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
Hello, hello, hello, Maximal Beings. We're back, baby. We're back. We're here. It is. I, Jacky P your favorite layman and I have, of course, the glowing, the sunshine, from the Sunshine State, living in the shine state, Sunshine State. Doc Mok, how are you?
Doc Mok 1:11
I'm great, Jacky. For those of you listening for the first time, don't forget to hit the subscribe button. Leave us a comment. It helps us to get the word out to your fellow gut health enthusiasts, Maximal Beings out there. I'm Doc Mok. I'm a therapeutic endoscopist, which is a fancy type of GI doctor that diagnosis treats, palliates, GI cancers. And I'm also a board certified functional medicine doctor, you know, Jacky, you said Sunshine State, and obviously, like you lived here for a while, it seems like we should just rename it the hurricane state. I think initially,
Jacky Homme 1:47
True. Yeah, yeah, it is. It is that season. And I feel like the hurricanes has been going later and later into the year, yeah.
Doc Mok 1:57
And we may get a storm next week. We don't know it's going to hit Honduras. And the worst thing of all, Jacky, is that this, the last hurricane. I can't get a haircut because my poor hairstylist, hair, the barber, she, her place, got totally flooded as a result.
Jacky Homme 2:12
Oh no
Doc Mok 2:13
I know, I know. It's such a bummer. So those of you that are watching us on YouTube, you can see like I got a little, you know the Jew-fro thing going on. But those of you that are driving, consider yourself lucky,
Jacky Homme 2:27
If I dare say, you still look great, Doc Mok and whatever look you got, you can crush it.
Doc Mok 2:32
You got the silver fox going on.
Jacky Homme 2:34
Yeah, that's what I'm talking about.
So we are here with Micah and Micah, we're going to talk about something interesting. We're gonna talk about the microbiome, which is obviously Doc Mok's favorite thing to talk about. But Micah, say hello to the people and introduce yourself.
Micah Lee 2:52
Well, first, it's a pleasure to be on. My name is Micah Lee. I'm 26 years old from Florida. I'm an advocate for African American mental and physical health, and I'm here to speak on Gen Z issues, queer issues, just overall health of colorectal specifically amongst my generation.
Doc Mok 3:14
And those of you that don't know this, I have the pleasure of working with Micah in the outpatient setting. She's a medical assistant, as well as being a strong advocate for such important parts of healthcare. And I think more than ever it's important to talk about these things right now.
Jacky Homme 3:36
Absolutely
Micah Lee 3:37
Absolutely. Yeah.
Doc Mok 3:39
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Jacky Homme 6:12
And I'm gonna, I'm gonna ask a question here, and I wish I could say, say, you know, English was my second language to make it me sound smarter, but it was my first language. If we're talking about the microbiome across the population, is it a macrobiome? Is that? Is that the the word, if we're like, kind of,
Doc Mok 6:33
I feel like that term has been thrown around as well, because I mean, we're talking trillions of species, trillions of bacteria, yeast, and parasites that live inside of us every day. The macrobiome absolutely, has been been described in a populist setting, because it's so many microbiomes can conglomerate together. But in the research setting, we kind of see each individual as their own unit, and we we put that those data together once we get it in each individual microbiome. But I love the fact that the economist, the financial guy, thinks about aggregates in terms of the microbiome.
Jacky Homme 7:15
Yes, I'm like the beautiful mind just looking numbers of everybody, just all gut bacteria, just like, just poop
Doc Mok 7:23
Sounds messy, sounds like, sounds sounds like we're at work Micah
Jacky Homme 7:26
Yeah,
So you know, so you know, Micah, you've had the pleasure to work with Doc Mok, and probably see his wonderful, massive calf muscles in person. But for, for those of that are first meeting you, you know, if you can give us you know the your, your, your superhero origin story, right? You know, I'm sure you know you, you went and also, hello, Floridian, by the way, by the way, but you know, how did you become such an advocate, right? For what you do? So if you want to catch us all up and walk us through your story,
Micah Lee 8:05
Well, where I gained my superpower just overall, entailing knowledge about myself. My mother was diagnosed with colorectal cancer, and she passed, and that gave me more so of an ambition to understand myself, my genetics, and how I can at least have somewhat of a control over those things, taking proactive measures in order to gain more control over my life.
Jacky Homme 8:41
Wow, that's, that's a powerful story, right? And again, like, I don't know how many times I've said this, right, Doc Mok on the show, but it's always so interesting, how personal, when, when folks take up, like, these types of, you know, missions, it's always just such a personal, raw story that you sometimes just can't duplicate. So, you know, thank you for for sharing. And you know, Doc Mok, I know you got, you know, you're gonna nerd out when you're gonna nerd out, but I've got a lot of questions as always, because I'm a questionable, I got questions. So let's start with, like, the very basic, right? So you said the microbiome specifically for African Americans and queer folk, if you can help, help me and people understand, you know, like, what? What are those like differences? Like, how did we just find with like data differences? Like, how did we learn that the gut bacteria can be different based on where you come from, where you're born. You know, familiar history, I'm sure.
Doc Mok 9:50
So, I mean, you know, I'll pick it up. I think that it's important to put into context that you're, ethnic group, your or your race, doesn't necessarily determine what your microbiome is. It may be one factor, but maybe more the result of the differences in what those cultures lead to, so different foods and different places that you may live in the United States, and maybe different religious practices, those sorts of things. So it's not specifically who you are as a person or the color of your skin it. It is really more a result of the things that your cultural differences lead to, like, diet and exercise, etc, yeah. Do you agree with that, Micah?
Micah Lee 10:47
Yeah, I agree with that. Yeah, yeah.
Doc Mok 10:50
But another important point is that, like a lot of things, and just to put this into context, like the Tuskegee Airmen experiments, which occurred, you know, years ago, which is one of the great travesties of medical research, has led to a lot of mistrust in the medical community, and that, I think, is always at the backdrop of, you know, gut health issues in the African American community, along with many other health issues, and rightly so. And for those of you that aren't aware of this, this is an experiment where the Tuskegee airmen who served in the military were given syphilis and essentially denied treatment, and the people that conducted the study watched them as their diseases progressed and studied them.
Micah Lee 11:42
Yeah.
Doc Mok 11:43
Which is completely unethical, and thank God we have, you know, institutional review boards that look over research for that reason, for things like that, and all of the Nuremberg experiments that happen during World War Two to the Jewish people. So I think that kind of sets the stage for the differences in gut health issues amongst different different communities.
Micah Lee 12:13
Yeah, I've noticed the general suspicion amongst African American people and Gen Z generation. There's still somewhat of a suspicion with the healthcare system, right? You don't know what is actually true or what is just like a inability to get more cash from you or something like that, or more money from you or something. So there's kind of like a hesitance at first when it comes to getting testing done, when it comes to just understanding your own genetics as an individual person, because we're all different people, right? So like that itself, that step first, that plays a huge part as to why, you know, people go into the doctor and they find out something, and it's already too late.
Jacky Homme 13:06
Yeah, that's, that's a good point, because you, you know, we've all seen it, you know, I have family members and folks that we know that, you know, when the vaccines came around, right, there was just like it was a very, very large, I'd say, foundation in our community that we're just like, Yeah, you know, you know, like the energy was and, and we've seen especially disparities in just the care for African American women just generally, right? Like, and don't hold my feet to the fire with the statistics, but right, like, you know, there's higher rate of death in black women who are giving birth in hospitals and all these things, right? So it is something that should be addressed and, and sometimes I think this is less of a medical issue more of a social
Micah Lee 14:02
Yeah.
Jacky Homme 14:02
Right. Like,
Micah Lee 14:03
Prepared that that distrust in the system. Yeah, for sure.
Jacky Homme 14:09
So, Micah, what do you see as, and this might be just a loaded question, but what do you see as a path to bridge that gap? Like, what can we see either on the patient side or provider side, that would begin to build that trust back.
Micah Lee 14:28
Um, I feel as if these conversations, these real conversations, happen at home, right? Because you can go to the doctor, the doctor can tell you something, but that's a doctor. That's a stranger. You don't know that person, but if it's your daughter telling you something, or if it's your cousin telling you something, giving you more base, you know, factual based information, you're more susceptible to that subconsciously, overall, you're more likely, well, they're next to you, they're probably going to see you more often than this doctor. So, I mean, you kind of have to understand that all conversations, whether it comes to education, when it comes to mental health, sexual health, physical health, it all happens in the home and where it's normalized to have these conversations on health, that's where you have a better chance of having your, you know, the health of the family being restored and eventually, the trust in the healthcare system being restored as well.
Jacky Homme 15:33
That's, that's a that's a great point of view, right? Because we are, we all get passed down. I just call them isms, right? Whatever bias you might have regarding, I guess, how you interact with the world with familiar ties, right? Yeah, yeah, yeah. So, and that's a good point. So, Doc Mok, what you know, we're going to do this kind of, like the caretaker side, like, you know, Doc lock your your trusted. Everyone knows your wicked smart, right? But I have, have you ever experienced any form of, I don't want to say resistance, but maybe just like distrust, you know, as a medical provider in your experience, and if you're able to share like, you know, how did that? How was that handled? How was that addressed?
Doc Mok 16:22
Yeah, I think that it absolutely happens. I think as healthcare providers, we blame ourselves, those of us that aren't psychopaths, that is, we think that there's something else that we can do, which is partially true for some people, but not always true. Like you're saying, like, I think that what you said is so insightful and so valuable. And the fact that, you know, if you're a healthcare provider listening to this, you know, go back and rewind what Micah just said, because it really is important for you to have that insight that people are talking about this and that, you know, you need to do your best to kind of make up that difference. If there is mistrust that exists under the surface, have I experienced it? Yes, you know, I did my training in Camden, New Jersey. It's a very underserved population. A lot of the times, you know, my, my, my secret as a doctor is that I just let I try to get to know people, right off the bat, I ask them what they like to do for fun, is usually my opening question, or where they're from, like, originally, what they do for a living, all those things, although what, what you do for a living does have some like socioeconomic context or biases that could be introduced. So I try to just talk about fun stuff most of the time, and I just listen to people. But despite that, you know, the Camden population, a lot of the times, they would tell me, like, you're the first person to actually listen to what I have to say. And thank you. You know, like there are people out there in the United States, not in other countries, that are suffering more than you can ever imagine, like living in terror each and every day, and nobody cares about them. They don't. And if you give, if you try to do something as a health care provider to help that person. It really has a great impact,
Micah Lee 18:25
Right, right.
Doc Mok 18:28
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Jacky Homme 20:18
Yeah, I could, I mean, I couldn't agree more. I you know everyone who listens. If this your first time, listen, I am a sickle cell warrior, because folks with sickle cell are warriors, and I will tell you, it is night and day when you speak to someone who is and I get it right again, you're busy, especially in the in the hospital, you got 30 patients, and you're overworked. But there's definitely something I think that helps me feel a bit more ease when someone just, even just 1% feels like, oh, you know what, they actually might care if I feel better, and not just, oh, your pain is a seven. Here's some pills, here's another pain dose, and I'm out the door. So that is something for me. I have built and earned more trust for care providers because of little interactions like that, because I have, you know, I don't know anyone who's has it, hasn't had any some poor prejudice and dealt with any biases. So, yeah, caretakers, you know, takes an extra 30 seconds just to act like you care and put your your best, best foot forward, you know, yeah. So,
Micah Lee 21:33
Yeah
Jacky Homme 21:34
Yeah, Micah?
Micah Lee 21:37
I agree. I also feel as if having a parent who was sick and would go to these doctor's appointments, and she had a habit of holding her tongue on any issues that would arise, and she would just say, oh, it's fine. It's fine. Everything's fine. Meanwhile, she's gonna go home and unfold all these issues that could have been, you know, give the doctor a chance to at least try to give you a solution, versus you just swallowing the pain until it becomes unbearable. I mean, I kind of feel like as her family member, as her daughter, it was my responsibility, just like, hey, no, you can be a little bit more honest. You can at least try to give them a hand in helping you. I mean, we're here for you at the end of the day.
Jacky Homme 22:29
Yeah. And education also goes a long way. I read a statistic which was scary. I don't remember. I could look it up real quick, but it was they just, I don't feel as med students or what level in the space, but literally, like, an alarming amount of care providers literally believe that African Americans had a higher pain tolerance.
Micah Lee 22:53
Yeah, yeah
Jacky Homme 22:54
Like, like, and I don't mean like, oh, 10% it was more than half, which was very scary. So
Micah Lee 23:01
Very scary, very dangerous way,
Jacky Homme 23:04
Very yeah, so even just the education component can really go a far, a long way with that, because, again, everyone has their isms, and it's not usually, and it can just be a belief they picked up along the way or, you know,
Micah Lee 23:19
Right, sit back and understand that, holy crap. There's a history as to why my, you know, my family members, specifically my mother and my aunts and stuff like that, would, they would hold back because they already felt like they weren't going to be believed, or their, you know, issues were going to be taken seriously. So I had to take a step back and understand the history behind her holding herself back. And that really reshaped, kind of brought a balance to the provider to patient and family relation. When it comes to health in general.
Doc Mok 23:56
You hit on something really useful, apologies for interrupting you Jacky. Really useful there Micah is like, not only was your mom African American, but she also was a woman. And there are oodles of data that as healthcare providers, we often dismiss the issues that women bring us, specifically in the GI space, myself and a very bright young doctor, Sarah Dwyer, did a study with our patients at various institutions across the United States who eventually needed a procedure to have a bile duct stone removed. And of that cohort, women, as opposed to men, were less likely to undergo a diagnostic workup, meaning, if a woman came to see a doctor with abdominal pain, and it's from a stone in their bile duct needs to be removed, that woman, as opposed to a man, was less likely to get labs.
Micah Lee 25:02
Right
Doc Mok 25:02
And that study is going to be published soon, but it's crazy, right?
Micah Lee 25:08
Very. Yeah, it's very insane. And I can also relate to that as well, not me personally, but again, my mother, she would go to the doctor with any issues, with any pain that could have given her more of an inside of what was happening on the inside, but because of the stigma, or just the general lack of education, she would go without and just, quote, unquote, suck it up or thug it out to be on and that was detrimental. Not only was it detrimental to her, but being her child, watching that it was detrimental to me, because if I see her just quote, unquote, thugging it out, I'm also going to grow up to do the same thing. So it keeps going.
Jacky Homme 26:08
Yeah, it is, it is a, it is a cycle, because then what happens is she, she thugs it out, right? And also, layman, for those who don't know what that means to thug it out.
Doc Mok 26:22
Can I throw a layman card?
Jacky Homme 26:23
Yeah, you know, it just means, like, just dealing with the pain, right? You know, I'll speak personal experience. Sometimes I don't want to deal with the hassle of the emergency department, and I can delay going to the hospital because I'm like, I'm just going to fight with this as long as possible. But what ends up happening is you get in worse condition. So then when you present to the emergency department, you know if you were there an hour or even a day before, you could have been in a better place for care, right? So it becomes this vicious cycle. And, you know, it it's sometimes hard to get out, even for me, who I know, okay, I'm sick. I'm in an episode. I need to go. It's, you know, 11am on a Wednesday, that place is going to be packed. I don't want to deal with the ends middle blue season people hawkin and goffin. So, yeah, you know. And I think there's a phrase that that, I don't know what industry, but the fake it until you make it where the trust we have to lend the trust, right? We have to just believe that the people we go see will take care of us and want to help us, you know, because the the saying, right? You gain it in spoonfuls, and you lose it by the gallon. But if we're trying to gain in spoonfuls, it's going to take forever to really trust the system, and sometimes it just might be not the right place for you, right? I changed hospital systems in here in Philly because one system I was like, you know, this didn't really work for me. And then I changed, and then now it's like, wow, it's night and day. So sometimes it just might be that particular provider, you know, finding the right provider for you that you know, the Doc Moks of the world, who's going to care for you, and you know, think about you at night and on the weekends, because, you know, he really cares about his patients.
Micah Lee 28:28
Right. I can also align with that as well. My mother went to an oncologist in Tallahassee, Florida, and it just felt like she was being rushed in and out of the clinic, and I felt her slowly withdraw with every appointment, so that kind of gave her more so psychologically, it just made her feel like she was just asking for too much. And then I ended up moving to Central Florida, working and stuff like that. And I suggested, like, just go check out Moffitt Cancer Center. And she ended up being seen by Dr Maharaj, shout out to you, and actually being heard, being listened to, being comforted as well. And it really does go into who you're being seen by as well, who, who's taking care of you, who's fighting for you, who's on your side. It all makes a difference.
Doc Mok 29:29
You know, all these things we're talking about are the symptoms and obviously the diagnosis are, you know, healthcare disparities. But then the result, if you look at the data, one of my societies, the AGA American gastroenterological Association, came out with a paper in which they evaluated the results of the African American population as compared to not African American population. And is largely based on the seer database, which is like a big national cancer database. And what they found is that if an African American person is diagnosed with colon cancer, they are 20% more likely to die from that colon cancer as compared to a non African American person, which is pretty astounding in my
Micah Lee 30:22
Yeah, and then I also had to have conversations with my father, with my brother. And you know that getting those exams alone, putting that pride to the side as a man, being able to like, hey, this doesn't seem right. Something feels off. What do I do? They're comfortable enough to come to me and ask me, What do I do? And it's to me, up to me to like, hey, you need to go get that checked out. That's not okay. So I'm happy to be able to redirect other family members to the correct care in a timely manner.
Doc Mok 31:02
And another thing that's not really well known by GI doctors is that, for some reason, African American men have a higher risk of colon cancer as compared to not African American men, and we don't really know why. I'm sure the microbiome is part of it, but you know, they the American College of Gastroenterology has always recommended screening for African American men about five years younger than that of even the general population. So now, most recently, the age dropped from 50 to 45 they've always recommended 45 for African American men, and so it'll be interesting to see. Do they move that needle back further, as we're noticing that people get diagnosed early and earlier with colon cancer.
Micah Lee 31:53
I thought it was it would be more helpful to reduce my brother's anxiety in general when it comes to cancer, to just go get the exam.
Doc Mok 32:03
Yeah
Micah Lee 32:04
He's 21 years old, so it gave him a sense of comfort, again, a sense of control over his own health. Genetics are genetics, but if you can do whatever you can to at least fight it off. Give it a shot.
Doc Mok 32:26
Well put.
Jacky Homme 32:27
Yep.
Doc Mok 32:28
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.
What's going on Maximal Beings, Doc Mok here. If you haven't done so already, leave us a comment and hit the subscribe button. Let your friends and family know that way we can get the word out and continue to bash the bro science.
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