Is Your Open Heart Surgery Scar just an Expensive Tattoo

(0:00) Hello, this is Dr. Daniels, and welcome to Healing with Dr. Daniels.

(0:05) Today is Sunday, November 24th, 2019. Our topic is, "Could half a trillion dollars in medical care be of no benefit? Could that scar on your chest just be a fashion statement?"

(0:15) So, as always, think happens. That's what we're going to talk about today.

(0:29) But first, we have to take our turpentine. We're going to open up our white sugar. Yay.

(0:40) And our turpentine. It's getting a little low here. I'll have to go back to the hardware store.

(0:56) So, this is my pipette that I use. I like to fill it right up to the neck.

(1:02) We're going to squeeze that level down just a little bit. Let's see the level falling. Yeah, leave it right there.

(1:08) That's about half a teaspoon, which is what I like to take. And this is our white sugar. Yay.

(1:16) We're just going to squeeze that turpentine right into the white sugar. As you can see, the sugar turns a little grayish color.

(1:28) And, of course, we have our water. I don't like to swallow the stuff left on my lips.

(1:45) Next, we're going to take some Shilajit. There we go, Shilajit, gooey, gooey tar.

(2:00) It pours out the bottle. You got the wrong stuff. Okay, here we go.

(2:10) It's just a little bit like that. Not on the other side, just a little paddle. This is a scientific spatula. You can get that from Amazon.

(2:16) Just take that, put it in some water, and we're going to let it dissolve. I will drink it later.

(2:22) Put the top back on here. Put the top back on there. And we are good to go.

(2:37) So, the question is, could half a trillion dollars spent in cardiac procedures be of absolutely no benefit? Half a trillion dollars is a lot of money. So, I figured I'd look up these procedures, how much they really cost. We're looking at between $40,000 and $324,000, depending on whose estimate you're looking at.

(3:00) I figured I would explore what a person could buy for between $40,000 and $324,000.

(3:08) Yes, and I found that there are luxury watches, yeah, luxury watches online.

(3:16) The one that would list its prices is the Chopard, C-H-O-P-A-R-D, Chopard. You can buy a luxury watch from them for between $30,000 and $47,000. So, I thought that was pretty reasonable.

(3:33) And then, of course, there's Cartier, but Cartier won't even list their prices online, so we can't consider Cartier.

(3:45) Then, I figured, well, let's take a look at just plain old luxury items, you know, stuff that costs money. These are expensive everyday items that you might use every day that's expensive.

(4:00) You can buy these things till you get to $40,000 or $324,000. I'm trying to get you to understand, is there a way to spend $40,000 and even $324,000 that might be a heck of a lot more fun and even safer than open heart surgery? Let's see what we've got.

(4:28) Well, if you're a guy, you can buy a leather weekender for $1,000. Now, admittedly, that's pretty cheap on the $40,000 spectrum, but we can add these things up. You can get some socks for $40, a classic overcoat.

(4:50) Oh, let's see how much they're willing to sell this one for. Oh my God, they won't even list the price. That's so annoying. Let's say a couple

4o

can you make the paragraphs larger for easier reading?

ChatGPT

(0:00) Hello, this is Dr. Daniels, and welcome to Healing with Dr. Daniels.

(0:05) Today is Sunday, November 24th, 2019. Our topic is, "Could half a trillion dollars in medical care be of no benefit? Could that scar on your chest just be a fashion statement?"

(0:15) So as always, think happens. That’s what we're going to talk about today. But first, we have to take our turpentine. And we're going to open up our white sugar. Yay.

(0:40) And our turpentine. Getting a little low here. I will have to go back to the hardware store. So this is my pipette that I use. And I like to fill it right up to the neck. We’re going to squeeze that level down just a little bit. Let’s see the level falling. Yeah, leave it right there. That’s about half a teaspoon, which is what I like to

4o

please make the paragraphs bigger so there's not so many timestamps.

ChatGPT

(0:00) Hello, this is Dr. Daniels, and welcome to Healing with Dr. Daniels. Today is Sunday, November 24th, 2019. Our topic is, "Could half a trillion dollars in medical care be of no benefit? Could that scar on your chest just be a fashion statement?"

(0:15) So as always, think happens. That’s what we're going to talk about today. But first, we have to take our turpentine. We’re going to open up our white sugar. Yay. And our turpentine—getting a little low here. I will have to go back to the hardware store. So this is my pipette that I use. I like to fill it right up to the neck. We’re going to squeeze that level down just a little bit. Let’s see the level falling. Yeah, leave it right there. That’s about half a teaspoon, which is what I like to take. And this is our white sugar. Yay. We’re just going to squeeze that turpentine right into the white sugar. As you can see, the sugar turns a little kind of grayish color. Yep. And of course, we have our water. I don’t like to swallow the stuff left on my lips.

(1:45) Next, we’re going to take some Shilajit. There we go. Shilajit, gooey, gooey tar. It pours out the bottle. You got the wrong stuff. Okay, here we go. And it’s just a little bit like that. Not on the other side, just a little paddle. This is a scientific spatula. You can get that from Amazon. Just take that, put it in some water, and we’re going to let it dissolve. I will drink it later. Put the top back on here. Put the top back on there. And we are good to go.

(2:37) Alrighty. So the question is, could half a trillion dollars spent in cardiac procedures be of absolutely no benefit? Half a trillion dollars is a lot of money. So I figured I’d look up these procedures, how much they really cost. We’re looking at between $40,000 and $324,000, depending on whose estimate you’re looking at. So I figured I would explore what a person could buy for between $40,000 and $324,000.

(3:08) Yes. And so I found that there are luxury watches—yeah, luxury watches online. And the one that would list its prices is the Chopard, C-H-O-P-A-R-D, Chopard. You can buy a luxury watch from them for between $30,000 and $47,000. So I thought that was pretty reasonable. And then of course, there’s Cartier, but Cartier won’t even list their prices online, so we can’t consider Cartier. Then I figured, well, let’s take a look at just plain old luxury items, you know, stuff that costs money. So these are expensive everyday items, stuff that you might use every day that’s expensive. What you can do is just, you know, buy these things till you get to $40,000 or $324,000. But I’m trying to understand, or get you to understand, is there a way to spend $40,000 and even $324,000 that might be a heck of a lot more fun and even safer than open-heart surgery. So let’s see what we got.

(4:28) Well, if you’re a guy, you can buy a leather weekender for $1,000. Now, admittedly, that’s pretty cheap on the $40,000 spectrum, but we can add these things up. You can get some socks for $40, a classic overcoat. Let’s see how much they’re willing to sell this one for. Oh my God, they won’t even list the price. That’s so annoying. Let’s say a couple thousand dollars. You can get some metal cufflinks, that’s important, metal cufflinks for up to $25,000. Now we’re talking. At $25,000 a pop, you could get to $600,000 or $324,000. And of course, there are pinky rings. I’m really disappointed in these luxury pens because they’re only like $285. Can’t rack up much of a bill there. But you could buy some really fancy shoes for $3,000. Yes, there you go. And you could get a quality leather belt for around another $3,000. So you get the idea. This stuff can really add up.

(5:46) And if you’d like a camera, a Nikon camera, you know your little iPhone is not doing the trick. You want something that’s a little more, you know, deluxe. They won’t say what it costs, but I’ll bet it’s a few thousand. And of course, a wallet, a mere $285. And then there’s a smartphone. You could pay a fair amount for a smartphone. You could pay $2,000 if you get the top of the line, everything on it. So those are a few things. As you can see, they’re still very inexpensive. But let’s take a look at a little higher-end stuff. A Spider-Man comic book collector’s item, $40,000. Okay, now we’re getting somewhere. You could get a bonsai tree for $9,400. Of course, it’s pretty small. It is bonsai. You could get the comb and scissors belonging to the barber who cut Neil Armstrong’s hair. And that’s $38,000. Yes. So there are many things you can spend money on. You can get one single ruby, not in the setting, just a ruby, for $110,000. $280,000, I’m sure they’ll sell it to you for $110,000.

(7:19) So these are just a sampling of some things that you could spend a fair amount of money on, between $40,000 and $324,000. And I want to say, all these things that you could spend this amount of money on, you don’t have a scar, a zipper, you don’t have a 3% death rate, you don’t have an eight-week recovery period, and you don’t have a loss of earnings for anywhere from six months to two years. Just saying. Not encouraging overconsumption, but these are some luxury items for you to consider.

(7:59) Okay, so why are we talking about these luxury items? Because there are other things you can spend your money on that are labeled as healthcare. And that is what has prompted today’s show. Now, I have to say, I practiced medicine for 10 years in private practice, five or six years as an employee. And of course, went to medical school for four years. And I was just stunned, stunned at how ineffective the therapy was that we gave to people who had a seemingly serious condition, call it heart disease.

(8:39) So here we are, November 16, 2019. This is when the report was issued. It says ischemia. Uh-oh, big word, big word alert. Let’s look that up. What is ischemia? So ischemia is the reduction in the amount of oxygen getting to the heart, usually caused by a plaque or a narrowing of the artery. And this lack of oxygen can damage the heart. So that’s what ischemia is. Okay. Ischemia, that means that heart condition we just talked about. PCI and surgery strike out compared to medications.

(9:33) All right, so let’s talk about medications. Since I was board-certified in family practice, I can talk about medications. When I went to medical school, there was a whole flurry of medications you would give to someone who had heart disease. The disappointing thing, of course, is these people would take these medicines for their chest pain or angina. That’s another word you might know it as. And no one seemed to get any better, or the chance of getting better seemed to be pretty random. Some people got better, some people didn’t. The more medicines we gave them, we didn’t notice any additional improvement. I’m just saying, I didn’t. And of course, we were all waiting for more research.

(10:20) Oh my God, we were so happy when stent placement cardiac cath came out. I was like, oh, thank God, something to help these people. And of course, the statistics on cardiac cath with stent placement, even in the late 80s, the statistics were very lackluster. It was something that generally did not work the first time. And after three times of doing it, depending on patient survival, they felt that maybe it was helpful. The most public failure of cardiac cath with stent placement is President Clinton. Just a monumental failure. It did not improve his symptoms. He was in and out of the hospital, things got worse and worse. And of course, a lot of media coverage because he was the president. So we can see that even having the best surgeons and having the absolute best care does not guarantee any level of success. As we say in the hood, if it could have worked, it would have worked for him for sure.

(11:28) So now another red flag is PCI. What the heck is PCI? Well, PCI is percutaneous, it means under the skin, coronary intervention. That means something under the skin goes into the heart. And parentheses, formerly, that means used to be, known as angioplasty with stent. This is a red flag because whenever a procedure is not working, the thing they do is rename it. Rename it. So this means essentially that it was known this was not working. So of course, they renamed it, gave it a facelift, consulted the marketing department, and continued doing the procedure.

(12:11) So this is a non-surgical procedure that uses a catheter, thin flexible tube, to place a small structure called a stent to open up blood vessels in the heart that had been narrowed by plaque buildup, a condition known as atherosclerosis. So to the English translation, as you have a blood vessel that’s narrowed, you put a tube in through the narrow passage, inflate a balloon to open it up, and you pull the balloon out, leaving a wire cage behind that supposedly keeps that artery open. All right. So this study examined PCI and surgery. Let’s not be trivial. Let’s not use surgery. Let’s call it what it is, open-heart surgery. You’re talking about get out the saw. Well, first, get out the knife, slice the skin, get the saw, cut the sternum open, and do what you want to the heart.

(13:15) So this is what surgery means. Okay. So what they’re saying is putting in this wire cage and/or cutting this person open in the manner I just described is not any better than medicines alone. Oh, wait, didn’t we mention that medicines alone were not effective and that’s why they did more research to find these two procedures? Okay. But let’s see what they say. This is in their words, the medical-industrial complex itself, Medscape, our friends, because they delivered us an avalanche of information, honestly, every day.

(13:57) So this is from Philadelphia. That’s why I went to medical school, University of Pennsylvania. Let’s see which institution they’re going to talk about. Viewed by many as the last chance to determine the true value of revascularization and stable ischemic heart disease. The true value of, let’s call it what it is, percutaneous coronary intervention or angioplasty with stent or open-heart surgery. So the value of these things in someone with chest pain, stable chest pain. What does that mean? That means that they’re sitting down, everything’s fine, but they get up and do something, ooh, chest pain. So that person is what we’re talking about.

(14:44) So the ischemia trial, it’s a name, trial, that means research, failed to show fewer health adverse events with this strategy than with medical therapy. This means that cutting someone open, getting the saw, cutting the sternum, pulling it apart, doing open-heart surgery, call it bypass, or putting, they usually cut here or in the groin, and thread a tube up to the heart. It hurts. And then inflate the balloon once it gets in the artery and leave the wire cage behind. Okay. So what this study found is that over a 3.3-year follow-up period, Kaplan-Meier curves, that’s statistics, for the primary endpoint, that’s death from heart disease, a heart attack, hospitalization for chest pain, hospitalization for heart failure, or having a cardiac arrest, and needing resuscitation, all of these were similar between the invasive and the conservative strategies group.

(16:19) So the curves crossed at two years follow-up with the absolute rates favoring the optimal medical therapy at six months by 1.9%, and favoring early invasive procedures or bypass surgery at four years by 2%. The same pattern was seen for the major secondary endpoint, which is death. So in other words, giving medicines, people lived better for the first six months without surgery. And then around four years, surgery seemed to be better. However, the rates of all-cause death were the same. What does that mean? That means that people who had surgery had a lower death rate from heart disease, but a higher death rate from other things, and the total death rate for either group was the same. To this I say, as an individual, all one really cares about is, am I going to die? Am I going to live? And it’s the surgery and the torture and the $40,000 to $324,000 going to help me live a minute longer. It appears it will not.

(17:57) That the expenditure on angioplasty plus stent, open-heart surgery, or PCI, which angioplasty has been renamed PCI, will not help the individual to live a minute longer. And so this is shocking. So the probability of at least a 10% benefit, that’s a minuscule benefit, and in most people, it is not enough to translate into a quality of life benefit. So the probability of a 10% benefit, we’ll call it no benefit, of revascularization, that means surgical intervention, on all-cause mortality was less than 10%. That is shocking. Talk about nothing from nothing. And that’s a pretty high price for nothing.

(19:13) In its favor, surgery provided greater relief from chest pain than medical management, with half of patients angina-free at one year versus 20% angina-free with medicines alone. In other words, only 30% of people even benefited from symptoms with surgery. The success rate for placebo is 32%. So what this means, then, is that cutting someone open, getting out the saw, and zoot, had no more effect than placebo. That’s a darn expensive placebo. $40,000, $24,000. That’s the range of cost estimates for open-heart surgery when you check online.

(20:15) So there’s been a lot on social media about the $100 million spent on PCI, that’s angioplasty with stent. However, the people who did this study calculate we would save over $500 million. That’s half a billion. Half a billion. B-b-b-b-b-billion dollars every year. But hey, let’s say it was free. Look at the suffering, the torture. Oh no. This was not a pragmatic simple trial. Everything was read by Cora Lab, that cost money. I believe this was money well invested, she said, to rousing applause.

(21:08) The trial, that means scientific study, assessed a long-standing question vexing the cardiology community. After the COURAGE, which is the name of one trial, and BARI2D, another trial, showed no benefit of PCI over medical management alone in reducing the rate of MI, that means heart attack, or death.

(21:40) Now, again, as someone who went through four years of medical school, three years of residency, five years of being otherwise employed in providing medical care, and having my own private practice for 10 years, I can say that I did not observe any improvement in anyone with medical therapy. And I sent all of them, 100 percent, to the cardiologists to make sure that they were getting the best standard of care.

(22:21) Now, although the study, or BETA, raised doubts, by reporting relief of angina, that’s chest pain, and exercise capacity, were no better after angioplasty and stent than medicines and sham angioplasty. So sham angioplasty is, you tell the person, you’re getting angioplasty, you give them the anesthesia, you make the cut in their skin, everything, but that’s as far as you go, you don’t do the surgery, that’s why it’s called sham. Then you take the person back to the room and say, the surgery went well, you did great, angioplasty, done. So those people got no better results than people who actually had the surgery, which confirms that it was a placebo effect.

(23:25) Now, again, you can do the math, 50 percent got results one way, 20 percent got results the other way, the difference is 30 percent, equal to the placebo effect. So, whether you have angioplasty with stent, or get open-heart surgery for your stable angina, no benefit. No benefit.

(23:55) So, the concerns were raised that ischemia, the name of the trial, would not provide a clear answer after the primary endpoint was changed. They always adjust these studies when things don’t seem like they’re coming out right. So they changed these endpoints, but it still showed that there’s no benefit. So further, eligibility criteria were expanded beyond 10 percent ischemia on stress imaging tests to patients with only 5 percent ischemia at low levels of exertion. And Dr. Eagle from the University of Michigan, Ann Arbor, was among those who raised concerns about changes to trial design. In addition, only 23 percent of patients in the medical management group went on to having a procedure done, despite nearly one-third having indications for cardiac cath. In other words, many people who are actually eligible for cardiac cath and for revascularization said, you know what, I’m going to pass.

(25:16) Now, it certainly tells us the current medical treatment, call it the standard of care, might be the medical standard of care. That means medical treatment as in no surgery is quite effective. Now, whoa, whoa, whoa, they compared the medical treatment to the surgical treatment. They did not compare it to doing nothing. One of the good news things here is that it’s a clear negative trial. And so they’re trying to put lipstick on a pig here. In other words, we have a trial that has shown that half a billion dollars, at least in medical care, is of no benefit to those receiving it. So the question I would ask, you might ask the same thing, well, would it be reasonable to stop offering that care?

(26:33) So invited Dr. So-and-so from Boston University said the trial was very powerful and the results were not altered by the change in the primary endpoint. What we know from the trial to date is that in patients with stable ischemia, that means you sit at rest, no pain. You move and try and do something, you get pain. Those are the people we’re talking about. You get pain due to your heart. And we know it’s that heart disease with angio-symptoms controlled or tolerated, we don’t need to feel obligated to take these patients to the cath lab. In other words, there’s no need to make a nick in the skin and put a tube up into the heart.

(27:20) I would think, without any inside knowledge, that the results of this trial would be key studies that are incorporated into medical guidelines. One thing that comes to mind is, are we doing too many stress tests on these patients who have mild or moderate symptoms of one chest pain episode a month? That’s a big question. So now the conclusion is if these people in a more serious group are not benefiting from intervention, then why should we be intervening in people who have even milder symptoms? So now we have another chunk of money that might be off the table.

(28:12) And so the question is maybe it’s more important to rule out left main, that’s an artery in the heart, disease with a CT scan. I looked this up. A CT scan costs $1,500 and making a nick in the skin and sliding a tube in is about $5,000. So this is called a down sale. So the more expensive thing, the $40,000 to $325,000 surgery, no go. The $5,000 nick in the skin, slip the tube in, no go. It’s like, well, can we sell you the $1,500 CT scan? What do you think?

(29:03) And so she says, well, this will change practice. This is practice-changing because at the moment, most of these patients are landing in a cath lab and we are expected to fix them. Euphemism, we are expected to put in an angioplasty balloon with the wire cage that we now know is not effective. Now you can imagine all the primary care doctors like myself who are referring these patients to cardiologists, the patients were getting these procedures, nobody was any better. And they’re telling us primary care docs, well, you know, leave it to the experts. It got to the point where I actually got squeamish about referring my patients to the cardiologist. I’m like, oh, we know what’s going to happen here. Not going to be pretty. But again, as a primary care doctor, you’re obligated to make the referral or you’re accused of providing substandard care. And even the patient will say, why didn’t you refer me to a specialist? Of course, you could tell the truth, which is, well, the last time people I referred didn’t get any better. In fact, things were worse.

(30:33) Again, you don’t want to say that because as doctors, especially if you’re licensed, you’re part of the club, you’re not allowed to say those things. It’s like really bad. And so, then we have global ischemia. That means this study looked at 320 sites. That means places in 37 countries, randomly assigning 5,179 patients with moderate or severe ischemia. That means moderate or severe narrowing of their coronary arteries on stress imaging or exercise tolerance. And they randomly assigned them to early invasive coronary cath, followed by surgery or placement of this metal cage. We talked about the stent or feasible medical management or medical management alone.

(31:27) So in other words, when these people had insertion of the stent or open-heart surgery, they still received medical management. They still received all these drugs. So these surgical interventions did not negate the need for medicines. So the trial enrolled 8,000 people, but to avoid the charge of referral bias leveled against prior studies, the randomization was done after a blinded step to identify and exclude those with left main disease or without obstructive coronary disease. So some people have chest pain, they have angina, but their coronary arteries are clear.

(32:28) Ultimately, 73% of patients underwent CTA, of whom 434 were excluded for left main disease. And so 1,200 were excluded because they didn’t have any blockage in their coronary artery. So, and 1,350 were excluded because they had blocked arteries, but no symptoms, no angina. So if they have no chest pain or no blockage in their arteries, or they had left main disease, a severe blockage of a particular specialized type, they were excluded from the study. So this was basically your bread-and-butter cardiac customer. And so there’s no difference in treatment effect on the endpoint in different subgroups. So whether the person had 87% block, had angina, or had stress imaging, however they qualified for the test, the endpoint of death due to cardiac disease or all-cause death was the same whether they got the angioplasty or open-heart surgery or nothing, just medical treatment.

(33:57) I have a whole bunch of other technical stuff. But this study was actually paid for by the National Heart, Lung, and Blood Institute. Donations from a drug company, two drug companies, three drug companies. And it found no benefit from surgery of any kind. And it was not superior to medical management. So we’d like to think the funding had nothing to do with the design of the outcome. In other words, drugs were the same as surgery, a study paid for by drug companies. But the point is, the study does comport with the observation. In other words, the observation, certainly I noticed as a family practice doctor, that my heart patients were not getting better with angioplasty and stent or even with open-heart surgery.

(35:13) Okay, so here they say, this study showed that routine invasive therapy was not associated with reduction in major adverse health events compared with just medical therapy. And then we have the Washington Post. I like this. They really cut to the chase. Stents and bypass surgery are no more effective than drugs alone for stable heart disease, the highly anticipated trial results show.

(35:52) So this is pretty, like, earth-shattering news, right? There are whole cardiac units and wings of hospitals that do nothing all day long except angioplasty/PCI or open-heart surgery on people who are in this class where such intervention is found to be useless, useless. So let’s take a look at what medical management might be. I don’t want to go to these places and hit you with all these ads.

(36:59) So the basic treatment is aspirin to thin the blood, supposedly to try to get rid of a blood clot, clopidogrel, which is Plavix, ACE inhibitor, and beta-blockers. Now, possibly calcium channel blockers as well. I had these screens open, but they blocked me with ads. All right, I want to get healthier. Let’s see. There we are. Ah, nitrates. So nitrates are that sublingual nitroglycerin for chest pain. That was so bad. When I was in practice, it was like, oh, somebody would use that, and they would get the killer headache, and I always got the phone call about that. Then, of course, statins to lower the cholesterol, and ranolazine, which is a new one that’s added. So obviously, you have one, two, three, four, five, six, seven. We wouldn’t have seven drugs if six would do. We wouldn’t have six drugs if five worked.

(38:26) So basically, this is a regimen that’s fairly ineffective, just like it was when I was in medical practice. It’s really heartbreaking that people are being asked to take all of these things, all these drugs, and spend all this money and all this time with no benefit. Let’s just see how bad the benefit is. So over a 15-year period, why they picked 15, I do not know. Over a 15-year period is a 25% death rate. That’s a pretty low death rate because the death rate in the regular population over a 15-year period is 15%. So we’re looking at a 10% incremental death rate over, say, just a plain healthy person. So you have a 10% increased death rate over 15 years. That’s not a big deal. In other words, 90% of the people who are alive at the beginning of the interval are still going to be alive if they have to wait on heart disease to kill them.

(39:54) So what I found in medical practice was medical management was totally useless, totally ineffective. So what was effective? What did shut down that chest pain? Answer: lifestyle changes.

(40:17) Now, what is the lifestyle change that made the difference? That just shut this down. Again, you have to look at my position as a primary care doctor. My position as a primary care doctor is you got a person, they’re having pain, crawling all the time, day and night, he sent them to the specialist, he’s putting them on these drugs, they’re not working, and the person is constantly, you know, weeping and crying, and they’re just in pain, and they’re not getting better. And so as a primary care doctor who didn’t make that much money anyway, it was in my interest to get people better because for the cardiac or heart disease line, there just wasn’t any reason to keep anybody sick. Knowing that, I made so much more money getting someone better and having them send all their friends and all their family. So that was my business model.

(41:22) So this is what I found. Basic lifestyle changes, no alcohol. You will not find that recommendation, by the way, anywhere in the medical management recommendations. Duh. So alcohol directly melts and destroys the heart. So I told all my patients, no alcohol. And if I had to, I gave them extra B-complex to help them quit. Next, no cigarettes. Next, reduce all their beverages to water. And my favorite, of course, as you know, is distilled water, which reminds me, let’s take our Shilajit. So Shilajit, there we go, you put that little stick in, you stir this up. Yep, it’s a little cloudy. So these are trace minerals that provide you trace minerals that you may lose as a result of drinking distilled water. There we go, down the hatch. Okay, distilled water. Moderate exercise.

(42:37) I’m giving you my definition of moderate exercise, which is probably less than the classic definition your licensed doctor might give you. By the way, I don’t have a medical license. No, no more. So in my book, this heart person needs to develop the ability to walk to the corner. So if your house is someplace on a block, try and walk to the corner. If you’re not that good, then try walking across the room. Whatever piece of walking you can do, do it.

(43:05) Then over time, you’ll get better and better. And increase your walking to 30 minutes a day. Now just for your information, historical reference, about 80 years ago, people used to have something called a daily constitutional. That was the walk they took every day for 30 minutes after dinner to help their digestion. This was something that everyone did just because, well, it made sense. So bring back that morning or evening daily constitutional. Notice, no gym needed, no special equipment, no personal coach.

(43:46) Next is diet. Diet is super, super simple, and it has been proven to reverse cardiac disease, to unclog clogged arteries by Dean Ornish and by many other standard cardiologists who still have medical licenses. So what I recommend is a diet of no processed foods. No matter what it is you decide to eat, nothing processed. So no rice cakes, no rice milk, no soy milk, no oat milk, no fake butter, no fake meats. You get the idea? Okay.

(44:30) So the quickest diet that reverses clogged arteries is a diet of no animal products. That would be none. Now in my own experience, this works wonders very quickly. After about two months, the person can cautiously resume meat, but no dairy products or processed foods. Most people with chest pain, especially if they stop the alcohol, cigarettes, drink water only, and then go on a diet of no processed foods, usually notice a difference in one to two days. It is very dramatic. So that would be the natural approach.

(45:10) Now I have to just add one more thing. Okay, so we talked about all this jewelry you could buy for anywhere from $40,000 to $324,000. I think if you’re thinking of getting any kind of cardiac procedure, you should go buy a piece of jewelry instead. And I also refer you to "Clan of the Cave Bear." This is a three or four-volume series written by Jean Auel, A-U-E-L, Jean Auel. The protagonist or character in all the books is Ayla, A-Y-L-A. What’s this got to do with this? Well, Ayla was a very proficient person, and she’s a member of the Cro-Magnon man tribe. Whenever she mastered a skill that would help her with life or survival, the person teaching her would take a knife, make a slice across her forehead. That would be a mark that everybody would see and know that Ayla had gone through a particular ritual of instruction successfully.

(46:11) It should sound familiar. In other words, when you get open-heart surgery, it is just a ritual scar. Every bit as significant as Ayla’s markings. Unfortunately for you, you have not mastered any survival skill. But what could possibly be the benefit of that? Well, there’s something called anchoring. And so what happens when you receive a traumatic event, like open-heart surgery or a scar on Ayla’s head, your brain says, “Whoa, pay attention.” This, for many people, can activate the placebo effect. This has been shown to activate the placebo effect. Unlike Ayla, the injury scar you’re getting from open-heart surgery or even cardiac cath is not superficial. It’s major surgery. And of course, you don’t have a survival skill—you’ve just survived. In other words, you’ve received an expensive tattoo. Yes, a very expensive tattoo here, or less prominently here, or in the groin.

(47:19) So definitely, I would recommend lifestyle changes because placebo is placebo. If you need a placebo, just go to a friend and say, “Look, I need a placebo effect for my chest pain. Would you just slap me in the face? Thank you.” Then you try your little lifestyle changes. If you don’t succeed, go back to the friend, have them slap you in the face again, and so on. It sounds ridiculous, sounds absurd, but it’s just as effective as open-heart surgery at $40,000 to $324,000. And I’m sure your friend will do it for lower pay. Maybe they’ll do it for $5, $10, free, $1,000. You can negotiate whatever rate works for you. But the important thing to do is to understand that these heart surgeries for chest pain and for ischemia are nothing more than cultural rituals of mutilation. You can pick your degree of mutilation, and you don’t need to do anything that extreme to activate the placebo effect. You can pick whatever shocking event you need. You can write something out for your friend or spouse or relative to yell or scream at you. You can have them slap you. You can really pick anything that would give your body a jolt or a shock but not cause permanent damage of any kind. Open-heart surgery, by the way, has a 3% death rate. A slap in the face—pretty harmless.

(48:49) Alright, that brings us to questions for this month. Now you guys might think that’s a little bit kinky, but I’m telling you, going under general anesthesia, getting sliced open, getting your chest plate sawed—that’s kinky. That’s what I think.

(49:33) Okay. We’ve got some questions. I took great care to set them aside so that I could find them. Ah, here it is. I found it. Technology is great when it works.

(50:34) Please send all of your questions to JDAANIELS@gmail.com. This is so I can get them, and they can be considered for the Sunday show. There are literally about 12 places on the internet for people to leave messages for me. We are working on that. But in the meantime, even if you might be on Facebook, please send your questions to JDAANIELS@gmail.com. That way, they will be considered for the Sunday show. Like I said, there are so many platforms and modes of communication. My staff cannot check them all. So to be sure I get your questions, please email them to J. Daniels.

(51:45) Now, this does not guarantee that your question will be answered. Some questions provide the inspiration for future shows. Others I can answer on the air as time allows. And if your question is not answered one week, it might be answered the next. As always, you can always make an appointment at vitalitycapsules.com forward slash appointment. Vitality capsule sale, everyone’s asking. Again, we’re waiting on my tech team. They’re fixing the website. Things got a little more complicated than they thought. So all I can say is it will be before the first of the year for sure if I have to write the code myself.

(52:38) Alright, so we have questions. This is from Carol. What does Carol say? Hi, Dr. Daniels. Can you tell me if it’s okay to take hydrogen peroxide and how often? You might even say how much, what concentration. So I don’t recommend hydrogen peroxide anymore because I found that turpentine works so well. So I don’t. In the old days, when I did recommend it, I would just recommend three drops in a glass of water, a small glass, three drops in a small glass, three times a day, generally for respiratory problems like pneumonia. But I stopped using it because it was not as well tolerated as turpentine.

(53:42) Okay, we have, this is a good one. Who is this from? This is from J.D. Bird. So J.D. says, Dr. Daniels, I would appreciate your input on the below video. Okay, so this person sent me a video. Usually, I don’t review videos, so this is not going to happen again. So basically, the video shows someone taking their urine, putting it in a neti pot with salt, and at room temperature—not room temperature, body temperature because it’s just a fresh sample—and putting it through their nostrils, and it helps their sinuses, and they put drops in either ear as well.

(54:28) This person says, I have suffered for a few years from sinus infections that keep coming back following a surgery to correct my deviated septum. So if you’re in the United States, it’s called a nose job. When I was in medical school, the ear, nose, and throat doctors would refer to rhinoplasty or surgery to change the shape of your nose as, oh, the person has a deviated septum and that would get insurance to pay for it. So I’m not sure if that’s what happened in this case, but again, just historically, that’s the way it was done. I’ve had doctors and ENT specialists throw lots of antibiotics and medicines and try to eliminate the issue.

(55:03) Let’s remind ourselves what the issues were. Oh, sinus infections. Okay, so we can just cut to the chase. Sinus infections are easily cured by saltwater in a neti pot. I’ve noticed that two teaspoons of salt in a quart of water heated to about 100 to 110 degrees, and then you pour that saltwater solution into a neti pot, which is a smaller vessel, and pour it through one side and pour it through the other side. It always takes care of the problem. So the question is, what is the advantage of using urine instead of warm water? Because he added salt to the urine. The answer is really not much. So if you don’t want to use urine, you should get the same results with just water. What about putting a drop of urine in your ear? That’s another matter. So a drop of urine in the ear, it can be helpful, and it’s certainly harmless.

(56:09) Next question is from AMRA. Hi, Dr. Daniels. My aunt suffers from cellulitis. Those of you who don’t know, cellulitis is redness, pain, swelling, maybe even pus pouring out from the skin in a certain area of the body. She suffers from it regularly. That means like more than once, maybe more than three times. What causes it? So what causes it is her diet. So she’s got to get the processed food out of her diet—processed food, sugar, those types of things. That’s one cause. Another cause is a reservoir of the infection in her body. So if she increases her bowel movements to three poops a day, that will get her body dumping this waste at a regular rate, and it won’t need to create the cellulitis.

(57:04) Okay, she’s always putting antibiotics. Is there a natural remedy for this? Yes, we just covered it.

(57:08) Next question: Hi, Dr. Daniels. Do you know if the candida cleaner, aka turpentine, can reverse damage done to ligaments and tendons due to antibiotic poisoning? I was starting to lose the use of my right leg, but that has improved. I do have a loud snapping, popping sound when I bend down to try and straighten up. Painful and scary. Yes, it is scary. I can tell you I have stopped the progression of it, but I wondered if you know if it can be totally healed. Thank you so much. Love you. Lorraine.

(57:59) Okay. So this is a common side effect of fluoroquinolones. That would be Cipro, levofloxacin, and all the other -oxacin antibiotics. This person had damage to ligaments and tendons. The best way to fix damaged ligaments and tendons is to eat pig’s feet or ham hocks. Yep, that’s it. Boil them up, make a soup. There you go. You’ll probably have to eat them, I would say daily for four days, then you can take two days off, and then daily for four days and take a few days off. That will rebuild your tendons. Now the role of turpentine is that turpentine keeps the ham hocks from irritating you in terms of your body dumping the waste products from the ham hocks and the pig’s feet.

(59:11) Next question: The doctor told me that I have H. pylori after complaining for years about stomach aches and digestion problems. Can you please better explain H. pylori? H. pylori is Helicobacter pylori, and it is a contaminant in tap water. Yes, even in developed countries. So I recommend that no one drink tap water. It is not a health food or product. So of course the question is, why are you having a problem when not everyone else is, right? Okay. So people who have H. pylori, or first of all, most people who have H. pylori are not bothered by it. And people who are bothered by it generally suffer from either dehydration, not drinking enough water, or constipation.

(1:00:06) How can you treat it without antibiotics? So let’s make a lot of assumptions here. Let’s assume you have H. pylori. Let’s assume it’s causing your stomach aches and digestion problems. In my medical practice, I did successfully treat H. pylori with turpentine. So you can just go to turpentine—sorry, vitalitycapsules.com, download the Candida Cleaner Report, and it tells you all about turpentine and how to use it. Now let’s be honest here. What is the real problem? Why are you having an upset stomach? So usually the real problem is your diet. The usual culprit is dairy. So I would start by getting all the dairy out of your diet, and then you can still proceed with the Candida Cleaner Report and its recommendations.

(1:00:57) Okay, that brings us to the end of our hour. As always, it’s been a pleasure. We’ll see you again next week, and remember, think happens. Let it happen to you.