Welcome back to Ditch the Lab Coat, the podcast where we dive deep into pressing health issues with a touch of scientific skepticism and a whole lot of heart. Today, we're peeling back the layers on a critical topic: suicide prevention. We're thrilled to have Dr. Mark Sinyor join us, a leading figure in the field, known for his extensive work on this very issue.

In this episode, we explore the complex realities of suicidal thoughts and behaviors, emphasizing the importance of promoting life, hope, and recovery rather than focusing solely on suicide itself. Dr. Sinyor sheds light on the often misunderstood factors that contribute to personal crises, from unemployment to relationship issues, and the vital role of interventions and coping strategies.

We'll also discuss groundbreaking initiatives like the implementation of suicide barriers in Toronto, which significantly reduced suicide rates, and touch on the power of media influence both for better and worse. From historical stigmas to current crises response strategies, you'll learn about the transformative potential of open conversations and humane interventions.

Tune in as Dr. Bonta and Dr. Sinyor tackle the urgent need for population-wide interventions and more accessible mental health care, aiming to create lives worth living and a society where everyone feels they belong. Whether you're a healthcare professional, someone struggling, or simply interested in this critical topic, this episode promises profound insights and actionable takeaways.

Don't miss out on this compelling conversation—let's ditch the lab coat and get to the heart of what really matters.

04:16 - General internist fascinated by patients' life stories.

07:21 - Addressing suicide openly reduces stigma, prevents contagion.

12:18 - Media, modeling influence suicide numbers significantly.

13:59 - Crisis line callers hear caring, supportive messages.

18:27 - Many regret suicide attempts; intervention often helps.

20:39 - Explore crisis options with Stanley and Brown.

26:00 - Major social issues often shift suicide rates.

28:48 - Cash transfers reduce suicide rates among low-income Brazilians.

31:41 - Means restriction: most evidence-based suicide prevention strategy.

34:58 - Thinking about mortality, dislike of cold weather.

38:55 - Understanding context provides relief and effective intervention.

40:43 - Deciding patient discharge involves risk of readmission.

44:21 - Effort is made to manage patients' risks.

48:00 - Openly talk about suicide; reduce stigma.

50:46 - Visit www.ditchthelabcoat.com for information.

Welcome to another insightful episode of "Ditch the Lab Coat," hosted by Dr. Mark Bonta. In this episode, we are joined by Dr. Brian Cho, a specialist in general internal medicine and critical care, who brings a wealth of experience from leading critical care outreach programs and mastering echocardiography techniques.

We delve into the intricate decisions surrounding Do Not Resuscitate (DNR) orders and the complexities of "full code" scenarios in the ICU. Dr. Cho shares his perspective on the emotional and practical challenges healthcare professionals face in these high-stakes environments, highlighting the importance of understanding patient values and navigating the communication with family members.

Listeners will gain an understanding of typical ICU patient trajectories, the emotional impact of resuscitation efforts, and the crucial role of cultural sensitivities in patient care. We also explore the often-misrepresented realities of ICU care in media, the delicate balance of risk and benefit in medical treatments, and the personal experiences of healthcare professionals transitioning between the intense healthcare setting and their personal lives.

Join us for this profound discussion as we shed light on the real-life dynamics of critical care, the vital aspect of communication in patient outcomes, and the enduring human element in medical practice. Don't miss this episode of "Ditch the Lab Coat."

00:00 - Informational, entertaining medical talk show with experts.

03:21 - Dr. Cho balances critical care responsibilities with family life.

09:21 - Four ICU outcomes: rapid death, chronic illness, palliative care, or recovery.

13:06 - Medical scores are often unvalidated and not disclosed to patients.

16:44 - Swelling from fluid buildup is common in ICU patients.

19:28 - Ventilators assist breathing by delivering pressurized air.

21:10 - ICU pneumonia differs due to resistant bacterial pathogens.

25:38 - ICU discussions involve proxies addressing multicultural language and cultural barriers.

27:52 - Building a therapeutic alliance is crucial for effective care.

32:56 - Quickly assess futility, prioritize patient dignity in ICU care.

37:09 - Invite family during CPR to help them understand the process.

39:40 - Collective decision-making when stopping life-saving efforts.

43:38 - Code status decisions reflect complex healthcare experiences.

46:24 - Evaluate life's worth by balancing independence against prolonged debilitation.

48:23 - Focus discussions on values and joys rather than solely on code status.

51:38 - Balancing hospital work with social life presents challenges.

54:42 - Thank you to the team and listeners. Happy holidays!

Welcome to another episode of "Ditch the Lab Coat," the podcast where we delve into science-based skepticism and medical insights. I'm your host, Dr. Mark Bonta, and today's episode is an eye-opener for anyone curious about men's health, specifically testosterone.

I'm joined by Dr. Adam Millar, a leading expert who will help us navigate the complexities and common misconceptions surrounding this vital hormone.

We'll discuss the optimal timing and conditions for measuring testosterone levels, the overprescription concerns, and the often overlooked role of the pituitary gland in testosterone production. We'll also touch on hypogonadism and its impact on testosterone and sperm production. Our conversation will differentiate between evidence-based medical advice and the often misleading claims from social media influencers.

Dr. Millar will share insights from high-quality studies, including the pivotal Traverse trial, and highlight the importance of informed decision-making when it comes to testosterone therapy. We’ll explore natural ways to boost testosterone and the potential risks of unwarranted treatments.

Whether you're considering testosterone therapy or just want to understand more about what drives these discussions, this episode is packed with valuable information. So, sit back and get ready to ditch the lab coat for some straightforward, evidence-based talk on testosterone. Don’t forget to check out our blog at ditchthelabcoat.com for more resources and share this episode to spread the knowledge!

• 05:11 - Growing interest and increasing prescriptions for testosterone worldwide.
• 08:31 - Non-uniform hypogonadism diagnosis complicates treatment decisions.
• 12:30 - Symptoms alone are not reliable indicators of low testosterone.
• 15:23 - Testosterone production occurs in Leydig cells, stimulated by LH.
• 17:26 - Semen analysis helps assess sperm production and fertility.
• 21:40 - Testosterone boosts energy and strength but can impair fertility.
• 24:39 - Potential harms of testosterone include reproductive and cardiovascular issues.
• 28:17 - Discussion on testosterone's necessity; symptoms are often nonspecific.
• 31:53 - Is testosterone's effect truly objective or just placebo?
• 35:08 - Exploring the role of testosterone in men’s health and aging.
• 39:35 - Testosterone gel is not linked to increased heart issues.
• 41:41 - Randomized studies suggest testosterone may not cause harm.
• 47:19 - Valuable conversation emphasizing informed health guidance.
• 50:19 - Empowering the audience to research and make informed decisions.
• 51:33 - Closing discussion on testosterone; visit ditchthelabcoat.com.

Welcome back to "Ditch the Lab Coat," the podcast that delves into important healthcare topics with a critical, scientifically skeptical lens.

I'm your host, Dr. Mark Bonta. In today's episode, we're honored to have Dr. Woganee Filate with us, a leading expert in women's health and co-founder of LOOM Women in Health. Dr. Filate is here to shed light on the often-overlooked subject of menopause.

Together, we'll explore the urgent need to include menopause education in medical school curricula, normalize discussions around this natural part of aging, and provide better care for women experiencing menopausal symptoms. We'll touch on the historical context of hormone therapy, the benefits and risks associated with it, and the disparity in attention given to women's health compared to men's.

Additionally, Dr. Filate will offer valuable advice for women navigating this stage of life and emphasize the importance of advocating for oneself in the healthcare system. Stay tuned for an enlightening conversation that promises to empower women to be their authentic selves and improve community health. Let's dive in!

01:00 - Introducing Dr. Wagani Falati, a dedicated advocate for women's health.

05:17 - Discussing puberty changes and lack of awareness around menopause timing.

06:36 - Perimenopause symptoms can begin up to 10 years before menopause.

11:05 - Menopause hormone therapy addresses low estrogen symptoms effectively.

13:40 - Vaginal changes due to aging can be treated with local estrogen.

17:13 - Hormone therapy also promoted for preventing chronic diseases.

21:24 - Highlighting disparities in women’s health research, including testosterone and cardiac studies.

23:31 - Women's health has historically been deprioritized in male-dominated medical research.

28:12 - Improving healthcare requires collective efforts and continuous learning.

30:01 - Women’s health empowerment benefits not just individuals but entire communities.

33:14 - Estrogen replacement therapy benefits vary and should follow a personalized approach.

38:04 - Comprehensive evaluations are vital to avoid premature diagnoses.

40:29 - Advising caution and verification when consuming health advice on social media.

45:40 - Groundbreaking work in female health research with a promise to address male health next.

Welcome to another episode of "Ditch the Lab Coat," where we break down complex medical science in an engaging and relatable way.

In today's episode, our hosts, Dr. Mark Bonta and Dr. Zachary Laksman, dive deep into the nuances of managing atrial fibrillation (AFib). We'll dissect the foundation and challenges of current treatment guidelines, explore the growing role of atrial fibrillation ablation, and discuss the fascinating phenomenon of "Holiday Heart."

Dr. Laksman will also share insights from his cutting-edge work at the intersection of genetics and personalized medicine, including the innovative MyTrials AI platform he's co-founded. This tool aims to democratize access to clinical trials using artificial intelligence, making them accessible irrespective of personal networks. We'll cover the emerging potential of wearables in heart rhythm monitoring, the importance of lifestyle interventions, and the evolving landscape of AFib treatment.

Whether you're a medical professional or simply curious about heart health, this episode offers valuable perspectives and practical advice. Stay tuned as we unravel these topics and more with the expertise of Dr. Zachary Laksman, an acclaimed heart rhythm specialist and leader in cardiogenetics. Don't forget to check out our new website and engage with us for more insightful content. Let's get started!

00:00 - Seek professional advice, not podcast opinions.

05:50 - Wearable devices: Reliable, clinically relevant, widely used.

08:50 - Heart doctor: Electrician managing heart's nerve impulses.

12:50 - Atrial fibrillation increases stroke risk despite rhythm.

14:19 - Smartwatch inconsistencies in detecting atrial fibrillation.

19:33 - Rhythm control improves life quality and longevity.

20:17 - Modifiable and unmodifiable risk factors affect atrial fibrillation.

25:56 - Researching interventions for high-risk patient outcomes.

28:24 - Lifestyle changes reduce recurrent atrial fibrillation likelihood.

31:10 - Shock hearts carefully; consider anticoagulants beforehand.

33:52 - Are guidelines fear-mongering or evidence-based?

37:55 - Electrophysiology advances improve atrial fibrillation ablation.

41:54 - Tailoring medicine to individuals for better outcomes.

46:02 - AI aids connection, education, breaking trial barriers.

48:43 - Helping people navigate medical concerns and care.

53:44 - Heart rhythms, paddles, blood thinners, stroke prevention.

55:27 - Zach's AI project expands clinical trial access.

Welcome back to "Ditch the Lab Coat," the podcast where we dive into complex healthcare topics with a scientific and skeptical lens. In this episode, our host Dr. Mark Bonta sits down with Dr. Akash Goel, an esteemed anesthesiologist and pain specialist, to explore the intricate world of chronic pain management.

We'll delve into the prevalence of chronic conditions like stenosis, myofascial pain dysfunction, and sacroiliac joint dysfunction, particularly in older adults and women. Dr. Goel sheds light on the challenges of pain assessment and the often-overlooked patient experience of feeling disbelieved by family and caregivers.

We'll discuss the limitations of traditional pain scales and the innovative tools reshaping pain treatment, such as quantitative sensory testing and real-time data from wearables. Dr. Goel's pioneering research, including a clinical trial with MDMA and ketamine for chronic pain management, will provide a glimpse into the future of pain therapy.

Join us for an engaging conversation that highlights the evolving interface of AI, psychedelics, and psychotherapy in tackling chronic pain. Dr. Bonta and Dr. Goel also touch upon the broader challenges within the healthcare system and the exciting potential of new research and technological advancements. Stay tuned for insights that could change how we understand and treat chronic pain.

06:40 - Doctors frequently encounter medically unexplained symptoms.

08:57 - Chronic pain is diverse, commonly affecting older women.

11:45 - Many patients feel disbelieved when reporting chronic pain.

16:45 - Pain-related disability and interference assessed using specific scales.

17:42 - Leveraging data to predict and manage chronic pain effectively.

23:45 - Psychedelic compounds shown to aid in chronic pain psychotherapy.

26:17 - Understanding chronic pain requires grouping patients into subcategories.

28:48 - Chronic pain alters the brain and spinal cord's response mechanisms.

33:58 - Emphasis on the need for quality placebo-controlled clinical trials to refine approaches.

37:49 - Research into safe MDMA dosing and administration frequency.

38:41 - 120mg of MDMA produces effects similar to 60mg of Ritalin.

43:03 - Psychotherapy improves connection, access, and creates lasting therapeutic impacts.

49:12 - Chronic pain’s complexities inspire exploration of new treatments.

50:16 - Psychedelics enhance psychotherapy, with Dr. Goel’s research showing optimism.

Welcome to another episode of "Ditch the Lab Coat," the podcast where we critically explore the latest in medical science and healthcare with engaging discussions and a dose of skepticism.

I'm your host, Dr. Mark Bonta, and today we have an insightful conversation lined up with our distinguished guest, Dr. Allan Detsky.

Dr. Detsky, a professor at the University of Toronto and former Chief Physician at Sinai Health Systems, brings his extensive knowledge in evidence-based medicine, health policy, and clinical experience into our discussion.

In this episode, we'll delve into the complex landscape of pain management and the opioid crisis, explore the future health challenges posed by climate change and societal shifts in civility, and critique the growing influence of unregulated health advice on social media. Dr. Detsky shares his candid views on the pharmaceutical industry's role in drug development, conflicts of interest, and the intricate relationship between lifestyle changes and medical advancements.

We'll also discuss the limitations of evidence-based medicine, especially when it comes to treating patients with multiple conditions, and the challenges of applying clinical guidelines to real-world settings. Plus, stay tuned for an announcement about a website overhaul, launching in December, featuring expanded blog content for our curious listeners.

Join us as we unravel these pressing issues and more, always questioning, always learning. "Ditch the Lab Coat" continues right now.

00:00 - Podcast begins with healthcare insights from Dr. Alan Detsky.

05:31 - Highlighting the role of randomized trials in improving evidence-based medicine.

08:52 - Questioning the efficacy of zinc supplements for healthy young adults.

10:27 - Clinical study results often fail to align with real patient demographics.

16:57 - Lack of shared decision-making opportunities for hospitalized patients.

19:22 - Discussing right-wing skepticism toward pharmaceutical companies, balanced with acknowledgment of their contributions.

21:21 - Exploration of how pharmaceutical companies prioritize profits over public-interest-driven drug development.

25:00 - Reflecting on personal and professional relationships with drug industry figures.

30:43 - Increasing dependency on lifelong medications in healthcare.

35:14 - Potential for AI to address systemic issues despite its resource demands.

36:35 - Emphasizing the importance of verifying credentials to avoid unqualified healthcare professionals.

Welcome back to another episode of "Ditch the Lab Coat," where we tackle health issues with scientific skepticism and bring you the latest insights straight from the experts. Today, we have the pleasure of hosting Dr. Christine Suess, a seasoned ophthalmologist with over two decades of experience and a former Chief of Ophthalmology at Cornwall Community Hospital.

Dr. Suess will shed light on the intricate world of eye health, from common conditions like presbyopia and myopia to the impacts of screen time on children's vision. We'll delve into the importance of regular eye exams, the realities of eye surgeries, and essential tips on preventing retinal damage with proper UV protection.

Tune in as we bust some myths, discuss ocular emergencies, and explore the evolving role of technology in eye care. Plus, you'll get some unique insights, including how eye health can reflect overall body wellness and why a career in ophthalmology might just be the perfect blend of precision and patient care. This episode is packed with valuable information to help you keep your vision clear and your eyes healthy. Stay with us as we uncover these fascinating topics!

01:00 – Dr. Christine Seuss discusses her ophthalmology expertise.

04:48 – Chose career for balance; nurses' supportive advice.

08:54 – How to connect with an ophthalmologist or optometrist?

11:55 – Glasses ease presbyopia; adaptation or denial, discussed.

13:43 – Screen time may increase myopia risks in children.

18:47 – Crusting on eyelids may indicate blepharitis.

22:00 – Use artificial tears and cool compresses; consult ophthalmologist.

23:02 – Medical specialties attract people with specific traits.

28:21 – Handling ocular emergencies and managing glaucoma remotely.

32:33 – Wear sunglasses with 100% UVA, UVB protection.

35:00 – Eye surgeries now use topical drops for numbing.

37:09 – No patch, use shield; hydrate wound closure.

39:18 – Serious eye injuries require urgent specialist care.

43:22 – Limited experience with ophthalmology as a student.

48:07 – Discussing teeth and vision care with an empathetic expert.