Intro 0:03
Welcome to Maximal Being, a podcast devoted to ditching fad diets and using real science to get you healthy and feeling great. I’m Doc Mok, a GI and functional medicine doctor who harnesses the power of gut health to get you achieving your goals. And I'm Jacky P, a well-informed layman who challenges the experts and ask the questions that you want. Don't forget to hit the subscribe button or leave a comment, and now onto the show.
Doc Mok 0:32
What's going on Maximal Beings, Doc Mok here with maximalbeing.com. Don't forget to hit the subscribe button. Leave us a comment, it does help us to get the word out. If you have any questions, you can email us at [email protected]. Enjoy the episode.
Jacky Homme 0:48
All right. All right. All right, everybody. It's me. Jacky P. Thanks for hanging on. I've been talking here with Dr Scott Peslak and and Kyle Smith about sickle cell and you know, we've been kind of all over the map about sickle cell care and and learning, right? Teaching folks what what sickle cell is. And I like to take a little bit of a pivot, a little bit, and just talk about one thing I felt like about sickle cell, Kyle, and maybe you can chime on this as well, is there's something about sickle cell where it's you're dealing with, not only the disease, but there's so many things like it shockwaves into other parts of your life. Right from a more like from a or a professional aspect, for instance, you know, I'm looking up them entrepreneurial. I work for myself, but, you know, I know a lot of folks who are more in a corporate world than they have sickle cell and their superiors are not really understanding. Hey, why are you gone all this side room for two weeks, you know, with no warning, and then when you're back, why aren't you just 100% right? So, Kyle, I mean, as much as you would like to share, like, you know, has this been something that you've had to deal with in your life? Is it something you've seen in the community? You know, what would be, you know, like some things you'd like to comment on that?
Kyle Smith 2:18
So fortunately, it's not something that I have to deal with, dealt with, or just because I have had very understanding employers. And, you know, I'm also very transparent about my diagnosis and disease, and understand that under the American Disabilities Act I am protected, you know, to, you know, through, through my employment, and if I am missing any time, and if I just happen to to get sick as well. Unfortunately, that is not everyone's case. And I do have a lot of friends who have told me horror stories, you know, and about how, you know they were in the hospital and you know, they were scared to pick up the phone because their boss was calling them repeatedly, you know, about, like, where they were, when they would be back, how long they would need, so on and so forth. Mind you, they've been in the hospital for the last, you know, three days trying to, like, really manage their sickle cell care pain. And also, too, you know, like, not everyone, like you said, is in the quote, unquote corporate space. You know, some people just have, like, regular jobs that would that really demand physical labor too, right? Which is hard, you know, for for anyone, but especially an individual living with civil cell disease, right? And I was talking to another community leader with sickle cell, and she said something that really resonated with me. She said, Kyle having sickle cell is like having a full time job, right, you know, and you have to really be so dedicated to your care, to understanding what it is you are putting in your body, to making all of your appointments you know, to getting to all your appointments and back so on, to dealing with the pain, to dealing with what other other complications you may be going through, so on and so forth. It's like a full time job, right? So if you take that, you know, and also you are working another full time job, and maybe you are one of those people who you know, very commonly, you know, especially in today's economy, has another job, whether it be part time or full time, you are literally saying that you have three to four full time jobs, you know. And one thing that we didn't really discuss about sickle cell is that another core component of sickle cell disease is fatigue, right? It's, it's a huge, huge, huge, huge deal, and it just is, unfortunately, something that is not always easily fixed when it comes to the different treatments and therapies that are currently available for sickle cell disease. But I mentioned the fatigue part because we all know what it's like after a long day at work, you know, and coming home and, you know, whatever you do if you, you know, take your shoes off and sit on the couch and you're so tired. But imagine having that feeling a long day of work just literally every day, just because of your your disease. So yeah, that I think that if folks are unfortunately dealing with, you know, the the pressures of employers trying to really enforce different types of rules and regulations of of their their their jobs. Please know that you are protected and that it's illegal. You know, for you to get to get fired because of your disease,
Jacky Homme 6:13
Yeah, and thanks for sharing that as well. That's one thing to I forgot to mention. It's yeah it, you know, when you really think about, you know, I have a I tell people I'd be like, the avengers of providers. I've got every type of special you think I've got one. I see them regularly. Like, there's, there's a doctor's meeting, check in, check up, almost bi weekly, you know. And, you know, it took me a while to realize, wow, if I had a nine to five job, you know, or if, if I was, like, an hourly employee, right, you know, you know, I'm grateful where I am, but this just the care, right, not even, you know, being in a the, you know, air quoting the healthy phase of a sickle cell person, just the upkeep and maintenance can can take a toll, you know. And it's funny about the I always call it kind of like the aftermath of having an episode. It's, you know, you're kind of sore, you know, I like to work out. And I'd say probably for the last six years, it's like I have, like, you know, amount of weights I can lift up. That's kind of like, I know, when I get back to it how long it's been since my last episode, because I get sick, and then the amount I can lift goes all the way back down to zero, and I rebuild again, right? You know. And the other day, I was at a board meeting, and I was still recovering from having some pain in my wrist, and I asked a friend of mine, who's on the board, to open a bottle of water for me, and he opened it for me, and he laughed, and he's like, man, Jack, you always have, like, some injury, right? And I didn't think about it. I didn't take it to offense, but I was like, I was like, yeah. Like, he doesn't know. I was like, hey, I have sickle cell, man, I always got something, you know, because last time I saw him, I was hobbling around because I had pain in my ankle, you know. So outwardly, he's like, oh, Jacky's just probably clumsy, you know, he just hurts himself. You know, I'm 6'6. They just think, I probably just don't know how to use my body. I'm running into things. But it's something that even when we're dealing with an episode. We have to deal with episode, but even after the episode, we're still dealing with that episode.
Doc Mok 8:27
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Jacky Homme 10:17
So you know, I like to talk about as well, the different types of treatment and the different things. So I personally just do the hydroxyurea, but I'm excited to learn and see how there's so many other treatments that are coming out and that are down the pipeline as well. So Dr Scott, if you can kind of walk us through some of the treatments that are coming out, some of the things that you see there on the horizon, they're, you know, giving some folks some some optimism.
Dr. Scott Peslak 10:46
Sure, absolutely. So. Jacky, as you, as you alluded to what I mentioned a little bit earlier, that one of the main stays for treatment of sickle cell disease is a drug called hydroxyurea, and this is given to, really, the majority of patients with SS or S beta zero, thalassemia, another subtype of sickle cell disease. And at this point, you know, we used to only use this in patients who had more severe episodes of pain, but we actually give this now standardly, to children as young as age six to nine months. And so this is we found. This is the one therapy so far that really can not only reduce pain episodes, but also prevent a lot of the long term complications that we see in sickle cell patients, including kidney disease and risk of stroke and other chronic organ complications. And it's, it's given in this different dose for each patient based on the patient's weight, and we titrate that to figure out exactly the right dose depending on what your labs look like and everything else. So again, it's individualized, just like everything else about sickle cell disease. But this is something that you know, I would definitely encourage listeners to talk to their providers about, because it is a mainstay of therapy. But that's not enough for many patients, and we are working very hard in the field to develop new therapies. There are two other currently available, approved therapies. One is a medicine called L glutamine, or indari. And this is, it's actually a kind of amino acid, so it's almost like something you can go to GNC and pick up, but it's in much higher doses, and, you know, pharmaceutical grade, and helps to reduce some of the stress on the red blood cell. And that's a that's a powder that's taken twice a day, and and then there's another approved medication, IV medication, called Crizanlizumab, or a Adakveo, and this is given through your through a vein once a month, and it helps to kind of reduce the stickiness of red blood cells. So as I mentioned before, a lot of the underlying cause of this is that red blood cells kind of get stuck in blood vessels and cause pain and cause decreased oxygenation. This helps to make the blood flow and the red blood cells a little bit smoother. We are the other main therapy that's out there that that is available for patients and improved now, and we're offering at Penn as well, is something called gene therapy. And this is a approach that essentially takes your own blood cells, we take them out of your body using a specialized technique, and add in a copy of non-sickling hemoglobin into the blood. And so effectively, we're able to transform the cells in your your body from sickle cell disease to what's equivalent to a sickle cell trait, a carrier state of sickle cell disease. And the so this is a great therapy, and but the problem is that it's it's long, and it does require, it's essentially kind of a smaller version of a bone marrow transplant, except it's your own cells instead of somebody else's cells that you might think of when you hear the words bone marrow transplant. So you won't reject those cells, but it still comes with a lot of the risks, including risk of infection. You need to get chemotherapy in order to actually get those cells back in. So there's a risk of fertility risks, and even in a second, a very small but secondary risk of cancer related to that as well. So it's, we're making a lot of progress in the field to get to deliver this in a safer and better way. It is a very safe therapy, but it is a long process, and so it's something that the patients, and you know, the community should know, is an option, but we want to talk to talk to your provider about that as well. Well, I'm really personally excited about some of the new drugs that are coming out to help treat sickle cell disease, many of which I mentioned I study in my lab here and many labs across the country. One of the ones furthest along is a drug called mitapivat, and this is a pill that helps to increase energy in each individual red blood cell and makes it less likely to undergo sickling and less likely to undergo vaso-occlusion, and overall improve the health of those individual red blood cells. And so that's in phase three trials, which is the kind of the final phase of clinical studies. And so far, the data. It's really good, but we're, we're excited about that as potential therapy in the next year or two that might be available to our sickle cell community.
Jacky Homme 15:06
Oh, that's, that's exciting. And, you know, and you mentioned this Kyle when he spoke at the superhero soiree, soiree, about learning. You tasked, you tasked the audience there to learn, right? To learn more. Because, you know, you mentioned, you said, hey, you know, if you think you know everything about sickle cell, the the doctors and the professionals, right, that Dr Scott Peslak and the world are still learning about it, and they're still learning and trying to uncover these new treatments. And I think that really resonated with me as well, because one, just from a higher standpoint, you know, no one knows everything. But two, it's it's you tasked everyone, not just the doctors and the professionals, but every individual, to to learn about it. And, you know, I like for you to kind of comment on that, right, like, what, what? You know, you you spoke for a while. And, I mean, it was, it was a great talk. But you know, why? Why would you encourage individuals with sickle cell or not to learn about it and to keep learning about sickle cell?
Kyle Smith 16:19
Yeah, yeah, no, sure. I think that to kind of go back to your earlier comments, I was tasking folks to I want, I want sickle cell to be everyone's disease of choice. You know, I went for whatever disease that, who you know folks that are listening to, you know, whatever disease that first pops up into your mind, I want to replace that with sickle cell disease, right? And I think it's imperative, because sickle cell, historically, has just been incredibly neglected and marginalized disease. You know, we were talking about hydroxyurea. Hydroxyurea was introduced in 1998 and originally it was a medication that wasn't even developed for individuals with sickle cell disease, right? It was originally, you know, meant to be a cancer treatment, right? So again, we're thinking about diabetes or cancer or, you know, HIV. Think about all of these different diseases, and think about all the different treatment options that they've had until 2019 sickle cell disease only had hydroxyurea. Now, I'm not the best at math, but I believe it is 21 years, right? One treatment in one in 21 years. And it's shameful, you know? It's, it is just so tragic to think about this. You know, one of the oldest genetic diseases that is studied to create treatments for different diseases has only had one treatment in 21 years. And now, you know, fortunately, we have two more. And also, you know, gene therapy option this, but that's those treatments and therapies aren't for everyone. You know this is again, this isn't a one size fits all. And recently, sickle cell disease community experienced another tragedy in a withdrawal of a medication that was out and FDA approved in 2019 it was three weeks ago, two or three weeks ago, that was withdrawn and sickle cell warriors who were on This medication, including myself, can no longer access this medication right, and will never be able to access this medication because the pharmaceutical companies deemed it to be unsafe, even though it was FDA approved, even though it was on, you know, It was on the market for for five years so on, close to five years, so on and so forth. And again, this is another just tragedy that this disease has experienced. And I just think that you know, if people really take a closer look into sickle cell disease and the history of this disease and its treatment and its neglect in treatment, I think people will find, hopefully, some type of some type of moral will to try to aid individuals who are part of this community. You know, whether they be someone who is. Living with the disease, whether they be someone who is caregiving for the disease, whether they be a provider, whether they be a researcher, so on and so forth. So yes, please, you know, just continue to to learn. Please, continue to share, because that's that's really how we've been able to have, you know, the progress that we've had so far,
Dr. Scott Peslak 20:25
If you could, you know, if you compare this to other disorders, right in terms of the amount of funding and the amount of research, it is a fraction of what has been committed to, you know, if you compare the say to cancer, and you said to the cancer community, we only have, we only have three or two or three treatments. But yeah, that's enough. Nobody that would not, that would not fly, right? And that should not fly in terms of what we're thinking about with with sickle cell disease as well. I agree completely with with Kyle that this is, it is really an emergency. And you know, comparing this to say, other other diseases, that where it's life threatening, this is absolutely life threatening on a daily basis for our sickle cell patients, and finding ways to allow our patients community to live and thrive and and be able to live their best possible lives. The only way we do that is with more resources and more dedication, and that's bringing more interest into the field in every level, meaning the community, among patients, among advocates, among researchers, but but also really making sure that we push forward to understand sickle cell disease at a at a very basic level, and what we're doing in the field to prevent these kind of withdrawals and these kind of long term complications and issues from happening to our community.
Jacky Homme 21:37
Yeah, yeah. Thanks. Thanks for adding that. It's, you know, we, one thing I am eternally optimistic about is the growing, you know, I say community that we have that's pushing for this, and the more visibility that we're getting. You know, we didn't touch on it. But I forget what the TV show was called Supercell, right? That just came out not too long ago, that, you know, had a little bit of a subplot line of sickle cell. And so, you know, we're on our way, brick by brick, as they say, we're going to get there. And I know we got folks like Dr Scott and Kyle in the mix. It emboldens me as well to know like, Hey, we got the right people for this fight and to grow the awareness.
Doc Mok 22:27
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Jacky Homme 24:59
So we have a few more minutes here left, so I'm going to switch gears slightly and do our three questions. And I just realized, I don't know if I can, if I confirm you guys, but we usually do three questions with our guests, and we'll just kind of go around very quick and easy. And there might be a bonus question, because sometimes I throw random things in there. So Dr Scott, you're going to go first. What is your favorite exercise?
Dr. Scott Peslak 25:33
My favorite exercise? I think my personal favorite exercise. So this is something, and it's something I because I can do it with my family is, maybe people wouldn't consider it exercise, but I really enjoy golfing, and the reason is, is my 11 year old daughter is learning how to play, and so is my wife, and it's something that you know, you can, you can actually, it's a low impact sport. You can play it at any age with any any group of folks, and it's very social, and also allows you to really engage in the community. So that's, that's my favorite. I guess if you want a more active sport, I really enjoy tennis and racquetball as well. But I would pick golf if I had to pick a sport,
Jacky Homme 26:11
You know. Dr Scott, you're in good company. I just started playing golf. I mean, it looks like I just started playing golf. Been playing for four years, but I'm still terrible. I'm going to play with my son as well, and he's five. Shout out to my little my little homie. But racquetball is my non golf favorite sport, so we'll have to talk about this too. And your local, yeah, that's awesome. Kyle. What about you?
Kyle Smith 26:40
Favorite exercise. I mean, usually a gym rat, but I really enjoy anything that can get my cardio going, you know, whether it be in low impact too. So, you know, elliptical, the bike, I love spin classes. I think I used to hate spin, but, you know, I still hate spin, but after the end, then you realize how much you love it, right? So, but, yeah, anything that really gets, gets gets my heart going.
Jacky Homme 27:08
Yeah, you know, spin is kind of like golf, because, like, you're pissed off the entire time you play golf, and you're like, Why did I sign up for this? But then when you're done, like, oh, man, I can't wait to come back to this. This was actually pretty good.
Dr. Scott Peslak 27:23
I felt that way too
Jacky Homme 27:26
Awesome. Yeah, also like, like spin as well. Alright, so I'll let you take this one first. Now, Kyle, what is the craziest diet you've been on? If a crazy diet.
Kyle Smith 27:41
Yeah, I mean, the craziest diet that I've been on, I was really vegan based for a while, like just and I don't know if it was crazy, but it was the best I had ever felt, you know? And you know, I fell off the wagon and back to eating meat and whatnot and enjoying that as well too. So no regrets, but, but no, yeah, I was really vegan based for a while.
Jacky Homme 28:15
Okay, what about you? Dr Scott, I'm pretty sure you've or, I guess you can also share Dr Scott, like any crazy diet you've you've, like a patients have told you they've tried because they read somewhere it helped them. Anything you've been on or heard of,
Dr. Scott Peslak 28:28
well, I guess I can comment on one. I would say the craziest, I wouldn't recommend it for anybody. But the craziest diet that I've been on is being a third year medical student, no time to eat. And so, you know, I think I lost 20 to 30 pounds during my third and fourth year of medical school. I would not as a medical professional, I would recommend eating a very balanced diet and not doing that. But so, one lesson I've learned in my training is that no matter how busy you are and how stressed you are, eating regular meals is really, really important, because even though I lost a lot of weight, I was not feeling healthy, and since incorporating a more balanced and regular diet, that's been super important for me. So I, I would say I've learned my lesson on that one. But
Jacky Homme 29:16
Nice. That's that's a good, that's a good. PSA, thanks, Dr Scott, that's a kind of recurring theme we have here at Maximal Being that the scale doesn't really mean anything, right? I mean, it does mean to a certain degree, but, you know, you gotta eat well, take care of yourself, be healthy. It's not just about calorie count, you know, Doc Mok, you know, always shares a story out he was, you know, running eight miles a day and only eating like, 1500 calories or something, and it was just like, and I believe he was also in medical school at the time, and he was just like, felt terrible for a while. So, yeah, that's, that's a good point. Next question, what is your and anyone, if anyone has one, you could go first here. What is your favorite health book? Yeah. If you have one,
Kyle Smith 30:03
I'll go, it's not, I don't know if it's necessarily a health book, but it's definitely, you know, aligns with our conversation today. It's called Dying in the City of the Blues, and it's a book about sickle cell disease, specifically in Memphis. And it's wonderful. You know, I can't think of the author right now, but yes, I'll definitely would recommend that
Jacky Homme 30:27
Well, and you said, Dying in the City of the Blues?
Kyle Smith 30:31
Yes, Dying in the City of the Blues. And actually, I have here, and it's by, it's called Dying the City of the Blues: Sickle Cell Anemia and the Politics of Race and Health. By Keith Wailoo
Jacky Homme 30:45
Wailoo, nice. Okay, that's a good one. I don't know you know. So Doc Mok usually has read almost every book anyone ever mentions on this podcast, so I'm very curious if he's aware or read it before. So I gotta check in with him. What about you Dr Scott?
Dr. Scott Peslak 31:01
I would, so I'm just thinking of a broader term of health. I think a fascinating book that I'm sure many of your listeners have read is The Immortal Life of Henrietta Lacks by Rebecca Skloot. It's really fascinating read, and I think for a lot of reasons. One is it addresses inequities and race and how that plays into has played into science historically, and how we should really obviously be avoiding that in the future, and strategies to be able to do that, but also scientifically, it's really fascinating in how this one woman, Henrietta Lacks, essentially contributed to decades of scientific research in a way that moved the entire field in many different areas forward In a very profound way, through the development of this cell line called the helo cell that's fascinating, read, really scientifically rigorous, and addresses a lot of aspects about science, race and the intersection of those in terms of understanding humanity.
Jacky Homme 31:57
Awesome. No, that sounds also fascinating. Yeah, those are two that definitely want to, want to check out. And for those listening, and I might be premature here, but I believe there should be a list of books that all of our guests have ever mentioned, because a lot of books have been recommended over the time. And these two particularly, I think I'm going to make a note to make sure I put on my my reading list. And we have a couple minutes, so I'm gonna call do a curveball here and do one more question each. So Dr Scott, you go first choose a number between 1 and 10.
Dr. Scott Peslak 32:32
Okay, do I say it out loud, or do I think of t?
Jacky Homme 32:34
Yeah. Sorry, yeah.
Dr. Scott Peslak 32:38
I'm gonna say nine.
Jacky Homme 32:40
Nine. Okay, I just randomized some questions here. Um, oh, okay, if you could have any animal in the world as a pet with no harm to you or the animal, what would you choose?
Dr. Scott Peslak 32:54
Wow, that is, uh, that is a deep question. Um, hmm, boy. I would say probably a dolphin. I think dolphins are fascinating. My wife loves dolphins. And I think that, you know, especially, even even not in isolation, though, I think any, I think my answer this would be any animal that I want would be a pair. Because I think many animals by themselves are actually really, really sad and really depressed in this. We see this in even, even in the laboratory. And so I think I would want a pair of something. But I think dolphins be fascinating to be able to, you know, interact with as a as a pet, but but in a very but in, not in a environmentally unfriendly way. Yeah?
Jacky Homme 33:40
Sure, yeah, no good answer, yeah, no. You know caveat, no harm to the animal. You know, just, you know, PETA folks don't come after us. It's just yeah,
Dr. Scott Peslak 33:48
Just within their natural environment. But they're fascinating animals,
Jacky Homme 33:54
Yeah, just for fun. Dr Scott is not a villain from the Bond movies. He's not going to put a dolphin in his pool in his backyard, right? So, all right, and Kyle same. So now I know what the numbers are for, but one, one to 10
Kyle Smith 34:07
Yeah, I'll choose seven
Jacky Homme 34:09
Seven. All right. Oh, this is interesting. You can, this seems like a heavy question, but we're going to go for it, and we can do a different one, if you had the power to erase one event from World History. Which would you choose? What do you think the impact will be? That's a heavy one.
Kyle Smith 34:29
We can do a different one.
Jacky Homme 34:35
Oh, here's here's the one. If you can take a glimpse of any time period for one year, past or future. Which would you choose, and why
Kyle Smith 34:48
Past or future?
Jacky Homme 34:50
Yeah
Kyle Smith 34:52
I mean, I would, honestly. I'm just curious to see where we would be in the next century. You know, so years from now, you know, I want to see where, you know what, what are, what's health like, you know, what's healthcare like? What's, what type of, you know are people, what type of phone has Apple released, where you can just kind of like, you know, like contacts and, you know, and contact lenses, and dial up people and FaceTime folks that way. And, yeah, I think I will be really curious to see, also to just the demographics of folks and how that's changed and in term. And also just, just love the idea of this politics as well, and in different regions, trees and whatnot. So, so yeah, I'll jump to the future 100%
Jacky Homme 35:48
Yeah, that's, that's a good question. I mean, good answer. Excuse me, I don't know, and the question wasn't for me, but I didn't think about it too. I am the same. I would love to see where technology has been. And, you know, I always think that a at some point is, just like, our AI versions of ourselves are going to be dealing with each other, right? And like, how will technology take over that? But then again, like, I'm really nerdy and dorky, and I like old things, so I would like love to have, like, seen the Coliseum in its hay day right? I don't want to see anyone again, eaten by a lion, but just like, filled with a warning, a roaring crowd and the chaos, or just, you know, seeing dinosaurs, right? How big a massive a Brachiosaurus would be out, but, yeah, cool. All right. Well, yeah, I appreciate you guys taking the time here out of your busy schedules. And you know, talking through this with with me before we kind of sign off here. You know any, any last words, you know, any brief comments you want to like say to the people that might be listening?
Dr. Scott Peslak 36:53
Yeah, I so I will say that thank listeners for listening to this really important discussion. And I think that we, we as a sickle cell community, want to be able to provide as much education, as much learning, as much awareness as we possibly can, and try to our goal is to try to engage as many people in the medical and and the lay community as we possibly can. And so I would say, if you're interested in learning more about sickle cell disease, you know, please reach out to, you know, I'm happy to talk to folks about this. I know that Kyle's organization is as well, a lot of advocacy, a lot of really strong, passionate people in the sickle cell research and patient communities, and so I would say that, you know, really try to try to be as engaged as you can with this incredibly important research topic and and on the clinical side, because it really is affecting our patients on daily life, on daily life, on a daily basis. And we need more people, more smart and engaged and committed people in the community, to be able to advance the mission of our patients moving forward.
Jacky Homme 38:15
Yeah, yeah, Dr Scott and you Kyle?
Kyle Smith 38:18
Yeah. No, absolutely. I agree with everything that Doctor Scott just said. And nope, yeah, please check us out. Our website is crescentfoundationscd.org, that's SCD as in sickle cell disease. So Crescent Foundation, scd.org, our socials are Crescent Foundation, a sickle cell initiative on LinkedIn and Facebook and then Crescent Foundation SCD on Instagram. But thank you all for tuning in. And you know, again, I'm going to task everyone to learn more and to share more about sickle cell disease.
Jacky Homme 38:56
Absolutely. Thanks. Thanks, guys. So if you have any questions, please don't hesitate to reach us out. Reach out to us at [email protected] and if you haven't done so already, I'm doing my best here Doc Mok, because he usually does this part. If you haven't done so already, hit the subscribe button. Leave a comment, because it does help us get the word out. This is Jacky P, Dr, Scott Peslak and Kyle Smith and we're here to maximize our health. Have good one everyone.
Doc Mok 39:26
The content included is not intended to be used as medical advice and viewers should consult their physician or health care provider should they have additional questions. The viewers should not rely on information contained in these presentation for immediate or urgent medical needs. Additionally, if you think you have a medical emergency, call your physician or go to the emergency department or call 911 immediately. Never disregard professional medical advice or rely on seeking medical care or delay medical care due to information contained in this presentation.
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Transcribed by https://otter.ai
