: time a glass of red wine was good for your heart.
47:41
Speaker 3: That has been disproven. There is evidence that alcohol is
47:46
Speaker 3: bad for your heart, even in very low quantities. Yes,
47:50
Speaker 3: we need to balance that with lifestyle factors, social factors.
47:56
Speaker 3: And I'm quite happy to tell you that I will
47:59
Speaker 3: always have a beer, and the Boxing day test matches on.
48:01
Speaker 3: I'll love a champagne on New Year's Eve. I'll have
48:04
Speaker 3: a glass of wine with some friends over dinner once
48:06
Speaker 3: once or twice a month. So I don't drink. But don't.
48:11
Speaker 3: Don't anyone out there think that alcohol is good for you,
48:13
Speaker 3: because it's not. Alcohol at any level is bad for
48:15
Speaker 3: the heart. Now where that level lies is somewhere between
48:19
Speaker 3: one and two standard drinks a week. But I would
48:23
Speaker 3: tell people if you want to drink, because it is
48:26
Speaker 3: helping you in other ways. And social, you know, we
48:28
Speaker 3: talk about social. You haven't mentioned that yet. Social interactions
48:31
Speaker 3: are critical for good heart health. And if your social
48:34
Speaker 3: interaction is having a glass of wine with some friends
48:38
Speaker 3: over dinner, then keep that up. If you can't go
48:41
Speaker 3: to soda water, so alcohol is bad for you, no
48:44
Speaker 3: question about that. But I don't want to be too
48:48
Speaker 3: rigid with people that they're having this prescriptive way of
48:50
Speaker 3: living that doesn't fit with their lifestyle. I'm okay with
48:53
Speaker 3: people enjoying themselves from time to time, as long as
48:55
Speaker 3: it's not in excess.
48:56
Speaker 2: I'm glad you raised that about socializing. Sociology, relationships, human connection, love,
49:03
Speaker 2: giving love, getting love, feeling valued. It's something that I
49:09
Speaker 2: forgot for this list, but I talk about corporately with
49:12
Speaker 2: It's quite a almost like a red herring in a
49:15
Speaker 2: corporate environment when you talk about, you know, being loved
49:18
Speaker 2: and feeling valued and seen and connected, and what a
49:23
Speaker 2: physiological impact that has, and not just on hard health,
49:26
Speaker 2: but a bunch of things. It's funny now we talk
49:30
Speaker 2: about the impact of whatever diet, lifestyle, exercise on your health,
49:37
Speaker 2: and now we talk about the importance of that that
49:41
Speaker 2: social connection as been possibly more important than sometimes exercise
49:46
Speaker 2: or movement, depending on sorry, exercise or food at times.
49:51
Speaker 3: And let's remember we're in a state where working from
49:54
Speaker 3: homes just become mandated. I'm not sure that we're fully
49:57
Speaker 3: appreciating the social impacts of that, yes, but anyway, that's
50:01
Speaker 3: a separate topic. But yeah, look, there's a great book,
50:03
Speaker 3: Lost Connections by Hari. I'm not promoting anyone that I've
50:06
Speaker 3: got a relationship with there, but it really talks about
50:09
Speaker 3: the science behind connections and you know the importance of
50:13
Speaker 3: having relationships with family, relationships at work and how that
50:17
Speaker 3: impacts your health, and it's really fascinating. He's more on
50:20
Speaker 3: the depression side, but it's absolutely the same part disease
50:23
Speaker 3: as well.
50:24
Speaker 2: Quite like that, dude, he's got an interesting mind. My
50:28
Speaker 2: last one, which is for me, the toughest one, although
50:31
Speaker 2: it's not a big struggle, but periodically it is. I
50:33
Speaker 2: feel like all of those like lifestyle, booze, daily movement,
50:39
Speaker 2: you know, exercise, like they're pretty much within our control.
50:43
Speaker 2: We can make a decision and just do it. But
50:46
Speaker 2: we can't make a decision and go I'm going to
50:48
Speaker 2: sleep great tonight. You know, it's like, yeah, your body's
50:51
Speaker 2: like no, you're not, fuck off. So that to me,
50:55
Speaker 2: because everything else is pretty in line For me, that's
50:59
Speaker 2: that move the need all the most. If I sleep great,
51:02
Speaker 2: I'm nine out of ten. If I sleep shit, I'm
51:04
Speaker 2: a four.
51:06
Speaker 3: Yeah, And that's been shown repeatedly in data that your
51:10
Speaker 3: performance as an athlete, your stress levels are all impacted
51:14
Speaker 3: by your sleep. You know, we were associated with the
51:19
Speaker 3: sleep business once upon a time, and the sleep doctors
51:22
Speaker 3: will tell you you can manage your own sleep, not
51:25
Speaker 3: every night, but you can put in strategies to get
51:27
Speaker 3: better sleep. But the fundamental thing from me is sleep
51:31
Speaker 3: is profoundly impacting heart health, and these people. The other
51:35
Speaker 3: thing we've got to remember is that we are all
51:36
Speaker 3: slightly different. I do not need nine hours sleep a night.
51:40
Speaker 3: I'm quite comfortable with six and a half to seven
51:43
Speaker 3: and that has no impact on my metabolic features. As
51:45
Speaker 3: soon as I dropped to five hours, it impacts it.
51:48
Speaker 3: So this sort of belief. When I was a young doctor,
51:51
Speaker 3: we used to work forty eight at seventy two hours straight.
51:53
Speaker 3: Your mind was fried. You couldn't possibly do it. So
51:57
Speaker 3: sleep is critical. I think people have real problems with sleep.
52:01
Speaker 3: Should say sleep specialist, not for medications, but for strategies.
52:04
Speaker 3: It's around blue light, around strategies, around what the bedroom's
52:08
Speaker 3: for around, what you have with your cup of tea
52:10
Speaker 3: before bed, all of these things that you can do.
52:12
Speaker 3: And I think it's about habit forming. It's the same
52:15
Speaker 3: that you've got a great habit of exercise and health,
52:18
Speaker 3: maybe your habit around sleep's not great and maybe that's
52:20
Speaker 3: something you should ask yourself about. Yeah.
52:23
Speaker 1: Yeah, I've got a lot of bad habits. You're great.
52:27
Speaker 1: Can we do another one?
52:29
Speaker 3: Absolutely? What's we talk about next time? Athletic performance shark
52:34
Speaker 3: attacks in Sydney. I'm an expert.
52:37
Speaker 2: Yeah, we can get You're a chatty Kathy and I
52:40
Speaker 2: like it. Hey, Doc, promote whatever you want to promote.
52:43
Speaker 2: Point my listeners any direction you'd like them to go.
52:47
Speaker 3: Look, as I said right at the start, my mission
52:49
Speaker 3: is to improve Australia's heart health. If you're over forty five,
52:53
Speaker 3: if you've got a family history of heart disease, if
52:55
Speaker 3: you've got risk factors for heart disease, please go and
52:57
Speaker 3: get your heart checked. You're not going to get shoved
52:59
Speaker 3: on treat and you're going to work out what is
53:01
Speaker 3: your risk and what can you do about that? And
53:04
Speaker 3: if no one else is looking after your at Varahatkerell,
53:06
Speaker 3: look after you, but by all means go to your
53:08
Speaker 3: normal GP and get them to do this test for you.
53:12
Speaker 2: Amazing. Thanks so much for debuting on the EU project.
53:17
Speaker 2: I think they're going to like you a lot, and
53:19
Speaker 2: I think they're going.
53:20
Speaker 3: To want you back.
53:21
Speaker 2: We'll say goodbye affair, but for the minute. Thanks David.
53:24
Speaker 2: Really appreciate you.
53:26
Speaker 3: Awesome. Thanks for the time.