Welcome to iHeartRadio Communities, a public affairs special focusing on the biggest issues in facting you this week.
Here's many munios.
And welcome to another edition of Iheartradios Communities. As you heard, I am manny Munyo's For too many of us, Memorial Day is about picnics and barbecues, visiting the beach. The real purpose for the holidays to honor and mourn the men and women who have died serving our nation in the armed forces. Let's talk about that and how we can help honor those who are currently serving. With Lieutenant General David Fridovich, thirty seven year US Army veteran who
spent twenty eight of those years as a Special Forces officer. General, wonderful to get some time with you. Thanks for joining us.
Hey, I rarely appreciate this opportunity. Thank you for doing this.
Yeah, let's talk about let's specifically, let's start off talking about Memorial Day personally. As a veteran and a leader, what does this day mean to you?
Well, you know, we go all the way back to you know, a sense of service and both my parents serving in World War Two. My mom is an Army nurse and the European theater and my dad, all six foot two of them, as a tail gunner in some US Army Air Corps aircraft. I don't know why they picked the guys for that. They have a sense of humor or they did anyway, you know, kind of brought
up on a sense of service. But you know, as time went on, you know, Vietnam was winding down, I did the most objectionable thing I could do as I joined the Army, and I was told I was ruining my life by doing so by an uncle who I knew, you know, was a questionable character anyway, So it was a good move on my part, and it was one of those things I was just supposed to do in my life, you know, kind of like you being in
the radio meeting in the army. But with that comes a sense of obligation, responsibility and duty, and the ultimate sacrifice that men and women give is besides broken bodies, is breaking themselves and you know, just coming back, I guess morally injured, that's one part of it. And then the ultimate sacrifice of losing your life and service to the nation. There's no highest honor, no higher honor, and something that we need to be mindful of all the time.
So your lead in in terms of the barbecue and the beach and all that, that's exactly what we normally focus on. But today or a Memorial Day weekend, it's about really remembering the people who made the ultimate sacrifice, and we all have friends that have done that. It was more important as the shrinking the population than service to the nation shrinks, So it's something that you need to be mindful and bring it forward. So I appreciate you doing that.
I appreciate you and obviously your service. Where do you think was there a point in time where we started losing focus about what this weekend was really supposed to be all about? Because it feels like when I was younger, we used to hold the holiday in higher esteem than.
We do today.
You know, that's a that brings to mind. I was in Europe for a school for a year and we went over to Belgium a Memorial Day. A friend of mine who'd worked for me before was over there in one of his final tours as a lieutenant colonel, and we watched the children of this Belgium village march to the cemetery, the Allied cemetery with American flags in Belgique Netherlands flags, and their sense of patriotism and sacrifice that we had given to them was you know, just right
up front. And that was in nineteen ninety nine. And while that's that date I remember clearly because of you know, being the school there, the real issue is because we no longer have a sense of service or responsibility of the country. I think we started slipping away probably at the end of Vietnam when the draft registration contained, the raft went away, and people no longer needed to even
think about serving the country. So this has been about two or three generations or more in coming that we've lost focus of what this really means.
How do you believe we could use Memorial Day itself, but the holiday overall to better educate our country, better educate civilians about the true cost of war, you.
Know, unless it really affects them immediately. And I heard this right at the beginning of the War on Terror, somebody said in the Pentagon. I remember being we were out Hawaii as where we were assigned at the time, and the War on Terror had started, and this very senior officer in the Pentagon says, we're at war and the rest of the country is at the mall. It
doesn't affect them. Nine to eleven atrocities had taken place that was kind of like a bump in the road, and people got out with their lives unless they were directly affected, like the nine to eleven survivors and people that had been affected in Pennsylvania and DC and other places. And I think what's really really happened is, you know, we really we lost it because somebody else was doing
the work. And I remember actually going back to college and talking to people and asking them did they know anybody or have anybody in their family? They had put the uniform of the country on, and I think one
out of fifty kids raised their hand. I thought that was startling, And I think I think some of the things that we have to do is kind of have, you know, have this kind of outreach and this kind of dissemination of what it means and why it's important, and then also thinking back about, hey, what kind of
national service can we have? And I know that's kind of contentious, but what kind of national service can we have that gets people to buy into would be a citizen soldier or a citizen even means these days, I think we might have lost that as well.
Yeah, it does strike me that that enlistment in the military, voluntary enlistment in the military, was for so long a generational thing, right, you had your grandfather was in the military, so your dad joined, your dad was in so you and your brother and your sister joined, and somewhere around somewhere along the line, we've kind of lost that.
That's that's absolutely accurate. Or in my case, as I brought up, you know, my uncle says, well, you know, why do you want to ruin your life or like that, that's a bad move r And I started laughing, going and I just got vindication of it's a good idea. Do you think it's a bad idea. It's a good idea, right, you know, And and he was wrong, and I was right. But you know again here we are. So but yeah,
we did generationally. And I mean even now you have to say, would you tell your kid or your grandchild to go into the military, and you'll get a variety of different answers. Normally it would be you know, well pick the right service. Yeah, I think that's a big part of it as well.
Yeah, I remember when I was when I was younger. I mean, I was in the Army reserves. But I remember when I was you know, when I was in junior and high school, the military promoted itself. I remember Army, Navy,
Air Force, Marines, what a great life. And there's so much talk these days in our country, for example, about college debt, and I don't see the military out there promoting the fact that the GI bill is a great way not only to get ahead in life, because I'd rather hire a veteran than anybody else, but but you don't have that college debt. And I'm wondering how much that has hurt our recruiting the fact that we don't see the military selling itself the way it once did.
You know, that's I don't know when you were in, but the nineteen eighties we did that. Yeah, it worked really well and we got high quality people, and we said, hey, look, you know, you can do this, you know, for a couple of years and get you know, the Montgomery g I Bill or whatever it was. I probably have that wrong, but you know, you'll get the ability to pay for college and then what we really missed. But then back up pretty quickly as hey, you can also stay you
don't have to leave. I mean, it's not just Saint Jude or four years and go. If something else is calling, you answer the call, but serve first to get the money for college and then go or you know, go to college Green and Gold where we had kids. You know, young men and women go to college for two or three years, finish and then become second lieutenis and go right into ROTC or right into you know, the military
after college. So you know, there were programs that worked well when I don't know, you know, where we lost it. And I mean I was still in during the time, and we talk about this. We can also see that the you know, the recruiting and who we got and the economics plays you well know, the economics of the country plays a huge part in who we get, who we don't get, and why they stay. So that's a that's another big, another conversation some other time.
I'm sure a few more minutes here with Lieutenant General David Fridovich, thirty seven year US Army veteran, A couple more things about Memorial Day, and then I want to get into really even more important stuff about your work with America's Warriors. Partnership are there any specific members that you served with comrades that you honor on Memorial Day.
How do you commemorate it for them?
Well, you know, one of the things that I do, and the list gets longer every year, but I've got dear friends that died in service to the nation or died later on for whatever reason, probably too soon. And I think one of the most important things that we can do is, and you've probably have heard this before, is say their name, say their name, say their name out loud. Since they're remembered, saying their name out loud is really this is a significant, important, minor thing that
you can do. Yeah, that makes a huge difference. They're not forgotten.
And that's really what this weekend and this holiday is about honoring those, as you mentioned, that paid the ultimate that made the ultimate sacrifice to our nation. We have thousands of veterans coming back home from overseas, whether it be Iraq, Afghanistan, somewhere else that just aren't able to assimilate back into society because they're different people, right, the mental health issues that have taken a toll on them.
Talk to me about that and the work you do with America's Warrior Partnership to try and bring that race of awareness about what we call the invisible wounds.
Of war, the invisible wounds of war also now known as you know, moral injuries or death by despair. I kind of, well, I don't I don't like what a conjures up. But death by despair is a better way of saying, you know, suicide, which normally just kind of makes people cringe. But what we do in America's Warrior Partnership, and I've been with him since about twenty fourteen, and Jim Lorraine, who's a wonderful guy who if you haven't talked to him, I'm sugar, either you should or you will,
but phenomenal guy. He and his wife and my wife saved my life when I had a severe injury and he got me the care I needed because that's what he was doing at Special Operations Command at the time. We became fast friends from there forward, and I finally got on the board and one of the first things that we had to do is we had to find the veterans because the one time that they really need a sponsors when they leave the military, and that's the
one time they don't have a sponsor. So finding them in different and Jim had a method and he did it through communities. Communities know the people in their own communities, so he did community outreach. And he also realized that the Veterans' Service Organization space has a lot of people in it that are kind of there, do wells and will take the money and run. And so he always and continues to this day, tracks how we do. So
it's not just a matter of outreach. Is how many we touched, how many people come back talk to us, how many do we get into the program, how do we successfully take care of them, what do they need, how do we get them married up? But tracking how we're doing by the veteran's output. And I think that's a critical part of why I'm still on the board with AWP, because they know what we know what we're doing, we know where we're going, and we know how we want to get there, and we can show you that
we're being successful. If not, we can figure out how to fix it. And that brought about Operation Deep Dive. Have you heard of that I've done? Operation Deep Dive is americod Warrior partnership with Duke University Duke Medical studying data from a variety of different locations, mostly state data.
I think about about seventeen state partners now that are sharing that their veteran data, which is different than other people better in data with Duke, and then the analysis that we're working on to better understand and try to get and say, hey, you know, we don't have to just react to it once it's happened. We want to get in front of it and make it preventable, make it understandable as to why are they in such desperate strains that we can't do something about this to reverse
the course. I know, as a guy who was in severe pain for many years, that if you were to tell me that I was going to be in pain the rest of my life, I would look differently at the rest of my life. If I had no hope, if I had no hope of relieving that pain, I would be hopeless, and that would lead me to you know, a different outcome than you and I speaking right now. You know you have teammates. You didn't do the military by yourself. You have teammates. You didn't do law enforcement
by yourself. You have teammates. Reach out to them. They'll help you, they'll point you in the right direction, but seek the help that's there. It'll work.
Lieutenant General David Fret, thirty seven year US Army veteran, Sir, I appreciate the time. I appreciate your service to our nation.
Be well, Thank you so much, appreciate this opportunity. You'll be well, have a great weekend, and say.
Their names osteoporosis. Do you know what it is? Is it even preventable?
Let's discuss that and the fact that may is Osteoporosis Awareness and Prevention Month as we bring in doctor Leila Tabatabaye. She is a member of the board of the Bone Health and Osteoporosis Foundation. Doctor Tabadabaie, I appreciate the time.
Thank you so much, Mannie, thank you for having me.
So what exactly is osteoporosis.
Osteoporosis is a disease of bone fragility, so it's characterized by weak and brittle bones and both bone density so the amount of bone is low and bone quality or the architecture of the bone is poor. So combined that leads to an increased risk of broken bone, which we call fractures.
Is this natural in aging or is it something that's acquired.
That's an excellent question. It's we don't consider it natural in the sense that it is a disease process. It is something that confers an increased risk for broken bones and even increased mortality. So it's very very important to diagnose and treat it and also to try to prevent it.
With that said, many older individuals will be diagnosed with osteoporosis in their lifetime, and as a matter of fact, over ten million people aged fifty and older in the United States have osteoporosis, and the prevalence is extremely high in adults age sixty five and older. It's close to twenty percent.
More women or men that get osteoporosis.
Great question. Absolutely more women than men. So about one in two women over the age of fifty will have a broken bone related to osteoporosis in her lifetime, but that statistics drops to one in four men, so you know, men are much less likely to have it. The key difference there is that women lose their estrogen at the time of menopause, so that is a key factor in their declining bone density. Men by and large maintain a
level of testosterone throughout their life. Of course, it does naturally go down at certain points and with aging, but testosterone protects their bone throughout their lifetime.
So menopause and menopause do have an effect on right. Are there ways to prevent getting osteoporosis?
That's an excellent question. So I do believe there are many ways that we can protect our bones, and it starts out with early recognition of healthy dietary behaviors and exercise, so making sure you have enough calcium in your diet. A lot of young children and young people don't drink milk anymore. They're avoiding dairy. So it is important that each individual person gets enough calcium in their diet, and there's a lot of plant based ways to do so
as well. But milk, cheese, yogurt, any dairy food, almond milk, oat milk, soy milk are some plant based alternatives. But the goal is about one thousand milligram of calcium per day and that is ideally obtained through food. Now, of course, there are many many supplements on the market, you know, many fancy expensive ones and expensive ones. We try to avoid those because there may be a risk of calcification of other organs like the blood vessels or kidneys with
high dose calcium supple elements. So for now, if we can get that from our food, we are much much better off. Vitamin D is also very important, so patients who are at risk for ostroporosis should have vitamin D levels measured and their doctor can guide them on how to supplement with vitamin D three to have an optimal level. So calcium and vitamin D are two very important building blocks.
And then exercise, manny, So we all know that exercise is critical for so many things, are part for cancer reduction,
et cetera. For ostroporosis, it's actually critical. So there was a large research trial called the Liftmore Trial, so it's really kind of a great name for it, LA F T m R. And this was an clinical trial conducted that examined exercise in women and the effects that it had on their bone density, and really the findings suggested that a high intensity resistance training program, so essentially a weightlifting program is better for preserving bone density and preventing
loss of bone density than a low intensity workout, so something like walking. Now, we of course still encourage everything, right, we just want everyone to be active, whatever that looks like. But weightlifting three times a week for women is something that I recommend routinely, and it's going to look different for an eighty five year old patient versus a forty five year old tation sure, So we just want people to get out there and work with a trainer to get an idea of what's safe for Them's.
Got a few more minutes here with doctor Layla Tabata Bye. She is a member of the board of the Bone Health and Osteoporosis Foundation.
Are there are there tests.
That could tell a doctor if somebody is developing osteoporosis?
Absolutely? Absolutely. The bone density Test or DEXA as it's called, and that's abbreviated DXA. That is a routinely available medical test that can be done at any radiology facility. And I highly recommend that patients who are concerned about this, and that's really every woman who's approaching menopause, I believe, should be screened with a DEXA scan, particularly higher risk groups such as white and Asian women. Also those who are thin, have a low body weight, or have a
family history of ostroporosis. So the guidelines currently from the USPSTF, which is the United States Prevention Task Force suggests that patients shouldn't get screened until they're sixty five, but that is concerning to a lot of US experts because many of our patients we have osteopenia or osteoporosis have already broken a bone by the time they're sixty five, or they're at high risk to do so. So if we can screen them earlier, early prevention is always key, right
with all of our chronic conditions. So I highly recommend that patients advocate for themselves. And the DEXA uses X ray technology, so it's very, very low risk, low radiation. It's a test that can be done right at their local radiology facility and very important for assessing their risk.
I'm surprised that it's not recommended until the age of sixty five or older. If it's associated with menopause, you would think, you know, definitely by the mid or late forties, it would be a required test.
Absolutely manny. And you know, honestly, a lot of our guidelines in the United States and around the world are made based on cost, and you know what's most efficient, and you know, it may be appropriate for certain individuals to wait till that age. But I certainly think that you know, many women should be screened at that earlier age of the perimenopause time as we like to call it,
which is the mid to late forties. And then even men who have risk factors such as a history of smoking or heavier alcohol intake, or if they have a family history of ostroporosis. Certainly men should not feel that they're immune from osteoporosis, and we encourage them to get screened if appropriate.
As well, you mentioned a term a couple of minutes ago, osteopenia. What is the difference between osteoporosis and osteopenia.
That's a great question. So osteopenia is really the precursor to osteoporosis. So, as I mentioned, about ten million adults in the US have osteoporosis, but close to forty five million people in the US have osteopenia. So this is a term for a low bone mass or low bone density. And to be honest, a lot of US experts don't really like this term because it implies that the risk of breaking a bone is much lower than it is
for osteoporosis. But to be honest with you, a lot of patients with quote unquote osteopenia still end up breaking a bone, and that's something that we certainly want to prevent. But the key is, if a patient's diagnosed with osteopenia at any point in their life, they do need to
have monitoring bone density tests. So the DEXA test should be done every two years for a patient with osteopenia and every one year for a patient with osteoporosis, And of course that will depend on the patient's individual case, but these categories are important really just for us to understand the patient's risk and how to best help them manage their bone density.
Yeah, you mentioned early detection.
Obviously there's a reason it's called preventative meta and sadly not how people practice it. So somebody is diagnosed, let's say, with osteopenia, is there a way to fend off increased deterioration or at least slow the deterioration down.
Absolutely. So I am a huge advocate, as I said, of a healthy diet, so making sure the calcium envitamin d intake, which we already discussed or optimized. A protein rich diet. So that doesn't mean high protein, that doesn't mean keto, but having good quality protein is very important because the bones and muscles are comprised of high protein intakes, so we need to make sure that as we age, we maintain an appropriate intake of that vital macronutrient. And
then furthermore, weight training. I'm a huge proponent of so. As I said, every patient, even those who've suffered broken bones before, can adopt a safe exercise program. And that they said might mean meeting with a professional or a physical therapist as a medical referral to make sure that they're doing a safe program, but that's a huge part of prevention. I also want to make a plug many for the appropriateness of hormone therapy, so menopause, perimenopause, you know,
it's a big buzzword these days. We have a lot of high profile women fortunately shedding a light on this very important transition in a woman's life, and I just want to say that the research on hormone replacement therapy in the perimenopausal period has come a long way. So I do encourage every woman to speak to her physician about whether hormone replacement therapy is appropriate for her, especially if she's in the perimenopause period and has osteopenia or osteoporosis.
So there's a key window the first three to five years after menopause that hormone own therapy can be safely started, So that conversation needs to happen earlier. And if their physician is not able or not willing to talk about hormone replacement therapy, then really a referral should be made to an expert who can help in that.
It does seem like for a long time there was maybe it was taboo to even talk about menopause.
And I don't want to call it, I don't want to call it.
A movement, but it does seem like the stigma surrounding discussing it publicly is has deteriorated, does it not?
Absolutely? And I think that's a wonderful thing. There's a lot of high profile, as I mentioned, wonderful women and also everyday wonderful women right in my own practice, who are asking me questions about menopause, asking how they can best handle all of the changes that their body is going through. And I do think that the taboo or stigma of it, as as you referred to, that is slipping away, and for good reason, you know, we should
be able to talk about these changes. And I heard a speaker the other day talk about how menopause and pregnancy and all of the health challenges and transitions that are specific to women, those are being brought up. They're being brought up in the workplace, at home, in the boardroom, everywhere. And that's an excellent thing because we shouldn't ever feel that any of these topics are off limits or anything
to be ashamed of it all. I think that, you know, just arming ourselves with good evidence based information so that we can make these decisions. And our health is so critical, and that's where your doctor can come in to help guide you and give you some really good information.
Yeah, fantastic, Absolutely right. Last thing for you, if I spoke to you again, doctor Tabatambaye, in five years, in ten years, how would the discussion about prevention or diagnosis or even treatment of osteoporosis be different.
That's such a wonderful question, Manny. First of all, I hope that I will still be around in this wonderful hospital that I work in with my patients whom I really love to see and to help. And as an endochronologist, what I hope to see in five or ten years is that we're looking at osteoporosis as a treatable condition and even a preventable condition for many many women and men in this country. We do have excellent medications now on the market which are safe and FDA approved that
can actually build bone and help to reverse osteoporosis. And again, these medications may not be appropriate for every patient, but in patients that can take them and benefit from them, this is actually changing the face of the disease. So that's a really exciting forefront that we've come up to, and it's a really exciting time, you know, in the
osteoporosis space. So my hope is that more patients have excellent information that they can rely on and also access to these wonderful medications and specialists who can help them. So that's really our goal for the future of ostroporosis.
It all starts with having that conversation with your doctor. Doctor Leila Tabata bay a Board certified endricnologist, board member of the Bone and Health, Bone Health and Osteoporosis Foundation. Wonderful conversation. Thanks so much for the time and for the information.
Thank you, manny, Take care.
And that'll do it for another edition. Of iheartradios communities. I'm Manny Muno's until next time.
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