S02_E03 - Hilden's House Calls - An AMA with the MD MPH FACP

Speaker 1: 0:04

Welcome to the Healthy Matters podcast with Dr. David Hilden, primary care physician and acute care hospitalist at Hennepin Healthcare in downtown Minneapolis, where we cover the latest in health, healthcare and what matters to you. And now here's our host, Dr. David Hilden.

Speaker 2: 0:20

Hey, everybody. Happy New Year. It's Dr. David Hilden, your host of the Healthy Matters podcast. Welcome to episode three of Season two, and to start the new year off right, we're gonna do another episode of Hilton's House calls. To help me out, I have John Lucas, one of the producers of the Healthy Matters podcast, and he's gonna help us get through some of the questions we've been accumulating over the past few months. John, take it away.

Speaker 3: 0:42

All right. Okay. So here goes, our first question comes from Miranda in St. Paul. She's wondering what's your routine as a doctor? It's kind of a personal question, but okay, let's roll with it. Uh, do you

Speaker 2: 0:53

Well, I get up, I comb my hair sometimes<laugh>,

Speaker 3: 0:55

So she asks more specifically, do you drink alcohol? Do you take a multivitamin? I can assume you're pretty busy, but what do you do for self-care? That's a pretty

Speaker 2: 1:03

Good question. That is a great question. It's a question probably every one of us could or should ask ourselves, regardless of what you do for a living or what your daily life. Absolutely. It's like, mine is, I'm a night person. Uh, so I, um, I have do, like the caller says, I have very busy days and so I try to find times for self-care when I can. That is not often the advice I give to patients. I say, schedule a time, do your workout. Sure. Monday, Wednesday, Friday. At the same time, make time for yourself. I don't do that. Uh, my schedule is too variable. Uh, okay. So I do try to work out at least three or four times a week by running, I'm an outdoor runner, even in Minnesota. I ran around one of our Minneapolis lakes yesterday as a little aside. There were people swimming and a hole in the ice and it was four degrees out. Um, but that's a Minnesota thing. Yeah. Um, I do a exercise bike in my basement. Uh, do I drink alcohol? I do. You know, an interesting thing about my, my work friends is that, uh, uh, it's fairly common I think for physicians to, um, have a glass of wine with dinner or a, a cocktail, but it doesn't necessarily mean physicians are any different. In fact, we're not. They're just as susceptible to alcohol abuse and, and using alcohol medicinally and when you're feeling stressed. And so I find myself having to tell myself that very thing. Do I want this glass of wine right now or am I just habitually reaching for it? Cuz it was a stressful day. And that is something that all people should do. If you come home without thinking and crack a beer every single day, you're not thinking about it. Right. That's not a good routine. None of us should be doing that. If it's a special day or it's, uh, you're thinking about it and it's like, wow, I'd really like a beer right now and you don't have alcohol abuse problems, go ahead and have that beer. That's what I try to do. Be more intentional. Okay. Um, and maybe not have it be, well, it's Tuesday I'm having a beer. Sure, sure. That's not a good way to go. So I'm trying to fit exercise, trying to fit healthy diet into my, uh, into my life. I've learned a lot about healthy diet from doing this podcast through Yeah,

Speaker 3: 3:05

Me too, me too. The

Speaker 2: 3:06

Last episode, for instance. Yeah. Go listen to Kate Shafto talk about diet on the very last episode. And, uh, I'm learning a lot about diet as well. So diet, exercise, moderate alcohol, and then that's what I try to do. Gotcha.

Speaker 3: 3:17

Okay. So doctors are people too.

Speaker 2: 3:19

Exactly. Yeah. Hard to believe. And then I also believe, and I didn't mention this strongly in the value of art and the arts, whatever that is for you, for me, it, it is classical orchestral music. So I go to, uh, the orchestra at, in Minnesota as one of the world's best orchestras. We do, we do. And I go hear that all the time. Um, I, I'm there frequently and I am also at the other end of sort of the genre spectrum. I'm a huge Bruce Springsteen fan. I consider that to be darn near a religious ex experience. Oh yeah. So self-care through the art, whatever it is that you like, doesn't have to be Springsteen or classical music. It can be anything. I think the arts make us healthier.

Speaker 3: 3:59

The, the healing properties of music and art. I huge.

Speaker 2: 4:01

It can be hiphop hop, I'm unbeliev. It can be dance, it can be going to your local art institute. It can be going to a coffee shop and listening to one guy strum a guitar, whatever it is.

Speaker 3: 4:10

Art oftentimes better than that beer, often

Speaker 2: 4:12

Better than the beer. I'm with you, John.

Speaker 3: 4:14

Okay. So onto our next question. And this came in from Teddy in Madison. He says, I'm in my mid forties and I recently chipped two teeth fairly easily, and I've also noticed that my fingernails are a bit more brittle now. I've never been in my mid forties before, so I'm not sure what to expect as I age. Is there something to this, do teeth weaken over time or is there anything I can do to help strengthen my teeth and nails? It

Speaker 2: 4:37

Is true that the, the nails and the teeth and even your hair, these things do change as you age. They tend to get more dry and brittle. Your teeth have a tough enamel coating that can, uh, age as you age. And so there are some things you can do. The first thing I would suggest you do though is find out if there is an underlying reversible cause or if you're just gonna chalk this up to the passing of the years, there are some things that cause your finger and toenails and to get more brittle and soft. It can be either excessive moisture, like maybe you are work as a dishwasher for a living, or your hands are always wet. It can be excessive dryness. And it, both of those cases reverse that. Cause if they're excessively dry, make'em less dry. Moisturizer. If, if you are around wet environments a lot, wear gloves, dry them off a lot. You also should look for underlying causes like thyroid disease, perhaps some autoimmune disorders, nutritional deficiencies like anemia that can lead to problems mostly with nails. As for your teeth, it's largely a self-care issue. Make sure you're brushing your teeth, you're flossing your teeth, and that you're getting adequate calcium and vitamin D in your diet. If all of those things are true, it could well be that you're just, you're getting more brittle as you age and those kind of self cares will be your best bet for, uh, uh, protecting yourself going

Speaker 3: 6:00

Forward. Gotcha. Okay. So you could chalk it up to rust, but in the meantime, let's look into these things. Exactly. Gotcha. All right. Very good. Excellent. Uh, well, thanks for that question, Teddy. All right. This one is from Alex in Duluth. She says, my feet get really cold, which I assume is from poor circulation. And I also recently noticed that I've been getting spikes in my heart rate. Is there a chance these two could be related, as in, does my heart pump faster to try to keep my extremities warm? That's an interesting question. It

Speaker 2: 6:28

Is an interesting question, and it is possible that they're related but not certain. Okay. I'll say a little bit more about that. Um, cold feet can be due to bad circulation. It can be due to something called ray nodes phenomenon, where your little bitty blood vessels kind of constrict people get that in their, in their hands and feet. And, uh, that can be something that is unrelated to anything else. And, uh, you don't have to worry so much about that. Again, like the previous question, I would look for underlying causes like thyroid disease. People who have cold extremities often, um, not often, but can have thyroid disease, anemia, things like that. Now, whether or not the heart rate is related is, uh, not quite so clear. It is true that your heart responds to all kinds of physiologic changes, um, in, in your environment. If your cold, your, your body tries to shunt blood to the areas to warm it up. If your, if a certain part of your body isn't getting enough, uh, blood, the blood vessels e expand and the heart can beat faster to try to do that. But the heart and the body somehow is quite smart. It knows that there are four places the blood needs to go preferentially. It needs to go to your brain, your heart itself, your liver, and your kidneys. Those four things get the majority of your blood supply at the expense sometimes of your feet. Okay. Uh, you can frankly live without your feet. You can't live without those four organs. So, um, it's complicated. Let's just say that. Um, sure it's quite complicated. It's

Speaker 3: 7:55

Never easy. But,

Speaker 2: 7:56

But, uh, you know, causes of a fast heart rate dehydration. Um, some of these vascular changes we've just been talking about, it could be due to, um, uh, anxiety or palpitations just because you're aware of it. Some people are simply aware of your heartbeat, a condition called palpitations. It doesn't necessarily mean there's anything wrong, it's just that it freaks the human body out to be aware of your own heartbeat. You're not supposed to be aware of it. Right. So I would suggest to you have a small evaluation, get a couple blood tests, make sure you're not anemic. Make sure you don't have thyroid problems. I would ask the doctor to get an EKG to make sure your heart is doing everything it's supposed to, and then put on a really good pair of socks.

Speaker 3: 8:36

All right. Well, in Minnesota, those are, uh, worth their weight and gold. Mm-hmm.<affirmative>. Hopefully that helps. Alex. Well, let's, uh, sneak one more in before our break here. And this one came in from Karen and she says, I keep reading about the benefits of sweating a bit each day, which, hey, this is kind of in line with the exercise question we got. Okay. Uh, what if you don't sweat? I just get a red face. What can one do? What

Speaker 2: 8:57

If you just glow

Speaker 3: 8:59

What you know,

Speaker 2: 9:00

<laugh>? Do you ever hear that? I don't sweat, I glow. Glow. I know. Well, um, that's a very interesting question that I haven't thought about lately. But sweating is your body's normal mechanism for cooling itself off. That's the whole point of it. As liquid evaporates, it takes heat with it. So liquid on your skin takes heat away and you literally radiate heat off of your body. That's why the human body is hot, thereby cooling yourself. The problem is, is that the price to pay for perspiration is loss of fluid inside your body. So your heart has to beat faster and faster and faster to keep up with it. So that's why you are supposed to drink water when you're perspiring. So that's the whole deal with pers perspiration. What if you don't sweat? Well, first of all, if it is just a little bit here and there, if you're one that doesn't drench the clothing, but you sweat a little bit and you're not symptomatic, you can exercise, you can work out. You don't, you're not embarrassingly, um, sweaty, but you're otherwise okay. It's probably nothing to worry about. Okay? But if you truly are dry, you never sweat. That is a condition called anhy

Speaker 3: 10:08

Anh hydrosis.

Speaker 2: 10:09

Okay? Anh hydrosis. It can be the sign of an underlying autoimmune disorder like lupus or something like that. Wow. It can be the sign of skin problems, neurologic problems, and then your body cannot cool itself off because you lack the main mechanism of sweating. It's interesting. Dogs don't sweat they pant. Right? And it's the same thing. They're, they're, they're trying to relieve heat. So if you don't sweat at all, tri paning and your face gets a little flushed, uh, your body isn't quite responding as it was supposed to. So I would have that looked at by your primary doctor, maybe a neurologist, maybe a rheumatologist to see if you have some autoimmune disorder. Okay? Because Anh hydrosis is generally a lifelong condition. Most of us don't have that. Most of us just have a minimal amount of perspiration. Um, but you don't have some underlying disorder, but you should look into it if, if you really, truly don't sweat at

Speaker 3: 11:00

All. Yeah. I mean, the truth is, is some people sweat more than others, right? Yeah.

Speaker 2: 11:03

Some people, you know, you just see like some guy working out and they've got some gray sweatpants and shirt on it. It's all drenched.

Speaker 3: 11:09

Yes. It's a very dark gray. Oh,

Speaker 2: 11:10

It's a very dark gray. We're not all like that. Everybody sweats a little bit, but if you don't have it looked at.

Speaker 3: 11:14

Okay, well, I think that earns us a break and maybe even a glass of water just to make sure. All right,<laugh>. Uh, so, okay. We'll be right back at right after this break with a couple more questions. Stay with us.

Speaker 1: 11:26

You are listening to the Healthy Matters podcast with Dr. David Hilden. Got a question or comment for the doc, email us at Healthy Matters hc m e d.org, or give us a call at six one two eight seven three talk. That's 6 1 2 8 7 3 8 2 5 5. And now let's get back to more healthy conversation.

Speaker 2: 11:48

And we're back with the Hilton's house calls, answering your questions about health and wellness. Wellness. John, what else you got?

Speaker 3: 11:54

All right. Well, our next question comes in from Carrie in Minneapolis. She asks, is it true that you should change your toothbrush after having the flu? Am I going to reinfect myself or am I already inoculated to the strain of flu I've already suffered through?

Speaker 2: 12:08

The latter part is true once you are relatively secure from getting the same flu virus you just had, okay, your body does have the defense in that. Now there are a zillion other strains when you can get another strain, but should you change your toothbrush? The, there's probably not just tons of data on this, but I did do some reading on that, um, a couple years ago. And there are people who change their toothbrushes, and I had not heard of that. Theoretically, it is possible for germs to live on your toothbrush generally as long as it's wet. Okay? And maybe a little bit longer for some of them, but here's the deal, as long as it's you just using it, I would not go use your partner's wet toothbrush, gross, even if they don't have the flu, just because it has a high nasty but oo factor. Um, but because germs, bacteria, and viruses and the light can live on those surfaces, if you wanna be super duper careful with your own toothbrush, uh, habits maybe have two toothbrushes. Okay.

Speaker 3: 13:09

Yeah. I, I think we've talked about that. Yeah. I

Speaker 2: 13:11

Think maybe we've even talked about in previous episode, put one on the counter or in a toothbrush holder and when you use it, let it dry and then use the other one the next time and replace your toothbrushes. Um, often, but the reason for doing that is not cuz of germs, it's because it's for your dental care. Gotcha. But I think in the grand scheme of things you can do for your health, this isn't high on what I would recommend, if you're really super, kind of obsessive about, about this kind of stuff, use two toothbrushes. But if you're not that person, I would just not

Speaker 3: 13:39

Worry about it. All right. Okay. Cool.

Speaker 2: 13:40

There's certain things you just can't worry about.

Speaker 3: 13:41

Sure. Well,<laugh> tell that to some of us, right?

Speaker 2: 13:44

<laugh><laugh>, yeah. Easy for you

Speaker 3: 13:46

To say. Cool. And we've got one from Kevin in Lakeville. Uh, he says, I've got an appointment with the her neologist at the beginning of next year. Ooh. Um, I'm not scared, but I also don't know what to expect. Can you talk me off the ledge?

Speaker 2: 13:59

Yeah. Uh, uh, first of all, I'm not sure I used the word her neologist, but I kind

Speaker 3: 14:03

Of like it. That's a$5 word.

Speaker 2: 14:04

There are surgeons who specialize in hernia repair. Okay? But, uh, I, I'm not sure I've ever used that word. A hernia anywhere in your body is one body part bulging out into another. So you can have a hiatal hernia where a portion of your stomach bulges through your diaphragm into your chest cavity. You can have an umbilical hernia where the defect in the muscles of your abdominal wall causes a little break in that right around your belly button and the contents of your belly. Read that as your intestines Sure. Can bulge their way through. You can have what is the most common kind, and that would be an inguinal hernia. This is present in both men and women. A certain kind is very common in men. And an your inguinal area is your groin. Okay? That's what that is. And in men, when your body was developing, your reproductive organ started in your belly. They, they descended your testicles into your scrotum, and they came through your belly, that belly, the hole they came through closed up. Okay? And it, the, the muscles grew together later in life. Uh, I don't even know what the causes are in increased pressure can do it or it can just be, uh, just, it just happened. Okay? That hole isn't so strong anymore, and the intestines bulge through again, as long as you can push your intestines back in. I know that sounds weird, but if you have a little teeny bulge, it's real, the size of a golf ball or something kind of in your groin area, and you can push it in and it doesn't hurt, it is not dangerous. Okay? At that moment, the when it could be dangerous is if you can't push it back in, your intestines could get stuck in the hole. This is not common, but it does happen. Okay? And, and it's not gonna get better. This attorney is not likely to get better. So this is one of the most common surgeries done in the world, I think. I'm not a surgeon, but it's so common that most of your surgeons are not losing sleep over how they're gonna pull off this amazing surgery. This is what they do day in and day out. And they simp There's two ways to do it. There might be more<laugh> sure. But the two I know about is they can simply take your abdominal muscles and, and fascia and connective tissue and sew'em back together. They can just sew'em together. But sometimes that hole gets kind of big and they reinforce it. The second method, they reinforce it with a surgical mesh, which looks like window screen, but costs a whole lot more. Wow.<laugh><laugh>, I think of it like I asked the surgeon one. So do you just like, go down to Home Depot, buy a bunch of window screen and cut it with a scissors? And they don't, but it's not so much different than that, and they put it over the hole and they sew in that window screen to hold your contents of your belly in your belly. So this is a minor surgery. I do recommend that men or women who get a hernia, have a look, have a talk with a surgeon. It's a minor surgery, and you can be done with it forever. And then you can eliminate the possibility of in the future, that thing gets stuck in their condition called, uh, incarceration or strangulation of the hernia.

Speaker 3: 17:03

And, uh, just curious recovery time. How, how long are you out? Yeah.

Speaker 2: 17:07

A few days of the acute recovery, and then after a few weeks, you're walking a little gingerly, but, uh, you're not in agony. Gotcha. You'll have a little soreness for a few weeks, and then you're, you're

Speaker 3: 17:16

Good to go. Gotcha. All right. Well, that's some good intel there. Thank you very much. Let's, uh, take a look at our next one. This is one that came into us from Jane in Smyrna, Georgia, and she wrote to us and was curious about celiac disease, had made a suggestion that we do an episode around it, which I think is a great idea, Jane, we're on it. But in the meantime, maybe we could just shed some light as to what's celiac disease and what's a quick primer around that.

Speaker 2: 17:38

Jane, thanks for listening and thanks for sending in this suggestion. I love that idea. I'm gonna get one of my colleagues and talk about celiac disease. You may or may not have heard of celiac disease, but it, it is being diagnosed way more than it was, right? A few decades ago. Now that's not clear. Why are we simply looking for it more mm-hmm.<affirmative>, or is the actual prevalence rising over the decades? Right. And it could be both. We do have better ways to look for it. There's simply a blood test you can do now to see if you might have it, and then, uh, so it's easier to diagnose. But it also could be that our diets have changed from the fifties and is causing more problems. But celiac disease is your body's inability to process gluten. Gluten is a protein that is found in many grains, including the big one, wheat. And there are wheat products in so much of what we eat. It is everywhere. Even if you didn't think you're eating a wheat product, there are fillers and preservatives and thickeners, and it's in everything. And so people with celiac disease simply cannot eat gluten. The treatment isn't a medication, the treatment is to a 100% eliminated. Eliminated, okay. Which is really hard. You, every restaurant you go to, if the server doesn't know if there's gluten in it, you can't eat it, right? So, so it's hard to do. Um, what happens in celiac disease is that, uh, the lining of your intestine gets, um, destroyed and it can't process that. But what I'm gonna talk about when we do this show is people who maybe don't have celiac disease, but they have a sensitivity to gluten, right? That is also on the rise. And we're gonna delve into that when we do this show. So that's what, that's what we'll say now about celiac and gluten. That's a great topic that affects a zillion people. And that's a, that's the correct figure. It's

Speaker 3: 19:22

A zillion, it's a zillion. A proper zillion,

Speaker 2: 19:23

Okay. Yeah. It's, it's very prevalent.

Speaker 3: 19:25

It sure is. And that show is now on the docket. Thank you for the suggestion, Jane. Uh, all right, moving on. We got one from Charlene. She says she's been taking hydralazine and losartan, something like that. Yeah, that's good. For around four to five years for blood pressure. Uh, she says, I've noticed an increase in joint pain in my shoulder and arm, as well as lower back and leg. No other issues. Now my blood pressure is running low and has been for some time. Can this be related to this medication? And I was wondering if a lower dose might help any word for Charlene.

Speaker 2: 19:56

Yeah, there's a lot there. Um, and, and of course I can't get specifics about Charlene's dosing, but there's a lot there to, to talk about. I'll, I'll, I'll say a few things. One, if you are having new symptoms of any kind in your body after starting a medication, yes, it is always possible that it's the medication. And hydralazine particularly is known to have some joint pains. Okay? On the other hand, if you have been on hydralazine for five years and your joint pains started last week, it's probably not. The hydralazine is probably something else because there's dozens of reasons people have joint pain and the hydralazine is only one of them. So I think it's probably not, but it's possible. Okay. The joint pains, as for the medications, you are on two blood pressure medicines. One of them is considered a first line medicine. There are three or four classes of medicines that are considered first line. First thing you should take, losartan would be in that group that is very common. It's called an, um, it's a, a receptor blocker. The other one, hydralazine is not considered first line. It is effective for blood pressure, but it has some drawbacks. One drawback is you have to take it two to three times a day. Most people are taking it three times a day. Any medication that you have to take that often is far less likely to be effective because there is, I've yet to meet the human being that can take a medicine three day, 10 a day. That really is without fail, I've yet to meet that person. We always try to reduce dosing to once a day or less if we can. So that's a drawback. The other drawback is it's not all that potent. Um, it, it has not, doesn't have the scientific, um, uh, evidence that the other ones do. So hydralazine is good to be on if you've exhausted all the other ones. Okay. So for this listener, if your blood pressure is low, it is clear to me that the one I would at least look at is your hydralazine. Now, you as, as one to cut back the dose or eliminate I, um, I don't care how you get your blood pressure down so much is that you do, but this listener said the blood pressure is low, right? And hydralazine would be a wonderful one to consider stopping. But again, I'm gonna say very clearly, I can't give specific advice, but talk to your doctor. Should I, my blood pressure's low, do I need all these medications? And if you could eliminate, wanna eliminate the one you have to take three times a day. Sure,

Speaker 3: 22:06

Sure. And as always, yeah, if you don't need it, if

Speaker 2: 22:08

You don't need it, if you don't need it at all, yeah. Oh, that would be the one first. Less medication. The best, the one you should stop is the hydralazine. It, it's a vasodilator. It makes blood vessels dilate, and that helps your blood pressure.

Speaker 3: 22:19

Gotcha. The important part would just be keeping that as low as we can. Yep.

Speaker 2: 22:24

Keeping hypertension is the leading cause, uh, leading risk factor for stroke. It is a major risk factor for heart disease and kidney disease. So get your blood pressure down. Preferably the top number should be in the one twentie s and the bottom number should be in the seventies or

Speaker 3: 22:37

Lower. Very good. All right, well let's wrap it up here. We got one more with David from New Jersey, because of course it wouldn't be a q and a show without something related to Covid. Right? So Right.

Speaker 2: 22:45

And, and from our, our listener base in New Jersey.

Speaker 3: 22:47

Yeah, of course, of course. Yeah. And thanks to David, we've got both here. Uh, okay, so he says, I've had a sore throat and a slight fever the other day and went to urgent care, although flu and covid tests were negative when I was there, they gave me an antibiotic just in case. Seems like pretty standard practice. And then he says, I've since tested positive for covid. Should I still take the antibiotic?

Speaker 2: 23:09

Ooh. Yeah. It is standard practice and it shouldn't be. Okay. Um, they never should have given'em that antibiotic. They

Speaker 3: 23:14

Give

Speaker 2: 23:14

'em all the time. You know, I, I often, um, so antibiotics don't treat viruses and I, I don't know the exact number, but it's something like 90%, nine 0% of the upper head symptoms that people come in for are caused by viruses. That would be sore throat, snuffy, nose sinusitis is 90% viral. Everyone says, yeah, but I have a sinus infection. Yeah, you do. It's viral. Okay.<laugh>. Alright. Um, but my stuff is green that comes outta my nose. Yep. It sure is. It's viral. Um, those are not predictors of a, a bacterial infection. And so this person who came in, David, when you went in and you had these symptoms, they thought it was viral, and yet they gave you the antibiotic anyway. And so that I, that is problematic. That is problematic for you personally because taking an an antibiotic puts you at risk for all kinds of things. Um, for you personally, the biggest risk is for gastrointestinal complications. You're gonna get diarrhea. Wow. And you are at risk for what you really, really don't want to get. And that's clostridium difficile c diff so that, so you don't take'em unless you have to. Okay. So it's not good for you. It's also not good for the earth. It is not good for all of humanity because, uh, the bacteria are outsmarting us. And pretty soon, over the course of years, every year, some bacteria becomes resistant to the antibiotics we have and we need to save the antibiotics for when we really need them. Now, David went in the next day and had covid. So his symptoms the first day were covid. And it's just that the test wasn't positive yet. So I wouldn't take that antibiotic. You do not need it. It's gonna do nothing for your c and it's just gonna put you at risk for gastrointestinal side effects, nausea, diarrhea. And so I would simply not take it. If you took one or two, I would stop it right now. Okay.

Speaker 3: 24:53

You don't need to taper off or,

Speaker 2: 24:54

Well, we do hear all the time about if you have this taken'til they're gone. That is a true statement. When you have an infection, that is true. Um, if you have a real true bacterial infection, let's say pneumonia, and you only take one or two doses, you've killed off all the weak bacteria. Think of an army. You killed off all the weak ones, right? You left a few of the strong bacteria to live another day. So you want to continue your antibiotics till they're gone. All

Speaker 3: 25:21

The tough

Speaker 2: 25:22

Guys are out. That's right. In this case, however, you didn't eat'em in the first place, they're, they're not killing anything except beneficial bacteria. So I think in your case, if you haven't started it, don't. And if you have, stop

Speaker 3: 25:33

It. Well, I think that's pretty much wrapping it up for today for us.

Speaker 2: 25:36

Thanks for helping out, John. These were great questions. Uh, absolutely. Thank you listeners for tuning in. I hope your 2023 New Year's resolutions are off to a great start, and I hope you'll join us for our next episode as well. In the meantime, be healthy and be well.

Speaker 1: 25:52

Thanks for listening to the Healthy Matters podcast with Dr. David Hilden. Got a question or a comment for the show, email us at Healthy Matters hc m e d.org or call 6 1 2 8 7 3 talk. There's also a link in the show notes. The Healthy Matters Podcast is made possible by Hennepin Healthcare in Minneapolis, Minnesota, and engineered and produced by John Lucas At highball Executive producers are Jonathan Comito and Christine Hill. Please remember, we can only give general medical advice during this program, and every case is unique. We urge you to consult with your physician if you have a more serious or pressing health concern. Until next time, be healthy and be well.