Stroke Awareness w/ Dr. Majidi | Trump Focuses on Pharmacy Fraud w/ Peter Basica

Welcome to American Medicine Today. I'm Kimberly Benati alongside Ethan Euchre. We have a lot to get to today. Let's get started. So, stroke is the fifth most common cause of death in America and the leading cause of adult disability. Here to kick off Survive Stroke Week is Dr. Sharam Majidi, Associate Professor of Neurosurgery at Mount Sinai Hospital in New York City. Welcome to the program, Dr. Majidi. Thank you for having me. Now, we've seen a dramatic rise in strokes among those under 65. Can you explain why? Yeah, that's a very important point. Stroke is a common disease and it is not an old person disease at all. It can affect children, young adults, even inpatients without any known underlying disease. So, that's why it is extremely important to understand the symptoms and act swiftly. Why don't you go over some of those warning signs? Because, I mean, especially as Kimberly mentioned at the top that we tend to associate strokes happening with those over 65. But now, I mean, you know, I'm going to be 47. Essentially, it could happen to me, right? So, what should I be, and people who are watching or listening, be on the lookout for? Absolutely. Stroke symptoms include acute onset, loss of balance, speech disturbance, weakness in the arm, or vision loss. Specifically, when it comes to young stroke population, it's not just about survival. The burden of a stroke is decades of lost productivity. Not years, but decades. You discuss metabolic risks like obesity and diabetes and even lifestyle factors contributing to stroke. Can you tell us why? Absolutely. The major risk factor, high blood pressure, diabetes, obesity. So, that's why from a young age, we should also focus on stroke prevention, identify a primary care doctor, because all of these factors that impact can increase the risk of stroke by damaging the vessel wall, by predisposing the patient for clot formation inside the vessel, which can travel to the brain and cause a very disabling stroke. Now, they also talk about what are known as non-traditional factors such as migraines and even autoimmune diseases, which I wasn't aware of. Can you explain? Migraine is also a vascular disease. We know that over the years, patients with migraines can have small vessel stroke or minor stroke, which can actually go unnoticed, but over the decades can have an accumulated impact on the brain. Similarly, autoimmune disease, coagulative coagulopathies, they can affect patient clot formation system and predispose them to clot formation and subsequent stroke. The other very common cause of stroke in young population is dissection, which is an injury to the vessel wall from inside, which can happen sometimes during sport or follow trauma to the head and neck area. That's why the young population, they need to be aware of the stroke symptoms. We're going to take a quick break. We'll be right back with Dr. Sharam Majidi after this. You are watching American Medicine Today. Revolutionary in his field, Dr. Benati created, perfected, and patented the Benati spine procedures. Using his genius, Benati invented the precise tools necessary to minimize surgery, scarring, anesthesia, and recovery. So successful are the Benati spine procedures, they consistently reflect 98.75% patient satisfaction. 80,000 procedures have been performed exclusively at our location. Nearly half our patients have suffered from failed back and neck surgeries at other facilities. Benati succeeds where others fail. Welcome back to American Medicine Today. We're continuing our discussion with Dr. Majidi. When you talk about the migraines, is the onset sudden? Does it present itself slightly different from just, I don't, plain migraines? A regular migraine. Are there other symptoms? Is it like a sharp ice pick pain versus maybe you feel it coming on? There are various forms of migraine, headache, migraine with aura, which starts with some non-headache symptoms, like some visual symptoms, progresses to the full-blown headache. And the severe forms of migraine can actually cause focal neurological deficits, such as weakness and speech disturbance and vision loss as well. So you're not saying if somebody just has a migraine, go rush to the hospital, correct? Absolutely not. Okay. So it would be that in conjunction with blurry vision, slurred speech, unable to raise both hands at the same level, correct? Exactly. So we can discuss BFAST, which is a very common acronym that we use to recognize a stroke symptom, B for balance. Sudden onset loss of balance and gait is very important. E for eyes, sudden onset vision loss in one or both eyes. And F for face, which is droopy face or numbness in one side of the face. A for arm, as you said, inability to raise both arms evenly. And then S for speech, slurred speech, word-finding difficulty. And then T for time, time is brain, you call 911 right away. A very interesting part of the BFAST acronym, to me at least, because I didn't know this, was T. The T in FAST stands for time, which obviously you referenced. And it says here that every 10 minutes saved in response time can equal one month of life. Can you explain that? Exactly. We know that time is brain. Every minute of stroke, untreated stroke, the brain is losing approximately 2 million neurons. And every hours of untreated stroke, the brain ages equal to 3.6 years of aging. So it's a significantly impactful consequence to the brain. So if the patients arrive in a timely manner, we have to offer that treatment. Thrombectomies, how quickly do you have to treat them with that? Are you limited to minutes or hours for it to be effective? So the current guideline from American Heart Association, patients with large vessel occlusion stroke, when they arrive within 24 hours from symptom onset, we offer a thrombectomy. And as soon as patient arrives to the hospital, we have a robust workflow to take the patient directly to CAT scan, from there to the angio suite. And the stroke surgery nowadays with the technological advances in thrombectomy devices and platform, it can take only 20 minutes. All right. And just real quick, where can people learn more? Well, there are a lot of platforms, Society of Neurointerventional Surgery, American Heart Association, and the hospitals. There are a lot of community activities that people can try to really learn more about the stroke symptoms and also what to do when they see one. Dr. Sharam Majidi, Associate Professor of Neurosurgery at Mount Sinai Hospital in New York City. Thank you for joining us on the program. Thank you for having me. Have a good day. 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. A dump truck came and hit us right behind. I had numbness in my toes, sharp pain. It started in my back, then it started radiating down my left leg. My balance was very off. The sciatica was so severe. I had to use a cane. So I started looking into Dr. Benati. After surgery, I felt like everything was back to normal. This is the best place I've been to. I'm Joseph Stroman. I come from Fort Myers, Florida. I'm a bail bondsman and I'm a notary public. Me and my mother was in a car accident together. We was coming around a roundabout. A dump truck came and hit us right behind. My back pain, it was very severe. I would say I would rate it about a nine at the most painful. And shooting down my leg with the sciatica, that was at a 10. It started in my back, then it started radiating down my left leg. So I had numbness in my toes on my left side. And that was very scary. Numbness, tingling, sharp pain, all in one. When it first came on, the sciatica was so severe. I had to use a cane. I can only walk for about 50 feet to 100 feet before I started feeling pain. My balance was very off. I put all my balance in my right leg. So when I tried to put my balance into my left leg, it would make it seem like I'm going to trip over. From my pain, I had to stop working. Lifting, I couldn't lift no more than 10 pounds. Me holding a gallon of milk for more than 50 yards would have gave me pain. Some nights, I might only sleep three hours a night because the pain would be so severe. I tried taking ibuprofen, but that didn't work. So Tylenol was my number one go-to. But when I went to physical therapy, it made it worse. After learning of the high failure rates of spinal fusions and considering his young age, Joseph opted for a spinal discectomy from another physician. So I did go to about two or three other places. A lot of places were saying, oh, we're going to want to use fusions and stuff. I don't want to put fusions in my back. I did have one surgery. So now, since it was a failed surgery, I wanted to find a doctor that was going to make sure that this was not going to be a failed surgery for the next one. So I started looking into Dr. Benati. Now suffering from failed surgery, Joseph continued to research for help. That's when he found success stories on social media from previous patients of the Benati Spine Institute. He didn't really like doing fusions and stuff like that. So that really kind of stuck with me right then. And then I started watching videos about people coming and giving their testimonials. So I said, I guess it's my time to come in. So right when I gave a call in, Dr. Benati called me and we had a talk over the phone and he was like, oh, this is what it is. You have an L4, L5 and your L5, S1 and stuff like that. And that was so amazing because he's the only doctor to tell me over the phone what's my problem. When I first met Dr. Benati, he would tell me everything that I need to know, what I need to do. I was so excited when he already gave me my plan. I was like, yeah, we finna go ahead and get the ball rolling. After no other physicians could help, Joseph was excited to learn Dr. Benati not only understood the cause of his pain, but how to eliminate it. Now a participant in his own plan, Joseph underwent conscious IV sedation, where the patient remains awake during surgery so they can communicate with their doctor to target the true source of their pain. I was a little nervous because the first day I'm getting here, they already said, yeah, you finna go into surgery. So I was a little nervous. And then I was like, I'm going to be awake. Dr. Benati makes sure he feels on you to say, is it pain here? You say yes or no. Is it pain here? Yes or no. That was kind of shocking to me because I'm like, I raised my leg. I'm still on the table, but that was kind of great. And then if there's no pain here, pain here, that means it's successful. I was watching it the whole time. Another unique feature of the Benati Spine procedures is that a family member can be present in the operating room during surgery. To have my family member to come in surgery with me, that's my first time ever hearing that. And my sister, she was so surprised to see everything. And she said she had a good experience. Following surgery, patients of the Benati Spine Institute are taken to the recovery room where they get up and walk within minutes and feel immediate relief. So once when you're in recovery, they get you up and then they get you to walk. So I walked twice and I didn't feel no pain. And then they let me jog. And I was like, oh wow, I get to jog? And that was the best. Before I walked into surgery, my pain level was about a nine. When I left surgery, my pain level was like a two. No weakness in my legs after surgery. I felt like everything was back to normal. Joseph is now looking forward to returning to work and enjoying the hobbies he loves. Getting back to work, going fishing, being able to ride a bike again, going to the beach, going to the gym. That's going to be back to normal. This is the best place I've been to. I would tell them, please, please, please, please come to Dr. Benati. He's going to get you all together. To see more stories of recovery just like this, search for the Benati 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 Benati alongside Ethan Euchre. A coalition of 14 state financial officials recently announced their support for Trump-era Labor Department proposal to increase transparency in health care and crack down on fraud. Joining us to discuss is Peter Basica, founder and CEO of 360 SmarterCare. Welcome to the program. Happy to be here. Nice to see you both. Certainly. So can you tell us more about the proposal and why there's so many state auditors who support it? The whole idea of transparency in health care is very interesting because health care is so complex. I am certain that there is a certain degree of fraud, but aside from the optics of working on this problem, I really don't think they're going to make much of a dent. So you go in and you have a procedure for CPT code X. Well, CPT code X should have a price of, let's just say $100 for sake of discussion. But it turns out that you're a little bit overweight like most Americans. Check, I now get a surcharge. Oh, you have a little bit of hypertension, a little high blood pressure. Check, the price goes up. Oh, you're pre-diabetic. Check. And the real problem is we've been trying to get control of health care costs for decades. It's never worked. We had the ACA passed. Costs just keep going straight up. The reason is very simple. People don't get healthy. If you don't get people healthy, the bills keep increasing. 27% of the people worldwide actually followed the prescription. In other words, you got the pill for high blood pressure. You lost five pounds, you exercised more, you reduced your sodium intake. That's worldwide. Take a wild guess what it would be in the United States with a bunch of people that think like cowboys. 3%. 3%. 97% of the people were not compliant. So they just keep taking the pills and the complications set in. They have liver damage, kidney damage, and the bills for those are enormous. Actually, I had to laugh and use the term, how are you supposed to get a bunch of people who act like cowboys to take a pill? And I thought, how American is that though? You're not going to tell me that I got to take this pill. And I'm guilty of that too. So I've been prescribed things and I've often turned to Dr. Bernardi and Kimberly and said, what do you really think about this? And doc will be like, just get out there and exercise. You don't need that. And he tends to be right. So I digress. So the main target of this new legislation is going to be pharmacies. Is that correct? And why is that? Big, big money. It's the old follow the money and it's huge money. Another problem that we have with healthcare in the United States is we don't have healthcare. We have conglomerate care. If you look at the institutional investors across the spectrum, literally from pharmacies to providers to health insurance, they're all the same. The top five are identical. If they actually own the companies, they'd be guilty of monopoly and price fixing because they're stockholders. They're an unregulated monopoly that are screwing up healthcare. A lot of big pharma is coming in and they are trying to switch the parameters to which people fall into those various categories. Why? Because it behooves them to make more money. So if you start saying your cholesterol levels need to come way down, we have seen that it triggers things like dementia and Alzheimer's. And then, oh, we have a pill for that. We have something else we can offer you. And the AMA doesn't help the doctors. We see that they have their hands in this coding that's used. It's terrible. And then you have these pharmaceutical companies that fluff their prices and they make money hand over fist with federal handouts and reimbursements and can basically charge whatever they want to the consumer. It's insane. So while we have people supporting the proposal, officials are urging a broader reform. So clearly, they know this isn't the answer. Absolutely. One of the things that the Trump administration has done that I do think will have long-term effects is most favored nation drug pricing. And that is long overdue. Having the ability or giving the ability to Medicare and Medicaid to negotiate drug prices is a really, really good step forward. So there are some things that are being done that will help. But again, what we really need is for people to get off the pills. Some of the things that are done by Secretary Kennedy are tremendous. We need to get some of these red dyes and this and that out of the food supply. Well, it's like that old. There's an expression, and I'm paraphrasing, but it's like those that promise to cure an affliction are often the ones who caused it to begin with. And I think there's some truth to that. My company was part of a study commissioned by a drug company using CGMs, continuous glucose monitors, on pre-diabetic patients. Did a study to see if we use those in conjunction with a digital correspondence to support the behavioral changes. Could we take a pre-diabetic and get them down to a level that they're no longer in that category? And the answer is yes, overwhelmingly. It was an incredibly successful study. With all the power that the pharmaceutical companies have, they've yet to get a single insurance company to approve the use of a CGM for pre-diabetics. So you talk about AI cloud-based health concierge. What does that mean, and should we be cautious with anything AI implemented into our public health? We absolutely need to be cautious with AI implemented in the public health. No question about it. What we're talking about doing is changing the way primary care medicine is practiced. And to be as brief as possible, part of it is technology, but we use technology to go backwards and get that personal contact back into the practice of medicine. Why don't you plug your business, 360 Smarter Care. You do a lot of good work from what I've read, by the way. 360 Smarter Care was founded to help people. This is our legacy company. Everybody here is dedicated to the concept that if we do the right thing for our users, if we help them get healthier, that we will get wealthy by doing the right thing. Go to our website, www.360, the digits of 360, smartercare.com. Thank you so much for being on the show, Peter Basica, founder and CEO of 360 Smarter Care. It was my pleasure. Thank you. Thank you for watching American Medicine Today. If you would like to see previous episodes, add American Medicine Today to your favorite streaming device. If you have any comments or questions, contact us at the numbers below, or you can tweet at Dr. Venati using the hashtag American Medicine Today or hashtag AMT. We would like to hear from you.