So in this event, I want to introduce Dr. David Wright. Dr. Wright and I know each
other from years ago. Dr. Wright is an internist. He's been way focused on
prevention.
He's run several clinics in the preventive space He and I are sort of
complementary. My background in training is in prevention, and
obviously, I have to do a little bit of internal medicine, given what we do.
Dr. Wright's an internist and who obviously has to do prevention in what
he does. So it's a good fit, and it's very exciting for me to announce
that Dr. Wright has joined us in terms of seeing patients. He'll also join us in
terms of doing some presentations for the YouTube video. So David, you want to
give us a little bit more about your background? Thank you so much Ford, and
thanks for inviting me to be a part of the PrevMed. You've really come a
long way with over the last few years and a great job. So my internal medicine
career started 40 years ago. And during my internship, my dad at age 52 survived
his heart attack. And in 1979, Burton disease had killed half of the people
before they either got to the hospital or by the time they left the hospital,
and the other half were left disabled. Fortunately, he returned to active life.
But because that happened during my internship, I really have paid attention
to what causes heart disease and what can we do about it. And the great news is
over 40 years, as you all have learned from Ford's channel, the science has
progressed tremendously. And so after about 10 years of traditional private
practice and growing weary of seeing my patients continue to have heart attacks
or strokes or become diabetic despite my best efforts to use the science that I
was trained with, I realized that I had to go outside of
that traditional training, find the science that's legitimate that is out
there, and start applying it to my patients. And so I started doing
about thirty years ago and Ford mentioned progressively have become more
and more prevention focused and really starting about a decade ago, started
opening a prevention center, helping other clinics open theirs. And the last
five years really focused on teaching colleagues and patients alike how they
can be prevention-minded. And so, I still practice. I have a concierge practice
here in Memphis, and nothing delights me more than to see the light bulb what's
possible come on in the eyes of the patients that I see. To see the hope that
they have for a different future ahead and for them to embrace everything that
they need to be doing and what to be doing to stay healthy. So that's a quick
sketch of my background, and probably those of you that have watched Dr.
Brewer's channel for the last few years can see why we are complementary to each
other. So thanks, David. You know, we started off talking about the
differences between internal and preventive medicine. One of the key
points behind preventive medicine is just what you referred to lifestyle is
the most important medicine, and you don't accomplish lifestyle changes just
by walking in, spending seven minutes with the patient, writing a script, and
walking out. It's an intensive educational process, and you've always
been very, very good in that space. Another space where you taught me a lot
had to do with the importance of prediabetes.
There's a fellow named Joseph Kraft. I know you know the
name. One of his more interesting quotes and I think it's very, very
appropriate is that those with heart attack are those with cardiovascular
risk that don't have diagnosed diabetes simply aren't diagnosed yet. So
any comments on that before we get into some of the other topics we're gonna
cover today? That's such a great point that he makes, Ford. In fact, many
patients over my career have come back into my office after their heart attack.
This is in the early years of my career and would tell me, well, I caught
diabetes in the hospital. Yeah, well, no they didn't catch the diabetes in the
hospital. It was just finally diagnosed. And exactly right is that 70%
of folks with atherosclerosis, with plaque in their arteries... 70 plus
percent of those are in some stage of insulin resistance. Guess what?
Only half of people that come to the hospital with their heart attack have an
abnormal cholesterol level, right? What are we missing?
So exactly, it's the insulin resistance. It's one of the foundational
drivers for every stroke I personally have a suspicion that that 70%
is way under diagnosed as well. I think it's higher than that. Yeah, it
could be right. I know early in my prevention effort, the
first 600 patients that we ran through with the glucose tolerance test we had,
and I was really picking people that were likely to have disease. Meaning they
had plaque and somewhere around 75% of that group in Memphis, Tennessee failed
their glucose tolerance test. I started testing people that were "low risk"
for disease, and I was still getting 60 plus percent it would fail the test. It
is epidemic. So here's the other point to add to that. I find after months of back
and forth with Quest I finally got them to add insulin response to the one
to our OGTT glucose tolerance test. And guess what? One or two patients per month
will have a normal OGTT, but it's taking them twice the physiological amount or
optimal amount of insulin to keep their blood sugars there. So these people are
obviously in a very early stage of insulin resistance, but it's clearly
classic insulin resistance it's just taking a lot. But they still have... they
have that reaction there. The cell in their brain that gauges the amount
of blood sugar is still working. It hasn't been adjusted upwards. And it's
still saying, okay, go ahead and release this insulin. But it's taking twice the
amount to get them where they where they are. Exactly and so that's a bunch of
other people that even with an OGTT are not going to be picked up. Well, it has
lived up to my expectations. I wanted to get specific questions
answered. I watched a lot of videos online, and so I came in feeling well
educated. But you learn a lot from the other people here, learning their stories
and their results and their experience. And so it's a filling in of a lot of holes
and answering a lot of questions. Plus you are able to interchange in a real
dynamic way with Dr. Brewer, so that's a big plus as well. So I thought
it was very worthwhile and definitely in terms of trying to make sure that you
take care of any issues you have with cardiovascular disease or whatever it is
you attending for. It sort of closed a lot of circles for me.