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 2: Fighting Inflammation: Insights on Diet, Sleep, and Medicine
Curious about how your diet, sleep, and lifestyle choices can influence inflammation in your body? Discover the powerful impact of anti-inflammatory foods like omega-3-rich salmon, flaxseed oil, and walnuts, as we peel back the layers on the controversial topic of fruit consumption. Nicole and I weigh in on the benefits of whole fruits over juices and smoothies, and dive into the world of turmeric and its active ingredient, curcumin, for their anti-inflammatory properties. We'll share our personal insights and practical tips to help you make informed choices for a healthier life.
Ever wondered how a good night's sleep can keep inflammation at bay? Chronic sleep deprivation isn't just exhausting—it's a serious health risk that can elevate inflammatory markers and stress hormones. Join us as we unpack the science behind the connection between sleep and inflammation, and offer actionable strategies to improve sleep quality. Nicole shares her personal challenges with sleep, underscoring the importance of prioritizing rest. From managing screen time to using blue light blocking glasses, we explore practical tips to help you get the restful sleep your body needs to fend off inflammation.
How do anti-inflammatory drugs really work? Learn about the mechanisms and potential side effects of NSAIDs like ibuprofen. We also reflect on our own medical journeys, sharing anecdotes that underscore the importance of humility and continuous self-improvement. Join us for an engaging conversation that blends medical insights with personal growth lessons, all aimed at helping you lead a healthier, more balanced life.
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Hey everybody, welcome back to part two of the inflammation episode of the Dr Big Guy podcast. We're really excited to be back. We actually had a really great reception for our first episode. We had some really great support from our friends and our family and got some really good feedback and comments on things we can do to improve the show. So we've been really excited to get back and get that part two of the episode. So, Nicole, thanks for coming back.
Speaker 1:Yeah, of course I mean. Most of the feedback we got was how awesome I was, so let's be serious.
Speaker 2:Yeah, she's not lying. That's actually. Most of the feedback is like yeah, caleb's a little stiff, he's a little dry. Nicole's really funny and keeps the whole thing down to earth, which is really kind of what I've been saying the whole time. But enough inflating Nicole's ego, let's get back to the show.
Speaker 1:Well, aren't we going to be talking about inflating egos, Dr Big Guy?
Speaker 2:Are we doing that this episode? Oh, spoiler alerts. Come on, come on, don't spoil the episode we got that. That's the way we're going to wrap up.
Speaker 1:OK, sorry.
Speaker 2:Sorry, all right.
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 do not necessarily represent the views of Dr Davis' medical practice group. If you have health concerns or conditions, it is recommended that you seek the advice of your own physician, who knows your medical history and can offer you personalized recommendations.
Speaker 2:So what are some of the other things that we think about when we think about foods that might be helpful? Since we've talked about what's bad, there's a lot of focus on omega-3 fatty acids right now as an anti-inflammatory food. If you really want to dive into the weeds, there's all sorts of literature out there talking about taking omega-6 fatty acids and omega-3 fatty acids, and they're talking about fish oil and having a good ratio between the two. You know, in general I'm not going to tell you what to do in that regard I do think supplementing omega-3 acids in a pill form can be helpful. Omega-3 fatty acids can also be found naturally in some fish like salmon and mackerel. You can see it in flaxseed oil walnuts, and some people think that that can be beneficial, and I think there's good evidence to point to that as well.
Speaker 1:I'm not sure I've ever been to a restaurant that serves mackerel. I think I've only ever heard it in terms of holy mackerel.
Speaker 2:You know you've been to Iceland and Norway. I figure we probably would have eaten a mackerel at some point in our life.
Speaker 1:Probably, but I bet it was in Icelandic and that's just all consonants.
Speaker 2:Yeah, that's true. It's a good point. Beautiful country, though.
Speaker 1:I love it.
Speaker 2:So fruits and vegetables are something people think about as healthy, and this is also controversial because there's some people who say you shouldn't eat any fruit.
Speaker 1:In general, I think those people are insane and I don't trust them.
Speaker 2:All right. Well, way to be dogmatic. No, in general, though, I think fruit is an excellent source of fiber, vitamins and other sort of nutrients and antioxidants. I think fruit is an excellent source of fiber, vitamins and other sort of nutrients and antioxidants Again we talked about and when we talk about antioxidants, we're talking about those oxidative reactive species we talked about that can cause cancer. That's what people are talking about when they talk about antioxidants that some of these natural getting less concentrations of sugar and you're eating fiber with it. That makes you full faster and instead of just consuming fruit juice, where you're having concentrated doses of sugar, where you take away fiber, so the sugar is being entered into your bloodstream more quickly and causing these spikes in blood sugar and spikes in insulin that we talked about before.
Speaker 1:But what if you're eating things like fruit smoothies?
Speaker 2:Fruit smoothies is a funny one because you're having some of the fiber, but there's a lot of people who theorize that because you're not doing the chewing and breaking down of that, it's still being digested faster. Again, I don't like to live in absolutes and I don't like to work in dogmas, so I think that a fruit smoothie occasionally is a good idea, but still eating the whole fruit will make you fuller faster and satisfy your cravings and not make you want to eat more over time. So there's an anti-inflammatory supplement on the market that probably a lot of people have heard about. Have you heard about people taking turmeric for anti-inflammation? Yeah, so that's one that's been getting a lot of attention, and I'm not a cure-all guy.
Speaker 2:I don't think one supplement is going to solve all your problems, but I do think that there's some promise in turmeric, or more specifically, curcumin, which is the active ingredient in turmeric that is supposed to reduce inflammation. Now turmeric is used a lot in cooking and in different recipes, but it's pretty hard to get an actual effective dose of turmeric and curcumin in your food to give it its anti-inflammatory effects. So I actually do recommend people consider taking a direct supplement in a capsule form to get the correct dose of curcumin that they might need.
Speaker 1:You know, I actually bought some powdered form of turmeric and it was supposed to you just add it to your drink or your smoothie. I think I'd rather just take a pill. It's a pretty strong flavor.
Speaker 2:Yes, I completely agree. I've tried the same thing, where you put that in something and it just is overwhelming. I'd rather just take the pill too. There have been studies that have shown taking curcumin in the correct amount of dosage can actually inhibit those interleukins. We talked about interleukin 1, 6, and tumor necrosis factor, and so, again, this is why I brought those up before you rolled your eyes at me, but I'm referring to them multiple times, so that's why we talked about it.
Speaker 1:Yeah, no one's going to remember those. I just remember grocery aisle six.
Speaker 2:You know I think there was a mnemonic in med school how we remembered all these things by doing things like that. So we've talked a lot about good diets and bad diets. So I think you have to be asking yourself what is the best diet for you? What can you adopt to help reduce the risk of having heart disease and cancer and diabetes? You know it all sounds really scary. So what do you think? What do you think would be a good diet you can take?
Speaker 1:Well, I've tried a whole bunch of diets and I'm not really a consistent person, so I have attempted to cut back on the amount of processed foods that I'm eating, and so I just focus more on making meals that are full of vegetables and meats, lean meats in particular. But I don't know. I mean, there's so many diets out there. There's like keto Mediterranean diet, there's the Whole30 diet, there's the gluten-free stuff. You know, there's a billion of them.
Speaker 2:Yeah, you nailed it. There's so many diets out there and so much information on who has the best diet. You can go on any sort of website or forum and find someone that says, oh, this is the best diet, this is the diet that will work for you. There's a saying in nutrition that I've adopted, and I think this holds true the best diet is the diet that you'll do, the diet that you'll follow, and that may sound a little simplistic, but in my mind, if there's a diet that you can actually consistently follow, that doesn't make your life miserable, that's the diet that's probably going to work.
Speaker 2:I have been every sort of body type you can imagine. I've been 170 pounds, I've been 290 pounds. I have followed every single diet you can think of and had success with almost every single one. When it comes to losing weight, now, weight's not the only thing you should focus on. There's lots of things that you can do to lose weight that make you unhealthy, so that should not ever be your only metric when talking about diet. We really want to focus on being healthy, happy and functional, not just about having a low body weight. What I think it comes down to is if you're being mindful of what you put in your body and you're actually thinking about what's in the food that you eat and you make decisions based on that, you can be healthier instead of just sort of just putting whatever's in front of you, whatever's convenient, whatever tastes good, whatever feels good. I think if you abandon that concept, you're going to be healthier than most people.
Speaker 1:I think it's also worth saying that the more your body adapts to something, the easier it is. For instance, if I eat a strawberry, I think that's delicious and sweet, but I've met people who put Splenda or sugar on top of their strawberries because they didn't think strawberries were naturally sweet enough. So I think if given time for your body and your taste buds to adjust, you would get used to other things that are healthier once your body starts leaning off of the added processed stuff.
Speaker 2:I think that's a great point and I think that's really relevant to a lot of people myself included, by the way, you know, as someone who does drink diet soda, even though I know I shouldn't. Things don't taste as sweet to me and I'm cutting back on my diet sodas and trying to replace it with sparkling water, just because I like that. I like that carbonation feel and that's been pretty good for me so far, and I definitely noticed that when I'm disciplined about what I eat, that sweetness and that palate does change. So that's a good point. So so other lifestyle factors that we can talk about, I think pretty much at this point, everyone knows that smoking is harmful. Let's talk about it just briefly.
Speaker 2:I don't think, if you are smoking I don't know that I'm going to be able to talk you out of smoking, but let's just talk about it briefly. Smoking does introduce a lot of different free radicals and toxins into your bloodstream that can cause cellular damage. But really, what I think probably the most acute thing that you see is it causes vascular compromise, where it damages the inner lining of the arteries that we talked about earlier, which is going to increase your risk for vascular disease. Both blood flow to your hands, to your feet and to your heart. That can cause problems. But it's also introducing all these different chemicals that can cause DNA damage, leading to increases chances of cancer. And, believe it or not, even though some people swear that smoking does keep their weight down, which, because you're consuming a stimulant in nicotine, it actually can keep your weight down Ultimately you're causing all this inflammation that's going to cause a lot more negative health effects down the road that are going to cause you some major problems.
Speaker 1:Now, when you say smoking, Dr. Big Guy, are you also including vaping?
Speaker 2:That's a great question. I think a lot of the data that's coming out about vaping is showing that it has a lot of negative health effects similar to smoking. I think people thought they found their magic cure to smoking when vaping came out and became really popular. But, as we like to say, there's no free lunch in medicine. There's nothing perfect. When you're taking a foreign substance and putting it in your body multiple times a day to get some sort of chemical effect, it's probably going to have problems, Just like taking Advil has problems, Just like consuming caffeine can have problems. There's nothing that you can take. That's just going to be perfectly safe. Now we have to measure the risks and benefits and decide what's good for us and what's not. But ultimately I'm going to tell people they should probably stay away from vaping for similar reasons to smoking. Now here's a topic that's near and dear to my heart and to Nicole's heart sleep. What can you tell me about sleep, Nicole? Why is it important?
Speaker 1:Well, I know you're supposed to sleep. I know it's your body's way of recovering from the day. It allows your mind and brain to process things that maybe you haven't been able to get through, but really it's just allows your cells time to actually regenerate and fix things that are issues right. So I know that an adult is supposed to have between seven and nine hours of sleep and I know that there are different REM sleep cycles deep sleep.
Speaker 2:All right, all right. Who's getting too complicated now?
Speaker 1:Yeah, sorry.
Speaker 2:All right, you're getting into the weeds again. You're supposed to keep things simple here.
Speaker 1:Do I ever do that?
Speaker 2:No, no, it's always complicated. So since you seem to know a lot about sleeping, how come you don't sleep?
Speaker 1:You know what that? Was a low blow, low blow, low blow.
Speaker 2:Sorry about that Okay, all right, so we could tell all sorts of stories about our different sleep habits, but we'll try not to get into that too much, as Nicole was so kind enough to enlighten us and get a little technical, which I don't appreciate. Sleep is critical to immune function, restoring different hormone balances and helping regulate inflammation in our bodies. You can actually see a lot of different problems with people who suffer chronic sleep deprivation. You actually see people who are chronically sleep deprived that have elevated CRP, elevated interleukin-6.
Speaker 1:Can you remind us what CRP is? I know you mentioned it at the beginning of this episode.
Speaker 2:CRP is that protein that is elevated in people with generalized inflammation that doctors will use to measure to see how badly affected their inflammation is. So that's one of those things that you see. You probably have also heard of a hormone called cortisol.
Speaker 1:Yeah, the stress.
Speaker 2:Called the stress hormone Perfect, and that is often elevated in patients who are not getting enough sleep, which can lead to an impaired immune system and lead to weight gain and increase inflammation as well.
Speaker 1:And also mental health disorders are also directly related with cortisol levels, and such and sleep, and probably poor sleep, I bet. Yeah, yeah, yeah.
Speaker 2:Yeah, so let's talk about the benefits of good sleep. Good sleep does help enhance your immune system, it helps reduce your stress and it helps lower inflammation. So tell me some of the barriers for you, nicolele, that keep you from getting a good night's sleep well, I get really invested in whatever tv show I'm watching, so I don't really want to stop it.
Speaker 1:Sometimes I really like snuggling my cats, so sometimes it's just easier to just stay up and snuggle them on the couch, because they're not allowed in the bedroom due to some dictator in our house I don't know who that might be Dr Big Guy and then let's see, I will enjoy an evening out with friends. Perhaps I also am just invested in reading something or just have a bunch of chores that I'm trying to get done, and I feel like I have to get it done before I can go to sleep.
Speaker 2:Okay, well, let me talk about some of the different things that I do to help try to improve my sleep. For me, it's all about consistency, and I need to have a really good night's sleep before I go to work. Especially on days that I need to operate on people, I'm very, very conscious about making sure I go to bed on time.
Speaker 1:Well, I guess your patients probably appreciate that.
Speaker 2:Yeah, I think that they probably do.
Speaker 1:Don't pilots? Aren't they required to have, like, at least eight hours of sleep before they can fly a plane?
Speaker 2:You know, I don't know, I don't know that for sure. I think that'd probably be a good idea. I'm not sure how you'd be able to monitor that effectively. I don't know if it's on the honor code.
Speaker 1:I think I remember watching it in that movie, sully with Tom Hanks.
Speaker 2:They monitor their sleep.
Speaker 1:Something like that.
Speaker 2:I don't know.
Speaker 1:Yeah, maybe through your, your strap, your whoop strap or whatever.
Speaker 2:Yeah, it could be, but I guess I won't find that out until I'm holding the court. But, as you can probably vouch for, I will turn off a TV. Turn off the TV or a movie in the middle of the most exciting sequence, cause I said it's time for bed.
Speaker 1:Yeah, it's a sacrilege.
Speaker 2:Yeah, it really upsets her, but that's how serious I take it. So consistency is key. It may be disruptive sometimes and of course, there's exceptions. I'm not telling people to just walk out of a party and leave social events early to make sure they get enough sleep, although, when it comes to surgery, sometimes it's the right thing to do, and sometimes I do have to leave because, well, I have surgery in the morning, but most people aren't going to have to do something like that. Keeping a consistent time that you go to bed is a reasonable thing to do. The other thing is creating a restful environment. So a lot of people have their phones, they have TVs in their rooms and there's a lot of studies to show that if you just keep the bedroom just for sleep, that's going to be a more effective way to sleep consistently and not be tossing and turning in bed. It's just a place where you sleep and that's all it's for you. Don't stay on your phone all night in bed.
Speaker 1:Just sleep, Dr Big Guy.
Speaker 2:We're not going there. Not a good idea to have a TV, not a good idea to sit on your phone in bed, and these are all things that can disrupt your sleep over time, even though it doesn't seem like it would be Another. And these are all things that can disrupt your sleep over time, even though it doesn't seem like it would be. Another hot topic in sleep is blue light. Nicole, what have you heard about blue light?
Speaker 1:It's the light that's emitted from your electronics.
Speaker 2:Right. So a lot of the spectrum of light that comes from electronics like your phones or laptops or TV screens in particular, help stimulate your brain to keep it more awake, and so sometimes limiting that before bed can actually be very helpful. Most of you probably have heard of a blue light blocking glass, where it just blocks that particular spectrum of light that your brain finds more stimulating. I will often put a pair of blue light blocking glasses on an hour before bed, and I find a significant improvement in how tired I feel, ready to fall asleep when the time comes, so that when I get into bed, when my head hits the pillow, I fall asleep. And a lot of phones and computers are now coming with dark settings when, if you're at night, they'll reduce the amount of blue light that's coming out of them, because this has become such a popular trend and this has been very helpful for people and myself included. Have you tried this?
Speaker 1:Consistently.
Speaker 2:Yeah, do you find that if you're consistently going to bed at a normal time, you feel better, rested, more functional, happier, more stable?
Speaker 1:This feels like a trap In general. Yeah, if I try to go to bed at the same time as you which is super boring and you know then, yeah, it is generally better. It's easier for me to get up in the morning and tackle what I need to get done.
Speaker 2:Yeah Well, this isn't the pile on Nicole show, so we'll leave her alone. One more thing is, if you weren't convinced about getting good sleep, there's multiple studies that have shown that people who are chronically sleep deprived are more injury prone to actual physical injuries. We're not just talking about diabetes and heart disease. We're talking about physical injuries in athletes. People who are chronically sleep deprived are shown to have higher risks of injury. We also see this in workplace injuries and people who aren't athletes, and even the general population, and this has been attributed to impaired judgment and slower reaction times due to this poor sleep. So it's not just about your overall bodily health. It's also about that you could be more prone to injuring yourself. So we've talked about anti-inflammatories quite a bit already leading up to this, but I did want to talk about how anti-inflammatories work. Are they safe? Are they effective? When should you use them? When should you be concerned about using them? So tell me your experience with anti-inflammatories. Do you find that you use them often?
Speaker 1:Well, I definitely have used ibuprofen or Advil and that I know is an anti-inflammatory, but sometimes I get it confused with things like aspirin or naproxen. What else is there for pain management? I guess I generally think of these things as pain management drugs for lighter pains.
Speaker 2:Well, I'm glad you brought up that distinction, because that's something I think is a very common question for people and it can be really confusing, to be fair.
Speaker 1:Tylenol, that's the other one. Tylenol I never know what Tylenol is made of, I just know it's a thing.
Speaker 2:So anti-inflammatories are generally drugs that inhibit two enzymes in the body called cyclooxygenase 1 and 2. I know your eyes are glazing over again.
Speaker 1:They're just narrowing because I was trying to distinguish Cyclooxygenase.
Speaker 2:Cyclooxygenase, or COX for short, C-O-X. We call it COX-1 and COX-2, cyclooxygenase Cool. These drugs that affect cyclooxygenase 1 and 2 help reduce the amount of a hormone called prostaglandin in the body. Now you may have heard of prostaglandin in terms of pregnancy and birth delivery, because it can affect contractions and things like that.
Speaker 1:Yes.
Speaker 2:But it also affects inflammation and it's a huge mediator of how inflammation works, both when inflammation is working for us and when it's working against us. So that is specifically really what it's referring to. So what we call that class of drug called called NSAIDs, or non-steroidal anti-inflammatory drugs, n-s-a-i-d-s. Nsaids are a broad category of things and most of those types of drugs you can get over the counter. But ibuprofen and Advil and Motrin are all the same drug, believe it or not. Ibuprofen is the generic name and naproxen is what you would probably hear over the counter is called Aleve, but naproxen is a generic name and aspirin is also an NSAID drug. They all work on similar chemical pathways to help block inflammation.
Speaker 2:Tylenol, or its generic name of acetaminophen, does not fall under that category. Although it does reduce pain, it does not affect the COX enzyme as directly as the NSAID drugs do. The exact role and mechanism of acetaminophen is not completely understood, but it is antipyretic, meaning it can help reduce fever and it can help reduce pain but doesn't affect that pathway of chemicals that we talked about quite as directly. So what's the big problem with NSAIDs? What do you know about side effects of NSAIDs?
Speaker 1:I know that if you take too many for a prolonged period of time it can damage your stomach.
Speaker 2:Yeah, that's very good. Stomach and kidneys is usually what we're thinking about. There are some instances where it can cause liver damage, but usually people think about Tylenol or acetaminophen as causing liver damage, since it's metabolized by your liver, and less so when it comes to NSAIDs, although there's exceptions to that.
Speaker 1:I also know that in some instances, patients who are on particular drugs, especially blood thinners, like they can't take certain medications that you're talking about now.
Speaker 2:That's right, and one of the parts of NSAIDs is that they can actually affect your platelets, which are particles in your blood that help cause clotting, in a good way when you're supposed to clot. Aspirin in particular is the most powerful inhibitor of platelets, and so it is sort of it has a fairly significant blood thing effect. You've probably heard of people taking a baby aspirin to help reduce their risks of heart attacks and they just take that every day. That is an NSAID, but it's not usually a high enough dose to cause pain reduction, so to speak. Usually you're going to be taking ibuprofen or Aleve for that sort of thing. There's also prescription strength anti-inflammatories like Toradol or Diclofenac or Celebrex.
Speaker 2:Celebrex is another one.
Speaker 2:Celebrex is a little bit interesting because it only affects one of the COX genes COX2, because COX1 is the one that affects more of the stomach lining, and so the idea of creating Celebrex was to make a drug that didn't affect your stomach so negatively.
Speaker 2:But again, there's no free lunch in medicine. Every single drug has its side effects, and Celebrex was found that it increased another hormone or chemical in your body called thromboxane, which actually increased the risk of blood clots causing heart attacks and strokes in certain patients. So patients who are more prone for clotting disorders are actually discouraged from taking Celebrex, and so, again, there's always unintended consequences of any medicine that we find in the Western world, and so you have to be aware of that. I know I've probably gone into more detail than I should on those, but it's such a fascinating subject and, as an orthopedic surgeon, it's something that comes up all the time. Patients take NSAIDs for pain, which is a reasonable thing to do, but overuse can cause problems with your stomach and kidneys that can have dire consequences if you let them go for too long.
Speaker 1:But isn't some of the treatment that even you dish out for somebody with, I don't know, carpal tunnel or joint pain or whatever?
Speaker 2:is to take a steady schedule of these NSAIDs. Yeah, and I think that's a great question because the distinction is important. If you have an acute injury causing significant impairment, disability and pain, I will sometimes have people take a regular dose of an anti-inflammatory for a week or two to help bring that inflammation down to a more tolerable level. But in it of itself I don't consider NSAIDs as fixing the problem. But they can be synergistic in helping fix the problem. But usually these things benefit from a combination of bracing and physical therapy and fixing whatever the underlying problem might be. So it's a good augment of the treatment. But I rarely think that it's adequate to do it alone. Little things like an ankle sprain usually anti-inflammatories, ice elevation and a brace you're going to be just fine. But for more serious things like a chronically entrapped nerve in your spine, it's not going to solve your problems but it can help give you some comfort and relief while you work through the problem.
Speaker 2:So we've talked a long time about all of the things that we see bad with inflammation, all of the harm that it can cause, all the long-term problems it can cause. So really let's kind of sum up and talk about what we can do to help reduce this, now that we know how dangerous and serious it is, now that we understand what inflammation is. We talked about anti-inflammatory foods, things like omega-3 fatty acids found in fish. We talked about fruits and vegetables in a whole format, or at least as whole as possible. We talked about not eating pro-inflammatory foods like processed foods, refined sugars and unhealthy fats, like things that are packed with seed oil, things that are fried, things that have trans fats added. We didn't talk so much about having regular physical exercise, but that is something that has also been shown to reduce inflammation.
Speaker 2:It's funny. Exercise is a little paradoxical, meaning you actually increase inflammation when you exercise, but it's short-lived and over the long term, your overall inflammation has been found to decrease with regular exercise. There's lots of different recommendations when it comes to how much you should exercise. In an ideal world, I'd say about 20 minutes a day if you can. But even just getting up and just walking more and getting more steps in has been shown to increase people's health. So if that's all you can manage, I'd still encourage it. But some form of steady state cardiovascular exercise and even a little bit of weightlifting is pretty much beneficial to almost everybody.
Speaker 1:I'm sure we'll do an entire episode specifically on weightlifting and the benefits for men and women.
Speaker 2:That's right. You can watch out for that episode coming later, because that would be something I could talk about for hours as a former powerlifter and as an orthopedic surgeon, and talking about bone density, especially for aging women who might be worried about their bone health, is something that could really benefit them. So look for that in another episode. So we also talked about mindful use of medication. Anti-inflammatories have their role and they have their place, but they have side effects and you need to be aware of if you're at risk for them, and using them too often can cause you major problems. So my final word on anti-inflammatories is use them if you need them in an acute injury, but don't rely on them and don't take them chronically and then avoid harmful habits.
Speaker 2:I don't recommend smoking. I certainly don't recommend chronic alcohol consumption, but I also understand that these are difficult things to overcome and that I would encourage anyone who is trying to struggle with quitting alcohol or tobacco use that even a slight reduction can bring significant health benefits. When it comes to trying to get better sleep, I'm a big fan of blue light blocking glasses. I do recommend wearing them about an hour before bed to help increase your chances of being able to sleep quickly when you get into bed and having consistent sleep. I also recommend keeping your phone away from the nightstand, plugging it in far away from the bed so you're not sitting on it and not having a TV in the bedroom while you are trying to sleep. Do you have anything to add on that?
Speaker 1:Well, I was going to ask we haven't talked about alcohol at all. Generally, when we go to a doctor's office, we're asked if we smoke and, if we drink alcohol, how much.
Speaker 2:That's a great question. You know I didn't get into the alcohol because it's such a controversial topic, but here's my two cents on it and I'm not going to be I'm not going to pound too hard on this because there's there's studies that have shown that alcohol in small usages has some anti-inflammatory effect, but there's also a lot of studies that show that heavy alcohol use has a host of medical problems, including increased inflammation. If you had to choose one way or the other, I'd tell you to probably avoid alcohol. I think it probably does more harm than good. If you have an occasional glass of wine, then I think that that's probably not going to be causing any major problems.
Speaker 2:Personally, I decided not to drink alcohol because I think it causes more harm than good. I think if you're someone who is good at moderation and controlling yourself, then it's a reasonable thing to do. Me personally and Nicole, I'm sure you can vouch for this that whenever I do something I do it wholeheartedly. So I decided at a young age that drinking just wasn't for me. Yeah, you do. Now I want to transition to a segment of the show that I called Lessons I Learned in Residency. I wanted to talk about a topic that's really important to me. That was really a lifelong lesson. That's taken me to learn, but I think I learned a lot of it in medical school and residency and that would be a lesson of humility being humble. Nicole, what's the first thing that you think of if you think of a surgeon?
Speaker 1:Not humility. I mean, I think of that Alec Baldwin, Nicole Kidman movie I think it's called Malice, and at one point she says something like what gives you the right to do this? And Alec Baldwin, as a surgeon, is like I am God and I'm like, yeah, you know, I feel like a lot of surgeons are, from what I hear, even though I'm not in the OR, I'm not in that medical world but a lot of feedback is surgeons are, uh, got some a big head.
Speaker 2:You know that's not a great movie, but that scene is great. He's being, he's in litigation, he's talking to these lawyers and uh, yeah, I think the question was, what gives you the right? And he's just belittling the lawyers, it's, it's a really well done scene, uh. But yes, he ends up by saying I am god. You know the joke. What does md stand for? You ever heard this one?
Speaker 1:I feel like I've heard a lot of iterations of this, and half of them are not appropriate, so why don't you enlighten us?
Speaker 2:this one's not inappropriate. Md stands for mini deity. Of course, most doctors would argue that the mini is inappropriate. No, I'm just kidding, that's a joke, that's a joke everybody. So there's obviously, there's obviously this, this stereotype about surgeons being arrogant, right. So I think that it's easy for surgeons to fall into that trap, especially because where you have to be such high achievers to get to the position that we're in. So that's something I think that I struggled with before medical school. The great thing about Nicole is that she met me when we were 13 years old, so she's seen me through a lot of different iterations and personalities and through a lot of development.
Speaker 1:Can I recount any of these?
Speaker 3:Oh yeah, go ahead.
Speaker 1:I'm scared. We have the feeler, poetic, sensitive Caleb. We have the powerlifting jockck, but not jock Caleb. We have the orthopedic resident Caleb. We have the angry, libertarian Caleb, and now I think you are very refined. What are we on?
Speaker 2:Caleb 6.0. At this point.
Speaker 1:Yeah, I think so. You keep me on my toes, babe. I appreciate that about you.
Speaker 2:You know, it's almost like that show, Mr Robot.
Speaker 1:He just brought up one of my favorite shows of all time.
Speaker 2:Yeah, but we are delving a little bit too much into my personal life, especially because we don't want to talk politics. But that being said, I don't know if you remember this, nicole, but I have very vivid memories in high school of people telling me that I was arrogant. I think it was the way I carried myself, the way I came across. I don't know that I necessarily thought that I was better than anybody else.
Speaker 1:I mean, you're a homeschooler, so you probably did think you were better than everyone else, right?
Speaker 2:Who's stereotyping now? That's just cruel and unnecessary and you're really showing a lot of my personal life here today. Thank you, but no, I've got nothing to hide. I think it was more of a social unawareness personally. But I'm sorry, nothing, it was a secret between me and the audience.
Speaker 2:Between you and everyone who's watching that I can go back and watch. Yeah, okay, all right, good, I'll have to go back and watch this. Just remember that I have the editing floor so I can go back and watch. Yeah, okay, all right, good, I'll have to go back and watch this. Just remember that I have the editing floor so I can cut out whatever I want. Okay, you are really on fire today with your personality. I think everyone telling you all that feedback of how great you've been has gone to your head a little bit.
Speaker 1:Yeah, well, I am God, Except I'm not at all.
Speaker 2:But yeah, careful of the blasphemy, we don't want to get struck by lightning. Yeah, anyway, since I've been totally derailed on lessons I learned, I do want to get back into it. I think that the tendency is for these high achievers when they're getting into medical school, you know you have to be at the very top of your game, you have to be the best of your class in high school and college. You have to really really beef up your resume with shadowing, volunteer research, experience, and from all accounts it gets harder and harder every year and more competitive. And by the time you get to medical school I think really appropriately you're really proud of yourself and you've realized your achievements. At least for me, though, my experience was wow, all these people are smarter than me, these people are really, really intelligent, and that was intimidating on some level. But also I took it and humbled myself and realized, well, I'm not as great as I thought I was and I really need to step up my game. But also I need to take that experience and realize that there's no real benefit of thinking about how great you are and resting your laurels on that, so to speak. The lesson only got harder once I got an orthopedic residency.
Speaker 2:Orthopedic residency is arguably one of the most competitive residencies. I don't remember the numbers off the top of my head so you'll have to forgive me for that, but I believe half of the people who apply to get into orthopedic residency after medical school don't get in. It's that competitive. So after you've already gotten to medical school, you have to be in the top of the top in medical school as well. Once I got to residency, the feeling that I had in medical school, I think, was quadrupled. It was just. These people are so impressive, they're so refined, they're so talented, their resumes are impeccable and they have all of these diverse interests and hobbies and research and accolades that some of which I didn't have. And then the way you're measured is your skill in the operating room and outcomes that are happening on real patients. You know the pressure to me was just incredible. I felt humbled on a daily basis.
Speaker 1:You know what you did have above everyone else, though. What's that Was your bench press.
Speaker 2:I guess that's true. Um, this ep, this segment's about humility, so I guess I really shouldn't talk about my bench press, uh, but I appreciate you bringing that up. Uh, there's a joke in orthopedics that your step one score needs to be um, I think the rule is 500 plus your bench press. Maybe I've forgotten.
Speaker 1:I'm really ashamed. I think it was like a combination of your step one score, your bench press and your squat or deadlift or something. Yeah, and that had to total a certain amount.
Speaker 2:Well, the average orthopedic step one score was 240, I believe when I matched into orthopedics, and so you know, the idea was, if you bench 260, then you would be okay. You know, the 240 plus the 260 would be 500. Did I do that math right?
Speaker 1:Yeah.
Speaker 2:I said I don't count so good, Um, and then you could, then you could be an orthopedics. It had to be at least 500. Um, of course, by the time, by the time I took step one, I think I was benching 350 at that point. So I was, you know, I was pretty safe.
Speaker 1:That's like small potatoes for you.
Speaker 2:Well, now it is again. You're not helping me at this humility case.
Speaker 1:I'm going to have to open up the doorways in our house to just accommodate your very large head.
Speaker 2:Well, I was born that way you can ask my mom. All joking aside, no matter how hard you work, no matter how smart you are, complications happen in surgery. Patients are hurt, patients die. Bad outcomes happen Patients, even if you did everything by the book and everything right, bad things happen to patients, especially when you're working at a level one trauma center where patients are very sick and patients are undergoing these horrible injuries and things don't always go the way you want them and you're humbled all the time.
Speaker 2:And I eventually learned to embrace that and I think there's different ways you can react to it and I think that was a really valuable lesson for me and something I've taken to this day. Anytime that I see a situation I've run into that hasn't turned out the way I thought it would, I look inward first. So okay, what did I do wrong? What could I do better here? What can I learn from this? And I think sometimes people have the opposite reaction of they lash out and want to defend themselves or make excuses for why things have gone wrong and ultimately, you might feel better when you're coping with that in the short phase, but in the long phase it can lead to less productive outcomes you can't really grow from it and learn from it and build off of your mistakes. That may seem sort of apparent on its face when it's said out loud like that, but I think it can be a really hard lesson to implement and, like I said, I didn't learn this overnight. I didn't just figure this out by snapping my fingers and saying, oh nope, just be humble and life's going to be great. There were certainly times where I wasn't and I took the wrong approach and I've seen that that doesn't work out and doesn't play well. Especially when patients' outcomes are on the line, when their health and their functionality and their lives are on the line, there's no place for ego. You have to let that go so you can grow and help your patient. I know that a lot of people don't think about humility as the first word when they think of a surgeon, but I think that it's a really important lesson for really anyone to learn, no matter what profession you're in, no matter what walk of life that you're in. Introspection and looking inward to your mistakes and embracing them and growing from them is going to help anybody, no matter what phase of life they're in.
Speaker 2:Let's get on to a more fun part of the show and move on to fractured facts. Now it's time for fractured facts, a fun orthopedic fact that we've chosen randomly for the day. This is actually nicole's idea, as are most good ideas on this podcast, so I'm gonna have to give her kudos for that one. So what's today? Today's fun fact?
Speaker 2:Your bones are stronger than concrete and even steel, at least pound for pound. In fact, when you compare bone to steel in terms of weight, bone is actually stronger. One cubic inch of bone can bear a load of up to 19,000 pounds, which is roughly four times the strength of concrete. This is equivalent to about four pickup trucks. This incredible strength comes from bone's unique structure a combination of a dense outer layer called cortical bone and a spongy, lattice-like interior layer called trabecular bone. That provides strength without excessive weight. Because of that lighter weight, we're able to walk around and carry that strong structure. This strength to weight ratio is why your skeleton is able to support your entire body while remaining relatively lightweight and allowing it for it to remain mobile and agile. Some of us are more agile than others. I feel like I could use a good stretch. How about you, nicole?
Speaker 1:I do yoga regularly, so why don't you just come with me?
Speaker 2:Like I said, some of us are more agile than others regularly, so why don't you just come with me? Like I said, some of us are more agile than others. However, despite the strength, bones can still be susceptible to fractures under certain conditions, especially if they're weakened by factors like osteoporosis, which is low bone density, or high-impact trauma. It is important to note that when I'm talking about this compressive force that bones can withstand, it is in what we call axial compression, meaning if I were to put a load directly on top of your legs, that's when bones are strongest. If I were to apply a strong force to the side of your thigh bone, directly transverse to that, it's not nearly as strong as in compression. Also, if you apply a twisting force to the bone, it's also not as strong as it is in compression.
Speaker 1:Why did they replace Wolverine's bones with that other stuff, if our bones are so strong?
Speaker 2:Well, that is a sci-fi movie about mutants, so I don't know that I can answer that question.
Speaker 1:I think that Ryan Reynolds and Hugh Jackman would they disagree. It's a very important question.
Speaker 2:If I remember correctly, they didn't replace his bones, they just infused them with adamantium.
Speaker 1:Oh you, know I get that, that actually I love the nerdy side of you, caleb, but I can't say what I'm thinking, but because we're trying to keep this family friendly.
Speaker 2:Yeah, please do. Thank you, Now that you've completely sidelined fractured facts for the day, let's move on to our conclusion and wrap up.
Speaker 1:All right.
Speaker 2:So, to conclude, we talked about different types of inflammation, including acute and chronic inflammation, and their roles in health and disease. We talked about how chronic inflammation can cause a whole host of diseases like cardiovascular disease, diabetes, arthritis and even cancer. We talked about the importance of lifestyle choices, diet and the mindful use of medication and only using it when it's appropriate and on the safer side of doing things, when to use it to control inflammation. We talked about non-steroidal anti-inflammatories when it's safe to use them, sometimes when it's not safe to use them and the way they work. And then we talked about a holistic approach to health, where we talked about integrating diet, exercise, sleep and avoidance of harmful habits that might help improve inflammation.
Speaker 2:So I'd encourage everybody listening to take a proactive step in their life to try to integrate some of these changes that we talked about, even if we did so briefly, and I'd encourage you that try not to do everything all at once. If you try to do everything all at once, it's going to make you crazy. Try to take small steps, like reducing the amount of soda you drink or, in my case, since I'm in Kentucky, the amount of sweet tea you drink. Try to eat a little bit less fast food. Try to cook your own whole foods at home. Do this and see how it works for you, and just take it step by step. It doesn't have to be overnight and you don't have to be perfect, and just because you mess up once doesn't mean that you have to give up. That's a good reminder.
Speaker 2:Well, I think that pretty much wraps up the episode. We're very excited to bring you more episodes in the future. I can't tell you what a pleasure it's been to record this episode with Nicole. She knows that I've been dreaming about doing a podcast for years and I've just finally had the gumption to do it, and I just can't tell you how supportive she's been and I look forward to her joining us on the podcast for future episodes to keep it let's face it listenable. So thank you so much for everyone for being here and listening, and we'll see you next time.
Speaker 1:Have a good day.
Speaker 2:This is Dr Big Guy reminding you to 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.
