Dr. Arnold and Pharmacist Mike on losing weight with the professionals and feel free to ask Everything

a entrepreneurial book club where Stephanie never read the right book and Stephanie was terrible at this book club I really suck at book club I did Fabulous I'm what I just had a visual I just had a visual proud of it happy Thursday everyone how are you today uh we have got the professionals lined up here on a panel for you today so be prepared to chat about weight loss doctors all the things that make you squirm in your seat and your uncomfortable situations this is a comfy Zone we're in a safe space everyone I'm just going to make sure that I tag you guys uh so in the studio with us today we've got doc Arnold who is back again looking like a less doc Arnold you're slimmer get nice and close to your microphone you guys and H we've got pharmacist Mike on the show with us today morning everyone so I am very excited since I'm part of the Veritas family I get all the emails I keep up to date with everything that is new and happening and I feel like you guys are always adding some new stuff to what's going on in your practice so maybe we'll just start out with the practice what is Veritas what exactly it is that you do so uh Veritas Direct Care were a primary care practice located in hyas we right across the street from Cape cot hospital and we follow the direct Primary Care model uh which means we don't work for insurance companies we work directly for our patients uh we don't work for Medicare we don't work for Blue Cross we work directly for our patients um we have uh two Primary Care MDS Dr Manning is an orthopedic surgeon who who does consultations in our office we have three wonderful physician assistants to wonderful nurse practitioners an army of nurses and uh the illustrious Mike saoli our clinical pharmacist uh it is a rare thing in a in a regular primary care practice to have a pharmacist embedded in the practice really amazing but Mike uh helps to take care of our patients who are on complex medications uh he helps to manage our diabetic patients uh if they're on expensive medications he helps them save money and what we're talking about today is he helped to start our weight loss clinic uh we um we know that weight is obviously a problem it's a problem all over the world but particularly in the United States this is something I have fought myself my entire life I have no idea what you're talking about it is constant it isn't such a it's not just a female issue to look and feel your best it's everyone's issue all the time it's always been a struggle I think for most people uh unless you're just naturally a slender person or even then people have tough time gaining weight I know a couple of my girlfriends which I hate are like can't get outs and I get it everybody has their body we're stuck with what it is that we're given whether it works for us or not that is true but it is and it's not about the number it's about being healthy and feeling well and it's something that I have I've been struggling with my entire life and I will tell you as a doctor uh I I went to Medical School in the early 2000s sorry uh and they were coming off the fenfen problem in this country in the 90s where uh there was a weight loss medication that actually caused people a lot of problems and so when I was in medical school uh there were nothing but ads from lawyers on TV saying you know did your doctor prescribe you this medication so it was instilled into me don't prescribe medication don't prescribe medication for weight loss um however we have new medications that have been out for quite a uh that are safe and can actually help people with weight loss and I think we need to uh get rid of the stigma about trying to actively help people um and we do have these tools these pharmaceutical tools in addition to Lifestyle management we all need to be healthier we need to be more active we need to eat better uh Dr Kelly on her exam room on her dry Ras board because I used it yesterday and I saw it all day she said movement is medicine yeah oh I love that we need to move we need to be healthy but we do have tools now and pharmaceutical tools that are safe and can help people when appro when used appropriately and that's where Mike comes in okay a good morning by the way to Nathan Wendy Kayla chrisy thank you for joining us on the show today we got doc Arnold here and we've got our pharmacist Mike hi good morning get close to your microphone we're not we don't bite I promise I know we've removed you from your clinical situation so you're the one who started this weight loss clinic so to speak at Veritas you could say that yeah all right so why why well the meds are expensive yeah uh and there's a large shortage of them and well there's a shortage commercially okay compounded preparations seem to be very easy to come by so maybe talk about that and maybe just explain to people what the medication is what it that you're doing and kind of give them a little background sure so these medications uh commercially let's say it's wovi uh Zep bound those are the two weight loss the big ones so they're glp1 agonists um zound has another incron hormone with it it's a glp1 Agonist and a GP what these meds essentially do is cause a caloric deficit by making you feel full longer okay and keeping food in your system in your stomach longer slows your gastric emptying rate okay so you're just not hungry that's the that's the basics of them okay because I was always just very curious and especially if you walk watch anything on Tik Tok Instagram the The Surge and the usage of this without any medical supervision is monstrous I think this is the first time I've ever seen anybody just actively go out there and get prescriptions from Canada random doctors online uh Mexico like wherever you are I've never seen any drug where people have reacted like this and that's why people are getting it at their gyms at their air salons it's that's that's why we want to bring it into our Clinic it's so we can help monitor people guide them um they are generally safe but they're not for everybody okay and we do need to Monitor and we in our practice were're able to monitor people's blood work appropriately uh they can follow with their veritos provider very closely they can we we evaluate their family history my suspicion is nobody at a gym is asking any B about their family history yeah Kristen Mike does look a little scared he'll get used to it he'll settle down it is bright lights and Randomness down here so it's fine thanks he's settling in just fine so be all right you're the one that that is mon so talk about the compound versus the regular just stick in the leg shot that you get from when you're paying $1,000 $2,000 with the insurance company or whatever it is and there was a big conversation about taking that medication away from diabetics like let's talk about that conversation as far as like why it was so readily grabbed by everyone and why people are going to Alternative markets spending stupid amounts of money instead of just going to their doctor why is this well is an embarrassment no I think it's a $300 you know uh cost versus if your insurance doesn't cover it $300 a month I mean there's a big difference there um it's also seems to be a pretty easy I get ads on Facebook all the time to go purchase I don't know Henry meds is one of them there's a few different ones that kind of scares me that this many people are willing to just go and just okay well this worked for so and so so I'll just do it it's a lot of people I agree with you it's what one of the reasons we decided to bring it into our office yeah you're like I'm not fighting it right people were doing it people are doing it anyway um I agree with you it's important that diabetics uh who need this medication get access to it all too often it's not the supply of medication that's the problem it's the insurance companies limiting what their patients can have access to and this has been your mission with Veritas all along so it's going along with the things that you're already doing so it makes sense so we work directly for our patients and not we try to avoid having Gatekeepers of insurance companies and Pharmacy corporate pharmacies and and uh Pharmacy Benefit Management systems that are limiting their patients limiting patients access to the drugs that they need uh we can there we have diabetic patients that are able to get the medicine through our Clinic yeah and and pay us directly for it and it ends up being a whole lot less than what they have to pay at the pharmacy okay yeah I've been a patient at Veritas since January and I can just I love how it works you can just go in and get your blood monitored I can call Andrea and be like how does that look where am I at here and just like really have numbers right away without having to have so many different appointments so many different paperwork so many different Labs it's just nice to be able to oh just go down the hall and get that or go over here and you have that continuity with Andrea you're on a first name basis she knows you she knows about your history she knows she can follow your blood work but also have the backup of our whole practice especially Mike yeah if uh medications are appropriate and then got me into the dermatologist before I could get myself in so thank you for that I appreciate that uh rtb I have to do the same with the jarian and have them not put it through insurance it's like it's a fight all the time with your insurance company it is a fight that's why we're doing what we're doing and we just by working directly with and for our patients it is a better system Mike you and I talked previously about um your seeking out this medication when you were first starting this clinic and you and Doc Arnold actually went to the facilities so no invited oh you were invited okay it's on my list of things to do okay we we use a supplier in um Orlando Florida and I'm down there a lot and it's on my well I just think it's important that you know you have a relationship with these people directly it's not like you're just like oh yeah truck it in we got nine million customers now because everybody wants to lose weight Bring It On in they're in the United States yeah which is nice my uh the other day we had ordered a shipment and uh it was lost with UPS I called our rep and within three minutes it was fixed oh I was wondering I was like were people stealing it no that hard up for for our weight loss drops now no no not good morning Natalie Don Laura Mary everybody wants to know about this drug um and since you're you're feeling comfortable enough to take it for yourself I think that that's really important to say so I yes I'm taking it um I started to see we've been using glp1 Agonist with diabetics for years they've been around for 20 years and we've seen safe results with our diabetics and of course say everybody knows I'm sorry 19 19 years thank you Mike the pharmacist knows pharmacist yeah so um and and we've seen good results with our diabetics they are safe they're become starting to become firstline medications for our diabetic patients uh they do help to manage their sugar levels that are when sugar gets released from the liver and generally people with diabetes can lose a little bit of weight as everybody knows watching the news and and we saw over the last couple of years we've seen that non-diabetic patients can lose weight with it I started seeing my patients ask about it I started seeing my patients actually using it and what I was hearing from them was that they were tolerating it and the biggest thing is that they weren't thinking about food all day and uh that has been my issue my entire life you know I spend 10 hours a day telling people to eat better and exercise more and I'm just as human as all of my patients and I like to talk about um Dr Kelly has a very kind patient if misguided but kind who uh brings us every two to three weeks BJ siiz bags of peanut butter cups which Dr Kelly puts in the freezer in the back I'm giving away veritos Direct Care secr and you know how it is at three o'clock when your willpower is at the at your lowest there's a line of our staff members at the freezer going to get peanut butter yeah you're tired you're running on fumes right speak for yourself not that I would ever do anything like that but you're like it's peanut butter it's chocolate it's you know protein we can get away with this so after after talking with my primary care provider who that had Fair of course and uh talking with Mike and looking at my blood work and reviewing my family history with Mike and um I worked with my team and determined that I think I would be a good candidate for this medication uh and since I've started it I have not had one peanut Buttercup it just doesn't I just don't even think about it really it's actually amazing um and uh the constant thinking about food just isn't happening and since I started it nine weeks ago I'm down 20 pounds that's impressive well it's I'm also you're also a guy well yeah I'm also I'm also working it's important to to that everybody also works on their lifestyle so I am working on what I'm eating I'm trying to eat more vegetables leaner protein less peanut butter cups um and I'm going to the gym you'll see me you'll see me at Fitness 500 at least six days a week I'm really trying to practice what I'm what I preach and uh and it's working and I feel good I'm not having bad side effects but I think that's a good segue for Mike to talk about some of the potential side effects yeah because you're seeing hundreds of people pretty much daily with every kind of body type every kind of issue every kind of thing that's going on in their life and then trying to medicate around that what are you seeing is constant um in your area of of medication that you're seeing either people complain about or worries worries uh first consult visit most people come in worrying about what they read on the internet oh it's nausea it's I'm gonna nauseous to the point of vomiting and then you know some GI symptoms those are the two biggest concerns okay um in general I would say the nausea is more of a what's explained be more of a the food noise is gone the food chatter is gone you just don't think about food maybe you wake up uh you know the day after an injection and you have a bit of an uneasy stomach or just not interested just feeling full almost like after Thanksgiving you know that I don't want to look I'm good I don't want to look at Food uh but other than that there's really no major side effects if you will right I noticed increased thirst so I drinking more water which is okay that's not really a problem also tell people 10 hours a day to drink more water and it's nothing for me to go the entire day without drinking water my nurses are always yelling at me about it but I um you have constant babysitters that's kind of nice so but now I do drink water through the day and that's actually a good thing but that's really the only major side effect I have personally noticed but it is important people can have side effects it just with any medication people can have side effects that's why it's important to be monitored closely and that's what we can do in our system yeah we're checking in with our patients we're checking their blood workor every four weeks uh the liver function and kidney function to make sure their metabolic system is tolerating the medication they don't damage your kidneys they don't damage your liver well I'm sure a lot of people are worried about that I mean any putting any medication in your body you have those concerns which is wild to me why people are going to their hairdresser to get medication and yet you're worried about how your body is functioning something is broken there I'm just curious what it is like where is the disconnect in our situation uh shelle says way to go doc Arnold uh Rick says I have glp1 and down 140 pounds it's really working for me he said constipation though Rich Amina Ricky thank you for joining us and Don says amazing practice I agree it is an amazing we have a great we have a great team yeah you do I would also like to say we're we're not just focusing on medications with our with our weight loss program lifestyle management is super important uh with a wonderful nurse in our practice Bethany EML who's worked with me for as she said on Instagram two days ago 11 years she no I'm very proud of her uh she has become a nurse coach uh she's gone through the training to become a nurse coach and this is something that I I haven't seen in any Cape Cod Primary Care practic but a nurse coach will help coach patients with lifestyle management I have to say that that really was kind of the Kickstart for me in in doing better for myself it wasn't like she told me anything profound it was that I had somebody there to just be like okay yep do this do this do this um I had doc Arnold on I want to say November my husband immediately became a patient because this is the thing that he was looking for with his very nervous self uh and then he started you know prodding me got to go you got to go you got to go you got to go and it was an email that I had gotten from Bethany that was talking about her nutrition clinic and I was like okay I need to be reminded of how I need to eat better for myself because I spend long hours sitting down in a studio I forget time I'm down here editing you know and and then I wait till the very end of the day and then I'm just eating everything in sight because I deprived my body all damn day long and now it's a disaster then we start the cycle over again so it was an email from Bethany where I sat there and she did uh like a FaceTime Zoom type of meeting with a bunch of other people and we just went over the basics of nutrition and I thought it was just a really good reminder and I was so thankful that that was part of the practice it wasn't like the upcharge of like waiting for my insurance to now charge me because I wanted to go and learn something better to take care of myself I thought that was nice and and just like any other coach in sports or anything a coach is going to help keep you accountable and guide you on yes and so she is uh going to be doing individual nurse coaching as well as group nurse coaching going forward so please if you're interested in getting that more personalized focus on lifestyle management check us out vasir care.com and look for information about Nurse coaching with Bethany Mike talk about the um the the medication itself and and people's are they afraid I mean it's needles I would say there's a good portion of people that walk in and they're like oh I have to inject myself yeah uh but I would say you have 100% of patient so far walk out they're like that's it that's a size the needle oh I didn't even feel it yeah so it's really not as scary as you think it is yeah and for my first dose Mike walked me through it he was my injection coach and and uh and no you you don't feel it the needles are very very tiny um if people have a needle phobia they could certainly come in and have any of our our nurses or Mike help them with the injection but that's really nice like that's the service that you have whatever your level of comfort is and I can't stress to you enough that you need to be monitored with this drug and if you're currently getting it from your hairdresser you and I were talking about that and I do have a couple of girlfriends that go that route and it's far cheaper for them but then the minute that you were like this has a shelf life oh uh the compounds themselves yeah yeah yeah the physical medication is the vial is 28 days once you puncture it that's any compounded that's a pharmaceutical across the board doesn't matter what the drug is so they've been using the same vial now for a year so not only is that scary but also it's now it it we're injecting it could be possibly poison toxic bacteria I mean I wouldn't I don't know if I'd go that far but uh every time you puncture it you're putting a needle in and potentially drawing bacteria from the air putting it in the vial and then you're putting it in yourself right to me that sounds like a great way for a staff infection or cellulitis or something I why I I do think it is it's important to have whether or not you're a patient at our clinic or any Clinic have your medical team monitor you yeah have them guide you make sure that what you're doing is safe what's the difference between all of them because I feel like there's one going from this one to this one to this one Whatever they can get their hands on that's a question yeah I'm just curious the way it's injected okay essentially I mean the drugs themselves so monjaro and Zep bound are tepati wovi OIC is seatide the structurers are a little bit different you know the physical medication itself okay really they do the exact same thing okay but one of them is an auto injector one of them is a an auto injector that you actually have to it's not an auto injector but you have to push it you know against your against your skin the other one you push a button the other one is a OIC is a pen you screw a pen tip on so they're just changing the name of it but really it's the same drug not the exact same drug but yes uh sister drugs if you will very very very similar and yeah it's just how how they work it's the supposedly most of the cost is because of the plastic in the pen the mechanism of the pen how to inject it so when we get the compound I'm drawing up the doses into an oldfashioned syringe and needle and again not not needle but quarter of an inch needle okay so very very small but right there most of the cost is mitigated because we're not using fancy injection mechanisms I love that you guys are really monitoring everything I think it's really important some you know we're we're watching so many videos and ticktockers and people that are using it and having great success with it but you're also seeing the nastiness come out and when people see that you're losing weight using a drug then they like personally attack you and I feel like it's really important that you've got the guidance you've got the support you've got people in your life that are checking in on you how's your mental health how are you feeling today what's going on because there is that component to not only weight loss but also this drug and and I realize there's stigma about it and I think we need to reduce that that's why I'm very open with people about that that I'm taking it and what would be the difference if somebody lost weight with Weight Watchers that's a tool is it not a there is no difference but it seems to me that this is like the angry where you've seen girls like all you're doing is giving yourself anorexia for a little while until you stop taking the drug how would you answer that so that is that we I get that question a lot okay do I have to stay on this medication forever um I have seen numerous patients uh who have lost weight on the medication are able to stop it and what they've done is they've learned the lifestyle techniques they've learned a lot about themselves and they're able to keep the weight off um we I'm still on it I'm gonna have to wait and see how I do on it I'm still progressing I'm on the third level of dosing now um with Mike's guidance I will also say about medications every day as a doctor I prescribe blood pressure medication help people lower their blood pressure right I prescribe cholesterol medication to help lower their cholesterol I don't hear much stigma angry stigma about that oh you're on a cholesterol medication your cholesterol no it's the Obesity is a problem and we can make we can help people improve it we can um there's lots of different ways yes people can use lifestyle medication lifestyle management to help lower their blood pressure lower their cholesterol that's excellent well we should use all the tools available to us and really it's our job to treat the patient in front of us and whatever is appropriate for them and not worry about public stigma about what people on Facebook that's always gonna H it's always going to happen anyway it's just a society in which we live in and it's a video primarily Society now where people are constant judging it's it's always going to happen anyway but I do like that you have this support team behind you when you're getting your medication from a doctor from a doctor and a pharmacist I think we have a good team and uh and you know if you're curious about it if you're a Veritas patient talk to your veritos provider and say hey can I maybe set up a meeting with Mike Mike has not slapped a patient in weeks so proud of you Mike yeah it's been a good n week n weeks slapped anybody and so uh he Mike is excellent at uh at talking to patients talking about their weight loss journey through their lives um in a non-judgmental way and he can talk to about options and uh a whole lot of times they the patient doesn't walk out with a new prescription for an yes that's important to talk about let's make a point here just because I am a pharmacist does not mean I push drugs now Bethany and nurse coaching she has a lot more experience than I do with you know nutrition in a holistic aspect but I do have a little bit of you know experience there so I'm not just going to say oh here have a drug so uh there are it's it's all encompassing you have to do in my opinion you you do everything you get the best result non-pharmacologic and pharmacologic and we are also uh open to seeing patients that are not currently members at our practice if uh if you are tied in and very close to your primary care provider who is and and that's great that's a great relationship to have talk to your primary care provider about it if you think you'd be a good candidate but the insurance and Pharmacy system is not allowing you to have this medication uh then talk to your primary care provider and get a referral over to us and we can have you sit down with that's a great conversation yeah we can have you sit down with Mike and and uh see whether or not you are a good candidate and if we can help you we want to help so again it's Veritas dare.com talk to your primary care provider give come come on in and make an appointment with Mike yeah if you're wondering where they are they're across from Cape Cod hospital Veritas care.com Nate says I want to go back to working out uh but if I go to GNC what ingredients or products should I be looking to avoid we don't have enough time to talk about was like how many things should you not be having that's a lot that's a loaded question I so one of the things you have as just right off the top it's a great question something that I see uh that is ubiquitous in gyms and people need to be cautious about are a lot of the protein powders there are some safe protein powders and there are some less than safe protein powders you got to be careful if you have high blood pressure if you have any sort of kidney disease liver disease you got to be careful about what you put in your body which is why you need to talk to your primary care provider about it um and then of course you got to watch out for any hormonal issues and there's lots of uh steroids flowing around and you know you flip through on Instagram and Facebook and all ads for the testosterone or hormones and all that you gotta be very very careful about that stuff most of it is unregulated and you need to uh get guidance from your doctor well yeah the next and best and healthiest is not necessarily that and who is actually verified these things which is a little frightening we have uh in our practice one of the really great things about our practice is we have we have wonderful people who work there and everybody has their own little uh niches and interests our lab manager Sue who is a a a medical assistant she's wonderful an amazing photographer and an amazing photographer Suzanne Marie Creations um she uh has developed a relationship with a supplement uh distributor who uh they focus on healthy supplements uh non-gmos less fillers less crud um and so she talks to our patients about different options for their supplements uh because we realize patients are taking supplements they are right and they might as well take healthy and good quality supplements it's things that they don't teach us in medical school yeah and so uh she helps to guide people and if we can save them a little bit bit of money on healthier supplements then we're happy to do it it's important to know what you're putting in there for ingredients especially when she's running their blood she knows what you need and we are we are we're trying to decide and we maybe we can have all of your H Facebook fans uh and YouTube fans vote we're trying to decide whether or not to call it our supplement guidance program or Sue supplement Shack oh I I kind of like Sue Shack isn't it slick Sue slick Sue supplement supplement Shack that's awesome what's up Rob Michelle says I can say firsthand that the staff at Veritas is top knot and you can tell everyone there loves their job I think that that's really important to talk about company culture as we always do here on the show uh when you walk into a place you know normally I am filled with anxiety when I walk into a doctor's office people are sick people are unhappy not ever there your front desk is immediately greeted they're so happy so energetic whoever is working back there even the even the people that are waiting in line that sometimes you wait a little longer you actually spend time with your patients so sometimes you have to wait a couple of minutes us two running behind it never I'm always on time Vicky says Mike is awesome and Nate says I had to get off the Pre-Workout creatine at one point I was working out was making me crazy yeah headaches no good right right and just make sure whatever you're doing just lots and lots of water yeah but your staff is really wonderful and I think that it's important to to go to a place where joyful to go to the doctor if that's that's weird to say but it's real I think I we are our system um because and it's because we were working directly for our patients happy patients mean happy healthcare workers and uh and vice versa so uh we're trying to bring a little joy to health care which is a rare thing to find these days yeah it it is bizarre but also a welcome change in my life so thank you very much for that also working for your patients with the nonprofit which I think is really incredible uh and all of your free time over there so our model it's a membership model our patients pay us directly um I went to medical school in New Orleans and did a whole lot of my training at Charity Hospital in New Orleans I did my residency training at uh Boston Medical Center Boston City Hospital I realize uh that there are patients that can't afford our model um we're not trying to steal money from people we're trying to do a good job trying to do a better job and keep our lights on pay our providers well um and uh but I also understand that people there are people out there that truly can't afford it so about three months ago we started a nonprofit uh called patient supporting patients we have a board and uh we are accepting donations um that will go directly towards patient scholarships for Primary Care purposes so um patients can go online and if they have Financial need actually apply uh for uh for a scholarship and then our board meets once a month and if we have enough money in the bank account then we're just going to award those scholarships last month we awarded seven scholarships that's amazing and uh I'm I'm very happy with it and we want to uh first thank our very generous donors uh but also we're just happy to take care of patients and the very first scholarship we awarded was a the nicest lady on the planet we've all known for a long time she worked at Cape Cod Healthcare in the Food Services industry for 45 years and it's just the nicest person everybody who works at capot hospital knew this person but she couldn't afford our membership wanted to stay on she filled out the application we had the money we scholarship for the year and and it was and she was she was thankful we're able to let our donors know that they were helping real people uh and it's just it's a it's a great thing so I'm hoping to that that can can grow and develop uh it's uh cap cpatient support.org patient supporting patients uh I think this is really the first time we started advertising W that's awesome so uh and we're hoping to put together some sort of a fundraiser in the late summer so stay tuned for that it means a lot to me we've got our dance marathon coming up this weekend over at keep Cod uh um why am I drawing a blank Osterville it is Cape cot Academy and and it is our 14th year doing it and Jen Reiko started the women's early detection fund and it's similar only it's for women that need uh mamogram before it's time or covered medically necessary or if you want to do some DNA testing that's not covered by your insurance so it's it it is important to me that you know I'm excited that you're doing this for your patients we have very generous people on Cape Cod who just who are excited about helping their neighbors yeah it's really nice good morning Chris hey Mari what's going on and Hey Thomas good to see your face today we're talking with Doc Arnold and also pharmacist Mike from Veritas direct care and we're talking about weight loss today a lot of people have been curious about semag tide did I say it right everybody says semi glue tide and I'm like I think that's wrong I said that once and Mike that was one of the times that was the last time I SLA he SLA nine weeks ago yeah but a lot of people are curious about this magic weight loss drug is it really a magic weight loss drug is it really helping people we see people dropping weight um yeah when you don't see people for months and months talk about the time frame because I feel like people feel like they're going to get one injection and magically they're going to lose 80 pounds today no yeah no okay um it depends it's so patient specific uh talk Arnold you lost what you said 20 pounds 20 pounds nine weeks so far the first dose so so the dose is titrated up uh which is important to note so we start at the lowest dose for the first four weeks um and the average person I think it loses two to four pounds that first four weeks give or take I usually tell people three to four in the first month and then your second month plus you know 6 to8 pounds 1 to two pounds a week is normal is healthy and uh it's and that's what why we also want to monitor them we actually don't want people to lose too much weight too fast okay it wants to be we want to be healthy about it people still need to eat they need to hydrate uh it's why we we at our practice are going to be monitoring their Labs every four weeks um as opposed to people who get it online or or who knows where um and so it's not a magic drug it has effects it it helps to regulate uh blood sugar and as Mike said uh slows down the GI system so people feel more full longer and just aren't and it turns it turns down the chemicals in the brain that make us think about food all day long well that's yeah that that's really a problem especially for Foodies it is I it's actually somewhat relaxing uh believe it or not you know and I think there are people out there who know what I'm talking about it's uh where you're just always always always think food obsess yeah Mari says I need this one Mark cut out sugar I always have a Pepsi or a Coke 2 L in my hand stopped switched to water 40 pounds disappeared isn't that amazing yeah yeah right exact small changes in your lifestyle I'm on it for type two I've lost 47 pounds in a year and a half good for you Don uh rtb you got the link thank you whoever is at your staff right now drop in that patient support link right there Thomas says he's down six pounds in a couple of months uh Mary Jane hello good morning thanks for joining us hey Trevor and Brooke uh yeah so it's not the magic drug that everybody thinks it is but it does cut off that food Obsession you said for yourself like this is what you've noticed personally yeah oh absolutely I have um I have great sympathy uh for uh or great empathy for alcoholics right who tell me you know they they wake up and start thinking about when their next drink is well I was like that for food and this medication is definitely helping to curb that it it definitely is I will say that um there is another version people often ask me as a doctor they said what about the pill version there is a pill version of seatide called rebellis which is only labeled for diabetes correct Mike that is correct correct yes um and so diabetics can use that medication I find that the injection once I got over my needle phobia and realized that you don't even feel it uh I like the one a week injection it's I just do it I don't have to think about it for the rest of the week yeah Mike and I gather for weight loss Wednesday oh Wednesday weight lost Wednesday what does that consist of oh that's your day yeah it's his day sh day yeah shot and it and then I don't have to think about it for the for the rest of the week um there are certain things uh I recently a little bit of plug March was colon cancer awareness month and I got my colon oscopy done oh fun if you're on one of these uh glp1 agonists you need to hold it for at least a week prior to a colonoscopy there are various surgeries we're hearing from orthopedic surgeons that they want their patients to hold it for a week prior mostly that is because uh the anesthesiologists don't want any leftover food in the St gotcha so just it's once again it's important to be monitored and to be open with your primary care team about it uh about all the medications you're on and your family history and how you're feeling and let's be open and honest Sue says she hasn't had a pastry in a year well good for you sue all right Sue I know brag brag brag why do you think personally as a doctor why patients lie to you the most uh is it judgment no no no I probably uh wow a tough one I know like you say it out loud then it's like what is it I think there's some of that honestly I think um concern over shame is a big deal there's a reason why uh you know we don't stress about having to weigh everybody all the time because people get so worried about all of that I get on backwards I just I don't even look at it I don't care I've removed myself from the care of that weight because I was in the military and I never made weight even when I was a size two I never made weight because I was always and I always had this like I shut it off when I was like 22 I'm like I don't give a crap what I weigh it is what it is and I'm not going to worry about it because I know I'm physically fit I fit in my uniform I'm not worried about it what branch of the service were you Army oh yeah we've got Ruck for hit coming up by the way this weekend tonight I get in a van and I don't leave it until Saturday morning I have to drive it and make sure everybody lives my team of eight is going to be tag team relay racing from Picassa all the way to Province Town and back um for the next so we've got 20 teams this year so I'm just letting you know if you're driving on Cap Cod roadways and you see people running just stay out of their way don't beep at them they've been running a lot leave them alone and ride around them pay attention um but I never made weight and it was always such a mental issue for me that I removed myself of the pounds on the scale situation because it didn't matter I was physically fit uh and thank you for your service by the way Steph we um you know back to the question about why people don't are not fully truthful with their doct I think it's a a little bit of built-in shame for thousands of years uh healthc care has been very paternalistic meaning you know your doctor is sort of you know like a parental figure yeah that's what I I've been telling people loves toag finger you need to you need to get that sugar down you need to lose weight you need to and that's what we need to change that that's what we're doing at our at our practice we want more of a personal relationship with between the patient and their health care provider that can be honest and open and and that's what is missing in so much of primary care out there in the world right now is that continuity people bouncing around from provider to provider to provider they can't build a relationship with somebody I want our patients to have a relationship with their provider that lasts decades yeah and all too often especially on Cape Cod we see primary care doctors they come in they leave after one or two years you can't build that good trusting relationship we know our Health Care system is broken yet it's not being repaired and this is why I love that Veritas is here because you're doing it differently we are and we just we wanna we W to Foster that that relationship the relationship is the most important thing and hopefully build a trusting relationship so that people can be honest and say you know what I fell off the wagon and I went back to Pizza you it's I have not Mike hasn't slapped a patient in nine weeks I have not wrestled a patient to the ground months I'm really proud of these guys they're working it I thought this was a confession on radio that he hasn't he went back to Pizza no you're like wait a minute what yeah just not feeling it that's awesome yeah so I think people lie to their Health Care Professionals their providers their doctors also because they don't like change okay yeah the paternalistic you need to stop eating pizza and you need to work out more with the wagging of your finger so they're like okay I'll do that well because people already feel bad enough you know if they're coming to you or they need some assistance or they're in a space you already feel bad so now you got to not only feel bad but now you got to go to somebody who you don't spend a ton of time with until them all your shame it's awkward and that's in the in the traditional way of doing primary care if you add up what Medicare pays a primary care practice you can look this up it's across the United States we're supposed to spend less than seven minutes per patient visit you can't actually develop any sort of a trusting relationship in seven minutes so you know I think it is time for thousands of years doctors have wagged our fingers at patients and told them to do this this and the other it's time for us to actually help them help them do those things yeah that's important that's what we're doing with with Mike it might be medications with Mike might be lifestyle management with nurse coaching uh but it is time for us to help patients actually achieve their health goals amazing uh Mike what else it's not just the the weight loss drugs although primarily I think it's keeping you real busy right now I would say so yeah what other stuff is like so I I just having a pharmacist I know that you've helped my family with a couple of medication issues and you like getting to the bottom of an issue or problem that we were dealing with with the pharmacies and other issues it's really nice to have a pharmacist that's in-house on your side advocating for you as a patient I gotta say my husband can't be the only one I can't be the only one my you know my friends can't be the only ones that are thankful for you being in house so are you asking me what else I do yeah uh all right I just in case you're out there going I need that uh well I'll stand on a soap box just like Dr Arnold and against a work or working for a patient instead of insurance companies I don't like Pharmacy benefit managers playing games trying to get prescriptions filled how is it that a a provider can write a script to try and help a patient okay we're going to treat your cholesterol yeah write a script for a Statin you go to the pharmacy oh insurance won't pay for it well then you got to go back to the doctor and it say back and forth and back and forth so I will do complete and in-depth medication reviews sit down with a patient uh patient might bring up oh yeah I've been paying $400 a month for whatever drug because it was just easier because the insurance won't cover it right then I'll help that patient will look up their formulary we'll see what the alternatives are see if the Alternatives match or interact with other drugs if it's appropriate and then if let's say it's a Dr Arnold's there their doctor I'll stick my head out and say hey what do you think about this and usually I get a yes no good okay that should work we work as a team right well it's really important I I had a friend of mine this week that took to Facebook to rant because that's what we do now and it was because her pharmacy was closed for the 11th time and she was trying to get her script filled and she was it wasn't unavailable and she's freaking out and can't get a hold of her doctor and now she's unmedicated and now she's unmedicated and ranting on Facebook which nobody needs was like this is not good this is it's broken the first 10 people that signed up for Veritas Direct Care a year ago and thank you for being part of the part of the Revolution they signed up because of Mike yeah not just because of his guidance they were very honest with me they said he saves me so much money that it's gonna pay for the membership I like honestly my the amount of hours my husband has spent fighting with a pharmacist that's not there doesn't care uh gone back and forth uh sorry we don't have time to deal with they don't have time to deal with you at your grocery store they don't have time to deal with you at CVS and Walgreens and all these places they just don't have time to deal with you and we love our retail pharmacist we love them their job is very very difficult but uh so difficult that I left I couldn't do it anymore yeah I begged Dr Arnold to hire me four months that's amazing though it was it a great decision seriously though um but they don't teach doctors in medical school I'm they don't teach nurses in nursing school anything about formularies or Pharmacy benefit managers or the dut hole I still don't exactly know what that is but people talk about the dnut hole all the time you're busy with your patience though you shouldn't have to sit there and and learn these things you should be working with your patients but Mike does know those things and he knows how to to help people save money and give them guidance on what the most appropriate medications that they should be on would be it's just it's a nice nice it's a nice team we have um and uh and you should check it out yeah for sure shell said I never met an overweight patient who didn't already know they were overweight we don't need to scold we need to give them tools to help them 100% good morning Gail and Kathy thank you so much for joining us on the show Doc Arnolds and pharmacist Mike have been here from Veritas Direct Care give out all the information so that people can get a hold of you if they want to start using you for primary care if they want to use the weight loss clinic and meet a nurse Bethany and work on their holistic approach to nutrition and actually making some real Lifestyle Changes where you just need to do it differently Veritas direct care.com Veritas is V RIT T Veritas direct care.com 508 418 6600 we are in the brown Condo building right across the street from the front door of Cape cot Hospital you can come on by you can stand on the sidewalk and say Hey where's Dr Dan you know I uh I'm happy to give people tours we uh I'm happy to introduce you to Providers um and I don't have any dates yet but we're going to be doing some seminars in the very near future uh in person and in line talking about direct primary care and what we're doing in our practice we are hoping to uh expand or uh hoping to bring on new primary care physicians in the not distant future and uh it's just a very exciting thing so Veritas dare.com or just call us if you have any questions if you want to walk around meet people meet Mike meet Bethany meet any of our providers our providers are wonderful so amazing so lots to choose from too so you can find the right person for you thank you gentlemen for coming in and talking to us today I think that uh you answered a lot of our questions and I'm sure if you've got more that you can reach out and follow back with these gentlemen I'm late for a chamber appointment I mash me chamber I'm coming I know we got a board meeting I'll be there all right everybody have a great day today uh everybody that's participating in Ruck for hit good luck we've got a very busy weekend over the weekend lots of people visiting us uh Daffy Festival we've got tons of an influx of visitors is definitely feeling like spring finally here on the cape so be safe I'll talk to you soon bye guys bye guys thank you so much thank you for coming bye so good for sure all right everybody Hank is up next we'll talk to you soon if you're listening to us on the stream lemonade r.com we thank you Roku TV Alexa play l8o radio