[00:00:01] Speaker A: The Michael Hatfield remax team presents real estate and more.
[00:00:06] Speaker B: Bay Area real estate is different than all of America. And why? What's up with buyers? What's on sellers'minds? How is the market? And much, much more.
[00:00:17] Speaker C: Now here's your host, Michael Hatfield.
[00:00:20] Speaker A: Welcome to the real estate and more show, and thank you for tuning in. Friends. We have amazing people living amongst us who care for others and deploy their extensive education, knowledge and skills to help others. These are individuals who go out of their way to make a patient better. Last week, Dr. Louis J. Wasilius, pulmonary and critical care specialist of the Mayo Clinic, shared information such as diagnosis, new treatments, and his experience regarding respiratory illnesses such as asthma, sleep apnea, COPD, and other related diseases. I must confess, my interest in this interview last week distracted me to the point I did not finish all my questions. Dr. Wasilius has so generously returned to allow me to accomplish just that. Finish my questions. Thank you, and welcome back to our show. Well, renowned male pulmonologist and one of those remarkable angels living amongst us.
[00:01:25] Speaker D: Are there any new advancements, new treatments in your field of pulmonology? And what are they?
[00:01:32] Speaker E: Well, yeah, medicine keeps moving forward different, sometimes at a faster pace, sometimes at a slower pace. But I wish I could say there were a lot of new treatments in, in pulmonary. A lot of it, you know, is in.
For example, lung cancer is an area where we see a lot of patients. We help mainly to diagnose lung cancer, and then the oncologists take over to treat the lung cancer if it's not surgically resectable. And there's been a lot of advancement in the treatment of lung cancer, so that those patients which used to be, if it wasn't resectable completely, it was pretty much of a death sentence. And now they have some very good oncology treatments for lung cancer, which are really extending the life expectancy in a lot of those patients.
Probably we used to not be able to treat the interstitial lung diseases very well that we talked about earlier, pulmonary fibrosis. There now are a couple of medications that will unfortunately not reverse the fibrosis, but will slow it or stop it for an extended period of time and allow those patients to live a longer life.
And then lung transplant has probably been one of the biggest changes that we have now available that wasn't available, you know, in the past, lungs have been one of the last organs to have become a reasonable option for transplant in a large number of patients.
Used to be, we didn't offer that to patients over the age of 65, but it's now moved up to 70 and even up into the early 70s, where we'll offer a lung transplant in patients with advanced lung disease.
[00:03:19] Speaker D: Very interesting. I don't know if you knew this, but before my airline career, I flew as a lifeguard pilot, and when my kids, or our kids were small, we had an 18 year old young lady that was just an amazing person, and she drug an oxygen bottle behind her. And then finally we were on this little getaway for two days, Nancy and I, out on the coast, and we get a call, and she says, I'm so excited, I can't sit still. But I have your children here. And I just got called for a heart and lung transplant.
[00:03:52] Speaker E: Oh, yeah.
[00:03:52] Speaker D: At Stanford. And she received that and lived several years thereafter. So the state of the art has definitely changed since that time, which has been over 20 years ago.
[00:04:04] Speaker E: Yeah. She must have been early in the course of that being offered.
[00:04:08] Speaker D: Yeah. And another thing, doctor, we had the former transplant coordinator for University of Chicago on the, you know, he was just talking about how behind the scenes it all worked. I, as a pilot, knew that we'd be sitting on the apron waiting for the helicopter to arrive, and we'd be go in front of everyone. But everything that went, coordination wise, behind the harvest of the organ to the new implant of the organ and how it was determined was just an amazing show. So what you and Mayo Clinic do in that arena is just beyond me.
It's angels walk among us. So I would think if I had an issue with my lungs or coughing or chronic cough, how does a person actually decide when to come see Dr. Wasilius?
[00:05:11] Speaker E: Okay, well, there are a couple of red flags and then some yellow flags. I think certainly if someone is coughing up some bloody, some blood, that's always a red flag.
It's not necessarily something serious. If it's a small amount and just very transient, a lot of people with a bad bronchitis, a bad infection in the lungs, maybe even, say, with COVID sometimes that would happen. But if it persists, if that's happening for more than a week or so, let's say, or the amount of blood seems to be increasing, that's certainly a red flag.
A cough with other symptoms, like weight loss or fevers, chills. A cough is a frequent symptom, but it is, in retrospect, often the first symptom in lung cancer. So a cough that doesn't go away and no clear reason for it, no obvious recent infection that deserves to be checked out, particularly in somebody who's sort of at risk for that? An older patient, let's say, maybe with a smoking history.
So those are red flags. Cough with shortness of breath. If there are other symptoms with it, that probably needs to be checked more quickly.
So it depends on the context and the age of the patient and those sort of issues.
[00:06:47] Speaker D: Isn't there a difference between men and women in regards to lung cancer? Isn't the lung cancer a little different between men and between women, or how does it best?
[00:06:57] Speaker E: Yeah, that's true. Yeah. The main difference that we're seeing, unfortunately, is that in women, there's a much higher frequency of lung cancer in women that are non smokers, that have never smoked cigarettes, let's say, or never smoked anything. So the reasons for that are not totally clear. But maybe 20% at least of lung cancer in women is in a non smoking population of women. It's a much smaller percentage in men. There are fewer men who've not been cigarette smokers. There are some things that can increase your risk of lung cancer if you have a family history or you've got exposed to toxic exposures that you may have worked around in a work environment. So some men are exposed that way, but in women, yeah, we're seeing lung cancer in more non smoking women. And younger women recently have had several women in their early 50s, which is young for lung cancer to show up.
So we have to be a little more careful in looking for that in women, even though they've never been a smoker and otherwise wouldn't think about lung cancer as being very likely.
[00:08:15] Speaker D: Very interesting.
[00:08:18] Speaker C: We're going to take a short break. We'll be right back.
[00:08:25] Speaker F: Michael, what traits should we look for in selecting an agent?
[00:08:28] Speaker A: Look for a deal maker with a.
[00:08:30] Speaker G: Positive attitude who will work tirelessly for you.
[00:08:33] Speaker A: An agent who is adept in multiple.
[00:08:35] Speaker G: 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.
[00:08:48] Speaker F: What can you do as a plus for clients?
[00:08:50] Speaker G: 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.
[00:09:01] Speaker F: 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.
[00:09:23] Speaker H: 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.
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[00:10:03] Speaker H: 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.
[00:10:16] Speaker C: That's michaelhatfieldhomes.com now welcome back to our show.
[00:10:22] Speaker D: I understand there's also been a few really great developments in regards to dealing with sleep apnea. And sleep apnea is when you keep waking at nighttime for one reason or another. But I understand there's new devices that can be used as well as a CPAP machine. Is that true or am I down the wrong path?
Interstitial, yeah.
[00:10:46] Speaker E: Interstitial, yeah. Well, I have to preface by saying that I have certainly worked with sleep apnea patients in the past, but currently we have a sleep medicine program, and so I refer the sleep apnea patients to those specialists in sleep medicine currently. And there is a device that basically stimulates the back of the tongue. There are some electrodes placed, I think it's called an inspire device. And the electrodes that are placed in the back of the tongue that keep the tongue from falling backwards, which is often what happens during sleep, that the tongue falls a little bit backwards and helps to, unfortunately leads to some obstruction of the airway when you're in deep sleep, very soundly asleep, and then that blocks breathing and oxygen level drops and you start to wake up and then the muscles tighten. But these implantable electrodes that are then stimulated by a remote device, and I don't know all the details of that, but it keeps the tongue from falling backwards. And that will treat sleep apnea in a subgroup of those patients who have, not all patients, but a subgroup, if they have the right anatomy, and they have to actually kind of check out your anatomy fairly carefully to make sure it'll be an option that works for you. But it is a new option that for patients who can't tolerate the CPAP mask, which can be tough for some people, that's another option that you can.
[00:12:27] Speaker D: Certainly look into, something to stimulate the tongue. I know you can also find down in Arizona. It's called a habanero.
[00:12:39] Speaker E: I don't know how well it works for sleep apnea. I think your mouth gets so you can't sleep.
[00:12:44] Speaker D: Best south of the border food ever.
[00:12:47] Speaker E: Yeah, if you like that.
[00:12:49] Speaker D: I don't know how you stay so young and slender, doctor.
[00:12:53] Speaker E: Well, I don't know. Hopefully.
[00:12:57] Speaker D: Wow. So, looking forward into the future, what do you foresee for pulmonary as well as critical care? Is there some things that come to mind that you are expecting that you may see in the future as far as advancements in treatments and diagnosis?
[00:13:14] Speaker E: Yeah, well, the technology is, and it's kind of amazing to see the technology that's developed over the course. The 40 plus years that I've practiced, the amount of imaging that could be done, the new ways of treating different diseases, it's really become a very technology driven field to a big extent.
So I think, at least in pulmonary diagnostics, testing is going to become progressively more sophisticated. And one of the areas that will be, I think, an area of big advancement is going to be looking at genetic factors and potentially gene therapies for different diseases.
A lot of disease, even some diseases, are very highly genetic. Cystic fibrosis, for example. And we now have diseases that can target specific gene defects that occur in some cystic fibrosis patients.
There are genetic factors in asthma. There are genetic factors in a number of interstitial lung diseases, for example. So if we can actually go back and treat the genetic defect in the future, which I think probably will become possible, we may be able to alter the life of somebody who otherwise would die from a genetic disease, risk that they would have a genetically determined disease, and we can prevent that.
I think transplantation is going to get better and better as we figure out ways to prevent rejection by the body. And so I wouldn't be surprised if that becomes something that's much more commonplace going in the future. And some of the things that are still real problems are really ones that have been difficult to solve so far. For example, Alzheimer's. And that disease has been a tough one to find good ways to treat. But I think eventually we will find some effective treatments for some of these diseases that lead to a lot of disability and loss of quality of life, particularly as we age.
[00:15:35] Speaker D: That's amazing. I know when I had the honor of flying the lifeguard organs that after the flight, you felt like you actually done something for other people, for mankind. For a doctor, I would imagine that feeling happens a little bit every day.
Do you still feel that way with helping people?
[00:15:58] Speaker E: Yeah, that's one of the great satisfactions of the job is seeing people get much better. And you still hear from patients, for example, that ended up having a lung transplant, let's say, and that they still remember. Some keep send cards each year on the anniversary of their lung transplant and express gratitude.
A lot of patients, there are a lot of wonderful people in the world and it's great to help people, and unfortunately, we can't help everybody. But I think compared to 30, 40 years ago, we're helping a much higher percentage than we did in the past.
So that's gratifying.
[00:16:46] Speaker D: Oh, yeah, for sure. I would think a doctor gets to see a lot of that gratification from helping others. I saw this quote the other day that said the pessimist thinks all of the bad things are going to happen where the optimist thinks all the good things are going to happen. And I think to be a doctor of your caliber and to do what you do for all of the people out there, it's almost you're one of the angels that walk amongst us. 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 a positive think it.
[00:17:41] Speaker E: 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.
[00:18:17] Speaker A: We're going to take a short break.
[00:18:18] Speaker C: We'll be right back.
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[00:19:11] Speaker F: Get help with buying or selling a home by calling the Michael Hatfield Remax Accord team at 1800 857 63. That's 1800 857 63.
[00:19:22] Speaker C: Remax, calbree 0149-3761 now back to our show.
[00:19:31] Speaker D: 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 conditions. What are the most common pulmonary problems that you see as a pulmonary specialist?
[00:20:05] Speaker E: 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.
[00:21:17] Speaker D: Yeah. Is there anything you'd like to say in closing today, sir?
[00:21:22] Speaker E: Well, I think you've asked a lot of good questions. I hope I've provided some reasonably good answers.
Medicine is a great field in terms of opportunity of meeting a lot of wonderful people and also seeing a lot of courageous people dealing with tough, tough problems.
It's not always fun when you're dealing with somebody who has a disease that's challenging to deal with, both for the patient and the doctor.
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.
[00:22:04] Speaker D: Very nicely. Very nicely done, my friend.
[00:22:08] Speaker A: I hope you've enjoyed our conversation today with world renowned Mayo clinic pulmonologist and critical care specialist Dr. Louis J. Wasilius. He is one of those remarkable people living amongst us, sharing what he has learned and helping those in need. Thank you, doctor, for being on the show.
At times during our show with Dr.
[00:22:35] Speaker C: Louis Vasilius, Mayo Clinic pulmonary specialist, I thought of a past interview with Bay Area's author, fit expert, and cardiopulmonary specialist Karen O'Walk, who endeavored to help patients for many years as well. Here are some important excerpts from the.
[00:22:52] Speaker A: Interview we did with Karen.
[00:22:56] Speaker G: Spent more.
[00:22:57] Speaker C: Than 20 years as a clinical exercise physiologist, having specialized in cardiopulmonary rehabilitation at the Palo Alto Va medical Center. As it is easy to say, you are very dedicated to the subject of nutrition, fitness and longevity.
[00:23:16] Speaker I: He had other diseases, too, at the same time. Type two diabetes, a lot of visceral fat, that's the belly fat. So high blood pressure.
Those are lifestyle diseases. And so I wanted to make sure that people knew that if they changed their lifestyle, they could live longer. And when they live longer, they don't miss out on a lot of things.
For some reason, as you get older, people stop bending their knees, and that means maybe their knees are a little sore, but oftentimes they've lost muscle mass in their lower extremities and their thighs and the hamstrings.
[00:23:57] Speaker C: I hate to confess, but I have some work to do. I got to get back in that gym.
Now, tell me about a person's functional fitness and how it affects the brain.
[00:24:08] Speaker I: Oh, so functional fitness. Okay, so part of being functional is having good balance. And the Japanese did a study of over 1400 men and women, average age, 67 years old, and they found a very strong correlation between being able to balance on one leg and, well, if they weren't able to balance on one leg, they saw a lot of ischemic strokes, microbleeds in the brain, lower tests on lower scores on cognitive tests, and then cerebral small vessel disease. So there is a strong correlation. And I think it's because when you have poor balance, you're not functional. Just some of the basic things is you can't walk very well, and if you're not walking well, you can't do a lot of activities. So one of the things I always look at is balance. I do a full functional assessment to get a good idea of what that person needs to work on. But balance is so important and everything starts with the feet on up.
[00:25:23] Speaker A: Interesting.
[00:25:24] Speaker C: You've really done a lot of work with this. I know we were talking off the air momentarily a few moments ago about the importance of our veterans taking care of themselves, especially when they get towards the back nine. It takes a lot to deal with what they have obviously had to go through in.
[00:25:47] Speaker I: And in my profession, I've worked with a lot of men and women, mostly men. Those are the ones that have a lot of the heart problems. The women generally don't survive.
[00:26:00] Speaker C: Karen also is a medical fitness trainer. I would say she's medical. She has that medical background and cardiopulmonary, and she also works with the physiology of your body at the same time.
[00:26:15] Speaker I: And type two diabetes, it's a very serious disease. We talk about dementia a lot, and type two diabetes and dementia are strongly associated. So and you think about how many people have diabetes? Well, you're going to see a lot of dementia cases later on.
[00:26:40] Speaker C: I read that men have actually more heart attacks than women, and I think you touched on that. But women who suffer an attack are more likely to be fatal.
[00:26:51] Speaker I: Some men said, why are there no women in our program? And I said, because most of them don't survive. And oftentimes it's because they do have their heart attacks a little later in life. So they have other comorbidities, they have other diseases that they are plagued with. So they're a little bit more compromised when you have symptoms. You have to get to the hospital right away.
[00:27:22] Speaker C: Thank you. Nutrition expert and cardiopulmonary specialist Karen Owak, a person who is also on the front lines regarding respiratory issues. You've been listening to real estate and more interesting people, important topics such as our health and, of course, real estate. You can listen to archive real estate and more
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