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What is long COVID? Plus, holistic approaches to heart health

 February 27, 2024 at 1:17 PM PST

S1: It's time for Midday Edition on Kpbs. Are your Covid symptoms still lingering ? Well , today we dive into what researchers are learning about long Covid. I'm Jade Hindman. Here's to conversations that keep you informed and inspired and make you think. Nationally recognized cardiologist Doctor Eric Topol shares what the latest research on long Covid reveals.

S2: So many people understandably want to make believe that the pandemic is over , but it's far from that.

S1: We'll talk about its impact on adults and then the potential long term effects on children. Plus , we'll explore a holistic approach to heart health. That's ahead on Midday Edition. Earlier this month , The Washington Post reported that the centers for Disease Control and Prevention is considering reducing its Covid isolation guidelines from five days to one , at which point alarms were raised within the medical community. Who are concerned that this goes against science based isolation guidance and really could further exacerbate the spread of disease. In spite of this potential change , Covid continues to infect hundreds of thousands of Americans per day. Doctors are also investigating long Covid , what's driving it and the harms it can pose after infection. Here to talk more about the current Covid landscape and long Covid is Doctor Eric Topol. He's the founder and director of the Scripps Research Translational Institute. Doctor Topol , welcome back to Midday Edition.

S2: Good morning Jade , it's good to be with you again.

S1: And it's good to have you here as always. So , Doctor Topol , this past winter we saw one of the biggest surges in Covid infections since the first Omicron wave. That's according to wastewater data.

S2: It was a second worst wave since the beginning of the pandemic. So there are a lot of infections. The particular variant that drove this was called June 1st , and we're through the most of it now. But still , there's plenty of infections out there and particularly here in the San Diego region.


S2: Now with Japan , one which originated with a variant called Ba2 86 , it was the same story , we can call it an Omicron event with over 35 new mutations in the spike protein. So that's what drove this very big wave , largely , uh , of course , in parts of the country and around the world , uh , you could attribute that bit to the winter. But we also saw this in the southern hemisphere. And so while some people would like to say there's some seasonality , there's no real indication that this virus , at any time along the way of the pandemic , and particularly for Jan one , was following some type of seasonal pattern. Yeah.

S1: Yeah. Well , I mean , and as you just said and as we mentioned , the CDC is possibly considering a change here and changing its five day isolation guidelines to just one in your eyes. Could that change in policy exacerbate the spread of the virus ? Yes.

S2: You know , in California as well as Oregon , adopted measures that were also quite lax. The CDC is taking it to yet another extreme. And what we're going to see if these , uh , guidelines are actually formalized in the days ahead , is that they will further promote infections. And as you touched on J long Covid , uh , which is the last thing we need right now. And even though we're at a downward trajectory for the number of infections each day , um , we're still there's still plenty. And we're going to face another wave at some point in the months ahead. So this is a very bad policy. It's reckless , in my view , and we have more and more evidence coming out about the dangers of long Covid. And that's what some people who get Covid at this point will suffer that as well. The chronic form of Covid.

S1: For some people , it's been a couple of months or over a year since they got their last booster.

S2: Whereas the booster that's been available since September works really well against Jan dot one. So the problem we have is a lot of people who think they're protected because they had an infection in the last year , they're off base. The data don't support that , particularly if they're more than six months out. It really falls off dramatically. And if you haven't had a booster beyond six months , that is a. Problem as well. The booster fortunately works really well against the N1. Multiple studies have corroborated that , but we've had too few people , particularly the ones at high risk , that are aged 65 and above. Only some 45% of people have had that booster in recent months. And so people will benefit from the booster , not just older age groups , because it helps protect against Covid and long Covid. And that's one of the things the only way we have to prevent long Covid , for sure is not getting infection. And the second best way is getting a booster shot. Mhm.

S1: Mhm. And I want to talk about long Covid more. Now our understanding of it really continues to evolve. So how are doctors and the medical community defining long Covid today.

S2: Well it's clearly uh a big huge problem. Uh , we just had a science perspective on it in , in , uh , last week to pull it together. What we know we've learned a lot about it over these years of the pandemic , and there are tens of millions of people around the world who are suffering , uh , not just the symptoms of , you know , marked fatigue and brain fog and , uh , exercise intolerance and a list that's , that's long , but also end organ damage of every system in the body , whether it's the heart , uh , the brain , uh , kidney and more. So the definition , uh , is a bit tricky because we don't have a biomarker that is a blood test or some other means of saying you unequivocally have long Covid. It's a clinical diagnosis made for a person who even had mild Covid. And within a matter of weeks , um , has developed these chronic symptoms. They could have gone away. The person feels like they're resolved , and then they come back. Uh , and so this suffering , which oftentimes leads , leads to severe disability , uh , and it waxes and wanes. So some people , they can't even , you know , get out of bed or , or move around a certain days and others , they can. But the problem is it's promoting not just suffering but severe disability in so many millions of people. And we don't have a treatment yet. We only have ways to prevent it , which is not getting an infection or getting vaccinated. But other than that , we don't have a treatment and that's what we desperately need right now.


S2: It does appear that over time throughout the pandemic , because of our immunity , because of vaccinations and boosters , um , and infections , uh , unfortunately , that the chance of developing it now is somewhat less than it was previously. Um , it was worst when there was no vaccines in the first year of the pandemic , but it's still a problem , and the chance of developing it is increased with more infections. So , uh , the variant doesn't seem to be so much of an issue. Uh , Jay , it's much more just the infections. And , you know , what we have at this point is because of these , uh , the laxity of people circulating with infections , uh , challenges with variants like the one we just have been through , we just have more and more people that are suffering long Covid and they will present they have extreme fatigue. They have , um , oftentimes chest pain , uh , that , uh , brain fog , you know , an assortment of many symptoms that are troubling and they don't typically go away. Uh , and they vary , you know , on a given day , but they are disabling and serious and something you don't want to have or have is long Covid. Uh , at this point , we know enough that this is , you know , really a horrible condition to have to , to work through. Yeah.

S1: Yeah. Now , does long Covid trigger , um , chronic issues like diabetes and or anything like that ? Yes.

S2: That's the key is it's not just the symptoms that we just touched on , but it's in fact there's more type two diabetes. There's more problems with the heart , with arrhythmias. Uh , there's more kidney injury , you name it , across the board , particularly the neurologic dysfunction. Cognitive , uh , hit the problem with this virus is it basically gets into every organ of the body and inciting inflammation. Uh , not that it necessarily has to infect cells throughout the body , but it can. But the. Formation is what drives a lot of this blood vessels. The lining of blood vessels called the endothelium , are inflamed. And so that also leads to any potential organ of the body getting affected. And so we see , you know , nothing is spared in the human body for potential end organ effects in people with long Covid.

S1: Here's really the big question. I mean , if someone suspects they may have long Covid , what's the first step they should take ? I mean , how can they explain it to their physician when symptoms might vary ? Physicians may not be familiar with it.

S2: But the problem is , making the diagnosis isn't that hard , uh , with the symptoms and the antecedent infection. The the problem is we don't have enough long Covid clinics around the country that are multidisciplinary to deal with the different symptoms and organ impact. Uh , so there are some of these multi-specialty clinics here in San Diego , but not enough for the large number of people who are suffering , um , beyond the , the dedicated clinics , because , you know , isn't just one doctor that can take care of all these different matters. Um , you know , certain things that are amenable , like the low blood pressure and fast heart rate that can occur in people when they when they stand up , the so-called postural orthostatic tachycardia that can be treated with a medication , uh , by doctors. But many of the symptoms , we just don't have much to offer at this point. Uh , so getting the diagnosis is not as much of an issue. Is getting effective treatments with a list of something validated is basically , you know , very close to zero.

S1: Um , what do you think people still need to be doing ? Still need to keep in mind when it comes to , I'll say , public health hygiene , you know , whether it's getting vaccinated or washing your hands.

S2: I think the vaccination is uh , story is central , uh , because if people along the pandemic of Covid have kept up with their vaccines and boosters , the chance of them getting long Covid will be markedly reduced by at least 50% or greater. And that's a big reduction just in the prevention side. Uh , the same thing for measles and all the other , um , illnesses that we're worried about in children are many months ago , we saw problems with polio , which we haven't seen in this country for so many years. Now it's measles. And these are the real central thing is we've got great science about vaccines , and we don't get the uniform uptake that is necessary. Uh , when there's a bunch of people who haven't been vaccinated that creates the weakest link. And that is a serious problem. But other than that , um , the isolation guidelines. So the other big part of the public health efforts has to be that , uh , if you aren't vaccinated or you are ill , that these are things that are you just don't want to hurt other people , uh , vulnerable people , uh , and that's essential. Uh , and it isn't respected enough. So many people understandably , want to make believe that the pandemic is over , but it's far from that. And these good practices of isolation , getting vaccinated , protecting people who are vulnerable , they're all so essential.


S2: I mean , if you're in a public transport , I mean , when I'm in clinic , uh , where I can 95 and seeing patients because I don't want them to be exposed. And of course , I don't know where they've been. And so even though health systems around the country have dropped mask protection , it made it optional. I still think it's essential , especially in a healthcare setting when there's so many people who don't have a competent immune system. So the setting is , I think , really important. Uh , and the dwell time in an indoor gathering , um , when you're in a crowded setting with a lot of people , uh , masks are going to help protect people. Unfortunately , we don't have enough , uh , people who who just understand how high quality masks really , uh , give us protection and and help all the others around us.

S1: I've been speaking with Doctor Eric Topol , founder and director of the Scripps Research Translational. Institute. Doctor Topol , as always , thank you so much for your insight and for joining us.

S2: Thank you Jade. I wish I had a more favorable outlook here today. Thanks.

S1: Well , you know , we've got to be real and honest about these things. Coming up , the conversation continues with the research Rady Children's Hospital is participating in to learn how long Covid manifests in children.

S3: I think the big thing that we're finding is that long Covid kids is not the same as long Covid and adults.

S1: You're listening to Kpbs Midday Edition. You're listening to Kpbs Midday Edition. I'm Jade Hindman. There's still a lot of uncertainty surrounding the dangers of long Covid , but how does it affect our youth ? Local doctors are hoping to uncover more through the Recover initiative started by the National Institutes of Health. It's an effort to better understand long Covid and how it affects different groups , including children , young adults and people who are pregnant. Here to talk more about the study and how long Covid might look in children is Doctor Kellen Sarah. He's the chief of the Division of Respiratory Medicine at Rady Children's Hospital and a professor of pediatrics at UC San Diego School of Medicine. Doctor Tanta. Sarah , welcome.

S3: Thank you for having me today.

S1: So , you know , our understanding of long Covid really continues to evolve.

S3: I think from a clinical perspective it is really any symptom that has either worsened or has persisted greater than 30 days after the onset of , of having acute Covid.

S1: So you're part of this effort called recover , to really better understand those symptoms of long Covid and how it affects different groups of people.

S3: And so there are there are multiple independent cohorts associated with this. You mentioned that there's a maternal and fetal cohort. There is the pediatric cohort for which we are members of here at Rady Children's Hospital. Um , there is an adult cohort that really spans , um , the full range of adults. And then there's even an autopsy cohort for evaluating why folks may have , uh , expired with Covid. Um , and then finally , there's an electronic health records cohort as well.


S3: So our current cohort and we are actually as a plug uh , recruiting for our pediatric cohort , any individuals , um , up until the age of 25 that have have been or are experiencing , uh , ongoing symptoms following infection with Covid.

S1: Um , and I mean , you know , obviously one of the most vulnerable groups , um , you know , that's that would be children. So , I mean , as a parent , it seemed the medical community and the Department of Education were pretty quick to send them back to school because it didn't seem the Covid infection had many immediate symptoms for kids. Um , that may not be the case once the infection is gone , though.

S3: And what everybody has heard of in long Covid in adults , as an example , is that many , many people have just chronic , chronic shortness of breath and they have a lot of changes in their taste and smell , um , and long Covid and kids , as we're finding out , really actually even varies over the pediatric age range. So , you know , in in some recent data that we've compiled , um , we've evaluated things in younger school age kids being between the ages of six and 11 and really more of the adolescent population. And we're finding in those younger school age kids that they really do have a lot of , uh , fatigue and , uh , congestion and coughs , as well as things like , uh , gastrointestinal symptoms such as stomach pain and nausea , which our adolescents , um , are also have a lot of problems with sleep and anxiety , um , as well as the smell and loss of taste that we find more with the adult population.


S3: Um , so far , uh , and so , so for many , many people , this is actually going on for years at this point in time.

S1: Oh , gosh. Um , research suggests that symptoms can vary. And there's more than 40 reported symptoms in children and young adults so far.

S3: I mean , so a lot of times people will come to my respiratory clinic , my pulmonary clinic , for instance , with. Of something like a chronic cough or chronic shortness of breath. And , and , you know , of course we can attribute that to many other things , but I think to just be aware of it and have it in the back of our minds in terms of that , this is , uh , truly a possibility , um , will really be beneficial to all. Yeah.

S1: Yeah.

S3: I think there is a community awareness , um , and it is evolving over time. Uh , and , and I think that that given that , um , people , you know , are clearly ascribing a lot of , of the more commonly known long-covid symptoms , such as the brain fog and the fatigue and the , uh , um , palpitations and shortness of breath to long Covid. What I think that might be , uh , an increased need is to , to recognize exactly what you said , that there are over 40 organ symptoms that have been reported in association with long Covid , and that some of these may not necessarily be , uh , be symptoms that we readily think of right away of , of , of being associated with long Covid , such as , you know , just regular insomnia , for instance , or , or , you know , feeling a little bit anxious or even just having things like joint pain , you know , all of those have been reported in the context of long Covid , for sure. Mhm.

S1: Mhm.

S3: One is , is that if they have symptoms really , you know , think about their symptoms in in a in both uh okay. What really is going on right now. But but but are there other subtle um , more systemic things going on as well. Right. You know , and so a lot of times we'll notice symptoms such as my child is coughing independent of , oh , well , he must only be tired because he's coughing. And and think of potential for long Covid to be a potentially multi-system disease. And the other thing is , is , you know , just to make sure that they're an advocate for for their children to just say , okay , well , this really does seem to be something that's new that hadn't come up until my child got Covid. You know , and and so making kind of that link really helps everybody in the community in terms of the awareness of , of the symptoms as well as providing optimal care. Hmm.

S1: Hmm.

S3: It really is just because , you know , the the prevalence of long Covid , you know , even from different , uh , viral variants of , of the , of the Covid virus , um , it seems to be a little bit different as well. And whether these are cumulative or whether they're independent is something that we're very interested in investigating. Yeah.

S1: Yeah. So and you mentioned that , I mean , does the severity of the infection play a role at all ? Absolutely.

S3: I think we all we are all aware this this is both in adult and pediatric studies , that the severity of your acute presentation absolutely affects the likelihood of you developing long Covid over time.


S3: So so we're doing , uh , tight neurocognitive longitudinal neurocognitive assessments specifically to designed to answer those questions. Um , over time , we do know that for some , some kids , uh , do struggle with school following Covid and whether that's more related to general symptoms , such as being really tired and fatigued , which obviously could affect your school performance , or whether their specific cognitive impacts is something that we don't quite know yet.

S1: So our doctors finding that long Covid impacts different demographics , um , in any specific way.

S3: And I think I briefly mentioned that , that even in our findings that there are age related effects that might be different between younger and older kids. And one of the things that we've been very interested here in San Diego , of course , is effects of , uh , Hispanic Latino heritage on on long Covid. And in our preliminary data at least do seem to , uh , to suggest that they may be particularly more susceptible to certain forms of long Covid , such as respiratory outcomes , whereas they might actually be more protected against other forms of long Covid , such as , you know , neurological , including the brain fog type of things.

S1: Um , you know , are there any available treatments or recommendations for ? Long Covid even with these varying symptoms. Yeah.

S3: Yeah. No , I think that that that's an outstanding question. I think first and foremost , I would say that the there are no FDA approved treatments for long Covid at this juncture. There are multiple clinical trials ongoing to investigate long Covid in both kids and adults. Um , included amongst those clinical trials across the country are our , uh , medications including Paxlovid , Monty , leukocyte and lithium for uh , for various types of symptoms. But again , those are not FDA approved. Those are all in the investigational stages at this point in time. Um , and , you know , the only thing that I think is universally recommended at this point is , is vaccination. Vaccination is preventative for long Covid. Um , in terms of the studies that have been published that have looked at this and you could really , um , you know , decrease your risk , um , by about 40% given the vaccine based on , uh , published studies. Yeah.

S1: Yeah. Um , and also this this study is called recover.

S3: That is certainly something that we're looking at from both a mechanistic perspective as well as , uh , as well as a longitudinal research and demographics perspective to find out exactly what are the underlying reasons why some people , even though they have had symptoms for perhaps even several months , um , eventually recover and other folks continue to have symptoms over time.

S1: There are so many questions , and this is a very important study that you all are participating in.

S3: Uh , um , and again , we are still looking for , for folks that are presenting with , with these symptoms. And this is the national effort. There has been preliminary commitment from the NIH to extend , um , their efforts into continuing to understand long Covid even beyond , um , this , this , uh , initial , uh , study timeline.


S3: There is a long Covid section of the Rady Children's Hospital um , website , or we have an email that they can contact us at , uh , home research at

S1: I've been speaking with Doctor Kellen , Tante Sarah , chief of the Division of Respiratory Medicine at Rady Children's Hospital and a professor of pediatrics at UC San Diego School of Medicine. Doctor Santa. Sarah , thank you so much for joining us.

S3: Thank you.

S1: Still ahead as Heart Month comes to a close and moves into Women's History Month , doctor Mimi Guinier shares her holistic approach to heart health and healing.

S4: Really motivating people to look at their lives and transform their lives and to create health. That , to me is a really deep and powerful work.

S1: You're listening to Kpbs Midday Edition. You're listening to Kpbs Midday Edition. I'm Jade Hindman. We want to switch gears from Covid to focus on women's heart health now , because nearly half of women in the United States suffer from some form of heart disease. Doctor Mimi Guarneri says treatment and prevention require more than what Western medicine can provide alone. The pills , the blood pressure checks and cholesterol screenings may not be enough without a mind , body and spirit approach to healing the heart. Doctor Guarneri is an award winning cardiologist and researcher nationally recognized for her leadership in integrative medicine. She is also founder and president of the Academy of Integrative Health and Medicine , along with medical director of Pacific Pearl , La Jolla , Doctor Guarneri. Welcome back to Midday Edition.

S4: I'm so happy to be here. Thank you. And thank you for your work.

S1: Thank you Watson , it's an honor to be able to do it , and I appreciate that. Um , so the last time we spoke , you explained that you take a a body , mind and spirit approach to heart health.

S4: I'd strengthen the soil. So I always explain to my patients that no matter what health condition or health challenge you have , you can think of that like a sick fruit on your tree. And then you say , what can I do to strengthen my soil to reverse this problem , correct this problem. So if you take something like diabetes and you would look in your soil and say , well , it's affected by macro micronutrients , it's affected by physical activity , it's affected by toxins in the environment. And to get to your point , um , it's affected by stress because stress raises your cortisol , raises your blood sugar , right ? It's affected by your anger , your emotions and so on.

S1: Tell me more about that.

S4: Think about the metaphors we use. Right ? I love you with all of my heart. You don't say I love you with all of my brain. You know , depending on your spiritual tradition , you may say the heart is the seed of the soul , right ? Uh , so we now know , of course , not getting too esoteric , though , that the heart , uh , very interesting research that the heart actually responds to emotions even before the brain registers the emotion , which is very fascinating to me. Uh , as a cardiologist. So , you know , we spend so much time talking about cholesterol , right ? Lower your cholesterol , lower your cholesterol. Well , when you think about the heart and the vascular system , it's like sitting in this room. Imagine we have 20 holes in the roof and it's raining on us. And you say , well , I'm going to fix that one hole and we'll call that cholesterol. It's still raining on us. Right. And , and and despite all of these great medications and things that we have which are good in their life saving , I use a lot of medicine in my practice. We still don't have a zero cardiovascular disease rate. Right. So we have to we have to think about this in a more holistic model , more holistic approach.

S1: How does that inform how you treat patients then ? Yeah.

S4: It's a great question because I always say , what's driving the train ? So for example , if someone's depressed and that's the reason they're not eating right and they're not going outside and they're , you know , I have 20 friends in this pack of cigarettes or these Cinnabon , it's make me feel really good right now. My sitting there and talking to that individual about eating brussel sprouts and a green salad isn't going to go very far. Right ? I have to get to the underlying cause of of what is driving this whole situation. Is it depression ? Is it stress ? How many people eat , smoke , drink , gamble ? They show I was under stress , right ? You have to really look at the whole person. And also , why would you want to get healthy ? What's your reason for feeling healthy ? I always start my questioning with what are your core concerns ? You know what is important to you as the individual ? Why are you here ? It's very easy for me as a doctor to say , oh , you have diabetes. Take this. You have high cholesterol. You know the ills of the pill game. Take this pill. Your knee hurts. Take this pill. You're depressed. I'll give you another pill. That's easy , but really , really motivating people to look at their lives and transform their lives and to create health. That , to me is a really deep and powerful work.

S1: You know , what are the signs of heart disease ? How do those signs present differently in women versus men ? Yeah.

S4: So there's a word we call angina or angina , depending on how you want to say it. This describes discomfort that comes when you exert yourself. So the typical scenario here might be , you know , for the last three months , every time I walk up the hill , I get a tightness or pressure in my chest , or discomfort in my chest , or discomfort in my left arm , or I feel a discomfort in my shoulder blades. And then I stop and it goes away. That's a classic description of angina right now. This may be different for men and women , like a women classically will say , I get a discomfort between the shoulder blades when I'm doing my hair , when they have their arms above their head , because that's usually that is causing exertion. Or I'll notice , like I had one woman say , every time I walked , I got pain in my teeth and she said , I went to three dentists. And finally the last dentist said , this may be your heart , you know , good for that dentist. So and sometimes women just present with fatigue. So not everybody has that classic pattern. But I have to say women also have the classic pattern. So the message here is if you notice , you were able to do something two months ago , a month ago , six months ago that you can't do now. Pay attention. Go and get checked. If you notice when you're walking , going up a flight of steps or heading up that hill , you're getting a discomfort or indigestion or discomfort in your chest , your arm , your teeth , your neck. Stop and go and get that evaluated. Right. I think a lot of times we all , um , you know , women were trained , at least in my generation , that women didn't get heart disease. Meanwhile , it's the number one cause of morbidity and mortality of death for women and men globally. Right.


S4: Right. How many women do I have in my practice who've showed up in emergency room and they're told , oh , it's probably a gallbladder , or you have indigestion. And men , even to this day , even with women heart being a major organization , that's been raising the level of awareness , even to this day , women still don't get the same treatment. And if you're a black woman or a Hispanic woman , I can almost guarantee you're not going to get the same treatment , because that's what the research shows. So , uh , first you have to find a physician that will listen to you , and that may be a nurse practitioner that will listen to you. Right. It doesn't have to be the old MD , but someone who will listen to you. And if you feel , gee , this could be my heart , you have to say , I'd like to have my heart evaluated. I'm concerned. Or if you have that family history , my mom had a heart attack , or my mom had a stroke , or my dad had a heart attack , a stroke. My brother , my sister , my grandmother. You know , you know , you have to sometimes you have to push it. Yeah.

S1: Yeah. I personally had a heart attack when I was 35 years old. Talk a bit about the symptoms because it was had I not been pushed to go to the E.R. , I wouldn't have.

S4: And you're not the only one. Many people. The biggest one I hear , of course , is. Oh , uh , indigestion. Right. Uh , the classic description , of course , is going to be , gee , I feel a pressure on my chest or like an elephant sitting on my chest. Oh , by the way , it's going into my left arm. Oh , by the way , I'm starting to sweat , or I feel nauseous. Well , if you if that happens , please , please , please call 911. Don't drive the car. Get the help that you need and get checked out. Sometimes it's more subtle. Could be a could be a tightness , a pressure that comes when you get up and walk around and then you stop and it goes away , and then it comes back. Uh , it or it could be completely not in the chest at all. Or it can just be indigestion. You know how many people think , oh , I had a bad indigestion. And then by the time I see them and do an EKG , I can see an old heart attack on the EKG. Mhm.

S1: Mhm. Yeah. Yeah. But I want to talk more about how you use sort of Western medicine and eastern medicine to , to reach a place of healing.

S4: Of soil and the tree. Let's start with the basics. Nutrition. Right. We really need to teach people nutrition. And the reality is is level A which is the best evidence in cardiovascular disease for Mediterranean diet. And the more you can make it plant based. So my first job is to teach people how to eat. Right ? Um , are people sleeping at night ? Right. We're talking this is lifestyle medicine , right ? So you say , okay , uh , somebody stressed what might be available to them. Well , in the western medicine side , here's your drugs on the other side. I'm going to send someone from transcendental meditation , which has , uh , evidence , particularly in the black community , beautiful research showing TM 20 minutes twice a day decreases cardiovascular events , 48% better than any drug. Transcendental meditation , well studied. So there are many tools in my toolbox that go beyond just drugs. It's sort of like if somebody has back pain , right ? But they're not paralyzed. A lot of people say , give me an MRI , that's the first thing I want. But we're going to look at maybe acupuncture , maybe chiropractic , maybe massage. Right. Let's , you know , we take what there's a therapeutic audit to things. So how do you begin to start incorporating things from all of the global healing traditions ? I , most of us in Western medicine , the way we raised in the United States , we just think about medicine as drugs , surgery and maybe a little physical therapy because that's the way doctors are trained. But there's traditional Chinese medicine. There's r Vedic medicine from India , there's homeopathic medicine , there's chiropractic , there's natural path medicine. I mean , there's all these global healing traditions that people are unaware of. And so the ability to use these with the goal being , how do we get this person toward health , right ? How do we create health , not just treat disease ? That's the difference.

S1: Well , looking forward , what should people ultimately know about heart disease and heart health ? I feel like we've gone around the world here in this , in this conversation. But what should people know ? Yeah.

S4: So the health of your heart is in your hands. Lifestyle can transform , uh , your cardiovascular health. There are , you know , there's a way you should be eating. You should be sleeping more than seven hours a night. You should be getting to your optimal weight. You should be walking , doing resistance training , yoga , uh , every week , if you can. You should be looking at how you respond to your emotions. Are you an angry person ? Are you a stressed out person ? If you are or depressed , get the help that you need to get. If you want to go in and talk to your doctor , you say , hey , uh , I need to know what my blood pressure is. I need to be checked for diabetes. I need to know what my inflammatory markers are. Things like CRP. For example , I want to do a advanced lipid profile which looks at all of my types of cholesterol. Uh , I want to know what my where my nutrients are at. Right. Do I need vitamin D ? Do I need magnesium ? Uh , so there's there's really a lot that goes into it. But at the end of the day , people need to know that they can transform their health. And you transform your health to begin with by getting rid of all the sugar , cutting your alcohol in half , and eventually eliminating that. Get rid of the pop. Get rid of the fruit juice. You know , uh , start eating more vegetables. Start walking. If you're not walking , you know , take small steps to improve your heart's health.

S1: All right. I've been speaking with Doctor Mimi Guarneri. She's the founder and president of the Academy of Integrative Health and Medicine. She also serves as the medical director of Pacific Pearl , La Jolla , doctor Guarneri , thank you so much for joining us.

S4: Thank you for having me.

S1: That's our show for today. Don't forget to watch Evening Edition tonight at five for in-depth reporting on San Diego issues. We'll be back tomorrow at noon , and if you ever miss a show , you can find the Midday Edition podcast on all platforms. I'm Jade Hindman. Thanks for listening and stay healthy , everyone.

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Three-year-old Zara sits in a chair ready for her first dose of a COVID-19 vaccine. San Diego, Calif. June 2022.
Nicholas McVicker
Three-year-old Zara sits in a chair ready for her first dose of a COVID-19 vaccine. San Diego, Calif. June 2022.

The Centers for Disease Control and Prevention is considering lowering its COVID-19 isolation guidelines from five days to one. This is raising alarms in the medical community, who are concerned lowering isolation time could exacerbate the spread of the virus. We look into the current COVID-19 landscape and what current research reveals about the harms of long COVID.

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