So I told Carl to do something a littlebit more like slow jazz and we're gonna try something else tomorrow maybe somepiano jazz today we're gonna be talking about the blood clotting conditioncondition the complication you know again as I mentioned yesterdayyou often hear some of the most interesting things from viewers andpatients and folks that are not in the medical area but just read a lot or theyhappen to run into a problem because of what's going on within somebody asked mea couple a couple of days ago about all this fighting and I thought they weretalking about DIC disseminated intravascular clotting it's part of whathappens with a lot of people in intensive care although I had heardabout the young actor the young Broadway actor that lost his leg due to someclotting we're gonna talk about that clotting yeah it's not crystal clear yetthat this is something different but I think it is so we're going to talk aboutthat today upcoming topics is it safe to eat takeout I hope sowe tried it last week for Janice's birthday coronavirus attacks the immunesystem like HIV and which states are doing enough COVID-19 testsCarl figured let Chris know I think we've got some updates on some of thetopics that he's got set up for us in the coming weeks I don't think it's anentirely that it correlates correct entirelycorrectly previous topics pulse oximetry and the silent infection that's killingus wanting to keep an eye on if you do get infected what's the most reliableindicator of going south are going bad and it may be our blood oxygen level JoeReilly suggested that there are folks that would say no you don't need to lookat that I think they may not be thinking throughthe whole process very well like specialists often do finding effectivetreatments for COVID-19 perennial interests area pregnant women andcoronavirus I just saw an article this morning about kids there is someinflammatory process serious inflammatory process being reported outof the UK for kids up until now we weren't seeing that much we plan to talkabout that a little bit more and my favorite topic recently is theconditions for anything locked down so there is a huge amount of debate growingin that area and a lot of folks are are saying that we're overreacting we needto just go ahead and let nature take its course just so you know I got ridiculed back atJohns Hopkins thirty years ago at the School of Public Health for being theguy that was most focused on the economy my perspective was that this thing thata rising tide raises all boats was very very true what that means in publichealth vernacular is it's the economy if you have a poor economy you're going tohave for public health if you have improving economy that will improve thepublic's health so I've been major focal focused on the economy much more so thanany of my peers in fact I've worked in the workplace area Toyota for a decadeKroger for helping set up access to careplaces where docs don't usually work because I believe that business driveshealth am I saying that we should all leave our houses not quite yetand I know again that's a very emotional topic a couple of quick items before weget started on the clotting discussion we've got a webinar if you if you're oneof those what let me see well there are 300 million people in theUS I don't remember how many of those heard maybe that's adults the CDC usedto think there are 80 million people with prediabetes 72 million don't knowabout it actually the the data would indicatethere's a lot more than that now also the facts the science would be very veryclear that these people are seeing doctors very well-qualified docs it'sjust what the docs are missing it if you'd like to find out a little bit moreabout whether you're one of those folks the majority then give us a call take alook we're setting it up we're setting this up where you don't have to breakyour relationship with your doctor please keep that but you can find outand confirm whether or not you have insulin resistance or prediabetes andof course we're available we still have slots available for care I'm getting forcare while you're locked up with COVID or locked up because of the COVIDpandemic I am getting much busier in terms of helping again large employersget folks back to work but we still do have slots if if you'rein need and speaking of webinars again thewebinars have been very popular it's a great way to get access to some types ofmedicine some things that I know and specialize in that your job your docjust does not know that much about for example CIMT plaque evaluation ofplaque again docs tend to think that most oftenthink well the way to find out if somebody has plaque is to do a stresstest a stress test is only going to tell you if you've got 50% occlusion or more2/3 of heart attacks occur with people less than 50% occlusion so again this isa great way to start finding out do I have plaque and maybe my doctordoesn't know it just like the other one do I have prediabetes and maybe mydoctor doesn't know it so quick update on the book again it'll be called stresswhat a stress test can't tell you it's between 5 and 8 million stress tests aredone each year in the US I think that the rate of those things has plummetedand personally I could not think of a better thing to happen for the health ofthe Americans the public the health of America know that you know what I'mtrying to what I'm trying to say we need to be doing less stress tests theyprovide a false sense of security at best we need to be looking at other waysof finding out whether we've got play and guess whatask your doctor this or Google Google this false positive false negative ratesof stress tests in the US the snippet will come up and tell you of the 8million stress tests being done we know that 1.
5 million are false results areyou feeling lucky ok so we're going to start with the blood clotting discussionright after the water ball Carl so as I said a viewer asked me aboutthese clots that were going on again I was thinking of the ICU class becausewith COVID-19 a lot of folks are ending up in ICU but one of the things they'refinding and it's mysterious is that blood clots are appearing in youngerpeople in fact significant blood clots even strokes so here let's go over acouple of points about it 38 percent of 184 COVID-19 patients in the ICU haveabnormal clots according to a Dutch study in Thrombosis on April 10th inChina more than 70% of the 183 patients who died of COVID-19 had small clotsjust riddled throughout their body the problem are well the problem we'rehaving is that we understand there's a clot yet we don't understand why that'sa quote from Louis Kaplan a University of Pennsylvania physician and head ofthe Society of Critical Care Medicine in autopsies instead of pneumonia anddamage to the air sacs they're just again these multiple tiny clotspermeating the tissue no one knows if it's a direct assault on blood vesselsor hyperactive inflammatory response again I think that's one of the keyquestions at this point blood clots in COVID-19 are differentfrom those with Ebola dengue Lhasa and other hemorrhagic fevers again theseknow I'll just go on to the next point some people's lungs fill with hundredsof micro-clots they break off and travel to the heart or brain and cause thestroke or heart attack I mean that's the definition of a stroke or heart attack aclot going to the brain or to the heart it raises the use of blood thinners foreveryone with COVID-19 even those at home to preventclots now even those at home I'm gonna clarify again these are just discussionsthat are going on with the any time you start having clotting problems there aremedicines for that warfarin and aspirin baby aspirin is a anti platelet that'snot exactly the same thing as an anticlotting mechanism but accomplishes alot of the same types of things and for those of us who know we have significantatrial fib like myself many of us are already on clotting mechanisms clottingdrugs NOACs novel oral anticoagulants Rivaroxaban (Xarelto) Eliquis one ofthe viewers commoners brought up that this is very these the NOACs are veryexpensive drugs there's no question about them I think when they came outthey're like 2, 000 a year for those of us who need to be on them or betweeninsurance companies for example at one time when I had been insured with anemployer had retired I went on with a a program that the the NOAC company theEliquis maker was making available for folks to make it less expensive butthat's pro that's purchasing those drugs let's go back to the actual informationabout this clotting because it's not that well understood yet again happeninga lot with very young people Thomas Jefferson University Hospitals found 12patients treated for large blood blockages in their brain in other wordslarge strokes 40% were under 50 years old and had few or no risk factors againwe keep saying this is a a disease that's killing baby boomer men it'smaybe what 2/3 men so there's a lot of women involvedguess what these people are some of these people are young have you seen thepictures of the actor the Broadway actor that lost his leg very young looked likehe was in his 30s and otherwise healthy young man that's what you're seeing here40% of these people are under 50 and no few to no risk factors so struck what forthose of us who are not that familiar with this channel or the issues what isa stroke it's a interruption of the blood supplyto the brain there a lot of things that can cause it usually when it happensit's due to what we call prediabetes insulin resistance a clot going into thebrain from inflammation of the cardiovascular system the arteries thatsupply the the the brain so our clot problems can cause that as wellthat's the reason that folks on atrial fibrillation take the novel oralanticoagulants many strokes often don't cause permanent damage but theydemonstrate that you've got that process going on and that you've got significantrisk a mini stroke should not be ignored and obviously bigger ones can becatastrophic they knock out huge portions of your brain COVID-19 patientsmostly experienced the deadliest type of stroke large vessel occlusions largeclots that knock out major chunks of the brain recent stroke patients with COVID-19are in their 30s and 40s now the median age for severe stroke outside ofCOVID-19 is 74 it's in the 70s this may be a direct direct consequence of bloodproblems that produces these mysterious clots all over the body the clotsusually appear in arteries but in COVID-19 they're seen also in veinswhich again significant difference from your typical cardiovascularinflammation prediabetic type of stroke and it makes it trickier totreat because again we don't understand those as well at this point some peoplesome patients are even developing more than one large clot so Carl you want toshow the the video we learned more each day about the coronavirus the symptomsare similar to pneumonia but we now know patients can lose their sense of tasteor smell and there are reports of patients with lesions on their feet orswollen toes here's our chief medical correspondent Dr.
Jon LaPook on anotherdangerous symptom blood clots so far the one predictable thing about the newcoronavirus is that it's unpredictable it first got our attention by damagingthe lungs but now doctors are finding it can wreak havoc throughout the body oneway is by causing blood clots for example in the legs and that adds insultto the injury already caused by the virus says cardiologist Dr.
SameenSharma of New York's Mount Sinai Hospital the abnormal clotting can bewidespread those clots can damage the kidneys leading to dialysis the braincausing confusion seizures or strokes and the heart causing an irregularrhythm or a heart attack and that's presenting doctors with a toughchallenge trying to figure out the different ways this virus can attack ourbodies and the various symptoms that can cause when we seem to be learning newthings about it every day growing very good thank you Carl we're gonna try towe've got a lot of people a lot of interests we're gonna try to get througha little bit earlier someone asked me if I would just take all of the thequestions from any day and continue to answer them on the on the YouTubecomment section I would love to do that here's the problem as I've shared withyou guys I'm spending a significant chunk of my day at this pointhelping large employers get their employees back into the workforce so I'mhaving to be a little bit more efficient with my timeright now so let's go back and take a look at some of these questions andanswers Bob Weis North Georgia Mountainsoximeter normally about 95 is that a problem95 is a good number fairly good number are you free of COVID virus well I thinkso I hope so Karen Black good morning more tech challenges oh it was such anightmare every time I mean it's not every timebut it seems like 2/3 of the time either the camera's not working or the computerdoesn't recognize the camera it's I hate technology good morning Dave how are youtoday I appreciate you joining us Robert Simpson hello there how are you BobWeiss North Georgia Mountains TrickyVickey good morning Doc critical-careRN here thank you for letting us know your background I'd appreciate itand if others when you make comments will let us know a little bit more aboutyour background we appreciate it I thought they're talking about DICtoo since again ICU nurse yeah that's what both of us would think since COVID-19affects the heat the heme on the red blood cells could it also be making themsticky hyper clogged well that's clearly a question and I think it's a veryinteresting question interesting theory Bob Weis if you if you hit if you startgoing below 94 unless you're somebody that routinely has it because of someother problems COPD and things like that if you're sick you're normally welldon't have any significant lung problems or breathing problems and if you getsick with a respiratory viral illness especially if you have evidence like apositive test that it's COVID-19 you hit 94 you need to be calling your BAand again I'm not a I'm not an expert in that area we may want let me do someresearch on that and and confirm that's the number that other folks aresuggesting Lori B I'm convinced I was insulin resistantI lost 41 pounds eating less carbs no sugar no more edema in the right ankleyou know what Lori B you are not alone over half of my patients come to me nowespecially folks because of this channel in what they've learned they they theycome to me and in most practices and when I first started seeing them theywould have been a mystery because they they come to us with significant plaquesignificant evidence of you know end evidence of insulin resistance but noobvious insulin resistance normal OGTT normal well let me clarifymost of my folks don't have a normal OGTT but much better results than youwould expect from the major problems that they have with their arteries andnow have become its yeah I know what to look for and it's because people havelost weight you lose 30 pounds like that and it saves your lifeit saves decades of healthy life and thank you so much Lori B for sharingthat most of the folks that are that are doing it by the way you're doing it insimilar ways first they're dropping their carbs then they're going tothey're closing that eating window and then they're losing that weight Bob Weisoximeter usually 95 again Lori B I'm convinced that okay and I thinkwe're having soon this thing jumped around Bob Weis most pulmonologists arehappy with 92% that's TrickyVickey from the ICU thank you Tricky for sharingthat happy with 92 percent or greater if you're sick but if your normal is 99percent you drop to 95 that could indicate a problem if your lungs arecompromised at 88% great comment thank you very much for the clarificationdepends on your normal and your baseline can't wait for your book youso much great information thank you very much Karen The Black Duke nuclear testsseemed somewhat reliable yes that's what your doc will tell you and again get thebook nuclear tests are by far they've taken over because their quotesensitivity and specificity are improved and they are dramatically improved overthe old non-nuclear aging stress but the you've got to go back and thinkabout the design of the test it's designed to show whether or not you'regetting appropriate oxygen because of appropriate blood flow in other wordsit's a flow study it is not a study for plaque and all of that is based on theassumption that you've got to have so much plaque that you're including flowbefore you'll get a heart attack two thirds of heart attacks occur in peoplethat don't have that much they don't have a collision that flow so thanks foryour comment about nuclear stress tests because it helps me makethat point maybe more emphatically that I what 80 to 90 95 percent of stresstests in America today are nuclear stress tests and they're still havingthat many false positive thoughts and negative results the bigger one is thefalse negative result so nuclear stress getting making sure that it's nuclear isnot going to help you out Lori B oxidative stressUda Wyma what's the purpose of this presentation you know what it itmight not I started to say something well I don't know how to answer thatquestion Lori B the endothelium are damaged because virus attaches to theACE2 receptors there are you meaning the intima the endothelium that may be a possibilityyou know this virus is attaching to a lot I think a lot more cells than justthe endothelium Nancy inCanada Canadian government just announced today thatcirculatory problems in the toes and fingers are new symptoms have COVID Idon't think they're new I think they are just now being recognized Karen Black Iwonder if the clots were there when the patients arrived at the hospital or ifthey formed when the patients were inactive immobile no I think there'ssomething you get a lot more inactivity that does not result in this there'ssomething unique going on with this virus that's causing some of thisproblem we just don't understand it yet mmm the I'm not sure why the system isdoing what it's doing but as you can tell I'm having a tech problem incovering the Q&A do you think it's too early to open the country you have totest the waters I don't think it's too early to start getting people back intothe economy into into work again that's what I'm spending getting close to halfmy time doing right now but you being you just people we talked about thisbefore I think it's a hit we passed the peak and getting folks back and wecovered both of those things it's similar to the question about past thepeak what do you mean by opening the country do you mean telling everybody togo act like to go out and act like we did six months ago I don't think that'sa good idea but are we able to start opening up theeconomy the workday yes depending on how you define it and what your what you'redoing Dave Murphy five bucks thanks again for all you do thank you Dave forall you've been doing you've helped us out many times and guys that's calledsuper chat Carl's got that up his up on the image here this top on theright you see where basically you go down to the chat area and if you'd liketo give us a donation for providing this information for free we'd certainly helpand we certainly appreciate it now here's the way the finances work yes I'ma I'm a physician I've done well but I'm well I'm supposed to be on retirement Iwas hundreds Ironmen again this is my third retirement I ended up gettingpulled back into things because of my interest in my background Icommitted to Janice that I'm not going to spend significant amounts of ourretirement money on this channel the purpose for this channel is to helpfolks recognize the major killer and disabler because the major killers anddisablers of viewers of this channel as well as you know everybody thirty yearsand older not only well in the country for sure but in most of the world isbecoming chronic diseases high blood pressure prediabetes heart diseasestroke and most people don't understand the major cost for it by far the majorcause as in over 80% is prediabetes unrecognized prediabetes I've mentionedit a couple of times already and it's because docs really are not geared intolooking at the the lower levels of it and those lower levels are what'scausing the majority of the damage thank you again Dave I appreciate it andagain any any little bit helps folks in terms of moving this channel forward andgetting that information out Lori B thank you for your response Doc JerryWest I'm in my 70s good to see you Jerry PO2 is usually 98 will increased to 99with deep breathing the number will drop to the mid 90s when you sleep yes infact you bring up a good point Jerry foryears I have heard about you know this yoga and meditation and hearing slowyour breathing down and slowing breathing down never really helped me Ithought it was just a little bit of slowing down until I did a thing calledI worked with a tool called a car box imager what is that car box carbondioxide it's a I've got a video on it it was like three years ago and it's buriedand good luck if you if you're looking if you try to look for it and find it Idon't think I could even find it maybe but here's what happens when you slowyour breathing down as in like half your other rate what you find is that yourbody will calm down there's no question about that so theythese it gets under that old analogy of or that old saying if I knew he saidthis but I didn't know it meant that yes just slowing your breathing down just alittle bit it's not something that you're going to notice but in themeditation area if you slow it down dramatically your your PO2 will drop alittle bit but what also happens is your CO2 your carbon dioxide willincrease and get back up where it needs to be as in the 40s usually when we getexcited our carbon dioxide drops significantly below 40 and that squeezesoff the arteries to the brain it makes us even more excited and less able tothink so try that and Barbara McIntosh up hit I haveMTHFR red blood cells are larger than normal is this more of aproblem for COVID-19 it's a great questionwe don't know I there is I mean you hear ZDogg and some of these other folkstalk about MTHFR and say well it's not a significant issue well you know what ifyou're seeing a patient for a week in the ICUthat's correct it's not a significant issue but if you're seeing a patient fordecades and helping the patient but if your time frame is like mine decade'sworth of life MTHFR makes a big big difference we actually have a couple ofthings that we provide we're gonna be doing a lot of interest in this spaceI've made some some changes and some improvements in what we provide weactually have a supplement now that we provide for MTHFR I have MTHFR over halfof us have MTHFR for those of you that do and don't want to get involvedin checking out our channel or our activities you can just get it on Amazonsomething like that's the B complex vitamins methylated B complex vitaminsif you have MTHFR problems thank you Barbara for sharing that topic At Roblast scare with clot in 2015 D dimmer was ten times normal on the blood workfound no clot after numerous tests did the D dimmer do its job it's a it's agreat question Rob Doug I was listening to DougThompson's presentation to his dental Wellness Dental Network last night wewere talking about D dimmer and again it's a great it's a great questionGianluigi hi Doc good day from Milan good day to youthank you so much for introducing yourself I'm also on baby aspirin once aday after an event myocardial infarction heart attack in 2016what's your opinion on using the lumbrokinase supplement instead of a babyaspirin lumbrokinase Gianluigi I haven't heard of heard about a lot aboutstreptokinase nattokinase if it's related to one of those yes the theoryis good the those two kinase is whether lumbrokinaseor not is is part of that we I'm not sure it will have to clarify for mebut nattokinase syrup at the Sarabeth base they are things that break downproteins so the theory is that they're going to break down the protein of Xwatch the problem is if you start looking at the clinical trials on itthey're not convincing at all and I suspect that it may be a problem ongetting the getting it past the stomach acidnow when I say well you know it's like you got to have skin as thick as awallet elephant or something to to do this stuff on YouTube people say Doc youidiot you don't know that that you take enteric-coated streptokinase nattokinase and I may be an idiot but I already know that it's nattokinase Ihaven't seen nattokinase that was not enteric coated maybe there's someavailable but here's the thing it's still and have you ever really those ofyou that are making that comment have you ever really looked at theeffectiveness of enteric coating it's not so goodso as you're on lumbrokinase maybe that was helpful maybe not I I appreciateyour interest Michele Curlee I've just read it's justas important for COPD to clear co2 and if CO2 gets too high is it bad too yeahyou'll you'll see people with COPD chronic obstructive pulmonary diseasechronic lung disease and those these folks will start getting used to theirbrain will start getting used to higher and higher levels of CO2 now this wholeCO2 issue is something we discussed at length yesterday if you are notavailable because we're talking about this problem on pulse ox where youroxygen is dropping significantly but you don't notice it because you're losingyour ability to to oxygenate but you haven't lost yourability to blow off the CO2 and so people that are waiting to go on aventilator or sitting in the ICU looking at their cell phone just weird that'swith COVID-19 Gaby Hernandez who is a candidate for anticoagulant meds clearlyI think this is sort of like the issue with prediabetes most people withprediabetes don't know it most people with paroxysmal atrial fibrillationdon't know it either and most people that have paroxysmal atrial fibrillation should be on these anticoagulants paroxysmal just means that it comes andgoes that we used to think that most strokes were cryptic he couldn't findout the reason for him and then as we started discovering this linkage toparoxysmal atrial fib we started finding more and more and more of the strokesthat we didn't know the origin for were actually due to atrial fibrillation andaspirin doesn't work for atrial fib it's a different type of mechanism Micheleeasy for me to say sickle-cell anemia a question question mark I don't reallyknow if there's an association but sickle cell it's an interesting pointDavid Ivers good morning Barb MacIntosh are you from Westchester Old Geezer 47love the name I think this is really all about underlying health problems thennot COVID-19 thank you I think you were rightI did a thank you for bringing it up I did a video clip and I showed the image acouple of times I showed the US and the map for heart attack the map for strokeand then the map for COVID-19 and my point was you know whatthe COVID-19 is something similar to heart attack and stroke and that it'skilling the same people though for the most part the guys that we talked abouttoday young people without any of this prediabetesthat's a mystery but that's not the majority of folks that are dying fromCOVID-19 the majority of folks that are dying from COVID-19 are folks that are atmuch higher risk for heart attack much higher risk for stroke in work becauseof underlying health problems and here's the here's the kicker on that Geezer 47the vast majority of that's preventable that's the purpose of this channelBarbara McIntosh no Georgia Ama Zon I measured my oxygen with free Android appIcare health it also measures blood pressure and right folks it's been agreat morning I appreciate the comments I appreciate the interest and as Imentioned I'm trying to to be a little bit more efficient to spend a little bitmore time helping folks get back to work so thank you.
