30% of Americans have a Brain Parasite! | Plus The Great Healthcare Disruption

>>Welcome to American Medicine today. I'm Kimberly Bonati alongside Ethan Youker. Exciting show lined up. We're going to get right to it. A new book that examines how technological advances, policy changes and emerging business models are fundamental Transforming American health care. And it was just released. Joining us to discuss is Dr. Marshall Runge, distinguished physician, scientist and author of The Great Health Care Disruption. Thank you for joining us, Dr. Runge. >>Thank you, Kimberly. It's great to be here. >>So, Dr. Runge, you describe this as kind of a Promethean movement in health care. Can you explain what you mean by that? >>Well, I found that term Promethean that had to do with the way people were describing AI and saying that this is a moment where everything changes and it is like that for health care. And part of that is AI and technology, part of its policy and major changes that are occurring in American health care. So it it is a moment that I think we all need to reflect on how can we be healthy. That's the bottom line and how can we take best to manage our health care opportunities. >>So obviously, Prometheus discovered fire according to mythology. And so do you think the AI is obviously if you used the term Promethean moment, is that mainly about A.I.? And do you really think that where do you see A.I. taking us? Let me rephrase that question. Where are we going? >>Well, I think A.I. is a big part of it, and A.I. is really already transforming health care. So, for example, there's a technology called Ambien A.I., where I could be having a conversation with you just as we are now. A.I. is listening, and at the end it provides not just a transcript, it provides a really outstanding medical note. So that means we can be talking rather than me typing on my computer, and it'll save me a lot of time at the end of the day. So that's one area. Another area is it's really rapidly having an impact on how we think about the practice of medicine, how we make sure we don't miss any opportunities, how we make it better for our patients and better in scheduling. Access is a is a big part of that. So I think it's going to touch all areas of medicine and it's happening at an astounding rate. >>Obesity and chronic disease are kind of reoccurring themes in the book. So what role do you see for medications like Ozempic and how should we address the cost in access to those medications? >>Great questions. So I do think obesity, obesity is a tremendous problem in the United States. Nearly half of the population is obese and it's a tough thing and it is a disease. So the new medications like Ozempic, I think have enormous potential. They've been shown to be safe. They've been shown to be effective. They've been shown to have a positive impact on other diseases besides other chronic diseases, besides obesity. So it's great. They improve diabetes, they reduce heart risk, but they're very expensive, as you alluded to. But I think if we are able to leverage the buying power of large organizations, including Medicare and federal sources, those prices can come down. >>And in the book, you call for bold federal policy. You even support a government role in health care and basic health care. To me, my first thought was, isn't that a form of socialism? Which means. >>Yes. You know, that's been the argument for my entire time in health care, which is now approaching 40 years. And I myself, I had no interest in serving in a in a socialist society. What I do mean, though, is I think if we can provide a sort of a basic level of health care for everyone with a real focus on health and prevention of chronic diseases, rather than people having to go to the hospital or the emergency room at the last minute. So I think we need to think about how can we provide that that baseline. Not everybody is going to be satisfied with that. In fact, many people won't. And if you look at countries that get a lot of a lot of credit for their government health care, so to speak, actually more than half the population has private health care on top of that. But there is a portion of the population that could so benefit from a health healthy approach to their lives. >>We're going to take a quick break. We'll be right back with Dr. Marshall Runge after this. You are watching American Medicine today. >>I went to Dr. Bonati and he went ahead and looked at my pictures. He told me, you have pain here. You have pain here. And I was like, Yeah, absolutely. I'd been to others, but he was a doctor that didn't want to fillet my back open like a fish and do like open spinal surgery because everybody else wanted to do that. And I was not having it. The anesthesiologist who was working with me, I was like having a conversation with this guy. And then I was watching on the monitor as Dr. Bonati is fixing my back, I really felt like I was in good hands. >>Bonati succeeds where others fail. Welcome back to American Medicine Today, we're continuing our discussion with Dr. Runge. Companies like Amazon and Google, they're kind of interceding into health care and they're doing so aggressively. So what can traditional health systems learn from them? And should they resist or should they follow suit? >>I think I think we ought to join forces. And a lot of what Amazon and Google and others bring is they bring access. So I never talk to somebody ever who says I don't have any trouble getting an appointment because everybody has trouble getting an appointment. And that access is really critical because if you can get answers immediately, that can improve your health. But moreover, we live in a world now where we're used to instant access so you don't have to get into a car and go to the mall and try to find a pair of shoes. You can get online and find a pair of shoes. I think we need to be consumer facing and health care in that same way. And I think these and a lot of this is it's those big companies. But also when I was writing the book, I looked and I found over 90 new startup companies that were focused around providing better access to health care. Now they won't all survive, but some will. And so I think we need to embrace that. I think that's part of part of the part of our opportunity for the future. >>Speaking of AI and back to AI, you actually warn in the book that unregulated, AI could actually widen gaps in care and eventually lead to misuse. Can you elaborate on that? >>Sure. So I think AI just like everything else in health care needs to have appropriate oversight. I'm not saying micromanagement, but appropriate oversight. So we do have that appropriate oversight in many areas of health. We don't want to make it harder, but we want to be sure that what we get is real. And to give you the worst possible example, if you look at what red it or social media says you ought to do for your health, that might be right or it might not be right. And I know I would want to have more confidence that myself, if I was taking health advice. >>You talk about how medicine is no longer just a science. It's really an art and it's also a business. So what do you say to those in health care who are kind of resisting that reality? >>Well, we have new medical students every year at the University Michigan, and I'll be talking to him about that. I mean, today is different than the Marcus Wellby days, sort of the prototype of the family physician who comes to your house and is all all knowing. We have technology, we have telehealth. We have many tools that just were not available during the era that people look back fondly and say, Oh, those were the great days of health care. Health care is a lot better now than it was in the sixties and seventies, and we need to change with it and we need to be able to adjust and adapt to technology entrepreneurship. There's really a link between the business of health care, which I think is important and optimum health care. So we have to find that balance. And I think right now that balance is okay. >>Tell us what is the great health care disruption that's tied to the title of your book? So what specifically is disrupting health care? >>Well, I think what's disrupting health care in the biggest picture, our response is to where we're not doing well on health care. So I talk a lot about preventive health and primary care, and we need more primary care. But I also talk about technology, new drug development, Ozempic That was nothing like Ozempic, you know, 15 years ago. And so the disruption is partly advances in technology. And that's the knowledge. That's partly our willingness to live in a world with disruption like that. And I, I view disruption in health care as a positive. A great positive. >>Thank you for sharing your insight. Dr. Marshall Runge, distinguished physician, scientist and author of The Great Health Care Disruption. Thank you for being on our program. >>Thank you. >>Take great care. Well, that's all the time we have for this segment. Make sure you stay tuned. We'll have more after the break. You are watching American Medicine today. >>I was really impressed with Dr. Bonati, so that's why I came to Florida. That was probably my life changing moment right there. It's been nine years before I went to the Berardi Spine Institute. I had neck pain. I was having trouble going side to side when I was driving. It was hard to see to back up. My lower back. Pain was also a problem. When I was scratching down or bending over, so I wasn't doing my exercises as much. I was walking a lot slower. But then after I went to the Bonati Institute and he was able to give me the surgeries that cleared out the canal so that I was able to move a lot freer and I feel a lot better. I'm able to travel. I can turn right around and almost look right out the back window to back up somewhere when I needed to get in and out of the car. It's much easier now. I'm able to go back to all the exercising and dancing is one of my primary things. I do that three or four times a week and so now I'm not limited at that. It was a wonderful experience and I would refer anyone to go to the Bonati Spine Institute to get anything corrected in their back because they do phenomenal work. >>It's hard to believe just how far Beth has come. Before the Bonati Spine Institute, she was stuck in pain every day. >>I had a couple of car accidents that I didn't go to the hospital for, so I had a whiplash or two. A couple of other things like that happened along the way. My pain was in my lower back, also in my neck area. It just was constant. So, you know, you didn't really get any relief. It just constantly hurt. >>Beth tells us how she tried conservative treatments, but none of the doctors, chiropractors or physical therapists she saw seemed to know how to help her. That all changed when she came to the Bonati Spine Institute. >>So I went to a primary doctor. They sent me to physical therapy. So I did physical therapy. Didn't really feel a lot of of correction at that point. So I said, Well, let's try chiropractor. I did that for a few years as well. It didn't really solve everything and I found myself getting stiffer and stiffer. So I went back to the primary doctor Thet decide, Well, you know, if you're in that much pain, maybe there's some kind of medicine we can give you while we were on hydrocodone for a while. And they say, Well, that's not really good. Let's try gabapentin. You can get up to eight pills a day. All right. Well, I went in after eight pills a day and said, well, it's still hurts. Well, you can go up to 12. Well, it seems like a lot, but I did that for a while, still working full time in my office, work and duties and so forth. So that feeling very good, limiting my exercise and that sort of thing. I also went to a doctor a few hours away. He said, You know, there's nothing we can really do until you're no longer mobile, then we can probably do something. I thought, Well, that doesn't sound very good at all now, does it? They don't have strength in my hands at that point, so caring about gallon of milk sometimes, you know, might fall out my hands. And I didn't want to wait until I was no longer mobile. I've heard of other people having back surgery, and a lot of times they go through the front instead of the back to the neck. Please do not go for effusions. That's definitely going to cause you more pain in the long run. >>Not wanting to endure a spinal fusion at any level. Beth began researching her alternatives. >>I checked a couple of Spine institute. I've heard about this Spine institute and I've known a couple of people that actually went there. I'll go talk to the nurse. She's actually one of my friends, and I knew she wouldn't steer me wrong. She would tell me what what was right and what was wrong or where. Maybe I should send myself. So I did contact Dr. Bonati and sent my MRI down and he said, Yes, you're definitely candidate. You should definitely come down here. And actually, we'd like to see you next week. >>Beth shares her experience with the exclusive Bonati spine procedures. >>Well, that was a phenomenal experience. You never watch someone working on you the way he did. You'll ask me. So let me know if there's any pain, because that way I'm able to fix what the problem is right there. So he does he and tell me specifically where it hurts. And to watch it on that screen was was amazing to see everything taken care of the way that he did with the tiny instruments that he uses to to get in there and take care of those things with such small, oh, small incisions. I mean, the scarring so minimal. It's just amazing. >>Like many patients at the Bonati Spine Institute, Beth was amazed by how quickly she was able to be up and walking so soon after surgery. >>I mean, you get after the table, after you recover just a few minutes and you're up and walking and you notice it immediately is great. It's been, what, nine years now? I'm doing great. I figured there would be a lot more recovery. I really did. This is so much better and you recover so much quicker. It's amazing. >>Nine years after her targeted Bonati spine procedures, Beth is still enjoying her favorite activities. Pain free. >>I'm back line dancing. I'm line dancing, three times a week now in a garden and I do all the things that I wanted to do before. So we travel and do all kinds of things. So yeah, it's been great. I can't say enough about it. >>To see more stories of recovery just like this. Search for the Bonati Spine Institute on YouTube. Rumble Apple's App Store. Google's Play Store, Roku and Amazon's Fire TV. Welcome back to American Medicine Today. I'm Kimberly Bonati alongside Ethan Youker. Well, a team of scientists at the University of California, Riverside, recently published a shocking paper which revealed that up to 30% of people in the U.S. are infected with a microscopic brain parasite without even knowing it. Joining us to discuss is Emma Wilson, professor of biomedical sciences at UC Riverside. Thank you for joining us, Emma. >>Thank you, Kimberly, for having me. It's nice to be here. >>Certainly. Well, tell us about this parasite and how it can be contracted. >>Yeah. So the parasite Toxoplasma we've known about for a very long time and the statistics that you just relayed to everybody. Those are very well known. And in fact, in some places like Brazil and France, up to 80% of people can be infected. So, yes, incredibly shocking statistics, but really somewhat of a relief. Right, Because obviously we're all doing just fine without knowing about it. >>I understand it comes from like consuming, undercooked meat. And and again, this cat feces comes up. You just had another guest on talking about viruses coming from cat feces. And I have four cats at home, so I'm a little concerned. >>I've had cats all my life. You're okay. And I'm still negative, so it's fine. But yes, that's one of the common ways the the parasite infects the and the cat and it excretes lots of eggs, parasite eggs that are very resistant. So they're resistant to bleach, for example. So they get into the environment. And if you don't wash your vegetables, if you you can get infected that way. But the other way is other animals are eating those eggs. They become infected and a portion of the parasite ends up in the meat that we eat. And so you have to kick your meat well, and you have to wash your vegetables. >>What types of symptoms does somebody who's contract did this parasite, this brain parasite feel? Well, or experience? >>Yeah. When you first when you first get it, you you probably get symptoms that are very generic. You might have a fever, maybe swollen lymph nodes feeling generally under the weather. And then your immune system, which is what we love and what we study, helps to control it really well and kills the parasite ends up is the dormant cyst form of the parasite in your tissue. Frequently the brain. Well, we realize that the immune response is so powerful and controlling these types of infections, especially in the brain. So my research focuses on on how the immune response is controlled in the brain. >>How does it get in the brain? This might be a silly question, but I mean, we talk about the blood brain barrier all the time. So how does this parasite, you know, traverse that blood brain barrier and embed itself in our brain? And then secondly, obviously, it's not that deadly. If, as you just said, I thought up to 30, you're saying up to 80% of us can be walking around with something up in our noggin. Can we just don't know about it. So, A, how does it get in the brain and be, you know, is it really something to worry that much about? Yeah. >>Great questions. Yeah, I think the parasite is going to get into the brain any way it can. And there are multiple ways it could. It could hide inside cells that traffic to the brain. Um, and, and during that process, it makes the cells move more quickly and traverse the blood brain barrier, as you pointed out. But then also just make it parasites get from the bloodstream as it's circulating around the body and squeeze in between the cells. And so it's got lots of really sophisticated machinery to invade a cell and get in between the cell. So it's even though it's kind of tiny and lives inside cells, this is a pretty sophisticated deed. And then to your second question, I think is really important, right? So loads of people are infected, but we're doing just fine and and often and that's because of the immune response in the brain. But often an immune response in the brain is considered a really bad thing, right? We associate it with diseases like multiple sclerosis, encephalitis. And so I'm really interested in the balance between a good and a bad immune response in the brain. >>Are pregnant women more susceptible to these parasites? >>Yeah, that's a really important thing to bring up. Pregnant women are not more susceptible. Everybody's equally able to get infected. But the real danger for people that are pregnant is that the parasite can cross the placenta. In fact, the fetus, and can cause significant congenital abnormalities. It can cause retinal toxoplasmosis and encephalitis and hydrocephalus. So women that are pregnant are advised not to change the cat litter. Always wash your fruit and veg. Don't eat undercooked meat. So all of these advisory things are actually very broad for a lot of infectious disease will help people not to get infected at this time. >>So we're hearing about what things not to do, but how do you actually become diagnosed? What is the process? Is there a certain test? You just say, hey, doc, I would like you, right? I would like you to check to make sure I don't have a parasite. >>Yeah, well, we can't do any imaging, for example. Right? It's too small, so you can't look in the brain, say, Oh, there it is. But because it's always there, we're generating antibodies and an immune response to all the time. And so you can go and ask your doctor if you're particularly interested. You could go and ask your doctor for to get your toxo antibody titers measured, and that will allow you to know whether you have a current immune response to the parasite, whether it's in your brain or not. We don't know because it could be elsewhere. But anything. And if you do and you're worried you're doing okay, it's just fine. >>I wouldn't be able to live. In fact, now I have. >>Something in my brain. >>I would my mind would go straight to a spooky movie and I'd be wondering whether it was going to, like, slither out or something. I don't know. >>Well, thankfully, my wife is the one that changes the litter boxes at home. So I'm not in I'm I'm in charge of most of the cooking. So I make sure that things are cooked up to speed. But with that said, what are, if any, are there any treatment options if you are diagnosed with this brain parasite? >>Yeah, if you're sick with the parasite. So there's two different forms. There's a form of the parasite that's going to replicate really quickly and kill yourself. And that's bad. We want rid of that. And we have drugs that will get rid of that, but we don't have drugs that will get rid of the cyst slow replicating form this most commonly found in the brain. And so a lot of people are still working to try and get those drugs available. >>So cook your meat, wash your vegetables, don't have cats. Correct. That's the summary. >>Cats are fine. The cats are fine. Okay. >>I take your word for it. >>Thank you so much for being on the show and imparting your wisdom. Thank you. Emma Wilson, professor of Biomedical Sciences at UC Riverside. Thank you for being on the show. >>It's lovely talking to you both. Thank you very much. >>Well, that's all the time we have for this episode of American Medicine today. If you would like to see previous episodes, make sure to download American Medicine today to your favorite streaming app. If you have any comments or questions, contact us at the numbers below or you can tweet @DrBonati using the hashtag American Medicine today or hashtag AMT We would like to hear from you.