Season 1 Recap

[00:00:00] Welcome back to Ask Dr. Mia podcast. This is a special episode where I will go through the entire first season of this podcast and give you all the highlights and recap in a very short format. And let's get started with episode one, which was the introduction and my definition of aging well. This is where I talked about why I wanted to do this podcast in the first place. The fact that there are so few geriatricians out there, the folks who are specialists in older adults. And even the word geriatrician is a new concept to a lot of people and defining kind of what makes a geriatrician different from your primary care doctor, which I am both a primary care doctor, as well as a memory specialist.

[00:01:00] This is where I share my stories of my four grandparents. I grew up in China until I was the age of 12. Their aging experiences and the vitality of the last chapters of their lives really inspired me to go into the field of geriatrics, even though I didn't quite realize it at the time during my training.

[00:01:27] In episode two, which is the story of how I decided on geriatrics. And I talk about the five M's: mind mobility, medications multi-complexity and what matters most. This is a very useful framework in thinking about older adults and their medical journeys: not from the typical disease focused silos, but crossing multiple organ systems, multiple diseases. I think multi-time complexity or multi-morbidity really encapsulates that. In the sense that. You are one person, not just a series of different organs with different diseases, but I think this is what makes geriatrics a really holistic specialty.

[00:02:25] So episode three, which I titled forks in the road, which really continues in describing the complexities of different healthcare settings. Not just from the home to the clinic, but from home to clinic to nursing facilities, rehab. What makes an assisted living different from a nursing home, different from a memory care, and where to find additional resources to find and to navigate a lot of these really challenging decisions that older adults and their families have to go through. This is an episode where I think could be tremendously helpful for a lot of older adults and their family members who don't necessarily know where to turn when the healthcare system is so complex and difficult to navigate.

[00:03:26] So episodes four and then the subsequent three episodes really take a slightly different turn and focus more on memory and memory related topics. Episode four is title, why so many Alzheimer's drugs fail and the two tales of Alzheimer's. This is where I talk about how 95% of Alzheimer's is different from the other 5% of the Alzheimer's. But the reality of diagnosing someone with Alzheimer's disease as a primary care doctor, as a clinician is very different from the research definition of Alzheimer's disease. And how these two different composites of Alzheimer's disease create some challenges in interpreting new medications that are coming out in the market. And this is where I also start mentioning one less discussed news report about a very effective way of controlling and preventing Alzheimer’s disease and other related dementias, which is getting the average systolic blood pressure where the, your top blood pressure number ,to as close to 120 or below as possible and how it can potentially reduce your risk of later developing cognitive changes and dementia.

[00:05:03] So episode five, six, and seven are a three-part series that I called memory series. Part one, which is episode five actually talks about a lot of other things that I check for as a memory specialist that may present like a memory problem, but are actually not memory problems. These include things like medications. There are certain medicines that can cause confusion. There are other medical issues like sleep apnea, hearing loss, alcohol use, head injury, some common medical conditions such as low thyroid function and low vitamin B12 levels that your primary care doctor, neurologist or geriatrician memory specialist would typically check as part of a complete evaluation for memory. And this is where I also talk about different domains of memory and cognition and how there are actually different types of memory domains that really help us be independent adults.

[00:06:17] Memory series part two out of three is where I go in more detail down the memory journey into people who have early dementia. And I define what dementia means compares to other age related memory changes or a different condition called mild cognitive impairment. I talk about the four M's. These are common safety issues that are that are particularly important to addressed when people have relatively mild memory problems, but notable changes that would be helpful to be on the lookout for. This is a good episode to listen to you if you have a loved one who have been told that they might have some memory problems, even if they don't necessarily have a diagnosis. This is a good episode to make sure that they are in a safe enough environment as possible while also respecting their autonomy and independence.

[00:07:22] Memory series part three or episode number seven is really all about care partners. And some of you who are listening may not even consider yourself a care partner or caregiver, but a lot of you have family members who might be going through memory problems or work with people, older adults who have memory problems. This is my first interview with a guest speaker and I talk with Samantha Culler, who is a licensed clinical social worker that I work with talking about her personal journey as a care partner for her mother going through a serious illness and ways to really support the care partner, who are an integral part of treating someone with memory loss.

[00:08:09] Episode eight gets back to a pretty personal story again. This is where I talk about my mom's story with lifelong anxiety, as well as a diagnosis that came about actually in the beginning of September. So a secret behind the scene tip was that this diagnosis actually came about during the previous episode, recording about care partners, where I found myself as a unwitting care partner and my mom's own diagnosis and journey, but I wasn't quite ready to share with the whole world at the recording with Sam. But it was really helpful for me too, to hear her experience and how she helped her mom navigate the healthcare system. Things definitely turn personal in many ways as my mom's diagnosis with ovarian cancer continues.

[00:09:07] Episode nine is where we get back out into current events. Episode nine came around right in the beginning of October a new Alzheimer's drug called lecanemab came out. And this is a episode where I had actually changed a title several times because I wasn't quite sure where I personally landed with this medication. The full results of this clinical trial for this new anti-amyloid antibody is actually due out this week some time, but at the time that the news release came out, there was very little information. And I tried to bring as much of what I could find to you all and explain it in a way that is hopefully helpful in making sense of the context of the drug development, as well as what are some considerations and questions that we all have going forward. I think this Lecanemab story will continue to unfold in the next couple of months.

[00:10:18] Episode 10, 11, and 12 are all guests interviews with people that I wanted to talk to. And I felt like I learned a lot and these last three guest interviews. Episode 10 was with Jack Hitchens, who is an audiologist in Georgia. And we talked about the new FDA authorization for the over-the-counter hearing aids sale and just what audiologists do, how do they distinguish what is a hearing problem from a memory problem? And we talked very briefly toward the end of that episode, about how hearing is very tightly related to memory loss and that it is one of the key things that is within your control to try to optimize not only your hearing, but your balance as well as your memory.

[00:11:17] Episode 11 was a really fun episode that I talked with geriatric psychiatrist, Dr. Matt Kern, who I also work with and he uh, he brought a new term called old codgers, uh, into my vocabulary, as I did not know what codgers meant. But these are older adults in his life that really influenced his career decision to become a geriatric psychiatrist.

[00:11:48] And when should you seek more medical attention for your mental health. We talked about mental health stigma and ways either as a clinician or as a family member to talk to older adults who might be struggling with mental health issues.

[00:12:07] Episode 12 and 13 are a two part conversation with the same guest speaker, Dr. Saloni Sharma. She is a physical medicine and rehab specialist, as well as a pain management specialist. Dr. Sharma gave a lot of great tips on what she calls micro boosts. These are small practical steps that anyone can take to feel better as holistic pain solutions. She also has a book called the Pain Solution that's available on Amazon and linked in the show notes. Please check out Dr. Sharma's book, as it's full of great tips that can really complement these two episodes. We talked for so long that I had to break it up into two episodes because it was significantly longer than my previous episodes. So I really call it episode 13, like the baker's dozen. I just gave you a little extra.

[00:13:08] This concludes the season for the first season for Ask Dr. Mia podcast. It has been tremendously fun and I learned a lot from putting this podcast out into the world. At the time of this recording, there are over 650 total downloads of all of these episodes, which I feel tremendously proud of. I feel like I'm telling everybody I know about my podcast. So please tell everyone you know about this podcast, because I really do think that the information that I put out could be tremendously helpful, whether you have no medical training at all, or if you are a clinician and work with older adults all the time.

[00:13:54] So with the holidays, I'm going to take a brief pause. I hope you all have a wonderful holiday season. The holidays can be particularly challenging because it is really a mixed bag of both joy and grief: joy to spend time with the people you love, who are in your life but also grief and perhaps family tension with the people who are no longer in your life. So I hope you all take good care of yourself. And the season two of the podcast will come back sometime in January, no later than February. And I hope to line up some more exciting topics to you. There are some special speakers that I'm reaching out to, to really talk about innovations in aging research as well as how to better design the healthcare system in a way that is age friendly. So hope to see you next time. Thank you very much.