So this is part 4 in the series on world-class preventive personal
prevention experience. Now, here's the first problem.
People pay between 1500 up to 15,000 for a typical Bale/Doneen type of
prevention experience. My goal was to make it far more affordable. So one of
the things I did, when I started this channel and we're going deeply into this
with this series, was I said, look I'm gonna make a lot of this basic
prevention information. It's, you know, prevention is something I've been doing
over 30 years and again, it's bailed on AIDS, a great approach to cardiovascular
prevention. I want to make this for free. At least the information free on YouTube.
And in this series we're actually using the, the deck that we used to use with
patients that paid routinely $5000 for our version of that
type of prevention experience. So we got a lot of good reviews. Actually, this is a
review from Steve Hubbard. Just a couple of days ago, "Dr. Brewer, great goal and we
really appreciate the videos. Would you please consider an entry level
consultation for something like $90 which would be online only
and might include recommendation and review of planned tests, then a basic
one-time email review of the results." Well, it's a great idea Steve and it
brings up a couple of other issues as we go down this path. The first is a legal
issue. There has to be something called, legally something called a
patient-doctor relationship. Now, you may remember I used to run the medical staff
for MD live, the number two telemedicine company in the world. I still do some
work with them. All the states and the states are responsible for these laws.
All the states are responsible for developing a law and saying, how the
doctor and patient can interact and when you can write scripts, when you
can give the patient advice, there has to be a personal description from the
patient of what's going on. Now, originally that all used to be face to
face. Telemedicine broke a lot of old ideas and thoughts and then it became
available to do that remotely. As you may know, I've done a couple of videos on
this. I'm still working now with a couple of other telemedicine companies. One of
them is K-health which is doing a great job. It's sort of like the
deep-blue of urgent care. Helping the doc diagnose
using computer, deep computer logic. I'm also working with Advil and a company
that is doing something very similar but in a medicare advantage space. The reason
I bring that up is now in - in most states of the union, you can develop a
doctor-patient relationship using email or even text. It's going on. There are
companies that have been doing that for over a year now. So there's a lot of
opportunity. Meanwhile I'll continue to work with these two companies to meld
the prevention experience into that type - of that type of experience. Before we go
into the video though just one other thing I want to tell you about in terms
of solutions in this area, have you seen the cardiovascular inflammation course?
It started off as sort of a an informal, all-I-could-do kind of you know just a
few videos on the basics. Caim Hermoso, our media manager, has come in and provided
captions and just today I saw the first draft on the entire text for the
inflammation course. That should be ready in about a week and guess what, and the
price is, it's not 1,500, it's not 15,000, it's 30 bucks.
That's the cardiovascular inflammation course. So we're making a lot of progress
in getting something that's available for masses. We're
already about 2/3 of the way through a course now on insulin
resistance, prediabetes, metabolic syndrome, so there's a lot of work going
in this area and thank you so much for your responsive - response to it and
your interest. Now, let's get back to the video. This one's going to be
specifically what - what the patient would hear in a - an interaction and deck
regarding the CI-MT. I start off with some introduction that's actually for
you - video, YouTube video viewers. You know we've got multiple videos out there that
talk about CI-MT. This is more about that personal experience.
Now, speaking of other videos, if you have other questions about CI-MT, I've got
cash, what about a half dozen, maybe more videos going into the details of CI-MT.
Todd Eldredge, pardon the - the bad visuals here. I'm plagued with those on a routine
basis, but Todd Eldredge is a PhD epidemiologist. He's focused on quality
and interrater reliability. Basically, the bottom line is, he's one of the best
qualified in the world for making sure that you get an excellent CI-MT, first
time, second time, every time you do it. Todd is one of my major suppliers for
this activity. Now we - to go a little bit further into
the - I mentioned cafes cave study a few minutes ago and I mentioned there were a
lot of people that we thought did not have risk until we looked and found that
they do have plaque. So here's what happens. If you go to those other 299
carotid ultrasound areas and get a carotid ultrasound, it's going to tell
you it's negative. Unless there's so much plaque that it actually obstructs
the flow. However, the literature is - the science is totally clear. If you have any
plaque whether it obstructs the flow or not, you have major risk as in 40% risk
for heart attack over the next 10 years. Now what the standard, nonpreventive
folks, and standard prevention folks use for assessing risk is things like the
Framingham studies, again other studies and try to apply those to you based on
your risk factors. The reason I mentioned that is, according to those just a
Framingham risk factor, the - the agreement is, the standard is, if you have a 10%
probability of heart attack or stroke over the next 10 years and some people
say 20%, then you have high risk. When you have class 3 CI-MT which you won't get
from a carotid ultrasound. In other words, if you have any plaque, your probability
is 40%. That gets a little complicated. Let's go look at this image and that'll
help us understand. These are people that have no plaque. People that have plaque but
it's less than one millimeter, in other words we would call that no plaque as
well. These are people on the fourth column here that have plaque so much
that it's obstructing the artery flow. Now, routine Framingham history risk
factors would, will differentiate usually this group from this group; but here's
what it'll also do. It'll usually - it will not differentiate this group at all. Some
of them at random will go into - into no risk. Others at random will go into high
risk. So here's the thing. We've got a test and that's why CI-MT is so
important if you're actually looking for your heart attack and stroke
risk. If you have plaque over 1 millimeter thick, your probability is at
least 40% of having a heart attack or stroke over the next 10 years.
So again, if you - if you patiently waited for me to get through that, I really
appreciate it it's an important point and it helps us understand why. Even
though it's hard to find the CI-MT in this - in most cities, it's important. Brad
and Amy loved to talk about the cat in the gutter. They're talking about a hot
plaque in - in the artery wall and here they're showing inflammation. If you've
got inflammation that cats more likely to jump out and get that bird. Now where
did this, where did this cat in the gutter thing come from with - with Brad
Bail and Amy Doneen? They were in Italy White's I think presenting some - some of
their science; and as you know in Italy there are plazas and they were sitting
having a having coffee or tea at a plaza and they noticed these - these pigeons,
these birds hanging around the plaza. They also noticed a cat who was hanging,
lurking around in the drainage air gutters, and that cat would jump out get
a snack on the - one of the pigeons. So Brad's point was, you know what, that's
just like a hot plaque in our arterial wall. It's just sitting there waiting and
it's going to get another pigeon if it jumps out of that artery wall and into
the artery. Now, a couple of comments about inflammation and the history of
inflammation and then we'll wrap up this this video in the series. If you've ever
seen the movie, or the series Charity or Charite', Charite' was a hospital built or
it still is as a hospital built just north of Berlin. It was built by Kaiser
Wilhelm. I think back in the days around the Black Death.
It was built north of the city. The reason for it was again, they didn't want
to be carrying bodies of people that had died to the Black Death through the city
itself. That's how far we're talking about. I
mean, Middle Ages, Dark Ages kind of time period, 150 well what Middle Ages, 157
years ago. Actually at this point, closer to 160 years ago. Virchow was a - Dr.
Virchow was they - was the chief of staff of the medical staff there and that's
medical staff by the way. Still going strong and has won more Nobel prizes
than any individual hospital medical staff in the world.
Dr. Virchow said, you know what I think atherosclerosis is not so much just
laying down plaque and fat, I think it's inflammation and there's the citation, if
you want to look it up, 160 years later we're finally
beginning to realize he was right. Virchow was right. The plaque is caused
from inflammation We'll go back into more details on this in the next video in the
series. If you've made it this far, thank you very much for your interest! Thanks
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