Ep. 66 | Eddie Distler, DO Leanne Bennett, NP, SGMC Health Cardiology

Transcript

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Many people know their blood pressure numbers, but not everyone understands what those numbers mean for their long term health. Welcome to what brings you in today, a podcast from GMC health. I'm Kara Hope Rockwell and I'm Erica Bennett. And today we're here with Eddie Deo and Leanne Bennett MP from MK Cardiology.

So what brings you in today? We're here today to talk about heart health and high blood pressure. All right. Very good. Well, let's just get to know you both a little bit. So if you'll tell us a little bit about your background, how you got here, and same thing, Leanne, for you. Okay. I've been here for years now.

I came here from Arizona. I followed Doctor Siebold out here. He'd been practicing for a year. And I trained in Arizona, got my cardiology training down there, and then my family and I moved out here, and we. We love it out here. We've been practicing for four years now out here. And, have enjoyed bringing some procedures and some new technology to South Georgia.

Very good. And I have been with cardiology for almost eight years. I grew up here, moved away for a long time and came back up and back 20 years. Went back to nursing school at 38 after being a police officer for a long time and then MP school. And I've been with Doctor Desert since he came here for years ago, and we love being able to follow our patients through the hospital and the clinic and take care of their whole heart health.

One drew you both to cardiology specifically. I, I like the there's a lot of aspects of cardiology in terms that you can do procedure. You can there's high stress situations, which I do kind of enjoy being able to, to do that, and to help patients out when they need it the most. And then there's also a more relaxed portion in the clinic where we can try to affect people's long term health and be preventative about trying to stop them from needing me in an emergency, too.

So I get to do both sides and I enjoy that. Mine was kind of accidental. I didn't apply for cardiology. I applied for another job and was asked to go to cardiology, and I loved to learn. So that was my answer. If they'll teach me, I'll learn. I still learn every day. Is there's so many aspects of cardiology, and being able to help people with their overall health is what attracts me.

And just the excitement to because there's always something different. And now you're more or more our most experienced cardiology in P. I don't know about that, but yeah, I've been most tenured. Yeah. Tenured. I appreciate that. So we recently launched our hypertension clinic to for patients that have uncontrollable high blood pressure. Can you talk about that a little bit and what that means.

So our purpose with establishing that clinic was to be a resource for the community. In a few aspects, we're trying to get patients to get their blood pressure more controlled because we know how important it is for their overall health. And we are trying to help work up why they have high blood pressure. What are some specific therapies we can do for them, whether it be medications, non-pharmacological ways, including lowering, lowering salt intake and exercise, those sorts of things.

And then if needed, we do have a newer procedure that can help them or the blood pressure if they are on multiple medicines and having a really tough time. We created it as a way where primary cares can connect patients into our clinic, and we will handle all aspects of the high pressure and then send them back to the primary care and utilize them to help us as well.

And the NPS are the ones that are in taking these patients. If it's just a hypertension issue that the primary care is are sending them, then they make the appointment with us. We see them try to get the blood pressure under control if we see that it's not controlled still on the multiple medications, then we refer them for, you know, and which doctor disorder and doctor see what all do.

And the goal is to get them off of some of those medications. They may not come off all of them, but it's to get a better control of their hypertension. So be speak about what renal Dean nerve patient is. You want to talk a little bit about that for someone that might not heard of that before since it is a newer.

00:04:19:07 - 00:04:50:13
Unknown
Yeah. So it's it's a newer procedure approved by the FDA in the last year or two now. And what it is, is we modify the kidney arteries and the nervous system that's around them to decrease their bodies almost adrenaline response. And it's a little more complicated than that in terms of how it works. But but really it's a very simple, safe procedure to help modify our drive to have high blood pressure.

00:04:50:13 - 00:05:11:01
Unknown
And really, in those who are who are having really tough time controlling the high blood pressure here in the South, we are in the stroke belt, heart attack belt, high blood pressure belt. And so these things were developed in big cities. But really they are needed in places down here. I, I got trained in it in Boston.

00:05:11:01 - 00:05:34:02
Unknown
And so these, these big cities developed these things. But but they're needed in places. Oftentimes more rural. So we're happy to bring it here now. Not everybody who has high blood pressure needs this, but we're glad to offer it to those who are having a tough time. I have patients who have blood pressure 190, 170 on five different medicines, and we've looked up other reasons and they don't have another reason.

00:05:34:02 - 00:05:59:13
Unknown
And this is this can help them have blood pressure. I mean, well, how do you even explain that to the average patient about what that is? And then how can what is the best way to take steps towards preventing high blood pressure to begin with. So high blood pressure or our body needs to get blood and get a blood to its tissues, and our blood pressure helps us do that.

00:05:59:17 - 00:06:29:02
Unknown
High blood pressure is when it's too high. It puts stress on areas of our our body. It puts stress on our heart, our heart arteries, our brain, and increases risk of heart attacks and strokes. And when we have two high blood pressure, there's reasons for that. Sometimes genetic reasons, diet reasons, weight reasons. And so we try to address all those things as a first line.

00:06:29:04 - 00:06:54:12
Unknown
If it's if we can't get it down with those non medication ways, then then we start with medicines and go from there. Do you ever have to deal with low blood pressure. Yeah. Yes. Occasionally. Yeah. The the things you do work too well. No not not necessarily that there's usually a different cause. But no, it's typically we'll, we'll try to remove medicines.

00:06:54:12 - 00:07:11:07
Unknown
We'll see that occasionally some folks will be on too many medicines and especially as they age, sometimes as they age, they don't need as much. So we have to come down on them. But the lower blood pressure or the hypertension is usually a different cause. They come in with that they didn't have to begin with. This is where our staff do a really good job.

00:07:11:07 - 00:07:28:04
Unknown
I'll see a lot of patients where they think they have high blood pressure, but it's white, high blood pressure where they come to the doctor's office and their blood pressure is 170. Then they'll figure out getting good, detailed information from them and figure out actually when they got that log of their blood pressure from home. It was 120.

00:07:28:05 - 00:07:46:17
Unknown
It was it was in a controlled range. It just got a little anxious coming to the doctor that way. Just over treat. Because if you treat that white coat hypertension and then they go home and they were 120 and now we put them down to low. So that's when we try to make sure we get a good history and make them do a log and that type of thing.

00:07:46:17 - 00:08:05:15
Unknown
So we know what's really going on at home. We try to dive deep into we're not just treating one number at one time. We're treating, kind of the global picture. Why is high blood pressure often refer to as a silent condition? You don't feel it typically. Any one of us could be right here. It could be having a high blood pressure.

00:08:05:15 - 00:08:24:11
Unknown
We wouldn't know it. So we don't feel it. We don't. You know, if you hurt your toe, you're going to feel that you broke your toe, but you don't feel your high blood pressure unless it's really high. And people that have had high blood pressure for a long time, they've adapted to living that way. So when they come to us and we say, your blood pressure is high and they're like, no, that's normal.

00:08:24:11 - 00:08:41:15
Unknown
For me. It's not normal when it's 141 50. But for them, that's what they've been living in. So they just let it go because they don't know. We'll have some where the top number is one 9200. Yes. And that that for us would cause us to not feel too would feel different. But for them, that's just that's what they feel.

00:08:41:19 - 00:09:00:18
Unknown
So you gradually your body gets used to an enormously to gradually bring it back down. And we have to be gradual because they feel bad if you take it down too fast and then they won't take their meds. So that's a big thing too, is okay. You're going to feel a little different, like, hang in with us, give us time to fix this slowly, but don't stop taking your meds.

00:09:00:21 - 00:09:21:08
Unknown
And it is supposed to be 120/80, correct? That's like the standard. Is that different for different people or different ages? No. So yeah, the there's a couple trials with sprint trial, but a couple trials that showed us we should really try to reach that threshold. In your 80s. We got to be careful with that.

00:09:21:08 - 00:09:51:07
Unknown
With balls. But but no, we should be. We should be aggressive about it. Diabetics specifically? Yeah. How many patients are surprised to learn that high blood pressure can remain elevated even when they're taking their medication? Or you mentioned, like, they quit taking their medication because it makes them feel bad. How often do you see that like noncompliance and that impact patients lives and, a lot we have a lot of patients and it's different reasons.

00:09:51:07 - 00:10:06:03
Unknown
They're noncompliant. Sometimes it's they can't afford the meds, and we have to work with them to make sure the meds we give them are cheap beds, because generic meds are cheaper, and there's a lot of meds that they can get for free from Publix or, you know, $5. So if we give them something they can't afford, they won't change it.

00:10:06:03 - 00:10:32:16
Unknown
Some of its they don't like taking meds because they just don't take them. They forget. And sometimes because they don't feel good when they take it and they think that's what's causing them to not feel good. So we do have a lot and we do a lot of education. He's really good at education. We really try to educate them on the importance of it and the end result of dialysis, stroke, heart attack like Dallas, this is the one thing we really hammer on because dialysis life changing.

00:10:32:18 - 00:10:51:23
Unknown
I mean, you're hooked to a machine three days a week. You don't want that. And when you start having high blood pressure in your early 20s and it's not controlled, that's where you're going to end up. And that is a up and coming indication for the renal of some folks, one of them, or had one patient who really didn't want to, didn't like medicines.

00:10:51:23 - 00:11:20:06
Unknown
And so this was an option for that, for that patient. Now, I don't I don't think that should be for everybody. But if we really try medicines, they don't like the medicines, then it could be an option to help reduce their likelihood of downstream dialysis. Heart attack strokes. Yeah. Do you think that is there any other up and coming, or are you seeing this same type of procedure being done in different specialties where it's like impacting the nerves?

00:11:20:07 - 00:11:41:19
Unknown
Oh, yes. Per se. To instead of oh yeah. Yeah. I know in pain management we're doing a lot of that. Yeah. No we're very it is a kind of a new area that people are looking at. Absolutely. Are there any common misconceptions about high blood pressure that you have to correct. I think one of the things we touched on is no this is my normal.

00:11:41:21 - 00:12:06:10
Unknown
That's that's not that's not real. That's just that's probably the biggest thing we see is not. Yeah. This is my normal. No. And it it does it should not be your normal. And if you want to call it your normal it that's going to increase your risk of heart attack strokes kidney failure like we talked about. And so it's really spending it's hard for patients because they it is normal for them.

00:12:06:10 - 00:12:28:04
Unknown
They feel that this is normal. But it's you have to hear them and understand that yeah this this is where you've lived. But it is not normal. And and if you put your head in the sand with this, if you pretend that this is okay, you're, you're, you're likely going to have downstream effects of it. And getting people to change their habits is hard.

00:12:28:06 - 00:12:45:09
Unknown
Getting people to not eat the things that they shouldn't eat, and understanding that everything needs to be in moderation. We don't tell everybody they can't ever have a piece of bacon, but you can't have bacon every day, you know, because it's so salty and pork and those type of things. So it's hard in South Georgia. People have a good story of that.

00:12:45:09 - 00:13:03:09
Unknown
I think the first couple months of moving out here, I didn't realize how much smoked meat are common out here in the. There was a patient that said, I don't put salt on anything. Then I dove deep into her what she was eating every day. And then she said, you know, I don't put salt on the meat that I eat.

00:13:03:09 - 00:13:23:00
Unknown
And I said, okay, tell me more about that. And then we learned that it was a lot of smoked meats. And you, they really sort up the smoked meat. And so a ton of salt in that, those things, it's kind of like deli meat to. Right, kind of assume that deli meat is like healthy for you to make and vegetables to canned vegetables have a lot of salt.

00:13:23:00 - 00:13:42:21
Unknown
And then we tell them to do the frozen vegetables if they're going to do it, or at least rinse the vegetables off in the can to try to get some of the salt out of them. But they're made their can with salt to preserve them. That's how you realize that. Keep it preserved. Yeah. What are some of the other tips that you give patients to help them exercise?

00:13:42:23 - 00:14:00:18
Unknown
That is a big thing for us is, you know, five days a week, 20 to 30 minutes a day of exercise, get your body moving. The heart likes to move. And we tell them that all the time. Less salt. Stay hydrated. But not, you know, with Cokes and coffee. And we are not a very good example of that because we drink a lot of coffee.

00:14:00:22 - 00:14:22:15
Unknown
But, you know, those type of things are the things that we try to. It's about building habits and it's about building lifetime habits, not just for a few weeks. What's your best advice for building a new habit? Like how do you. Because like you said, it's hard. So what's your go to to help somebody? That's a really good question.

00:14:22:17 - 00:14:41:10
Unknown
I'm asking for myself. You know what I mean? Because I think you have to start slow, even with like, exercise. Like we tell people, okay, we don't expect you to go run a marathon. You got to start slow. So if you're eating bacon five days a week or seven days a week, then cut back and don't eat back in two days a week, you know, two of those days, it's like people quitting smoking.

00:14:41:10 - 00:14:59:10
Unknown
It's the same. Like, if you're not going to be able to just quit cold turkey, then back down. And today you have 15 cigarettes, tomorrow you have ten or next week. And it's just got to be a process that you get in your mind. This is something I have to do. Like with exercise. I mean if you the biggest obstacle is getting there.

00:14:59:12 - 00:15:20:04
Unknown
Yeah, it's starting to do that habit. Once you start you've just got to build on that. Yes. I think there's two aspects that we'll focus on a lot is when you when we're eliminating things, it doesn't mean I love ice cream. Right. I but we need to make it an event. It should be a Sunday night thing or whatever you make it.

00:15:20:05 - 00:15:34:09
Unknown
It's a it's a special thing and don't if you cut it out completely, oftentimes you're going to jump off more. Yeah. Jump off the wagon and and do it again. And you're going to want it more. And you're going to do it every night. And so I talk about making it an event with your with your family, with your loved ones.

00:15:34:09 - 00:15:54:04
Unknown
We're going to have ice cream tonight. And popcorn. It's going to be great. We do that every Sunday night at our house. We have mug shakes and popcorn and and so I think that that if you make it an event, it, it, it preserves its part in your soul that makes you happy. But it's not every day you're looking forward to it.

00:15:54:10 - 00:16:13:14
Unknown
And so you make it an event. And then so that's when we're eliminating something. I think what we're trying to bring a habit on a big part of that is, is accountability. You know, them to get their wife or husband to want with them, like make it a family thing, make it a your your significant other goes with you to walk every day and you enjoy that time together.

00:16:13:14 - 00:16:31:07
Unknown
So you're getting exercise and communication with. Yeah. Or a friend if you if you're going to the gym and you're doing it with a friend, someone who holds you accountable. We all know that it's difficult to stay in bed when you're receiving that text. I'm not saying, hey, where are you? Yeah, your husband saying, my shoes are on.

00:16:31:07 - 00:16:49:01
Unknown
Let's go. Yeah. And so and so I think accountability, when you're trying to add a good habit is is important and starting low. So we're not going for what some patients are who are pretty immobile. We don't go to 30 minutes right away. We do five and then we work to seven and then ten. And how far can you walk?

00:16:49:01 - 00:17:05:15
Unknown
Can you watch your mailbox okay. Tomorrow? Watch your mailbox and walk back without stopping. Like just add. Yeah, but it definitely is motivating to have somebody that does it with you. My husband is my motivator to go to the gym on the weekends. I go every day during the week, but on the weekends, like I'm tired and he's like, oh no, we're going.

00:17:05:16 - 00:17:27:11
Unknown
So we get up and go, so well, isn't it is so ironic that you feel better and have more energy when you exercise, but like you use that as a risky or something. So tired, but it literally gives you energy when you move. Our our brains are funny things. You know. On our last podcast episode, you said that when patients quit smoking, you give them a hug.

00:17:27:12 - 00:17:41:11
Unknown
Yeah. Do you still do that? Yeah. Is that still a motivator? Funny story. The other day we had a patient and I said, did you quit smoking? And he goes, no, I'm working on it. And I said, oh, I was going to give you a hug if you quit smoking. He goes, I quit.

00:17:41:13 - 00:17:56:23
Unknown
I did not work. He did not get a hug. I said, you quit next time you're gonna. He hugged. He hugs the female patients I get. I did it. It was a couple that this last week and I gave him both. Usually he said, okay, I'm going to give you a hug. If it's a guy I love that.

00:17:57:00 - 00:18:18:06
Unknown
That's okay. Yeah. We had a celebration this week for that one. They were. That's good. Husband and wife. That's a big deal for us. I mean, that's huge. It is that that's a habit that we had 100 years total, so. Oh my goodness. I was real proud of him. Oh, that was awesome. So let's just talk about cardiac care just in general.

00:18:18:07 - 00:18:38:17
Unknown
You all have accomplished a lot over the past couple of years at your clinic. Just offering or in the hospital, you know, both spectrums, bringing new technologies. And I know you all go to different places and learn, like, how do you stay abreast of what's happening in the heart field and what are you most excited about?

00:18:38:19 - 00:18:42:16
Unknown
In your respective areas?

00:18:42:18 - 00:19:04:15
Unknown
You know, I think in terms of being the professional part about staying on top of things, we got a read. I think that's important is to keep reading on what's going on and what's what's new and what's, what the new data showing us. So I think that's important just from a professional standpoint. And then, I, I always am thinking, what what is the next thing that we can do to help the community?

00:19:04:15 - 00:19:23:18
Unknown
And so, right now I was just thinking about messaging or one of our manager people to say, where are we at with that? And so we're always just trying to move things forward. Try to make sure we can help. Help folks. An example of what we recently brought was a newer version of the stress test that's more accurate.

00:19:23:20 - 00:19:48:11
Unknown
So we're having a little less false positives, which is good for patients. You want your results to be, be as accurate as possible and we can get them out the door sooner. And so just being able to, to fine tune what we're doing, I think is what I'm excited about here is, provide the top of the line care to South Georgia?

00:19:48:13 - 00:20:04:20
Unknown
So where if you were to drive to Jacksonville, you're going to get the same thing that you're going to get here. That's what I want to be able to do. Yeah. Because when I came here, we were sending everyone out. We only had, you know, a couple of cardiologists. We didn't have any interventional cardiologists employed by SMC.

00:20:04:22 - 00:20:32:18
Unknown
And over the past seven and a half years, we've grown amazingly. And these cardiologists that are here now are amazing. Their skills are amazing. Their bedside manner are amazing. I'm feeding his ego right now, but they they really are like all of our docs. There's not any doc in our clinic that I wouldn't send my family to or have already sent my family to, and my family's kind of spread out amongst the clinic on who they see because of the time frames that they had to go see them.

00:20:32:20 - 00:20:54:14
Unknown
He wasn't here yet when some of them were seeing them. But, the bedside manner and the way that they treat their patients is why I continue to work here. And I tell him that a lot. We'll walk out of a patient's room and I'll say, that's why I work with you, because he sits down and takes the time to explain to patients everything they need to know to understand what they're going through.

00:20:54:16 - 00:21:14:21
Unknown
Even if we have a thousand other things to do there, they're only person that matters right then. And they feel that. And we hear that from our patients. And to me, that makes me proud. I think we have the best cardiology anywhere around. And I would tell everybody that I would there's no reason that I wouldn't come see any of these dogs.

00:21:15:02 - 00:21:35:00
Unknown
Yeah, I know, I myself. I haven't seen you in the clinic before. And, and then even my stepdad, I had him see you as well. And he ended up having to have some, stints and had some major blockages and things like that. So I do think that is the ultimate, compliment when you or your family members will use the same services.

00:21:35:00 - 00:21:54:10
Unknown
So we appreciate what you are bringing to the area so that people don't have to travel because it's already hard enough to be compliant, as we were talking about when it's right here and convenient. But then you add in that extra layer of having to travel hours away, then finances, stress. I mean, it's a lot to have to travel out of town.

00:21:54:12 - 00:22:15:10
Unknown
Yeah. So I think it's really cool. I feel like we're always doing a press release or a social media announcement about somebody. O'Neal's team, especially having the access to specialized heart care to now with electrophysiology and, the structural heart program. So a lot of really good things. Having them here is a huge help. I mean like 200 watchman's.

00:22:15:12 - 00:22:33:11
Unknown
Yeah, they just 200 Tavares. All those patients used to have to leave and to be able to do that here, to be able to spend the night in the hospital here rather than at a hotel somewhere else is great. And to provide this same quality of care is important, too. Yeah. And those aren't, you know, 200 procedures.

00:22:33:11 - 00:22:55:18
Unknown
It's 200 patients and 200 families have been affected. And that's just so wonderful that you can you can go sleep in your own bed, and be able to see your wife the next morning after her procedure is great. And I love that we see them in the clinic and the hospital because we follow their journey. And I had a patient this morning tell me that, like they don't, they love that we actually get to see the same docs.

00:22:55:18 - 00:23:14:11
Unknown
And if we're not in the hospital that week, when they're in the hospital, they see one of our docs and we all communicate about them. So we already know they're there. They'll say, hey, we have your patient, we're doing this, this and this, and if we have any input, then we give it. And it's great because the patient knows, because we'll always tell them if we're in the hospital, doctor, who knows you're here and you know or doctor knows you're here.

00:23:14:11 - 00:23:31:08
Unknown
We've already talked to them. And that makes them feel confident that their doc knows what's going on. Yeah. So I think it's a great thing when they're in the hospital because I'm sure that's so scary. So to be able to be like, okay, my dog knows what's going on and it's still, has a presence and is being communicated with.

00:23:31:09 - 00:23:58:07
Unknown
Is he looking at the bigger picture? What impact do you hope this hypertension clinic has on the future of the region for years to come? Yeah. You know, I, I hope that in every aspect I, you know, I think, that we can be the center for this region. So if you need help with high blood pressure, if you need help with a valve, we can help you with that.

00:23:58:08 - 00:24:20:07
Unknown
And our hope is to provide that care to where? It's, where we can be the place people think about when when they need help. That's all we want to do. I think that's all we have for you. Thank you so much for coming on. We really appreciate it. Thanks for having us. Thanks for having us. And you can tune in to our next episode and subscribe.

00:24:20:12 - 00:24:22:22
Unknown
SDM podcast.