Participants: Dr. James Marcum (Host), Carlton Vollberg
Series Code: BRX
Program Code: BRX00012A
00:01 Are you confused by the conflicting health reports
00:03 in the news today?
00:05 In this well marketed world is hard to know who or
00:07 even what to believe, but there are answers
00:10 you can depend on.
00:11 Hi, I'm Dr. James Markham.
00:14 Join me for Bible RX, a program exploring the
00:18 healthcare world.
00:19 Looking at all aspects of healing, using the Bible
00:23 and biblical prescriptions as the ultimate
00:26 source of truth.
00:49 You know what I was growing up I heard this saying,
00:53 "an ounce of prevention is worth a pound of cure. "
00:56 Well in health care prevention is very important.
00:59 In fact it is probably more important to prevent a
01:02 disease or condition than it is to treat it.
01:05 We have an expert today to talk to us about prevention.
01:08 His name is Dr. Carlton Vollberg, he is an internist
01:12 and he is going to share his insights into the very
01:15 important aspects of preventative medicine.
01:20 Prevention is not a 4 letter
01:22 word, in fact some of the best
01:24 medicine is the diseases
01:25 and conditions we prevent.
01:27 And we're so lucky to have with us Dr. Carlton Vollberg,
01:30 who is very good at practicing preventive medicine.
01:33 Dr. Vollberg, thanks for joining us here today.
01:36 I want to ask you what got you interested in
01:39 medicine to begin with?
01:40 Well my father is a physician.
01:43 I come from many family members,
01:45 my grandfather was
01:46 a physician as well.
01:47 As a young boy I loved medicine and I loved science,
01:51 and I loved helping people.
01:53 It was a natural gravitation into the field of
01:57 medicine for me.
01:58 Now prevention is such an all-encompassing practice.
02:01 When someone comes in and then you look at them,
02:04 and have to prevent all these different diseases,
02:07 that seems overwhelming sometimes?
02:09 That is overwhelming.
02:10 People come into the office and have many varying complaints,
02:13 they have hypertension, they have diabetes,
02:15 and you have 15 or 20 minutes to try to figure out and
02:18 get to the heart of the issue with what is going on.
02:21 Most people now want to be well.
02:22 They want you to try and prevent
02:24 these problems from happening.
02:26 So it is at times somewhat overwhelming.
02:28 Well that is what we are going to talk about today.
02:31 We collected questions from all over the country,
02:34 and the world, talking about prevention.
02:36 Hopefully some of these questions we will be able
02:38 to answer, some we might not be able to but will
02:41 direct people to where they should go.
02:42 Our first question for you Dr. Vollberg is from Jordan.
02:46 Jordan lives in Ohio.
02:47 Jordan writes in:
02:58 So basically Jordan wants to know, they feel well,
03:01 is it still needed to get a good physical by a doctor,
03:04 and secondly, if they do get a good physical,
03:07 what is a good physical?
03:09 Now that is a very good question.
03:11 Jordan, much of this depends on your age.
03:14 If you are young person, and I don't know Dr. Markham,
03:18 do we have his age?
03:19 No we do not have the age, but I assume he is probably
03:21 coming to the age where insurance will pay for,
03:24 might be 65, I don't know.
03:26 Well if you are 65 years old there are some basic
03:28 things that you need.
03:29 I would recommend an annual physical.
03:31 A detailed family history, a questionnaire.
03:34 We tend to develop diseases that our parents and
03:37 grandparents developed, so it is very important,
03:40 particularly for cancer is concerned, heart disease,
03:43 stroke, to look at these very closely.
03:45 Secondly we need to address the issue of any
03:49 potential medications, any natural supplements
03:52 that you might be taking, we want to do an intense
03:55 inventory of everything that you have in your
03:58 lifestyle and in your practice at home.
04:00 There may want to give you a good physical exam.
04:02 And talk about the screening tests,
04:04 if you are 65 years old.
04:06 Have you had a colonoscopy?
04:07 Colon cancer is preventable, but we are not going to
04:10 know if you have Colon cancer unless we look.
04:11 So once you hit the age of 50,
04:13 you should have a screening colonoscopy.
04:16 We need to look at your skin and make sure
04:18 there are no moles.
04:19 We probably need to consider doing an
04:21 EKG and stress tests.
04:23 These are all the basic components of a good
04:25 physical exam including lab work.
04:27 Looking at the cholesterol, and blood sugar,
04:29 checking blood pressure, all these things need
04:32 to be done an annual basis.
04:33 Now what age, he is probably lets say about 65,
04:37 what age would you recommend anyone getting
04:40 a good base line physical?
04:41 What if you feel well?
04:43 That is a very good question.
04:44 Probably about the age of 20.
04:46 20, wow!
04:48 I think in fact in my practice we see people
04:51 over the age of 18 since I am an internist.
04:54 I have been some high school physicals before and
04:57 we have been able to pick up hypertension at a
04:59 relatively early age.
05:00 So really the sooner the better.
05:02 Of course most people have been seen by a pediatrician
05:04 before they get to us in internal medicine.
05:07 In general we probably need to be doing a physical probably
05:11 the early to mid 20's and certainly as people get older,
05:14 over 30 or 40 we really need to be doing
05:16 an annual physical.
05:17 I think that is a good point because sometimes when you
05:21 quit seeing a pediatrician, you feel good and invincible.
05:24 There are years and years of lag time when this disease
05:27 could be developing in you that you could maybe
05:30 help knock it out.
05:31 That is right in the biggest thing we want to
05:32 make sure is that you don't have any family
05:34 history of premature disease.
05:36 I mean you do hear these stories somebody that is
05:39 35 or 36 dropping over from an in aneurysm or
05:41 a heart attack or even a stroke.
05:43 You do hear of isolated cases of colon cancer striking
05:47 at an early age with these familiar Polyposis syndromes
05:51 and things like that, so again the family history
05:53 is extremely important.
05:55 Trying to jump on this early is of paramount importance.
05:58 I try to tell some my patients they spend more time and
06:02 effort taking care of their cars than their own bodies.
06:05 That is absolutely right, I mean what is more important
06:07 than your own body?
06:09 Truly if you don't take the initiative nobody else is.
06:11 Right in a really makes a difference.
06:13 Let's go to another question, this is from
06:15 Randy Righten from Oregon, and Randy writes:
06:21 why is it called silent killer?
06:23 Well Randy that is a good question.
06:24 The reason it is called silent killer is because most
06:27 people do not know they have it until it is too late.
06:29 Now what is a normal blood pressure,
06:31 and what is high and what is low?
06:33 When do you get concerned?
06:34 The benchmark has always been 120/80.
06:38 There are some variations to that, if you are diabetic,
06:41 if you have renal disease, they tend to want the blood
06:44 pressure to be a little bit lower.
06:45 In fact most studies will tell us that the lower your
06:48 blood pressure is, the longer you are going to live.
06:52 So the rule of thumb is, if you are not feeling like
06:54 you are dizzy or going to pass out, then you probably
06:57 have a good build pressure no matter how low it is.
06:59 Okay, so you can't go too low can you?
07:02 You can't really go too low.
07:03 You know a lot of people that come to me,
07:05 they come elderly and never had it checked before.
07:08 That's right!
07:09 They come with damage to their heart, and their brains
07:11 and kidneys, and if they could start early out.
07:13 Now what is the earliest patient age that you seen that has
07:16 had high blood pressure?
07:17 I've seen people in their, age 13 to 14 starting to
07:22 develop some pre-hypertension, hyper-tension, and it is really
07:25 those people that we want to identify early because you
07:27 can prevent complications from happening down the road.
07:30 Do you first try diet and exercise,
07:33 or do you jump to a medication?
07:35 How do you work that through?
07:37 It really depends on the situation, it depends on
07:40 the family history and the risk factors that go into it.
07:42 If somebody comes in, and often times will see somebody
07:44 comes in there 55 or 60.
07:46 They walked through the front door and have a 180/120 blood
07:51 pressure, which is really pretty high.
07:52 We look at them, they are obese, they have risk factors,
07:57 a family history of heart disease.
07:58 Sometimes we will jump on those people pretty quickly
08:01 and start some medication on their first visit.
08:03 Often time we'll have somebody come in their middle age,
08:06 they have no symptoms, no real risk factors, and their
08:09 blood pressures may be 140/90, we try a low salt diet,
08:13 some exercise, a low-fat diet and do an intense workup
08:17 to make sure there is nothing there.
08:18 Then we monitor them for a few months.
08:20 So I guess this disease is called the silent killer
08:23 because it goes on for years and years and years and
08:25 you don't even know about it,
08:26 yet it is destroying you on the inside.
08:28 That is very true and the real problem is if you let
08:31 blood pressure go unchecked for too long,
08:34 you can develop a heart attack, stroke's and
08:36 things like that.
08:37 So we really need to take care of it, and I have had some
08:39 people who have had their blood pressure treated either
08:42 through lifestyle diet and exercise, weight loss, and
08:45 even with medication and the blood pressure comes down.
08:47 Occasionally they can come off their medication,
08:50 oftentimes they don't and what we need to realize
08:53 is once you have hypertension, you really have it
08:56 for the rest of your life.
08:57 You may be able to control with lifestyle changes,
08:59 but you still have hypertension.
09:01 Well that was an excellent question Randy.
09:03 During a short break I'm going to go out and
09:06 get my blood pressure checked and
09:08 we will be back in a moment.