Latest / Sweat Community / Ep 19. Are You Exercising Enough? Dr. Noah Kaufman on Fitness, Nutrition and Injury Recovery
Transcript
- Sheena: Okay. Noah T. Kaufman, MD: Yeah, you're Sheena: So all right. Welcome to Sweat Community, where we connect you with the people, businesses, and leaders shaping health, wellness, and fitness here in Colorado. Have you ever wondered, am I exercising enough? What should I actually be eating? And when I get hurt, do I go to urgent care, the ER, or do I just wait it out? Today I'm joined by Dr. Noah Kaufman, a Denver emergency physician, rock climber, and former American Ninja Warrior Competitor. After 23 years in the ER, he founded Cough Care, a new approach to acute care. We're talking about exercise, nutrition, injury recovery, and knowing when it's time to get medical care. And Noah, you are actually the first podcast guest whose team reached out to me who I've chosen to interview. So I am so, so excited and glad to have you on here. Welcome to Sweat Community. Noah T. Kaufman, MD: thank you, Sheena. It's incredible to be here. I love what you're doing like I'm literally a part of the sweat community because I love exercise and I love the whole front range health and athleticism scene. Sheena: my gosh, know Reading about you I am so impressed by all that you've done. So before we get into all of the questions, I want to hear just a little bit about your journey. You've spent 23 years in emergency medicine, you're also rock climber and former American Ninja Warrior competitor. How did you get so passionate about both medicine and movement? Noah T. Kaufman, MD: Yeah, absolutely. I mean my whole life, like I grew up climbing trees and with two younger brothers Sheena: Yeah. Noah T. Kaufman, MD: falling out of trees climbing local buildings. So I was like always kind of a ninja. Like I literally had a ninja outfit and throwing stars And you know, that just turned into rock climbing and gymnastics I was just always very athletic. I looked up to, dudes with six pack abs and I imagined Sheena: ha. Noah T. Kaufman, MD: myself that someday becoming this superhero type of person I wanted Sheena: Yeah. Noah T. Kaufman, MD: to be. And so I worked really hard at it. and medicine was always something I wanted to do as well. we all know how great being healthy and active and participating in sports and being in the mountains can be for our psyches, right? Like it's so healthy psychologically. And so it was always a kind of therapy, I guess, to do rock climbing and I've been climbing for 36 years. And so when Ninja fell in my lap, I was like, wait, I could run on the world's funnest obstacle course and I've got an advantage because I've got good grip strength. and so I ended up doing seven seasons of American Ninja Warrior. And it was just so much fun. I never won the million dollars, but I did sweat for it a lot. good shape. Sheena: There you go. Noah T. Kaufman, MD: and you know, my medical practice there's been a huge component about helping athletes as an athlete. I understand chronic Elbot tendinitis joint pain and things that hold us back from performing at our maximum level. and how Each one of us is different. So yeah, it's been an incredible path and I'm excited about what we're doing here. Sheena: that is incredible. like you said, movement is just so healing. the fact that you Noah T. Kaufman, MD: Mm, yeah. Sheena: I have rheumatoid arthritis, and that's why I move is to help my joints, to help feel better. So it's truly a testament. and so after 23 years in the ER, you ultimately created cough care. Noah T. Kaufman, MD: Mm-hmm. Sheena: What did you see in health care that made you want to create a different approach to acute care? Noah T. Kaufman, MD: yeah, well I mean being in the ER, like nobody wants to be there. patients have to wait for hours. And people would come and say, Hey doc, what is this gonna cost me? Last time I was here, it cost me three thousand dollars. And I'm like, I don't know. we gave an oath in medicine to first do no harm. And I was part of this system that was doing massive financial harm. even though we do a lot of good, we're part of this system, the hospitals charge a gazillion dollars. I just felt like I could do it a lot better by not taking insurance, cutting out all the middlemen. Taking the price of the ER down 70 to 90% and just doing transparent direct pay. all of our prices are published online. And most people Sheena: Ha ha. Noah T. Kaufman, MD: are cash pay anyway because deductibles are so dang high and the insurance companies are laughing all the way to the bank. So I'm just creating something better for people We can do complex things that the emergency department does, that the urgent cares cannot. And we do see a lot of athletes for chronic problems. we do steroid injections x-rays ultrasound and even acupuncture and supplements and all the things to get people back on their feet with chronic injuries. Cause I know firsthand what it's like to be out for nine months with a really horrible shoulder injury and nurse that back to health. So, you know, I've been there, done that, and just want to help people at this point and build something really cool that's just better. Sheena: Wow. and then the fact that you Noah T. Kaufman, MD: There's a lot, I know. Sheena: are looking at people, as a whole, doing Noah T. Kaufman, MD: Mm-hmm. Sheena: you're doing the full wellness. you know, with acupuncture, Noah T. Kaufman, MD: Yeah. Sheena: you're doing like Eastern, western, that you're combining, which is so cool and unique. And I love the transparency because that is something I don't think you can Find anywhere. You go in and you go and you're just like, all right, what is the damage gonna be after I'm here, Noah T. Kaufman, MD: it's really a big grift And it's like a multi-trillion Sheena: Mm. Noah T. Kaufman, MD: dollar industry and everything is based on like extracting the maximum value out of the patient's hard earned dollar. And that is just so messed up. Like I would use stronger words, but you know, it is so Sheena: Yeah Noah T. Kaufman, MD: ethically wrong So yeah, I'm glad you're seeing that and I think most people agree it's time for a change. Sheena: Absolutely, I feel like we could go on about this for a very long time, but Noah T. Kaufman, MD: Mm-hmm. Sheena: I I do want to transition a little bit because you've spent decades seeing what happens when things go wrong and then also the active part, helping somebody put their own body to work. so how should we actually be exercising? If you could give the average healthy adult a basic exercise prescription for living a long, healthy life, what would you want them to be doing each week? Noah T. Kaufman, MD: Yeah, absolutely. And there's a difference between achieving maximal performance and trying to force what we call adaptation, which is getting better and better and better at something, whether it's skiing or rock climbing or ice skating. you know, Sheena: Mm-hmm. Noah T. Kaufman, MD: that's different than the daily in and out, weekly in and out habits that create a healthy long lifestyle. This is something that's really interesting. They did a study. And they looked at people who are 80 years old. if you're 80 years old and you can walk three miles an hour, for like three or four blocks, about 10 minutes, let's say, you have a 90% chance of living to be 90. Okay. let's say Sheena: what? Noah T. Kaufman, MD: that again. Yeah, yeah. And that's actually based on research. That's incredible. it's, you know, like keep it simple, stupid, The kiss, all all we need to do Sheena: Yeah. Uh-huh. Noah T. Kaufman, MD: is focus on movement and focus on using our bodies. They also did studies that showed that tennis players live on average nine years longer than everybody else. So, you know, like having fun and doing something that you're gonna love, whether it's pickleball or tennis or a walk in the mountains, as long as you're doing it consistently over your lifetime, that is the foundational. component to health and exercise that everyone should have. that is the easy low lift. if you don't have time for a few times a week getting out, especially into nature. I think nature is very Sheena: Mm-hmm. Noah T. Kaufman, MD: important for the mind. do something that you love and stay active and get your heart rate up a few times a week at least, Sheena: Mm-hmm. Noah T. Kaufman, MD: we're Sheena: Yeah, I love what you said, like finding something that you love because then you'll be consistent with it, you'll stick with it. So as far as you were saying get the heart rate up, how important are cardio and strength training and do we really need both or do you just recommend doing something you love that gets a heart rate up? Noah T. Kaufman, MD: it depends on what you're doing and where you're at in your life. optimally you would have both. And there's a lot of reasons for that. increased muscle mass by weight training really helps with insulin resistance, helps with pre-diabetes, But weight training really improves your metabolism. so both are important. If I had to choose one and you were really strapped for time, the most important thing you can do is increasing your VO2 max, which is a measure of high intensity workout basically how good your body is at using oxygen in a heightened exercise demand state. The studies have shown that the increase in longevity is most associated with an increased VO2 max. Okay? And so a lot of times doing exercise with weights. and weight training can get you into that HIIT kind of area, HIIT workouts, those high intensity workouts, are the ones that confer the most longevity gains. so it'd be better run for five minutes and get super out of breath than to, walk for 45 minutes three times a week. Sheena: Hm. that like buns me out because I'm I'm all about walking. I'll go walk like every day, but I don't do the Noah T. Kaufman, MD: walking's good for you. Sheena: cardio. I don't do the Noah T. Kaufman, MD: walking's good for you. Sheena: Or I I feel like now maybe just like adding a few sprints in there might might help with that. You know. Noah T. Kaufman, MD: Yeah. hundred percent. Like thirty seconds of really hard and then recover for five or ten minutes and then keep it going on your walk. can sprint, that Sheena: Mm-hmm. I'll totally do that. Noah T. Kaufman, MD: and you will notice it too. it helps with a lot of everyday Monday and things like being out of breath going upstairs or like stamina during sexual intercourse or hiking and getting out of breath You really Sheena: Right. Noah T. Kaufman, MD: want to get winded, get your heart like really pounding blood. And that is so good for you. Sheena: Yeah, I'm curious now just because we're talking about running. What? Noah T. Kaufman, MD: Mm-hmm. Sheena: I've heard a lot of people who were runners, even sprinters, but it really hurts the knees. So if someone's like, I want to get my heart rate up quickly, or if I go on walks, how would you recommend that without finding that damage to the knees? has a sensitive knees. Yeah, exactly. Like an injury. How Noah T. Kaufman, MD: Or lower back or right. A hundred percent. Sheena: can they get that higher? heart rate without that Noah T. Kaufman, MD: Right. Sheena: impact. Noah T. Kaufman, MD: as someone with some back issues, I actually may need a fusion, which is kind of crazy to think, but Sheena: wow. Noah T. Kaufman, MD: I'm 51 now and I've been super athletic my whole life. it's been very important for me to do low impact stuff. And swimming is like one of the best things you can do. as long as you're a decent swimmer, you're not gonna drown. But swimming Sheena: Yeah. Noah T. Kaufman, MD: hard is really good for you. but then also hiking is much lower impact. and that's a great way to go. Running is hard unless your technique is perfect. but getting on an exercise machine like an elliptical or a bike, those are much lower impact. Sheena: Or like a rower. Noah T. Kaufman, MD: of impact. You a row or that's a very good one. whatever's not gonna cause you long term problems. A lot of people can get away with running because their genetics and their biomechanics are good and better than some of ours. Sheena: Sí, sí, Noah T. Kaufman, MD: It's a really good point, Shina. Sheena: thank you. Yeah. that's really helpful. and then people who go to a gym and they're like, I'm doing chest and back or chest and arms and then legs and glutes, Noah T. Kaufman, MD: Mm-hmm. Sheena: or they isolate specific muscle groups. and I see that all the time and I'm like, is that what people should be doing focusing on a certain muscle groups at a time, or do you recommend doing that full body workout in and out, you're done. Noah T. Kaufman, MD: that depends on your goals specifically. So, like when I work out, I'm trying to get stronger for rock climbing And that's a very different goal than just preventative health maintenance. if you're looking for adaptation, if you're looking to improve and push yourself. Then absolutely the biggest gains are from the rest, okay? when you push real hard and then you rest and you recover. And of course, you need more rest as you age. nine times out of ten for most people, it is smart to alternate between different muscle groups, pushing and pulling groups, leg and upper body groups. And so coming up with a program that works between those. is really really intelligent. And for most of us who aren't training super intelligently like Olympians and have the coaches and have the money and the time, it's easy for us to overtrain because a lot of us are really Sheena: Mm-hmm. Noah T. Kaufman, MD: hard workers. And then you get into injury patterns and then that'll set you back. it's usually better to have more rest. And just go a couple few times a week and building that strength mass. burns calories just sitting there while you're not doing anything? And it burns calories in your off days when you're recovering. And that's better Sheena: that's great. Noah T. Kaufman, MD: for a lot of the things that we think about as doctors contributing to long-term health care issues. Sheena: Yeah, absolutely. it just now clicked to me that the reason you isolate is to rest those muscles. and then just on that note with strength training, I've heard and I say this all the time too, that you want to work the muscle to fatigue or failure, as that's how you will grow the muscle, bone density, is that what you would agree? Like even if you just do a couple reps but do it to failure, versus a ton of reps that you're not getting to that fatigue. Noah T. Kaufman, MD: Right. And that's that is a great question. Cause I I think most people get this wrong. if you are an Olympian, if you are a hardcore competitive, know, tennis player hockey player or snowboarder and you're looking for performance, then yes, you need to walk that line between injury and between the status quo. Cause it's really hard to get the body to improve, you can improve technique, Sheena: Mm-hmm. Noah T. Kaufman, MD: but it's it's hard to improve unless you have adaptation. where you've pushed hard enough that you've pushed towards failure. Okay. And there's an art to that as well. For most of us, it's better to stay in that window. and you'll have more longevity. You'll stick with it. whatever it is you're trying to do. That's a great question. Sheena: thank you. I think most of us listening, we're not trying to be professional athletes. You know, we just want to feel good, be strong, stay healthy. Noah T. Kaufman, MD: If you did something, that's a huge success and a huge win. even 10 minutes of Sheena: Absolutely. Noah T. Kaufman, MD: doing push-ups or, getting in a walk. And maybe, you could sprint and if you could push yourself that's confers the most benefit. And that's true. but you don't need to do that. we go through ups and downs in our lives. We go through times when we can sweat more, right? And Sheena: Mm-hmm. Noah T. Kaufman, MD: and there's times when we're stressed and just getting some activity is good at decreasing the stress. Sheena: Yeah, absolutely. And that also makes me feel better about my goal of getting ten K steps a day that I think it Noah T. Kaufman, MD: Yeah. Sheena: actually benefits my mental health more than anything, getting out in nature. Noah T. Kaufman, MD: that's exactly right. There you go. Yeah, that that's exactly right. Sheena: know, but just getting out in nature. Yes, yes. awesome. Well, I think now, like I'd love to get into the other half of the equation, because what we put into our bodies absolutely matters. and nutrition Noah T. Kaufman, MD: Absolutely. Sheena: advice seems to be changing every few minutes. Protein is everywhere right now, fiber is everywhere. We hear about gut health, about supplements, about fasting, about sugar. So what do you think that people should actually be paying attention to? Noah T. Kaufman, MD: Well, first thing is everybody's an expert, right? Like everybody knows the answer. No, no, you gotta try Atkinson. no, you gotta do paleo. No, you gotta do and Sheena: Yeah. Right. Noah T. Kaufman, MD: the science shows this. Now remember, all science and data that we have is population based, okay? Each one of us is just this unique, infinitely complex, beautiful machine. And we're all so different. We look very different on the outside, and our biomechanics are different, our biochemistries are different. Our nutrition are different and our genetics and how we express proteins Like Some people get gassy, because they eat vegetables, some people don't. And what is our gut microbiome? There's a million variables that are so different for each of us. And so why would one diet fit all or one approach to nutrition? And the answer is it doesn't. the first thing I would say is don't trust anyone, when it comes to nutrition. Sheena: Mm. Noah T. Kaufman, MD: it's very easy. Stay away from chemicals and anything you can't pronounce or you don't know what it is. Single ingredient foods are very good. Organic is very good. Sheena: Yeah. Noah T. Kaufman, MD: eat healthy, and then everything in moderation, it's literally that simple. And then if you want to optimize further, okay, get some genetic testing see what your cholesterol is, your hemoglobin A1C, which is a measure of How you deal with sugar spikes in your body, which causes inflammation. these are really easy, cheap tests to do. so, you know, and try and stay away from doctors for the most part, and try and stay off of medications. Because, you know, medicine Sheena: Yeah. Yeah. Yeah. Noah T. Kaufman, MD: will try and steer you towards medications, which is one thing I hate about modern medicines. And I'm not on any medications, and I don't want my patients to be either, unless it's like absolutely necessary. Sheena: I love that. especially that you try to stay off the medicine. Because I mean food is medicine or it could also be I mean food is poison. You know, it's it makes such Yeah. Yeah. Noah T. Kaufman, MD: Exactly. Yeah, Hippocrates said that. Let let food be thy medicine. Right. Sheena: Right, right. And it's so hard. I know it's like, just stay away from processed food. but processed food is just everywhere. It's hard to stay away from it. like we are trying to limit it but it can be tricky, man. yeah, it's Noah T. Kaufman, MD: Farmers markets, go to the farmers market every week, buy, real bread, real produce, real meat, from your neighbors. like you know, and part of this Sheena: Yeah. Noah T. Kaufman, MD: there's this incredible corporate kleptocracy that, you know, not to get political, but it influences our health. there's great documentaries that are a little bit hyperbolic. you go watch Food Inc. or Fast Food and it's like, my gosh, I need Sheena: Mm. Noah T. Kaufman, MD: to eat a more natural diet. it's very motivating to watch those documentaries. And so and so depressing, you're right. Sheena: Yeah. Yeah. Yeah. And depressing. Absolutely. my gosh. Yes. you are also saying that you could do the genetic testing Does that actually guide you of where like how you should be eating? Noah T. Kaufman, MD: yeah, some of us don't process certain foods well. Like some people do well with coffee, other people don't. take for example, some of us get gout when we have a lot of uric acid. there's vegetables and stuff we need to avoid and blah blah blah. But gout is when crystals build up in your joints and then they grind and it hurts it causes real problems. And this is just a simple one off example. Well, if you get some genetic testing and you realize 20 years beforehand, I'm predisposed to gout then you can stay away from these types of foods. and there's a lot of examples of that. And you know, most people Sheena: Amazing. Noah T. Kaufman, MD: listening in this community care about themselves and their health and their families and their neighbors. Sheena: And it's just a simple blood test. Noah T. Kaufman, MD: yeah. I mean genetic testing is as simple as is swab your cheek, there are blood tests. then, you some of the other yeah, some of the other tests Sheena: So it's very easy to get not less invasive Noah T. Kaufman, MD: and then I use balanced health, a local direct primary care and I'm happy to refer people out. Sheena: Yeah, I love that. That's amazing. So let's talk a little bit about protein because I know a lot of people have questions about that. How important Noah T. Kaufman, MD: Yeah. Sheena: is getting protein for the average person, especially someone who is exercising? Noah T. Kaufman, MD: Not as important as you think. Yeah, it it's so funny. Sheena: Really? Noah T. Kaufman, MD: if you are a hardcore athlete, Sure, try and get your hundred grams of protein in a day. Most of us don't need that. And if you think about like a racehorse or like a bull that's like all muscle, What do they eat all day? yeah, they eat grass. you have a genetic disposition. Sheena: Grass. Great. Noah T. Kaufman, MD: Some people are gonna be muscular and have a relatively low protein diet. this gets back to what I'm saying this is an individual question. Some people eat a ton of protein and it's horrible for their kidneys it's Horrible for them. And some people, it's really good for them. like and I think that we all think in these kind of global terms of I'm not getting enough protein. we're living in this age of abundance and you may actually be doing more damage than good by eating somebody else's determination of how much protein you need and like I'm gonna get my hundred and fifty grams of protein. And people would argue with me, but show me the data. Show me the research that says a high protein diet confers a longevity advantage, or a happiness feeling healthy health span advantage. And you can't do it. That data doesn't Sheena: Yeah, right. Noah T. Kaufman, MD: doesn't exist. I think we get sucked into other people's, selling us what Sheena: Mm-hmm. Noah T. Kaufman, MD: we need to be doing. Sheena: a hundred percent we do. A hundred percent. I it's that's hyping right now, and everybody's like, we have to get that number. I hear a hundred and fifty like, that's the goal, Noah T. Kaufman, MD: Yeah. Sheena: we have to get it. we're all like jumping on that train. But like you said, it's so individualized. Noah T. Kaufman, MD: Yeah, no. You know, it's very easy for us to become obsessed or neurotic about our health and to have anxiety about our health. And that's a really important consideration, also. Let's say it's good for you to get protein. It might keep you from getting as sick all the time. It might, make you feel healthier. But if you're trading that by obsessing about I didn't get my hundred grams of protein and like what am gonna do? Like now I'm gonna get sick. Now I'm gonna well now you've introduced something else, which Sheena: Yeah. Noah T. Kaufman, MD: is stress levels, cortisone. And you're starting Sheena: Yeah. Noah T. Kaufman, MD: to obsess about something, you know, like the healthiest people Sheena: Yeah. Noah T. Kaufman, MD: just enjoy their time in the mountains and they're not really like obsessing about their health. They're going snowboarding and like, living life Sheena: Living life. Noah T. Kaufman, MD: and they're healthy. I've got grandmas who are 90 years old who do a shot of whiskey every day and smoke a cigarette. And I was like, what's the magic, did you Sheena: What's the Noah T. Kaufman, MD: do a hundred grams of protein every day. And they look at you like, what? It's like, like I went and Sheena: Ha ha Noah T. Kaufman, MD: enjoyed I enjoyed my life. like happiness it can't be understated how important it is to be happy. that is way Sheena: Mm. Noah T. Kaufman, MD: more important than X grams of protein. Sheena: Yeah, absolutely. what about fiber? Is the fiber hype real? Noah T. Kaufman, MD: Okay, fiber hype is real. Just about everybody does better with some amount of fiber. And there's a very good reason for that, So there's different kinds of fiber, right? There's insoluble and soluble. And these fibers do different things in your gut. you're basically Creating a gelatinous border in your intestines that helps you not absorb as much sugar or absorb it slower so you don't have as much inflammation and keep your gut microbiome happy healthy and keep it at bay. especially for people who are pre-diabetic, which is so many of us, or people who eat a lot of sugar, know, walking after a meal is another example of something that's easy, that all of us should be doing. if you can do it 80% of the time and you can include fiber, and some of it's as easy as like whisking up a glass of a teaspoon of organic psyllium in the morning, And again, I'm a big fan of organic. everything was organic for hundreds of thousands of years until we invented, chemicals that are literally associated with all kinds of problems, most of which we don't even know about, but hormonal access problems and cancers and diabetes and it's just a nightmare. so but yes, Sheena: it's horrible. Noah T. Kaufman, MD: fiber is more important than stacking protein Sheena: Awesome. so speaking of food and exercise, I think most of us have heard that, weight loss is about, seventy, eighty percent nutrition and like only Noah T. Kaufman, MD: Mm-hmm. Sheena: twenty, thirty percent exercise. Do you agree with that? Noah T. Kaufman, MD: a hundred percent calorie restriction and especially sugar. If you cut out the sweets and you add a little fiber, that is the easiest path And I've got Sheena: sugar's bad. Noah T. Kaufman, MD: a bad sweet tooth. I love chocolate. I love sweets. And so it's not easy. And I know that. And sugar is highly addictive. Sheena: And that sugar, does that include fruits, like fructose as well, or just like the added sugar, like the white sugar? Noah T. Kaufman, MD: so that's a good question. fructose is a very interesting sugar because it is like more bioavailable than other sugars. So that means the moment you eat fructose, you get a mad rush of sugar. And so if you're doing sports. that is a very, very quick way to replenish your stores of glucose. So if you're on a big hike into the mountains, fructose is great. If you are marathoner, fructose is great. But if you're doing anything other than that stuff, it will go straight into your body, it's not going to be used, and it's going to be what? Stored as fat. It's going to be converted into fat and stored. it can be bad. So fruit juice can be horrible for you. If you're eating it with fiber, or if you're about to exercise or work out, fine. you gotta be really careful with fructose. Sheena: Mm-hmm. So the saying an apple a day keeps a doctor away but yeah. Noah T. Kaufman, MD: That's right. The skin has a ton of fiber apple is a great food, so are natural fruits. Some are better than others, Sheena: Awesome. Well, so we were talking about building a healthier body and doing things right, but sometimes bodies don't cooperate. You know, we have that inflammation. We get injured. so when you do get injured, how do you know if you should actually rest versus using movement to help heal? Like, can completely resting an injury sometimes make things worse? Noah T. Kaufman, MD: Yes. And Sheena: 'Cause I hear different things on that. Noah T. Kaufman, MD: yeah, no, it absolutely can. this is where having expertise and having someone who really knows what they're talking about help guide you through that. but the general rule of thumb is if it doesn't hurt to do low level exercise, that's usually helpful to increase blood flow, help with remodeling. And movement is usually good for low level problems. Now, if you've really torn something, if it hurts no matter what you're doing, then that is something to avoid and then see a professional because it's almost never the answer to not move or not work. we're designed to remodel and heal, You know, we're trying to box everybody into one box, and we can say rule of thumbs, but at the same time, it's important to see someone. If you're hurting and you're not better in like, a week, or especially if you've gone a few months, you should probably come in to be seen. And that's a lot of our care. And we'll do an x-ray. and sometimes you find something surprising we need to do something about it. Sheena: Absolutely. Yeah, until you've really know what's going on and what kind of injury it is and the extent. Noah T. Kaufman, MD: That's right. That's right, Shane. Sheena: yeah, yeah, for sure. So, I know it depends on the injury, but what if I'm home? I've injured myself. How do I decide between staying home, going to urgent care, going to somewhere like cough care, or going straight to the ER? Noah T. Kaufman, MD: Well, that's a great question. And if you don't know, or you're really short of breath, or you're in pain, or you have any medical history, especially if you're over 65, always err on the side of caution and call nine one one and go to the ER. Okay. we're gonna send you to the ER if we think it's bad. Now that being said, ninety percent of the time you could get away with coming to cough care. So if you're like, I know something's wrong, but it's not chest pain. I don't have weakness or something like dire that I'm very worried about. come in to cough care. I've been doing this for 25 years, our other doctors have been doing it for 30 years. you're gonna get the highest level care possible. And if we think you need to go to the ER, we're either gonna call nine one one or we're gonna send you to the ER. Sheena: it Yeah, no, that makes sense. All right. So something that we do all the time in sweat community is this little part called rapid fire, which is usually like fun little questions. but I'm gonna mix it up a little bit with you. I'm gonna ask like, yeah, Noah T. Kaufman, MD: let's do it. Yeah. Sheena: a little bit more of what would you do for a rapid fire? Noah T. Kaufman, MD: Let's do it. Sheena: let's do it. So the ankle. You roll your ankle on a hike, it's swollen, but you can walk. What would you do? Noah T. Kaufman, MD: Yeah, I'd ace wrap, I would ice, maybe take it easy for a day. and honestly, if you can walk on it, I'd give it a few days and I would walk on it as much as possible. Try not to twist, but use like a decently tight ace wrap. Don't take ibuprofen or neproxen for the first day. You want that inflammation. Try and keep it elevated, it's gonna bleed, it's gonna bruise, and you're gonna see blood pool in your heel. and then, if it's a sharp pain and it hurts on the actual bone on either side, like those balls that stick out, which are called the malleoli, then you might consider an x-ray. You can always come in and see me, but honestly, I would try and walk it off and really try and use it. Your body is designed to have ankle sprains. Sheena: Okay, awesome. The pop. You're lifting weights, you hear a loud pop, what do you do? Noah T. Kaufman, MD: Loud pop depends on where it is. I would probably get that evaluated. a pop is usually something tearing it could cause a problem. I mean you could try and lay off of it for a day or a week, and it depends on if it's associated with numbness or tingling or any kind of weakness. But yeah, a pop is usually worth getting X-rayed or you know get Sheena: Great. Noah T. Kaufman, MD: getting something figured out. Sheena: Hmm. that makes sense. The back. You hurt your back during a workout, but you don't have numbness or weakness. Do you stop exercising completely or do you keep going? Noah T. Kaufman, MD: You should stop. that's a good time to take Sheena: Okay. Noah T. Kaufman, MD: inventory anytime you get injured. Don't push through it. See where you're at the next day. It's easier to heal a simple injury over a day or two with some ice and ibuprofen than it is a more serious injury that you get from keep going. Sheena: Great. And then the walk off. what is one injury or symptom that you wish people would stop saying, I'll just walk it off? you're like, gosh, don't just walk it off? Noah T. Kaufman, MD: yeah. so that's a really good question. the big one that comes to mind is something that is more serious, like a chest pain or a severe sudden headache, it's not actually like a physical injury to walk off. anything that is like debilitating pain where you're seeing stars, if that doesn't start getting better almost immediately, after a couple of minutes, don't try and walk that off. Get seen. If it's lingering pain, you got a real problem. Sheena: Yeah, absolutely. Really good advice. And then last rapid fire, I ask every single person, what made you, Dr. Kaufman, sweat this week? It could be actual sweat, it could be from stress, it could be anything. Like Noah T. Kaufman, MD: I am getting married next week. And we thank Sheena: congratulations! Noah T. Kaufman, MD: you. So you can imagine putting together this wedding. We're way over budget. Things are crazy. I gotta take care of the clinic. Sheena: Yeah. Noah T. Kaufman, MD: my gosh. So yeah, just the whole thing has Sheena: Yeah. Noah T. Kaufman, MD: definitely made me sweat. The finances have made me sweat. Yeah. Sheena: Yes. Absolutely. Weddings are very high sweat inducing. wow. Well, congrats. That's amazing. and then Noah T. Kaufman, MD: Thank you. Sheena: if you could give everybody listening one piece of advice about exercise, nutrition, taking care of their bodies, something that you wish more people understood, what would it be? Noah T. Kaufman, MD: Have fun. you gotta find Sheena: Mm. Noah T. Kaufman, MD: what you love and have fun. That'll give you, the wherewithal to do it all the time. If it's not fun, if you're really pushing yourself, it's just more work. that's not gonna last more than six months, or you're gonna fall off the wagon with it. But if you love going on hikes in the mountain, or you love swimming in a mountain lake, or you love bowling. Go bowling three times a week. have fun with it. And don't obsess, the little things. Sheena: Yeah. amazing. And I feel like that's been pretty evident like throughout. it's just so important. Life is too short. Why not enjoy it while we're here, I love that advice. So how do people find you? Where do they find cough care? How do they get more information if they are interested in getting to you? Noah T. Kaufman, MD: Well, we're everywhere on socials at KoughCare and then our website is just KoughCare dot com and you can see all of our transparent pricing. You can book a consultation. we do peptide therapy for people who are overweight, we do all kinds of stuff, executive physicals, we obviously do all the urgent care stuff and all the ER stuff as well. So you can book an appointment or just walk in, see how busy we are on our website. Thanks. Thanks, Sheena. Yeah, thanks for asking. Sheena: Yeah, absolutely. Well, thank you so much. I so appreciate chatting with you and all the amazing advice that you gave us. you saw me in between patience, and I know you are so busy, so I'll let you get back to it. But appreciate you. Thank you. Noah T. Kaufman, MD: Thank you. You're a great interviewer. this was awesome and I hope it helps the community and I'm always here and I'm gonna recommend this podcast to literally everybody I know. Sheena: my gosh, you are incredible. Thank you so much. That means a lot. Noah T. Kaufman, MD: Thank you. Sheena: right. Thank you. Noah T. Kaufman, MD: Thank you, Sheena, and thank you everybody out there for tuning in. Sheena: thank you so much for joining me and sharing your perspective on movement, nutrition, injury recovery, and knowing when it's time to get checked out. I love your reminder to find movement you enjoy and have fun with it. And not get so caught up in doing everything perfectly. And if you are in the Denver area and want to learn more about cough care, we'll have information linked in the show notes. If you enjoyed this conversation, be sure to check out sweatcommunity.com So you can stay in the know about upcoming episodes, local events, and things wellness. As always, I want to know what made you sweat this week. Until next time, bye.