The Dr. Big Guy Podcast
"The Doctor Big Guy Podcast" offers listeners expert advice on injury prevention, healthy living, and longevity, all aimed at helping you avoid chronic illness and the need for surgery. Join Dr. Caleb Davis, AKA "Dr. Big Guy" as he shares insider tips from his experience as an orthopedic surgeon, provides a behind-the-scenes look at the life of a surgeon, and answers questions about health and medical careers. Whether you're interested in staying fit, curious about the medical field, or just want to live a healthier life, this podcast has something for you!
The Dr. Big Guy Podcast
Episode 1: Unraveling Inflammation: Balancing Health, Diet, and Lifestyle
Can inflammation be both your body's friend and foe? Join me, Dr. Big Guy along with Nicole, as we discuss inflammation and its profound impact on our health. We kick off by dissecting its dual nature – a protector in acute situations but a stealthy saboteur when chronic. Dive into the differences between acute and chronic inflammation, and discover practical ways to manage this double-edged sword through diet, lifestyle changes, and medication. We'll also touch on the debate surrounding NSAIDs, offering you a balanced perspective on these common remedies.
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Hello everyone and welcome to the Dr Big Guy podcast, a place to discuss injury prevention, optimizing health and educating yourself on all aspects of medicine. I'm Dr Caleb Davis, aka Dr Big Guy. As an orthopedic surgeon, I love to fix people after an injury, but my true passion is helping you stay healthy, injury-free and keeping you out of the operating room. Today's episode is going to be on inflammation and everything that comes with it. We've decided we're going to break this up into two episodes, so I hope that you stick with us for the second episode so you can hear all the different things there are to learn about inflammation, how it affects your body and, hopefully, some strategies that you can utilize in your life to help reduce inflammation and chronic pain and injury.
Speaker 2:Inflammation is a buzzword that is used all the time in many different contexts, but how many of us really understand what it means? More importantly, do we know how it impacts our health, especially when it becomes chronic? In this episode, we're going to discuss what inflammation actually is, how it functions within the body and why it can be both a crucial defense mechanism and a serious health risk. We'll explore the link between chronic inflammation and a range of diseases, including heart disease, diabetes, arthritis and even cancer. I'll explain how persistent inflammation can gradually damage tissues, disrupt normal bodily functions and set the. I'll explain how persistent inflammation can gradually damage tissues, disrupt normal bodily functions and set the stage for long-term health issues.
Speaker 2:In addition to understanding inflammation, we'll discuss practical ways to manage it. I'll cover the role of diet, identifying which foods can either cause or reduce inflammation, and lifestyle factors like smoking, alcohol consumption and poor sleep and stress management that all play a significant role in either controlling or exacerbating inflammation. Finally, we'll take a closer look at anti-inflammatory medications, such as non-steroidal anti-inflammatories, also known as NSAIDs, their effectiveness and the potential risks that come with long-term use. We'll talk about how to balance these medical interventions with lifestyle changes and how to manage inflammation effectively. By the end of this episode, you'll have a clear understanding of what inflammation really means, how it affects your health and actionable strategies to manage it. I'm joined today by my lovely wife, nicole Davis, who has graciously agreed to be on the podcast to keep it a little bit more relevant and interesting and help you know, let's just face it make it much more entertaining than I could possibly do on my own. So thank you for being here, nicole.
Speaker 1:You're welcome, Dr Big Gay.
Speaker 2:Before we get started, I have to give our standard disclaimer.
Speaker 3:The information shared on this podcast is intended for educational and entertainment purposes only. The content of this podcast should not be considered medical advice, nor is it a substitute for professional consultation with a qualified physician. The views on this podcast. So, Nicole, we want to talk about inflammation today.
Speaker 2:So how would you define inflammation? What's your understanding of what that really means?
Speaker 1:take something like Advil or ibuprofen for and I think of tissues in my body that are becoming inflamed over time, like a lot of buzzwords, like I don't know you read about, sugar causes inflammation, or IBS is like some sort of inflammatory response to diet, or rheumatoid arthritis is a reaction to inflammation, but pretty much that's about as much as I know.
Speaker 2:Well, that's already a really great starting point for us because, as you've mentioned, inflammation really is something that we see everywhere in the media. We hear our doctors talk about it, we hear our friends talk about it, dieticians talk about it, but I find that it's sometimes just so jumbled it's kind of hard to tell what it actually means. So we'll go into that a little bit.
Speaker 2:Inflammation is a very broad term that can cover many different things, but essentially, if you want to really sum it up shortly, inflammation is the body's immune response to harmful stimuli, including pathogens like bacteria or viruses, damaged cells, like you're talking about if you twist your ankle or hurt or sprain a ligament, or they can also be environmental irritants like chemicals, toxins or sometimes bad foods that we eat. But then we get into acute inflammation and chronic inflammation. So, like you talked about, the acute inflammation can be normal and a normal, healthy part of your body's response to something that's negatively affecting it. So, in the short term, the immediate response to infection or injury is a normal part of inflammation. You'll see redness, heat, swelling, you'll have pain and sometimes loss of function in an extremity or a joint. The purpose is to eliminate whatever is causing injury to the cell, clear out damaged cells that you may have had from trauma and they can start repairing the body.
Speaker 1:Okay, but I have a question. Yeah, Because normally when I have like a sprained ankle or something, I feel like I'm told to go ahead and put some ice on it and cut back on that inflammation. So are you saying inflammation is actually useful? Do I want my body to experience that?
Speaker 2:You know that's a really, really good question and it's a controversial one too, because that's actually been a topic that people have been asking about a lot lately. Um, that's, that's actually been a topic that people have been asking about a lot lately on. Should I actually be icing and reducing inflammation and taking NSAIDs like Advil to reduce the swelling? And there's actually not a great answer for that. I think sometimes the answer is a happy medium where, if you're having so much pain and swelling that you can't function, uh, by doing doing your job or living and doing your day-to-day activities, sometimes it's necessary to reduce some of that inflammation, just so you can get by. But I think aggressively treating swelling and inflammation to the point where it disappears is probably a mistake, because there are actually some healing factors associated with that.
Speaker 1:I've also heard. I remember back when I was in college played the cello a lot, you know had some carpal tunnel syndrome issues. There was an issue where if you would take Advil before a big performance, it was said you know had some carpal tunnel syndrome issues. There was an issue where if you would take Advil before a big performance, it was said you know you might end up irritating that issue further down the line because your body is not able to tell you when it's hurting. So if you're just constantly taking Advil to kind of numb the pain but then you do more to hurt it later on, like as an athlete you hear that or as a musician.
Speaker 2:When you're dealing with professionals, people who work labor, intensive jobs, professional athletes and even musicians, you can be causing inflammation by doing a recurrent, repetitive activity that's causing you harm. And if you're just masking inflammation, your body signal to tell you that something is wrong, then yes, you're just reducing it and possibly causing more problems down the road. The classic example would be an athlete who has developed some sort of chronic tendonitis in their biceps or their Achilles and they just keep ignoring it and getting shots and icing and anti-inflammatories and eventually the tendon ruptures because it's been undergoing all of this trauma. So that's an excellent example where, if you're not treating the underlying cause and actually letting it recover and heal and unfortunately we see that all the time. But that's a great topic Next we'll be moving on to one of my favorite parts of the show Fractured Facts. Now it's time for Fractured Facts Time to impress your friends with all of your orthopedic knowledge. Nicole, did you know that babies are born with about 300 bones?
Speaker 1:That's a lot of bones, man.
Speaker 2:That's a lot of bones.
Speaker 1:Tiny little baby.
Speaker 2:Do you know how many bones you have?
Speaker 1:300 or less 300 or less.
Speaker 2:What did you have some cut out while you were sleeping, or what I mean? I know I'm a weird orthopedic surgeon, but I promise I didn't take any out.
Speaker 1:You're not keeping them in a jar somewhere.
Speaker 2:No, that sounds like serial killer behavior. Yeah, I know all y'all are into listening to these serial killer podcasts, but this is not one of them. So the interesting fact is that the average adult has 206 bones in their body. I say average because there are people who have some extra bones in their body and some people who have more or less depending, and there's some variability in normal human anatomy.
Speaker 1:Like the six fingered man from the Princess Bride.
Speaker 2:I guess he would probably have about four extra bones. You know give or take, I don't know. I'd have to take a look at his x-ray. I don't think they had x-rays in the pit of despair. But the the reason. It's not like these bones magically melt away, it's. It's actually that they fuse together. You know, you, you probably heard of a baby having a soft spot in their head uh, the self-destruct button the self-destruct button.
Speaker 2:Right, that's right. Do not push this button. The bones are actually have these small cartilaginous layers between them and they. That's what allows us to grow. We have growth plates in our, in our bones. We have bones that end up fusing together as we age, and so that's why we technically have less bones. Your pelvis is made up of lots of small bones that then ends up fusing together in what some people would consider I don't know, I have to think about it two bones. Actually, I've got a pelvis right back here.
Speaker 1:Oh yeah, Show us, Dr Davis.
Speaker 2:It's a model. It's not real Just for everyone out there, but, that being said, it's always an interesting fun fact, something that might come up at your neighborhood bar trivia night Okay wait, so babies have 300?. Roughly 300. And the average answer would be 206 for adults.
Speaker 1:So babies lose 94 bones through fusion.
Speaker 2:That's some pretty quick math right there.
Speaker 1:That was it right. That's pretty good yeah.
Speaker 2:Well, I hope you enjoyed this fractured fact. Go share it with your friends. So with prolonged inflammatory responses, let's say we have been dealing with a chronic problem now Responses lasting weeks, months or even years that's when we start to get into chronic inflammation. That's where a lot of people start seeing big problems in their overall health. So you can have persistent chronic infections that are never cleared. You can have prolonged exposure to irritants Think about your diet or external environmental factors that could be causing that and recurrent mechanical injuries, which we kind of discussed already.
Speaker 2:You can also have autoimmune reactions, and you've probably heard of rheumatoid arthritis or lupus or any other number of autoimmune diseases where your immune system is attacking normal, healthy tissues and causing chronic inflammation as well. Now there's all sorts of consequences, and we'll get into that a little bit. You can have chronic tissue damage and you can even have chronic diseases like inflammatory bowel syndrome, like you mentioned. There's a whole number of subsets of that disease as well, and you can even sometimes some instances have increased risk of developing cancers because of chronic inflammation.
Speaker 2:I wanted to bring up one particular type of cancer that I thought was really interesting, called a Marjolin's ulcer, and that comes from chronic wounds. So it's not necessarily that you have a gene that predisposes you to cancer. It's if you have a burn wound that never quite heals and is constantly being irritated and rubbed on. There's actually small amounts of DNA damage in those tissues that can eventually lead to dysregulation of reproduction of cells, causing spontaneous cancer that arises from these wounds. So that's just an example of a chronic inflammatory change that can actually lead to cancer.
Speaker 1:Oh, and do you actually see that?
Speaker 2:in real life. It's pretty rare but it does come up. You know, if I have a patient come in to see me and they say I've been dealing with this wound for 10 years, I'll get a biopsy and say, okay, we need to see if this is a cancer. Most commonly it's a skin cancer and can be resected safely without metastasis where it spreads to the rest of the body. But it can be a real concern.
Speaker 1:Okay, but it's not something that your average person like me I get cut because I pick up my cat funny or something Like. That's not. That's not going to cause cancer.
Speaker 2:If you have a wound that takes a while to heal, even if it's a few weeks. You don't normally have to be concerned about cancer, and it's an extreme situation, but it still illustrates the point of what chronic inflammatory non-healing processes can do to our bodies.
Speaker 2:That question was for hypochondriacs everywhere Takes one to know one, huh, yeah. And of course, as a doctor, I married one. Yeah, of course, as a doctor, I married one. Yeah, of course you did, yeah. So let's talk a little bit about the cytokines and the different cellular signaling pathways of inflammation I'm sorry, cyto what cytokines.
Speaker 2:Now I promise I'm not going to do a deep dive into this, I promise I'll just keep it simple, but I'm going to refer to some of these chemical pathways down the road. So I just want to lay a groundwork, okay okay, okay, I'll allow it, thank you.
Speaker 2:So there's lots of different chemicals that your body releases that are all normal parts of inflammation, and a lot of times your body signals the body on what to do by sending cellular cascades of different chemicals that have this whole different pathways. And I could pull up a chart for you, but I think Nicole's eyes are already glazing over, so let's keep moving. There's different cell lines called interleukins, and we're going to talk about IL-1 and IL-6.
Speaker 1:And also Like a grocery store aisle.
Speaker 2:That's actually you know what. We're not even going to go there. There's also another chemical called tumor necrosing factor, but we're going to call it TNF for short. And then there's a chemical you may have heard of called CRP, called C-re, c reactive protein, and that's a test that a lot of people run to see how much Inflammation is in our body. When you have acute increases in CRP, that's a sign that we have inflammation in our body and something your doctor may often order to see. If you have levels that are more High than you would expect. Now these levels rise and fall quickly, so it's an extremely useful test.
Speaker 2:Usually this is elevated in people with autoimmune diseases, chronic inflammation from some sort of irritant, but it can also be elevated even if you have a bad car accident and have some sort of bodily trauma. It can be elevated for a short time. So those are important things to consider. I'm not going to go into the cellular pathways of all the interleukins, don't worry. Okay, we're moving on. So let's talk about some of the diseases you might be worried about with chronic inflammation. Do you know what the number one killer of adult Americans is?
Speaker 1:I'm pretty sure it's heart disease.
Speaker 2:That's right.
Speaker 1:Okay.
Speaker 2:And if you wanted to talk about heart disease, there's lots of different types. There's people who have arrhythmias, where the heart doesn't beat in the correct order. People have diseases where the heart doesn't pump correctly, but probably the most common one is what we call ischemic heart disease, meaning that the arteries that feed the heart are not getting enough blood flow, and so that's what we talk about when we think about a heart attack the muscle tissue isn't getting enough blood flow. Do you have any idea why that happens?
Speaker 1:Well, if I go by the food pyramid that I was taught, typically that has to do with eating too much red meat and not enough grains.
Speaker 2:That's, you know, not an unreasonable thing to think. Nicole, I think that the food pyramid is at this point is kind of outdated, and in my book there's a lot of different people who will argue that we're not going to get into it today. We might have to do an episode on the food pyramid. I think we should. I think we should too.
Speaker 2:You kind of hit on the red meat thing where a lot of people used to think it's purely fats and cholesterol that led to cholesterol plaques and arteries causing blockages, which makes sense.
Speaker 2:You open up someone who had a heart attack, you open up the arteries they have these clogged arteries and you see a lot of cholesterol in those plaques.
Speaker 2:So it's easy to think okay, that's where that's cholesterol is the problem.
Speaker 2:We've had a lot of evolution in our thinking and it's not so much a cholesterol and fat only model anymore. That goes to show how things are always changing and we need to keep an open mind on how these disease processes work. And just because we think we haven't nailed down, we need to keep an open mind to maybe be open to examining changing the way we think. Now there's a lot of people who think, well, even if there's a lot of cholesterol in your blood, as long as there's no damage to the lining of the arteries, that you're actually going to be okay. People have now speculated that you have to first have damage to the inner wall of the artery to allow those plaques to sort of get inside the wall and cause these big clots to form. So it may not be cholesterol and fats and lipid tissues I'm sorry, lipid particles alone that are causing these problems, and if you are able to keep a low inflammatory environment in your body, it may not be as big of a deal as we thought before.
Speaker 1:Okay, okay, wait a second. You're saying low inflammatory in my body, but I feel like all the things that I eat are called inflammatory response. Things like, uh like anything with sugar, anything with a gluten in it, uh, anything with dairy, anything with red meat those are all things that I regularly see cause excess inflammation in my body. So are you saying that I have to cut out all of these things that go whole 30 or whatever in order to not damage the plaque in my heart?
Speaker 2:online to read about these things what's healthy, what's not they get so much conflicting information on what is and what isn't good for you, and that's really hard, and that's one of the reasons I wanted to start this podcast was to try to make things a little bit clearer and easier. As a general rule of thumb, whole foods that are not highly processed or have added sugar are going to be your best bet. So things with a lot of added sugar have been shown to increase inflammation and increase levels of these interleukin cytokines that we talked about that are associated with high inflammation. I don't think that you need to cut out red meat. You don't need to cut out all whole food groups, but what you should eat are foods in their whole state that are as minimally processed as possible, and those have been shown to show decreases in inflammation overall.
Speaker 1:So you just mean like pulling a Dwight Schrute and eating a beet, like you know, just like an apple or what? Are you talking about? Like I can chop up that beet, maybe, like you know, cook it in a pan a bit and then add it to something.
Speaker 2:What do you mean by whole foods? By whole foods I mean things that you prepare on your own that don't come out of a bag or a frozen food aisle or a box. Now, obviously there's exceptions I don't want to paint with too broad of a brush but in general, if you're eating highly processed foods that have been manufactured down to their small components and have a hundred ingredients in them, those are the ones you're going to want to look out for. Does that answer your question?
Speaker 1:Yeah.
Speaker 2:These are really good questions. You're really keeping me on my toes for this.
Speaker 1:Well, I try, that's my job, babe.
Speaker 2:So moving on, try not to flirt on the air, please. You know this is a family show.
Speaker 1:Yeah, okay, all right.
Speaker 2:So the next disease that I want to talk about was diabetes. Can you tell me what you know about diabetes?
Speaker 1:Sure. Yeah, I know there's type one and type two diabetes. Type one, you're typically born with, is very life-threatening, and there's a lot of medication like insulin to manage it. Type 2, typically that's developed later in life although I know there's been a higher instance of adolescents getting it lately, in America at least and that is when your body can't process the insulin because you're overweight, chronically overweight, or maybe have a very bad diet. So maybe it's not even that you're super overweight, it's just you're not eating the types of foods your body needs and so it's reacting poorly to whatever you're bringing in.
Speaker 2:You know it's getting to the point where I think that you could probably just do this podcast on your own. I brought you in to sort of be the non-medical person to help balance me out, but really you seem to know all this stuff already. It's almost as if you've been paying attention during the 15 years of schooling where you had that you had to suffer with me yeah, almost, but you hit a lot of really great points. We're not going to talk about type one diabetes too much, because it's really more of a deficiency of your body to be able to produce insulin correctly and there's a number of reasons that this can happen. But it is generally more in a young population, and type two diabetes is thought of more as what they used to call adult onset diabetes, and the model of why we think that happens has a lot to do with inflammation. It has a lot to do with being able to regulate blood sugar levels and insulin becoming less effective. So, even though your body is producing it, it is being required to produce more and more to get the blood sugar out of your blood vessels, out of the bloodstream and into cells where it needs to go, and that causes all sorts of havoc on the different tissues around your body, including the lining of your arteries, causing plaques, but there's a whole host of different tissues and different organ systems that it involves what they call metabolic syndrome, where you're talking about obesity, hypertension, meaning high blood pressure, high blood sugar, liver disease.
Speaker 2:This whole sort of spectrum of things that often go hand in hand are contributing a lot to mortality in the United States in particular, and I think that it even contributes a lot more to dementia and mental decline than we have once appreciated as well. We think about heart attacks and strokes as these big acute events. But really over time we're seeing a lot of people have stepwise cognitive decline, meaning when you're there, a little bit less cognitively sharp, and as time goes on, every year goes by, they lose a little bit more of their cognitive function. And that's probably due to small vessels in the brain being damaged slowly over time by high blood sugar and other sort of inflammatory markers, causing them to lose little bits of pieces of their brain. Maybe a little oversimplified, but that's the best way to kind of illustrate it for people.
Speaker 2:Now, I'm an orthopedic surgeon, so I deal with joints, right, I deal with a lot of joint pain, so this is probably where the thing that's most relevant to me and most interesting to me. What can you think about with inflammation in joints? What thing that's most relevant to me and most?
Speaker 1:interesting to me. What can you think about with inflammation in joints? What comes to mind for you? Well, I mean, arthritis is not really something that an orthopedic surgeon would deal with. That's more of a rheumatologist, right? So that's what I think of first when it comes to joints.
Speaker 2:Well, I'm glad you brought that up because as an orthopedic surgeon I see a lot of people with arthritis. Now, if it can be controlled medically, I think that's great, and a lot of times rheumatoid arthritis is taken care of really well with modern medications. However, sometimes, unfortunately, when the disease progresses so much that it becomes severely painful and uncontrolled, sometimes people do have to see an orthopedic surgeon. See an orthopedic surgeon. There's a number of different things that we can do to treat it, like cortisone injections in the knee. There's also injections called hyaluronic acid. Some people call them gel injections. That sort of help lubricate the knee joint. And there's also preventative medicine or preventative lifestyle factors like increasing healthy foods, increasing sleep and reducing inflammation in the body. That can actually help slow down progression of arthritis for people and sometimes prevent them ever having to have surgery like a knee replacement so you're trying to put yourself out of a job, aren't you?
Speaker 2:I hear that question a lot. In all seriousness, if I could prevent people from needing to have joint replacements, I would do it. You know there's always going to be people breaking their bones, so there's always going to be work for us. If we could prevent people from needing joint replacements, I think that would be. That would be better for society.
Speaker 1:Certainly better for your wallet.
Speaker 2:Certainly better for the patient's wallet. Yes, I'm more worried about people being happy and functional than making a buck. There will always be need for me, so I'm not too worried about that. So I wanted to get a little bit more into overuse, injuries, which you already sort of alluded that was a thing and various issues with a winged shoulder blade, things like that.
Speaker 1:For those of you who don't know, the cello is an instrument, a stringed instrument that you sit down and play it, and it's smaller than like a big double bass, but it's much bigger than a violin.
Speaker 2:I find that a lot of people don't know what a cello is, and I don't hold that against anybody. Usually I I just tell them it's a big violin and I sit down and play it. They can sort of picture it. Now, what a lot of you may not know about Nicole and myself is that we've been together a long, long time. We have known each other since we were 13 years old and we played in the orchestra together. So we both played the cello, so we're giantwaves and make no promises.
Speaker 2:She's very dangerous. You wouldn't think about musicians as dealing with chronic use injuries, but it actually is quite common Tendonitis, carpal tunnel syndrome, cubital tunnel syndrome, like you said, I experienced some of these things as well. Fortunately, Nicole and I were both able to recover from all these things without needing any sort of surgical intervention, but not everyone's so fortunate. I'm sure everyone who's listening to this has probably experienced some sort of overuse injury, whether it being you just lifted, having to do repetitive lifting, having to lift your shoulders overhead for long periods of time I take care of a lot of people who are carpenters or having to do all sorts of overhead work with screwdrivers.
Speaker 1:Or people who scoop ice cream, like college kids who are, you know, working at the local ice cream shop. They're scooping all day. They end up with those types of injuries. I hear about Tennis elbow for tennis players, pickleball players, I don't know.
Speaker 2:Whoever else. Pickleball's becoming really popular. If you want to talk about keeping orthopedic surgeons busy, the rise of pickleball is one of those things. I hate to say it because I really encourage people getting out and playing and being active, but I've seen such an increase in muscle strains, tendon injuries and even people falling and breaking bones. Unfortunately, it's definitely been an interesting trend to see how many injuries have come from that sport. I'm not discouraging anyone from playing it, but just keep in mind, be careful.
Speaker 2:Now, where were we? We were talking about repetitive motion and, as you said, it can really affect anybody. I see, mostly in people who work in factories. I see a lot of blue collar workers in my office who are coming with aches and pains tennis elbow, shoulder, bursitis, rotator cuff, tendonitis. That sort of thing is very, very common and in general, honestly, you can get rid of it just by resting it. But unfortunately that's often not a choice for people. You know they can't take four to six weeks off from work, whatever motions irritating them, causing that pain.
Speaker 2:So there's a number of different things that you can do to try to help alleviate those things. This would be an example of inflammation that's not coming from your diet. It's not coming from an injury per se, but it is coming from either improper use, overuse, or perhaps poor sleep and stress can lead you to being more susceptible to having these sorts of problems. So when we're talking about these chronic mechanical irritations in tissues, most people will recover from them, giving it enough time. A lot of times it's not an option, because people who have to work in manual labor of any kind can't take the time off and give it rest. Now there are options like icing it, taking anti-inflammatories or wearing a brace that might help support the joint. If this continues to go on chronically, you can be more susceptible to having, say, a tendon or ligament rupture, which may end up requiring surgery down the road. So sometimes it's best not to ignore these things.
Speaker 1:I've met a couple of guys here in town who had a bicep rupture because they were picking up pieces of furniture and somehow that movement caused their bicep to rip off.
Speaker 2:I take care of a lot of people with biceps ruptures. In fact it's one of my favorite surgeries, just because it's so gratifying to take a tendon that ruptured off somebody. They can't use their arm correctly. You attach it and they do really well. So it's actually a surgery I really enjoy doing, just because it's such a tangible benefit to the patient and it's also, um, you know, an area of the body I'm particularly interested in the elbow and the shoulder. Uh, it's just. It's just such a joy to see people recover and be able to regain their function after that surgery.
Speaker 2:But yeah, a lot of times people probably think about going to the gym and rupturing their biceps. But more often than not it's exactly what you said. They are lifting a heavy piece of furniture and suddenly they just can't hold it anymore and as they straighten their arm out, that biceps ruptures. Sometimes they've been, you know, lifting too much and develop chronic tendonitis. They didn't realize it and they just sort of ignored it and that made them more susceptible, but that's not always the case. Sometimes it just comes out of nowhere with no warning, but that's a great example. That's probably one of the most common tendon injuries that I see in my office that often require surgery. Probably the other one I see a lot is tennis elbow, which would be an inflammation of the ligaments and, I'm sorry, the tendons on the outside part of your elbow, the lateral part of the elbow, sometimes called lateral epicondylitis.
Speaker 2:For people who are not watching a video, who are just listening when you say the outside of the elbow, explain that in normal people terms. Well, I think most people consider the outside versus the inside portion of their elbow. If you look at your thumb and you have your palm up out in front of you, the outside of your elbow would be your thumb side and the inside of your elbow would be your pinky side.
Speaker 1:Okay, yeah, that was perfect.
Speaker 2:All right, yeah, there we go, see. This is why Nicole's on the podcast. She's got to help me tell me when people can't understand what I'm saying. So, since we've talked so much about what is inflammation, what does it do? How is it damaging you, let's talk about some of the things that you can do to try to reduce that. A lot of times, we kind of touch base on this processed foods that are high in refined carbohydrates, that have fats, high amounts of added fat, which often come from seed oils, and they have all sorts of different ingredients and additives that keep them having a longer shelf life. These are things that have been shown to contribute to inflammation. They've been shown to increase insulin resistance, meaning your body can't use insulin as effective. It increases oxidative stress, which, if you ever heard people talking about free radicals in the body, is that a term you're familiar with?
Speaker 1:I have heard it couldn't tell you what that is, other than, like you know, I'm super radical and I'm everywhere oxidative stress would mean that during um energy metabolism there are these what they call reactive oxygen species.
Speaker 2:Don't lose me here yeah, I did that that are causing damage to cells and can actually increase your risk for cancer, and so that's one of those things we're talking about, and remember those cytokines we talked about earlier in the interleukins, the Dr who sounding thing yeah. This is Dr Big Guy, not Dr who.
Speaker 1:Yeah, I know I know.
Speaker 2:Okay, those cytokines can be seen in increased levels when you're eating these types of foods as well. So examples would be anything from fast food, restaurant packaged snacks, anything like a sugary beverage like soda. There are also a lot of people who have suspected and speculated that artificial sugars may also be causing inflammation, although the direct links to that and cancer and inflammation have not quite been sussed out yet. Um, this is a on a personal note for me. Um, this has been a controversial topic for me because in medical school, I started drinking more Coke and I realized well, this is terrible, I can't keep drinking Coke and I had to switch to diet Coke.
Speaker 2:Uh, coke is not a sponsor of this program, by the way and uh, I've had to struggle with the fact that these artificial sugars might be bad for me. Now I've looked high and low for studies showing that, oh, it causes cancer or oh, it causes problems. And there are studies showing in rats and other animals that if you do a dose of aspartame a thousand times the normal dose that you consume, it causes cancer. So that was never that convincing to me. However, more and more research is coming out showing all these artificial sugars, like aspartame and Splenda may actually be causing harm to us, so stand by for that. I may consider doing a whole episode on that, but I'm having to think much more about cutting back on diet sodas.
Speaker 1:I wonder if just the general wisdom of maybe let's not consume things that are chemicals, that aren't naturally occurring but I know that gets a little crazy too, because you think about white sugar sugar is naturally occurring, but I guess it goes through processes that make it less natural yeah, that that's a good point, and I think you can go crazy trying to cut out anything that's artificial and anything that's not quote unquote natural you can, but then you become really, really obsessed with the idea of microplastics and everything, and then you just become a nihilist.
Speaker 2:And you're also a lot less fun at parties. Yeah, it's true. So in my world I try to live in moderation and cut back on things that I know harm me, and knowing that I'm not always going to be perfect, but I do try to be mindful of these things and that's a general approach I take, for I think most people should take. You can drive yourself crazy by trying to be perfect, and a lot of times when we fail at being perfect, then we just give up and then we're in a worse spot than we started with. So I encourage people to take little steps with taking this advice and trying to implement into your life, but don't go crazy. It could just drive you mad Up. Next, lessons that I learned in residency one of the things that I considered that I was lacking before I became a physician was empathy, and I think empathy means different things to a lot of different people. For me, I always thought empathy meant really feeling something that somebody else was feeling. What do you think, nicole? How would you define it?
Speaker 1:Yeah, I always think of it as I can feel the other person's pain or, at the very least, I can understand it, like put myself in their shoes and understand it from their perspective and maybe feel a small portion of what I would feel if I were experiencing that situation. Small portion of what I would feel if I were experiencing that situation.
Speaker 2:Yeah, I think that sums it up pretty nicely. I think that I don't know. Before I was a doctor, I feel like I could understand that people were hurting and having pain and you don't have to be a doctor to be empathetic. There's plenty of people who are very feeling and emotional and connected to other people and it's natural for them. But I don't think it was that way for me. But seeing so many people suffering in such a real, tangible way and seeing so much hurt in people's lives day in and day out made me just shifted something in me, and you've known me since I was 13 years old, so I think you know. Give me your honest opinion. I'd say that there was a big change.
Speaker 1:Yeah, I would definitely say so.
Speaker 2:You know before I don't know, I may have been classified as a sociopath.
Speaker 2:Probably that's, a little bit of a joke. I don't think it was that bad, but it's actually taken a radical shift over the last 10 years or so that sometimes I feel too much and that can be hard on a doctor or any kind of medical worker, any healthcare worker, any kind of medical worker, any healthcare worker, any kind of caretaker. If you feel too much and you feel other people's pains too much, it can really lead to burnout and a lot of hurt and suffering and stress and anxiety, and so that's something I have to battle with constantly. I wouldn't say that I'm on the verge of burnout. I love my work, I love what I do, but I do have to keep a balance of not taking pain home with me me. But I'm getting a little bit off on a tangent. What, what I really respect about the medical field and any kind of field where you're helping others, is the, the way. The way it makes you grow and look at other people's lives and see it through their eyes and and just makes you grow as a person and challenges things that you may have perceived and when you can really maybe not walk in their shoes literally, but it may become as close as you possibly could. So I'm eternally grateful for all the lessons that my patients have taught me about what it is to empathize and suffer with them and cry with them and hurt with them and also take the opportunity to celebrate in their, in their recovery and their joy and their healing as well. It's been wholly invaluable.
Speaker 2:We're going to go ahead and wrap up the episode for now, because it's a lot of content to digest and we've talked about a lot, so I do hope that you'll join us for the next episode when we continue on inflammation and talk about some healthy strategies. And don't forget be be humble, be happy and be healthy. I'll see you next time. Hey, listeners, if you're enjoying the podcast, don't forget to like, subscribe and leave a review on whatever platform you're tuning in from. Your support helps us reach more people and bring you even more great content. Also, be sure to follow me on social media at DrBigGuyPodcast for updates, behind-the-scenes content and more. Thanks for listening.
