The Breakfast Club - INTERVIEW: Dr. Joseph Puma Talks Ozempic Rx, Weight Loss, Signs Of Heart Attack; Preventative Measures + More

Episode Date: February 2, 2024

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Had enough of this country? Ever dreamt about starting your own? I planted the flag. This is mine. I own this. It's surprisingly easy. 55 gallons of water, 500 pounds of concrete. Or maybe not. No country willingly gives up their territory. Oh my God.

What is that? Bullets. Listen to Escape from Zakistan. We need help! That's Escape from Z-A-Q-istan on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. Hey guys, I'm Kate Max. You might know me from my popular online series, The Running Interview Show, where I run with celebrities, athletes, entrepreneurs, and more. After those runs, the conversations keep going. That's what my podcast

Post Run High is all about. It's a chance to sit down with my guests and dive even deeper into their stories, their journeys, and the thoughts that arise once we've hit the pavement together. Listen to Post Run High on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. As a kid, I really do remember having these dreams and visions, but you just don't know what is going to come for you. Alicia shares her wisdom on growth, gratitude, and the power of love. I forgive myself. It's okay.

Have grace with yourself. You're trying your best. And you're going to figure out the rhythm of this thing. Alicia Keys, like you've never heard her before. Listen to On Purpose with Jay Shetty on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. like you to join us each week for our show Civic Cipher. That's right. We discuss social issues, especially those that affect black and brown people, but in a way that informs and empowers

all people. We discuss everything from prejudice to politics to police violence, and we try to give you the tools to create positive change in your home, workplace, and social circle. We're going to learn how to become better allies to each other. So join us each Saturday for Civic Cipher on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. Daphne Caruana Galizia was a Maltese investigative journalist who on October 16th, 2017, was assassinated. Crooks Everywhere unearths the plot to murder a one-woman WikiLeaks. She exposed the culture of crime and corruption that were turning her beloved country into a mafia state. Listen to Crooks everywhere on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.

Wake that ass up in the morning. The Breakfast Club. Morning, everybody. It's DJ Envy, Charlamagne Tha Guy. We are The Breakfast Club. We got a special guest in the building. Dr. Joseph Puma is here. Dr. Puma, welcome. Thank you for inviting me. Now, you know, Dr. Puma's been here before.

Yes. You know, but it's very important to note that February is American Heart Month. Correct. Yes, as well as Black History Month, of course. That's right. But that's why we have him here today to talk about all things heart health. Now, for people that don't know or didn't hear when you were here previously, tell people what you do. I'm a cardiologist. I'm the founder of Soarin Medical, which is the largest independent cardiology practice in New York City.

My goals are to democratize health care. We have the objectively we've won an award four quarters in a row for the number one heart scan in America, the highest quality imaging. We're insurance based. We take care of everybody that comes through our doors, whether they're a billionaire or they're undomiciled. Our goal is to be part of the communities that we work in and to try and educate and help people live longer. I tell people all the time, man, you know,

I've dealt with real bad anxiety my whole life. So, you know, I always have the heart palpitations, always feel like I'm having a heart attack. So at the end of 2022, I did like every single, you know,

heart test you could imagine. But the one that put me at ease the most was the Soren heart scan. Could you tell people what the Soren heart scan is? So when we image the heart, we're basically using a camera, right? The Soren heart scan uses the fastest camera available in the world. It's a CAT scan. It's the only one of its kind in New York City dedicated to evaluating heart disease. And in a three to four minute scan, we're able to see the arteries

in the heart, see if there's any blockage, to see if there's any plaque, buildup of beginning of blockage, calcification. We can see the heart chambers, the major arteries in the body, the aorta, pulmonary arteries. In addition, we get a limited view of the lungs and other structures. But it's the most accurate scan. It takes three, four minutes. It's eliminated the need for having stress testing. And more importantly, it's eliminated the need, and this is all peer reviewed published data, eliminated the need by almost this is all peer-reviewed, published data, eliminated the need by almost half for having invasive heart catheterizations where you have to go in the hospital and we have to put catheters in. So a simple test.

Charlamagne, I think you're right. You've been a big promoter of mental health. And, you know, about half the people that come to a cardiologist have symptoms that sound like it's from their heart, but it's often just from anxiety and stress. And so often that one simple scan, if it's completely normal, like yours, DJ Envy, was perfectly normal, could put your mind at ease and allow you to get on with your life without worry. Well, let's talk about the scan.

So, you know, every year I go get a physical, and I heard Charlemagne talk about this test that he did for his heart and how, you know, how he felt comfortable after. So I have six kids, so I like to as much as I can try to prevent anything or try to check up on anything. So I went and got the heart scan. I didn't take that long. Like you said, maybe 10 minutes, the longest I was in the office at in totality. So just tell people what what it consists of. And we can do a reading on mine. I'm fine with it. And so let's let's go there. So people come there. And now what happens when they get there? Okay, so first thing I think that's important to understand is number one, heart disease is the number one killer in America.

Okay, even if you add all the cancers in the world, in America together, heart disease kills more people every year. And that's not to minimize, you know, the effects of cancer. That's just to say this is a major public health problem. Correct. Second, I appreciate you inviting me during Heart Health Month, February, because it's also Black History Month. And for the African-American community in particular, they die at twice the rate of whites from heart disease. They develop high blood pressure, diabetes, at a much earlier age. And so they're more likely to have complications.

What the Soren Heart Scan does is you come in the office. You can arrange it on your own. You can call pound 250. You can go on our website and schedule it at your convenience. When you come in, you know, you get the initial paperwork, which takes a minute or two. We bring you in. We put an intravenous in, an IV in your arm. We bring you in the lab.

You lay on the table for the CAT scan. Our unbelievable nurses then will monitor your heart rate and blood pressure. Because we're imaging a moving object as opposed to doing a scan of your brain or your abdomen, which is not moving, we want to get your heart rate down to around 60 to 65. So they might give you some intravenous medication to lower your heart rate. They'll put a nitroglycerin under your tongue because that helps dilate the arteries around the heart so we get better pictures and we can really see the flow. And then we do the scan. And all of that, as you said, shouldn't be more than 15 minutes in the office and the scan itself about three to four minutes. Now, you did my scan a couple of months ago and I was very nervous, not nervous of what is wrong, but I guess nervous about finding out. Right. I think that's what most people like. Yeah. Most people don't want to find out if something is wrong.

Shoot. I do. when it comes to the heart because tell them about that widowmaker doc yeah so again just from uh uh the standpoint of understanding heart disease better a third of people who have heart attacks never even knew they had heart disease before they had a third of people who have heart attacks die the day they have their heart attack. So it's not pleasant. So some of this is silent. It grows as time goes on, right? Especially if you have risk factors, high blood pressure, diabetes, smoke, you're overweight, you're sedentary. If you have high cholesterol or a family history of heart disease. Okay. These are all the things that as time goes on, the body changes

and you're building up plaque and blockage in the arteries. But once you have the test, even if you have a severe blockage, we can easily treat it. Nine out of ten times if a blockage is severe, the flow is limited through the artery, and we have some objective data, you know, objective approaches to figuring that out, nine out of 10 times we can treat it with a stent, which is an outpatient procedure. Unfortunately, one in 10 times you

might need open heart surgery. Yikes. But it's proven you'll live longer. And even in the people who say they don't have any symptoms, oftentimes after we've treated their arteries in their heart, they come back to the office and follow up and say, you know what? I actually feel better. I didn't think I felt bad, but now I feel better. So I understand there's a lot of stress and anxiety about it. The other thing is if the scan is completely normal, no plaque, no calcification, no blockage, let's say like your scan, that means over the next 10 years your risk of having a heart attack, stroke, or death is less than 2%.

Jesus. That is the best risk group you could be in. But we're able, even if there is mild or moderate plaque, we're able. Like me. Right. We talked about your risk factors. We talked about the goals of cholesterol treatment or blood pressure treatment. And once we know that, your survival should be exactly the same or pretty close

to DJ Envy's, your lifespan. And in fact, we calculated a risk. And it was like 2.5% over the next 10 years, a risk of heart attack, stroke, or death. So the key is just show up. You never know what you find. You know, one of the most amazing experiences I had last year, Charlemagne, was when we attended your Mental Wealth Expo. Thank you for coming. Oh, thanks for inviting us. I mean, it was inspirational to us. There were thousands of people there. Many of them were there because of mental health issues.

But the reality is many of them were there just because they were trying to take charge of their health. They were searching for information. And you're someone, the two of you are people that have influence. People listen to you, okay? And they trust you. And so we set up a booth and we were doing free blood pressure screenings. We must have screened 400 people that day. Wow. Over 200 of them, their blood pressure was out of control. And out of that 200, about 50 or 60 didn't even know they had high blood pressure. So just show up. It's simple things. As a community, as physicians, we can do screenings, for instance, in local churches, barbershops, you know, anywhere really, schools. And once you know, once you have that information, DJ Envy, then it's just a matter of finding a doctor or a health care provider that you have faith in, that you trust and working with them to control. Get on the right medicines and monitor and control your blood pressure or your cholesterol, your diabetes. I'm on statin for my cholesterol, but you mentioned, you keep mentioning high blood

pressure. You keep mentioning diabetes. You keep mentioning stroke. What I find interesting is that young black people are living with diseases more common at older ages. They're living with these diseases that should be, that are usually more common at older ages. That's scary. That's exactly right. In the black community compared to the white community, the rate of high blood pressure in blacks between 35 and 49 is 50% higher than whites. The rate of diabetes is 40% higher. And if you have these chronic diseases earlier, they're more likely over time

to cause complications, to have problems, to cause heart attack and stroke. And even at 65, heart disease, blacks are 50% more likely to die of heart disease than whites. So these are chronic problems that can cause devastating acute complications. And so finding it early and treating it and following with the doctor. From a physician standpoint, it's our job to make it easy. It's our job to listen. It's our job to build a relationship. It's our job to make sure when you have a test for instance you get the results of the test and we explain to you you know clearly in language you can understand what the implications are and how best to treat it i was going to ask if you just you know go over some of the stuff so what are you looking for

when you're actually doing the scan of the heart? Now, is it easy to detect plaque and like, you know, where somebody does have plaque or somebody does have a problem? You can actually fix the problem right then and there, correct? In most cases? In most cases, in New York State, we still have to bring it to the hospital to do it. Although, as you reflect, we have an ambulatory surgical center in lower Manhattan and we can fix lots of problems there, but we're not allowed to go into the heart yet. So we still have to do it in the hospital. But if we see a widowmaker lesion, we'll get you in the hospital same day or next morning. But the images we get, we get two things.

We get images of the arteries as if we did a catheterization so we can see blockage. And then we do what's called a heart flow. It's a company in California that has this amazing artificial intelligence software that can give us an objective assessment of flow in the artery. And we have some cut points that tell us if it's significant or not, any of the plaques, and that they might need a stent. Is there a way to lower cholesterol without taking medication? Yeah, there are a lot of ways. Will I be on statins forever? Right now, you'll be on statins forever only because all the research studies we have done are so powerful and show that people who take statins

live longer because of the reduction in heart attack or stroke. However, through diet, exercise, you can lower cholesterol. And so some people don't necessarily need statins. One of the first. Is your country falling apart? Feeling tired, depressed, a little bit revolutionary? Consider this. Start your own country. I planted the flag. I just kind of looked out of like, this is mine. I own this. It's surprisingly easy. There's 55 gallons of water for 500 pounds of concrete. Everybody's doing it. I am King Ernest Emmanuel.

I am the Queen of Ladonia. I'm Jackson I, King of Capraburg. I am the Supreme Leader of the Grand Republic of Mentonia. Be part of a great colonial tradition. The Waikame tribe owned country. My forefathers did that themselves. What could go wrong? No forefathers did that themselves. What could go wrong? No country willingly gives up their territory.

I was making a rocket with a black powder, you know, with explosive warhead. Oh my God. What is that? Bullets. Bullets. We need help! We still have the off-road portion to go. Listen to Escape from Zakistan.

And we're losing daylight fast. That's Escape from Z-A-Q-istan on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. Hey, guys. I'm Kate Max. You might know me from my popular online series, The Running Interview Show, where I run with celebrities, athletes, entrepreneurs, and more. After those runs, the conversations keep going. That's what my podcast Post Run High is all about. It's a chance to sit down with my guests and dive even deeper into their stories, their journeys, and the thoughts that arise once we've hit the pavement together. You know that rush of endorphins you feel after a great workout? Well, that's when the real magic happens. So if you love hearing real, inspiring stories

from the people you know, follow, and admire, join me every week for Post Run High. It's where we take the conversation beyond the run and get into the heart of it all. It's lighthearted, pretty crazy, and very fun. Listen to Post Run High on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. As a kid, I really do remember having these dreams and visions,

but you just don't know what is going to come for you. Alicia Keys opens up about conquering doubt, learning to trust herself, and leaning into her dreams. I think a lot of times we are built to doubt the possibilities for ourselves. For self-preservation and protection, it was literally that step by step. And so I discovered that that is how we get where we're going. This increment of small, determined moments. Alicia shares her wisdom on growth, gratitude, and the power of love.

I forgive myself. It's okay. Like grace. Have grace with yourself. You're trying your best. And you're going to figure out the rhythm of this thing. Alicia Keys, like you've never heard her before. Listen to On Purpose with Jay Shetty on the iHeartRadio app,

Apple Podcasts, or wherever you get your podcasts. Daphne Caruana Galizia was a Maltese investigative journalist who on October 16th, 2017, was murdered. There are crooks everywhere you look now. The situation is desperate. My name is Manuel Delia. I am one of the hosts of Crooks Everywhere, a podcast that unhurts the plot to murder a one-woman Wikileaks. Daphne exposed the culture of crime and corruption that were turning her beloved country into a mafia state. And she paid the ultimate price.

Listen to Crooks everywhere on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. Hey, what's up? This is Ramses Jha. And I go by the name Q Ward. And we'd like you to join us each week for our show Civic Cipher. That's right. We're going to discuss social issues, especially those that affect black and brown people, but in a way that informs and empowers all people to hopefully create better allies. Think of it as a black show for non-black people.

We discuss everything from prejudice to politics to police violence, and we try to give you the tools to create positive change in your home, workplace, and social circle. Exactly. Whether you're black, Asian, white, Latinx, indigenous, LGBTQIA+, you name it. If you stand with us, then we stand with you. Let's discuss the stories and conduct the interviews that will help us create a more empathetic, accountable, and equitable America. You are all our brothers and sisters, and we're inviting you to join us for Civic Cipher each and every Saturday with myself, Ramses Jha, Q Ward, and some of the greatest minds in America. Listen to Civic Cipher every Saturday on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. Cholesterol medicines ever, I don't want to say invented, but ever used to treat cholesterol is actually a naturally occurring vitamin, niacin. That lowers cholesterol very well. It has lots of side effects, which is why it's not so commonly used.

It can cause facial flushing. But yeah, there are ways. And people who are overweight, you're not overweight, so it would be more difficult. But people who are often overweight, I don't think it's a big surprise that there's an obesity epidemic in this country. And that affects blacks more than whites as well. Diet and exercise can lower their cholesterol. We've had many patients that through diet and exercise are able to come off of diabetes medicines, less blood pressure medicines. And now we have these weight loss drugs.

And I'm smiling because I had a patient two weeks ago that I discussed one of the weight loss drugs. You know, there's like, I think, three or four of them now. Ozempic, Wegovi. And when I told him, you know, maybe we can talk about it and consider it, he said, no, just this morning I was listening to the Breakfast Club. And Charlemagne said that when you're on these weight loss drugs, you got diarrhea all the time. Uncontrollable diarrhea. That's one of the side effects I thought they said sometimes, right, or no? Yeah, that's what I read.

So it could be a side effect. Again, when you read about side effects, these aren't – often the side effects are in the low single-digit percentages. I did have a homeboy who was on it. He was an Olympic gold medalist, and he definitely had had diarrhea he definitely said diarrhea was one of the side effects yeah and it's possible listen there are definitely what do you think about ozempic like because you know it's a i guess it was supposed to be a for diabetes right to fight diabetes but people are using for weight loss is that a healthy thing is that a healthy thing so it would be healthier if you weren't overweight in the first place. Correct. But I don't think we should stigmatize people that are overweight. Some

people's metabolism is different. I think I am much more on board now with these medications. At the American Heart Association meetings in November of 2023, there was for the first time a research study that proved that patients who took these weight loss drugs, Ozempic and Wegovy, which are the same drug, actually had a lower risk of heart attacks and death. Really? So in certain populations, usually what we do is, you know, we'll try and counsel people. We'll try and work with them, educate them on diet and exercise, and then monitor them. To the extent they can lose weight that way, that would be preferable. But if they can't, there are options. I would

prefer a drug to surgery. You know, there are a lot of surgical options to lose weight, but there's lots of side effects, you know, with surgery as well. You know, patients lose weight. If patients have surgery for weight loss, their weight loss is usually greater than if they take the drugs. If you're taking the injections for weight loss, maximum or the median, I would say, is about 15% of your weight, you know, you'll drop. So if you're 250 pounds, you'll lose maybe 35, 40 pounds. Last question on this. I know you're not here for that, but what does Ozempic do to make you lose weight?

Like does it, you know, shrink your stomach? Like what does it do where people lose weight and so fast? So it affects metabolism and transit time, okay? So you're transiting your food that you eat much slower through the body. So you feel full more often. So most patients who are on Ozempic or Wagovi or Munjaro, they don't have an appetite. They don't feel hungry. So I saw someone yesterday, for instance, who had lost 42 pounds, been on it for six months, wants to stay on it.

But he said he used to eat three meals a day and have snacks. He has one meal a day now. Is that healthy? It depends. Yeah, yeah, yeah. Everything depends. Again, it would be better if we could do all these things naturally. It would be better if we didn't need to use medications. It would be better if we didn't need to use medications.

It would be better if people didn't need to see me. But, you know, and I spent most of my career dealing with the complications of all these problems. And in the last few years, I've really focused on prevention and trying to increase awareness and education. Um, so these conversations are so important. What you all are doing is critically important, um, for all communities to, to start understanding these things. So, you know, is it healthy? Would be better if we didn't need it, right? Right. It's American Heart Month. What should people be doing right now, Dr. Poon? So it's American Heart Month. I love February because it's Heart Health Month.

Every place you turn, every media, no matter how you consume media, you're going to see something about awareness. Get your blood pressure checked. Get blood tests. Check your sugar levels. OK, go see your doctor. If you don't want to do that or you can't do that, let's start getting healthy. Get off the couch. You don't need to train for the marathon. How about we just get off the couch or, you know, on the way home from work before you go in, take a brisk walk around the block, you know, in a few weeks, try two walks, you know, two blocks, just start getting active. But I think that, you know, February is a great month because it's a great reset month. We think about it, we talk about it, and hopefully it encourages people to take charge of their health. What, you know, since I've been on the show last time, what's just amazed me and just

blown me away is how many people you've inspired and encouraged to take charge of their health and to just show up. And then the other thing I would do is if I was a patient, I would put pressure on my doctors. Remember, when you go see the doctor, that doctor works for you. So have a list of questions before you go in, whether it's things you don't feel well about or things that you're not sure about or side effects of your medicine.

Have a list of questions. Don't let them leave that room until your questions are answered. Don't let them leave that room until they schedule the test to give you an answer. So really, it's just take charge of your own life. I have one last question. Signs of a heart attack. Right. And I think this is what gives a lot of people anxiety. We're talking. What are the signs of a heart attack? Right. Because, you know, if you get a tingling in your left hand, people think heart attack, right? If you get pain on your left side, you think heart attack. If tightness, pressure, like a crushing sensation in your

chest. We call it chest pain, but most people say it's not really a pain. Okay. It's a crushing pressure in your chest. You get short of breath. You can get diaphoretic, which means cold, clammy, and sweaty. The symptoms often radiate to the left arm associated with numbness, and we're not really sure why that occurs. The problem is in women and in diabetics, they get atypical symptoms. What I just described are the typical symptoms. So I'd expect a man like yourself to have those symptoms. But women and diabetics can get atypical symptoms. They can feel fatigued.

They can feel a little short of breath. They might feel indigestion-like symptoms. People who have sharp chest pain, chest pain that increases when they take a deep breath, chest pain that occurs, you know, when they do a particular motion, go to pick up a box or reach for something. That's almost always not from your heart. That's almost always musculoskeletal. But let's go back to anxiety. When you're anxious, your heart rate goes up. You hyperventilate.

You can get tightness in your chest. It becomes hard to breathe. And you can get numbness in your arm. So it could be exactly the same. The point is, you're not alone out there. You're not alone out there. There's people to help you. Go seek attention.

Take charge of your health. Get the answer you need. So you can rid yourself of some of this anxiety. That doesn't mean the anxiety will go away. You might still have anxiety and panic attack. But at least now you'll have the information to know I'm not having a heart attack. That's right. And that alone takes away some of the anxiety in this group. Give me your information, Dr. Puma.

Tell me where to find you. Well, we have offices all over New York City, into New Jersey, Monroe, even up in Middletown, New York, sorenmedicalny.com. You can find us there. We have our ambulatory surgical center, and our award-winning Soren Heart Scan is based at 120 Wall Street on the corner of South Street, right across from the river near the South Street seaport. And we accept everyone and anyone, regardless of your insurance status or ability to pay. We're here for the communities that we serve. We have about 25 offices across the New York City area. All right. Well, thank you, Dr. Pullman. We appreciate you for joining us. Absolutely. Thank you so much. Thank you all for having me here.

I really appreciate it. It's the breakfast club. Good morning. Wake that ass up in the morning. Had enough of this country ever dreamt about starting your own. I planted the flag. This is mine. I own this. It's surprisingly easy. 55 gallons of water, 500 pounds of concrete. Or maybe not. No country willingly gives up their territory. Oh my God.

What is that? Bullets. Listen to Escape from Zakistan. That's Escape from Z-A-Q-istan on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. After those runs, the conversations keep going. That's what my podcast, Post Run High, is all about. It's a chance to sit down with my guests and dive even deeper into their stories, their journeys, and the thoughts that arise once we've hit the pavement together. Listen to Post Run High on the iHeartRadio app, Apple Podcasts, or wherever you get your best. And you're going to figure out the rhythm of this thing. Alicia Keys, like you've never heard her before.

Listen to On Purpose with Jay Shetty on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. Daphne Caruana Galizia was a Maltese investigative journalist who on October 16th, 2017, was assassinated. Crooks everywhere unearths the plot to murder a one-woman wiki leaks she exposed the culture of crime and corruption that were turning her beloved country into a mafia state listen to crooks everywhere on the iheart radio app apple podcasts or wherever you get your podcasts. Hey, what's up? This is Ramses Ja.

And I go by the name Q. Ward. And we'd like you to join us each week for our show, Civic Cipher. That's right. We discuss social issues, especially those that affect black and brown people, but in a way that informs and empowers all people. We discuss everything from prejudice to politics to police violence, and we try to give you the tools to create positive change in your home, workplace, and social circle. We're going to learn how to become better allies to each other. So join us each Saturday for Civic Cipher on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.