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Sonoma County, a diverse county of over one million acres is famed for its agriculture industry and recreation boasting a booming economy and a unique lifestyle for its citizens described by the same Luther Burbank as the chosen spot of all the earth. Sonoma County is the place

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to live, work and play as we move into the 21st century. Led by the forward looking philosophy of its governing bodies. Sonoma County's 340,000 residents are a harmonious, successful blend of ethnic and economic backgrounds. We invite you to take a closer look at Sonoma County in

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the nineties with your host Rich McGlinchey. Hello everyone welcome to this edition of Sonoma County in the nineties were going to be talking to two gentlemen who you've seen before. Now you get the feeling you've seen this program before. You haven't but you might have seen

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these gentlemen with us before. We were talking to on the left ear screen. Dr James Price, cardiologists in the middle as usual. Dr James, kelso good. A pulmonary specialist I believe. Is that right? Nice to have you back. We've we've had some good effect. We're going

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to one of the things that we're gonna be talking a lot about is our usual subject uh cessation of smoking to those who do and we're gonna also be talking about little uh news in the cardiology field. First. Have you gentlemen been looking All right, how

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about you? You go back to Japan. All right, we have a tennis doubles team now. So we're getting some exercise. We don't win, but I must be invited to see this. It's a heart lung team. Alright, listen, let's start with you dr price. I don't know

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these things down. It would be interesting, I think to discuss the recent studies that suggest the tight control of cholesterol, both with diet and drug therapy substantially decrease coronary attacks and recurrent engineer. I guess they also decrease the need for hospitalization. Comment on that. Well, again,

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I think for a long time, I guess I did characterize the last 10 years is having a big emphasis on intervention, bypass surgery, angioplasties or balloon dilatation of arteries. And what's what we found is that those modalities are successful and help, but it also becomes apparent

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in the last five years or so that if you take people with coronary disease, even some people that are that have relatively unstable symptoms and you just change their diet and modify their cholesterol that you can get symptoms to go away stabilize the problem and probably,

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uh, prevent the need for surgery or these interventions. And I think what's even really more exciting is that patients that have come in and had the procedures if they get on the diet, there's really good good evidence and get on a diet and control the cholesterol

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that we can prevent them from having progression of the disease and substantially decrease any further problems they have. So I think we're, it's interesting. We went through a real technological phase of cardiology, technological approach to this disease. We're kind of back to some of the basics

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and I think diet uh drug management where it's appropriate is now looking as if um it's a very, very successful way to manage this. And I think the good news in this era of cost containment finances and concern over the the dollars in health care, Uh

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it's very important. This can be done relatively inexpensively and uh I would say probably in 60, of the patients that just would diet. Um uh don't ask you tie that in with Palmeri to now. How how does that affect to you? I'm gonna say the same

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thing for the lungs have do with wellness, pursuing wellness and doing things such as for example, first of all, not starting to smoke and having a good diet and exercise and enough sleep and stress management your life. But smoking is the critical thing and the emphasis

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in terms of initially not smoking, that's primary prevention. And secondly, is picking up people who are at risk and getting them to stop smoking. Secondary prevention and jim and I are mainly in territory medicine were involved in seeing Late expressions of disease and individuals who are

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far advanced. But they also helped by stopping smoking by diet and by these other modalities. And my message would be whether you're a teenager age 50 or age 80 it pays to pursue wellness to reduce the risk factors and probably the one biggest risk factor in

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lung diseases is smoking beyond a doubt. This is one of the things I wanted to dwell on to have some thoughts about cardiology I want to talk with but but both jim you in the past and you talked to us and you said that a lot

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of coronary problems directly stem from excessive smoking. Is that still the case? I think that I have to say I have maybe a slight bias, but I think smoking probably is a greater risk factor for coronary disease than than diet is. I mean, it's kinda hard

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to wait. These diets are very important thing. Your cholesterol is important. But smoking incredibly important. What happens is it seems to be sort of a destabilizing force in the vascular de lesions that the plaques and things that build up. And if you're a heavy smoker that

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destabilizes the plaque and causes people to have the acute problems. Let's talk about smoking a minute with you jim. When did smoking start? And why do so many people smoke or have they? Well, tobacco, tobacco was in the new world and columbus brought back tobacco to

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Seville Spain. They began to roll it into cigarettes. So smoking europe. He began around 1500. Well, that was, in a way, a certain revenge if you will pay back and then cigarette smoking wasn't that popular because you couldn't really manufacture cigarettes in large numbers until they

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got rolling machines. A hand roller could roll about 1000 a day. A machine could do 200,000 day. And then came World War One. That's when smoking really became popular because of the figures like Humphrey Bogart and others who were our actors and actresses who made smoking

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popular, who made it like the smoothie in the, The camel advertisements or the Marlboro man. These things really deceived the public and led them to think smoking would lead to them being that if you will. Um and then it it was recognized probably about 1950 that

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smoking was a big problem and then Gemini are carrying on from there. What we can do given the data that clearly shows smoking is very detrimental. And if you want to have a panel, you'd have to have an addition to ourselves. An expert on esophageal cancer,

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on oral cancer and pancreatic cancer, on breast cancer, on many other fields of corn, heart disease and pulmonary diseases are some of the impacts of smoking. But it's it's an enormous field and there's so much can be done about it the next year. About a year

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from now. The Good Lord willing uh we'll do, we'll do that. We'll have a panel like that. We'll have everybody give their input and maybe will affect a few more people. One of the things that pleased me from the shows we've done in the past is

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that In excess of 30 people, which is not a great number, but it's that represents we've been on together maybe four or five times. That's half a dozen people each time have contacted us in the studio and said that they no longer smoke as a result

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of what was said on these programs. So it is just a bit of a drop in the bucket. But at least it's a start. We're still on it. All right, jim back to coronary uh, problems if you will. I think we should mention maybe even discuss

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the fact that recent statistics show there is a substantial decline in the overall amount of coronary artery disease in the United States. Now talk about that. And does that tie in with this trust on that earlier? But let's go back to that. Jim probably knows the

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data better for the number of the decrease in smoking. But there is a there has been a substantial decline in smoking in the United States in certain populations, particularly the older groups of people. Unfortunately, I think we uh parenthetically have a problem with some of the

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use their young women, there's a there's an increase in that segment, but It's too they're too young to manifest some of these end stage problems with smoking. But clearly the cessation of smoking in the elderly population, the 40, 50, 60 year old people has really led

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to a substantial decline. It's one of many factors. I think this uh jim mentioned earlier, I think the focus on wellness and, you know, we've been seeing this, you read about in reader's digest, you read about it in the sunday paper, the diet, the cholesterol, blood

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pressure, all of these things have contributed. And I think what the good news is that the problems with coronary disease are are substantially preventable. Certain groups of people that are have a genetic predisposition for that. But even those patients can be helped substantially. We know, and

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and at least we I think we all probably accept this as a given fact now that the physical activity and exercise programs do have an effect on coronary disease do. Is that is that also true with the pulmonary? Yes. Um for example, a person who is

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breathless may think it's due to cigarette smoking or asthma, chronic bronchitis emphysema, but a lot of times it's due to muscle de conditioning and many times I'll see a person who comes to me for lung problems and let's say, I can't get their lungs better, but

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I can get all the muscles around the lungs better. The diaphragms, the quadriceps, the thighs and so on. So that a good exercise program will help them decrease their breathlessness, which is their chief complaint without changing their lungs at all. Exercise has a lot to do

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with the way one feels and decreasing breathlessness. Yes. If a person uh quit smoking jim, how, what benefit will they derive in the cardiology. Since it's almost immediate benefit as far as the decreased risk of having coronary disease in itself or the manifestations. Again, it's interesting,

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you can have a population of people that have narrowed arteries have plaque. They can live for. I mean, they live into their nineties, live into their hundreds and never be symptomatic. It's the unfortunate person that is a smoker that destabilizes the plaque and causes a problem.

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And once you stop the risk just immediately starts to go away, it's been said that after five years that your risk returns to that of a nonsmoker. I don't know. That's an arbitrary but still, I think it's a positive thing. I mean, if you stop smoking,

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you're gonna get a big, big benefit from heart disease, vascular disease, possibility of a stroke. I hope all of you folks out there listening are are listening to these two gentlemen are, I'm happy to say good friends, but they're also excellent physicians. They're very serious about

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this matter and they do their darndest to get people who do smoke not to smoke. And I hope you're listening because you'll get a sort of a preview if you haven't already of what can happen to you. If you insist on continuing this. I smoked as

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you know, Jim until 20 years ago, five packs a day and why I'm here, I have no idea. But uh at the first heart attack, which you were there at that time. Uh I quit and I had no choice. I mean, I wanted to live a

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while and never been near him since and don't intend to, that's for sure. Which I think perhaps you're alive today because you stopped smoking 1973. I mean that and you know if if a 50 year old man comes and sees me who's a smoker and I

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can get that individual stop smoking, he'll live 11 years more. That's a big factor, isn't it? There's another thing which, which isn't just um, the amount of time you live is the quality of life. When I see a person in the office, I measure their lung

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age For example, I'm 54 and my lung age is 54 people come and see me who were 54 and I measure on this parameter where they stand in terms of their values. And I correlate that with age. I saw a fellow yesterday who was with 80

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year old lungs, he was a 54 year old man, but he had the breath capacity of an 80 year old man and that he was breathless with walking up one flight of stairs trying to walk into the kitchen, go out and get the newspaper and it's

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very important not only to lead a longer, better life, but with good quality and a lot of wellness has to do with better vitality. It's not only you live long, you've got more breath and, and at any age, Whether it be the 50 year old or

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the eight year old or the teenager not to start smoking and if you are smoking to stop smoking will help you. There's never an age in which you're too old not to stop smoking and get benefit. And it does, it does kind of, I've heard you

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say in the past that if a person stops smoking at whatever age 30 or 40, that in a few years the lungs tend to strengthen themselves to some degree. Is that true? That's true. Yeah, that's that's reason enough right there, One of the things we ought

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to cover on this first part of the thing is two things 1 diet. Now there's a new deal recently McDougall plan and McDougall I believe as a resident of our Sonoma County discuss that a little bit tim, what's your feeling about that and what effect does

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that happen? Well, again, I, I think uh dr Mcdougal is uh, I guess would be fair to say as a controversial figure in Sonoma County and that he's a big advocate of a no fat vegetarian type diet uh, for a variety of things. I think that

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um, I feel really only comfortable to address it as it relates to heart disease and I think that in in some ways it's been a positive thing in the county for john McDougall to, to uh, get all this out into the public, may increase the public

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awareness of this kind of diet. Now personally, I have to say I have a hard time. I I don't think I could ever go on a no fat vegetarian diet. It's not real appealing. But I think as we increase people's awareness of of the fat content

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in their diet, uh we're doing them a favor because it's the fat content really, a proportional amount of cholesterol in your diet and then lowering that one. I think you can achieve lower body weight. You can certainly, if you have a problem with high blood pressure

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to some extent, improve that and clearly you can and you can lower your cholesterol. So I think he has established an awareness within our community that that is positive. Now I have to say I lend I tend more to be more middle of the road and

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I don't think you need to do as drastic dieting. But The educational tools that he has put out, I think at least gets you focused on how to get fat out of the diet. And I think that's that's good. Anything you can do to lower your

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fat intake after you're like an adult, let's say 35-25 would help keep your arteries clear. Would help would probably help all things being equal living along your life, wouldn't it certainly looks like that. That's becoming a contributing factor. I think that there is evidence now that

00:17:17.930 - 00:17:32.770

the fat content contributes to some forms of cancer prosthetic cancer, I think is now mentioned some correlation. Some people feel that breast cancer has a relationship to that. Uh not to mention the coronary disease, I'd come and see the prudent diets that I'd follow and I

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wouldn't pick any brand name. Um but I think the generic approach of having really a a weight losing diet if your overweight, holding your weight be low in fat, um and balanced with exercise. But one thing emphasized, the biggest risk factor in America that can be

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changed is smoking. If you look at risk factors in terms of it's not cholesterol. So it really it is smoking and there's a cure for it. If a person stop smoking. So getting back to the biggest preventable thing. We have other things. Our seat belts and

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um uh not to carry handguns and there's lots of other things that are risk factors that we can mention here. But cigarette smoking is the biggest reversible factor. United States in terms of heart disease, lung disease, cancers and so forth. You can take it one step

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further. And I think is if you look at the segments of the society people 40 50 60. If you look at that segment of society smoking is by far, if you stop smoking, you're not gonna end up in Jim's office, Jim's office, you're not gonna have

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the problem is you just are not gonna have the problems and I would agree. I mean the diet is important. But boy, I tell you if you could, if you could wish one thing out of this equation would be smoking. I wouldn't wish obstructive lung disease.

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Emphysema, chronic bronchitis on anybody. Jim wouldn't wish corn are disease on anybody. We don't want these patients to come to us. We'd rather than be prevented. And this is really where the grassroots of medicine has to be prevention. If you guys don't wish either one of

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them, how come I am? Both. We got you too late. Ladies and gentlemen, we're going to pause here for a moment to the station. Can bring you a public service announcement after after to which Doctor James Price, cardiologist and Dr James K good pulmonary specialist. And

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I will come back. We'll talk more about coronary disease. We'll talk more about pulmonary problems. But we'll certainly talk more about not smoking first. This message 1976. George Cisneros had a stroke, 1990, Stanley Monroe had a stroke, 1982. George. Fabolous had a stroke. But stroke didn't

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mark the end of their lives or their lifestyles. Find out the warning signs of stroke from your American Heart Association because the sooner your symptoms are recognized and treated, the faster you'll get back into the swing of things if you smoke, please listen, smokers don't just

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harm themselves. They also endanger the people around them who have no choice but to breathe their smoke, Children get more colds bronchitis, ear infections, even pneumonia. If apparent smokes and being around a smoker may increase the risk of lung cancer for Children and adults if you

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don't want to quit for yourself, quit for the people you love for a free booklet that could help write the will Rogers Institute, White Plains new york. Welcome back to this edition of Sonoma County in the 90s. As I said earlier in the program. If you

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see our two guests and you think you've seen this program before you have it? We've had the pleasure of having these gentlemen visit with us a few times. And one of the primary reasons we get together annually is to reaffirm the idea that you if you

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do now should give up smoking. And we sincerely hope that we reach a lot of you and we hope that something the doctors have to say today will make you change your mind about continuing smoking dr price, Doctor good smoking horrible habit. I had it for

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years. Um what do you tell first you dr price and then your doctor, what do you tell a patient that comes in that maybe you're thinking has little some signs of coronary problems, but this person is a heavy smoker, what do you do? And as far

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as you can determine what effect does it have? Well, again, I think one of the we're at somewhat of an advantage when we see these patients because they've come to us because they stubbed their toe, They've had some heart problems uh in jim's case they probably

00:21:51.930 - 00:22:08.520

had significant lung problems or whatever. So they I think they're more prone to listen. And you know, our basic approach in our offices to discuss the potential problems that it's going to cause them and the potential risk. And I think one of the things lung disease

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is more insidious and as a slower chronic, more chronic disease with heart disease, it certainly there is a chronic aspect of it. But the sad part about coronary disease is that there is a large segment of these people that can die suddenly and that group really

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relates. There's a high correlation between smoking and sudden death and I think that's one of the first approach is that you have to let somebody know about if they have coronary disease, they continue to smoke. The risk of sudden unexpected death is very high. And so

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I think you hate to dwell on negatives, but I think that you have to get people's attention and beyond that we have a thing that we've set up with a heart association that after they meet with us. And again, I think one of the, I think

00:22:52.960 - 00:23:04.640

the doctor can provide a small role in this. I mean you can get the patient's attention, you can talk about it. But unfortunately because as busy as the schedule, most of doctors in their offices, you can't spend the time that you need to. So I think

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they need to go to a class and we've arranged a class in conjunction with lung association that goes through routine proven algorithms for how do you stop smoking? And I think the other part of it too is that I think you have to be sort of

00:23:18.710 - 00:23:32.420

a nag as a physician when they come back in, I think you have to, it's easy to to ignore it and not to bring it up because it's, you know, it's a sensitive thing and I think if the physician is a continual nag, it helps to,

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to continue to get the point across, it doesn't bring the patient any closer to you in your relationship, but I think you have to do it again, I think we're all kind of experimenting trying to find effective ways and I don't know if there are, you

00:23:47.990 - 00:24:02.330

know, great, great effective ways at this point. Sometimes you have to sacrifice being the patient's best friend of being a stern taskmaster. Your thoughts on that. First of all, I ask if they smoke, that's important they're coming to me and said, do you smoke most of

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them lie, I don't smoke. I said, well did you smoke? I stopped last week and how many, 50 years, but but you have to ask and you have to get a real history of smoking for example, Let's say they smoke a pack a day for 50

00:24:14.120 - 00:24:29.480

years, that's 50 pack years and and then then I then the next thing I do is I advise that I advise that the best professional advice I can give them Is to stop smoking. And I asked if they want to try it on their own or

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if they want to try it with my help regarding medications or in a group setting. Those who try it on their own. I'm about 20% effective. I mean just advice, the next thing I do is assist if they can't stop smoking that's the 80% who can't

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stop smoking. The 20% stopped on just advice for those. I give them an option. One is joining a group I think lung association, a good group, good group. The community hospital has a good group in terms of stopping smoking. And then I'll talking about first of

00:25:00.090 - 00:25:14.470

all getting off the addiction of nicotine and if they're really addicted it can help to be on an addiction withdrawal program which is using a nicotine gum or a patch or they're coming out with a spray now it's not available yet but the spray will be

00:25:14.470 - 00:25:30.370

coming out and these are ways for about a month to get them off the physical physiological the body addiction because it is addicting drug. But then the important thing is to deal with the psychological addiction, the using of the hands the feeling like uh the Campbell

00:25:30.370 - 00:25:50.130

smoothie. Yeah and you have to contract all those things and My success rate is about 50% with all these things done. But that's 50% who don't respond. But the best I can do this is follow up in a year. That's great. So 50%. Um One of

00:25:50.130 - 00:26:07.170

the things we've just about three minutes, that's three or four minutes left to us, One of the things I want to mention to jim, um There's an increasing number of women who have developed peripheral vascular and coronary disease over the last 10-15 years now. What does

00:26:07.170 - 00:26:20.270

this relate to? What is causing it? What are you doing? And we'll protect you in the long to in a minute. Well it's actually Jim and I can relate really well to this. It's probably it goes back a little bit further than 15-20 years but I

00:26:20.270 - 00:26:41.990

think it relates clearly to smoking. I think that is, it turns out at least from a cardiovascular, peripheral vascular standpoint women or at least some women actually are more susceptible to the ravages of smoking than some men. And as a result have actually there in the

00:26:41.990 - 00:26:57.720

ketchup phenomenon where men used to get coronary disease or vascular disease earlier than women. The women now in some stages are are almost accelerated and have a very malignant form of vascular disease which I think clearly relates to smoking. And then there's the problem now with

00:26:57.720 - 00:27:17.600

lung cancer which for women, the number one cause of death per year in cancer is lung cancer. That's number one that's in death per year, it's over. For example, breast cancer and that's clearly related to smoking, 90% of lung cancer is directly related to smoking. Lung

00:27:17.600 - 00:27:33.220

cancer is the number one cause of death in cancers, corn argies. Number one cause of death across the board. But lung cancer is number one for men and now for women and it has to do with how many Virginia slims and Winston and all these things.

00:27:33.220 - 00:27:50.740

I mean if if I could, I would go into anti advertising that people are drawn in to do this is unconscionable. In fact, I'm gonna say a very strong comment. It's unethical again, I think you've seen, we've seen, I think as jim said in World War

00:27:50.740 - 00:28:05.570

Two during that period of time, men were targeted. We now have, we had a high high incidence of coronary disease, lung cancer in men. Then I think the next market that was exploited if you will was the women. And unfortunately what we're seeing now is that

00:28:05.570 - 00:28:25.100

the next market is young men and young women, Um which I agree is an unethical one minute you have 30 seconds we have so much to say. Rich, which the message is clear you did it in 1973, you stopped the five pack per day habit in

00:28:25.100 - 00:28:41.630

one night you said I won't smoke anymore because you have chest pain and anybody who is motivated enough can stop smoking. And the benefits are enormous whether you're 15 and don't smoke 50 and stop smoking and live an extra 11 years or whether you're 80 and

00:28:41.630 - 00:28:58.320

you'll breathe better the rest of your life. That means we have run out of time. I want to thank you. Dr James Price and Dr James. Good ladies and gentlemen, we've been talking to Dr James Price cardiology. Dr James good pulmonary specialist. They visit with us

00:28:58.320 - 00:29:10.720

about once a year. Next year we're going to live in the group. We talk to you about the fact that smoking is one of the most destructive habits and american or anyone else can acquire and if you required it, I hope you listen to what they

00:29:10.720 - 00:29:23.090

had to say and you try to get rid of the habit because it will and it has mine extend your life quite a bit. My name is Rich McGlinchey program, Mr Gnome account. In the nineties we'll be back with you next week with a member of

00:29:23.090 - 00:29:31.230

the county government family or to other interesting individuals such as Price and Good. Till then tonight, good luck, good health. Each and every one of you