America's #1 Heart Risk & How You Can Prevent It

30:34But when you're around really drunk people and you're not drunk, it's not enjoyable. It's different if it's like, I'm having a glass or two. It's like, cool. I can be around that. It's fine. But it's like, if you're just unable to think clearly, we're not having fun. And you don't look like your body is having fun the next couple of days either. So how is there a benefit to this? You know, I get it culturally, religiously for some religions, societally, there's benefit for bringing people together, but you can come together and play board games. You can come together and have fun and talk and open up vulnerability versus needing the courage of alcohol to start sharing the truth.

31:12Knowing that the damages are way stronger. Now I might die of some random thing and be like, Oh, you died of this. You could have been drinking your whole life and whatever, but I just don't think there's benefit to it personally. There's, there's not benefit. And it hurts your, your heart. It sounds like. It hurts every cell of your body. So I had a little different path than you. Didn't you used to drink? I did, but I want to validate. You were like a good Southern boy who was like, let's drink every few nights. And you know, well, tell me your drinking experience. I'm not going to admit to too much.

31:45I don't judge. I'm just, I enjoyed, I enjoyed alcohol. I enjoyed wines. I enjoyed carrying wines with food. I enjoyed the whole experience like you discussed. Yes, I did. It was, it was very much part of my lifestyle. It, no question about it. And when, um, I started to not feel well prior to my own cardiac situation that I said to myself, well, i mean the one thing you can do at least is quit drinking at least remove that from your life and make sure because i didn't really know what was going on and see what happens see what happens how old were you i was 55 at the time it's like a year ago or what was this no thank you that was three years ago um and it didn't really make a lot of difference because i had something else going on.

32:42Yes. It made some difference for sure. But once I knew what was happening and I got a stint and I felt much better, the first thing my wife said to me, she's like, and she doesn't drink by the way. She said to me, are you gonna start drinking again? I said, this has been a year at this point. I said, no way. I don't even want to because of all the things that you just mentioned. I like to live my life untampered. You know, the good times are the good times. I deal with the bad times accordingly. And with alcohol, people drink it both times. Yeah. To celebrate. And they're sad. And when you're sad.

33:20And it's the one drug that your friends will encourage you to continue to do. Let's have a beer. Yeah, yeah. And one of the other things that really got my attention that you said is that it's really not fun to be around a bunch of drunk people. If you're sober. and I didn't realize that for a long time. Interesting. And it, I can tell you that removing alcohol for my life was probably the single most transformative decision I've made as an adult. That's great. No, there's no question about it. And you know, I heard Lance Armstrong say on a podcast not long ago when he was talking about, I guess he's removed alcohol recently or in the last year or two.

33:57He said, I've never heard anyone say, I regret moving alcohol for my life. I wish I hadn't quit. And I was like, that's so true. And for me, it is like the, this, this magic sauce of every day is the same. Every day is predictable. I'm clear. And, And, you know, people feel like I'm very judgmental when I talk about it this way. I'm not at all. Like when I say your body, your rules, like go for it. Live your life. I don't have any room to be judgmental, nor, nor, nor do I want to be. But it's kind of like when you read a good book or go see a good movie, you want to like share that experience.

34:41And that's kind of the sense I got from you when you were sharing, you know, your experience without alcohol. I have seen the contrast of that. and just how powerful that change has been for me. And so... Life has gotten better for you. No question. Yeah. On all fronts. Yeah. Health-wise, relationship-wise, you're saving money. Like all these things. Absolutely. Yeah, yeah. Now, do you wish you could go back and quit sooner? Or do you feel like, okay, it served a purpose for 50 years of my life and now... Well, yeah. I mean, I do. because it's been so powerful that I, I, I do wish I had realized it sooner, but it just wasn't my path.

35:30Yeah, exactly. Wasn't my path. And I'm okay with that. Yeah, of course. You know, I've, I've, I'm enjoying it now. Yeah. Yeah. I'm curious about this. You've done over 6 ,500 plus heart operations, heart surgeries. How many hearts have you held in your hand? Well, all of those, You put them, you like take it out of the body or some of them you leave? No, no. It's every, everything remains in the body, but you have to manipulate the heart. Wow. So the arteries that I was talking about on the front of the heart are these red, red lines. So if we're operating on the front of the heart, the heart can kind of sit here.

36:05But if it's on the back. But if on the, you're right. So we stop the heart for the majority of these operations. Stop it. Utilizing a heart lung machine. Holy cow. So the blood, the blood continues to go around the body. But not through the heart. We put a clamp here. Because otherwise there's blood coming out everywhere. Exactly. And then we infuse the heart with a high potassium containing cold solution that puts the heart muscle in a hibernating state. And then we can actually maneuver the heart, open the heart. That's how we fix the valves. That's how we do all of that. And then we maneuver the heart.

36:39So you're actually handling the heart when you're doing all those things. But no, we don't remove it like that. Yeah, yeah. But you're kind of adjusting. Absolutely. In the chest cavity. Sure. Yeah. What is that like holding the heart of a human being? You know, I look at what I do as an honor and a privilege, honestly. And it starts well before I ever get into the operating room. And that's the relationships that I develop with my patients. and that is just one component of it for me for the patients it's like you've had my heart in your hand i get that comment a lot you know i think it's and i don't i don't want to i don't want to deprioritize or belittle the comment that they're making but when you're doing something every day, it becomes, it becomes part of the routine.

37:36But again, to develop a relationship that there's enough trust that I'm given that opportunity to do that, that's what's meaningful for me. Yeah. Yeah. Now this may be very sensitive topic. We don't have to talk about it if you don't want to, but I'm assuming you've been a surgeon for 25 years. There's been people that haven't made it from surgery, right? Sure. Have you ever talked about that stuff of what that is like when you're invested in a person and you know how high risk it is? Like they may not make it either way and you've got to go in and operate and then they don't come out of that alive.

38:15How does that impact you either emotionally, mentally, confidence wise, just kind of how do you deal with that in general? And I know a lot of doctors have to face this, unfortunately. Yeah. You know, brain surgeons, heart surgeons, this is, this happens, unfortunately. Sure. Obviously you hope it doesn't happen that often, but what has that been like for you? So for elective operations, lowest risk operations, the risk of patients dying is, is 2%, one to 2%, which sounds like a small number until you put it in the perspective of 6 ,000 patients. Right. Right. And so if you ask me what the single most difficult part of what I do is it's patients dying.

38:59Wow. And that's no easier today than it was when I started 25 years ago. It is absolutely no easier. And, you know, you mentioned the patients that are really high risk and aren't going to make it, you know, honestly, from a mindset standpoint, if it's a real Hail Mary operation, the expectations with that patient and the family are very lower. Oh man. But for elective operations, when someone walks into the hospital and they're a mother, a husband, you know, and they fall in that one to 2%. Oh my gosh. It is really, really, really difficult and remains so to this day. And I still wake up in the middle of the night thinking about some of those losses over the years.

39:55But, you know, in the end, when and if that were to ever go away, I would quit what I do. What do you mean? Because if, if that sense of attachment and the importance of that event occurring and the way it impacts me personally was never. Yeah. Then I don't think I should be doing what I'm doing. If it didn't bother you or affect you. Exactly. Wow. Exactly. And, um, you know, you do, as you mentioned, have to compartmentalize because you can't take that home and you got to get up the next day and you got to come back. You can't do it in a heart surgery the next day and thinking about that. Right.

40:43I mean, obviously you're thinking about it and wanting to do the best job you can and making sure you're taking the right actions, but you can't. I hope this doesn't happen again. You cannot go into the operating room with that mindset and you have to compartmentalize. How did, did anyone teach you? I don't know if they teach you this in med school, but did anyone teach you how to navigate when you lose a patient? Like how to process that emotionally? or is it more you have to just compartmentalize, do the job and almost like not stuff it, but stuff the emotion so you can show up your best self the next day?

41:15So the first part of your question, can you teach that? No. And it doesn't really happen until you're technically out of training entirely. Yeah. And the responsibility is 110 % on your shoulders. So you're like 10 years in as a doctor, training student. You're like, you've done so many reps. But you're not truly the response. But the buck doesn't stop with you. Yes. And until you get into that situation, it's very difficult. It's like trying to instill ownership into someone as an employee, right? Like you can't really do that until they're there and they're part of your business and what have you.

41:56And they either have that or they don't. Same thing as a physician, as a surgeon. You know, until you show up and all of that responsibility is on you, you don't have that emotional attachment, even though you see it and are part of it in training. Because you've seen other doctors, those patients that you were helping or guiding. Absolutely. And you're still, of course, I mean, you feel badly in those situations. Not that you're non-emotional. But you're not the one in there doing the job. You don't have to go out and look the family in the eye and have that conversation. I don't know how you do that.

42:29Yeah. It's not easy. And it's never gotten any easier. Oh, my goodness. Yeah. It's never gotten any easier. It has not. It is not the fun part of my job. It is not. Has there ever been a patient that has come in on the operating table that you said, this is the biggest long shot of success? Like, there's a 1 % chance this will work or something like that. And they have somehow recovered and lived a longer life because of that operation? Absolutely. I mean, yeah, absolutely. I think most cardiac surgeons would identify with that too. Just like miracles. Yeah. I mean, look, we never walk in the operating room alone.

43:15That's the bottom line. We're just people operating on people. And there's certainly, you know, we always do the best we can. but the end is not up to us. That's that ultimate... The ultimate outcome is not up to us, but we certainly have taken patients, particularly younger patients, that come in with really grave problems, we're going to give them an opportunity, even if it's a very low percentage, because why wouldn't we? Of course. You know, if somebody's lived a long life and they're in their 90s and they have multiple medical problems, they come in with that same problem, it's a different conversation with the family.

43:53Yeah. Yeah. Wow. But absolutely that, that does occur. Do you have a ritual before you go into surgery and do you have a relationship with God where you bring God to the, the room with you? So I go through very much a process. It doesn't necessarily happen right before the operation, but days leading up potentially. And much like military or sports where I visualize the operation that I'm going to do. I then identify the three or four worst possible scenarios that I can get into. Wow. And how I'm going to get out of it. That's smart. Because, you know, we never rise to the occasion. We always fall to our level of training.

44:43Yes. I mean, that's just human nature. Military 101. Exactly. I mean, I like to occasionally believe that we do rise to it occasionally, but that's under duress. You can't count on that. No. And so. Unless you train for it. You're going to fall to the level of your training. Every time. And so that's absolutely what I do. And then I always bring it back the morning of when I see patients before surgery to the patients that we're actually going to be operating on that day. Because I tell patients in the pre-op conversation that I can't guarantee them that we're not going to have bumps in the road.

45:20But what I can guarantee them is they're going to have 110 % of my attention at all times. And I'm going to care for them like they're my own family. Wow. And that I truly mean. That's great. And I think that that's how I express to them that I'm truly going to be a part of this and fully engaged. Do you bring God into your ritual at all or is that not part of your life? I don't specifically. Some doctors are full faith based and other doctors alike. Absolutely. I just got to, I am a very, I'm a very spiritual person. I'm not a very religious person. And I also find that with the breadth of religions that, you know, there's times when it's appropriate and there's other times when it's uncomfortable for patients.

46:08And so my job is to try to make them as comfortable as possible. And so I want them to know that, that I'm coming to them fully engaged and open and fully responsible. You know, a lot of the topics that we talk about on the School of Greatness is around relationships. I think relationships is one of the keys to either living a fulfilling life or suffering in life based on the quality of your relationships. I'm curious from a heart surgeon standpoint, do you think someone can die from a broken heart?

46:49based on relationships, not like, can the mind and the emotions impact the heart so much if they feel devastated from a loss, grief, a breakup, a divorce, where the heart just cannot go on? The short answer is yes. Really? And there is an actual syndrome. What is that? Tokusobu's cardiomyopathy or broken heart syndrome. Really? It is a thing. Come on. So you could be a healthy human being have none of these you know workouts absolutely no body fat now it is most commonly occurs in women over the age of 55 or 60 most commonly it happens in men too you've seen this oh absolutely we see it multiple times during the year typically as you pointed out it's after the death of a loved one financial loss major emotional stress so we think and we don't truly know the cause, that it is an overstimulation of the autonomic nervous system, which is that fight or flight or the rest or digest.

47:58It's like an imbalance of that, that then causes like acute heart failure and patients present just like they've had a heart attack. And many times they end up being evaluated by a cardiologist, actually having the dye put in the arteries, the catheterization, and they have no blockages. But the heart function that was before normal is now down to like 20%. Now, here's the good news and bad news. The majority of these patients get better just with support. Some medications, support and time, and it gets better.

48:40women it's much more common but the death rate is very low somewhere around one to two percent men it happens much less commonly but the death rate is much higher five to eight percent there was some research early on that this maybe has something to do with the decrease in estrogen which is why we're seeing it in perimenopausal and menopausal women more commonly, but men get it too. So those theories aren't holding water across the board. So we don't really understand it. But yes, you can die from a broken heart and we see it and we see this syndrome. I have had patients that I have operated on that have been really sick.

49:27And then their family member comes in two weeks later with broken heart syndrome and they're both in the hospital at the same time oh yeah it's crazy but you can't operate on broken heart syndrome no you don't have to there's no there's no blockages there's no blockages and the valves are working fine it's just that the heart function that heart pump that normally is strong is now weak and with time and support thank goodness the majority of them come yeah wow don't start drinking when you have a broken heart this don't start overeating and drinking. That's good advice. That's good advice. What is the difference?

50:04You know, I hope I never witnessed this and I hope no one has to witness this, but what is the difference between someone having a stroke or stroke-like symptoms versus a heart attack or heart attack like symptoms? What do they do? How do they respond? What are they saying between the two? That's a good question. And I think that it's not an uncommon confusion because people think that that there's a lot of overlap and sometimes there can be, but let's start with stroke first. Okay. So that you understand what's happening. Basically with a stroke, it's lack of blood flow to a portion of the brain.

50:42And does the heart influence the blood flow to the brain? Not typically in standard stroke symptoms. And I don't want to get too far in the weeds. There are cardiac sources that can cause strokes. It's not a blood flow issue though, from a heart problem most of the time. Where's the most common places that strokes come from? It's blockages in the carotid arteries that break off, pieces break off and go north and cause blockages in the small arteries in the head and then cause a lack of oxygen and nutrients to the brain, just like a heart attack in the heart. So the essential problem is the same.

51:23The symptoms are very different. So when someone's having a stroke, what are the symptoms that you'll see or notice? The things that you want to look for are changes in speech, drooping of the mouth, weakness, typically on one side of the body and not on the other, but it can be, you know, there can be some crossover, but it's usually facial changes, slurred speech, visual changes, and one side of the body, meaning upper extremity, hand and or leg, not moving properly, weakness. Okay. So that's a stroke. And that is a medical emergency. 911 now. Absolutely. Stop what you're doing. 100%. Call the paramedics.

52:08Get them to the hospital. Absolutely. That's a medical emergency, as is a heart attack. And what are the main symptoms of a heart attack? So the main symptoms are going to be crushing chest pain, typically described as like an elephant sitting on your chest, shortness of breath, radiation of pain into the arms or up into the jaw. That being said, as I mentioned earlier, can be the great masquerader. Patients can have intense abdominal pain that doesn't go away. it can be difficult to discern, but those symptoms of crushing chest pain that does not go away, pain that radiates or into the jar, shortness of breath, 9-1-1.

52:509-1-1. 9-1-1. Absolutely. I hope I never have to witness that, but that's good information to know. So you're taking action as opposed to, ah, you'll be fine or, you know. And always when in doubt, you're never, you're never going to be, you know, you're never going to be criticized for calling 911 and going to the hospital when there's a concern. The commodity is too great to not do that. Yes. Yeah. You got to take care of your life. And what would you say are the three biggest things then everyone should be adding to their life to help their heart? And the three biggest things people should be removing from their life to support their heart health.

53:35Okay. We talked about some of them already, but if you're like, here's the three things you need to add to your life and three things to remove and you'll improve the quality of your heart health much better. What would you say those things are? So let's talk about the things that you should add. Cause I think people are much more willing to add things to their life than to remove things that they've gotten accustomed them to or they've enjoyed. So I think the first is to move every day and not live a sedentary lifestyle. And that comes in a lot of forms. Ideally, like if we're following the data, what do we want that to include?

54:14We want that to include aerobic training where you are getting your heart rate up at least two to three times a week significantly so that you can move what's called your vo2 max again a fancy term what does it mean it just simply means how efficient your cardiovascular system is working so the better your vo2 max the more efficient your heart is working that increases your health span and and lifespan probably the single most important predictor honestly is vo2 max okay then along with that is resistance training yep so important as Gabrielle Lyon says muscle is the organ of longevity why does she say that well obviously having a solid muscular mass as we age because we know we're going to be losing muscle mass after the age of 30 it's dramatic having that in place you're more stable you're less likely to fall you're you're able to pick up your grandchildren and pick up suitcases and function have a functional life in addition muscle is a glucose sink or a sugar sink in our bodies and maintaining stable blood glucose levels is critical not just for cardiovascular health but for chronic disease in general so i think exercise is so important yeah to add okay i think the next one would be a solid sleep hygiene program.

55:52Because, you know, you as an athlete understand that the biggest gains happen during recovery. And it's hard for guys like you and me that just want to go harder to get those results, right? Just push harder, harder, sometimes to take the step back and actually allow your body to recover. And it's not just your heart and your muscles. It's our brain too. Our brain rejuvenates when we sleep. That's when all of the waste products that have occurred in the brain during the day get washed out. So sleep is important across the board, both from a cardiovascular standpoint and whole body. And then I think the third is what you mentioned earlier, I think relationships are really, really important to longevity.

56:48You know, my dad's about to be 89 years old this month, actually. And he called me one time and said, you know, I'm going to give you one piece of advice as you age. He said, keep your friends really close to you. He goes, because you're not sure which ones you're going to lose, which ones are going to be able to communicate because having someone pick up the phone and just say, Hey, what you doing? Yeah. Or how are you doing? He goes, not that you have to make any great plans, but just that connection, I think is a really, really important factor. That's cool. In the reasons we get up every morning.

57:31And that really stuck with me when he made that comment, Good wisdom. Particularly on the eve of his 89th birthday. And he said this actually years ago. It wasn't recently. Wow. So three things to add to increase your heart health is to move every day, aerobic and resistance training, have a healthier, better sleep hygiene program, you know, get quality sleep every night and improve the quality of your relationships. And what would be three things to remove to improve your heart health? Okay. so the first would be be conscious of what you're putting in your mouth remove the processed and ultra processed foods and added sugars because glucose management sugar management is such an important risk factor when we look at things like type 2 diabetes metabolic syndrome all of these things that drive coronary disease, as we discussed earlier.

58:32Obviously, ultra processed foods, again, driving this inflammatory engine. So removing those, focusing on a whole foods diet, and really just being thoughtful about what you're putting in your mouth. The next one is obviously smoking. We got to remove that from the list. And vaping, right? I would love to include both. If I could support it with the data, I would definitely put it on there. But I think that ultimately, yes. Well, the data of you've seen young people come in your operating room from vaping that has impacted their heart. I mean, that's your personal data. You haven't seen the data in the literature, I guess, right?

59:11Exactly. And the third thing to remove? Yeah. I would have to put alcohol on that list, both from my personal experience and from my clinical experience that the patients that I, you know, the patients that I care for that don't drink are a different group of patients than the ones that do. Interesting. Just because typically the rest of the pieces of that lifestyle also go in line with that mindset. Yeah. It's hard for someone to be healthy with their sleep and prioritize sleep, move their body, eat really clean. Right. have good relationships and then also be an alcoholic. Right. Like it's hard to have, you know, it's like if you're doing all these things well, you see the effects of alcohol.

59:59It's hurting my sleep. It's hurting my relationships. It's hurting my fitness levels. I can't train as hard. So you're probably more mindful. Maybe you drink every now and then, but you're not drinking every night, you know. You're more mindful. If you're conscious of all these other things, but not here, something's off. You know, and I think that brings up a point. You know, we all have our own instruction manuals. Yeah. Right. Like yours is different than mine. Your diet is going to be a little bit different than mine. It's about what what works for you. And I think a big part of this whole journey is is figuring out what that instruction manual is.

1:00:33These are kind of the the major levers. And then you need to figure out how and where and when you're going to. Yeah, exactly. Work after those. I mean, and I and I speak with a lot of conviction, but I hope the people watching or listening. listening to both of us, you know, if people want to drink, drink, you know, my, I know I don't live a perfect healthy lifestyle. I have too much sugar. I probably have too many processed foods and I know that, but I'm conscious of it. And I have more whole foods than I do processed most of the time. Yeah. But I also know when I'm doing it, I'm like, ah, you know, I need to be doing better.

1:01:12That's right. Let me pause this. What did I say earlier? We know better, but we don't do better. So it's about being, you know, being conscious of it. If you are drinking, it's about like, okay, I'm only going to do this once a week, maybe, or once every now and then, or something like that. And really try to limit it if you can. No one needs to be perfect. And you don't have to worry about that. And I'm, I'm not here to judge people, but I am here to elevate myself and others to living a better life. And if that means calling people up, then that's what I want us to do. Absolutely. And it's about, it's about progression, not perfection.

1:01:45And you're right. Like even for me personally, if I'm eating whole foods 80 % of the time, it's amazing. And 20 % of the time I fall off. That's a W for me. That's a win. It's a big win. And I'm comfortable with that for me. Yes. And when you talk about, you know, like, how do you evaluate where I start with my health or, you know, what's the one thing I would say, do it's very difficult when we talk about all of us as individuals to give that one thing. Because if I came to you and said, well, you need to move every day, you'd be like, well, I do that. It's like, I don't need to do that. I don't need to do that.

1:02:22What we need to do is we need to identify what we're bad at. Yes. You know, I'm a terrible sleeper. Right. Yeah. So I need to work on my sleep. That's my Achilles heel, you know? And so first having the intellectual honesty to identify those things that you don't do well is the greatest opportunity to move the needle with your health span. That's amazing. And I want to ask you, I know a lot of people are confused about this. What is the difference between a heart attack and a panic attack? Because some people have a panic attack and they think I'm having a heart attack. What is the difference?

1:02:58It's tough to tell the difference many times because the symptoms can be so similar and panic attacks can be very physical. as well. Of course. And, you know, so what are those symptoms? Well, some of the things we've already talked about, shortness of breath, sweating, chest discomfort, you know, nausea, changes in vision, you know, all these things, they can be panic attack, they can be heart attack. How do you tell the difference? Well, panic attacks typically are brought on by emotional scenarios, not always, but typically speaking, they'll typically last 10 to 30 minutes, self-limited, and then they'll ease off.

1:03:43Heart attacks, on the other hand, are typically, you typically have some warning signs of the progression of the discomfort before it comes on and doesn't go away. It's crushing chest pain, not a sharp chest pain, and it doesn't get better with time. And that's a key, and that is a true medical emergency. Now, if you're in one of those scenarios and you're not sure, then you need to go to the hospital because that's always is the safest thing to do because with an EKG and a simple blood test, you know, that can be, that can be delineated pretty easily. So it's a difficult, it's a difficult scenario.

1:04:30It really is. And people frequently during panic attacks will say, I'm having a heart attack. Now, the other important thing is panic attacks do not cause heart attacks. And I think that's a spin that a lot of folks will get into, yes, I'm having a panic attack, but now I'm having a heart attack. That would be very, very unusual. Very rare. Very, very rare. Panic attacks, you know, don't make you feel good, but it's not killing you. Correct. Right. Exactly. It might be influencing your overall health, but it's not creating a heart attack. Right. Right. And you may fear for your life during a panic attack.

1:05:10I've seen that many, many times, but you're not in danger. What's the best thing someone can do to recover from a panic attack? Yeah. So, so it doesn't happen again, you know? Yeah. Well, so it doesn't happen again requires coping skills, but to break a panic attack, what you really want to do is divert your nervous system in some way. The fastest way that I have found to do that is take a bag of ice, fill it up and put it on the back of the neck and it just kind of changes your whole focus if you don't have a bag of ice you can you know just put your face under cold water whatever whatever opportunity you have if you're driving please pull over you know get a get a cup of ice from the convenience store and put your hands in it or just hold on to some ice is usually enough and it'll frequently break a panic attack.

1:06:04Now, treatment of panic attacks is way outside of my wheelhouse as far as long-term coping skills and things of that nature. But I think the good news is in most cases with appropriate support and guidance, people can get over panic attacks. I mean, I really think in anxiety in general, I think that it's not something that people have to live with forever. Okay. So I'm going to ask you one through 10, 10 being the best one being the least best one through 10, how valuable is saunas for helping heart health? So I am a huge believer in sauna therapy. Now, all of the data has been done in traditional finished saunas.

1:06:56um i i don't have a problem with the the other alternatives or whatever with the infrared type saunas and there's there's some other ones out there but if we're going to talk about the data and what i personally use that's that's where i think the the money lies if you will so the numbers are dramatic that if you are utilizing sauna four to five times a week sessions of 11 to 12 minutes each that 11 minute mark seems to be important somewhere over 175 to 180 degrees fahrenheit your decrease in cardiovascular events is greater than 50 and all-cause mortality is in that same level as well in addition now the neurocognitive benefits of sauna are starting to come out as far as being protective from alzheimer's dementia what have you why does all of this happen and i don't i i don't really have the capability to dive deeply into the science but the basics is that we release something called a heat shock protein when you're in the sauna particularly when you get to that uncomfortable place in the sauna seems to be where you really have this release you stay just a couple of minutes a little bit a little bit longer is where you really get the benefit and that that is where the cardiovascular all-cause mortality and neuroprotective benefits come from.

1:08:26So one through 10, what do you think? Is that a 10 for you? Is that an eight, nine? It's a 10 for me. I sauna at least three to four times every single week. Okay. One through 10, ice therapy, cold therapy. So personally speaking, I am a huge believer in cold plunges. It's my morning routine every single morning for a, um, you know, I like to start the day with something hard. It puts, puts my whole mindset in perspective. It wakes me up because you get this cortisol release and it really sets the tone. Plus as I'm peaking at 60 here and like to stay really active, you know, when I get out of bed in the morning, my wife will say to me, what hurts?

1:09:09And I'll say, look, it'll be quicker for me to tell you the things that don't hurt right now. She's like, well, that's not good. But cold plunging really helps on a day-to-day basis to keep all of that under control. The data from a cardiovascular standpoint and really overall longevity standpoint is not as powerful as it is with sauna. I can't tell you specifically what it is off the top of my head, but from a cardiovascular standpoint, I would say that I would have to put that on the lower end of the spectrum, one to 10, but for personal impact and the way that I've utilized it, it's an 11. What about over seven hours of sleep?

1:09:54Yeah. On one to 10 scale for heart health. It is, it's a 10 plus. Really? It really is. Because again, if we look at the recovery piece, what does that really impact? Well, the risk of type two diabetes and metabolic syndrome and how your body metabolizes glucose all changes when you're recovered and well rested. Sleep apnea, where your oxygen level is changing during the evening, again, affecting the hours of sleep that you have, is a direct risk factor for high blood pressure, which we know is a risk factor. Consequently to heart disease. Yeah, I guess the only thing I could, you know, I've never been drunk, so I don't know what that feels like.

1:10:37But I have been on a lack of sleep at different times in my life. And I can almost sense that it feels like you're drunk. So if you're not sleeping well, you're not performing well the next day and it's starting to stack if you don't sleep well every night. And so I can only imagine how much it could be hurting your physical health and creating excess fat and therefore impacting your heart. Absolutely. I think it's one of the pillars that people miss many times. You know, it's not a new gym membership. It's not whatever, PR lifting or cold plunging or whatever. It's like, you know, you need to prioritize your sleep.

1:11:21We all have to sleep. That's great. Dr. London, this has been powerful. I've got a few final questions for you, but I want people to follow you. You've got amazing content on Instagram, Dr. Jeremy London on Instagram, also Dr. Jeremy London.com, your website. You've got a podcast as well, right? We do. We do. So you have a lot of the insights, the information. If people want to learn more, where can they go to get the podcast? YouTube, Spotify, Apple Podcasts. We've got a newsletter that usually tries to parallel many times. Okay. So whatever format you enjoy getting this information, we like to get it out to you so that, you know, we're spreading the word and hopefully giving folks insight into things that is going to allow them to live longer and live better.

1:12:08Dr. Jeremy London dot com for the newsletter as well. That's correct. And you're working on a book right now. So in the future, we'll get a book from you. Hopefully we'll have more of this stuff for people, more research and data as well. This is a question I ask you. If you could go back right before you started medical school, I don't know, where were you? Where'd you go to medical school? Like, I went to medical school in Augusta, Georgia. Okay, cool. So how old were you when you went to medical school? Do you remember? I was 21. 21. Yeah. So you make the decision, I'm going to medical school.

1:12:40You're getting your plans together. You go for the first day, whatever. You're in class or you're in the clinic, wherever you are. I don't know if you can remember that first day of medical school. Nearly 40. I'm not that old. Nearly 40 years ago, right? I can remember that day. I know, yeah. Yeah, I mean, 40 years ago, almost 38, 39 years ago, right? If you could remember the excitement and the joy and the unknown of what was about to happen. And now almost 7 ,000 surgeries, thousands of lives impacted in a positive way, the influence you've had on people's life personally, their families, the miracles that have happened.

1:13:16If you could go and give three pieces of advice to the younger you going into med school for the first day, what would you share? Wow. First one would be don't take yourself so seriously. Mm-hmm. For sure. Be willing to live in the gray. That's hard. And always trust your gut. Mm. That's good advice. Would your 21-year-old self having advice for you currently for this next season of life as you're rounding into 60, would he give you any advice? on what to expect for the next decade or two. Get outside. Relax. Enjoy the day. Let go. Yeah. That 21-year-old was pretty good at all that. Yeah, yeah.

1:14:07Yeah. You got to remember some of that, huh? Yeah. Yep. Hopefully your son will remind you of that every day too because he's working with you. Got lots of people to remember. But listen to that inner voice inside of you. Absolutely. He's your gut. Yeah. That 21-year-old's still in there. Yeah. There's no doubt. He's still in there, man. There's no doubt. I want to acknowledge you, Dr. London, for the work you've done to inspire millions of people around the world. Helping people. Even if just one video you shared has helped someone change their life and live better, healthier, happier life. You're saving lives with the content you're sharing.

1:14:45So I want to acknowledge you for your 40 years of experience, hands on, literally helping people's hearts heal, but also now using your wisdom to share with others. So hopefully they can make better decisions in their life and impact the families and friends around them to live better as well. I want to acknowledge you for the gift that you are. Well, thank you. And you may not be holding people's hearts literally in the future, but you're doing it, you know, spiritually, emotionally, mentally through the content you're sharing through this conversation. So I acknowledge you for all the work you're doing.

1:15:22Thank you. That means a lot coming from you. It really does. And I think you really touched on what's important with the platforms and the effort that we're making. If we can just touch one life, it's all worthwhile. That's it. And we get so much feedback that it's been so much more than that, that it is really, that's the motivation for us to continue in doing this. So thank you for acknowledging it. Of course. I appreciate that. Final question, Jeremy, what's your definition of greatness? Always being willing to change. That I don't ever feel like I've arrived. Mm-hmm. And I feel like I'm always open to change.

1:16:11And that is one of the things that I think has enabled me to accomplish many of the things that I have in my life. And I hope to accomplish many, many more as a result of maintaining a very open attitude towards opportunity. Thanks so much for coming on. Appreciate you. I hope you enjoyed today's episode and it inspired you on your journey towards greatness. Make sure to check out the show notes in the description for a full rundown of today's episode with all the important links. And if you want weekly exclusive bonus episodes with me personally, as well as ad-free listening, then make sure to subscribe to our Greatness Plus channel exclusively on Apple Podcasts.

1:16:56Share this with a friend on social media and leave us a review on Apple Podcasts as well. Let me know what you enjoyed about this episode in that review. I really love hearing feedback from you and it helps us figure out how we can support and serve you moving forward. And I want to remind you if no one has told you lately that you are loved, you are worthy and you matter. And now it's time to go out there and do something great.