1 00:00:01,568 --> 00:00:02,635 >>> ON "HEALTH MATTERS," 2 00:00:02,635 --> 00:00:03,770 TELEVISION FOR LIFE, WHEN A 3 00:00:03,770 --> 00:00:06,539 TUMMY ACHE BECOMES A LOT WORST 4 00:00:06,539 --> 00:00:08,541 IT'S TIME TO CALL A DOCTOR. 5 00:00:08,541 --> 00:00:09,509 >> IT TOOK ABOUT A YEAR FOR THEM 6 00:00:09,509 --> 00:00:11,144 TO FIGURE IT OUT. 7 00:00:11,144 --> 00:00:12,846 >> A COLLEGE STUDENT COPES WITH 8 00:00:12,846 --> 00:00:14,547 CELIAC DISEASE. 9 00:00:14,547 --> 00:00:15,949 >> CELIAC CAN ACTUALLY KILL 10 00:00:15,949 --> 00:00:17,017 SOMEONE. 11 00:00:17,017 --> 00:00:19,252 >> HOW CHANGING HER DIET MADE A 12 00:00:19,252 --> 00:00:20,754 WORLD OF DIFFERENCE. 13 00:00:20,754 --> 00:00:22,288 PLUS ANSWERS TO YOUR QUESTIONS 14 00:00:22,288 --> 00:00:25,158 ON GASTROINTESTINAL ILLNESSES. 15 00:00:25,158 --> 00:00:31,898 RIGHT NOW, ON "HEALTH MATTERS." 16 00:00:31,898 --> 00:00:33,466 >> "HEALTH MATTERS" IS MADE 17 00:00:33,466 --> 00:00:34,901 POSSIBLE BY OUR VIEWERS, THE 18 00:00:34,901 --> 00:00:36,503 FRIENDS OF KSPS. 19 00:00:36,503 --> 00:00:39,839 AND BY PROVIDENCE HEALTH CARE. 20 00:00:39,839 --> 00:00:40,540 >> PROVIDENCE'S MOTTO IS KNOW 21 00:00:40,540 --> 00:00:40,907 ME. 22 00:00:40,907 --> 00:00:41,474 CARE FOR ME. 23 00:00:41,474 --> 00:00:42,242 EASY MY WAY. 24 00:00:42,242 --> 00:00:43,276 AND PROVIDENCE DOES THAT. 25 00:00:43,276 --> 00:00:43,910 I'VE SEEN IT OVER AND OVER 26 00:00:43,910 --> 00:00:44,978 AGAIN. 27 00:00:44,978 --> 00:00:46,046 I'M DR. STEPHEN MURRAY, AND I 28 00:00:46,046 --> 00:00:47,080 CHOSE PROVIDENCE BECAUSE I 29 00:00:47,080 --> 00:00:47,914 BELIEVE IN THE MISSION 30 00:00:47,914 --> 00:00:49,783 STATEMENT. 31 00:00:49,783 --> 00:00:50,583 AND WORKING TOGETHER WITH OTHERS 32 00:00:50,583 --> 00:00:51,684 OF LIKE MIND IS A VERY POWERFUL 33 00:00:51,684 --> 00:00:55,088 WAY TO TAKE CARE OF PATIENTS. 34 00:00:55,088 --> 00:00:56,089 >> MY NAME IS BETH PEREZ, AND I 35 00:00:56,089 --> 00:00:57,090 AM A REGISTERED NURSE. 36 00:00:57,090 --> 00:00:58,324 AND I WORK AT HOLY FAMILY 37 00:00:58,324 --> 00:00:58,958 HOSPITAL ON THE LABOR AND 38 00:00:58,958 --> 00:00:59,392 DELIVERY UNIT. 39 00:00:59,392 --> 00:01:00,460 I'M ABOUT TO HAVE MY SECOND 40 00:01:00,460 --> 00:01:02,595 CHILD, AND I CHOSE PROVIDENCE 41 00:01:02,595 --> 00:01:03,496 BECAUSE I LOVE AND TRUST THE 42 00:01:03,496 --> 00:01:05,665 PEOPLE THAT I WORK WITH, AND WHY 43 00:01:05,665 --> 00:01:11,404 WOULDN'T I SEEK CARE FROM PEOPLE 44 00:01:08,601 --> 00:01:12,272 I LOVE AND TRUST. 45 00:01:12,272 --> 00:01:13,640 ♪ 46 00:01:13,640 --> 00:01:15,275 >> GOOD EVENING AND THANKS FOR 47 00:01:15,275 --> 00:01:19,345 JOINING US, I'M TERESA LUKENS. 48 00:01:19,345 --> 00:01:20,013 EVERYONE GETS A STOMACH ACHE 49 00:01:20,013 --> 00:01:20,513 FROM TIME TO TIME. 50 00:01:20,513 --> 00:01:24,050 BUT WHEN IS IT A SIGN OF 51 00:01:24,050 --> 00:01:26,386 SOMETHING MORE, THEN YOU NEED TO 52 00:01:26,386 --> 00:01:28,054 SEEK HELP. 53 00:01:28,054 --> 00:01:28,655 DIAGNOSING THE CAUSE OF 54 00:01:28,655 --> 00:01:29,389 ABDOMINAL PAIN CAN BE DIFFICULT, 55 00:01:29,389 --> 00:01:32,058 BECAUSE MANY DISEASES CAN CAUSE 56 00:01:32,058 --> 00:01:34,060 SYMPTOMS IN YOUR GUT. 57 00:01:34,060 --> 00:01:34,727 TONIGHT OUR PANEL DISCUSSES 58 00:01:34,727 --> 00:01:35,462 GASTROINTESTINAL DISORDERS FROM 59 00:01:35,462 --> 00:01:36,129 IRRITABLE BOWEL SYNDROME TO 60 00:01:36,129 --> 00:01:38,465 CELIAC DISEASE, EVEN ACID 61 00:01:38,465 --> 00:01:39,966 REFLUX. 62 00:01:39,966 --> 00:01:43,903 SO LET'S MEET OUR PANEL. 63 00:01:43,903 --> 00:01:44,637 DR. LANCE FERRIN SPECIALIZES IN 64 00:01:44,637 --> 00:01:45,138 DIGESTIVE HEALTH. 65 00:01:45,138 --> 00:01:45,839 HE WORKS AT ROCKWOOD DIGESTIVE 66 00:01:45,839 --> 00:01:47,474 HEALTH CENTER. 67 00:01:47,474 --> 00:01:48,141 DR. HAROLD PREIKSAITIS IS A 68 00:01:48,141 --> 00:01:49,609 GASTROENTEROLOGIST AT KOOTENAI 69 00:01:49,609 --> 00:01:50,276 CLINIC GASTROENTEROLOGY AND 70 00:01:50,276 --> 00:01:52,011 ENDOSCOPY. 71 00:01:52,011 --> 00:01:53,413 ALLI STANTON IS REGISTERED 72 00:01:53,413 --> 00:01:54,380 DIETICIAN AT PROVIDENCE SACRED 73 00:01:54,380 --> 00:01:57,750 HEART MEDICAL CENTER. 74 00:01:57,750 --> 00:01:59,285 AND THANK YOU ALL FOR BEING HERE 75 00:01:59,285 --> 00:02:00,153 THIS EVENING. 76 00:02:00,153 --> 00:02:02,555 IT'S AN IMPORTANT TOPIC. 77 00:02:02,555 --> 00:02:04,958 OR STOMACH AND OUR GUT IS 78 00:02:04,958 --> 00:02:05,859 RELATED TO SO MANY OTHER 79 00:02:05,859 --> 00:02:07,393 DISEASES AND THE WAY OUR BODY 80 00:02:07,393 --> 00:02:09,262 WORKS AND HOW WE FUNCTION AND 81 00:02:09,262 --> 00:02:10,196 OUR OVERALL HEALTH. 82 00:02:10,196 --> 00:02:12,031 LET'S START WITH DR. FERRIN, 83 00:02:12,031 --> 00:02:15,235 AND -- ACTUALLY, I WANT TO START 84 00:02:15,235 --> 00:02:16,202 WITH DR. PREIKSAITIS AND TALK 85 00:02:16,202 --> 00:02:17,470 ABOUT WHEN WE BECOME ALARMED 86 00:02:17,470 --> 00:02:19,305 WHEN THAT STOMACH ACHE MIGHT BE 87 00:02:19,305 --> 00:02:21,341 SOMETHING MORE, WHEN WE BECOME 88 00:02:21,341 --> 00:02:22,842 CONCERNED OR WHAT WE SHOULD BE 89 00:02:22,842 --> 00:02:24,043 PAYING ATTENTION TO. 90 00:02:24,043 --> 00:02:25,678 >> WELL, THANKS, TERESA. 91 00:02:25,678 --> 00:02:28,548 THAT'S AN EXCELLENT QUESTION. 92 00:02:28,548 --> 00:02:33,253 I THINK THE ANSWER WOULD INCLUDE 93 00:02:33,253 --> 00:02:34,454 A CONSIDERATION OF WHAT OUR 94 00:02:34,454 --> 00:02:36,689 PATTERN OF STOMACH HAS BEEN IN 95 00:02:36,689 --> 00:02:38,358 THE PAST. 96 00:02:38,358 --> 00:02:39,826 EVERYONE GETS TUMMY ACHES FROM 97 00:02:39,826 --> 00:02:40,260 TIME TO TIME. 98 00:02:40,260 --> 00:02:42,729 IF YOU HAVE AN EXTRAORDINARY 99 00:02:42,729 --> 00:02:47,167 SYMPTOM ONSET, IF THE DURATION 100 00:02:47,167 --> 00:02:48,568 IS OUT OF WHAT WE USED TO, IF 101 00:02:48,568 --> 00:02:50,236 THE SEVERITY IS MORE EXTREME 102 00:02:50,236 --> 00:02:52,172 THAN WHAT WE ARE ACCUSTOMED TO 103 00:02:52,172 --> 00:02:53,573 OR IF THERE ARE ASSOCIATED 104 00:02:53,573 --> 00:02:56,342 SYMPTOMS SUCH AS NAUSEA, 105 00:02:56,342 --> 00:02:57,443 VOMITING, CERTAINLY DIARRHEA 106 00:02:57,443 --> 00:02:59,045 WITH BLEEDING WOULD BE SYMPTOMS 107 00:02:59,045 --> 00:03:01,781 THAT SHOULD CAUSE ONE TO SUSPECT 108 00:03:01,781 --> 00:03:07,253 THAT THIS IS NOT THE USUAL SORT 109 00:03:07,253 --> 00:03:08,354 OF TUMMY ACHE THAT WILL 110 00:03:08,354 --> 00:03:09,455 DISAPPEAR ON ITS OWN. 111 00:03:09,455 --> 00:03:10,290 >> WE CAN TALK ABOUT EVERYTHING 112 00:03:10,290 --> 00:03:13,259 FROM ACID REFLUX TO MORE SERIOUS 113 00:03:13,259 --> 00:03:15,795 DISEASES SUCH AS CELIAC DISEASE 114 00:03:15,795 --> 00:03:16,462 OR CROHN'S DISEASE. 115 00:03:16,462 --> 00:03:18,565 WHEN I PICK UP THE PHONE AND 116 00:03:18,565 --> 00:03:20,466 CALL MY DOCTOR TO MAKE THAT 117 00:03:20,466 --> 00:03:21,367 APPOINTMENT, DO I WANT TO SEE 118 00:03:21,367 --> 00:03:23,136 YOU AS A SPECIALIST THEN? 119 00:03:23,136 --> 00:03:24,671 DO I GO TO MY G.P. FIRST? 120 00:03:24,671 --> 00:03:27,373 WHERE DO I START THE PROCESS? 121 00:03:27,373 --> 00:03:29,042 >> WELL, IT'S TYPICAL BEFORE 122 00:03:29,042 --> 00:03:32,078 SEEING A GASTROENTEROLOGIST THAT 123 00:03:32,078 --> 00:03:34,280 YOU SEE YOUR G.P. FIRST AND HE 124 00:03:34,280 --> 00:03:35,848 WILL EVALUATE YOUR SYMPTOMS AND 125 00:03:35,848 --> 00:03:40,253 PERHAPS DO SOME PRELIMINARY 126 00:03:40,253 --> 00:03:44,991 TESTS AND REFER YOU TO A 127 00:03:44,991 --> 00:03:45,858 GASTROENTEROLOGIST IF HE'S NOT 128 00:03:45,858 --> 00:03:47,860 ABLE TO ANSWER YOUR PERSONAL 129 00:03:47,860 --> 00:03:48,228 CONCERNS. 130 00:03:48,228 --> 00:03:50,029 THEN WHEN YOU SHOW UP AT THE 131 00:03:50,029 --> 00:03:50,797 GASTROENTEROLOGIST, HE WILL HAVE 132 00:03:50,797 --> 00:03:52,565 SOME BASIC LAB WORK DONE, AND 133 00:03:52,565 --> 00:03:57,370 THAT WILL SPEED UP THE 134 00:03:57,370 --> 00:03:57,770 EVALUATION. 135 00:03:57,770 --> 00:03:59,872 MOST OF THE PATIENTS THAT I SEE 136 00:03:59,872 --> 00:04:01,374 ARE PATIENTS REFERRED 137 00:04:01,374 --> 00:04:04,177 SPECIFICALLY FOR EVALUATION OF 138 00:04:04,177 --> 00:04:07,280 ABDOMINAL PAIN BECAUSE IT'S SUCH 139 00:04:07,280 --> 00:04:08,748 A DIFFICULT THING TO EVALUATE. 140 00:04:08,748 --> 00:04:11,451 THERE ARE LOTS OF ORGANS IN THE 141 00:04:11,451 --> 00:04:13,353 G.I. TRACT AND LOTS OF DISEASES 142 00:04:13,353 --> 00:04:15,455 THAT CAN AFFECT EACH ORGAN AND 143 00:04:15,455 --> 00:04:17,257 TRYING TO -- AND THEY SEEM TO 144 00:04:17,257 --> 00:04:19,058 ALL CAUSE PAIN IN SOME PEOPLE, 145 00:04:19,058 --> 00:04:22,762 AND SO FIGURING OUT EXACTLY WHAT 146 00:04:22,762 --> 00:04:25,598 THE CAUSE IS CAN BE QUITE A 147 00:04:25,598 --> 00:04:26,766 DAUNTING TASK. 148 00:04:26,766 --> 00:04:28,268 BUT IT'S SOMETHING THAT 149 00:04:28,268 --> 00:04:30,370 ESSENTIALLY WE DO FOR A LIVING, 150 00:04:30,370 --> 00:04:34,941 PROBABLY HALF OF MY PATIENTS ARE 151 00:04:34,941 --> 00:04:35,608 REFERRED FOR ABDOMINAL PAIN. 152 00:04:35,608 --> 00:04:37,744 PLEASE FIGURE OUT WHY IT IS. 153 00:04:37,744 --> 00:04:39,879 >> ARE YOU SEEING MORE OF IT? 154 00:04:39,879 --> 00:04:41,347 >> YOU KNOW, I THINK OVER THE 155 00:04:41,347 --> 00:04:42,749 LAST 20 YEARS, WE HAVE BEEN 156 00:04:42,749 --> 00:04:44,884 SEEING MORE OF IT. 157 00:04:44,884 --> 00:04:48,688 WE LIVE IN A VERY FAST PACED 158 00:04:48,688 --> 00:04:51,090 LIFE AND PEOPLE ARE OVERWHELMED, 159 00:04:51,090 --> 00:04:53,860 I THINK, WITH THE THINGS 160 00:04:53,860 --> 00:04:55,862 HAPPENING IN THEIR LIFE AND WITH 161 00:04:55,862 --> 00:04:57,063 ALL THE ADRENALINE IN THEIR 162 00:04:57,063 --> 00:04:58,765 SYMPTOM AND IT SEEMS LIKE THAT 163 00:04:58,765 --> 00:05:00,066 ADRENALINE REALLY TAKES IT OUT 164 00:05:00,066 --> 00:05:02,368 ON THE G.I. TRACT. 165 00:05:02,368 --> 00:05:04,237 AND SO I -- I THINK I DO SEE A 166 00:05:04,237 --> 00:05:06,973 LOT MORE OF IT NOW THAN I 167 00:05:06,973 --> 00:05:09,075 REMEMBER 10 OR 20 YEARS AGO. 168 00:05:09,075 --> 00:05:09,509 >> MM-HMM. 169 00:05:09,509 --> 00:05:12,312 AND THAT CAN BE SOMETHING LIKE 170 00:05:12,312 --> 00:05:14,847 ACID REFLUX WHICH WHAT IS ACID 171 00:05:14,847 --> 00:05:15,181 REFLUX? 172 00:05:15,181 --> 00:05:18,584 >> WELL, ACID REFLUX IS WHAT 173 00:05:18,584 --> 00:05:20,486 MANY PEOPLE UNDERSTAND TO BE 174 00:05:20,486 --> 00:05:21,654 HEARTBURN, BUT FOR A LOT OF 175 00:05:21,654 --> 00:05:23,456 PEOPLE, IT'S NOT JUST HEARTBURN. 176 00:05:23,456 --> 00:05:24,991 IT CAN BE CHEST PAIN. 177 00:05:24,991 --> 00:05:27,160 IT CAN BE MANIFEST AS 178 00:05:27,160 --> 00:05:27,960 DIFFICULTIES SWALLOWING. 179 00:05:27,960 --> 00:05:30,063 IT CAN BE A COUGH THAT WON'T 180 00:05:30,063 --> 00:05:31,397 STOP, SORE THROAT. 181 00:05:31,397 --> 00:05:32,565 THERE'S A WHOLE RANGE OF 182 00:05:32,565 --> 00:05:33,666 SYMPTOMS AND PICKING UP ON THE 183 00:05:33,666 --> 00:05:35,468 POINT THAT WAS JUST MADE, I 184 00:05:35,468 --> 00:05:36,969 THINK ONE OF THE THINGS THAT IS 185 00:05:36,969 --> 00:05:41,574 DRIVING THE INCREASE IN NOT JUST 186 00:05:41,574 --> 00:05:42,308 GASTROINTESTINAL COMPLAINTS BUT 187 00:05:42,308 --> 00:05:44,210 A WHOLE RANGE OF HEALTH PROBLEMS 188 00:05:44,210 --> 00:05:46,412 IS, OF COURSE, THE OBESITY 189 00:05:46,412 --> 00:05:47,513 EPIDEMIC THAT WE ARE SEEING AND 190 00:05:47,513 --> 00:05:51,517 WE CERTAINLY SEE A LOT OF 191 00:05:51,517 --> 00:05:52,385 PATIENTS WHO HAVE SYMPTOMS THAT 192 00:05:52,385 --> 00:05:54,320 ARE RELATED TO THAT REFLUX BEING 193 00:05:54,320 --> 00:05:55,988 ONE OF THEM. 194 00:05:55,988 --> 00:05:56,989 >> ALLI, THAT'S WHERE COME IN AS 195 00:05:56,989 --> 00:05:59,659 A DIETITIAN, A LOT OF THEM, 196 00:05:59,659 --> 00:06:01,294 ESPECIALLY WITH ACID REFLUX, AND 197 00:06:01,294 --> 00:06:02,328 TAKING THE WEIGH OFF AND 198 00:06:02,328 --> 00:06:03,629 CONTROLLING THE DIET CAN REALLY 199 00:06:03,629 --> 00:06:05,231 COME INTO PLAY. 200 00:06:05,231 --> 00:06:05,732 >> ABSOLUTELY. 201 00:06:05,732 --> 00:06:06,699 A LOT OF PEOPLE NEED TO LOSE A 202 00:06:06,699 --> 00:06:07,600 LITTLE BIT OF WEIGH AND THEY 203 00:06:07,600 --> 00:06:09,068 WILL ACTUALLY SEE A HUGE 204 00:06:09,068 --> 00:06:10,770 IMPROVEMENT IN THEIR REFLUX 205 00:06:10,770 --> 00:06:12,271 SIGNS AND SYMPTOMS BUT ALSO JUST 206 00:06:12,271 --> 00:06:14,073 MAINTAINING A HEALTHY WEIGHT 207 00:06:14,073 --> 00:06:15,174 HELPS WITH A WHOLE BUNCH OF 208 00:06:15,174 --> 00:06:16,409 OTHER HEALTH PROBLEMS ACROSS THE 209 00:06:16,409 --> 00:06:16,709 BOARD. 210 00:06:16,709 --> 00:06:17,577 SO IT'S REALLY IMPORTANT THAT 211 00:06:17,577 --> 00:06:19,178 PEOPLE ARE MAINTAINING A HEALTHY 212 00:06:19,178 --> 00:06:19,479 WEIGH. 213 00:06:19,479 --> 00:06:20,980 IT'S JUST PART OF A HEALTHY 214 00:06:20,980 --> 00:06:21,347 LIFESTYLE. 215 00:06:21,347 --> 00:06:22,181 >> WHEN YOU SIT DOWN WITH A 216 00:06:22,181 --> 00:06:23,416 PATIENT WHO IS CONSCIOUSED WITH 217 00:06:23,416 --> 00:06:24,951 SOMETHING LIKE ACID REFLUX, WHAT 218 00:06:24,951 --> 00:06:26,552 ARE SOME OF THE FOODS THAT YOU 219 00:06:26,552 --> 00:06:28,354 LIKE TO SEE THEM START EATING OR 220 00:06:28,354 --> 00:06:31,691 MAYBE ELIMINATE FROM THEIR DIET? 221 00:06:31,691 --> 00:06:33,860 >> THERE ARE SOME COMMON 222 00:06:33,860 --> 00:06:35,161 CULPRITS THAT WE TALK ABOUT, 223 00:06:35,161 --> 00:06:36,963 SPICY FOODS, THAT SEEMS TO BE A 224 00:06:36,963 --> 00:06:37,964 PROBLEM FOR SOME PEOPLE. 225 00:06:37,964 --> 00:06:40,166 CHOCOLATE CAN BE A PROBLEM, 226 00:06:40,166 --> 00:06:41,667 CAFFEINE, CARBONATED BEVERAGES. 227 00:06:41,667 --> 00:06:43,069 THOSE ARE ALL THINGS WE ASK THE 228 00:06:43,069 --> 00:06:44,103 PATIENT ABOUT AND TRY TO FIND 229 00:06:44,103 --> 00:06:45,838 OUT IF THOSE THINGS -- IF THEY 230 00:06:45,838 --> 00:06:47,373 CAN FIGURE OUT IF THAT'S A 231 00:06:47,373 --> 00:06:48,141 TRIGGER FOR THEM. 232 00:06:48,141 --> 00:06:49,475 AS FAR AS THINGS THAT CAN HELP, 233 00:06:49,475 --> 00:06:52,879 SMALLER MEALS, EATING SMALLER, 234 00:06:52,879 --> 00:06:55,281 FOR FREQUENT MEALS CAN SOMETIMES 235 00:06:55,281 --> 00:06:56,582 HELP WITH REFLUX AND 236 00:06:56,582 --> 00:06:57,483 INDIVIDUALIZING WHAT WORKS FOR 237 00:06:57,483 --> 00:06:57,750 YOU. 238 00:06:57,750 --> 00:06:59,485 WE HAVE SOME HANDOUTS AND TOOLS, 239 00:06:59,485 --> 00:07:00,887 BUT WHAT WORKS FOR ONE PERSON 240 00:07:00,887 --> 00:07:02,188 DOESN'T ALWAYS WORK FOR THE NEXT 241 00:07:02,188 --> 00:07:02,522 PERSON. 242 00:07:02,522 --> 00:07:04,490 SO TRYING TO JUST GET THEM ON A 243 00:07:04,490 --> 00:07:06,292 HEALTHY DIET AND APPROPRIATE 244 00:07:06,292 --> 00:07:07,360 WEIGHT AND WORKING WITH THAT 245 00:07:07,360 --> 00:07:08,127 PATIENT INDIVIDUALLY. 246 00:07:08,127 --> 00:07:09,896 >> TO WORKING WITH YOUR DOCTOR 247 00:07:09,896 --> 00:07:12,265 AND DIETITIAN CAN COME INTO 248 00:07:12,265 --> 00:07:12,565 PLAY. 249 00:07:12,565 --> 00:07:14,500 AND THERE ARE ASOME GREAT 250 00:07:14,500 --> 00:07:15,368 OVER-THE-COUNTER PRODUCTS THAT 251 00:07:15,368 --> 00:07:17,336 CAN TREAT AS ACID REFLUX OR 252 00:07:17,336 --> 00:07:18,538 HEARTBURN AS WE KNOW IT. 253 00:07:18,538 --> 00:07:20,573 SOME THINGS THAT USED TO BE 254 00:07:20,573 --> 00:07:23,075 PRESCRIBED THAT ARE NOW OVER THE 255 00:07:23,075 --> 00:07:26,412 COUNTER. 256 00:07:26,412 --> 00:07:31,818 >> ELMEPROZOL OR PROTON PUMP 257 00:07:31,818 --> 00:07:32,552 INHIBITORS AND OVER THE COUNTER 258 00:07:32,552 --> 00:07:35,588 THEY ARE JUST AS GOOD AGO 259 00:07:35,588 --> 00:07:38,291 ANYTHING WE CAN PRESCRIBE. 260 00:07:38,291 --> 00:07:40,593 >> LET'S GO TO IRRITABLE BOWEL 261 00:07:40,593 --> 00:07:42,929 SYNDROME, I.B.S. HAS BEEN A BUZZ 262 00:07:42,929 --> 00:07:44,831 PLAY AND THAT CAN BE ANYTHING 263 00:07:44,831 --> 00:07:47,533 BEING EXTREMELY CONSTIPATED TO 264 00:07:47,533 --> 00:07:49,535 BOUTS OF DIARRHEA. 265 00:07:49,535 --> 00:07:51,337 EXPLAIN WHAT HAPPENS WITH I.B.S. 266 00:07:51,337 --> 00:07:52,071 >> OR ALTERNATING. 267 00:07:52,071 --> 00:07:53,406 THERE ARE SOME PATIENTS, IN 268 00:07:53,406 --> 00:07:54,507 FACT, THE MOST DIFFICULT 269 00:07:54,507 --> 00:07:55,741 PATIENTS TO HELP ARE THE ONES 270 00:07:55,741 --> 00:07:58,377 THAT SOMETIMES WILL GO FROM 271 00:07:58,377 --> 00:08:00,880 BEING CONSTIPATED TO HAVING 272 00:08:00,880 --> 00:08:02,715 SEVERE BOUTS OF DIARRHEA. 273 00:08:02,715 --> 00:08:05,218 I THINK ONE OF THE INTERESTING 274 00:08:05,218 --> 00:08:06,285 THINGS THAT'S COME UP IN THIS 275 00:08:06,285 --> 00:08:09,288 WHOLE AREA IS THE RELATIONSHIP 276 00:08:09,288 --> 00:08:09,655 OF GLUTEN. 277 00:08:09,655 --> 00:08:11,023 WE HAVE ALWAYS KNOWN THAT GLUTEN 278 00:08:11,023 --> 00:08:13,926 WAS THE CULPRIT IN CAUSING 279 00:08:13,926 --> 00:08:14,927 CELIAC DISEASE BUT A LOT OF 280 00:08:14,927 --> 00:08:16,829 PEOPLE ARE NOW FINDING THAT 281 00:08:16,829 --> 00:08:18,030 ELIMINATING CERTAIN TYPES OF 282 00:08:18,030 --> 00:08:19,532 FLOODS FROM THEIR DIET IS 283 00:08:19,532 --> 00:08:21,133 HELPING QUITE A LOT WITH 284 00:08:21,133 --> 00:08:22,101 IRRITABLE BOWEL SYNDROME. 285 00:08:22,101 --> 00:08:24,637 AND ONE OF THE NEW ACRONYMS 286 00:08:24,637 --> 00:08:26,405 THAT'S BEEN PUT FORWARD IS 287 00:08:26,405 --> 00:08:29,442 SOMETHING CALLED FOGMAPS WHICH 288 00:08:29,442 --> 00:08:37,350 STANDS FOR FERMENTABLE DYES. 289 00:08:37,350 --> 00:08:38,451 IT TURNS OUT THAT ELIMINATING 290 00:08:38,451 --> 00:08:40,319 THESE SORTS OF SUGARS FROM YOUR 291 00:08:40,319 --> 00:08:42,655 DIET ARE VERY HELPFUL IN SOME 292 00:08:42,655 --> 00:08:43,823 PEOPLE WITH CELIAC -- SORRY, 293 00:08:43,823 --> 00:08:46,959 WITH IRRITABLE BOWEL SYNDROME, 294 00:08:46,959 --> 00:08:48,227 AND MIGHT BE ONE OF THE THINGS 295 00:08:48,227 --> 00:08:50,463 THAT HAPPENS WHEN YOU ACTUALLY 296 00:08:50,463 --> 00:08:52,298 ELIMINATE GUTEN FROM YOUR DIET. 297 00:08:52,298 --> 00:08:53,432 IS YOU ARE BY THE WAY, 298 00:08:53,432 --> 00:08:54,967 ELIMINATING A LOT OF THESE OTHER 299 00:08:54,967 --> 00:08:56,035 COMPONENTS THAT TRIGGER 300 00:08:56,035 --> 00:08:56,402 SYMPTOMS. 301 00:08:56,402 --> 00:08:57,937 >> WHICH LEADS US INTO THAT 302 00:08:57,937 --> 00:08:59,539 DISCUSSION ABOUT CELIAC DISEASE 303 00:08:59,539 --> 00:09:02,275 AND THE OTHER HOT TOPIC BEING 304 00:09:02,275 --> 00:09:04,210 GOING ON GLUTEN-FREE DIETS AND 305 00:09:04,210 --> 00:09:06,779 WHAT IS CELIAC DISEASE? 306 00:09:06,779 --> 00:09:09,015 >> IT'S A TYPE OF ALLERGIC 307 00:09:09,015 --> 00:09:11,918 REACTION TO A PROTEIN FOUND IN 308 00:09:11,918 --> 00:09:13,986 WHEAT, AND RELATED GRAINS. 309 00:09:13,986 --> 00:09:18,991 IT OCCURS IN ABOUT ONE IN 100 310 00:09:18,991 --> 00:09:19,325 PEOPLE. 311 00:09:19,325 --> 00:09:20,893 IT'S NOT PROBABLY ANY MORE 312 00:09:20,893 --> 00:09:23,496 COMMON NOW THAN IT HAS BEEN 100 313 00:09:23,496 --> 00:09:25,798 YEARS AGO, BUT WE HAVE GOOD 314 00:09:25,798 --> 00:09:27,400 TESTS FOR IT NOW, AND DOCTORS 315 00:09:27,400 --> 00:09:31,404 ARE VERY CLUED INTO TAKING IT, 316 00:09:31,404 --> 00:09:33,673 OR INTO EVALUATING FOR IT, 317 00:09:33,673 --> 00:09:35,308 SIMPLE BLOOD TEST IS REALLY VERY 318 00:09:35,308 --> 00:09:35,608 GOOD. 319 00:09:35,608 --> 00:09:36,876 >> THERE IS A BLOOD TEST NOW? 320 00:09:36,876 --> 00:09:37,977 >> THERE IS A BLOOD TEST. 321 00:09:37,977 --> 00:09:44,116 AND IT'S CALLED TISSUE 322 00:09:44,116 --> 00:09:45,985 TRANSGLUTAMINASE, IT'S 90% 323 00:09:45,985 --> 00:09:47,286 ACCURATE IN SAYING WHETHER YOU 324 00:09:47,286 --> 00:09:49,088 DO OR DO NOT HAVE CELIAC 325 00:09:49,088 --> 00:09:49,422 DISEASE. 326 00:09:49,422 --> 00:09:52,692 THE BEST TEST IS TO GET A LITTLE 327 00:09:52,692 --> 00:09:54,293 SAMPLE OF THE SMALL BOW HEALTH 328 00:09:54,293 --> 00:09:57,597 WE DO WITH ENDOSCOPY, BUT A TTG 329 00:09:57,597 --> 00:09:58,798 IS A GREAT SCREENING TEST. 330 00:09:58,798 --> 00:10:00,766 >> I WANT TO TALK MORE ABOUT 331 00:10:00,766 --> 00:10:02,134 DIET AND CELIAC DISEASE AND 332 00:10:02,134 --> 00:10:03,903 GOING GLUTEN-FREE WITH ALLI. 333 00:10:03,903 --> 00:10:10,176 FIRST, THE 334 00:10:10,176 --> 00:10:10,843 NEXT TIME YOU DINE OUT AT A 335 00:10:10,843 --> 00:10:11,544 RESTAURANT, TAKE A CLOSER LOOK 336 00:10:11,544 --> 00:10:11,944 AT THE MENU. 337 00:10:11,944 --> 00:10:12,612 YOU MIGHT JUST SEE THE WORDS 338 00:10:12,612 --> 00:10:13,045 "GLUTEN FREE." 339 00:10:13,045 --> 00:10:13,779 IT'S AN OPTION THAT IS BECOMING 340 00:10:13,779 --> 00:10:14,246 EASIER TO FIND. 341 00:10:14,246 --> 00:10:15,047 BUT GLUTEN FREE IS MORE THAN A 342 00:10:15,047 --> 00:10:16,015 TREND. 343 00:10:16,015 --> 00:10:17,383 FOR PEOPLE WITH CELIAC DISEASE, 344 00:10:17,383 --> 00:10:18,084 IT MEANS FOOD THAT WON'T MAKE 345 00:10:18,084 --> 00:10:24,256 THEM SICK. 346 00:10:24,256 --> 00:10:25,191 >> HOLLY FRAZIER IS A TYPICAL 347 00:10:25,191 --> 00:10:26,759 COLLEGE STUDENT, BUT THERE IS 348 00:10:26,759 --> 00:10:27,426 ONE COLLEGE STAPLE SHE CAN'T 349 00:10:27,426 --> 00:10:28,661 HAVE. 350 00:10:28,661 --> 00:10:29,996 >> I REALLY MISS PIZZA. 351 00:10:29,996 --> 00:10:35,434 >> HOLLY HAS CELIAC DISEASE. 352 00:10:35,434 --> 00:10:36,102 >> IT'S KIND OF LIKE AN ACID 353 00:10:36,102 --> 00:10:37,303 FEELING THAT'S ALWAYS THERE, 354 00:10:37,303 --> 00:10:38,738 THAT NEVER GOES AWAY FOR ME. 355 00:10:38,738 --> 00:10:41,340 >> THIS AUTOIMMUNE DISORDER 356 00:10:41,340 --> 00:10:42,041 MEANS HOLLY GETS ILL WHEN SHE 357 00:10:42,041 --> 00:10:43,042 EATS FOOD WITH GLUTEN FOUND IN 358 00:10:43,042 --> 00:10:46,746 WHEAT, BARLEY AND RYE. 359 00:10:46,746 --> 00:10:49,115 >> IT'S KIND OF LIKE A BOILING 360 00:10:49,115 --> 00:10:51,717 FEELING IN MY INTESTINES WHEN I 361 00:10:51,717 --> 00:10:57,723 ACTUALLY EATS GLUTEN. 362 00:10:57,723 --> 00:10:58,391 >> IT ALSO MAKES HER TIRED. 363 00:10:58,391 --> 00:10:59,091 AT TIMES, HOLLY CAN BARELY GET 364 00:10:59,091 --> 00:10:59,492 OUT OF BED. 365 00:10:59,492 --> 00:11:00,226 >> IT'S VERY EXHAUSTING ACTUALLY 366 00:11:00,226 --> 00:11:00,960 AND IT TAKES ABOUT TWO TO THREE 367 00:11:00,960 --> 00:11:01,460 DAYS TO GO AWAY. 368 00:11:01,460 --> 00:11:02,862 >> THOSE DAYS ARE BEHIND HER NOW 369 00:11:02,862 --> 00:11:03,596 THAT HOLLY KNOWS WHY SHE GETS SO 370 00:11:03,596 --> 00:11:07,867 SICK. 371 00:11:07,867 --> 00:11:08,901 >> IT BOOK A YEAR BEFORE THEY 372 00:11:08,901 --> 00:11:11,270 FIGURED IT OUT. 373 00:11:11,270 --> 00:11:11,937 >> BUT KEEPING HEALTHY MEANS 374 00:11:11,937 --> 00:11:12,672 KEEPING A CLOSE EYE ON WHAT SHE 375 00:11:12,672 --> 00:11:12,972 EATS. 376 00:11:12,972 --> 00:11:13,673 >> IT DEFINITELY MAKES MY LIFE 377 00:11:13,673 --> 00:11:15,041 DIFFICULT BECAUSE I'M A COLLEGE 378 00:11:15,041 --> 00:11:16,676 STUDENT, AND IT'S EASIER TO BUY 379 00:11:16,676 --> 00:11:21,113 TOP RAMEN AND MAC AND CHEESE. 380 00:11:21,113 --> 00:11:21,881 >> MORE AND MORE PLACES LIKE 381 00:11:21,881 --> 00:11:22,982 SPOKANE'S MAIN MARKET ARE MAKING 382 00:11:22,982 --> 00:11:24,116 IT EASIER FOR HOLLY TO SHOP, 383 00:11:24,116 --> 00:11:25,451 PROVIDING CUSTOMERS WITH A 384 00:11:25,451 --> 00:11:27,319 VARIETY OF GLUTEN FREE OPTIONS. 385 00:11:27,319 --> 00:11:28,287 EVEN RESTAURANTS ARE GETTING 386 00:11:28,287 --> 00:11:30,089 INTO THE GLUTEN FREE GAME. 387 00:11:30,089 --> 00:11:33,926 >> IT'S NICE. 388 00:11:33,926 --> 00:11:34,660 IT MAKES IT EASIER FOR ME TO GO 389 00:11:34,660 --> 00:11:35,428 OUT WITH MY FRIENDS. 390 00:11:35,428 --> 00:11:37,329 >> FOR HOLLY, GOING GLUTEN FREE 391 00:11:37,329 --> 00:11:38,898 WILL ALWAYS BE PART OF HER LIFE. 392 00:11:38,898 --> 00:11:39,932 AND FOR THOSE WHO THINK IT IS A 393 00:11:39,932 --> 00:11:42,134 FAD, SHE HAS THIS TO SAY. 394 00:11:42,134 --> 00:11:43,469 >> IT'S DEFINITELY A REAL 395 00:11:43,469 --> 00:11:46,305 DISEASE, AND IT REALLY BUGS ME 396 00:11:46,305 --> 00:11:48,174 -- IT REALLY BOTHERS ME WHEN 397 00:11:48,174 --> 00:11:50,509 PEOPLE THINK IT'S NOT A BIG 398 00:11:50,509 --> 00:11:50,810 DEAL. 399 00:11:50,810 --> 00:11:51,410 BECAUSE IT IS NOT. 400 00:11:51,410 --> 00:11:55,848 IT'S AN AUTOIMMUNE DISEASE. 401 00:11:55,848 --> 00:11:58,217 IT'S LIKE RHEUMATOID ARTHRITIS. 402 00:11:58,217 --> 00:12:00,252 >> IT SOUNDS LIKE HOLLY HEARS 403 00:12:00,252 --> 00:12:00,920 THAT A LOT. 404 00:12:00,920 --> 00:12:03,389 YOU DON'T REALLY HAVE A DISEASE. 405 00:12:03,389 --> 00:12:04,790 YOU JUST GO GLUTEN FREE. 406 00:12:04,790 --> 00:12:07,893 IT'S THE TREND NOW. 407 00:12:07,893 --> 00:12:08,794 INDEED, IT'S VERY SERIOUS. 408 00:12:08,794 --> 00:12:10,696 >> THERE ARE A LOT OF PEOPLE WHO 409 00:12:10,696 --> 00:12:13,099 ARE VERY DEBILITATED FROM CELIAC 410 00:12:13,099 --> 00:12:14,400 DISEASE IF THEY HAVE NOT BEEN 411 00:12:14,400 --> 00:12:15,401 DIAGNOSED OR TREATED. 412 00:12:15,401 --> 00:12:17,436 >> HOW IMPORTANT IS DIET WHEN IT 413 00:12:17,436 --> 00:12:18,604 COMES TO CELIAC? 414 00:12:18,604 --> 00:12:19,905 >> DIET IS 100% OF THE TREATMENT 415 00:12:19,905 --> 00:12:21,407 WHEN IT COMES TO CELIAC. 416 00:12:21,407 --> 00:12:24,076 IT'S ABSOLUTELY ESSENTIAL THAT 417 00:12:24,076 --> 00:12:27,513 YOU GO GLUTEN FREE. 418 00:12:27,513 --> 00:12:31,751 THAT DOESN'T MEAN CUTTING OUT 419 00:12:31,751 --> 00:12:33,385 WHEAT AND BREAD. 420 00:12:33,385 --> 00:12:35,521 SOY SAUCE, LUNCH MEATS, YOU 421 00:12:35,521 --> 00:12:38,624 REALLY HAVE TO SCRUTINIZE THE 422 00:12:38,624 --> 00:12:39,191 FOOD LABELS. 423 00:12:39,191 --> 00:12:40,693 THERE'S NO CHEAT DAYS WHEN IT 424 00:12:40,693 --> 00:12:42,094 COMES TO BEING GLUTEN FREE. 425 00:12:42,094 --> 00:12:43,896 IF YOU HAVE CELIAC, IT'S 100% OF 426 00:12:43,896 --> 00:12:44,396 THE TIME. 427 00:12:44,396 --> 00:12:46,098 >> AS A DIETITIAN, YOU ARE 428 00:12:46,098 --> 00:12:46,999 PROBABLY VERY HAPPY TO SEE ALL 429 00:12:46,999 --> 00:12:48,501 OF THE PRODUCTS THAT ARE COMING 430 00:12:48,501 --> 00:12:49,702 OUT AND THE RESTAURANTS OFFERING 431 00:12:49,702 --> 00:12:53,105 THOSE CHOICES? 432 00:12:53,105 --> 00:12:53,606 >> ABSOLUTELY. 433 00:12:53,606 --> 00:12:54,707 FOR SOMEONE WITH CELIAC DISEASE, 434 00:12:54,707 --> 00:12:56,408 IT'S A HUGE LIFESTYLE CHANGE AND 435 00:12:56,408 --> 00:12:58,177 IT'S HUGE TO HAVE MORE OPTIONS 436 00:12:58,177 --> 00:12:59,078 AS FAR AS WHEN THEY ARE GOING 437 00:12:59,078 --> 00:13:01,147 OUT AND GROCERY SHOPPING. 438 00:13:01,147 --> 00:13:02,381 A LOT OF PEOPLE IN THE PUBLIC 439 00:13:02,381 --> 00:13:04,416 ARE TRYING GLUTEN-FREE DIETS FOR 440 00:13:04,416 --> 00:13:04,884 WHATEVER REASON. 441 00:13:04,884 --> 00:13:06,619 BUT FOR PEOPLE WITH CELIAC 442 00:13:06,619 --> 00:13:07,720 DISEASE, IT'S LIKE A MEDICINE 443 00:13:07,720 --> 00:13:08,120 FOR THEM. 444 00:13:08,120 --> 00:13:09,688 THEY HAVE TO HAVE A GLUTEN-FREE 445 00:13:09,688 --> 00:13:10,890 DIET IN ORDER TO TREAT THEIR 446 00:13:10,890 --> 00:13:11,223 DISEASE. 447 00:13:11,223 --> 00:13:13,459 >> CAN I FEEL BETTER GOING 448 00:13:13,459 --> 00:13:14,693 GLUTEN-FREE IF I DON'T HAVE 449 00:13:14,693 --> 00:13:16,896 CELIAC DISEASE OR THE ALLERGY? 450 00:13:16,896 --> 00:13:17,897 >> SOME PEOPLE SAY THEY FEEL 451 00:13:17,897 --> 00:13:19,999 BETTER GOING GLUTEN-FREE, AND IF 452 00:13:19,999 --> 00:13:22,234 YOU FEEL BETTER, I SAY OKAY, 453 00:13:22,234 --> 00:13:23,402 THAT'S FINE BUT I ALSO LIKE TO 454 00:13:23,402 --> 00:13:24,503 ASK PEOPLE WHY THEY FEEL BETTER. 455 00:13:24,503 --> 00:13:25,805 WHAT ARE YOU TAKING OUT OF YOUR 456 00:13:25,805 --> 00:13:27,206 DIET THAT IS MAKING YOU FEEL 457 00:13:27,206 --> 00:13:27,540 BETTER? 458 00:13:27,540 --> 00:13:30,509 ARE YOU TAKING OUT COOKIES AND 459 00:13:30,509 --> 00:13:32,178 REFINED CARBOHYDRATES AND 460 00:13:32,178 --> 00:13:34,413 REPLACING THEM WITH FRUITS AND 461 00:13:34,413 --> 00:13:34,814 VEGETABLES? 462 00:13:34,814 --> 00:13:35,881 THAT'S PRETTY MUCH A GIVEN THAT 463 00:13:35,881 --> 00:13:36,715 YOU WILL FEEL BETTER. 464 00:13:36,715 --> 00:13:38,317 AND ALSO NOT EVERY GLUTEN-FREE 465 00:13:38,317 --> 00:13:39,718 PRODUCT IS A HEALTHY 466 00:13:39,718 --> 00:13:40,119 ALTERNATIVE. 467 00:13:40,119 --> 00:13:42,421 A LOT OF THEM ARE LOW IN FIBER, 468 00:13:42,421 --> 00:13:43,322 VITAMINS, MINERALS BECAUSE THEY 469 00:13:43,322 --> 00:13:45,925 ARE NOT MADE WITH WHOLE GRAINS. 470 00:13:45,925 --> 00:13:48,427 IT'S NOT ALWAYS HEALTHY, THEY 471 00:13:48,427 --> 00:13:49,428 MAKE GLUTEN-FREE COOKIE AND CAKE 472 00:13:49,428 --> 00:13:51,130 AND THAT'S SOMETHING WE SHOULD 473 00:13:51,130 --> 00:13:53,365 EAT IN MODERATION, REGARDLESS OF 474 00:13:53,365 --> 00:13:53,833 GLUTEN OR NOT. 475 00:13:53,833 --> 00:13:55,701 >> I THINK THERE'S A CAUTIONARY 476 00:13:55,701 --> 00:13:57,169 TALE HERE, ALTHOUGH IT'S BECOME 477 00:13:57,169 --> 00:13:59,205 A LOT EASIER FOR THE CELIAC 478 00:13:59,205 --> 00:14:02,208 PATIENT TO FIND GLUTEN-FREE 479 00:14:02,208 --> 00:14:03,108 ALTERNATIVES BECAUSE IT BECOME 480 00:14:03,108 --> 00:14:04,944 SUCH A TREND, THERE IS A DANGER 481 00:14:04,944 --> 00:14:07,313 OF GOING ON A GLUTEN-FREE DIET 482 00:14:07,313 --> 00:14:08,447 BECAUSE OF THE IMPLICATIONS THAT 483 00:14:08,447 --> 00:14:08,914 MIGHT HAVE. 484 00:14:08,914 --> 00:14:11,884 I MEAN, IT CAN BE SOCIALLY 485 00:14:11,884 --> 00:14:13,552 ISOLATING, AND IT LIMITS YOUR 486 00:14:13,552 --> 00:14:14,887 OPTIONS EVEN THOUGH WE HAVE A 487 00:14:14,887 --> 00:14:16,488 LOT MORE AVAILABLE. 488 00:14:16,488 --> 00:14:17,823 I THINK IT'S PARTICULARLY 489 00:14:17,823 --> 00:14:19,692 IMPORTANT FOR CHILDREN, FOR 490 00:14:19,692 --> 00:14:20,993 INSTANCE, YOUR -- YOU KNOW, NO 491 00:14:20,993 --> 00:14:22,628 PIZZA FOR YOU. 492 00:14:22,628 --> 00:14:24,997 IT'S REALLY NOT A TRIVIAL CHANGE 493 00:14:24,997 --> 00:14:27,466 TO MAKE IN YOUR DIET, WHICH IS 494 00:14:27,466 --> 00:14:29,535 WHY SOME PEOPLE, WHILE THEY TAKE 495 00:14:29,535 --> 00:14:30,236 OUT GLUTEN MAY ACTUALLY FEEL 496 00:14:30,236 --> 00:14:30,936 BETTER BECAUSE OF SOME OF THE 497 00:14:30,936 --> 00:14:32,938 OTHER THINGS THAT COME OUT WITH 498 00:14:32,938 --> 00:14:35,207 THE GLUTEN. 499 00:14:35,207 --> 00:14:37,209 IT ALSO UNDERSCORES THE 500 00:14:37,209 --> 00:14:38,510 IMPORTANCE OF GETTING AN 501 00:14:38,510 --> 00:14:39,612 ACCURATE DIAGNOSIS AND THAT 502 00:14:39,612 --> 00:14:41,413 DIAGNOSIS IS BETTER MADE IN THE 503 00:14:41,413 --> 00:14:44,149 TRUE CELIAC PATIENT WHILE THERE 504 00:14:44,149 --> 00:14:46,285 THEY ARE STILL GETTING GLUTEN. 505 00:14:46,285 --> 00:14:47,853 SO HAVING PATIENTS TO US WHEN 506 00:14:47,853 --> 00:14:51,523 THEY ARE ON A GLUTEN-FREE DIET 507 00:14:51,523 --> 00:14:53,626 AND WONDERING IF THEY HAVE 508 00:14:53,626 --> 00:14:55,027 CELIAC DISEASE, MAKES IT 509 00:14:55,027 --> 00:14:55,427 CHALLENGING. 510 00:14:55,427 --> 00:14:58,197 WE HAVE TO ASK THEM TO RETURN TO 511 00:14:58,197 --> 00:14:59,832 A GLUTEN CONTAINING DIET -- 512 00:14:59,832 --> 00:15:02,601 >> YOU HAVE TO FEEL CRUMMY FOR A 513 00:15:02,601 --> 00:15:04,536 WHILE. 514 00:15:04,536 --> 00:15:06,105 >> EXACTLY. 515 00:15:06,105 --> 00:15:07,806 BONE HEALTH, REPRODUCTIVE 516 00:15:07,806 --> 00:15:08,140 HEALTH. 517 00:15:08,140 --> 00:15:10,142 WE RECOMMEND THAT PEOPLE WHO 518 00:15:10,142 --> 00:15:11,977 HAVE CELIAC DISEASE, A PROVEN 519 00:15:11,977 --> 00:15:14,480 DIAGNOSIS, ALL OF THEIR 520 00:15:14,480 --> 00:15:17,416 FIRST-DEGREE RELATIVES SHOULD BE 521 00:15:17,416 --> 00:15:19,418 SCREENED FOR CELIAC DISEASE AS 522 00:15:19,418 --> 00:15:19,718 WELL. 523 00:15:19,718 --> 00:15:20,920 VERY NOW BECOME A WEAR THAT 524 00:15:20,920 --> 00:15:23,122 THERE'S A LARGE RANGE OF 525 00:15:23,122 --> 00:15:24,523 MANIFESTATIONS OF CELIAC DISEASE 526 00:15:24,523 --> 00:15:26,525 THAT ARE NO LONGER, WE USED TO 527 00:15:26,525 --> 00:15:28,928 THINK OF AS JUST THE YOUNG CHILD 528 00:15:28,928 --> 00:15:30,496 WITH DIARRHEA WHO IS NOT 529 00:15:30,496 --> 00:15:31,130 GROWING. 530 00:15:31,130 --> 00:15:34,333 WE NOW SEE IT THIBLE TIRE AGE 531 00:15:34,333 --> 00:15:36,101 SPECTRUM AND MANIFESTING IN MANY 532 00:15:36,101 --> 00:15:37,503 DIFFERENT WAYS. 533 00:15:37,503 --> 00:15:38,203 >> THAT'S INTERESTING. 534 00:15:38,203 --> 00:15:41,006 >> I WORK PRIMARILY IN 535 00:15:41,006 --> 00:15:41,407 PEDIATRICS. 536 00:15:41,407 --> 00:15:42,107 WE RECOMMEND THAT THE WHOLE 537 00:15:42,107 --> 00:15:43,709 FAMILY GETS TESTED, AS YOU WERE 538 00:15:43,709 --> 00:15:44,810 SAYING BUT WE ALSO DO RECOMMEND 539 00:15:44,810 --> 00:15:47,012 THAT THE HOUSEHOLD STAY 540 00:15:47,012 --> 00:15:48,013 GLUTEN-FREE FOR PEOPLE THAT HAVE 541 00:15:48,013 --> 00:15:49,114 CHILDREN WITH CELIAC DISEASE 542 00:15:49,114 --> 00:15:50,215 BECAUSE YOU DON'T KNOW WHAT YOUR 543 00:15:50,215 --> 00:15:52,217 KIDS ARE GOING TO GET INTO AND 544 00:15:52,217 --> 00:15:53,519 CROSS CONTAMINATION IN THE HOME 545 00:15:53,519 --> 00:15:54,720 CAN BE A CONCERN AS WELL. 546 00:15:54,720 --> 00:15:56,422 SO WE ENCOURAGE PARENTS TO EAT 547 00:15:56,422 --> 00:15:57,723 WHAT YOU CHOOSE WHEN YOU ARE 548 00:15:57,723 --> 00:15:59,425 OUTSIDE OF THE HOME WITHOUT YOUR 549 00:15:59,425 --> 00:16:02,761 CHILD BUT MAKE THE HOUSEHOLD 550 00:16:02,761 --> 00:16:04,163 GLUTEN-FREE AND THAT CAN BE A 551 00:16:04,163 --> 00:16:05,431 CHALLENGE FOR FAMILIES. 552 00:16:05,431 --> 00:16:06,699 >> WE ARE ENCOURAGING YOUR PHONE 553 00:16:06,699 --> 00:16:07,833 CALLS AND EMAILS. 554 00:16:07,833 --> 00:16:09,635 WE HAVE RYAN CALLING IN FROM 555 00:16:09,635 --> 00:16:11,003 SPOKANE THIS EVENING. 556 00:16:11,003 --> 00:16:12,905 HELLO, RYAN. 557 00:16:12,905 --> 00:16:13,539 >> Caller: HI, THERE. 558 00:16:13,539 --> 00:16:16,809 >> YOU HAVE A QUESTION FOR OUR 559 00:16:16,809 --> 00:16:17,242 PANELISTS? 560 00:16:17,242 --> 00:16:18,010 >> Caller: SORRY. 561 00:16:18,010 --> 00:16:20,746 I HAVE A 4-YEAR-OLD WITH 562 00:16:20,746 --> 00:16:22,915 CEREBRAL PALSY WHO GETS VERY 563 00:16:22,915 --> 00:16:27,720 CONSTIPATED AND WE DO DAILY 564 00:16:27,720 --> 00:16:29,722 MERILAX AND CHILDREN'S EX-LAX. 565 00:16:29,722 --> 00:16:32,624 IS THERE ANY TYPE OF REGIMEN 566 00:16:32,624 --> 00:16:34,626 THAT WOULD BE BETTER FOR HIM TO 567 00:16:34,626 --> 00:16:38,330 BE MORE REGULAR? 568 00:16:38,330 --> 00:16:38,731 >> OKAY. 569 00:16:38,731 --> 00:16:40,232 EXCELLENT QUESTION, RYAN. 570 00:16:40,232 --> 00:16:42,034 RYAN, ARE YOU STILL THERE? 571 00:16:42,034 --> 00:16:42,568 >> Caller: I AM. 572 00:16:42,568 --> 00:16:45,838 >> WHAT KIND OF DIET DO YOU HAVE 573 00:16:45,838 --> 00:16:46,572 YOUR LITTLE GUY ON? 574 00:16:46,572 --> 00:16:49,008 >> YOU KNOW, HE'S EATING 575 00:16:49,008 --> 00:16:49,608 NORMAL -- 576 00:16:49,608 --> 00:16:51,543 >> WHAT 4-YEAR-OLDS EAT? 577 00:16:51,543 --> 00:16:53,912 >> WELL, YEAH, THEY HAVE THE 578 00:16:53,912 --> 00:16:57,383 SAME DINNER WE HAVE AND CHICKEN 579 00:16:57,383 --> 00:16:58,684 AND RICE, IS WHAT WE ARE EATING 580 00:16:58,684 --> 00:17:00,719 RIGHT NOW. 581 00:17:00,719 --> 00:17:01,120 >> OKAY. 582 00:17:01,120 --> 00:17:02,221 >> THANK YOU SO MUCH. 583 00:17:02,221 --> 00:17:03,155 >> YOGURTS, THINGS LIKE THAT. 584 00:17:03,155 --> 00:17:05,424 >> ALL RIGHT. 585 00:17:05,424 --> 00:17:06,725 >> THAT'S A TOUGH ONE. 586 00:17:06,725 --> 00:17:10,029 >> I'M NOT A PEDIATRIC 587 00:17:10,029 --> 00:17:11,030 GASTROENTEROLOGIST, I'M AN ADULT 588 00:17:11,030 --> 00:17:12,331 ONE AND THERE MAY BE A BIG 589 00:17:12,331 --> 00:17:12,731 DIFFERENCE. 590 00:17:12,731 --> 00:17:16,702 I KNOW IN AN ADULT, THE 591 00:17:16,702 --> 00:17:17,669 FUNDAMENTAL PRINCIPLE THAT I 592 00:17:17,669 --> 00:17:20,739 WOULD OFFER TO RYAN IS THAT HIS 593 00:17:20,739 --> 00:17:22,508 CHILD SHOULD HAVE, YOU KNOW, 594 00:17:22,508 --> 00:17:23,909 HIS -- HIS CHILD'S COLON SHOULD 595 00:17:23,909 --> 00:17:25,210 SEE THE SAME THING EVERY DAY. 596 00:17:25,210 --> 00:17:28,514 SO TRY TO GET INTO A REGULAR 597 00:17:28,514 --> 00:17:28,847 ROUTINE. 598 00:17:28,847 --> 00:17:32,317 AND IN MY PATIENTS WITH 599 00:17:32,317 --> 00:17:33,919 CONSTIPATION, FIBER IS THE KEY 600 00:17:33,919 --> 00:17:34,286 COMPONENT. 601 00:17:34,286 --> 00:17:35,320 YOU WANT TO MAKE SURE YOU ARE 602 00:17:35,320 --> 00:17:36,855 GETTING PLENTY OF FIBER, AND IF 603 00:17:36,855 --> 00:17:38,257 IT'S HARD TO GET TO THE STORE, 604 00:17:38,257 --> 00:17:40,025 TAKE A FIBER SUPPLEMENT THAT'S 605 00:17:40,025 --> 00:17:42,327 EASY EVERY DAY. 606 00:17:42,327 --> 00:17:45,931 AND THEN YOU CAN ADD MEROLAX ON 607 00:17:45,931 --> 00:17:48,734 TOP OF THAT, WHICH IS A CHEMICAL 608 00:17:48,734 --> 00:17:50,836 THAT MIXES IN THE STOOL AND 609 00:17:50,836 --> 00:17:51,537 KEEPS IT SOFT. 610 00:17:51,537 --> 00:17:52,538 >> ARE THERE ANY CONCERNS 611 00:17:52,538 --> 00:17:54,973 GETTING HIM ON THAT AND THEN 612 00:17:54,973 --> 00:17:56,675 BEING DEPENDENT UPON THAT? 613 00:17:56,675 --> 00:17:59,445 >> NOT WITH FIBER OR MEROLAX. 614 00:17:59,445 --> 00:18:01,780 THERE ARE WITH STIMULANT 615 00:18:01,780 --> 00:18:04,216 LAXATIVES SUCH AS EX-LAX. 616 00:18:04,216 --> 00:18:07,519 PEOPLE CAN DEVELOP AN DEPENDENCE 617 00:18:07,519 --> 00:18:08,954 AND IT CAN WEAKEN YOUR COLON 618 00:18:08,954 --> 00:18:10,923 LONG TERM BUT THERE WOULD NOT BE 619 00:18:10,923 --> 00:18:12,124 LONG-TERM SIDE EFFECTS WITH THE 620 00:18:12,124 --> 00:18:13,225 MEROLAX OR WITH FIBER. 621 00:18:13,225 --> 00:18:15,527 AND THEN THERE ARE ADDITIONAL -- 622 00:18:15,527 --> 00:18:17,262 WE HAVE TWO ADDITIONAL 623 00:18:17,262 --> 00:18:19,231 PRESCRIPTION MEDICATIONS WE CAN 624 00:18:19,231 --> 00:18:19,498 USE. 625 00:18:19,498 --> 00:18:20,432 BUT I DON'T KNOW IF THEY ARE 626 00:18:20,432 --> 00:18:22,935 USED IN CHILDREN OR NOT. 627 00:18:22,935 --> 00:18:23,735 >> ALLI. 628 00:18:23,735 --> 00:18:25,137 >> SOMETHING IN THE PEDS WORLD 629 00:18:25,137 --> 00:18:26,438 THAT WE RECOMMEND ARE FRUITS 630 00:18:26,438 --> 00:18:29,641 THAT ARE HIGH IN SORBITAL, 631 00:18:29,641 --> 00:18:32,878 PRUNES, PEA RS, PEACHES, PLUMS 632 00:18:32,878 --> 00:18:34,446 AND THE ONES WITH THE P. 633 00:18:34,446 --> 00:18:37,783 IT SOFTENS THE STOOL AND IT 634 00:18:37,783 --> 00:18:43,555 MAKES IT EASY FOR THE CHILD TO 635 00:18:43,555 --> 00:18:44,323 PASS THE STOOL. 636 00:18:44,323 --> 00:18:45,824 SOMETIMES THEY HOLD ON AND IT 637 00:18:45,824 --> 00:18:47,626 GETS HARDER AND IT'S MORE 638 00:18:47,626 --> 00:18:49,428 UNCOMFORTABLE AND IT CREATES A 639 00:18:49,428 --> 00:18:50,429 CONTINUAL PROBLEM. 640 00:18:50,429 --> 00:18:55,033 SO IN THE PEDS G.I. CLINICS WE 641 00:18:55,033 --> 00:18:57,836 RECOMMEND THREE TO FIVE SERVINGS 642 00:18:57,836 --> 00:19:00,405 OF THOSE FRUITS. 643 00:19:00,405 --> 00:19:03,509 >> WOULD HIS CEREBRAL PALSY HAVE 644 00:19:03,509 --> 00:19:05,444 ANYTHING RELATED TO THAT? 645 00:19:05,444 --> 00:19:08,847 >> I'M NOT A PEDIATRIC 646 00:19:08,847 --> 00:19:11,483 GASTROENTEROLOGIST, BUT THERE'S 647 00:19:11,483 --> 00:19:15,220 SUCH A LARGE AREA OF CEREBRAL 648 00:19:15,220 --> 00:19:15,521 PALSY. 649 00:19:15,521 --> 00:19:17,156 >> ONE OF THE KEYS TO KEEPING 650 00:19:17,156 --> 00:19:18,557 CONSTIPATION AT ANY AGE IS 651 00:19:18,557 --> 00:19:21,126 HAVING THAT REGULAR PROGRAM, AND 652 00:19:21,126 --> 00:19:23,428 WHAT SOME PEOPLE DO IS THEY ARE 653 00:19:23,428 --> 00:19:25,164 AFRAID OF LAXATIVES BECAUSE THEY 654 00:19:25,164 --> 00:19:26,832 ARE CONCERNED THAT THEY MIGHT BE 655 00:19:26,832 --> 00:19:28,333 HABIT FORMING AND SO ON. 656 00:19:28,333 --> 00:19:30,435 SO THEY WILL WAIT UNTIL THEY ARE 657 00:19:30,435 --> 00:19:32,037 REALLY UNCOMFORTABLE CONSTIPATED 658 00:19:32,037 --> 00:19:33,839 AND THEN DO THE BIG CLEANOUT, SO 659 00:19:33,839 --> 00:19:37,142 TO SPEAK, AND THAT -- IN MAKING 660 00:19:37,142 --> 00:19:40,445 THAT SORT OF A CYCLE IS NOT 661 00:19:40,445 --> 00:19:43,048 PROBABLY A GOOD WAY TO ENJOY 662 00:19:43,048 --> 00:19:44,516 YOUR LIFESTYLE, CERTAINLY. 663 00:19:44,516 --> 00:19:48,887 AND SO I ENCOURAGE MY PATIENTS 664 00:19:48,887 --> 00:19:52,624 TO USE FIBER SUPPLEMENTS, 665 00:19:52,624 --> 00:19:58,430 OSMOTIC SUPPLEMENTS AND USE THE 666 00:19:58,430 --> 00:19:59,298 MORE STIMULANT LAXATIVES. 667 00:19:59,298 --> 00:20:00,599 OKAY, IF YOU HAVEN'T HAD AN 668 00:20:00,599 --> 00:20:01,900 ADEQUATE BOWEL MOVEMENT IN THREE 669 00:20:01,900 --> 00:20:04,503 OR FOUR DAYS, THEN USE THE 670 00:20:04,503 --> 00:20:05,370 RESCUE LAXATIVE BUT THEN RETURN 671 00:20:05,370 --> 00:20:06,505 TO THE REGULAR PROGRAM. 672 00:20:06,505 --> 00:20:08,273 >> HOW IMPORTANT IS IT TO OUR 673 00:20:08,273 --> 00:20:11,043 OVERALL HEALTH TO STAY REGULAR? 674 00:20:11,043 --> 00:20:12,578 TO GO ONCE A DAY? 675 00:20:12,578 --> 00:20:13,345 TWICE A DAY? 676 00:20:13,345 --> 00:20:14,913 HOW OFTEN SHOULD WE BE HAVING A 677 00:20:14,913 --> 00:20:16,682 BOWEL MOVEMENT TO KEEP OUR 678 00:20:16,682 --> 00:20:18,917 OVERALL HEALTH IN CHECK? 679 00:20:18,917 --> 00:20:25,924 >> WELL, PEOPLE VARY A LOT. 680 00:20:25,924 --> 00:20:28,227 AND THE NORMAL RANGE FOR BOWEL 681 00:20:28,227 --> 00:20:31,430 MOVEMENTS IS THREE TIMES A DAY, 682 00:20:31,430 --> 00:20:32,731 TO ONCE EVERY THREE DAYS. 683 00:20:32,731 --> 00:20:34,900 IF YOU ARE GOING OUTSIDE THAT 684 00:20:34,900 --> 00:20:37,002 RANGE, YOU SHOULD BE EVALUATED 685 00:20:37,002 --> 00:20:38,570 TO MAKE SURE THAT NOTHING ELSE 686 00:20:38,570 --> 00:20:39,504 IS GOING ON. 687 00:20:39,504 --> 00:20:40,772 >> LET'S TAKE A PHONE CALL FROM 688 00:20:40,772 --> 00:20:43,809 LINDA IN LEWISSTON. 689 00:20:43,809 --> 00:20:45,677 >> Caller: HI, HOW ARE YOU 690 00:20:45,677 --> 00:20:46,011 DOING? 691 00:20:46,011 --> 00:20:48,380 I'M CALLING ABOUT MY 31-YEAR-OLD 692 00:20:48,380 --> 00:20:48,747 DAUGHTER. 693 00:20:48,747 --> 00:20:50,215 SHE HAS STRUGGLED WITH THE 694 00:20:50,215 --> 00:20:52,017 SYMPTOMS THAT YOU GUYS ARE 695 00:20:52,017 --> 00:20:53,685 DESCRIBING SINCE SHE WAS 18. 696 00:20:53,685 --> 00:20:55,687 SHE TOOK HER GALLBLADDER OUT. 697 00:20:55,687 --> 00:20:57,689 SHE'S BEEN TESTED FOR I.B.S. 698 00:20:57,689 --> 00:21:00,192 SHE'S BEEN TESTED FOR CELIAC 699 00:21:00,192 --> 00:21:00,525 DISEASE. 700 00:21:00,525 --> 00:21:02,394 THEY HAVE DONE EVERYTHING. 701 00:21:02,394 --> 00:21:03,929 SHE IS A MOM OF THREE. 702 00:21:03,929 --> 00:21:06,231 SHE HAS DAYS SHE LITERALLY 703 00:21:06,231 --> 00:21:07,766 CANNOT FUNCTION. 704 00:21:07,766 --> 00:21:10,402 SHE DID THE BLOOD TEST FOR THE 705 00:21:10,402 --> 00:21:11,703 WHEAT, THE GLUCOSE OR WHATEVER. 706 00:21:11,703 --> 00:21:13,905 THEY SAID SHE'S NOT ALLERGIC TO 707 00:21:13,905 --> 00:21:14,172 IT. 708 00:21:14,172 --> 00:21:15,807 THEY PUT HER ON A MEDICATION. 709 00:21:15,807 --> 00:21:19,077 SHE TAKES A HALF A TABLET A DAY 710 00:21:19,077 --> 00:21:20,279 AND SHE CAN'T FUNCTION. 711 00:21:20,279 --> 00:21:23,415 IT PUTS HER INSTANTLY TO SLEEP 712 00:21:23,415 --> 00:21:24,683 BUT SHE CANNOT GET ANY ANSWERS 713 00:21:24,683 --> 00:21:26,818 OF WHAT IS GOING ON WITH HER. 714 00:21:26,818 --> 00:21:28,220 >> LINDA, BESIDES THE FATIGUE, 715 00:21:28,220 --> 00:21:29,121 WHAT OTHER SYMPTOMS DOES SHE 716 00:21:29,121 --> 00:21:31,990 HAVE? 717 00:21:31,990 --> 00:21:33,492 >> THE EXTREME PAIN, THE 718 00:21:33,492 --> 00:21:35,794 BURNING, SEVERE DIARRHEA, TO 719 00:21:35,794 --> 00:21:37,396 WHERE SHE'S PASS OUT. 720 00:21:37,396 --> 00:21:39,698 AND THEN SHE'LL GET CONSTIPATED. 721 00:21:39,698 --> 00:21:42,267 SHE HAS CUT OUT ALL THE SUGARS. 722 00:21:42,267 --> 00:21:44,603 SHE HAS CUT OUT ALL THE WHEAT 723 00:21:44,603 --> 00:21:44,970 PRODUCTS. 724 00:21:44,970 --> 00:21:45,904 NOTHING IS WORKING. 725 00:21:45,904 --> 00:21:48,707 SHE'S HAD THE COLONOSCOPY. 726 00:21:48,707 --> 00:21:49,474 THEY'VE DONE THE -- I DON'T KNOW 727 00:21:49,474 --> 00:21:50,709 WHAT IT IS, THE TEST THEY PUT 728 00:21:50,709 --> 00:21:52,210 THE TUBE DOWN HER THROAT, THEY 729 00:21:52,210 --> 00:21:56,181 HAVE DONE EVERYTHING. 730 00:21:56,181 --> 00:21:56,581 >> WOW! 731 00:21:56,581 --> 00:21:57,816 THAT SOUNDS LIKE A CHALLENGING 732 00:21:57,816 --> 00:21:58,116 CASE. 733 00:21:58,116 --> 00:22:00,118 ANY THOUGHTS TOWARDS WHAT 734 00:22:00,118 --> 00:22:02,220 LINDA'S DAUGHTER MIGHT BE GOING 735 00:22:02,220 --> 00:22:02,554 THROUGH? 736 00:22:02,554 --> 00:22:03,955 >> IT CERTAINLY SOUNDS LIKE A 737 00:22:03,955 --> 00:22:05,223 CHALLENGING CASE AND 738 00:22:05,223 --> 00:22:06,391 UNFORTUNATELY, IT'S NOT THAT 739 00:22:06,391 --> 00:22:09,127 ATYPICAL TO SEE PATIENTS WHO 740 00:22:09,127 --> 00:22:11,997 REALLY OVER TIME DEVELOP VERY 741 00:22:11,997 --> 00:22:15,067 INTRACTABLE AND SEVERE ABDOMINAL 742 00:22:15,067 --> 00:22:15,434 SYMPTOMS. 743 00:22:15,434 --> 00:22:18,503 THERE ARE NO SPECIFIC TESTS TO 744 00:22:18,503 --> 00:22:19,604 DIAGNOSE IRRITABLE BOWEL 745 00:22:19,604 --> 00:22:19,971 SYNDROME. 746 00:22:19,971 --> 00:22:22,107 IT'S A CLINICAL DIAGNOSIS AND I 747 00:22:22,107 --> 00:22:23,575 THINK IN SOME CIRCUMSTANCES, 748 00:22:23,575 --> 00:22:25,010 IT'S REASONABLE TO LOOK FOR 749 00:22:25,010 --> 00:22:26,978 OTHER CONDITIONS THAT MIGHT BE 750 00:22:26,978 --> 00:22:32,651 CAUSING THOSE SYMPTOMS, BUT -- 751 00:22:32,651 --> 00:22:34,086 BUT THERE IS NOT A SPECIFIC TEST 752 00:22:34,086 --> 00:22:36,121 THAT WE CAN DO AND SAY THIS IS 753 00:22:36,121 --> 00:22:37,789 IRRITABLE BOWEL SYNDROME. 754 00:22:37,789 --> 00:22:40,225 THE DIAGNOSIS IS BASED ON THE 755 00:22:40,225 --> 00:22:44,162 ABSENCE OF OTHER CONDITIONS AND 756 00:22:44,162 --> 00:22:46,832 PARTICULAR MANIFESTATION, 757 00:22:46,832 --> 00:22:48,900 ABDOMINAL PAIN, DIARRHEA 758 00:22:48,900 --> 00:22:50,569 ALTERNATING WITH CONSTIPATION 759 00:22:50,569 --> 00:22:52,237 SOUNDS LIKE DIFFICULT IRRITABLE 760 00:22:52,237 --> 00:22:53,305 BOWEL SYNDROME. 761 00:22:53,305 --> 00:22:55,340 >> SO SHE PROBABLY NEEDS TO SEEK 762 00:22:55,340 --> 00:22:57,509 MORE MEDICAL ADVICE? 763 00:22:57,509 --> 00:22:59,378 >> WELL, IRRITABLE BOWEL 764 00:22:59,378 --> 00:23:00,812 SYNDROME, EVEN THOUGH SOME 765 00:23:00,812 --> 00:23:02,147 PEOPLE, INCLUDING PHYSICIANS USE 766 00:23:02,147 --> 00:23:06,518 IT AS KIND OF A BASKET TO HOLD 767 00:23:06,518 --> 00:23:08,620 PATIENTS IN, IT CAN REALLY 768 00:23:08,620 --> 00:23:10,122 RUIN'S SOMEBODY LIFE. 769 00:23:10,122 --> 00:23:12,491 THEY TOOK 100 I.B.S. PATIENTS 770 00:23:12,491 --> 00:23:14,326 AND ASKED THEM TO RANK THEIR 771 00:23:14,326 --> 00:23:15,994 LIFE AND THEIR PAIN AND THEY 772 00:23:15,994 --> 00:23:17,996 TOOK 100 PATIENTS WITH 773 00:23:17,996 --> 00:23:19,598 METASTATIC PANCREATIC CANCER AND 774 00:23:19,598 --> 00:23:21,299 THE PEOPLE WITH I.B.S. HAD A 775 00:23:21,299 --> 00:23:23,335 WORSE LIFE AND MORE PAIN THAN 776 00:23:23,335 --> 00:23:25,337 THE PEOPLE WITH PANCREATIC 777 00:23:25,337 --> 00:23:25,670 CANCER. 778 00:23:25,670 --> 00:23:27,506 IT CAN REALLY -- IT CAN REALLY 779 00:23:27,506 --> 00:23:28,607 RUIN YOUR LIFE. 780 00:23:28,607 --> 00:23:30,108 OUR GOAL IS, YOU KNOW, WHEN I 781 00:23:30,108 --> 00:23:31,610 SEE SOMEONE LIKE THIS IN MY 782 00:23:31,610 --> 00:23:33,311 OFFICE, AND IT SOUNDS LIKE SHE 783 00:23:33,311 --> 00:23:34,813 HAS GOOD DOCTORS TAKING CARE OF 784 00:23:34,813 --> 00:23:35,080 HER. 785 00:23:35,080 --> 00:23:37,015 THEY HAVE BEEN VERY THOROUGH BUT 786 00:23:37,015 --> 00:23:39,017 WHEN I SEE SOMEBODY LIKE THIS MY 787 00:23:39,017 --> 00:23:42,220 GOAL IS, MAKE THEIR LIFE MORE 788 00:23:42,220 --> 00:23:42,621 MANAGEABLE. 789 00:23:42,621 --> 00:23:45,524 AND THE WAY I DO THAT IS, YOU 790 00:23:45,524 --> 00:23:48,493 KNOW, MODERATE DIET WITH LOTS OF 791 00:23:48,493 --> 00:23:51,196 FIBER IN IT, A FIBER SUPPLEMENT, 792 00:23:51,196 --> 00:23:53,732 REGULAR EXERCISE IS REALLY KEY. 793 00:23:53,732 --> 00:23:55,700 LIMIT STRESS IN YOUR LIFE TO THE 794 00:23:55,700 --> 00:23:57,235 EXTENT YOU CAN, AND GET PLENTY 795 00:23:57,235 --> 00:23:58,403 OF SLEEP. 796 00:23:58,403 --> 00:24:01,039 AND THAT'S PROBABLY GOING TO BE 797 00:24:01,039 --> 00:24:02,841 9 BEST YOU ARE GO -- THE BEST 798 00:24:02,841 --> 00:24:04,709 YOU ARE GOING TO BE ABLE TO DO. 799 00:24:04,709 --> 00:24:08,013 >> AND CHANGE YOUR DIET. 800 00:24:08,013 --> 00:24:11,116 >> SHE MAY WANT TO LOOK INTO THE 801 00:24:11,116 --> 00:24:13,652 LOW FOGMAP DIE THAT THE DR. P 802 00:24:13,652 --> 00:24:15,821 WAS SPEAKING ABOUT EARLIER. 803 00:24:15,821 --> 00:24:20,592 IT'S NOT JUST AVOIDING WHEAT. 804 00:24:20,592 --> 00:24:22,227 >> WHERE IS A GOOD PLACE FOR HER 805 00:24:22,227 --> 00:24:24,830 TO SEEK THAT INFORMATION? 806 00:24:24,830 --> 00:24:25,697 IS THERE INFORMATION ONLINE? 807 00:24:25,697 --> 00:24:27,532 >> I HAVE SEEN OUT OF STANFORD 808 00:24:27,532 --> 00:24:28,300 UNIVERSITY, I BELIEVE A LOT OF 809 00:24:28,300 --> 00:24:30,402 IT HAS COME FROM AUSTRALIA. 810 00:24:30,402 --> 00:24:33,905 >> A LOT OF STUDIES FROM 811 00:24:33,905 --> 00:24:35,640 AUSTRALIA, THAT'S RIGHT. 812 00:24:35,640 --> 00:24:36,808 >> WORTH AN INTERNET CHECK ON 813 00:24:36,808 --> 00:24:37,309 THAT ONE. 814 00:24:37,309 --> 00:24:39,110 >> FOR SURE. 815 00:24:39,110 --> 00:24:40,612 >> LET'S TAKE ANOTHER PHONE 816 00:24:40,612 --> 00:24:40,912 CALL. 817 00:24:40,912 --> 00:24:41,880 WOLF, YOU HAVE A QUESTION FOR 818 00:24:41,880 --> 00:24:44,015 OUR PANEL THIS EVENING? 819 00:24:44,015 --> 00:24:44,916 >> Caller: YEAH, ACTUALLY, I 820 00:24:44,916 --> 00:24:47,919 JUST WANT TO COMMENT ABOUT THE 821 00:24:47,919 --> 00:24:48,453 SUBJECT OF GLUTEN. 822 00:24:48,453 --> 00:24:51,223 I HAVE A DAUGHTER THAT HAS SOME 823 00:24:51,223 --> 00:24:53,425 SPECIAL NEEDS AND SHE'S ALSO 824 00:24:53,425 --> 00:24:57,028 GLUTEN INTOLERANCE FROM THE TIME 825 00:24:57,028 --> 00:24:58,597 SHE -- 826 00:24:58,597 --> 00:25:00,832 >> DID WE LOSE -- OKAY. 827 00:25:00,832 --> 00:25:03,702 ROLF, IF YOU ARE LISTENING, 828 00:25:03,702 --> 00:25:04,703 PLEASE GO AHEAD AND CALL THE 829 00:25:04,703 --> 00:25:05,403 PHONE NUMBER BACK. 830 00:25:05,403 --> 00:25:07,138 WE WILL BE HAPPY TO TAKE YOUR 831 00:25:07,138 --> 00:25:08,607 PHONE CALL TONIGHT AND GET YOUR 832 00:25:08,607 --> 00:25:10,342 QUESTION INTO OUR PANEL. 833 00:25:10,342 --> 00:25:15,647 IN THE MEANTIME, LET'S TALK 834 00:25:15,647 --> 00:25:16,314 ABOUT LACTOSE INTOLERANCE. 835 00:25:16,314 --> 00:25:18,450 THIS FITS IN WITH THE TREND OF 836 00:25:18,450 --> 00:25:21,019 GLUTEN FREE, I GUESS, BUT A FEW 837 00:25:21,019 --> 00:25:22,587 YEARS AGO IT BECAME THE PHRASE 838 00:25:22,587 --> 00:25:24,689 WE WERE HEARING A LOT. 839 00:25:24,689 --> 00:25:25,891 AND THERE WERE MILK AND ALL 840 00:25:25,891 --> 00:25:27,058 KINDS OF DAIRY PRODUCTS THAT 841 00:25:27,058 --> 00:25:29,294 WERE COMING INTO PLAY THAT WERE 842 00:25:29,294 --> 00:25:29,728 LACTOSE-FREE. 843 00:25:29,728 --> 00:25:31,496 WHAT IS THIS LACTOSE INTOLERANCE 844 00:25:31,496 --> 00:25:32,931 AND HOW CAN THAT AFFECT MY 845 00:25:32,931 --> 00:25:33,532 HEALTH? 846 00:25:33,532 --> 00:25:36,835 >> WELL, IT'S ACTUALLY THE SAME 847 00:25:36,835 --> 00:25:39,971 PATH OF PHYSIOLOGY THAT PLAYS 848 00:25:39,971 --> 00:25:40,772 INTO LACTOSE INTOLLersANCE 849 00:25:40,772 --> 00:25:42,707 THAT WE HAVE BEEN TALKING ABOUT. 850 00:25:42,707 --> 00:25:44,309 BASICALLY OUR SMALL INTESTINE IS 851 00:25:44,309 --> 00:25:47,245 THE PART OF OUR GASTROINTESTINAL 852 00:25:47,245 --> 00:25:48,513 TRACT WHERE WE ABSORB A LOT OF 853 00:25:48,513 --> 00:25:49,915 THESE SUGARS AND WHAT WE HAVE 854 00:25:49,915 --> 00:25:53,084 COME TO REALIZE IS THAT OUR 855 00:25:53,084 --> 00:25:54,419 EFFICIENCY IN ABSORBING THESE 856 00:25:54,419 --> 00:25:56,488 VARIOUS SUGARS, INCLUDING 857 00:25:56,488 --> 00:25:57,923 LACTOSE VARIES FROM INDIVIDUAL 858 00:25:57,923 --> 00:26:00,091 TO INDIVIDUAL, AND ALSO VARIES 859 00:26:00,091 --> 00:26:03,929 DEPENDING ON WHAT SUGARS YOU 860 00:26:03,929 --> 00:26:05,597 INGEST AND CERTAIN PEOPLE LOSE 861 00:26:05,597 --> 00:26:08,533 THE ABILITY, AS THEY AGE, TO 862 00:26:08,533 --> 00:26:09,801 DIAGNOSE LACTOSE. 863 00:26:09,801 --> 00:26:11,736 THE LACTOSE, OR ANY POORLY 864 00:26:11,736 --> 00:26:12,904 DIGESTED SUGAR GOES THROUGH TO 865 00:26:12,904 --> 00:26:15,106 THE LARGE INTESTINE, WHICH IS 866 00:26:15,106 --> 00:26:17,309 INHABITED BY BACTERIA, WHICH ARE 867 00:26:17,309 --> 00:26:19,544 THERE AS PART OF OUR NORMAL 868 00:26:19,544 --> 00:26:19,945 PHYSIOLOGY. 869 00:26:19,945 --> 00:26:23,114 AND THOSE BACTERIA FEAST ON THE 870 00:26:23,114 --> 00:26:25,317 LACTOSE, BASICALLY AND TURN IT 871 00:26:25,317 --> 00:26:28,620 INTO GAS AND SMALL PARTICLES 872 00:26:28,620 --> 00:26:32,524 WHICH WE CAUSE OSMOLES AND THAT 873 00:26:32,524 --> 00:26:34,893 CAN RESULT IN FLATULENCE AND 874 00:26:34,893 --> 00:26:36,428 BLOATING, AND SYMPTOMS OF 875 00:26:36,428 --> 00:26:37,529 IRRITABLE BOWEL SYNDROME. 876 00:26:37,529 --> 00:26:39,531 OTHER SUGARS THAT WE BECAME 877 00:26:39,531 --> 00:26:43,335 AWARE OF, FRUCTOSE, THAT'S BEEN 878 00:26:43,335 --> 00:26:44,836 SUPERSEDED BY THE FACT THAT WE 879 00:26:44,836 --> 00:26:47,272 RECOGNIZE A LOT OF THESE THINGS, 880 00:26:47,272 --> 00:26:49,240 HENCE THE FOGMAPS CAN BE 881 00:26:49,240 --> 00:26:51,109 ABSORBED POORLY AND CAN CAUSE 882 00:26:51,109 --> 00:26:53,578 SYMPTOMS IN SOME PATIENTS. 883 00:26:53,578 --> 00:26:54,913 >> WOW, THAT'S SO INTERESTING. 884 00:26:54,913 --> 00:26:56,881 AGAIN, THAT COMES DOWN TO DIET 885 00:26:56,881 --> 00:26:59,618 AND CUTTING OUT A LOT OF DAIRY 886 00:26:59,618 --> 00:27:00,585 PRODUCTS, UNFORTUNATELY, THERE 887 00:27:00,585 --> 00:27:05,624 ARE PRODUCTS ON THE MARKET THAT 888 00:27:05,624 --> 00:27:06,958 YOU CAN SUBSTITUTE WITH. 889 00:27:06,958 --> 00:27:08,860 >> SOME PEOPLE CAN HAVE A SMALL 890 00:27:08,860 --> 00:27:10,562 AMOUNT OF LACTOSE. 891 00:27:10,562 --> 00:27:15,533 SOMETIMES YOU CAN BUILD UP YOUR 892 00:27:15,533 --> 00:27:17,736 TOLERANCE. 893 00:27:17,736 --> 00:27:20,338 AND SOME CAN'T DRINK COWS MILK, 894 00:27:20,338 --> 00:27:21,940 BUT THEY CAN HAVE THE OTHER 895 00:27:21,940 --> 00:27:23,608 DAIRY PRODUCTS AND IT'S BASED ON 896 00:27:23,608 --> 00:27:25,110 A PERSON'S SENSITIVITY. 897 00:27:25,110 --> 00:27:26,544 THERE'S CERTAINLY A LOT OF 898 00:27:26,544 --> 00:27:27,946 ALTERNATIVE PRODUCTS OUT THERE 899 00:27:27,946 --> 00:27:28,313 NOWADAYS. 900 00:27:28,313 --> 00:27:29,614 >> WE HAVE ANOTHER PHONE CALL, 901 00:27:29,614 --> 00:27:31,916 DIANE CALLING FROM SPOKANE. 902 00:27:31,916 --> 00:27:32,984 HELLO, DIANE. 903 00:27:32,984 --> 00:27:35,520 >> Caller: HI, HI. 904 00:27:35,520 --> 00:27:39,824 I FOR THE LAST TWO YEARS, I HAVE 905 00:27:39,824 --> 00:27:42,727 HAD BOUTS OF INTESTINAL PAIN. 906 00:27:42,727 --> 00:27:45,730 IT DOESN'T HAPPEN ALL THE TIME. 907 00:27:45,730 --> 00:27:51,002 JUST EVERY SO OFTEN AND IT 908 00:27:51,002 --> 00:27:52,303 DOUBLES ME UP, BUT I DON'T HAVE 909 00:27:52,303 --> 00:27:55,173 THE DIARRHEA OR CONSTIPATION. 910 00:27:55,173 --> 00:27:59,210 I HAVE NORMAL BOWEL MOVEMENTS 911 00:27:59,210 --> 00:28:01,112 AND I HAVE DONE A LOT OF 912 00:28:01,112 --> 00:28:02,514 RESEARCH ONLINE FOR ALL THE 913 00:28:02,514 --> 00:28:08,586 DIFFERENT INTESTINAL MALDID IS 914 00:28:08,586 --> 00:28:11,723 AND -- MALL DID IS AND I COULD 915 00:28:11,723 --> 00:28:13,058 NOT FIGURE OUT WHY I DIDN'T HAVE 916 00:28:13,058 --> 00:28:14,626 THESE THINGS. 917 00:28:14,626 --> 00:28:16,728 MY DAD HAD COLITIS REAL BAD AND 918 00:28:16,728 --> 00:28:18,329 I REMEMBER AS A KID HE WOULD 919 00:28:18,329 --> 00:28:19,764 SUFFER WITH THAT. 920 00:28:19,764 --> 00:28:21,533 >> CAN YOU RELATE IT, DIANE TO 921 00:28:21,533 --> 00:28:23,501 ANYTHING YOU HAVE EATEN OR A 922 00:28:23,501 --> 00:28:24,636 CERTAIN TIME OF OR SOMETHING 923 00:28:24,636 --> 00:28:26,271 ELSE THAT MIGHT BE HELPFUL 924 00:28:26,271 --> 00:28:26,671 INFORMATION? 925 00:28:26,671 --> 00:28:28,873 >> I PRETTY MUCH -- I'M A PRETTY 926 00:28:28,873 --> 00:28:29,974 NATURAL TYPE OF PERSON AND I 927 00:28:29,974 --> 00:28:34,479 WATCH MY DIET AND I REALLY HAVE 928 00:28:34,479 --> 00:28:36,314 NEVER RELATED TO ANYTHING. 929 00:28:36,314 --> 00:28:38,883 IT JUST HITS ME. 930 00:28:38,883 --> 00:28:40,885 AND -- BUT WHAT I COULD NEVER 931 00:28:40,885 --> 00:28:43,388 FIGURE OUT IS WHY I NEVER HAD 932 00:28:43,388 --> 00:28:45,890 THE -- LIKE THE DIARRHEA OR 933 00:28:45,890 --> 00:28:46,624 CONSTIPATION BECAUSE THAT SEEMS 934 00:28:46,624 --> 00:28:48,193 TO BE THE THING THAT GOES WITH 935 00:28:48,193 --> 00:28:51,896 ALL OF THESE INTESTINAL 936 00:28:51,896 --> 00:28:52,263 PROBLEMS. 937 00:28:52,263 --> 00:28:52,797 >> HMM. 938 00:28:52,797 --> 00:28:54,866 AND IT'S A STABBING PAIN THAT 939 00:28:54,866 --> 00:28:58,403 HITS YOU OUT OF NOWHERE? 940 00:28:58,403 --> 00:28:58,803 >> YEAH. 941 00:28:58,803 --> 00:28:59,537 >> Caller: AND IT LASTS FOR 942 00:28:59,537 --> 00:29:00,371 ABOUT A WEEK. 943 00:29:00,371 --> 00:29:01,106 >> OH, REALLY? 944 00:29:01,106 --> 00:29:02,373 THAT LONG. 945 00:29:02,373 --> 00:29:03,475 IT'S SHOT SHORT TERM. 946 00:29:03,475 --> 00:29:05,777 >> Caller: AND THEN IT JUST GOES 947 00:29:05,777 --> 00:29:06,177 AWAY. 948 00:29:06,177 --> 00:29:06,611 >> OKAY. 949 00:29:06,611 --> 00:29:08,079 ANY ADVICE FOR DIANE THIS 950 00:29:08,079 --> 00:29:08,480 EVENING? 951 00:29:08,480 --> 00:29:09,681 >> WELL, I GUESS SHE CAN BE 952 00:29:09,681 --> 00:29:11,015 HAPPY THAT IT GOES AWAY. 953 00:29:11,015 --> 00:29:12,183 >> IT DOES GO AWAY. 954 00:29:12,183 --> 00:29:14,085 >> HOW CONCERNED SHOULD SHE BE 955 00:29:14,085 --> 00:29:16,621 TOO, IF IT'S LASTING FOR A WEEK 956 00:29:16,621 --> 00:29:17,989 AT A TIME. 957 00:29:17,989 --> 00:29:19,791 >> BUT SHE'S HAD IT FOR TWO 958 00:29:19,791 --> 00:29:20,091 YEARS. 959 00:29:20,091 --> 00:29:21,359 SO IN TERMS OF CONCERN, THIS IS 960 00:29:21,359 --> 00:29:22,660 NOT LIKELY TO BE SOMETHING 961 00:29:22,660 --> 00:29:25,997 THAT'S PROGRESSIVE OR -- I'M 962 00:29:25,997 --> 00:29:28,099 SURE IT'S A BIG NUISANCE FOR 963 00:29:28,099 --> 00:29:31,569 HER, AND -- BUT PROBABLY NOT -- 964 00:29:31,569 --> 00:29:35,907 NOT INDICATIVE OF MORE WORRY 965 00:29:35,907 --> 00:29:36,574 UNDERLYING PATHOLOGY. 966 00:29:36,574 --> 00:29:38,176 ONE WOULD HOPE THAT SHE HAD BEEN 967 00:29:38,176 --> 00:29:40,879 CHECKED OUT CAREFULLY BY A 968 00:29:40,879 --> 00:29:41,780 GASTROENTEROLOGIST OR AT LEAST 969 00:29:41,780 --> 00:29:43,882 BY HER INTERNIST, AND I THINK 970 00:29:43,882 --> 00:29:46,785 PART OF WHAT WE ARE SEEING HERE 971 00:29:46,785 --> 00:29:48,186 WITH COMPLAINTS OF THIS TYPE, 972 00:29:48,186 --> 00:29:49,621 IT'S A BIGGER BASKET THAN WHAT 973 00:29:49,621 --> 00:29:52,390 WE WERE TALKING ABOUT. 974 00:29:52,390 --> 00:29:57,328 AND THE BASKET INCLUDES 975 00:29:57,328 --> 00:30:00,965 IRRITABLE BOWEL SYNDROME BUT 976 00:30:00,965 --> 00:30:02,967 FUNCTIONAL GASTROINTESTINAL 977 00:30:02,967 --> 00:30:04,302 DISORDERS WHICH MEANS WE 978 00:30:04,302 --> 00:30:05,703 RECOGNIZE THAT IT'S A PROBLEM 979 00:30:05,703 --> 00:30:06,504 THAT THERE ARE SYMPTOMS 980 00:30:06,504 --> 00:30:07,605 ASSOCIATED PAIN OR WHAT HAVE 981 00:30:07,605 --> 00:30:09,874 YOU, BUT WE CONDITION FIND THE 982 00:30:09,874 --> 00:30:11,876 SPECIFIC PIECE THAT HAS TO BE 983 00:30:11,876 --> 00:30:13,878 REMOVED OR SPECIFIC MEDICINE 984 00:30:13,878 --> 00:30:15,280 THAT HAS TO BE NECESSARILY GIVEN 985 00:30:15,280 --> 00:30:17,315 TO FIND THE CURE FOR THAT. 986 00:30:17,315 --> 00:30:22,387 IT MIGHT JUST BE PART OF NORMAL 987 00:30:22,387 --> 00:30:24,289 PHYSIOLOGICAL FUNCTION THAT'S 988 00:30:24,289 --> 00:30:25,990 PERCEIVED AS BEING PAINFUL BY 989 00:30:25,990 --> 00:30:27,125 SOME PEOPLE FOR SOME REASON. 990 00:30:27,125 --> 00:30:28,393 >> AS I WAS DOING MY RESEARCH 991 00:30:28,393 --> 00:30:29,794 FOR TONIGHT'S TOPIC, I WAS 992 00:30:29,794 --> 00:30:31,596 FINING THINGS LIKE THYROID 993 00:30:31,596 --> 00:30:32,997 DISEASE ASSOCIATED WITH THINGS 994 00:30:32,997 --> 00:30:35,533 THAT CAN BE GOING ON IN YOUR 995 00:30:35,533 --> 00:30:36,267 STOMACH AND ABDOMEN AND ALL OF 996 00:30:36,267 --> 00:30:38,002 THESE DIFFERENT RELATED -- YOU 997 00:30:38,002 --> 00:30:39,103 KNOW, HOW IMPORTANT IT IS TO, 998 00:30:39,103 --> 00:30:41,272 YOU KNOW, FOR OUR GUTS TO BE 999 00:30:41,272 --> 00:30:41,673 HEALTHY. 1000 00:30:41,673 --> 00:30:43,208 AND ANOTHER THING I HAVE BEEN 1001 00:30:43,208 --> 00:30:45,476 FASCINATED WITH LATELY IS THE 1002 00:30:45,476 --> 00:30:45,877 PROBIOTICS. 1003 00:30:45,877 --> 00:30:47,512 AND THE FACT THAT WE ARE SEEING 1004 00:30:47,512 --> 00:30:49,981 NOW A LOT OF PRODUCTS WITH 1005 00:30:49,981 --> 00:30:51,282 PROBIOTICS IN KEEPING OUR GUT 1006 00:30:51,282 --> 00:30:51,983 HEALTHY. 1007 00:30:51,983 --> 00:30:55,019 ALLI, I EAT YOGURT EVERY DAY, AM 1008 00:30:55,019 --> 00:31:08,566 PROBIOTICS, OR DO I 1009 00:31:08,566 --> 00:31:11,903 NEED TO BUY A SPECIAL YOGURT. 1010 00:31:11,903 --> 00:31:13,371 >> IT'S THE GOOD BACTERIA. 1011 00:31:13,371 --> 00:31:16,207 WE WILL GIVE THEM THE GOOD 1012 00:31:16,207 --> 00:31:20,979 BACTERIA TO CALM THE DIARRHEA. 1013 00:31:20,979 --> 00:31:22,580 YOU PROBABLY DON'T NEED TO GO 1014 00:31:22,580 --> 00:31:25,783 OVERDOSING ON THEM, BUT YOU HAVE 1015 00:31:25,783 --> 00:31:28,586 A FUNCTION OUT THERE FOR CERTAIN 1016 00:31:28,586 --> 00:31:28,987 POPULATIONS. 1017 00:31:28,987 --> 00:31:33,391 >> LET'S TAKE A PHONE CALL FROM 1018 00:31:33,391 --> 00:31:34,325 SUSAN IN SPOKANE. 1019 00:31:34,325 --> 00:31:36,394 >> I HAVE A FRIEND WHO HAS A 1020 00:31:36,394 --> 00:31:38,997 BOWEL MOVEMENT MAYBE ONCE A WEEK 1021 00:31:38,997 --> 00:31:40,498 AND THIS HAS BEEN GOING ON FOR 1022 00:31:40,498 --> 00:31:43,568 YEARS AND THEY HAVE NOT -- NEVER 1023 00:31:43,568 --> 00:31:45,203 DIAGNOSED ANYTHING. 1024 00:31:45,203 --> 00:31:48,373 >> SHE HAS A REGULAR DIET AND 1025 00:31:48,373 --> 00:31:49,607 DOESN'T SEEM TO HAVE ANY 1026 00:31:49,607 --> 00:31:52,176 ASSOCIATED SYMPTOMS WITH THAT? 1027 00:31:52,176 --> 00:31:53,878 >> NO. 1028 00:31:53,878 --> 00:31:54,612 EXERCISES REGULAR. 1029 00:31:54,612 --> 00:31:57,382 EATS A GOOD DIET, AND JUST 1030 00:31:57,382 --> 00:31:59,984 NEVER, EVER, WANTS TO GO BEFORE 1031 00:31:59,984 --> 00:32:01,586 THEN AND THEN IT'S A BIG ONE 1032 00:32:01,586 --> 00:32:04,122 THAT IS NOT HEALTHY. 1033 00:32:04,122 --> 00:32:07,125 >> OKAY. 1034 00:32:07,125 --> 00:32:09,527 WELL, AGAIN, OUR SYSTEMS ARE 1035 00:32:09,527 --> 00:32:11,229 DIFFERENT, BUT A WEEK, ONCE A 1036 00:32:11,229 --> 00:32:12,397 WEEK IS THAT -- 1037 00:32:12,397 --> 00:32:14,933 >> THAT'S OUTSIDE THE NORM. 1038 00:32:14,933 --> 00:32:17,735 AND, YOU KNOW, I'M GLAD SHE'S 1039 00:32:17,735 --> 00:32:19,904 HAD A COLONOSCOPY AT LEAST, AND 1040 00:32:19,904 --> 00:32:26,911 HOPEFULLY SHE'S HAD HER THYROID 1041 00:32:26,911 --> 00:32:27,278 LOOKED AT. 1042 00:32:27,278 --> 00:32:28,279 THERE ARE A COUPLE OF THINGS 1043 00:32:28,279 --> 00:32:29,914 THAT I WOULD IMMEDIATELY DO WHEN 1044 00:32:29,914 --> 00:32:33,518 SOMEONE CAME INTO MY OFFICE. 1045 00:32:33,518 --> 00:32:34,919 >> IT SOUNDS LIKE HER FRIEND IS 1046 00:32:34,919 --> 00:32:37,221 MORE TROUBLED BY IT THAN THE 1047 00:32:37,221 --> 00:32:37,889 PATIENT IS. 1048 00:32:37,889 --> 00:32:38,723 >> IT COULD BE. 1049 00:32:38,723 --> 00:32:40,091 IT'S A LITTLE CAUSE FOR CONCERN, 1050 00:32:40,091 --> 00:32:40,558 I GUESS. 1051 00:32:40,558 --> 00:32:41,960 >> ALL RIGHT, LET'S TOUCH ON A 1052 00:32:41,960 --> 00:32:44,829 FEW OTHER THINGS WHEN WE TALK 1053 00:32:44,829 --> 00:32:45,396 ABOUT TUMMY TROUBLE. 1054 00:32:45,396 --> 00:32:48,199 WE HAVE TALKED ABOUT CELIAC 1055 00:32:48,199 --> 00:32:50,335 DISEASE BUT WHAT ABOUT COLITIS 1056 00:32:50,335 --> 00:32:51,936 WHICH CAN BE A FAIRLY SERIOUS 1057 00:32:51,936 --> 00:32:54,339 CONDITION ALSO. 1058 00:32:54,339 --> 00:32:56,007 >> WELL, COLITIS IS A VERY BROAD 1059 00:32:56,007 --> 00:32:56,307 TERM. 1060 00:32:56,307 --> 00:32:59,277 WHAT IT SPECIFICALLY MEANS IS 1061 00:32:59,277 --> 00:33:01,145 INFLAMMATION OF THE COLON AND 1062 00:33:01,145 --> 00:33:02,513 THERE ARE MANY THINGS THAT CAN 1063 00:33:02,513 --> 00:33:04,482 CAUSE INFLAMMATION OF THE COLON, 1064 00:33:04,482 --> 00:33:07,585 ACUTE INFECTION, AND TO MORE 1065 00:33:07,585 --> 00:33:12,023 CHRONIC DISORDERS SUCH AS 1066 00:33:12,023 --> 00:33:12,690 CROHN'S DISEASE. 1067 00:33:12,690 --> 00:33:17,395 WHAT MAKES THE TERM COLITIS MORE 1068 00:33:17,395 --> 00:33:20,498 CONFUSING IS IRRITABLE BOWEL 1069 00:33:20,498 --> 00:33:22,333 SYNDROME USED TO BE REFERRED TO 1070 00:33:22,333 --> 00:33:24,002 AS COLITIS AND IT WAS A TERM 1071 00:33:24,002 --> 00:33:25,503 THAT HAS BEEN USED TO DESCRIBE A 1072 00:33:25,503 --> 00:33:27,105 LOT OF INTESTINAL DISORDERS. 1073 00:33:27,105 --> 00:33:31,709 SO IT'S REALLY A VERY VAGUE 1074 00:33:31,709 --> 00:33:32,010 TERM. 1075 00:33:32,010 --> 00:33:33,211 SO TO BE MORE PRECISE ABOUT IT, 1076 00:33:33,211 --> 00:33:36,647 I MEAN, THE WORRISOME-TYPE OF 1077 00:33:36,647 --> 00:33:39,517 COLITIS WOULD BE INFLAMMATORY 1078 00:33:39,517 --> 00:33:43,855 BOWEL DISEASE, MAINLY ULCERATIVE 1079 00:33:43,855 --> 00:33:46,524 COLITIS AND CROHN'S DISEASE. 1080 00:33:46,524 --> 00:33:48,092 INFECTIOUS COLITIS CAN HAPPEN. 1081 00:33:48,092 --> 00:33:49,994 THERE'S ANOTHER ONE THAT'S A BIG 1082 00:33:49,994 --> 00:33:50,328 CONCERN. 1083 00:33:50,328 --> 00:33:52,497 IT WAS A CONCERN IN HOSPITALIZED 1084 00:33:52,497 --> 00:33:53,431 PATIENTS BUT WE ARE SEEING MORE 1085 00:33:53,431 --> 00:33:56,801 AND MORE OF IT IN THE COMMUNITY. 1086 00:33:56,801 --> 00:33:58,102 AND THEN THERE ARE FORMS OF WHAT 1087 00:33:58,102 --> 00:34:01,039 WE CALL MICROSCOPIC COLITIS 1088 00:34:01,039 --> 00:34:04,809 WHICH CAN RESULT IN DIARRHEA AND 1089 00:34:04,809 --> 00:34:06,611 PROBLEMS THAT ARE HELPED BY A 1090 00:34:06,611 --> 00:34:07,378 SPECIFIC DIAGNOSIS AND 1091 00:34:07,378 --> 00:34:08,146 TREATMENT. 1092 00:34:08,146 --> 00:34:08,646 >> ALL RIGHT. 1093 00:34:08,646 --> 00:34:10,715 WE HAVE AN EMAIL TO ADDRESS THIS 1094 00:34:10,715 --> 00:34:12,116 EVENING, AND THIS PERSON IS 1095 00:34:12,116 --> 00:34:14,318 ASKING, PLEASE ADDRESS THE 1096 00:34:14,318 --> 00:34:16,220 DIFFERENCE BETWEEN FOOD 1097 00:34:16,220 --> 00:34:17,889 INTOLERANCE AND FOOD ALLERGY. 1098 00:34:17,889 --> 00:34:20,024 THAT'S AN EXCELLENT QUESTION. 1099 00:34:20,024 --> 00:34:21,292 ALLI, YOU WOULD LIKE TO TAKE 1100 00:34:21,292 --> 00:34:21,592 THAT? 1101 00:34:21,592 --> 00:34:24,328 >> THEY CAN PROBABLY GIVE YOU A 1102 00:34:24,328 --> 00:34:25,596 MORE SCIENTIFIC DIAGNOSIS THAN I 1103 00:34:25,596 --> 00:34:25,863 CAN. 1104 00:34:25,863 --> 00:34:28,499 IF YOU HAVE A FOOD ALLERGY, YOUR 1105 00:34:28,499 --> 00:34:30,701 BODY HAS A TRUE REACTION TO THAT 1106 00:34:30,701 --> 00:34:32,703 PROTEIN AND IF YOU HAVE A FOOD 1107 00:34:32,703 --> 00:34:35,306 ALLERGY, YOU SHOULD HAVE 100% 1108 00:34:35,306 --> 00:34:36,107 AVOIDANCE. 1109 00:34:36,107 --> 00:34:37,809 WHEREAS A FOOD INTOLERANCE, IT'S 1110 00:34:37,809 --> 00:34:39,277 MORE LIKE SIGNS AND SYMPTOMS 1111 00:34:39,277 --> 00:34:42,013 MAYBE OF BLOATING, ABDOMINAL 1112 00:34:42,013 --> 00:34:44,315 DISTENTION, DISCOMFORT, SUCH AS 1113 00:34:44,315 --> 00:34:45,616 WITH THE LACTOSE INTOLERANCE, 1114 00:34:45,616 --> 00:34:47,418 BUT YOU CAN DIGEST SOME OF THAT 1115 00:34:47,418 --> 00:34:47,718 FOOD. 1116 00:34:47,718 --> 00:34:51,155 SO SOME PEOPLE WILL SAY THEY 1117 00:34:51,155 --> 00:34:53,224 HAVE LACTOSE INTOLERANCE AND 1118 00:34:53,224 --> 00:34:54,892 THEY CAN STILL TOLERATE SOME 1119 00:34:54,892 --> 00:34:56,461 SMALL QUANTITIES OF MILK. 1120 00:34:56,461 --> 00:34:58,529 BUT IF YOU HAVE A TRUE MILK 1121 00:34:58,529 --> 00:34:59,664 ALLERGY, YOU ARE ALLERGIC TO THE 1122 00:34:59,664 --> 00:35:02,700 PROTEIN AND YOU COULDN'T 1123 00:35:02,700 --> 00:35:04,302 TOLERATE ANY MILK OR CHEESE, OR 1124 00:35:04,302 --> 00:35:05,603 DAIRY PRODUCTS AT ALL. 1125 00:35:05,603 --> 00:35:07,405 >> THAT'S AN EXCELLENT 1126 00:35:07,405 --> 00:35:07,805 DESCRIPTION. 1127 00:35:07,805 --> 00:35:09,507 DO YOU WANT TO PIGGYBACK ON 1128 00:35:09,507 --> 00:35:09,807 THAT. 1129 00:35:09,807 --> 00:35:12,009 >> I AGREE 100%, THAT FOOD 1130 00:35:12,009 --> 00:35:13,911 ALLERGIES ARE TRULY DANGEROUS 1131 00:35:13,911 --> 00:35:14,412 THINGS. 1132 00:35:14,412 --> 00:35:15,613 PEANUT ALLERGY, FOR INSTANCE, 1133 00:35:15,613 --> 00:35:17,115 CAN BE LIFE THREATENING AS CAN 1134 00:35:17,115 --> 00:35:18,516 OTHER FOOD ALLERGIES. 1135 00:35:18,516 --> 00:35:22,353 A FOOD INTOLERANCE, FOR 1136 00:35:22,353 --> 00:35:23,087 INSTANCE, LACTOSE INTOLERANCE, 1137 00:35:23,087 --> 00:35:24,422 IT MIGHT MAKE YOU MISERABLE BUT 1138 00:35:24,422 --> 00:35:28,826 IT'S NOT GOING TO SHORTEN YOUR 1139 00:35:28,826 --> 00:35:30,528 LIFE OR CAUSE MAJOR PROBLEMS FOR 1140 00:35:30,528 --> 00:35:30,795 YOU. 1141 00:35:30,795 --> 00:35:33,664 YOU WILL GET OVER THAT BOUT AND, 1142 00:35:33,664 --> 00:35:35,066 YOU KNOW, NEXT TIME YOU WANT TO 1143 00:35:35,066 --> 00:35:36,400 TREAT YOURSELF TO ICE CREAM, YOU 1144 00:35:36,400 --> 00:35:37,902 WILL PAY THE CONSEQUENCES, BUT 1145 00:35:37,902 --> 00:35:39,504 IT'S NOT -- IT DOESN'T HAVE THE 1146 00:35:39,504 --> 00:35:41,939 DIRE CONSEQUENCES THAT A TRUE 1147 00:35:41,439 --> 00:35:45,409 FOOD AL HER 1148 00:35:45,409 --> 00:35:46,644 ALLERGY DOES HAVE. 1149 00:35:46,644 --> 00:35:51,015 >> YOU WILL DISCOVER YOU HAVE AN 1150 00:35:51,015 --> 00:35:52,416 INTOLERANCE AFTER YOU EAT A 1151 00:35:52,416 --> 00:35:53,518 CERTAIN GROUP OF FOODS. 1152 00:35:53,518 --> 00:35:54,719 >> THERE'S NOT A LOT OF TESTING 1153 00:35:54,719 --> 00:35:57,421 THAT YOU CAN ALWAYS DO BUT FOOD 1154 00:35:57,421 --> 00:35:58,523 ALLERGIES YOU CAN DO TESTING FOR 1155 00:35:58,523 --> 00:36:00,825 TO SEE IF YOU HAVE A TRUE 1156 00:36:00,825 --> 00:36:01,159 ALLERGY. 1157 00:36:01,159 --> 00:36:01,993 >> LET'S TAKE ANOTHER PHONE CALL 1158 00:36:01,993 --> 00:36:03,261 THIS EVENING FROM SHARON. 1159 00:36:03,261 --> 00:36:07,298 HI, SHARON IN SPOKANE. 1160 00:36:07,298 --> 00:36:08,332 >> Caller: HI, HOW IS EVERYONE 1161 00:36:08,332 --> 00:36:08,633 THERE? 1162 00:36:08,633 --> 00:36:09,200 >> WE ARE GREAT. 1163 00:36:09,200 --> 00:36:09,934 DO YOU HAVE A QUESTION? 1164 00:36:09,934 --> 00:36:12,203 >> Caller: I DO AND IT'S A 1165 00:36:12,203 --> 00:36:13,004 TWO-PART QUESTION. 1166 00:36:13,004 --> 00:36:17,008 ABOUT TWO AN A HALF YEARS AGO, I 1167 00:36:17,008 --> 00:36:22,013 WAS DIAGNOSED WITH PLONIC 1168 00:36:22,013 --> 00:36:22,346 INERTIA. 1169 00:36:22,346 --> 00:36:24,515 I WANTED TO FIND OUT MORE ABOUT 1170 00:36:24,515 --> 00:36:29,820 IT, IS IT DUE TO HEREDITARY 1171 00:36:29,820 --> 00:36:30,221 INFLUENCES? 1172 00:36:30,221 --> 00:36:33,624 I TAKE MIRALAX EVERY DAY, AND 1173 00:36:33,624 --> 00:36:34,192 IT'S WORKING. 1174 00:36:34,192 --> 00:36:37,428 I'M WORRIED AT SOME POINT THAT 1175 00:36:37,428 --> 00:36:39,564 IT WILL STOP WORKING S. THAT A 1176 00:36:39,564 --> 00:36:40,431 PROBLEM? 1177 00:36:40,431 --> 00:36:44,268 >> THAT MEANS THAT THE COLON IS 1178 00:36:44,268 --> 00:36:44,569 SLOW. 1179 00:36:44,569 --> 00:36:45,636 AND THERE CAN BE A NUMBER OF 1180 00:36:45,636 --> 00:36:47,171 REASONS FOR THAT. 1181 00:36:47,171 --> 00:36:49,440 THERE COULD BE A NEUROLOGIC 1182 00:36:49,440 --> 00:36:51,409 CONDITION AND GENERALLY THOSE 1183 00:36:51,409 --> 00:36:52,910 PEOPLE HAVE HAD SLOW COLONS 1184 00:36:52,910 --> 00:36:54,312 SINCE BIRTH. 1185 00:36:54,312 --> 00:36:56,214 THE COLON GENERALLY SLOWS DOWN 1186 00:36:56,214 --> 00:36:58,716 AS WE GET OLDER, AND SHE MIGHT 1187 00:36:58,716 --> 00:37:00,117 HAVE BEEN BORN WITH A COLON THAT 1188 00:37:00,117 --> 00:37:03,020 WAS A LITTLE BIT SLOWER THAN 1189 00:37:03,020 --> 00:37:04,922 AVERAGE, AND IT MIGHT BE SLOWING 1190 00:37:04,922 --> 00:37:09,227 DOWN MORE SINCE THEN. 1191 00:37:09,227 --> 00:37:11,996 HYPOTHYROIDISM CAN CAUSE A SLOW 1192 00:37:11,996 --> 00:37:12,296 COLON. 1193 00:37:12,296 --> 00:37:15,733 I SUPPOSE PROBABLY THE BIGGEST 1194 00:37:15,733 --> 00:37:20,037 CATEGORY JUST IDIOPATHIC SLOW 1195 00:37:20,037 --> 00:37:20,371 COLONS. 1196 00:37:20,371 --> 00:37:21,339 SHE WILL ALWAYS BE BETTER OFF 1197 00:37:21,339 --> 00:37:23,808 WITH MIRALAX THAN WITHOUT IT, 1198 00:37:23,808 --> 00:37:25,643 BUT IN 20 YEARS IF HER COLON 1199 00:37:25,643 --> 00:37:28,312 SLOWS DOWN MORE, SHE MAY NEED 1200 00:37:28,312 --> 00:37:29,513 ADDITIONAL MEDICATIONS TO TAKE 1201 00:37:29,513 --> 00:37:30,715 ON TOP OF THAT. 1202 00:37:30,715 --> 00:37:31,916 >> AND SHE WAS CONCERNED THAT IT 1203 00:37:31,916 --> 00:37:33,618 COULD STOP WORKING AT SOME 1204 00:37:33,618 --> 00:37:33,918 POINT. 1205 00:37:33,918 --> 00:37:35,219 IS THAT SOMETHING SHE SHOULD BE 1206 00:37:35,219 --> 00:37:37,021 WORRIED ABOUT? 1207 00:37:37,021 --> 00:37:40,458 >> NO, MIRALAX IS A CHEMICAL 1208 00:37:40,458 --> 00:37:41,325 THAT MIXES IN WITH THE STOOL. 1209 00:37:41,325 --> 00:37:44,428 IT'S NOT ABSORBED AND IT KEEPS 1210 00:37:44,428 --> 00:37:46,297 THE STOOL FROM GETTING HARD. 1211 00:37:46,297 --> 00:37:47,331 >> THE OTHER THING SHE WAS 1212 00:37:47,331 --> 00:37:50,334 CURIOUS ABOUT, WAS IT 1213 00:37:50,334 --> 00:37:50,735 HEREDITARY? 1214 00:37:50,735 --> 00:37:52,103 >> THERE ARE SOME TYPES OF 1215 00:37:52,103 --> 00:38:02,847 COLONIC INERTIAL THAT ARE 1216 00:38:02,847 --> 00:38:03,247 HEREDITARY. 1217 00:38:03,247 --> 00:38:04,382 IF THEY DON'T HAVE A BOWEL 1218 00:38:04,382 --> 00:38:06,150 MOVEMENT FOR A WEEK, PEOPLE ARE 1219 00:38:06,150 --> 00:38:09,720 ALWAYS AWARE OF THAT. 1220 00:38:09,720 --> 00:38:11,822 IT MIGHT BE A LITTLE BIT MORE 1221 00:38:11,822 --> 00:38:13,424 LIKELY, BUT IT'S THE SORT OF 1222 00:38:13,424 --> 00:38:14,825 THING THAT IF THE PROBLEM COMES 1223 00:38:14,825 --> 00:38:16,027 UP, DEAL WITH IT THEN. 1224 00:38:16,027 --> 00:38:19,497 YOU WOULDN'T HAVE TO DO ANYTHING 1225 00:38:19,497 --> 00:38:21,032 PROACTIVELY TO LOOK OUT FOR 1226 00:38:21,032 --> 00:38:21,332 THAT. 1227 00:38:21,332 --> 00:38:21,732 >> OKAY. 1228 00:38:21,732 --> 00:38:22,033 OKAY. 1229 00:38:22,033 --> 00:38:22,533 VERY GOOD. 1230 00:38:22,533 --> 00:38:24,302 WE TALKED ABOUT A CONTRIBUTOR TO 1231 00:38:24,302 --> 00:38:25,636 SOME OF THESE ISSUES BEING 1232 00:38:25,636 --> 00:38:26,937 STRESS AND THAT'S WHERE WE ARE 1233 00:38:26,937 --> 00:38:28,606 SEEING MORE ULCERS TOO. 1234 00:38:28,606 --> 00:38:30,741 WHAT IS AN ULCER AND HOW IS IT 1235 00:38:30,741 --> 00:38:31,909 TREATED AND ARE WE SEEING MORE 1236 00:38:31,909 --> 00:38:35,880 OF THEM? 1237 00:38:35,880 --> 00:38:37,715 >> WELL, I PRESUME WE ARE 1238 00:38:37,715 --> 00:38:38,482 TALKING ABOUT PEPTIC ULCER 1239 00:38:38,482 --> 00:38:40,017 DISEASE BECAUSE ULCERS CAN OCCUR 1240 00:38:40,017 --> 00:38:41,752 ANY PLACE IN THE INTESTINE. 1241 00:38:41,752 --> 00:38:43,020 AND ONE OF THE THINGS THAT WE 1242 00:38:43,020 --> 00:38:44,822 HAVE LEARNED OVER THE LAST 1243 00:38:44,822 --> 00:38:47,325 DECADE OR MORE, IS THAT STRESS 1244 00:38:47,325 --> 00:38:48,626 PROBABLY ISN'T SUCH A BIG FACTOR 1245 00:38:48,626 --> 00:38:50,528 AS ONE WOULD THINK IN TERMS OF 1246 00:38:50,528 --> 00:38:51,729 THE CAUSING ULCERS. 1247 00:38:51,729 --> 00:38:55,733 IN FACT, MOST ULCERS ARE CAUSED 1248 00:38:55,733 --> 00:38:59,537 BY 9 PRESENCE OF A BACTERIA IN 1249 00:38:59,537 --> 00:39:07,445 THE SYMPTOMATIC CALLED HELOB 1250 00:39:07,445 --> 00:39:10,548 ATERCO CALORI, IT'S ONE OF THE 1251 00:39:10,548 --> 00:39:13,084 MAIN RISK FACTORS FOR GASTRIC 1252 00:39:13,084 --> 00:39:13,417 CANCER. 1253 00:39:13,417 --> 00:39:15,586 THE OTHER BIG, BIG, CAUSE OF 1254 00:39:15,586 --> 00:39:16,887 PEPTIC ULCER DISEASE IS THE USE 1255 00:39:16,887 --> 00:39:20,658 OF ASPIRIN, AND NSAID DRUGS, I 1256 00:39:20,658 --> 00:39:21,459 BEAU PROFENN. 1257 00:39:21,459 --> 00:39:24,128 >> AND WE SEE THE WARNING LABELS 1258 00:39:24,128 --> 00:39:24,395 NOW. 1259 00:39:24,395 --> 00:39:24,829 >> WE DO. 1260 00:39:24,829 --> 00:39:26,197 WE CERTAINLY SEE A LOT OF 1261 00:39:26,197 --> 00:39:27,698 PATIENTS WHO COME IN WITH 1262 00:39:27,698 --> 00:39:30,034 COMPLICATIONS OF ULCER DISEASE, 1263 00:39:30,034 --> 00:39:32,436 ESPECIALLY BLEEDING WHO HAVE 1264 00:39:32,436 --> 00:39:35,139 BEEN TAKING NSAID DRUGS. 1265 00:39:35,139 --> 00:39:37,775 SOMETIMES TAKING THEM ON TOP OF 1266 00:39:37,775 --> 00:39:38,309 OTHER NSAID DRUGS. 1267 00:39:38,309 --> 00:39:41,011 FOR INSTANCE, THEY MIGHT BE ON A 1268 00:39:41,011 --> 00:39:43,114 PRESCRIBED NSAID AND NOT 1269 00:39:43,114 --> 00:39:44,448 KNOWINGLY TAKE ADVIL OR ALEVE IN 1270 00:39:44,448 --> 00:39:46,784 ADDITION TO THAT, WHICH REALLY 1271 00:39:46,784 --> 00:39:50,254 CAN GET YOU INTO MAJOR TROUBLE 1272 00:39:50,254 --> 00:39:54,792 WITH PEPTIC ULCER DISEASE AND 1273 00:39:54,792 --> 00:39:55,226 COMPLICATIONS. 1274 00:39:55,226 --> 00:39:57,628 >> CAN ACID REFLUX, LETTING 1275 00:39:57,628 --> 00:39:59,130 SOMETHING LIKE THAT GO TOO LONG, 1276 00:39:59,130 --> 00:40:00,731 LEAD TO AN ULCER? 1277 00:40:00,731 --> 00:40:03,033 ARE THEY TWO UNRELATED ISSUES. 1278 00:40:03,033 --> 00:40:04,135 >> WELL, THEY ARE REALLY 1279 00:40:04,135 --> 00:40:05,136 DIFFERENT DISEASES. 1280 00:40:05,136 --> 00:40:07,638 THE ACID COMPONENT IS PART OF 1281 00:40:07,638 --> 00:40:16,013 BOTH OF THEM, BUT MOST RELUX 1282 00:40:16,013 --> 00:40:16,714 DISEASE, GASTRO REFLUX DISEASE 1283 00:40:16,714 --> 00:40:18,816 HAS TO DO WITH THE ACID IN THE 1284 00:40:18,816 --> 00:40:20,017 WRONG PLACE. 1285 00:40:20,017 --> 00:40:22,219 PEPTIC ACID DISEASE IS THE LOSS 1286 00:40:22,219 --> 00:40:25,122 OF THE STOMACH OR DUODENUM TO 1287 00:40:25,122 --> 00:40:26,657 PROTECT ITSELF WHICH IT 1288 00:40:26,657 --> 00:40:28,259 NATURALLY DOES THAT'S PRESENT 1289 00:40:28,259 --> 00:40:30,728 NORMALLY IN OUR G. I. TRACTS. 1290 00:40:30,728 --> 00:40:31,729 FORTUNATELY WE HAVE GREAT 1291 00:40:31,729 --> 00:40:32,730 MEDICATIONS TO TREAT THESE 1292 00:40:32,730 --> 00:40:33,831 THINGS NOW AND ONE OF THE 1293 00:40:33,831 --> 00:40:36,333 IMPORTANT THINGS IS AVOIDANCE OF 1294 00:40:36,333 --> 00:40:37,835 NSAIDS, ESPECIALLY IF YOU ARE AT 1295 00:40:37,835 --> 00:40:38,135 RISK. 1296 00:40:38,135 --> 00:40:38,636 >> ALL RIGHT. 1297 00:40:38,636 --> 00:40:41,138 WE HAVE SUE CALLING FROM 1298 00:40:41,138 --> 00:40:42,273 NEWPORT. 1299 00:40:42,273 --> 00:40:43,507 HELLO, SUE. 1300 00:40:43,507 --> 00:40:44,008 >> Caller: HI. 1301 00:40:44,008 --> 00:40:47,344 I HAVE A QUESTION ABOUT 1302 00:40:47,344 --> 00:40:49,847 IRRITABLE BOWEL SYNDROME, 1303 00:40:49,847 --> 00:40:53,317 CROHN'S DISEASE AND I'M DIABETIC 1304 00:40:53,317 --> 00:40:57,521 AND MY GRANDFATHER HAD CANCER 1305 00:40:57,521 --> 00:40:58,222 THE BOWEL. 1306 00:40:58,222 --> 00:40:59,657 >> YOU ARE CONCERNED THAT THAT 1307 00:40:59,657 --> 00:41:01,525 COULD BE SOMETHING THAT YOU ARE 1308 00:41:01,525 --> 00:41:04,328 GOING TO SUFFER WITH TOO? 1309 00:41:04,328 --> 00:41:06,230 >> Caller: WELL, I THINK I HAVE 1310 00:41:06,230 --> 00:41:07,431 IRRITABLE BOWEL SYNDROME RIGHT 1311 00:41:07,431 --> 00:41:07,698 NOW. 1312 00:41:07,698 --> 00:41:09,066 I AM GOING TO SEE MY DOCTOR NEXT 1313 00:41:09,066 --> 00:41:13,437 WEEK ABOUT IT. 1314 00:41:13,437 --> 00:41:13,838 >> OKAY. 1315 00:41:13,838 --> 00:41:15,039 AGAIN, THERE'S SOME CANCER IN 1316 00:41:15,039 --> 00:41:16,507 THE FAMILY. 1317 00:41:16,507 --> 00:41:17,641 SHOULD SHE BE CONCERNED 1318 00:41:17,641 --> 00:41:19,443 CONSIDERING SHE BELIEVES SHE 1319 00:41:19,443 --> 00:41:20,945 IRRITABLE BOWEL SYNDROME? 1320 00:41:20,945 --> 00:41:22,046 >> WELL, I THINK WE ALL NEED TO 1321 00:41:22,046 --> 00:41:23,647 BE CONCERNED ABOUT THE HEALTH OF 1322 00:41:23,647 --> 00:41:26,650 OUR COLON. 1323 00:41:26,650 --> 00:41:28,819 AS A GASTROENTEROLOGIST, I SAVE 1324 00:41:28,819 --> 00:41:30,521 MORE LIVES WITH A COLONOSCOPE 1325 00:41:30,521 --> 00:41:32,923 THAN I DO ANYTHING ELSE -- 1326 00:41:32,923 --> 00:41:35,459 EVERYTHING ELSE I DO COMBINED. 1327 00:41:35,459 --> 00:41:37,928 AND IT'S, YOU KNOW, COLON CANCER 1328 00:41:37,928 --> 00:41:38,429 AWARENESS MONTH. 1329 00:41:38,429 --> 00:41:39,830 I WANT TO MAKE THAT KNOWN TO 1330 00:41:39,830 --> 00:41:41,732 YOUR VIEWERS. 1331 00:41:41,732 --> 00:41:44,435 AND HER ISSUES WOULD BE, YOU 1332 00:41:44,435 --> 00:41:48,839 KNOW, TOTALLY CLARIFIED BY A 1333 00:41:48,839 --> 00:41:49,640 COLONOSCOPY. 1334 00:41:49,640 --> 00:41:51,342 >> 90% TREATABLE AND 95% 1335 00:41:51,342 --> 00:41:51,742 PREVENTIBLE? 1336 00:41:51,742 --> 00:41:54,445 I THINK I JUST READ THAT 1337 00:41:54,445 --> 00:41:54,812 SOMEWHERE. 1338 00:41:54,812 --> 00:41:55,446 IF YOU ARE DIAGNOSED? 1339 00:41:55,446 --> 00:41:56,647 >> IF YOU LOOK AT THE DATA A 1340 00:41:56,647 --> 00:41:58,649 CERTAIN WAY, I THINK -- I THINK 1341 00:41:58,649 --> 00:42:00,351 YOU COULD SUPPORT THOSE NUMBERS. 1342 00:42:00,351 --> 00:42:01,352 >> OKAY. 1343 00:42:01,352 --> 00:42:02,052 VERY GOOD. 1344 00:42:02,052 --> 00:42:03,153 SO ANOTHER GOOD THING TO KEEP AN 1345 00:42:03,153 --> 00:42:05,222 EYE OUT AND GOOD REMINDER TO GET 1346 00:42:05,222 --> 00:42:08,325 OUR COLONOSCOPES THIS MONTH AND 1347 00:42:08,325 --> 00:42:08,859 THE MONTH OF MARCH. 1348 00:42:08,859 --> 00:42:09,360 >> ALL RIGHT. 1349 00:42:09,360 --> 00:42:10,794 WE HAVE AN EMAIL WE WANT TO 1350 00:42:10,794 --> 00:42:11,128 ADDRESS. 1351 00:42:11,128 --> 00:42:13,764 I HEAR THE BENEFITS AND WARNINGS 1352 00:42:13,764 --> 00:42:14,164 OF CLEANSES. 1353 00:42:14,164 --> 00:42:14,765 THIS IS A GREAT TOPIC. 1354 00:42:14,765 --> 00:42:16,634 WHAT ARE THE DOCTORS' 1355 00:42:16,634 --> 00:42:17,768 PROFESSIONAL OPINIONS ON 1356 00:42:17,768 --> 00:42:20,738 SHORT-TERM AND LONG-TERM EFFECTS 1357 00:42:20,738 --> 00:42:21,138 OF CLEANSES? 1358 00:42:21,138 --> 00:42:21,605 ARE THEY SAFE? 1359 00:42:21,605 --> 00:42:22,506 THIS IS COMING IN FROM SAM. 1360 00:42:22,506 --> 00:42:23,874 THIS IS SOMETHING I WANTED TO 1361 00:42:23,874 --> 00:42:24,208 ADDRESS. 1362 00:42:24,208 --> 00:42:25,809 SO THANK YOU SO MUCH, SAM. 1363 00:42:25,809 --> 00:42:28,779 WE ARE HEARING JUICE CLEANSE. 1364 00:42:28,779 --> 00:42:30,080 WE ARE LEARING ANY NUMBER OF 1365 00:42:30,080 --> 00:42:30,614 DIFFERENT CLEANSES. 1366 00:42:30,614 --> 00:42:32,850 WHAT IS YOUR TAKE? 1367 00:42:32,850 --> 00:42:34,051 >> I WISH I KNEW THE ANSWER. 1368 00:42:34,051 --> 00:42:37,054 WHAT I CAN TELL YOU IS THAT 9 1369 00:42:37,054 --> 00:42:43,761 WHOLE ISSUE OF WHAT WE CALL THE 1370 00:42:43,761 --> 00:42:47,164 HUMAN MICROBIOM, WE FIND THEY 1371 00:42:47,164 --> 00:42:48,532 ARE IMPORTANT TO KEEP US 1372 00:42:48,532 --> 00:42:51,135 HEALTHY, WE ARE STARTING TO 1373 00:42:51,135 --> 00:42:52,636 UNDERSTAND HOW THAT WORKS. 1374 00:42:52,636 --> 00:42:53,837 WE ARE ALSO STARTING TO 1375 00:42:53,837 --> 00:42:57,041 UNDERSTAND THAT NOT ALL 1376 00:42:57,041 --> 00:42:58,576 MICROBIOMES ARE EQUAL AND BY 1377 00:42:58,576 --> 00:43:01,645 CHANGING A PERSON'S MICRO BIOM, 1378 00:43:01,645 --> 00:43:03,581 YOU MAY IMPROVE THEIR HEALTH OR 1379 00:43:03,581 --> 00:43:05,316 CHANGE THEIR HEALTH. 1380 00:43:05,316 --> 00:43:07,084 I HAVE NOT SEEN A RASH OF 1381 00:43:07,084 --> 00:43:08,552 PATIENTS WHO HAVE COME TO SEE ME 1382 00:43:08,552 --> 00:43:09,653 WITH PROBLEMS BECAUSE THEY HAVE 1383 00:43:09,653 --> 00:43:12,289 BEEN GOING THROUGH CLEANSES, AND 1384 00:43:12,289 --> 00:43:15,559 I THINK THERE'S A LOT ABOUT THAT 1385 00:43:15,559 --> 00:43:16,760 MANIPULATION OF THE G.I. TRACT 1386 00:43:16,760 --> 00:43:18,762 THAT WE DON'T UNDERSTAND YET, 1387 00:43:18,762 --> 00:43:20,364 BUT WE SHOULD HAVE MORE 1388 00:43:20,364 --> 00:43:21,565 INFORMATION ABOUT IT DOWN THE 1389 00:43:21,565 --> 00:43:21,865 ROAD. 1390 00:43:21,865 --> 00:43:24,835 BUT I HAVE NOT SEEN ANY MAJOR 1391 00:43:24,835 --> 00:43:26,236 PROBLEMS ASSOCIATED WITH THAT IN 1392 00:43:26,236 --> 00:43:27,471 MY PRACTICE. 1393 00:43:27,471 --> 00:43:28,872 >> AND WE HAVE HEARD ABOUT 1394 00:43:28,872 --> 00:43:31,342 PEOPLE DOING CLEANSES FOR ANY 1395 00:43:31,342 --> 00:43:32,443 NUMBER OF REASONS TO LOSE WEIGH 1396 00:43:32,443 --> 00:43:34,044 OR SOME PEOPLE SAY THAT IT CAN 1397 00:43:34,044 --> 00:43:36,747 ACTUALLY REMOVE TOXINS FROM YOUR 1398 00:43:36,747 --> 00:43:38,048 SYSTEM, THOSE SORT OF THINGS. 1399 00:43:38,048 --> 00:43:39,149 IS THERE ANYTHING TO 1400 00:43:39,149 --> 00:43:39,817 SUBSTANTIATE THAT? 1401 00:43:39,817 --> 00:43:40,951 I MEAN OBVIOUSLY YOU WILL LOSE 1402 00:43:40,951 --> 00:43:42,820 WEIGHT IF YOU ARE JUST DOING A 1403 00:43:42,820 --> 00:43:44,088 JUICE CLEANSE FOR A FEW DAYS. 1404 00:43:44,088 --> 00:43:47,324 >> I HAVE PEOPLE ASK ME ABOUT 1405 00:43:47,324 --> 00:43:47,925 DOING CLEANSES AND IT'S 1406 00:43:47,925 --> 00:43:48,626 PRIMARILY FOR WEIGH LOSS. 1407 00:43:48,626 --> 00:43:50,394 SOME PEOPLE SAY THEY WANT TO GET 1408 00:43:50,394 --> 00:43:51,562 HEALTHIER AND I REMIND THEM THAT 1409 00:43:51,562 --> 00:43:54,632 WE HAVE A LIVER AND THAT DOES 1410 00:43:54,632 --> 00:43:55,332 NATURALLY CLEANSE OUR BODY AND 1411 00:43:55,332 --> 00:43:57,134 FILLER OUT TOXINS. 1412 00:43:57,134 --> 00:43:58,402 FOR THE MOST PART, IT'S NOT A 1413 00:43:58,402 --> 00:43:59,503 GOOD WAY TO LOSE WEIGHT. 1414 00:43:59,503 --> 00:44:00,804 WHAT YOU WILL LOSE IS VERY SHORT 1415 00:44:00,804 --> 00:44:02,039 TERM AND AS SOON AS YOU START 1416 00:44:02,039 --> 00:44:03,107 EATING A REGULAR DIET AGAIN, YOU 1417 00:44:03,107 --> 00:44:04,708 WILL GAIN IT BACK. 1418 00:44:04,708 --> 00:44:05,709 SO I DON'T THINK ENCOURAGE THEM 1419 00:44:05,709 --> 00:44:07,044 FOR MOST PEOPLE FOR WEIGHT LOSS. 1420 00:44:07,044 --> 00:44:09,380 THEY ARE NOT USUALLY 1421 00:44:09,380 --> 00:44:10,147 NUTRITIONALLY COMPLETE EITHER 1422 00:44:10,147 --> 00:44:11,482 BUT FOR THE NORMAL HEALTHY 1423 00:44:11,482 --> 00:44:12,816 PERSON, IF THEY DO ONE FOR TWO 1424 00:44:12,816 --> 00:44:14,385 TO THREE DAYS, THEY SHOULDN'T 1425 00:44:14,385 --> 00:44:15,886 HAVE ANY LONG-TERM HEALTH 1426 00:44:15,886 --> 00:44:16,587 CONSEQUENCES FROM THAT. 1427 00:44:16,587 --> 00:44:17,821 >> WE HAVE AL WITH A PHONE CALL 1428 00:44:17,821 --> 00:44:19,490 THIS EVENING. 1429 00:44:19,490 --> 00:44:20,324 HELLO, AL. 1430 00:44:20,324 --> 00:44:21,525 >> Caller: HI, HEY, DON'T LAUGH 1431 00:44:21,525 --> 00:44:24,895 AT THE QUESTION. 1432 00:44:24,895 --> 00:44:28,399 BUT AS I'M GETTING OLDER, AND I 1433 00:44:28,399 --> 00:44:31,702 LOOK BACK AT THE ACTIVITIES OF 1434 00:44:31,702 --> 00:44:33,704 YOUNG CHILDREN AND YOUNG ADULTS, 1435 00:44:33,704 --> 00:44:45,015 OF SOMER SALTS SOMERSAULTS AND 1436 00:44:45,015 --> 00:44:47,217 STANDING ON THEIR HEAD AND 1437 00:44:47,217 --> 00:44:50,954 WALKING THEIR ON THEIR HANDS IS 1438 00:44:50,954 --> 00:44:52,456 THERE ANYTHING RELATED TO THE 1439 00:44:52,456 --> 00:44:54,858 LITTLE KIDS HAVE SOMETHING 1440 00:44:54,858 --> 00:44:55,159 THERE. 1441 00:44:55,159 --> 00:44:57,995 AS I GET OLDER AND I LOOK AT MY 1442 00:44:57,995 --> 00:44:59,596 PEERS, I SEE ALL SORTS OF 1443 00:44:59,596 --> 00:45:01,699 INTERNAL PROBLEMS. 1444 00:45:01,699 --> 00:45:05,703 AND I'M JUST WONDERING, HEY, 1445 00:45:05,703 --> 00:45:08,205 MAYBE THERE SHOULD BE SOME KIND 1446 00:45:08,205 --> 00:45:13,310 OF A THERAPY WHERE YOU CAN GO IN 1447 00:45:13,310 --> 00:45:15,746 AND HANG UPSIDE DOWN FOR A WHILE 1448 00:45:15,746 --> 00:45:16,714 OR WHATEVER. 1449 00:45:16,714 --> 00:45:18,615 IF YOU COULD HELP ME WITH THAT 1450 00:45:18,615 --> 00:45:20,050 QUESTION, I WOULD APPRECIATE IT. 1451 00:45:20,050 --> 00:45:20,818 >> ALL RIGHT, AL. 1452 00:45:20,818 --> 00:45:21,485 THANK YOU SO MUCH. 1453 00:45:21,485 --> 00:45:22,786 NOTHING OFF THE TABLE TONIGHT, 1454 00:45:22,786 --> 00:45:23,520 AL. 1455 00:45:23,520 --> 00:45:25,889 THERE ARE ACTUALLY SOME 1456 00:45:25,889 --> 00:45:27,124 PRODUCTS, NOW THAT PEOPLE ARE 1457 00:45:27,124 --> 00:45:29,026 PURCHASING TO DO THE INVERSION, 1458 00:45:29,026 --> 00:45:30,594 TO HANG UPSIDE DOWN. 1459 00:45:30,594 --> 00:45:32,830 CAN IT HELP OUR OVERALL HEALTH 1460 00:45:32,830 --> 00:45:34,598 OR INTESTINAL -- 1461 00:45:34,598 --> 00:45:35,532 >> WELL, I CERTAINLY WOULDN'T 1462 00:45:35,532 --> 00:45:38,402 RECOMMEND IT FOR ANYONE WHO 1463 00:45:38,402 --> 00:45:44,842 SUFFERS FROM GASTROESOPHAGEAL 1464 00:45:44,842 --> 00:45:46,009 REFLUX DISEASE BECAUSE THAT WILL 1465 00:45:46,009 --> 00:45:47,311 BE A CATASTROPHE. 1466 00:45:47,311 --> 00:45:48,378 I THOUGHT WE WERE GOING TO HEAR 1467 00:45:48,378 --> 00:45:50,914 ABOUT KIDS BEING MORE ACTIVE TO 1468 00:45:50,914 --> 00:45:52,349 IMPROVE THEIR PHYSICAL WELL 1469 00:45:52,349 --> 00:45:55,519 BEING AND CUT DOWN ON 1470 00:45:55,519 --> 00:45:56,620 PEDIATRIC -- CHILDREN AND THE 1471 00:45:56,620 --> 00:45:58,489 OBESITY PROBLEMS, BUT I DON'T 1472 00:45:58,489 --> 00:45:59,490 THINK THAT HANGING IN A 1473 00:45:59,490 --> 00:46:02,760 PARTICULAR POSITION IS GOING TO 1474 00:46:02,760 --> 00:46:04,762 HAVE BENEFICIAL IMPACT ON YOUR 1475 00:46:04,762 --> 00:46:05,829 INTESTINE. 1476 00:46:05,829 --> 00:46:06,230 >> OKAY. 1477 00:46:06,230 --> 00:46:07,564 IT'S NOT MOVING THINGS AROUND? 1478 00:46:07,564 --> 00:46:10,501 IT'S NOT SORT OF REPURPOSING 1479 00:46:10,501 --> 00:46:12,102 YOUR ORGANS OR ANYTHING LIKE 1480 00:46:12,102 --> 00:46:14,905 THAT WHEN YOU HANG UPSIDE DOWN? 1481 00:46:14,905 --> 00:46:16,373 >> IT REMANDS ME I HAD A FRIEND 1482 00:46:16,373 --> 00:46:17,808 WHO WAS A CARDIOLOGIST WHO 1483 00:46:17,808 --> 00:46:19,076 WANTED TO TRY OUT FOR THE SPACE 1484 00:46:19,076 --> 00:46:20,611 PROGRAM AND DID TRY OUT FOR IT. 1485 00:46:20,611 --> 00:46:22,112 HE WOULD ALWAYS ASK OUR 1486 00:46:22,112 --> 00:46:24,414 PROFESSORS IN MEDICAL SCHOOL HOW 1487 00:46:24,414 --> 00:46:27,618 A SYSTEM WOULD FUNCTION UNDER 1488 00:46:27,618 --> 00:46:28,719 ZERO GRAVITY. 1489 00:46:28,719 --> 00:46:31,822 IT ALWAYS THROUGH FOR THE 1490 00:46:31,822 --> 00:46:32,890 PROFESSOR TO A LOOP. 1491 00:46:32,890 --> 00:46:34,825 I'M NOT AWARE THE ASTRONAUTS 1492 00:46:34,825 --> 00:46:36,293 REALLY HAD TO DO ANYTHING 1493 00:46:36,293 --> 00:46:37,795 SPECIAL TO TAKE CARE OF THEIR 1494 00:46:37,795 --> 00:46:40,631 G.I. TRACT, NOR DID THEY SUFFER 1495 00:46:40,631 --> 00:46:41,932 ANY ILL CONSEQUENCES OF IT. 1496 00:46:41,932 --> 00:46:43,233 >> SO MAYBE AL IS JUST GOING 1497 00:46:43,233 --> 00:46:44,401 THROUGH WHAT WE CALL GO THROUGH 1498 00:46:44,401 --> 00:46:46,637 IN THE AGING PROCESS AND HANGING 1499 00:46:46,637 --> 00:46:49,339 UPSIDE DOWN MIGHT NOT HELP THAT. 1500 00:46:49,339 --> 00:46:51,108 WELL, LET'S GO AROUND AND JUST 1501 00:46:51,108 --> 00:46:52,409 GET SOME LAST THOUGHTS ON 1502 00:46:52,409 --> 00:46:54,645 KEEPING OUR GUTS HEALTHY AND 1503 00:46:54,645 --> 00:46:55,813 OVERALL HEALTH WHEN IT COMES TO 1504 00:46:55,813 --> 00:46:57,147 OUR DIGESTIVE SYSTEM. 1505 00:46:57,147 --> 00:46:58,682 ALLI, WHAT WOULD YOU RECOMMEND 1506 00:46:58,682 --> 00:46:59,016 OVERALL? 1507 00:46:59,016 --> 00:47:00,083 >> YOU KNOW, I THINK ONE OF THE 1508 00:47:00,083 --> 00:47:01,518 MOST IMPORTANT THINGS THAT 1509 00:47:01,518 --> 00:47:03,020 PEOPLE CAN DO FOR THEIR OVERALL 1510 00:47:03,020 --> 00:47:05,022 G.I. HEALTH IS PLAIN TAKEN A 1511 00:47:05,022 --> 00:47:06,623 HEALTHY WEIGH AND MINIMIZE YOUR 1512 00:47:06,623 --> 00:47:07,925 INTAKE OF PROCESSED FOODS. 1513 00:47:07,925 --> 00:47:09,426 I THINK PROCESSED FOODS REALLY 1514 00:47:09,426 --> 00:47:10,527 FOR THE MOST PART ARE NOT 1515 00:47:10,527 --> 00:47:11,728 HEALTHY FOR A LOT OF PEOPLE. 1516 00:47:11,728 --> 00:47:16,233 THEY HAVE A LOT OF HIDDEN 1517 00:47:16,233 --> 00:47:17,267 INGREDIENTS THEM. 1518 00:47:17,267 --> 00:47:18,735 IF YOU EAT MORE FRESH PRODUCE, 1519 00:47:18,735 --> 00:47:22,539 DAIRY PRODUCTS WHOLE GRAINS ARE 1520 00:47:22,539 --> 00:47:23,240 NATURAL, I THINK MOST OF US 1521 00:47:23,240 --> 00:47:24,708 WOULD BE HEALTHIER AND AVOID THE 1522 00:47:24,708 --> 00:47:26,243 INNER AISLES OF GROCERY STORE 1523 00:47:26,243 --> 00:47:27,811 WHERE ALL THE PROCESSED, 1524 00:47:27,811 --> 00:47:28,912 PACKAGED FOODS ARE HIDDEN WITH 1525 00:47:28,912 --> 00:47:30,314 ALL THE PROBLEMS THAT THEY COME 1526 00:47:30,314 --> 00:47:31,215 WITH. 1527 00:47:31,215 --> 00:47:32,816 >> DR. FERRIN? 1528 00:47:32,816 --> 00:47:34,885 >> WELL, WHAT I OFTEN TELL MY 1529 00:47:34,885 --> 00:47:35,953 PATIENTS IS THAT THE G.I. TRACT 1530 00:47:35,953 --> 00:47:38,055 CAN REALLY TAKE A JOKE. 1531 00:47:38,055 --> 00:47:40,791 YOU CAN PUT A PEPPERONI PIZZA IN 1532 00:47:40,791 --> 00:47:44,328 THE G.I. TRACT AND HANDLE IT 1533 00:47:44,328 --> 00:47:44,628 FINE. 1534 00:47:44,628 --> 00:47:45,896 9 PART OF YOUR BODY THAT CAN'T 1535 00:47:45,896 --> 00:47:47,898 TAKE A JOKE IS YOUR HEART. 1536 00:47:47,898 --> 00:47:50,033 SO LIVE A HEART HEALTHY 1537 00:47:50,033 --> 00:47:50,801 LIFESTYLE. 1538 00:47:50,801 --> 00:47:52,569 DON'T EAT TOO MANY CALORIES. 1539 00:47:52,569 --> 00:47:56,306 EAT A BALANCED DIET AND, YOU 1540 00:47:56,306 --> 00:48:01,812 KNOW, IF YOU SMOKE STOP SMOKING 1541 00:48:01,812 --> 00:48:03,647 BECAUSE YOUR G.I. TRACT WILL DO 1542 00:48:03,647 --> 00:48:03,947 FINE. 1543 00:48:03,947 --> 00:48:05,515 AND BY AND LARGE, PEOPLE DON'T 1544 00:48:05,515 --> 00:48:07,618 DIE OF CONDITIONS OF THE G.I. 1545 00:48:07,618 --> 00:48:11,154 TRACT COMPARED TO, YOU KNOW, 1546 00:48:11,154 --> 00:48:12,723 BEING HURT BY HEART CONDITIONS. 1547 00:48:12,723 --> 00:48:13,824 >> ALL RIGHT. 1548 00:48:13,824 --> 00:48:15,225 AND DR. P, SOME FINAL THOUGHTS 1549 00:48:15,225 --> 00:48:18,428 IN THE NEXT FEW SECONDS. 1550 00:48:18,428 --> 00:48:18,962 >> COLONOSCOPY. 1551 00:48:18,962 --> 00:48:20,330 IF YOU ARE AGE -- 1552 00:48:20,330 --> 00:48:21,932 >> ONE WORD. 1553 00:48:21,932 --> 00:48:22,933 >> IF YOU ARE AGE 50, OR MORE, 1554 00:48:22,933 --> 00:48:24,268 HAVE A COLONOSCOPY, WHICH YOU 1555 00:48:24,268 --> 00:48:25,435 HAVE SYMPTOMS OR NOT, WHETHER 1556 00:48:25,435 --> 00:48:28,538 YOU HAVE A FAMILY HISTORY NOT. 1557 00:48:28,538 --> 00:48:29,539 IF YOU ARE AN AFRICAN-AMERICAN, 1558 00:48:29,539 --> 00:48:30,941 IT SHOULD BE AGE 45. 1559 00:48:30,941 --> 00:48:32,743 >> VERY GOOD. 1560 00:48:32,743 --> 00:48:33,810 GREAT DISCUSSION THIS EVENING. 1561 00:48:33,810 --> 00:48:35,712 I WANT TO THANK YOU ALL FOR 1562 00:48:35,712 --> 00:48:37,414 BEING HERE TONIGHT. 1563 00:48:37,414 --> 00:48:38,815 OUR THANKS WITH EVERYONE WOULD 1564 00:48:38,815 --> 00:48:40,217 CALLED IN WITH THEIR QUESTIONS 1565 00:48:40,217 --> 00:48:43,253 AND EMAILED. 1566 00:48:43,253 --> 00:48:46,089 WHEN WE COME BACK, AN UPDATE ON 1567 00:48:43,987 --> 00:48:50,060 THE AFFORDABLE CARE ACT. 1568 00:48:50,060 --> 00:48:50,794 YOU HAVE JUST 12 DAYS LEFT TO 1569 00:48:50,794 --> 00:48:51,461 SIGN UP FOR HEALTH INSURANCE 1570 00:48:51,461 --> 00:48:53,030 UNDER THE AFFORDABLE CARE ACT. 1571 00:48:53,030 --> 00:48:53,730 OPEN ENROLLMENT ENDS ON MARCH 1572 00:48:53,730 --> 00:48:56,366 31. 1573 00:48:56,366 --> 00:48:58,101 IF YOU WANT COVERAGE, BUT MAYBE 1574 00:48:58,101 --> 00:48:59,703 NEED SOME HELP, THERE ARE PEOPLE 1575 00:48:59,703 --> 00:49:00,771 LOCALLY WHO CAN HELP YOU. 1576 00:49:00,771 --> 00:49:02,005 JOINING ME NOW, WITH MORE IS RAY 1577 00:49:02,005 --> 00:49:03,473 WHITE, WITH COMMUNITY-MINDED 1578 00:49:03,473 --> 00:49:04,508 ENTERPRISES, HE HELPS 1579 00:49:04,508 --> 00:49:06,076 COORDINATES THE IN-PERSON 1580 00:49:06,076 --> 00:49:07,110 ASSISTORS PROGRAM HERE IN 1581 00:49:07,110 --> 00:49:10,013 SPOKANE. 1582 00:49:10,013 --> 00:49:10,714 RAY, THANKS SO MUCH FOR BEING 1583 00:49:10,714 --> 00:49:11,014 HERE. 1584 00:49:11,014 --> 00:49:14,117 >> I'M HAPPY TO BE HERE. 1585 00:49:14,117 --> 00:49:15,819 >> THIS IS A BIG JOB CORD 1586 00:49:15,819 --> 00:49:17,955 NAILING ALL THE FOLKS WHO GET ON 1587 00:49:17,955 --> 00:49:20,757 THE PHONE OR THE COMPUTER WHO 1588 00:49:20,757 --> 00:49:21,892 SIGN UP FOR THE COVERAGE. 1589 00:49:21,892 --> 00:49:23,160 IT'S GOING WELL BUT THERE ARE 1590 00:49:23,160 --> 00:49:24,461 STILL A LOT OF PEOPLE WITH 1591 00:49:24,461 --> 00:49:24,828 QUESTIONS. 1592 00:49:24,828 --> 00:49:25,862 WHAT KIND OF THINGS ARE YOU 1593 00:49:25,862 --> 00:49:27,130 HEARING AT THIS POINT? 1594 00:49:27,130 --> 00:49:27,931 >> ACTUALLY, A LOT OF WHAT WE 1595 00:49:27,931 --> 00:49:29,333 ARE HEARING IS A LOT OF PEOPLE 1596 00:49:29,333 --> 00:49:32,035 REALLY HAVE NOT REALLY BEEN -- 1597 00:49:32,035 --> 00:49:33,637 THEY HAVE NOT REALLY RESPONDED 1598 00:49:33,637 --> 00:49:35,038 TO THE ADVERTISING RELATED TO 1599 00:49:35,038 --> 00:49:37,441 THE ACT, AND I THINK I SAW A 1600 00:49:37,441 --> 00:49:38,842 POLL LAST WEEK THAT SOMETHING 1601 00:49:38,842 --> 00:49:41,244 LIKE 23% OF ALL AMERICANS ARE 1602 00:49:41,244 --> 00:49:42,879 TOTALLY UNAWARE THAT THERE EVEN 1603 00:49:42,879 --> 00:49:44,314 IS AN AFFORDABLE CARE ACT. 1604 00:49:44,314 --> 00:49:46,516 WHEN YOU ADD THAT TO 509 HIGH 1605 00:49:46,516 --> 00:49:47,617 PERCENTAGE OF PEOPLE WHO KIND OF 1606 00:49:47,617 --> 00:49:48,819 KNOW WHAT IT IS, BUT DON'T 1607 00:49:48,819 --> 00:49:50,821 REALLY KNOW IF THERE'S GOING TO 1608 00:49:50,821 --> 00:49:52,622 BE ANY IMPACT TO THEM 1609 00:49:52,622 --> 00:49:53,857 PERSONALLY, THEN THERE'S REALLY 1610 00:49:53,857 --> 00:49:55,225 A MUCH SMALLER GROUP OF PEOPLE, 1611 00:49:55,225 --> 00:49:56,660 I THINK THAT REALLY ARE ON TOP 1612 00:49:56,660 --> 00:49:58,829 OF WHAT'S GOING ON AND 1613 00:49:58,829 --> 00:50:00,430 UNDERSTAND THAT NOT ONLY 1614 00:50:00,430 --> 00:50:01,131 OPPORTUNITIES BUT ALSO 1615 00:50:01,131 --> 00:50:02,332 UNDERSTAND THAT THERE ARE SOME 1616 00:50:02,332 --> 00:50:04,234 TAX PENALTIES THAT UNFORTUNATELY 1617 00:50:04,234 --> 00:50:05,836 MIGHT BE APPLIED TO PEOPLE THAT 1618 00:50:05,836 --> 00:50:06,937 DON'T HAVE HEALTH INSURANCE 1619 00:50:06,937 --> 00:50:08,138 AFTER MARCH 31st. 1620 00:50:08,138 --> 00:50:09,840 >> SO WHEN THAT DATE COMES AND 1621 00:50:09,840 --> 00:50:11,241 GOES, YOU WILL BE PENALIZED FOR 1622 00:50:11,241 --> 00:50:13,043 IT IF YOU ARE NOT SIGNED UP? 1623 00:50:13,043 --> 00:50:13,477 >> RIGHT. 1624 00:50:13,477 --> 00:50:15,145 IT WILL BE A TAX PENALTY ON 9 -- 1625 00:50:15,145 --> 00:50:17,114 WHEN YOU FILE YOUR TAXES IN THE 1626 00:50:17,114 --> 00:50:18,615 NEXT -- DURING THE NEXT YEAR. 1627 00:50:18,615 --> 00:50:20,050 >> WHAT OTHER KIND OF THINGS ARE 1628 00:50:20,050 --> 00:50:21,385 PEOPLE KIND OF CONFUSED ABOUT OR 1629 00:50:21,385 --> 00:50:23,420 WHAT KIND OF QUESTIONS ARE THE 1630 00:50:23,420 --> 00:50:25,789 IN-PERSON ASSISTORS HEARING 1631 00:50:25,789 --> 00:50:27,657 RIGHT NOW ABOUT SIGNING UP, THE 1632 00:50:27,657 --> 00:50:29,259 CONFUSION MAY BE THAT IS APPLIED 1633 00:50:29,259 --> 00:50:30,027 TO IT? 1634 00:50:30,027 --> 00:50:30,927 >> WELL, I THINK PEOPLE HAVE 1635 00:50:30,927 --> 00:50:32,929 BEEN REALLY GOOD AT -- ONCE THEY 1636 00:50:32,929 --> 00:50:34,231 KNOW WHERE THE WEBSITE, IS AND 1637 00:50:34,231 --> 00:50:35,265 ACTUALLY GOING THERE AND TAKING 1638 00:50:35,265 --> 00:50:36,533 A LOOK. 1639 00:50:36,533 --> 00:50:42,606 I THINK WHEN THE HEALTH BENEFIT 1640 00:50:42,606 --> 00:50:44,007 EXCHANGE THAT RUNS WASHINGTON 1641 00:50:44,007 --> 00:50:44,941 EASEFUL CHANGE WHEN THEY PUT 1642 00:50:44,941 --> 00:50:46,643 TOGETHER THE PROGRAM, I THERE 1643 00:50:46,643 --> 00:50:48,512 WAS AN ASSUMPTION NOT ONLY HERE 1644 00:50:48,512 --> 00:50:49,746 BUT ALSO NATIONALLY THAT MOST 1645 00:50:49,746 --> 00:50:52,549 PEOPLE WOULD BE ABLE TO GO ON TO 1646 00:50:52,549 --> 00:50:53,450 THE WEBSITE AND PURCHASE THE 1647 00:50:53,450 --> 00:50:54,518 INSURANCE VERY EASILY IF YOU 1648 00:50:54,518 --> 00:50:56,153 WERE USED TO GOING TO THE 1649 00:50:56,153 --> 00:50:58,388 INTERNET, FOR EXAMPLE, POSSIBLY 1650 00:50:58,388 --> 00:50:59,890 BUYING AIRLINE TICKETS, YOU 1651 00:50:59,890 --> 00:51:03,293 KNOW, RESERVING HOTEL ROOMS. 1652 00:51:03,293 --> 00:51:05,195 >> THAT ANALOGY WAS USED A FEW 1653 00:51:05,195 --> 00:51:05,996 TIMES. 1654 00:51:05,996 --> 00:51:06,797 >> I'M IN THERE QUITE A BIT AND 1655 00:51:06,797 --> 00:51:07,998 IT'S A LITTLE MORE DIFFICULT 1656 00:51:07,998 --> 00:51:09,366 THAN THAT. 1657 00:51:09,366 --> 00:51:10,967 IT'S, YOU KNOW, SEQUENTIAL. 1658 00:51:10,967 --> 00:51:12,436 IT WORKS VERY, VERY WELL, PAGE 1659 00:51:12,436 --> 00:51:14,671 TO PAGE TO PAGE, BUT IT BUILDS 1660 00:51:14,671 --> 00:51:16,440 ON SOME KIND OF A LOGIC MODEL 1661 00:51:16,440 --> 00:51:17,574 THAT FORCES THEM TO ASK 1662 00:51:17,574 --> 00:51:18,875 QUESTIONS THAT WOULD REALLY TAKE 1663 00:51:18,875 --> 00:51:19,576 PEOPLE BY SURPRISE. 1664 00:51:19,576 --> 00:51:22,479 AND IF THEY ANSWER A QUESTION 1665 00:51:22,479 --> 00:51:23,413 WRONG, SOMETIMES THIS WILL STOP 1666 00:51:23,413 --> 00:51:25,082 THEIR PROCESS AND YOU GET A LOT 1667 00:51:25,082 --> 00:51:26,683 OF CALLS FROM PEOPLE WHO 1668 00:51:26,683 --> 00:51:28,085 ACTUALLY ENTERED INTO THE 1669 00:51:28,085 --> 00:51:29,419 PROCESS AND HAVE BEEN UNABLE TO 1670 00:51:29,419 --> 00:51:30,053 GO FURTHER. 1671 00:51:30,053 --> 00:51:32,089 AND A LOT OF TIMES THEY WILL 1672 00:51:32,089 --> 00:51:33,190 CALL THE CALL CENTER. 1673 00:51:33,190 --> 00:51:34,591 THIS' A STATEWIDE CALL CENTER 1674 00:51:34,591 --> 00:51:36,693 WHICH HAPPENS TO BE LOCATED IN 1675 00:51:36,693 --> 00:51:37,494 SPOKANE, BUT THE TRAFFIC THERE 1676 00:51:37,494 --> 00:51:38,695 IS MUCH HIGHER THAN THEY THOUGHT 1677 00:51:38,695 --> 00:51:39,896 IT WOULD BE AS WELL. 1678 00:51:39,896 --> 00:51:42,299 SO PEOPLE ARE EXPERIENCING 1679 00:51:42,299 --> 00:51:43,400 LONGER WAIT TIMES. 1680 00:51:43,400 --> 00:51:45,569 THE ADVICE I GIVE PEOPLE IF THEY 1681 00:51:45,569 --> 00:51:47,070 ARE REFERRED BY A FRIEND OR IF 1682 00:51:47,070 --> 00:51:50,474 THEY CALL ME, OR SEND ME AN 1683 00:51:50,474 --> 00:51:51,675 EMAIL, IT'S TO TRY TO FIND SOME 1684 00:51:51,675 --> 00:51:52,609 HELP FROM ONE OF THE 1685 00:51:52,609 --> 00:51:54,377 ORGANIZATIONS AND THERE ARE IN 1686 00:51:54,377 --> 00:51:54,711 SPOKANE. 1687 00:51:54,711 --> 00:51:58,482 THERE'S PROBABLY WELL OVER 100, 1688 00:51:58,482 --> 00:51:59,616 MAYBE 150 IN SPOKANE COUNTY 1689 00:51:59,616 --> 00:52:01,118 ALONE THAT HAVE PEOPLE THAT ARE 1690 00:52:01,118 --> 00:52:02,686 IN-PERSON ASSISTORS OR 1691 00:52:02,686 --> 00:52:03,587 NAVIGATORS IS ANOTHER WORD FOR 1692 00:52:03,587 --> 00:52:05,388 WHAT WE DO. 1693 00:52:05,388 --> 00:52:06,790 THEY HAVE SOMEONE THAT CAN SIT 1694 00:52:06,790 --> 00:52:07,657 DOWN WITH YOU AND GUIDE YOU 1695 00:52:07,657 --> 00:52:08,492 THROUGH THE PROCESS. 1696 00:52:08,492 --> 00:52:09,759 >> AND WHAT KIND OF INFORMATION, 1697 00:52:09,759 --> 00:52:10,994 AGAIN, DO THEY NEED TO HAVE WHEN 1698 00:52:10,994 --> 00:52:12,395 THEY SIT DOWN TO START THE 1699 00:52:12,395 --> 00:52:13,130 PROCESS, EVEN IF THEY ARE 1700 00:52:13,130 --> 00:52:14,731 WORKING WITH ONE OF THE 1701 00:52:14,731 --> 00:52:15,632 IN-PERSON ASSISTORS? 1702 00:52:15,632 --> 00:52:16,800 YOU NEED SOME VITAL INFORMATION 1703 00:52:16,800 --> 00:52:18,468 THAT IS GOING TO NEED TO BE 1704 00:52:18,468 --> 00:52:20,203 AVAILABLE SO THAT YOU CAN GET 1705 00:52:20,203 --> 00:52:20,770 SIGNED UP. 1706 00:52:20,770 --> 00:52:21,171 >> SURE. 1707 00:52:21,171 --> 00:52:22,239 AND THE FIRST THING WE NEED TO 1708 00:52:22,239 --> 00:52:24,141 DO WE NEED TO VERIFY THEIR 1709 00:52:24,141 --> 00:52:24,508 IDENTITY. 1710 00:52:24,508 --> 00:52:25,742 SO WHAT A PERSON WOULD NEED TO 1711 00:52:25,742 --> 00:52:27,277 DO IS TO MAKE SURE THEY HAVE 1712 00:52:27,277 --> 00:52:28,178 THEIR DRIVER'S LICENSE, MAKE 1713 00:52:28,178 --> 00:52:29,880 SURE THEY HAVE -- IF POSSIBLE, A 1714 00:52:29,880 --> 00:52:31,014 SOCIAL SECURITY CARD. 1715 00:52:31,014 --> 00:52:32,382 I KNOW A LOT OF PEOPLE DON'T 1716 00:52:32,382 --> 00:52:34,284 CARRY THEM AROUND, BUT IF AT ALL 1717 00:52:34,284 --> 00:52:35,185 POSSIBLE, IT WOULD BE A GOOD 1718 00:52:35,185 --> 00:52:36,086 THING TO BRING. 1719 00:52:36,086 --> 00:52:37,888 WE RECOMMEND THAT PEOPLE BRING 1720 00:52:37,888 --> 00:52:39,689 COPIES OF THEIR LAST YEAR'S 1721 00:52:39,689 --> 00:52:42,092 TAXES BECAUSE YOU ARE REQUIRED 1722 00:52:42,092 --> 00:52:44,895 TO ESTIMATE YOUR INCOME, AND 1723 00:52:44,895 --> 00:52:48,198 ALSO -- AND ALSO TO IDENTIFY ALL 1724 00:52:48,198 --> 00:52:49,699 THE HOUSEHOLD MEMBERS BY NOT 1725 00:52:49,699 --> 00:52:51,201 ONLY NAME BUT ALSO BY SOCIAL 1726 00:52:51,201 --> 00:52:53,136 SECURITY NUMBER, SO THAT'S 1727 00:52:53,136 --> 00:52:54,371 TYPICALLY PRETTY CONVENIENTLY 1728 00:52:54,371 --> 00:52:55,872 LOCATED ON YOUR TAXES, 1729 00:52:55,872 --> 00:52:58,909 ESPECIALLY IF YOU HAVE CHILDREN 1730 00:52:58,909 --> 00:52:59,809 AS DEPENDENTS. 1731 00:52:59,809 --> 00:53:01,077 WE ASK PEOPLE TO BRING THOSE 1732 00:53:01,077 --> 00:53:02,979 KINDS OF THINGS. 1733 00:53:02,979 --> 00:53:03,813 THE AFFORDABLE CARE ACT IS 1734 00:53:03,813 --> 00:53:05,415 AVAILABLE TO NOT ONLY REGULAR 1735 00:53:05,415 --> 00:53:07,350 CITIZENS BUT ALSO PEOPLE WHO ARE 1736 00:53:07,350 --> 00:53:08,885 HERE ON A LEGAL BASIS. 1737 00:53:08,885 --> 00:53:10,086 IF PEOPLE ARE HERE ON CERTAIN 1738 00:53:10,086 --> 00:53:11,621 TYPES OF VISAS, WE MIGHT 1739 00:53:11,621 --> 00:53:13,390 RECOMMEND THAT THEY BRING A COPY 1740 00:53:13,390 --> 00:53:14,391 OF A VISA. 1741 00:53:14,391 --> 00:53:15,725 SOMETIMES THE SYSTEM WILL ASK 1742 00:53:15,725 --> 00:53:17,694 YOU TO VERIFY YOUR STATUSES IN A 1743 00:53:17,694 --> 00:53:19,095 CERTAIN WAY OF SOCIAL SECURITY 1744 00:53:19,095 --> 00:53:20,564 NUMBER, YOU KNOW, A VISA NUMBER 1745 00:53:20,564 --> 00:53:21,164 OR SOMETHING LIKE. 1746 00:53:21,164 --> 00:53:24,434 LIKETHAT. 1747 00:53:24,434 --> 00:53:26,269 SO WE HAVE THE ABILITY TO 1748 00:53:26,269 --> 00:53:27,504 ACTUALLY UPLOAD THEM TO THE 1749 00:53:27,504 --> 00:53:28,405 SYSTEM AND MAKE THEIR JOURNEY 1750 00:53:28,405 --> 00:53:30,473 THROUGH THE PROCESS EASTIER. 1751 00:53:30,473 --> 00:53:32,209 >> WHAT IS THE BEST WAY TO 1752 00:53:32,209 --> 00:53:33,810 CONTACT AN IN-PERSON ASSISTOR TO 1753 00:53:33,810 --> 00:53:35,212 GET THAT HELP, YOU SAY WHEN THEY 1754 00:53:35,212 --> 00:53:35,512 COME? 1755 00:53:35,512 --> 00:53:36,279 IS THERE A LOCATION THAT THEY 1756 00:53:36,279 --> 00:53:37,914 CAN ACTUALLY PHYSICALLY GO TO OR 1757 00:53:37,914 --> 00:53:41,585 SET UP AN APPOINTMENT TO GO TO? 1758 00:53:41,585 --> 00:53:42,252 >> WELL, THERE ARE MANY. 1759 00:53:42,252 --> 00:53:43,987 AS I SAID EARLIER, WE ARE ONE OF 1760 00:53:43,987 --> 00:53:45,188 MANY ORGANIZATIONS IN SPOKANE 1761 00:53:45,188 --> 00:53:47,591 THAT DO THIS WORK. 1762 00:53:47,591 --> 00:53:48,792 I WOULD RECOMMEND THAT THEY 1763 00:53:48,792 --> 00:53:50,193 COULD START BY CALLING OUR 1764 00:53:50,193 --> 00:53:53,296 ORGANIZATION, AND WE HAVE AN 1765 00:53:53,296 --> 00:53:55,298 APPOINTMENT LINE NUMBER. 1766 00:53:55,298 --> 00:53:57,701 IT'S 444-3066. 1767 00:53:57,701 --> 00:53:59,302 AND WE ALSO HAVE A GREAT PRIMARY 1768 00:53:59,302 --> 00:54:06,209 PARTNER WITH THE SPOKANE COUNTY 1769 00:54:06,209 --> 00:54:08,578 LIBRARY DISTRICT AND THEY HAVE 1770 00:54:08,578 --> 00:54:14,184 EIGHT NAVIGATORS ON THEIR STAFF 1771 00:54:14,184 --> 00:54:19,489 THAT IS 893-8400. 1772 00:54:19,489 --> 00:54:19,956 >> 893-8400? 1773 00:54:19,956 --> 00:54:24,094 >> YES AND YOU CAN GO TO THE 1774 00:54:24,094 --> 00:54:27,397 HEALTH PLAN, THE WA 1775 00:54:27,397 --> 00:54:28,031 HEALTHPLAN.ORG AND YOU CAN 1776 00:54:28,031 --> 00:54:30,500 ACCESS A LIST OF NAVIGATORS NOT 1777 00:54:30,500 --> 00:54:31,801 ONLY -- THROUGHOUT THE STATE 1778 00:54:31,801 --> 00:54:34,871 ACTUALLY BY NAME AND ZIP CODE, 1779 00:54:34,871 --> 00:54:35,305 ORGANIZATION. 1780 00:54:35,305 --> 00:54:36,273 >> DO YOU ANTICIPATE, RAY, THAT 1781 00:54:36,273 --> 00:54:37,941 IT WILL GET QUITE BUSY IN THE 1782 00:54:37,941 --> 00:54:38,875 NEXT WEEK? 1783 00:54:38,875 --> 00:54:40,043 >> WELL, ACTUALLY, IT'S BEEN 1784 00:54:40,043 --> 00:54:42,912 QUITE BUSY FOR A WHILE. 1785 00:54:42,912 --> 00:54:45,315 BECAUSE EVEN THOUGH, AS I STATED 1786 00:54:45,315 --> 00:54:46,816 EARLIER, A HIGH PERCENTAGE OF 1787 00:54:46,816 --> 00:54:48,318 PEOPLE REALLY DON'T KNOW HOW IT 1788 00:54:48,318 --> 00:54:49,586 AFFECTS THEM OR IF IT AFFECTS 1789 00:54:49,586 --> 00:54:49,886 THEM. 1790 00:54:49,886 --> 00:54:53,390 A LOT OF PEOPLE DO AND WORD OF 1791 00:54:53,390 --> 00:54:54,924 MOUTH FROM PEOPLE'S EARLIER 1792 00:54:54,924 --> 00:54:55,892 EFFORTS ARE STARTING TO DRIVE 1793 00:54:55,892 --> 00:54:57,494 PEOPLE TO NOT ONLY OURSELVES BUT 1794 00:54:57,494 --> 00:55:00,297 MOST OF THE MEDICAL CLINICS 1795 00:55:00,297 --> 00:55:01,598 HAVE -- IN TOWN HERE HAVE 1796 00:55:01,598 --> 00:55:02,932 IN-PERSON ASSISTORS, THE 1797 00:55:02,932 --> 00:55:03,600 HOSPITALS DO. 1798 00:55:03,600 --> 00:55:04,634 THERE'S AN ORGANIZATION CALLED 1799 00:55:04,634 --> 00:55:06,803 BETTER HEALTH TOGETHER, WHICH 1800 00:55:06,803 --> 00:55:08,805 ACTUALLY IS 9 -- KIND OF A 1801 00:55:08,805 --> 00:55:09,472 CLEARINGHOUSE OF THE OVERALL 1802 00:55:09,472 --> 00:55:10,407 ORGANIZATION THAT WE ALL REPORT 1803 00:55:10,407 --> 00:55:13,109 TO AND REPORT THROUGH. 1804 00:55:13,109 --> 00:55:13,877 THERE'S JUST A NUMBER OF 1805 00:55:13,877 --> 00:55:15,412 DIFFERENT PLACES THAT PEOPLE CAN 1806 00:55:15,412 --> 00:55:15,679 GO. 1807 00:55:15,679 --> 00:55:20,116 SO IT'S NOT A LACK OF RESOURCES. 1808 00:55:20,116 --> 00:55:21,318 I THINK -- MAYBE NOT NECESSARILY 1809 00:55:21,318 --> 00:55:23,219 BEEN A LACK OF INFORMATION, BUT 1810 00:55:23,219 --> 00:55:24,688 SOME PEOPLE JUST HAVEN'T REALLY 1811 00:55:24,688 --> 00:55:26,222 LOOKED IN THE RIGHT PLACE TO SEE 1812 00:55:26,222 --> 00:55:27,257 THE INFORMATION THAT'S OUT THERE 1813 00:55:27,257 --> 00:55:28,825 ABOUT THE RESOURCES THAT ARE 1814 00:55:28,825 --> 00:55:29,192 AVAILABLE. 1815 00:55:29,192 --> 00:55:31,861 >> AND, OF COURSE, A LOT OF 1816 00:55:31,861 --> 00:55:32,896 PEOPLE ANTICIPATING THAT THE 1817 00:55:32,896 --> 00:55:34,297 YOUNG ARE NOT SIGNING UP AND MAY 1818 00:55:34,297 --> 00:55:36,199 JUST TAKE THE PENALTY AND 1819 00:55:36,199 --> 00:55:38,001 PERHAPS WAIT THE NEXT YEAR AND 1820 00:55:38,001 --> 00:55:39,536 SEE SORT OF HOW THINGS GO. 1821 00:55:39,536 --> 00:55:41,871 IT'S JUST SORT OF HARD TO SAY 1822 00:55:41,871 --> 00:55:43,239 WHAT THEY ARE THINKING, THE 1823 00:55:43,239 --> 00:55:44,407 YOUNG AND HEALTHY AS THEY ARE 1824 00:55:44,407 --> 00:55:45,008 CALLING THEM. 1825 00:55:45,008 --> 00:55:46,042 >> RIGHT AND ONE THING I WOULD 1826 00:55:46,042 --> 00:55:47,844 SAY TO ANYONE WHO MIGHT BE 1827 00:55:47,844 --> 00:55:49,012 LISTENING, IS THAT A LOT OF 1828 00:55:49,012 --> 00:55:50,280 PEOPLE ARE ALSO UNAWARE THAT THE 1829 00:55:50,280 --> 00:55:51,815 STATE OF WASHINGTON CHOSE TO 1830 00:55:51,815 --> 00:55:54,317 EXPAND THEIR MEDICAID PROGRAM. 1831 00:55:54,317 --> 00:55:55,518 STATES HAD THE OPTION AND 1832 00:55:55,518 --> 00:55:56,720 WASHINGTON CHOSE TO DO THAT. 1833 00:55:56,720 --> 00:55:58,722 AND WHAT THAT MEANS IS THAT NOW 1834 00:55:58,722 --> 00:56:00,824 YOU CAN ACTUALLY HAVE MUCH MORE 1835 00:56:00,824 --> 00:56:02,726 INCOME AND BE ELIGIBLE FOR 1836 00:56:02,726 --> 00:56:03,693 ABSOLUTELY FREE HEALTH 1837 00:56:03,693 --> 00:56:04,060 INSURANCE. 1838 00:56:04,060 --> 00:56:05,395 AND WE WORKED WITH A NUMBER OF 1839 00:56:05,395 --> 00:56:07,063 YOUNG PEOPLE, PARTICULARLY 1840 00:56:07,063 --> 00:56:08,598 STUDENTS, FOR EXAMPLE, AND THEY 1841 00:56:08,598 --> 00:56:10,133 MAY THINK, WELL -- IF THEY DON'T 1842 00:56:10,133 --> 00:56:11,201 KNOW ANYTHING ABOUT MEDICAID, 1843 00:56:11,201 --> 00:56:13,803 YOU KNOW, NOT TOO LONG AGO, YOU 1844 00:56:13,803 --> 00:56:16,673 COULD ONLY MAKE JUST A FEW 1845 00:56:16,673 --> 00:56:17,807 HUNDRED DOLLARS A MONTH AND BE 1846 00:56:17,807 --> 00:56:18,908 ELIGIBLE FOR MEDICAID. 1847 00:56:18,908 --> 00:56:20,944 THEY EXPANDED THAT TO ALMOST 1848 00:56:20,944 --> 00:56:21,411 $16,000 A YEAR. 1849 00:56:21,411 --> 00:56:24,214 SO A LOT OF MINIMUM AGE WORKERS 1850 00:56:24,214 --> 00:56:25,415 AND COLLEGE STUDENTS WORKING 1851 00:56:25,415 --> 00:56:27,417 PART TIME COULD BE ELIGIBLE FOR 1852 00:56:27,417 --> 00:56:28,885 THE FREE HEALTH INSURANCE AND 1853 00:56:28,885 --> 00:56:30,120 IT'S GOOD COVERAGE AND IT IS 1854 00:56:30,120 --> 00:56:33,289 HEALTH INSURANCE, AND IT 1855 00:56:33,289 --> 00:56:34,224 SATISFIES THE MANDATE. 1856 00:56:34,224 --> 00:56:35,925 A LOT OF PEOPLE DON'T KNOW THAT 1857 00:56:35,925 --> 00:56:36,259 EITHER. 1858 00:56:36,259 --> 00:56:37,227 AND IT'S REALLY SOMETHING THAT'S 1859 00:56:37,227 --> 00:56:38,628 BEEN REALLY GOOD IN WASHINGTON 1860 00:56:38,628 --> 00:56:38,928 STATE. 1861 00:56:38,928 --> 00:56:40,630 I WOULD SAY THAT WASHINGTON 1862 00:56:40,630 --> 00:56:41,931 STATE'S EXPERIENCE, FROM WHAT I 1863 00:56:41,931 --> 00:56:44,000 HAVE OBSERVED, AS USUAL, IS 1864 00:56:44,000 --> 00:56:45,435 ALWAYS, YOU KNOW, RIGHT ON AND 1865 00:56:45,435 --> 00:56:49,239 VERY GOOD RELATED TO, YOU KNOW, 1866 00:56:49,239 --> 00:56:51,141 HEALTH, BUT ALL SOCIAL SERVICES 1867 00:56:51,141 --> 00:56:53,910 IT SEEMS LIKE WASHINGTON IS ON 1868 00:56:53,910 --> 00:56:54,878 THE CUTTING SMEENGE VERY GOOD 1869 00:56:54,878 --> 00:56:56,312 INFORMATION AND LOTS OF HELP 1870 00:56:56,312 --> 00:56:56,679 AVAILABLE. 1871 00:56:56,679 --> 00:56:59,416 THE DEADLINE IS MARCH 31st, 1872 00:56:59,416 --> 00:57:00,817 OPEN ENROLLMENT WON'T BEGIN 1873 00:57:00,817 --> 00:57:03,219 AGAIN UNTIL NOVEMBER OF 2014. 1874 00:57:03,219 --> 00:57:05,588 SO THERE'S A GAP IN THERE BEFORE 1875 00:57:05,588 --> 00:57:07,223 YOU CAN GO THROUGH OPEN 1876 00:57:07,223 --> 00:57:08,091 ENROLLMENT AGAIN. 1877 00:57:08,091 --> 00:57:08,992 >> RIGHT, HOWEVER, PEOPLE CAN 1878 00:57:08,992 --> 00:57:10,827 SIGN UP FOR MEDICAID ALL YEAR 1879 00:57:10,827 --> 00:57:11,127 ROUND. 1880 00:57:11,127 --> 00:57:12,228 >> THAT'S AN EXCELLENT POINT. 1881 00:57:12,228 --> 00:57:13,830 >> AND ALSO PEOPLE WHO MAY 1882 00:57:13,830 --> 00:57:17,934 HAVE -- WHAT THEY ARE CALLING 1883 00:57:17,934 --> 00:57:18,435 QUALIFYING EVENTS. 1884 00:57:18,435 --> 00:57:20,236 FOR EXAMPLE, IF YOU ALL OF A 1885 00:57:20,236 --> 00:57:21,805 SUDDEN BECOME UNEMPLOYED HALFWAY 1886 00:57:21,805 --> 00:57:22,806 THROUGH THE YEAR, YOU CAN GO 1887 00:57:22,806 --> 00:57:24,808 INTO THE HEALTH PLAN FINDER WITH 1888 00:57:24,808 --> 00:57:26,709 THE HELP OF SOMEONE AND ACTUALLY 1889 00:57:26,709 --> 00:57:27,310 PURCHASE A PLAN. 1890 00:57:27,310 --> 00:57:28,011 >> VERY GOOD. 1891 00:57:28,011 --> 00:57:29,112 RAY WHITE THANK YOU SO MUCH. 1892 00:57:29,112 --> 00:57:30,613 IF YOU WANT TO SCHEDULE AN 1893 00:57:30,613 --> 00:57:31,614 APPOINTMENT WE HAVE TWO NUMBERS 1894 00:57:31,614 --> 00:57:32,649 THAT YOU CAN CALL, THEY ARE ON 1895 00:57:32,649 --> 00:57:35,251 YOUR SCREEN. 1896 00:57:35,251 --> 00:57:38,988 (509) 444-3066 OR 1897 00:57:38,988 --> 00:57:43,927 1-(855)-487-7686. 1898 00:57:43,927 --> 00:57:46,596 RAY WHITE, THANK YOU SO MUCH FOR 1899 00:57:46,596 --> 00:57:47,831 YOUR KNOWLEDGE AND WITH THE 1900 00:57:47,831 --> 00:57:51,534 LOOMING DEADLINE COMING UP ON 1901 00:57:51,534 --> 00:57:55,605 MARCH 31st. 1902 00:57:55,605 --> 00:57:56,306 WE'RE BACK ON APRIL 17TH WHEN 1903 00:57:56,306 --> 00:57:56,973 OUR TOPIC WILL BE ALLERGIES. 1904 00:57:56,973 --> 00:57:57,607 UNTIL THEN, THANK YOU FOR 1905 00:57:57,607 --> 00:57:57,974 WATCHING. 1906 00:57:57,974 --> 00:57:58,475 I'M TERESA LUKENS. 1907 00:57:58,475 --> 00:58:02,378 GOOD NIGHT. 1908 00:58:02,378 --> 00:58:03,680 >> "HEALTH MATTERS" IS MADE 1909 00:58:03,680 --> 00:58:04,514 POSSIBLE BY OUR VIEWERS, THE 1910 00:58:04,514 --> 00:58:06,182 FRIENDS OF KSPS. 1911 00:58:06,182 --> 00:58:10,220 AND BY PROVIDENCE HEALTH CARE. 1912 00:58:10,220 --> 00:58:10,920 PROVIDENCE'S MOTTO IS KNOW ME. 1913 00:58:10,920 --> 00:58:11,354 CARE FOR ME. 1914 00:58:11,354 --> 00:58:12,288 EASY MY WAY. 1915 00:58:12,288 --> 00:58:13,923 AND PROVIDENCE DOES THAT I'VE 1916 00:58:13,923 --> 00:58:15,058 SEEN IT OVER AND OVER AGAIN. 1917 00:58:15,058 --> 00:58:16,125 I'M DR. STEPHEN MURRAY AND I 1918 00:58:16,125 --> 00:58:16,926 CHOSE PROVIDENCE BECAUSE I 1919 00:58:16,926 --> 00:58:18,027 BELIEVE IN THE MISSION 1920 00:58:18,027 --> 00:58:19,229 STATEMENT. 1921 00:58:19,229 --> 00:58:20,163 AND WORKING TOGETHER WITH OTHERS 1922 00:58:20,163 --> 00:58:21,464 OF LIKE MIND IS A VERY POWERFUL 1923 00:58:21,464 --> 00:58:24,167 WAY TO TAKE CARE OF PATIENTS. 1924 00:58:24,167 --> 00:58:25,568 >> MY NAME IS BETH PEREZ AND I 1925 00:58:25,568 --> 00:58:26,769 AM A REGISTERED NURSE, AND I 1926 00:58:26,769 --> 00:58:27,737 WORK AT HOLY FAMILY HOSPITAL ON 1927 00:58:27,737 --> 00:58:29,272 THE LABOR AND DELIVERY UNIT. 1928 00:58:29,272 --> 00:58:31,174 I'M ABOUT TO HAVE MY SECOND 1929 00:58:31,174 --> 00:58:32,475 CHILD, AND I CHOSE PROVIDENCE 1930 00:58:32,475 --> 00:58:33,576 BECAUSE I LOVE AND TRUST THE 1931 00:58:33,576 --> 00:58:35,345 PEOPLE THAT I WORK WITH, AND WHY 1932 00:58:35,345 --> 00:58:38,181 WOULDN'T I SEEK CARE FROM PEOPLE 1933 00:58:36,346 --> 00:58:38,948 I LOVE AND TRUST. 1934 00:58:40,783 --> 00:58:42,886 CLOSED CAPTION PRODUCTIONS www.ccproductions.com