13: Congestive Heart Failure/Fitness Guru John

Welcome to the Jock Doc Podcast featuring Dr. London Smith

Home of dr. London Smith himself host of the Jock Doc Podcast

Now let me introduce your host Dr. London “Jock Doc” Smith

Hello and welcome to Jock Doc Podcast where we

discuss fitness and health and how to

incorporate our modern understanding of

science and medicine into our daily

lives but without it being so boring I’m

your host dr. LondonSmith.com I would

like to begin by apologizing to our

listeners we’ve received some feedback

complaining about the amount of

technical terms we’ve been using such as

pedestrian and nipple so I will try to

speak more simply in the future here to

assist with that is our producer Cameron

hey hey hey Cameron is like a buoy on

the sea recognizing and rolling with the

waves of the world then applying that

understanding to helping me connect with

listeners also with us is DJ Dylan IN DA HOUSE

[Music]

Plus Cameron tells me that we have a

fitness guru arriving later in the show

we sure do

yeah so that’s stepping a little bit

more into the the jock aspect of the

jock podcast fittin’ this guru in our

podcast yeah all right well before we

move on I would like to address a small

sample of a listener feedback quote this

is such a beautiful so tree my wife

Olive RIP in pieces best suit aful

woman once told me to be thankful for

only losing the one eye to polio

god bless ha ha ha and quote first of

all I would like to thank you for

contacting us a jock doc it is of course

always a pleasure to hear from our

listeners an answer to that question I’m

not sure to which story you are

referring but it does indeed sound

beautiful and I’m sorry to hear about

your wife and that you lost your eye to

polio which that actually sounds like an

unusual medical case to me but I wish

you well in future endeavors thank you

for reaching out you’re so heartless dr.

London it heard these people are clearly

struggling and here you are you’re I

mean millionaire billion I don’t even

know you don’t even offer to send them a

check you don’t even offer them to like

buy them new shoes

well I was lucky the new i well and

that’s well for one thing

so polio is always an excuse well and

this was just more feedback on how we

are doing on the podcast it wasn’t like

a you know the feedback is they don’t

have an eye and you’re crazy rich I I

don’t think that that’s necessarily the

case

let’s move on okay so now for a tale

from the psych ward we had a patient in

the psychiatric ICU or PICU who claimed

to be God and expanded with a claim that

he was the reincarnated Judas Iscariot

so when asked how we came to this

conclusion he said basically just

through meditation he had been what’s

reasonable well so he had been brought

in because like in the intensive care

unit because he was throwing things in a

drugstore while yelling about finding a

gateway to another world okay well I

mean if you found a gateway to another

world wouldn’t you be a little kind of

pissed off I mean well no I don’t think

so but also I would you know I found out

anything that I don’t already know about

I’m furious I’m fuming I’m fuming

thinking about about covering something

that I’m not already aware of so so

learning makes you aim is disgusting so

so this podcast disgusts me well I don’t

learn anything from those podcasts I’m

disgusted by this podcast for many other

reasons but I’ve never learned anything

from this podcast I’ve learned how much

of a hassle you are like well okay so

anyway said this patient we had we did

what we do with most patients which is

to ask if any medications have helped

them in the past so we asked what made

him feel worse and he didn’t really have

an answer and then we asked what made

him feel better what helped and he said

meth and of course what really helps him

was a few days of anti-psychotic

medication and after that point he began

to realize that perhaps he was not a

deity so you sucked the joy and the

imagination out of this man this is what

society does to people these days so a

little creativity you’re a little

different and then people like dr.

London are like oh you’re uh you’re a

circle trying to fit into this square

become a square well especially in this

instance that the man was the cops were

called on him because he was tearing up

his drugstore he had a vibe tries just

trying to vibe out and then dr. London

comes in and says no you have to be like

everybody else

I do just ride the vibe

all right well so we’ll go ahead and

move on from there to UM today’s topic

congestive heart failure congestive

heart failure is a chronic progressive

condition that occurs when the heart is

unable to efficiently pump blood to the

rest of the body this results in the

blood backing up into the lungs and can

even progress further into backing up

blood into the neck veins and the liver

so depending on the stage of the disease

progression patients can present with

orthopnea which is when they have

shortness of breath while lying down

mm-hmm

they can also have what’s called

paroxysmal nocturnal dyspnea which is a

sort of a breathless awakening from

sleep they feel like they can’t breathe

whenever they’re asleep so they wake up

and like rush to the window to get a

breath and they can also have pulmonary

edema which is sort of congestion in the

lungs essentially the easy way to think

about it is blood backing up on the left

side of the heart into the lungs and

that excess blood circulating through

the lungs causes congestion that results

in difficulty breathing what do you call

it

I actually really like your advice on

this because I’ve been struggling with

with this lately what do you call it

when you have shortness of breath after

you kind of dive-bomb off your roof I in

okay did you dive bomb off your roof

yeah well I do it every day that’s my

main form of exercise and I’m so out of

breath afterwards it hurts like hell

okay so you dive bomb from you and this

is just like your form of exercise every

day to in the morning do you say I

didn’t specify it okay so that but this

is your exercise use anyong be in the

morning cuz I can happen is that the

issue to my understanding dive-bombing

is not necessarily best friend but

everybody say sorry to clarify when you

say dive-bombing you mean you just jump

off headfirst yeah off of your roof yeah

until like a pipe like a pile of boxes

or something to catch my fall I’m not

diving off into the ground I’m not I’m

okay good okay but I am just out of

breath

well probably like are you how are you

landing are you landing on your chest

yeah so okay that’s that’s what I’m

trying to work out is my chest so I

guess it kind of does depend if it’s leg

day then yeah I’m gonna land on my legs

but if it’s chest day which it almost

always is yeah of course I’m gonna land

on my chest but then I just can’t

breathe at all

well I don’t think that that’s

necessarily the best way to get exercise

because nobody exercises sort of using

the muscles rather than just putting

sudden violent pressure on them it

sounds like you are you just causing

bruising to your chest probably is it

like blue and like has a discolored

afterwards well yeah absolutely yeah and

but that’s what working out is it’s you

hurt yourself and then it heals itself a

little bit bigger yeah in a way but so

in that case what you’re doing is just

hurting yourself rather than it’s not

breaking down muscle in the sort of the

constructive way that like weightlifting

would be which is more intentional it

it’s not the same so you’re saying at

the Olympics weightlifting is more of a

sport than diving then dive-bombing off

of a roof and do a pile of boxes yes

well I’m trying to make that an Olympic

sport oh this is this is part of the

whole thing yeah okay for those maybe

who who haven’t heard my favourite sport

is the Olympics and I’ve been trying to

get some of my games into the Olympics

we had talked about getting like my

nephew’s gun and you shoot targets off

people’s back and talked about like

picking up coins a few facts yeah this

is sort of the the third game that I’m

testing okay

and the game is once again you it’s

exercise sorry it’s not a game you

jumping off of your roof into a pile

depending on whatever whatever’s around

I get out of curiosity does what you

jump into factor into the time

of game you’re doing the does that

second which because I know you talked

about leg day

and chest day yeah I’m not jumping into

like a pile of legs that were you’re

asking no no I could

okay and once I mean I feel like you

probably have access to I don’t right

I don’t think cuz you get me some legs

this isn’t this talk after the pot yeah

what you’re getting is a workout it just

isn’t being give me like human legs that

I could dive bomb into right

I cuz that’s an interesting thread okay

yeah no let’s move on okay let’s move on

we’ll talk about the body parts later

okay well uh Cameron do we have any

sponsors today we absolutely do dr.

London okay

[Music]

we are our sponsor for today is another

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I mean I recognize that there’s

technically a generation gap but

whenever it’s gap whenever you reach

that age I would assume that kind of

becomes like somewhat irrelevant that

the 10 or 15 years situation it’s just I

mean if you’re born in 1903 are you

really gonna be able to relate to

someone who was born in 1919 I

there’s no sense born I guess one born

into the war kids born in 1919 they

don’t know what life was like before the

Great or yeah

World War one or whatever yeah joint

you’ve tried to sneak in and join them

even though you don’t fit into that

demographic messes oh right right right

you didn’t you didn’t try that with this

one I mean of course I did because

you’re I don’t I don’t want to give away

your age or anything but you’re not I I

know you’re under a hundred years old

let me just put it this way I’m not

gonna go into too many details because a

gentleman never kisses and tells

so did I get I guess so how did say you

joined the dating app yep and it went

really really really well in the past I

know with other dating apps you’ve been

rejected quite a bit oh yeah

because you were breaking the rules or

whatever so this one I guess security is

not quite as tight wellhe’s then I just

use the face up old age thing to h me up

okay I just ran it through that like

seven times just over and over again so

just kept making it older right cuz it

had to be that old and then the you know

my girlfriend that I had met through the

app she she is your girlfriend sort of

sees everything as just kind of blurry

blobs okay okay yeah with vision loss

and everything cataracts that kind of

thing at that age and I mean look does

she get the same references I I wouldn’t

I would imagine that she does not

whatever

so what love is about you know right so

okay so you really feel like a real

connection oh yeah her romantic

connection with her lips okay could I

could I ask your name no okay and what

does she well I would ask what she do

but I’m guessing she’s retired I haven’t

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am so this isn’t nothing

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right well thank you to our sponsor

[Music]

Cameron uh you said you had a fitness

guru here as a guest today yeah

absolutely

all right fitting disc guru into the

podcast yeah no you did say that earlier

huh all right uh hello yeah hi hello my

name is dr. London smith.com and this is

the jock doc podcast well and this is

Cameron yeah thank you for stopping

behind no I I really appreciate you guys

having me it’s a it’s a blessing to be

here really is and was your name John

John okay well nice to meet you John

all right and so Cameron tells me the

years sort of a fitness guru yeah I mean

fitness is my life um and and it’s it’s

all I do but you know I would I would

really say that I’m just a guy with a

passion you know I wouldn’t say that I’m

an expert or a guru but I suppose

someone like yourself would so it’s more

of a hobby for you but you know so much

about it that to the average person

maybe your hobby is extensive knowledge

maybe the in compared to the ignorant

masses like yourself wouldn’t really

understand that’s the one kind of

fitness knowledgeable people like John

and myself see you can’t when you would

also group yourself into this business I

mean I just talked to you about my

regimen I mean can I be honest with you

no I walked into the room and this is

what usually happens I pick out people

that have a passion for fitness and I

can just see it yep and and producer

Cameron definitely has that passion

that’s what what what was part of your

assessment what factors go into that

initial assessment because for me be you

know looking at the muscle groups like

seem like do they have you know sizeable

deltoids can the biceps without those

kinds of things well that I don’t know

what those words are but I just look a

man in the eyes and I’ll stare for about

3.8 seconds that’s all it takes

yep and I know Wow so for you see he

doesn’t need devices like you do oh let

me stick you into this cat scan machine

let me let me get this little thing that

I used to hit your knees and elbows to

see if they pop because I’m crazy it’s

not like that if you’re a real expert

you just see someone’s heart okay so

what you’re saying is that rather than

looking at muscle aches and those are

pretty basic muscle groups that most

people know like the deltoids those are

kind of your shoulder area like would

you say that one more time for me

deltoids deal what okay no not the

computer no this is so the delt anyway

so there are these muscle groups that

usually you can sort of size people up a

little bit and say like oh this person

works out or like their pecs that kind

of thing pectoralis major minor PEC

major is what you see pectoralis yeah no

you sound incredulous so what I feel

like right now do you watch Jimmy Fallon

because what he does he’s got this bit

on the show where he goes on the

sidewalk and he makes up these facts

people don’t know that they’re fake and

so they agreed to him is that what you J

Jimmy here today that would be great

with breakfast the whole show makes so

much more sense if it was just Jimmy

Fallon making dr. London tell us insane

nonsensical stupid wait ignorant waste

of time that would make it make sense

yeah if Jimmy Fallon was manipulating my

words if Jimmy Fallon told you hey go

out there as a fun prank why don’t you

say the stupidest dumbest things you can

possibly think of waste everyone’s time

and just make everyone’s lives

significantly worse that would oh my god

you think the DEF CON is really onto

something but that would make more sense

than just medic trying to educate people

but would you call it more sense when

one thing makes a zero sense and one

thing just does yeah would that be more

would that just be sense I your times

anything by zero at zero you know boom

yeah all right

okay so times anything by negative it’s

a negative no I don’t know about that

well if it’s a positive okay so John

what um what about your fitness what

about your lifestyle makes you feel like

you are a fitness guy aside from the eye

contact sure absolutely

so I don’t know if you noticed when I

walked in I’ve got to walk a little

sideways through the doorways the

latinus door sigh it’s actually the

largest muscle group in the upper body

it’s what I focus on

well it’s it’s not like it’s it’s a it’s

a large muscle on the back like door

side comes from but it’s for the back

like the dorsal fan of a fish it’s the

it’s like a doctor and so and then let’s

hissa mess well the whole group of word

is like big muscle on the back which is

miss Doris I so that muscle is normally

like for climbing specifically right

being able to hang for a long amount of

time and pull yourself up right and and

that’s what I spend you know I would say

probably in 95 to 99.99% of my time on

Wow

what okay what about the rest of your

time that other what five ish percent

yeah that’s spent walking into and out

of the gym hmm okay so you your training

exclusively and with all of your time on

this one particular muscle because that

I will say like your arms are just

atrophied like there’s there’s nothing

there they’re gaunt and your legs also

like very spindly your neck like

everything looks pretty like

malnourished almost but but

admittedly your latissimus dorsi is kind

of there

what from what I can see at least it’s

it’s an odd shape to be honest because

sure yeah I can see how someone like

yourself might think that and you said a

lot of big worries before it’s it’s what

he tries to do we tries to trip you up

around these terms just to kind of make

you feel small sure and it’s got me on

edge cuz I don’t know them so I feel

like you want me to be smaller because I

am so large with my lat amidst door sigh

so careful alright a little respect for

our guest dr. London and I did not mean

to offend in any way I am more trying to

clarify and understand maybe education

needs clarification okay well okay so

you’re you’re working out this

particular muscle group why not work out

your I guess to be more simple about

your arms okay or any of that yeah

because you don’t need your arms as much

in climbing you need your ladder missed

door sigh okay so you’re climbing

enthusiast I should have asked that of

course no okay well what then why are

you so you not you don’t you work out

your climbing muscles exclusively but

you do not climb that’s correct I don’t

like to climb in fact I only plumbed

once mmm by accident and I don’t intend

to go I’m sorry on an accident you

clubbed that’s correct

in what in what scenario was how did

this come about and how I I don’t often

accidentally climb that seems like a

very sort of a in action that requires

more initiative you don’t fall into that

it’s the opposite of right well in one

morning I woke up in a tree and I fell

out but my shoes were still in the top

of the tree so I had to climb back up it

was an accident that I fell out no okay

so the falling out was the accident but

the client okay that makes sense so was

it based on that

experience though I I am just prepared

and it’s a specific preparation I

understand but what if I go to the Grand

Canyon okay right and my tour guide

chadwick Howell the third Chadwick

Howell

he goes by Chad though but with a name

like that you got to think he’s from the

Northeast there’s nothing to climb up

there what is he no yeah so I’ve got to

be prepared right okay right so I’m in

the Grand Canyon Colorado River nice and

cool all of a sudden Chad looks like hey

let’s get out of here he falls and hits

his head Wow so Chad’s got blond hair so

you can see all of the blood right and I

can see the way out it’s straight up

I’ve got to be able to climb yeah dr.

London Smith everyone’s biggest fear

right Wow so you’re so okay do you have

any plans to go to the Grand Canyon why

is this no it’s actually very hot there

and I’m not into that okay so so this

you know this sounds just so specific

this scenario that you have in your head

this is this is this is everyone’s

biggest fear dr. London specific broad

those are just words yeah lad amidst

door sigh these are muscles well I mean

well I’m not Cameron you say it’s

everyone I’ve never heard you mentioned

this particular fear this is what keeps

me awake at night and all day all day

yeah I can’t sleep and when I do I’m

dreaming about this okay and sorry to

restate the issue here your you okay

you’re preparing you’re working at these

muscles latissimus dorsi you’re working

these out specifically for this scenario

in which you’re in the Grand Canyon with

the tour guide Chad and that tour guide

becomes incapacitated correct and then

you just have to climb your way out of

the situation

and that’s that’s this hypothetical that

you don’t you don’t want to go there

even mm-hmm this hypothetical is why you

work out you’re a real survivalist huh

absolutely yeah I am prepared for that

situation anytime any day and the thing

is Chad never has the proper climbing

equipment so it’s not like I’ve got

ropes and I can anchor in the wall it’s

a free climb you’ve seen that

documentary free solo III have not yeah

me neither but he doesn’t use ropes

I think okay so sorry to clarify on this

you said you were not like a climbing

enthusiast have you tried let’s say free

climbing like you’re saying like that’s

that seems like something that would be

reasonable like beyond the building the

muscles learning the technique have you

learned to free climb and well he told

you that he climbed into that tree that

he fell out of I was presumably free

didn’t cost him any money

lot of that was a point but there was a

sorry I gunpoint well yeah I mean

producer Cameron mentioned that I was

free to climb the tree but it was a gun

point so was it really free yeah that’s

true so okay I guess so that that

situation there okay gun when you’re in

the Grand Canyon yes okay good

it’s a rubberband gun but I have a gun

okay Wow okay the kind of survivalist

stuff we need to be talking about dr.

London okay i’il raw stuff real stuff

that people deal with okay so so with

the tree situation maybe and I’m sorry

if this is gonna be getting a little bit

more more uncomfortable but I would like

to ask was that a traumatic experience

for you and maybe that’s that that fear

is is that what drives you to have all

of this was it like sort of a

post-traumatic situation Wow Wow it I

just producer Cameron can I talk to you

for a second yeah just dr. London could

you just

just alts here do you want to play a

game on my phone just play a game on my

faul shit I’m just gonna load up the

that poppy jump from 15 years ago and

you can play that okay is is he always

this insensitive yeah it was he always

just a huge just jerk ass piece of a

piece of jerk basically yeah yeah okay

he go he finds the things that he thinks

will humiliate you and then he shoves it

in your face over and over and over yeah

from the beginning when I walked in I

felt like he wanted me to feel small and

the thing is when we leave when we’re in

the parking lot he’s gonna go me and

that guy was a loser oh he’s such a big

lose like I see your the phone just had

one of the stickers on it with the the

pictures of apps uh-huh was that like so

that’s not a game well let me shake it

there’s kind of like like little beads

in there and I think it lights up well I

feel like you guys are probably done

talking about whatever or it was like 30

more seconds okay yeah you just just

shake the phone just write a list yeah

perfect

yeah if we get into the parking lot it’s

gonna be like oh I hate everyone I hope

all my patients die I’m gonna do surgery

on them even if they don’t need it just

to screw with them because that’s what

makes me feel powerful that’s yeah

that’s yeah okay well I’m just glad I’m

not so it’s not specific to you okay are

the expert right here well don’t worry

thank you

okay okay um well so let’s I did want to

clarify one thing though yeah you did

mention that 5% to point zero one

percent of your time is spent leaving

and then coming to the gym correct but

you also spend time falling out of this

tree do you live in this tree and is out

this way okay this is actually a fair

question do you believe him climb up

into the tree live in that tree leave

the tree and go back to the gym because

the tree situation that seems awesome i

I was gonna say I that was the partition

waking up in a tree is what I didn’t

Stan it sounded like pretty sure he

lives in the tree that’s dedication

something you would never understand

right he would never live in a tree

outside the hospital I will say you’re

you’re too obsessed with your cozy bed

and your big TV and you know when I

spent that 3.8 seconds staring into your

eyes I thought about giving it a little

more time because I thought maybe it’s

there it just wasn’t so to answer your

question yes and also yeah okay to both

of the same question of do you live in a

tree uh-huh okay so you just use

affirming twice okay right well you seem

like you needed a little extra

affirmation from me I don’t know why

okay now wait a minute what I fear that

you think of me is that I just live in a

tree like a bird I in this sense that

birds often live in trees like that as

far as that comparison goes yes but no

further I don’t think that you are a

bird person if that’s what you’re

getting at

it wasn’t but now that you’ve mentioned

it okay that’s are pretty wide oh I’m

sorry

latts that’s what we in the gym biz call

latissimus dorsi right Wow

so lats it’s just easier for you guys

yeah I mean I I know

producer Cameron you understand oh I

don’t know the jar I I just know how to

like work out and sure yeah you don’t

you don’t help you spend time on target

absolutely yeah no I can see that I

didn’t even get the 3.8 for you I I saw

that right away so that in that one

scenario and I’m sorry if this is and if

this is too if I’m crying too much then

please just just stop me and we can move

on okay but um that time whenever you

fell out of the tree and wanted to climb

back up and you had a gun held to your

head

was that a rubberband gun and was that

was there a child there with rubberband

gun and that’s that was the coercion

going on there dr. London are

you scared of someone pointing a

rubberband gun at you uh slight slightly

egg maybe okay so if you’re only

slightly scared of that would I be

scared at all

I it’s tough to tell at this point is it

okay so is that that’s the answer we’re

gonna get for that one is okay I mean I

think it’s pretty clear that John was

probably nesting in his tree and a

hunter came by and you know tried to do

what hunters do because I wasn’t wearing

bright orange so in fairness to the man

he just sees something in the tree he

saw it fall he thought hey that’s easy

yeah

luckily he got close enough before

anything happened and then you climbed

back up I did again my shoes were up

there okay and I was headed to the gym

which is right beside my house I mean

the tree the hunter was was there at the

gym

well would you say hunter

we’ve been when we say enter here do we

mean do we mean a child why are you so

fixated on these kids only sorry it’s

only because you the rubberband guns

genuinely are thing associated with

children toys and so just because I’m

prepared to be stuck in the Grand Canyon

with the tour guide Chad with blonde

hair that’s bleeding that can’t climb

and I’ve got a rubberband gun doesn’t

mean that everyone around me has a

rubberband gun or that I’ve ever seen a

rubberband gun and it sort of sounds

like you’re calling our guest a child

because he happens to have a rubber game

of rubberband gun in preparation for

survival except that he doesn’t have the

the rubberband gun it it’s a

hypothetical scenario in which well yeah

I don’t think he has a rubberband gun no

but I’m prepared in this scenario with

the rubberband gun right it’s all part

of this very very specific hypothetical

you’ve got to be ready it’s my biggest

fear

right I cry I can’t blink longer than an

instant because if I do I see it and

you’re not not prepared so for you it’s

just the idea of climbing in the Grand

Canyon I don’t know anything about Chad

at all the are you scared because you

just heard about Chad I just don’t know

anything about him he’s an enigma and so

Chad’s the scary part for you what are

we going to talk about so so for you

it’s not just the climbing situation

it’s all of it

it’s the the conversation before he gets

incapacitated just everything what I’m

gonna wear

right okay uh this is why I need advice

from someone like our guest to help me

through these kind of things to teach me

survival right okay well thank you why

I’m here to announce I am moving into

John’s tree yeah there’s plenty of space

sweet and so nice a tree I should

clarify this is a tree house or is that

a tree like just you you mentioned

Cameron you mentioned nest as if like

have you visited this tree living space

I can imagine it okay and John is it I

don’t know if you ever if you dig

confirmed that you live in a tree is it

a tree house is that a I know it means

my house yes well the tree is your house

correct like as part of it I think about

it whenever kids leave their parents

house the parents become empty nesters

the house is the nest so with all that

yes the tree is my house okay I I get I

guess nevermind so Kevin you’re gonna go

live in the same tree to learn survival

yeah and you’re calling it a tree house

even though it possibly is just a tree

that you refer to as a house all right

well um that that’s great thank you John

for coming by and sharing your

of your fitness knowledge with us yeah

absolutely

Thank You Cameron as always thank you to do to doing the hose and this has been

the jock Doc podcast

you

[Applause]