Since You Put It That Way
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Since You Put It That Way
Holistic Cardiology with Dr. Alicia Williams
This episode explores the world of cardiology through a holistic lens. Dr. Louder and Dr. Alicia Williams discuss the many factors that play into cardiovascular health, from hormones to cholesterol to diet and gut health to emotional and mental health and so much more. They highlight unusual symptoms that might point to cardiovascular problems and spotlight women's symptoms in particular, since they can often differ and be more subtle.
Dr. Alicia Williams has been a cardiologist for 30 years and a holistic cardiologist and a functional medicine physician for 25 years. She's board certified in cardiology, internal medicine and obesity medicine, and has an extensive background in adult echocardiography . For the last 5 years, she's done advanced vascular screening with carotid intimal medial thickness (CIMT) as it applies to vascular risk assessment. Although she has cared for complex cardiology patients for many years, she is especially interested in helping adult clients identify vascular risk and options for not only reversing risk factors and disease, but preventing them.
Intro for "Since you put it that way" podcast.
Outro for "Since you put it that way" podcast
Hi, and welcome to the next episode of Since You Put It That Way. Today our guest is going to be Dr. Alicia Williams. She is a cardiologist. She's a holistic cardiologist and we're going to discuss about all things heart as we continue on in our series here of maybe the summer of lovin' because it's the summer and we're loving our hearts, or maybe just all things about heart health, however we want to take this, serious or not. So Dr. Williams as our guest, she has been a cardiologist for 30 years, and she has been a holistic cardiologist and a functional medicine physician for 25 years. She graduated from the University of Michigan with her undergraduate, and then from Michigan State University College of Osteopathic Medicine as an osteopathic physician. She did her internship in Botsford in Botsford Hospital in Farmington Hills, as well as a three year noninvasive cardiology fellowship at Botsford as well. And she's board certified in cardiology, internal medicine and obesity medicine. Over the last 25 years, her training and practicing functional medicine has led her down this pathway of being what's considered a holistic cardiologist. So this is a rare treat for us to have her as our guest, speaking really not only as an expert in cardiovascular health, but really at looking at things holistically. She has cared for complex cardiology patients pretty much her whole career, and she's really interested in helping adult clients identify vascular risk and options for not only reversing risk factors, but also preventing it. To connect with her, her office is the Center for Optimal Health. And that's in East Lansing, Michigan. And you can google her in East Lansing, Dr. Alicia Williams at the Center for Optimal Health and find out her information. We're also going to have for you an article that she's provided for us for our listeners, as well as a list of books that she feels are important books for us to read and understand regarding cardiovascular health. So with that, we'll move into the podcast and welcome Dr. Alicia Williams. Well, welcome to you, Dr. Alicia Williams, my favorite cardiologist, and you're a holistic cardiologist in East Lansing, Michigan, and we gave you an introduction just a little bit ago, so they know where and how to find you and a little bit about you. But tell us: what led you into both cardiology, and then even the holistic aspect of cardiology?
Dr. Alicia Williams:I was always interested in nutrition.
Mary Louder:Maybe.
Dr. Alicia Williams:I can't do that. But I like to make it real That was actually the first thing I was interested in. I was for people, and I like to tell people that you know, this doesn't have to be your story, you know, this is my story. But I knew I always wanted to make people healthy. And initially I went into medicine wanting to do family practice. My, my doctor, if--if anybody remembers Captain Kangaroo--
Mary Louder:Yes.
Dr. Alicia Williams:My doctor looked like Captain Kangaroo. And he was the most wonderful man you could ever meet. And I hardly had to go in. And when I did, I felt really comfortable with him. I thought, I just want to be like him. And then when I got into medical school, I just loved cardiology, it was so exciting. You could do all these things. And at the time, stents weren't even around. And, you know, people would have balloon one of those nerdy kids that read all the time. And I, my angioplasty, and you'd save them from a heart attack and septic shock. And all these things were really exciting. And that was good experience. But then I started to go back to think, well wait a minute. They came in and said, Okay, I'm all fixed now. I had my heart artery open. And it's like, no, I don't think so. I think there's more to that. But we didn't know as much about the health of the artery wall being so important. So as--as I finished my cardiology training, that was the year that Dean Ornish, his book was published on reversing heart disease. And I was given that copy by a fellow that was ahead of me. And I was kind of angry that I didn't learn any of that hero was Linus Pauling and Vitamin C and all the nutrition, in medical school. I thought, you know, here I was always interested in nutrition, and no one taught me anything about the possibility, even if you didn't do that program, that it was actually possible to reverse heart disease. So then I really dove into that. And it was interesting because Dean Ornish's program, he did show on us, and it's a reasonable group of people with very sophisticated technology, that you could actually reverse heart disease and improve blood flow. And he utilized, you know, group support and yoga, and quitting smoking, and exercise, in a very, very low fat, vegetarian diet. And also really looking at the mind-body and grew up with my mom and I going to the health food stores. connection. And so I tried to get that program when I was in Kalamazoo, it was, it was starting to expand across the nation, but we couldn't get it. They were trying to get it approved through Medicare. And it was a very intense program. And so instead, I did a different program that I was just really delighted with, which was the Coronary Health Improvement Project. That was a community-based program. And it did involve a lower fat, high fiber kind of Pritikin-style diet. But it was all about food to start with, and education. So Dr. Hans Diehl came in, and I thought, you know, this, this food part is really the key. And so I became interested, and I used to tell my partners, you know, my job is really to keep everybody away from you. I love you to bits, but you know, I don't want my patients having to see you. And so because of that interest, I just became more and more So I'm a little different than maybe some people. And I tell interested in what could you do, to really not only reverse but prevent heart disease. And now we're in such an exciting time, there's a lot of options for people. But I think we really do have to go back to the basics. So the more I get along--because I've been in cardiology 30 years now--the further along I get in traditional medicine, the more I like to get back with basics, because that is the key for people. And also empowering people with information. And really telling people, you know, you do not want a passive relationship most of the time. In an emergency, maybe that's the case. But most of the time, you have to be your best advocate, bring someone with you, a family member, a friend, I write things down for people, people when I see them, that I could shove a whole thing of because I think more and more, we have to empower people with the knowledge and desire to take control over their health. And so that's been my driving force in the last several years is doing more and more, not only holistic cardiology, but oral systemic health. So the health of the oral cavity, the gut. And then for many years, I've been training in functional medicine. So since the early 90s, in my background was biochemistry, and so when I went to the functional medicine conferences, it just made perfect sense to me. And so that was kind of the key was really giving the body back what it means and taking away with parsley in my mouth and be happy. So I know that makes me a the body can't handle. Those two things. Simple as that. We can't change the genes, but why don't we we give what Jeffrey Bland talks about, let's feed the genes signals of bliss. And when we feed the genes signals of bliss, the genes will be more able to handle the environment. So that was my, kind of my passion for many years. And I still find that I go back to that. I mean, it ruins your brain for traditional medicine. I used to go around in the hospital, giving people pieces of paper towel with a book. Get this book, get this test, get these, you know, come see me. And they'd hold on to that. And it was like their lifeline because they knew that it wasn't little freaky, because--or it might scare people-- over. That, you know, getting this stent or this balloon, and that people in their 30s--when I finally backed out of hospital-based, you know, aggressive cardiology practice, I was seeing 30- and 40-year-olds coming back for their 10th stent. And it's it's too much. You know, we're missing the boat. And I think a lot of it goes back to metabolism, toxins, foods, stress. And we're, we're not doing the right thing for people when we don't empower them to know what they have as far as options.
Mary Louder:Yeah, I think that that's, that's beautifully stated. Okay, we're done here. Okay.
Dr. Alicia Williams:Well, that was the other thing Dean Ornish had talked about. And I found it over the years is that part of the group support was you know, talking about laughter and joy. And, and I think one of the things I really liked to do and, and sometimes, you know, in the clinic, they would come in and say, What are you doing? That was like rolling laughter coming out of the room. I said, Listen, we're busy. We're busy in here. We're curing disease.
Mary Louder:Exactly. We're healing, we're healing. Yeah. I've always said laughter's the best medicine and you--there's really no copay. So there you go, no deductible. So that's always good. Well, it's interesting because you know, they're talking now, some of the articles I'm reading, where they're really finding heart disease in 15 year olds. What they're seeing is the coronary arteries, the arteries that attach to the heart, that supply blood to the heart, are blocked at 15 years of age.
Dr. Alicia Williams:Yep. You know, we knew this, when the Vietnam veterans came back, and they died in car accidents, they already had fatty streaks in their aorta. Now, we're going to be much younger than that, and part of the reason is obviously, the food and the activity, and toxins. And one of the things that has delighted me over the last, you know, five or six years is doing the carotid screenings, the CIMT. And when I looked through the literature, and this is a way to screen, they've actually, I think, almost 18,000 articles now using this technology, not only to track medical therapy, you know, what does blood pressure do? What does cholesterol medicine do? How does it help the arteries? And it--but also in population studies, they've, they've studied kids, they've studied pregnant women, they've studied groups, and looked at the thickness of their carotid arteries, and it's not normal. And that is the beginning of what progresses over many years. And so it gives us a way to know hey, you know, we're not on top of this, you might feel okay, you might even look okay, but you're not okay. And so that's very eye-opening for a lot of people.
Mary Louder:It is. You mentioned, food, so our teenagers, what a lot of it's packaged foods, right, the ultra-processed foods.
Dr. Alicia Williams:75% of what kids eat now.
Mary Louder:Yes. And now the intention of that came, what? After World War Two, and things began to be canned, packaged in the 60s, even into the 70s, where things became more convenient. And it was a small fraction of foods at that time. And then, now we have, I call them Frankenfoods, if they're the ultra-processed foods, because we take components and chemicals and bolt them onto some type of food molecule and make something new. And I maintain that in our GI system, that that's just not identifiable. The body doesn't know what to do with it. And that's where the inflammation gets kicked off. You know, that's where changes occur within the lining of the gut, and then it affects the immune system, triggering inflammation.
Dr. Alicia Williams:I was just listening--I can't remember his name. I was listening to an expert because last year, I decided to get boarded in obesity medicine. It's been a fascinating amount of information about the signals. And this gentleman was talking about food cravings. And he's--and he taught--he's at Yale, I think, doing research. And he said, when we get this mismatch, we get an artificial sweetener, or an artificial fat or an emulsifier, or a chemical attached to a food, it's not what our brain thinks it does. So it makes us want more, because it's a mismatch. And so we think we're doing the right thing, but actually, it's creating these cravings. And he said, you'd think that people would be satisfied, but actually, their brain gets frustrated and makes them seek out and that's the, you know, our primal brain wants certain things. And it's really interesting how that just creates in these kids hunger, when they shouldn't be hungry. It's these these foods that are unidentifiable to our body.
Mary Louder:Right. And that's really at the dopamine receptor, the feel-good receptor. So, the pleasure centers, things like that, that, where, you know, people have, that's where addiction comes in, really, with all those pathways. Now, as I look at genomics, we see some folks who have a higher predisposition to that. So for them, the Frankenfoods are literally like crack.
Dr. Alicia Williams:Well, in the maternal, the maternal patterns of eating and how that's passed on generational--it's, it's really fascinating. You know, I, I think of how important it is, you know, we talk about safe spaces for trauma. What, when does our body get a safe space? If we feed it signals, we're not allowing any safe space in our body because we're not allowing our body and brain to get the nutrients that it needs and also getting all the toxins and then we end up with these bacteria in our mouth and our stomach that create inflammation. And so it is it's a it's a terrifying aspect of where we're at, but I don't like to live in fear. I tell people, you know, we need to live with joy. But health can be joyful.
Mary Louder:Yeah. Yeah, I think that that's true. And so, if we bring now the heart into that concept, what you're saying is, it's not just about cholesterol, it's just not about what your numbers are. It's just not about, you know, what your family history is, it's how can you modify those things? It's dental health, which is really gum health, periodontal disease, how is your digestion working, which is really a functional way to look at. So we, you know, we're both osteopaths, you and I, so we know structure and function are interrelated. And so it's you've got the structure of the GI tract, mouth, all the way through to the out shooting through the rectum. And all those have different--all those different areas have different functions. And they're really important to--for us to gain nutrients for us to avoid things from the outside getting in. Because really, the gut tube is going through us, but it's not in us. It's in us but, but not in us. So it's outside of us, but in us.
Dr. Alicia Williams:And we used to think it was this So whether it's a heart rhythm thing, or a blood pressure impermeable, I can shove anything in my mouth, and it just goes through. My husband's concept was, if I eat a whole thing, or a circulation thing, we have to look at what these container of ice cream, how can I possibly absorb all those triggers are, and try to remove as many triggers as possible. calories? I said, it doesn't work like that. But it's interesting, now that we know the gut is not like a solid, you And otherwise we're having to put in medications to correct know, plastic tube, it's permeable. And we get these compounds that get absorbed, like pieces of bacteria, or it, which sometimes we have to do. I use medications every day. chemicals that circulate, and we find some of those bacteria from And so we don't have to correct every single risk factor. If we the mouth and the gut, in the artery walls, as part of it, and But I like to have that conversation with people, say can correct whatever risk factors that we can, we can still improve risk. But if someone's cholesterol is 300, and their LDL cholesterol is over, you know, 200, and they have a strong premature coronary disease in the family, they might be eating a pristine diet. But then you've got to look at even things you know, like Lyme disease or molds. But I tell all the other things that can contribute. And I'll--and, you what are you able to do? What can we help you pull off so that know, they can benefit them from a statin drug. But that is is a subset, and people have had events like a stroke or a heart people that these triggers--and that's why I try to describe for attack, yeah, maybe we need to use some of these medications in appropriate ways and support the body so it can handle it. And then you start to--I tell people, it's a short game and a long game. So the short game is keeping you safe. And not having side effects from meds. The long game is what can you get by with people, whatever concept that we have, like, for example, H you don't need as much medication, but you need to be the least amount possible? But you have to heal and understand what's happening first, because otherwise, you're just pulling a bunch of meds away and leaving yourself unprotected. So I really, I think we both have utilized you know, like the Pylori can trigger a-fib. So atrial fibrillation can be Boston Heart some of the inflammatory markers in some of the nutrient levels like Coenzyme Q10 and the fatty acid protected at this point. And so the back to the cholesterol balance, even if people don't have money to get some of these things done, can they use an electric toothbrush? Can they do triggered by gut bacteria. But if we, if we consider our body some oil pulling? Can they eat a whole foods diet and do an elimination diet? Can they take some nutrients, some basic nutrients? Because most of the people that I test are low on Coenzyme, Q10, and fatty acids, so they might tell me, I don't as something that's getting challenged every day, like if part--it's the inflammation. It's what is the cholesterol have money for the test. Just take them. I mean, you have to sometimes balance that. Same thing with homocysteine. So if you have someone with high homocysteine and high cholesterol, what can we get done? So it's, it's kind of the you had a bear that was hibernating, and you poke that environment. Same thing with uric acid. Uric acid crystals, you know, somebody has high blood pressure, and they have high uric acid, and they're eating a bunch of refined foods surrounded by? What are the risk factors? So as we fill the and sugars, I, you know, until they can tackle that, it's going bear with a stick, it may not wake up. But if you get enough to be very difficult to protect them from these damages to the artery wall, unless we go back to the foods in the gut. So I usually start with the foods, the gut, the sleep, the stress, and, and at the same time, say, okay, these risk sticks, and enough people poking it, and irritating it, the factors are way out of control. What can we do to pull these bucket with these irritants, what can we get rid of to make down as we go forward? And then just keep peeling it like an onion. What layer can we work on now? And that way, it's in, in barrel, wake up and eat you. And then you don't have to worry doable pieces for the person that's coming in. Because you know, what's in our brain can be
Mary Louder:Now-- terrifying to pitch to patients. It's like, Oh, my goodness, I can't do all this. Oh, yeah.
Dr. Alicia Williams:You know, what can we do right now? And let's work on food. Can you eat more vegetables? Can you eat one less thing happen? about, you know, anything else. more beans? Can you do a little bit of movement? And so those are things that they can hopefully tackle.
Mary Louder:So do you see the difference--I mean, right now, heart disease is a leading mortality, and, I think, morbidity statistic in the world. 17.3 million people die every year, in--on the planet, off the planet, leave the planet, because of a heart attack or stroke, cardiovascular Right. So, which brings up a point. I mean, women disease.
Dr. Alicia Williams:Oh, it's horrible. It's a huge number. And over 50% of the time, the first symptom is sudden death, for heart attacks. So are we gonna wait for a symptom? Doesn't sound logical, does it? And so that's why I tell people, you know, we have to wake up, we have to become aware of where are we at. Because if you are in the dark on this, it's--you're losing a chance to make some big changes. So one of my real goals the last five or six years, is we've got to identify the health of the artery. Whether you do a calcium score, or a CIMT, carotid thickness test, be aware of the health of the artery, know if you're inflamed, know the basic numbers, and start eating healthy, and then educate yourself. And those things are very doable and can be cost effective. And so I tell people, you know, and I have, I can--I think I--I may have given you my book list, but there's a book, the--Healthy Heart, Healthy Brain, by Dr. Bradley Bale and Amy Doneen, it's a good reference book, it might be a little overwhelming at first. But when you look at that book, you realize, you know, I could have risk, and I don't know it. Their first first book was Beat The Heart Attack Gene. And so that book is very invaluable. But the other book I like, is the whole series Clean by Dr. Alejandro Junger, and he is a functional medicine cardiologist. And I've had a lot of people tell me they really like his book, because he gives his personal story. So I think that when we give patients our personal story, and we make it relatable and doable for them, and of course, my first visit is a longer visit, because you just have to know what's going on, because otherwise, you're kind of shooting in the dark. You know, five minutes, you can write a script. But if you want to really get to the bottom of something, you know, do they have food intolerances, do they have gut imbalances, it takes that little bit of time and effort between both you and the patient, to become a team and try to get to the bottom of it. and heart disease present differently than men with heart disease. Yes.
Mary Louder:Can you say a little bit about that?
Dr. Alicia Williams:Well, and I think over the years, we never thought women could have heart disease. "Oh, you won't get it till you're older," and it's so wrong. We now know, especially now, because the increasing risk of 85% of the people in in the US are not metabolically flexible. So that means either insulin resistance, metabolic syndrome, pre-diabetes, diabetes. That's horrible.
Mary Louder:That's a high number.
Dr. Alicia Williams:So we really know. And, and so one of So there's a lot of those factors, but a lot of it does go the things that we thought of in the past is yes, pregnancy can impact the heart, you can get weakness of the heart, you can get heart attacks with pregnancy, because of the arteries tearing, you can get takasubo, which is stress-related, broken heart syndrome, with sudden stress. We see more what we call non-obstructive artery disease, meaning that there's just a partial plaque. And yet someone has a heart attack, or they have chest pain. So could there be spasm of the arteries, or the artery wall is not functioning properly? Or are the teeny tiny blood vessels that we can't even back to hormone changes. So when women with PCOS, polycystic see in the heart--are they stressed? And and we treat that as if it is heart disease. So if somebody had a stress test, a woman had a stress test, and it wasn't normal, and then they had a heart catheterization, say your arteries are open, well, that doesn't mean they don't have heart disease. So now we know this. And, and we have smaller hearts than men. So if we have high blood pressure and the heart, the heart gets crowded, it gets smaller, meaning you're crowding what can happen. And the heart can become inflexible from both diabetes, inactivity. And then we add on to that blood pressure. And so we get more heart failure in women because their heart size is already smaller than men. ovarian syndrome, have high insulin levels, or you have women that are on birth control pills, or they're going through menopause or perimenopause, we know that there is a change in heart risk. And now we know that women become insulin resistant as they go into menopause. That's why we get the little potbelly. And that's why we start to gain weight, even though we don't know why, you know, we've done the same thing as we did before. And probably some women maybe are more attracted to carbs than their meat, because we tend to maybe eat more of those things. And then we lose muscle. And so that affects our metabolism. The other thing that can happen is more autoimmune disease. Women are more prone to connective tissue disease, which kind of prunes out the arteries, and lupus. And then, of course, airway issues, you know, if we have smaller mouths and airway issues, you can get into sleep apnea. And we used to think it was all the men with the big pot bellies that had sleep apnea, and we just know that's not the case. There's a lot of those factors. And then of course, losing sleep because of hormone changes. And you know, I think about how much sleep I lost on call, I don't even want to think about it. I mean, talk about a risk factor. It's like, oh, okay, you know, I don't need to sleep. I can just keep going.
Mary Louder:Right. Yeah, so that, I mean, looking at that, because even when women go into their cardiologist, or their family doctor, let's start there, they go into their primary care doctor, and they're around menopause, or they're just menopausal, and they present the very things that you just talked about. Gosh, I put on weight, can't seem to take it off. I don't seem to have the same stamina. There is not, I promise you, there's probably less than one hand of people that are thinking heart disease in women. They're saying you're overstressed, you're doing too much, it's all in your head. You know, what's wrong with you? You know, things like that. Those are the messages people get when they go to see their primary care.
Dr. Alicia Williams:You know, I think in both men and women, but I think we we didn't necessarily notice it as much in men, but fatigue, especially with exertion, is one of the first things that, I just, my spidey sense goes up. Everybody thinks there's going to be this elephant on their chest. And that, you know, is like such a small percentage of people. It can be pressure, it can be in the pit of the stomach. I had someone tell me it felt like they had mashed potatoes in their throat, or dizziness or palpitations, and it may not be a heart attack, but it may be your body just giving you that signal. Waking up, feeling panicky. All those things become really important to discuss with your provider. And I had one young woman, unfortunately, when she was 29, went to five different emergency rooms before they did an EKG. And she had a heart attack five days earlier. Now that was many, many years ago. And hopefully we never see that happen again. But her family history was very strong and no one even thought that this crushing chest pain could be even a heart attack in someone that young.
Mary Louder:So you mentioned the fatigue, because women are tired all the time, for the very reasons. Lack of sleep because of hormone changes, family, you know, they're often sandwiched between taking care of children and their aging parents. So how does a woman identify that? Is it fatigue while they're exercising? After they're exercising? What have you noticed the most?
Dr. Alicia Williams:You know, I think by the time people that come,--they come to see me, they're already worried about something. They know something's not right. So I have kind of a pre-selected group of people that are coming in, and I have a very low threshold. At least get an EKG. I can't tell you how many people I've seen over the years that have had high blood pressure, and they never had an EKG done. It's so simple. The other thing is seeing what happens when they--when they exercise. You know, my favorite technology is stress echocardiography, there's no radiation, there's no dye, you do an ultrasound at rest, you walk the treadmill, you repeat the ultrasound and you look at the walls of the heart, it can give us the size of the heart, the shape of the heart, the valves, the strength, what's your blood pressure doing, your heart rate doing, and then if the walls become sluggish, then it's a sign that there's poor circulation in that area. And so I have a low threshold to at least get some type of image, and maybe not even with walking, sometimes just a regular ultrasound of the heart. And it can be very enlightening, because you know, again, pregnancy impacts the heart, hormones impact the heart. Could it be heart rhythm? So you know, that's where monitors now are very small and easy to put on, or people have their Apple Watch or their Fitbit. What is your heart rate doing? Is it racing? Is it irregular? What's your blood pressure doing? 80% of women over the age of 60 have hypertension, and all our guidelines now, hypertension, if you're in the 120s, you're getting too close to the edge, and if you're above 80. So they've lowered all the blood pressure readings so that hypertension is a lot stricter now. And so start measuring blood pressure. Because if we're having that many issues with blood pressure, then we're missing a good opportunity. So I think that these self monitoring things, and of course, then keeping an eye on you know, your body composition, keeping an eye on your sleep habits, I mean, not everybody's gonna get an aura ring. But if you're waking up tired in the morning, and not getting restorative sleep, you got to start looking at why. And so I think those are the biggest things that I tend to see. And of course, obviously any swelling, a lot of women swell for different reasons. But if it's heart related things, you know, there's some simple things we can do to check that. Women with breast cancer treatments, radiation to the chest, especially the left side of the chest, impacts the heart. The old radiation used to go up into the neck and then we'd see carotid disease because of radiation side effects, but targeted radiation, chemotherapy, medication, side effects, all these things can impact. And we've got a lot of people with mood issues on different meds that then create side effects that can impact how we feel and how our body feels.
Mary Louder:Yeah. Okay, so it's way more complex. So where would a woman start? She goes into a primary care doc, says, Hey, I'm not feeling right. And they--I have some family history, my cholesterol is on the edge. And they said, Okay, well, fine. We'll do your blood work and give you a tablet. That's often the extent of it. Now I'm a little bit playing devil's advocate here with you because that's what--that's why people often come to me, is because they say I've tried to get a workup, I've tried to get help, and nobody's listening. So what they want to do is put me on a statin and, if my blood pressure is minimally elevated, an ACE inhibitor, because that meets insurance criteria, you know, then the box is ticked, literally for the physician, as being compliant with insurance guidelines. But that doesn't mean that the patient's cared for.
Dr. Alicia Williams:No.
Mary Louder:We've got this weird thing going on here.
Dr. Alicia Williams:There's a real dynamic now with, with medical care, and it's many, many, many people are coming, saying that they're just not getting--they're not even able to get their story out. And it's, it's really frustrating. It puts more onus back on the patient, which is, is really tough because a lot of people just don't even know where to go to look. And, and sometimes if I'm very busy on call, I'll tell people, listen, you have to get this book or check out this website. And sometimes that's all we can do is try to educate, what to look for. And I think what you're doing, Mary with your education here is phenomenal, because people then can seek out, what can I do that's different than just taking this pill? And of course, the network of people doing health related things, doesn't always have to be a physician. Yes, if it's a medical issue, but can you get in to see a nutritionist, a health coach, you know, a naturopath, a chiropractic provider to at least work on the basics? But the most important thing is, and I think really primary care providers really try, is if you are not feeling well, you need to be persistent. And find someone that listens. Because even if they get you into a specialist, or someone that can at least do some basic things, that's reasonable. But a lot of chronic illnesses just doesn't fit into that category. But you need to be persistent. If you're not feeling good, there's a reason. And that's really important for people.
Mary Louder:Yeah, so what I hear you say is advocate, advocate, advocate for yourself. And if your doctor's or your provider's not listening, find someone who will.
Dr. Alicia Williams:Correct.
Mary Louder:So, a woman could ask for an EKG, they could ask for cholesterol panel plus inflammatory markers. We could select the highly sensitive C reactive protein, homocysteine, there are lipids, you've got the balance between Omega-6 and Omega-3. Those can be gotten at regular labs, like Quest has that. I'm not sure what LabCorp has. We're running a special right now--yes, this is a commercial break on the Boston Heart--we put together with them a specialized panel, a Cairn wellness panel for cholesterol that looks at absolutely everything. It's the most advanced panel on the market. And--
Dr. Alicia Williams:Well, and I tell people, it's just, sometimes, you have to look at the cost of that may be the biggest difference, because it may identify risk you never know you had.
Mary Louder:It, I have found more people who had elevated cholesterol, but it's not because they made cholesterol in the liver, it's because they absorbed it through their diet. And it explained why a statin really didn't impact them that much. And we had to use a different medication to bind up the cholesterol that they would just absorb like a sponge.
Dr. Alicia Williams:And the other thing I think for a lot of people, if they're hesitant with these medications, is, is then I go back and tell them, listen, you really have to work on your foods. You have to get more fiber, any way that you can get it, because if you're constipated for four days, whatever we do is not going to be effective until you kind of work through that. The other thing that's readily available through any lab is Apo B. So Apo B is attached to every bad Cholesterol particle it gives us a snapshot of risk. The other thing that's available through the regular lab is lipoprotein a. Lipoprotein a frequently is a risk factor that's never checked. People can have a completely normal cholesterol panel, and their lipo-a is elevated. But they're Apo B is also elevated. So that's one of the things that makes those two nice to get. And lipoprotein a is very different treatment than trying to lower cholesterol, and it's a very high risk of heart disease, stroke, blood clots. And we can sometimes see, we know aortic valve disease with that, we don't know the connection. And the higher the level, the more the risk. And I would refer people back to the Bale-Doneen book, Healthy Heart, Healthy Brain. And there's some really nice descriptions in that book for people that want to read about these risk factors.
Mary Louder:So--so then the question, I'm just hearing it right there. I'm hearing everybody stopping for a minute and going, okay, so then why don't these routinely get tested? Why do you think that is, as a cardiologist?
Dr. Alicia Williams:I see people coming in now that have
Mary Louder:That's correct.
Dr. Alicia Williams:And it's, it's, it is a time consuming Right. Yeah, because I think, so your office, I mean, just to be had no lab tests done for a couple of years. Part of it is thing, to order the lab, have the patient get the lab, then availability to get into their primary care. It takes time to fill a lab slip out, and then if you don't know what to do with they need a visit back. And then you have to know what to tell the results, why would you want to order it? And so part of the them. And that takes time. And I see this as a time-pressured challenge is the training that happens currently does not always involve some of these more advanced lab panels. People environment, of not being able to spend the time that it takes just look at the cholesterol, look at the blood sugar. Well, to educate and guide the patient. And that's why it that's okay, but you miss a lot of risk. If your hemoglobin A1C is normal, considered normal, you still can be, you know, becomes even more important to widen your team, not only to metabolically imbalanced. include yourself, and hopefully educate your family, your community. For example, Mark Hyman, who's in charge of the Cleveland Clinic, Functional Medicine Clinic, did a large program through the Saddleback Church, out west, and they had, I think, 50,000 people go through a lifestyle program. So what they did was they showed the church how to do group visits, cook together, learn about what to do, and it was able to impact a large group of people. That is going to need to be the future, is going out into the community, and really trying to get people on task with taking care of each other, and yourself. So, I think that's going to be the key. So if people need these lab tests, they're going to have to search out people that will do them. And that's where functional medicine or American Holistic society, that the International College of Integrative Medicine, these are groups that are able to provide, and people may have to say, I need to take this savings to put forward to do this with someone as part of their care, even if it's not all their care. clear, do you participate with insurance? I do. My partner, Dr. Pawsat, who owns the practice, he is completely cash-based, has a lot of very innovative treatments. And I am currently cash-based, but it's challenging, it's a different conversation. And eventually, I may have to back away from insurance because of that. But my goal is to try--to try to develop affordable programs for people to start to really look at the bigger issues. It's really hard one-on-one in an insurance based practice, but I do. I do take insurance, most insurances, and I try to make it efficient. And it may not be everything with each visit. But at least it's something.
Mary Louder:Right. And that's what, yeah, for years, I took insurance, and then for a period of time I didn't. And it was really this issue of time, what I needed to do to literally make the practice work because of the employees, I had my overhead. I mean, it was business, right. And you have to be able to keep the doors open to be able to do what you're doing. And so now with the amount of education I do, because physician really means teacher, right?
Dr. Alicia Williams:Yeah.
Mary Louder:The amount of teaching that I do, there's just no way I can get reimbursed for it, you know, and do the same amount and have the impact. And so we're also developing coaching, and classes. Classes, I'm not sure is the right word, but group setting or mastermind settings where people are really working by digging into their genomics together, where they're looking at maybe there's a subset of people that have cardiovascular disease or other folks, it's the gut-brain, or the gut-emotional axis that we're really working on, or some folks with autoimmunity. So we come together and share our experiences and figure out a way forward by supporting one another. And I agree with you fully that that's the way forward because I think with all of the things we have in medicine, if we had cracked the code, we wouldn't be still with heart disease as the number one issue. We still wouldn't be where people have 85% metabolic syndrome, diabetes, metabolic inflexibility as you talk about and you know, I--and then right on the heels of that is the obesity epidemic. And now the mental health, anxiety epidemic coming out of the pandemic. I mean it just--I'm not sure where we've really done herself any favors with our current model that's in place for medical care.
Dr. Alicia Williams:Right. And they're understaffed, which is really, is really challenging. So I think that there's a lot of dedicated people hanging in there. Yeah. And I think it's important for people again, just to try to do what you can to take care of yourself. That's, the key. And, and there's enough resources that are available with what you're doing. I mean, you can learn how to cook for free online now. And it's always more fun to do it with someone in the kitchen, but there really shouldn't be any excuses anymore. I think we have to say, You know what? I gotta put, I gotta just really, when I can, reach up and do one thing today, that is a healthier thing than what I did yesterday.
Mary Louder:Yeah. I think that's an excellent--and I think hearing you say there are no excuses, because there is so much information available. The key is finding a trusted professional, such as a physician, a specialist, somebody with a medical license and training, even if that's a nurse practitioner, or a physician assistant, that has full unrestricted scope of practice, that they really--because that means depth of training, that means, you know, broadened knowledge base, that means a deeper knowledge base. And, you know, health coaches are great as they come a part of the team. Nutritionists are great as they become a part of the team. But the team has to work together and really be driven by proper, I'm going to call it clinical principles. Accurate research and accurate findings, rather than like, selling a stack of supplements, or programs that people get down in, but really don't get the results from and that are front loaded, and then just overwhelm the individual. It's a matter of meeting them where they're at. And then even just bringing in the whole concept of that emotional trauma, the concept of what they grew up in with what happened to them and how that affects their heart. I mean, we haven't even touched on the emotional concept of heart attacks or heart disease and how that weighs on people. Because that is one of the things that is, has to be addressed for them to be able to change their motivation to even care for themselves. And that requires a team approach as well. And so and looking at the mind-body connection, and looking at how globally, we fit within our community in one to another. I mean, so heart health could be not only the individual, but the heart health of the community, of the world, of the planet, of you know, you could really expand philosophically and all that and just, and it's really, are we even heartfelt people? You know, are we living from our hearts? Are we living from anger? Are we living from frustration? You know, or are we really heartfelt and really taking things to heart to live that way? Because you know, the body has the inherent capacity to heal. If we didn't, we wouldn't--none of us would be here this long, that's for darn sure, you know, the body--and the body has carried us around a long time, even if we haven't done things as maybe well as we should, or well-intended as we should, or whatever. So coming together, bringing that heart back into it. I guess what I'm hearing you say is, you know, really, really spend time learning and knowing your risks.
Dr. Alicia Williams:That's the first step. And I think the second thing because especially all ages, people don't know quiet. They're constantly stimulated. They're being pulled from all different angles. And I think that as fun as it can be, you have to find that still point, the quiet thing, to bring everything together. Like what you had talked about in a recent podcast is sitting out under a tree.
Mary Louder:Yeah. Did that this morning, same tree.
Dr. Alicia Williams:It's nice. And Stephen Sinatra talked about this. He's unfortunately passed now, wonderful integrative cardiologist, talked about earthing, you know, just being outside, digging in the soil, going out barefoot. But it's the quiet. And that's the moments where you have to say, Do I really need to do these 50 things today, or can I take a moment to go in the kitchen, make a good meal, go for a walk, spend time, you know, with a pet? And that's what Dean Ornish really found with the groups support in the meditation and the yoga is kind of finding whatever brings you joy in the quiet or prayer and allow the heart to take a breath.
Mary Louder:Yes, yes. So heartfelt living means setting a pause button, and it means connecting with your heart, connecting with your soul, connecting with the things that make and help you find joy. And then working with someone who understands health care, medical care from that same level. That's what that sounds like.
Dr. Alicia Williams:I think we fixed it.
Mary Louder:Yeah. Okay.
Dr. Alicia Williams:Now we have to just get people to--and I, and I tell people that, you know, it can be overwhelming. And you have to laugh about the mistakes you make, or the things you do. And it's just, you know, it is life, and life throws us a lot of loops. But it just has to be something that becomes more important. So I like to tell people as my job is to hopefully wake them up and also give them some direction. So they don't feel so overwhelmed and lost in the medical field.
Mary Louder:Well, I, I, I know you're doing that. I, it's not just something that you're saying here for the podcast. I know that's how you live and how you practice. And I think that, thank you for that, for being in that space for us as patients, and being who you are, to bring that right into your profession, and then being able to share that with as many patients as possible. So I'm, I'm grateful for that. I'm thankful for that. And I know that, you know, you said at the very beginning of the podcast, I'm different, I would put you in the rare bird category, I would, I would, I would reframe that and say that's a rare--
Dr. Alicia Williams:I want a large plume on my head, okay?
Mary Louder:Exactly! Because I think patients respond to that it's that same, that's that connection. And I think the more we can can can find folks to connect first with themselves, and with another peop--with another person or a group of folks that are going in the same direction, the more I think we can find an impact and even create a critical mass and change things. So I know you and I have the same goal of nothing less of changing health care, and affecting as many folks as possible in a positive way. So I thank you, Dr. Alicia Williams, for your time today, for your expertise, for your heart and soul that you share with us. You know, in California, they would do this, so in Michigan, we'll do that too, you know. And I thank you very much from the bottom of my heart for sharing with us today and bringing your knowledge and passion to our podcast Since You Put It That Way. And I would just put an open invitation to invite you back at some time in the future
Dr. Alicia Williams:Well, thank you. I think it's fantastic what when-- you're doing with your education and reaching out to people. I know I'm an avid listener, so--
Mary Louder:Oh, thank you.
Dr. Alicia Williams:I'll be looking forward to the next podcast.
Mary Louder:Yeah, good. Good. Now, when you listen to yours, listen with an open heart. Don't be critical. It's like, we always sound funny.
Dr. Alicia Williams:I know I'm goofy looking. So it's okay.
Mary Louder:We all are on this screen. It's great. All right. Well, thank you for your time, and I hope you continue to enjoy your day today.
Dr. Alicia Williams:Thank you, you too.
