I then cover compliance from a physician's perspective.

Ladies and gentlemen, welcome to the Morrissey Movement, the purpose of this podcast to discuss and share one aspect of fitness and one aspect of medicine. Being a general surgeon and a garage gym athlete, I have a strong passion for both of these aspects of life. So sit back and enjoy the show. This podcast is for entertainment purposes only. I am in no way forming a patient doctor relationship. All the aspects discussed in this podcast are medically accurate. You should always discuss with your doctor any questions that you may have about the content, you should always discuss with your doctor before starting any new exercise or dietary changes. Hey, what's going on everybody? It's Dr. Chris Morrissey back with another episode of The Morrissey movement. Hope everybody had a great and safe New Year, today's January 1 As of recording this. So the New Year 2022 has launched and so hopefully it'll be a better year than it was last year. So today, I felt this is kind of appropriate time to discuss this. Today's episode six, it's called appendix and all or nothing. So I'm going to discuss the history of an appendix and also what happens when you get your appendix removed, and then proceed into the all or none mentality when it comes to diet and exercise. Because this is the time of year when people join gyms with high hopes. And then things can get derailed very quickly. So I'm hoping that we can shed some light and kind of maybe change your mindset a little bit about what it's like to do training, as well as diet. And hopefully you can get and obtain your goals this coming year. So I'm going to start off with the medical portion today. So I'm gonna start off with the appendix. So the appendix is located down on the right side of your colon, which is kind of close to your right hip bone. The appendix averages about three, three and a half inches long in length, but it can be anywhere from two to 12 inches, it just kind of depends on the person, the diameter or the health how big across it is, is approximately about a quarter of an inch or so. And so anything over about half a half an inch is kind of considered thickened or inflamed. When we look at taking the appendix out. The longest longest appendix has ever been removed was approximately 10 inches long. This is per the internet, so nothing is ever falls on the internet as we all know. So again, it's usually located in the right lower quadrant of the abdomen, which again is near kind of the right hip bone area. The base of the appendix is located about two centimeters, or almost an inch beneath what's called the ileocecal valve. So that you'll have Ileocecal valve is what dumps where the small intestine connects to the large intestine or the small bowel connects to the colon. So its position within the abdomen can be kind of variable that can be located kind of pointing down into the pelvis, it can be pointing over towards the left side, it can actually be behind the colon, which is called retrocecal. So sometimes it makes it difficult to find the appendix especially in the old fashioned way that we used to take appendix is out. Nowadays, when we have CT scans in the laparoscope, we can usually find it. Sometimes it does take a while however. So the appendix is actually connected to the, what's called the mesentery in the lower region of the of the ilium. So your small intestine is broken down into three parts. So the first part is what's called the duodenal or duodenum, which comes right off the stomach. And then there's the jejunum, and ileum. So it's roughly 30, some feet of small intestine and then connects to your colon. There's a little blood vessel called the appendiceal artery that is located inside this little kind of fatty layer where all the blood supply a lot is located for the small bowel in the colon. So what is this thing? It's kind of been identified as a few different things. There is some literature that supports that it...]]>Unknown Speaker 0:04

Ladies and gentlemen, welcome to the Morrissey Movement, the purpose of this podcast to discuss and share one aspect of fitness and one aspect of medicine. Being a general surgeon and a garage gym athlete, I have a strong passion for both of these aspects of life. So sit back and enjoy the show. This podcast is for entertainment purposes only. I am in no way forming a patient doctor relationship. All the aspects discussed in this podcast are medically accurate. You should always discuss with your doctor any questions that you may have about the content, you should always discuss with your doctor before starting any new exercise or dietary changes. Hey, what's going on everybody? It's Dr. Chris Morrissey back with another episode of The Morrissey movement. Hope everybody had a great and safe New Year, today's January 1 As of recording this. So the New Year 2022 has launched and so hopefully it'll be a better year than it was last year. So today, I felt this is kind of appropriate time to discuss this. Today's episode six, it's called appendix and all or nothing. So I'm going to discuss the history of an appendix and also what happens when you get your appendix removed, and then proceed into the all or none mentality when it comes to diet and exercise. Because this is the time of year when people join gyms with high hopes. And then things can get derailed very quickly. So I'm hoping that we can shed some light and kind of maybe change your mindset a little bit about what it's like to do training, as well as diet. And hopefully you can get and obtain your goals this coming year. So I'm going to start off with the medical portion today. So I'm gonna start off with the appendix. So the appendix is located down on the right side of your colon, which is kind of close to your right hip bone. The appendix averages about three, three and a half inches long in length, but it can be anywhere from two to 12 inches, it just kind of depends on the person, the diameter or the health how big across it is, is approximately about a quarter of an inch or so. And so anything over about half a half an inch is kind of considered thickened or inflamed. When we look at taking the appendix out. The longest longest appendix has ever been removed was approximately 10 inches long. This is per the internet, so nothing is ever falls on the internet as we all know. So again, it's usually located in the right lower quadrant of the abdomen, which again is near kind of the right hip bone area. The base of the appendix is located about two centimeters, or almost an inch beneath what's called the ileocecal valve. So that you'll have Ileocecal valve is what dumps where the small intestine connects to the large intestine or the small bowel connects to the colon. So its position within the abdomen can be kind of variable that can be located kind of pointing down into the pelvis, it can be pointing over towards the left side, it can actually be behind the colon, which is called retrocecal. So sometimes it makes it difficult to find the appendix especially in the old fashioned way that we used to take appendix is out. Nowadays, when we have CT scans in the laparoscope, we can usually find it. Sometimes it does take a while however. So the appendix is actually connected to the, what's called the mesentery in the lower region of the of the ilium. So your small intestine is broken down into three parts. So the first part is what's called the duodenal or duodenum, which comes right off the stomach. And then there's the jejunum, and ileum. So it's roughly 30, some feet of small intestine and then connects to your colon. There's a little blood vessel called the appendiceal artery that is located inside this little kind of fatty layer where all the blood supply a lot is located for the small bowel in the colon. So what is this thing? It's kind of been identified as a few different things. There is some literature that supports that it being part of your mucosal immune function, particularly what's called B cell mediated immune responses. So you have kind of two main types of cellular immune responses, there's T cell and B cell and that's way above the scope of this discussion. So so it helps in the proper movement and removal of waste matter in the digestive system. It contains lymphatic vessels that can regulate pathogens or microbes. And lastly, it might even produce some early defenses to prevent more serious diseases. Additionally, it is thought that this may provide more immune defenses from invading pathogens and getting into the lymphatic system to fight viruses and bacteria.

Unknown Speaker 4:53

But it's still kind of up in the air whether this is all really happens or not. Some research also shows a positive correlation between the existence of appendix and concentration of SQL lymphoid tissue which supports that, not only does the appendix evolve as a complex with the cecum, but also has major immune benefits. So the appendix does have a few functions. And some people believe it's called a vestigial organ, which means that it's kind of has no function today, but it's evolved over millions of years of evolution. But, you know, some people don't really believe in that either. So, looking at history, back in 1735, Dr. Claudius Amyand performed the world's first successful appendectomy at St. George's Hospital in London. Per history, the patient was an 11 year old boy whose appendix had become perforated by a pin that he had swallowed. The first successful operation to treat acute appendicitis was performed soon after a 19. I'm sorry, in 1759 in Bordeaux. So, general anesthesia wasn't available until the mid 1840s. And so some of these operations basically, kind of was what they call hold still anesthesia where people will hold the patient down and will perform the procedure in an open fashion which is, you know, undoubtedly super painful. Surgical treatment for appendicitis began during the 1880s. Although doctors struggled to decide who should undergo the knife some patients who would recover on their own without surgery, surgical technique and anesthesia has significantly improved outcomes to such an extent that the surgery would rapidly became the gold standard approach. By the end of the 20th century, laparoscopic surgery replaced open surgery in most cases, and I'll get into that here in a little bit. And laparoscopic appendectomy is now considered one of the safest lowest complication surgical procedures that we perform today. According to one source. Despite the excellent track record, many questions about the appendix still persist. The cause of appendicitis is not 100% Understood. And we do not understand why the appendix will rupture in some people and recover and others. In 2007, researchers finally offer a compelling case for the function of the appendix, the tiny organ appears to play a role in both, again, digestive and immune function by acting as a storehouse for viable bacteria, which are enlisted when the GI tract loses its benefit. Sorry, beneficial gut flora. So that's a little bit of the history. Now as far as typical presentation of people that come into the emergency room most most commonly once in a great while, they'll show up in a primary care office with right lower quadrant pain or just generalized abdominal pain. So typically, if you read the textbooks, you'll begin having an adult kind of vague ache around the belly button region, and then it will eventually migrate down to the right lower quadrant. This is due to how you develop in utero where organs actually they start to you start off as a little ball of cells and then things actually stretch out and then different pieces of tissue turn into different organs and they're kind of take their place in the abdomen, and your at your intestines actually herniated come out through your bellybutton and spin on its axis and then actually track back down inside the belly button and then into the abdomen and take you know their place in your anatomic location. So, so yeah, typically, you know, vague abdominal pain around the belly button that goes down the right lower quadrant. Sometimes you'll have a fever, sometimes not. Sometimes you'll have nausea and vomiting, sometimes not. Sometimes they'll be diarrhea, sometimes there isn't. When they arrive in the emergency room, depending on the age of the patient, if it's a child, we typically try not to use CAT scan, since it does submit the patient to a lot of radiation, so we try to use an ultrasound first to find the appendix. If the appendix can be found with ultrasound, it is very specific for appendicitis. However, just because you can't find an appendix with an ultrasound doesn't mean that it's not there and then you're not having an issue with appendicitis. Most commonly, you'll get a CAT scan of the abdomen and the pelvis looking for inflammation around the colon as well as a thickened or sometimes perforated appendix. Typically award or lab work, sometimes you'll get what's called a C reactive protein or CRP which can be elevated in patients that have appendicitis, and usually have an elevated white blood cell count as well.

Unknown Speaker 9:33

Kind of how things happen most often either a small little piece of food will get stuck inside the appendix opening or a kind of a solid piece of stool. The appendix is actually a blind in pouch and it empties into the main main lumen have a colon so if some of them blocks this what happens is it secretes mucus and has a few immune functions like we talked about earlier. Well, if this is blocked, then there's no way for the whatever's inside the appendix, the bacteria and the mucus to get out. So what happens is it keeps doing its job like it's supposed to, and then you start getting bacterial replication. And so pretty soon now the appendix begins to swell. And then after a certain period of time, then the veins become congested, because the veins, you know, the veins take blood away from the appendix. And so once the outflow is obstructed, then it starts putting pressure on the artery. So then once the artery loses, you know, the inflow to the appendix, that's when you get what's called ischemia, where you lose blood flow to the Oregon and then ultimately suffer what's called a perforation or the the appendix bursts, so to speak. So you know, the textbooks will say, between presentation of pain and perforation or rupture is typically within 48 to 72 hours. However, in real life, I've seen it when people said they started hurting three to four hours ago, and they come in with a ruptured appendix. And other people stayed, they've been having abdominal pain for five days, and they still have early appendicitis with no signs of rupture. So it's kind of hard to delineate who is going to show up in this fashion so so once you know we get everything figured out with the diagnosis of appendicitis, typically we end up going to the operating room, and I almost routinely 100% Before my appendectomies laparoscopically. So what what does that mean? So you'll have an IV in your arm will start giving you fluids and IV antibiotics, and then we'll administer anesthesia, you'll get a tube placed in your throat and put on a ventilator. And then your abdomen will be paralyzed, so I can do my job. So then I'll make a small cut above your belly button. And then put an instrument called a trocar, in which is like a little sheath, and then connect it to a tubing and pump co2 into the abdomen or carbon dioxide to then expand the space, I'll have more room to work, then once this is inflated, then I'll place your bed in what's called Trendelenburg position, which is actually kind of put the head down and the feet up that way it kind of uses gravity to move the intestines out of the pelvis. And then what next I typically do is make another cut above the region where your bladder would be kind of above your pubic bone and put another trocar or a sleeve inside. And then another one in the left lower quadrant kind of about partway between the hip bone and the belly button. And this one's typically a little bit larger of a trocar that way that'll accommodate the stapler, so I can staple off the appendix. So what happens next is will roll you to your left side a little bit, and then find the appendix sometimes just sitting there ready to be grasped at the time it takes some digging and dissecting to find it. Once I find it I'll kind of lift it up towards the front of your body. And then there's a little thin membrane at the bottom of the appendix where it attaches to the colon. And then I'll make a little window with an instrument called a Maryland a sector which kind of looks like a compare needlenose pliers. And then we use a staple gun, put a staple gun right along the base of the appendix snug up against the colon and fire that so there's a little stapler that fires and a little knife that cuts and then take down the artery and then put it in a little bag and pull it out through the hole on the left side. And then kind of go back inside and look around maybe irrigate if there's been any spillage control, any bleeding if there is bleeding, and then release all of the gas that was pumped into your abdomen and then remove the three little ports. And then all the stitches are under the skin that usually that'll dissolve on their own in a few months and then you'll just wake up as a medical superglue. So if it all goes nicely like that, then it can be almost an outpatient procedure depending

Unknown Speaker 13:33

on the time of day this is done. I usually tell people you're off work a week, sometimes it's three days, sometimes it's 14 days, it just kind of depends. But now if we get in there and it's so nasty that it's stuck and we can't visualize the structures we need to see sometimes we'll do it in an open fashion. But typically, once we've started laparoscopically, we'll typically do a moat a low midline laparotomy incision. So basically taken knife from underneath the bellybutton straight down to the above the pubic bone. And we have to put our hands in there and kind of do it the old fashioned way. Traditionally, old school open appendectomy is kind of a blind procedure. So they typically make a cut in the right lower quadrant, kind of at an angle, and then go through each layer of the abdomen. So you go through skin and go through fat, then you get to a few layers of muscle, and you kind of split the muscles with an instrument and you go in and kind of find the appendix with a little grasper or a clamp and pull it up and then you either tie it off or use a staple gun or whatever you're have at your disposal to remove the appendix. So that was the old fashioned way to do it. Now, there is some literature out there currently, that does suggest that you can manage this without surgery with just IV antibiotics. There has been some studies done in the pediatric population. You know, it's kind of deemed as one of the safer procedures that we can do so typically, you know, yes, I'm a surgeon but I would just advocate to take it out because on average, you're out of the hospital faster and recovery is quicker. And you know, you Never say always, never say never and medicine but you should never get appendicitis again and if it is removed properly and correctly the first time, once in a great while the entire appendix isn't removed which is called a subtotal, appendectomy, and you can get what's called stump appendicitis if the little remnant of the appendix is left behind, but that's super rare. So, really, that is kind of the the jest of everything now, there is a great once in a while, where if the appendix has already perforated or ruptured, and actually as an abscess cavity formed, we'll do what's called a CT guided drainage so usually send you to interventional radiology. And they'll numb up your skin and and place a really skinny drain tube into the abscess cavity, and then drain that out. And then there's, you know, discussion of whether you do what's called an interval appendectomy later on, which means that you come in as an outpatient, and they get this removed electively, some people do this some people don't it depends on medical comorbidities, it depends on the age of the person. And there's a lot of variables that goes into this as well. Now there is a small subset of people that can get what's called chronic appendicitis, which is basically just it kind of gets irritated here and there and just kind of has a smoldering kind of intermittent right lower quadrant pain and everything else that's been done, all the other workups endoscopy and other procedures can't ever really find the source. So sometimes we'll go in and take someone's appendix out electively to try to alleviate the right lower quadrant pain. And typically, in my practice, more often than not, it does take care of that. But that's kind of as a last resort. And only if we can't figure anything else out, sometimes we'll offer that as a procedure as well. So so that's really kind of the spiel on the appendix part. And now, I'm going to kind of shift gears and go into the all or none mentality and spend a little bit of time talking about this, especially this time of year. You know, in January is kind of the most common time for people to either buy a new gym membership, or they're going to get in shape, or they're going to diet, or you buy some sort of whatever the new sexy workout equipment is on Facebook or on Instagram or on TV or on the internet that you see that you'll use for a few months, and it becomes a expensive coat hanger in your room or in your garage or in your home office wherever you decide to put it. Now since COVID hit I feel there's probably more people doing more workouts at home, instead of going back to the gym. Now some people I know did kind of build a home gym for a while, but then they went back to the gym, as soon as everything was open back again with it, pandemic, but there's still probably a good majority of people that decided they like working out at home better, me included, I'll probably never go back to a gym again, because I love working out of my garage. But anyway, that's neither here nor there. So So again, when it comes to working out and with diet and exercise, there's so many people that I see the get into the what's called the all or none mentality. So basically, kind of what happens is, you know, people will set a goal for themselves, that, you know, you have to work out at least an hour, or you have to burn this many calories and an exercise session or you have to do, you know, spend a certain amount of time doing each exercise for the week. And then what will happen is, is if you have to cut it short for life, or your job or something like that, or you have to skip for whatever reason, then all of a sudden now you think, Well, you know, it's only Monday, but my week is wrecked. You know, I'm just going to scrap everything I'm not going to work out i'll just restart again next Monday.

Unknown Speaker 18:22

So, you know, sometimes we'll just do that just by missing one session. Sometimes, you know, if your didn't get a lot of sleep, if you had to stay up all night, kind of depending on whatever is going on in your life, that you just kind of scrap it it's like I'm you know what, why should I even try, which is the complete opposite of what you should be doing. So if you kind of think about it, this is a silly example but it's kind of like if you lost $1 out of your wallet, then you just throw the whole thing away in the trash regardless of how much money and credit cards are left in there. Or if you get a flat tire you're like well screw it I'm just gonna slash the other three tires because one is wrecked I might as well wreck the whole thing which is completely ridiculous...]]>b00b6a4b-a2ef-4036-9e2b-cfb108e53c92Sat, 01 Jan 2022 00:00:00 -060029:37nofull6Christopher A Morrissey, DOEpisode 5 - Who is this guy??Unknown Speaker 0:04

Ladies and gentlemen, welcome to the Morrissey movement, the purpose of this podcast to discuss and share one aspect of fitness and one aspect of medicine. Being a general surgeon and a garage gym athlete, I have a strong passion for both of these aspects of life. So sit back and enjoy the show. This podcast is for entertainment purposes only. I am in no way forming a patient doctor relationship. All the aspects discussed in this podcast are medically accurate. You should always discuss with your doctor any questions that you may have about the content, you should always discuss with your doctor before starting any new exercise or dietary changes. Hey, what's going on everybody? Dr. Chris Morrissey here for episode five. So hope everybody had a Merry Christmas and is going to have a safe and happy new year. We had a great Christmas at our house. My kids got way too much stuff. But anyway, they had a good time everybody is healthy. So that was great. So I thought I would change up my format a little bit typically I know I do medical and fitness type of stuff. But I just figured since I've actually made up to five episodes. Now. I'm just going to give you just kind of my little rendition of about me, and there's some of that on my website, but I decided to give a quick little podcast it won't be a typical long one like some of the other ones have been just to kind of tell you who I am and where I come from. So I'm just going to jump right into this. So I was born and raised up in Phillipsburg, Kansas, which is the kind of upper corner of the state to the west, where we are about like 10 miles south of Nebraska border and about three to four hours east of Colorado. I grew up in a small town of about 3000 people went to grade school, junior high and high school there. I was a multi sport athlete. I played basketball, football, I wrestled in junior high I was also on the track team. I loved sports, loved being in the weight room and I got in there anytime that I could. So I had a early start to fitness and athletics in my life and it just continued through the rest of my life pretty much so once I graduated high school, I ended up going to Fort Hays State University which is a division two school at the time. I was lucky enough that I received a track scholarship and I was a sprinter for one year at Fort Hays State. I ran the 100, 200 meters also ran the four by one and four by four relay. So I really enjoyed that. I'm glad I got the opportunity to do that. Unfortunately, I was plagued with injuries. Actually my senior year in track, I pulled my hamstring at our home meet in the 200 meter dash preliminaries. And I was pretty much done for the rest of the year I tried to come back but I never could really fully sprint again. And then during my college career, I had strained hamstrings and groin muscles off and on. So I decided to hang up the spikes after a year of doing that it just wasn't fun anymore. And I was hurt more than I was healthy. So I decided to focus on other things. So still love the opportunity that I had. I wouldn't change it for anything but so then I decided to pursue physical education with an athletic training emphasis. So I was a student athletic trainer for four years, I was a trainer for the track team, the basketball team, I did football as a junior, and then cross country and other sports here and they're accumulating approximately 1500 hours of observation and work. On top of having two other jobs in college. I actually worked at Applebee's, where I actually met my wife that I'm still married to 22 years later, and also worked in trade home shoes in the mall. So I usually worked both jobs on the weekends and a few times during the week if time allowed. But so, up until about April of my senior year, I thought I always wanted to be an athletic trainer. So I have a fairly good background in sports medicine to start with. Dan, I decided that I felt I wanted to do a little...]]>Unknown Speaker 0:04

Ladies and gentlemen, welcome to the Morrissey movement, the purpose of this podcast to discuss and share one aspect of fitness and one aspect of medicine. Being a general surgeon and a garage gym athlete, I have a strong passion for both of these aspects of life. So sit back and enjoy the show. This podcast is for entertainment purposes only. I am in no way forming a patient doctor relationship. All the aspects discussed in this podcast are medically accurate. You should always discuss with your doctor any questions that you may have about the content, you should always discuss with your doctor before starting any new exercise or dietary changes. Hey, what's going on everybody? Dr. Chris Morrissey here for episode five. So hope everybody had a Merry Christmas and is going to have a safe and happy new year. We had a great Christmas at our house. My kids got way too much stuff. But anyway, they had a good time everybody is healthy. So that was great. So I thought I would change up my format a little bit typically I know I do medical and fitness type of stuff. But I just figured since I've actually made up to five episodes. Now. I'm just going to give you just kind of my little rendition of about me, and there's some of that on my website, but I decided to give a quick little podcast it won't be a typical long one like some of the other ones have been just to kind of tell you who I am and where I come from. So I'm just going to jump right into this. So I was born and raised up in Phillipsburg, Kansas, which is the kind of upper corner of the state to the west, where we are about like 10 miles south of Nebraska border and about three to four hours east of Colorado. I grew up in a small town of about 3000 people went to grade school, junior high and high school there. I was a multi sport athlete. I played basketball, football, I wrestled in junior high I was also on the track team. I loved sports, loved being in the weight room and I got in there anytime that I could. So I had a early start to fitness and athletics in my life and it just continued through the rest of my life pretty much so once I graduated high school, I ended up going to Fort Hays State University which is a division two school at the time. I was lucky enough that I received a track scholarship and I was a sprinter for one year at Fort Hays State. I ran the 100, 200 meters also ran the four by one and four by four relay. So I really enjoyed that. I'm glad I got the opportunity to do that. Unfortunately, I was plagued with injuries. Actually my senior year in track, I pulled my hamstring at our home meet in the 200 meter dash preliminaries. And I was pretty much done for the rest of the year I tried to come back but I never could really fully sprint again. And then during my college career, I had strained hamstrings and groin muscles off and on. So I decided to hang up the spikes after a year of doing that it just wasn't fun anymore. And I was hurt more than I was healthy. So I decided to focus on other things. So still love the opportunity that I had. I wouldn't change it for anything but so then I decided to pursue physical education with an athletic training emphasis. So I was a student athletic trainer for four years, I was a trainer for the track team, the basketball team, I did football as a junior, and then cross country and other sports here and they're accumulating approximately 1500 hours of observation and work. On top of having two other jobs in college. I actually worked at Applebee's, where I actually met my wife that I'm still married to 22 years later, and also worked in trade home shoes in the mall. So I usually worked both jobs on the weekends and a few times during the week if time allowed. But so, up until about April of my senior year, I thought I always wanted to be an athletic trainer. So I have a fairly good background in sports medicine to start with. Dan, I decided that I felt I wanted to do a little bit more as far as more in the medical field. So I started looking at my options. I looked at PA school. I looked at physical therapy. I looked at a few other entities and then I decided you know what, I'll just give med school a try. We'll see what happens. So I graduated my undergraduate degree, bachelor's degree in physical education with athletic training. And then that summer, my wife and I actually got married and then we moved from Hays up into a small town of Clyde, Kansas which is close to Concordia.

Unknown Speaker 4:52

And I ended up taking prerequisites for medical school. And at the same time I found a job at Republic county hospitals and nurse's aide and also did some on the job training of respiratory therapy eventually. But that's where I got my start into medicine really, I took two years of prerequisite classes at Cloud County, including inorganic and organic chemistry, also physics one and two, I did microbiology also. And then I went to K State for a year and took a few different classes, I took genetics, which I needed for medical school and also biochemistry, and took a few other classes for fun. Still worked almost full time while doing that. And then I had to take the dreaded MCAT exam, which is completely different now that compared to what it was the medical school admission test. I did fair on that, and applied to medical school that, for that following fall, I was actually lucky enough that I received a letter of acceptance from at the time it was called the University of Health Sciences. And then the name change to Kansas City University of Medicine and biosciences while I was there, and actually now it has changed names again. So now it's is called Kansas City University. So both my acceptance letter and my diploma is actually worthless now because those schools don't exist anymore. But anyway. So once I finished medical school, I actually started off doing wanting to do family practice, thinking that I would get to do a lot of different entities. Based off my experience, replica Republic County Hospital, however, it was during a march of my third year where I did a trauma surgery month. And actually, that was the turning point. For me. It was actually the second to last day of my rotation, I got lucky enough to go the operating room, there was a gunshot wound to the chest and abdomen, and an 18 year old kid drug deal gone bad. So I got to go back and watch that. And that really opened my eyes and turned me on to surgery and critical care. So I actually that day changed my mind. And so I finished my third year medical school. And then I actually took a year off and spent a year at back at my Kansas City at the KCM be to do a osteopathic medicine fellowship. So I spent one year of school learning extra and teaching and doing more things with manipulation. So I know I alluded to this on a previous podcast of a difference between MDS and DEOs that I spent another full year just working on this skill, which I'm totally glad that I did it, I wouldn't change that either. So I use that quite a bit of my practice today. Then once my fellowship was over, then I went back to my fourth year where we had to do what are called audition months. So you basically kind of figure out where you want to train. And then you go do rotations at the hospitals you would like to do your train training at in those specialties. So for me, you know, I ended up doing general surgery. So I went up into the Michigan area, and ended up training at Genesis Regional Medical Center up in Grand Blanc, Michigan, had some fantastic preceptors there. And I thought it was one of the better training programs in the Midwest, especially being an osteopathic training program. So I loved my time up there. So I spent a full five years up there doing general surgery. And then I started looking for jobs about no the middle of my fourth year. And then I signed a contract for the current hospital than a mat which is Republic County Hospital. I'm sorry, I forgot to ask. Well, I William Newton hospital down in Winfield, Kansas. So I've been here since I graduated, which is approximately nine and a half years ago. It's definitely been a roller coaster of emotions and experiences. But it's been great. Taking a little bit of backtracking. Once my wife and I were married, we ended up adopting two of her nieces shortly after we got married. And long story on that for a different day. But so we raised them as our own plus, we also ended up having two children in a short timeframe as well. So by the time I started medical school, we had four kids, three girls and a boy. And then during residency, we ended up having one of my other sons Dominic. So and then we decided to have one more so then we had six during residency and then we moved down here we ended up having three more kids. So it's definitely been again, a whirlwind of different things, but it's been great. I love my family. I love my job for the most part on those days. So that's pretty much my medical background up to now since graduating though, and since being down here.

Unknown Speaker 9:43

As a physician, we don't really learn very much about exercise and sleep and diet. When we're in medical school. We may get a few lectures but not very much so I've actually taking on a lot of extra classes and courses and a lot of self teaching Through research and learning way more about fitness. So I actually, once I graduated residency, I was overweight, my diet was terrible. I'm five, eight, and I was weighing about 215 pounds. I just felt awful most of the time secondary to eating crappy fried food and living on sugary energy drinks as a resident trying to function and make it through. So once I came here, I decided I need to do something and get back into exercise. So basically, for five years, I didn't know exercising at all, other than buzzing through the hospital running up or down stairs, doing different things throughout residency, so I decided I needed a diet first. So I will cover diets on a couple different podcasts itself. But for me, what I ended up doing I did what was called the 17 day diet. And basically what that entails is there's four different cycles, each cycle, as you guess, based off the name and 17 days, and I ended up losing, I don't know, about 3035 pounds in three or four months without really doing much exercise. And then I was kind of trying to figure out what I wanted to get into. And I came across CrossFit. And I thought that sounded pretty awesome. So I started building my garage gym, and started off with getting a squat rack and a set of weights off of Facebook marketplace or something, I think and then slowly but surely, I began building my gym. And it is now fairly full, I have a two car garage that is pretty much packed to the gills with equipment. And I also have an outdoor rig that's 15 foot on one side and approximately 10 foot on the other side. So I have a climbing rope outside, as well as a wall ball target and then three to four pull up bars around the rig, I also have a pegboard that's mounted to one side of it as well. So about any workout that I need to do, I can get done at home, which is awesome. So I dabbled in CrossFit for a couple of years, just found a couple different websites to get workouts from, and then ended up stumbling across a garage gym Athlete Program, which are what I still currently do. So I started that back in 2017, I believe. And I made tremendous progress from that. So again, not a sponsor whatsoever. But if you're interested, go ahead and check them out at www dot Koco garage gym athlete.com You actually get two weeks for free to see if you like it. And then after that there's a bunch of different tracks you can jump on. So it's been phenomenal for me. So I encourage anyone looking for some sort of program that you don't really have to even think about, they just send it to you and you do all your stuff. It's totally worth your time. So then once I got into Garage Gym Athlete, I've pretty much been faithful to that. And I've done different tracks on their program. But I made tremendous gains and progress. And I'll talk about a few the different things that I've done on different podcasts as well. But I just really found myself and that's kind of my go to place when it's been stressful. Or I just need to get away, I'll go out to the garage gym for about an hour and get all my work done and just feel much better after the fact. So that's kind of my, my hobby, so to speak. So by Yeah, it's been great. Anyway, that's pretty much my story other than I was gonna also say some of the things that I did so during the beginning of the COVID pandemic, I actually got my personal trainer certification through is ISSA. And I'm currently finishing up a health coaching program through there. I've also just spent a ton of time reading different books on nutrition and sleep, learning more about these. And I've also started doing a functional medicine fellowship, which is basically, in a nutshell, talk about how healing through food and exercise and really focus on the pillars of health, including sleep and nutrition, and exercise. So that's been a nice journey for me as well. So I'm currently trying to finish that fellowship up. So hopefully I'll get that down within another year or so. And planning on implementing that in my practice. So I'm also working on trying to get a personal training side hustle going. So in the future, once I finish everything for that I'll definitely be dabbling in that as well, trying to find a few other more things for me to do.

Unknown Speaker 14:26

Anyway, I think I'm going to stop with all of that, and I'll delve into some more things later on. But thanks again for listening. You know, like I said was the fifth episode, I wasn't sure how much of this I would do. I did spike quite a few listeners, which is awesome. And if you feel like you want to give a rating, please give up to five star rating and let me know how you're feeling about the show. And also please feel free to email me at any time. And I would love to tackle any topics if anybody would like to. I would be more than happy to do that. You know, I've got kind of a list created about things I'm going to talk about but eventually I'll probably start running out of things and I'm gonna have to start repeating or going into things that people would like to be answered and talk about. So, anyway, thanks a lot for listening today and again, the My email is the Morrissey movement@gmail.com. Please feel free to give me an email and I'll definitely hit you back. And remember, movement is medicine.

Transcribed by https://otter.ai

Ladies and gentlemen, welcome to the Morrissey movement, the purpose of this podcast to discuss and share one aspect of fitness and one aspect of medicine. Being a general surgeon and a garage gym athlete, I have a strong passion for both of these aspects of life. So sit back and enjoy the show. This podcast is for entertainment purposes only. I am in no way forming a patient doctor relationship. All the aspects discussed in this podcast are medically accurate, you should always discuss with your doctor any questions that you may have about the content, you should always discuss with your doctor before starting any new exercise or dietary changes. Hey, what's going on everybody? Welcome back to the Morrissey movement where movement is medicine. This is episode three. So the title of this episode is called gear and gallbladders. So hopefully it's gonna be another good show. I appreciate everybody downloading and listening to my previous podcasts. And again, if you feel like you can give a rating please do so so we can reach more listeners. Before we get started. I'm going to just give a quick little shout out to our sponsor of the week, which is called Dad Life Tees. I'm actually the CFO of this company, my brother and I formed a little dad life T Shirt Company. So if you're are a dad or you have a dad and you'd like to get a t shirt, feel free to go to our website at www.dadlifetees.com. There's quite a few pretty cool products on there that you can get your hands on. So anyway, we'll go ahead and get started with the show today. So I'm going to start off with talking about gear first. Even though in the previous podcasts I've done the medical aspect first. So today I'm going to review some of the different fitness type of gear that one could purchase and use. The ones that I'm choosing to talk about today are the Garmin watches. I'm going to go over a few of the different kinds of watches and all the different functions that you can get on these type of equipment. I'm also going to talk about the Apple Watch, the Oura ring and also the whoop. So I have actually used all of these products except for the whoop so I am just going to basically talk about what it entails but I have no personal experience. And again, these are all my own entities and not my entities my own experiences with these products. So I'm going to talk about kind of the differences in them and give you my opinion at the end of which ones I feel are better. So I'm gonna start off with the Garmin watch. So the company a Garmin Ltd was established back in 1989 by a guy named Gary Purell with someone else named Min k. O. K O as makers of GPS devices for aviation and automobiles. They later decided to expand their GPS for sports and wearable technology to the point where they're best known for their activity trackers and smartwatches. The reputation has grown over the last many years to where they compete with more established companies such as Fitbit and apple. Fitness watches have a number of fitness sensors and features for recording steps taken monitoring your sleep monitoring your heart rate and many more things. So some of the Garmin watches that are going to kind of be briefly talked about today is the four runner series, the Vivoactive series, the vivo move, HR, the vivo fit and the Phoenix. So one website that I had was looking at these different things. They read it the top five Garmin watches as the Garmin Forerunner 35 The Garmin vivo HR GPS smartwatch, the Garmin vivo three GPS smartwatch, the Garmin instinct rugged outdoor watch with GPS, the Garmin vivo move HR sport hybrid smartwatch. And I'm actually going to add one which is the Garmin Phoenix, I actually have the Garmin Phoenix six Pro which has a solar charger on this as well. So I'm going to give a few brief different little qualities of each of these watches. So the Garmin five four runner three, I'm sorry 35 Watch. It'll check your heart rate from your...]]>Unknown Speaker 0:04

Ladies and gentlemen, welcome to the Morrissey movement, the purpose of this podcast to discuss and share one aspect of fitness and one aspect of medicine. Being a general surgeon and a garage gym athlete, I have a strong passion for both of these aspects of life. So sit back and enjoy the show. This podcast is for entertainment purposes only. I am in no way forming a patient doctor relationship. All the aspects discussed in this podcast are medically accurate, you should always discuss with your doctor any questions that you may have about the content, you should always discuss with your doctor before starting any new exercise or dietary changes. Hey, what's going on everybody? Welcome back to the Morrissey movement where movement is medicine. This is episode three. So the title of this episode is called gear and gallbladders. So hopefully it's gonna be another good show. I appreciate everybody downloading and listening to my previous podcasts. And again, if you feel like you can give a rating please do so so we can reach more listeners. Before we get started. I'm going to just give a quick little shout out to our sponsor of the week, which is called Dad Life Tees. I'm actually the CFO of this company, my brother and I formed a little dad life T Shirt Company. So if you're are a dad or you have a dad and you'd like to get a t shirt, feel free to go to our website at www.dadlifetees.com. There's quite a few pretty cool products on there that you can get your hands on. So anyway, we'll go ahead and get started with the show today. So I'm going to start off with talking about gear first. Even though in the previous podcasts I've done the medical aspect first. So today I'm going to review some of the different fitness type of gear that one could purchase and use. The ones that I'm choosing to talk about today are the Garmin watches. I'm going to go over a few of the different kinds of watches and all the different functions that you can get on these type of equipment. I'm also going to talk about the Apple Watch, the Oura ring and also the whoop. So I have actually used all of these products except for the whoop so I am just going to basically talk about what it entails but I have no personal experience. And again, these are all my own entities and not my entities my own experiences with these products. So I'm going to talk about kind of the differences in them and give you my opinion at the end of which ones I feel are better. So I'm gonna start off with the Garmin watch. So the company a Garmin Ltd was established back in 1989 by a guy named Gary Purell with someone else named Min k. O. K O as makers of GPS devices for aviation and automobiles. They later decided to expand their GPS for sports and wearable technology to the point where they're best known for their activity trackers and smartwatches. The reputation has grown over the last many years to where they compete with more established companies such as Fitbit and apple. Fitness watches have a number of fitness sensors and features for recording steps taken monitoring your sleep monitoring your heart rate and many more things. So some of the Garmin watches that are going to kind of be briefly talked about today is the four runner series, the Vivoactive series, the vivo move, HR, the vivo fit and the Phoenix. So one website that I had was looking at these different things. They read it the top five Garmin watches as the Garmin Forerunner 35 The Garmin vivo HR GPS smartwatch, the Garmin vivo three GPS smartwatch, the Garmin instinct rugged outdoor watch with GPS, the Garmin vivo move HR sport hybrid smartwatch. And I'm actually going to add one which is the Garmin Phoenix, I actually have the Garmin Phoenix six Pro which has a solar charger on this as well. So I'm going to give a few brief different little qualities of each of these watches. So the Garmin five four runner three, I'm sorry 35 Watch. It'll check your heart rate from your wrist during the day and the night making use of the Garmin elevate wrist heart monitor technology. It has GPS which tracks your speed, distance and the place where you run. It has features such as smart alerts, live tracking music controls, and direct and automatic uploads to Garmin Connect which is Garmins tool for tracking your fitness activities. I track your movement throughout the day, such as the number of steps you take the calories that you consume, and gives you the reminder to move if you're idle for too long. It automatically uploads your information to the Garmin website to display your progress and also let you set your fitness goals. So that is the

Unknown Speaker 4:57

that is the Garmin For runner 35 Watch sorry about that. The next minute is briefly talked about as the Garmin Vivoactive HR GPS smartwatch. So this has high resolution touchscreen that can read even in the sunlight the screen resolution is 205 by 140 pixels. This can be used for tracking, biking, running and swimming even without a smartphone. This allows you to select the watch face from a wide range of styles. You can also download apps from the Garmin control IQ store. It also sends you alerts to your smartphone. The next one is Garmin Vivoactive three GPS smartwatch. The physical dimensions of this device is 43.4 by 43.4 by 11.7 millimeters. It'll fit on the wrist sizes from 127 to 204 millimeters, the screen resolution is 240 by 240 pixels. It has more than 15 pre loaded pre loaded GPS has sports apps, it can also measure oxygen consumption and has a stress monitor. The next one is a Garmin instinct rugged outdoor watch with GPS. This is built to be like a military grade specifications and has thermal shock and water resilience to withstand the elements. It provides smart notifications and as a global satellite navigation capability. It also features a three axis compass and a barometric altimeter, and a number of global navigation satellite systems that can track your heart rate activity and stress reminding you to keep up your pace than the last one that was reviewed on the website that I chose to use as the Garmin vivomove HR sport hybrid smartwatch. It's more of a traditional watch, Facebook gives you fitness information, and alerts by means of the touchscreen. It checks your heart rate monitor sleep count steps and measures calories burned. It gives you stress alerts over the course of the day reminding you to take a break from the action. It also allows you to share data and compete with other people via the Garmin Connect app. So the final verdict based off this website, talking about Garmin fitness watches are a popular and convenient innovation to make fitness training easier. Before making a decision, you need to determine what you really need or what options that you really want. I'm going to add to the final part of this, which is the Garmin Phoenix six, I feel it was the most data tracking watch. There's multiple different preloaded workouts that are on here. There's a walk, there's run, there's like a CrossFit style hit. There's treadmills there's bike, indoor bike, outdoor, there's open water swim, there's pool swim, there's strength, there's cardio, you can also build multiple workouts within the Garmin Connect app itself, I have a free a few pre loaded workouts on here that I will use from time to time, especially some different runs, you can actually pre program it. So it'll tell you, if you want to do intervals, it'll tell you to stop, it'll tell you to start, it'll keep track of your of your distance. And then once you're all done, you can go into the Garmin app and it does a whole lot of different things such as stride breakdown, it'll tell you the percentage, the amount of time you're using your right leg versus your left leg, it'll give you your lap intervals. So it'll give you your average mile time. It'll give you your specific mile time, if you're doing multiple mile runs. It'll talk about the elevation, how high you went up, it'll give you temperature, it'll give you your average heart rate. It'll also track your different zones of running, which is zones one through five, which I'll cover on a different podcast in the future. So me personally, having used an Apple Watch, which is I'm going to review here in just a second versus the Garmin watch, I feel the Garmin watch is has much more data than the Apple Watch actually tracks I also use a Garmin pro heart rate strap. So if I'm going to go out doing any type of running, or any type of other cardio events, I always wear my heart my chest strap because it's more accurate, especially if you're running in heart rate zones and it just keeps track of more data for you. I feel that it's better in my opinion. So the Apple Watch which I was also an Apple Watch user for quite some time until I recently switched to Garmin within the last year or so. So the Apple Watch has a ton of different functions also. And I'll go through some of these that I retrieved from the internet just so I didn't forget anything. So the heart rate monitor. It's both has an optical and an electrical heart rate sensor. Pairing these two offers great accuracy anytime you need it. The Apple Watch will constantly monitor your heart rate and let you know if there are any abnormalities either high or low beats per minute.

Unknown Speaker 9:41

There's an EKG feature on there which will actually take a small rhythm strip of your Apple Watch. So if you're having any type of symptoms, which is like pounding in your chest or it feels like your heart is skipping beats or having palpitations, you can actually do a little EKG rhythm strip this data can actually be sent to your doctor if he had to set up with them to make decisions about your health. Now again, this is not by any means replacing any type of medical grade equipment to monitor your heart rate. But this is something that can be helpful for people, especially if they do have a history of palpitations of their heart or a condition called atrial fibrillation. So the Apple Watch is designed to pick up on this only it will not actually analyze any other cardiac rhythms such as ventricular tachycardia, or supraventricular tachycardia, svt, or any type of those other medically alarming heart irregularities. There's also the Apple Watch six added up blood oxygen monitoring. So you can actually monitor the oxygen level in your blood, which is measured in a percentage in your heart and your red blood cells. It's fairly accurate, but again, does not take the place of any type of medical grade monitoring devices. There's also a really cool feature called fall detection. So if you have a sudden fall while wearing your Apple Watch, it'll send a notification to a designated SOS contact on your phone to let them know that you might need help. Moreover, if you don't respond, after 60 seconds, the watch will automatically call the police and share your location. Though this could also be on the con list in case you set it off by accident. I actually read an article about a year ago about a physician that his father was in his 70s I believe he's out mountain biking somewhere in the mountains. And he actually did have a fall. And the Apple Watch actually saved his life by detecting this and sending a alert to him and also to the police where they're able to come and find him after he fell off his bike in the mountains. So that's pretty cool. Also, sleep tracking. There's a separate sleep app on your on your Apple Watch, it allows you to create a bedtime schedule that will reflect your sleep goals. However, you do have to wear the watch over night, which can be good, it can be bad, you can track your night's sleep. I actually feel this is not that great of a feature. And I'll go into more detail about this in a little bit. But it is an option. However, with the Apple Watch, you do kind of have to charge your watch every night. So it would make it difficult to monitor your sleep. Also, you have to wear your watch while you sleep, which I find is kind of annoying. So that's just another option for you though. Supposedly, this will not affect me. But you can track your menstrual cycle with the Apple watch for those people that do min straight. So again, I do not. The Apple Watch has an app to monitor your cycles that are recorded symptoms like cramps, headaches, and fatigue. And you can use this information to build up a prediction when your symptoms will return and your ovulation window if you're trying to conceive, monitor noise levels, there's a built in microphone on the Apple Watch to listen to ambient sounds and levels in decibels via the noise app. It'll tell you if anything goes beyond what is healthy for your hearing. If you're using headphones a lot, it'll automatically turn the volume down at a point in time where continuing with the volume at the level you had could start causing damage. There's a hand washing feature, which you can have a 22nd hand wash counter which is on the Apple Watch. Also, things to the Coronavirus, the Apple Watch can detect if you're starting to wash your hands and will encourage you to continue for a minimum of 20 seconds. It'll also remind you if you haven't to wash your hands shortly after arriving home, which is kind of a cool feature. Some of the other smart features on the Apple Watch phone calls you can actually receive and or even make phone calls from your Apple Watch without being near your phone. On the cellular models with Wi Fi modes, you would need your phone in your pocket or have it nearby to make calls. You can also read and reply to text messages including emails, which is kind of cool. You can use voice to text pre loaded responses or if you have the patient's using the pad you can type or write responses one letter at a time which is again in this day and age kind of annoying. The other thing you can kind of do you can do with your with your Apple Watches, you can do Apple Pay. So there's a contactless payment option. That's even more convenient. Since Apple Pay was released, you don't even have to get out your phone out of your pocket, you can simply call your card up on your watch display.

Unknown Speaker 14:28

Hold it near a card reader, though this does require the passcode to be enabled. Another cool thing you can do with your Apple Watch is you can unlock your MacBook if you have one. So it does pair nicely with Apple products. I actually have a MacBook but I've never used this feature. So I don't know how well this works. But for other people it actually works really well which is kind of cool. If you have Apple TV, you can use your watch as an Apple Remote to run and turn on your Apple TV. iPhone camera remote, you can also use your eye watch as a remote switch for your iPhone. So if you want to take photo, you can set up a timer so it'll automatically go off so you don't have to set that up on your phone. You can also monitor the battery life. On other devices. If you have an Apple ecosystem, you can actually monitor your devices like air pods, or Beats headphones. It'll do it via Bluetooth and give you the battery status. There's also another kind of cool feature which is a walkie talkie feature. You can pick a friend that has an Apple Watch and set up a walkie talkie feature to send voice notifications automatically that'll play on the others watch, unless they have a silent feature set up, you can tell your person any type of messages that you would like to do if you choose to do so you can also control smart appliances in your home from your Apple Watch. Excuse me, if you have an Opel, I'm sorry, a HomeKit enabled devices are gone. You can control it with your Apple watch things like smart plugs, lights, heating blinds, cameras, garage doors, you name it, this is another cool feature that you can do. One of the probably coolest features of the Apple Watch is the Find your iPhone. If you're like me, and you set your phone down and you have no clue where you left it, you can use your Apple Watch to ping your phone. And it'll flash and make noise. So you're able to easily find this, which is really nice. There's an always on display. So you can set it up to where your Apple Watch is always on. But you can also set it up to shut it off after a certain amount of time if it is inactive. If your kids actually have an Apple Watch, which none of mine actually do, but there's a school time feature that you can actually set it up for hours of school so that it's not disturbed and can't distract them and completely limits the features in the app so they can have access to but you can still send them a text and get ahold of them if needed. You can also get the time in more ways than just visually use either the traditional visual form or sound and Pat and haptic. Of course using the sound gives you a chime the lateral vibrate in a certain pattern with no sound and without needing to wake up the display. If you happen to know Morse code, so does the Apple Watch so you can actually have it tell you what time it is in that fashion. You can also use Siri with your Apple Watch with built in commands so you can do virtually anything with Siri. If it's set up to your other devices, you can connect to a Bluetooth speaker with your Apple Watch. So if you happen to have music stored on your phone, or I'm sorry on your Apple Watch you can actually play it in via bluetooth speaker. You can also see in the dark with this there's a an LED flashlight that you can turn on on your Apple Watch. It's pretty neat if you're happen to be in a room without your phone you can turn on the bright LED light and be able to see what you're doing. There's also location sharing which the Apple Watch you can use to kind of see where you are in the map if you share your GPS location with a friend that also has an Apple Watch, they can see this on their Apple Watch maps. There's also a compass there's also an elevation built in altimeter to to kind of tell you where you're if you're ascending or descending. It's also water resistant. So I believe it's up to 100 meters if I remember right. So you can go swimming with this and also can can you can track your swimming if you're doing some type of workout. So those are kind of all the pros that are listed but the Apple Watch the cons. It is expensive, you know runs around $400 It only works with iPhones. So if you're a Samsung person or Google phone or something like that, you really can't use your Apple watch for that. The battery life it's roughly 17 to 18 hours so you do have to charge it every day. Which is sort of annoying. You can get interchangeable bands they are somewhat expensive. With that so so that's the Apple Watch. Like I said I was a big apple watch user for a while. However I have switched to Garmin, the Apple Watch was nice to it communicates with your iPhone, way better than the Garmin does. It streams music you

Unknown Speaker 19:19

can do all the texting everything like I listed above. So the Garmin, the Garmin Phoenix six that I have it does not locate your iPhone very well streaming music this is not very good for this either. So those are kind of my biggest complaints about the Garmin watch is that your compatibility with your iPhone is not nearly as sexy and nice as the high watches. So if you're not really a big data person, and you love it to function with your iPhone, I would say an Apple Watch is probably better in this instance but if you're wanting way more data on your exercise and workouts, I would say Garmin is superior to this. Now another thing I'm going to cover today is the aura rang, which I actually have also, I have probably had the aura ring for approximately a year and a half I did by the generation two and when it was, was my first aura ring. And they reached recently upgraded to the aura ring generation three, which is a little bit...]]>52ead94b-de67-4526-a157-74d5f1218e7bFri, 10 Dec 2021 00:00:00 -060051:44nofull3Christopher A Morrissey, DOEpisode 2 - DOs and DOMSUnknown Speaker 0:04

Ladies and gentlemen, welcome to the Morrissey Movement, the purpose of this podcast to discuss and share one aspect of fitness and one aspect of medicine. Being a general surgeon and a garage gym athlete, I have a strong passion for both of these aspects of life. So sit back and enjoy the show. This podcast is for entertainment purposes only. I am in no way forming a patient doctor relationship. All the aspects discussed in this podcast are medically accurate. You should always discuss with your doctor any questions that you may have about the content, you should always discuss with your doctor before starting any new exercise or dietary changes. Hey, what's going on everybody? This is Dr. Chris Morrissey here with another episode of The Morrissey movement. For those of you that listen, thank you so much feel free to leave any type of feedback that you feel is necessary. So this is episode two. So today I decided to discuss a few different topics. The medical topic for the day is actually going to be the differences in physicians meaning MD versus DO me being an osteopathic physician or a do I've been asked that throughout my career as far as what are the main differences? So I thought I'd spend some time kind of discussing this and maybe giving some light on the subject for people that don't know. And then the fitness aspect I'm going to talk about is what's called Dom's or delayed onset muscle soreness, because there's a lot of controversy of what this actually is. So I felt I would talk about these two things today. All right, so let's get started. So as far as talking about MD versus DO so an MD or a doctor of medicine or an allopathic physician versus a DO which is a doctor of osteopathy or osteopathic physician. So as far as an allopathic physician goes the, the word allopathic comes from the Greek aulos, meaning opposite and Pathos, meaning to suffer. So the phrase of allopathic was coined by the German physician Samuel Hahnemann, which I may have not said that correctly back in the 1800s is roughly refers to treating a symptom with its opposite. So an example would be if you're constipated, you would give someone the laxative, so you're kind of doing the opposite of what it would be. So if you have hypertension or high blood pressure, you're going to give a medicine that will make your blood pressure go down or an anti hypertensive. So that is the kind of the rough definition of allopathic osteopathic actually is a branch of medical practice that emphasizes the treatment of medical disorders through the manipulation of massage of bones, joints and muscles. So, in general terms allopathic physicians are thought to have focused on treatment of disease whereas osteopathy traditionally refers to treating the patient and not the disease. So where did osteopathic medicine come from? There was a Dr. Andrew Taylor still, who actually was an MD. Back in the late 1800s. He was the very first osteopathic physician in the United States. He had lost a few of his children to disease, one with pneumonia and one from like cholera, dysentery or something like that. And he just felt that modern medicine was failing. So we actually took about eight to 10 years sabbatical from medicine and studied the human body more intensively on an Indian reservation. So throughout his studies, he discovered that the spinal cord was more intimately related to the organs than previously thought. So he came up with the idea of manipulating the spine in order to alleviate pain and some diseases. Thus, osteopathy was born. The first osteopathic medical school was actually opened in Kirksville, Missouri, which is actually a fairly small town. I think today, they may have a Walmart and a few other things and then a medical school. So he actually migrated there from Baldwin, Kansas, so you can actually stay that osteopathic medicine was created in Kansas. As far as schooling go, there are approximately 155 accredited MD...]]>Unknown Speaker 0:04

Ladies and gentlemen, welcome to the Morrissey Movement, the purpose of this podcast to discuss and share one aspect of fitness and one aspect of medicine. Being a general surgeon and a garage gym athlete, I have a strong passion for both of these aspects of life. So sit back and enjoy the show. This podcast is for entertainment purposes only. I am in no way forming a patient doctor relationship. All the aspects discussed in this podcast are medically accurate. You should always discuss with your doctor any questions that you may have about the content, you should always discuss with your doctor before starting any new exercise or dietary changes. Hey, what's going on everybody? This is Dr. Chris Morrissey here with another episode of The Morrissey movement. For those of you that listen, thank you so much feel free to leave any type of feedback that you feel is necessary. So this is episode two. So today I decided to discuss a few different topics. The medical topic for the day is actually going to be the differences in physicians meaning MD versus DO me being an osteopathic physician or a do I've been asked that throughout my career as far as what are the main differences? So I thought I'd spend some time kind of discussing this and maybe giving some light on the subject for people that don't know. And then the fitness aspect I'm going to talk about is what's called Dom's or delayed onset muscle soreness, because there's a lot of controversy of what this actually is. So I felt I would talk about these two things today. All right, so let's get started. So as far as talking about MD versus DO so an MD or a doctor of medicine or an allopathic physician versus a DO which is a doctor of osteopathy or osteopathic physician. So as far as an allopathic physician goes the, the word allopathic comes from the Greek aulos, meaning opposite and Pathos, meaning to suffer. So the phrase of allopathic was coined by the German physician Samuel Hahnemann, which I may have not said that correctly back in the 1800s is roughly refers to treating a symptom with its opposite. So an example would be if you're constipated, you would give someone the laxative, so you're kind of doing the opposite of what it would be. So if you have hypertension or high blood pressure, you're going to give a medicine that will make your blood pressure go down or an anti hypertensive. So that is the kind of the rough definition of allopathic osteopathic actually is a branch of medical practice that emphasizes the treatment of medical disorders through the manipulation of massage of bones, joints and muscles. So, in general terms allopathic physicians are thought to have focused on treatment of disease whereas osteopathy traditionally refers to treating the patient and not the disease. So where did osteopathic medicine come from? There was a Dr. Andrew Taylor still, who actually was an MD. Back in the late 1800s. He was the very first osteopathic physician in the United States. He had lost a few of his children to disease, one with pneumonia and one from like cholera, dysentery or something like that. And he just felt that modern medicine was failing. So we actually took about eight to 10 years sabbatical from medicine and studied the human body more intensively on an Indian reservation. So throughout his studies, he discovered that the spinal cord was more intimately related to the organs than previously thought. So he came up with the idea of manipulating the spine in order to alleviate pain and some diseases. Thus, osteopathy was born. The first osteopathic medical school was actually opened in Kirksville, Missouri, which is actually a fairly small town. I think today, they may have a Walmart and a few other things and then a medical school. So he actually migrated there from Baldwin, Kansas, so you can actually stay that osteopathic medicine was created in Kansas. As far as schooling go, there are approximately 155 accredited MD schools in the United States currently versus 37 accredited Do schools across the country both do an MD is you have to have an undergraduate degree. For the most part, there's a few early decision programs but for the most part, you have to have some sort of undergrad degree. And actually this can be in anything. It's a common misconception that all physicians have to be biology or chemistry majors. You know, what I recommend to people is do something you love. So if your loved music and you want to get a music major, you just have to take the prerequisite courses to get into medical school but you do not have to be a science bachelor's to get into medical school. So then once you go through medical school, you do typically four years of that and then you move on to residency anywhere between three to eight years depending on your area of focus.

Unknown Speaker 4:50

So during medical school do is actually learn OMM or osteopathic manipulative medicine or OMT, which is osteopathic manipulative therapy. You learn it for the first two years of medical school. So we typically begin by focusing on physical assessment, learning how to assess the spine searching for any type of dysfunctions or differences in the tissue. As we fill in our hands. We then learn how to attempt to correct any of these dysfunctions through a variety of ways, including myofascial release, which is basically firm pressure on different areas to try to get the tissues to relax. There's triggerpoint type therapy, there's a therapy called muscle energy, which is actually like a resistive type treatment. And there's also the ever popular hvla Or you know, the cracking backs and necks, which you kind of, most people have at least heard of, or seen that before. So anyway, after the first two years of classroom work, then we all go to rotations for third and fourth year, going through different areas of specialties. So typically, most of the time, you have two months of Internal Medicine, two months of Family Medicine, two months of surgery, two months of arms are one month of OBGYN one month of Pediatrics, one month of Psych and then some sort of elective, and then the fourth year is focused on your desired specialty. So about half of the fourth year is going to be in different programs trying to make a good impression on places where you would like to train at a particular facility. This is somewhat of a working job interview so to speak. Once you have to decide what kind of field of medicine you go into, which can very be very difficult to sometimes then once you get this figured out, then you go through a process called the match. This is where you basically decide what program you want to train in, you know in what certain city or state or hospital system. And then you basically make a list going from favorite to least favorite. And then the programs that you are choosing also do the exact same thing with his applicants. And then it goes through some sort of random computer algorithm. And then hopefully you get what you wanting to do. So this is a fairly stressful process because it's a lot of unknowns. And you feel like you have really no control over where you're going to end up. When you're looking at MDS versus DOs. They can be any type of physician. Traditionally, back in the day, osteopathy was primarily focused on family practice. However, there are deals in every single specialty in medicine, me myself and I, you know, I'm a general surgeon. So this is obviously an issue or, I mean a a specialty selection. But there's family medicine, there's gi radiology, emergency room, ENT, cardiothoracic surgeons, etc. I'm sure a lot of you have actually seen it do in your lifetime. And maybe you didn't realize this is what you had me growing up personally, up in Northwest Kansas, all of our hometown positions were DOs. And I had no idea there was even a difference until I started really looking at applying to medical school. If I had to venture a guess only about 10% or so of do is actually performed the manipulation. You some people just don't feel comfortable doing it. I actually utilize this in my practice, I would say around eight to 10% of my patients that I see is only for manipulation. So I thoroughly enjoyed doing it. And I've helped a lot of people with it. There are so many forms and uses of manipulation. So if you're having certain ailments that aren't being addressed or improving, seeking out someone that does manual therapy may be a benefit from you. However, you know, it has its specific place in medicine. Can it cure cancer? Absolutely not. It's just simply one tool in your bag that you can use to try to alleviate symptoms. There were times in history that deals were actually viewed as inferior to MDS. This was kind of true mid 1900s or so. Sometimes, osteopaths are lumped into alternative medicine, holistic medicine and so on. Now, there are so many different types of medicine that's warranted. So back in California, I know for instance, DOs were not recognized as physicians so they could actually buy their MD license for some fee like $500 or something. So they weren't even allowed to practice in the state of California. But today, most the time, they're looked at as equals. In other parts of the world, they are not recognized as fully licensed physicians in the UK, for example, DOs are viewed the equivalent of chiropractors, which you know, chiropractic medicine was developed separately from osteopathy. Our views and training compared to chiropractors are different as well as our approach to patient treatments. Sometimes I will use the term chiropractor just to make it easier for patients to understand what type of manipulation I'm going to be performing, since most people are more familiar with chiropractors versus osteopaths. So, that's kind of a brief rundown of the differences.

Unknown Speaker 9:42

Again, like I said, I'm sure you've seen both types of positions in their lifetime, you just may not have realized that so. So that is the medical component for today. Now I'm going to move on to the fitness component, which is somewhat sort of overlap with medicine as well. So I'm going to talk about this arms, which is delayed onset muscle soreness. So I have a few different reference guidelines that I use off the internet. The first one comes from medicine net. So basically, any exercise can cause delayed onset muscle soreness when you start a new routine, or increase the intensity. But exercises that require the eccentric muscle contraction in particular are more likely to cause Dom's. So I'm going to refer to it as Dom's throughout the rest of this discussion, since it's easier to say than delayed onset muscle soreness. Eccentric attraction of an exercise is basically the muscles slow load against gravity as the muscles being lengthened. So an example a few examples of eccentric muscle contraction would be bicep curl, which most people can understand the visual visualization of that. So the as you're bringing the bar from your hips up towards your shoulders, that is going to be the concentric or the shortening of the muscle, and then the eccentric portion is going to be lowering the weight slowly from the shoulders down back to the hips. A few other examples is going to be downhill running, because the quads are being forced to lengthen and brace against gravity, downward motion in squats, or the downward motion and push ups. Also, if you're looking at doing a pull up as you lower yourself back towards the floor, that is another example of eccentric. So like I said, concentric on the other hand, as when you're shortening the muscle. essentra contraction is actually more efficient way than concentric contraction to exercise a muscle because it uses less energy to work harder. Though beneficial eccentric contraction is also more likely to produce Dom's because it places more stress on the muscle. So what exactly is this that I'm talking about delayed onset muscle soreness, so basically, it is the muscle pain you feel after a workout. It does not occur during the workout but typically starts the day after maybe a few days later peaks after 24 to 72 hours and start seizing up after that it can last up to five days and anything longer is not normal. What is the main cause, you know, it's usually a combination of microscopic tears in the muscle fibers that result from a workout and the muscles response to repair the damage. So you get little tiny muscle tears when you stretch your muscles more than they're used to or in a newer different ways. So if you have been primarily a runner or did a lot of circuit training, and then you go to a bodybuilding style approach or even maybe CrossFit, your muscles are not used to reacting that way. The muscle tissue then releases enzymes to repair the tears in the tissue which results in inflammation and soreness. Contrary to belief. lactic acid buildup can cause pain during a workout, but this is not the source of Dom's. Lactic acid builds up when the muscle does not get enough oxygen to break it down, which causes cramping and muscle fatigue. The pain typically goes away within a few hours with rest and hydration unlike Dom's, which can last much longer. It can happen to anyone regardless of fitness levels. When the muscles are challenged in a way they are not accustomed to even elite athletes can develop Dom's when they start training after a break, or when they increase their training intensity. So I'll use myself in this example I was doing on my garage, gym athlete workout protocols. I was doing one that primarily focused on squats and running it was called BCT. And we basically squatted three days a week and ran three days a week and I was on this circuit for approximately six months. And then I decided to go a different route. So then I started going back to more of a concurrent training model which was well, the BCT was concurrent training also but it was focusing mainly on lower body. So then I went back to normal and so I started doing quite a bit of pull ups and I feel I got Dom's in my lat muscles because I've been doing pull ups for like six months and then when I got back into these, I was sore for probably five to six days and it just hurt to do everything so I'm sure some people can relate to what this feels like. Is Dom's a good sign. muscle soreness is commonly equated with a good workout but Dom's does not need to always be there to be a good sign soreness does indicate that the muscle has been worked, which encourages and motivates you to continue with the activity but it also is important to be aware that how much of soreness says beneficial if it makes you to sort of carry on through daily activities, it's

Unknown Speaker 14:15

probably a little bit too much. muscle strength grows with exercise even if you do not feel soreness so once you get accustomed to the work that you're doing, you may not be getting as sore as you used to before. Excessive or persistent soreness is detrimental to muscle recovery and can in fact be negative effects that you are looking for an exercise and may affect your athletic performance. If you ignore this persistent soreness can also damage the capacity of the muscle to repair and grow stronger. Is it okay to work out through Dom's? Yes it is some soreness from Dom's is temporary and it's perfectly fine to work out through these as long as the ache is moderate in nature. Keeping those muscles active in fact has been official because it improves blood supply and speeds up healing. You can do General exercises like walking or swimming until the soreness subsides or rest for a day or so if the activity increases the pain, one of the things I'll typically do is and all the dresses and different podcasts but some zone to running which is basically others five heart rate zones. Zone two is like, you know, you can keep a conversational pace that's, you know, fairly low intense in nature, but it does help with blood flow and can also you know, build your cardiovascular base, but that'll be a separate podcast topic for in the future. How can you prevent Dom's? It may or may not be possible to prevent those, but you can reduce the severity by gradually increasing the intensity when you start a new exercise routine. Warming up before and cooling down and stretching after an intensive workout can greatly help in relaxing the muscles and reduce soreness. So the biggest thing I you typically see is people go from being fairly sedentary nature, and all of a sudden, you know, they're on Instagram and they see, you know, Rich Froning, his new workout or some sort of superstar CrossFit athlete that has been doing this for a long time and you just get this kind of all in mentality. And you go from not doing much to doing a whole lot and then you can barely walk for a week and then you kind of go back to the way you work because you did not like how that made you feel. So this is one common Miss conception or mistake people make when they go into training. varying your daily routine by cross training with exercises that engage different groups of muscles may be another good way to handle Dom's. Again, it gives your muscles a chance to recover between workouts without really disrupting your training. A few other aspects that is super important for this is eating a very nutritious diet that includes all groups of foods that help muscles heal. Also adequate hydration with electrolytes before during and after workout may help minimize this as well. So now what happens if you get this so how do I treat this? Dom's usually does not require treatment it typically goes away on its own. Again the best thing for Dom's is to keep those muscles moving unless the pain is intolerable. Other things that can help reduce Dom's include gentle massage, which may help increase blood flow, you can use a foam roller they can help loosen up knotted muscles, wearing compression clothing, which many athletes say improves blood flow and reduces pain. Although there's really no conclusive evidence or studies for this that I've seen. Applying ice packs can numb the nerve endings to the muscle that may help a little bit alternating between hot and cold showers. topical application of pain really bombs like Icy Hot or Asper cream or some sort of thing like that may be beneficial. Current research suggest non steroidal anti inflammatory drugs or NSAIDs such as aleve or Motrin are not really effective for Dom's. Further preventing inflammation with NSAIDs is self defeating the purpose of the exercise because inflammation is the central process in which makes our muscles grow and get stronger. Now if you get to the point where the pain is super bad, you may need to see a physician. So a few key things you may see is if the pain is completely unbearable, if you're paying last longer than a week, you have swelling in your arms or legs and your urine becomes really, really dark despite adequate hydration, which may be a sign of a term called rhabdomyolysis, which is very, a very severe condition that needs immediate medical attention. So I'm going to kind of go through another there's this is off of pain science.com. This is a Paul Ingram is a gentleman that took a deep dive into Dom's. It's the biology and treatment of muscle fever quote unquote, which is another word for Dom's. The deep muscle soreness that suggests or I'm sorry, that surges 24 to 48 hours after an unfamiliar exercise. So he kind of goes through so this is termed muscle fever, which is a distinctive muscle pain that nearly everyone experiences after intense or unfamiliar exercise. It's often called Dom's, as you said before, the biology of it kind of remains unclear, we really don't know. And there's really no way to cure like I said before, this kind of goes through different reasons of why and I'm going to skip over a lot of this because a lot of...]]>8c8c1d9b-946d-4a81-a1fb-8103ffdf63a6Sun, 05 Dec 2021 00:00:00 -060025:11nofull2Christopher A Morrissey, DOEpisode 1 - The 2 Cs: Colonoscopies and Concurrent TrainingLadies and gentlemen, welcome to the Morrissey Movement, the purpose of this podcast to discuss and share one aspect of fitness and one aspect of medicine. Being a general surgeon and a garage gym athlete, I have a strong passion for both of these aspects of life. So sit back and enjoy the show. This podcast is for entertainment purposes only. I am in no way forming a patient doctor relationship. All the aspects discussed in this podcast are medically accurate. You should always discuss with your doctor any questions that you may have about the content, you should always discuss with your doctor before starting any new exercise or dietary changes. Alright, what's up everyone? Welcome to the pilot podcast the Morrissey movement. I'm your host, Dr. Chris Morrissey. In this first episode, I will cover a few separate topics. The purpose of my podcast is to convey information in one aspect of medicine and one aspect of fitness. One thing I plan on not covering is the topic of COVID. I feel there is much info out there right now. So I'm not going to be talking about this at all on my show. Why is this called the Morrissey Movement, I thought this would be a great name for my podcast for a few reasons. First, I believe movement is medicine. The more we move, the more we can help augment our health and possibly decrease in disease simply by moving. Second, I have six sons, as well as three daughters. So the Morrissey name is going to be around for quite some time. So it's like we're trying to take over the Midwest. Third, I am trying to convey the importance of moving in day to day living and we'll try my best to educate as many people as I can. The term movement is sometimes used in reference to a revolution. So there is that aspect as well. So in this first episode, I'm going to discuss a couple different things. First off, I'm going to talk about colonoscopies and the importance of doing these and also the fitness aspect I'm going to cover as concurrent training. So starting off with a colonoscopy. What exactly does this mean for me? A colonoscopy is an exam that is performed by a general surgeon, or a gastroenterologist or sometimes family medicine physicians. It is a flexible tube that is typically three to four feet long, and that is inserted into the patient's rectum and goes all the way over through the entire colon over to an area what's called the terminal ileum, which is the end of the small intestine, where it inserts into the large intestine or the colon. The main reason to have this performed is to screen for colon cancer. But there are multiple other reasons to have this test performed including but not limited changes in bowel habits, blood in the stool, abdominal pain,and inflammatory bowel disease. The great thing about a colonoscopy is that you get direct visualization of the entire colon. But also multiple interventions can be performed if a polyp or a little small mass is detected. polyps can be removed with a bunch of different devices. Something like a snare, which is like a little wire lasso looking apparatus. There's also cautery and there's also pincher forceps that you can just grasp and remove the little piece of tissue if you need to. Another common question Will the procedure hurt? Usually it doesn't. When you arrive at the hospital, you usually get an IV at the beginning of your day, you will then go to the endoscopy room and receive some sort of anesthesia. At our hospital we perform this procedure under what's called propofol, which is a general anesthetic to put you to sleep just enough so you won't remember anything but you can still breathe on your own. Once you are indeed asleep, the scope will begin. Someone may ask when should I have this done. The current recommendations are if you have no family history of colon cancer and have no health issues, the age of 50 is when you start getting these done. However, in recent years, as in within the last year, it is actually recommended at 45. But...]]>Ladies and gentlemen, welcome to the Morrissey Movement, the purpose of this podcast to discuss and share one aspect of fitness and one aspect of medicine. Being a general surgeon and a garage gym athlete, I have a strong passion for both of these aspects of life. So sit back and enjoy the show. This podcast is for entertainment purposes only. I am in no way forming a patient doctor relationship. All the aspects discussed in this podcast are medically accurate. You should always discuss with your doctor any questions that you may have about the content, you should always discuss with your doctor before starting any new exercise or dietary changes. Alright, what's up everyone? Welcome to the pilot podcast the Morrissey movement. I'm your host, Dr. Chris Morrissey. In this first episode, I will cover a few separate topics. The purpose of my podcast is to convey information in one aspect of medicine and one aspect of fitness. One thing I plan on not covering is the topic of COVID. I feel there is much info out there right now. So I'm not going to be talking about this at all on my show. Why is this called the Morrissey Movement, I thought this would be a great name for my podcast for a few reasons. First, I believe movement is medicine. The more we move, the more we can help augment our health and possibly decrease in disease simply by moving. Second, I have six sons, as well as three daughters. So the Morrissey name is going to be around for quite some time. So it's like we're trying to take over the Midwest. Third, I am trying to convey the importance of moving in day to day living and we'll try my best to educate as many people as I can. The term movement is sometimes used in reference to a revolution. So there is that aspect as well. So in this first episode, I'm going to discuss a couple different things. First off, I'm going to talk about colonoscopies and the importance of doing these and also the fitness aspect I'm going to cover as concurrent training. So starting off with a colonoscopy. What exactly does this mean for me? A colonoscopy is an exam that is performed by a general surgeon, or a gastroenterologist or sometimes family medicine physicians. It is a flexible tube that is typically three to four feet long, and that is inserted into the patient's rectum and goes all the way over through the entire colon over to an area what's called the terminal ileum, which is the end of the small intestine, where it inserts into the large intestine or the colon. The main reason to have this performed is to screen for colon cancer. But there are multiple other reasons to have this test performed including but not limited changes in bowel habits, blood in the stool, abdominal pain,and inflammatory bowel disease. The great thing about a colonoscopy is that you get direct visualization of the entire colon. But also multiple interventions can be performed if a polyp or a little small mass is detected. polyps can be removed with a bunch of different devices. Something like a snare, which is like a little wire lasso looking apparatus. There's also cautery and there's also pincher forceps that you can just grasp and remove the little piece of tissue if you need to. Another common question Will the procedure hurt? Usually it doesn't. When you arrive at the hospital, you usually get an IV at the beginning of your day, you will then go to the endoscopy room and receive some sort of anesthesia. At our hospital we perform this procedure under what's called propofol, which is a general anesthetic to put you to sleep just enough so you won't remember anything but you can still breathe on your own. Once you are indeed asleep, the scope will begin. Someone may ask when should I have this done. The current recommendations are if you have no family history of colon cancer and have no health issues, the age of 50 is when you start getting these done. However, in recent years, as in within the last year, it is actually recommended at 45. But to my knowledge, not every insurance is on board with this yet. So typically it's the age of 50. However, if you have a family history of colon cancer, then you need to get a scope at the onset 10 years prior to the person that was diagnosed. So for instance, if your dad had colon cancer at the age of 40, you should get a screening colonoscopy at the age of 30. And so on.

Unknown Speaker 4:10

When should I have a repeat colonoscopy? This depends a lot of what we find during your scope. So if your first colonoscopy is negative and you have no family history of colon cancer, then the current recommendation is we should do this every 10 years. If you do have a family history of colon cancer and there is nothing that is found in your scope or it is considered negative then you should have it done every five years. If a polyp is found, then there are different variables that come into play with this. There are different types of polyps that can be found. One is called hyperplastic, which accounts for approximately 50% of all polyps found in the rectum in the sigmoid colon. These are benign lesions that virtually never turned a cancer. There are three types of what are called adenomas that can also be found. Tubular adenomas account for approximately 80% of all adenomas that are found inside The colon, they have approximately five to 10% potential to become a cancer. If these are left alone and nothing is done with them to below villus adenomas have about a 20% risk of becoming a malignancy. And the third type which is called villus adenoma is have about a 40 to 50% chance or risk of developing into a malignancy. Low Risk polyps include one or two small what are called sessile polyps that are less than 10 millimeters in size. And if they don't have any cellular changes, which is referred to as dysplasia, or changing of the cells, the follow up bench should be within five to 10 years depending on what is found. High risk polyps include three to 10 tubular adenomas in one single colonoscopy, at least one tubular adenoma greater than 10 millimeters in size, or at least one adenoma with a villus type features or what is called high grade dysplasia, meaning the cells have a high degree of change. Follow up colonoscopy then should be done at three years or less.

Unknown Speaker 6:03

What can happen during this colonoscopy, there are a few complications with any medical procedure that can be occurring during this procedure. There can be heart and lung issues due to anesthesia. During the actual colonoscopy, there can be bleeding after a polyp is removed, which is typically seen at approximately seven to 10 days. When your bowel movements get back to normal. There can be a missed lesion, which is why the prep is the most important part of the procedure. The prep is done the day before the procedure so that the colon is cleaned out in order for the endoscopy to be able to see the entire colon during the procedure. There can also be a perforation of the colon, which usually happens of cautery is used to remove a polyp that may require an operation to repair. This risk is very rare that occurs less than 1% of each colonoscopy that is performed. While the thought of a colonoscopy is not appealing to all, it is one of the best preventative tests we have available in medicine, because it can be both diagnostic and therapeutic. So diagnostic meaning we can actually diagnose a problem and therapeutic meaning we can actually treat it at that time. There is always someone who knows someone that had a bad experience, people also tend to get on the internet and look up things and end up going down some sort of negative rabbit hole and get a whole lot of bad information. So just be careful what resources you look at when you're doing your research. At the facility where I perform these, I typically tell my patients that it's approximately about three hours out of your day, it is usually about an hour before the procedure is boarded for. So if you're supposed to have your colonoscopy performed at eight o'clock, you usually show up at around 7am Or you'll get an IV, then the anesthesia provider will talk with you go through going through your medical records and ensuring everything is safe to proceed. Then once the procedure is underway, it is typically boarded for an hour at our facility. However, it very rarely takes that long. There's a lot of variables, including how good the prep is, how easy it is to get through the colon, some people have more sharp curves and bends than others. How much work the endoscopy is has to perform as far as removing multiple polyps, or how easy it is to transition through the colon. So if you're around that age ever go get a colonoscopy is actually not that bad, I'm probably going to have to have mine done here in the next few years. Even though I am 45 and have no family risk factors, I'm still probably going to go ahead and proceed to get this done. So now that the medicine part is finished, I'm going to go ahead and move on to the fitness aspect of today's talk. So I'm going to start off with something which called concurrent training. So the definition of this as the combination of resistance and endurance training, and a periodized program to maximize all aspects of physical performance. There are many aspects that can negatively affect performance, including volume, intensity, duration, and also more importantly, hydration, nutrition and sleep. So you may have heard the bro science kind of big back in the 80s and 90s, that cardio or endurance will kill your gains. You either are a strength athlete, or you're an endurance athlete, but you can do both. So there's actually been numerous articles in the last, I don't know 5-10 years and studies to disprove this old line of thinking. So there's one paper I'm going to quote, the title of the paper is endurance training induced increase in muscle oxidative capacity without loss of muscle mass and younger and older resistance trained men from the European Journal of Applied Physiology. This was actually done November of 2021. So basically, the summary of this study, it was actually fairly small in nature, they took eight younger athletes that were in their 20s or early 30s and compared them to older athletes that were in their 60s or 70s. There's actually only seven subjects in this group, and they performed a 10 week endurance cycling program and the actual training program they had five six minute intervals at 75% of their maximum heart rate separated by four minute intervals and 90% Maximum heart rate. So after performing these

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workouts, then they would get MRIs and they would analyze the anatomic cross sectional area of the thigh muscles. And then also they ended up getting biopsies of what's called the vastus lateralis muscle which your quadricep muscles or your thigh muscles, actually, there's four separate muscles, and they're taking biopsies at the outer of the outer thighs. And so the results at the very end of this study basically stated that, by adding resistance training, and endurance training together can actually lead to positive endurance related adaptations without any negative consequences to muscle size and strength and older and younger resistance train people. So I actually use concurrent training in my everyday training, and I have noticed a tremendous difference. Since I've been doing this, I've been using this type of training program for approximately three to four years, and I have had increase in strength and also increase in endurance. So my mile time has dropped down pretty significantly. And I've gone up on all my lifts, including deadlift, back squat, and strict press and also bench press. So I can say that this type of training works. Now not everyone will get the same results. Not everyone has the same goals. Some people are mainly strength focus, some people are mainly endurance focus. But if you read a lot of the current literature on any type of program strength, or endurance, there's always the opposite. That is usually added in at least once or twice a week. So in running programs, you'll typically see at least one or two days per week of some sort of strength training and or cross training exercises to better increase the athletes capacity to perform different tasks is actually another study that I looked at, to discuss concurrent training. So this one is entitled the compatibility of concurrent aerobic and strength training for skeletal muscle size and function. This is a meta analysis and systematic review. So the background of this, both athletes and recreational exercises often perform relatively high volumes of aerobic and strength training at the same time. However, the compatibility of these two distinct training mode modes remain unclear. So the objective of this study that they performed was, it was a systematic review that they looked at the compatibility of both aerobic and strength training, just compared to strength training alone in terms of adaptations and muscle function, including maximum and explosive strength and also muscle mass. They also had a subgroup analysis that they conducted to compare training modalities, training types, exercise order, training, frequency, age and training status. So the methods they use there was a systematic literature search. That they use what's called the Prisma guidelines, which is preferred reporting items for systematic reviews and meta analysis. This is on PubMed Medline, they looked between August 12 2020, all the way up to March 15 2021. So as far as the population goes, they use healthy adults of any age and sex intervention, they use supervised concurrent aerobic and strength training for at least four weeks. And they are comparing the comparison was identical strength training prescription with no aerobic training, the outcome of maximal strength, explosive strength and muscle hypertrophy. So the results of this, there's a total of 43 studies that were included. And their conclusion that they found after all this literature review is that concurrent aerobic and strength training does not compromise muscle hypertrophy and maximum strength development. However, explosive strength games may be attenuated, especially when you're using aerobic and strength training performed in the same session. These results appear to be independent of the type of aerobic training frequency of concurrent training, training, status and also age. So you know, the old school way of thinking has actually been proven by science that you can indeed do aerobic training as well as resistance training and seek gains in both areas. As I'd said before, you know, the program that I typically use, being a garage gym athlete, actually is called garage gym athlete so they're not a sponsor. This is just where I get my training programs from. So if you're interested, you can go to garage gym athlete calm and check them out. The last thing I want to talk about just something random that I found on the internet a month ago or so ago, I tend to kind of go down some rabbit holes when getting up in the morning and looking online at various things.

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You know, I was on the interwebs one morning and you know, when you will sing a song and you think the lyrics go a certain way. And that's actually incorrect. Well, there's actually a word for that, which I had no idea before this, it's actually called a monda green. The definition is a miss hearing or misinterpretation of a phrase in a way that gives it a new meaning. So mondegreens are most often created by a person listening to a poem or a song, the listener being unable to clearly hear what the Lyric is. And they substitute words that sound similar and make some tries to make some sort of sense of what it is. So, some of the examples that I found growing up that I've heard over the years so number one, the song by starship, the we built the city song there's a part in the song that says my Cody plays the mamba, listen to the radio. My thought was Who the hell's Cody and why is he playing the mamba? But actually, the correct lyrics is Marconi plays the mamba, listen to the radio. So if you're interested in that there's actually a whole website dedicated to this starship band. And I spent like 15 minutes reading about this and sort of lost a few brain cells reading it. But anyway, it's kind of fun to read. So anyway, the second one, the song by CCR Creedence Clearwater Revival. So the lyrics that I thought they were saying is that there's a bathroom on the right. But actually, they are saying there's a bad moon on the rise, hence the title of the song. Bad Moon Rising. So again, I was incorrect on that. There's also another song by warrant on the very first album from back in the day, dirty, rotten, filthy, stinking rich. It's the lyrics that I thought they were his 32 pennies and a right good time. However, they were stating 32 pennies in a Ragu jar, which to me makes absolutely no sense. I think you could probably have a really good time with only 32 cents but who knows. And the last one that I'll talk about is sung by Elton John called Tiny Dancer, which it always sounds like he says, Hold me closer Tony Danza. But actually he is saying the words Tiny Dancer. So I don't know. And there's tons of other ones out there. If you're, you know, so inclined, feel free to send those to me. I was like hearing other people's interpretations of songs. I think it's pretty funny. So So basically, you get the idea. Again, thank you very much for listening to my first podcast. I hope you enjoyed the show and the content. You know, I plan on releasing one every week, we'll see how things go. You know, I'll probably only have like one person ever listened to this excluding myself. So that is fine. But I would love to hear ideas for episodes or any questions you'd like me to be addressed because I'd be happy to do those. Please feel free to email me anytime at the Morrissey movement@gmail.com. So that's th e m o r r i s s EY movement, Mo ve M E and t@gmail.com. No underscore or spaces or anything like that. And please feel free to leave comments and anything up to a five star review. That'd be greatly appreciated. So other people can be able to listen to this podcast as well. Have a great week and remember, movement is the best medicine so get up and get moving

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