04-15-24 Dr. Villarreal with Dr. Binnie Desai- Heart Disease in Women

Episode Transcript

(00:00):
Mix one O six' five.Good morning, It's Christina Wolford. Welcome
to Lady Parts with doctor Richard Villarrealof Adina Women's Health and today doctor villa
Real, We've got a very specialguest, like we do each and every
month, so let's introduce her.Oh absolutely well, good morning to you.
We'll get started. Thank you.So today, Yeah, this is
a great one. I've got doctorBenny Desaill. She is one of our

(00:22):
cardiologists and she specializes women cardiology.She did her medical school in Chicago at
the Chicago Medical School. She didher internal medicine residency at the University of
Illinois and Chicago. She did herfellowship in cardiology at the University of Vermont
and she's now been with us ataDNA for six months or so. Fortunate
to have her, so welcome,Thank you so much for having me here.

(00:44):
Absolutely so today this show, Iusually is for the women, and
what the goal of today. We'retalking about cardiology. We're talking about heart
disease and women. And what Iwant the women to understand is the risk
factors. You know, I wastelling Doctor Decide when I walked in,
I said, you know, Isaw patients today and two ladies that I

(01:06):
had seen a year or two ago, both of them, you know,
in their fifties, that had heartattacks, and they were telling me how
their symptoms were a typical. Sothat just more or less stressed to me
the importance. I said, weneed to get the word out to these
women to understand that they're just asmuch at risk, or if not more
risk than some of the men forsome of their symptoms just because their symptoms
go, they're not known, andpeople blow off their symptoms because they're so

(01:30):
atypical. So let's start with you. Let's talk about you a little bit,
and then we're going to get intoall this. So you went in
the internal medicine. Why did youchoose cardiology? So it's a long story.
I was born and raised in India. My brother, my younger brother,
had a congenital heart disease and welost him to that. Because I
was raised in a small town wherethe access to medical care was very limited,

(01:53):
So that kind of inspired me togo into medicine. And the fact
that my brother had like heart disease, I was like five then, so
it kind of just drew me tothat field. Wow, that's perfect.
I'm so glad, I'm going tojump into how's your brother now? Oh
he passed away. Yeah, likeAvenue was four months old, so like
really yeah, he had like somesort of hole in his heart, but

(02:15):
like we could like never diagnose likewhat it was. Yeah. Well yeah,
this was like a long time ago, like in nineteen nineties and especially
like in small towns in India,it was like it wasn't like this devilop.
Yeah you didn't have that care wellthen, yeah, that must have
made such an impression on you asa child and then inspired you to do
that so become a cardiology. Yeah, it's so unfortunate for your brother,
but that is great that he inspiredyou to do this and now you're helping

(02:36):
other people. That's amazing. That'swonderful. Well, good for you so
well, and that's a long journeyin cardiology, so it's a rough fellowship
and good for your congratulations to you, and we're so fortunate to have you
here. So well, here's whatwe want to do today. So you've
got a great background, you havea desire to be a cardiologist. You
to have the desire to help people. So what we want to do today

(02:59):
is talk about women. So let'stalk about women in heart disease. So,
as we all know, right,cardiovascular disease is the number one leading
cause of death in the United States, like sixty million page Like females in
US have some sort of heart disease, but like studies have shown that only
about like fifty percent of patients,like female patients are aware that they are
at increased risk of heart disease.So typically, there are like many things

(03:23):
that they can do to prevent theirrisk of heart disease, like having like
routine screenings, proper education, makinglifestyle changes, but they need to know
fast that they are at risk andare having symptoms to like adapt to like
different lifestyle. Right, So whatare some of the risk factors for these
women? So, some of therisk factors are like normal risk factors that

(03:44):
even men can have, like highblood pressure, diabetes, high cholesterol,
having a strong family history of prematurecoronariatter disease like having their parents like first
degree relatives passing away at a youngage from any kind of heart disease,
and especially for like female patients,if they have had any like pregnancy related
complications such as pre ecclempsia or gestationaldiabetes or even like perrypartum cardiomopathy. All

(04:09):
of that are respectors. And manystudies have shown that if patients female patients
have pregnancy related complications, then theyare at like two to four fold increased
risk of having heart disease like lateron, like even ten years after like
delivering their baby. So that caninclude having high blood pressure, like having
heart attack, having heart failure withlike normal pumping function, and like reduction

(04:32):
in the pumping function of their heart, and also like stroke. Okay,
so wow, you covered a lotof territory there, so let's start with
Okay, let's start with my area. Let's start with the obstetrics. So
you brought that up, and thatis very significant because the problem that we
see is a lot of these womenare younger and they have issues, and

(04:53):
nobody really mentions to them saying,you know what, this is something you
need to talk to your primary carephysician about because down the road you have
an increased risk of having heart attackand strokes. So you brought up preeclampsia,
you brought up to stational diabetes,you brought up well eclamsy, got
placental abruption, just any of thehypertensive disorders going along with pregnancy, and
also growth restriction is another one,so if you have a baby that's very

(05:15):
small, that puts you at anincreased risk also, So these are huge
risk factors for later in life forthese women. So what would you tell
these women that you know right noware having babies that are having these issues.
And I can tell you there's asignificant number of them right now.
The number of people that we're seeingwith hypertension, with diabetes, with obesity
that are having issues with heart diseaseor heart hypertension and even small, small

(05:40):
babies is significant. It's a hugeportion of our practice right now. So
what would you want these ladies toknow? So I think it's very important
because it's very important for them torealize that having any kind of pregnancy related
complication is a risk factor for heartdisease. And normally, like if they
are not aware, they don't knowthat they need to be referred to cardiology.

(06:01):
So FoST step is to talk toyour primary care doctor, because that's
that primary care doctor is like FoSTline, right, so patients see them
first before usually get referred to likespecialists. So I would say, talk
to your primary care doctor mentioned tothem that you have any kind of like
any pregnancy related complications mentioned to them, so then they can screen you for
like diabetes, high cholesterols, evaluateyour like risk factors like family, having

(06:27):
family history, all of that kindof place, and then helps us like
be more aggressive at like studying onmedications if you have like high cholesterol at
a young even if you are ata younger age, so that we can
limit your risk of having future heartdisease. So we don't want to wait
until they're starting to have issues.Ye want to catch them early. Yeah,
we don't want to wait till havethey have symptoms. Okay. So

(06:48):
the issue is a lot of times, you know, we see these women
and then they go on and Idon't see them back, or I'll see
just for their annuals. They're comingin and just having their their pastngers and
mammograms and all that stuff. We'retalking, we're talking about the babies and
all that stuff, and we reallydon't get to the point of talking about,
well, you have this, sothat puts you an increase risk down
the road. So I think that'sa part of this show is that we

(07:09):
want the women to understand you haveto take care of yourself. You know,
you have to be the one tosay I had these issues, I
had these issues, and so peopleyou know that, my physicians need to
know this so they can get meto the right people as I get older.
So that's why you know, youknow, having doctor Desai here to
say, you know what, youneed to come see me exactly. Yeah,
it's so important and so not justwhen you're in your fifties and sixties,

(07:30):
so we want you there. Youknow, if you have your babies
in your twenties and your thirties andyou've had issues, then even in your
thirties forties, you know, youneed to be seeing somebody and get all
your risk factors down. So that'sgreat to know, and I hope everybody
pays attention to that and gets intotheir primary care doctors for that. So
okay, that's number one that wewanted to talk about because I was like,
okay, we'll take knock mine off. And you mentioned the cardiovascular disease

(07:53):
being the number one killer. Youknow, it's a huge problem for women,
and so let's talk about that fora little bit. How can we
mediate this, how can we helpthese women? So what are some things
that we can do. Let's startwith things. Let's talk about diets and
drinks and things. What are goodfor them, what are not good for

(08:13):
them? Because when you see peopleout there with their monster drinks or my
diet, look guilty. Guilty.So I think like all of us are
so busy in our life that wedon't take time out for ourselves, especially
like women, because they're busically takingcare of their family. Right, So
physical inactivity is one of the biggestrisk factors. So just taking time out

(08:35):
of your daily schedule, like justwalking or doing any kind of like aerobic
exercises, brisk walking for like thirtyminutes a day, five times a week,
kind of helps improve your heart health. Then the other thing that we
can do is stress has also shownto increase your risk of having heart disease,
just because like when you're exposed tolong term stress, your body releases
cortisol, which is in hormone thatkind of increases like your blood pressure,

(09:00):
also increases your cholesterol levels, whichare intern risk factors. So working towards
reducing your stress, like doing anythingthat you like, like meditation, breathing
exercises, yoga, reading, anythingbe like that helps you relieve your stress
is important. Then the third thingis like diet, And like I don't
recommend my patients to like go followlike Mediterranean diet or any kind of like

(09:22):
strict diet, because you need tofollow a diet where which you can sustain
for the rest of your life,right like that. Yeah, so if
you do aggressive diet, then you'rejust gonna fall for like a month or
two months, and then you're gonnaget tired of it and go back to
your normal like normal common see right, yeah, of course. Yeah,
So I just say, like startlike start cutting down on your portion sizes.

(09:45):
Include more fruits and veggies, eatlike more grains, try and eat
food that is high in protein.Cut down on your fatty foods unsaturated fats,
and then like do one thing atthe time so that way, like
overall you can adapt to a dietthat you like, and then you can
also sustain. And it's not wrongto like have like few cheap meals,
but that should not be your everydaything, right I like that. So

(10:07):
you know, i'd heard that.You know, when we talk to women,
I usually talk to them, Isay, you know, if you're
trying to lose weight, we tryto talk about your portions. I usually
tell the women, I say,you shouldn't really have a portion bigger than
the palm of your hand. SoI don't know if that's a good rule
to follow. Yeah, I thinkit's a good rule. Yeah, but
you know, as long as youcut down and say, okay, as
long as your stomach is not toofull. That's what I tell my patience

(10:30):
that like, keep your stomach alittle empty, Like you should always be
a little hungry after you have hadyour meals. So that's how you know
that you're not eating too much.Op. Yeah, I don't think I
follow them, so I need todo a little bit hungry. Okay,
good advice, but yeah, butI think those are all good things.
So you really don't. You know, all these diets are out there,

(10:52):
that's truthful. They're all fad diets. We all start, you know.
I've seen people do it, andyou do it, and I even tried
it, and you can't keep themup tired of Yeah. Yeah, So
for this, for your heart,for things like that, you need to
find something like she's saying that youcan keep doing something that you can sustain.
That's important. Yeah, So Ilike that idea. So what about
let's talk about like coffee and teaand these uh monster drinks and mountain dews,

(11:16):
and you know, are they goodfor you? They bad for you?
Or is it moderation or I thinkit's not good for you. Right,
it has not shown to improve yourheart health, but people like it
just for the taste. Right.So if I go say, like to
my patient, stop completely, they'renot going to follow my advice. So
I say, like, drink everythingin moderation. Like, if you have

(11:39):
heart disease, then you have tobe a little stricter. Right, If
you have high blood pressure, thenwe have to limit on your salt in
take. If you have heart failure, then we have to limit your salt
intake and fluid intag. But ifyou if you're if you don't have significant
risk factors, then drinking like onecup of coffee a day, limiting the
amount, like having soda like oncea week or like a few times a
week like in moderation is okay.Okay, So but these monster drinks and

(12:03):
things like that are probably pretty bad. Yeah, yeah, exactly. The
caffeine, yeah, caffeine, yeah, sugars, all of that is bad
for you. So they're going toget me. What I hate is I
hate when I see these young peopledrinking these just chugging them, you know,
And it has an impact on youngpeople. I think a lot of
people have that Well I'm only youknow, I'm fifteen, I'm sixteen,

(12:24):
I'm eighteen, i'm twenty one,whatever, I'm going to live forever,
you know, and it does.We've seen those tragic stories where, you
know, a lot of times theyoung people we have patience, like thirty
year olds coming up with like havingheart attacks. So yeah, so we
don't realize that, like the dietthat we take in is very important.
It plays a huge role, likemore so than like even like having a

(12:45):
strong family history, Like all ofthose are like modifiable risk factors. So
like like making sure you're eating healthyis very important. Well and even you
know, for the moms, ifyou're watching your children, don't let them
drink these monster drinks. It's like, you know, because my wife's pedutrition
also, it was telling you said, you know, they can go into
a fib you know, all kindsof issues with their heart and cause hypertension
prematurely in these children. Yeah,yeah, you don't want to give them

(13:09):
these issues, right, so youknow, even for the kids, these
are bad. But now let's talkabout when you say limiting salt intake,
But what does that mean? Sothat what I mean by that is if
you're adding salt on top of yourfood, then don't do that. And
most of like meals, pre cookedmeals that you get out in grocery stores

(13:31):
are pretty high and like because it'spreservady right, so it's pretty high in
salt intake. So I normally tellmy patients to avoid that, especially like
if you have high blood pressure orany kind of like heart failure other heart
issues. There's the sodium from thesalt. Sodium in all of those pre
there are many hidden things that gointo that label that no one really pays

(13:52):
attention to. So you don't realizethat there is a lot of salt in
all these meals and you consume that, which is are that good because it
increases your blood pressure? So thenon top of that, you don't want
to add salt yep, exactly,So if you're doing any of those type
of meals, you really got tosay no, no. That's one thing
I'm guilty of and I and Itry to think of that a lot of
times, you know, I'll orderat a restaurant or something to come out,

(14:13):
I just grabbed the salt shaker,you know, if I have mashed
potatoes before I even taste it,and I hear the people in the background
saying, you haven't even taste it, you don't even know if it needs
salt. It's I think, Idon't know. I know this is an
excuse, but it's it's how Iwas raised. You know. We're in
the country, and I think thatwas just a thing, you an appellation
thing. You just grab the saltand you put on it, and it's
so it's it's it's kind of trainingyourself not to and there's times that I

(14:37):
don't need the salt, you know, and they've got so many other seasonings
and flavorings right now that you areso much better anyway, Yeah, so
many different ways. Ye that,but that's something I continue to struggle with.
I know, I add to much, so much important to do it
now before you have problems, right, So it's you know, and I
think that's where the things we're justtrying to set out the warnings so you

(14:58):
know, take care of yourself,take care of your family. And it's
just not for the moms. Hereusfor the moms, the grandmothers, and
if you're taking care husbands, youknow, you and other people that are
in your family, Yeah, particularlyand your kids. Yeah, because you
know, the childhood obesity and otherissues going along with that, the hyphpertension
and everything else that's going along,and this next generation may be in trouble.
So if we don't take care ofthem, they're the ones that are

(15:20):
really going to have issues with theirhearts. So we've got to be very,
very careful. So we've hit alot of things. So let's talk
about some of the signs. Whatshould people? What should these women in
particular, since these are the onesthat we really care about right now because
they take care of the family.I always talk about how the women are
the ones that run the household.They take care of everything. I like,

(15:41):
if my wife wasn't around, myhouse would fall apart, my kids
would fall apart, everything would justgo to heck. And so we got
to make sure that these moms andthese grandmothers who are running these families,
who are the heads, you know, like the matriarchs, really are taking
care of themselves and are paying attentionto their bodies so that they can stick
around for these and their grandkids.So what are some of the signs or

(16:02):
some of the things that they reallyneed to be paying attention to. So
typical warning signs of heart attack inwomen and even like as a general rule,
like if you have chest pain likesit on onset associated with like chop
pain, radiation down your arm,feeling super sweaty, like feeling tired and
winded, that concerns for having ablockage in your heart artery. So that's
when you should seek immediate care.But like, like female patients can have

(16:26):
atypical symptoms and they don't realize itfor a long time before they need to
see a heart doctor or talk toa physician about that. Those symptoms can
just be like noticing a reduction inyour functional status. So if you're doing
things over time, if you realizeit, I only do so much and
I become vinded or I start feelinglike chess heaving as pressure, So that
would be another thing that worries usfor having a possible blockage in your heart

(16:49):
auteries. The other thing is ifyou have like significant like high like family
history of having someone dying suddenly atan earlier age. And if you're having
like atypical symptoms just feeling like superfatigue, having some shortness of bride when
you're doing like minimal activity, thatis also like a warning sign that you

(17:10):
should talk to someone for further evaluationof heart disease. So, like I
mentioned at the beginning of the show, I said, one of the patients
I saw today she had was refluxed. Yeah. Wow, and that was
her only symptom. Yeah, andshe had a heart attack. She had
a massive heart attack thing though shehad a stance and everything. Yeah,
you can also feel like indigestion,just feeling like winded all and then having

(17:34):
like upper back ache, which noone can think about having like heart attack,
right, So those would be likesome of the other atypical symptoms.
I think one thing too, withthe women maybe are hesitant sometimes to report
those symptoms because, like you said, they're the one that's strong. You
know, It's like, I don'twant to be a baby. I'm just
got indigestion and take care of everybody. But the problem is they let it
go and then you know, andthe other issue is I think you know,

(17:57):
as physicians, you know other thanif this is what you do,
but you don't pay as much attentionif they come in with you know,
I have reflux or I have this. Yes, the doctors don't think in
the ers org cares first thing.They don't think about a heart attack or
something like that in women because theysay, oh, you're just men apausal,
or you're just having this, orit's just that exactly. You know,

(18:18):
you're overweight, so now you haveall this lower exterm swelling, you
know, and so there's a lotof issues. But I think the women
themselves need to be cognizant that,yes, you're at risk, this can
happen to you, and you needto make sure that you see somebody.
Do they encourage these women to beon baby aspirin for example, you know,

(18:40):
so it depends on your respectors.I don't typically put patients, all
of my patients on baby aspirin.If they have like obviously, if they
have had like a prior history oflike prior like cardiovascular disease, then I
do put them on a sprain.But otherwise, like I look at their
family history, like do they havea strong family history, do they have
like reskpectors like high blood pressure,diabetes, what is there like risk of

(19:00):
getting like future heart disease, andthen taking all of that into consideration,
that's when I put them on babyas briend. Oh see, okay,
so it's just not a quick fix. No, not a quick fix.
So that that's the importance of seeingyour physicians and getting into the cardiologis.
So okay, So what are someof the things that we're going to do.

(19:22):
Somebody comes into you, Okay,the primarcure doctor sends somebody and they
think, you know, they're anincreased risk, and so what are you
going to do? So typically,like we do some of the screening tests,
right, So what so starting withblood work, so checking your cholesterol
levels, see what the numbers are. Then also like making sure your blood
pressure is at goal, like screeningyou for diabetes, So that is step

(19:45):
one. And then based on thesymptoms you tell me, So I look
at your cholesterol levels, right,and then if they're based on the numbers,
we can see like do you needcholesterol medication for primary prevention meaning preventing
you from having your first heart attackor stroke versus secondary prevention meaning if you
have already had like heart disease orany kind of like blockage in your heart

(20:07):
art race. Those patients are alreadyon cholesterol medication, so management is kind
of different for them. But someonecoming and seeing me for the first time
without any kind of like heart disease, that's when we like take a look
at like look at calculate their riskof having future heart disease, and then
based on that, we put themon cholesterol medication. So is there any
difference in the coluster of the screeningnumbers between a woman and a man as

(20:30):
far as where you want them?Because I mean, I know they're the
difference in that you have the ELDERA, you have the good cluster, you
have the bad clusterol, then youhave the total closterol. So you know,
my wife always brags to me thatare HDL is so high and I'm
like, well, that's not fairbecause you're a woman. Yeah, you
know, so how does that comein. I don't specifically just look at
one number. So normally, ifyou don't have any like kind of like

(20:51):
prior heart disease, then I justfollow the guidelines, Like having LDL is
a bad cholesterol. Having it lessthan one hundred is your goal. If
you tell me that you have asignificantly strong family history of like someone dying
suddenly at a young age, andhave like multiple other respectors, then we
can go a little more aggressive tobring your cholesterol number less than seventy,

(21:11):
like the bad cholesterol. So that'sfor like patients for primary prevention, like
if they have never had like anykind of like cordiac or any kind of
like stroke or other events. Sojust don't look at one number, and
you just don't have to be overweightto have these issues, right, yeah,
correct, it can be like superlike like normal weight. Yeah,
normal patients still have bad numbers.Yeah, okay, so a total cholesterol

(21:34):
of what is a good one?A total cholesterol less than two hundred lesson,
So that's what we aim for,YEP is less than two hundred,
and you want your LDL less thanone hundred normally and then tri closter rides
normally less than one fifty. Okay, so I don't think mine are there.
So how's that normally controlled by medication? So fast step is lifestyle changes,

(21:59):
So like exercising, like I said, like thirty minutes for five days,
making sure sweat and yeah, yeah, your heart rate, like things
that increase your heart rate and thenmaking changes to your diet like cutting down
on like fatty food eating and moderation. So we usually give I usually give
them like three months to see likeand make sure that they're following like life

(22:19):
strategy and chating yeah, and notcheating, and then and then recheck cholesterol
levels then and then see if they'rereally high. Then we have a conversation
again about starting cholesterol medications. Okay, And then there's different cholesterol medications because
I try them, yeah, andsometimes you get because I couldn't even get
my muscles hurts so bad. Yeah, on zocors and things like that.

(22:40):
I really had a rough time withthem. So I had to go to
like every third day because yeah,so they're hard. Sometimes there heart takes.
So are there other things that canbe done other than these medications?
So again, like I usually justdo. There are medications, right,
So if someone doesn't tolerate statins,which is like normally like fast line to
reduce your cholesterol, they are likeneuer medica as that to my like some

(23:02):
so that is also that that typicallydoesn't have like side effects of body ex
and muscle eggs, so it doesn'timprove your cholesterol to the same extent ast
and but it's still useful if you'reunable to toilerate any medications. Okay,
so there's there is help out there. And then lifestyle and exercise. I
emphasize on it a lot. Everybody. Yeah, everybody needs that. Well,
it seems like that that seems tobe the medication prescribed for tons of

(23:26):
ailments is your diet. And youknow, and part of the problem,
most of the people tell me,you know, and the women in particular,
say, I am so busy.You know, it's from as soon
as I wake up to bed,I'm with the kids, I'm the family,
running here, running there, goingto the grocery, shopping, cooking,
cleaning, and most of them havejobs and doing that in between.
And it's like, where do youfind the time to exercise and you're a

(23:49):
busy person, Yeah, what doyou say? I would say, you
don't have to take thirty minutes ina day at the same time, right,
So you could take ten minutes threetimes oday that that can be easy
to do, right, Like,So if you're like, if you're at
a job, instead of taking alivator, you can take some stairs. So
that's some Kodiak exercise. Then ifyou're parking somewhere, like park a little

(24:11):
further so you can walk to work, like specially in summer. So finding
out things that you could do differentlyso that you can save time and at
the same time, like take alittle bit time out of your schedule to
exercise, and it's important. Itcan save your life. I think a
lot of people think, oh,well, I've got to go join a
gym. But like you said,there's it's hard to take time like it
is y it is, but whenthere's just things in your everyday life like

(24:33):
that, literally five or ten minuteshere and there a few times during the
day adds up. Yeah, andit's much easier and easier to do and
cheaper, you know. And peopledo have things. A lot of people
have a lot of my pictures.I talked and they say, well,
my husband bought me a treadmill,but now right now my clothes are hanging
on it, and so they said, I don't have time to use it.
I said, well, you knowwhat all you need to do is
just get up a few minutes earlierin the morning. Yeah, get up,

(24:53):
I you know, and my wifedid the same thing. We got
one of the pelotons so it sittingin my bedroom and that's the first thing
you see in the morning. It'shorrible because then you feel guilty. Yes,
And then she started doing it.She gets up every morning and she
writes. So I'm like, okay, fine, I'll come home and do
it. But you know, youdo you feel guilt if you don't see

(25:14):
it? Yeah, Or you don'thave something that you can do or say,
you know what, I'm going togo or you you can get your
spouse to go with you, oryour kids to go with you. Yeah,
you get somebody to go with youand talk, or put some music
on or something and just go tenminutes, do your couple favorite songs and
go do it. You know.So there's so many ways that we can
do this to protect you. SoI think those are a lot of good

(25:36):
examples of things that you can do. So what are some of the other
other risk factors that we need totake? Is there anything else that we
need to take consideration? First ofall, I think all of those that
I've mentioned so far. Yeah,So then what about things that they can
do? Are there any Is thereany other things that you can think of
alleviating in their lifestyle or we talkedabout weight, So let's talk about somebody

(25:57):
who you can have issues when you'rejust your normal, you know, normal
size, But what about when youare very heavy? Would you suggest it?
Because it is difficult for these womenand men to get out in exercise.
Yeah, yeah, So I don'tsay, like, if they have
never exercised, right, then theycannot probably walk thirty minutes a day,
right, So then I just saygo out and walk for five minutes,

(26:19):
then slowly, if you toilet walkingfor five minutes, increase it to ten
minutes and fifteen minutes. And that'show you're building up. So don't go
out and start doing things that youhave never done before. Start slowly so
that way your body can get usedto it, and then you can increase
the amount of time you exercise.That makes sense. So you want them
to be safe, so start slowly. You never do it. If you

(26:41):
have any symptoms and you stop andlet us know, then yes, then
you call immediately. Yep. Soany things that like you'd mentioned the chin,
I think, chest pressures, shotas a bread, feeling really tired
with activity, all of those wouldbe warm. And then other things you
know, like you mentioned too.If you have the increased swallowing of your
lower extremities. If you have otherissues or all could be carted. Yeah,
it could be cardiac. Yeah,so you need to make sure and
if you're not one that gets intoyour primary care physician and see them on

(27:03):
a regular basis, you should dothat because we have wonderful cardiologists that we
can get you in now. SoI think it's fabulous. So we only
have a few minutes left, butI want to you know, I think
this has been great. I thinkthere are so many things that we've talked
about, so many issues. Ireally hope that women were paying attention and
the men, whether you're a motheror your grandmother again, because you know,

(27:23):
we talk about it every time I'mon the show. I talk about
you are the ones that take careof your families. You have to make
sure you're okay. We've got tomake sure to extend your life so that
you can be there for your children, for your grandchildren, and whoever else
needs you. So please please pleasetake care of yourself. Listen, you

(27:44):
know to what doctor Decia is talkingabout today. Take care of yourself,
any of the stuff that you need. We've got wonderful providers that can take
care of you, that will gladlyhelp you and make sure that you do
well. Is there anything else youknow? You talked about relieving stress,
you talked about anxiety, things likethat. Is there anything else that we
want to cover today or anything elsethat you would like to say to these

(28:04):
women. I would just say,like, if you're concerned about your health,
if you notice anything new, likein terms of like breathing issues,
fatigue, any new symptoms, thenplease let us know, like we are
all here to help you. Likeyou can see your primary care doctor if
they're worried, they can refer youto cardiology and we can take good care
of you. Yeah, and thendoctor decide you are located at Adina Hospital

(28:29):
the hospital and to get into you, we can go through Adena Cardiology exactly
the appointment or talk to your primarycare physician. You heard doctor Desai on
the radio and she's a lovely personand I think you loved you know,
she loved the sereal She's got agreat personality. So I think it's wonderful.
Thank you so much for having mehere, So thank you for being
here again. If anybody has anyissues, and you can get on website

(28:51):
for Adena and they'll be glad tohelp you. Or Adena Cardiology Rightadina dot
org. Everything you can find outthere. That is the greatest website I
think. You know, you cankind of shop around for your primary care
physician. I had to do thistwice because my doctors you know, kind
of switched and did some other things. But it's so easy to go on
there. You have their pictures,you have their bios. You know,
there's really no excuse to not getyour primary care position. And like you

(29:12):
said that that's the key to itbecause that's where everything starts. It's where
the testing starts. It's where youcan have these discussions with them and they
can you know, find those riskfactors and things that could literally save your
life. So it's so easy ifyou don't have a primary care physician to
do that, or you can callthe Adina number and just tell them,
hey, I need a primary carephysician, and within like two minutes you're

(29:32):
set up, you know, withyour first appointment with somebody. So so
definitely get in in there and dothat, get your testing done. And
I'm finding the older I get,you know, the more I need to
do that. But it is Iknow when you're younger. Like we talked
about you, nothing happen to you, right, but it can happen at
any age. So it's in parbsolutelynot let go off your symptoms. Absolutely,
So that's the same people with thesethings or your your kids or your

(29:56):
you know, anybody, get themseen. Yeah, yeah, right,
like you say, doctor Villarreal,that's women. We have to take care
of the families, but we can'tdo that. We don't take care of
ourselves. Correct, that's what youalways say that we need to stress that.
So get in there take care ofyourselves, all right. So again,
thank you so much, doctor RichardVillarreal and our special guest this month,
doctor Benny Deci, cardiologist at aDina Regional Medical Center. Lady Parts

(30:18):
with Doctor Richard Villareal airs the thirdMonday of every month at ten ay I'm
a mixed one oh six five inChilicothe. You can also catch the podcast
on iHeartRadio. Also all the podcastsof past shows that we have done the
last couple of years. It's easy. Just open the free iHeartRadio app,
click on podcasts, then do asearch for Lady Parts with Doctor Richard Villarreal