Ep. 2 | Edward Distler, DO, Interventional Cardiologist, SGMC Health

Transcript

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- Welcome to another episode of "What Brings You in Today?" I'm Erika Bennett.

- And I'm Taylor Fisher.

- And today we are here with Eddie Distler, DO, an interventional cardiologist. So, Dr. Distler, what brings you in today?

- I'm here to talk about heart health.

- Awesome. So, interventional cardiology. Tell us a little bit about your background.

- So, I was born and raised in Phoenix, Arizona, and I went to medical school in West Virginia, and I went further training into internal medicine, cardiology, interventional cardiology, and then came out here to practice, and I've loved it ever since, I think it's been two years now.

- What made you decide to become a, what led you to cardiology or to become a physician in general?

- Cardiology would be, I love the instant gratification that we can get from interventional cardiology of someone coming in with a heart attack. We can fix them instantaneously with a stent and it's gratifying. It's fulfilling, so I enjoy that from a professional standpoint. Medicine, I just kind of, I was drawn to it I think at a younger age and just kind of kept going.

- What would you describe, what is the overall importance of your cardiovascular health? Like, what role does that play in your overall health?

- It's a good question. I think there's many aspects or many ways I can answer that question. But I think number one, heart or cardiovascular disease is the most common cause of death in men and women. And so there's a lot of communication about some of the other, cancers and things like that, but really in the end, it's cardiovascular disease is number one. And so it's very important from that standpoint just trying to be healthy. And then how you feel. If you can focus on your cardiovascular health and eating well and exercising, then you tend to feel better. And so I think in terms of symptoms and how you're feeling and in terms of length of life and kind of top to bottom, I think it's important.

- So, when would someone, I know I actually am a patient of yours, so I have recently been to a cardiologist and got a checkup. And what did you say about my heart?

- It was good.

- It's beautiful.

- A beautiful heart.

- So yeah, I can do the punny joke that, yes, I do have a heart indeed. You know, that's what everyone says, but my heart is beautiful, but anyways, let's go back.

- It was not three sizes too small.

- Okay, there we go. There we go. So, I had, I was feeling what I thought was kind of things in my, you know, with my heart, I was stressed, but it turns out, a lot of people don't think about stress and the impact that stress has on your heart. So how important, what would you recommend to people how they should think about stress when it comes to their overall health and how that does impact it?

- We carry our stress on our heart. Our heart carries a burden of that a lot. When we are stressed out, our cortisol is increased, which is a hormone within our body, and that creates an environment in our body that stress puts undue stress on our heart, so it causes us to feel things. We feel uncomfortable. We don't like the way it makes us feel. So stress management in my practice is a big role in what and what I talk about and what we focus on because of its effect on the heart. So, yeah, so it's very important, and it's dynamic. Each person is different. What is causing someone's stress is different from person to person, age, all of that.

- Do you have any suggestions for something someone could do to help manage the stress or in terms of their heart, what they could do to help with that?

- Yeah, like I said, it's very dynamic. So someone who is maybe younger, in their 20s, 30s, 40s, exercising, eating right, getting on the treadmill, doing those sorts of things can really be good for the heart from a stress relief standpoint. 80s and 90s, I just focus on spending time with your family, and that warms their heart. That relieves a lot of their stress. So, it's dynamic. It's not just getting on the treadmill for everybody, but for some people, that does. For others, it's seeing a counselor. It's dynamic. I think you have to get at the reason.

- What did we recommend for Erika? What are you doing to relieve your stress?

- Exercise.

- What are you addicted to?

- Exercise, all, every day. Closing my rings on my watch. That is my goal. I have to at least close all three of my rings on my watch, and so I can do that multiple ways, so that gives me some options-

- She's an Orangetheory-

- and variety.

- addict.

- Yes, I do prefer Orangetheory, just because I can close my major ring within an hour guaranteed, so that helps limit any variable options. But, so when it comes to your heart, there's a lot of different diagnostic things you can do to kind of check out your heart and make sure it's okay, and I did some of those. So, kind of walk us through what the tools we have available nowadays.

- And the tools are dependent on the symptoms. So a good starting test for a lot of patients would be a echocardiogram or ultrasound of the heart. Like they do on pregnant mamas, looking at the babies, we're looking at the heart. We get about 100 videos, video clips of the heart. We get to see if the heart's squeezing well, if the valves are working well, if the heart is too thick or too small. So we get a really good understanding from a variety of symptoms what's going on with the heart. Then it kind of, from there, your doctor, your cardiologist, or your primary care physician will choose a test or test based on the symptoms. Chest pain leads to different things than palpitations or shortness of breath go down different pathways for each.

- Yeah, so the echocardiogram, am I saying that right? So that's super interesting if you've never had one done. I mean, just the ability, what they can see with those machines.

- You can kind of keep it-

- The technology.

- as a patient, too.

- Yeah, you can real life see what's happening, and it's kind of weird when you're there because you do see it real life. It's kind of freaky, but very cool. And then also just, so I had to wear the Holter monitor, and now they're so, I've had one before, like maybe 10 years ago, but it's so easy now. It's just like a little sticker you put on and then it connects to a little phone, so it's not the old wires that you had to wear and strap on.

- Yeah. Yeah, a lot of what we're doing now is not very scary. Things from the Holter monitor to even we do sleep studies at home now. So there's been a, and a big part of my practice is diagnosing sleep apnea 'cause of it's effect on the heart. It increases cortisol and stress. And so you can do that at home now, and there was a big burden in a lot of my patients of having to leave their loved one to go to the sleep center. And so the sleep center now has a process in which we can do the sleep studies at home, and that's been really nice for a lot of patients. So a lot of our testing is more not as scary as it used to be. Not a lot of wires.

- Right.

- My husband had to do a sleep study and wear the monitor, and he had to come to the hospital to do the sleep study. This was a few years ago. And I don't think you're sleeping very well if you're in a strange place, and then the monitor he wore several years ago had the wires. And so what Erika's describing and what I saw her have, I was like, "That is so much more comfortable "than what it used to be."

- But sleep, let's take a moment for sleep, because that is something that affects every single person in our society and it's highly underrated. And with our busy, busy schedules that we have now and kind of overscheduling ourselves, it tends to be something that people don't prioritize or don't realize the impact that good quality sleep has on their health. Som iterate a little bit more on that, doc.

- Yeah, no. You hit it spot on, and it's focused on a little bit of what our theme I think of this first part of the conversation is. You can't help rid your body of stress if you're not sleeping. Our bodies almost carry that debt of sleep the more and more we don't sleep. It needs that back. It wants that. So the recommendation's eight to 10 hours. It's hard to do that, but that is the recommendation. And if you can't do it one night, you gotta try to catch up the other night.

- How accurate are the watch? So the watch, you know, I keep going back to the watch, but we have so much tools at our disposal now, just normally. So like the watch, it can track your sleep and it can tell you kind of the quality of sleep you're getting. And, I mean, is that a good just first step, see-

- Yeah, I think they're relatively accurate from what I've seen, but they're not, and what I've read, but they're not diagnostic really of anything. But it does help you, "Hey, how much sleep am I getting?" And it can help you keep track of it. I would keep it in a book after that to say, "Okay, where am I trending? "Am I getting getting that eight to 10 "or am I sitting at like six because I'm doing this "or I answer the phone or," you know? I think it's a good way to monitor and to keep track of yourself, but I wouldn't focus on the details of it so much.

- Be right.

- Because I don't think it's well validated for that, but.

- Okay.

- Is it true, I've heard, talking about common misconceptions, do women need more or less sleep than men? Is that something-

- No.

- that's true? No?

- I disagree, in my humble opinion.

- Well that, yeah. No, everybody needs sleep.

- I've heard that misconception, that women need more sleep.

- You keep saying misconception, but I'm not 100%-

- I mean, I just don't know-

- it's a misconception.

- because I'm not a doctor.

- I like to, you know how people say they believe-

- I think that the burden of the-

- the facts that they want, that best fits their narrative? I think this one is mine.

- For a lot of women with the burden of the family and everything, I do think maybe they do.

- Are there any other-

- I know my wife, with our three kids-

- Okay.

- She deserves more than-

- Exactly, I feel like, yeah.

- she probably gets.

- Are there any other things that maybe would be misconceptions that people believe about their heart health or even overall health?

- Yeah, I think we're hitting towards it a little bit. With women, I think there's an interest, or I'll go on a tangent, but I think it helps prove the point. When we studied things from a heart standpoint and symptoms of cardiovascular disease and what heart attacks are, it was done on men. The studies were done on men. They were done on white men. And over the last 15, 20, 30 years, we've realized that we need to dig deeper into that, and so they've done more studies. And so the symptoms that they describe on TV of the elephant on the chest, the substernal, the right here, that's for men. That's for white men. That's where it commonly presents, but that's not women, not African American women especially. They often present differently with their heart attacks. They'll present with reflux or just not feeling right here in their belly or something different or shortness of breath. And so noticing just a change in your body I think is important, and especially with women, I think that, like I said, the number one cause of mortality is still cardiovascular disease. And so to focus on other things I think is not necessarily-

- Yeah, do women tend to just kinda blow it, you know, blow it off, like, "Oh, I've got all this other things to do "and I do feel a little weird, but-

- In our community-

- "I don't have time "to go to the doctor."

- we can help with that, with how we described what we should be looking for. And I think we're trying to change that narrative, and you'll hear more of that when you go to your doctors, that they'll be asking you not just chest pain, but how else are you feeling? Are you feeling something here? What's going on?

- My mom had a heart attack several years ago, and I think maybe she had symptoms for a week of acid reflux and things like that in the esophagus maybe. And she just thought she just wasn't feeling good, and then finally she was just unable to deny the symptoms anymore.

- And that's what I see a lot of, and I hate it because sometimes time is money with heart attacks, and you wanna get seen earlier for these things. So my advice for people, and especially women, is you know your body, and if it's not feeling right, go seek help.

- And don't worry about feeling like you went to the ER and you really shouldn't. "Oh, it was just acid reflux-

- Yeah, there's a lot of that.

- "or something." It's better to be safe than sorry in those cases, for sure.

- And our ER will check. They'll make sure, are you having a heart attack? Is it something we need to worry about? They'll figure that out quickly for you.

- What about birth control and its impacts on heart health? Has there been anything-

- No, from-

- that's very prevalent?

- Yeah, from birth control, no, there's no direct link to increase in, for birth control. From estrogen replacement and for folks going through menopause, that's a different story. There's some observational studies that link an increase of cardiovascular risk, but they're looking backwards. There's not a definitive link, but there's a suggestion that maybe there's a small increase for hormone replacement therapy, which is when you take the estrogen when you're going through menopause, but not exactly from a birth control standpoint. They haven't found anything with that.

- Well, I know since you've been here, we've started doing some new procedures in the realm of cardiac. You wanna tell us about some of those?

- Yeah. I think, and we'll go over things. I think for the last two years, two or three years, we've had the cardiac CTs, which are great. They help folks who have chest pain or who are trying to decide if they need to go on more intensive therapy for their risk factors for heart disease, like statin medications and blood pressure medications. I think we're one of the only areas in this half of the state that has that, so I think that's a big help for a hospital.

- And would would qualify for something like that? Is that someone who maybe has a history of heart disease and/or-

- Mostly it's someone-

- genetics, or?

- who's trying to get more ideas about their heart health and to understand, "Do I have blockages? "Do I not have a high likelihood of blockages?" And really it does take kind of a, it takes a doctor or primary care cardiologist to decide, "Hey, is that a good test for me?" But I think asking about it is definitely warranted and really advocating for yourself, "Hey, should I, is this something "that I should be considered for?" There's that, and that test plays a big role with TAVR planning, which TAVR is a transcatheter aortic valve replacement, where you're replacing the aortic valve through the leg, not requiring open heart surgery, which is a very forward procedure done in the last 10 years or so. And in many patients were having to go out of town for this, to Tallahassee or Jacksonville, and we are happy to be able to have that here. That's in the last year.

- Yeah, that's huge.

- Things for, and then going into things for heart attacks or when patients come in with acute issues, we have a shockwave, which delivers a lithotripsy, which is like, it can fracture the calcium in heart arteries, which we can deliver our stents in a better way. And then we also have a heart pump device called Impella, which can really help save a patient's life when they're crashing and burning and really not doing well with a heart attack.

- Yeah, tell a little bit-

- It does the work-

- more about that.

- of the heart for them.

- That one fascinates me.

- Yeah, so a normal heart will pump somewhere between five to 10 liters per minute, and this heart pump device can do about four. And so it does the work of the heart when your heart is not able to do it. It's not a permanent device. It goes in through the leg and it temporarily bridge someone if we're either working on the heart and needing to do the work of the heart for the patient, or if the patient is not doing well in a heart attack or the heart's failing. I could tell you, if my mom was to have a heart attack, I'd want it on the table or I want it available so that I have all the tools at our disposal, so we were happy to be able to bring that in.

- So it lets your heart rest?

- It lets your heart rest, yeah.

- And it, like, and you can never do that otherwise, right? So, I mean, I think it's pretty cool.

- It is, it is. And it allows the heart to recover from something bad like a heart attack.

- Awesome.

- Yeah.

- So, if someone is thinking that maybe they're having something going on with their heart, they're just not feeling right, what would you recommend the first step they take?

- I would say go to your primary care doctor. If it's something that you feel that is more scary or ominous, or like for those women where it's a big change, I'd go to urgent care or the ER to seek help. But if it's something, "Hey, I've been dealing, you know, "I've been having this something for a year," you know, then start off with primary care to try to get to a cardiologist, absolutely.

- Tell us about the difference between an interventional cardiologist versus a non-invasive cardiologist, versus then what like cardiothoracic surgery, kind of how, 'cause I'm sure that's confusing to most if you've never seen a cardiologist. So tell us about the differences.

- Yeah, so we'll start with this. Cardiac surgeons, cardiothoracic surgeons, they do open heart surgery. They do bypasses, so where they go in and they cut the sternum open and then access the heart. But there needs to be a diagnosis of a heart problem first, like a blockage in the heart arteries. And a cardiologist will do that, whether it be a general cardiologist, someone who doesn't do the procedures, or an interventional cardiologist. A good healthy practice or community needs a little bit of both often so that you can see the large volume of patients that may be required but still need time to do the cases or do the procedures if patients need that, too. So there's a mixture of those often in a practice.

- And what are the most common heart procedures that you perform?

- Heart catheterizations are-

- And tell us a little bit about what that is.

- So, some of those-

- And we've heard, we've all heard someone that says they got a heart patch-

- You'll hear of-

- but what is that?

- of stress test or CT coronaries or CT scans, and all of these things are done to try to screen patients to see if they have blockages in their heart arteries. And if there's evidence that there is, then the next test, the definitive test would be a angiogram or heart catheterization, all the same thing. They're all different words for the same thing, which is where we go in either through the wrist or through the leg and take a catheter, which is like a big long straw, all the way to the heart arteries to take pictures of the heart arteries. And if we think that the patient would benefit, if there is a blockage, we'd fix it with a stent to open it up.

- How long does that take?

- Anywhere between 15 minutes to an hour, hour and a half.

- Interesting. And then as far as like community health, you kind of hit, we live in South Georgia, and, well, commonly known as a stroke belt.

- Comma, fried food.

- Yes, so, what can our area do or what would you, I mean-

- Most of 'em already-

- how do I get-

- know the answers, to be blunt.

- Yeah.

- But a big thing is, number one is smoking. I tell my patients, "I want you to take my medicines, but number one, "put the cigarettes down." That's the number one risk factor for heart disease by and far, and I'm very passionate about it. My patients have a heart attack. I tell 'em all, "If you put your cigarettes down "at the , you get a big hug." I don't care who you are, you get a giant hug. And so it's a huge deal for me to put down the cigarettes. That's number one. Then number two is to get treated for your other risk factors for heart disease. Number one, cigarettes. Number two is diabetes, and then blood pressure, cholesterol and genes. And so your blood, you're getting your blood sugar after putting down the cigarettes would be a big focus of mine.

- What about vaping?

- Vaping is bad. I mean, it is bad period. It's bad for your lungs, it's bad for your heart.

- I think there's a lot of misconception that it's the better alternative from cigarettes, but that doesn't mean that it's good for you.

- No, it's not a good alternative. It is a good, for folks that have a good plan to try to wean and transition from cigarettes to not smoking and not requiring either nicotine or a vaping source. It's good if it is used as a way to wean from the cigarettes, but it needs to be done with a planned pathway rather than a replacement.

- Okay, well that's good to know. Everybody, stop vaping.

- And I get that it's hard. I mean-

- I know.

- It's hard. It's a very addictive substance, and I get that when things hit that part of our brain, it's hard to put it down. It's a habit and I get it, but there's another way. There's another way. What I am grateful for, to be honest, is that it's not very cool for kids anymore, and I think that's a big thing. I'm happy that it's not cool for kids. I'm happy that it's, often our teenagers aren't picking it up like they used to decades ago, and so I think that's a good thing, and I give our community a good job, I think, for changing how that is.

- Can you tell us what you do to keep your heart healthy?

- I try to run. I try to exercise. I try to eat healthy, but-

- You notice he says "try"-

- I try.

- in front of all of those?

- And it's hard, I get it.

- Just so long as you try, folks.

- No.

- Just try.

- And doing it, but the people close to me know that I have a sweet tooth and it's hard for me to put down the sugary stuff. But I think setting goals and trying to achieve those goals. Erika's very good at setting goals, and I think that we could all learn a little bit from that, and setting goals and achieving the goals that are-

- Yes, she is a goal getter.

- Yes, I'm a little obsessive about it, so you can join me if you want to. I'll be glad to get you on that-

- You could do things like Walk with a Doc?

- Yes, yes.

- Yes.

- So we're definitely trying to implement some more heart healthy things just from and wellness into our workplace, so we did start our Walk with a Doc program a few months ago. and so if you wanna Walk with a Doc, which is the safest place to walk, because if something happens to you, there's about 20 other-

- That's right.

- physicians around.

- That's right.

- But you also get the opportunity to speak with them just on a off the cuff basis, and so it's just a way to meet some physicians without having to do it under that pressure of a doctor's appointment. So if you don't like doctor's appointments, this is your way to come connect. So you can go to our website, sgmc.org, to find more information about that.

- Yes, definitely. I know we probably have to let you go 'cause you're very important and you have to go save lives, but I did wanna ask, if you eat at the cafeteria, what is your favorite meal at our cafeteria?

- At our cafeteria, the salmon is so good.

- At our cafeteria?

- I love the salmon.

- It really is, it is really good. I don't know how they mass produce salmon as good as they do, but they do. They do a really good job of it. I love the salmon, hands down.

- Yeah, I think Erika's a fan of the salmon.

- Yeah, I am too, yes.

- They have it about once a week, and so I enjoy that.

- They've done a really good job of implementing more healthy foods, too, options for us, and I definitely appreciate it 'cause it does make it a little bit more easy to stay on task. So shout out to our Food Services Department.

- Big shout out.

- Yes, definitely. We've heard fried chicken, we've heard buffalo wrap.

- I like the salmon. I know Erika does, too.

- Yeah, oh, I get it, like, anytime it's there, so.

- Yeah.

- Alright, well, that's gonna wrap us up on this episode of "What Brings You in Today?" Thank you all for joining and tuning in. If you want to subscribe on our channel, then you can stay up to date on our next episodes. But if you have any suggestions for content or anybody you wanna hear from specifically, please let us know and we'll do our best to get them on the show. But thank you, Dr. Distler-

- Yes.

- Thank you for having me.

- for joining us today.

- Thank you.

- Thank you for having me.

- Like share, review, all that good stuff.

- Yep, thank you very much, and we'll see you next time.

- Bye.

- Bye.