S02_E20 - Mental Health Stressors...and Strategies!

Speaker 1: 0:00

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Speaker 2: 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 3: 0:21

Hey, everybody, it's Dr. David Hilden, your host of the Healthy Matters podcast. Welcome to episode 20. As we head towards winter and the days get shorter, it can take a toll on people's mood and more importantly, their mental health and their wellbeing. On today's episode, I am joined by Hennepin Healthcare psychiatrist, Dr. Katie Thorne , an expert on mental health, and we are gonna discuss strategies for improving and sustaining your own mental health. Katie , welcome to the podcast and thanks for joining us.

Speaker 4: 0:50

Thanks, David. It's good to be here. So let's just

Speaker 3: 0:52

Start right out. How do you define good mental health?

Speaker 4: 0:56

It's a great question, and it's complex, I'm sure, as you might have guessed, it

Speaker 3: 1:00

Can be , it's pretty open-ended <laugh> ,

Speaker 4: 1:01

It's pretty open-ended. So we also have to think about how this can be influenced by social and cultural factors, but thinking of it as a dynamic state that changes over time. I like the World Health Organization sort of loosely definition of that, that it is more than just the absence of disease. It's a state of mental wellbeing that enables people to cope with stressors, be in a state of able to learn, contribute to communities, maintain nourishing relationships, and feel that they have a life worth living. So

Speaker 3: 1:30

What are some of the most common causes, especially in this state that you're seeing of, of, of threats to people's good mental health. Mm-hmm. <affirmative>,

Speaker 4: 1:38

Also multifaceted. Lots of different things that can contribute to that. I think one of the biggest one that we see is a lack of access to basic needs, including housing, affordable housing, affordable childcare , healthcare , food security. Also decreased connection, you know, loneliness, we know , um, can increase , uh, deteriorating mental health , um, as well as toxic stress, trauma, substance use, sleep disruption, hormonal changes, the list could go on.

Speaker 3: 2:09

It's what that you're basically describing the life experience of most of our listeners right now, they're experiencing some of that.

Speaker 4: 2:17

We all are. Yes.

Speaker 3: 2:19

It , it , it brings to mind. Somebody told me the other day, wow, you looked really happy at such and such and such event. And I said, really? I felt really, really stressed. And so it , it , it strikes me as that your mental health is this balance maybe , um, between the stressors, the things that are going on in your life , um, and how you cope with that. I, I think it's more than depression, isn't it?

Speaker 4: 2:40

It is, yeah. And I think what you're talking about too is we all have stressors in our life, right? And there's a normal amount and a healthy amount of stress. And sometimes when it becomes too much for too long without healthy connections and relationships to buffer that it can be toxic and tipping over into that depression. And it's, it's not always just depression. A lot of times what we see is, again, all of the background pieces about who , um, makes , um, up individuals, their family, the social connection, but also sometimes it's anxiety , sometimes it's trauma, sometimes it can be substance use, medical conditions that can play into this grief loss. It's rarely, rarely just depression.

Speaker 3: 3:22

So how does one know if the feelings you're having are depression or I'm just feeling blue, or this is just normal anxiety or just this is normal stressors. When does it become something that some, that someone should seek help for or be more, more concerned about? Mm-hmm.

Speaker 4: 3:39

<affirmative> such a good question. One thing I tell people is never worry alone. And there's a lot of people who would love to help think about that. So if anyone is thinking about, is this depression, is it anxiety, is it normal? Just reach out and ask, ask a therapist. Ask a trusted family member or a friend, a psychiatrist. And one way that I help people think about it is in either , um, bad weather days or bad climate. And so we all have bad weather days, right? So here and there a day that just isn't going our way that we don't feel as well. But when it really feels like the climate is not, you know, not going the way that we want, and the climate is unhealthy, sometimes that can be more of the depression versus kind of the blues that we all feel.

Speaker 3: 4:21

I love that metaphor. I have not heard that before. The weather or versus climate thing. A a few weeks ago or a few months ago, we did an episode with another psychiatrist here at Hennepin, Dr. Eduardo Colon , where we talked about the loneliness epidemic. And as the Surgeon General had come out with , uh, some thoughts on that, you've mentioned connectedness and isolation a couple times already in this episode. Could you say more about that? How does being isolated affect a person and and what ought to do about it if you're just kind of in this rutt and, and don't have a lot of connections? Yeah.

Speaker 4: 4:54

So we are all hardwired as human beings to connect. Since we are born babies, we are all driven to connect with our caregivers, with people in our lives. That does not change as we become adults, as we become older adults. And that has looked different since the pandemic, since a lot of different things and how to reach out and how to actually connect. And I , I would encourage listeners to think about connection on even small levels. It doesn't have to be you go out to that neighborhood block party. If it is, great, get out there and do it. That's

Speaker 3: 5:25

So funny. You mentioned that we had a neighborhood block party last Friday, and my wife said, I'm not going to that block party

Speaker 4: 5:30

<laugh> . Right? Yeah. It's a spectrum, right? I've missed a few block parties myself. Um, but thinking about, maybe it's a text, right? You start small, it's a text to someone you trust. It's , um, connecting around a song, you know, maybe it's sometimes talking or sharing feelings can feel too overwhelming for people to make that connection. Maybe you are just sitting together with someone that you trust doing something you enjoy, right? Or getting out. Um, but you can really start small with connection.

Speaker 3: 5:57

Do you think this has gotten worse since the pandemic? You know, we talk about before pandemic in the before times and the after times we're in the after times. Now it, it strikes me that is that this, this sense of disconnectedness is higher. Now I blame virtual meetings and all that because that's the bane of my existence. I just absolutely hate them. I've even told people in my department, no more, I'm not doing 'em good. I'm not doing zoom meetings. No offense to the good people at Zoom. I'm not doing that. If we can absolutely help it. But do you think that, are we in a new kind of era of isolation? No , I think we

Speaker 4: 6:31

Are. And I think we're in a new normal, as people have been talking about. And we do know that depression has risen dramatically since covid in adults, right? We know that from statistics

Speaker 3: 6:42

Diagnosed depression.

Speaker 4: 6:43

Diagnosed depression, yeah. We're also screening for it more, which I think is a good thing. And Covid has helped with that, is to say, Hey, we've been missing this, right? Or we are missing this. And we also know that in certain populations we miss it more. And that includes , um, uh, black Americans, indigenous Americans, women are twice as likely to experience depression , uh, than men as well. And so we are doing a better job of picking it up

Speaker 3: 7:11

Too. So I guess that's a, that's a mixed blessing. It's good that we're picking it up more, but it , it's a little disheartening that it's on the rise. Do we know why certain groups experience mood problems, mood disorders, like you just said, women, people of color, native people. Do we know why that is?

Speaker 4: 7:29

I think we have a lot more to learn, of course in that. And I would guess , uh, starting for women , uh, so I'm a perinatal psychiatrist, so I do a lot of perinatal work with women. And so it's very complex. I think hormones can play a, a part in that, especially postpartum and parent during pregnancy. Um, also , um, I think we have a lot more to learn about inflammation and how um, different diagnoses are connected to our mental health and women are more common to get some of these , uh, other diagnoses, autoimmune stuff. Um, and then I think in our culture we tend to place , um, more of the mental load and family work. So during the pandemic we know that women were in charge of , uh, more of the mental load of the house. So distance learning, some of those things. And um, and that contributes to more stress, more depression, anxiety too.

Speaker 3: 8:23

That makes sense. Do you, do most of your practice, just as an aside with um, uh, new moms and new families? Is that where most of your, your psychiatry work is?

Speaker 4: 8:31

Yeah, that is where most of my work is. I also see residents for their own mental health here at Hennepin Healthcare as well.

Speaker 3: 8:37

So residents being doctors in training? Correct. Yeah . Yeah, I'm aware of that. And thank you for that by the way. Yeah . I'd like to shift if we could a little bit, if you could address how could somebody identify when there's sort of an imbalance in their own mental health?

Speaker 4: 8:52

Yeah. I tell patients and families I work with bottom line, trust your gut. If you're feeling like something isn't right, you might not have the words for it or what to describe, reach out and ask. That's what we're here for. As psychiatrists, as therapists, as as healthcare providers, as we will help. 'cause it's really complex and we might not always know, but trust your gut. And sometimes we ourselves can be the last to notice that we're depressed. So not only trust your gut, but trust what loved ones and trusted people in your life might be pointing out to you. Other things that we can all look for is a sense of maybe not enjoying things we once enjoyed. That can be a shift. Are there things coming up in relationships that maybe there's more relational strains in your life? Are your sleep and appetite affected? That's another thing between kind of feeling blue and when it's crossing over to depression, we see our functioning being impacted, including sleep appetite. And one big thing that we see quite a bit is irritability. Um, to , can actually show up as anxiety and depression as well.

Speaker 3: 9:54

You bring up , um, uh, um, mental health professionals. It , it strikes me that , uh, there might be, I dunno if it's generational, but you see resident physicians, physicians who are generally in their twenties and thirties, you, you help care for their mental health. I don't remember, I'm not in my twenties or thirties or forties, <laugh> , <laugh> . I don't , I don't ever recall once anyone asking the doctors of my generation how you're doing, or you certainly wouldn't have brought it up. You wouldn't have said, I'm gonna go see a psychiatrist for heaven's sakes like you and now , um, the , the younger doctors or seem more willing to do that. So my question is, do you see any generational differences in how people , um, respond to their mental health , um, in , in particularly in how they seek assistance?

Speaker 4: 10:38

I do. I think that culture is shifting and I think the stigma is being reduced and not to bring , consistently bring it back to the pandemic, but I think that actually has been a big shift of the pandemic where we realized, oh, it's not just someone else who suffers from depression. Right? It's like that other person has anxiety, not me. And then when we saw it become so pervasive with the isolation and the increased stressors in our world, it was all of us. And so that actually was a collective unification for people to connect on is that we're all suffering and struggling and it's okay.

Speaker 3: 11:12

And it's okay. I think that's a really good message. So you've mentioned some, some changes in people's lives or, or their, their day-to-day experiences of irritability and sleep problems and all that. If someone feels like they have some of those, what should they do next?

Speaker 4: 11:28

Yeah, I think again, that message, don't worry alone and find someone to connect with and confide in. That doesn't mean you have to tell them every single thing you might be thinking or feeling, but again, that message of something just doesn't feel right and I need more support or I'd like more support. And that could be someone in your life that could be a mental health professional, but find someone and not worry alone.

Speaker 3: 11:51

I really, really like that advice. Um, does it have to be , uh, a professional?

Speaker 4: 11:56

No, no. It can be anyone that you trust , um, and that maybe understands you and that you feel that you can safely talk about things with. And it also doesn't have to be a mental health professional. Um, you can go to a primary care doctor, internal medicine, you know, anyone on your healthcare team, a physical therapist , um, that you trust. It can get you connected to the rights care and support.

Speaker 3: 12:20

So for the professional network of support, I think our mental health system, this is a little opinion or editorializing, hasn't been well supported or or developed in our country and it's fragmented as heck. And here you are a psychiatrist who works in that system. What advice would you give to people who do need to access the mental health system? How do they do that? I think a lot of people don't even know where to begin. You're

Speaker 4: 12:46

Right. And that leads to actually a lot of people not getting treatment. Mm-hmm . <affirmative> . And we know that depression and anxiety are so common, but a lot of people actually never receive the treatment they deserve. And this is a big part of it and this access. And so , um, anyone, again, any healthcare professional, you have an appointment, ask them about it, get connected. Uh , that's one way in. Also, nami, the National Alliance for Mental Illness is a wonderful organization that helps get people and families connected to resources. And so when you're just not sure where to start, right? You Google therapist and a million people come up and some people accept insurance. This person has openings , this person doesn't. It's too overwhelming. Mm-hmm. <affirmative> . And so starting with somewhere like NAMI can be another really nice place to start.

Speaker 3: 13:29

So NAMI is a great resource. And for listeners, we will put a link to the NAMI website on the show notes. Katie , what happens if someone is really in a bad way? I mean really acutely having a mental health crisis, what should they do then? Yeah,

Speaker 4: 13:45

It can be really a scary situation for the individual and the family. And we have a suicide prevention lifeline that they or family members could dial 9, 8 8.

Speaker 3: 13:55

And that's a nationwide number nationwide. Good tip there. We're talking to Dr. Katie Thorne about your mental health. When we come back, we're gonna talk about some things you can do in your daily life and also how you can help others who are in your life. Stay with us. We'll be right back.

Speaker 2: 14:13

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@hcme.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 3: 14:36

And we're back. Katie. We've been talking a lot about depression in the setting of stressors in people's lives. A lot of people experiencing something a little bit different. They experience anxiety or even panic attacks. What tips might you have for those folks?

Speaker 4: 14:50

Yeah, I'm glad you asked. Anxiety is so common and often really linked right to depression. It's pretty rare that someone only has depression, right? Anxiety and depression go hand in hand . And anxiety is a state that is trying to protect ourselves, right? Our body and our brain are trying to say danger. There's something that we need to pay attention to. But when it's anxiety, that alarm bell is going off when it shouldn't be. And that's exhausting and not sustainable for our bodies and our mind. And so, one thing to know about anxiety is very common, treatable. And there are some skills that can be really helpful and effective. Like

Speaker 3: 15:27

Day-to-day skills.

Speaker 4: 15:28

Day-to-day skills. There's something that I learned in residency and I carry with me every day . They're called tip skills.

Speaker 3: 15:34

Okay, tell us about 'em . <laugh> .

Speaker 4: 15:36

Yeah. So TIP stands for , um, uh, T is for temperature. I is for intense exercise, P is for paced breathing. And the last P is progressive muscle relaxation, which I could talk about. But all of these tip skills are evidence-based and they work through our vagal nerve, which is the biggest nerve in our body that helps regulate our stress response and our anxiety and help give us some room to breathe and, and think. Could we

Speaker 3: 16:02

Dig into that a little bit more? Yeah. Yeah . Tell us about 'em. What's temperature? That's the tea .

Speaker 4: 16:06

Yeah. So temperature, we know that cold temperature can help with anxiety. And so when at the moment we start to feel anxious, overwhelmed, grab an ice pack . If you can put 'em, you know, shut your eyes, put the ice pack over your eyes, under your eyes. And that will help shock kind of our body to say, Hey, wait, we're okay. We're safe.

Speaker 3: 16:25

Okay. First of all, that's fascinating. From a , from a my doctor point of view, I get that. 'cause you mentioned the vagus nerve, which is when it's sort of like the break in the heart, it slows things down. Mm-hmm . <affirmative> . So if you put ice on it, it , it slows that down. But that strikes me as counterintuitive that I would think heat and warmth and danish huga and all that are , are the things that would be better for anxiety. You say put in a cold pack on your face. Yeah.

Speaker 4: 16:46

Sometimes our nervous system needs a reset. Right? And the tricky thing about anxiety is it spiral, spiral, spiral spirals and keeps going. Right? And sometimes our body and our nervous system just need, Hey wait, we need a reset. And in Minnesota, walk outside. It doesn't even have to be an ice pack . It's cold. It's coming up here in a couple months. Just walk outside and, and be exposed to that cold

Speaker 3: 17:06

Air . It's all good Minnesota. See, there's something beneficial to have it being 10 below zero outside. Okay, that's the tea . What's the I in tips? The

Speaker 4: 17:14

I is intense exercise. Not always possible, but we also know that that can also do that reset right? When we're feeling so anxious. And so sometimes what I'll tell people is do 10 jumping jacks. You know, if you can or run up the stairs. Especially the resident doctors I work with here. I say if anyone sees a doctor running up the stairs, they're not gonna take twice it .

Speaker 3: 17:32

'cause you told them to. They'll run up the stairwells. <laugh> . Yes .

Speaker 4: 17:36

Um, so some form of just, it doesn't have to be going for a mile run or anything. Just move your body, get outta your chair. Do something.

Speaker 3: 17:43

Makes perfect sense. P

Speaker 4: 17:45

P first P paced breathing. There's a lot of ways to breathe and a lot of talk about how to breathe best for anxiety mood. What I want people to know is I want, I want people to exhale for a little longer than they're inhaling. Because when we exhale things calm, our heart rate can decrease a little bit. So if we're spending more time in the breathing out the exhalation, that can also be a reset.

Speaker 3: 18:09

I've been doing it for the last 30 seconds,

Speaker 4: 18:11

<laugh>. I did it before we started today .

Speaker 3: 18:12

Okay. Perfect. What's the last piece?

Speaker 4: 18:14

The last piece is something called progressive muscle relaxation. We know that if we tense up our muscles first and then relax them , they actually relax more than if I were to say, David, just relax over there. Right? Relax. Yeah. But if we can tighten our whole body up, and then if we can think kind of from top down even, I like to think of this golden light kind of coming from the top of my body down and just relaxing each muscle group one, one little bit of a time. So starting even with your, with your head, your ears, which sounds silly, but really kind of drawing attention to our body. Um, and working all the way down to our feet. That can be a really good one for sleep. 'cause a lot of times anxiety comes, is awake at night. And if we're lying in bed and we're feeling that, try this.

Speaker 3: 18:57

T I P P. Those are awesome. Yeah . Tips. By the way , let's talk now about the people in our lives. So if, how, how can you help identify mental health concerns in the people in our lives? And what might we do about that? Not about ourselves now about helping others?

Speaker 4: 19:17

I think the, one of the biggest messages I can say is ask, A lot of times people are afraid to ask. Right? What if I ask if they're depressed and they're not? Or what if I'm missing it? Don't be afraid to ask people feel connected when we know that other people are worried or caring about us. And so something to phrase you , you could say, I care for you and I'm worried what's going on. They might say, I'm fine. And but they will always remember that you noticed and that you were on their minds. It's

Speaker 3: 19:46

So simple and it , we don't maybe think about that so much. Mm-hmm. <affirmative>, is that, is that for all people? Is that for young people, old people? Is it just the people close to us, or, I mean, should, like at work, are we supposed to go around asking people how you're doing? We do say, how are ya <laugh>? I think that that's not what you're talking about. Yeah.

Speaker 4: 20:02

I , uh, as a psychiatrist I would say ask everybody. Right? And I know that's not always possible, but as part of that stigma and culture changing and, and making sure we are not alone, right? Because I guarantee even in this room in the hospital, there are people who are suffering, right? And , uh, so yes, I would say ask in a way that feels okay and safe if you're worried about someone.

Speaker 3: 20:25

So how can you help others? Uh , particularly if you did ask and they said, well, now that you mention it, I'm not doing so great. Mm-hmm. <affirmative>, how can you help?

Speaker 4: 20:34

So you let them know that you're there. So if if they say, I'm not doing well, they need to know they have supports and help. And , um, whether that's you, yourself and other supports, you say, I'm here, we're gonna figure this out. And again, you can call any medical professional, you can come in for an appointment. Um, you can reach out to nami and maybe you do that together because it's hard for someone who's feeling depressed and anxious to even make that call and

Speaker 3: 21:00

Connect . Right. To even just do something about It's hard. Yeah. Yeah.

Speaker 4: 21:02

Yeah. What

Speaker 3: 21:03

About the tendency to try to fix things? I think I might fall, fall , fall prey to this. I'm reminded of, of some old video that was on years ago where a woman had a big nail sticking out of her forehead and, and her partner kept saying, but there's a nail in the forehead. Why don't we pull this thing? And she kept saying, quit trying to fix me <laugh>. Uh , um, but um , but there's a tendency to say, why don't you do this? Why don't you do this? Oh, I'd had that happen to me. Why ? This is what I did. Is there a tendency for us to try to fix things for others as opposed to maybe just being present?

Speaker 4: 21:33

Absolutely. And I think especially in medical training as a psychiatrist myself, I think we're, we're taught to fix things right? And be the fixers in the problems. And so I think we all experience that. And to your point, the best thing we can do in that moment is to let someone know that we are there and to validate their feelings. They are not alone. And to bear witness with them, right? Sometimes we just need someone to see us. Our pain needs to be visible. And if you're not sure what to do next or how to connect someone, you just send the message and say, I'm here with you. You might not know what to say.

Speaker 3: 22:05

So as we go into the winter, Katie and as family gatherings come up at Thanksgiving and, and into the winter holidays, and this is a time for many of, of gatherings and connectedness, and for many people it's actually not. And it could be a harder time. We're swamped with social media and we're swamped with the fast pace of life. Given all that context, what tips would you leave people with?

Speaker 4: 22:30

Holidays certainly can be joyous, and both painful and both can be true at the same time. And I like to lead with hope. And I think it was Jane Goodall who said something that hope, hope is an action, something to that point, right ? Mm-hmm. <affirmative>. And so any action that we can take for ourselves can be hope. And so sometimes that's as simple as self-care, having a glass of water , um, doing something that you enjoy. Um, reducing that isolation can be part of that hope and that action. So

Speaker 3: 23:00

It's very proactive. It sounds like, you know, hope isn't just like sitting on your, with your thoughts and hope something changes you. You're using it as more do some simple things that yeah. For

Speaker 4: 23:09

Yourself and identify other supports. Sometimes it's not our , um, you know, our family of origin or our family's there, it's other people in our lives or other pets or things in our lives. And not only identifying those supports, but leaning into them. Sometimes that's the hard part, at least for me , right? I can say, oh, I have all these people in my life who would love to help me and then I don't ask. So

Speaker 3: 23:28

I like that about taking things to , um, um, that are hopeful and hope as an action verb actually. What other things can people do?

Speaker 4: 23:36

So again, back to kind of self-care and basic needs, moving your body. We talk a lot about exercise and mental health and exercise can mean a lot of different things. I think it can, can be overwhelming for people to say, Ugh , I'm feeling depressed and now you're telling me I have to go run a mile outside,

Speaker 3: 23:50

Right? I wanna open the Ben and Jerry's and watch Netflix.

Speaker 4: 23:52

Yeah, well, what I'm talking about is just moving your body, you know, being, sitting on the ground on a yoga mat, getting out of that chair, moving scenery in your house. It can be small and meaningful moments in moving your body. Also diet, right? And around the holidays, that's, that can be tough. But thinking of things like one thing a day that can be nourishing to your body. Small changes in, in, in that,

Speaker 3: 24:15

Something that everybody can actually do. Could I ask you a little bit of the, the converse of that question, what things aren't helpful?

Speaker 4: 24:23

There can be a lot of different coping skills that we all develop, whether growing up we learn things from that are modeled in our family or that we do to survive. And then sometimes in adulthood they don't work as well, or we pick up new things in adulthood to cope when we're feeling so overwhelmed. And one of those things that we've seen , uh, can be substances. And so some people might feel a pull to drink or to use other substances when they're feeling depressed or anxious. And that we know tends to make things a lot worse. Also, when we feel depressed or anxious, we have this desire, a lot to disconnect, right? To isolate. And what I will say is if we can just push past that, it'll be uncomfortable. But try as much as you can to push past that isolation. But we know again, this topic keeps coming up that makes things worse.

Speaker 3: 25:11

Before I let you go, what final tip would you leave people with?

Speaker 4: 25:15

I want people to know these three things that I tell everybody and myself and I mean them. That if you are suffering with any stress, depression, anxiety, you are not alone. This is not your fault. And with help, you will feel better.

Speaker 3: 25:31

We've been talking with Dr. Katie Thorne about your mental health . Katie , thank you so much for being on the episode with me today.

Speaker 4: 25:37

Yeah, thanks for having me, David. It's been a pleasure. We've

Speaker 3: 25:39

Had a lot of good tips about your mental health listeners. I do want to remind you that if you are having an acute crisis or you just need to talk to a mental health professional, please pick up the phone and dial nine, eight eight. That is the nationwide number for , uh, to connect you with a mental health professional, 9 8 8. Also, we will put the NAMI link in our show notes. I would encourage you to, to learn more about this topic from a little slightly different angle with another psychiatrist, Dr. Eduardo Colon. He was on episode 13 of the podcast. So go into archives and you can check that out. So that's all for today. I hope you have picked up some good tips, as have I, and I hope you'll join us for the next episode. And in the meantime, be healthy and be well.

Speaker 2: 26:22

Thanks for listening to the Healthy Matters podcast with Dr. David Hilden . To find out more about the Healthy Matters podcast or browse the archive, visit healthy matters.org. You got a question or a comment for the show? Email us at Healthy matters@hcme.org or call 6 1 2 8 7 3 talk. There's also a link in the show notes. And finally, if you enjoy the show, please leave us a review and share the show with others. 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, CTO 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.