Participants: Dr. James Marcum (Host), Dr. Carlton Vollberg
Series Code: BRX
Program Code: BRX00023A
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
00:08 even what to believe, but there are answers
00:10 you can depend on.
00:12 Hi I'm Dr. James Markham, join me for Bible RX, a program
00:16 exploring the health care world, looking at all aspects
00:20 of healing, using the Bible and Biblical prescriptions
00:24 as the ultimate source of truth.
00:52 Who wants to have a heart attack?
00:55 Who wants to have colon cancer?
00:57 Who wants to have their prostate checked?
00:59 Those are some of the issues we are going to be exploring
01:02 today on Bible RX.
01:04 We have an esteemed internist here and his name is
01:06 Dr. Carlton Vollberg and we are going to talk about
01:09 these issues and much more in just a few seconds.
01:17 Today we are trained to be talking about a very
01:18 interesting and important subject that we don't talk
01:21 enough about and that is prevention.
01:23 How to actually prevent disease, and yes for those that
01:26 never want to go to the doctor.
01:28 When should I go to the doctor? How do I choose a doctor?
01:32 With us today we have Dr. Carlton Vollberg, welcome
01:35 Dr. Vollberg to Bible RX and thank you for joining us.
01:39 Tell us what got you interested in internal medicine and
01:42 this whole healing process.
01:44 Well thank you Jim for having me, I like eternal medicine
01:48 because it represents variety.
01:49 When I go into an exam room I do not know its going
01:52 to be behind that door.
01:54 It maybe somebody suffering from a hemorrhoid,
01:57 maybe somebody suffering from severe depression,
01:59 there is always something different and I enjoy that.
02:02 So there's a variety in internal medicine.
02:04 Well we have collected questions from all over the United
02:07 States and world that talk about internal medicine issues.
02:09 Hopefully we can answer some of them today.
02:12 Let's tackle our first one and it says,
02:18 what needs to be done?
02:20 So this person wants to know when do
02:21 I start getting a physical?
02:23 That is a very good question, probably about
02:27 the age of 20.
02:29 We need to have people come in annually and do a good
02:32 inventory, look at their family history, do a physical
02:35 examination, appropriate lab work, basic lab work.
02:38 Nothing to elaborate but just some basic numbers to see
02:41 if they have high blood sugar, high cholesterol,
02:44 check their urine, making sure they get a good skin exam
02:48 eye exam and those sorts of things.
02:50 Then we look at family history, if there is some
02:51 particular alarm there.
02:53 Maybe a family member died at an early age, why did that
02:56 happen then maybe we need to look a little further.
02:59 Let's say I have never gone to the doctor, I had never
03:01 been ill and I'm 55 years of age.
03:03 I come to you, is there any other recommendations
03:06 at the age of 55?
03:07 Well yes exactly, I mean at 55 you are definitely past
03:11 due, about 30 years past due.
03:13 It is one of those things where, like your car, you don't
03:17 want to run your car without changing the oil.
03:19 You want to make sure you are getting your body checked
03:21 because there are a lot of diseases that could be
03:22 happening without you feeling it.
03:24 For instance you can have high blood pressure.
03:26 You may not know that your blood pressure is going up
03:28 until it is too late.
03:30 You could have sugar problems going on and high sugar
03:33 can lead to damage to the eyes, the kidneys and several
03:36 things you would not know about unless you are checked
03:39 or until as things became so bad that brought
03:41 you to the doctor's office.
03:42 It is very important at the age of 55 you need to have
03:45 a good physical and then you start getting into colon
03:48 cancer screening, prostate cancer screening, GYN exams,
03:51 mammograms, bone density tests, and things like that.
03:54 So a lot of looking under the hood, so to speak?
03:57 Absolutely. - now tell me why do you think it is in
04:00 America right now that no one is doing this?
04:03 Most people spend more time choosing their bank,
04:06 or their Internet provider, or even their cell service
04:09 than they do looking at their most important asset,
04:12 their body. Why is that?,
04:13 I think people are pinched for time and money,
04:16 many people are working two jobs.
04:18 They have families and what ever is not bothering them
04:21 at the moment they don't think is important.
04:24 Your bank account, you have to keep money
04:26 in your bank account.
04:27 You have keep food on your table, those are things that
04:29 seem to be a driving force in everybody's life.
04:32 Often times the health care prevention takes
04:35 a back seat until it is too late.
04:37 Something pops up 10 or 15 years from now, like a heart
04:39 attack or a stroke and it forces you to slow down and
04:42 make lifestyle changes, we don't want that.
04:45 What we want to do is to identify it now, take a little
04:47 bit of extra time now and prevent it from happening later.
04:50 You are much better off.
04:51 You have convinced me now that we should have a physical.
04:54 The next step is how do I choose who to go to?
04:58 There are so many providers out there.
05:00 For instance, I see all sorts of doctors here and there.
05:04 There are nurse practitioners, there's family
05:06 practitioners, there is internist, there's specialists.
05:09 How do you know who to go to, to get evaluated?
05:12 That is a very good question, the most important thing
05:14 to do is find someone you are comfortable with.
05:17 Internal medicine deals with adult health care.
05:20 So people that are over the age of 18, internalists do
05:23 a three year residency after medical school in adult
05:27 medicine, cardiology, endocrinology, hematology,
05:31 all the specialties so they are equipped to handle
05:34 adult problems ranging from general wellness exams,
05:37 colds and flu to complicated problems that involve
05:40 hypertension and diabetes.
05:42 The important thing is to find somebody that you identify
05:46 with, usually if you ask around in the community and say
05:49 hey, who do you use? Who have you heard is a good doctor?
05:53 The same couple of names will keep resurfacing.
05:55 That is the best way, don't necessarily look for the
05:58 most flashy ad, open up the phone book, you can't always
06:02 find the best person that way but if you ask around
06:04 usually the same name, or the same group of
06:07 names will keep popping up.
06:08 Now let's say I go to this person and we talk about
06:12 preventive medicine and I just don't think they are the
06:15 type of person I want to go to.
06:17 I just don't feel comfortable sharing because after all
06:19 this provider is going to go through some of the world's
06:21 toughest decisions, they might go through a death in the
06:24 family or cancer. What if I'm not comfortable?
06:26 Right, you are going to divulge information you wouldn't
06:29 tell just anybody, maybe things in your life that
06:31 you don't want anybody to know about.
06:32 There is a confidentiality issue between you and the doctor.
06:35 It is very important to feel comfortable with who
06:39 you are seeing and if you are in that first visit and
06:42 you leave their thinking you know I'm not sure about this
06:46 man or woman, find another doctor.
06:49 It's okay to do that? - it's okay, absolutely.
06:51 Shop around, I mean it is your body and your health and
06:55 nobody cares more than you do and that is
06:56 the way it should be.
06:57 I just can't over emphasize that this is an important
07:01 matter to deal with.
07:03 You just cannot deal with your body and having
07:06 somebody you are comfortable with
07:07 in preventing these major catastrophes.
07:08 Absolutely correct and we talked about this earlier.
07:11 An ounce of prevention is worth a pound of cure.
07:14 Ben Franklin said it the best, it is the age old advice
07:17 for all of us.
07:19 We need to be proactive with our healthcare, wellness
07:21 is extremely important, don't put off tomorrow.
07:24 Go in, get your checkup and get this prevention rolling.
07:29 It is very important.
07:30 Let's move onto another question in this question is
07:33 about hormones in this question comes to me and says,
07:40 Should I be taking these hormones and are they safe?
07:43 They want to know about hormones to prevent
07:45 the aging process.
07:47 Anti-aging medicine is actually involving into another
07:51 specialty within medicine, there are
07:54 many aspects of anti-aging.
07:56 Let me interrupt you, not getting old? Is that possible?
08:00 Everybody's going to get old, but how you age can be
08:04 affected by lifestyle changes and also possibly some
08:08 supplementation in certain areas.
08:10 The area you are referring to is hormone therapy.
08:12 The problem is many areas haven't been
08:16 researched fully yet.
08:17 Particularly were hormones are concerned and human growth
08:20 hormones, and testosterone and estrogen and
08:22 all these things.
08:23 We do know a little bit about women's hormones, menopause.
08:26 It used to be that women have these hot flashes and
08:29 night sweats and they would get put on hormone therapy
08:32 and it would help that.
08:33 There were some information in the 1990s that went against
08:36 the hormone therapy and every body came off their hormones
08:38 and now they'll have osteoporosis because their
08:40 bones are getting weaken.
08:42 So now some women are slowly going back on hormone therapy,
08:44 the jury is still out a little bit.
08:47 We don't really fully under- stand the recommendation now
08:50 is if you have some symptoms were some compelling
08:52 reason you should consider some hormone therapy.
08:54 Certainly if a woman has a history of breast cancer,
08:57 or a strong family history proceed with caution.
09:00 There are some anti-aging implications,
09:03 and there is a division of medicine that is headed in
09:05 an anti-aging realm.
09:07 Much of it is on the edge and I will caution our viewers
09:12 to proceed carefully because there are a lot of
09:15 people doing these things.
09:16 But just because they are doing it doesn't mean that it
09:18 is right and it doesn't necessarily mean that it has
09:21 solid science behind it. I so you really need to know
09:23 what you are doing when you get into anti-aging,
09:25 but yes there are some things out there that can make
09:27 you feel better, look better and maybe help you live
09:30 a little bit longer.
09:31 Now how about men, we hear about women and hormones.
09:34 Do men ever need hormones?
09:36 That is a very, very good question and yes men have
09:39 taken a backseat in this regard to women.
09:41 It use to be that women were ignored and they would come
09:43 in with chest pain and they would get blown off by
09:45 their doctor, ah only men have heart attacks.
09:47 Women have heart attacks too.
09:49 Likewise in this realm may also develop Adrenopause.
09:54 You have menopause for women and have Adrenopause for men.
09:56 I've never heard that term and Adrenopause.
09:58 I've never heard Adrenopause.
10:00 Well Adrenopause basically means that
10:01 you are losing testosterone.
10:03 You are evolving in this could happen for men as early
10:06 as their mid-30s, the testosterone levels start
10:10 to drop about 10% a year.
10:11 Tell me, how can you tell that is happening?
10:13 You have to see a doctor who knows what they're doing
10:16 with hormone therapy and the problem is most doctors
10:19 coming through don't get a whole lot of education on
10:21 hormone therapy and the other problem has been there
10:24 has been a dearth of information out there.
10:27 We still need more research, if you are testosterone
10:30 deficient how much testosterone do you need?
10:31 So there are a lot of questions but definitely Adrenopause
10:35 exists and basically men will suffer with many of the same
10:39 symptoms, hot flashes, low energy, moodiness,
10:44 irritability, decreasing sexual desire, loss of muscle
10:49 mass, all those things can be addictive of Androgen
10:53 deficiency and you can actually test through the blood
10:57 for low testosterone levels.
10:59 So let's say someone does have a low testosterone level,
11:01 is it a pill, is it a shot, is it a cream?
11:04 Well there is a lot of varieties of things you can do.
11:06 There are some injections you can do, there are some
11:09 creams that you can do.
11:10 It is important to find a doctor that is well
11:12 represented and has done some research and has gotten some
11:15 education in this area.
11:17 You don't want to get just anybody, you want to research
11:20 this one, this is important because there is a lot of
11:23 stuff out there that isn't being done correctly.
11:26 There are supplements you can take and they can be
11:28 monitored, you do need to have some surveillance.
11:31 I mean you don't want to give testosterone to somebody
11:33 who has prostate cancer because testosterone because
11:35 testosterone accelerates the growth of prostate cancer.
11:38 So you need to use and caution but definitely the syndrome
11:41 exists and I would encourage people to go in and get
11:44 tested and ask questions and do their own research.
11:47 Now anti-aging you see it on the Internet, the news,
11:50 our listeners, we get bombarded with questions because
11:53 no one wants to feel the effects of aging.
11:55 But sometimes there is common sense things to help aging
11:58 like osteoporosis, making your bones strong and making
12:02 the mind sharp, basics are not being done now.
12:04 Most of this is the logic driven, you're 25 or 30 years
12:08 old, you are in a good position now.
12:10 We know we are entering an aspect in health care were
12:13 people are demanding wellness instead of just drugs.
12:16 People are not interested in disease care and we all know
12:19 you and I have had patients that have come in and have
12:22 diabetes, hypertension, high cholesterol, and they are 65
12:25 years old and have already had a heart attack,
12:26 have already lost a leg, there is not much we can do
12:29 for those people, we can try to make them comfortable.
12:32 We might be able to extend their life with medications,
12:35 which there is a place for medications.
12:37 But the 25 or 30-year-old now we can look at and say okay
12:41 you have family members that have diabetes or
12:44 hypertension or heart disease, here is a program
12:46 we need to get with it.
12:48 We need to start exercise, or start lifestyle
12:50 modification, we're going to do things that help
12:52 you proactively and as they age you can start looking
12:56 at some anti-aging things.
12:57 The checking people that come in with fatigue, checking
13:00 hormone levels, how many people have been labeled with
13:03 depression that probably had an androgen deficiency
13:06 or in estrogen deficiency and they were basically
13:09 given Prozac to take.
13:11 I have actually unfortunately seen that quite a bit
13:14 in my practice.
13:15 I saw someone the other day that had a vitamin D
13:18 deficiency. - vitamin D deficiency I am very glad
13:20 you brought that up because that's huge.
13:22 50% of the population is vitamin D deficient.
13:27 We now have drugs to treat osteoporosis, your drugs like
13:32 Fosamax, Actonel and all these different drugs but how
13:36 many doctors are checking for a vitamin D deficiency?
13:39 I actively check for vitamin D deficiency in my practice
13:43 and it is an alarming rate, we are talking horribly
13:47 about vitamin D. deficiency.
13:48 People don't always have osteoporosis they have
13:52 osteomalacia I mean they have tremendous vitamin D
13:55 deficiency and we supplement and correct that problem
13:58 their bones gets stronger and vitamin D has also been
14:01 linked to issues with immunity.
14:04 Dr. Vollberg this is excellent.
14:06 These are very important things and this is where
14:08 you need to demand from your primary care physician,
14:11 hey I have been reading about androgen deficiency, I've been
14:14 reading about menopause, osteoporosis and now they are
14:17 saying there is vitamin D deficiency, these are things
14:20 we need to in tune with as primary care providers.
14:23 Well this is an excellent information for listeners and
14:26 I hope you are enjoying this talk so far and
14:28 we will be right back after this short break.