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Attend the last COVID-19 live online symposium with leading physicians answering questions from all previous symposiums.

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  • May 17, 2020
    4:30 PM
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Hello welcome it is such a pleasure to have you with us again I'm Dr Lee Lewis a board certified up situation and gynecology and also the medical director for Advantage world radio it is hard to believe it has been 5 weeks since we embarked on the mission a looking at the $918.00 pandemic and comparing those novel lessons learned during that period time to our current coded 19 crisis we've investigated these lessons and found that none of them that were employed at 7th Day Adventist institutions at the time referred to as sanitary and have scientific a plaque ability to our current coated crisis while tonight we'll be answering your questions our medical experts are going to be looking at the questions that you've sent and and addressing them over the next hour and a half again thank you so much for joining us and again as we have said over and over and over and over it is a blessing to be with you I am going to welcome my good friend Dr Duane the key he's the president of Aves World Radio and he's going to give us our welcome opening prayer Thank you Dr Lemole and happy Mother's Day to you. All all the mothers that are listening we just pray for each one of them they will be especially blasts that angry Father in heaven from Adam is what radio we're so grateful for all these wonderful people who listen all of our physicians and our assistance here and Dr Lemole that we just pray your glass each one marked family each one has on the you can but I thank you for your love I thank you for all the mothers. All the mothers in the special day that we remember them and we pray blessings on each one of them all of us father have had a mother we praye a blessing on our mothers father we thank you for your love bless us now as we continue to study into learn together how we can take better care of our l. in Jesus' name amen. And man thank you so much Dr McKee Like I said it's been a pleasure to be with you over the last few weeks now and to night we want to investigate a little bit further by answering some of your questions the 1st question has to do going back to the 1900 pandemic and as we stated this organization that sponsoring this medical Symposium is a 7th Day Adventist Church and back at that time in the 1900 Penn Demick these institutions are sanitariums run by the 7th Day Adventist Church employed Afro principles we've been looking at particularly hydro therapy we're going to be talking to Dr Roger Schwab right now Dr Schweller Dr Scholl's is a poem a knowledge of intensivist and he is in Associate Professor at Loma Linda University Well Dr Shaw one of our 1st questions that came in and besides hydrothermal therapy that were employed at the sanitariums that had really good results what were some of the other mo Dalla teas that were utilized in these institutions. Well they used what they had with them and that was some light they took them outside of course naturally they got fresh air we talked about that and and one of our previous episodes we talked about. Bathing in the forest and the and that the Alpha pine Ians and the beta piny And these are substances that are aromatic and are given off by trees so all of these things are working together sunlight as you know of course allows you to make vitamin d. And so that is one of the things that's very very important fact there is a study that was done just recently on covert 1000 that showed that patients that presented to the hospital with low vitamin d. levels had a worse outcome recent data out of Ireland showing that patients with vitamin d. deficiency as and that were supplements have reduced their acute chest infection rate by 50 percent at Rasool so. Light certainly was one of those things obviously drinking lots of water and if you look back to see what was written about what they dead strict bed rest and sleep these are all things that were employed in the sanitarium it wasn't just a matter of of giving treatments it was also a multifaceted approach well when they used this multifaceted approach what was the overall success rate as compared to some of the other institutions that were nearby such as the Army hospitals Yeah let's take a look at at that very question what I have here up on the board is a a shot at the from our update on med crown where we looked at this and Dr Rubel who is the president of the College of medical evangelist later to become Loma Linda University before that was the medical director of one of the sanitariums there in the North East specifically the New England sanitarium and he wrote down what his findings were we can see here in the army camps which were full of a lot of recruits coming back from World War One some of them coming back with the flu some of them bring it with them some of them becoming infected about 20 percent of these cases had influenza and about 16 percent of them came down with pneumonia remember this is before penicillin there was about a 40 percent death rates once they got pneumonia so the mortality rate in the death and in the camps was about 6.4 percent now let's look at the end of Terri and the sanitariums of course we're doing things in there that you didn't have to be in the sanitarium to do so they would send people out into the outpatient world and they would work their course a little bit less control so let's look at actually what happened in the in patient setting about 446 patients only 2 percent of those got pneumonia was to 16 percent and that then because of pneumonia was sort of a almost like a death sentence not my quiet but almost no and. Arctics nothing 6 of those die they got the money $6.00 out of 11 which of course is greater than 50 percent so in terms of the mortality rate from the Monia very comparable but in the air that you can see they ended up with a 1.3 percent mortality as opposed to 6.4 percent in the army camps but the key there was not that they could manage an ammonia better than the army camps it's that they could prevent the progression of this disease to pneumonia the 1st place that's phenomenal and that those modalities are what we will be answering again tonight and if you haven't had the chance to go back and watch all of the presentations previously you can still do that at 8 o r g forward slash health and you can watch those are kind of videos doctors did a wonderful job presenting earlier on a folk presentation while doctors Well we want to talk a little bit more about the path followed she made 19 several people have asked what are the stages again can you repeat those stages for asked for code 1000. And these are just phases that we've come up with that I've come up with they're not official in any way but it kind of makes us think about areas that we can intervene phase one being before you get the infection and this is where a lot of people are putting in a lot of effort in prevention so mad distancing closing down places where this sort of thing could spread face to would be after you pick up the infection whether it's in the incubation period which is on media in about 5 days or whether or not you have symptoms but have not needed to go to the hospital and for those that do need to go to the hospital that period to last up to 7 days on average based on the Lancet article out of the early will hand data finally phase 3 of those patients that need to go to the hospital because they need oxygen they're saturations are low they have shortness of breath and unfortunately the data that we're seeing in the Lancet article and also here in the United States is that. Cambia rapid progression. Well the question is also subsequent to that why are we waiting until stage 12 or 3 to talk about interventions why are we not talking in the prevented if that and I know your answer is going to be you've sort of already alluded to it by talking to us about the 1900 pandemic and what they were doing as far as preventing going to pneumonia. So it's a complicated question and this is this is the bottom line is it's a Imagine of it's a big funnel and the further back you go the much much more people you're going to have to treat so for looking at treating people in phase 2 who have infection here talking about treating millions and millions of people as opposed to meeting them when they get to the hospital you have a much smaller amount of people and you have the means to treat those people that is if you're talking about a f.d.a. approved medication like red dresses for instance they got a 1000000 and a half vials of medication apparently that's been donated by Gilliatt And of course they're going to be ramping up production but what what's going on right now and I can tell you this personally I have a patient in the hospital I have patients that I'm treating Kogut and we don't have that medication as we speak right now in the hospital only very few if you centers have it and I've called them up and when you ask them about transferring your patient there they they say that the only people that they're giving this medication to are the people that are the sickest and the ones on the ventilator Ok so these this is what happens when you have a very good medication but not enough of it so that's one extreme you are talking about very sick people and a very low number of those people and it may be that by that point the medication is not very useful Let's go to the other extreme let's talk about when people are not so sick they have mild symptoms at the beginning but there's millions of these people so what are you going to do you don't have the capacity to meet that need and so that is the question my love that is the question at hand is is there something that's easily available to everybody in their own homes that they can get a head start on instead of just sitting there and waiting and so what I'm saying is. Since we can't get randomized placebo controlled trial data medications to them right away instead of going back thousands of years and lighting a candle and saying a chance why don't we just go back a 100 years when we've got hydrotherapy that something's actually worked very very good point and many of the other modalities that we talked about as well so another question came in as far as the immunology as concerned is it advantageous to inhibit tumor necrosis factor beyond interleukin 6 Interleukin 8 and increase I all 10 and ordered to decrease cytokine storm or is this more dangerous excellent question so the bottom line is that at the beginning of this infection you want your immune system to kick out this fires and hit it hard we know that the virus has proteins that's a pressure immune system and allows it to go on and on and on for 7 days until finally the immune system has woken up and then it hits it was such an immune hits that you go into pneumonia so there's sun at the beginning of this you want to strong immune system at the end you want to kind of suppress some of these cytokines that are causing a lot of problems I was impressed to find an article that really went into this topic because I was concerned about giving hydrotherapy to patients and maybe that might make it worse rash road that giving people raising their temperatures could actually reduce actually reduce having trying times allow by by. The messenger r.n.a. that is needed for the translation of the r.n.a. into the protein that makes the cytokine can actually be degraded by increasing the temperature in those patients and so that was fascinating in fact they had a mouse model that showed that when they had colon induced arthritis that increasing the temperature of the mice actually reduce the inflammation in those joints and I know we have another question coming up in just a little bit about that but that is absolutely profound it. Give us some encouragement as far as the cytokine storm is concerned another question has come in and I think it's actually a very good question you know we're trying to optimize our immunity should we be and we're trying to find therapies that actually meet the specific person's need and we're talking more along the lines of these simple methods that work we've been discussing should we be measuring specific lab tests for example white blood cell count and those kinds of things and then apply therapies accordingly would that help us to be able to delineate the appropriate treatment to patients a little better Yeah unfortunately some of these lab tests are very very specific so if you're a community hospital you're not going to get an aisle 6 back door and been 3 level back and any useful time if you're at a big center that might be useful but if you're not you might have to just kind of look and see how the patients doing so like toss Elysium out is a body against aisle 6 might be helpful to measure aisle 6 if you can do so if you can't the patient looks like they're in a very bad ammonia we've been giving that medication for patients it's a one time dose if somebody has an elevated the dimer usually can get that back pretty fast there's some data that shows that very elevated d. dimer levels correlate with micro from by and it may be beneficial that we don't have randomized control trial may be beneficial to start those on not prophylactic doses of ansi quite elation but full doses of anticoagulation fascinating Ok Well we're going to go into hydrotherapy thermal hydrothermal therapy right now so we talked about the 3 phases of coke at 19 and the question is is there a specific who arm of hydrothermal therapy that would apply to each one of the 3 different phases or is it better just to utilize whatever you have in front of you. That's a good question and the the most aggressive form of hydrothermal therapy in my thinking would be you know heating up the body with very hot warm compresses both front and back and then for about 30 minutes 2530 minutes and then ending with cold and then doing that about 2 to 33 to 4 times daily we've done that with patients I can tell you that in my intensive care and after they got their 1st dose they ask for it they say I'm ready for my hydrotherapy they're ready they they don't quite like the cold rag at the end but it makes them feel better and they feel as though they can cough up the sputum better and so we're happy to do it and we're using particularly hydroxyl later which is a machine that heats up gel so it's very easily sterilized of all we're not doing this as part of a study we're doing it for patient comfort we're hoping that it helps I know that my colleague that will put her on here later Erik is actually doing studies will be issued and see how that turns out. Whereas people who are more mild I have a colleague who is currently tested positive he's not working he's at home the sec and I've told him to start in with similar things at home if you're not sick and you're you're doing fine you want to do it as a prophylactic I think the contract showers is a perfect thing to do it's easy it's convenient it's literally just turn the knob on the shower and you do that I think someone else is going to get into the practicalities of that as well perfect Here's another question and if the mom the same lines is it safe to do hydrothermal therapy if you've already gone out about 10 days and the progress of this disease for example you have a high fever or is it tonight and you've kind of already almost addressed that with some of the questions as far as the cytokine storm is concerned. Yeah I you know I think that the the concern about fever revving up the immune system making the pneumonia worse is a theoretical concern I've seen practical experiments and at least expert opinion that fever may not actually rev up the immune system in a bad way we don't have data we don't know that for for sure so it's always an interesting thing it's true in the data that I just showed you at the beginning regarding the sanitariums they really did no better with hydrotherapy and fresh air then than the Army hospitals in terms of when patients developed pneumonia again I'm not sure they were getting all chest x. rays they certainly didn't have pulse ox emitters at that time so how they were making the clinical diagnosis was probably with the stethoscope listening for rails and seeing if the patients were cyanotic those are pretty late stages of pneumonia. Yeah fascinating what how is speaking of fever how permissive with fever should we be should you know what is your cut off as far as anti pyrite extends particularly pretty you and I see you you know so it is so long as there is no co-morbidities and we'll talk about that in a 2nd I have never seen an adverse of fat from a temperature of 103 even up to 104 of that being said if somebody has a low seizure threshold has a history of issuers if somebody goes into atrial fibrillation that's where the heart goes into irregular rhythm and they go very fast fevers going to exacerbate that and so it really has to be on a case by case basis about which patients you're going to treat and which ones you're going to allow But certainly I wouldn't advocate for simply treating a number all things being equal Ok very good and that's actually have the application of our next question Do you have a target core body temperature for your patients about particularly when you switch between the hot and cold are you doing that in the i.c.u. at all you know that's a good question I don't think there's a specific core body temperature target 1st of all patients come in with all sorts of core body temperature I every single time I go into my clinic for the last week they have to record my temperature and write it down to make sure they're doing their due diligence and literally just walking in one day versus another I've just got an experiment here in the last week knowing that my body temperature can be anywhere from $98.00 to $99.00 And so you know what's my target I have no idea I think that hydrothermal therapy is doing more than just elevating the core body temperature there's a lot to be said for the vasculature that's occurring when you hydrothermal therapy there's there's a dilation basic constriction the endothelium is a very important organ when it comes to cope in 1000 so I'm not sure I don't know exactly what the mechanism is and I don't know if core body temperature is the be all for hydrothermal therapy so you're not currently testing on a regular basis the fluctuation between core body temperature when you make your transitions between hot and cold. No not my patients but then again I'm not doing a study I could see why I think he would want to check that would be important especially if you're doing a study perfect now a question as far as the he is concerned is moist heat preferable to dry heat and if so why you know I don't know the end on that answer I have heard people say yes it should be more Steve I could see why that might be here's the reason we all learned back in chemistry in high school that water has a very high entropy if he what does that mean it means it takes a lot of energy to increase the temperature of water as opposed to air and that might be something that allows it to deliver more energy Think of water as being a big battery a very powerful battery whereas errors are a small capacitance and so when you when you heat up water it and it gets transferred in the liver to somebody it's able to give off more energy and that might be the reason why moist heat is is better it's also the reason why Layla when you go to Florida at night it's nice and toasty in the evening whereas in California where there is no water in the atmospheric cools off very rapidly and point well question for you as far as different population several questions came an axiom about this how would you change the hydrothermal process for pregnancy infants children and have you begun to discuss that amongst your colleagues. Yeah I haven't really because. I don't treat pregnant women or children Ok And we've had to secure a long time ago but that was something for other people to do because you can only know so much about one thing that being said I you know we do hydrothermal therapy at home and I'll tell you what my kids are the most excited and 1st in line to do those things I would say that you want to make it a positive experience for them and so for kids particularly if they don't like the the cooling off at the end that may be something I wouldn't do although I've never had to do it for a child but I was really concerned that their life was in danger was more of a preventative when it comes to pregnant women I know there are some issues there and you probably be more of an expert to answer that question and if that to you thank you what I recommend to my patients is don't don't do the Sonas on the. A bomb American born of such a guy college is very clear about that don't do this on a stunt do the Jacuzzis accept that hot cold showers are very reasonable you can use even on the chast hydrothermal therapy to the chest area just to avoid the uterus you really want to decrease the direct heat to the baby but yes I've noticed the same thing with my children we've done preventative measures and I cut the time and happen we come back in just a little bit practically speaking we're talking I decrease in the time for the children I think it's very beneficial so we'll only use hydrothermal therapy be problematic and the hypertensive that patient Have you noticed that in the i.c.u. Are you concerned about that at all no I would love to have hypertensive coated patients Leyla if that's the case that's a reason for me to add the lower one starts and actually because that's my favorite antihypertensive medication to go to Not that I have evidence for this but they are radically it should help because it's going to block angiotensin 2 which I believe in a lot of studies have shown. And a lot of what we're seeing may be mediated through an elevated and you tense into level. But I do not believe and I've not seen any both practically of theoretically or in my own experience of a hypertensive patient having an ill affects from hydrothermal therapy Ok Now if you have another question and I think it's also a valid question what about hide him with therapy in haemodialysis or renal in stage renal patients yes so that's because and stage renal patients typically have a lower set temperature because of their kidney issues. Again it shouldn't really matter if we are raising the temperature we're still raising the temperature again I believe that there's more to hydrothermal therapy than just a set core body temperature although that may have a lot to do with it as we saw with Dr your reg the psychiatry in Austria at the turn of the last century with is treating. Neuro syphilis patients with malaria and getting good results there there may be more to it than just that great well one last question on our hydrothermal therapy factions the civically for some populations and that's the geriatric population they tend to have a little bit of a relative hypothermia when you consider adjusting protocols have you done such things for elderly patients within the i.c.u.. No I haven't I don't think it needs to be adjusted but I would say one thing particularly in the i.c.u. and only because elderly patients are more risk for one of about the say and that is being unconscious being unable to tell the person giving the hydrothermal therapy that it's too hot and also there's being more apt to burn and this fragile so we've made a kind of a rule the beginning of this that we would probably refrain from doing hydrothermal therapy until we felt more comfortable with it. On patients who are unconscious and unable to tell us that it was too. Well thank you so very much Dr Shaw and as always your information has been quite enlightening and we really appreciate it Rick spinning in it with me hearing from you in just a few more minutes as well but thank you again Up next we have Dr John Kelly Dr Kelly is the founding president American Cademy lifestyle medicine He currently teaches lifestyle medicine to medical professionals Dr Kelly you have taught hydrothermal therapy for many years you've been practicing it for many many years and we have some practical application questions that have come in is it health is it a political will to use hydrothermal therapy for healthy people. Thank you Lena it's 1st I just want to say thank you it's going to be with you tonight and I appreciate all these great questions Well the short answer is yes done properly thermal therapy poses no danger and it can actually perhaps help stimulate our activate the immune system as we've been hearing Dr swelter another of the contrast shower is probably the hydrothermal therapy the most commonly used for healthy people but also a hot foot bath I see you've got a slide there for those and those are the 2 most commonly used in fact we use a hot bath often to relieve headache with a cold cloth to the forehead and a hot foot bath for 20 minutes 15 to 20 minutes and it's can be really very effective. Excellent now how and we have it on the screen but can you describe to us that the process that has come and several times over can you tell us how long for hot versus cold treatments for both the contrast showers and find out specifically Sure so typical let's do the contrast shower the alternating hot and cold 1st so typically what we do here is we say it's a 513131 but basically you can oftentimes we do this after taking a shower so on the say taking morning shower that's in our home that's how it's often done so we might shower for 10 or 15 minutes and then increase the water temperature and begin the treatment so at that time it would be say 3 minutes one minute cold 3 minutes hot and another minute cold and the key thing here is that we're looking for. I learned this fairly recently that the way the original ideas there are moral therapy was done by a century ago was the cold was always actually applied starting with the nape of the neck in. Water coming down on the your neck in your back and they and the point was it was felt that you needed to have that spontaneous. You know really in your life all as cold so and they've the indication was that is Roger we're just saying doctors well they're just saying is it's not us the Civic. Temperature or body core temperature it's the effect you're looking for for the contrast So anyway it's a pickle says right there 5 if you're if you do this just starting off with the shower in this you're not doing your normal shower be 5 minutes hot a minute cold 3 minutes more hot and minute cold in 3 minutes hot again and then a minute cold people say how hot well so hot that that is the. It is you take you understand to be hot it doesn't matter exactly the temperature but we say somewhere between 104160 degrees if you're measuring the water temperature and the cold not cold as you can handle. That's right and how do you make it cold practically speaking how would how would you do that the sides just turning in as cold as you can cut outs are concerned well on the footbaths I don't actually use cold until the end so on a hot foot bath we would use the use of hot say $14106.00 degrees and if there's a decrease in sation say with diabetic foot or something then we would not go above $140.00 degrees but so if say 15 minutes of hot and then at the end just poor cold water crossed the feet and dry them is the that's the expense that I've had with it. Can you tell us a little bit about patients with and without symptoms hydrothermal therapy with and without something and says the treatment the same that you would recommend Yeah this is a great question the only really the only difference in applying hydrothermal therapy is that when symptoms are present we may need to adjust the intensity of the treatment so we may need to reduce the level for example to that we elevate the body temperature for a patient let's say that's weak or infirm as we've already emphasize and multiple times in this course symposiums we don't want to overtax the patient. And in fact if I err on the so I would say err on the side of a more gentle treatment and then you can repeat the treatment if you want to have increased the fact. And then we might reduce the water temperature when decrease in sation is present like we've already mentioned with the hot foot and like I said again you can repeat the treatment and a mile and use a mild form and repeat it a little more often and you can get increased effect that way great now another question if the separately regarding the types of heating can a heating blanket be just as beneficial as moist heat and ice pack. Who know. That's a good question too I would say probably yes at least in some applications but I would point out one important point and that is the beneficial effects of the alternating hot and cold will not be present with a heating blanket because that's that's going to start off typically start of a cool and then it heats up and there's no there's no contrast going on there Ok great now the question is the civically regarding sun and is there an inexpensive way to do how different will there be at home if you don't have a sauna I mean we should all have showers that let's just pretend we didn't want to shower we want to do another way what we want we are not and I have been in places where I do not have a shower. And I am so when I do and the answer is absolutely absolutely a hot tub bath or example is one I remember I've done hot tub asked when I was not feeling well and I was out of town on a business trip and it was great effect fomentations moist heat packs This is another thing that can be done relatively simply with just a nice thick terry cloth towel. Put it in a plastic bag in the microwave I mean so there's many different ways of doing these kind of treatments when you don't have a shower Asuna Another one is electric heating packs like the thermal for some of the other brands those those can work very well and we already mentioned the hot foot bath you know all you have to have for a hot foot bath is. Like a dish pan or some kind of a I've even done it in a trash can. And hitting compress for the next this is another we haven't heard much about that's a very simple treatment where you put a wet cloth around the neck and then put say a wall around that and this starts it's called a heating compress and it actually increases the blood flow and circulation to the pharynx and to this Rotarian that's often very helpful. We're sore throat so these can all be used with actual effects and we certainly don't need a song or a shower Axon What's the bass time for hydrothermal therapy or is there a best time for things such as sauna bounce or any any part of hydrothermal therapy for that matter yes that's another really really good question and I got a lot I would say this in general a Slauson other whole body hydrothermal therapy is tiring we must realize that if you do this treatment a treatment like this the whole body treatment for 20 minutes you're the person is going to be tired and by the way before you ever do one of these you should do it yourself don't don't give a treatment you know to someone or are even a family member and tell you've done it to yourself but anyway so they are tiring and so it's best to do them when the subject can sleep an hour or more after the treatment. And also I think it's best to have eaten 2 or 3 hours before the treatment if if the person is eating because you don't want to do it right after eating and at the same time you don't want to do it when the person is going to faint and maybe have a low blood sugar or whatever so I recommend somewhere around 2 to 3 hours after eating. I like to do I'm actually and mid-morning and then another one in the mid afternoon and then if it's really if I'm really have had cases where I'm treating someone that's quite sick and I'm very serious about doing these I'll do one more an hour or so before bed so but that's why General you know my general approach is to use the watch watch the meal time and and be sure that they can rest afterwards excellent and the last question we've already addressed the time limits for thought as in contrast showers that specifically for our chests hydrothermal therapy and also sauna and I think you've kind of mentioned at about 20 minutes but if you could just tell us. Funimation for that yes well the one thing I want to say is that the hot should be long enough to fully hit the target anatomy so if you're doing like a chest fomentation you want to put a high just normal pack on and have it on long enough to impart the heat that Dr sweat was talking about the water is a wonderful reservoir for for bt use and so typically that would be for 4 minutes 5 minutes I've heard of people doing it 3 minutes but somewhere in neighborhoods for 5 minutes and then you have a Coleman friction with a cold claw if you number one that feels good but it also actually makes They heat more tolerable to have that then intermittent cold and then you would put another pack on for another 4 minutes or so the total time is somewhere around 15 to 20 minutes would be the total amount of time and maybe takes 30 seconds to do this. Cold Ridge Rob we call Coleman friction. With Ana and this same typical prochoice 15 to 20 minutes with a one minute cooldown and again there is. Cation that if you make that cool down have a contrast so that it's it's not just cool but a little start being way cold a contrast is good and then I've actually you know we've all heard of the the regions and they in the. That area they they go take a hot sun and they go out into the snow so anyway Jane each but. Well I thank you for the opportunity Thank you Donna Kelley thank you so much for your experience and we really appreciate your information and making it practical to us thank you so much and we'll look forward to more presentations from you in the future again thank you Dr Kelly Now next we have an amazing physician Dr Eric Nelson he's an assistant professor of surgery at the University of Chattanooga Tennessee and Dr Nelson is one of the chief investigators of an amazing study that's taking place there on hydrothermal therapy several people have asked us what 1st of all welcome Dr Nelson thanks let me back with. Sam I have to ask how do we access the i.r.b. proposal we are looking to find out more information about potentially doing that at our facility how would you propose that we access that information Yeah well thank you for having me on again and I just want to give a quick shout out to the 31 individuals and hopefully centers who are already trying to implement something along these lines I'm very excited to see the worldwide response I actually have had people from all around the world. Russia several countries in South America and of course a lot here in the United States that are looking to implement this the best way is to email me emails and 06 m. at yahoo dot com I'm happy to answer any questions I'm happy to send you our proposal it's not the kind of thing that I can post publicly on the internet but I'm happy to interact with folks individually and the reason I'd like to do that is again so that we can hopefully collaborate in the future if many different setters are using a somewhat similar protocol we can then combine data in the future again email 706 am yahoo dot com Thank you so much for that Dr Nelson and so another question specifically regarding your study what did you use as exclusion criteria sure so I heard you and. Roger already talking about pregnant patients were simply excluding all pregnant patients so again this is a very preliminary feasibility study and we're being very cautious so we're excluding pregnant patients patients with any history of symptomatic rate of cardio as uncontrolled a truly arrhythmias or ventricular a rhythm Yes certainly hypertensive patients anyone is unable or unwilling to participate in the treatment again we're not set up such that. We wouldn't feel comfortable if someone was not able to verbalize back to us how hot they were experiencing the treatment any patient that has a forensic wound or a Dermatologic condition over or under the area that we would be treating on their thorax any neuropathic or other pain syndromes that would preclude hydrotherapy to that area. We do have one patient that we had to talk with neurology and we are treating them but we waited for 72 hours after they had an acute stroke likely do that. And they didn't have a problem with that but we did want to wait 72 hours after their stroke and then something called the h score greater going to 169 I know Rogers shared information about how it's possible that hydrothermal therapy actually modulators the immune response so it ramps up the initial an immune response and modulator such that you would not proceed to a cytokine storm but if patients being to be very close to a cytokine storm based on the h or we're not including them in our study Ok All right what about climate considerations are some questions of foreigners community based models have you guys considered or any other of your colleagues consider doing community based models the civically at different places in the country and I'm hunted Teenie higher humidity or mar dry climate. Yeah I don't know that we've made any particular changes based on the local climate one thing that did come up I corresponded with someone who had a lot of experience in Africa doing hydrothermal Ferebee and they didn't have enough water to do the hydro in hydrothermal therapy and so what they did do is literally got some ponchos or some. Some plastic wraps many of them dark colored or black or wrapped the patient up in these and set them out in the sun they made out they were excited raided and of course they started sweating very quickly and profusely and they measure their temperature they heated them up that way and then they did their best to cool them down to provide that contrast but they didn't have the ability to put them in a shower or a hot tub bath or anything because they had limited reserve water front. So that was one way that in a resource austere environment you can still do a hydrothermal therapy that's amazing speaking of cooling down what ways did you utilize that your facility firm cooling down measures or did you use them specifically to the head so I do see the question I think is a lot of for example the footbath there was application of a cool washcloth to the forehead for for headache that is our study that if patients wish it were happy to give them a cool wash off of the forehead. It's not part of our protocol as far as your question on how are we cooling the patients were using a cold towel. Dipped in cold water and as soon as the 20 minutes are up and we're taking off the thermal 4 or applying that tell to their chest for approximately one minute. Very good last question many have asked this how can we keep a brass to the outcomes of the progress of the hydrothermal therapy study particularly what you're doing but also as you look at these multicenter kind of analysis we'd like to know how we can keep up to date on. Sure fall of the medical literature hopefully within a year or 2 will be able to publish something but I understand there are some further presentations planned here that you can probably tell us a little bit about Lila that undoubtedly I'm happy to share as the study progresses fortunately again we flatten the curve here in Chattanooga it seems fairly effectively and we probably only have about 4 or 5 patients on the study currently compared to approximately 20 to 25 controls that. Were also treated for Cove it in the hospital where we're performing the study so it'll be a while before we are able to provide any actual results and again this is a feasibility study we believe that works based on the historical data that you and Roger already discussed this evening and we've discussed in the past but we'd like to see how we can apply this in a hospital setting patients that are kind of in that phase 2 or Phase 3 a treatment for get over it well thank you so much Dr Nelson and yes you are correct we will be inviting you back again we have another upcoming program called Level up and you're going to want to stay tuned for that but we will be following your research very closely so I thank you again not or now son and thank you for your inspiration to many physicians around the world up next we have Dr Neil medley you know many of the modelling he's that we've been discussing it wasn't just hydrothermal therapy that was a utilized in 1800 as we've known and they had a very special diet that they used they had other aspects of how exercise sleep and many different things that were again utilized as a holistic approach to health well one of those things that was used was nutrition and we've seen and Dr Natalie's presentation a couple weeks ago be a fact nutrition does play as far as the immune system for that 1000 so we have some classics and it's about nutrition I'm good I want to welcome Dr Neil Natalie he is an internal medicine specialist hospitalized and also the president. We mark and jute which really specialize and in life our medicine Thank you Dr Natalie for joining us thank you great to be here so our 1st class Jane and why are we not intruding and we've talked about the phases of coke at 19 Why are we not intervening that's why phase one with things that we know are top adding oxidant such as I can see bottom in d.s. the x. factor a well I think it actually is a good idea who could do that I'm not advocating we wait necessarily particularly if you have some health concerns or some flaws in the New Start lifestyle I think getting extra vitamin c. like a 1000 milligrams twice a day getting x. 3 and saying we mentioned beef and person 10 before and that the seal sifting these things theoretically I can give us a potential significant advantage can reduce oxidative stress and help our immune response be optimized and so why not in a lot of individuals are it's hard to find things in the stores these days because. Many people are taking that is that they go about their daily activities then specifically if they are what we call. The workers that are necessary workers that are going to be exposed to this every day. And and so there's no problem taking this very fateful. Excellent thinking of zinc and asocial coaling actual size and a healthy diet all the things that we've been talking about this question comes to us Are these enough to fight off coke at 19 in the case that a vaccine comes available in the near future or at some point in the future are is are these things sufficient for us to avoid the necessity of taking a vaccine. Of course we don't have any comparison to the trial and the back thing I wouldn't necessarily look for this to be a great vaccine. You know r.n.a. vaccines are actually top you know they tried for years on the h.i.b. hour and a vaccine and we know how terrible that vaccine was. The influenza vaccine has actually not been that great particularly the last few years some years they've had it better than others. And of course this is going to be another r.n.a. vaccine and of course there can be conflict of interest even in regards to government officials even at the end I ask that are vested in this vaccine and are going to try to mandate everybody to take it despite the fact that we're really not going to know how well it works or or what the complication rate is going to be having said that we really don't know for sure how effective the other mode allergies are like an ass cyst think we do know how effective it is against influenza and if we were to compare although there's not been a head to head comparison trial if we were to compare the statistics of the influenza vaccine versus just taking an acid feel 15 and ask that the old sifting does far better as far as you not getting symptoms of the flu then actually taking the vaccine and of course there's lower risk as well with the and they the versus the vaccine and so we anticipate maybe that's going to be the case as well and of course these other modalities are already available they are potentially effective side effect profile is virtually nil and so well that the veterans of x. same may be. Do you have you noticed any contraindications for an acid Yoko and I've heard a few My thout but have you noted any yourself as far as an acid peel this thing one of the concerns was what pregnancy actually there's been some large studies done on pregnancy and then at the tail sifting one of them was a randomized controlled trial looking at an AC and women who had had fun Fannius abortions and the n.a.c. actually protected them from having a recurrence fine Cheney is abortion with no effects at all of the fetus or the fragment individual and so although some are saying that we don't know for sure there's actually been a lot larger number of cases of people taking n.a.c. while they're pregnant if they are I don't recommend more than 600 milligrams but that there are some individuals because an acid seal sits being has fall for containing amino acids they can have a little bit Nazia they might have an upset stomach if they take at the tickling on an empty stomach they might get some g.i. symptoms of diarrhea or constipation and of course if they're having this and it's persistence and don't take it let's go through some of the other mother ality that can be helpful axons Her couple questions came in again and coming back to the antioxidant and the donor that should actually be given particularly right now as many people are afraid to go to their physician they're a little nervous about going that you know just to be exposed to potentially you know just to find out what their vitamin d. or they think levels are do you have any recommendations for patients who just may want to there are people that may want to take some and they Occident some of the counter aren't doses are concerned well the nice thing about Thing is it's not near as toxic as what it was once thought to be in fact virtually all of the symptoms that are talked about of zinc toxicity are due to. Copper deficiency does think an excess can lower Hopper's but copper excess is a far greater problems than think excess and so taking you know 20 milligrams a day is certainly very safe and effective we would rather recommend if you want to build it up further even 100 milligrams a day is say we have individuals that have copper excess that they're taking 2 to 400 milligrams a day and that's fine the main issue with saying is not the and that can be actually lemonade it by taking it right after a meal in both cases or right before going to bet you go to sleep you don't get the nausea. And so. Yeah there's not really an issue was think toxicity like there was thought to be at that. Either any specific vitamin that you would recommend that we haven't mentioned are well vitamin d. of course that is a very Mantei Occident vitamin and has some very positive immune modulating effects of vitamin a as well vitamin d. as these anti-oxidant vitamins are also healthy and even the trace mineral Solenn am could have some benefit as well actually I'm not bashing came in as far as any oxidant and wrong versus cooked foods or dried vegetables particularly tail chips is it better to eat the rock a.o.r. can we count. Well we can or my current best personally but. Well we can get both ways actually the way Erica makes fail it's very just likely being done the way she does that everybody likes the kale if it's really as popular as kale chips for say and would have some advantages over the kale chips but in reality it's better to get kale whether it's cooked or Roth and not getting it all x. then a sense of garlic we've heard a lot of those you shared with us some of them but one of our viewers was curious what about garlic and the next question directly related to that does it transfer in bras now Ok well garlic is of course a very potent Antiochus and vegetable is actually the most potent that we know of and in addition it has some anti-viral activity in and of itself also some anti-bacterial activity and so garlic is great and of course Cook is maybe not quite as good as raw but almost as good and of course you don't have the disadvantage of the odor of your breath when it's cooked versus want to draw and in regards to does it passed over to the mother's milk was that the question or were the company passed you by now that's correct yes it does pass through breast milk and your baby can benefit from it as well but it may decrease the flavor of the breast this is absolutely the case but you know what the benefits are definitely back green Cheney was been told many times that green tea is an amazing antioxidant do you recommend green tea as similar to some of these other any accident that we've just been discussing. Well Greenpeace does have antioxidants but it tends to also have caffeine and of course that's the benefit risk ratio and we look for things that are only going to have the benefits without the risk now there is an active ingredient in green tea all the e.c.g. see that can be helpful and certain all of the likeness sees the Kamya things of that nature and we would give that just in capsule form that separate from the caffeine so we don't have to have that effect and that have perfect timing the next question chocolate has a compound and see a bra mean specifically the x. similar to capping would you recommend avoiding chocolate and wow I would avoid chocolate not so much for that the overwhelming but for the sugar on fat and for grated fat content of cocoa eaten by itself is not palatable for most people it's a very bitter and so in order to get it palatable we have to or a lot of sugar and a lot of fat into it and the sugar is going to be immune suppressing and even the saturated fat can be as well. Excellent wot role do essential oils play they're known for their antioxidants and anti-microbial properties but do they also have immune optimizing agents or aspects as well they possibly do now I'd like to know what I think of the central boil I'm thinking of it from the medical nutritional standpoint which are omega 6 and omega 3 fatty acids those are actually essential because we can't live without those and those are incorporated into our cells but what the world sees as was essential oils are actually just whales that can have some sort of potential therapeutic effect like oil of oregano or those sorts of things as far as omega 3 and omega 6 yes we need those essential oils as far as oil regen No yes it could have and it may have some anti-viral properties some other oils may as well if not is as well understood in regards to its positive effects like the Omega 6 in a magazine. Making listen Blair Another question came and some are recommending the use someone like acid doofus Blair of the arms come to Iran do you agree with that assumption. Little Black Acid theoretically could have some benefit particularly in the typical American mediator who is short in both Omega 6 and omega 3 they have a high cholesterol in their diets high saturated fat but really not enough of the polyunsaturated fats to have the right let that layer of their membranes and so for people like that yes oil of Evening Primrose which is a little like gas that can be very healthy for them and that sick early may have some anti-viral anti coverts properties and the same goes for omega 3 but for different reasons the omega 3 can really attenuated the oxidative stress response and it's anti-inflammatory Omega 6 tends to be more pro-inflammatory particularly in excess but omega 3 is anti-inflammatory and could theoretically help prevent that coverts and speaking of me in my own community have an army and as far as professional and concerned how to fish around to prevent harm comes to instruct the oil and save on trying to tend to special. Ok all of those are going to have omega 3. As a flax oil is going to have the medium chain a bag of freeze and the fish oil. Will have a particular launching the e.p.a. and the p. h. a 20 carbon 22 carbon like the fish actually do not make that themselves they get it from the plants to the water and so the problem with getting it in fish is that we are also getting toxins the toxins that are in the water concentrated 1000 to a 1000000 fold in the fat of fish and then we go through this Great expensive process to try to remove mercury and all those sorts of things which it cannot be removed entirely and so we end up getting a very expensive fish oil that actually has more mercury than if we got it straight from the plan for the water and so if you're talking about supplementing long chain omega 3 s. I would use a supplement like Oxy rere new i.q. that comes straight from the plants of the water it has the benefits without the rats official. After meeting classrooms about fasting you had mentioned in your nutrition faction the benefits of an American fasting specifically as far as the immune system can you elaborate perhaps a little bit on that yes intermittent fasting actually has been shown to increase natural killer cells double or triple them over the short term and that's part of the innate immune system on both sides are also increased and so this is why if we know we're facing an infectious battle it's actually better to say as often we're not hungry you know when we in fact that's one of the symptoms of cope with 19 is that you just have anorexia and you don't want to eat and that actually is a sign that you really shouldn't eat. And your immune system would be able to fight that off better so we recommend up to 72 hour fast 24 hour fast is normally all that's needed and then maybe more fruits things that are not going to be really high in protein particularly those 1st 3 days and that can actually have some positive effects on the immune system because over 72 hours you definitely need to have a medically supervised fast because then you can start breaking down the body running into more issues with that but most individuals can undergo a one to 3 day fast without medical supervision and it actually can. Handle being a mark 9 gas to Europe a day you mentioned that in your nutrition talk as well what time something day would you recommend as far as the best time to eat is to me on the time restricted feeding that bath and other words where you restrict any feeding is going to be afternoon and evening and so we recommend a good healthy breakfast a good healthy lunch early in the afternoon and then nothing to eat in the evening this is a good way to be able to lose weight and. They are your ideal weight without gaining it back it also put you into ketosis which actually has some benefits as far as narrow in your knowledge is concerned b.d.n.f. for instance goes up as a result of this 12 to 17 hour daily fast and that does have some advantages they've been shown in Cancer Research UK skin and other words if you have a response to like breast cancer treatments you're going to be far less likely to develop breast cancer again if you're on this ketosis type of regimen and for the same reason it could have some benefits in regards to infectious agents as well as meaning when the additional cost just aren't fasting the office that being snacking one of the active snacking have on the immune system well that's that is a good question and it actually does not have a very good effect so this 6 meal a day program that's been shown actually is not immune and Hansing a regimen and one of the reason for that is our gastrointestinal tract is vitally important in regards to our immune system and the majority of our lymphatics are right there in the small intestinal area and we need rest for those immune system cells those t. cells and b. cells to be able to perform optimally and when we're eating 6 mall meals a day we do see some suppressant effects on the lymphatic system. Meaning Well another more galloping at me also talked about in the 1918 pandemic was the fact we actually spies now in those institutions they put their patients primarily on front of a modified that raft when we're talking about exercise we talked about the benefits one of the best forms of exercise that we're looking more of a preventative measure. This is your aerobic exercise here in durance exercise and this is what's going to have a direct role in regards to the mitochondria you know aggressive a. Non aerobic exercise which is really meant to build up muscle that actually causes an inflammatory response in fact that's one of the reasons why the muscles look so big and people like to take pictures right after working out is because there's actually an inflammatory response to the muscles breaking down from excessive exercise and then you have all of these white cells coming in as a team and those sorts of things and this is not what we want to have if we're getting exposed to cope with it or it actually like that but the aerobic exercise that's not over and we mentioned how marathon running can actually suppress the immune system but running up to a pile is a day or walking now you walking brisk walking you can do that for 20 or 30 while today and that's very healthy that's one of the advantages of walking over running is that you can do it helpful like the more you know like. Then you can running and of course swimming is healthy bicycling as well 80 percent of our skeletal muscles are there in the leg and so these are all exercises involving the those big large skeletal muscles to prove mitochondria and to have that that improves as success that we talked about that comes with a different sex acts are wrong thank you so much Dr Natalie as always it's a pleasure to learn from you your experience is amazing we look forward to a couple more questions from you in the hospital practical action but again thank you for joining us and thank you for providing your and by great to do it thank you we had a little bit about exercise with Dr Natalie we've talked about nutrition we've talked about hydrothermal therapy hydrothermal therapy. It really is water that's done extremely Of course we don't want to forget the benefits of water taken and turn away as well well now let's dive a little deeper as far as exercise let's answer some of the questions that you have specifically to actual size I'm excited to welcome my good friend Dr Oz you know Charles Marcel doctors Dino is an internal medicine specialist he's also in a job adjunct professor at Loma Linda University and he works at the General Conference of the world church for 7th Day Adventists for Health think it obvious you know for joining us my pleasure I'm a privilege thank you now we were just talking a little bit about action or size how often and how long should one exercise to optimize their immune function or Ok Well Dr Natalie just gave. A very good summary of some of the issues revolving around exercise but if we're talking about mixed exercise the part that would be the most important for purposes of the new function is we're looking at the aerobic part of exercise even though the best exercise is a combination of aerobic and resistance and even isometric exercises nonetheless there is a sweet spot so to speak somewhere around 45 to 60 minutes of moderately intense exercise per day 5 days a week that usually would be enough to stimulate the immune response that we're looking for. Excellent next question as far as the Kobe patient is concerned is it better to actual size or utilize that dress now Dr Nunley mentioned a little bit about that as far as healing process is concerned but given the effect on the exertion of the heart what would you recommend is the best for the coma patient Ok. There is a little bit tricky we have to consider at what stage the patient would be if Who person has a creamy symptomatic stage then exercise would be most prudent if they're mildly symptomatic that is they don't require hospitalization than exercise there would also be prudent however once they get to the phase where they are need to be hospitalized and certainly when they get to the intensive care unit then bed rest is the more prudent approach to take you see part of the issue is that people with with this particular syndrome they develop cardiac anomalies arrhythmias. One patient even have a cardiac rupture Ok. These are not things that you typically see with normal individuals so there is an imminent logic response to the SARS cough to that can stimulate the. Situs We also now see that some children are having an immunologic type problem that might be associated It's similar to our psyche disease that's color Saki like. So that's something that we're keeping an eye on and certainly under those circumstances better recipe most prudent and of course there are some individuals who because of their underlying heart disease that need to be taken into account as well and along the same lines is it possible to over exercise this was kind of alluded to a few minutes ago as well. Well yes it is possible to overexercise there's some big debate still in the literature regarding how much exercise is over exercising but. Let me just try to simplify it is less than 45 minutes a day 5 days or 5 or 6 days a week. Will be considered. You know some optimal 45 to 60 minutes is about the optimal and about 2 hours of moderately intense exercise is about the amount that would give you the benefit is it part of the issue is that when they looked at back in the ninety's when they looked at the development of our effort or infections and looking at Secretary i.g.a.. They found that these were decreased after intense exercise of people doing Martha on running and things like that they ended up with with that increase in upper respiratory infections and they use that as the marker for the press to be in function now so if you're not in the line of running marathons. Basically up to about 2 hours of exercise will be safe for just about anyone assuming that you have the cardiovascular and the and the muscular skeletal apparatus to be able to do that exercise for more than that you can end up with injuries you can end up with depression of your immune system even though that's debatable and you can also develop something that is called runner's psychosis there are some people who become addicted to running and they start planning their day around their runs as opposed to plan in their runs within the of these parents or less so that's a psychological issue that can develop to parent a runner's high and. Along those lines does intense aerobic exercise spread 30 minutes increase oxidative stress. Yes it does. You're asking me questions that are not that easy to. To give a short answer to but let me say this. Almost any exercises be do will increase the amount of reactive oxygen species that is it will cause some issues however the body is able to handle this this is a normal physiologic process so up to 30 minutes of exercise of moderately intense exercise is supposed to be normal so even though you're producing. Oxidative stress the body is able to handle that when you get beyond the 2 hour mark on the other hand then your ability to handle it Minot be as well adapted to take care of it and therefore you end up with the negative or the potentially negative parts of that especially for people who are not trained. Excellent Well that's very exciting talk about exercise and I wish we had more time we'll have to revisit that in our upcoming Again level up because it is a very very important topic but we also want to talk about ultraviolet radiation has been a lot of whom had come in from that again we're talking about all these different modalities that reviewed allies did 1918 and the sanitariums of the 7th Day Adventists institutions and we've again seen them to be scientifically in some ways a clickable threw at her that 1000 crisis full of rock about some might are altered by radiation some question poor man's The physically what is the best body part to have exposure to sunlight in order to have the best vitamin d. conversion. Well I don't think that I have seen any literature suggesting the best body part what what I have seen what seems to be most reasonable is that exposure of more State of the body assuming that. It's legal where you are to expose your body right exposure most of the body to direct sunlight for a short space of time should give you. The exposure that is needed now here is here is the. People tend to have sunburn in particular areas they tend to have sunburn on the face and the tend to have sunburn on the tops of the ears and undiscovered if they're bald they're getting more like me right so if if this is an issue then you need to protect those areas and they would not be the best places for you to try to to get. Your vitamin d. created from. Any part of the body that is exposed that then becomes sunburnt this is not good it doesn't matter what the complection of the skin is it doesn't it for anyone. Being out in the sun to get sunburned is not good any part of the body at any time and that leaves are the next question what's the best time to get vitamin d. conversion from ultraviolet light Ok now I don't know if the person who sent that question in give any indication to where they where they're from I would assume not so I have to talk about the whole. The whole kit and caboodle there are depending on where you are geographically where you are in terms of your degree of latitude if you're above the 37th degrees or below 37 degrees and as well we have the cancer of the Tropic of Cancer Tropic of Capricorn if you're outside of that to the north or to the south of there you will have difficulty getting you know vitamin vitamin d. from sunshine because depending on the time of year that you are and what season the sun may not give enough direct radiation few to give enough u.v. be Ok so that's one thing the altitude that you are would have or would play a part. Or also the amount of pollution in the air plays a part the season of The Year present part of all of these things make a difference given all of that if someone is below if the person is in the United States and they're below Atlanta. They should be able to get enough vitamin d. and if their skin complection is on the light side Ok that person with 10 to 15 minutes of. Sun exposure to the face to the arms to the back to the chest to the abdomen to the legs that should be enough for the person to make vitamin d. assuming that they have all of the other things in place and the other things in place means that they don't have an inborn metabolic condition that causes vitamin d. to be. Transport systems to not work or things like that. Next month well along those same lines that have been the levels and sometimes are noted to be lower and darker skinned populations could this be somehow related we talked about some of the racial disparities and could give one of their factors related to these some of these racial disparities that we've seen. I believe that it might be associated but I don't think that it's the whole story. Even the issue of skin complection and vitamin d. levels it's interesting that the studies that I'm most familiar with have looked at people in the United States African-Americans in United States and other people of color in United States and also in in Switzerland Ok Of all places looking at people with with varying skin shades and they were looking in pregnant people so that. Right but what they found was that the darker skin you have the lower your vitamin d. levels and one might say Well Ok then that that seals it but that is not the that's not the same situation when people in sub-Saharan Africa and in other parts in not Africa are checked with regard to their their vitamin d. levels they may have dark skin but they're vitamin d. levels are above what you would fine people with vitamin d. levels in the United States so it's not really an ethnic issue per se unless there is some ethnic drift as someone moves from. From Africa or the Indian subcontinent or from South America to North America or something else is happening with them so it's not just that so I would I would say while this may be part of the explanation it's not the whole thing and the social determinants of health may actually be playing in a more significant role even though again back may not be the whole story either. Well I think that sounds like an additional topic for our upcoming level up so we will definitely have you back again with us Dr z. No again it's a pleasure to hear from you work with you and again thank you for all of your amazing lectures and your input that you've provided Well thank you thank you and thank you up next again we have another topic that we discussed at the relationship of sleep or rest now we talked about let's just review great quickly we've talked about hydrothermal therapy which again is extra water treatment not forgetting the entering a lot of treatment again reviewing nutritional principles exercise and alter violent radiation we want to talk now about sleep Let's bring back our good friend Dr Roger shalt pulmonologist and intensive that's dealing with COPD patients on a day to day basis John Trish while we have several questions as far as 3 or Rast are concerned you recommended in your lecture no naps a question came in regarding naps haven't siestas been noted to have some benefit particularly even immunologic benefit. Yes So siestas naps I don't have a problem with anybody taking a nap so long as they don't have a problem with insomnia so that's the key is I limit the say No naps to those that have insomnia and the reason why I say that is because of this substance called a dentist scene the dentist scene is a substance that builds in your body throughout the day and it is the highest right before you go to bed and it's a drive for you to go to sleep the problem is that if you have insomnia the inability to fall asleep or stay asleep you need as much adenosine as you possibly can get when you are trying to go to sleep the problem is that a map will temporarily reduce your levels of adenosine and you'll have to try to build them up later as you go towards the evening time so I restrict patients to know now if they have insomnia I say print thank you for clarifying that next question is as far as the net body is concerned you talked about double the amount of sleep for those who get midnight so the question is if an individual goes to bed at 10 pm or wakes up at 4 am do you get 8 hours of sleep and if so can you clarify how that's the case. You know you still get the same amount of sleep but don't don't misunderstand that those hours of sleep are not all the same in terms of the benefit that you get we know that slow wave sleep which is concentrated at the beginning of the night is very very important in terms of restored to physical sleep it's coupled with growth hormone secretion and so those hours of sleep towards the beginning of the night are also tied to your circadian rhythm and so if you're skipping out on those you may be skipping out on slow wave sleep and so generally speaking if you get tired around 10 o'clock at night and you get up at 6 o'clock in the morning those slow wave hours of sleep are going to be rich in that 10 a pm to 1 am range and if you don't if you're not sleeping you're not to get that benefit and I remember we talked about that book ministry of healing you know a lot of these principles that we're talking about right now were listed are written in that book quite some time ago and you know lived in the 1918 pandemic at the various sanitarium So it's interesting I don't think that that kind of research was available back in 1900 or even before that that but it's fascinating that that kind of research is coming out today. Absolutely do you advise waking up early for the elderly and we talked about going to batter early and going getting up early sometimes the elderly sleep cycles are a little different than that maybe younger populations Yes tend to go to bed and get up or earlier so long as they don't have a problem with it so long as their bed partner is doing the same thing and and they're getting along fine if they're not disturbed with it I don't recommend any change if However it is causing social problems for instance they want to stay up later and they can't well that's usually pretty easy to fix just by exposing your eyes to the lights in the evening will delay your circadian rhythm so that you can stay up later but that's not usually the issue that we have we don't usually see that kind of a problem we see the opposite problem we see people on their electronic devices getting blue light if in the lights on this evil as it said turning night into day causes their circadian rhythms to be pushed back and so you're not really finding yourself needing to fall asleep until one or 2 in the morning but unfortunately well as we get back to normalcy here you have to fight traffic get up at 5 in the morning to try to get into work and that really limits your sleep on both ends absolutely how Speaking of that is it good to take melatonin supplements for insomnia for those individuals having a hard time going to sleep or is it better just to get it from sunlight exposure and sleep all of those things are good melatonin is not a regulated substance so it's hard to find out whether or not you're actually getting it Melatonin is a great medication to take for people who have a difficult time falling asleep unfortunately it's pretty short acting it won't necessarily keep us sleep there's other medications that work on that but a small dose at nights $3.00 to $5.00 milligrams no more than that can it's can sometimes cause problems it's also a great antioxidant as Dr Natalie has told us in the past. Higher symposiums but there's nothing wrong with taking a small dose of melatonin to try to fall asleep both and also has the effect of advancing your circadian rhythm so if you have a issue with falling asleep very very late and you want to try to fall asleep a little bit earlier taking that maybe an hour or 2 before bedtime it's also very beneficial. And one of the breasts associated with melatonin supplementation not much but if you take too high of a dose or too much of a dose it can make you area tainted that's a known side effect and not irritated because it's not helping just actually can make you more era civil. Ok very good and. Very good Friday and review so much Dr for all of your great information we have a couple more questions from a practical perspective on the hospitals I think both for yourself and Dr Net removed there is are there is doctor normally wonderful So again this is for hospitalized patients and if your experience serving us hospitalised or intensive This is your case. So in phase 3 This question is for doctors in phase 3 where the patients are already entered main Are you using intravenous vitamin c. and chast hydrothermal there yeah not only that Layla we're also giving zinc we're also giving an acid feel cysteine although I don't really know if we have an appropriate dose on that as yet we're giving it intravenously for those the tech can't take it orally we're throwing the kitchen sink at these patients who are on the ventilator because really these people have a really high mortality rate. Ok And how are the original Have you noticed anything obviously don't have any case control study just curiosity how your results are showing up know that some of them are dying some of them are getting better it's we see it on both extremes I will say that most of the patients that are ending up on the ventilator are not so much the patients that I would have thought would be ending up on the ventilator it's not my asthmatic so my c o p 2 years for the most part these are patients with cardiovascular diabetes large b.m.i. as these are the type of patients that I'm seeing on the ventilator Thank you Dr Krop Dr Natalie does increasing viscosity agent such as alcohol and dietary dietary fat adversely affect how the patients particularly if the collapse you mentioned hypothesis is true. Well once again we don't know for sure but certainly there is enough evidence in regards to other infection that we know that alcohol and dietary fat in excess are problems we mentioned I think last week in regards to all of the issues that alcohol causes it increases the risk of pneumonia and increases the risk of death from the Mona. And it's very likely being the toxin that it is actually increases the risk of death to cope with ninety's as well and so this is one agent that you might be able to use on your hands to get rid of cope with one thing but you don't want to ingest it and that pretty much is the case for anything that you're going to use that disinfect your hands you don't necessarily want to ingest it whether it's so or whether it's alcohol. Very good point we've had a few cases of that recently of people doing some things that probably they shouldn't take into their body and getting very very ill trying to protect themselves so Dr Another question are you using steam and hellacious in the hospital and community setting as far as a treatment or prevention for covet no not using steam inhalation in that sense I will have to admit that I was tempted to ask the respiratory therapist to turn up the humidifier heated humidifier on the ventilator to sort of help out with hydrotherapy but that's not really too much of a deviation from what they're doing already we already get them heated humidification on the ventilator so no we're not doing that and I think that that's a good clarification and there's been different ideas out there and I think we should probably address that just very briefly is it safe to use a. And again it is unusual question but is it safety news a hair dryer to increase the temperature. Of the rest the trade tract and thereby try to fight off that 90. It's going to be dry air that you're pushing in there at a very hot amount but some of those white her dryers can get very very hot and you know I haven't seen I think I've seen one study that was looked at this and a number of years ago and they used a device that was not a hair blow dryer but rather a device that used humidified air that actually did show an improvement in symptoms of the cold but it was it was actually published in the British Medical Journal so it was a very prestigious journal and they did find that there was some subjective improvement but I don't think that's been done in this type of virus and I think we just want to get the point across that we want to be wise steam as hot hair dryers are hot and we wouldn't want to cause any damage to our respiratory tract so thank you gentlemen thank you so much and we'll look forward to continuing to depend upon your expertise as we continue to want to improve our holistic health of thinking thank you both of you as you know Well next we're going to be talking about self restraint and we've talked another term that was utilized in 1900 we learned more with temperance was essentially self restraint using those things that are good for us moderately but whining things that are harmful or as we learned last week that by taking into our body certain substances it interferes with the effect of our frontal lobe and thereby makes it harder for us to make improved changes in our health we want to improve our nutrition we want to improve our exercise and ultraviolet radiation that when we take certain substances and it affects our front runner and it makes it less likely and our circle goes the opposite direction Well we want to invite our friend and colleague Dr Peter Lammas He's a cardiologist he's also in charge of health for the General Conference of 7th Day Adventist. Well Billy Dr Lammas thank you so much for joining us to pleasure good to see you again you as well well you mentioned last week that the some of the documents that some of the substances particularly alcohol the question came in is it isn't the use of a moderate use of alcohol save and possibly even cardio protective and we would like to ask you that question well this is the conversation that I've had so many times of so many patients across the desk where they would come along to me to say Doc little alcohol just to my heart's sake and you know one would look at some of the literature that had been reading the Reader's Digest and some of them had been reading cardiological literature and yes there have been reports showing some cardio protective benefits to alcohol as far as diseases consent and even in the incidence of diabetes Having said that. When needs to remember that those effects were not unique were not uniform across age groups and not rip rip nickel across or society and many of the studies that were quoted and have been reading looked to act have shown that they were not this many confounding factors the confounding picked as being level of education health insurance availability of health care preexisting disease previous thing alcohol use and then having stopped because of illness reasons so when all those confounding in Queens has had been removed there was actually found to be very little if any cardiac benefit not they have being many who continue to say well the moderate drinking until 2018 a landmarks to. He came out of the lawsuit which looked at many many thousands of patients many studies and showed that not only is it the 7th leading cause of death across the world. And disability years but also with the leading cause of between the age of 15 and 49. So we're looking at death by accident overdose trauma murder or racing so not one system is the conclusion of that will Ogust body and many others say what is the same level of alcohol intake because of cancer cardiac cardiovascular issues all the other problems 0. 0 level of alcohol intake is what the authors of the launch that article were constrained to say so they said there's got to be a lot of policy revision of the wise it's going to be a lot of unnecessary So there's your answer. I have a question as far as the current covert crisis is concerned are we seeing an increase in drug and alcohol dependence during the current crisis people are socially isolated in depression anxiety tend to be on the rise what are you seeing as far as as far as those substances right now or where when you use the word dependence we're not yet sure if they are dependent or they just continuing to use it and and what is what has happened is and was noted by March 15 it was a particular alcohol in the United States which showed and he crease in 55 percent alcoholic beverage. In their business very big one in Canada and they had noticed up to an 11.5 increase in the use of alcohol but the same time. Has shown that 11 percent increase in visits to pornography we're also seeing that domestic violence the injuries that. They have been not reported related to domestic violence and abuse now that everyone's on the lockdown people on scene that doesn't mean that it's not occurring so the onset of the short answer is sadly yes w.h.o. has warned and many health organizations are predicting unfortunately and I believe correct that following the lockdown and the opening up we are going to see a Toonami of mental health issues addictions and problems related to alcohol and other dependencies following that 19. And that's a perfect segue to the next question we're seeing a rise and they being in marijuana use particularly in the younger population are we noting that this is putting them in an increased risk these younger populations for have been 18 Well you know. Looking at a very new disease code 19 is new coronavirus itself is not new We've seen it before and it's comes in various forms and guises However there are a basic principles of petto physiology which was still very much in play so when you have the corona virus the novel coronavirus code 19 coming along what is a do that course has information to fix and damages and destroys lung tissue What does baking do baking does exactly the same what does tobacco do does exactly the same what does Mary on inhalation do well if you smoke it does exactly the same and there was a very interesting. Phenomenon which took place in 2018 called the event a belly was. Isa great or bacon product use associated with lung injury there was an outbreak that sent more than 2800 people to the hospital and killed 68 across the United States the disease called permanent lung damage and result in the least one double lung transplant so the basic inflammatory changes which coated causes of a ping causes smoking inhalation. So the conclusion is that putting this all together and studies starting very early in the Penn day make right in on showed that smokers and China has 55 percent of the of the men in China smoke showed a significant negative impact on covert 19. Yes it's a real problem and for old and I think that's that's a very good point you know there are so many people that are hurting right now and I know you have a lot of programs there at the General Conference a Senate they haven't is in and out are different locations throughout the world and diction is not just alcohol it's not just to back oh it's not just drugs there's many other forms of addiction gambling you talked about sex addiction lots of different things unfortunately people are turning to right now because of the Depression and the anxiety where can they go to get additional assistance for additional addiction recovery. That is a very important question and a really problematic one because so often people don't want to go for or they don't feel the heavy treat him to help and when when you use the term so frustrate. Temperance the using of all things healthy wisely and all things harmful and boiling those things yet in so many there's also the additional constraint of the genetic component as well there's also the addictive component but others struggle even more than some so when we go often people go to church instance that pasta they may go to him on they make good temple they may seek help other places that people go to the negative Alcoholics Anonymous that may seek help from one of those organizations which is very helpful. President Adventist Church has a very strong impulse is on the importance of being there for recovery ministries and Edmonton's recovery ministries global Arman global Arman North America has been to recovery ministries as well as a very meaningful program and number of churches throughout the world have adopted the program and are adopting the program to become a haven which people can go to and get help this is very important component as well is we in general not only in the church sitting in a specific denominational sitting but in the community city we need to have our eyes in is open and bade walk and be ready to extend a helping hand this is one of the hugest problems people places not having someone your kid is enough to help and that's where we can make a difference. Sadly many of the detox programs cost a huge amount of money we're actually doing maybe recovery programs but the actual detox in programs they're limited availability very costly in many settings but we do try and recommend that churches involve themselves in very very importantly in reaching out and making safe havens that people can come once who week and help to stay recovered. Thank you so much tactile and that's what we're going to do so that if any of you were today finds themselves and we all have addictions let's face it we might not have this this of the kind of addictions that we've been discussing here but we all have ways that we would like to improve our how things that were chanted where whether that be some of the substances that we were talking about just now or maybe some of the nutritional aspects and what we will be doing Dr Lambesis listing on our website 800 r g forward slash health that it's Ok with you alone where people can go so we will be definitely doing that thank you so much her heart need to have with me dead just one thing which is a hugely important yes or no in the Alcoholics Anonymous who talks about the higher. We would be remiss not to encourage people who say we go it may sound almost Well we've heard this all before we can turn to God and I think it's a times like this particularly that when we feel that every avenue has failed to reach out to reach up. 2 Coast households it is Misty and Oscar quick to help and so many people have become good relying on him as the highest. So let's never forget that absolutely thank you so much Dr Lammas you appreciate it and continue to look forward to inviting you back on level up thank you so much a fear of base here thank you God bless you too so speaking to the holistic approach that the 7th Day Adventist Church has taken it actually began back in the 860 s. and some of the guinea's principles that we've been talking about everything from nutrition to action or size to sunshine and yes self restraint were talked about in the 1000 and practiced I dare say in the 1918 pandemic at that sanitariums with such good results Well we have next with us my very good friend my mentor and my colleague Dr Richard Hart Dr Hart is an internal medicine specialist he is the chief executive officer and the president of Loma Linda University my alma mater Dr Hart we talked about the effect on the sanitariums utilizing these principles these holistic health principles How long has the 7th Day Adventist Church been teaching these principles of health. Own Wife or started walking as well into this whole understanding along with still her strip and crackers and others per back in the $860.00 z.t. seventy's. And then but the formal program really started with John Harvey Kellog Battle Creek and the 865807080 or so on the 1st medical school start of their bad weekend of sanitarium with for example and then nobody started 1000 or 5 and again it's a long storied history of not only preparing health professionals but started doing research on this stuff as well the significant research really started about 65 years ago now in the 1950 s. with Dr Lemmon Frank Lemmon and Richard Walden and what was a 1st of the Adams more politics that he. Was compared to what. Compared to what committee people were dying. And that was discovered that time that there's the things we thought would probably be true that had been asleep longer and so on so that's when that that's when the research really started building up and then developing some sort of principles backed by science excellent And along those lines currently there is our research I believe as far as scientific and research to indicate that these principles not only a factor immunity but other aspects of health with agonise health studies in particular is what the night seems to be really for Dr Robi Phillips over a factor here Professor of Epidemiology develop what we call Adam so study one in listing $30000.00 add them as a cross California to look at their impact their health status. And discover that in fact there was many things were happening was axed be funded to look at cancer but they quickly discover that heart disease was left of many other autoimmune diseases burlesque because of the plant based diet the sort of emphasis that the administration put on a plant based diet This is followed by 20 years later with Dr Gary Fraser doing it in the source 32 which is still ongoing documenting the improvement that adding this to many of these diseases typically are that instead of 10 years longer than cohort met control of the community because of largely the pathways that as well as avoiding alcohol tobacco and other sorts of things that we do as an eating now there was a recent in the last couple years a recent study and publication coming out about the blue zones can you tell us a little bit about 7th Day Adventists and the blue zones there particularly in La Melinda. Yes a fellow by the way Dan Buettner working for the National Geographic started looking at where do people live the longest around the world and he just discovered 5 places that people will live the longest only one of those was in the United States and that was part of a little known fact it was especially based on the eyes of us in California not just normal but this demonstrated that they were living 7 to 10 years longer than the average people with their master age and social economic status and that was because of the plant based diet the social connections the regular exercise there was less obesity there's many other variables that factored into this because the evidence was solid gave that longevity that's amazing Well Dr heart I just want to say a very very special thank you to you thank you for everything that you do for training students like myself and being able to go through medical school and residency and and for continuing to purport these principles that again were founded a long time ago that have again been found to be scientifically a political for us today so thank you Dr Hart. Thank you it's always a previously with you later thank you Dr Hart you know that leaves me a big question in my mind one of the main factors related to momentous Bluestone was that it was a faith based community a 7 am a faith based community we know that holistic health physical mental emotional and spiritual health is completely intertwined they don't seem to be separate and fact if they are one's total wellbeing is affected I am excited to enjoy right my good friend Dr Mark Penn rank Dr and Lee is a world renowned speaker he's also the special assistant to the president of the General Conference of 7th Day Adventists and has his masters in public how as well Dr Finlay is there additional evidence besides what we heard with the blues with the Adams house study that's your actual health actually affects and improves physical and mental health well thank you oh it's always a joy to be with you there have been over $200.00 studies that have looked at the relationship of religion and health in fact to Dr Linda Powell an epidemiologist at Rush University Medical Center in Chicago took a look at those 150 studies and she was looking at specifically mortality rates and what did the study say about mortality rates between people who are religious and people that are not religious people that go to church and people that don't go to church she discovered that about the people that went to church and had a deep religious experience of prayer and Bible study had a 25 percent less mortality than those that did not do this so that was just taking a look at those $150.00 states. Dr Harold coning has made it a really old life and work in studying religion and health accounting is a Duke University and I'll give you just a couple of the studies that he has participated in one was a study of $4000.00 older adults was a 6 year study and it was looking at blood pressure and the question was do people who of faith do they have lower blood pressure than people who are not of things he discovered that those people who were attending religious services prayed and had a meaningful thing a study their Bible had 40 percent who are diastolic blood pressure much also for tension so when you begin to look at multiple studies have been studies done on the unused system and particularly into who can sit at the study done in 198-619-9092 showing that bet there were much lower rates of interest 6 Parliament which is of course of the insistence marker so when you take a look at the vast array of studies that there are I think is not much question for when you look at the scientific data today that a positive religious experience where one is a loving God where one has a social connection in church that those studies indicate that is religion is beneficial to all. That's amazing that's amazing Dr Ben Knight and when in if the relationship did you find the 5th make relationships with those who actually regularly attend church and their physical and mental well being as well there are there are other give you just a couple of those here is one that was call the Berkeley human populations study so they took 5000 adults they followed them for 28 years and they took they said Ok we look at these 5000 adults let's take a look at the ones who go to church the ones that don't go to church this is what they discovered the ones that were faithful in their church attendance were much less likely to spoke that means the UK had a lot less cancer a lot less heart disease they had on Jeopardy Secondly and this was surprising they increased their exercise and so people who tended to go to church tended exercise more than those that didn't. They have increased social contacts so that there be pressure in levels were less and incidentally they tended to stay married to a longer reducing the stress of the divorce etc So the Brickley human population study is just one of the studies that have been done on religious people and their overall health has been sound as well that they tend to their diets they believe their bodies at the temple of God and there's an amazing passage in the book of proverbs but it kind of puts together physical health mental health and spiritual health and really shows the relationship of faith and prayer and this belief in God with our own physical health and in Proverbs Chapter 3 it says trust in the war with all your heart lead not here at understanding you know your ways. Knowledge and he will direct your paths don't be wise of your own eyes listen to this seer go hot that is not fear in the sense of being freed of that respect and depart from evil What will the result be of that faith experience that religious experience it will be health to your flesh and strength to your bones so here the ancient scriptures reveal what science is discovering today that a meaningful faith experience with God is health to our bodies. It's. Absolutely phenomenal. I must say that you know the principles that we've learned from 1900 pandemic those novel lessons as we've discovered recently do pan out for our cope and 19 crisis would you mind giving us closing prayer as we close out this last 8 Dr trusting in God you know we've talked about all these other principles everything from water x. turn only an entrant only air fresh air up our open spaces we referred to it nutrition proper nutrition we heard about a plant based diet and all the any oxidant awaiting those things that are harmful for us and doing those things that are good for us in moderation or temperance or self restraint Rast strength exercise sunshine but you know there's that foundational principle of trusting in a higher power our God you know I believe all 7 of those other principles are built on the and that's your family do you have a closing thought and a closing prayer for us pretty wonderful you know a lot often there are individuals that would like to make changes in their advice they recognize that their habits and their advice that are detrimental to their health they recognize as well that they like to make changes in their diet or an issue of self-restraint smoking drinking alcohol they want to get out of their exercise program and sometimes they even make new year's resolutions a month or 2 later they don't have the power equipment is one of the things I found in dealing with people in the area of health is that to take that ideal and put it into practice one needs a power beyond themselves one needs a strength beyond themselves and as we've heard a I want thank you is our. Our participants that assurance that every time we make a positive choice it's God through His Holy Spirit that puts within our hearts that desire to make the positive choice and the got the puts that in our hearts will give us the strength to carry out that choice let's pray Father in heaven we want to thank you for giving us positive noble desires we know every desire to treat our bodies as temples of God Every desire for good health comes from you that you prompt us with those positive desires we don't have the strength to do this on our own we ask you this very day that you give us strength give us power that's beyond human to put into practice these principles of health also help us to see our patients as whole human beings physical mental emotional and spiritual help us to treat them with respect and dignity and lead them to the source of that higher power in God and help them to know that you are their Redeemer Savior who are in crisis. You know and thank you so much Dr Stanley you now at the request of our dinner is really the NAFTA what are we going to do next what's coming back. Well we are very happy to announce the program level out we've been mentioning it a couple times Dr Mark Fenley and an expert medical physician will be joining us this coming week it will be Dr Steven Lee So next Sunday the 17th at 7 pm we will be having our very 1st level up let 7 pm Eastern level at quarantines Illinois we will be asking some very difficult questions we'll start with Dr Lee Dr Lee has an ear nose and throat specialist who is also an oncologist and the vice chair of the e.m.t. department of Loma Linda University he'll be providing to us the scientific background for the coring $200.00 situation we'll be asking questions such as when will a vaccine be available how are we going to deal with this question of quarantine but then Dr Marc Finley will be taking us deeper and we will be looking at the history of Korean team has it happened in the past for even thousands of years is there a biblical they says for it question such as Is it Ok or wrong that we be asked to wear masks again these are difficult questions but they are questions that need to be addressed so we hope that you'll be able to join us starting next week we also want to invite you to tomorrow's program this will be medical Monday question and answer session part too many of you have sent your questions and tonight we apologize we weren't able to get to those this evening but you have another opportunity 11 am Pacific 2 pm Eastern tomorrow we will have a requestion and answer session so we hope that you'll be able to join us again at 8 w.r. for any more information you'd like. Forward slash health and be able to watch that program live as well finally I want to ask you to pray for our program pray that God will continue to bless as we each of us seek to. I have holistic health One final question that has come in as far as the kind of category one see in the credit for those of you who registered clean if you haven't done so already make sure you complete your evaluation form by tomorrow because tomorrow is the deadline for your up to 12 hours of category one seamy credit we will be having another see in the symposium in the early fall please stay tuned we will let you know again God bless you and I want to wish each and everyone of us continued hell Holistic Health says it cleanly mentally and spiritually until next time God's blessing and stay happy and healthy and whole.

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