Managing chronic inflammation for better long-term health

Podcast transcript

INTRO
Welcome to Docs in a Pod presented by WellMed. Over the next half hour, Docs in a Pod will educate you about the health and wellness of adults everywhere. Co-hosts Dr. Brooke Mobley and Carmenn Miles will share information to improve your health and well-being. And now here are Carmenn Miles and Dr. Brooke Mobley.

CARMENN MILES
Hello, everyone, and thank you so much for joining us today on the award winning Docs in a Pod presented by WellMed. I'm Carmenn Miles, and I'm excited to jump into another great conversation centered around health and wellness topics that really matter, especially for our seniors. If you're listening for the first time, you can find this podcast on any podcast listening platform, and we're also available on the radio in several Texas markets. Each week we share practical health information that hopefully helps us all live healthier, happier lives. So, thank you for tuning in. We have a great topic for discussion today. Before we get into that, I want to introduce our co-host for today, Dr. Brooke Mobley. Dr. Mobley graduated from Xavier University of Louisiana, where she obtained a master's in business administration from Saint Joseph's Hobbs School of Business and Doctor of Osteopathy from Philadelphia College of Osteopathic Medicine. Dr. Mobley began her nephrology career in Lake City, Florida, where she established a renal disease clinic and served as medical director of a dialysis clinic for DaVita Kidney Care. In 2015, she relocated to Tampa, Florida, where she started her hospitalist career with Optum. Today she's the medical director of Post Acute Care. Hey there, Dr. Mobley, how are you?

DR. BROOKE MOBLEY
Hello! I am so excited about today's episode. I can't wait to hear more about chronic inflammation.

CARMENN MILES
Absolutely. Let's introduce our guest today. Our guest is PA Magdalena Chavez, currently at WellMed at Bedford, located in the Dallas Fort Worth area. She received her master's degree in physician assistant studies from the University of Texas Southwestern, where she received several awards, including the UT Southwestern Dean's Scholarship, Dallas Women's Scholarship, and Schermerhorn Service Award. She's been published in the American Academy of Physician Associates Monthly Journal, as well as the Society of Dermatology PAÕs monthly journal. Last year, she also published her own health and wellness book entitled Throw Away the Scale. You Don't Have to Tell Me Twice. She enjoys establishing long lasting relationships with her patients and believes in helping them work towards their long term goals. PA Chavez is married and has two children. Outside of the office, she enjoys cooking, running, sailing and singing with her church choir. She has two second place and one first place finishes in women's RS Arrow 7 sailing and hopes to add another win to that count later this year. That's pretty impressive. How in the world did you get into sailing? Have you been doing that for quite some time?

MAGDALENA CHAVEZ, PA
It was totally by accident. I love water sports in general, and I was heading out for stand up paddle board and somebody said you should really try sailing. It's a lot of fun. So, I took a class and fell in love. The rest is history.

CARMENN MILES
That sounds like me with volleyball. Well, welcome to the show. ItÕs your first time, right?

MAGDALENA CHAVEZ, PA
Yes. IÕm excited to be here.

CARMENN MILES
All right, well, let's hop into this. Today we're talking about inflammation. I don't know of anyone who has not experienced some type of inflammation, whether it be from a sprained ankle or even a small cut or any type of minor or major injury. We've all experienced inflammation to some degree or another, as it comes in many forms. I will say personally, when I experience inflammation specifically in my knees being the washed up athlete that I am, I begin to think of the worst case scenario. PA Chavez, tell us exactly what is inflammation and what are some of the classic signs of inflammation?

MAGDALENA CHAVEZ, PA
So, this is like med school 101. There are four factors that we associate with inflammation. It's pain, redness, heat and swelling. So, like you mentioned, sprained ankle is a classic example. We injure that ligament and then it gets swollen, it gets red, it gets hot, and it really really hurts.

CARMENN MILES
Very good. At any point, is there a loss of functionality within that joint due to the inflammation? Is that another factor that comes into play?

MAGDALENA CHAVEZ, PA
Sure. When we have swelling in an area, that can affect the function just by itself, but also all those inflammatory factors going in there doing what they do to try to repair that damaged tissue. There are a lot of things that will impair function. We also get inflammation in the lungs when we get an infection, and of course, that makes us cough, that makes us sometimes wheeze. That inflammation is there to try to help those tissues repair, but sometimes it creates as much of a problem as it does in helping us.

CARMENN MILES
Gotcha. Let's take a moment to welcome those who may have just joined us. You're listening to the award winning Docs in a Pod presented by WellMed. Our podcasts are available wherever you listen to your favorite podcast. We're also available on the radio in several Texas markets. I'm Carmenn Miles alongside co-host Dr. Brooke Mobley and our guest today, PA Magdalena Chavez, currently at WellMed at Bedford, located in the Dallas Fort Worth area. Today we're talking about inflammation. What causes inflammation, the pros and cons of inflammation, and how to manage the condition. PA Chavez just shared with us that the presence of inflammation itself. Let's talk about that. The presence of inflammation itself is not always a bad thing, right? It's a good thing. It's kind of part of the healing process, right? Let's get into that a little bit. Because like I said, when I see it, I always think, oh my gosh, worst case scenario. But it doesn't mean that it's a bad situation, unless it's persistent. Tell us about it.

MAGDALENA CHAVEZ, PA
Yeah. You said it exactly right. Inflammation is our body's response to an injury or an infection or an acute problem. We need those inflammatory factors, those processes that happen in our body in order to repair damaged tissue or in order to fight off an infection. So, inflammation itself is not a horrible thing. In fact, it's a very necessary thing. But the problem becomes when that inflammation becomes long lasting or it goes from acute to chronic, and then we have a situation where, say that knee pain that maybe initially was a tiny sprain, a little bit of a strain, some something small that starts to become long term and then that does affect that function on an ongoing basis. Those inflammatory factors in the body switch from instead of being able to repair the tissue, now they're kind of actually damaging the tissue. They're doing the opposite of what they're meant to do.

DR. BROOKE MOBLEY
I think is very important to piggyback that with a lot of times when people think about inflammation, they think about the inflammation that they can see. They think about inflammation in their joints. They think about inflammation from an allergic reaction, something that they can see like hives or something of that nature. But any organ we have can get inflammation. You can get gastritis because of inflammation. You can get diverticulitis because of inflammation. You can get esophagitis because of inflammation. So, if you have inflammation in the esophagus or in the lungs, as PA Chavez said earlier, these sometimes aren't as easily diagnosed because they're not necessarily things where you see the red increase warmth. Those are certain symptoms that you have to be aware of. So, I think one of the take home points to that is that we can internally have inflammation. It's important to know how your body normally functions and to be able to be aware when you notice that there are differences or changes in what seems to be normal for us, because then we may need to go see our primary care physicians so we can start working up some of the inflammatory processes internally that we can't easily see.

CARMENN MILES
Not just so acute inflammation is the body's short term fix to a wound maybe, or a sprained ankle. But chronic inflammation is much different, right? What are some of the conditions that we can link or have linked chronic inflammation to? Obviously, arthritis. We just talked about that on our osteoarthritis session. Are there any other conditions that we can link chronic inflammation to?

MAGDALENA CHAVEZ, PA
Of course. Several of those are those autoimmune conditions that we think about a lot with chronic inflammation. Often those will come from a genetic predisposition and genes that just make the body's immune system overreact and create way too much inflammation. In the case of something like rheumatoid arthritis, the body tends to attack the joints, but it can also attack, like Dr. Mobley was saying, sometimes those internal organs. So, sometimes we see inflammation in the eyes, in the bladder, in the gut. Anything from rheumatoid to lupus can cause those types of long lasting chronic inflammation as well. We also can get some low levels of chronic inflammation just from our lifestyle choices. Lack of sleep ruins our body's ability to balance that inflammatory cycle with our anti-inflammatory cycle. Certain foods are very pro-inflammatory. It's not the same thing as having a food allergy, which, that's another in telemetry process. But almost all of us are going to release some inflammatory cells in reaction to things like trans-fat or sugar, especially when we ingest high amounts of those. So, that's why we tend to not feel good after we have a lot of those types of foods. Lack of exercise. Just being sedentary also creates inflammation. So, there's a lot of things that we do in our day to day lives that that will alter that balance and make inflammation worse. Then there's those genetic factors that sometimes we don't have any control of. Any kind of chronic infection is another one. Acute infection, we get a cold, we get something, we get inflammation in, say, the throat, the nose, the lungs. Our body gets all those unpleasant symptoms. We sneeze, we cough, we feel congested for a little bit, but then our immune system kicks in, does what it needs to do and we feel better. Sometimes when that infection is a really, really bad one or one we can't figure out or one that the immune system is not great at fighting off quickly, that can lead to really long lasting symptoms and that creates a problem as well. So, several things that can tip that scale from acute inflammation into chronic.

CARMENN MILES
Thank you for reiterating those conditions that have been linked to chronic inflammation. Do you want to expand on that before we go to our break, Dr. Mobley? Anything to add there?

DR. BROOKE MOBLEY
No. I think that there are certain things that predispose us to some of those chronic inflammatory conditions. Fortunately, or unfortunately, inflammation is linked to estrogen. So, a lot of the anti-inflammatory conditions, autoimmune conditions, are more likely in women than they are in men because we have a higher level of estrogen. Then some of those autoimmune diseases such as lupus are more associated with patient populations who have melanin. So, there are risk factors people should look to if they had symptoms that they should have evaluated.

CARMENN MILES
Very good information. It's time for us to take just a quick break. Please stay with us as we continue this discussion on inflammation, the good and the bad. You're listening to Docs in a Pod presented by WellMed. We'll be right back.

AD
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CARMENN MILES
We're back on Docs in a Pod. I'm your host, Carmenn Miles, alongside Dr. Brooke Mobley and our guest today, PA Magdalena Chavez. Just before the break, PA Chavez explained the difference between acute inflammation, which I would describe as more of a controlled campfire, whereas chronic inflammation is more like a smoldering fire that never really completely goes out. So, now that we understand the differences, what causes chronic inflammation? What are some of the factors that can contribute to chronic inflammation?

MAGDALENA CHAVEZ, PA
We talked about some underlying genetic causes. So, things like autoimmune conditions. Dr. Mobley also pointed out things like estrogen, some other factors that we can't necessarily change. But there are a lot of factors that we have some control over. Those being things like our sleep and our diet and our exercise routine. I mentioned a bit ago, certain foods, especially foods high and trans-fat, foods high in sugar, those tend to cause the body to release a lot of inflammatory cells. On the other hand, there are some healthy foods that reduce how much of those we release. So, the healthy fats, think like fatty fish., nuts and seeds. Those omega three fatty acids help us produce less of those inflammatory markers. Lots of vegetables and fruits as well. You hear the term antioxidants. I don't know if a lot of people know what that really means, but antioxidants also reduce inflammatory signaling in the body. So, those berries, those citrus fruit, those kinds of things are wonderful in an anti-inflammatory based diet. Alcohol is another one that creates a lot of inflammation in the body. Smoking is a huge factor we haven't mentioned yet that damages those blood vessels and damages the lungs and creates a lot of inflammatory cells to be released in the body. The same advice that we give people for a lot of things. More fruits, more vegetables, avoid smoking, getting plenty of sleep. There's a reason that we feel better when we do those things because we're not in that chronic inflammatory cascade. Like you mentioned, that's that forest fire that you really have a hard time getting control over. Making a few changes like reducing how much sugar you're taking in, that can really get you started and feeling better to where you can start to get control over that inflammatory cascade.

DR. BROOKE MOBLEY
I think that was all really, really great. I have a question, though, for some of our patient populations, what are some things that they can do to help decrease inflammation, especially if they are predisposed to it?

MAGDALENA CHAVEZ, PA
Even with those genetic risk factors, a healthy diet can help you decrease inflammation significantly. Again, avoiding those high inflammatory foods, those trans fats, those high sugary foods, sugary beverages, avoiding smoking, avoiding alcohol, those will go a long way toward reducing inflammatory risk or even inflammatory processes in patients, especially with high risk. Getting a good amount of sleep also makes a big difference. While we sleep, our body tends to reset the scales really well. So, a lot of our anti-inflammatory chemicals that our own body produces are released and that helps balance that system out. So, getting enough sleep, getting those healthy anti-inflammatory foods in the diet. Exercise is another huge one. When we exercise, we release a little bit of pro-inflammatory chemical chemicals at first, but in the long run, we produce much lower amounts of those inflammatory chemicals and we produce lower amounts of cortisol in the long run, which is part of that inflammatory anti-inflammatory balance. So, that whole system tends to work better when we're exercising. Now, one time is not going to do it, it's got to be consistent. So, if you want to take up walking, we've got to be doing it every day for a while, but that will kick in and make a really big difference.

DR. BROOKE MOBLEY
I think it's important to encourage consistency with everything. Just eating blueberries one time is not going to give you the antioxidant effects that we're speaking of. Any of these things that PA Chavez has discussed today, it has to be consistent and on a more regular basis for you truly to get the benefits and the treatment kind of modality out of the different things that she has suggested for you. I also want to say that a lot of other chronic conditions like stress tend to be a very high factor for not only causing inflammation but causing chronic inflammation. So, decreasing our levels of stress is going to help with conditions associated with inflammation. So, there are other things like yoga and meditation, things of that nature that just has a more holistic approach to trying to decrease stress, which would help decrease inflammation or treat any chronic inflammatory conditions, or at least decrease the inflammatory process associated with these conditions. You still may need your medication. I am someone who has rheumatoid arthritis, so I do take medication for it. But decreasing my levels of stress and doing things that make me happy and doing things that take off not only stress from a mental standpoint but taking stress off my joints like weight bearing exercises and things of that nature. Yoga. Those all help to contribute the success of the medications required for chronic inflammatory conditions.

MAGDALENA CHAVEZ, PA
100%. I think exercise as a form of stress relief is wonderful because then you're kind of hitting things from multiple directions. You're getting that anti-inflammatory effect of the movement itself. You're strengthening the muscles, and they get better at responding to inflammation. You're also getting that mental break and that deep breathing too, which, deep breathing is another great way to reduce our inflammatory signal.

CARMENN MILES
This is all great information and itÕs making me think of other things to ask. Ongoing inflammation, I imagine, again, can affect memory, it can affect your mood and cognition. But I'm wondering, are there any studies out there that link inflammation to depression or anxiety or neurodegenerative diseases, which you've kind of mentioned, but do you have any insight on that at all? Are there any studies that that link the two?

MAGDALENA CHAVEZ, PA
Yeah, we we're starting to see more and more data in this field and particularly with relation to cognition, but thankfully with a focus on mood as well. So, depression and anxiety are heavily linked to inflammation. As far as cognition, we've seen a lot of data come out in the last decade that shows that inflammation in the brain of any type or inflammation in the blood vessels, which affects the brain, tends to lead to higher risk of dementia over time. So, those same lifestyle factors that we've been talking about, stress relief, exercise, sleep, healthy diet, all of those factors, it's no surprise, are also now being found to reduce the risk of dementia as we age. They've also seen a lot of studies recently where particularly exercise was, as effective as SSRIs for reducing depression symptoms. Now, I really want to be clear when we say that, please don't stop your serotonin medications if you're on them. But if you feel like you're already on one and you're just still not 100%, it's not working all that well, maybe before adding on a second medication or upping your dose, maybe try adding 30 minutes of walking to your day. You're going to get as much of a serotonin boost from that as you would from adding on another pill.

CARMENN MILES
Do you want to talk a little bit about lifestyle factors? We've talked about the different things that we can eat like beans and whole grains and nuts, vegetables and that type of thing. What about from a gastrointestinal perspective? Any connection there? Does it affect any type of inflammatory bowel disease. I imagine there is a connection there, right?

MAGDALENA CHAVEZ, PA
Yeah. As the name implies, inflammatory bowel disease means that the colon is getting inflamed very, very often. So, things like ulcerative colitis or Crohn's, different areas of that digestive tract are literally swelling. Like Dr. Mobley mentioned, you can't really see all that swelling, but when we look at imaging studies, we see it with the CT scan. Certain triggers are going to be across the board. So, those high sugary foods. Smoking is a huge component or huge risk factor for worsening symptoms with inflammatory bowel disease. There are also some food triggers that are going to be more individual. Some people have a sensitivity to what we call nightshade chemicals. So, those are things like tomatoes, potatoes, eggplant, some things in that category are going to give certain people with that predisposition those symptoms. Only like 10% of the population has that predisposition. So, if that's not you, you can eat those things just fine, but you may have sensitivity to other things. So, pay attention to your own body's triggers too.

CARMENN MILES
That's important. Pay attention to your own body. Ladies, we're just about out of time. I want to thank you both for your great medical insight today and for our listeners. Thank you for joining us. The good news is that many of the factors influencing inflammation are within our control. Small, consistent choices, as Dr. Mobley said, can have powerful effects. Eating nutrient rich foods, move routinely, get quality rest, try to alleviate that stress and avoid alcohol and tobacco products best you can. Don't be a stranger. Subscribe to this podcast so you never miss an episode. If today's show helped you, sharing is caring. Tell your friends and family where to find us on any podcast platform, and you can also catch us on the radio in several Texas markets. Until next time, stay well.

OUTRO
Executive producer for Docs in a Pod is Dan Calderon. The producer is Cherese Pendleton. Thank you for listening to Docs in a Pod presented by WellMed. Be sure and listen next week to Docs in a Pod presented by WellMed.

DISCLAIMER
This transcript is generated using a podcast editing tool; there may be small differences between this transcript and the recorded audio content.

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