Parkinsons Awareness w/ Dr. Schwartz | Reversal: Science Beyond Aging w/ Dr. Fossel

Welcome to American Medicine Today, I'm Kimberly Bennati alongside Ethan Euchre. Incredible show lined up, let's get right to it. A new book is proposing a radical shift in the science of aging. Instead of treating it as a decline to be managed, we should instead be treating it as a problem to be solved. Joining us to discuss is returning guest Michael Fossil, M.D., neurobiologist and author of Reversal, Science, Medicine, and a Future Beyond Aging. Welcome to the program, Michael. Thanks, Kimberly. Good to see you again. Thank you. So we've had you on the show before, but just to refresh, can you explain what telomeres are? Well, they are the pieces at the end of your chromosomes, and people often compare them to the little plastic pieces, aglets in your shoelaces, which turns out to be not quite right because they're more important than that. Think of them as the clock that sets the pattern of gene expression throughout your cells. Is there ways to maintain them? Because obviously once they start deteriorating, that is essentially what aging is, correct? Yeah, I think that's putting it simplistically, but it sets the pace for aging, and it's the changes in gene expression that downstream result in all the things that you and I see in our patients and others ourselves as aging and age-related diseases. But telomeres are a central part of that process. Well, and then your book also challenges the idea that aging is just, quote, wear and tear. How do you mean by that? Yeah. Well, it clearly is not. I mean, when you think about it, every cell in your body you got from your mother, who got it from her mother, who got it from her mother, and the provenance of those cells goes back 4 billion years. And your mitochondria, same line, goes back about 2 billion years. So you are, in some biological sense, 4 billion years old. A lot of cells don't appear to age, other cells do age, so we can't simply wave our hands and say, it just happens, it's entropy, it's wear and tear, things rust, they fall apart, without explaining why they sometimes don't, sometimes do, and certainly do at different rates. You know, mice live about 2 or 3 years, dogs and cats about 10 or more years, depending on breed and species, gorillas about 40. We live about 75. Well, why the difference? Well, we all want to know how to turn back the hands of time. So you talk about this resetting the aging process at its most fundamental level. Can you explain? Yeah, you know, if I wanted to deal with your heart disease, I could always do a cardiac transplant. Expensive, painful, all sorts of risks. Can we do it using statins? Can we do it using coronary bypass grafts? Less expensive. But can we get even more fundamental and reverse it? The real question is, can we do it to you and I? Can we do it to our patients? And there, the answer is, probably. Well, and we talked about telomeres, but there's also something called telomerase. Yeah, telomerase is an enzyme. It's actually a two-part enzyme that a lot of your cells make. I mean, the reason you and I don't run out of making blood at age 105 is because those cells transiently express little bits of telomerase. So the question is, what happens if we do that to more cells? Telomerase is the key that resets the clock. The question is, can we use it effectively and safely? The answer again is, probably. We're going to take a quick break. We'll be right back with Michael Fossil, MD. After this, you are watching American Medicine Today. Welcome back to American Medicine Today. We're rejoining our discussion with Dr. Fossil. All right. Well, show us the data. You co-authored a book called The Immortality Edge. I mean, how long is it that we can truly live? We don't know. Almost all the approaches you see on social media and YouTube and so on are dealing with what I think of as short jeopardy. They'd like to give us all a few more years and slow down the onset of Alzheimer's and osteoporosis and osteoarthritis. And that's a great idea. But I think we can do a lot better and extend the human lifespan, perhaps double the effect of healthy human lifespan. But we don't know. It partly depends on how well it works and partly how well we can do it. And those are unknowns at the moment. You had emailed me about something called the Cochrane Review. If I remember correctly, did that have to do with Alzheimer's? Yeah, it did. The Cochrane Reviews are very well-respected reviews, very carefully thought out reviews. It doesn't mean they're right, but they have a lot of respect from my point too. And they did a review of a lot of the monoclonal antibody work, Leukembe and Acetamide for Alzheimer's. And their conclusion is similar to I think a lot of us globally, which is to say, it doesn't really work. Let me put it differently. It doesn't work as well as we'd like to and the risks are high and the expense can be high too. I think the monoclonal antibody approach is targeting the wrong, they're digging in the wrong place, quote Indiana Jones. So you think we're quite a few years or decades away from clinical trials for Alzheimer's? No, I think we're probably about two years away from clinical trials using the approach that we're talking about, which is going straight to what causes aging. But we'll see, it depends on a lot of things not in my control. For example, the investors, the FDA, the vendors that produce what we need. There are a lot of things that are, again, only very minimally in my control. I remember reading or seeing somewhere a long time ago, and tell me if you've heard about this, that the higher the heartbeat or the heart rate, usually the shorter the age span or the lifespan. So for instance, like a hummingbird, its pulse is crazy high versus say a tortoise, which is really low and tortoises live a long time. Hummingbirds do not. Have you heard of that and is there any truth to that? Yeah, I've heard of it. It's been around for many decades, probably well more than 50. I've been involved in this thing. But it's another one of those points where you have a correlation, but not a causation. Let me give an example of this. If I measure everything you buy and everything everyone buys in the supermarket, what I'll rapidly discover is that people who buy infant diapers don't get Alzheimer's. But that's because people who buy infant diapers are 25 years old with two kids at home. It's a correlation. It's a very high correlation, but it's not causation. I think that's what you're looking at here. Little animals tend to have a short lifespan, but it's not because of the heartbeat, but they have rapid heartbeats, very rapid metabolisms. So what can we do? Are they supplements? Are these transdermal patches? How would something like this be introduced? Well, it looks like we'll be able to do this IV, that is as an intravenous, and ultimately probably other ways, for example, oral. It will probably be a single treatment, and then you probably will need re-treatments in a number of years. Where can people learn more about your book? They can find it on Amazon.com. There's a hardcover, a paperback, an electronic copy. My person I hired to do this has just finished doing the Audible, so that'll be out in probably a couple of weeks. Thank you so much for joining us yet again on the program. Michael Fossil, MD, always a pleasure. Take great care. My pleasure, Kimberly. Thanks. 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. Six years ago, I had a really bad back episode. Back conditions kept getting worse and worse and worse. It got to the point where I had a lot of numbness in my left leg. The disc would bulge, and it throws you crooked. And I noticed myself more leaning over and crunching over. Stiffness, tightness. I couldn't pretty much walk anymore. Some mornings I couldn't even get out of bed. Dr. Bonatti's calling me on the phone saying, I think we can fix your problem. I feel that I have a lot less pain. I also felt a lot of relief. As a young man, John worked in home construction, which would be the beginning of his long-term back problems. I'm John Bannon from Watkins Glen, New York. When I was younger, I did some scaffolding work with my father. I did a lot of construction, residential construction and stuff. Heavy labor, where you overdo yourself. My back conditions kept getting worse and worse and worse. The disc would bulge, and it throws you crooked. Some mornings I couldn't even get out of bed. I'd have to roll out onto the floor and pull myself up at the bedpost. It got to the point where I had a lot of numbness in my left leg. I noticed myself, if I was standing there doing the dishes or cooking, I could only stand there for a few seconds. If I climbed the stairs, I'd use more hand railing. I couldn't even wash the dog. If I had the dog in the driveway, I had to give him a bath. Anything that I did bending over, picking something up, it was just like excruciating pain because the nerves were getting hit. It just sends shockwaves through your body. It was like a lightning bolt went through me from bottom up. That puts you to the ground. It really does. It knocks you to the ground. You're like, oh man, it just got bad. It got very aggravating. The quality of life that I'd seen losing. I was like, I've got to do something. I've got to do something. After years of agony and frustration, John realized his pain wasn't going away. He sought treatment from a local physician. I went to my local doctor where I live and had an MRI done. They told me there wasn't much that they could do. Is this just old age or can I do something about it? Ice pack, stretching, chiropractor visits. I found a chiropractor that I liked and I stuck with him. Last time I went to see him, he was like, I think it's time you get an MRI. With physicians unable to help, it was beginning to look like a fusion was his only answer. But after speaking with a friend who had already suffered through a fusion surgery, John knew there was a better solution. I had a buddy of mine that had an accident a long time ago in the early 90s. They had pins in them and cages and everything. They had all these screws, these stainless steel screws and brackets, hold this, hold that. I didn't want none of that. I didn't want any of that. Fortunately, John spoke with another friend who had a much better outcome to his surgery at the Benati Spine Institute. I had a couple of buddies that had been to Benati Institute and my one buddy was telling me, look into these people, look into Dr. Benati. Finally, I went to my doctor and I got another MRI. I sent it down and within a week and a half, Dr. Benati's calling me on the phone saying, I think we can fix your problem. When can you come down? I said, when do you got open? Speaking with Dr. Benati on the phone and learning everything he wanted to know, John was anxious to make the trek from New York down to sunny Florida for an in-person evaluation. When I got here at the clinic at the Benati Institute and got into the examination room and Dr. Benati came in and put my stuff on the monitor there. He sat back and he read it like a map, like a roadmap and he's going this, this, this, and this. I can fix this. Monday, I had the consultation. Monday afternoon, I had the first surgery from the lumbar three and four. And then yesterday I had the five to S1. I think I'm walking better. I'm not moaning and groaning. The Benati spine procedures are performed incrementally with conscious IV sedation, where the patient remains awake and able to communicate during surgery. This helps to target and eliminate the source of their pain while still on the operating table. Any pain here? No. Any pain here? No. Any pain here? No. Okay. I feel that I have a lot less pain. I also felt a lot of relief. And even my wife noticed it. She said, you're not moaning and groaning. And I go, I know, I know. Happy with the outcome he experienced at the Benati Spine Institute, John is looking forward to a better quality of life and activities with friends and family. Well, I'm a golf player. I like golfing. You know, I took up golf a few years ago. I like to go golf and stuff. Fishing, my boys just bought me a new fly rod. I'm going to get some fishing done, doing. My experience at the Benati Institute was, you know, they explain it to you. They go over what's on the MRI, on the CD with you, what they're going to do, how they're going to do it. If you got issues with your back, I'm not kidding you. Take, take the chance, get on the phone, make a call, call Dr. Benati up. You're going to get a call back. 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 Spire TV. Welcome back to American Medicine Today. I'm Kimberly Benati alongside Ethan Euker. Parkinson's is the second most common neurodegenerative disease in the country. An estimated 1 million people living with this condition. Joining us to discuss is Dr. Guy Schwartz, Director of the Stony Brook Parkinson's and Movement Disorders Center in New York. Welcome to the show, Dr. Schwartz. Thank you for having me. Certainly. So to start, can you explain what Parkinson's disease is? Sure. It's a neurologic disease, a neurodegenerative neurologic disease. And what that means is that over time, there's a slow attrition or premature cell death of cells of the brain. We call these neurons. Think about when I say neurodegenerative diseases, think about Alzheimer's disease, Lou Gehrig's disease, Parkinson's is one of several. And with the disease progression because of ongoing cell death, new symptoms appear and old symptoms worsen. Typically, the symptoms are tremor, which is a repetitive movement of typically a hand or foot, slowest movements that gets progressively worse over time, muscle rigidity or stiffness, and problems with posture and balance. So the ability to get up and walk, move around, all these become compromised. These are called the four cardinal signs of the disease. That was going to be my question where, A, what were some of the symptoms? But I think a lot of people are generally pretty familiar with some of the symptoms of Parkinson's. I mean, I know growing up, a good friend of the family, she worked at this little grocery store and she just tremored like crazy. And I remember as a little kid, but she was still functional, sharp in the mind and everything. She just tremored all over the place. And I just remember being confused as a child thinking, what's wrong with her, mom? And it's Parkinson's disease. So before it gets to that point, what are some of the early signs for people to look for? Sure. So there's a prodromal stage to Parkinson's disease. And this can appear approximately a decade before the onset of the motor symptoms, motor symptoms referring to movements. And the appearance of motor symptoms is what we define as the onset of the disease. But prior to that, we see what we call non-motor symptoms in that those are symptoms that manifest with diminished sense of smell, sometimes complete loss of sense of smell, constipation due to slow motility of the gut, lightheadedness because of low blood pressure, and perhaps most specific to Parkinson's disease is a condition called REM sleep behavior disorder. This is a sleep phenomenon whereby individuals are able to act out their dreams in a way that we can't because during this state of sleep called REM, we are paralyzed. And that's a normal phenomenon in those with Parkinson's and those in the prodromal state of Parkinson's disease that paralysis is impaired and they're able to act out of their dreams and sometimes in a dangerous way that they fall out of bed or strike the bed. So I would say that's the one that stands out. But we consider these four to be the main prodromal symptoms of Parkinson's disease. They seem though like those symptoms would also be other problems. I mean, is this something that quite frequently gets misdiagnosed to begin with? Yeah, you're right. Constipation has what we call a broad differential diagnosis, multiple diseases of disorders that cause the same symptom. For example, IBS or medications, other conditions, diminished sense of smell, also not specific to Parkinson's disease. We see it in smokers and individuals who have traumatic brain injury. But the REM behavior disorder, this sleep phenomenon is the one that stands out as specific to Parkinson's disease. And two other neurologic similar kind of sister neurologic diseases called dementia with Lewy bodies and multiple system atrophy will focus on Parkinson's disease. Well, and then, I mean, so talk about the progression of the disease because I think you said at the top of the segment that, so people actually die from Parkinson's? I'd say that's accurate. That's a fair statement. It is when it's really a dementia, the state of dementia that leads to early death. But many individuals with Parkinson's disease who do not have dementia, do not have this debilitating manifestation of the disease can live a long time, 20 years. I have a few patients who will live with it since the 90s. So they're going on 30 years. So it's not a death sentence. And so, I mean, do we know, do you know personally what actually causes the condition, the disease? Right. That is an enigma. We think that there was what's called a two-hit hypothesis. There is a certain genetic predisposition, perhaps nothing that we can detect by genetic testing, a certain chemical makeup, how you metabolize, how your metabolism and your immune system, something that's unique to you. But that's not enough. That's only one hit of the two-hit hypothesis. We believe that the second hit is something environmental. And that's really been part that's difficult to identify. And here we have more associations between certain toxins in the disease, whereas cause and effect, what we call causality, has been difficult to prove. And maybe that it's a compilation of several environmental toxins that we're exposed to over time and minuscule amounts that over time leads to premature cell death, this neurodegenerative process. And so how is it actually diagnosed? You said this is or isn't genetic? Like, is it, say your mother or father has it, is it assumed that you will as you age, as a child? I would say that individuals who have a first degree relative with Parkinson's disease are three times more likely to develop the disease itself. But when I tell my patients, and certainly we see it in families, that it skips generations. So you may carry the genetic mutation. You may have the abnormality in your DNA, but you will never experience Parkinson's disease. So there's no really linear correlation between the gene and disease, but we do know incidence of disease, but we do know that there is a higher probability, higher risk factor. And that is because the people you're most genetically similar to are your parents and siblings, right, the first degree relatives. And then again, that diagnosis, is there a specific test one needs to ask for if they're afraid they're becoming symptomatic? Sure. So the diagnosis I mentioned defines when the physical exam changes. In other words, when we see the typical motor signs, even though we know that the REM behavior disorder state is highly predictive of the disease, technology has helped us. I would say it's been now more than a decade that we've had some imaging, imaging tools that have been reliable. And most recently, skin biopsy. Nowadays, we can do skin biopsy. Our challenge and our skill is in putting together all the data points and coming up with a diagnosis and treatment plan. That's what we do every day. All right. Well, thank you so much for being on the show, Dr. Guy Schwartz, Director of the Stony Brook Parkinson's and Movement Disorder Center in New York. Thank you for sharing your insights on Parkinson's disease. Absolutely. Thanks for having me. Well, that's all the time we have for this episode. If you care to see more of our programs, search American Medicine Today and download it on your favorite streaming device. If you have any comments or questions, contact us at the numbers below, or you can tweet at Dr. Binotti using the hashtag American Medicine Today or hashtag AMT. We would like to hear from you.