Episode Transcript
[00:00:00] Speaker A: Sam Foreign.
[00:00:30] Speaker B: Welcome to Vital Signs, where we dive deep into protecting your greatest asset, your health.
Really excited to be here today because I have Dr. Yasir Sambal, Interventional cardiologist back who's helping us rethink heart disease not just in terms of treatment, but also in terms of prevention. And today's focus is all about how to start, how to stop heart disease before it starts, especially for the next generation. You may have inherited your grandfather's eyes or your mother's smile, but heart disease, that doesn't have to be passed down. Welcome back to the show, Dr. Sombol.
[00:01:07] Speaker A: Hey, Jen, thanks for having me back.
[00:01:09] Speaker B: I'm really excited to dive into this because I've had a lot of feedback on our sessions and people are asking about how much of this heart disease, how much of heart disease risk am I passing down to my children? How much of this is genetic versus lifestyle.
[00:01:28] Speaker A: So, I mean, with everything, right, there's a genetic component to everything. Like you mentioned, your hot, your eye color, your hair color, everything that happens to you, there's probably some genetic component to it, right? And so diseases are no different, whether it's diabetes, whether it's heart disease, kidney disease, etc. All of these have some sort of genetic predisposition for somebody getting something.
Heart disease. There are certain things that are definitely genetic. You know, whether it's coronary artery disease, blockages, heart failure, there's heart failure that's passed on by genetics.
Unfortunately, I think in medicine, there's not a lot you can do to prevent, you know, genetic transmission of a disease, Right? So. But there are things you can look at to try to prevent whether or not that genetic transmission translates into the actual disease. So, or.
So, for example, let's just say you have a genetic predisposition to having high cholesterol, right? There are people that just have familiar hyperlipidemia. So it is. They're inclined to have really high cholesterol numbers even though they're healthy, etc. In those patients, Right. You don't give them the general first line of therapy, which is diet and exercise for six months to see whether their cholesterol improves, because there's nothing they can do that's going to help that. So in that situation, you recommend that they be on medical therapy, Right. So they take a statin drug to make sure that they reduce their cholesterol levels, which in turn hopefully helps prevent any sort of bad outcomes that come with high cholesterol, whether it's heart disease, plaque buildup, strokes, all those things that, that can be caused by high cholesterol.
So let's just say somebody has a familial heart failure disorder.
So there are people that are genetically predisposed to developing what we call systolic heart failure. So low function heart failure. And again, you can't do anything about the genetic transmission. And we don't know a lot about what genes exactly cause it, but we do know that screening these people on a routine basis for heart failure is important in being aggressive about treating the disease.
So let's just say somebody comes in with early signs of heart failure. So their heart function is kind of getting low by ultrasound that we're noticing.
It's a great time to intervene by putting them on medications that hopefully prevents the progression of that heart failure and deteriorating to a point where, you know, they need a transplant or a left ventricular assist device or any of those things. So although we can't prevent the transmission of genetics, and we don't have technical gene therapy to reverse that, we do have things in place and mechanisms in place that are designed to help screen people for things in order to try to be aggressive about treating it on the front end rather than chasing it on the. On the back end. And that goes with a lot of things. You know, it's the same why people at a certain age are required to get colonoscopies, right? Because we want to prevent, you know, get ahead of colon cancer when they get it. So if they have polyps, which is a precursor to colon cancer, you know, we take those polyps out and then we screen them more aggressively. Because we know people that have polyps are predisposed to having more polyps. The same way, you know, women are required to get a female exam every year or two, right? There there's reasons for that, because those things have been proven to prevent or early detect cancers and early detect certain situations to hopefully get ahead of the game. For example, people that are smokers are required to get a CT scan at some point of their chest to prevent. To look to early screen for lung cancer. Right? Because the earlier you catch a lung cancer, the better somebody's survival is. So it's the same with heart disease.
There are things like genetic diseases like amyloid, which are infiltrative diseases of the heart. Now, although you can't prevent amyloid and you can't don't have a technical treatment for it, but if, you know, somebody's genetically predisposed, that may early on allow you to screen for heart disease in them on a routine basis or consider Transplant evaluation in them on a routine at some point.
So the mechanisms in place to prevent genetic diseases is not there, but the mechanism to early detect and to early try to prevent the major consequences of it are there, in my opinion.
[00:05:58] Speaker B: I really, I really like that clarification. Thank you for that. So for everybody who's watching, if you do have a genetic predisposition, it's all about screening and early detection and catching it early so that you can keep it from progressing. And of course, we've talked about lifestyle changes, we've talked about weight and blood pressure management, exercise routine, stress reduction in the past. So of course there's that lifestyle aspect. We don't want to be adding fuel to the genetic fire, if you will.
So talk to me a little bit about this because I've gotten a lot of questions for the parents watching who maybe they know there's a strong heart history.
[00:06:34] Speaker A: Maybe.
[00:06:36] Speaker B: I mean, I'm a perfect example of this. My father had a heart attack at age 50, which is a risk factor in screening. Right. And so that's something that we know and we have some genetic predispositions as well. So if we have a strong family history of heart disease, what are some powerful things that we can do or ways that we can help our children so that they can build heart healthy habits and be aware? What does that conversation look like? How can we empower those watching so they can really help change the outcomes for the future generations?
[00:07:10] Speaker A: Sure. So let's just take what you mentioned about your father having a heart attack at the age of 50. So at the age of 50, we consider that premature coronary artery disease. Right. Because they're less than 65, and so they've had early onset heart disease. And so I, I get a lot of that actually in my office and in my clinic, there's people that come all the time, like, you know, I, I just want to see you because I just want to make sure I'm okay. Because my father had heart disease, my mom had her disease, my grandpa did, et cetera. Right. And so, you know, one of the things you can do, for example, is, is a, what's called a coronary calcium score. Very simple test. You know, you go, you sit in the CT scanner, they calculate the amount of calcium deposits in your arteries. And we have clinical data that shows that your calcium score can give you a correlation of what your risk of heart disease is. So let's say your calcium score was less than 100. Well, we know that those people are really at low risk for having heart disease anywhere between 100 to 400, your risk of having heart disease is an intermediate risk. And then anything above 400, your risk of having heart disease is high.
And so what do we do in that situation to help prevent future heart disease? Well, again, we talked about cholesterol medicine. So we know that cholesterol drugs, although they have a lot of bad reputation and bad side effects sometimes, and et cetera, but we do know that these drugs actually really improve survival in people who are high risk for heart disease.
And I have this notion that if you were to put cholesterol drugs in the water for people, we may actually all live longer because of them, especially statins, believe it or not. And so, you know, those are early detection methods where you can say, well, I have people that come to my office that say, you know, their calcium score is 1,000. I say, well, you know, this is a time where I would say it's probably important that you're on a statin drug so that we hopefully prevent the progression of your risk of heart disease, because those drugs can not only reduce your cholesterol, but stabilize plaque, reduce, you know, the. The bad things in the plaque that causes heart attacks.
And so it's a good time to do that. I may say, hey, I think we should get a stress test here because your calcium score is high, and I want to make sure you don't have what we call silent ischemia, meaning people can actually have blockages, and it builds over time. And the body is an amazing thing. I mean, it's just a miracle, right? And so we adjust our body, adjust to things over time that we're just not even aware it's doing it. And so your heart has this thing called ischemic preconditioning. So you can have a blockage, and you're. Because it's built over a long period of time, your heart can adjust to that blockage being there and still perfuse the heart muscle. And you may not even have any symptoms or not know it's there, but at some point, it may get tired of adjusting, and then bad things happen. And so you may say, well, you have a high calcium score. We should screen you for silent ischemia, make sure that all the heart vessels are not. Are perfusing the blood flow appropriately. So these are. These are important things you can do.
And these conversations should be had with family members. The same with people who have, you know, if you're the, you know, you're. You're a sports medicine person, so, you know, athlete's Heart. Right. These people that collapse, you know, during sports activities, well, they're at. They have what's called hypertrophic cardiomyopathy, which is a genetic disease.
They're born with abnormal fibers in their heart muscle, and those abnormal fibers predispose them to that electrical condition. You remember we talked about your heart's like your house, it's architecture, plumbing and electricity. Well, they have an architecture problem that leads to an electrical issue that causes them to collapse. And so, you know, you can screen people with genetic markers for that. You can screen people with ultrasounds for that. So if there's a family history of people dying suddenly for no reason, they just collapse and die. That's a reason to look into that, especially if they're young.
So there's a lot of mechanisms in place and a lot of things we should talk to, especially if somebody has a family history or a strong family history of certain diseases related to heart disease, that there's a good way to be able to screen for those and get ahead of the game, hopefully.
[00:11:39] Speaker B: Thank you so much for that. You know, genetics might load the gun, but our lifestyle pulls the trigger. And we have the power to change the outcome by early screening, early detection, and having the conversations with our children, with our family members, and ultimately with our medical practitioners, because that's who can break it down for us and make sure that we are ready. We do have to take a brief break, but we will be right back after these important messages.
The future is now. How tiny implants are transforming heart fail care. But before that, are you loving what you're watching? Don't miss a moment of vital signs or any of your favorite NOW Media TV shows, live or on demand.
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Okay, so welcome back, Dr. Sombol. We dove into a lot in the last segment, but I want to move into more innovation because during the break we were talking a little bit about some of the really interesting changes with implantables and some of the other aspects. So let's start with the big picture.
You sort of mentioned a little bit about heart failure in the first episode. So talk to us a little bit about what is heart failure and why is it such A major challenge for patients and hospitals and what's happening behind the scenes innovatively with regards to that.
[00:13:52] Speaker A: Great, you're right, that is a big thing. And it's probably one of the most common things that we see people in the hospital for, maybe even more common. It's probably just as common as people that come in with chest pain and heart blockages, et cetera, and if not, even more so. Heart failure is defined in two different ways. Think of just your heart as a pump. You can either have a low functioning pump or you can have a normal functioning pump. But in either one of those scenarios, that pump is not perfusing the body correctly. And so your vascular system, your blood flow is a one directional system. Everything should kind of go in one direction, rotate through the body, come back so it comes out of your heart to your body, feeds all the organs, nutrients, oxygen, et cetera. The veins bring all that stuff back to the lungs, it gets re oxygenated, then it starts all over again. And so that's what's happening all day long, whether you're awake, sleeping, etc. That's what's happening. And so your heart function, which is what we diagnose by an ultrasound, is the squeeze of your heart, which is we call in medicine the ejection fraction. And so that ejection fraction is what we determine, you know, whether somebody's heart function is normal or not. When you say the word heart failure, it doesn't necessarily mean that your heart is not working. Heart failure is a syndrome. It's a syndrome defined by symptoms. Symptoms such as shortness of breath, swelling, laying flat and feeling short of breath, waking up in the middle of night gasping for air because you're short of breath. So heart failure itself is a syndrome that we diagnose people with. Now when you diagnose somebody with heart failure, it's important to know whether they have low function heart failure or they have normal function heart failure. And because that changes not only the diagnostic route that we go on, but also changes some of the management that we do. And so in the end, medical therapy is pretty similar in both scenarios. But when people have a low functioning heart function or low functioning heart failure, what we call systolic heart failure, there's usually, sometimes there's reversible causes. So if they have major blockages in all the arteries, that can be a reversible cause. If they have a valve that's not working correctly, that can be a reversible cause. If they've been subjected to chemotherapy, that may be a reversible cause.
Other drugs, for example, that may be a reversible cause. So you want to rule out a reversible cause in hopes that their heart function comes back to normal. In the end, they still get medical therapy similar to what a normal heart function person would have had. But in most normal heart function people, this is what we call diastolic dysfunction, meaning your heart is a muscle. It's like a balloon. It's supposed to expand to let blood in and it's supposed to squeeze to let blood out. Well, as we get older, that muscle becomes stiff and so it doesn't expand as well. Right. And so. And then it doesn't squeeze as well, so it doesn't let blood out. So what happens? Blood has to go somewhere, so it ends up going backwards. So it goes in your lungs and in your legs and in your belly and all these places and causes the volume overload that we cause or swelling that people get.
And so there's other, there's other things that may cause what we call diastolic dysfunction, like infiltrative diseases, other things. But those are zebras. Those are not horses in medicine. That's how I like to see it. So you have to kind of think outside the box to get to that point because usually it means somebody's heart failure is out of proportion to their heart function. Okay. So in those scenarios, medical therapy is both important and the medical therapy is designed a to make sure your heart rates well controlled, to give your heart time to fill appropriately, reduce your blood pressure so that your heart's not pumping against this big pressure so it can perfuse better.
You may use medications such as diuretic therapy so that you can reduce the extra volume that people have, so it reduces their symptoms of shortness of breath, the swelling in their legs, etc. So they become more functional.
So why is heart failure such a big deal? Well, it's because people get readmitted all the time to the hospital for it. And they get readmitted because they're home taking their medicines. But there's also lifestyle factors you can't control with them. So they may be home taking their medicine by drinking a ton of water. They may be home taking their medicine and eating a bag of potato chips, which is a lot of salt that causes you retained fluid. So by the time people get to the hospital in heart failure because they can't breathe and because their medicine is no longer effective because that fluid they've been retaining is absorbed in their gut wall as well. And so you're not maybe not absorbing your medicine, and the pills aren't effective anymore.
And so by the time they get to that point, they need to have IV diuretics. And so that usually is a few weeks preceding the actual symptoms being so bad they've been accumulating that food for three weeks or more.
So what new innovations you mentioned? Innovation. So what new innovation that we have in medicine, for example, to help reduce hospitalizations? Well, there's a device called the cardio MEMS device.
It's an implantable device, actually, that people can have.
It sits in your pulmonary artery, which actually sits in between the right chamber of your heart and your lungs. And it's a minimally invasive procedure, so there's no cutting. It involves putting a little tube in a vein and putting a catheter through that vein using X ray, and you deploy this device. And so that device sits there. And so that device is equivalent to what we call a Swan's gang catheter, which we use in the hospital to assess people's volume status to understand in heart failure, are they really volume overloaded? It helps us manage, you know, whether they're using medicines to support their heart function, their blood pressure. So there's all sorts of uses to it. And so this is kind of having now that. That Swan Gans goes through your neck and stays in people's neck while they're in the hospital. This is kind of like having a Swan Gans, but at home. Okay? So they. They lay on this pillow every night when they go home after it gets implanted, and it transmits information to this database. So wherever the provider is, like myself, for example, who does it, I get this information transmitted to my office. And so I can look at it twice a week or have my nurse practitioner, my nurse look at it twice a week. And I have a goal set for each patient. And each goal, each patient is different, what their goal may be depending on their heart function, depending on who they are, etc. And so I may say your goal is 20. So anytime this patient is above 20 on this device, I call them and I say, I need you to take a few extra fluid pills over the next few days in order to reduce that number in order to prevent you from having to go to the hospital and be admitted. And so that device has actually shown almost an 80% reduction or more in hospitalizations for heart failure. And it's very underused, very.
[00:20:48] Speaker B: Wow.
I just want to take a pause here because what I'm hearing is your pillow is telling your doctor if you're headed for a heart failure crisis and hospitalization before you even detect a symptom. Is that correct?
[00:21:02] Speaker A: Yes.
[00:21:03] Speaker B: Wow. And so what happens after implementation of this?
They have the implant, the pillow is monitoring, like, how do you ensure compliance?
How does that transmit? I have all the questions.
[00:21:21] Speaker A: So it transmits basically electronically, probably using some sort of WI fi or everything else nowad.
But the compliance thing is where the problem comes in. So, you know, I've probably implanted. I was the first person to implant this in the Sugarland area in Fort Bend county.
And it was mostly used at the medical center for a lot of advanced heart failure. And those guys use it a lot down there. And I was the first one to do it out here in the Fort Bend County. And, you know, most of my patients are very compliant with it and it was great. And honestly, most of my patients never got readmitted for heart failure. I probably had one or two stragglers who were not compliant with it who, you know, eventually end up getting readmitted because I can't track that when they're home. And so I can't help them despite putting the device in. But that device works. And it is, I hate to say it, it's very, very underused in community medicine and in general because one, there's a lot of, there's a lot of reasons. One, clearly it's a physician issue, right? Physicians, you know, they, they're, we're all, we're still in, we're working, we're, you know, seeing patients, et cetera. They may not know about the procedure, they may not do it.
Two, insurances, you know, you have to get this approved by the insurance and, you know, not to, not to digress and talk about insurance companies, but that's a whole nother ball game. But in general, you know, they may say, well, this is not medically necessary and you don't know who you're talking to on the other line that's telling you that.
So the third may be the patient. They're apprehensive about getting a device implanted in the first place and they don't want to do it.
Nothing may be cost, right? There's deductibles that are associated with this, so they may not get done.
But my experience, and it's limited, obviously, in how many patients that I have on it, but the data is really clear and the literature is really clear. It's about an 80% reduction in hospitalizations, which is the number one thing Medicare looks at for heart failure for hospitals. So when a Hospital gets dinged by Medicare. They're being dinged because this patient has come in within 30 days of the recent admission for another heart failure admission. And so you would think that the system would get with the time and use the technology, but unfortunately the system lags behind any technology that we innovate in cardiology.
[00:23:40] Speaker B: And I think that we see that across the board. And it's hard, right? It's a lot harder to turn a massive ship than it is a little nimble boat.
So talk to me a little bit for the people who are watching. We probably have several people watching who have heart failure or a loved one, or caring for someone who has heart failure.
This tech is life changing. It's able to reduce hospital visits. How can they, like, what should they be asking their practitioners? Or how could they advocate or ask about this the next time they go in? Like, how can they open the door for this, this opportunity?
[00:24:18] Speaker A: Well, I mean, you know, information's all over the Internet, right? So the device is called a cardiomens device. And you know, if you have a cardiologist, I would ask them, am I a candidate for this device? If you've ever been admitted to the hospital for heart failure and had to spend a couple of days there to get IV diuretics or a medicine through an IV to reduce the volume or the fluid in your lungs and the fluid in your legs, you're a candidate for that.
Especially in people with low heart function, because they're the hardest to manage and they're very hard to manage. And, you know, it really helps them quite a bit stay out of the hospital, because those people are in and out of the hospital a lot with volume overload. And so, you know, if you don't have a cardiologist and you've been in the hospital for heart failure, I suggest you get one, because that's important.
If your cardiologist is opposed to it and you're not convinced of the answer, there's nothing wrong with getting a second opinion, right? And finding out whether or not you're a candidate for that device and that procedure, you can come see me. I'd be happy to talk to you about it because I think it's a great device and I think it works really, really well.
And, you know, I have no problem with implanting that device in people to reduce their hospitalizations. I mean, one of the things I do in my office all the time when I have a patient with heart failure and I see them in the office, I tell them, I say, before you go to the hospital, if you start to notice your shorter breath, and it's Monday through Friday and the clinic is open, call my office, come see my nurse, she'll put an IV in you, give you IV Lasix if you need it, and send you home to try to reduce you being in the hospital.
So it's a very common thing. It's gonna happen once in a while. But if you can get it to, you know, instead of it happening once every other month, which I've seen people like that, if you can get it to be maybe once a year, they get hospitalized just because things get really bad.
That's far better than being hospitalized five, six, seven times a year. Because every time you go in the hospital and stay there, you're at risk of infection, you're at risk of complications, you're at risk of all this stuff happening. So as nice as the hospital is, it is not a safe place to be.
[00:26:24] Speaker B: Thank you for sharing this. And really, you're opening the door for hope. Fewer ER trips, fewer hospitalizations, proactive, proactive medication and more independence. That's a better quality of life.
Dr. Sambal, how can people reach out to you if they'd like to learn more about this, or if maybe they don't have a cardiologist and they're in the area, how can they reach you?
[00:26:45] Speaker A: Sure, we're available online. It's complete cardiology care. Yasser Sambal MDPA we have a website. I'm on Facebook, I'm on Instagram, I actually have a YouTube channel. Yasser Sambal MD anywhere. My information is all over the Internet.
[00:27:03] Speaker B: And you have a show now too?
[00:27:05] Speaker A: I have a show, yes. Called Real Medicine, Real Lives. Yes.
[00:27:09] Speaker B: So definitely check out Real Medicine, Real Lives because you'll get even more of this. So the moral of the story is don't wait for symptoms to tell you you're in trouble. There's new technology out there that really can give your physicians feedback and help you manage things before they get out of control.
It's really important that we stay up to date on these innovations that we advocate for ourselves. Because if we don't advocate for ourselves and our loved ones, then how do you know what's coming down the pipes or what's already here that can actually help you better manage? Thank you so much for your time and your expertise, Dr. Sombol, for your commitment to bringing this life saving technology to patients in our community. Thank you for coming today.
[00:27:47] Speaker A: Thank you for having me.
[00:27:49] Speaker B: Absolutely. And for you, if you or a loved one is managing heart failure, talk to your cardiologist. If you need a second opinion, reach out to Dr. Sombol. But today's the day to find out what's possible so that you can have a better quality life. We will be right back with more life changing insights right here on Vital Signs after these important messages.
[00:28:30] Speaker C: Foreign.
[00:28:39] Speaker B: Welcome back to Vital Signs. If you're just tuning in, you're going to want to go to NowMedia TV, click on shows and catch the first half of today's show where we talked about all things cardiology and innovations and technology in that space. It was really exciting. You're not going to want to miss a moment of it. But now we're going to switch gears a little bit because I have a global leader in innovation, technology and future forward solutions. Stephen Ibaraki has been at the forefront of AI robotics, everything you can imagine technology, and he's really a good resource for what's coming down the pipes in healthcare. And what does this mean for us? How can we pull back the curtain and take really take ownership of our health and our well being?
What do we have access to and what's coming next in medicine? How do we maximize our greatest asset? Welcome back. Welcome to the show, Stephen.
[00:29:36] Speaker C: Yeah, it's a real pleasure, Jen and I love that energy.
Really excited about what's up coming here.
[00:29:43] Speaker B: You know, medicine's transforming faster than ever. I was in sports medicine for 20 years and when I look at what I was doing in the 90s compared to what's here today, it's mind boggling. AI, robotics, meditech, rewriting the rules.
But a lot of our average people, our average practitioners and our patients feel a little bit left behind.
You're sitting at the intersection of innovation. What major shifts are you seeing shaping the future of medicine and healthcare?
[00:30:15] Speaker C: Before I get into that, let me just give you a little bit of context.
I was predicting the future when I was really like, actually I built an AI computer and then in about 60 years out, and then the 70s when I was building microcomputers, predicting, you know, 50 years out. And let's bring that now back to so like the present, right? In 2015, I was asked by a group of 100 CEOs to predict where we're going to be Today, you know, 10, 15 years in the future. So really today. And I actually was predicting what's happening in bioscience and quantum computing and chip technologies, AI, machine learning. And I did the same thing at a software engineering conference the following year. And I've been doing this since then. So what we're leading to is really the unimaginable. I mean the just amazing things that are going to be upcoming. For example, I believe that in the lab anyways, aging will be resolved within the next few years though through regulatory hurdles. And that it maybe take 10 years to kind of reach different parts of America. But let's say in other parts of the world where they have different regulatory schemes. It'll be sooner than that.
Basically every kind of cancer, you'll have some kind of regimen to effectively cure it. I'm actually working right now on the Terasaki Institute, one of the top biomedical institutes in the world today.
Our CEO Ali Condamusini is ranked in the top 10 in the world. And we're actually working on 3D printing of organs. Can you imagine that you need a new liver, you can basically order one. You're not going to have any immune response issues and it'll be at a reasonable cost because you'll be to kind of manufacture these.
So can you imagine that? You know, I've got eye issues. Well, these being completely cured in some way through using gene technologies and their kind of regenerative technologies. You know, let's say you're diabetic and then again using regenerative technologies being able to address that. And I'm not talking 50 years out or 100 years out, I'm talking within the next five, 10 years.
[00:32:35] Speaker B: That's fascinating. So before, before we go deep, I'm going to interject a little humor because when you're talking about replacing body parts, I immediately think about so cyborgs and like science fiction. But the reality is science fiction is a reality. Today it's coming, it's here or it's on the 5 year to 10 year timeline.
So what can we do to prepare ourselves for this? Because this is frightening for a lot of patients, especially a lot of people, because we've grown up watching Terminator and Cyborg, all of these crazy things and they're very fear, probably provoking. So what can we start doing to move through that so that we're ready for the technology as these breakthroughs come through?
[00:33:21] Speaker C: You know, I did an interview a few years ago with Philip Huang. He's really the top chip scientist in the world today. And in fact he won an IEEE award for this work. And he talked about current work and this is two years ago where they're able to implant chips into a cell and then manage how that cell functions or even being able to micro dose through these chips that are implanted into Cells. So what's happening then is how do you prepare for all of this revolution that's occurring?
And that is you've got to stay up to date and make yourself sort of open minded to what's happening in the different research labs and what's happening through government labs and things like that. Now how do you do that then? You've got to access materials. So for example, I always recommend there's an organization called the ACM association of Computing Machinery. We're number one in computing science. And ieee, we're number one tech engineering. And we actually produce a daily newsletter, both of them kind of taking it from different angles. But we cover things like magical things that are happening in healthcare and that is accessible or will soon be accessible. And this way you can keep up with what's happening in the medical space.
[00:34:40] Speaker B: So I'm going to ask you, because you have been predicting these things for years, what are you most excited about with regards to the breakthroughs today or in the next couple of years? What excites you the most in this arena?
[00:34:56] Speaker C: Yamanaka won the Nobel Prize in 2012, where this ability, the four Yamanaka factors, right, you inject it into an adult cell and you can regress it into a stem cell, but let's say you put it into an organ and you stop it somewhere mid in its rejuvenation journey. So variations of that and other kinds of technologies. The fact that really myself, even though I'm in my eighth decade of life, I will now have the option to live forever. So what does that mean? That means I'm contemporary with my kids.
It means that I got to think about sustainability in a different way for me professionally, but business wise in terms of my integration with the global ecosystem. And then all of you have to consider that as well. What does that mean to you in your life? So I would say that's the thing that will have the biggest impact.
[00:35:49] Speaker B: Well, let me ask you a question, and this is a very human question. The first thing that I go to, because I've been following this and I've been thinking, thinking about this a lot. If I always planned that I would live to like, you know, 90s, 100 maybe, because that's how I grew up as well.
And now we're faced with these other options and this is a reality in my lifetime, there's a little bit of existentialist fear there because, well, I didn't plan to live that long. So I've done so much and sort of, if we think about we're living to 120, 180.
We've crammed a whole lot into now. What else is there? Where do we go from here? So what does that do for our mental health and well being? How do we prepare for that? How do we shift our mindset around that? Because that is another fear provoking observation and opportunity. But it also is an exciting one at the same time. So how do we shift from fear towards this is exciting. This is how I'm going to look at this. Because our identity has been for so long wrapped up in we're going to die at a certain point in time. And we've planned for that for so long now.
[00:36:58] Speaker C: One of the advices I give in all these private, you know, I do a lot of private talks and things like that is think in a combinatorial way. So in other words, access things like the ACM or the ieee and we have these daily news feeds of the latest technologies and solutions and the impact it's going to have. And then think and then spend time when you're in the shower, going for a walk, when you're doing other activities, kind of think in a combinatorial way. And what I mean by that is think about this piece of information here and this piece of information here and your neighbors who are artists and there's musicians and all their conversations and think about the integration and the synergies that are existing across all of these different areas. And then put your mind forward in an optimistic way and that will help you to prepare, but also help you to co create in your new future and to ensure that you're prepared for your new future.
[00:38:00] Speaker B: I love the way that you put that. And I couldn't agree more because you know, our life is already filled with many transitions, you know, from school into the workplace, as our career advances, as we come parents, parents, as we become grandparents. This is just another transition and hopefully more future transitions. So if you're watching, I just want to summarize.
Start learning.
Use the ACM or IEEE resource. Learn about AI. Overcome your fear. There's a lot of things happening in healthcare that's really exciting and longevity is the most exciting for me as well. But it does mean that things that we've thought were going to be the case may actually be completely different. And we're seeing it in real time. What an exciting time to live. Shift that fear into excitement and begin to imagine and create what that next level might look like for you.
But Steven, we do have to take a brief break. How can people reach out to you or follow you. I know you've interviewed many people in the space, so how can they find those interviews?
[00:39:05] Speaker C: Just search for the term ACM or IEEE and my name and interviews and you'll see my interviews. And I've been doing interviews for decades, but they still exist from 2000 forward.
So there's about 1500 there. We definitely have a lot of people in the healthcare space.
I got one coming up with Bob Langer, by the way, he's the most biomedical innovator in history with over 450,000 citations.
[00:39:36] Speaker B: I can't wait for that. I'll be watching that. So folks, if you're listening, check out Stephen, follow Stephen, go to the ieee, find his interviews, start learning about the future of healthcare. Because guess what? It's not in some distant lab, it's already in motion. From diagnostics to robotic surgery, you're going to stay informed. That's your first step. Know what's coming. Stay informed. And that empowers you to make the best decisions for you so that you can advocate for your health and well being. We will be right back after these important messages.
[00:40:21] Speaker C: Foreign.
[00:40:38] Speaker B: Welcome back to Vital Signs. We are here with Stephen Ibaraki breaking down what does the future of medicine and wellness look like? We have talked about the tools to radically improve our health, our longevity and our well being.
But you need to be your own health strategist. So Stephen, one of the biggest things that I am an advocate for on this show is how can we advocate and ask our doctors, our healthcare providers to adopt some of these newer technologies and to stay informed? Because the reality is there's a divide in medical practitioners. The ones who are very technology forward and staying up with the times and introducing these and then the ones that are not. So how can we as patients and general population, what can we do, say or advocate for ourselves with the practitioners who we currently are working with?
[00:41:39] Speaker C: That's the interesting thing. You want to make sure that there's this kind of idea of incorporating inclusion so whenever new technology is there that the practitioner feels that they're part of that circle of trust. And any of your conversations, when you're engaging different kinds of technology tools to assist you, making sure that you're acknowledging the value of the practitioner and that engagement you have in that practitioner and indicating that you see that engagement continuing forever because you need that human touch and the value of that human touch and what the technology does, it just, it creates a more optimism or options or kind of a safer route for you working in conjunction and partnership and co creation with the practitioner. So, you know, use words of inclusion anytime you're talking with your practitioner.
[00:42:42] Speaker B: I love that. You know, it's really funny because some of the things, some of communication has kind of broken down over the years with technology. We've gotten more comfortable texting in shorthand than we have actually having that human conversation. But the reality is, is as technology advances, as some of these amazing things come to fruition, it's going to free up our practitioners time so they can spend more time with us. So talk to me a little bit about what you see in the next 12 to 18 months for personalized care, AI supported diagnostics and some of the things that are here now and being rolled out now. What do you see in the immediate future as a benefit to us when we're looking for that advanced, maybe advanced testing or early detection or that more personalized care?
[00:43:33] Speaker C: There is something called Microsoft for Startups and there's an entire division within Microsoft for Startups called Health and Life Sciences.
The head of that program, her name is Sally Ann Frank and she's written a book called the Startup Protocol and she's got a new one coming out in January called the Unicorn Protocol. I recommend you have a look because it'll tell you how to integrate different kinds of solutions into your practice, like your personal regimen and things like that. Because you'll discuss some of the, the great innovators that are out there. And by the way, it's free if you're a startup or entrepreneur or you're thinking that way. Anybody can join the Microsoft First Startups program.
You can get up to $150,000 of Azure credits. It's non dilutive. That means they don't take equity or anything like that. And you know, there's a lot of capabilities within that system.
There's another gentleman that I really, really respect, his name is Dr. Stephen Chaya and he's a really a servant leader. I follow his work. In fact, I'm working with him now on co leading a new investment vehicle.
So you can search for him, you can search myself. But we're definitely, you know, investing in this space. And so some of the things that we'd be investing in would be things that you could use.
It would be practical for you.
Microsoft actually recently announced something called the Microsoft AI Diagnostic Orchestrator. And I may have the terms maybe slightly wrong, but you know, take a look. It was really interesting work. What they did is they did a piece of research with, they looked at maybe 300 of the most difficult problems that are out there or challenges in healthcare. And they wanted to see how good this orchestrator was versus doctors.
And it scored four times better, about an 85% accuracy rating.
And what they did is they used a variety of AIs and these variety of AIs would talk to each other and discuss a particular health challenge to come up with a diagnosis.
So can you imagine as this becomes more readily available and things like that, and then working in conjunction with doctors, so never replacing them, but working in conjunction with doctors, then you're going to have the means to have quicker access to what the particular issue is and then ways to actually address it and a, in a faster way. You know, there's more sensors in your, up in your watch or in your, in your phone than existed, let's say 10 years ago.
And they can increase your well being. So continue to track what's in your, the different kind of wearables that you have so that you know it'll increase your ability or both your mental well being but also your physical well being as well. So and the thing is you'll be able to track that by keeping like looking at the news briefs with the ACM or eee.
[00:46:43] Speaker B: I'm giggling to myself because I'm thinking you're always talking about these innovations and how amazing is it as a former healthcare provider to have the access to all of the data, all kinds of data points and have that at your fingertips. It just makes you a better clinician, a better diagnostician because you're able to leverage so much more information in a short period of time. It allows you to ask better questions and it allows you to give more personalized care. So basically these innovations are allies to our clinicians and practitioners. So if you're watching this today, this is gold.
Educate yourself and then advocate. Have the conversation with your preferred providers because it may be that they've just been busy and haven't kept up with this, but bring up some of these innovations and say, hey, I'm really curious, is this something that we can expect in the future of care? Because that's how we advocate for ourselves. We don't have to be a scientist to be empowered, but we do have to be curious and proactive and well informed. So I strongly recommend you reach out and follow Steven's work, look at what's happening, utilize the resources that he provided and advocate for yourself and Steven to you. Thank you so much for unpacking some of these complex ideas in a clear and practical way.
So before we close, we do have just a couple more minutes. What do you want to leave with audiences? If you could leave them with one thing that they could take away today and take action on, what would that be?
[00:48:21] Speaker C: Think about the embodiment. You talked about this before. Think about the embodiment of all of this tech and a robot and that's going to be living with you and assist you in your day to day wellness and plan for it.
[00:48:34] Speaker B: Thank you so much. I appreciate your time. Thank you for bringing your expertise and I know you're an exceptionally busy individual. So thank you for spending time and bringing all of this to our audience. I appreciate you.
[00:48:47] Speaker C: Thank you.
[00:48:49] Speaker B: And you. Yes, you. Unfortunately, all good things do come to an end, including this show. But the good news is we'll be here same time, same station next week. But before then, stay curious, get proactive, learn and take your health into your own hands.
Have an amazing rest of your day and I'll see you same time, same station next week.
[00:49:22] Speaker A: Sam.
