[00:00:00] Speaker A: Well, ladies and gentlemen, we have a real treat this morning. I'd like to welcome you to the real estate and more show, and thanks for listening. This segment I call catch your breath. Our guest is a man of highly respected for his life's work in the field of pulmonology and critical care. He's well known for helping folks with respiratory and lung issues while employing the late research from one of the greatest medical institutions on earth, the Mayo Clinic. Today, the good doctor will share with us issues of the lungs facing our population and inform us of treatments for them. Highly regarded amongst his peers as a world class pulmonologist, welcome to the show. Dr. Louis Wecilias from Mayo Clinic.
[00:00:45] Speaker B: Thanks very much, Michael.
[00:00:46] Speaker A: It's certainly our pleasure to have you on board. Well, thank you again for being on. We appreciate your professionalism and willingness to share this information with our listeners, because where else do you go except waiting for doctors appointments and such? It's really, well, not at Mayo, but at a lot of long time to get a doctor appointment. And it's really good to be able to provide some information to our listeners to where they have some kind of an idea of what pulmonary issues are, what can be done, how they're treated, diagnosed, and so forth. And you're the source, my friend.
[00:01:21] Speaker B: Sure.
[00:01:22] Speaker A: So how old were you when you first started your interest in medicine?
[00:01:27] Speaker B: Well, I grew up in a medical family because my father was a doctor and my mother was a nurse. So you sort of start off with that being kind of front and center as a career option.
And I always enjoyed hearing my dad talk about cases, and my mom worked as a nurse once we were a little bit older, so it was kind of always there in front of me, and it was a field I thought I would enjoy. And it turns out it's been a good career choice for me.
[00:01:59] Speaker A: So when did you decide to narrow it to pulmonary care? I mean, it seemed like it would be a hard decision. You become a physician, and then how do you decide which direction to take as a Specialty?
[00:02:13] Speaker B: Yeah, I think a lot of it depends on kind of just your experiences in medical school. You go through each of the rotations, and I sort of like some aspects of each rotation I was on, whether that was pediatrics or OB.
I wasn't real wild about surgery, but medicine was appealing. It's a little more, I guess, academic or thought in terms of trying to solve mysteries. And that challenge I enjoyed. And then I liked cardiology. I liked pulmonary. Pulmonary and critical care seem to offer a wide diversity of patients so that's probably what attracted me the most to that field, folks.
[00:02:56] Speaker A: Pulmonology is the branch of medicine that specializes in diagnosing and treating diseases of the lungs and other parts of the respiratory system. We're talking diseases like asthma, emphysema, tuberculosis. And, you know, doctor, you are a resident of the University of Arizona, then a fellow in pulmonary and critical care at the University of California and San Diego. I bet you wish that you had bought property in San Diego back then before coming to Mayo.
[00:03:25] Speaker B: You're right about that, Michael.
Looking back at some of the places where I used to live and what they're going for now, it's pretty amazing.
[00:03:36] Speaker A: Were you a surfer back in those.
[00:03:39] Speaker B: No. Well, a boogie board, but that's about it. Not a surfer.
[00:03:44] Speaker A: I should mention to our folks that you received the Upjohn Achievement Award for outstanding resident at the University of Arizona, as well as the outstanding teaching award at the University of Kansas. That's pretty amazing. And since 2005, he contributed as the fellowship program director at the Department of Internal Medicine. That's impressive. I mean, I'm not trying to brag on you, but I'm bragging on you further. I have to mention that Dr. Wasilius has authored more than 58 medical publications, not to mention articles just on matters of the lungs. And I'm sorry, doc, but I got to ask you these questions. No, you're not a realtor. I can go very long without taking the pulse of the current real estate market conditions. And how is the Phoenix area down there? Are you seeing a lot of multiple offers? Is it still a seller's market slowed down? What do you see?
[00:04:39] Speaker B: Yeah, well, sure, I think with, not that it's something that I watch every real often, but I think the market is still pretty good, even though interest rates, obviously mortgage rates are higher. But I know just in our neighborhood, homes have still sold pretty quickly. I don't know about the multiple offers, but a few of them have been very close to offering price or even one I saw recently still above offering.
You know, I think the market is remaining pretty healthy. I think the know in the Phoenix area is fairly know. So I think still from that standpoint, it is a seller's market.
[00:05:19] Speaker A: We're seeing a lot of the same here, too. My, you know, the Phoenix area offers so many things like hiking, biking. What do you do if you ever have time off?
[00:05:31] Speaker B: Well, if it's not the summer and it's hard to do much except swim, but, yeah, the rest of the year, I do enjoy hiking. I do play some golf, not well, but I do play golf.
I'm sort of a runner. I try to keep running as long as hopefully my legs last a little bit longer.
Allow me to keep doing that for a bit.
[00:05:52] Speaker A: My doctors are on me for not running so much, but walking fast, and I haven't really been the best patient, so I'm going to have to really step up my game on that one. So enough of real estate and hiking and all that, but let us get into medical a little bit. Am I correct in understanding that you practice in the field of critical care as well as the field of pulmonology? Are you like me? Do you just love to work?
[00:06:18] Speaker B: Well, I have always enjoyed the work.
When I was younger, I did a little more critical care, and now that's sort of a younger person's field since there's a lot of nighttime work. But I practice predominantly pulmonary at this point. But I really do enjoy it. It's a challenging field. I wish a lot of times there was more we could do for patients, but it's come a long way since I was a fellow and a resident. There's much, much more we offer today that just wasn't available 30, 40 years ago.
[00:06:54] Speaker A: Wow.
Interesting. And tell me if I'm not right. The Mayo Clinic is known for its ability to coordinate specialists to discover the cause and then treat medical issues further. It seems to me Mayo clinics practice to huddle together their doctors for the purpose of solving complex diseases is like a norm there. Can you add anything to this in.
[00:07:17] Speaker B: A positive think it. I think that has been one of the strong pluses of Mayo Clinic and some of the other multispecialty clinics like the Cleveland Clinic, is probably on a fairly similar model. But yeah, it is, I think, very helpful, particularly in complex problems, to have people kind of in the same office space close by so you can easily interact, discuss things with the radiologist, discuss things with the pathologist. Having that all together and working regularly together does, I think, benefit the patient.
[00:07:55] Speaker C: We're going to take a short break. We'll be right back.
[00:08:02] Speaker D: Michael, what traits should we look for in selecting an agent?
[00:08:05] Speaker C: Look for a deal maker with a positive attitude who will work tirelessly for you. An agent who is adept in multiple offer situations, drafting contracts, marketing and advertising. A client's home is familiar with multiple cultures, experienced in mortgage financing, inspections and escrow is a huge asset to his client.
[00:08:25] Speaker D: What can you do as a plus for clients?
[00:08:27] Speaker C: Your agent is your eyes and your ears, one who works behind the scenes on your behalf. A great attitude, working well with others and keeping clients priorities. Number one is a given for us.
[00:08:38] Speaker D: Call 925-32-2775 now to schedule an appointment or complimentary home analysis for excellence in real estate, call the Michael Hatfield remax team at 925-322-7775 or go to michaelhatfieldhomes.com.
With low housing inventory and constantly changing mortgage rates, buying or selling home is challenging. Choose an experienced team. Who cares? Here's Michael Hatfield in a quiet cul.
[00:09:10] Speaker C: De sac near the quaint town of Clayton. Revel in the wonderfully tall ceilings and open and spacious elegance of this immaculate 3320 1 bedroom, three bath masterpiece. 22 Wordsworth Court in Concord boasts outdoor living at its best, with sparkling pool and newly built gazebo. Plenty of room for an rv or a possible adU. Highly ranked schools in a warm, sensitive neighborhood here. Don't miss this dream home.
[00:09:40] Speaker D: Get help with buying or selling a home by calling the Michael Hatfield remax team at 925-32-2775 that's 925-32-2775 or go to michaelhatfieldhomes.com. That's michaelhatfieldhomes.com.
[00:09:57] Speaker C: Now welcome back to our show.
[00:10:01] Speaker A: I understand that Mayo in Scottsdale has bought a lot of property to add to their research and development.
I'm not sure if it's north of the 101 loop, but mostly south, but a tremendous amount of land to expand the research and development facilities. Folks, a lot of people don't know that Mayo is really a leader with research and development in specialties and such, and it's hard to beat. I know that my experience at Mayo Clinic has just been amazing.
So anyways, part of pulmonary and critical care, a physician needs to be somewhat knowledgeable in all of these areas of the body, and the body is so complex that the more that you know, at least on the surface, can lead you in a direction with a diagnosis that you might not have thought of before. Do you find that that happens a bit? I know you have a lot of background.
[00:11:02] Speaker B: Yeah, I think being one of the things I think that's maybe been not as helpful in medical care is the extent to which a lot of people in medicine specialize when you get into a narrow, focused area. And I think having a pretty good knowledge base.
For example, pulmonary and cardiology overlap quite a bit. Patients can be shorter breath because of lung problems. They can be shorter breath because of heart problems. And sometimes distinguishing that is not the easiest. So you have to be able to pick up cardiac problems, pulmonary problems. Sometimes it can be musculoskeletal or neurologic problems. So having that broader background and keeping up to date to some extent in those areas is, I think, important to really provide optimal care for patients.
[00:11:57] Speaker A: Oh, I understand. So your primary specialty and focus is on interstitial lung disease?
[00:12:05] Speaker B: Yeah.
[00:12:06] Speaker A: Institial. Okay, interstitial. Well, I'm a layman here.
[00:12:11] Speaker B: Tough word.
[00:12:13] Speaker A: An obstructive lung disease for people like me that can't even pronounce it, just what is interstitial disease and what is obstructive lung disease?
[00:12:24] Speaker B: Yeah, well, one of the oldest diseases that people have been aware of going back even to hippocrates in that area is asthma, which would be one of the main types of obstructive lung disease.
That's where airflow is obstructed. Patients just can't move air in and out of the lungs easily and quickly. The lungs really just have to do two things, as I tell patients, be able to move air in and out quickly if needed. When you're exercising easily, and then also get oxygen from that air into your blood.
The obstructive lung disease makes it difficult to move air in and out. So COPD or chronic obstructive pulmonary disease is another obstructive airway disease. And then there's some that are less common, cystic fibrosis, more of a congenital disease in children, and bronchiectasis is another disease of the airways. Those are all airway disease, obstructive diseases.
Interstitial disease is more of a scarring, inflammation and scarring in the lungs. And we can see that. Well, for example, people that get exposed to toxic dust like asbestos or silica, that'll scar the lungs. Some patients who have rheumatoid arthritis, let's say, can get scarring of the lungs.
But then there are a number of idiopathic diseases that can scar the lungs. Sarquidosis, some of your listeners may be familiar with that. Idiopathic pulmonary fibrosis is another one that's a devastating disease that often those patients, if they're candidates, require a lung transplant because of the progression of the disease.
[00:14:06] Speaker A: Good to know, folks. We're speaking with Dr. Louis J. Wasilius. He's a pulmonologist in Scottsdale, Arizona, and is affiliated with the Mayo Clinic, Arizona. He received his medical degree from University of Kansas School of Medicine and has been in practice for more than. We're not saying he's a young guy, long time. Dr. Brucillius has expertise in treating sleep apnea, asthma, bronchitis, among other know it's just amazing to me when we start talking to the human body or we look at something, it's just amazing how all of it tends to be interconnected. It is a work of art unlike any other, and we just have to applaud physicians such as yourself that take it upon themselves to walk among us and help us with these issues. So have you found that sometimes issues of the heart sometimes affect or manifest into lung and respiratory issues, and if so, how often?
[00:15:08] Speaker B: Well, yeah, definitely.
The heart and the lungs really have to work well in tandem, because the lungs basically put oxygen into the blood, and the heart pumps that oxygen and other nutrients throughout the rest of the body. So the most common interaction, I would say, is if you end up with any component of heart failure, if the heart is no longer pumping blood very well. And that's a fairly common problem, particularly as we get older.
But then fluid can often back up into the lungs and give you what we call pulmonary edema, or congestive heart failure with pulmonary edema. So that's a very common interaction where the fluid is backing up into the lungs. It can sometimes look like a pneumonia or look like other problems that are specific to the lungs, when in fact, it's really more a manifestation of the heart not functioning well. Similarly, when the lungs get diseased, it becomes harder for the heart's right ventricle, the ventricle that pumps blood through the lungs. There can become more resistance to that blood flow going through the lungs. So the heart can fail, the right ventricle can begin to fail. And we actually call that core pulmonali is a term we use which means right heart failure due to the lungs.
So they interact quite a bit, and the symptoms overlap a lot, too. Shortness of breath can be due to the heart not pumping enough blood or the lungs not getting enough oxygen into the blood, or people having to work very hard to breathe because they have some underlying lung disease.
[00:16:45] Speaker A: Good to know. I know. Persistent cough, it's all over the place. I run into people coughing all the time, and you don't know if they're sick or whether or not it's asthma or whether or not they have other. Some complex type of ailment that affects them. It's right up there with the top three with shortness of breath, abnormal findings on a chest or x ray. What are the most common pulmonary problems that you see as a pulmonary specialist?
[00:17:14] Speaker B: We're sort of in a referral program practice here at Mayo. So we see a lot of referred patients that are fairly complex, but still, I would say chronic cough is right up there as one of the top ones, as well as somebody coming in because somebody had a CAT scan for one reason or another, a CT scan, and something showed up on the CT scan, and they're worried about lung cancer or some other serious problem. But the chronic cough. In chronic cough, we define as any cough that persists longer than eight weeks.
Shorter than that. It's usually related to a respiratory infection. But if it lasts longer than eight weeks, then we start thinking of other causes of chronic cough, such as asthma, chronic bronchitis reflux, gastroesophageal reflux can be a cause, allergies with nasal drainage. And then we're picking up more patients now that have what we call laryngeal hypersensitivity, which is just a problem where the cough receptors in the larynx get overly active, so that it takes less and less to trigger a cough in those individuals. Wow.
[00:18:27] Speaker A: Very interesting. In my view. Is the voice box and chronic cough sometimes associated or interconnected?
[00:18:35] Speaker B: Yeah, absolutely.
You have a tremendous number of what we call cough receptors. Those are nerve endings that will trigger a cough. The cough centers in the brain, but those receptors and nerves that are in the larynx or right above the vocal cords, there's a lot of cough receptors there. So anything that irritates that area, and that can often be reflux or post nasal drainage. And sometimes we don't know why. It's just idiopathic. That area becomes very sensitized. And so cough things that would not normally trigger a cough, like just an odor, cooking odor, let's say, or somebody with cologne or perfume being close by, that'll trigger a cough when typically. Normally, it wouldn't be enough to cause that.
[00:19:27] Speaker A: And are some of these issues that we have, are they associated with age? I know you alluded to that earlier. Maybe we can expand a little bit on that. I mean, I'm a young guy. I'm only 25.
[00:19:37] Speaker B: Yeah, I know.
[00:19:38] Speaker A: I've got a few years before I have to worry about it.
[00:19:41] Speaker B: Yeah, you don't have to worry about. That's a good age to be because your lungs, both in men and women, start to decline in. Your lung function actually does start declining for men, like around 30, maybe late twenty s. You start losing a little lung function each year just with aging.
So what's normal at age? Let's say 40 is less than age 20 or 30, and certainly at age 70, let's say normal lung function is less than age 60 or 50. So we all lose a little bit of lung function gradually, but we don't notice it because we're not as active at 70 as we are at 30.
[00:20:21] Speaker C: We're going to take a quick break. We'll be right back.
Michael Hatfield remax team with low housing.
[00:20:28] Speaker D: Inventory and constantly changing mortgage rates, buying or selling home is challenging. Choose an experienced team. Who cares? Here's Michael Hatfield in a quiet cul.
[00:20:37] Speaker C: De sac near the quaint town of Clayton. Revel in the wonderfully tall ceilings and open and spacious elegance of this immaculate 3320 1 bedroom, three bath masterpiece. 22 Wordsworth Court in Concord boasts outdoor living at its best, with sparkling pool and newly built gazebo. Plenty of room for an rv or a possible adu. Highly ranked schools in a warm, sensitive neighborhood here. Don't miss this dream home.
[00:21:07] Speaker D: Get help with buying or selling a home by calling the Michael Hatfield remax team at 925-32-2775 that's 925-32-2775 or go to michaelhatfieldhomes.com. That's michaelhatfieldhomes.com, wakelehatfield real estate and more.
[00:21:26] Speaker C: Now, welcome back to our show.
[00:21:31] Speaker B: But yeah, even some patients who are near Arizona here, some patients who are in their 90s, find that if they're living at elevation, they begin to have trouble just because their lung function has declined as they've aged. But other things go on when you're getting older, too. For example, issues like reflux, gastroesophageal reflux, become much more common.
And that's one of the mechanisms by which you can sometimes get pneumonia. You can get reflux into the back of the throat, a little bit of that material can get into the lungs, and that's a common way for patients to get pneumonia is a little bit of what we call micro aspiration, and then you're a little less active if accidents happen, people get sick, have a bone or joint issues.
That level of inactivity can kind of complicate things in terms of the lungs.
[00:22:26] Speaker A: So very interesting.
I never really thought that there was so much behind each specialty, especially pulmonology. It just seems like there's a depth there that you have to constantly stay on. I know in the airline business you're always trained every six months for issues and such, and I would think that with the institution that you're at that they constantly provide that training and interactivity with other physicians and other specialties. And I got to say that I think that's really something to be admired in my book. Anyway, a few shows back, we interviewed Bay Area personality and author Karen O'owock. She a really nice lady. She's worked in cardiopulmonology rehabilitation for a few decades in the Bay Area VA medical centers. And she was saying, interestingly, they should make sure when doctors intake that they have on their form. Did you have military service? Because military tenure tends to affect a lot of individuals, I would think, and would give you a hint at a diagnosis that you might be interested in.
[00:23:43] Speaker B: Yeah, that's very true.
It depends a lot on the era of service and knowing kind of what was unique to each time in service. There's fewer and fewer World War II veterans, but through World War II, particularly, but also in Korea and to some extent in Vietnam, military service personnel were exposed to a lot of asbestos that was very commonly used in ships, aircraft, submarines were very often, because it's a great insulator against fire. So it was used extensively. So a lot of veterans that were in the Navy, let's say, got exposed to quite a bit of asbestos. So we certainly ask about that.
And then there's been some health risks associated with Agent Orange, of course. So you can ask about that. Not so much lung issues, but there have been some, it's been a little controversial in terms of how significant that was for lung issues.
And then Iraq war veterans. There were these burn pits in Iraq that a lot of veterans got exposed to in the iraqi war, Desert Storm, I guess.
And so that clearly had some damaging effects on the lungs of some veterans. So kind of knowing exposure history, what they may have been exposed to in their military service, that's very important in kind of assessing what's maybe causing lung issues.
But it's a gratifying field, and I'm glad we're making some progress, and hopefully the next generation is going to benefit from some of the progress we've made in this generation.
[00:25:34] Speaker C: What a great subject. I have to confess that I've been unable to finish with some of my best questions regarding the subject of pulmonology with our esteemed guest, Dr. Louis J. Wasilius of the Mayo Clinic. Dr. Wasilius has so generously offered to come back next week and finish our show entitled catch your breath, part two.
[00:25:56] Speaker A: Thank you so very much for being on the show. Dr. Louis J. Wasilius, the Mayo clinic specialist, one of the world class specialists in pulmonary as well as critical, know these wonderful human beings like Dr. Wasilius go entirely out of the way to make patients in some way better. And having the vast research and development resources of the amazing AO clinic behind these efforts. Miracles can and do happen. Thank you again for being on the show, doctor.
[00:26:27] Speaker B: Well, thanks very much, Michael.
[00:26:29] Speaker A: Listen to ondemand real estate and more
[email protected]. Slash Radio the real estate and more show is also podcast on all major podcast platforms. Tune in next week and until then, have a blessed week.
[00:26:45] Speaker E: The views and opinions expressed are based on current economic and market conditions and are subject to change. Information on the show provided for illustrator purposes only and does not constitute professional or legal advice. Information from sources deemed reliable but accuracy and completeness not guaranteed. Michael Hatfield and the Michael Hatfield Remax team have no liability for information discussed on the show. Consult with qualified professionals prior to taking action.
[00:27:14] Speaker D: We at the Michael Hatfield Remax team enjoy representing our valued clients. If you or someone you know is interested in buying or selling and wishes to schedule a complimentary appointment with the Michael Hatfield remax team, call us at 925-32-2775 that's 925-32-2775 or go to our website, michaelhatfieldhomes.com.
[00:27:38] Speaker C: I'm Michael Hatfield. Thank you for listening today. Join us next Saturday for the next real estate and more when we again sharpen our focus on house the market.
[00:27:48] Speaker D: Join us next Saturday and have a wonderful week. Best wishes and blessings to you.
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